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Pereira de Araújo T, de Moraes MM, Afonso C, Rodrigues SSP. Trends in ultra-processed food availability and its association with diet-related non-communicable disease health indicators in the Portuguese population. Br J Nutr 2024; 131:1600-1607. [PMID: 38174417 DOI: 10.1017/s0007114523003045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Broad variations in dietary and physical activity patterns are part of nutritional transition concept. An additional nutritional transition has as main characteristic the change of consumption of processed foods for ultra-processed foods (UPF). This study aims to evaluate trends of UPF availability in Portuguese population and its association with diet-related non-communicable diseases (NCD) health indicators. This ecological study used data from the Household Budget Surveys conducted by the National Statistics Institute each 5 years within a national representative sample of households. The percentage of UPF was calculated based on the total daily amount of food and beverages available per capita (in grams). Data from the years 1990, 1995, 2000 and 2005 were used, which were retrieved from DAFNE-Anemos Software. NCD age-standardised mortality, prevalence and incidence were obtained from the Global Burden of Disease database, for the years 2000, 2005, 2010 and 2015. Between 1990 and 2005, the UPF availability increased from 3·9 % to 13·8 %. Over the years, almost all food and beverages categories increased the UPF availability contribution, mainly noticeable for milk, sugar, cereal and meat products. Positive correlations were observed between UPF availability and digestive diseases both in prevalence (r = 0·062; P = 0·037) and incidence (r = 0·005; P = 0·010) measures. Neoplasms incidence also showed positive correlation with UPF availability (r = 0·002; P = 0·012). Trends in UPF availability in Portugal increased exponentially. At the same time, there is a trend towards a decrease in unprocessed and processed food availability. The Portuguese population should be made aware of the health risks resulting from excessive consumption of UPF.
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Affiliation(s)
- Taissa Pereira de Araújo
- Faculty of Nutrition and Food Sciences, University of Porto - Rua do Campo Alegre, 823 Porto4150-180, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
| | - Milena Miranda de Moraes
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
| | - Cláudia Afonso
- Faculty of Nutrition and Food Sciences, University of Porto - Rua do Campo Alegre, 823 Porto4150-180, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
| | - Sara Simões Pereira Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto - Rua do Campo Alegre, 823 Porto4150-180, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
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Maleki Z, Hassanzadeh J, Ghaem H. Correlation between socioeconomic indices and epidemiological indices of thyroid cancer from 1990 to 2019 year: a global ecologic study. BMC Cancer 2024; 24:467. [PMID: 38622568 PMCID: PMC11017482 DOI: 10.1186/s12885-024-12176-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 03/24/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND The incidence of thyroid cancer as the most common type of endocrine gland malignancy has risen more significantly than any malignancies in recent years. Estimated new cases of thyroid cancer in the United States in 2024 were 12,500 and 31,520 for men and women, respectively, and estimated deaths were 1,180 for women and 990 for men. Indices of socio-economic have been commonly used to measure the development of countries. Therefore, this study aimed to examine the correlation between indices of socioeconomic status and epidemiological indices of thyroid cancer throughout the world. In addition, this study has compared two indices of human development and a socio-demographic index. METHOD This worldwide ecological study used data on thyroid cancer incidence, mortality, human development index (HDI), and sociodemographic index (SDI) between 1990 and 2019 from the Global Burden of Disease (GBD). We evaluated the correlation between incidence and mortality rates with socioeconomic indices by using Pearson's correlation coefficient. Furthermore, for the first time, the generalized additive model (GAM) was employed for modeling. The statistical software R, version 4.2.2, was used to conduct all statistical analyses. RESULTS The correlation between the incidence of thyroid cancer and the HDI was significant and positive (r = 0.47, p-value < 0.001). While the correlation between thyroid cancer mortality and HDI was not statistically significant (r = 0.01, p-value = 0.076). Besides, the incidence of thyroid cancer was significantly positively correlated with SDI (r = 0.48, p-value < 0.001). The multiple GAM showed that for one unit increase in HDI, the risk of thyroid cancer was increased by 2.1 times (RR = 2.1, 95%CI = 2.04 to 2.19), and for one unit increase in SDI, the risk of thyroid cancer was shown to increase by 2.2 times. (RR = 2.2, 95%CI = 2.19 to 2.35). CONCLUSION It has been evident that countries with higher incidence of thyroid cancer display higher socioeconomic indices. While, countries with higher socioeconomic indices, report lower mortality rates. However, based on the modeling results, it can be concluded that the SDI is slightly more useful in this regard. Therefore, examining the epidemiological indices of thyroid cancer by socio-economic indices can be useful to reflect a clear image of the distribution of this cancer in each country, and can be used for planning cancer prevention strategies.
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Affiliation(s)
- Zahra Maleki
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jafar Hassanzadeh
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Haleh Ghaem
- Non-Communicable Diseases Research Center, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
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Gomes ECDS, da Silva IEP, de Araújo HDA, Barbosa CS. Malacological, socio-environmental evaluation, and evidence of local transmission and maintenance of schistosomiasis in an urban area of Northeast Brazil. Acta Trop 2024; 252:107145. [PMID: 38336344 DOI: 10.1016/j.actatropica.2024.107145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 01/27/2024] [Accepted: 02/06/2024] [Indexed: 02/12/2024]
Abstract
To present the current epidemiological scenario of schistosomiasis related to urban transmission through an epidemiological risk assessment in Porto de Galinhas, a coastal area of Pernambuco, Brazil. Malacological and parasitological surveys were performed between the years 2018 and 2020. Snails were identified taxonomically and examined to confirm infection by Schistosoma mansoni, and so to identify Schistosomiasis Transmission Foci (STF) by the artificial light exposure technique. Stool samples were examined using the Kato-Katz method to identify schistosomiasis cases. Socioeconomic, environmental, behavioural and health data were collected by a questionnaire applied to participates in the survey and used to predict the schistosomiasis risk occurrence by multivariate logistic regression. In all, a total of 6466 snails of Biomphalaria glabrata were collected and 36 breeding sites were identified, of which 25 % were STF. A total of 2236 individuals took part of the survey which identified 187 cases of schistosomiasis, registering a positivity percentage of 8.36 %. The surveys identified the neighbourhoods with the highest risk for transmission while the socioenvironmental analysis identifies other risk factors for disease occurrence, such as gender, age range, level of education and absence of water drainage. We found that areas with poor sanitation, flooding during winter periods and dwellings located near mangroves should be treated by health authorities as priority areas for health interventions to minimize disease transmission. In addition, efforts to improve the population's educational level could certainly contribute to the adoption of measures to prevent and control this neglected tropical disease.
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Affiliation(s)
- Elainne Christine de Souza Gomes
- Department of Parasitology, Aggeu Magalhães Institute, Fiocruz - Ministry of Health, Cidade Universitária, Av. Professor Moraes Rego, 1235, CEP: 50.740-465, Recife, PE, Brazil.
| | - Iris Edna Pereira da Silva
- Department of Parasitology, Aggeu Magalhães Institute, Fiocruz - Ministry of Health, Cidade Universitária, Av. Professor Moraes Rego, 1235, CEP: 50.740-465, Recife, PE, Brazil
| | - Hallysson Douglas Andrade de Araújo
- Health Department of Ipojuca County (PE) - Brazil, Rua Cel. João Souza Leão, CEP: 55.590-000, Ipojuca, PE, Brazil; Biotechnology and Drugs Laboratory and Biomaterials Technology Laboratory - Academic Center of Vitória de Santo Antão, Federal University of Pernambuco, Rua Alto do Reservatório, s/n - Bela Vista, CEP: 55.608-680, Vitória de Santo Antão, PE, Brazil; Keizo Asami Institute (iLIKA), Federal University of Pernambuco, Cidade Universitária, Av. Prof. Moraes Rego, 1235 CEP: 50670-901, Recife, PE, Brazil
| | - Constança Simões Barbosa
- Department of Parasitology, Aggeu Magalhães Institute, Fiocruz - Ministry of Health, Cidade Universitária, Av. Professor Moraes Rego, 1235, CEP: 50.740-465, Recife, PE, Brazil
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Imai T, Miyamoto K, Sezaki A, Kawase F, Shirai Y, Abe C, Sanada M, Inden A, Sugihara N, Honda T, Sumikama Y, Nosaka S, Shimokata H. Traditional japanese diet score and the sustainable development goals by a global comparative ecological study. Nutr J 2024; 23:38. [PMID: 38509554 PMCID: PMC10956220 DOI: 10.1186/s12937-024-00936-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/28/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Reducing the environmental impact of the food supply is important for achieving Sustainable Development Goals (SDGs) worldwide. Previously, we developed the Traditional Japanese Diet Score (TJDS) and reported in a global ecological study that the Japanese diet is associated with reducing obesity and extending healthy life expectancy etc. We then examined the relationship between the TJDS and environmental indicators. METHODS The average food (g/day/capita) and energy supplies (kcal/day/capita) by country were obtained from the Food and Agriculture Organization of the United Nations Statistics Division database. The TJDS was calculated from eight food groups (beneficial food components in the Japanese diet: rice, fish, soybeans, vegetables, and eggs; food components that are relatively unused in the traditional Japanese diet: wheat, milk, and red meat) by country using tertiles, and calculated the total score from - 8 to 8, with higher scores meaning greater adherence to the TJDS. We used Land Use (m2), Greenhouse gas (GHG) emissions 2007/2013 (kg CO2eq), Acidifying emissions (g SO2eq), Eutrophying emissions (g PO43- eq), Freshwater (L), and water use (L) per food weight by Poore et al. as the environmental indicators and multiplied these indicators by each country's average food supply. We evaluated the cross-sectional and longitudinal associations between the TJDS and environmental indicators from 2010 to 2020. This study included 151 countries with populations ≥ 1 million. RESULTS Land use (β ± standard error; -0.623 ± 0.161, p < 0.001), GHG 2007 (-0.149 ± 0.057, p < 0.05), GHG 2013 (-0.183 ± 0.066, p < 0.01), Acidifying (-1.111 ± 0.369, p < 0.01), and Water use (-405.903 ± 101.416, p < 0.001) were negatively associated with TJDS, and Freshwater (45.116 ± 7.866, p < 0.001) was positively associated with TJDS after controlling for energy supply and latitude in 2010. In the longitudinal analysis, Land Use (β ± standard error; -0.116 ± 0.027, p < 0.001), GHG 2007 (-0.040 ± 0.010, p < 0.001), GHG 2013 (-0.048 ± 0.011, p < 0.001), Acidifying (-0.280 ± 0.064, p < 0.001), Eutrophying (-0.132 ± 0.062, p < 0.05), and Water use (-118.246 ± 22.826, p < 0.001) were negatively associated with TJDS after controlling for confounders. CONCLUSIONS This ecological study suggests that the traditional Japanese dietary pattern might improve SDGs except Fresh water.
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Affiliation(s)
- Tomoko Imai
- Department of Food Science and Nutrition, Doshisha Women's College of Liberal Arts, Kyoto, Japan.
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan.
| | - Keiko Miyamoto
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Department of Nursing, Nagoya University of Arts and Sciences, Aichi, Japan
| | - Ayako Sezaki
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- National Cancer Center Japan, Tokyo, Japan
| | - Fumiya Kawase
- Department of Nutrition, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Aichi, Japan
- Graduate School of Nutritional Science, Nagoya University of Arts and Sciences, Aichi, Japan
| | - Yoshiro Shirai
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Persuasive Technology Group, Life Science Laboratories, KDDI Research, Inc, Fujimino, Japan
| | - Chisato Abe
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Department of Food and Nutrition, Tsu City College, Mie, Japan
| | - Masayo Sanada
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Department of Nursing, Heisei College of Health Sciences, Gifu, Japan
| | - Ayaka Inden
- Clinical Nutrition Unit, Hamamatsu University Hospital, Shizuoka, Japan
| | - Norie Sugihara
- Faculty of Health and Social Services, Kanagawa University of Human Services, Kanagawa, Japan
| | - Toshie Honda
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Department of Nursing, Nagoya University of Arts and Sciences, Aichi, Japan
| | - Yuta Sumikama
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Department of Nutrition, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Aichi, Japan
| | - Saya Nosaka
- Department of Food Science and Nutrition, Doshisha Women's College of Liberal Arts, Kyoto, Japan
| | - Hiroshi Shimokata
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Graduate School of Nutritional Science, Nagoya University of Arts and Sciences, Aichi, Japan
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Newall AT, Nazareno AL, Muscatello DJ, Boettiger D, Viboud C, Simonsen L, Turner RM. The association between influenza vaccination uptake and influenza and pneumonia-associated deaths in the United States. Vaccine 2024; 42:2044-2050. [PMID: 38403498 DOI: 10.1016/j.vaccine.2024.01.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND The influenza mortality burden has remained substantial in the United States (US) despite relatively high levels of influenza vaccine uptake. This has led to questions regarding the effectiveness of the program against this outcome, particularly in the elderly. The aim of this evaluation was to develop and explore a new approach to estimating the population-level effect of influenza vaccination uptake on pneumonia and influenza (P&I) associated deaths. METHODS Using publicly available data we examined the association between state-level influenza vaccination and all-age P&I associated deaths in the US from the 2013-2014 influenza season to the 2018-2019 season. In the main model, we evaluated influenza vaccine uptake in all those age 6 months and older. We used a mixed-effects regression analysis with generalised least squares estimation to account for within state correlation in P&I mortality. RESULTS From 2013-2014 through 2018-2019, the total number of all-age P&I related deaths during the influenza seasons was 480,111. The mean overall cumulative influenza vaccine uptake (age 6 months and older) across the states and years considered was 46.7%, with higher uptake (64.8%) observed in those aged ≥ 65 years. We found that overall influenza vaccine uptake (6 months and older) had a statistically significant protective association with the P&I death rate. This translated to a 0.33 (95% CI: 0.20, 0.47) per 100,000 population reduction in P&I deaths in the influenza season per 1% increase in overall influenza vaccine uptake. DISCUSSION These results using a population-level statistical approach provide additional support for the overall effectiveness of the US influenza vaccination program. This reassurance is critical given the importance of ensuring confidence in this life saving program. Future research is needed to expand on our approach using more refined data.
