Journal of Environmental and Public Health The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Body Mass Index Trajectories among Middle-Aged and Elderly Canadians and Associated Health Outcomes Wed, 27 Jan 2016 12:54:59 +0000 Background. Whether there is heterogeneity in the development of BMI from middle-age onward is still unknown. The primary aim of this study is to analyze long-term obesity and how BMI trajectories are associated with health outcomes in midlife. Methods. Latent Class Growth Modelling was used to capture the changes in BMI over time. In this study, 3070 individuals from the National Population Health Survey (NPHS), aged 40–55 years at baseline, were included. Results. Four BMI trajectory groups, “Normal-Stable” (N-S), “Overweight-Stable” (OV-S), “Obese I-Stable” (OB I-S), and “Obese II-Stable” (OB II-S), were identified. Men, persons of White ancestry, and individuals who had no postsecondary education had higher odds of being in the latter three groups. Moreover, members of the OV-S, OB I-S, and OB II-S groups experienced more asthma, arthritis, hypertension, diabetes, heart disease, cognitive impairment, and reduced self-rated overall health. Individuals in the OB II-S group were at greater risk for back problems, chronic bronchitis or emphysema, and emotional issues when compared to the N-S group. Conclusion. Understanding different BMI trajectories is important in order to identify people who are at the highest risk of developing comorbidities due to obesity and to establish programs to intervene appropriately. Meng Wang, Yanqing Yi, Barbara Roebothan, Jennifer Colbourne, Victor Maddalena, Peizhong Peter Wang, and Guang Sun Copyright © 2016 Meng Wang et al. All rights reserved. Consumption Frequency of Foods Away from Home Linked with Higher Body Mass Index and Lower Fruit and Vegetable Intake among Adults: A Cross-Sectional Study Tue, 26 Jan 2016 06:57:04 +0000 Introduction. Consumption of foods prepared away from home (FAFH) has grown steadily since the 1970s. We examined the relationship between FAFH and body mass index (BMI) and fruit and vegetable (FV) consumption. Methods. Frequency of FAFH, daily FV intake, height and weight, and sociodemographic data were collected using a telephone survey in 2008-2009. Participants included a representative sample of 2,001 adult men and women (mean age years) residing in King County, WA, with an analytical sample of 1,570. Frequency of FAFH was categorized as 0-1, 2–4, or 5+ times per week. BMI was calculated from self-reported height and weight. We examined the relationship between FAFH with FV consumption and BMI using multivariate models. Results. Higher frequency of FAFH was associated with higher BMI, after adjusting for age, income, education, race, smoking, marital status, and physical activity (women: ; men: ). There was a negative association between frequency of FAFH and FV consumption. FAFH frequency was significantly () higher among males than females (43.1% versus 54.0% eating out 0-1 meal per week, resp.). Females reported eating significantly () more FV than males. Conclusion. Among adults, higher frequency of FAFH was related to higher BMI and less FV consumption. Rebecca A. Seguin, Anju Aggarwal, Francoise Vermeylen, and Adam Drewnowski Copyright © 2016 Rebecca A. Seguin et al. All rights reserved. Noise Exposure and Hearing Capabilities of Quarry Workers in Ghana: A Cross-Sectional Study Thu, 21 Jan 2016 11:20:11 +0000 Introduction. Although quarry operations have high economic significance, the effects they cause to the workers in terms of excessive noise production cannot be overlooked. This cross-sectional study assessed the extent of noise exposure and its influence on hearing capabilities among quarry workers in Ashanti region. Methods. The study involved 400 workers randomly selected from five quarries in Ashanti region from April to June 2012. Data was collected using structured questionnaires, physical examination, and audiological assessments. A logistic regression model was fitted to assess independent predictors of hearing loss. Results. All the machines used at the various quarries produced noise that exceeded the minimum threshold with levels ranging from 85.5 dBA to 102.7 dBA. 176 (44%) of study respondents had hearing threshold higher than 25 dBA. 18% and 2% of these were moderately (41–55 dBA) and severely (71–90 dBA) impaired, respectively. Age, duration of work, and use of earplugs independently predicted the development of hearing loss. Use of earplugs showed a protective effect on the development of hearing loss (OR = 0.45; 95% CI = 0.25, 0.84). Conclusion. This study provides empirical evidence on the extent of damage caused to quarry workers as a result of excessive noise exposure. This will support the institution of appropriate protective measures to minimize this threat. Charles Kwame R. Gyamfi, Isaac Amankwaa, Frank Owusu Sekyere, and Daniel Boateng Copyright © 2016 Charles Kwame R. Gyamfi et al. All rights reserved. Compliance with Iron-Folate Supplement and Associated Factors among Antenatal Care Attendant Mothers in Misha District, South Ethiopia: Community Based Cross-Sectional Study Tue, 29 Dec 2015 13:45:00 +0000 Background. In Ethiopia, higher proportions of pregnant women are anemic. Despite the efforts to reduce iron deficiency anemia during pregnancy, only few women took an iron supplement as recommended. Thus, this study aimed to assess compliance with iron-folate supplement and associated factors among antenatal care attendant mothers in Misha district, South Ethiopia. Method. Community based cross-sectional study supported with in-depth interview was conducted from March 1 to March 30, 2015. The sample size was determined using single population proportion to 303. Simple random sampling technique was used to select the study participants. Bivariate and multivariable logistic regression analyses were employed to identify factors associated with compliance to iron-folate supplement. Results. The compliance rate was found to be 39.2%. Mothers knowledge of anemia (AOR = 4.451, 95% CI = ()), knowledge of iron-folate supplement (AOR = 3.509, 