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1.
Emission and dispersal of microorganisms and odours from composting facilities were studied in a 3-year project at nine different composting facilities in Germany. Measurements were carried out under so-called ‘normal-case’, i.e. typical local climate conditions and working activities within the facilities, and ‘real worst-case’ conditions (‘drainage flow’ conditions) being characterized by the translocation of cold air mostly at night, and containing large amounts of bioaerosols. Highest concentrations of microorganisms were observed during turning of compost with a maximum of 2.4×106 cfu m−3 for thermophilic actinomycetes. Other groups of microorganisms were detected in concentrations of about 105 cfu m−3. During shredding of fresh organic material, the concentrations of all microorganisms reached 104 cfu m−3. Here, odour concentrations turned out to be highest (up to 1,367 odour units (OU) m−3). At facilities equipped with a biofilter (odour reduction), a decrease in OU by a factor of 10 was observed. In the surrounding of the facilities, highest concentrations ranged between 101–103 cfu m−3 upwind and from 101–104 cfu m−3 downwind. The specific local meteorological situations must be considered carefully in advance and during sampling. Especially ‘drainage flow’ situations can lead to high microorganism concentrations (>104–105 cfu m−3 of thermophilic actinomycetes and thermophilic fungi) in the surroundings of composting facilities.  相似文献   

2.
Composting is a natural dynamic biological process used to valorise putrescible organic matter. The composting process can involve vigorous movements of waste material piles, which release high concentrations of bioaerosols into the surrounding environment. There is a lack of knowledge concerning the dispersal of airborne microorganisms emitted by composting plants (CP) as well as the potential occupational exposure of composting workers. The aim of this study was to investigate the workers exposure to bioaerosols during working activities in three different types of composting facilities (domestic, manure, carcass) using two different quantification methods (cultivation and qPCR) for bacteria and moulds concentrations. As expected, even if there are differences between all CP frameworks, independently of the type of the raw compost used, the production of bioaerosols increases significantly during handling activities. Important concentrations of mesophilic moulds and mesophilic bacteria were noted in the working areas with a respective maximal concentration of 2.3 × 105 CFU/m3 and 1.6 × 105 CFU/m3. A. fumigatus and thermophilic Actinomycetes were also detected in all working areas for the 3 CP. This study emphases the risks for workers to being in contact with aerosolized pathogens such as Mycobacterium and Legionella and more specifically, L. pneumophila. The presence of high concentration of these bacteria in CP suggests a potential occupational health risk. This study may lead to recommendations for the creation of limits for occupational exposure. There is a need for identifying the standards exposure limits to bioaerosols in CP and efficient recommendation for a better protection of workers' health.  相似文献   

3.
Microorganisms and odour emissions from composting plants often lead to complaints by residents, especially by people living close to such plants. Both parameters were studied in a systematic approach under specific local meteorological conditions at nine different composting plants in Germany with emphasis on dispersal of microorganisms. Measurements were done at emission points and at sampling sites in the downwind and upwind directions of the facilities under ‘normal case’ (i.e. weather conditions typical for the location in combination with working activities at the plants) and ‘real worst case’ conditions (dispersal of bioaerosols into the surroundings expected to occur with high probability). Airborne microorganisms were sampled using filtration and impingement. Subsequent cultivation on four different culture media allowed quantification and identification of the culturable microflora. It turned out that a general assessment of emissions and dispersal of bioaerosols from composting plants is not possible because of the coherences of various factors influencing the dispersal. The site-specific meteorological situations must be considered carefully, whenever sampling locations are selected and need to be recorded in any sampling protocol. Air inversions in particular can lead to high concentrations of microorganisms (>104–105 cfu m−3 of thermophilic actinomycetes and thermotolerant fungi) in the surroundings of composting plants. Finally, it was shown that both thermotolerant fungi and thermophilic actinomycetes can serve as indicator organisms.  相似文献   

4.
The emission and dispersal of bioaerosols from open-air commercial composting facilities continues to be contentious. A meta-dataset enumerating cultivable microorganism emission and downwind concentrations is not yet available. A dataset derived from repeated and replicated field studies over a period of two years at two commercial composting facilities is presented. The data characterises patterns in Aspergillus fumigatus, actinomycetes, Gram-negative bacteria and endotoxin emission and downwind concentrations. For all bioaerosols, compost agitation activities had a significant impact on concentrations; levels were variable up to 600 m downwind from site. Bioaerosols declined rapidly from source and exhibited a secondary peak 100–150 m from site boundary. All bioaerosols were found downwind from site in elevated concentrations. Compared to those found 100 m upwind, levels were significantly higher at 180 m downwind for A. fumigatus; at 300–400 m for actinomycetes and Gram negative bacteria, and at 100 m for endotoxins. Periodically, elevated concentrations could be found for all bioaerosols at distances further downwind. The evidence provided by this data set provides operators and regulators of facilities with reliable data to inform the location, risk assessment and bioaerosol sampling strategies of commercial composting facilities.  相似文献   

