Psychological distress and the perception of radiation risks: the Fukushima health management survey

Objective

To assess relationships between the perception of radiation risks and psychological distress among evacuees from the Fukushima nuclear power plant disaster.

Methods

We analysed cross-sectional data from a survey of evacuees conducted in 2012. Psychological distress was classified as present or absent based on the K6 scale. Respondents recorded their views about the health risks of exposure to ionizing radiation, including immediate, delayed and genetic (inherited) health effects, on a four-point Likert scale. We examined associations between psychological distress and risk perception in logistic regression models. Age, gender, educational attainment, history of mental illness and the consequences of the disaster for employment and living conditions were potential confounders.

Findings

Out of the 180 604 people who received the questionnaire, we included 59 807 responses in our sample. There were 8717 respondents reporting psychological distress. Respondents who believed that radiation exposure was very likely to cause health effects were significantly more likely to be psychologically distressed than other respondents: odds ratio (OR) 1.64 (99.9% confidence interval, CI: 1.42–1.89) for immediate effects; OR: 1.48 (99.9% CI: 1.32–1.67) for delayed effects and OR: 2.17 (99.9% CI: 1.94–2.42) for genetic (inherited) effects. Similar results were obtained after controlling for individual characteristics and disaster-related stressors.

Conclusion

Among evacuees of the Fukushima nuclear disaster, concern about radiation risks was associated with psychological distress.     

White Blood Cell,Neutrophil, and Lymphocyte Counts in Individuals in the Evacuation Zone Designated by the Government After the Fukushima Daiichi Nuclear Power Plant accident: The Fukushima Health Management Survey

Background

Lymphocytes are susceptible to damage from radiation, and the white blood cell (WBC) count, including counts of neutrophils and lymphocytes, is a useful method of dosimetry. According to the basic survey of the Fukushima Health Management Survey (FHMS), among 13 localities where evacuation was recommended, Iitate and Namie had more individuals with external radiation exposure of more than 5 mSv than the other evacuation areas. We analyzed whether or not WBC, neutrophil, and lymphocyte counts decreased after the disaster.

Methods

The subjects of this study were 45 278 men and women aged 20 to 99 years (18 953 men and 26 325 women; mean age 56 years) in the evacuation zone who participated in the Comprehensive Health Check (CHC) from June 2011 to the end of March 2012.

Results

Significant differences were detected in the mean values of WBC, neutrophil, and lymphocyte counts, and for the proportion of individuals under the minimum standard for WBC and neutrophil counts, among the 13 localities. However, the distribution of individuals at each 200-cell/µL increment in lymphocyte count were similar in these areas, and the WBC, neutrophil, and lymphocyte counts did not decrease in Iitate or Namie specifically.

Conclusions

No marked effects of radiation exposure on the distribution of WBC counts, including neutrophil and lymphocyte counts were detected within one year after the disaster in the evacuation zone.Key words: radiation exposure, white blood cells, The Fukushima Health Management Survey     

Effects of extremely low-frequency electromagnetic fields (ELF-EMF) exposure on B6C3F1 mice

Objective

Long-term exposure study was conducted to investigate the effects of extremely low-frequency electromagnetic field on the tumor promotion process and fertility.

Methods

Ten pregnant C57BL/6NCrj mice were exposed to 50 Hz field 500 mG for 1 week (12 h per day), and 24 male and 42 female B6C3F1mice born from them were further exposed up to 15.5 months. As a control group, 10 pregnant mice were bred without exposure, and 30 produced male and 32 female mice were observed without exposure for the same period.

Results

Mean body weights of exposed groups of male and female mice were decreased significantly than those of the control groups. In exposed mice, there was no increased incidence of liver and lung tumor. In female mice, the incidence of chronic myeloid leukemia [3/42 (7 %)] in the exposed group was significantly greater than in the control group. The size of seminiferous tubules in the EMF exposed groups were significantly less than the control group.

Conclusions

These data support the hypothesis that long-term exposure of 50 Hz magnetic fields is a significant risk factor for neoplastic development and fertility in mice.     