95% CI = ()), and counseling on iron-folate supplement (AOR = 4.093, 95% CI = ()) were significantly associated with compliance to iron-folate supplement. Conclusions. Compliance rate of iron-folate supplementation during pregnancy remains very low. This study showed that providing women with clear instructions about iron-folate tablet intake and educating them on the health benefits of the iron-folate tablets can increase compliance with iron-folate supplementation. Abinet Arega Sadore, Lakew Abebe Gebretsadik, and Mamusha Aman Hussen Copyright © 2015 Abinet Arega Sadore et al. All rights reserved. Regional Variation in Human Exposure to Persistent Organic Pollutants in the United States, NHANES Tue, 29 Dec 2015 11:02:57 +0000 We examined serum levels of persistent organic pollutants (POPs) among geographical regions of the United States as defined by the US Census Bureau. National Health and Nutrition Examination Survey (NHANES) data for adults aged 20 years and older are presented for selected survey periods between 1999 and 2010. From NHANES 1999 through 2004, dichlorodiphenyldichloroethylene (DDE) concentration levels were consistently higher among people living in the West than in the Midwest, Northeast, or South. In 2003–2010, perfluorinated compound concentrations tended to be highest in the South. The sum of 35 polychlorinated biphenyls (PCBs) congeners was significantly higher in the Northeast [GM: 189; 95% CI: 173–204 ng/g lipid] than the remaining regions. The regional differences in higher body burdens of exposure to particular POPs could be attributed to a variety of activities, including region-specific patterns of land use and industrial and agricultural chemical applications, as well as different levels of regulatory activity. Wendy A. Wattigney, Elizabeth Irvin-Barnwell, Marian Pavuk, and Angela Ragin-Wilson Copyright © 2015 Wendy A. Wattigney et al. All rights reserved. Pesticide Application among Farmers in the Catchment of Ashaiman Irrigation Scheme of Ghana: Health Implications Mon, 21 Dec 2015 09:05:31 +0000 Pesticide use in modern day agriculture has increased tremendously. Pesticides are used to control pests and weeds, as well as protect crops from postharvest losses; however, their effects on humans and the environment cannot be overstated. This study examined pesticide acquisition, handling, and use among 120 farmers within the catchment of a small urban irrigation scheme. Also, in-depth interviews and focus group discussions were conducted among selected farmers through which further data was collected to augment that of the survey. Twelve types of pesticides, including herbicides, insecticides, and fungicides, were found in use in the study areas. Three main sources of information about pesticides were identified, 43.3% from extension officers, 39.2% from agrochemical dealers, and 10% from colleague farmers. Seventy-five percent (75%) of the respondents purchased the pesticides from agrochemical shops. Out of 74 farmers who were observed spraying pesticides on their farms, only 25.7% wore dresses that covered their whole body but without goggles. About sixty-seven percent (66.7%) of the farmers whose chemical got finished left the containers on their farms or threw them into the bushes around. The frequency of application was influenced by affordability and size of farm, among others. The study recommended that training of farmers on pesticide handling and use should be intensified. Memuna M. Mattah, Precious A. D. Mattah, and Godfred Futagbi Copyright © 2015 Memuna M. Mattah et al. All rights reserved. Assessing Factors Related to Waist Circumference and Obesity: Application of a Latent Variable Model Thu, 03 Dec 2015 09:25:39 +0000 Background. Because the use of BMI (Body Mass Index) alone as a measure of adiposity has been criticized, in the present study our aim was to fit a latent variable model to simultaneously examine the factors that affect waist circumference (continuous outcome) and obesity (binary outcome) among Iranian adults. Methods. Data included 18,990 Iranian individuals aged 20–65 years that are derived from the third National Survey of Noncommunicable Diseases Risk Factors in Iran. Using latent variable model, we estimated the relation of two correlated responses (waist circumference and obesity) with independent variables including age, gender, PR (Place of Residence), PA (physical activity), smoking status, SBP (Systolic Blood Pressure), DBP (Diastolic Blood Pressure), CHOL (cholesterol), FBG (Fasting Blood Glucose), diabetes, and FHD (family history of diabetes). Results. All variables were related to both obesity and waist circumference (WC). Older age, female sex, being an urban resident, physical inactivity, nonsmoking, hypertension, hypercholesterolemia, hyperglycemia, diabetes, and having family history of diabetes were significant risk factors that increased WC and obesity. Conclusions. Findings from this study of Iranian adult settings offer more insights into factors associated with high WC and high prevalence of obesity in this population. Sahar Dalvand, Jalil Koohpayehzadeh, Masoud Karimlou, Fereshteh Asgari, Ali Rafei, Behjat Seifi, Seyed Hassan Niksima, and Enayatollah Bakhshi Copyright © 2015 Sahar Dalvand et al. All rights reserved. Preliminary Study on the Skin Lightening Practice and Health Symptoms among Female Students in Malaysia Thu, 26 Nov 2015 06:06:11 +0000 Many cases of dermatologic complication were reported with the use of skin lightening products. This study assessed the skin lightening practice and health symptoms among female students. Self-administered questionnaire was distributed to 104 female students (56 undergraduates and 48 postgraduates) aged years in Universiti Putra Malaysia. A total of 60.6% () of the female students used skin lightening products (61.9% of undergraduates and 38.1% of postgraduates). Reasonable price (, 55.6%) and ingredients (, 46%) were considered the most important factors in the product selection. Most respondents purchased the product from drugstores (, 61.9%). Twenty-two respondents (34.9%) in this study experienced skin problem from the products they