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1.
Anna Maria Ingelido Vittorio Abate Annalisa Abballe Fulvia Lucia Albano Tatiana Battista Valter Carraro Michele Conversano Rosa Corvetti Silvia De Luca Silva Franchini Anna Rita Fulgenzi Laura Giambanco Nicola Iacovella Anna Laura Iamiceli Antonio Maiorana Francesco Maneschi Valentina Marra Flavia Pirola Elena De Felip 《International journal of hygiene and environmental health》2017,220(2):378-386
Background
Polychlorinated dibenzodioxins (PCDDs), polychlorodibenzofurans (PCDFs), and polychlorobiphenyls (PCBs) are persistent organic pollutants that represent a major concern for women of reproductive age because of the neurodevelopmental effects associated to perinatal exposure.Objectives
This study was aimed at characterizing exposure of women of reproductive age to PCDDs, PCDFs, and PCBs as a function of residence in different Italian Regions, in areas at presumable different environmental contamination and human exposure to these pollutants.Methods
Study participants were enrolled in 2011–2012 in 6 Italian Regions representative of Northern, Central and Southern Italy; in each region, areas at presumed different exposure (rural, urban and industrial) were selected for enrolment. Each participant provided a serum sample for the analysis of PCDDs, PCDFs and PCBs.Results
Median concentrations of PCDDs + PCDFs, DL-PCBs, NDL6-PCBs and NDL9-PCBs in serum samples were respectively 6.0 and 3.5 pgWHO-TE05/g fat, and 75 and 93 ng/g fat.Age was the variable that most affected median serum concentrations.Age adjusted concentrations were found significantly different between geographical zones: women from Northern Italy showed the highest values, followed by Central and Southern Italy.PCDDs + PCDFs concentrations were significantly higher in the group of women residing in industrial areas compared to the group residing in rural areas.A clear diminishing temporal trend was observed compared to levels reported in previous studies.Conclusions
This study produced the largest dataset on serum concentrations of PCDDs, PCDFs and PCBs in women of childbearing age in Italy.Results
confirmed that environmental and lifestyle factors may influence exposure to these contaminants and thereby the body burden.The observed marked temporal decline in body burden during three decades is in agreement with the general trend observed worldwide. 相似文献2.
Ramon Mir-Abellán Anna Falcó-Pegueroles María Luisa de la Puente-Martorell 《Gaceta sanitaria / S.E.S.P.A.S》2017,31(2):145-149
Objective
To describe attitudes towards patient safety culture among workers in a hospital setting and determine the influence of socio-demographic and professional variables.Methods
The Hospital Survey on Patient Safety Culture was distributed among a sample of professionals and nursing assistants. A dimension was considered a strength if positive responses exceeded 75% and an opportunity for improvement if more than 50% of responses were negative.Results
59% (n = 123) of respondents rated safety between 7 and 8. 53% (n = 103) stated that they had not used the notification system to report any incidents in the previous twelve months. The strength identified was “teamwork in the unit/service” and the opportunity for improvement was “staffing”. A more positive attitude was observed in outpatient services and among nursing professionals and part-time staff.Conclusions
This study has allowed us to determine the rating of the hospital in patient safety culture. This is vital for developing improvement strategies. 相似文献3.
Objective
To explore what hospitals and primary care (PC) are doing to reduce the negative social impact of a serious adverse event (AE).Methods
We surveyed 195 hospital (n = 113) and PC (n = 82) managers from eight autonomous communities to explore the level of implementation of five interventions recommended after an AE to protect the reputation of healthcare institutions.Results
Most institutions (70, 45.2% PC, and 85, 54.8% hospitals) did not have a crisis plan to protect their reputation after an AE. Internal (p = 0.0001) and external (p = 0.012) communications were addressed better in PC than in hospitals. Very few institutions had defined the managers’ role in case of an AE (10.7% hospitals versus 6.25% PC).Conclusion
A majority of healthcare institutions have not planned crisis intervention after an AE with severe consequences nor have they defined plans to recover citizens’ trust after an AE. 相似文献4.
