Disaggregating the effects of daytime and nighttime light exposures on obesity, overweight, prostate and breast cancer morbidity worldwide

Hormone-dependent cancers and overweight/obesity are not necessarily linked but might have similar underlying causes, such as circadian disruption, lack of physical activity, and unhealthy nutrition. Several empirical studies also attribute the rise in these types of morbidity to vitamin D deficiency, linked in turn to insufficient sunlight exposure. Other studies place an emphasis on melatonin (MLT) hormone suppression, associated with artificial light at night (ALAN) exposure. Yet no studies, carried out to date, have attempted to determine which of these environmental risk factors is associated stronger with the morbidity types in question. In this study, we aim to narrow this knowledge gap by analyzing data available for 100+ countries worldwide, while controlling ALAN and solar radiation exposure estimates by several potential confounders, such as GDP_pc, GINI inequality index and unhealthy food consumption. As the study reveals, all the morbidity types under analysis are significantly and positively associated with ALAN exposure estimates (p < 0.05), while solar radiation appears to be significantly associated with prostate cancer rates only (p < 0.05), but not with breast cancer or overweight/obesity rates (p > 0.1). To the best of our knowledge, this study is the first that separates the effects of ALAN and daylight exposures on the abovementioned types of morbidity.

Investigating the combined effect of ALAN and noise on sleep by simultaneous real-time monitoring using low-cost smartphone devices

The association between artificial light at night (ALAN) and noise, on the one hand, and sleep, on the other, is well established. Yet studies investigating these associations have been infrequent and mostly conducted in controlled laboratory conditions. As a result, little is known about the applicability of their results to real-world settings. In this paper, we attempt to bridge this knowledge gap by carrying out an individual-level real-world study, involving 72 volunteers from different urban localities in Israel. The survey participants were asked to use their personal smartphones and smartwatches to monitor sleep patterns for 30 consecutive days, while ALAN and noise exposures were monitored in parallel, with inputs reported each second. The volunteers were also asked to fill in a questionnaire about their individual attributes, daily habits, room settings, and personal health, to serve as individual-level controls. Upon cointegration, the assembled data were co-analyzed using bivariate and multivariate statistical tools. As the study reveals, the effect of ALAN and noise on sleep largely depends on when the exposure occurred, that is, before sleep or during sleep. In particular, the effect of ALAN exposure was found to be most pronounced if it occurred before sleep, while exposure to noise mattered most if it occurred during the sleep phase. As the study also reveals, the effects of ALAN and noise appear to amplify each other, with a 14-15.3% reduction in sleep duration and an 8-9% reduction in sleep efficiency observed at high levels of ALAN-noise exposures. The study helped to assemble a massive amount of real-time observations, enabling a robust individual-level analysis.

Using mobile phones as light at night and noise measurement instruments: a validation test in real world conditions

Exposure to noise from road traffic and industries is known to be linked to various health dysfunctions, including hypertension, cardiovascular diseases and hearing loss. Exposure to artificial light at night (ALAN) is also increasingly recognized as being associated with ecosystem damage and various illnesses, including cancers, excessive weight gain and sleep disorders. However, measuring and monitoring these environmental risk factors by professional equipment are laborious and expensive, which impede large-scale research and various citizen science initiatives. In this study, we test a possibility that reliable noise and ALAN exposure estimates can be gathered using smartphones (SPs) sensors. To verify this assumption, we develop a standardized testing protocol, and use Andro-Sensor app, installed on three different Samsung Galaxy SPs - S7, S20FE5G, and SM520F, - to perform measurements of ALAN and noise in real-world conditions while comparing these measurements with measurements performed by professional (type 2) equipment - SL814 for noise and LX-1330B for illumination. The analysis of 3450 measurements, performed in two different locations in Israel, reveals that the SPs measurements and measurements performed by control instruments correlate strongly for noise (r = 0.76-0.94) and are nearly identical for ALAN (r = 0.998-0.999). The association between the two types of measurements is also found to be close to linear, with the slope of the trend line being close to 45° for ALAN and varying between 30° and 45° for noise, depending on the SPs used. Our conclusion is that the level of accuracy of ALAN measurements by SPs is greater for ALAN than for noise, which can make SPs a useful tool for large-scale ALAN studies that do not require the accuracy of professional instruments.

Assessing the impacts of ALAN and noise proxies on sleep duration and quality: evidence from a nation-wide survey in Israel

Sleep is a reversible state that sustains physiological and psychological processes in humans. As well established, individual-level factors, such as stress, smoking, drugs, and caffeine intake, reduce sleep duration and quality. However, studies of the effect of environmental risk factors, such as artificial light at night (ALAN) and noise, on sleep have been infrequent. Using records obtained from the 2017 Social Survey of Israel and combined with ALAN satellite data and various proxies for traffic noise, the present study aimed to determine how the combination of ALAN and traffic noise impact sleep duration and quality in urban areas. The increase of road density at the place of residence reduces average sleep duration by ~4.5% (~18 min.) and increases the frequency of reported sleep difficulties by ~3.5%, all other factors held equal. Similarly, an increase in ALAN exposure reduces average sleep duration by ~3% (~12 min) and increases the frequency of reported sleep difficulties by ~11%. The study also reveals a significant interaction between the two environmental risk factors in question, with the adverse impact of ALAN on sleep quality especially pronounced in high noise exposure areas.

Linking nighttime outdoor lighting attributes to pedestrians' feeling of safety: An interactive survey approach

Public space lighting (PSL) contributes to pedestrians' feeling of safety (FoS) in urban areas after natural dark. However, little is known how different PSL attributes, such as illuminance, light temperature, uniformity and glare, affect people's FoS in different contextual settings. The present study aims to bridge this knowledge gap by developing a model linking different PSL attributes with FoS, while controlling for individual, locational, environmental and temporal factors. To develop such model, the study employs a novel interactive user-oriented method, based on a specially-designed mobile phone application-CityLightsTM. Using this app, a representative sample of observers reported their impressions of PSL attributes and FoS in three cities in Israel, following a set of predetermined routes and points. As the study shows, higher levels of illumination and uniformity positively affect FoS, while lights perceived as warm tend to generate higher FoS than lights perceived as cold. These findings may guide future illumination polices aimed at promoting energy efficiency while ensuring urban sustainability.