used. Skin peeling (, 12.5%) and acne (, 8.7%) were the most frequent symptoms experienced. Most of the respondents have the perception that lighter skin provides high self-esteem (, 53.8%) and looks beautiful and healthier (, 51.9%). The use of skin lightening products is common among female students in this study and some of these products can cause skin problems such as skin peeling, acne, and itching. Siti Zulaikha Rusmadi, Sharifah Norkhadijah Syed Ismail, and Sarva Mangala Praveena Copyright © 2015 Siti Zulaikha Rusmadi et al. All rights reserved. ZnO-PLLA Nanofiber Nanocomposite for Continuous Flow Mode Purification of Water from Cr(VI) Mon, 23 Nov 2015 16:05:58 +0000 Nanomaterials of ZnO-PLLA nanofibers have been used for the adsorption of Cr(VI) as a prime step for the purification of water. The fabrication and application of the flexible ZnO-PLLA nanofiber nanocomposite as functional materials in this well-developed architecture have been achieved by growing ZnO nanorod arrays by chemical bath deposition on synthesized electrospun poly-L-lactide nanofibers. The nanocomposite material has been tested for the removal and regeneration of Cr(IV) in aqueous solution under a “continuous flow mode” by studying the effects of pH, contact time, and desorption steps. The adsorption of Cr(VI) species in solution was greatly dependent upon pH. SEM micrographs confirmed the successful fabrication of the ZnO-PLLA nanofiber nanocomposite. The adsorption and desorption of Cr(VI) species were more likely due to the electrostatic interaction between ZnO and Cr(VI) ions as a function of pH. The adsorption and desorption experiments utilizing the ZnO-PLLA nanofiber nanocomposite have appeared to be an effective nanocomposite in the removal and regeneration of Cr(VI) species. T. Burks, F. Akthar, M. Saleemi, M. Avila, and Y. Kiros Copyright © 2015 T. Burks et al. All rights reserved. Metals Exposures of Residents Living Near the Akaki River in Addis Ababa, Ethiopia: A Cross-Sectional Study Sun, 22 Nov 2015 10:01:29 +0000 Background. The Akaki River in Ethiopia has been found to contain elevated levels of several metals. Our objectives were to characterize metals exposures of residents living near the Akaki River and to assess metal levels in their drinking water. Methods. In 2011, we conducted a cross-sectional study of 101 households in Akaki-Kality subcity (near the Akaki River) and 50 households in Yeka subcity (distant to the Akaki River). One willing adult in each household provided urine, blood, and drinking water sample. Results. Urinary molybdenum (), tungsten (), lead (), uranium (), and mercury () were higher in Akaki-Kality participants compared to Yeka participants. Participants in both subcities had low urinary iodine; 45% met the World Health Organization (WHO) classification for being at risk of moderate iodine deficiency. In Yeka, 47% of households exceeded the WHO aesthetic-based reference value for manganese; in Akaki-Kality, only 2% of households exceeded this value (). There was no correlation between metals levels in water samples and clinical specimens. Conclusions. Most of the exposures found during this investigation seem unlikely to cause acute health effects based on known toxic thresholds. However, toxicity data for many of these metals are very limited. Ellen Yard, Tesfaye Bayleyegn, Almaz Abebe, Andualem Mekonnen, Matthew Murphy, Kathleen L. Caldwell, Richard Luce, Danielle Rentz Hunt, Kirubel Tesfaye, Moa Abate, Tsigereda Assefa, Firehiwot Abera, Kifle Habte, Feyissa Chala, Lauren Lewis, and Amha Kebede Copyright © 2015 Ellen Yard et al. All rights reserved. An Investigation of Cancer Rates in the Argentia Region, Newfoundland and Labrador: An Ecological Study Sun, 08 Nov 2015 08:35:35 +0000 Background. The Argentia region of Newfoundland and Labrador, Canada, was home to a US naval base during a 40-year period between the 1940s and the 1990s. Activities on the base resulted in contamination of the soil and groundwater in the region with chemicals such as heavy metals and dioxins, and residents have expressed concern about higher rates of cancer in their community. This study investigated the rate of cancer diagnosis that is disproportionately high in the Argentia region. Methods. Cases of cancer diagnosed between 1985 and 2011 were obtained for the Argentia region, two comparison communities, and the province of Newfoundland and Labrador. Crude and age-standardized incidence rates of cancer diagnosis were calculated and compared. The crude incidence rate was adjusted for differences in age demographics using census data, and age-standardized incidence rates were compared. Results. Although the Argentia region had a higher crude rate of cancer diagnosis, the age-standardized incidence rate did not differ significantly from the comparison communities or the provincial average. Argentia has an aging population, which may have influenced the perception of increased cancer diagnosis in the community. Conclusions. We did not detect an increased burden of cancer in the Argentia region. Pauline Duke, Marshall Godwin, Mandy Peach, Jacqueline Fortier, Stephen Bornstein, Sharon Buehler, Farah McCrate, Andrea Pike, Peizhong Peter Wang, and Richard M. Cullen Copyright © 2015 Pauline Duke et al. All rights reserved. Linking Environmental Exposure with Public Health: Dichlorodiphenyltrichloroethane Extracted from Soils and Water of Recently Exposed Communities of Selected Locations in Zambia Thu, 22 Oct 2015 08:24:16 +0000 Background. In 2000, a Zambian private mining company reintroduced the use of dichlorodiphenyltrichloroethane (DDT) to control malaria in two districts. From 2000 to 2010, DDT had been applied in homes without any studies conducted to ascertain its fate in the environment. We aimed to quantify the presence of DDT and its metabolites in the soil and water around communities where it was recently used. Methods. We collected superficial soil and water samples from drinking sources of three study areas. DDT was extracted by QuEChERS method and solid phase extraction for soils and water, respectively. Analysis was by gas chromatography-mass