Noise exposure and public health

Exposure to noise constitutes a health risk. There is sufficient scientific evidence that noise exposure can induce hearing impairment, hypertension and ischemic heart disease, annoyance, sleep disturbance, and decreased school performance. For other effects such as changes in the immune system and birth defects, the evidence is limited. Most public health impacts of noise were already identified in the 1960s and noise abatement is less of a scientific but primarily a policy problem. A subject for further research is the elucidation of the mechanisms underlying noise-induced cardiovascular disorders and the relationship of noise with annoyance and nonacoustical factors modifying health outcomes. A high priority study subject is the effects of noise on children, including cognitive effects and their reversibility. Noise exposure is on the increase, especially in the general living environment, both in industrialized nations and in developing world regions. This implies that in the twenty-first century noise exposure will still be a major public health problem.     

Manganese--a public health concern: its relevance for occupational health and safety policy and regulation in South Africa

Concerns about the effects of low-level manganese exposures on human health arise at a time when South Africa finds itself in competition with newcomers to the market economy, China and the CIS. This case study illustrates how decisions about occupational health and safety and the environment are influenced by incompleteness of scientific knowledge, competing interests, differences over what is fair or just, and the compartmentalization of public policy. In addition, an assessment is made of the ability of the occupational health and safety system in South Africa in its current form to address the challenges posed by manganese-related issues. The importance of tracking developments abroad, strengthening participatory processes, developing national policy, linking economic policy and OHS policy, and establishing appropriate trade agreements is stressed.     

Promotion of public health research: attempting to balance relevance and excellence]

Those in charge of directing scientific research face a daunting task: finding a proper balance between excellence in research and that research's relevance to people's health problems. In developing countries, this task is further hampered by deficient scientific and technological infrastructure, the lack of competitiveness of its research community, and the shortage of research funds. This article explains some of the mechanisms that have been put in place in Latin America to achieve a balance between excellence and relevance, especially by promoting research that targets pertinent public health problems. Within this context, the multicenter studies being conducted under the auspices of the Pan American Health Organization's Program for the Support of Research are described. The article also lays out the fundamental features of a new model for international cooperation to generate knowledge to help resolve the public health problems of the countries of the Americas.     

Dietary isoflavones: biological effects and relevance to human health

Substantial evidence indicates that diets high in plant-based foods may explain the epidemiologic variance of many hormone-dependent diseases that are a major cause of mortality and morbidity in Western populations. There is now an increased awareness that plants contain many phytoprotectants. Lignans and isoflavones represent two of the main classes of phytoestrogens of current interest in clinical nutrition. Although ubiquitous in their occurrence in the plant kingdom, these bioactive nonnutrients are found in particularly high concentrations in flaxseeds and soybeans and have been found to have a wide range of hormonal and nonhormonal activities that serve to provide plausible mechanisms for the potential health benefits of diets rich in phytoestrogens. Data from animal and in vitro studies provide convincing evidence for the potential of phytoestrogens in influencing hormone-dependent states; although the clinical application of diets rich in these estrogen mimics is in its infancy, data from preliminary studies suggest beneficial effects of importance to health. This review focuses on the more recent studies pertinent to this field and includes, where appropriate, the landmark and historical literature that has led to the exponential increase in interest in phytoestrogens from a clinical nutrition perspective.     

Soyabean glyceollins: biological effects and relevance to human health

Glyceollins, one family of phytoalexins, are de novo synthesised from daidzein in the soyabean upon exposure to some types of fungus. The efficiency of glyceollin production appears to be influenced by soyabean variety, fungal species, and the degree of physical damage to the soyabean. The compounds have been shown to have strong antioxidant and anti-inflammatory activities, and to inhibit the proliferation and migration of human aortic smooth muscle cells, suggesting their potential to prevent atherosclerosis. It has also been reported that glyceollins have inhibited the growth of prostate and breast cancer cells in xenograft animal models, which is probably due to their anti-oestrogenic activity. In essence, glyceollins deserve further animal and clinical studies to confirm their health benefits.     

Assessment of health risks upon exposure to methylated mercury

Accumulation of a toxic agent (2-4-fold maximum allowable concentrations) was found in the fish caught in the polluted area of the water storage basin of the Angara river. The authors quantified a risk for major pathological syndromes in individuals exposed to mercury on fish ingestion and assayed biosubstrates for the substance. The integral risk of major pathological syndromes in the potentially mercury loaded persons increased by 62.1% with age and only by 17.1% in the control group. In the risk pattern there were risks for neurological diseases, arterial hypertension, coronary heart disease, borderline mental disorders, and endocrine diseases.     