Characterization of Localities with a High Likelihood of Illicit Connections between Runoff and Sewage Systems

Flooding of the sewage system is an environmental hazard often caused by illegal connections between drainage and sewage systems. The timely detection of such illicit connections, often done by property owners in an attempt to remove rainwater promptly from their private courtyards, is a complex task due to the high cost of field surveying and limited manpower of environmental law-enforcement authorities. This paper suggests an empirical approach to the identification and characterization of localities with an elevated likelihood of illegal connections between runoff and sewage systems. The proposed approach is implemented in three stages. First, the association between rainfall and the amount of wastewater arriving to sewage treatment facilities from different localities is analyzed. Next, regression residuals are investigated, to identify localities with an especially strong association between the amount of rainfall and sewage surplus. The identified localities are then analyzed, to determine their geographic location, physical and socioeconomic attributes. In the present study, the proposed approach is tested using data for 623 urban and rural localities in Israel. As the study shows, the probability of association between the amount of rainfall and sewage surplus, which we consider as an indicator of pirate connections between drainage and sewage systems, tends to increase as a function of socioeconomic welfare of the local residents, surface slope, and the level of urbanization. The proposed approach can help law-enforcement authorities to focus their efforts on specific locations and to reduce economic and environmental damages associated with illegal connections between drainage and sewage systems.

Forecasting health effects potentially associated with the relocation of a major air pollution source

Epidemiological studies often focus on risk assessments associated with exposures to specific air pollutants or proximity to different air pollution sources. Although this information is essential for devising informed health policies, it is not always helpful when it comes to the estimation of potential health effects associated with the introduction or relocation of local health hazards. In this paper, we suggest a novel approach to forecasting the morbidity-reduction impact of hypothetical removal of a major air pollution source from a densely populated urban area. The proposed approach is implemented in three stages. First, we identify and measure the strength of association of individual environmental factors with local morbidity patterns. Next, we use the estimated models to simulate the impact of removal of the pollution source under analysis and its replacement by green areas. Using this assessment, we then estimate potential changes in the local morbidity rates by mutually comparing the observed risk surface of disease with the risk surface simulated by modelling. To validate the proposed approach empirically, we use childhood asthma morbidity data available for a major metropolitan area in Israel, which hosts a large petrochemical complex. According to our estimates, relocation of the petrochemical complex in question is expected to result in about 70% drop in the childhood asthma morbidity rate area-wide. To the best of our knowledge, the present study is the first that suggests an operational approach to incorporating epidemiological assessments as an input for urban development plans related to local sources of air pollution.

Estimating the effectiveness of different environmental law enforcement policies on illegal C&D waste dumping in Israel

Illegal dumping of construction and demolition (C&D) waste is a major concern for environmental policy-makers. Three different environmental law enforcement policies, aimed at the reduction of illegal C&D waste dumping, are enforced in Israel. These policies include fines (F), vehicle impoundment (V), and criminal indictment (I) by the court. Although, the scope of illegal C&D waste dumping in Israel appears to decline, little is known which of the above policies has been effective in combating the phenomenon. In an attempt to answer this question, we use data on F-V-I instances, recorded between July 2007 and December 2016, and compare them with monthly changes in the ratio between the amount of waste brought to authorized waste dumping sites and the estimated amount of C&D waste generated in the country each month. As the study shows, only the V-sanction was found to be significantly affecting the ratio (t = 3.083; p < 0.01), while the effect of other policy was found insignificant. We explain low efficiency of other law enforcement policies by relatively small fines imposed on the offenders, long court proceedings, combined with a relatively low chance of being caught. By contrast, the V-sanction may be more effective because it results in immediate and severe economic losses to the offenders, causing C&D waste transporters to haul their load to authorized sites. As we argue, for an environmental enforcement policy to be effective, it should be adequate to the severity of the offense and applied swiftly.

Prevalence of Asthma among Young Men Residing in Urban Areas with Different Sources of Air Pollution

BACKGROUND

Asthma is a common respiratory disease, which is linked to air pollution. However, little is known about the effect of specific air pollution sources on asthma occurrence.

OBJECTIVES

To assess individual asthma risk in three urban areas in Israel characterized by different primary sources of air pollution: predominantly traffic-related air pollution (Tel Aviv) or predominantly industrial air pollution (Haifa bay area and Hadera).

METHODS

The medical records of 13,875, 16- 19-year-old males, who lived in the affected urban areas prior to their army recruitment and who underwent standard pre-military health examinations during 2012-2014, were examined. Nonparametric tests were applied to compare asthma prevalence, and binary logistic regressions were used to assess the asthma risk attributed to the residential locations of the subjects, controlling for confounders, such as socio-demographic status, body mass index, cognitive abilities, and education.

RESULTS

The asthma rate among young males residing in Tel Aviv was 8.76%, compared to 6.96% in the Haifa bay area and 6.09% in Hadera. However, no statistically significant differences in asthma risk among the three urban areas was found in controlled logistic regressions (P > 0.20). This finding indicates that exposure to both industrial- and traffic-related air pollution is associated with asthma prevalence.

CONCLUSIONS

Both industrial- and traffic-related air pollution have a negative effect on asthma risk in young males. Studies evaluating the association between asthma risk and specific air pollutants (e.g., sulfur dioxide, particulate matter, and nitrogen dioxide) are needed to ascertain the effects of individual air pollutants on asthma occurrence.

Light pollution in USA and Europe: The good, the bad and the ugly

Light pollution is a worldwide problem that has a range of adverse effects on human health and natural ecosystems. Using data from the New World Atlas of Artificial Night Sky Brightness, VIIRS-recorded radiance and Gross Domestic Product (GDP) data, we compared light pollution levels, and the light flux to the population size and GDP at the State and County levels in the USA and at Regional (NUTS2) and Province (NUTS3) levels in Europe. We found 6800-fold differences between the most and least polluted regions in Europe, 120-fold differences in their light flux per capita, and 267-fold differences in flux per GDP unit. Yet, we found even greater differences between US counties: 200,000-fold differences in sky pollution, 16,000-fold differences in light flux per capita, and 40,000-fold differences in light flux per GDP unit. These findings may inform policy-makers, helping to reduce energy waste and adverse environmental, cultural and health consequences associated with light pollution.