spectrometry. A revalidated method with limits of detection ranging from 0.034 to 0.04 ppb was used. Results. Median levels of total DDT were found at 100.4 (IQR 90.9–110) and 725.4 ng/L (IQR 540–774.5) for soils and water, respectively. No DDT above detection limits was detected in the reference area. These results are clinically significant given the persistent characteristics of DDT. Conclusion. DDT presence in these media suggests possible limitations in the environmental safeguards during IRS. Such occurrence could have potential effects on humans, especially children; hence, there is a need to further examine possible associations between this exposure and humans. Nosiku Sipilanyambe Munyinda, Charles Michelo, and Kwenga Sichilongo Copyright © 2015 Nosiku Sipilanyambe Munyinda et al. All rights reserved. Rules regarding Marijuana and Its Use in Personal Residences: Findings from Marijuana Users and Nonusers Recruited through Social Media Tue, 20 Oct 2015 12:27:00 +0000 Recent changes in policy and social norms related to marijuana use have increased its use and concern about how/where marijuana should be used. We aimed to characterize rules regarding marijuana and its use in homes. We recruited 1,567 US adults aged 18–34 years through Facebook advertisements to complete an online survey assessing marijuana use, social factors, perceptions of marijuana, and rules regarding marijuana and its use in the home, targeting tobacco and marijuana users to ensure the relevance of this topic. Overall, 648 (41.6%) were current marijuana users; 46.0% of participants reported that “marijuana of any type is not allowed in their home or on their property.” Of those allowing marijuana on their property, 6.4% prohibited use of marijuana in their home. Of the remainder, 29.2% prohibited smoking marijuana, and 11.0% prohibited vaping, eating, or drinking marijuana. Correlates of more restrictive rules included younger age, being female, having <Bachelor’s degree, not having parents or people living with them who use marijuana, perceiving use to be less socially acceptable and more harmful, and being a nonuser (’s ). Attitudes and subjective norms regarding marijuana are correlates of allowing marijuana in residential settings. Future work should examine areas of risk regarding household marijuana rules. Carla J. Berg, David B. Buller, Gillian L. Schauer, Michael Windle, Erin Stratton, and Michelle C. Kegler Copyright © 2015 Carla J. Berg et al. All rights reserved. Timing of First Antenatal Care Attendance and Associated Factors among Pregnant Women in Arba Minch Town and Arba Minch District, Gamo Gofa Zone, South Ethiopia Mon, 12 Oct 2015 09:04:13 +0000 Objective. To assess the timing of first antenatal care attendance and associated factors among pregnant women in Arba Minch Town and Arba Minch District, south Ethiopia. Method. Facility based cross-sectional study employing both quantitative and qualitative methods was conducted from February to March, 2014, in Arba Minch Town and Arba Minch District. Data were collected from 409 pregnant women attending antenatal care clinics in nine public health facilities using systematic random sampling. Analysis was done using SPSS version 20. Descriptive statistics and binary and multiple logistic regression analysis were done. Results. The mean (SD±) age of the respondents was 26 ± 5.5 years. The mean gestational age at first antenatal care attendance was 5 ± 1.5 months. This study indicated that pregnant women with low monthly income (AOR = 4.9, CI: 1.71, 14.08), women who did not receive advise on when to start ANC (AOR = 3, CI: 1.48, 6.24), women with household food insecurity (AOR = 4.66, CI: 1.007, 21.59) and women with unplanned pregnancy (AOR = 4.49, CI: 2.16, 9.35) had higher odds of late antenatal care attendance compared with their counterparts. Conclusions. The study showed that majority of the pregnant women attended late for first antenatal care. Hence, providing health education on the timing of antenatal care is important. Feleke Gebremeskel, Yohannes Dibaba, and Bitiya Admassu Copyright © 2015 Feleke Gebremeskel et al. All rights reserved. Are Healthcare Providers Asking about Environmental Exposures? A Community-Based Mixed Methods Study Thu, 08 Oct 2015 13:18:04 +0000 People living near environmental hazards may develop symptoms and health conditions that require specialized monitoring and treatment by healthcare providers. One emerging environmental hazard is coal ash. Coal ash is comprised of small particles containing heavy metals, polycyclic aromatic hydrocarbons, and radioactive elements. The overall purpose of this study was to explore whether healthcare providers ask patients if they live near an environmental hazard like coal ash storage sites and to assess what health conditions prompt a provider inquiry. Focus groups were conducted in 2012 and a cross-sectional survey was administered in 2013. Overall, 61% of survey respondents reported that their healthcare providers never asked if they lived near an environmental hazard. One focus group member stated “No, they don’t ask that. They just always blame stuff on you….” Respondents with asthma and other lung conditions were significantly more likely to be asked by a healthcare provider if they lived near an environmental hazard. Due to the unique exposures from environmental hazards and the low prevalence of patients being asked about environmental hazards, we recommend that healthcare providers take environmental health histories in order to understand patients’ exposures, to monitor symptoms of exposure, and to assist with education about reducing exposure. Kristina M. Zierold and Clara G. Sears Copyright © 2015 Kristina M. Zierold and Clara G. Sears. All rights reserved. Bacteriological and Physical Quality of Locally Packaged Drinking Water in Kampala, Uganda Mon, 05 Oct 2015 14:18:11 +0000 Objective. To assess the bacteriological and physical quality of locally packaged drinking water sold for public consumption. Methods. This was cross-sectional study where a total of 60 samples of bottled water from 10 brands and 30 samples of sachet water from 15 brands