Insecticide Residues in Soil,Water, and Eggplant Fruits and Farmers’ Health Effects Due to Exposure to Pesticides

Objectives

Eggplant (Solanum melongena L.) is an important vegetable crop that is widely cultivated in the tropical and subtropical areas in Asia. Globally, the top three eggplant producers are China, India, and Egypt. The Philippines has been one of the top 10 eggplant-producing countries based on area planted and crop productivity. This study aims to describe the insecticide residues found in soil, water, and eggplant fruits in eggplant farms in Sta. Maria, Pangasinan.

Methods

The study design is a cross sectional of randomly selected eggplant farms in Sta. Maria, Pangasinan. Soil, water, and eggplant fruits were collected and subjected to gas chromatography (Shimadzu) analysis for multi-pesticide residues.

Results

Farmers from Sta. Maria, Pangasinan were found to be applying a broad spectrum of insecticides on their eggplant crop. Soil samples from 11 (about 42 %) out of the 26 farms tested positive for insecticide residues, six of which from four farms exceeded the acceptable maximum residue limit. These residues were profenofos, triazophos, chlorpyrifos, cypermethrin, and malathion. No insecticide residues were detected from water samples taken from the 26 farms. Cypermethrin and chlorpyrifos were the insecticide residues detected in eggplant fruit samples. A maximum of 20 % of the eggplant samples tested positive for insecticide residues. In the eggplant fruit study, all farmers have been using Prevathon^® for 24 years at a rate of 10 ml/application, and Malathion^® for 25 years at about 16.5 ml/application, respectively equivalent to 0.24 liter-years and 0.413 liter-years of exposure. Similarly, to the findings in the soil and water study, although Brodan^® and Magnum^® were not prevalently applied, the farmers’ liter-years of exposure to these insecticides, and their active ingredients, were highest at about 18.92 and 10.0, respectively. The farmers and farm workers in the soil and water study reported experiencing itchiness of the skin (63.8 %), redness of the eyes (29.3 %), muscle pains (27.6 %), and headaches (27.6 %), as being related to their pesticide exposure.

Conclusion

In summary, a maximum of 20 % of the eggplant samples tested positive for insecticide residues at any one stage of sampling done. The farmers and farm workers also reported of pesticide-related illnesses but none of them sought any medical attention. Intervention to reduce the farmers’ pesticide exposure can focus on the risk factors identified, primarily the toxicity of pesticides used, the unsafe application practices, and the adverse health effects of pesticide exposure.

Electronic supplementary material

The online version of this article (doi:10.1007/s12199-014-0425-3) contains supplementary material, which is available to authorized users.     

Effects of Electromagnetic Radiation from Smartphones on Learning Ability and Hippocampal Progenitor Cell Proliferation in Mice

Objectives

Nonionizing radiation is emitted from electronic devices, such as smartphones. In this study, we intended to elucidate the effect of electromagnetic radiation from smartphones on spatial working memory and progenitor cell proliferation in the hippocampus.

Methods

Both male and female mice were randomly separated into two groups (radiated and control) and the radiated group was exposed to electromagnetic radiation for 9 weeks and 11 weeks for male and female mice, respectively. Spatial working memory was examined with a Y maze, and proliferation of hippocampal progenitor cells were examined by 5-bromo-2′-deoxyuridine administration and immunohistochemical detection.

Results

When spatial working memory on a Y maze was examined in the 9^th week, there was no significant difference in the spontaneous alternation score on the Y maze between the two groups. In addition, there was no significant difference in hippocampal progenitor cell proliferation. However, immunoreactivity to glial fibrillary acidic protein was increased in exposed animals. Next, to test the effect of recovery following chronic radiation exposure, the remaining female mice were further exposed to electromagnetic radiation for 2 more weeks (total 11 weeks), and spontaneous alternation was tested 4 weeks later. In this experiment, although there was no significant difference in the spontaneous alternation scores, the number of arm entry was significantly increased.

Conclusion

These data indicate that although chronic electromagnetic radiation does not affect spatial working memory and hippocampal progenitor cell proliferation it can mediate astrocyte activation in the hippocampus and delayed hyperactivity-like behavior.     