Spatial identification of environmental health hazards potentially associated with adverse birth outcomes

Reduced birth weight (RBW) and reduced head circumference (RHC) are adverse birth outcomes (ABOs), often linked to environmental exposures. However, spatial identification of specific health hazards, associated with these ABOs, is not always straightforward due to presence of multiple health hazards and sources of air pollution in urban areas. In this study, we test a novel empirical approach to the spatial identification of environmental health hazards potentially associated with the observed RHC and RBW patterns. The proposed approach is implemented as a systematic search, according to which alternative candidate locations are ranked based on the strength of association with the observed birth outcome patterns. For empirical validation, we apply this approach to the Haifa Bay Area (HBA) in Israel, which is characterized by multiple health hazards and numerous sources of air pollution. We identified a spot in the local industrial zone as the main risk source associated with the observed RHC and RBW patterns. Multivariate regressions, controlling for personal, neighborhood, and geographic factors, revealed that the relative risks of RHC and RBW tend to decline, other things being equal, as a function of distance from the identified industrial spot. We recommend the proposed identification approach as a preliminary risk assessment tool for environmental health studies, in which detailed information on specific sources of air pollution and air pollution dispersion patterns is unavailable due to limited reporting or insufficient monitoring.

Environmental risk factors associated with low birth weight: The case study of the Haifa Bay Area in Israel

BACKGROUND

Low birth weight (LBW) is known to be associated with infant mortality and postnatal health complications. Previous studies revealed strong relationships between LBW rate and several socio-demographic factors, including ethnicity, maternal age, and family income. However, studies of association between LBW rate and environmental risk factors remain infrequent.

STUDY METHODS

We retrieved a geo-referenced data set, containing 7216 individual records of children born in 2015 in the Haifa Bay Area in Israel. Using this dataset, we analysed factors affecting LBW prevalence by applying two alternative techniques: analysis of LBW rates in small census area (SCAs) and more recently developed double kernel density (DKD) relative risk (RR) estimates.

RESULTS

In the SCA models, LBW rate was found to be associated with proximity to petrochemical industries (B=-0.26, 95%CI=-0.30, -0.22), road density (B=0.05, 95%CI=0.02, 0.08), distance to the seashore (B=0.17, 95%CI=0.14, 0.22), PM_2.5 (B=0.06, 95%CI=0.04, 0.09) and NO_x (B=0.10, 95%CI=0.06, 0.13) exposure estimates. Although similar factors emerged in the DKD models as well, in most cases, the effects of these factors in the latter models were found to be stronger: proximity to petrochemical industries (B=-0.48, 95%CI= -0.51, -0.30), road density (B=0.05, 95%CI=0.02, 0.08), distance to the seashore (B=0.24, 95%CI=0.21, 0.27), PM_2.5 (B=0.08, 95%CI=0.05, 0.10) and NO_x (B=0.20, 95%CI=0.17, 0.23) exposure estimates. In addition, elevation above the sea level was found to be statistically significant in spatial dependence models estimated for both DKD and SCA rates (P < 0.01).

CONCLUSION

The analysis revealed an excess LBW rate in residential areas located close to petrochemical industries and a protective effect of seashore proximity and elevation above the sea level on the LBW rate. We attribute the latter finding to the moderating effect of elevated seashore locations on outdoor temperatures during the hot summer season.

Kernel density analysis reveals a halo pattern of breast cancer incidence in Connecticut

Breast cancer (BC) incidence rates in Connecticut are among the highest in the United States, and are unevenly distributed within the state. Our goal was to determine whether artificial light at night (ALAN) played a role. Using BC records obtained from the Connecticut Tumor Registry, we applied the double kernel density (DKD) estimator to produce a continuous relative risk surface of a disease throughout the State. A multi-variate analysis compared DKD and census track estimates with population density, fertility rate, percent of non-white population, population below poverty level, and ALAN levels. The analysis identified a "halo" geographic pattern of BC incidence, with the highest rates of the disease observed at distances 5-15 km from the state's major cities. The "halo" was of high-income communities, with high ALAN, located in suburban fringes of the state's main cities.

Population-level study links short-wavelength nighttime illumination with breast cancer incidence in a major metropolitan area

Several population-level studies revealed a positive association between breast cancer (BC) incidence and artificial light at night (ALAN) exposure. However, the effect of short-wavelength illumination, implicated by laboratory research and small-scale cohort studies as the main driving force behind BC-ALAN association, has not been supported by any population-level study carried out to date. We investigated a possible link between BC and ALAN of different subspectra using a multi-spectral year-2011 satellite image, taken from the International Space Station, and superimposing it with year-2013 BC incidence data available for the Great Haifa Metropolitan Area in Israel. The analysis was performed using both ordinary least square (OLS) and spatial dependency models, controlling for socioeconomic and locational attributes of the study area. The study revealed strong associations between BC and blue and green light subspectra (B = 0.336 ± 0.001 and B = 0.335 ± 0.002, respectively; p < 0.01), compared to a somewhat weaker effect for the red subspectrum (B = 0.056 ± 0.001; p < 0.01). However, spatial dependency models, controlling for spatial autocorrelation of regression residuals, confirmed only a positive association between BC incidence and short-wavelength (blue) ALAN subspectrum (z = 2.462, p < 0.05) while reporting insignificant associations between BC and either green (z = 1.425, p > 0.1) or red (z = -0.604, p > 0.1) subspectra. The obtained result is in line with the results of laboratory- and small-scale cohort studies linking short-wavelength nighttime illumination with circadian disruption and melatonin suppression. The detected effect of blue lights on BC incidence may help to develop informed illumination policies aimed at minimizing the adverse health effects of ALAN exposure on human health.

Identifying areas under potential risk of illegal construction and demolition waste dumping using GIS tools

Construction and demolition (C&D) waste, dumped illegally in ravines and open areas, contaminates soil and can cause underground water pollution and forests fires. Yet, effective monitoring of illegal C&D waste dumping and enforcing legislation against the offenders are often a difficult task due to the large size of geographic areas that need to be monitored, and limited human and financial resources available to environmental law enforcement agencies. In this study, we use Geographic Information System (GIS) tools and geo-statistical modelling to identify the areas under potentially elevated risk of illegal C&D waste dumping in the Haifa district of Israel. As our analysis shows, locational factors, significantly associated with the accumulated amount of waste in the existing illegal C&D waste sites, include: distance to the nearest main road, depth of the ravine present at the site (p<0.01), and forest proximity (p<0.05). Using the model incorporating these locational parameters, we mapped the areas under the elevated risk of illegal C&D waste dumping for future monitoring. As we suggest, the proposed approach may be useful for environmental law enforcement authorities, by helping them to focus on specific sites for inspection, save resources, and act against the offenders more efficiently.