purchased randomly were analyzed for bacteriological contamination (total coliform and faecal coliform per 100 mL) using membrane filtrate method and reported in terms of cfu/100 mL. Results. Both bottled water and sachet water were not contaminated with faecal coliform. Majority (70%, 21/30) of the sachet water analyzed exceeded acceptable limits of 0 total coliforms per 100 mL set by WHO and the national drinking water standards. The physical quality (turbidity and pH) of all the packaged water brands analyzed was within the acceptable limits. There was statistically significant difference between the median count of total coliform in both sachet water and bottled water brands (, ). Conclusion. Both bottled water and sachet water were not contaminated with faecal coliforms; majority of sachet water was contaminated with total coliform above acceptable limits. Government and other stakeholders should consider intensifying surveillance activities and enforcing strict hygienic measures in this rapidly expanding industry to improve packaged water quality. Abdullah Ali Halage, Charles Ssemugabo, David K. Ssemwanga, David Musoke, Richard K. Mugambe, David Guwatudde, and John C. Ssempebwa Copyright © 2015 Abdullah Ali Halage et al. All rights reserved. Phenotypic and Molecular Characterisation of Extended-Spectrum Beta-Lactamase Producing Escherichia coli Obtained from Animal Fecal Samples in Ado Ekiti, Nigeria Mon, 31 Aug 2015 11:51:09 +0000 Production of extended-spectrum β-lactamases (ESBLs) producing E. coli in animals and different methods of identifications from Ado Ekiti, Ekiti State, Nigeria, were investigated. Three hundred and fifty fecal samples, collected from apparently healthy cattle and pigs, were cultured and identified following standard procedures. ESBL phenotypic detection was carried out using combination disc test, double disc synergism test, and ESBL brilliance agar screening. Molecular detection of TEM, SHV, and CTX-M genes was carried out using standard molecular method. One hundred and fourteen E. coli isolates were recovered from the 350 samples processed, out of which 72 (63.2%) isolates were positive for ESBLs with multiple resistance to the antibiotics used. Eighty-one (71%) isolates were positive for ESBL by combination disc test, 90 (78.9%) were positive for double disc synergism test, and 93 (81.6%) were positive for ESBL brilliance agar. TEM and CTX-M genes were detected in 48 (42.1%) and 51 (44.7%) isolates, respectively. SHV gene was not detected in any of the isolates while TEM and CTX-M were detected in 33 (28.9%) isolates. This study showed high resistance of E. coli to antibiotics, particularly to the third generation cephalosporins. Regular monitoring and regulated use of antibiotics in livestock should be encouraged. Olugbenga Adekunle Olowe, Olufunmilayo Adewumi, Gbolabo Odewale, Olusola Ojurongbe, and Olusolabomi Jose Adefioye Copyright © 2015 Olugbenga Adekunle Olowe et al. All rights reserved. The Social Determinants of Health in Military Forces of Iran: A Qualitative Study Mon, 24 Aug 2015 07:13:48 +0000 Providing effective health interventions and achieving equity in health need to apply the community-based approaches such as social determinants of health. In the military organizations, these determinants have received less attention from the military health researchers and policymakers. Therefore, this study aimed to identify and explain the social determinants affecting the health of military forces in Iran. This was a qualitative study which was conducted in 2014. The required data were collected through semistructured interviews and analyzed through Conventional Content Analysis. The studied sample consisted of 22 military health experts, policymakers, and senior managers selected using purposeful sampling method with maximum variation sampling. MAXQDA.2007 was used to analyze the collected data. After analyzing the collected data, two main contents, that is, “general social determinants of health” and “military social determinants of health,” with 22 themes and 90 subthemes were identified as the social determinants of military forces’ health. Main themes were religious rule, spirituality promotion policies, international military factors, military command, and so forth. Given the role and importance of social factors determining the military forces’ health, it can be recommended that the military organizations should pay more attention to these determinants in making policies and creating social, economic, and cultural structures for their forces. Mohammadkarim Bahadori, Hormoz Sanaeinasab, Mostafa Ghanei, Ali Mehrabi Tavana, Ramin Ravangard, and Mazyar Karamali Copyright © 2015 Mohammadkarim Bahadori et al. All rights reserved. Organic Compounds Detected in Deciduous Teeth: A Replication Study from Children with Autism in Two Samples Tue, 28 Jul 2015 13:31:52 +0000 Biological samples are an important part of investigating toxic exposures and disease outcomes. However, blood, urine, saliva, or hair can only reflect relatively recent exposures. Alternatively, deciduous teeth have served as a biomarker of early developmental exposure to heavy metals, but little has been done to assess organic toxic exposures such as pesticides, plastics, or medications. The purpose of our study was to determine if organic chemicals previously detected in a sample of typically developing children could be detected in teeth from a sample of children with autism. Eighty-three deciduous teeth from children with autism spectrum disorders (ASD) were chosen from our tooth repository. Organic compounds were assessed using liquid chromatography tandem mass spectrometry and gas chromatography methods. Consistent with a prior report from Camann et al., (2013), we have demonstrated that specific semivolatile organic chemicals relevant to autism etiology can be detected in deciduous teeth. This report provides evidence that teeth can be useful biomarkers of early life exposure for use in epidemiologic case-control studies seeking to identify differential unbiased exposures during development between those with and without specific disorders such as