Biomonitoring of mercury,cadmium, and lead exposure in Japanese children: a cross-sectional study

Objectives

To measure current Hg, Cd, and Pb exposure in Japanese children, and to estimate dietary intakes of foods responsible for high body burden.

Methods

Blood, hair, and urine samples were collected from 9 to 10-year-old 229 children in Asahikawa and measured for Hg, Cd, and Pb in these matrices. Diet history questionnaire was used to estimate intake of marine foods and other food items. Hg level was measured by cold vapor atomic absorption spectrometry. Cd and Pb levels were determined with inductively coupled plasma mass spectrometry.

Results

Geometric mean (GM) of blood Hg, Cd, and Pb was 4.55 μg/L, 0.34 μg/L, and 0.96 μg/dL, respectively. Urinary Cd level was 0.34 μg/g creatinine (GM) and hair Hg was 1.31 μg/g (GM). Approximately one-third (35 %) of blood samples had Hg level above the U.S. EPA reference dose (RfD; 5.8 μg/L). Hair Hg level exceeded U.S. EPA RfD (1.2 μg/g) in 59 % samples. Children in the upper quartile of blood Hg level had significantly higher intake of large predatory fish species compared to those in the lower quartile of blood Hg.

Conclusions

Those with high blood Hg level may be explained by more frequent intake of big predatory fish. Cd and Pb exposure is generally low among Japanese children. As no safety margin exists for Pb exposure and high exposure to MeHg is noted in Japanese population; periodic biomonitoring and potential health risk assessment should continue in high-risk populations, notably among children.     

Factors associated with tuberculosis cases in Semarang District,Indonesia: case–control study performed in the area where case detection rate was extremely low

Objectives

Indonesia is ranked as the 4th highest contributor to tuberculosis (TB) in the world. Semarang District in Central Java displays extremely low case detection rate (CDR), possibly contributing to the local prevalence of TB.

Methods

A case–control study was performed to explore the factors that cause such low CDR. We recruited 129 TB cases and 83 controls that visited the same centers and were not diagnosed with TB.

Results

The cases had 7.5 ± 2.3 symptoms/person on average, indicating the delay in diagnosis because the controls only displayed 1.0 ± 1.7. The multiple logistic regression analysis comparing the cases/controls extracted following factors as a risk to have TB: farmer, close contact with TB patients, ignorance of whether Bacillus Calmette-Guérin (BCG) was accepted or no, smoking, low income, a lot of people living in the same room, irregular hand wash before meals, not wash hands after blow, soil floor, and no sunlight and no ventilation in the house.

Conclusions

Neither the cases nor the controls knew the symptoms and how to avoid TB infection, which probably caused the delay in diagnosis. It is difficult to change the current living conditions. Thus, the amendment of the community-based education program of TB seems to be required.     

The correlation between mental health and multiple chemical sensitivity: a survey study in Japanese workers

Objective

This study was designed to determine the correlation between mental health and multiple chemical sensitivity (MCS).

Method

The present study was conducted at two companies in 2011; both in Kyushu, Japan. The “subjective symptoms” subscale of the “Self-diagnosis Checklist for Assessment of Workers’ Accumulated Fatigue” was used as a mental health subscale. To determine if multiple chemical exposure has an impact on mental health, we composed an original path model using structural equation analysis.

Result

Our final path model can be regarded as good: CMIN/DF = 1.832, CFI = 0.996, and RMSEA = 0.038, AIC = 71.158. As expected, chemical sensitivity and other chemical sensitivity scores predicted the health effects of multiple chemical exposure (β = 0.19, 0.64). Mental health was predicted by symptom severity and life impact (β = 0.56 and 0.12), which were both affected by multiple chemical exposure (β = 0.38 and 0.89, respectively).

Conclusion

As far as we are aware, this is the first study using path analysis to explore whether MCS can indicate mental health in worker populations worldwide, and we found a significant causal relationship between them. This could indicate that more focus should be placed on the impact of MCS on mental health in future investigations.     