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Affiliation(s)
- Anthony T Newall
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
| | - Allen L Nazareno
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia; Institute of Mathematical Sciences and Physics, College of Arts and Sciences, University of the Philippines Los Baños, Laguna, Philippines
| | - David J Muscatello
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - David Boettiger
- The Kirby Institute, University New South Wales, Sydney, Australia
| | - Cécile Viboud
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD 20892, USA
| | - Lone Simonsen
- Department of Science and Environment, University of Roskilde, Roskilde, Denmark
| | - Robin M Turner
- Biostatistics Centre, Division of Health Sciences, University of Otago, Dunedin, New Zealand
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Zheng JX, Zhu HH, Xia S, Qian MB, Nguyen HM, Sripa B, Sayasone S, Khieu V, Bergquist R, Zhou XN. Natural variables separate the endemic areas of Clonorchis sinensis and Opisthorchis viverrini along a continuous, straight zone in Southeast Asia. Infect Dis Poverty 2024; 13:24. [PMID: 38475922 DOI: 10.1186/s40249-024-01191-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/02/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Clonorchiasis and opisthorchiasis, caused by the liver flukes Clonorchis sinensis and Opisthorchis viverrini respectively, represent significant neglected tropical diseases (NTDs) in Asia. The co-existence of these pathogens in overlapping regions complicates effective disease control strategies. This study aimed to clarify the distribution and interaction of these diseases within Southeast Asia. METHODS We systematically collated occurrence records of human clonorchiasis (n = 1809) and opisthorchiasis (n = 731) across the Southeast Asia countries. Utilizing species distribution models incorporating environmental and climatic data, coupled machine learning algorithms with boosted regression trees, we predicted and distinguished endemic areas for each fluke species. Machine learning techniques, including geospatial analysis, were employed to delineate the boundaries between these flukes. RESULTS Our analysis revealed that the endemic range of C. sinensis and O. viverrini in Southeast Asia primarily spans across part of China, Vietnam, Thailand, Laos, and Cambodia. During the period from 2000 to 2018, we identified C. sinensis infections in 84 distinct locations, predominantly in southern China (Guangxi Zhuang Autonomous Region) and northern Vietnam. In a stark contrast, O. viverrini was more widely distributed, with infections documented in 721 locations across Thailand, Laos, Cambodia, and Vietnam. Critical environmental determinants were quantitatively analyzed, revealing annual mean temperatures ranging between 14 and 20 °C in clonorchiasis-endemic areas and 24-30 °C in opisthorchiasis regions (P < 0.05). The machine learning model effectively mapped a distinct demarcation zone, demonstrating a clear separation between the endemic areas of these two liver flukes with AUC from 0.9 to1. The study in Vietnam delineates the coexistence and geographical boundaries of C. sinensis and O. viverrini, revealing distinct endemic zones and a transitional area where both liver fluke species overlap. CONCLUSIONS Our findings highlight the critical role of specific climatic and environmental factors in influencing the geographical distribution of C. sinensis and O. viverrini. This spatial delineation offers valuable insights for integrated surveillance and control strategies, particularly in regions with sympatric transmission. The results underscore the need for tailored interventions, considering regional epidemiological variations. Future collaborations integrating eco-epidemiology, molecular epidemiology, and parasitology are essential to further elucidate the complex interplay of liver fluke distributions in Asia.
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Affiliation(s)
- Jin-Xin Zheng
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 20025, China
- One Health Center, Shanghai Jiao Tong University, The University of Edinburgh, Shanghai, 20025, China
- National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasites and Vectors Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, China
| | - Hui-Hui Zhu
- National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasites and Vectors Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, China
| | - Shang Xia
- National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasites and Vectors Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, China
| | - Men-Bao Qian
- National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasites and Vectors Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, China
| | - Hung Manh Nguyen
- Institute of Ecology and Biological Resources, Graduate University of Science and Technology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet Street, Hanoi, Vietnam
| | - Banchob Sripa
- WHO Collaborating Centre for Research and Control of Opisthorchiasis (Southeast Asian Liver Fluke Disease), Tropical Disease Research Laboratory, Department of Tropical Medicine, Faculty of Medicine, Khon Kaen University, 123 Mittraparb Road, Khon Kaen, 40002, Thailand
| | - Somphou Sayasone
- Lao Tropical and Public Health Institute, Ministry of Health, Vientiane, Lao PDR
| | - Virak Khieu
- National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - Robert Bergquist
- Ingerod, Brastad, Sweden (formerly at the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases), World Health Organization, Geneva, Switzerland
| | - Xiao-Nong Zhou
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 20025, China.
- One Health Center, Shanghai Jiao Tong University, The University of Edinburgh, Shanghai, 20025, China.
- National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasites and Vectors Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, China.
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Yang TC, Kim S, Matthews SA, Shoff C. Social Vulnerability and the Prevalence of Opioid Use Disorder Among Older Medicare Beneficiaries in U.S. Counties. J Gerontol B Psychol Sci Soc Sci 2023; 78:2111-2121. [PMID: 37788567 PMCID: PMC10699735 DOI: 10.1093/geronb/gbad146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Indexed: 10/05/2023] Open
Abstract
OBJECTIVES Recent research has investigated the factors associated with the prevalence of opioid use disorder (OUD) among older adults (65+), which has rapidly increased in the past decade. However, little is known about the relationship between social vulnerability and the prevalence of OUD, and even less is about whether the correlates of the prevalence of OUD vary across the social vulnerability spectrum. This study aims to fill these gaps. METHODS We assemble a county-level data set in the contiguous United States (U.S.) by merging 2021 Medicare claims with the CDC's social vulnerability index and other covariates. Using the total number of older beneficiaries with OUD as the dependent variable and the total number of older beneficiaries as the offset, we implement a series of nested negative binomial regression models and then analyze by social vulnerability quartiles. RESULTS Higher social vulnerability is associated with higher prevalence of OUD in U.S. counties. This association cannot be fully explained by the differences in the characteristics of older Medicare beneficiaries (e.g., average age) and/or other social conditions (e.g., social capital) across counties. Moreover, the group comparison tests indicate correlates of the prevalence of OUD vary across social vulnerability quartiles in that the average number of mental disorders is positively related to OUD prevalence in the least and the most vulnerable counties and social capital benefits the less vulnerable counties. DISCUSSION A perspective drawing upon contextual factors, especially social vulnerability, may be more effective in reducing OUD among older adults in U.S. counties than a one-size-fits-all approach.
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Affiliation(s)
- Tse-Chuan Yang
- Department of Sociology, University at Albany, State University of New York, Albany, New York, USA
| | - Seulki Kim
- Department of Sociology, University of Nebraska—Lincoln, Lincoln, Nebraska, USA
| | - Stephen A Matthews
- Departments of Sociology and Criminology, and Anthropology, The Pennsylvania State University, University Park, Pennsylvania, USA
- Population Research Institute, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Carla Shoff
- Independent Consultant, Baltimore, Maryland, USA
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Rughiniș C, Dima M, Vulpe SN, Rughiniș R, Vasile S. Patterns of protection, infection, and detection: Country-level effectiveness of COVID-19 vaccination in reducing mortality worldwide. Public Health Pract (Oxf) 2023; 6:100416. [PMID: 37547810 PMCID: PMC10400461 DOI: 10.1016/j.puhip.2023.100416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/25/2023] [Indexed: 08/08/2023] Open
Abstract
Background The relationship between COVID-19 vaccination and mortality has been established through clinical trials and other investigations at the individual level. In this study, we aimed to investigate the negative relationship between mortality and COVID-19 vaccination at country level. Study design We conducted an exploratory, correlational, country-level analysis of open data centralized by Our World in Data concerning the cumulative COVID-19 mortality for the winter wave (October 2021-March 2022) of the pandemic as function of the vaccination rate in October 2021. Methods We controlled variables that capture country-level social development and level of testing. We also deployed three segmentation tactics, distinguishing among countries based on their level of COVID-19 testing, age structure, and types of vaccines used. Results Controlling for confounding factors did not highlight a statistically significant relationship between vaccination and cumulative mortality in the total country sample. Still, a strong, significant, negative relationship between cumulative mortality (log scale) and vaccination was highlighted through segmentation analysis for countries positioned at the higher end of the social development spectrum. The strongest estimate for vaccine effectiveness at ecological level was obtained for the set of countries that used Western-only vaccines. Conclusions COVID-19 testing (log scale) has a significant and positive relationship with cumulative mortality for all subsamples, consistent with patterns of under- and overreporting of COVID-19 deaths at country level, partly driven by testing. This indicates that testing intensity should be controlled as a potential confounder in future ecological analyses of COVID-19 mortality.
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Affiliation(s)
- C. Rughiniș
- Department of Sociology, University of Bucharest, Bucharest, 030167, Romania
| | - M. Dima
- Department of Physics, University of Bucharest, Bucharest, 030167, Romania
| | - S.-N. Vulpe
- Interdisciplinary School of Doctoral Studies, University of Bucharest, Bucharest, 050107, Romania
| | - R. Rughiniș
- Department of Computer Science and Engineering, University POLITEHNICA of Bucharest, Bucharest, 060042, Romania
| | - S. Vasile
- Interdisciplinary School of Doctoral Studies, University of Bucharest, Bucharest, 050107, Romania
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Tahani B, Baghban AA, Kazemian A. Determinants of oral health status: an ecological study in Iran. BMC Oral Health 2023; 23:910. [PMID: 37993816 PMCID: PMC10666374 DOI: 10.1186/s12903-023-03557-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/19/2023] [Indexed: 11/24/2023] Open
Abstract
OBJECTIVES The aim of this ecological study was to assess the association between behavioral, social position, circumstance factors, and caries experience in 35- to 44-year-old adults in Iran at a provincial level. MATERIALS AND METHODS The data from the 2011 Iranian Oral Health Survey were obtained from all 31 provinces across Iran on the population level. Oral health status was measured as the number of decayed, missing (MT), and filled (FT) teeth and the percentage of the population who were edentulous. Data were also gathered from each province on the percentage of smokers (Non-Communicable Diseases Risk Factors Surveillance Provincial Report 2009), per capita consumption of free sugars, concentration of fluoride in the drinking water (National and Sub-national Burden of Disease (NASBOD) Survey), number of dentists per 10,000 people, mean years of schooling of adults, expected years of schooling of children, life expectancy at birth and Gross National Income (Integrated Public Use Microdata Series, Global Data Lab). The data were analyzed using simple and multiple linear regression (α = 0.05). RESULTS Mean DMFT was positively associated with the percentage of smokers (B = 0.01 95%CI 0.01-0.14), and negatively with fluoride concentration (B =-2.6 95%CI -4.3- -0.96). The edentulousness percentage was positively associated with smoking (B = 0.2 (with 95%CI: 0.07-0.37) and negatively with mean years of education (B =-1.08 (with 95%CI: -2.04- -0.12). DT was associated with expected years of schooling (B =-0.6 (with 95%CI: -1.07- -0.17), negatively. Mt was negatively associated with life expectancy (B =-0.5 (with 95%CI: -1.1- -0.007), fluoride concentration (B =-3.4 (with 95%CI: -4.5- -1.5) and number of dentists per 10,000 people (B =-0.4 (with 95%CI: -0.8- -0.01). Mean Years of Schooling (B = 0.5 (with 95%CI: 0.2-0.8) and number of dentists per 10,000 people (B =-0.62 (with 95%CI: 0.51 - 0.48) were positively in associated with FT. CONCLUSIONS The present findings indicate that there were differences in the oral health measures and their social determinants among the provinces of Iran. Regarding the limitations of the study especially the limitation of the number of independent variables, it seems, this discrepancy could be better explained by social variables of the provinces such as income than by environmental factors.
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Affiliation(s)
- Bahareh Tahani
- Department of Oral Public Health, Dental Research Center, Dental Research Institute, Dental School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Center, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Kazemian
- Department of Community Oral Health, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
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Hiilamo A, Keski-Säntti M, Niemelä M, Ristikari T. The increasing association between child poverty and children in out-of-home care - an ecological longitudinal analysis of Finnish municipalities in the period 1992-2021. Child Abuse Negl 2023; 145:106395. [PMID: 37595326 DOI: 10.1016/j.chiabu.2023.106395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 07/29/2023] [Accepted: 08/03/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND International evidence indicates that child poverty increases the risk of child welfare intervention needs but Finland, paradoxically, has low child poverty rates and high child welfare intervention rates. We investigate the extent to which the rate of social assistance use in families with children, as a proxy for child poverty, can be associated with the rate of children in out-of-home care in Finnish municipalities. METHODS Data on the annual rate of social assistance use and out-of-home care were drawn from national registers for 216 Finnish municipalities from 1992 to 2021. Linear regression models were utilised to investigate the extent to which the social assistance use rate explained child out-of-home care rates, both spatially and temporally, across municipalities and years while adjusting for the unemployment rate. RESULTS The rate of out-of-home care increased from some 700 to 1600 per 100,000 children over the period 1992-2021. A percentage point higher rate of the social assistance use was associated with 44-72 more children placed in out-of-home care per 100,000 children, net of the unemployment rate. This association was stronger in more recent time periods. A smaller association was observed within municipalities over time: a percentage point increase in social assistant use was linked to some 4-25 more children placed in out-of-home care per 100,000 children. CONCLUSION Out-of-home care is increasingly concentrated in Finnish municipalities with high rates of families receiving social assistance. Preventative child welfare interventions are therefore required in areas with higher rates of economic difficulties among families.
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Affiliation(s)
| | | | - Mika Niemelä
- Faculty of Medicine, Research Unit of Population Health, University of Oulu, Oulu, Finland
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Santos MCS, Oliveira GLD, Mingoti SA, Heller L. Sewerage as a protective factor for prevalence of hookworm infection in schoolchildren in Brazil: A multilevel ecological analysis of national prevalence surveys (1950-2018). Sci Total Environ 2023; 895:164621. [PMID: 37271392 DOI: 10.1016/j.scitotenv.2023.164621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/05/2023] [Accepted: 05/31/2023] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The prevalence of hookworm infection in Brazil has decreased considerably in recent decades. However, there is no definitive consensus as to which changes have contributed to this reduction. A hypothesis is that improvements in environmental factors have contributed to lowering the parasite load and the level of host-parasite contact. METHODS This is an ecological study using unbalanced panel data from two Brazilian surveys (1947-1953 and 2010-2015), with municipalities as the analysis unit. The sample comprised 1428 municipalities, in which a total of 745,983 schoolchildren aged 7 to 14 were examined. Zero-inflated Poisson regression models, with fixed and random effects were estimated to evaluate the association of potential explanatory variables with the prevalence of hookworm infection at a significance level of 5 %. RESULTS We identified a significant decrease in the prevalence between the first and last analyzed periods (RR 0.096; CI 0.086-0.107); The following variables were found to have a protective effect: access to sanitary sewage systems (RR 0.984, CI 0.982-0.986), urbanization (RR 0.995, CI 0.993-0.997), and gross domestic product (RR 0.929, CI 0.912-0.945). CONCLUSION The findings of this study show a decrease in the prevalence of hookworm infections over six decades in schoolchildren in the Brazilian municipalities. Environmental, demographic, and economic factors were associated with this trend. A historical analysis indicates that interventions aimed at improving sanitation contributed to reducing the disease prevalence.