autism. Raymond F. Palmer, Lynne Heilbrun, David Camann, Alice Yau, Stephen Schultz, Viola Elisco, Beatriz Tapia, Noe Garza, and Claudia Miller Copyright © 2015 Raymond F. Palmer et al. All rights reserved. A Survey of Residents’ Perceptions of the Effect of Large-Scale Economic Developments on Perceived Safety, Violence, and Economic Benefits Mon, 27 Jul 2015 06:18:40 +0000 Background. Emerging research highlights the promise of community- and policy-level strategies in preventing youth violence. Large-scale economic developments, such as sports and entertainment arenas and casinos, may improve the living conditions, economics, public health, and overall wellbeing of area residents and may influence rates of violence within communities. Objective. To assess the effect of community economic development efforts on neighborhood residents’ perceptions on violence, safety, and economic benefits. Methods. Telephone survey in 2011 using a listed sample of randomly selected numbers in six Pittsburgh neighborhoods. Descriptive analyses examined measures of perceived violence and safety and economic benefit. Responses were compared across neighborhoods using chi-square tests for multiple comparisons. Survey results were compared to census and police data. Results. Residents in neighborhoods with the large-scale economic developments reported more casino-specific and arena-specific economic benefits. However, 42% of participants in the neighborhood with the entertainment arena felt there was an increase in crime, and 29% of respondents from the neighborhood with the casino felt there was an increase. In contrast, crime decreased in both neighborhoods. Conclusions. Large-scale economic developments have a direct influence on the perception of violence, despite actual violence rates. Anthony Fabio, Ruth Geller, Michael Bazaco, Todd M. Bear, Abigail L. Foulds, Jessica Duell, and Ravi Sharma Copyright © 2015 Anthony Fabio et al. All rights reserved. Coal Mine Air Pollution and Number of Children Hospitalizations because of Respiratory Tract Infection: A Time Series Analysis Sun, 12 Jul 2015 12:30:36 +0000 To analyze the relationship between levels of air pollution and number of children hospitalizations because of respiratory tract infection in Shenmu County, the data regarding meteorological factors, environmental pollutants, that is SO2 and NO2, Particulate Matter 10 (PM10), and hospitalizations of children less than 16 years of age was collected during the time duration of November 2009 to October 2012. Using SAS 9.3, descriptive data analysis for meteorological and environmental factors and hospital admissions were performed along with main air pollutants determination. Using the statistical software R 3.0.1, a generalized additive Poisson regression model was established, the linear fitting models of the air pollutant concentrations and meteorological factors were introduced considering the lag effect, and the relative risk of the main atmospheric pollutants on children hospitalization was evaluated. The results showed that the primary air pollutant in Shenmu County is PM10 and its Pearson correlation coefficient with Air Pollution Index (API) is 0.917. After control of long term climate trend, “week day effect,” meteorological factors, and impact of other contaminants, it was found that, on the same day and during the lag of 1 to 10 days, PM10 concentrations had no significant effect on children hospitalization rate. Yonglin Liu, Juan Liu, Fenglian Chen, Shamsi Bilal Haider, Qiang Wang, Fuyong Jiao, Yanmei Qiao, and Yanhua Shi Copyright © 2015 Yonglin Liu et al. All rights reserved. Impacting Environmental and Public Health through the Use of Dual Targeted and Tailored Asthma Educational Interventions Thu, 09 Jul 2015 12:19:14 +0000 Home-based asthma environmental education for parents of asthmatic children is needed since many health professionals lack the time to offer it. However, developing targeted and tailored education is important in order to address the individual needs of participants. This nonrandomized longitudinal study examined knowledge on asthma with an Asthma and Healthy Homes educational intervention training offered to parents of children from low income families who reside in the Rio Grande Valley of Texas. Eighty-nine parents received the training and pre- and posttest surveys were used to measure knowledge outcomes. A standardized assessment on asthma triggers was used to identify the different triggers each child was exposed to, and a follow-up survey was conducted 6 months after the educational intervention to identify how many parents reported household and behavior changes as a result of the training. Results showed significant changes in behavior by participants as a result of the training received. This study suggests that these behavioral changes are attributed to the dual “targeted” and “tailored” educational interventions delivered to parents which resulted in a greater understanding of how to manage asthma by eliminating asthma triggers in their respective homes. Genny Carrillo, Daikwon Han, Rose L. Lucio, Yoon-Ho Seol, Betty Chong-Menard, and Kenneth Smith Copyright © 2015 Genny Carrillo et al. All rights reserved. Impact of Coal Mining on Self-Rated Health among Appalachian Residents Thu, 09 Jul 2015 11:00:22 +0000 Objective. To determine the impact of coal mining, measured as the number of coal mining-related facilities nearby one’s residence or employment in an occupation directly related to coal mining, on self-rated health in Appalachia. Methods. Unadjusted and adjusted ordinal logistic regression models calculated odds ratio estimates and associated 95% confidence intervals for the probability of having an excellent self-rated health response versus another response. Covariates considered in the analyses included number of coal mining-related facilities nearby one’s residence and employment in an occupation directly related to coal mining, as well as potential confounders age, sex, BMI, smoking status, income, and education. Results. The number of coal mining facilities near the respondent’s residence was not a statistically significant