Coarse particulate matter and emergency ambulance dispatches in Fukuoka,Japan: a time-stratified case-crossover study

Objectives

There is no conclusive evidence of adverse health effects caused by short-term exposure to coarse particulate matter, so in this case-crossover study we looked for an association between exposure and emergency ambulance dispatches (as a proxy of acute health outcomes).

Methods

We used data on emergency ambulance dispatches in Fukuoka City, Japan between 2005 and 2010. After excluding ambulance dispatches related to external injuries and pregnancy/childbirth, we analyzed data on 176,123 dispatches. Citywide daily mean concentrations of suspended particulate matter (SPM) and fine particulate matter (PM_2.5) were calculated from ambient monitoring data, and the differences between concentrations of SPM and PM_2.5 were used as an exposure surrogate of coarse particulate matter. Using a conditional logistic regression model, we estimated the ambient temperature and relative humidity adjusted odds ratios (ORs) per 10 μg/m³ increase in coarse particulate matter.

Results

The average daily concentration of coarse particulate matter over the study period was 9.9 μg/m³, representing 33 % of the total concentration of SPM. Elevated concentrations of coarse particulate matter were associated with an increase in respiratory disease-related emergency ambulance dispatches for adults aged 65 years or older (9,716 dispatches, OR for lag0–1 = 1.065, 95 % confidence interval = 1.023–1.109). After additional adjustment for exposure to PM_2.5, we observed a statistically non-significant increased risk (OR = 1.035, 0.986–1.086).

Conclusions

We found weak evidence of adverse effects of short-term exposure to coarse particulate matter on human health.     

Exposure to Dichlorodiphenyltrichloroethane and the Risk of Breast Cancer: A Systematic Review and Meta-analysis

Objectives

This study extended and updated a meta-analysis of the association between exposure to dichlorodiphenyltrichloroethane (DDT) and the risk of breast cancer.

Methods

We reviewed the published literature on exposure to DDE and breast cancer risk to update a meta-analysis from 2004. The total of 35 studies included 16 hospital-based case–control studies, 11 population-based case–control studies, and 10 nested case–control studies identified through keyword searches in the PubMed and EMBASE databases.

Results

The summary odds ratio (OR) for the identified studies was 1.03 (95% confidence interval 0.95–1.12) and the overall heterogeneity in the OR was observed (I² = 40.9; p = 0.006). Subgroup meta-analyses indicated no significant association between exposure to DDE and breast cancer risk by the type of design, study years, biological specimen, and geographical region of the study, except from population-based case–control studies with estimated DDE levels in serum published in 1990s.

Conclusion

Existing studies do not support the view that DDE increases the risk of breast cancer in humans. However, further studies incorporating more detailed information on DDT exposure and other potential risk factors for breast cancer are needed.     

The change in lifestyle data during 9?years: the reliability and continuity of baseline health practices

Objectives

To reveal change patterns in self-reported lifestyle data for 9 years, and examine the characteristics of changes by type of lifestyle and ageing.

Methods

The authors used the lifestyle data of 7,080 male workers aged 20–59 who received checkups for 9 years. The proportions of change patterns during the 9 years were determined in seven health practices; smoking, eating breakfast, sleeping hours, working hours, physical exercise, eating nutritional balanced diets, and mental stress.

Results

Among seven health practices, the keep rate of good health practice was highest for the non-smoking (90.8 %), followed by eating breakfast (69.0 %);and the lowest was physical exercise (13.7 %). The keep rate of poor health practice was highest for smoking (73.8 %), followed by non-physical exercise (67.1 %). The lowest rate of multiple changes during 10 years was smoking (7.1 %); the highest was mental stress (68.5 %).

Conclusions

As for the life style on smoking and eating breakfast seemed to be stable, using the data obtained at a specific point in time wouldn’t much affect the results. On the contrary, for other life styles, they showed poor continuity during 9 years, so it would be necessary to take into consideration the time point of data collection.     