A new approach to spatial identification of potential health hazards associated with childhood asthma

RESEARCH BACKGROUND

Childhood asthma is a chronic disease, known to be linked to prolonged exposure to air pollution. However, the identification of specific health hazards, associated with childhood asthma is not always straightforward, due to the presence of multiple sources of air pollution in urban areas. In this study, we test a novel approach to the spatial identification of environmental hazards that have the highest probability of association with the observed asthma morbidity patterns.

METHODS

The effect of a particular health hazard on population morbidity is expected to weaken with distance. To account for this effect, we rank potential health hazards based on the strength of association between the observed morbidity patterns and wind-direction weighted proximities to these locations. We validate this approach by applying it to a study of spatial patterns of childhood asthma in the Greater Haifa Metropolitan Area (GHMA) in Israel, characterised by multiple health hazards.

RESULTS

We identified a spot in the local industrial zone as the primary risk source for the observed asthma morbidity patterns. Multivariate regressions, controlling for socio-economic and geographic variables, revealed that the observed incidence rates of asthma tend to decline as a function of distance from the identified industrial location.

CONCLUSION

The proposed identification approach uses disease patterns as its main input, and can be used by researches as a preliminary risk assessment tool, in cases in which specific sources of locally elevated morbidity are unclear or cannot be identified by traditional methods.

Lower Cancer Rates Among Druze Compared to Arab and Jewish Populations in Israel, 1999-2009

The Druze are a small ethnic minority in Israel amounting to about 130,000 residents (or 1.7 % of the total population of the country). Unlike other population groups, the Druze strive to keep their own traditions and marry mainly inside their own community. During the last decade, cancer morbidity among both Jews and Arabs in Israel has been increasing, while data on the Druze are little known and have not been analyzed and compared to other population groups to date. To compare cancer morbidity rates among Druze, Arabs and Jews in Israel during 1999-2009, gender-specific and age-standardized incidence rates of all site cancers and specific cancers of three population groups (Jews, Arabs and Druze) were received from the Israel National Cancer Registry for the period 1999-2009. Based on these rates, periodical incidence rates were calculated and mutually compared across the groups stratified by gender. As the analysis shows, the Druze had significantly lower cancer rates compared to both Arabs and Jews. Thus, for all site cancers, there were significantly higher cancer rates in Jewish males versus Druze males (RR = 1.39, 95 % CI = 1.16-1.65) and in Jewish females versus Druze females (RR = 1.53, 95 % CI = 1.27-1.85), but not statistically significant for Arab males versus Druze males (RR = 1.12 95 % CI = 0.93-1.35). Lung cancer rates in Arab males were also higher compared to Druze males (RR = 1.84, 95 % CI = 1.13-3.00). Jewish males had statistically significant higher rates of prostate cancer compared to Druze males (RR = 2.47, 95 % CI = 1.55-3.91). For thyroid and colon cancers, risks were not significantly different at the 95 % CI level; however, the risks were significantly different at the 90 % CI level (RR = 3.62, 90 % CI 1.20-11.02 and RR = 1.69, 90 % CI = 1.03-2.77, respectively). Jewish females had significantly higher rates of invasive breast cancer (RR = 2.25, 95 % CI = 1.55-3.25), in situ cervical cancer (RR = 4.01, 95 % CI = 1.27-12.66) and lung cancer (RR = 3.22, 95 % CI = 1.12-9.24) compared to Druze females. We thus observed lower cancer rates among Druze versus Arab and Jewish populations in Israel. A reason for these differences may be due to different nutritional habits. Druze still keep a less processed nutritional lifestyle, than is common in industrial society. There may also be other reasons that have not been identified yet.

Public Fears in Ukrainian Society

Numerous experimental studies have revealed that two statistical measures of biological populations—(a) the correlation between certain parameters of their members and (b) the dispersion of theses parameters—simultaneously increase under stress conditions. Later on, this effect was confirmed also for financial systems. In our study we tested the applicability of these two stress-indicating statistical measures to Ukrainian society. We examined the prolonged stress period preceding the 2014 Ukrainian economic and political crisis. We considered the dynamics of 19 major public fears which got spread in the Ukrainian society during this period: of economic regress, of breakdown of the state, of losing sovereignty, etc. The study revealed that there was a simultaneous increase in the total correlation between the fears (by about 64 per cent) and also in their statistical dispersion (by 29 per cent) during the pre-crisis years. It is suggested that these measures may be a useful tool for monitoring stress onset and for possible steps that can be taken to prevent societal crises.

Is prostate cancer incidence worldwide linked to artificial light at night exposures? Review of earlier findings and analysis of current trends

Widespread use of artificial light at night (ALAN) might contribute to the global burden of hormone-dependent cancers. Previous attempts to verify this association in population-level studies have been sparse. Using GLOBOCAN, US-DMSP, and World Bank 2010-2012 databases, we studied the association between ALAN and prostate cancer (PC) incidence in 180 countries worldwide, controlling for several country-level confounders. The PC-ALAN association emerged marginally significant when year-2012 PC age-standardized rate data were compared with ALAN levels (t = 1.886, p < .1); this association was more significant (t > 2.7; p < .01) when only 110 countries with well-maintained cancer registries were analyzed. Along with other variables, ALAN explains up to 79% of PC ASR variability. PC-ALAN association appears to vary regionally, with the greatest deviations in Central Africa, Small Island Developing States, Southeast Asia, and Gulf States.

Spatial identification of potential health hazards: a systematic areal search approach

Background and aims

Large metropolitan areas often exhibit multiple morbidity hotspots. However, the identification of specific health hazards, associated with the observed morbidity patterns, is not always straightforward. In this study, we suggest an empirical approach to the identification of specific health hazards, which have the highest probability of association with the observed morbidity patterns.

Methods

The morbidity effect of a particular health hazard is expected to weaken with distance. To account for this effect, we estimate distance decay gradients for alternative locations and then rank these locations based on the strength of association between the observed morbidity and wind-direction weighted proximities to these locations. To validate this approach, we use both theoretical examples and a case study of the Greater Haifa Metropolitan Area (GHMA) in Israel, which is characterized by multiple health hazards.

