There was performed a comparative analysis of the dynamics of newly diagnosed and the overall morbidity of children's population of the Republic of Tatarstan (RT) and the city of Kazan of main classes of diseases for 2004- 2012 according to the statistical reporting form N12. As an assessment of the possible impact of environmental factors on the formation of separate groups of diseases and changes in the systems of the body there was used health risk assessment according to annual average concentrations of chemicals in the ambient air Average annual indices of prevalence for the most of classes of diseases in children (0-14 years) of the population of the Republic of Tatarstan (RT) and the city of Kazan 2004-2012 (per 1000 children) showed significant differences for most classes of diseases and their rise in children of the city. Results of the assessment of the non-carcinogenic risk based on evolutionary models determined the magnitude of additional risks for the respiratory system. Non-carcinogenic health risk is assessed before the age of 19 years as negligible, until the age of 36 years as a moderate, until the age of 45 years as highfor persons over 46 years as very high.
Alaska Native children experience high rates of respiratory infections and conditions. Household crowding, indoor smoke, lack of piped water, and poverty have been associated with respiratory infections. We describe the baseline household characteristics of children with severe or chronic lung disease participating in a 2012-2015 indoor air study. We monitored indoor PM2.5, CO2 , relative humidity %, temperature, and VOCs and interviewed caregivers about children's respiratory symptoms. We evaluated the association between reported children's respiratory symptoms and indoor air quality indicators using multiple logistic regression analysis. Compared with general US households, study households were more likely overcrowded 73% (62%-82%) vs 3.2% (3.1%-3.3%); had higher woodstove use as primary heat source 16% (9%-25%) vs 2.1% (2.0%-2.2%); and higher proportion of children in a household with a smoker 49% (38%-60%) vs 26.2% (25.5%-26.8%). Median PM2.5 was 33 µg/m3 . Median CO2 was 1401 ppm. VOCs were detectable in all homes. VOCs, smoker, primary wood heat, and PM2.5>25 µg/m3 were associated with higher risk for cough between colds; VOCs were associated with higher risk for wheeze between colds and asthma diagnosis. High indoor air pollutant levels were associated with respiratory symptoms in household children, likely related to overcrowding, poor ventilation, woodstove use, and tobacco smoke.
Division of Risk Management, Department of Environmental and Life Sciences, Karlstad University, Karlstad, Sweden; Centre for Public Safety, Karlstad University, Sweden. Electronic address: firstname.lastname@example.org.
Residential fires represent the largest category of fatal fires in Sweden. The purpose of this study was to describe the epidemiology of fatal residential fires in Sweden and to identify clusters of events.
Data was collected from a database that combines information on fatal fires with data from forensic examinations and the Swedish Cause of Death-register. Mortality rates were calculated for different strata using population statistics and rescue service turnout reports. Cluster analysis was performed using multiple correspondence analysis with agglomerative hierarchical clustering.
Male sex, old age, smoking, and alcohol were identified as risk factors, and the most common primary injury diagnosis was exposure to toxic gases. Compared to non-fatal fires, fatal residential fires more often originated in the bedroom, were more often caused by smoking, and were more likely to occur at night. Six clusters were identified. The first two clusters were both smoking-related, but were separated into (1) fatalities that often involved elderly people, usually female, whose clothes were ignited (17% of the sample), (2) middle-aged (45-64years old), (often) intoxicated men, where the fire usually originated in furniture (30%). Other clusters that were identified in the analysis were related to (3) fires caused by technical fault, started in electrical installations in single houses (13%), (4) cooking appliances left on (8%), (5) events with unknown cause, room and object of origin (25%), and (6) deliberately set fires (7%).
Fatal residential fires were unevenly distributed in the Swedish population. To further reduce the incidence of fire mortality, specialized prevention efforts that focus on the different needs of each cluster are required.
Cooperation between various societal functions, e.g. rescue services, elderly care, psychiatric clinics and other social services, with an application of both human and technological interventions, should reduce residential fire mortality in Sweden.