Exposure of Infants to Aflatoxin M1 from Mother's Breast Milk in Ilam,Western Iran

Objectives

Aflatoxins as a highly toxic group of mycotoxins are present in the environment and foodstuff. These have been reported to cause serious health problems in humans. Since aflatoxin M1 (AFM1) is excreted into breast milk, investigating the exposure of infants to AFM1 is of special concern.

Methods

In the present study, breast milk samples were collected from 85 lactating mothers in Ilam province, Iran, and the levels of AFM1 were analyzed using the enzyme-linked immunosorbent assay-based technique. AFM1 was detected in breast milk of all lactating women. The mean contamination level was 5.91 ± 2.031 ng/L, ranging from 2 ng/L to 10 ng/L.

Results

Multiple regression analysis indicated no significant associations of consumption of milk and dairy products, meat, fish, legumes, grain products, fruits, and nuts with the concentration of AFM1 in breast milk. Furthermore, no significant association was observed between AFM1 concentration and anthropometric data of infants.

Conclusion

In western parts of Iran, lactating mothers and their infants could be at risk of aflatoxin B1 and AFM1 exposure, respectively. Therefore, in Iran, the evaluation of AFM1 in human breast milk as a biomarker for postnatal exposure of infants to this carcinogen requires more attention in different regions and various seasons.     

Social capital and suicide: an ecological study in Tokyo,Japan

Objective

The aim of this study is to clarify the association between area-based social capital and suicide rate among municipalities of Tokyo.

Methods

The study areas were 20 administrative municipalities of Tokyo. Social capital (i.e., organizational membership, social trust, fairness, helpfulness, and confidence in organizations) was measured based on data from a previous survey (response rate 28 %). Gender-specific age-adjusted suicide rates averaged over 5 years, sociodemographic, and other area characteristics were obtained from relevant national statistics. Multiple linear regression analysis of suicide rates was applied on each social capital variable, adjusting for the other area characteristics.

Results

There was no significant crude Pearson’s correlation between any social capital variable and suicide rate. Multiple regression analyses revealed a significant negative association between social trust and suicide rate for men (p = 0.04).

Conclusions

While based on only limited evidence from a cross-sectional ecological study, area-based social trust may be associated with decreased suicide rates for men in Tokyo.     

Nurse-Perceived Patient Adverse Events depend on Nursing Workload

Objectives

The purpose of this study was to investigate the correlation between nursing workload and nurse-perceived patient adverse events.

Methods

A total of 1,816 nurses working in general inpatient units of 23 tertiary general hospitals in South Korea were surveyed, and collected data were analyzed through multilevel logistic regression analysis.

Results

Among variables related to nursing workload, the non-nursing task experience had an influence on all four types of patient adverse events. Nurses with non-nursing tasks experienced patient adverse events—falls [odds ratio (OR) = 1.31], nosocomial infections (OR = 1.23), pressure sores (OR = 1.16), and medication errors (OR = 1.23)—more often than occasionally. In addition, when the bed to nurse ratio was higher, nurses experienced cases of pressure sores more often (OR = 1.35). By contrast, nurses who said the nursing workforce is sufficient were less likely than others to experience cases of pressure sores (OR = 0.78). Hospitals with a relatively high proportion of nurses who perceived the nursing workforce to be sufficient showed a low rate of medication error (OR = 0.28).

Conclusion

The study suggested that the high level of nursing workload in South Korea increases the possibility of patient adverse events.     

Using Residential History and Groundwater Modeling to Examine Drinking Water Exposure and Breast Cancer

Background

Spatial analyses of case–control data have suggested a possible link between breast cancer and groundwater plumes in upper Cape Cod, Massachusetts.

Objective

We integrated residential histories, public water distribution systems, and groundwater modeling within geographic information systems (GIS) to examine the association between exposure to drinking water that has been contaminated by wastewater effluent and breast cancer.

Methods

Exposure was assessed from 1947 to 1993 for 638 breast cancer cases who were diagnosed from 1983 to 1993 and 842 controls; we took into account residential mobility and drinking water source. To estimate the historical impact of effluent on drinking water wells, we modified a modular three-dimensional finite-difference groundwater model (MODFLOW) from the U.S. Geological Survey. The analyses included latency and exposure duration.