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Affiliation(s)
- Mariana Cristina Silva Santos
- Rene Rachou Institute (IRR), Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Ave, Barro Preto, Belo Horizonte, Minas Gerais 30190-009, Brazil.
| | - Guilherme Lopes de Oliveira
- Federal Center for Technological Education of Minas Gerais, 5253 Amazonas Ave, Nova Suiça, Belo Horizonte, Minas Gerais 30421169, Brazil.
| | - Sueli Aparecida Mingoti
- Federal University of Minas Gerais, 6627 Pres Antônio Carlos Ave, Pampulha, Belo Horizonte, Brazil
| | - Léo Heller
- Rachou Institute (IRR), Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Ave, Barro Preto, Belo Horizonte, Minas Gerais 30190-009, Brazil.
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Lu T, Cao JMD, Rahman AKMA, Islam SS, Sufian MA, Martínez-López B. Risk mapping and risk factors analysis of rabies in livestock in Bangladesh using national-level passive surveillance data. Prev Vet Med 2023; 219:106016. [PMID: 37696207 DOI: 10.1016/j.prevetmed.2023.106016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/13/2023]
Abstract
Rabies is a major zoonotic disease around the world, causing significant mortality to both humans and animals, especially in low- and middle-income countries. In Bangladesh, rabies is transmitted mostly by the bite of infected dogs and jackals to humans and domestic livestock, causing severe economic losses and public health hazards. Our study analyzed national passive surveillance data of veterinary hospital-reported rabies cases in cattle, buffalo, sheep, and goats from 2015 to 2017 in all 64 districts of Bangladesh. We used a zero-inflated negative binomial regression model to identify the main environmental and socio-economic risk factors associated with rabies occurrence in livestock, and we used model results to generate risk maps. Our study revealed that monsoon precipitation (RR=1.28, p-value=0.043) was positively associated with rabies cases in livestock, and the percentage of adults who have completed university education was also a significant predictor (RR=0.58, p-value<0.001) likely suggesting that districts with higher education levels tended to have a lower reporting of rabies cases in livestock. The standardized incidence ratio maps and predicted relative risk maps revealed a high risk of rabies cases in southeast areas in Bangladesh. We recommend implementing risk-based vaccination strategies in dogs and jackals in those high-risk areas before monsoon to reduce the burden of rabies cases in domestic ruminants and humans in Bangladesh.
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Affiliation(s)
- Taotao Lu
- Center for Animal Disease Modeling and Surveillance (CADMS), Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - José Manuel Díaz Cao
- Center for Animal Disease Modeling and Surveillance (CADMS), Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - A K M Anisur Rahman
- Department of Medicine, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Sk Shaheenur Islam
- Department of Livestock Services, Krishi Khamar Sarak, Dhaka, Bangladesh
| | - Md Abu Sufian
- Department of Livestock Services, Krishi Khamar Sarak, Dhaka, Bangladesh
| | - Beatriz Martínez-López
- Center for Animal Disease Modeling and Surveillance (CADMS), Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, USA.
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Nojiri S, Kawakami Y, Nakamoto D, Kuroki M, Nishizaki Y. Case fatality rate considering the lag time from the onset of COVID-19 infection to related death from 2020 to 2022 in Japan. IJID Reg 2023; 8:36-48. [PMID: 37361016 PMCID: PMC10149354 DOI: 10.1016/j.ijregi.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 06/28/2023]
Abstract
Importance On an ecological scale, the lag time between coronavirus disease 2019 (COVID-19) infection and related fatality has varied between epidemic waves and prefectures in Japan. The variability in lag time across areas of Japan during the seven distinct waves can help derive a more appropriate estimation of the weekly confirmed case fatality rate (CFR) of COVID-19. Objective To estimate the 7-day moving average CFR across area block levels in Japan from February 2020 to July 2022 using the lag time between COVID-19 infection and related fatality. Main outcomes and measures The 7-day moving average CFR of COVID-19 for area blocks in Japan considering the lag time between infection and death (total and subgroup analysis of elderly). Results Lag time was found to vary substantially among prefectures in Japan from the first wave to the seventh wave of the COVID-19 epidemic. The estimated 7-day moving average CFR based on the lag time reflects the Japanese COVID-19 pandemic and related policy interventions (e.g. vaccination of elderly people) rather than other standard CFR estimations. Conclusions and relevance The variation in estimated lag time across prefectures in Japan for different epidemic waves indicates that it is inadequate to use the clinical results of the period from the start of infection to death for evaluation of the ecological scale of the CFR. Moreover, the lag time between infection and related fatality was found to be either shorter or longer than the clinically reported period. This revealed that preliminary reports of CFR may be overestimated or underestimated, even if they consider the lag based on clinical reports.
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Affiliation(s)
- Shuko Nojiri
- Clinical Translational Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Medical Technology Innovation Centre, Juntendo University, Tokyo, Japan
| | - Yuta Kawakami
- Clinical Translational Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Faculty of Engineering, Yokohama National University, Kanagawa, Japan
| | - Daisuke Nakamoto
- Clinical Translational Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Manabu Kuroki
- Faculty of Engineering, Yokohama National University, Kanagawa, Japan
| | - Yuji Nishizaki
- Clinical Translational Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Medical Education, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Busch P, Cifuentes LA, Cabrera C. Chronic exposure to fine particles (PM 2.5) and mortality: Evidence from Chile. Environ Epidemiol 2023; 7:e253. [PMID: 37545809 PMCID: PMC10402952 DOI: 10.1097/ee9.0000000000000253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/26/2023] [Indexed: 08/08/2023] Open
Abstract
Many Chilean cities suffer from high air pollution from industrial, mobile, and residential wood-burning sources. Several studies have linked PM2.5 air pollution exposure to higher mortality risk from cardiovascular, pulmonary, and lung cancer causes. In recent years, Chile has developed an extensive air pollution monitoring network to enforce air quality standards for PM2.5, allowing the study of the medium-term association between PM2.5 and mortality. Methods A negative binomial regression model was used to study the association between 3-year average PM2.5 concentrations and age-adjusted mortality rates for 105 of the 345 municipalities in Chile. Models were fitted for all (ICD10 A to Q codes), cardiopulmonary (I and J), cardiovascular (I), pulmonary (J), cancer (C), and lung cancer (C33-C34) causes; controlling for meteorological, socioeconomic, and demographic characteristics. Results A significant association of PM2.5 exposure with cardiopulmonary (relative risk for 10 µg/m3 PM2.5: 1.06; 95% confidence interval = 1.00, 1.13) and pulmonary (1.11; 1.02, 1.20) age-adjusted mortality rates was found. Cardiovascular (1.06; 0.99, 1.13) and all causes (1.02; 0.98, 1.07) were positive, but not significant. No significant association was found between cancer and lung cancer. The positive associations remained even when controlling for multiple confounding factors, model specifications, and when considering different methods for exposure characterization. These estimates are in line with results from cohort studies from the United States and European studies. Conclusion Three-year average PM2.5 exposure is positively associated with the age-adjusted mortality rate for cardiopulmonary and cardiovascular causes in Chile. This provides evidence of the medium-term exposure effect of fine particles on long-term mortality rates.
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Affiliation(s)
- Pablo Busch
- Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Camila Cabrera
- Pontificia Universidad Católica de Chile, Santiago, Chile
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Li X. The need for ecological nested models as emerging theoretical frameworks in the investigation of affective variables in L2 education. Heliyon 2023; 9:e16891. [PMID: 37346336 PMCID: PMC10279815 DOI: 10.1016/j.heliyon.2023.e16891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/20/2023] [Accepted: 05/31/2023] [Indexed: 06/23/2023] Open
Abstract
As an emotionally dynamic process, language learning is marked by fluctuations in students' affective constructs (e.g., enjoyment, playfulness, boredom). Thus, clues supporting an ecological perspective on behavioral trends and changes in language learners' emotional constructs driven by relational person and contextual components may be discovered. Therefore, an ecological approach enriched with the nested ecosystems model and complex dynamic system theory (CDST) can facilitate the investigation of dynamics of language students' affective constructs. These are first categorized and analyzed on the microsystem scale concerning students' motivation, beliefs, linguistic factors, cognitive factors, affective factors, and classroom context. Then, they are analyzed in 3 ecosystems including meso-, exo-, and macrosystems, each revealing an invaluable dimension of the reality of the emergent dynamicity of the variables. The present paper first draws attention to the dynamic nature of L2 learners' emotional factors and raises awareness of the ecological dynamic system theory. Then, it reviews the existing ecological studies of L2 affective variables and summarizes the findings. It ends with several conclusive remarks and suggestions for the future line of research.
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Maulida R, Goel R, Labib SM, Oni T, van Sluijs EM. Environmental correlates of adolescent active travel to school in Asia: An ecological study. Health Place 2023; 81:103024. [PMID: 37043940 DOI: 10.1016/j.healthplace.2023.103024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 03/02/2023] [Accepted: 04/02/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVES This study aimed to examine the association between country-level environmental correlates and the prevalence of active school travel (AST) in Asia and country-level differences in AST by age and sex. METHODS This ecological study involved 31 Asian countries. Dependent variables were AST prevalence, AST prevalence difference by age, and by sex. Independent variables were country-level environmental correlates extracted using publicly available datasets, classified into physical and social environments. Association estimates of each dependent variable and each of the independent variables were calculated using univariate linear regression. All variables were standardized to have a mean of 0 and a standard deviation of 1. RESULTS Results showed that 1 standard deviation (SD) difference in urban population percentage, night-time light, secondary-school enrolment, and prevalence of adult insufficient physical activity were negatively associated with AST prevalence (SD difference: -0.44 (-0.78 to -0.09), -0.40 (-0.76 to -0.04), -0.39 (-0.74 to -0.04), and -0.40 (-0.76 to -0.03), respectively). A 1 SD difference in car per people was associated with a -0.46 (-0.84 to -0.09) difference of AST prevalence by age. A 1 SD difference in PM2.5 concentration and of prevalence of adult insufficient physical activity were associated with a difference of 0.38 (0.01-0.74) and 0.42 (0.03-0.80) difference of AST prevalence by sex. CONCLUSIONS This study shows that Asian countries with a greater number of people living in urban areas, lower levels of overall adult physical activity and higher levels of night-time light have a lower prevalence of adolescent AST. Country-level physical and social environmental correlates explained some of the regional variance in AST. Future policy actions and interventions for the region need to be contextually sensitive to the environmental correlates that vary between countries.
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Affiliation(s)
- Rizka Maulida
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom; Department of Epidemiology, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia.
| | - Rahul Goel
- Transportation Research and Injury Prevention Centre, Indian Institute of Technology Delhi, New Delhi, India
| | - S M Labib
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom; Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, the Netherlands
| | - Tolu Oni
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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Lange S, Cayetano C, Jiang H, Tausch A, Oliveira e Souza R. Contextual factors associated with country-level suicide mortality in the Americas, 2000-2019: a cross-sectional ecological study. Lancet Reg Health Am 2023; 20:100450. [PMID: 37095770 PMCID: PMC10122114 DOI: 10.1016/j.lana.2023.100450] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/23/2022] [Accepted: 02/01/2023] [Indexed: 04/26/2023]
Abstract
Background The suicide mortality rate in the Region of the Americas has been increasing, while decreasing in all other World Health Organization regions; highlighting the urgent need for enhanced prevention efforts. Gaining a better understanding of population-level contextual factors associated with suicide may aid such efforts. We aimed to evaluate the contextual factors associated with country-level, sex-specific suicide mortality rates in the Region of the Americas for 2000-2019. Methods Annual sex-specific age-standardized suicide mortality estimates were obtained from the World Health Organization (WHO) Global Health Estimates database. To investigate the sex-specific suicide mortality rate trend over time in the region, we performed joinpoint regression analysis. We then applied a linear mixed model to estimate the effects of specific contextual factors on the suicide mortality rate across countries in the region over time. All potentially relevant contextual factors, obtained from the Global Burden of Disease Study 2019 covariates and The World Bank, were selected in a step-wise manner. Findings We found that the mean country-level suicide mortality rate among males in the region decreased as health expenditure per capita and the proportion of the country with a moderate population density increased; and increased as the death rate due to homicide, prevalence of intravenous drug use, risk-weighted prevalence of alcohol use, and unemployment rate increased. The mean country-level suicide mortality rate among females in the region decreased as the number of employed medical doctors per 10,000 population and the proportion of the country with a moderate population density increased; and increased when relative education inequality and unemployment rate increased. Interpretation Although there was some overlap, the contextual factors that significantly impacted the suicide mortality rate among males and females were largely different, which mirrors the current literature on individual-level risk factors for suicide. Taken together, our data supports that sex should be considered when adapting and testing suicide risk reduction interventions, and when developing national suicide prevention strategies. Funding This work received no funding.