Occupational mercury exposure and male reproductive health

This retrospective cohort study was designed to investigate the relationship of male occupational exposure to elemental mercury and several reproductive outcomes. All subjects worked at least 4 months between 1953 and 1966 at a plant that used elemental mercury; 247 white male employees who had the highest exposures were compared to 255 matched nonexposed employees. Individual exposure to mercury was estimated from urinary mercury measurement records. Information on reproductive history and potential confounding variables was obtained through personal interview with each of the employees and with a subset of their wives. No associations were demonstrated between mercury exposure and decreased fertility or increased rates of major malformations or serious childhood illnesses. After controlling for previous miscarriage history, mercury exposure was not a significant risk factor for miscarriage. Because of this study's potential problems with long-term recall, further studies of the effect of mercury on pregnancy outcome are warranted in other populations.     

Calcium and iron absorption--mechanisms and public health relevance

Studies on human subjects have shown that calcium (Ca) can inhibit iron (Fe) absorption, regardless of whether it is given as Ca salts or in dairy products. This has caused concern as increased Ca intake commonly is recommended for children and women, the same populations that are at risk of Fe deficiency. However, a thorough review of studies on humans in which Ca intake was substantially increased for long periods shows no changes in hematological measures or indicators of iron status. Thus, the inhibitory effect may be of short duration and there also may be compensatory mechanisms. The interaction between Ca and Fe may be a lumenal event, affecting Fe uptake through DMT1 (divalent metal transporter 1) at the apical membrane. However, it is also possible that inhibition occurs during Fe transfer into circulation, suggesting roles for the serosal exporter ferroportin (FPN) and hephaestin. We explored these possibilities in human intestinal Caco-2 cells cultured in monolayers. Iron transport ((59)Fe) and expression of DMT1, FPN, and hephaestin were assessed after 1.5 and 4 hours with 0 or 100 μM CaCl(2.) Although Ca did not affect Fe uptake or DMT1 expression at 1.5 hours, FPN abundance at the basolateral membrane decreased, resulting in increased cellular Fe retention and decreased Fe efflux. After 4 hours, DMT1 and FPN expression increased and there was increased FPN at the membrane, suggesting a rebound effect. Thus, the effect of Ca on Fe absorption may be of short duration and adaptation may occur with time. This may explain why studies on long-term Ca supplementation of different groups fail to show any adverse effects on Fe status.     

Research into mercury exposure and health education in subsistence fish-eating communities of the Amazon basin: potential effects on public health policy

The neurotoxic effects of fish-methylmercury (meHg) consumed regularly are considered hazardous to fetuses and newborn infants; as a result fish consumption advisories are an important asset to control meHg exposure in affluent societies. These concerns are now part of health promotion programs for Amazon subsistence villagers. While urban dwellers in affluent societies can choose an alternative nutritious diet, traditional and subsistence communities are caught up in controversial issues and lifestyle changes with unintended health consequences. Traditional fish-eating populations of industrialized and non-industrialized regions may be exposed to different neurotoxic substances: man-made pollutants and environmentally occurring meHg. Additionally, in non-industrialized countries, pregnant women and infants are still being immunized with thimerosal-containing vaccines (TCVs) which degrade to ethylmercury (etHg). Therefore, the complexity involving fish-meHg associated with wild-fish choices and Hg exposure derived from TCVs is difficult to disentangle and evaluate: are villagers able to distinguish exposure to differently hazardous chemical forms of Hg (inorganic, fish-meHg, and injected etHg)? Is it possible that instead of helping to prevent a plausible (unperceived) fish-meHg associated neurocognitive delay we may inadvertently arouse panic surrounding Hg exposure and disrupt subsistence fish-eating habits (necessary for survival) and life-saving vaccination programs (required by public health authorities)? These questions characterize the incompleteness of information related on the various chemical forms of Hg exposure and the need to convey messages that do not disrupt nutritional balance and disease prevention policies directed at Amazonian subsistence communities.     

Protecting the public from mercury exposure: success through microexchange events

Mercury is a growing environmental threat that can cause serious health problems and birth defects. Household thermometers are high-risk sources of mercury because most people lack the knowledge to properly dispose of one when it is broken. The Boston Public Health Commission's Environmental Health Office, with local and national partners, created the Boston Mercury Thermometer Exchange Program to address this hazard. Large central exchanges are successful, but multiple smaller targeted "microexchanges" can be another effective way to reach the general public and specific vulnerable subpopulations such as the elderly, the homebound disabled, or recent immigrants. By conducting exchanges in community health centers and public housing developments for the elderly and disabled, and by working through home health care providers, the program collected 4477 thermometers.