Results

Wastewater effluent impacted the drinking water wells of study participants as early as 1966. For > 0–5 years of exposure (versus no exposure), associations were generally null. Adjusted odds ratios (AORs) for > 10 years of exposure were slightly increased, assuming latency periods of 0 or 10 years [AOR = 1.3; 95% confidence interval (CI), 0.9–1.9 and AOR = 1.6; 95% CI, 0.8–3.2, respectively]. Statistically significant associations were estimated for ever-exposed versus never-exposed women when a 20-year latency period was assumed (AOR = 1.9; 95% CI, 1.0–3.4). A sensitivity analysis that classified exposures assuming lower well-pumping rates showed similar results.

Conclusion

We investigated the hypothesis generated by earlier spatial analyses that exposure to drinking water contaminated by wastewater effluent may be associated with breast cancer. Using a detailed exposure assessment, we found an association with breast cancer that increased with longer latency and greater exposure duration.     

Effect of breastfeeding on immunogenicity of oral live-attenuated human rotavirus vaccine: a randomized trial in HIV-uninfected infants in Soweto,South Africa

Objective

To investigate the effect of abstention from breastfeeding, for an hour before and after each vaccination, on the immune responses of infants to two doses of rotavirus vaccine.

Methods

In Soweto, South Africa, mother–infant pairs who were uninfected with human immunodeficiency virus (HIV) were enrolled as they presented for the “6-week” immunizations of the infants. Each infant was randomly assigned to Group 1 – in which breastfeeding was deferred for at least 1 h before and after each dose of rotavirus vaccine – or Group 2 – in which unrestricted breastfeeding was encouraged. Enzyme-linked immunosorbent assays were used to evaluate the titres of rotavirus-specific IgA in samples of serum collected from each infant immediately before each vaccine dose and 1 month after the second dose. Among the infants, a fourfold or greater increase in titres of rotavirus-specific IgA following vaccination was considered indicative of seroconversion.

Findings

The evaluable infants in Group 1 (n = 98) were similar to those in Group 2 (n = 106) in their baseline demographic characteristics and their pre-vaccination titres of anti-rotavirus IgA. After the second vaccine doses, geometric mean titres of anti-rotavirus IgA in the sera of Group-1 infants were similar to those in the sera of Group-2 infants (P = 0.685) and the frequency of seroconversion in the Group-1 infants was similar to that in the Group-2 infants (P = 0.485).

Conclusion

Among HIV-uninfected South African infants, abstention from breastfeeding for at least 1 h before and after each vaccination dose had no significant effect on the infants’ immune response to a rotavirus vaccine.     

Food safety in Thailand 1: it is safe to eat watermelon and durian in Thailand

Objectives

The wide use of pesticides raises serious concerns regarding food safety and environmental impacts. There is increasing public concern about the potential health risks linked with exposure to pesticides. Regulation of maximum residue limits (MRL) of pesticide residues in food commodities has been established in many developed countries. For developing countries, like Thailand, this regulation often exists in law, but is not completely enforced in practice. Thus, pesticide residue levels in vegetables and fruits have not been thoroughly monitored. The present study aimed to examine potential health risks associated with pesticide exposure by determining the pesticide residues in two commonly consumed fruits, watermelon and durian.

Methods

The fruit samples were purchased from markets in central provinces of Thailand and assayed for the content of 28 pesticides. Analysis of pesticides was performed by multiresidue extraction and followed by GC–MS/MS detection.

Results

Of 28 pesticides investigated, 5 were detected in 90.7 % of the watermelon samples (n = 75) and 3 in 90 % of durian samples (n = 30). Carbofuran, chlorpyrifos, diazinon, dimethoate and metalaxyl were found in watermelons, whereas dichlorvos, dimethoate and metalaxyl were detected in durians. However, their levels were much lower than the recommended MRL values.

Conclusions

These pesticide levels detected in the fruits are unlikely to harm the consumers; therefore it is safe to eat watermelon and durian in Thailand. While our results found negligible risk associated with pesticide exposure from consuming these common tropical fruits, special precautions should be considered to decrease total exposure to these harmful pesticides from various foods.     

