The aim of this study was to examine modifiable biological, psychological, behavioral and social-environmental correlates of physical activity among 1129 Norwegian 11-year-old children within a cross-sectional sample from the HEalth In Adolescents study. Physical activity was assessed by accelerometer, and weight and height were measured objectively. Age- and gender-specific cut-off points proposed by the International Obesity Task Force were used to define body mass index. Social-environmental variables were self-reported by questionnaire. Hierarchical regression (linear mixed models) revealed that normal weight children scored higher on percentage daily moderate-to-vigorous physical activity [% daily moderate to vigorous physical activity (MVPA)] than overweight/obese children (P
To investigate relative frequency and features of diisocyanate (ISO) and non-diisocyanate (N-ISO) allowed occupational asthma (OA) claims in Ontario, Canada, during a 5-year period (1998 to 2002).
Records were abstracted from the Ontario Workplace Safety and Insurance Board using methodology similar to our previous investigation that had identified 30 ISO and 30 N-ISO claims/yr during 1980 to 1993.
There were 99 OA claims: 37 ISO (7.4 claims/yr) and 62 N-ISO (12.4 claims/yr). The ISO group had more males (86% vs 69%, p = 0.01), but there were no other significant differences. The commonest professions were spray painters (41%) and production workers (38%) in the ISO group and production workers (49%) and health care workers (8%) in the N-ISO group.
ISO and N-ISO claims declined from the previous period, especially for ISO, perhaps because of effective surveillance programs.
Short-term changes in levels of fine ambient particulate matter (PM2.5) may increase the risk of acute ischemic stroke; however, results from prior studies have been inconsistent. We examined this hypothesis using data from a multicenter prospective stroke registry.
We analyzed data from 9202 patients hospitalized with acute ischemic stroke, having a documented date and time of stroke onset, and residing within 50 km of a PM2.5 monitor in 8 cities in Ontario, Canada. We evaluated the risk of ischemic stroke onset associated with PM2.5 in each city using a time-stratified case-crossover design, matching on day of week and time of day. We then combined these city-specific estimates using random-effects meta-analysis techniques. We examined whether the effects of PM2.5 differed across strata defined by patient characteristics and ischemic stroke etiology.
Overall, PM2.5 was associated with a -0.7% change in ischemic stroke risk per 10-µg/m increase in PM2.5 (95% confidence interval = -6.3% to 5.1%). These overall negative results were robust to a number of sensitivity analyses. Among patients with diabetes mellitus, PM2.5 was associated with an 11% increase in ischemic stroke risk (1% to 22%). The association between PM2.5 and ischemic stroke risk varied according to stroke etiology, with the strongest associations observed for strokes due to large-artery atherosclerosis and small-vessel occlusion.
These results do not support the hypothesis that short-term increases in PM2.5 levels are associated with ischemic stroke risk overall. However, specific patient subgroups may be at increased risk of particulate-related ischemic strokes.
Cites: Eur Heart J. 2006 May;27(10):1238-4416537554
The Eastern Townships (ETR) is a region in Québec (Canada) where the soil is naturally rich in arsenic (As). About a third of the people in the ETR obtain their water from a private well. A quasi-experimental design was used to compare two campaigns designed to promote As screening in well water: a mass-media campaign (MMC) followed or not by a community-based intervention (CBI). The MMC is based on a press release issued for the ETR, along with a leaflet on As made available on the Internet, and in strategic places. The CBI, formulated according to the factors of the Precede-Proceed model, was aimed at mobilizing local authorities and small media. It targets only one municipality; the intervention community (IC). Using a separate pre-post samples design, two population-based cross-sectional (pre-CBI and post-CBI) surveys were conducted by phone at 6-month intervals, by means of random samples. The samples counted, for the IC and the ETR, respectively, 87 and 156 well owners in pre-CBI, and 106 and 190 in post-CBI. The results in post-CBI showed that the proportion of well owners who had their water test increased by four times in the IC after (16% p = 0.004). When adjusting for age and gender among all the post-CBI respondents, As screening is related with intervention status (exposed to MMC and CBI; p = 0.001) and on previous microbiological water analysis behavior (p = 0.05), but is not related to knowledge. This study demonstrates the superiority of a community-based campaign over a MMC when environmental health is concerned.