Borami Ahn Shin-Hye Kim Mi-Jung Park 《International journal of hygiene and environmental health》2017,220(1):37-42
Objective
To assess blood cadmium levels in Korean adolescents with respect to demographic and lifestyle factors.Methods
We analyzed data from the Korea National Health and Nutrition Examination Survey from 2010 to 2013, totaling 1472 adolescents aged 10–18 years. Geometric means of blood cadmium were calculated using a complex samples general linear model to compare blood levels in different demographic and lifestyle groups. Multivariate logistic regression analyses were also used to find predictors for high blood cadmium (>90th percentile).Results
The geometric mean of the blood cadmium concentrations was 0.30 μg/L in Korean adolescents. Older age, type of housing (multifamily house and commercial building), smoking and alcohol consumption, and iron deficiency/iron deficiency anemia (IDA) were significantly associated with higher blood cadmium concentrations (P < 0.05). Blood cadmium concentrations were not significantly affected by gender, region, body mass index status, or household income. In multivariate logistic regression analysis, independent predictors for higher blood cadmium levels included current smoker (OR = 7.77), alcohol consumption (OR = 4.31), living in a multifamily house or commercial building (OR = 3.11–3.46), and IDA (OR = 2.64).Conclusions
Possible associations between blood cadmium levels and type of housing or alcohol consumption in adolescents are suggested for the first time in this study. Further studies are needed to elucidate the mechanism of these findings. 相似文献5.
Xavier Continente Anna Pérez Albert Espelt Carles Ariza María José López 《Gaceta sanitaria / S.E.S.P.A.S》2017,31(4):332-335
Objective
We aimed to analyse the prevalence of having multiple lifestyle risk behaviours (LRB) and the potential relationship between excess weight (including overweight and obesity) and cumulative multiple LRB among adolescents in Barcelona, Spain.Methods
A cross-sectional study was performed among a representative sample of 3,114 secondary school students in Barcelona. Height and weight were objectively measured and excess weight was defined in accordance with World Health Organization criteria. Information on screen time, breakfast, physical activity and sleep duration was obtained through a self-administered questionnaire.Results
More than 80% of the students had at least two LRBs. In compulsory schooling, the adjusted prevalence ratio (aPR) of excess weight increased with a higher number of reported LRBs (four LRBs: aPR = 1.56; 95% confidence interval: 1.19-2.05).Conclusions
These results highlight the importance of a multiple-behaviour approach in preventive programmes aimed at reducing adolescent obesity. 相似文献6.
Martin Emmert Fatemeh Taheri-Zadeh Benjamin Kolb Uwe Sander 《Health policy (Amsterdam, Netherlands)》2017,121(1):17-26
Background
Evidence from the US has demonstrated that hospital report cards might generate confusion for consumers who are searching for a hospital. So far, little is known regarding hospital ranking agreement on German report cards as well as underlying factors creating disagreement.Objective
This study examined the consistency of hospital recommendations on German hospital report cards and discussed underlying reasons for differences.Methods
We compared hospital recommendations for three procedures on four German hospital report cards. The agreement between two report cards was determined by Cohen’s-Kappa. Fleiss’ kappa was applied to evaluate the overlap across all four report cards.Results
Overall, 43.40% of all hospitals were labeled equally as low, middle, or top performers on two report cards (hip replacement: 43.2%; knee replacement: 42.8%; percutaneous coronary intervention: 44.3%). In contrast, 8.5% of all hospitals were rated a top performer on one report card and a low performer on another report card. The inter-report card agreement was slight at best between two report cards (κmax = 0.148) and poor between all four report cards (κmax = 0.111).Conclusions
To increase the benefit of public reporting, increasing the transparency about the concept of – medical – “quality” that is represented on each report card seems to be important. This would help patients and other consumers use the report cards that most represent one’s individual preferences. 相似文献7.
