For the solution of ecological problems in the framework of the preparation of the municipal ecological program in the city of Verkhnyaya Pyshma (Sverdlovskaya Oblast) there was peiformed the assessment of the state of population health, the evaluation of carcinogenic and non-carcinogenic health risk from chemicals that pollute the air and drinking water Atmospheric air was established to be the main environment cause for carcinogenic and non-carcinogenic risks. The obtained results served as the basis for the development of technological, sanitary and hygienical measures of the program aimed at optimizing of the population health.
Currently, due to the increase in motorization, the problem of environmental pollution by emissions of objects of auto-road complex is becoming more and more important not only for cities, butfor dynamically developing regional cities. The negative impact is characterized by the increase of the morbidity rate of environmentally-dependent diseases, primarily respiratory diseases, neoplasms. This exposure is most pronounced near the motorways, at the gas station, and also spreads to residential areas, which requires the optimization of protective and preventive measures. Presented article is devoted to the characterization of air pollution of various areas in the city of Surgut due to emission of sources of auto-road complex with the assessment of public health risks.
In the article there are considered the main problems of assessing public health risks of the combined effects of high temperatures and air pollution with the account taken of the consequences of abnormally hot weather observed in summer 2010 in Moscow and without equals in the history of meteorological measurements in the city. The daily average concentrations of fine suspended particles matter (PM10) in the city during peatland fires from 4 to 9 August are emphasized to be within the range of 431-906 µ/m3, being 7.2-15.1 times the Russian maximum permissible concentration (MPCs) (60 µ/m3). The anomalous heat and high levels of air pollution in this period were shown to cause a significant increase in excess mortality among the population of Moscow. There was established the relative gain in mortality from all natural causes per 10 µg/m3 increase in daily average concentrations of PM10 and ozone, which was respectively: 0.47% (95%; CI: 0.31-0.63) and 0.41% (95%; CI: 0.31-1.13). On the base of the statistical analysis of daily mortality rates, meteorological indices, the concentrations of PM10 and ozone there was developed marking scale for the risk assessment of these indices accordingly to 4 gradings--low (permissible), warning, alert, and a hazard level. There has been substantiated the importance of the introduction of the system for the early alert for hazard weather events and the unified rating scale for the hazard of high air temperatures and high levels of air pollution with PM10 and ozone, which allows to take timely measures for the protection of the public health.
The negative impact of urbanization on public health is obvious. However; due to the comprehensiveness and polymorphicity of its manifestations there are not established criteria for them. Health risk methodology allows, in principle, to obtain quantitative indices of the separate results of the impact on the health status of the citizens of metropolis that can be extremely effective in this area. The total cross-media riskfrom traffic pollution, drinking water quality, open ponds, noise, etc. permits to use of hygiene criteria in urban planning, insurance, taxation, etc.
In recent years, there has been escalating concern over the possible association between exposure to pesticides and adverse human health effects by a number of non-governmental organizations, professional and public interest groups. Recognizing the need to document the scientific basis of these concerns as a foundation for initiating a research theme devoted to linkages between exposures to pesticides and human health effects, the Canadian Institutes of Health Research (CIHR) requested a summary of recent research trends that address these linkages. Experts across Canada in the field of pesticide regulation and research were invited to participate in the review. The review summarizes the limitations of past and current studies related to pesticides and human health effects research and makes suggestions for future research priorities and proposed study designs that will improve the assessment of pesticide exposure, the associated health risks, and improved methodology for regulatory decision making.
The aim of this survey was to study the ecological state in the Kurgan Region in the period of 1993 to 2003. The survey showed the west and northwest part of the Kurgan Region to be areas at risk for environment-dependent diseases. The major risk factors included a high pollution of water sources with limited water resources due to the radioactive pollution occurring in the 1940s to the 1950s in some areas of the region; transformation of natural landscapes caused by spring floods and soil erosions among other things.