5.
In order to assess the potential exposure hazard to workers and people living in the immediate surroundings of an area characterized by an open composting facility and a wastewater treatment plant, a quantitative and a qualitative analysis of airborne microorganisms were carried out. Air sampling was performed once a week for four consecutive weeks in summer and winter. Six sites were selected as air sampling sites: one was upwind at approximately 40 m from the facilities; the other five were downwind at increasing distances from the facilities, with the furthest at 100 m away. Monitoring permitted us to verify the influence that the composting activities and wastewater treatment had on the bacterial and fungal contamination of the air. The results obtained have been expressed by means of contamination indexes that have already been used in previous works: a major microbiological contamination near the plants was evidenced. Near the facilities, mesophilic bacteria, psychrophilic bacteria and microfungi showed the highest median concentrations, respectively, of 307.5, 327.5 and 257.5 CFU/m3. Moreover, the season generally influenced the concentration of the bacteria as well as of the fungi; higher in summer than in winter. The contamination index global index of microbial contamination (GIMC/m3) showed mean values of 4058.9 in summer and 439.7 in winter and the contamination index—amplification index (AI) showed values of 4.5 and 1.1 in the same seasons, respectively. Controlling the seasonal effect, mesophilic bacteria, Pseudomonas spp. and Enterobacteriaceae showed a significant decline in concentration with respect to upwind air samples and with increasing distance. Both GIMC and AI showed a significant decline with respect to upwind air samples by increasing the distance from facilities after adjusting for the seasonal effect. In conclusion, even if these plants do not represent a potential risk for nearby populations, they may pose a potential health risk for workers.  相似文献   

6.

Background

Rapid population growth and urbanisation around the world has led to increasing waste generation rates. Composting of organic waste in large-scale facilities is part of a growing trend in the UK, and elsewhere, to better manage and re-use the organic waste. However, composting inevitably generates bioaerosols, which have been associated with human health effects. In 2015, we reported that there was some, albeit limited, qualitative evidence linking bioaerosol emissions from composting facilities to poor respiratory health in nearby residents. However, the limited evidence precluded any quantitative assessment. Since then, the number of operational industrial-scale composting facilities in England has increased by 9% - nearly twice the growth from 2012 to 2014. At the same time, rapid urbanisation has led to expansion of city borders with more people living near large composting facilities and exposed to bioaerosol pollution. It is essential that regulatory authorities have access to the most up to date and accurate information.

Objective

In this update of a systematic review published in 2015, we review and summarise the evidence from more recent studies that have assessed bioaerosol exposures within and near composting facilities and their associated health effects in both community and occupational health settings. Specifically, we wanted to find out if new evidence has emerged since the previous review to strengthen and confirm its conclusions.

Material and methods

Two electronic databases (Medline and Embase) and bibliographies were searched for studies reporting on health outcomes and/or exposure to bioaerosols from composting facilities published between 1 January 2014 and 15 June 2018. Identification of relevant articles and data extraction was undertaken and studies were assessed for risk of bias.

Results

23 studies met the inclusion criteria (15 exposure studies, 4 health studies, 4 health and exposure studies (one of which used an exposure proxy)). The majority of studies were conducted in occupational settings, and over short time periods. Some progress has been made in the characterisation of bioaerosol emissions from these composting facilities, with the application of molecular-based methods. Whilst the latest health studies do not rely solely on subjective self-reported measures of health status but include more objective health measures, these studies were almost exclusively carried out in compost workers and were characterised by profound methodological limitations. Only one community health study was identified and used a proxy measure of bioaerosol exposure.

Conclusions

Although this review identified an additional 23 studies since the earlier review, the conclusions remain largely unchanged. Given the absence of any consistent evidence on the toxicity of bioaerosols from composting facilities, there is insufficient evidence to provide a quantitative comment on the risk to nearby residents from exposure to compost bioaerosols. To improve risk assessment and to best advise on risk management, it is important to ensure that the research recommendations outlined in this review are addressed.  相似文献   