Cristina Martínez Carlos Méndez María Sánchez José María Martínez-Sánchez 《Gaceta sanitaria / S.E.S.P.A.S》2017,31(2):132-138
Objective
To assess attitudes towards the extension of outdoor smoke-free areas on university campuses.Methods
Cross-sectional study (n = 384) conducted using a questionnaire administered to medical and nursing students in Barcelona in 2014. Information was obtained pertaining to support for indoor and outdoor smoking bans on university campuses, and the importance of acting as role models. Logistic regression analyses were performed to examine agreement.Results
Most of the students agreed on the importance of health professionals and students as role models (74.9% and 64.1%, respectively) although there were statistically significant differences by smoking status and age. 90% of students reported exposure to smoke on campus. Students expressed strong support for indoor smoke-free policies (97.9%). However, only 39.3% of participants supported regulation of outdoor smoking for university campuses. Non-smokers (OR = 12.315; 95% CI: 5.377-28.204) and students ≥22 years old (OR = 3.001; 95% CI: 1.439-6.257) were the strongest supporters.Conclusions
The students supported indoor smoke-free policies for universities. However, support for extending smoke-free regulations to outdoor areas of university campuses was limited. It is necessary to educate students about tobacco control and emphasise their importance as role models before extending outdoor smoke-free legislation at university campuses. 相似文献8.
Carmen Franken Nathalie Lambrechts Eva Govarts Gudrun Koppen Elly Den Hond Daniëlla Ooms Stefan Voorspoels Liesbeth Bruckers Ilse Loots Vera Nelen Isabelle Sioen Tim S. Nawrot Willy Baeyens Nicolas Van Larebeke Greet Schoeters 《International journal of hygiene and environmental health》2017,220(2):468-477
Background
In Belgium, around 8.5% of the children have asthmatic symptoms. Increased asthma risk in children has been reported in relation to exposure to phthalate plasticizers but the underlying mechanisms are largely unknown.Aim
The aim of this study was to identify if oxidative stress, assessed by excision of 8-hydroxydeoxyguanosine (8-OHdG) from damaged DNA, is an intermediate marker for the association between phthalate exposure and doctor-diagnosed asthma.Material and methods
In 418 14–15-year-old youngsters, recruited as a representative sample of residents of Flanders (Belgium), personal exposure to phthalates was assessed by measuring phthalate metabolites in urine: mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-n-butyl phthalate (MnBP), mono-benzyl phthalate (MBzP), mono-isobutyl phthalate (MiBP) and mono-ethyl phthalate (MEP). Analysis of 8-OHdG in urine was used as a sensitive biomarker of oxidative stress at the level of DNA. The presence of doctor-diagnosed asthma was elicited by a self-administered questionnaire. Associations were assessed using multiple linear and logistic regression models. Mediation was tested using Baron and Kenny's regression approach.Results
A significant increased risk of a youngster being diagnosed with asthma was found for both urinary MnBP (metabolite of dibutyl phthalate (DBP)) and the sum of the three di(2-ethylhexyl) phthalate metabolites (ΣDEHP = MEHP + MEHHP + MEOHP), with respective odds ratio of 1.84 [95% CI: 1.02, 3.32] for MnBP and 1.94 [95% CI: 1.07, 3.51] for ΣDEHP. In addition, we observed significant associations between all urinary phthalate metabolites and increased urinary levels of 8-OHdG. The associations were stronger in girls than in boys. We did not found evidence that 8-OHdG was associated with doctor-diagnosed asthma.Conclusion
The results of our study are in line with other findings from epidemiological surveys and raise further concern about DEHP and DBP as risk factors for asthma, however, the underlying mechanisms are not yet well understood. 相似文献9.
10.
Seungho Lee Miyeon Shin Yun-Chul Hong Jin Hee Kim 《International journal of hygiene and environmental health》2017,220(2):407-414
Background
Biological measurements have been employed as useful biomarkers for exposure. Because of its property of reflecting toxicokinetic differences, however, within-subject variability leads to biased results in epidemiologic studies.Method
We examined the variability of lead (Pb), mercury (Hg), and cadmium (Cd) levels in blood samples from 1429 participants among 1677 elderly individuals aged over 60 years who lived in an urban area from August 2008 to April 2015.Results
The geometric means of blood Pb, Hg, Cd were 1.92 μg/dL, 2.48 μg/L, and 1.33 μg/L, and the intra-class correlations (ICCs) were 0.81, 0.71, and 0.83, respectively. The mean values of Pb and Hg levels in this study were lower than the results from single spot samples in other national biomonitoring surveys in Korea, with the exception of Cd was higher than those in other studies. Moreover, the predicted exceedances over the guidance levels for Pb, Hg, and Cd were 1.9%, 4.2%, and 0.3%, respectively.Conclusion
Korean elderly were exposed to high levels of Pb, Hg and Cd. Especially, those who had high levels of Cd were continuously exposed to Cd during study period with the 6 collection intervals. Therefore, factors affecting environmental Cd exposure should be further studied in the future. 相似文献11.