Effective management of contaminated sediments is important for long-term human and environmental health, but site-management decisions are often made under high uncertainty and without the help of structured decision support tools. Potential trade-offs between remedial costs, environmental effects, human health risks, and societal benefits, as well as fundamental differences in stakeholder priorities, complicate decision making. Formal decision-analytic tools such as multicriteria decision analysis (MCDA) move beyond ad hoc decision support to quantitatively and holistically rank management alternatives and add transparency and replicability to the evaluation process. However, even the best decisions made under uncertainty may be found suboptimal in hindsight, once additional scientific, social, economic, or other details become known. Value of information (VoI) analysis extends MCDA by systematically evaluating the impact of uncertainty on a decision. VoI prioritizes future research in terms of expected decision relevance by helping decision makers estimate the likelihood that additional information will improve decision confidence or change their selection of a management plan. In this study, VoI analysis evaluates uncertainty, estimates decision confidence, and prioritizes research to inform selection of a sediment capping strategy for the dibenzo-p-dioxin and -furan contaminated Grenland fjord system in southern Norway. The VoI model extends stochastic MCDA to model decisions with and without simulated new information and compares decision confidence across scenarios with different degrees of remaining uncertainty. Results highlight opportunities for decision makers to benefit from additional information by anticipating the improved decision confidence (or lack thereof) expected from reducing uncertainties for each criterion or combination of criteria. This case study demonstrates the usefulness of VoI analysis for environmental decisions by predicting when decisions can be made confidently, for prioritizing areas of research to pursue to improve decision confidence, and for differentiating between decision-relevant and decision-irrelevant differences in evaluation perspectives, all of which help guide meaningful deliberation toward effective consensus solutions.
Exposure to methylmercury (MeHg) from fish and marine mammal consumption continues to present a public health concern. To date, developmental neurotoxicity is the most sensitive health outcome, forming the basis for health-risk assessments and the derivation of biomonitoring guidance values. This article summarizes existing Health Canada MeHg blood guidance values for general population and expands them to include a harmonized provisional interim blood guidance value of 8 microg/L based on the existing provisional Tolerable Daily Intake for children, pregnant women and women of childbearing age. Associated public health actions, according to age, sex, and level of exposure are recommended.
This study investigated the public health risk from exposure to infectious microorganisms at Sandvika recreational beaches, Norway and dose-response relationships by combining hydrodynamic modelling with Quantitative Microbial Risk Assessment (QMRA). Meteorological and hydrological data were collected to produce a calibrated hydrodynamic model using Escherichia coli as an indicator of faecal contamination. Based on average concentrations of reference pathogens (norovirus, Campylobacter, Salmonella, Giardia and Cryptosporidium) relative to E. coli in Norwegian sewage from previous studies, the hydrodynamic model was used for simulating the concentrations of pathogens at the local beaches during and after a heavy rainfall event, using three different decay rates. The simulated concentrations were used as input for QMRA and the public health risk was estimated as probability of infection from a single exposure of bathers during the three consecutive days after the rainfall event. The level of risk on the first day after the rainfall event was acceptable for the bacterial and parasitic reference pathogens, but high for the viral reference pathogen at all beaches, and severe at Kalvøya-small and Kalvøya-big beaches, supporting the advice of avoiding swimming in the day(s) after heavy rainfall. The study demonstrates the potential of combining discharge-based hydrodynamic modelling with QMRA in the context of bathing water as a tool to evaluate public health risk and support beach management decisions.
Climate change is the primary threat to public health in the 21st century. There is a huge need for creation of new knowledge on how most effectively and efficiently to respond to the negative effects on health. Participatory research and development projects may be essential in creation and dissemination of new knowledge. Theoretically underpinned interventions and implementation strategies are necessary to ensure that knowledge is translated into action. Universities and health care organisations have a central role in preparing future health professionals by giving them the skills and knowledge needed.
The literature on the association between health and weather in the temperate to semi-arid cities of the Eastern Mediterranean is scarce. The quantification of the relationship between temperature and daily mortality can be useful for developing policy interventions such as heat-warning systems. A time-series analysis of total daily mortality and weather data for the city of Beirut was carried out. The study covered the period between 1997 and 1999. Poisson auto-regressive models were constructed, with mean daily temperature and mean daily humidity as explanatory variables. Delayed effects, up to 2 weeks, were accounted for. The regression models were used next to assess the effect of an average increase in temperature on yearly mortality. The association between temperature and mortality was found to be significant. A relatively high minimum-mortality temperature (TMM) of 27.5 degrees C was calculated. A 1 degrees C rise in temperature yielded a 12.3% increase (95% confidence interval: 5.7-19.4%) and 2.9% decrease (95% confidence interval: 2-3.7%) in mortality, above and below TMM, respectively. Lag temperature variables were found to be significant below TMM but not above it. Where the temperature change was less than 0.5 degrees C, annual above-TMM losses were offset by below-TMM gains, within a 95% confidence interval. TMM for Beirut fell within the range usually associated with warm climates. However, the mild below-TMM and steep above-TMM slopes were more typical of cities with temperate to cold climates. Our findings suggest that heat-related mortality at moderately high temperatures can be a significant public health issue in countries with warm climates. Moreover, at the projected climate change over the next 50 years, heat-related losses are unlikely to be offset by cold-related gains.