The Windsor, Ontario Exposure Assessment Study evaluated the contribution of ambient air pollutants to personal and indoor exposures of adults and asthmatic children living in Windsor, Ontario, Canada. In addition, the role of personal, indoor, and outdoor air pollution exposures upon asthmatic children's respiratory health was assessed. Several active and passive sampling methods were applied, or adapted, for personal, indoor, and outdoor residential monitoring of nitrogen dioxide, volatile organic compounds, particulate matter (PM; PM
The aim of the study was to evaluate the agreement between self-reported and operator-derived estimates of call time based on a three-month monitoring period, as well as the consistency of mobile phone use over time. Alternative approaches to improve participation in a cohort study of mobile phone users were also compared.
A total of 5,400 subjects were identified from network operators' subscriber databases for recruitment to the pilot study. Operator and questionnaire data were used to quantify mobile phone use. Operator data were available for a subset of the subjects for a three-month period in three consecutive years. We also evaluated the effect of the length of the questionnaire and one- or two-phase recruitment on participation.
The average response rate for both questionnaires and recruitment procedures was 12%. The response rate was not affected by the length of the questionnaire or the recruitment method.Operator data were available for 83% of the participants for 2007, the first study year. The agreement between self-reported and operator-derived call times decreased with the level of use among intermediate and heavy mobile phone users. During 2007-2009, mobile phone use increased fairly constantly over time.
The agreement between self-reported mobile phone use and operator databases was moderate and overestimation of the call time by participants was common. A prospective cohort study would be feasible in Finland, although the potentially low participation rate would increase the resources required for recruitment.
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Genetic variation in the melatonin receptor 1B (MTNR1B) is associated with type 2 diabetes. Melatonin contributes to the regulation of sleep, and sleep problems are a documented risk factor for type 2 diabetes. The aim of this study was to investigate whether the MTNR1B gene variant rs10830963 is associated with sleep problems and whether this variant contributes to the association between sleep disturbances and type 2 diabetes.
This was a case-control study nested within the population-based Nord-TrÃ¸ndelag Health Study, including 1,322 prevalent cases of type 2 diabetes and 1,447 controls. In addition, prospective data were available for 838 incident cases and 1,133 controls. Genotyping was done by TaqMan single-nucleotide polymorphism allelic discrimination analysis. ORs and 95% CIs were calculated using logistic regression models.
Our findings confirm an association between sleep disturbances and type 2 diabetes (OR 1.69, 95% CI 1.22-2.33, p = 0.0016) and between the risk allele of rs10830963 and type 2 diabetes (OR 1.12, 95% CI 1.00-1.27, p = 0.0579). There was a tendency for an association between the risk allele and prevalence of sleep problems (specifically early awakening). However, the risk allele did not influence the association of sleep problems with diabetes, which was unaltered after adjustment for the MTNR1B risk allele (OR 1.69, 95% CI 1.23-2.34, p = 0.0014). Results based on prospective data were similar, although non-significant.
Our findings do not support participation of the MTNR1B gene variant rs10830963 in the well documented association between sleep disturbances and type 2 diabetes.
The role that the urban environment plays in influencing drug users' injection and needle disposal decisions is poorly understood. We identified potential attractors and deterrents of needle discarding, and then used a geographic information system (GIS) to quantify these factors for a neighborhood in Montréal, Canada. In multivariate logistic regression, discarded needles were found to have more associations with physical factors than with social factors. Visual exposure and proximity to a single-room occupancy hotel, a pay phone, an adult service or a pawnshop were important physical environmental predictors. These findings are discussed in relation to developing public health and urban design-based harm reduction approaches to needle discarding in public space.
We describe a centralized automated multi-function detection and reporting system for public health surveillance--the Alberta Real Time Syndromic Surveillance Net (ARTSSN). This improves upon traditional paper-based systems which are often fragmented, limited by incomplete data collection and inadequate analytical capacity, and incapable of providing timely information for public health action.
ARTSSN concurrently analyzes multiple electronic data sources in real time to describe results in tables, charts and maps. Detected anomalies are immediately disseminated via alerts to decision-makers for action.
ARTSSN provides richly integrated information on a variety of health conditions for early detection of and prompt action on abnormal events such as clusters, outbreaks and trends. Examples of such health conditions include chronic and communicable disease, injury and environment-mediated adverse incidents.