María G. Rodríguez-Zamora Lourdes Medina-Escobar Glend Mora Jan-Paul Zock Berna van Wendel de Joode Ana M. Mora 《International journal of hygiene and environmental health》2017,220(6):1039-1045
Background
About 12 million workers are involved in the production of basic grains in Central America. However, few studies in the region have examined the occupational factors associated with inhalable dust exposure.Objectives
(i) To assess the exposure to inhalable dust in workers from rice, maize, and wheat storage facilities in Costa Rica; (ii) to examine the occupational factors associated with this exposure; and (iii) to measure concentrations of respirable and thoracic particles in different areas of the storage facilities.Methods
We measured inhalable (<100 μm) dust concentrations in 176 personal samples collected from 136 workers of eight grain storage facilities in Costa Rica. We also measured respirable (<4 μm) and thoracic (<10 μm) dust particles in several areas of the storage facilities.Results
Geometric mean (GM) and geometric standard deviation (GSD) inhalable dust concentrations were 2.0 mg/m3 and 7.8 (range = < 0.2–275.4 mg/m3). Personal inhalable dust concentrations were associated with job category [GM for category/GM for administrative staff and other workers (95% CI) = 4.4 (2.6, 7.2) for packing; 20.4 (12.3, 34.7) for dehulling; 109.6 (50.1, 234.4) for unloading in flat bed sheds; 24.0 (14.5, 39.8) for unloading in pits; and 31.6 (18.6, 52.5) for drying], and cleaning task [15.8 (95% CI: 10.0, 26.3) in workers who cleaned in addition to their regular tasks]. Higher area concentrations of thoracic dust particles were found in wheat (GM and GSD = 4.3 mg/m3 and 4.5) and maize (3.0 mg/m3 and 3.9) storage facilities, and in grain drying (2.3 mg/m3 and 3.1) and unloading (1.5 mg/m3 and 4.8) areas.Conclusions
Operators of grain storage facilities showed elevated inhalable dust concentrations, mostly above international exposure limits. Better engineering and administrative controls are needed. 相似文献12.
Dan Norbäck Jamal Hisham Hashim Zailina Hashim Vinoshini Sooria Syazwan Aizat Ismail Gunilla Wieslander 《International journal of hygiene and environmental health》2017,220(4):697-703
Background
There are few studies on ocular effects of indoor mould exposure in schools, especially in the tropicsObjective
To study associations between eye symptoms and tear film break up time (BUT) in students and demographic data and fungal DNA in schools.Methods
A school environment study was performed among randomly selected students in eight randomly selected secondary schools in Penang, Malaysia. Information on eye symptoms and demographic data was collected by a standardised questionnaire. BUT was measured by two methods, self-reported BUT (SBUT) and by the non-invasive Tearscope (NIBUT). Dust was collected by vacuuming in 32 classrooms and analysed for five fungal DNA sequences. Geometric mean (GM) for total fungal DNA was 7.31*104 target copies per gram dust and for Aspergillus/Penicillium DNA 3.34*104 target copies per gram dust. Linear mixed models and 3-level multiple logistic regression were applied adjusting for demographic factors.Results
A total of 368 students (58%) participated and 17.4% reported weekly eye symptoms the last 3 months. The median SBUT and TBUT were 15 and 12 s, respectively. Students wearing glasses (OR 2.41, p = 0.01) and with a history of atopy (OR = 2.67; p = 0.008) had more eye symptoms. Girls had less eye symptoms than boys (OR = 0.34; p = 0.006) Indoor carbon dioxide in the classrooms was low (range 380–720 ppm), temperature was 25–30 °C and relative air humidity 70–88%. Total fungal DNA in vacuumed dust was associated with shorter SBUT (4 s shorter per 105 target copies per gram dust; p = 0.04) and NIBUT (4 s shorter per 105 target copies per gram dust; p < 0.001). Aspergillus/Penicillium DNA was associated with shorter NIBUT (5 s shorter per 105 target copies per gram dust; p = 0.01).Conclusion
Fungal contamination in schools in a tropical country can be a risk factor for impaired tear film stability among students. 相似文献13.