Cell phone use during pregnancy is a public health concern. We investigated the association between maternal cell phone use in pregnancy and child's language, communication and motor skills at 3 and 5 years.
This prospective study includes 45,389 mother-child pairs, participants of the MoBa, recruited at mid-pregnancy from 1999 to 2008. Maternal frequency of cell phone use in early pregnancy and child language, communication and motor skills at 3 and 5 years, were assessed by questionnaires. Logistic regression was used to estimate the associations.
No cell phone use in early pregnancy was reported by 9.8% of women, while 39%, 46.9% and 4.3% of the women were categorized as low, medium and high cell phone users. Children of cell phone user mothers had 17% (OR = 0.83, 95% CI: 0.77, 0.89) lower adjusted risk of having low sentence complexity at 3 years, compared to children of non-users. The risk was 13%, 22% and 29% lower by low, medium and high maternal cell phone use. Additionally, children of cell phone users had lower risk of low motor skills score at 3 years, compared to children of non-users, but this association was not found at 5 years. We found no association between maternal cell phone use and low communication skills.
We reported a decreased risk of low language and motor skills at three years in relation to prenatal cell phone use, which might be explained by enhanced maternal-child interaction among cell phone users. No evidence of adverse neurodevelopmental effects of prenatal cell phone use was reported.
First, to explore item pools developed to measure the physical home environment of pre-school children and assess the psychometric properties of these item pools; second, to explore associations between this environment and vegetable consumption among Norwegian 3-5-year-olds.
Data were collected in three steps: (i) a parental web-based questionnaire assessing the child's vegetable intake and factors potentially influencing the child's vegetable consumption; (ii) direct observation of the children's fruit, berry and vegetable intakes at two meals in one day in the kindergarten; and (iii) a parental web-based 24 h recall.
The target group for this study was pre-school children born in 2010 and 2011, attending public or private kindergartens in the counties of Vestfold and Buskerud, Norway.
A total of 633 children participated.
Principal component analysis on the thirteen-item pool assessing availability/accessibility resulted in two factors labelled 'availability at home' and 'accessibility at home', while the eight-item pool assessing barriers resulted in two factors labelled 'serving barriers' and 'purchase barriers'. The psychometric properties of these factors were satisfactory. Linear regression of the associations between vegetable intake and the factors showed generally positive associations with 'availability at home' and 'accessibility at home' and negative associations with 'serving barriers'.
This age group has so far been understudied and there is a need for comparable studies. Our findings highlight the importance of targeting the physical home environment of pre-school children in future interventions as there are important modifiable factors that both promote and hinder vegetable consumption in this environment.
Exposure to moldy or damp indoor environments is associated with allergic disease in young children, but it is unclear whether the effects persist to adolescence. Our objective was to assess whether exposure to mold or dampness during infancy increases the risk of asthma, rhinitis, or IgE sensitization in children followed from birth to 16 years of age.
We collected questionnaire derived reports of mold or dampness indicators and allergic outcomes from 3798 children in a Swedish birth cohort (BAMSE). Sensitization was assessed from blood samples in 3293 children. Longitudinal associations between prevalent asthma, rhinitis, and IgE sensitization and mold or dampness indicators were assessed using generalized estimating equations.
Exposure to any mold or dampness indicator was associated with asthma up to 16 years of age (OR 1.31; 95% CI 1.08-1.59), while exposure to mold odor (OR 1.29; 95% CI 1.03-1.62) and visible mold (OR 1.28; 95% CI 1.04-1.58) were associated with rhinitis. Increased risks were observed for nonallergic asthma (OR 1.80; 95% CI 1.27-2.55) and rhinitis (OR 1.41; 95% CI 1.03-1.93). No association was observed between mold or dampness indicators and IgE sensitization. Exposure to any mold or dampness indicator was associated with persistent asthma (OR 1.73; 95% CI 1.20-2.50), but not with early-transient or late-onset asthma.