Key advantages of ARTSSN over traditional paper-based methods are its timeliness, comprehensiveness and automation. Public health surveillance of communicable disease, injury, environmental hazard exposure and chronic disease now occurs in a single system in real time year round. Examples are given to demonstrate the public health value of this system, particularly during Pandemic (H1N1) 2009.
The intimate interdependence of human health and the ecosystems in which we are embedded is now a commonplace observation. For much of the history of public health, this was not so obvious. After over a century of focus on diseases, their biologic causes and the correction of exposures (clean water and air) and facilitation of responses (immunizations and nutrition), public health discourse shifted to embrace the concept of determinants of health as extending to social, economic and environmental realms. This moved the discourse and science of public health into an unprecedented level of complexity just as public concern about the environment heightened. To address multifactorial, dynamic impacts on health, a new paradigm was needed which would overcome the separation of humans and ecosystems. Ecosystem approaches to health arose in the 1990s from a rich background of intellectual ferment as Canada wrestled with diverse problems ranging from Great Lakes contamination to zoonotic diseases. Canada's International Development Research Centre (IDRC) played a lead role in supporting an international community of scientists and scholars who advanced ecosystem approaches to health. These collective efforts have enabled a shift to a research paradigm that embraces transdisciplinarity, social justice, gender equity, multi-stakeholder participation and sustainability.
Impaired semen quality and testicular cancer may be linked through a testicular dysgenesis syndrome of foetal origin. The incidence of testis cancer has been shown to increase among Finnish men, whereas there is no recent publication describing temporal trends in semen quality. Therefore, we carried out a prospective semen quality study and a registry study of testis cancer incidence among Finnish men to explore recent trends. A total of 858 men were investigated in the semen quality study during 1998-2006. Median sperm concentrations were 67 (95% CI 57-80) million/mL, 60 (51-71) and 48 (39-60) for birth cohorts 1979-81, 1982-83 and 1987; total sperm counts 227 (189-272) million, 202 (170-240) and 165 (132-207); total number of morphologically normal spermatozoa 18 (14-23) million, 15 (12-19) and 11 (8-15). Men aged 10-59 years at the time of diagnosis with testicular cancer during 1954-2008 were included in the registry study, which confirmed the increasing incidence of testicular cancer in recent cohorts. These simultaneous and rapidly occurring adverse trends suggest that the underlying causes are environmental and, as such, preventable. Our findings necessitate not only further surveillance of male reproductive health but also research to detect and remove the underlying factors.
Some persistent environmental chemicals are suspected of causing an increased risk of type 2 diabetes mellitus, a disease particularly common after the age of 70. This concern was examined in a cross-sectional study of elderly subjects from a fishing population with elevated contaminant exposures from seafood species high in the food chain.
Clinical examinations of 713 Faroese residents aged 70-74 years (64% of eligible population) included fasting plasma concentrations of glucose and insulin, and glycosylated hemoglobin. Lifetime exposure to persistent environmental chemicals from pilot whale and other traditional food was estimated from a dietary questionnaire and by analysis of blood samples for polychlorinated biphenyls (PCBs) and related food contaminants.
Septuagenarians with type 2 diabetes or impaired fasting glycemia tended to have higher PCB concentrations and higher past intake of traditional foods, especially during childhood and adolescence. In nondiabetic subjects, the fasting insulin concentration decreased by 7% (95% CI = -12% to -2%) for each doubling of the PCB concentration after adjustment for sex and body mass index at age 20. Conversely, the fasting glucose concentration increased by 6% (-1% to 13%) for each doubling in PCB. Similar associations were seen in subjects without impaired fasting glycemia, while further adjustment for current body mass index and lipid metabolism parameters attenuated some of the associations.
Impaired insulin secretion appears to constitute an important part of the type 2 diabetes pathogenesis associated with exposure to persistent lipophilic food contaminants.
The etiology of preeclampsia is complex, with susceptibility being attributable to multiple environmental factors and a large genetic component. Although many candidate genes for preeclampsia have been suggested and studied, the specific causative genes still remain to be identified. Catechol-O-methyltransferase (COMT) is an enzyme involved in catecholamine and estrogen degradation and has recently been ascribed a role in development of preeclampsia. In the present study, we have examined the COMT gene by genotyping the functional Val108/158Met polymorphism (rs4680) and an additional single-nucleotide polymorphism, rs6269, predicting COMT activity haplotypes in a large Norwegian case/control cohort (n(cases)= 1135, n(controls)= 2262). A low COMT activity haplotype is associated with recurrent preeclampsia in our cohort. This may support the role of redox-regulated signaling and oxidative stress in preeclampsia pathogenesis as suggested by recent studies in a genetic mouse model. The COMT gene might be a genetic risk factor shared between preeclampsia and cardiovascular diseases.