Results

In our theoretical examples, the proposed approach helped to identify correctly the predefined locations of health hazards, while in the real-world case study, the main health hazard was identified as a spot in the industrial zone, which hosts several petrochemical facilities.

Conclusion

The proposed approach does not require extensive input information and can be used as a preliminary risk assessment tool in a wide range of environmental settings, helping to identify potential environmental risk factors behind the observed population morbidity patterns.

Electronic supplementary material

The online version of this article (doi:10.1186/s12942-017-0078-8) contains supplementary material, which is available to authorized users.

Modeling long-term effects attributed to nitrogen dioxide (NO2) and sulfur dioxide (SO2) exposure on asthma morbidity in a nationwide cohort in Israel

Studies have provided extensive documentation that acutely elevated environmental exposures contribute to chronic health problems. However, only attention has been paid to the effects of modificate of exposure assessment methods in environmental health investigations, leading to uncertainty and gaps in our understanding of exposure- and dose-response relationships. The goal of the present study was to evaluate whether average or peak concentration exerts a greater influence on asthma outcome, and which of the exposure models may better explain various physiological responses generated by nitrogen dioxide (NO₂) or sulfur dioxide (SO₂) air pollutants. The effects of annual NO₂ and SO₂ exposures on asthma prevalence were determined in 137,040 17-year-old males in Israel, who underwent standard health examinations before induction to military service during 1999-2008. Three alternative models of cumulative exposure were used: arithmetic mean level (AM), average peak concentration (APC), and total number of air pollution exposure episodes (NEP). Air pollution data for NO₂ and SO₂ levels were linked to the residence of each subject and asthma prevalence was predicted using bivariate logistic regression. There was significant increased risk for asthma occurrence attributed to NO₂ exposure in all models with the highest correlations demonstrated using the APC model. Data suggested that exposure-response is better correlated with NO₂ peak concentration than with average exposure concentration in subjects with asthma. For SO₂, there was a weaker but still significant exposure response association in all models. These differences may be related to differences in physiological responses including effects on different regions of the airways following exposure to these pollutants. NO₂, which is poorly soluble in water, penetrates deep into the bronchial tree, producing asthmatic manifestations such as inflammation and increased mucus production as a result of high gaseous concentrations in the lung parenchyma. In contrast, SO₂, which is highly water soluble, exerts its effects rapidly in the upper airways, leading to similar limited correlations at all levels of exposure with fewer asthmatic manifestations observed. These data indicate that differing exposure assessment methods may be needed to capture specific disease consequences associated with these air pollutants.

Light at night and breast cancer incidence in Connecticut: An ecological study of age group effects

The aim of this study was to test the prediction that within the state of Connecticut, USA, communities with high nighttime outdoor light level would have higher breast cancer incidence rates. Breast cancer cases were identified from the Connecticut Tumor Registry, the oldest within the United States, for years 2005 and 2009 and geocoded to the 829 census tracts in the state. Nighttime light level (LAN) was obtained from the Defense Meteorological Satellite Program (DMSP), 1996/97 satellite image, providing a 10-year lag. Regression models were used incorporating the LAN levels and census level data on potential confounders for the whole female population of the state, and for separate age groups. Light level emerged as a significant predictor of breast cancer incidence. After taking account of several potential confounders, the excess risk in the highest LAN level census tracts compared to the lowest was about 63% (RR=1.63; 95% CI=1.41, 1.89). The association of LAN with breast cancer incidence weakened with age; the association was strongest among premenopausal women.

Application of the double kernel density approach to the analysis of cancer incidence in a major metropolitan area

RATIONALE

Although cancer is a main cause of human morbidity worldwide, relatively small numbers of new cancer cases are recorded annually in single urban areas. This makes the association between cancer morbidity and environmental risk factors, such as ambient air pollution, difficult to detect using traditional methods of analysis based on age standardized rates and zonal estimates.

STUDY GOAL

The present study investigates the association between air pollution and cancer morbidity in the Greater Haifa Metropolitan Area in Israel by comparing two analytical techniques: the traditional zonal approach and more recently developed Double Kernel Density (DKD) tools. While the first approach uses age adjusted Standardized Incidence Ratios (SIRs) for small census areas, the second approach estimates the areal density of cancer cases, normalized by the areal density of background population in which cancer events occurred. Both analyses control for several potential confounders, including air pollution, proximities to main industrial facilities and socio-demographic attributes.

RESULTS

Air pollution variables and distances to industrial facilities emerged as statistically significant predictors of lung and NHL cancer morbidity in the DKD-based models (p<0.05) but not in the models based on SIRs estimates (p>0.2).

CONCLUSION

DKD models appear to be a more sensitive tool for assessing potential environmental risks than traditional SIR-based models, because DKD estimates do not depend on a priory geographic delineations of statistical zones and produce a smooth and continuous disease 'risk surface' covering the entire study area. We suggest using the DKD method in similar studies of the effect of ambient air pollution on chronic morbidity, especially in cases in which the number of statistical areas available for aggregation and comparison is small and recorded morbidity events are relatively rare.

The new world atlas of artificial night sky brightness

Artificial lights raise night sky luminance, creating the most visible effect of light pollution-artificial skyglow. Despite the increasing interest among scientists in fields such as ecology, astronomy, health care, and land-use planning, light pollution lacks a current quantification of its magnitude on a global scale. To overcome this, we present the world atlas of artificial sky luminance, computed with our light pollution propagation software using new high-resolution satellite data and new precision sky brightness measurements. This atlas shows that more than 80% of the world and more than 99% of the U.S. and European populations live under light-polluted skies. The Milky Way is hidden from more than one-third of humanity, including 60% of Europeans and nearly 80% of North Americans. Moreover, 23% of the world's land surfaces between 75°N and 60°S, 88% of Europe, and almost half of the United States experience light-polluted nights.

The new world atlas of artificial night sky brightness

Artificial lights raise night sky luminance, creating the most visible effect of light pollution-artificial skyglow. Despite the increasing interest among scientists in fields such as ecology, astronomy, health care, and land-use planning, light pollution lacks a current quantification of its magnitude on a global scale. To overcome this, we present the world atlas of artificial sky luminance, computed with our light pollution propagation software using new high-resolution satellite data and new precision sky brightness measurements. This atlas shows that more than 80% of the world and more than 99% of the U.S. and European populations live under light-polluted skies. The Milky Way is hidden from more than one-third of humanity, including 60% of Europeans and nearly 80% of North Americans. Moreover, 23% of the world's land surfaces between 75°N and 60°S, 88% of Europe, and almost half of the United States experience light-polluted nights.