Exposure to mold or dampness during infancy increased the risk of asthma and rhinitis up to 16 years of age, particularly for nonallergic disease. Early exposure to mold or dampness appeared particularly associated with persistent asthma through adolescence.
Cites: PLoS One. 2014 Aug 19;9(8):e105125 PMID 25136984
Data of hygienic studies of air and soil during last 20 years have confirmed their correlating relationship with the general morbidity and a group of musculoskeletal diseases in children living in cities with the technogenic pollution of the environment. Their bones were established to grow unevenly and disproportionally, in 76% of children there have been violations in the development and growth of bones. The results of X-ray examination of hand bones in children and adolescents in the Irkutsk and Shelekhov cities are presented. Significant differences in morbidity patterns among children and adolescents including an increased incidence of musculoskeletal diseases by 5.6 in children and by 12 in adolescents have been revealed.
Most previous studies on the association between moisture damage and asthma have been cross-sectional and relied on self-reported exposure and health. The present authors studied the association by carrying out careful home inspections among new, clinically determined cases of asthma and controls. New cases of asthma aged 12-84 months (n = 121) were recruited prospectively and matched for year of birth, sex and living area with two randomly selected population controls (n = 241). Trained engineers visited all homes. Both cases and controls had lived >or=75% of their lifetime or the past 2 yrs in their current home. Risk of asthma increased with severity of moisture damage and presence of visible mould in the main living quarters but not in other areas of the house. Cases more often had damage in their bedroom. Associations were comparable for atopic and nonatopic asthma and for children aged >30 months or
The paper presents some indices that characterize morbidity in the Moscow population, which suggest positive trends in the health status in all population groups. These include stabilization of overall morbidity rates; a down-increase in the incidence of respiratory diseases and bronchial asthma; a reduction in overall morbidity in infants of the first year of life, including a reduction in the incidence of life-threatening diseases (perinatal pathology and congenital malformations; a decrease in the incidence of alimentary diseases associated with social factors. The found positive changes reflect the efficiency of introduction of the sociohygienic monitoring (AHM) system. One of the mechanisms of introduction of AHM results is to submit data to the Moscow Government in the annual reports "On the Moscow population's health status" which cover demography, morbidity, female health, and the regional features of the population's health in relation to environmental factors. Based on information, managerial decisions and measures to improve the sanitary-and-epidemiological situation in Moscow are taken and implemented.
In humans, immune development begins early in embryonic life and continues throughout the early postnatal period. Although a number of pesticides have been observed to induce developmental immunotoxicity in mice, few human studies have examined the long term effects of in utero pesticide exposure on childhood morbidity. Empirical evidence suggests that the vulnerable period for toxic insults to the developing immune system extends from early gestation to adolescence in humans and animals. Using data from the Ontario Farm Family Health Study, we examined the relationship between farm couple exposures to pesticides during pregnancy and subsequent health outcomes in their offspring, including: persistent cough or bronchitis, asthma, and allergies or hayfever. No strong associations between pesticide exposures during pregnancy and persistent cough or bronchitis, or asthma were found. There was suggestive evidence that allergies and hayfever appeared to be more common in offspring, especially male offspring, exposed to certain specific pesticides during the period of pregnancy. Nevertheless, given the indirect indicators of pesticide exposure used in this study, and the scarcity of human studies on in utero exposure to pesticides and the development of allergies and other child health outcomes, these findings serve primarily to generate hypotheses for future research.
The number of children in daycare centers (DCCs) is rising. This increases exposure to microorganisms and infectious diseases. Little is known about which bacteria and viruses are present in the DCC environment and where they are located. In the study described in this article, the authors set out to determine the prevalence of pathogenic bacteria and viruses and to find the most contaminated fomites in DCCs. Fifteen locations in each DCC were sampled for bacteria, respiratory viruses, and gastrointestinal viruses. The locations were in the toilet, kitchen, and playroom areas and included nursery pillows, toys, and tables, among other things. Coliform bacteria were primarily found in the toilet and kitchen areas whereas nasopharyngeal bacteria were found mostly on toys and fabric surfaces in the playroom. Respiratory viruses were omnipresent in the DCC environment, especially on the toys.