To determine whether parent-reported perennial rhinitis or objectively measured nasal resistance is more common in children from smoking families. To assess tonsillar size, nasopharyngeal airway and upper airway surgery frequency in children with smoking and non-smoking parents.
Ninety-five children (age 3-6 years, median 68 months) participated in this prospective cross-sectional clinical study. History of nasal symptoms was obtained, and all underwent an ear-nose-throat examination, anterior rhinomanometry and a lateral cephalogram. Regular smoking by either parent and their child's snoring was inquired about with a parental questionnaire. We compared children with a parental smoker and children without a parental smoker in the family.
Smoking in the family led to increased risk for perennial rhinitis in the children up to 2.76-fold (aOR, 95%CI 1.00-7.67), but with no difference in nasal resistance between children from smoking and non-smoking households. Neither tonsillar size, nasopharyngeal airway nor upper airway surgery was associated with parental smoking.
Parental smoking is associated with symptoms of perennial rhinitis in children. The possible role of environmental tobacco smoke should be taken into account in parent counselling and in evaluation of children being treated for symptoms of rhinitis and nasal obstruction.
The aim of this study was to assess relationships between sleeping problems and the psychosocial work situation based on the job-strain and iso-strain models among Swedish commercial pilots.
Three hundred fifty-four pilots participated (61%), who are in 2008 responded to a questionnaire concerning sleep problems, the psychosocial work situation, personal factors, and flight length.
Low social support was associated with sleep problems for pilots. High demands were associated with sleep problems among captains and long-haul flights were associated with sleep problems among first officers. Low skill discretion was associated with less sleep problems among first officers.
Psychosocial climate at work such as low social support affects negatively sleep for both captains and for first officers. More research on what creates a best social support for pilots and cabin crew is needed. Adjusting scheduling work crew teams could increase social support at work and contribute to a better sleep quality.
Many studies have reported an increased incidence of psychiatric disorder (particularly psychotic disorders) among first generation adult immigrants, along with an increasing risk for ethnic minorities living in low-minority concentration neighborhoods. These studies have depended mostly on European case-based databases. In contrast, North American studies have suggested a lower risk for psychiatric disorder in immigrants, although the effect of neighborhood immigrant concentration has not been studied extensively.
Using multi-level modeling to disaggregate individual from area-level influences, this study examines the influence of first generation immigrant status at the individual level, immigrant concentration at the neighborhood-level and their combined effect on 12-month prevalence of mood, anxiety and substance-dependence disorders and lifetime prevalence of psychotic disorder, among Canadians.
Individual-level data came from the Canadian Community Health Survey (CCHS) 1.2, a cross-sectional study of psychiatric disorder among Canadians over the age of 15 years; the sample for analysis was n=35,708. The CCHS data were linked with neighborhood-level data from the Canadian Census 2001 for multi-level logistic regression. Immigrant status was associated with a lower prevalence of psychiatric disorder, with an added protective effect for immigrants living in neighborhoods with higher immigrant concentrations. Immigrant concentration was not associated with elevated prevalence of psychiatric disorder among non-immigrants.
The finding of lower 12-month prevalence of psychiatric disorder in Canadian immigrants, with further lessening as the neighborhood immigrant concentration increases, reflects a model of person-environment fit, highlighting the importance of studying individual risk factors within environmental contexts.
The paper substantiates a need for specific regulation of biological waste products due to their high potential danger to the environment. Being governed by the normative legal acts on the provision of the population with sanitary-and-epidemiological well-being, adopted by the federal executive bodies and the federal executive bodies of the subject of the Russian Federation, the Inspectorate for the Protection of Consumer Rights and Human Welfare in the Republic of Bashkortostan is competent to supervise and control the activity of enterprises and institutions, the conditions and procedures for collection, usage, decontamination, transportation, storage and disposal of waste products and utilization in accordance with the current sanitary rules and regulations. As a result, the authors took part in the elaboration of several long-term programs and resolutions of the Government of the Republic of Bashkortostan Government, realization of which will reduce the impact of environmental pollution on human health.