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Affiliation(s)
- Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Corresponding author. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, T521, Toronto, ON, Canada M5S 2S1.
| | - Claudina Cayetano
- Mental Health and Substance Use Unit, Pan American Health Organization, Washington, DC, USA
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Amy Tausch
- Mental Health and Substance Use Unit, Pan American Health Organization, Washington, DC, USA
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Kasdagli MI, Katsouyanni K, de Hoogh K, Zafeiratou S, Dimakopoulou K, Samoli E. Associations between exposure to blue spaces and natural and cause-specific mortality in Greece: An ecological study. Int J Hyg Environ Health 2023; 249:114137. [PMID: 36806046 DOI: 10.1016/j.ijheh.2023.114137] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/07/2023] [Accepted: 02/11/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND A growing body of evidence suggests that exposure to natural environments, such as green space, may have a beneficial role in health. However, there is limited evidence regarding the effects of exposure to blue spaces and mortality. We investigated the association of exposure to blue spaces with natural and cause-specific mortality in Greece using an ecological study design METHODS: Mortality and socioeconomic data were obtained from 1,035 municipal units (MUs) from the 2011 census data. To define exposure to "blue" we used a rate of the land cover categories related to blue space from the COoRdination and INformation on the Environmental (CORINE) 2012 map per 10,000 persons in the municipal unit. We further assessed the exposure to blue space in the MUs that are located in the coastline of Greece using the distance to the coast as a proxy for proximity to blue space. the Annual PM2.5, NO2, BC and O3 concentrations for 2010 were predicted by land use regression models while the normalized difference vegetation index was used to assess greenness. We applied single and two exposure Poisson regression models accounting for spatial autocorrelation and adjusting for unemployment and lung cancer mortality rates, percentages of the population aged 25-64 with upper secondary or tertiary education attainment and of those born in Greece, and urbanicity. The analysis was conducted for the whole country and separately by varying geographical definitions. RESULTS An interquartile range (IQR) increase of blue space per 10,000 persons was associated with decreased risk in natural mortality (Relative Risk (RR): 0.98 (95% confidence interval (CI): 0.98, 0.99), as well as in mortality due to cardiovascular causes, respiratory causes and diseases of the nervous system 0.98 (95% CI: 0.97, 0.99); 0.97 (95% CI: 0.95, 0.99); 0.94 (95% CI: 0.88, 1.00) respectively). We estimated protective associations for ischemic heart disease (IHD) mortality (RR = 0.98, 95% CI: 0.97, 1.00 per IQR); COPD mortality (RR = 0.97, 95% CI: 0.93, 1.00 per IQR) and mortality from cerebrovascular disease (RR = 0.97 (95% CI: 0.96, 0.99 per IQR). We estimated protective associations for the distance from the coast and mortality from the diseases of the nervous system (RR = 0.75, 95% CI: 0.61, 0.92, ≤1 km from the coast versus >1 km). Our results were stronger for inhabitants of the islands, the coastline and in the rural areas of Greece while the estimates were robust to co-exposure adjustment. CONCLUSIONS We estimated statistically significant protective effects of exposure to blue space on mortality from natural, cardiovascular and respiratory causes, diseases of the nervous system, cerebrovascular and ischemic heart disease for in Greece with higher estimates in the coastline and the islands. Further research is needed to elaborate our findings.
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Affiliation(s)
- Maria-Iosifina Kasdagli
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Environmental Research Group, MRC Centre for Environment and Health, Imperial College, United Kingdom
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Sofia Zafeiratou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantina Dimakopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Butt M, Eisler RA, Hu A, Rogers AM, Rigby A. Incidence of Substance Use Disorder Following Bariatric Surgery: A Retrospective Cohort Study. Obes Surg 2023; 33:890-896. [PMID: 36477697 DOI: 10.1007/s11695-022-06400-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND New-onset substance use disorder (SUD) following bariatric surgery is a significant concern that is likely multi-factorial, although the etiologies are unclear. Previous studies have identified variable rates of SUD along with utilizing different methods and measures. The objective of this study is to evaluate new-onset SUD diagnoses among adults following bariatric surgery and compare these rates to those in the general population as well as those diagnosed with overweight or obesity. METHODS Data was extracted from TriNetX Research Platform and used to build three cohorts of adults: those who had bariatric surgery (bariatric surgery cohort), those diagnosed with obesity or overweight, and a general population cohort. Rates of incident SUD were compared among these three groups. Initial encounters for all individuals were from January 1, 2018, to June 30, 2019. RESULTS The incidence rate of SUD in patients with a history of bariatric surgery was 6.55% (n = 2523). When compared to the general population, persons who had any type of bariatric procedure had a decreased risk of new-onset SUD with an overall odds ratio (OR) [95% confidence limits (CL)] of 0.89 [0.86, 0.93]. When compared to persons with overweight or obesity, bariatric patients were less likely to develop any form of SUD (OR: 0.65 [0.62, 0.67]). CONCLUSION While overall rates of new-onset SUD are lower among those who had bariatric surgery, they also vary by surgery and substance type. Efforts should still be made to address new-onset SUD in order to optimize the post-surgical care of patients.
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Affiliation(s)
- Melissa Butt
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, USA.
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
| | - Riley A Eisler
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Antoinette Hu
- Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Ann M Rogers
- Department of Surgery - Division of Minimally Invasive Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Andrea Rigby
- Department of Surgery - Division of Minimally Invasive Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
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Qu B, Wu S, Zhao P, Ma ZF, Goodacre R, Yuan L, Chen Y. Geographical pattern of minerals and its association with health disparities in the USA. Environ Geochem Health 2023:10.1007/s10653-023-01510-1. [PMID: 36805365 DOI: 10.1007/s10653-023-01510-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to determine the common latent patterns of geographical distribution of health-related minerals across the USA and to evaluate the real-world cumulative effects of these patterns on overall population health. It was an ecological study using county-level data (3080 contiguous counties) on the concentrations of 14 minerals (i.e., aluminum, arsenic, calcium, copper, iron, lead, magnesium, manganese, mercury, phosphorus, selenium, sodium, titanium, zinc) in stream sediments (or surface soils), and the measurements of overall health including life expectancy at birth, age-specific mortality risks and cause-specific (summarized by 21 mutually exclusive groups) mortality rates. Latent class analysis (LCA) was employed to identify the common clusters of life expectancy-related minerals based on their concentration characteristics. Multivariate linear regression analyses were then conducted to examine the relationship between the LCA-derived clusters and the health measurements, with adjustment for potential confounding factors. Five minerals (i.e., arsenic, calcium, selenium, sodium and zinc) were associated with life expectancy and were analyzed in LCA. Three clusters were determined across the USA, the 'common' (n = 2056, 66.8%), 'infertile' (n = 739, 24.0%) and 'plentiful' (n = 285, 9.3%) clusters. Residents in counties with the 'infertile' profile were associated with the shortest life expectancy, highest mortality risks at all ages, and highest mortality rates for many reasons including the top five leading causes of death: cardiovascular diseases, neoplasms, neurological disorders, chronic respiratory conditions, and diabetes, urogenital, blood and endocrine diseases. Results remained statistically significant after confounding adjustment. Our study brings novel perspectives regarding environmental geochemistry to explain health disparities in the USA.
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Affiliation(s)
- Bingjie Qu
- Xi'an Jiaotong-Liverpool University, Wisdom Lake Academy of Pharmacy, Suzhou, China
- Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UK
| | - Shiqiang Wu
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Peng Zhao
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Zheng Feei Ma
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, UK
| | - Royston Goodacre
- Department of Biochemistry and Systems Biology, Centre for Metabolomics Research, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Linxi Yuan
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Ying Chen
- Xi'an Jiaotong-Liverpool University, Wisdom Lake Academy of Pharmacy, Suzhou, China.
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Patil P, Sarang B, Bhandarkar P, Ghoshal R, Roy N, Gadgil A. Does women's empowerment and their socioeconomic condition affect the uptake of breast cancer screening? Findings from NFHS-5, India. BMC Womens Health 2023; 23:7. [PMID: 36611149 PMCID: PMC9824936 DOI: 10.1186/s12905-022-02147-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 12/26/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Screening for breast cancer results in early diagnosis of the disease and improves survival. However, increasing participation of women in screening programs is challenging since it is influenced by socioeconomic and cultural factors. This study explores the relationship of socioeconomic and women empowerment factors with breast cancer screening uptakes in the states and union territories of India. METHODS We used summary reports of secondary data from all the states and union territories based on the fifth wave of the National Family Health Survey in India. This ecological study compares the uptake of breast cancer screening across states of India. We considered socioeconomic status (SES) and women empowerment status (WES) indicators from the survey as independent variables and state-wise breast cancer screening uptake as dependent variables for studying their association. The determinants of breast cancer screening were calculated using a simple linear regression model. RESULTS We found that socioeconomic status and women empowerment status moderately correlated with breast cancer screening uptake (correlation coefficient 0.34 and 0.38, respectively). States with higher rates of literacy among women and of women who had their own bank accounts that they decided how to use reported higher uptake of breast cancer screening (p = 0.01 and 0.03, respectively). However, the correlation was not uniform across all the states. The states of Chandigarh, Delhi, Telangana, and Karnataka showed lower participation despite a higher percentage of literate women and women with their own bank accounts. CONCLUSION This study indicates that women's literacy and having their own bank account may moderately improve their participation in cancer screening. However, higher SES and WES did not translate into better screening in many of the states. More research is needed, especially for states which had low screening uptake despite relatively higher rates of women empowerment.
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Affiliation(s)
- Priti Patil
- grid.414251.70000 0004 1807 8287Department of Statistics, BARC Hospital, Mumbai, 400094 India
| | - Bhakti Sarang
- Department of Surgery, Terna Medical College and Research Center, Mumbai, India
| | - Prashant Bhandarkar
- grid.414251.70000 0004 1807 8287Department of Statistics, BARC Hospital, Mumbai, 400094 India ,grid.419871.20000 0004 1937 0757Tata Institute of Social Sciences, School of Health System Studies, Mumbai, India
| | - Rakhi Ghoshal
- grid.427901.90000 0004 4902 8733CARE India, Okhla Industrial Estate, New Delhi, 110020 India
| | - Nobhojit Roy
- grid.4714.60000 0004 1937 0626Department of Global Public Health, Karolinska Institute, 171 77 Stockholm, Sweden ,grid.464831.c0000 0004 8496 8261The George Institute for Global Health, New Delhi, India
| | - Anita Gadgil
- grid.414251.70000 0004 1807 8287Department of Surgery, BARC Hospital, Mumbai, 400094 India
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Das A, Trivedi MM, Bellingham-Young DA. Food environment index and preterm birth rate in the counties of the United States. J Neonatal Perinatal Med 2023; 16:491-500. [PMID: 37718862 DOI: 10.3233/npm-221180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
OBJECTIVES To determine the relationship between Food Environment Index (FEI) and Preterm Birth (PTB) rate at the county level of the United States of America (USA) (primary), while evaluating the interaction of multiple factors within a framework of sociodemographic, maternal health, maternal behavioral, and environmental factors. METHODS This is a population-based retrospective cohort ecological study from 2015-2018. The study compares the characteristics of the population of the counties of the USA. All counties with complete data on their PTB rate and the independent variables were included in the study. Independent variables with greater than 20% missing data were excluded from the study. Purposive sampling technique was applied. A total of 2983/3142 counties were included in the study. RESULTS The median PTB rate of all counties was 9.90%. The highest PTB rate (23.3%) was in Tallapoosa County, Alabama and the lowest (3.4%) in San Juan County, Washington State. After adjusting for variables, PTB rate had a significant association with FEI (coefficient of correlation - 0.36, p < 0.01, 95% CI - 0.19 to - 0.04). Increase in the rate of unemployment, African American race, adult smoking, obesity, uninsured rate, sexually transmitted diseases (STD), high school education and air pollution was associated with an increase in PTB rate, while an increase in FEI and alcohol abuse rates was associated with a decrease in PTB rate. CONCLUSIONS FEI can predict the PTB rate in USA counties after adjusting for sociodemographic, health, behavioral and environmental factors. Future studies are needed to confirm these associations and consider them when making policies to reduce PTBs.
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Affiliation(s)
- A Das
- Department of Neonatology, Cleveland Clinic, Cleveland, OH, USA
| | - M M Trivedi
- Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, OH, USA
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Chen Y, Ma ZF, Yu D, Jiang Z, Wang B, Yuan L. Geographical distribution of trace elements (selenium, zinc, iron, copper) and case fatality rate of COVID-19: a national analysis across conterminous USA. Environ Geochem Health 2022; 44:4423-4436. [PMID: 35098416 PMCID: PMC8801196 DOI: 10.1007/s10653-022-01204-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/09/2022] [Indexed: 06/01/2023]
Abstract
Severe outcome particularly death is the largest burden of COVID-19. Clinical observations showed preliminary data that deficiency in certain trace elements, essential for the normal activity of immune system, may be associated with worse COVID-19 outcome. Relevant study of environmental epidemiology has yet to be explored. We investigated the geographical association between concentrations of Se, Zn, Fe and Cu in surface soils and case fatality rate of COVID-19 in USA. Two sets of database, including epidemiological data of COVID-19 (including case fatality rate, from the University of John Hopkinson) and geochemical concentration data of Se, Zn, Fe and Cu in surface soils (from the National Geochemical Survey), were mapped according to geographical location at the county level across conterminous USA. Characteristics of population, socio-demographics and residential environment by county were also collected. Seven cross-sectional sampling dates, with a 4-week interval between adjacent dates, constructed an observational investigation over 24 weeks from October 8, 2020, to March 25, 2021. Multivariable fractional (logit) outcome regression analyses were used to assess the association with adjustment for potential confounding factors. In USA counties with the lowest concentration of Zn, the case fatality rate of COVID-19 was the highest, after adjustment for other influencing factors. Associations of Se, Fe and Cu with case fatality rate of COVID-19 were either inconsistent over time or disappeared after adjustment for Zn. Our large study provides epidemiological evidence suggesting an association of Zn with COVID-19 severity, suggesting Zn deficiency should be avoided.
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Affiliation(s)
- Ying Chen
- Wisdom Lake Academy of Pharmacy, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, China
| | - Dahai Yu
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, ST5 5BG, UK
| | - Zifei Jiang
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, China
| | - Bo Wang
- Suzhou Centre for Disease Control and Prevention, Suzhou, 215004, China
| | - Linxi Yuan
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, China.
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Sampaio APN, de Souza LP, de Lima Moreira JP, Luiz RR, Fogaça HS, de Souza HS. Geographic Distribution and Time Trends of Colorectal Cancer in Brazil from 2005 to 2018. Dig Dis Sci 2022; 67:4708-18. [PMID: 35040020 DOI: 10.1007/s10620-021-07357-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/03/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) is the third most common malignancy and the second leading cause of cancer-related death in the world. The aim of this study was to investigate the geographic distribution and time trends of CRC in Brazil. METHODS Data were retrospectively retrieved from January 2005 to December 2018 from the Brazilian Public Health System. The incidence and lethality rates of CRC per 100,000 inhabitants in each municipality were estimated from hospitalizations and in-hospital deaths and were classified by age, sex, and demographic features. RESULTS During the study period, the mean incidence of CRC estimated from hospitalizations and adjusted to available hospital beds more than tripled from 14.6 to 51.4 per 100,000 inhabitants (352%). Increases in CRC incidence were detected in all age ranges, particularly among people aged 50-69 years (266%). Incidence rates increased in all 5 macroregions, with a clear South to North gradient. The greatest changes in incidence and lethality rates were registered in small-sized municipalities. CRC lethality estimated from in-hospital deaths decreased similarly in both sexes, from 12 to 8% for males and females, from 2005 to 2018. The decline in lethality rates was seen in all age ranges, mainly in people aged 50 to 69 years (- 38%). CONCLUSIONS CRC incidence is increasing, predominantly above fifty years of age, and also in areas previously considered as having low incidence, but the increase is not paralleled by lethality rates. This suggests recent improvements in CRC screening programs and treatment, but also supports the spread of environmental risk factors throughout the country.