predictor of self-rated health. Employment in a coal-related occupation was a statistically significant predictor of self-rated health univariably; however, after adjusting for potential confounders, it was no longer a significant predictor. Conclusions. Self-rated health does not seem to be associated with residential proximity to coal mining facilities or employment in the coal industry. Future research should consider additional measures for the impact of coal mining. Shannon M. Woolley, Ada O. Youk, Todd M. Bear, Lauren C. Balmert, Evelyn O. Talbott, and Jeanine M. Buchanich Copyright © 2015 Shannon M. Woolley et al. All rights reserved. Exposure Perception as a Key Indicator of Risk Perception and Acceptance of Sources of Radio Frequency Electromagnetic Fields Wed, 01 Jul 2015 11:32:59 +0000 The presented survey was conducted in six European countries as an online study. A total of 2454 subjects participated. Two main research questions were investigated: firstly, how does the cognitive, moral, and affective framing of radio frequency electromagnetic field (RF EMF) exposure perception influence RF EMF risk perception? Secondly, can the deployment of mobile phone base stations have greater acceptance with RF EMF exposure reduction? The findings with respect to the first question clearly indicated that the cognitive framed exposure perception is the main determinant of RF EMF risk perception. The concomitant sensitivity to exposure strength offers an opportunity to improve the acceptance of base stations by exposure reduction. A linear regression analysis supported this assumption: in a fictional test situation, exposure reduction improved the acceptance of base stations, operationalized as the requested distance of the base station from one’s own home. Furthermore, subjects with high RF EMF risk perception were most sensitive to exposure reduction. On average, a 70% exposure reduction reduced the requested distance from about 2000 meters to 1000 meters. The consequences for risk communication are discussed. Frederik Freudenstein, Peter M. Wiedemann, and Tim W. C. Brown Copyright © 2015 Frederik Freudenstein et al. All rights reserved. Air Quality and Respiratory Health among Adolescents from the United Arab Emirates Sun, 17 May 2015 11:44:18 +0000 Purpose. To examine the role of air quality in relation to chronic bronchitis, emphysema, asthma, wheeze, and dry cough among adolescents from the United Arab Emirates (UAE). Methods. A survey was administered on 6,363 adolescents from 9 UAE regions. Data consists of demographic, socioeconomic, residential, and behavioural variables, such as location of residence, residing near industry/gas stations/dumpsites/construction sites, residing near overhead power line/plants, exposure to tobacco, residential exposure, ethnicity, concern over air pollution, smoking, and purposely smelling gasoline fumes/glue/correctors/car exhaust/burning black ants. Logistic regression modeling was used to determine significant predictors of respiratory health. Results. Asthma prevalence was 12.3%, followed by chronic bronchitis (1.8%) and emphysema (0.5%). Overall 12.2% reported wheeze and 34.8% reported a dry nocturnal cough in the past year. Multivariate analyses suggest that sex is a significant predictor of asthma and dry cough. Exposure to tobacco and arts/crafts/ceramics/stain is significant predictor of respiratory health. Tobacco smoking and purposely smelling gasoline fumes/glue/correctors/car exhaust/burning black ants are significant predictors of wheeze and dry cough. Conclusions. This study suggests that exposure to air quality and behavioral factors such as smoking and purposely smelling gasoline fumes, glue, correctors, car exhaust, or burning black ants are significant predictors of respiratory health among UAE adolescents. Caroline Barakat-Haddad, Sheng Zhang, Ayesha Siddiqua, and Rania Dghaim Copyright © 2015 Caroline Barakat-Haddad et al. All rights reserved. Epidemiologic Study of Blastocystis Infection in an Urban Community in the Philippines Wed, 13 May 2015 09:17:57 +0000 Blastocystis has been considered as the most common intestinal parasite in humans and has an augmented impact on public health. However, the prevalence of this parasite in the Philippines has not been determined. To contribute to a better understanding of the epidemiology of this infection, a cross-sectional study aimed at providing the first documented data on the prevalence and correlates, sociodemographic factors, hygiene practices, source of water supply, and dog ownership, associated with Blastocystis infection was carried out in randomly selected communities at Pateros, Metro Manila. Fecal samples from respondents were collected and cultured in diphasic agar medium for 3–7 days and examined using light microscopy. Of the 1,271 respondents, 12.98% (95% CI: 11.13–14.83) were detected positive for Blastocystis. Among the correlates of Blastocystis infection, dog ownership was found significantly associated as confirmed by multivariate analysis. Therefore, this factor should be considered in information to create awareness about Blastocystis and to prevent and control Blastocystis infection in particular and diarrheal diseases in general. Further studies using molecular approaches to distinguish subtype and to determine genetic characteristics of isolates from humans and dogs are recommended to analyze their relationship and provide more conclusive evidence of cross-transmission. Maria Luz B. Belleza, Jessa Louise C. Cadacio, Maridel P. Borja, Juan Antonio A. Solon, Mildred A. Padilla, Pilarita N. Tongol-Rivera, and Windell L. Rivera Copyright © 2015 Maria Luz B. Belleza et al. All rights reserved. Phenotypic Detection of Genitourinary Candidiasis among Sexually Transmitted Disease Clinic Attendees in Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria Wed, 06 May 2015 08:58:38 +0000 The management of genitourinary candidiasis (GC) is fraught with challenges, especially, in an era of increasing antifungal resistance. This descriptive cross-sectional study conducted between May 2013 and January 2014 determined the prevalence and characteristics