Does artificial light-at-night exposure contribute to the worldwide obesity pandemic?

BACKGROUND

Worldwide overweight and obesity rates are on the rise, with about 1 900 billion adults being defined as overweight and about 600 million adults being defined as obese by the World Health Organization (WHO). Increasing exposure to artificial light-at-night (ALAN) may influence body mass, by suppression of melatonin production and disruption of daily rhythms, resulting in physiological or behavioral changes in the human body, and may thus become a driving force behind worldwide overweight and obesity pandemic.

METHODS

We analyzed most recent satellite images of night time illumination, available from the US Defense Meteorological Satellite Program (DMSP), combining them with country-level data on female and male overweight and obesity prevalence rates, reported by the WHO. The study aims to identify and measure the strength of association between ALAN and country-wide overweight and obesity rates, controlling for per capita GDP, level of urbanization, birth rate, food consumption and regional differences.

RESULTS

ALAN emerged as a statistically significant and positive predictor of overweight and obesity (t>1.97; P<0.05), helping to explain, together with other factors, about 70% of the observed variation of overweight and obesity prevalence rates among females and males in more than 80 countries worldwide. Regional differences in the strength of association between ALAN and excessive body mass are also noted.

CONCLUSIONS

This study is the first population-level study that confirms the results of laboratory research and cohort studies in which ALAN was found to be a contributing factor to excessive body mass in humans.

Different effects of long-term exposures to SO2 and NO2 air pollutants on asthma severity in young adults

Numerous studies demonstrated that exposure to ambient air pollutants contributes to severity and frequency of asthma exacerbations. However, whether common air pollutants, such as nitrogen dioxide (NO2) and sulfur dioxide (SO2), exert differential effects on asthma occurrence and severity is unclear. The aim of this investigation was to determine whether exposure to NO2 and/or SO2 may initiate different long-term effects on prevalence and severity of asthma in young adults. Medical records of 137,040 males, 17 years old, who underwent standard premilitary service health examinations during 1999-2008 were examined. Air-pollution data for NO2 and SO2 were linked to the place of residence of each subject. The influence of specific air pollutants on asthma prevalence and severity was evaluated using bivariate logistic regression, controlling for individuals' sociodemographic attributes. For both ambient air pollutants, there was a significant dose-response effect on severity of asthma at ambient concentrations below the current National Ambient Air Quality Standards. However, in residential areas with high levels of SO2 (13.3-592.7µg/m(3)) and high levels of NO2 (27.2-43.2µg/m(3)) the risk of asthma occurrence was significantly higher than that in residential areas with high levels of NO2 (27.2-43.2 µg/m(3)) and intermediate levels (6.7-13.3 µg/m(3)) of SO2 pollution. The effects of exposure to SO2 and NO2 air pollutants on the respiratory airways system appear to differ, with possible implications regarding medical management, even in cases of exposure to mixtures of these pollutants.

Air Pollution and Respiratory Morbidity in Israel: A Review of Accumulated Empiric Evidence

Studies of the respiratory effects of air pollution in Israel published in peer-reviewed journals have been infrequent. Most empiric evidence relates to the association between air pollution and childhood asthma; other air pollution effects on other illnesses are less thoroughly studied. Our evaluation provides a possible explanation for the quite contradictory results demonstrated in the various studies. Actual effect estimates appear to differ considerably, ranging from no air pollution effect to a reasonably strong association detected between PM10 and asthma. We attribute these discrepancies to different research methodologies and different types of data used in various studies.

Evaluating the effect of vehicle impoundment policy on illegal construction and demolition waste dumping: Israel as a case study

Construction and demolition (C&D) waste dumped alongside roads and in open areas is a major source of soil and underground water pollution. Since 2006, Israeli ministry for environmental protection enacted a policy of vehicle impoundment (VI) according to which track drivers caught while dumping C&D waste illegally have their vehicles impounded. The present study attempted to determine whether the VI policy was effective in increasing the waste hauling to authorized landfill sites, thus limiting the number of illegal unloads of C&D waste at unauthorized landfill sites and in open areas. During the study, changes in the ratio between the monthly amount of C&D waste brought to authorized landfills sites and the estimated total amount of C&D waste generated in different administrative districts of Israel were examined, before and after the enactment of the 2006 VI policy. Short questionnaires were also distributed among local track drivers in order to determine the degree of awareness about the policy in question and estimate its deterrence effects. According to the study's results, in the district of Haifa, in which the VI policy was stringently enacted, the ratio between C&D waste, dumped in authorized landfill sites, and the total amount of generated C&D waste, increased, on the average, from 20% in January 2004 to 35% in October 2009, with the effect attributed to the number of vehicle impoundments being highly statistically significant (t=2.324; p<0.05). By contrast, in the Jerusalem and Southern districts, in which the VI policy was less stringently enforced, the effect of VI on the above ratio was found to be insignificant (p>0.1). The analysis of the questionnaires, distributed among the local truck drivers further indicated that the changes observed in the district of Haifa are not coincident and appeared to be linked to the VI policy's enactment. In particular, 62% of the truck drivers, participated in the survey, were aware of the policy and 47% of them personally knew a driver whose vehicle was impounded. Furthermore, the drivers estimated the relative risk of being caught for unloading C&D waste in unauthorized sites, on the average, as high as 67%, which is likely to become a deterrent on its own. Our conclusion is that the VI policy appears to have a deterring effect on truck drivers, by encouraging them to haul C&D waste to authorized landfill sites. As we suggest, the research methodology implemented in the study and its results may help policy makers in other regions and countries, which experience similar environment enforcement problem, to analyze policy responses.

Residential proximity to petroleum storage tanks and associated cancer risks: Double Kernel Density approach vs. zonal estimates

BACKGROUND AND AIMS

The relationship between exposure to petroleum products and cancer is well-established in occupational studies carried out among employees of transportation and oil-producing industries. However, question remains whether living near petroleum storage facilities may represent a cancer risk. In the present study, we examined cancer incidence rates associated with residential proximity to the Kiryat Haim industrial zone in Northern Israel, using different analytical techniques and adjusting for several potential confounders, such as road proximity, population density, smoking rates and socio-demographic attributes.