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Zhu Y, Tong M, Wang Y, Liu Y, Wang B, Yang W, Ning Y. Prevalence of thyroid nodules and its association with water iodine among Chinese men and women. Environ Res 2022; 212:113270. [PMID: 35461842 DOI: 10.1016/j.envres.2022.113270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/13/2022] [Accepted: 04/06/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Because of the large change in iodine nutrition and other lifestyle in China, there is concern that thyroid nodules (TNs) may become epidemic. However, few data are currently available on the national prevalence of TNs. In addition, whether excess iodine in drinking water is associated with an increased risk of TNs, following universal salt iodization, has been less studied. We aim to estimate a national prevalence of TNs and its association with drinking water iodine. METHODS We conducted a national survey of 9,381,032 adults, aged 18 years or older, from 30 provinces and municipalities in China, who underwent a thyroid ultrasound test from January 2018 to December 2018. Crude and standardized prevalence of TNs were estimated. We further evaluated the ecological association between province- or city-specific iodine levels in drinking water and the prevalence of TNs using linear regression. RESULTS The age-standardized prevalence of TNs in men, women, and both sexes were 29.8%, 44.7%, and 37.1%, respectively. The prevalence increased with age from 22.7% (18-30 years) to 71.5% (≥70 years), and body mass index from 26.1% (<18.5 kg/m2) to 40.8% (≥28 kg/m2). Participants living in the eastern, northern, and northeastern regions had a higher prevalence of TNs (ranged from 38.7% to 43.7%) than those in other regions (ranged from 30.1% to 35.5%). The coastal residents (40.1%) had a higher prevalence of TNs than those in inlanders (35.4%). Higher levels of iodine in drinking water were linearly associated with increased prevalence of TNs, with Pearson correlation coefficients of 0.47 (P < 0.01) in men, 0.40 (P = 0.03) in women, and 0.46 (P = 0.01) in overall participants. CONCLUSION This was a nationwide prevalence study of TNs in China, showing that TNs were common health problems, and increased concentration of iodine in drinking water was associated with a higher prevalence of TNs.
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Affiliation(s)
- Yu Zhu
- Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Mingkun Tong
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yingying Wang
- Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yuchen Liu
- Department of Nutrition and Food Science, University of Alberta, Edmonton, Canada
| | - Bo Wang
- Meinian Institute of Health, Beijing, China; Peking University Health Science Center, Meinian Public Health Institute, Beijing, China.
| | - Wanshui Yang
- Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
| | - Yi Ning
- Meinian Institute of Health, Beijing, China; School of Public Health, Hainan Medical University, Haikou, Hainan, China.
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Nishiura H, Jung SM, Hayashi K. High population burden of Omicron variant (B.1.1.529) is associated with the emergence of severe hepatitis of unknown etiology in children. Int J Infect Dis 2022; 122:30-32. [PMID: 35577248 PMCID: PMC9364819 DOI: 10.1016/j.ijid.2022.05.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/08/2022] [Accepted: 05/09/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES To explore a potential country-based ecological link between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant (B.1.1.529) infection and an apparent current global outbreak of severe hepatitis of unknown etiology among children. METHODS We examined country-level statistical associations between reported detection of one or more unexplained severe hepatitis cases in children and the cumulative number of Omicron (B.1.1.529) cases in 38 Organisation for Economic Co-operation and Development (OECD) member countries plus Romania. RESULTS At least one focal hepatitis case was detected in 12 of the 39 countries included in our analysis. Numbers of confirmed Omicron cases reported in these 12 countries ranged from 4.4 to 11.9 million. Among the remaining 27 countries, this measure ranged from 0.5 to 5.5 million cases. Countries which reported focal hepatitis cases experienced higher precedent population burdens of Omicron cases relative to those which did not report any such hepatitis cases (p=0.013). CONCLUSION Prior exposure to Omicron variant (B.1.1.529) may be associated with an increased risk for severe hepatitis among children, indicating a critical need to conduct cofactor studies.
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Affiliation(s)
- Hiroshi Nishiura
- Correspondence to Hiroshi Nishiura at: Address: Yoshidakonoecho, Sakyoku, Kyoto city, Kyoto, 6068503, Japan, Tel: +81-75-753-4456; Fax: +81-75-753-4458
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Wakasugi M, Narita I. Impact of adherence to CKD-MBD guidelines on mortality among Japanese dialysis patients: an ecological study. J Bone Miner Metab 2022; 40:810-818. [PMID: 35759144 DOI: 10.1007/s00774-022-01351-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/06/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This study evaluated the association between prefecture-level achievement of chronic kidney disease-mineral and bone disorder (CKD-MBD) parameter targets and mortality in Japanese dialysis patients. MATERIALS AND METHODS We conducted an ecological study of all prefectures in Japan using data from the Japanese Society of Dialysis Therapy and National Vital Statistics between 2016 and 2017. We calculated adherence rates to recommend target ranges for CKD-MBD parameters, including phosphate, corrected calcium, and parathyroid hormone (PTH), and explored associations of these rates with prefecture-specific standardized mortality rates (SMRs) among the general population and among prevalent dialysis patients using bivariate association analysis and structural equation modeling. RESULTS Prefecture-level adherence to the target phosphate range was significantly and negatively associated with prefecture-specific SMRs in men (standardized estimate (β) = - 0.61, p < 0.001) and women (β = - 0.41, p < 0.001). However, prefecture-level adherence to the target corrected calcium range was significantly and negatively associated with prefecture-specific SMRs only in men (β = - 0.28, p = 0.01). Meanwhile, prefecture-level adherence to the target PTH range was significantly and positively associated with prefecture-specific SMRs in men (β = 0.23, p = 0.04). Prefecture-level SMRs of females in the general population had a significant impact on prefecture-level SMRs of female dialysis patients (β = 0.27, p = 0.03). The models explained 52% of variance in SMR for men and 33% for women. CONCLUSION A higher prefecture-level achievement rate of the target phosphate range recommended by the Japanese CKD-MBD guidelines was associated with a lower prefecture-specific SMR in the Japanese dialysis population.
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Affiliation(s)
- Minako Wakasugi
- Department of Inter-Organ Communication Research, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi 1-757 Chuo-ku, Niigata, 951-8510, Japan.
| | - Ichiei Narita
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Lee KS, Min HS, Jeon JH, Choi YJ, Bang JH, Sung HK. The association between greenness exposure and COVID-19 incidence in South Korea: An ecological study. Sci Total Environ 2022; 832:154981. [PMID: 35378185 PMCID: PMC8975592 DOI: 10.1016/j.scitotenv.2022.154981] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 05/10/2023]
Abstract
BACKGROUND The rapid spread of COVID-19 has caused an emergency situation worldwide. Investigating the association between environmental characteristics and COVID-19 incidence can be of the occurrence and transmission. The objective of this study was to evaluate the association between greenness exposure and COVID-19 cases at the district levels in South Korea. We also explored this association by considering several environmental indicators. METHODS District-level data from across South Korea were used to model the cumulative count of COVID-19 cases per 100,000 persons between January 20, 2020, and February 25, 2021. Greenness exposure data were derived from the Environmental Geographic Information Service of the Korean Ministry of Environment. A negative binomial mixed model evaluated the association between greenness exposure and COVID-19 incidence rate at the district level. Furthermore, we assessed this association between demographic, socioeconomic, environmental statuses, and COVID-19 incidence. RESULTS Data from 239 of 250 districts (95.6%) were included in the analyses, resulting in 127.89 COVID-19 cases per 100,000 persons between January 20, 2020 and February 25, 2021. Several demographic and socioeconomic variables, districts with a higher rate of natural greenness exposure, were significantly associated with lower COVID-19 incidence rates (incidence rate ratio (IRR), 0.70; 95% confidence interval (CI), 0.54-0.90; P-value = 0.008) after adjusting covariates, but no evidence for the association between built greenness and COVID-19 incidence rates was found. CONCLUSION In this ecological study of South Korea, we found that higher rates of exposure to natural greenness were associated with lower rates of COVID-19 cases.
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Affiliation(s)
- Kyung-Shin Lee
- Research Institute for Public Health, National Medical Center, Seoul 04564, Republic of Korea.
| | - Hye Sook Min
- Research Institute for Public Health, National Medical Center, Seoul 04564, Republic of Korea.
| | - Jae-Hyun Jeon
- Research Institute for Public Health, National Medical Center, Seoul 04564, Republic of Korea; Department of Infectious disease, National Medical Center, Seoul 04564, Republic of Korea.
| | - Yoon-Jung Choi
- National Cancer Center Graduate School of Cancer Science and Policy, Gyeonggi-do 10408, Republic of Korea.
| | - Ji Hwan Bang
- Office for the Central Infectious Disease Hospital, National Medical Center, Seoul 04564, Republic of Korea.
| | - Ho Kyung Sung
- Research Institute for Public Health, National Medical Center, Seoul 04564, Republic of Korea; National Emergency Medical Center, National Medical Center, Seoul 04564, Republic of Korea.
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Souza MPA, da Natividade MS, Werneck GL, Dos Santos DN. Congenital Zika syndrome and living conditions in the largest city of northeastern Brazil. BMC Public Health 2022; 22:1231. [PMID: 35725427 PMCID: PMC9208747 DOI: 10.1186/s12889-022-13614-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 06/09/2022] [Indexed: 12/01/2022] Open
Abstract
Background The Zika virus (ZIKV) epidemic hit Brazil in 2015 and resulted in a generation of children at risk of congenital Zika syndrome (CZS). The social vulnerability of certain segments of the population contributed to the disproportional occurrence of CZS in the Brazilian Northeast, the poorest region in the country. Living conditions are essential factors in understanding the social determination of CZS, which is embedded in a complex interaction between biological, environmental, and social factors. Salvador, the biggest city in the region, played a central role in the context of the epidemic and was a pioneer in reporting the ZIKV infection and registering a high number of cases of CZS. The aim of the study was identifying the incidence and spatial distribution pattern of children with CZS in the municipality of Salvador, according to living conditions. Methods This is an ecological study that uses the reported cases of ZIKV and CZS registered in the epidemiological surveillance database of the Municipal Secretariat of Health of the city of Salvador between August of 2015 and July of 2016. The neighborhoods formed the analysis units and the thematic maps were built based on the reported cases. Associations between CZS and living conditions were assessed using the Kernel ratio and a spatial autoregressive linear regression model. Results Seven hundred twenty-six live births were reported, of which 236 (32.5%) were confirmed for CZS. Despite the reports of ZIKV infection being widely distributed, the cases of CZS were concentrated in poor areas of the city. A positive spatial association was observed between living in places with poorer living conditions and births of children with CZS. Conclusions This study shows the role of living conditions in the occurrence of births of children with CZS and indicates the need for approaches that recognize the part played by social inequalities in determining CZS and in caring for the children affected.
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Affiliation(s)
- Marcos Paulo Almeida Souza
- Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Bahia, Brazil. .,Department of Surgery, University Hospital of Lagarto, Federal University of Sergipe, Lagarto, Sergipe, Brazil.
| | | | - Guilherme Loureiro Werneck
- Instituto de Estudos em Saúde Coletiva, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,Instituto de Medicina Social, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Aloisi V, Gatto A, Accarino G, Donato F, Aloisio G. The effect of known and unknown confounders on the relationship between air pollution and Covid-19 mortality in Italy: A sensitivity analysis of an ecological study based on the E-value. Environ Res 2022; 207:112131. [PMID: 34619131 PMCID: PMC8487852 DOI: 10.1016/j.envres.2021.112131] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 05/09/2023]
Abstract
Back in December 2019, the novel coronavirus disease 2019 (Covid-19) started rapidly spreading worldwide, especially in Italy that was among the most affected countries. The geographical distribution of air pollution and Covid-19 mortality in Italy suggested atmospheric pollution as a worsening factor of severe Covid-19 health outcomes. The present nationwide ecological study focused on all 107 Italian territorial areas, aiming to assess the potential association between Particulate Matter concentration, less than 2.5 μm in diameter (exposure), and Covid-19 mortality rate (outcome) throughout 2020, by looking at 28 potential confounders. A potential positive association between exposure and outcome was observed when performing a multivariate regression analysis with a Negative Binomial model, suggesting that an increase of 1 μg/m3 in the exposure is associated with an increase of 9.0% (95% CI: 6.5%-11.6%) in the average Covid-19 mortality rate, conditional on all 28 potential confounders. A sensitivity analysis, based on the E-value, shows that a hypothetical unmeasured confounder would have to be associated with both PM2.5 concentration and Covid-19 mortality rate by a rate ratio of at least 1.40-fold each to explain away the exposure-outcome association, conditional on all 28 covariates included in the main analysis model. Moreover, the Observed Covariate E-value (OCE) was reported to provide a contextualization of the E-value on the observed covariates included in the study. The OCE sensitivity analysis shows that a set of unknown confounders similar in size and magnitude to the set of the considered climatic factors could potentially explain away the estimated exposure-outcome association. Consequently, the role of climatic factors in the Covid-19 pandemic is worth of further investigation.
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Affiliation(s)
- Valeria Aloisi
- Department of Innovation Engineering, University of Salento, Via Prov.le Lecce-Monteroni, Lecce, Italy; Euro-Mediterranean Center on Climate Change (CMCC) Foundation, Via Augusto Imperatore, 16, 73100, Lecce, Italy.
| | - Andrea Gatto
- Department of Innovation Engineering, University of Salento, Via Prov.le Lecce-Monteroni, Lecce, Italy; Euro-Mediterranean Center on Climate Change (CMCC) Foundation, Via Augusto Imperatore, 16, 73100, Lecce, Italy.
| | - Gabriele Accarino
- Department of Biological and Environmental Sciences and Technologies, University of Salento, Via Prov.le Lecce-Monteroni, Lecce, Italy; Euro-Mediterranean Center on Climate Change (CMCC) Foundation, Via Augusto Imperatore, 16, 73100, Lecce, Italy.
| | - Francesco Donato
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Unit of Hygiene, Epidemiology, and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia, Italy.
| | - Giovanni Aloisio
- Department of Innovation Engineering, University of Salento, Via Prov.le Lecce-Monteroni, Lecce, Italy; Euro-Mediterranean Center on Climate Change (CMCC) Foundation, Via Augusto Imperatore, 16, 73100, Lecce, Italy.