Strategic environmental assessment (SEA) of sewage sludge management in a Danish municipality (Aalborg), with 160,000 inhabitants using alternative methods for aggregation of environmental impacts was performed. The purpose is to demonstrate the use of SEA in relation to sludge management and to improve SEA methodology. Six different scenarios for management of sewage sludge within the Aalborg municipality involving thermal treatment, composting and landfilling of sludge were evaluated. Environmental impact categories considered were global warming, non-renewable resources (nutrients and fossil fuels) and land use. Impact categories human health, ecotoxicity and soil quality were excluded as methodology for their assessment is not yet fully developed. Thermal sludge treatment with energy utilisation was shown to be a promising option for sewage sludge management in Aalborg. Sensitivity of the relative environmental impacts with respect to calculation methodology and input parameter values were evaluated to identify important parameters and calculation methods. The analysis showed that aggregation procedures, sludge biogas potential and sludge production were very important whereas sludge transport was not.
A failure in treatment or in the distribution network of a surface water-works could have serious consequences due to the variable raw water quality in combination with an extended distribution. The aim of this study was to examine the theoretical impact of incidents in the drinking water system on the annual risk of infection in a population served by a large water treatment plant in Sweden. Reported incidents in the system were examined and a microbial risk assessment that included three pathogens, Cryptosporidium parvum, rotavirus and Campylobacter jejuni, was performed. The main risk incidents in water treatment were associated with sub-optimal particle removal or disinfection malfunction. Incidents in the distribution network included cross-connections and microbial pollution of reservoirs and local networks. The majority of the annual infections were likely to be due to pathogens passing treatment during normal operation and not due to failures, thus adding to the endemic rate. Among the model organisms, rotavirus caused the largest number of infections. Decentralised water treatment with membranes was also considered in which failures upstream fine-pored membranes would have little impact as long as the membranes were kept intact.
To contrast the population and clinical approaches to stroke prevention and to review Canadian data relevant to estimating disease burden, assessing risk factors, designing preventive strategies and organizing health services.
A narrative review of the published literature and statistical data accessible through the Internet.
Unlike the clinical approach, which emphasizes individual patients at high risk diagnosed and treated intensively, usually by medical or surgical means (or both), a population approach focuses on the entire population and bases interventions on behavioural and environmental changes. Stroke offers a particularly promising target for prevention. It represents a leading cause of serious disability, death and reduced quality of life. The aging of our population threatens to increase the already considerable burden. Stroke shares several risk factors with other chronic diseases, especially ischemic heart disease. These risk factors vary in their impact on Canadians (population attributable risk proportion), which is a function of their prevalence and strength of association with the occurrence of stroke. Although effective preventive measures are available for people at high risk, they are not being applied systematically among potential beneficiaries. Small reductions in the exposure to risk factors in the entire population offer an alternative, where even modest success may translate into major gain.
The clinical and population approaches to stroke prevention are complementary. Existing national strategies directed at promotion of healthy life-styles (especially physical activity) and hypertension control, when fully implemented, will reduce the frequency, severity and impact of stroke on Canadian society.
This paper explores the relation between healthcare expenditures (HCEs) and environmental variables in Ontario, Canada.
The authors used a sequential two stage regression model to control for variables that may influence HCEs and for the possibility of endogenous relations. The analysis relies on cross sectional ecological data from the 49 counties of Ontario.
The results show that, after control for other variables that may influence health expenditures, both total toxic pollution output and per capita municipal environmental expenditures have significant associations with health expenditures. Counties with higher pollution output tend to have higher per capita HCEs, while those that spend more on defending environmental quality have lower expenditures on health care.
The implications of our findings are twofold. Firstly, sound investments in public health and environmental protection have external benefits in the form of reduced HCEs. Combined with the other benefits such as recreational values, investments in environmental protection probably yield net social benefits. Secondly, health policy that excludes consideration of environmental quality may eventually result in increased expenditures. These results suggest a need to broaden the cost containment debate to ensure environmental determinants of health receive attention as potential complements to conventional cost control policies.