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15.
Nadine Bonberg Beate Pesch Nadin Ulrich Susanne Moebus Lewin Eisele Anja Marr Marina Arendt Karl-Heinz Jöckel Thomas Brüning Tobias Weiss 《International journal of hygiene and environmental health》2017,220(6):998-1005
Objective
This study investigated the metal distribution in blood samples from the general population and the risk of having high metal concentration for metal workers.Methods
Metal concentrations were determined in archived blood samples from 1411 men and 1410 women (median age 59 and 57 years, respectively) collected at baseline (2000–2003) of the prospective Heinz Nixdorf Recall Study. Retrospective information on working in metal industry was obtained from previous follow-up survey (2011–2014). Odds ratios (ORs) with 95% confidence intervals (CI) of having a metal concentration >90th percentile (P90) for working in metal industry were calculated using logistic regression with adjustment for covariates.Results
More men than women worked in metal industry (57 vs. 3 at baseline). Male metal workers had increased blood lead (Pb) (OR: 2.86; 95% CI: 1.38-5.91) and manganese (Mn) (OR: 2.92; 95% CI: 1.46-5.81). Smoking (≥30 cigarettes/day) strongly influenced cadmium (Cd) in blood (OR: 168; 95% CI: 55–510). Women had higher Mn (8.92 μg/L) and Cd (0.36 μg/L) concentrations than men (Mn: 8.11 μg/L; Cd: 0.29 μg/L). Blood Pb in women (29.2 μg/L) was lower than in men (33.2 μg/L). None of the studied risk factors was significantly associated with chromium and nickel concentrations above their 90th percentiles.Conclusions
In this population-based cohort we found evidence that working in metal industry was predictive for having elevated blood Pb and Mn concentrations. However, the 95th percentiles of all investigated metals were not significantly influenced by metal-related occupations. The present study is supportive for gender-specific reference values to limit occupational exposure to Mn and Pb. The strong influence of smoking on blood Cd hinders establishing reference values. 相似文献16.
Suicidal behaviours in male and female users of illicit drugs recruited in drug treatment facilities
Elisabet Arribas-Ibar Josep Maria Suelves Albert Sanchez-Niubò Antònia Domingo-Salvany M. T. Brugal 《Gaceta sanitaria / S.E.S.P.A.S》2017,31(4):292-298
Objective
We assessed prevalence of suicidal ideation and plans among illicit drug users and their association with contextual factors, by gender.Methods
Cross-sectional study. In a sample of 511 illicit drug users recruited during spring 2012 in drug treatment and prevention facilities in Catalonia (Spain), the prevalence of suicidal ideation/plans in the last 12 months was assessed. Poisson regression was used to examine associations between suicidal ideation/plans and various factors (socio-demographic, psychological, illegal drug market activities and marginal income generation activities, which included any reported sex work, stealing, peddling, begging or borrowing on credit from a dealer).Results
The average age was 37.9 years (standard deviation: 8.62); 76.3% were men. Suicidal ideation/plans were reported by 30.8% of men and 38.8% of women, with no significant differences by age or gender. Recent aggression (male prevalence ratio [PR] = 2.2; female PR = 1.4), psychological treatment (male PR = 1.2; female PR = 1.3) and illegal/marginal income generation activities (male PR = 1.5; female PR = 1.1) were associated with suicidal ideation/plans. Men who trafficked were more likely to have suicidal ideation/plans (PR = 1.3), while prison history was positive for women (PR = 1.8) and negative for men (PR = 0.7).Conclusions
Prevalence of suicidal ideation/plans was high among illicit drug users recruited from healthcare facilities. Besides psychological variables, participation in illegal market activities and crime ought to be considered in drug users’ suicidal prevention. Suicide risk needs to be evaluated in drug treatment facilities and psychological status and context contemplated. 相似文献17.