7.
BackgroundBovine allergens can induce allergic airway diseases. High levels of allergens in dust from stables and homes of dairy farmers have been reported, but sparse knowledge about determinants for bovine allergen levels and associations between exposure level and sensitization is available.ObjectiveTo investigate levels and determinants of bovine allergen exposure among dairy, pig and mink farmers (bedroom and stable), and among former and never farmers (bedroom), and to assess the prevalence of bovine allergen sensitization in these groups.MethodsIn 2007–2008, 410 settled dust samples were collected in stables and in bedrooms using an electrostatic dust-fall collector over a 14 day period among 54 pig farmers, 27 dairy farmers, 3 mink farmers as well as 71 former and 48 never farmers in Denmark. For farmers sampling was carried out both during summer and winter. Bovine allergen levels (μg/m2) were measured using a sandwich ELISA. Determinants for bovine allergen exposure in stables and bedrooms were explored with mixed effect regression analyses. Skin prick test with bovine allergen was performed on 48 pig farmers, 20 dairy farmers, 54 former and 31 never farmers.ResultsBovine allergen levels varied by five orders of magnitude, as expected with substantially higher levels in stables than bedrooms, especially for dairy farmers. Bovine allergen levels in bedrooms were more than one order of magnitude higher for dairy farmers compared to pig farmers. Former and never farmers had low levels of bovine allergens in their bedroom. Bovine allergen levels during summer appeared to be somewhat higher than during winter.Increased bovine allergen levels in the bedroom were associated with being a farmer or living on a farm. Mechanical ventilation in the bedroom decreased bovine allergen level, significant for dairy farmers β = −1.4, p < 0.04. No other significant effects of either sampling or residence characteristics were seen. Allergen levels in dairy stables were associated to type of dairy stable, but not to other stable or sampling characteristics. Sensitization to bovine allergens was only found in one pig farmer.ConclusionThis study confirms high bovine allergen levels in dairy farms, but also suggests sensitization to bovine allergens among Danish farmers to be uncommon. Furthermore the importance of a carrier home effect on allergen load is emphasized. Whether the risk for bovine sensitization is related to the allergen level in the stable or the dwelling remains to be determined.  相似文献   

8.
9.
The validity of a diary that estimates exposure to tasks, activities, and postures of the trunk was determined by comparing these self-reported exposure data with observational data of a whole working day. Two populations were studied: 32 professional drivers and five nurses. The nurses and 16 drivers also filled out a shortened version of the diary during another working day. Both versions of the diary showed poor agreement with observations over the same period. However, for variables concerning activities and postures of the trunk agreement was improved by the shortening of the diary. It is concluded that in epidemiologic studies observational measurements of exposure cannot validly be replaced by diaries or similar self-reported exposure data, because the self-reports easily lead to misclassification.  相似文献   

10.
国内外城市生活垃圾处理处置技术及发展趋势   总被引:8,自引:1,他引:8  
城市生活垃圾的处理、处置方法目前达到规模化应用的有填埋、焚烧和堆肥3种方式。阐述上述3种方式的国内外发展状况,提出源头控制和多种技术并存是生活垃圾处理、处置的有效途径。  相似文献   

11.
Objectives The purpose of the present study was to compare validity of various biomarkers of occupational exposure to toluene (Tol) at low levels. The focus was placed on the comparison of un-metabolized toluene in urine (Tol-U) and peripheral blood (Tol-B) with hippuric acid in urine (HA-U). Methods Surveys were conducted in 16 workplaces on the second half of working weeks, with participation of male solvent workers. Urine and peripheral blood samples were collected at the end of the shifts. After exclusion of cases with dense or diluted urine samples, 473 valid sets of samples were obtained for statistical evaluation. Time-weighted average exposure (for about 8-h) were monitored by diffusive sampling for toluene and other four solvents. Blood samples were subjected to the analyses for Tol-B, whereas urine samples were analyzed for HA-U and Tol-U. Results The solvent exposures were low, i.e., a grand geometric mean (GM) Tol concentration was 1.6 ppm, and the GM for the SUM in the additiveness equation was 0.12. The correlation analyses of the biomarkers in urine and blood with Tol exposure showed that Tol-U and Tol-B were more closely [correlation coefficients (r) being 0.67 and 0.60, respectively] related than HA-U (r = 0.27). Results of receiver operator characteristic analyses were in agreement with the correlation analysis results. Conclusions Taking the non-invasive nature of sampling together, Tol in the end-of-shift spot urine sample appears to be the marker of choice for biological monitoring of occupational exposure to Tol at low levels such as <2 ppm as a geometric mean.  相似文献   

12.
We developed the Life Course Sociodemographics and Neighborhood Questionnaire (LSNEQ) to query older adults about perceived neighborhood greenspaces across the life course (i.e., distance to park, number of neighborhood parks/playgrounds, and neighborhood greenness) and about characteristics hypothesized to confound or moderate/mediate greenspace-health associations. Six perceived life course indices are derived from the LSNEQ: neighborhood socioeconomic status, neighborhood walking/biking, urbanicity, neighborhood amenities, neighborhood park access, and neighborhood greenness. Older adults from St. Louis, Missouri, and Sacramento, California, completed the LSNEQ in 2020–2021. The indices demonstrated borderline acceptable to good internal consistency (alpha = 0.60–0.79) and good to excellent test-retest reliability (ICC = 0.71–0.96) and detected different patterns of park access and neighborhood greenness by racialized group and location. Individuals with index scores indicating more neighborhood walking/biking and greater presence of neighborhood amenities over their life course were more likely to report neighborhood-based walking in older age. Overall, the LSNEQ is a reliable instrument to assess perceptions of life course social determinants of health including neighborhood greenspaces.  相似文献   

13.