Indoor air pollution (IAP) from environmental tobacco smoke (ETS) and biomass fuel smoke (BMS) poses respiratory health risks, with children and women bearing the major burden.
We used a systematic review and meta-analysis to investigate the relation between childhood tuberculosis (TB) and exposure to ETS and BMS.
We searched three databases for epidemiological studies that investigated the association of childhood TB with exposure to ETS and BMS. We calculated pooled estimates and heterogeneity for studies eligible for inclusion in the meta-analysis and stratified studies on ETS by outcome.
Five case-control and three cross-sectional studies were eligible for inclusion in the meta-analysis and quality assessment. Pooled effect estimates showed that exposure to ETS is associated with tuberculous infection and TB disease (OR 1.9, 95%CI 1.4-2.9) among exposed compared to non-exposed children. TB disease in ETS studies produced a pooled OR of 2.8 (95%CI 0.9-4.8), which was higher than the OR for tuberculous infection (OR 1.9, 95%CI 0.9-2.9) for children exposed to ETS compared to non-exposed children. Studies on BMS exposure were too few and too small to permit a conclusion.
Exposure to ETS increases the risk of childhood TB disease or tuberculous infection.
The immediate postnatal period is the period of the fastest growth in the entire life span and a critical period for lung development. Therefore, it is interesting to examine the association between growth during this period and childhood respiratory disorders.
We examined the association of peak weight and height velocity to age 36 months with maternal report of current asthma at 36 months (n = 50,311), recurrent lower respiratory tract infections (LRTIs) by 36 months (n = 47,905) and current asthma at 7 years (n = 24,827) in the Norwegian Mother and Child Cohort Study. Peak weight and height velocity was calculated using the Reed1 model through multilevel mixed-effects linear regression. Multivariable log-binomial regression was used to calculate adjusted relative risks (adj.RR) and 95% confidence intervals (CI). We also conducted a sibling pair analysis using conditional logistic regression.
Peak weight velocity was positively associated with current asthma at 36 months [adj.RR 1.22 (95%CI: 1.18, 1.26) per standard deviation (SD) increase], recurrent LRTIs by 36 months [adj.RR 1.14 (1.10, 1.19) per SD increase] and current asthma at 7 years [adj.RR 1.13 (95%CI: 1.07, 1.19) per SD increase]. Peak height velocity was not associated with any of the respiratory disorders. The positive association of peak weight velocity and asthma at 36 months remained in the sibling pair analysis.
Higher peak weight velocity, achieved during the immediate postnatal period, increased the risk of respiratory disorders. This might be explained by an influence on neonatal lung development, shared genetic/epigenetic mechanisms and/or environmental factors.
Cites: Environ Health Perspect. 2014 Jan;122(1):93-924162035
Toxocariasis is an important neglected tropical disease that can manifest as visceral or ocular larva migrans, or covert toxocariasis. All three forms pose a public health problem and cause significant morbidity in areas of high prevalence. To determine the burden of toxocariasis in North America, we conducted a systematic review of the literature following PRISMA guidelines. We found 18 articles with original prevalence, incidence, or case data for toxocariasis. Prevalence estimates ranged from 0.6% in a Canadian Inuit community to 30.8% in Mexican children with asthma. Commonly cited risk factors included: African-American race, poverty, male sex, and pet ownership or environmental contamination by animal feces. Increased prevalence of Toxocara spp. infection was linked in a group of case control studies conducted in Mexico to several high risk groups including waste pickers, asthmatic children, and inpatient psychiatry patients. Further research is needed to determine the true current burden of toxocariasis in North America; however the prevalence estimates gathered in this review suggest that the burden of disease is significant.