METHODS

Both traditional zonal approaches and more recently developed Double Kernel Density (DKD) tools were used to estimate relative risks of lung and NHL cancers attributed to residential proximity to the petroleum storage site.

RESULTS

Zonal approaches based on comparing ASRs across small census areas (SCAs) did not detect any significant association between residential proximity to the industrial zone and the two types of cancers under study (P>0.2). In contrast, the DKD approach revealed that the relative density of both lung and NHL cancers declined in line with distances from the industrial zone, especially among the elderly (Lung: t>-12.0; P<0.01; NHL: t>-9.0; P<0.01), adjusted for proximity to main roads, population density, smoking rate, average income, and several other potential confounders.

CONCLUSIONS

Living near petroleum storage sites may represent significant cancer risk which cannot always be detected by traditional zonal approaches commonly used in epidemiological studies, especially if the number of census areas available for the analysis is small.

Environmental factors associated with overweight and obesity in taiwanese children

BACKGROUND

We explored the relationship among sociodemographic, behavioural, household environmental and perinatal factors, and risks of childhood overweight and obesity in Taiwan.

METHODS

A total of 7930 children aged 9 to 14 years were recruited from 14 randomly selected Taiwanese communities in 2007 and 2010. Height and weight were measured using standard protocols during school visits. Questionnaires that contained children's family information, birth conditions, exercise habits and household environmental factors were answered by the parents. Associations between risk factors and childhood overweight and obesity were estimated through odds ratio and 95% confidence interval from mixed models.

RESULTS

In this cohort, 32.3% of the children were overweight and 17.5% were obese. Male gender, high birthweight, exposure to in utero maternal smoking and current exposure to household environmental tobacco smoke (stronger effect of maternal than paternal smoking) were positively associated with childhood overweight/obesity. In contrast, higher parental education level, number of siblings, active exercise habits and taking vitamins were associated with reduced risks of childhood obesity. Birthweight revealed a J-shaped relationship with the probability of childhood overweight/obesity.

CONCLUSIONS

This study uncovers several modifiable risk factors for childhood overweight and obesity, and parents are encouraged to provide an anti-obesity environment such as quitting smoking, controlling birthweight of child during pregnancy and building up exercise habits.

High prevalence of childhood asthma in Northern Israel is linked to air pollution by particulate matter: evidence from GIS analysis and Bayesian Model Averaging

The medical records of 3922 school children residing in the Greater Haifa Metropolitan Area in Northern Israel were analyzed. Individual exposure to ambient air pollution (SO(2) and PM(10)) for each child was estimated using Geographic Information Systems tools. Factors affecting childhood asthma risk were then investigated using logistic regression and the more recently developed Bayesian Model Averaging (BMA) tools. The analysis reveals that childhood asthma in the study area appears to be significantly associated with particulate matter of less than 10 μm in aerodynamic diameter (PM(10)) (Odds Ratio (OR) = .11; P<0.001). However, no significant association with asthma prevalence was found for SO(2) (P >0.2), when PM(10) and SO(2) were introduced into the models simultaneously. When considering a change in PM(10) between the least and the most polluted parts of the study area (9.4 μg/m(3)), the corresponding OR, calculated using the BMA analysis, is 2.58 (with 95% posterior probability limits of OR ranging from 1.52 to 4.41), controlled for gender, age, proximity to main roads, the town of a child's residence, and family's socio-economic status. Thus, it is concluded that exposure to airborne particular matter, even at relatively low concentrations (40-50 μg/m(3)), generally below international air pollution standards (55-70 μg/m(3)), appears to be a considerable risk factor for childhood asthma in urban areas. This should be a cause of concern for public health authorities and environmental decision-makers.

Cancer risks in the Druze Isifya Village: Reasons and RF/MW antennas

BACKGROUND

The present study was initiated to examine the claims of the residents of the Druze Isifya Village in Northern Israel that their high cancer rates were associated with the past exposures to radiation from radio and cellular transmitters.

OBJECTIVE

To investigate the association between past exposure to RF/MW transmitters and cancer risks, taking into account familial cancer history, occupational exposures and indicators of life-style.

METHODS

We carried out a population-based case-control study involving 307 residents, of whom 47 were diagnosed between 1989 and 2007 with different types of cancer and 260 controls. Cancer diagnoses were obtained from medical the records. Exposure status of individual houses were determined from a map, based on the distances between each house and RF/MW antennas, and were calculated using geographic information systems (GIS) tools. Data on additional risk factors for cancer, like smoking and occupation, were obtained from individual questionnaires. The analysis was adjusted for measures of life style and occupational exposure, and Binary multiple logistic regressions was used, for all cancer sites and for individual cancer types for those cancers with at least 5 documented cases.

RESULTS

Past occupational exposures to chemicals (e.g., pesticides) and electronics, were found to be strongly associated with increased cancer risks (all sites: OR=2.79; CI=1.14-6.82; P<0.05), but no discernible trend in overall cancer risk was associated with proximity to sources of past RF/MW radiation exposure (n=47 OR=1.00; CI=0.99-1.02; P>0.4). Colorectal cancer showed a negligible elevated adjusted risk associated with radiation intensity (n=11 OR=1.03; CI=1.01-1.05; P<0.01).

CONCLUSION

There was evidence for an increased risk of cancers which were associated with chemicals in manufacturing and agriculture and electronics, where there may have been exposures to EMF, but the study did not confirm the suspicion of increased cancer risks associated with radiation for most cancer types in this village. Misclassification of past exposures could explain the negative finding.

Nighttime light level co-distributes with breast cancer incidence worldwide

Breast cancer incidence varies widely among countries of the world for largely unknown reasons. We investigated whether country-level light at night (LAN) is associated with incidence. We compared incidence rates of five common cancers in women (breast, lung, colorectal, larynx, and liver), observed in 164 countries of the world from the GLOBOCAN database, with population-weighted country-level LAN, and with several developmental and environmental indicators, including fertility rate, per capita income, percent of urban population, and electricity consumption. Two types of regression models were used in the analysis: Ordinary Least Squares and Spatial Errors. We found a significant positive association between population LAN level and incidence rates of breast cancer. There was no such an association between LAN level and colorectal, larynx, liver, and lung cancers. A sensitivity test, holding other variables at their average values, yielded a 30-50% higher risk of breast cancer in the highest LAN exposed countries compared to the lowest LAN exposed countries. The possibility that under-reporting from the registries in the low-resource, and also low-LAN, countries created a spurious association was evaluated in several ways and shown not to account for the results. These findings provide coherence of the previously reported case-control and cohort studies with the co-distribution of LAN and breast cancer in entire populations.