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Romain-Scelle N, Elias C, Vanhems P. COVID-19 vaccine is correlated with favourable epidemiological indicators in the Auvergne-Rhône-Alpes region (France): An ecological study. Vaccine 2022; 40:695-700. [PMID: 34969543 PMCID: PMC8692069 DOI: 10.1016/j.vaccine.2021.12.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 01/25/2023]
Abstract
COVID-19 vaccination has proven to be effective in preventing severe cases, reducing viral load, and transmissibility. The aim of this study was to evaluate the impact of vaccination 11 months after implementation on epidemiological indicators and the effective reproduction number in one French region. We plotted four indicators with vaccination coverage as the explaining variable and estimated the impact of vaccination using the reduction rates in infections and hospital admissions. A reduction of 98% in COVID-19-related hospitalisation 11 months after the vaccine campaign began in January 2021 has been reported while vaccine coverage increased over time. Those results do not make it possible to postulate a causal relationship but do support the effect of vaccination against multiple variants of concern. Non-pharmaceutical measures remain necessary to attain complete epidemic control. Open epidemiological data should be considered to monitor vaccine effectiveness wherever possible.
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Affiliation(s)
- Nicolas Romain-Scelle
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Christelle Elias
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France,Équipe Santé Publique, Epidémiologie et Eco-évolution des Maladies Infectieuses CIRI-Centre International de Recherche en Infectiologie, Université de Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Lyon, France
| | - Philippe Vanhems
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France,Équipe Santé Publique, Epidémiologie et Eco-évolution des Maladies Infectieuses CIRI-Centre International de Recherche en Infectiologie, Université de Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Lyon, France,INSERM, F-CRIN, Lyon Centre of Innovative Clinical Research Network in Vaccinology (I-REIVAC), CIC 1417, Paris, France,Corresponding author
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Purushothaman V, Cuomo RE, Li J, Nali M, Mackey TK. Association of tobacco retailer count with smoking population versus vaping population in California (2019). Arch Public Health 2022; 80:42. [PMID: 35086563 PMCID: PMC8793220 DOI: 10.1186/s13690-022-00799-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 01/12/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Access to tobacco products, including vape products, from local brick-and-mortar stores influences the exposure, uptake, and use of these products in local communities. METHODS Licensed tobacco retailers in California were classified as specialized tobacco/vape stores or non-specialized stores by obtaining categories published on Yelp. California smoking and vaping prevalence data were obtained from the 500 cities project and ESRI community analyst tool respectively. A series of simple linear regression tests were performed, at the zip code level, between the retailer count in each store category and smoking/vaping population. The Getis-Ord Gi* and Anselin Local Moran's I statistics were used for characterization of tobacco retail density hotspots and cold spots. RESULTS The association between CA smoking/vaping population and number of tobacco retailers was statistically significant for all store categories. Variability in smoking population was best explained by variability in non-specialized storefronts(R2=0.84). Spatial variability in tobacco-only storefronts explained the least proportion of variability in the overall smoking population. Similar results were obtained specific to vaping population, although the proportion of population explained by variability in the number of non-specialized storefronts was comparatively lower(R2=0.80). CONCLUSIONS Localities with greater numbers of non-specialized tobacco retailers had higher rates of smoking/vaping populations, and this association was much stronger for localities with greater numbers of specialized retailers. Non-specialized storefronts may represent convenient access points for nicotine products, while specialized storefronts may represent critical access points for initiation. Hence, regulations that address the entirety of the tobacco/vaping retail environment by limiting widespread access from non-specialized stores and reducing appeal generated by specialized retailers should be incorporated in future tobacco regulatory science and policymaking.
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Affiliation(s)
- Vidya Purushothaman
- Department of Anesthesiology, San Diego School of Medicine, University of California, La Jolla, CA, USA
- Global Health Policy and Data Institute, San Diego, CA, USA
| | - Raphael E Cuomo
- Department of Anesthesiology, San Diego School of Medicine, University of California, La Jolla, CA, USA
- Global Health Policy and Data Institute, San Diego, CA, USA
| | - Jiawei Li
- Global Health Policy and Data Institute, San Diego, CA, USA
- S-3 Research LLC, San Diego, CA, USA
| | - Matthew Nali
- Department of Anesthesiology, San Diego School of Medicine, University of California, La Jolla, CA, USA
- Global Health Policy and Data Institute, San Diego, CA, USA
- S-3 Research LLC, San Diego, CA, USA
| | - Tim K Mackey
- Global Health Policy and Data Institute, San Diego, CA, USA.
- S-3 Research LLC, San Diego, CA, USA.
- Global Health Program, Department of Anthropology, University of California, San Diego, La Jolla, CA, USA.
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Grech V, Scherb H. No Local Birth Sex Ratio Changes following the August 2019 Shootings in Montgomery County, Ohio, and in El Paso County, Texas. Med Princ Pract 2022; 31:83-87. [PMID: 34875654 PMCID: PMC9001977 DOI: 10.1159/000521338] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 11/27/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE In humans, males are born slightly in excess of females. Many factors have been shown to affect this ratio, including stressful events such as terrorist attacks. Two shootings occurred in early August 2019 in the Oregon District in Dayton, Montgomery County, Ohio, and in El Paso County, Texas, in the USA. This study was carried out in order to identify whether there were any effects on sex ratio at birth at the state or county level 3-5 months later. SUBJECT AND METHODS Births by sex, month of birth (2015-2019), and county were obtained for Ohio and Texas from the website of the Centers for Disease Control and Prevention. Ordinary linear logistic regression was used to assess the time trend in the probability of boys and to investigate changes in the trend functions. Poisson regression (SAS GENMOD) and linear logistic regression using SAS procedure LOGISTIC was applied. RESULTS This study analyzed 2,623,714 live births, 1,939,938 in Texas (sex odds [SO] 1.044) and 683,776 in Ohio (SO 1.045). The only significant effect noted was seasonality (month) at the state level. CONCLUSION It has been postulated that male fetal loss in pregnant women during stressful periods may occur in accordance with the Trivers-Willard hypothesis. Several studies have found significant effects after terrorist attacks in the USA (as well as in other countries), but this study did not reveal such effects. This may be due to several reasons including underpowered datasets and the possibility that populations may be becoming relatively immured to these events.
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Affiliation(s)
- Victor Grech
- Medical School, University of Malta, Malta, Montana, USA
- *Victor Grech,
| | - Hagen Scherb
- Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
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Schwartz GG, Williamson MR. Lead service lines and Parkinson's disease prevalence in U.S. States. Clin Park Relat Disord 2021; 5:100122. [PMID: 34927049 DOI: 10.1016/j.prdoa.2021.100122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/09/2021] [Accepted: 11/21/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction We recently showed that the prevalence of Parkinson’s Disease (PD) in U.S. states is positively associated with the quantity of acid rain. Acid rain could play an etiologic role in PD by mobilizing metals, e.g., lead, from watersheds and pipes into drinking water. We assessed the correlation of PD with lead service lines, the underground pipes that connect homes to municipal water sources, which are a major aqueous source of lead. Methods We used multiple regression techniques to examine PD prevalence rates by state relative to the number of lead service lines. We included known or suspected aqueous risk factors, e.g., the Acid Precipitation Index (a measure of acid rain) and well water use. Results Age-, race-, and sex-adjusted prevalence rates for PD were significantly and positively correlated with the log number of lead service lines (p = 0.0004). The effect of lead service lines remained significant after adjusting for the effects of acid rain and well water use (p = 0.0019). Conclusion These findings are consistent with a role for lead in the etiology of PD. Studies of lead service line exposure in relation to PD at the individual level are warranted.
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Ma Z, Wang X, Li M, Zhou D, Chen J. An ecological comparison study on the causal association between leptospirosis and moyamoya disease in Hubei, China, 2017-2019. Clin Neurol Neurosurg 2021; 210:107007. [PMID: 34741974 DOI: 10.1016/j.clineuro.2021.107007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/17/2021] [Accepted: 10/21/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The importance of environmental factors (especially leptospirosis) of moyamoya disease (MMD) has not been clarified. Here we investigated the epidemiological characteristics of MMD in Hubei province, China. METHODS We conducted a population-based study to describe the epidemiologic characteristics of MMD in Hubei province between 2017 and 2019. The regional clusters of the hot spots (high incidence) and cold spots (low incidence) of MMD were identified using the spatial statistical method. To evaluate the role of leptospirosis in MMD, we performed an ecological comparison study to evaluate whether the socioeconomic and environmental variables of hot spots are more suitable for leptospirosis spread. RESULTS The average annual sex and age adjusted incidence of MMD was 3.07 per 100,000 person-years from 2017 to 2019. The middle-aged had apparently higher incidence of MMD than the children. There existed an obvious geographic distribution difference of MMD at county level. The hot spots were identified mainly in the low mountainous and hilly terrain, while cold spots were located in the Jianghan Plains. Compared to cold spots, the hot spots had larger cattle density (32.0 vs 3.1, p = 0.002), higher percentages of rice field (85.6% vs 47.0%, p = 0.007), and lower elevation (33.6 vs 157.4, p < 0.001) CONCLUSIONS: There exists geographic distribution difference of MMD in Hubei province and was likely to be caused by leptospirosis in the early years. The MMD in China is dominant by middle-aged adults, which might be driven from leptospirosis outbreaks in the last century.
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Affiliation(s)
- Zhiyang Ma
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Xiong Wang
- Research Centre for Spatial Planning and Human-Environment System Simulation, School of Geography and Information Engineering, China University of Geosciences (Wuhan), Wuhan 430074, China
| | - Meifang Li
- School of Geography and Environment, Jiangxi Normal University, Nanchang 330022, China
| | - Da Zhou
- Information Statistical Bureau, Hubei Health Committee, Wuhan 430079, China
| | - Jincao Chen
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
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McDonald K, Machado DB, Castro-de-Araujo LFS, Kiss L, Palfreyman A, Barreto ML, Devakumar D, Lewis G. Trends in method-specific suicide in Brazil from 2000 to 2017. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1779-1790. [PMID: 33782727 PMCID: PMC8429168 DOI: 10.1007/s00127-021-02060-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/10/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Understanding long-term patterns of suicide methods can inform public health policy and prevention strategies. In Brazil, firearm-related policies may be one salient target for suicide prevention. This study describes trends in method-specific suicide at the national and state-levels in Brazil, with a particular focus on firearm-related suicides. METHODS Brazilian mortality data for suicide and undetermined intent among people aged 10 years and older between 2000 and 2017 were obtained from the National Mortality Information System. We examined national and state-level trends in age-standardised suicide rates for hanging, self-poisoning, firearms, jumping from a high place, other, and unspecified methods. We also compared total rates of mortality from suicide and undetermined intent over the period. Applying Joinpoint regression, we tested changes in trends of firearm-specific suicide rates. RESULTS The total suicide rate increased between 2000 and 2017. Rates of hanging, self-poisoning by drugs or alcohol and jumping from a high place showed the largest increases, while firearm-specific suicide rates decreased over the study period. Trends in methods of suicide varied by sex and state. CONCLUSION It is of public health concern that suicide rates in Brazil have risen this millennium. Restricting access to firearms might be an effective approach for reducing firearm-specific suicides, especially in states where firearm availability remains particularly high. Treatment and management of substance misuse may also be an important target for suicide prevention policies. More work is needed to understand the causes of rising suicide rates in Brazil and to improve the mental health of the population.
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Affiliation(s)
- Keltie McDonald
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
| | - Daiane Borges Machado
- Center of Data and Knowledge Integration for Health (CIDACS), Salvador, Brazil
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Luís F S Castro-de-Araujo
- Center of Data and Knowledge Integration for Health (CIDACS), Salvador, Brazil
- The University of Melbourne, Department of Psychiatry, Austin Health, Heidelberg, VIC, Australia
| | - Lígia Kiss
- Institute for Global Health, University College London, London, UK
| | | | - Maurício L Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Salvador, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | | | - Glyn Lewis
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
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Ladha KS, Wijeysundera DN, Wunsch H, Clarke H, Diep C, Gomes T. The association between prescription opioid dispensing and opioid-related morbidity and mortality in Ontario, Canada: an ecological study of public health units. Drug Alcohol Depend 2021; 227:108989. [PMID: 34482045 DOI: 10.1016/j.drugalcdep.2021.108989] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Overdose and death rates from opioids continue to rise. However, the relative contribution of prescription opioids to the ongoing crisis is unclear. The purpose of this study was to assess the association between prescription opioid dispensing and opioid-related morbidity and mortality. METHODS Regional-level data for this ecological study were extracted from publicly available databases for the years 2013-2018 in Ontario, Canada. The primary exposure variable was opioids dispensed, in milligram morphine equivalents (MME), per capita by public health unit (PHU) in a given year. The primary outcome was the rate of opioid-related emergency department (ED) visits per 100,000 by PHU. Generalized estimating equation (GEE) analytic models were developed to account for clustering by PHU over time while adjusting for demographic and population health characteristics at the regional level. RESULTS Higher per capita MME of opioids dispensed was associated with lower rates of opioid-related ED visits per 100,000 (β=-0.091, 95 % CI: -0.110 to -0.077, p < 0.001), as well as with lower rates of opioid-related deaths per 100,000 (β=-0.012, 95 % CI: -0.014 to -0.007, p < 0.001). In subgroup analyses based on time periods (2016-2018 vs. 2013-2015), this negative association was seen only for the period 2016-2018. INTERPRETATION Higher per capita regional opioid prescribing was not positively associated with an increased rate of opioid-related emergency room visits or opioid-related deaths. Further studies with patient-level data are needed to better understand our findings.
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Abstract
BACKGROUND The number of persons infected with COVID-19 continues to increase with deaths reported daily across the globe. High income countries such as the US, the UK, Italy and Belgium have reported high COVID-19 related deaths but low-and-middle-income countries have recorded fewer deaths despite having poor healthcare system. This study aimed to investigate the association between malaria prevalence and COVID-19 mortality. METHODS An ecological study was conducted with data from 195 countries. Spearman's correlation was used to test the association between the population variables and COVID-19 mortality. Generalized linear model with Poisson distribution was used to determine the significant predictors of COVID-19 mortality. RESULTS There was a significant positive correlation between median age, life expectancy, 65+ mortality and COVID-19 mortality while malaria prevalence, sex ratio and cardiovascular mortality were negatively correlated with COVID-19 mortality. Malaria prevalence, life expectancy and mortality rate were significant on multivariate regression analysis. CONCLUSION The results of this study support the hypotheses that there are reduced COVID-19 deaths in malaria endemic countries, although the results need to be proved further by clinical trials.
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Affiliation(s)
- Michael U Anyanwu
- Department of Community Health, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda.