Solar ultraviolet radiation (UVR) is known to be the most important etiological factor in skin cancer development. The main objective of this thesis was to achieve an objective, basic knowledge of the individual UVR exposure dose pattern and to reveal the factors and with which power they influence on the UVR dose among the Danes. Eight open prospective, observational studies and one study analyzing the compliance and reliability of data were performed in healthy Danish volunteers with an age range of 4-68 years. The subjects were chosen to cover an age span group of children, adolescents, and indoor workers and in addition, groups with expected high UVR exposure, sun worshippers, golfers, and gardeners. We developed a personal, electronic UVR dosimeter in a wristwatch (SunSaver). The subjects wore the UVR dosimeter that measured time-stamped UVR doses in standard erythema doses (SED) and completed diaries with data on their sun exposure behaviour. This resulted in corresponding UVR dosimeter and diary data from 346 sun-years where one sun-year is one person participating in one summer half-year (median 119 days). The annual UVR doses were calculated based on the personal and ambient measured UVR doses. We found a huge variation in annual UVR exposure dose within the total population sample, median 173 SED (range, 17-980 SED). The inter-group variation in annual UVR dose was from median 132 SED among indoor workers to median 224 SED among gardeners. No significant correlation was found between annual UVR dose and age either within the total population or among the adults. But the subjects below 20 years of age had an increase in annual UVR dose of 5 SED per year. Young people before the age of 20 years did not get a higher proportion of the lifetime UVR dose than expected (25%) when assuming a life expectancy of 80 years. There was no significant difference in annual UVR dose between males and females in the total population sample. But, among children, girls received a significantly higher UVR dose than boys due to more days with risk behaviour (sunbathing or exposing shoulders outdoors). This exposure pattern, with females having more risk behaviour than males, was also found among adolescents and adults. Sunbathing or exposing shoulders (risk behaviour) outside the beach resulted in a median of 2.5 SED per day in northern Europe and 3.2 SED per day in southern Europe, while the corresponding values were 4.6 SED and 6.9 SED per day at the beach. UVR doses above 10 SED per day were connected with risk behaviour. The subjects had a median of 13 days with risk behaviour (range, 0-93 days). The subjects used sunscreen on a median of five days (range, 0-130 days), but have a median of seven days with risk behaviour without sunscreen applied (range, 0-47 days). They had a median of one sunburn per sun-year (range 0-10). Fifty percent of the UVR dose was received between 12.00 and 15.00. Only the gardeners received the main part of their UVR dose on workdays. Conclusions : - High UVR doses are connected with risk behaviour. Reduction of cumulative lifetime UVR dose could be obtained by minimizing risk behaviour. - Sunburns were highly correlated to risk behaviour. - Use of sunscreen correlated with days "sunbathing with the intention to tan", indicating that sunscreens were used to avoid sunburn during risk behaviour. - Scheduling lunch breaks and other breaks indoors at noon, where ambient UVR peaks, could reduce the occupational UVR exposure significantly. - In the winter-half-year in Denmark. the UVR dose received from solar exposure is negligible and no UVR precautions are needed. This study documented that high subject compliance rate and data reliability could be obtained in long-time UVR dosimeter study as ours by being service minded but persistent, offering dosimeter maintenance service within 24 hours and scrutinizing data for errors and mistakes just after data collection.