Global co-distribution of light at night (LAN) and cancers of prostate, colon, and lung in men

The incidence rates of cancers in men differ by countries of the world. We compared the incidence rates of three of the most common cancers (prostate, lung, and colon) in men residing in 164 different countries with the population-weighted light at night (LAN) exposure and with several developmental and environmental indicators, including per capita income, percent urban population, and electricity consumption. The estimate of per capita LAN exposure was a novel aspect of this study. Both ordinary least squares (OLS) and spatial error (SE) regression models were used in the analysis. We found a significant positive association between population exposure to LAN and incidence rates of prostate cancer, but no such association with lung cancer or colon cancer. The prostate cancer result is consistent with a biological theory and a limited number of previous studies of circadian disruption and risk. The LAN-prostate cancer connection is postulated to be due to suppression of melatonin and/or disruption of clock gene function. An analysis holding other variables at average values across the 164 countries yielded a risk of prostate cancer in the highest LAN-exposed countries 110% higher than in the lowest LAN exposed countries. This observed association is a necessary condition for a potentially large effect of LAN on risk of prostate cancer. However, it is not sufficient due to potential confounding by factors that increase the risk of prostate cancer and are also associated with LAN among the studied countries.

Exploratory analysis of potential risk factors of a rare disease: spatial distribution of adrenocortical carcinoma in Israel as a case study

The underlying assumption of the proposed exploratory approach is that, if the geographic patterns of different diseases are compared, the cases of a 'subject' disease should occur closer to cases of a disease with similar environmental risk factors (etiology) and farther away from cases of a disease with different etiology. In the present study, the performance of proposed approach is investigated by cross-examination of the spatial patterns of three widespread cancers--lung, larynx and colorectal (CRC)--with that of a rare malignant disease--Adrenocortical Carcinoma (ACC). As the analysis indicates, the spatial distribution of ACC is more likely to be related to hereditary factors than to environmental causes, in accordance with current knowledge about this rare disease.

Estimating the effect of air pollution from a coal-fired power station on the development of children's pulmonary function

Using geographical information systems (GIS) tools, the present study analyzed the association between children's lung function development and their long-term exposure to air pollution. The study covered the cohort of 1492 schoolchildren living in the vicinity of a major coal-fired power station in the Hadera sub-district of Israel. In 1996 and 1999, the children underwent subsequent pulmonary function tests (PFT) (forced vital capacity (FVC) and forced expiratory volume during the first second (FEV(1))), and the children's parents completed a detailed questionnaire on their health status and household characteristics. A negative association was found between changes in the results of PFT and the estimated individual levels of air pollution. A sensitivity test revealed a FEV(1) decline from -4.3% for the average pollution level to -10.2% for the high air pollution level. The results of a sensitivity test for FVC were found to be similar. Association with the reported health status was found to be insignificant. As we conclude, air pollution from a coal-fired power station, although not exceeding local pollution standards, had a negative effect on children's lung function development. As argued, previous studies carried out in the region failed to show the above association because they were based on zone approaches that assign average concentration levels of air pollutants to all individuals in each zone, leading to a misclassification bias of individual exposure.

On ecological fallacy, assessment errors stemming from misguided variable selection, and the effect of aggregation on the outcome of epidemiological study

In social and environmental sciences, ecological fallacy is an incorrect assumption about an individual based on aggregate data for a group. In the present study, the validity of this assumption was tested using both individual estimates of exposure to air pollution and aggregate data for 1,492 schoolchildren living in the in vicinity of a major coal-fired power station in the Hadera region of Israel. In 1996 and 1999, the children underwent subsequent pulmonary function tests (PFT), and their parents completed a detailed questionnaire on their health status and housing conditions. The association between children's PFT results and their exposure to air pollution was investigated in two phases. During the first phase, PFT averages were compared with average levels of air pollution detected in townships, and small census areas in which the children reside. During the second phase, individual pollution estimates were compared with individual PFT results, and pattern detection techniques (Getis-Ord statistic) were used to investigate the spatial data structure. While different levels of areal data aggregation changed the results only marginally, the choice of indices measuring the children's PFT performance had a significant influence on the outcome of the analysis. As argued, differences between individual-level and group-level effects of exposure (i.e., ecological or cross-level bias) are not necessary outcomes of data aggregation, and that seemingly unexpected results may often stem from a misguided selection of variables chosen to measure health effects. The implications of the results of the analysis for epidemiological studies are discussed, and recommendations for public health policy are formulated.

Sustainability of population growth: a case study of urban settlements in Israel

"One of the most sensitive criteria for gauging the degree of socio-economic prosperity of an urban settlement is the ability to sustain stable rates of population growth by attracting newcomers and retaining existing population. The present paper argues that after reaching a particular size (on the average, 20-30,000 residents), urban localities in Israel tend to experience substantial changes in components of their annual population growth. Starting with this inflection point, the growth of settlements gradually becomes less dependent on natural causes (birth and death rates) than on the ability to attract newcomers and retain current residents. On the basis of this conclusion, a strategy of ¿redirecting priorities' to developing the peripheral regions of the country is suggested."

Investigating the effect of clustering of the urban field on sustainable population growth of centrally located and peripheral towns

In a previous study (Portnov and Erell, 1998a), an Index of Clustering was defined, which allowed an analysis of the combined effect of spatial isolation and remoteness of peripheral towns on the long-term patterns of their population growth. In the present paper, the analysis of the effect of clustering of the urban field on the patterns of population growth is extended to centrally located urban places, and the validity of this index is tested in two unevenly populated countries--Israel and Norway. In both countries, the effect of clustering of the urban field on the patterns of urban growth is twofold. In sparsely populated areas, the presence of neighboring towns appears to increase their chances of attracting potential migrants due to inter-urban exchanges, while in more densely populated areas, increasing clustering tends to reduce migration influx to a given locality due to inter-town competition. Following this conclusion, a strategy of "redirecting priorities" leading to the formation of urban clusters is proposed, which may enhance the potential of urban growth in geographical areas where this is desirable.