Xinyang Hua Guido Erreygers John Chalmers Tracey-Lea Laba Philip Clarke 《Health policy (Amsterdam, Netherlands)》2017,121(4):426-433
Objectives
Australia’s universal health insurance system Medicare generates very large amounts of data on out-of-pocket expenditure (OOPE), but only highly aggregated statistics are routinely published. Our primary purpose is to develop indices from the Medicare administrative data to quantify changes in the level and distribution of OOPE on out-of-hospital medical services over time.Methods
Data were obtained from the Australian Hypertension and Absolute Risk Study, which involved patients aged 55 years and over (n = 2653). Socio-economic and clinical information was collected and linked to Medicare records over a five-year period from March 2008. The Fisher price and quantity indices were used to evaluate year-to-year changes in OOPE. The relative concentration index was used to evaluate the distribution of OOPE across socio-economic strata.Results
Our price index indicates that overall OOPE were not rising faster than inflation, but there was considerable variation across different types of services (e.g. OOPE on professional attendances rose by 20% over a five-year period, while all other items fell by around 14%). Concentration indices, adjusted for demographic factors and clinical need, indicate that OOPE tends to be higher among those on higher incomes.Conclusions
A major challenge in utilizing large administrative data sets is to develop reliable and easily interpretable statistics for policy makers. Price, quantity and concentration indices represent statistics that move us beyond the average. 相似文献18.
Maria Victoria Zunzunegui Emmanuelle Belanger Tarik Benmarhnia Milena Gobbo Angel Otero François Béland Fernando Zunzunegui Jose Manuel Ribera-Casado 《Gaceta sanitaria / S.E.S.P.A.S》2017,31(4):313-319
Objective
To examine whether financial fraud is associated with poor health sleeping problems and poor quality of life.Methods
Pilot study (n = 188) conducted in 2015–2016 in Madrid and León (Spain) by recruiting subjects affected by two types of fraud (preferred shares and foreign currency mortgages) using venue-based sampling. Information on the monetary value of each case of fraud; the dates when subjects became aware of being swindled, lodged legal claim and received financial compensation were collected. Inter-group comparisons of the prevalence of poor physical and mental health, sleep and quality of life were carried according to type of fraud and the 2011–2012 National Health Survey.Results
In this conventional sample, victims of financial fraud had poorer health, more mental health and sleeping problems, and poorer quality of life than comparable populations of a similar age. Those who had received financial compensation for preferred share losses had better health and quality of life than those who had not been compensated and those who had taken out foreign currency mortgages.Conclusion
The results suggest that financial fraud is detrimental to health. Further research should examine the mechanisms through which financial fraud impacts health. If our results are confirmed psychological and medical care should be provided, in addition to financial compensation. 相似文献19.
Marina Tarrazo Mónica Pérez-Ríos María I. Santiago-Pérez Alberto Malvar Jorge Suanzes Xurxo Hervada 《Gaceta sanitaria / S.E.S.P.A.S》2017,31(3):204-209
Objective
To assess changes in smoking prevalence and study roll-your-own (RYO) tobacco and e-cigarette use in the Galician population between 2007 and 2015.Methods
Data were obtained from five independent, cross-sectional studies carried out in Galicia (Spain) between 2007-2015 in the population aged 16 and over (n = 8,000/year). Prevalence of use was estimated, with 95% confidence intervals, overall, according to sex and by age group, area of residence and level of education.Results
Smoking prevalence decreased from 25.4% in 2007 to 21.8% in 2015. In 2007, 1.8% of current smokers declared that they had smoked RYO tobacco, compared to 18.6% in 2015. Among smokers, RYO tobacco consumption increased across all demographic groups. In both 2014 and 2015, ever use of e-cigarettes was 0.7%. E-cigarette use was more frequent in urban settings.Conclusion
Smoking prevalence decreased in Galicia between 2007 and 2015, and there has been rapid growth in the prevalence of RYO tobacco use. Although smokers are more likely to use e-cigarettes, both former and never smokers declared their use. The boom of RYO cigarettes and the emergence of e-cigarettes highlight the importance of having continuous surveillance systems to identify smoking behavioural changes. 相似文献20.
José Manuel Terán Carlos Varea Cristina Bernis Barry Bogin Antonio González-González 《Gaceta sanitaria / S.E.S.P.A.S》2017,31(2):116-122