OBJECTIVES: The Norwegian Mother and Child Cohort Study (MoBa) aims to provide new insights in a broad variety of diseases. The goal of the study is to understand pathways in disease development, and identify preventive measures. Several designs are suitable for studying genetics in complex diseases like asthma and allergy, in MoBa. METHODS: MoBa is a prospective population based cohort of 100 000 pregnancies, following offspring into adulthood. Enrollment started in 1999, and will be completed in 2008. A biobank with samples from the mother, father and child, together with detailed questionnaires from early pregnancy and childhood constitute the basis of the study. When studying complex diseases like asthma, a design with case-parent triads is useful. Parental effects and interactions between maternal and fetal genes can be detected. Stratifying triads by environmental exposure enables assessment of gene-environment interactions. RESULTS: By July 2006, more than 73,000 pregnancies have been included, with nearly 7,000 siblings and 1,300 pairs of twins enrolled. Biological samples are processed and stored at the biobank. The first children are reaching age seven in 2006. CONCLUSION: The MoBa cohort provides an excellent basis for studying genetic, epigenetic and environmental influences on complex diseases.
Intermittent exposure to UV-radiation at an early age is a known important factor in the aetiology of malignant melanoma. We surveyed data from the Swedish Cancer Registry for melanoma by body site for age and gender cohorts from 1960 to 2004, in an attempt to discern a reflection of major behavioural and societal changes in the relative distribution of melanoma by body site. The study comprised patients with malignant melanoma from the Swedish Cancer Registry, including information on body site of tumour (January 1, 1960 - December 31, 2004). In total, 46,337 malignant melanomas were diagnosed in 44,623 patients. Trends were assessed by incidence per site, and relative site distribution per age group and calendar period, and dividing body sites by exposure type to the sun: head (mostly continuous), trunk (mostly intermittent), and limbs (mixed exposure). Between calendar periods 1960-1964 and 2000-2004 melanomas increased most rapidly on the upper limbs (men 885%, women 1216%) on the trunk (men 729%, women 759%) and on the lower limbs (men 418%, women 289%) in both genders. The incidence increase of head tumors was slower. Across the life span, melanomas of the trunk and lower limbs dominate among patients or= 70 years. Tumors of the trunk formed an increasing proportion of all melanomas during the period studied, particularly in females. The relative shift of melanomas from the head to the trunk with mostly intermittent UV exposure coincides with behavioral and societal changes with regard to sun exposure. This supports the hypothesis of a relationship between intentional exposure to ultraviolet radiation and malignant melanoma.
A brief discussiÃ³n on "the social" approach in nutritional research is presented. The relevance that socioeconomic factors have acquired in recent years for this type of studies, is also discussed. The main purpose of our communication was to identify and validate some socioeconomic and environmental indicators and their association with the nutritional status of preschool children in a Mexican indigenous community (Sierra Norte de Puebla). A total of 89 children below five years of age were studied and classified according to their nutritional status. A socioeconomic questionnaire was applied to their parents. Results revealed ample correlation between the degree of malnutrition of the preschool child and the following indicators: housing conditions, father's main occupation, land tenure, income, etc. It is argued that the analysis of these indicators is relevant, emphasizing the importance that the combination of anthropometrical, food consumption and socioeconomic data have for detecting population groups vulnerable to malnutrition. The obtention of these indicators is therefore highly recommended, but should not imply great obstacles; on the contrary, they should be highly sensitive and easy to detect.
The purposes of this study were to measure household food security and to determine its association with potential predictor variables related to household and community environments, as well as the relationship between household food insecurity and preschool children's nutritional status.
In this cross-sectional study, household food security was measured in a convenience sample of households (n=142) with children aged 2-5 years in Vancouver in March 2004. We assessed the association between environmental predictors and household food security status, adjusted for household income. Indicators of children's nutrition were compared between categories of household food security.
Household food insecurity was associated with indicators of suboptimal health status in preschoolers. After controlling for household income, parents with less access to food of reasonable quality, fewer kitchen appliances and a lower rating of their cooking skills had greater odds of experiencing household food insecurity.
Our study results support the need to test interventions involving collaborative efforts among government, social planners and public health practitioners to remove barriers to food security for families. Multiple measures, including opportunities to gain practical food skills and household resources that enable convenient preparation of nutrient-dense foods, could be examined. Our findings suggest the need for improved selection and quality at existing small stores and an increase in the number of food outlets in low-income neighbourhoods.