Cites: Soc Sci Med. 1991;33(4):489-5001948163
Cites: Soc Sci Med. 1990;31(12):1347-632126895
Cites: CMAJ. 1992 Sep 1;147(5):617-231521207
Cites: J Health Econ. 1992 Aug;11(2):173-8110122977
Cites: Milbank Q. 1993;71(2):279-3228510603
Cites: Can J Public Health. 1993 Mar-Apr;84(2):112-78334602
Cites: JAMA. 1994 Feb 9;271(6):431-78295317
Cites: Environ Health Perspect. 1993 Oct;101(5):378-848080506
Cites: Environ Res. 1994 May;65(2):172-948187735
Cites: Am J Public Health. 1994 Jun;84(6):932-78203689
Cites: Int J Health Serv. 1994;24(2):189-2008034389
Cites: Health Aff (Millwood). 1994 Fall;13(4):88-997989013
Cites: Am J Epidemiol. 1995 Jul 1;142(1):15-227785669
Cites: Am J Community Psychol. 1994 Dec;22(6):745-657639201
Cites: BMJ. 1995 Nov 11;311(7015):1264-97496235
Cites: J Health Econ. 1996 Feb;15(1):127-3710157426
Cites: Health Aff (Millwood). 1996 Summer;15(2):216-348690378
Cites: CMAJ. 1997 Mar 15;156(6):817-239084388
Cites: Milbank Q. 1997;75(3):343-649290633
Cites: J Health Econ. 1998 Apr;17(2):211-2810180916
Cites: Soc Sci Med. 1998 Jul;47(1):33-499683377
Cites: Health Place. 1997 Mar;3(1):1-1310670960
Cites: Health Policy. 2000 Jun;52(2):87-11210794839
Cites: Am J Epidemiol. 2001 Jun 1;153(11):1050-511390322
Faculté de Médecine, CRCHUM (Centre de Recherche du Centre Hospitalier de l'Université de Montréal), Department of Social & Preventive Medicine, Université de Montréal, Montréal, Québec, Canada. firstname.lastname@example.org
To examine the combined influence of poverty and dangerousness of the neighborhood on active transportation (AT) to school among a cohort of children followed throughout the early school years.
Growth curve modeling was used to identify determinants of AT to school among 710 children participating in the Quebec Longitudinal Study of Child Development from 2003 through 2006. Parent-reported dangerousness and pedestrian-vehicle collision data were merged with travel mode and health data.
At age 6 years, insufficient household income, having an older sibling, and living in a neighborhood that is not excellent for raising children, or characterized with high decay were predictive of greater likelihood of using AT and remained unchanged as children progressed from kindergarten through grade 2.
A public health concern is children experiencing environmental injustice. Since AT is most likely to be adopted by those living in poverty and because it is also associated with unsafe environments, some children are experiencing environmental injustice in relation to AT. Interventions may be implemented to reduce environmental injustice through improvements in road safety.
The programming concept suggests that poor early nutrition causes an array of medical problems later in life. Public health messages about the implications of programming may not be reaching parents and influencing infant feeding behaviors.
The views of new mothers were sought about the extent to which lifelong health is influenced by diet as an infant, rather than by genetic predispositions or lifestyles and behaviors.
A questionnaire survey of first-time mothers was undertaken in 5 European countries.
A convenience sample of 2071 mothers from England (438), Finland (426), Germany (414), Hungary (389), and Spain (404) self-completed the questionnaire. High proportions of mothers agreed that how an infant is fed affects his or her health over the first year (95.8%) and in subsequent years (88.5%), but the effect of infant feeding decisions on the development of long-term conditions was the least-cited underlying reason. Diet as an infant was rated an extremely/very important influence on adult health by 64% of mothers, equivalent to environmental pollution (63%), but by fewer mothers than were diet and physical activity in childhood/adolescence (79%, 84%) and adulthood (81%, 83%), genetics/inheritance (70%), and exposure to cigarette smoke (81%). Inter- and intracountry differences were observed.
Mothers in this study consider diet as an infant to be a less important influence on lifelong health than many lifestyle, behavioral, and environmental factors and genetics. Further dissemination of the implications of programming to consumers may be warranted.