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Osawa E, Kodama T. Regional socio-environmental characteristics associated with inadequate prenatal care during pregnancy: an ecological study of 47 prefectures in Japan. BMC Pregnancy Childbirth 2021; 21:619. [PMID: 34517823 PMCID: PMC8439025 DOI: 10.1186/s12884-021-04100-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prenatal care (PNC) is a crucial health service that reduces the potential risks of adverse pregnancy and childbirth outcomes. It is monitored as one of the indicators of Universal Health Coverage (UHC) under the United Nations' Sustainable Development Goals. However, there are still mothers who do not use PNC, even when UHC has been achieved. As there have been few reports on the impact of local socio-environmental characteristics within the country, this study aimed to examine the association between local socio-environmental factors and inadequate use of PNC in Japan. METHODS We conducted an ecological analysis of 47 prefectures in Japan using public open data. The dependent variables were the inadequate use of PNC, which are the rates of pregnant women who missed visiting PNC until 28 weeks' gestational age (GA) or those who never attended PNC before childbirth, and the independent variables were prefectural data of socio-economic, educational, and healthcare workforce-related factors. Multiple logistic regression analysis was used to examine the associations. RESULTS The rate of pregnant women with late PNC initiation and never attending PNC before childbirth was 3.00-11.24 and 0.23-8.06 per 1000 pregnant women, respectively. Population numbers and densities, divorce rates, percentages of non-Japanese nationalities, and low percentages of high school enrolment were positively associated with inadequate PNC use. There was no statistically significant association with healthcare workforce, such as the number of obstetricians and gynaecologists. CONCLUSIONS This ecological study revealed that inadequate PNC use is more common in urban areas with more non-Japanese nationality and lower education enrolment. There may be a need to provide education for those who do not have access to reproductive health education, such as that offered in high schools. Further studies are required to examine factors that affect access to PNC in Japan.
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Affiliation(s)
- Eri Osawa
- Department of International Health and Collaboration, National Institute of Public Health, 2-3-6 Minami Wako-shi, Saitama, 351-0197, Japan.
| | - Tomoko Kodama
- Department of International Health and Collaboration, National Institute of Public Health, 2-3-6 Minami Wako-shi, Saitama, 351-0197, Japan
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Rose N, Matthäus-Krämer C, Schwarzkopf D, Scherag A, Born S, Reinhart K, Fleischmann-Struzek C. Association between sepsis incidence and regional socioeconomic deprivation and health care capacity in Germany - an ecological study. BMC Public Health 2021; 21:1636. [PMID: 34493250 PMCID: PMC8424852 DOI: 10.1186/s12889-021-11629-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 08/13/2021] [Indexed: 12/29/2022] Open
Abstract
Background Sepsis is a substantial health care burden. Data on regional variation in sepsis incidence in Germany and any possible associations with regional socioeconomic deprivation and health care capacity is lacking. Methods Ecological study based on the nationwide hospital Diagnosis-related Groups (DRG) statistics data of 2016. We identified sepsis by ICD-10-codes and calculated crude and age-standardized incidence proportions in the 401 administrative German districts. Associations between socioeconomic and health care capacity indicators and crude and age-adjusted sepsis incidence were investigated by simple and multiple negative binomial (NB) regressions. Results In 2016, sepsis incidence was 178 per 100,000 inhabitants and varied 10-fold between districts. We found that the rate of students leaving school without certificate was significantly associated with crude and age-standardized explicit sepsis incidence in the simple and multiple NB regressions. While we observed no evidence for an association to the capacity of hospital beds and general practitioners, the distance to the nearest pharmacy was associated with crude- and age-standardized sepsis incidence. In the multiple regression analyses, an increase of the mean distance + 1000 m was associated with an expected increase by 21.6 [95% CI, 10.1, 33.0] (p < 0.001), and 11.1 [95% CI, 1.0, 21.2]/100,000 population (p = .026) after adjusting for age differences between districts. Conclusions Residence in districts with lower socioeconomic status (e.g., less education) and further distance to pharmacies are both associated with an increased sepsis incidence. This warrants further research with individual-level patient data to better model and understand such dependencies and to ultimately design public health interventions to address the burden of sepsis in Germany. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11629-4.
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Affiliation(s)
- Norman Rose
- Center for Sepsis Control and Care, Jena University Hospital, Bachstraße 18, 07743, Jena, Germany.,Institute of Infectious Diseases and Infection Control, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Claudia Matthäus-Krämer
- Center for Sepsis Control and Care, Jena University Hospital, Bachstraße 18, 07743, Jena, Germany
| | - Daniel Schwarzkopf
- Institute of Infectious Diseases and Infection Control, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.,Department for Anesthesiology and Intensive Care Medicine, Jena University Hospital, Am Klinikum 1, 07740, Jena, Germany
| | - André Scherag
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Bachstraße 18, 07743, Jena, Germany
| | - Sebastian Born
- Center for Sepsis Control and Care, Jena University Hospital, Bachstraße 18, 07743, Jena, Germany.,Institute of Infectious Diseases and Infection Control, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Konrad Reinhart
- Department of Anesthesiology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Carolin Fleischmann-Struzek
- Center for Sepsis Control and Care, Jena University Hospital, Bachstraße 18, 07743, Jena, Germany. .,Institute of Infectious Diseases and Infection Control, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
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Liu X, Wang Y, Han S, Zhang Y, Zou Y, Su S, Zhou H, Zhang X, Liang H, Hou J, Wang T. A Spatial Ecological Study on Serum Selenium and Keshan Disease in Heilongjiang Province, China. Biol Trace Elem Res 2021; 199:3253-3261. [PMID: 33159624 DOI: 10.1007/s12011-020-02478-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/03/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND There are no reports on the spatial ecology of serum selenium and Keshan disease in Heilongjiang Province in China. OBJECTIVE This study aimed to conduct a spatial assessment of Keshan disease elimination at the level of the etiological molecular marker. METHODS An ecological study design was used. The levels of serum selenium of the 571 residents aged between 17 and 35 years and living in rural areas, townships, and cities in 63 Keshan disease endemic counties and 46 non-endemic counties in Heilongjiang Province were measured using atomic fluorescence spectrometry. A spatial analysis of serum selenium levels was conducted. RESULTS The median serum selenium level of the 571 participants was 1.00 μmol/L, and that of participants living in Keshan disease endemic areas was 0.97 μmol/L, which was significantly lower compared to the level of those living in non-endemic areas (1.01 μmol/L, P = 0.0037). Serum selenium levels of the participants living in rural areas, townships, and cities were significantly different (P < 0.001) at 0.95 μmol/L, 1.00 μmol/L, and 1.04 μmol/L, respectively. Spatial regression analysis showed that the distribution of serum selenium levels was positively correlated with the per capita gross domestic product. CONCLUSION The analysis of the spatial distribution of serum selenium levels provided precise visual evidence that selenium deficiency may still be present among residents of Keshan disease endemic counties of Tangyuan, Mulan, Lingdong, Suiling, and Dongshan. Selenium levels should therefore be included in the national surveillance of Keshan disease.
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Affiliation(s)
- Xu Liu
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Yanan Wang
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Shan Han
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
- Infectious Disease Hospital of Heilongjiang Province, Harbin, China
| | - Yiyi Zhang
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Yuanjie Zou
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Shengqi Su
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Huihui Zhou
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
- Jining Medical University, Jining, China
| | - Xiao Zhang
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
- Qingdao Municipal Hospital, Qingdao, China
| | - Hong Liang
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
- Qiqihar Medical University, Qiqihar, China
| | - Jie Hou
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Tong Wang
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China.
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Smith RA, Schneider PP, Cosulich R, Quirk H, Bullas AM, Haake SJ, Goyder E. Socioeconomic inequalities in distance to and participation in a community-based running and walking activity: A longitudinal ecological study of parkrun 2010 to 2019. Health Place 2021; 71:102626. [PMID: 34333371 PMCID: PMC8522482 DOI: 10.1016/j.healthplace.2021.102626] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 01/07/2023]
Abstract
Objectives To conduct a longitudinal ecological analysis of the distance to and participation in free weekly outdoor physical activity events (parkrun) in England from 2010 to 2019, and related socioeconomic and ethnic inequalities, to inform policies to support participation in physically active community events. Methods We calculate distance to the nearest parkrun event for each English Lower Layer Super Output Area (LSOA) each month from January 2010 to December 2019. We then report the trends in distance to and participation in parkrun by Index of Multiple Deprivation quintile. We also report trends in the Relative Index of Inequality (RII) by deprivation for participation and distance to nearest event. We go on to investigate trends in LSOA level determinants (e.g. deprivation and ethnic density) of parkrun participation between 2010 and 2019, using multivariable Poisson regression models. Results Mean distance to the nearest parkrun event decreased from 34.1 km in 2010, to 4.6 km in 2019. Throughout the period, parkrun events tended to be situated closer to deprived areas compared to less deprived areas. Participation rates increased superlinearly (greater than linear increase) from 2010 to 2013 before slowing to linear growth. Participation over the period exhibits a clear socioeconomic gradient, with people from deprived areas having consistently lower participation rates over the period. parkrun participation rates became more equal between 2010 and 2013 (RII improved from 189 to 39), before stabilising at an RII between 32.9 and 39.6 from 2014 to 2019. The results of the Poisson regression model validate this finding; the coefficients on IMD score initially increased from −0.050 in 2010 to −0.038 in 2013, and then remained relatively stable to 2019 (−0.035). Conclusions Over the past 10 years, geodesic distance to the nearest parkrun decreased from a mean of 34 km to 5 km. In 2010, there was equality between the least and most deprived areas but by 2017 the distance of the most deprived areas was 29% that of the least deprived. Participation was shown to have increased over the past 10 years which can be split into two distinct phases: from 2010 to 2013 participation increased super-linearly and inequality in participation fell dramatically; from 2013 to 2019 participation increased linearly, and inequality in participation remained stable. Despite parkrun's ambitions of creating inclusive events and engaging with deprived communities, the socioeconomic gradient in participation rates remained high and stable since 2013. Gaining a better understanding of the reasons why parkrun grew so quickly may be useful for other physical activity movements, while further analysis of the relatively lower participation rates in areas with higher socioeconomic deprivation is important for developing initiatives to encourage physical activity in these communities. Geographical access to & participation in parkrun in England improved every year from 2010 to 2019. However, the rate of improvement slowed down, especially after 2013. New events reduced distance to parkrun in high deprivation areas more than low deprivation areas. Socioeconomic inequalities in participation fell from 2010 to 2013 and stabilised after.
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Affiliation(s)
- Robert A Smith
- School of Health and Related Research, 30 Regents Court, Sheffield, S1 4DA, UK.
| | - Paul P Schneider
- School of Health and Related Research, 30 Regents Court, Sheffield, S1 4DA, UK
| | - Rami Cosulich
- School of Health and Related Research, 30 Regents Court, Sheffield, S1 4DA, UK
| | - Helen Quirk
- School of Health and Related Research, 30 Regents Court, Sheffield, S1 4DA, UK
| | - Alice M Bullas
- Sports Engineering, Sport and Physical Activity Research Centre, Sheffield Hallam University, S10 2LW, UK
| | - Steve J Haake
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Olympic Legacy Park, Sheffield, S9 3TU, UK
| | - Elizabeth Goyder
- School of Health and Related Research, 30 Regents Court, Sheffield, S1 4DA, UK
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Qeadan F, Mensah NA, Tingey B, Bern R, Rees T, Madden EF, Porucznik CA, English K, Honda T. The association between opioids, environmental, demographic, and socioeconomic indicators and COVID-19 mortality rates in the United States: an ecological study at the county level. ACTA ACUST UNITED AC 2021; 79:101. [PMID: 34130741 PMCID: PMC8204068 DOI: 10.1186/s13690-021-00626-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 06/01/2021] [Indexed: 01/08/2023]
Abstract
Background The spread of the COVID-19 pandemic throughout the world presents an unprecedented challenge to public health inequities. People who use opioids may be a vulnerable group disproportionately impacted by the current pandemic, however, the limited prior research in this area makes it unclear whether COVID-19 and opioid use outcomes may be related, and whether other environmental and socioeconomic factors might play a role in explaining COVID-19 mortality. The objective of this study is to evaluate the association between opioid-related mortality and COVID-19 mortality across U.S. counties. Methods Data from 3142 counties across the U.S. were used to model the cumulative count of deaths due to COVID-19 up to June 2, 2020. A multivariable negative-binomial regression model was employed to evaluate the adjusted COVID-19 mortality rate ratios (aMRR). Results After controlling for covariates, counties with higher rates of opioid-related mortality per 100,000 persons were found to be significantly associated with higher rates of COVID-19 mortality (aMRR: 1.0134; 95% CI [1.0054, 1.0214]; P = 0.001). Counties with higher average daily Particulate Matter (PM2.5) exposure also saw significantly higher rates of COVID-19 mortality. Analyses revealed rural counties, counties with higher percentages of non-Hispanic whites, and counties with increased average maximum temperatures are significantly associated with lower mortality rates from COVID-19. Conclusions This study indicates need for public health efforts in hard hit COVID-19 regions to also focus prevention efforts on overdose risk among people who use opioids. Future studies using individual-level data are needed to allow for detailed inferences.
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Affiliation(s)
- Fares Qeadan
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA.
| | - Nana Akofua Mensah
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Benjamin Tingey
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Rona Bern
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Tracy Rees
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Erin Fanning Madden
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA
| | - Christina A Porucznik
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Kevin English
- Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque, NM, USA
| | - Trenton Honda
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
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Takahashi N, Nakao M. Social-life factors associated with participation in screening and further assessment of colorectal cancer: A nationwide ecological study in Japanese municipalities. SSM Popul Health 2021; 15:100839. [PMID: 34189242 PMCID: PMC8215283 DOI: 10.1016/j.ssmph.2021.100839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 12/24/2022] Open
Abstract
The burden of colorectal cancer in developed countries is high, and it is a major public health concern in Japan. Improving the quality of evidence on colorectal cancer screening participation and further assessment participation rates is important to reduce this burden. This study examined the social-life factors that influence colorectal cancer screening programs in Japan, particularly the effects of the proportion of elderly people and social capital, using a municipality-level national database and existing health reports. Data from a national municipality-based study were analyzed to identify social-life factors associated with participation in colorectal cancer screening and further assessment. Administrative data on the Japanese municipal screening programs were drawn from the Report on Regional Public Health Services and Health Promotion Services 2017. Available data used as predictors of interest for all 1719 municipalities as of 2017 were from the national census, statistical reports on the land area by prefecture and municipality, municipal financial surveys, a survey of physicians, dentists and pharmacists, and other databases. The mean rate of participation in colorectal cancer screening was 13.8%, and that of further assessment was 73.6%. Multiple linear regression analyses of the two outcomes showed that the proportion of elderly people was most significantly positively associated with colorectal cancer screening programs (β = 0.51 for participation, β = 0.13 for further assessment participation), and the proportion of single-elderly-person households was most significantly negatively associated (β = −0.45 and −0.19, respectively). It is suggested that the health behaviors required for participation in colorectal cancer programs in Japanese elderly populations are greatly affected by family members. The disease burden of colorectal cancer is increasing in developed countries. An ecological study of the colorectal cancer screening program was conducted. The proportion of elderly people was positively associated with the screening rates. The single-elderly-person households was negatively associated with the screening rates.
