Exposure assessment as a component of observational health studies and environmental risk assessment

Assessing pesticide and nonpesticide exposures in agricultural settings is a daunting task. This is especially the case when such assessments are undertaken as a component of health studies to evaluate cancer risk. In this review, key exposure assessment issues are outlined and discussed in the context of pesticide-specific health risk assessments and three recent studies of large, geographically defined farmer and farm family populations. The specific topics addressed include the assessment of cumulative exposures to both older and more recently registered pesticides, the role of biomarker studies in exposure assessment, and uses of data on nonroutine high-exposure events.     

Cardiovascular risk factors and the neighbourhood environment: a multilevel analysis

BACKGROUND: This article examines whether the neighbourhood environment influences intermediate cardiovascular disease (CVD) risk factors, such as obesity (body mass index [BMI]), and lifestyle factors, such as no physical activity and smoking, when adjusted for the individual socioeconomic status (SES). METHODS: The study consists of face-to-face interviews from the Swedish Annual Level of Living Survey (SALLS) matched with the social status of the respondents' residential areas measured by two composite indices, the Care Need Index (CNI) and the Townsend score. The response rate was about 80%. This study was limited to the residents aged 25-74 years and consists of 9240 interviews from the years 1988-1989, when there were extended items in the SALLS about health and lifestyle. The data were analysed using a hierarchical logistic regression model. RESULTS: There was a gradient within every SES group so that respondents with a low (or intermediate or high) educational level exhibited an increasing proportion of daily smokers, physically inactive people and obese individuals with increasing neighbourhood deprivation. The multilevel model showed that respondents living in the most deprived neighbourhoods had an increased risk for being a daily smoker, engaging in no physical activity and being obese when adjusted for the individual SES. CONCLUSIONS: We showed that the area level has an important influence on risk factors for CVD which goes beyond the individual educational attainment. An increased level of living standard, more resources for primary health care and health promotion targeting the community level should be beneficial.     

Health maintenance organizations: improvements in the regulatory environment

Health maintenance organizations (HMOs) can help slow rising health care costs. State regulatory statutes are needed that will protect critical interests of HMO members while freeing HMOs from needless statutory requirements. A model HMO regulatory law is designed to strike a balance between protection of members and freedom for HMOs to deliver programs that can reduce health care costs.     

Modifiable risk factors as predictors of all-cause mortality: the roles of genetics and childhood environment

The authors studied familial aggregation of mortality risk factors and their association with future deaths in the Finnish Twin Cohort. Cohort members (n = 15,904) aged 24-60 years and healthy at the end of 1981 who had responded to questionnaires in 1975 and 1981 were followed up for death through June 30, 2001. In individual-based analyses, the age- and sex-adjusted risk of death was higher among persons who were not participating in vigorous leisure physical activity in 1975 and 1981 than in those who were (p < 0.001), and risk was increased among smokers (p < 0.001) and heavy users of alcohol (p < 0.001). The study sample included data on both members of 3,551 dizygotic same-sex twin pairs and 1,772 monozygotic same-sex twin pairs. In pairwise analyses of discordant dizygotic pairs, risks of death were increased among co-twins who were not participating in vigorous activity (p = 0.05), co-twins who were smokers (p < 0.001), and co-twins who were heavy alcohol users (p < 0.001). Correspondingly, among monozygotic twin pairs, a difference in risk was seen only for smoking (p = 0.03). The authors conclude that, after adjustment for childhood environment, a low level of leisure physical activity, smoking, and heavy use of alcohol are associated with increased risks of death, but genetic selection may account for some of the association concerning physical activity and heavy use of alcohol.     

Meat and cancer: meat as a component of a healthy diet

Based on epidemiological studies it is assumed that meat, especially red meat, enhances risk for cancer, particularly of the colon, breast and prostate. Meat and meat products are important sources of protein, some micronutrients and fat. High fat intake has been blamed for correlation with different diseases, including cancer. Meat protein is reported to contribute to cancer formation. However, meat, including liver, is not only composed of fat and protein, it contains essential nutrients which appear exclusively in meat (vitamin A, vitamin B12) and micronutrients for which meat is the major source because of either high concentrations or better bioavailability (folate, selenium, zinc). In particular, vitamin A, folate and selenium are reported to be cancer-preventive, with respect to colon, breast and prostate cancer. Taken together, meat consists of a few, not clearly defined cancer-promoting and a lot of cancer-protecting factors. The latter can be optimized by a diet containing fruit and vegetables, which contain hundreds of more or less proven bioactive constituents, many of them showing antioxidative and anticarcinogenic effects in vitro.     

Styrene and methyl methacrylate in the industrial environment as a risk factor of chronic obstructive lung disease

Summary The main objective was to assess the biological effect of styrene and methyl methacrylate on the respiratory system in the industrial population. A total of 454 males from the exposed group and 683 workers from the control group were examined. The health status of the workers was evaluated by standardized interviews on chest symptoms and lung function testing. The environmental measurements were performed in all work places where the persons under study were employed.There was practically no differences in the prevalence of chronic chest symptoms in both groups of workers but the frequency of lung obstruction appeared to be more than twice as high among the exposed persons in comparison with the controls. A large proportion of cases with lung obstruction did not show any chronic chest symptoms. It appeared from the study that the environmental factor developed a much more harmful effect on lung function than smoking, and one effect was independent of the other.     

Genetically modified organisms: an analysis of the regulatory framework currently employed within the European Union.