of GC and the species of Candida among 369 attendees of a Sexually Transmitted Disease (STD) clinic of Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria. Appropriate urogenital specimen collected from each attendee was examined by microscopy and culture for Candida, with preliminary species identification by CHROMAgar Candida and confirmation by Analytical Profile Index (API) 20C AUX. The age range of attendees was 1-80 years, mean age was years, and male to female ratio was 1 to 3. The prevalence of genitourinary candidiasis was 47.4%, with 4.9% in males and 42.5% in females (). The age groups 31–45 and 16–30 have the highest prevalence of 23.3% and 16.8%, respectively. The species of Candida recovered include Candida glabrata 46.9%, Candida albicans 33.7%, Candida dubliniensis 9.7%, Candida tropicalis 5.7%, Candida krusei 1.7%, Candida lusitaniae 1.7%, and Candida utilis 0.6%. This study reported non-C. albicans Candida, especially C. glabrata, as the most frequently isolated species in GC, contrary to previous studies in this environment and elsewhere. Oluranti J. Obisesan, Olugbenga A. Olowe, and Samuel S. Taiwo Copyright © 2015 Oluranti J. Obisesan et al. All rights reserved. Prevalence of Upper Extremity Musculoskeletal Disorders in Dentists: Symptoms and Risk Factors Sun, 03 May 2015 12:08:46 +0000 Aim. The purpose of the present research was to examine the factors that lead to musculoskeletal disorders in dentists by assessing their posture using RULA method. Materials and Methods. In this cross-sectional study, 130 dentists (84 male and 46 female) participated. The posture of the subjects during their normal workload was recorded by using the RULA method, and the range of musculoskeletal pains by using the Nordic Musculoskeletal Questionnaire (NMQ), and individual and professional data was assessed by a demographics questionnaire. All tests were performed at the level. Results. Assessment of the physical status of the subjects showed that 82.8% of subjects were at high risk of musculoskeletal disorders. The majority of musculoskeletal pains were in the neck (55.9%) and the shoulder (43.8%). Moreover, 68.9% of the subjects had experienced pain at least once over the last year. Significant relationships were observed between musculoskeletal pain and daily work hours and number of patients , but the pain was not significantly associated with BMI and experience. Conclusion. The present findings showed that unsuitable posture of dentists during work has a considerable effect on musculoskeletal disorders. Therefore, further investigation is required to avoid the detrimental effects of wrong posture. Forouzan Rafie, Azadeh Zamani Jam, Arash Shahravan, Maryam Raoof, and Ali Eskandarizadeh Copyright © 2015 Forouzan Rafie et al. All rights reserved. Slum Sanitation and the Social Determinants of Women’s Health in Nairobi, Kenya Tue, 28 Apr 2015 12:45:05 +0000 Inadequate urban sanitation disproportionately impacts the social determinants of women’s health in informal settlements or slums. The impacts on women’s health include infectious and chronic illnesses, violence, food contamination and malnutrition, economic and educational attainment, and indignity. We used household survey data to report on self-rated health and sociodemographic, housing, and infrastructure conditions in the Mathare informal settlement in Nairobi, Kenya. We combined quantitative survey and mapping data with qualitative focus group information to better understand the relationships between environmental sanitation and the social determinants of women and girls’ health in the Mathare slum. We find that an average of eighty-five households in Mathare share one toilet, only 15% of households have access to a private toilet, and the average distance to a public toilet is over 52 meters. Eighty-three percent of households without a private toilet report poor health. Mathare women report violence (68%), respiratory illness/cough (46%), diabetes (33%), and diarrhea (30%) as the most frequent physical burdens. Inadequate, unsafe, and unhygienic sanitation results in multiple and overlapping health, economic, and social impacts that disproportionately impact women and girls living in urban informal settlements. Jason Corburn and Chantal Hildebrand Copyright © 2015 Jason Corburn and Chantal Hildebrand. All rights reserved. An Exploratory Analysis of Public Awareness and Perception of Ionizing Radiation and Guide to Public Health Practice in Vermont Tue, 28 Apr 2015 09:48:06 +0000 Exposure to ionizing radiation has potential for acute and chronic health effects. Within the general public of the United States, there may be a discrepancy between perceived and actual health risks. In conjunction with the Vermont Department of Health, a survey designed to assess public perception and knowledge of ionizing radiation was administered at 6 Vermont locations . Descriptive and inferential statistical analyses were conducted. Eighty percent of respondents underestimated the contribution of medical imaging tests to total ionizing radiation exposure. Although only thirty-nine percent of participants were confident in their healthcare professional’s knowledge of ionizing radiation, most would prefer to receive information from their healthcare professional. Only one-third of individuals who received a medical imaging test in the past year were educated by their healthcare professional about the risks of these tests. Those who tested their home for radon were twice as likely to choose radon as the greatest ionizing radiation risk to self. Although respondents had an above-average education level, there were many misperceptions of actual risks of exposure to ionizing radiation, particularly of medical imaging tests. Educating healthcare professionals would therefore have a profound and positive impact on public understanding of ionizing radiation. Katherine M. Evans, Jenna Bodmer, Bryce Edwards, James Levins, Amanda O’Meara, Merima Ruhotina, Richard Smith, Thomas Delaney, Razelle Hoffman-Contois, Linda Boccuzzo, Heidi Hales, and Jan K. Carney Copyright © 2015 Katherine M. Evans et al. All rights reserved.