Relationship between cigarette smoking and one leg with eyes closed balance in Japanese men

Objective

To investigate the link between cigarette smoking and one leg with eyes closed balance in Japanese men.

Subjects and methods

We used data from 4224 Japanese men, aged 43.3 ± 13.9 years, in this cross-sectional study. Balance, such as one leg with eyes closed balance was measured. In addition, cigarette smoking habits were obtained by well-trained medical staff. The effect of cigarette smoking on one leg with eye closed balance was evaluated.

Results

A total of 1613 men (38.2 %) had smoking habit and 1471 men (34.8 %) regularly exercised. Age-related changes in one leg with eyes closed balance were noted. One leg with eyes closed balance in subjects with cigarette smoking (30.9 ± 31.8 s) was significantly lower than those in subjects without cigarette smoking (32.4 ± 33.5 s) even after adjusting for confounding factors i.e. age, body weight and exercise habits.

Conclusion

Cigarette smoking might be associated with one leg with eyes closed balance in Japanese men.     

Hospital admissions as a function of temperature,other weather phenomena and pollution levels in an urban setting in China

Objective

To explore the relationship between weather phenomena and pollution levels and daily hospital admissions (as an approximation to morbidity patterns) in Hong Kong Special Administrative Region (SAR), China, in 1998–2009.

Methods

Generalized additive models and lag models were constructed with data from official sources on hospital admissions and on mean daily temperature, mean daily wind speed, mean relative humidity, daily total global solar radiation, total daily rainfall and daily pollution levels.

Findings

During the hot season, admissions increased by 4.5% for every increase of 1 °C above 29 °C; during the cold season, admissions increased by 1.4% for every decrease of 1 °C within the 8.2–26.9 °C range. In subgroup analyses, admissions for respiratory and infectious diseases increased during extreme heat and cold, but cardiovascular disease admissions increased only during cold temperatures. For every increase of 1 °C above 29 °C, admissions for unintentional injuries increased by 1.9%. During the cold season, for every decrease of 1 °C within the 8.2–26.9 °C range, admissions for cardiovascular diseases and intentional injuries rose by 2.1% and 2.4%, respectively. Admission patterns were not sensitive to sex. Admissions for respiratory diseases rose during hot and cold temperatures among children but only during cold temperatures among the elderly. In people aged 75 years or older, admissions for infectious diseases rose during both temperature extremes.

Conclusion

In Hong Kong SAR, hospitalizations rise during extreme temperatures. Public health interventions should be developed to protect children, the elderly and other vulnerable groups from excessive heat and cold.     

Identifying Barriers to Human Immunodeficiency Virus Testing for Men Who Have Sex with Men in South Korea

Objectives

The principal objective of this study was to identify the barriers to testing for men who have sex with men (MSM) in Korea, something that might prove useful in future studies of this nature.

Methods

This study was conducted at gay bars nationwide in Korea. After considering several offline locations (gay bars) where MSM candidates are commonly located, random recruitment was performed using time–location sampling. A total of 944 individuals participated in this survey. A total sample of 921 cases (23 cases were excluded) was used for analysis. A self-administered questionnaire measuring the individuals'' demographics, human immunodeficiency virus (HIV)/AIDS knowledge, stigma, phobia, optimism bias, self-efficacy for condom use, and sexual practices was used.

Results

About 61.8% (N = 569) of respondents reported having been tested at least once in their lifetime, and 38.9% (N = 358) acknowledged being tested within the past 12 months. After adjusting for age, education, and number of partners in a logistic regression analysis, awareness of testing place [odds ratio (OR) = 4.04], exposure to HIV prevention campaign (1.54), fear (OR = 1.13), and discrimination toward people with HIV/AIDS (OR = 0.94) were the main factors associated with HIV testing.

Conclusion

To accomplish widespread HIV testing for Korean MSM, the accessibility of testing centers and advertisement of voluntary counseling and testing to MSM are needed.