BACKGROUND: Genetic engineering technology is starting to bring many commercial products to the market. These genetically modified organisms (GMOs) and their derived products are subject to topical debate as to their benefits and risks. The strengths and weaknesses of the regulatory framework that controls their development and application is central to the question of whether this technology poses significant risk to the public health during this critical phase of its evolution. METHODS: A critical review was carried out of the legal framework regulating the contained use, deliberate release and some aspects of consumer protection relevant to the control of GMOs in Europe and the United Kingdom. RESULTS: The current legal framework is failing to provide a speed of adaptation commensurate with the development of the science of genetic engineering; failing to properly respond to democratic control; failing to resolve significant conflict between the protection of free markets and protection of public health and the environment; and failing to implement obligations on biodiversity. CONCLUSION: The present legal framework must be replaced. Current European Union proposals for new standards of regulation are welcome, but provide only for further incremental change, and do not address some significant fundamental flaws in our current laws.     

The impaired upper respiratory environment as a criterion for a risk of respiratory diseases in firemen

Microbiocenoses were qualitatively and quantitatively determined; the cytomorphological parameters of the upper respiratory tract mucosae were studied, and the concentrations of SIgA were measured in the saliva of firemen. In the latter, nonspecific infection resistance was found to diminish due to the influence of poor occupational factors. A strong correlation was found between the influencing factors and the development of upper airway diseases; the latter were greatly affected by occupational factors.     

Backache in a hospital environment: epidemiologic aspects and the role of various risk factors

A cross-sectional study was carried out in 1985 among 5941 hospital workers from the Regional and University Hospital Center (CHRU) of Strasbourg on the occasion of the occupational medical examinations. The purpose was to determine the importance of low back pain among hospital staff and to describe the relationship between individual and occupational characteristics and the onset of these symptoms. Our results confirm the risk-factors determined by other investigators: age, sex, length of service, heavy work assignments (nursing aides, stretcherbearers, nurses, etc.) but also underline the role of obesity and previous attacks of low back pain, and invalidate the part musculoskeletal abnormalities play in this pathology.     

The physical environment as a fall risk factor in older adults: Systematic review and meta-analysis of cross-sectional and cohort studies

Background/aim:  Evidence that the physical environment is a fall risk factor in older adults is inconsistent. The study evaluated and summarised evidence of the physical environment as a fall risk factor.
Methods:  Eight databases (1985–2006) were searched. Investigators evaluated quality of two categories (cross-sectional and cohort) of studies, extracted and analysed data.
Results:  Cross-sectional: falls occur in a variety of environments; gait aids were present in approximately 30% of falls.
Cohort:  Home hazards increased fall risk (odds ratio (OR) = 1.15; 95% confidence interval (CI): 0.97–1.36) although not significantly. When only the high quality studies were included, the OR = 1.38 (95% CI: 1.03–1.87), which was statistically significant. Use of mobility aids significantly increased fall risk in community (OR = 2.07; 95% CI: 1.59–2.71) and institutional (OR = 1.77; 95% CI: 1.66–1.89) settings.
Conclusions:  Home hazards appear to be a significant risk factor in older community-dwelling adults, although they may present the greatest risk for persons who fall repeatedly. Future research should examine relationships between mobility impairments, use of mobility aids and falls.     

The family environment and American adolescents' risk of obesity as young adults

In this article, the effects of the family environment and adolescents' behaviors while in school grades 7 through 12 on their weight status 6 years later are examined using data from the United States National Longitudinal Study of Adolescent Health. Ordinal regression models of 6378 adolescents reveal that their family environments exert an influence on their weight that lasts into young adulthood. Parental obesity puts both males and females at greater risk for being overweight or obese as young adults, as does already having excessive weight in adolescence. The findings also reveal significant gender differences in the intergenerational transmission of body weight within families. Higher parental educational attainment, a stronger perception that parents care about them, and a higher self-esteem reduce female adolescents' risk for excessive weight as young adults, while being African American or Native American increases it. In contrast, only a perception that their parents are trying to control their diets and a higher degree of closeness with a parent put male adolescents at greater risk for excessive weight as young adults. Adolescents' participation in physical activities does not predict subsequent weight for either males or females, although the amount of time spent in sedentary activities does for females, but not males. The only adolescent behavior examined that influenced male weight in young adulthood was eating breakfast.     

Persistent organic micropollutants in Mediterranean organisms and risk associated

Persistent organic pollutants are object of a global threaty between governments, including measures to reduce or eliminate their release in the environment. Their presence and levels found in some organisms of the Mediterranean Sea appear to give some concern. The preliminary risk assessment presented here, infact, for dioxin-like action chemicals, shows a potential hazard for species belonging to higher levels of the food web. For example, in the eggs of a Mediterranean shark species, dioxin-like action PCBs concentration levels are one magnitude order higher than the No Observed Effect Level, evaluated on eggs of a laboratory fish species. Marine mammals, in addition, appear particularly sensitive to tissue levels of POPs. Their sensitivity to specific pathogenic organisms appears increased in specimen showing higher levels of these microcontaminants.     

Mirex incorporation in the environment: Uptake in aquatic organisms and effects on the rates of photosynthesis and respiration

Exposure of selected aquatic invertebrates to mirex reveals species variability in uptake which is generally a function of exposure period and mirex concentration. The metabolic effects examined relate to photosynthesis and respiration rates. Dissolved oxygen changes, in light and dark bottles containing naturally occurring plankton populations previously exposed to 1 ppb mirex, show progressive photosynthetic inhibition in time from 16% at 6 days exposure to 33% at 18 days exposure. Pure culture of the phytoplankton,Chlamydomonas sp., exhibits a 55% photosynthetic reduction after exposure to 1 ppm mirex for 168 hours. Respiration rates of plankton,Physa gyrina (pond snail),Gambusia affinis (mosquitofish), andLepomis macrochirus (sunfish) demonstrate an initial increasing trend to a maximum of 62%, at low concentration of mirex or during early incubation period, but decrease by as much as 50%, at elevated concentration or extended exposure at low concentration.