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Affiliation(s)
- Noriaki Takahashi
- Division of Screening Assessment and Management, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Graduate School of Public Health, International University of Health and Welfare, 4-1-26 Akasaka, Minato-ku, Tokyo, 107-8402, Japan
| | - Mutsuhiro Nakao
- Graduate School of Public Health, International University of Health and Welfare, 4-1-26 Akasaka, Minato-ku, Tokyo, 107-8402, Japan.,Department of Psychosomatic Medicine, School of Medicine, International University of Health and Welfare, Hatakeda 852, Narita, Chiba, 286-8686, Japan
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Freire de Souza CD, Machado MF, Gonçalves da Silva Junior A, Bastos Rolim Nunes BE, Feliciano do Carmo R. Airports, highways and COVID-19: An analysis of spatial dynamics in Brazil. J Transp Health 2021; 21:101067. [PMID: 33868924 PMCID: PMC8039633 DOI: 10.1016/j.jth.2021.101067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 03/04/2021] [Accepted: 03/25/2021] [Indexed: 05/07/2023]
Abstract
INTRODUCTION The high transmissibility and infectivity of the new coronavirus, the high proportion of asymptomatic transmitters and the rapid and continuous spatial displacement of people, by the different mechanisms of locomotion, are elements that can contribute to the dissemination of COVID-19. This study aims to describe the geographical dispersion of COVID-19 in the state of Bahia and the importance of major airports and highways in the dynamics of disease transmission. METHODS This is an ecological study involving all cases of COVID-19 registered in the state of Bahia between March 6, date of the first registered case and May 16, 2020. After collection, an exploratory spatial analysis was performed, considering the cases accumulated on the last day of each epidemiological week. RESULTS The first cases of COVID-19 were concentrated in areas served by three important airport complexes in the state, located in Salvador, Ilhéus and Porto Seguro. From week 16-20, there was a more intense expansion of COVID-19 to the interior of the state. A global spatial autocorrelation was observed (I Moran 0.2323; p = 0.01), with the influence of distance: positive correlation at distances less than 205.8 km (I Moran 0.040; p = 0.01) and greater than 800 km (I Moran 0.080; p = 0.01). CONCLUSIONS Based on the spatial dispersion pattern of COVID-19 in the state of Bahia, airports and highways that cross the state were responsible for the interiorization of the disease.
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Affiliation(s)
- Carlos Dornels Freire de Souza
- Department of Medicine, Post-graduation Program in Health Family, Federal University of Alagoas (UFAL), Arapiraca, Brazil
| | - Michael Ferreira Machado
- Department of Medicine, Post-graduation Program in Health Family, Federal University of Alagoas (UFAL), Arapiraca, Brazil
| | | | | | - Rodrigo Feliciano do Carmo
- Postgraduate Program in Health and Biological Sciences, Federal University of Vale do São Francisco (UNIVASF), Petrolina, Pernambuco, 56304-917, Brazil
- Postgraduate Program in Biosciences, Federal University of Vale do SãoFrancisco (UNIVASF), Petrolina, Pernambuco, 56304-917, Brazil
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Kasdagli MI, Katsouyanni K, de Hoogh K, Lagiou P, Samoli E. Associations of air pollution and greenness with mortality in Greece: An ecological study. Environ Res 2021; 196:110348. [PMID: 33127394 DOI: 10.1016/j.envres.2020.110348] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 10/01/2020] [Accepted: 10/12/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Epidemiological studies have documented the adverse effects of long-term exposure to fine particulate matter (PM2.5) on health, while there has been less research on the effects of nitrogen dioxide (NO2), black carbon (BC) and especially ozone (O3). Furthermore, there is limited evidence for the synergistic effects of exposure to pollutants and greenness. We investigated the association of long-term exposure to air pollution and greenness with natural-cause, cardiovascular and respiratory mortality in Greece using an ecological study design. METHODS Mortality and socioeconomic data were obtained from 1035 municipal units from the 2011 census data. Annual average PM2.5, NO2, BC and O3 concentrations for 2010 were derived from 100 × 100 m surfaces predicted by hybrid LUR models. The normalized difference vegetation index was used to assess greenness. We applied Poisson regression models on standardized mortality rates adjusted for socioeconomic indicators and lung cancer rates, accounting for spatial autocorrelation. The analysis was conducted initially for the whole country and then separately for urban and rural areas. We assessed interactions between pollutants and greenness and applied two-exposure models. RESULTS An interquartile range (IQR) increase in PM2.5, NO2 and BC was associated with increases in natural-cause mortality (Relative Risk (RR) 1.09, 95% confidence interval (CI): 1.08, 1.11; RR 1.03 (95% CI: 1.03, 1.04) and RR 1.02 (95% CI: 1.02, 1.03), respectively), while PM2.5 and NO2 were also associated with cause-specific mortality. Greenness was associated with lower natural-cause (RR 0.95, 95% CI: 0.94, 0.96 per IQR) and cause-specific mortality. For all outcomes we estimated a protective association with O3 (natural-cause mortality RR 0.79, 95% CI: 0.76, 0.82 per IQR). All associations were stronger in urban areas. We estimated negative statistically significant interactions between air pollution and greenness for respiratory morality and positive ones for cardiovascular mortality. Estimates were mostly robust to co-exposure adjustment. CONCLUSIONS Our findings support associations of air pollution and greenness with mortality, both in urban and rural areas of Greece. Further research is needed to elaborate on the synergies in cause-specific mortality. Our results on the interactions between pollutants and greenness may imply differential biological mechanisms for cause-specific mortality and warrant further investigation.
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Affiliation(s)
- Maria-Iosifina Kasdagli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Environmental Research Group, MRC Centre for Environment and Health, Imperial College, United Kingdom
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
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Alshogran OY, Altawalbeh SM, Al-Azzam SI, Karasneh R. Predictors of Covid-19 case fatality rate: An ecological study. Ann Med Surg (Lond) 2021; 65:102319. [PMID: 33936591 DOI: 10.1016/j.amsu.2021.102319] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 02/06/2023] Open
Abstract
Background The outbreak of novel coronavirus (Covid-19) has a significant burden on global health and could be associated with significant mortality. Limited information exists about determinants of its fatality worldwide. Thus, this ecological study examined the association of various predictors with Covid-19 fatality. Methods International data bases of Covid-19 statistics and health metrics available primarily at WHO were reviewed to collect information for 113 countries. The dependent variable was Covid-19 case fatality rate. Independent variables were demographic, social, clinical, economic, heath care and child health factors. Results Case fatality rate of Covid-19 varies across countries with an average of 4.2 ± 3.8%, and about half of countries had fatality rate >3.2% (median). Significant relationships were observed between Covid-19 fatality rate and socio-economic, clinical, and health variables at the unadjusted regression analysis. At the multivariate adjusted model, percentage of population with age>60 years was positively associated with Covid-19 fatality (B = 0.032, p = 0.005), while Polio-3 immunization at 1-year old was inversely related (B = −0.057, p = 0.017). Conclusions This ecological investigation highlights the higher risk of death among elderly with Covid-19 pandemic and suggests that Polio-3 immunization coverage among 1-year-olds may be associated with better survival. Future research is warranted to validate these findings. Covid-19 pandemic spread globally and associated with emergent mortality. Predictors of covid-19 case-fatality rate are presented among 113 countries. Percentage of people with age>60 years was positively associated with covid-19 fatality. Polio-3 immunization at 1-year old was inversely associated with covid-19 fatality.
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De Angelis E, Renzetti S, Volta M, Donato F, Calza S, Placidi D, Lucchini RG, Rota M. COVID-19 incidence and mortality in Lombardy, Italy: An ecological study on the role of air pollution, meteorological factors, demographic and socioeconomic variables. Environ Res 2021; 195:110777. [PMID: 33485909 PMCID: PMC7826113 DOI: 10.1016/j.envres.2021.110777] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/22/2020] [Accepted: 01/19/2021] [Indexed: 05/10/2023]
Abstract
Lombardy, the most populated and industrialized Italian region, was the epicentre of the first wave (March and April 2020) of COVID-19 in Italy and it is among the most air polluted areas of Europe. We carried out an ecological study to assess the association between long-term exposure to particulate matter (PM) and nitrogen dioxide (NO2) on COVID-19 incidence and all-cause mortality after accounting for demographic, socioeconomic and meteorological variables. The study was based on publicly available data. Multivariable negative binomial mixed regression models were fitted, and results were reported in terms of incidence rate ratios (IRRs) and standardized mortality ratios (SMR). The effect of winter temperature and humidity was modelled through restricted cubic spline. Data from 1439 municipalities out of 1507 (95%) were included in the analyses, leading to a total of 61,377 COVID-19 cases and 40,401 deaths from all-causes collected from February 20th to April 16th and from March 1st to April 30th, 2020, respectively. Several demographic and socioeconomic variables resulted significantly associated with COVID-19 incidence and all-cause mortality in a multivariable fashion. An increase in average winter temperature was associated with a nonlinear decrease in COVID-19 incidence and all-cause mortality, while an opposite trend emerged for the absolute humidity. An increase of 10 μg/m3 in the mean annual concentrations of PM2.5 and PM10 over the previous years was associated with a 58% and 34% increase in COVID-19 incidence rate, respectively. Similarly, a 10 μg/m3 increase of annual mean PM2.5 concentration was associated with a 23% increase in all-cause mortality. An inverse association was found between NO2 levels and COVID-19 incidence and all-cause mortality. Our ecological study showed that exposure to PM was significantly associated with the COVID-19 incidence and excess mortality during the first wave of the outbreak in Lombardy, Italy.
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Affiliation(s)
- Elena De Angelis
- Department of Mechanical and Industrial Engineering, University of Brescia, Via Branze 38, 25123, Brescia, Italy
| | - Stefano Renzetti
- Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
| | - Marialuisa Volta
- Department of Mechanical and Industrial Engineering, University of Brescia, Via Branze 38, 25123, Brescia, Italy; B+LabNet - Environmental Sustainability Lab, University of Brescia, Via Branze 45, 25123, Brescia, Italy
| | - Francesco Donato
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Unit of Hygiene, Epidemiology, and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
| | - Stefano Calza
- Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123, Brescia, Italy; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 17177, Stockholm, Sweden
| | - Donatella Placidi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Unit of Hygiene, Epidemiology, and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
| | - Roberto G Lucchini
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Unit of Hygiene, Epidemiology, and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia, Italy; Department of Environmental Health, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street AHC5, Miami, FL 33199, USA.
| | - Matteo Rota
- Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
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Demoury C, Faes C, De Schutter H, Carbonnelle S, Rosskamp M, Francart J, Van Damme N, Van Bladel L, Van Nieuwenhuyse A, De Clercq EM. Childhood leukemia near nuclear sites in Belgium: An ecological study at small geographical level. Cancer Epidemiol 2021; 72:101910. [PMID: 33735659 DOI: 10.1016/j.canep.2021.101910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/14/2021] [Accepted: 02/14/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND A previous investigation of the occurrence of childhood acute leukemia around the Belgian nuclear sites has shown positive associations around one nuclear site (Mol-Dessel). In the following years, the Belgian Cancer Registry has made data available at the smallest administrative unit for which demographic information exists in Belgium, i.e. the statistical sector. This offers the advantage to reduce the potential misclassification due to large geographical scales. METHODS The current study performed for the period 2006-2016 uses Poisson models to investigate (i) the incidence of childhood acute leukemia within 20 km around the four Belgian nuclear sites, (ii) exposure-response relationships between cancer incidence and surrogate exposures from the nuclear sites (distance, wind direction frequency and exposure by hypothetical radioactive discharges taking into account historical meteorological conditions). All analyses are carried out at statistical sector level. RESULTS Higher incidence rate ratios were found for children <15 years (7 cases, RR = 3.01, 95% CI: 1.43;6.35) and children <5 years (< 5 cases, RR = 3.62, 95% CI: 1.35;9.74) living less than 5 km from the site of Mol-Dessel. In addition, there was an indication for positive exposure-response relationships with the different types of surrogate exposures. CONCLUSION Results confirm an increased incidence of acute childhood leukemia around Mol-Dessel, but the number of cases remains very small. Random variation cannot be excluded and the ecological design does not allow concluding on causality. These findings emphasize the need for more in-depth research into the risk factors of childhood leukemia, for a better understanding of the etiology of this disease.
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Lin PC, Peng CY, Pan CH, Lee JY, Hsieh TJ, Chuang YS, Turesky RJ, Wu CF, Wu MT. Risk of two common glandular cell-type cancers (breast and colorectal cancers) in Chinese occupational chefs: a nationwide ecological study in Taiwan. Int Arch Occup Environ Health 2021; 94:1363-73. [PMID: 33646334 DOI: 10.1007/s00420-021-01673-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/21/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Cooking oil fumes (COFs) contain many carcinogens. We investigated the association between COFs and incidence risk of colorectal cancer and female breast in chefs. METHODS We identified Chinese food chefs and non-Chinese food chefs from Taiwan's national database of certified chefs in 1984-2007. In total, 379,275 overall and 259,450 females had not been diagnosed as having any cancer before chef certification. We followed these chefs in Taiwan's Cancer Registry Database (1979-2010) and Taiwan's National Death Statistics Database (1985-2011) for newly diagnosed colorectal cancer and female breast cancer. RESULTS A total of 4,218,135 and 2,873,515 person-years were included in our analysis of colorectal cancer and female breast cancer incidence, respectively. Compared to non-Chinese food chefs, the Chinese food chefs had an adjusted IRR for colorectal cancer of 1.65 (95% CI 1.17-2.33). The risk of colorectal cancer was even higher among female Chinese food chefs certified for more than 5 years (adjusted incident rate ratio (IRR) = 2.39, 95% CI 1.38-4.12). For female breast cancer, the risk was also significant (adjusted IRR = 1.40, 95% CI 1.10-1.78) and the risks were even higher in female Chinese food chefs certified for more than 5 years (adjusted IRR = 1.74, 95% CI 1.37-2.22). CONCLUSIONS This study found that Chinese food chefs had an increased risk of colorectal cancer and female breast cancer, particularly female chefs who had worked for more than 5 years. Future human and animal studies are necessary to re-confirm these findings.
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