Background

Millions of workers are exposed to polycyclic aromatic hydrocarbons (PAHs), a well-known family of carcinogens, but occupational exposure data about PAH mixture compositions are scarce.

Objectives

To provide a detailed picture of airborne PAH exposures encountered in the French industrial landscape over the previous 20 years and to identify determinants driving exposures.

Methods

Results from 1643 airborne samples of 16 gaseous and particulate PAHs implemented into the Exporisq HAP database from 1995 to 2014 were used to describe exposure levels and aerosol chemical composition in many industries and activities. Compliance of benzo[a]pyrene (BaP) levels with several existing occupational exposure limits for long-term exposure was assessed.

Results

BaP levels were lower than those reported in the literature, but the level and composition of PAH mixtures were highly variable between and within industries. Numerous exposure determinants (e.g., product composition, type and temperature of process, ventilation and confinement) were assumed to explain these differences. The highest levels were found in industries using products derived from coal (aluminum, silicon, and coke production, manufacturing of carbon products and foundries), with mean BaP levels up to 23 times higher than the French recommended value of 150?ng/m3. Forty-seven percent of the occupational activities exceeded this value. Conversely, exposures resulting from petroleum-derived products were relatively low.

Conclusions

As health effects depend on PAH levels but also on the composition of the mixture, exposure assessments must characterize the entire mixtures and record specific determinants to define homogeneous exposure groups and to accurately assess health risks.  相似文献   

14.
OBJECTIVES—In a cross sectional study, work related health complaints and diseases of 58 compost workers and 53 biowaste collectors were investigated and compared with 40 control subjects. Levels of specific IgG antibodies to moulds and bacteria were measured as immunological markers of exposure to bioaerosols.
METHODS—With a standardised protocol, the participants of the study were interviewed for work related symptoms, conditions of exposure to bioaerosols at their workplaces, exposure to bioaerosols from other sources, atopic diseases, and smoking habits. They were clinically examined by physicians specialised in occupational medicine. Also, concentrations of specific IgG antibodies against antigens of moulds and actinomycetes occurring regularly at these workplaces were measured and compared with the health complaints of the workers.
RESULTS—Compost workers had significantly more symptoms and diseases of the airways (p=0.003) and the skin (p=0.02) than the control subjects. Health complaints of biowaste collectors did not differ significantly from those of the control group. Subjects with atopic diseases were underrepresented in the compost workers (p=0.003). Significantly increased antibody concentrations against fungi and actinomycetes were measured in workers at composting plants. The concentrations in biowaste collectors did not differ significantly from those in the control subjects. A significant association between the diseases and increased antibody concentrations were found in the compost workers.
CONCLUSION—The high exposure to bioaerosols of compost workers is significantly associated with a higher frequency of health complaints and diseases as well as higher concentrations of specific antibodies against moulds and actinomycetes. A healthy worker effect is indicated by the underrepresentation of atopic diseases among the compost workers compared with biowaste collectors and the control group.


Keywords: exposure to bioaerosols; organic dust; IgG antibodies; moulds; actinomycetes  相似文献   

15.
In the framework of a cohort study of pregnant women conducted in Brittany (France), we assessed the exposure to trihalomethanes (THM) during pregnancy in a subset by evaluating (1) potential sources of variability in household THM levels; (2) the between- and within-subject variability in THM levels; (3) THM levels in swimming pools; and (4) the role of water-related habits on total THM uptake. We visited 109 women from the ongoing cohort study at home for an interview and collection of tap water from October to December 2004. Forty-three of them were re-contacted to obtain a second tap water sample in April-May 2005. We designed a questionnaire to collect individual information on source and amount of drinking water, frequency of showering, bathing, and swimming pool attendance, and household characteristics. We obtained 282 THM measurements, 152 specifically for the study and 130 from a regulatory agency. Personal information and environmental data were combined using two methodologies (method 1 using regulatory data and method 2 using our THM measurements) with a different set of assumptions. We calculated ingestion, showering, bathing, and swimming pool THM uptakes and added up those uptakes to calculate total THM uptake. Average THM levels from our measurements in October, November-December, and April-May were 61.3, 45.1, and 54.5 microg/l, respectively. Geographical variability was low and characteristics of the household did not influence THM levels. Within-subject variability in THM levels was three times higher than between-subject variability. Average THM level in swimming pools was 80.4 microg/l. Average water consumption during pregnancy was 1.9l/day. The source of the household drinking water was 90% bottled, 8% municipal, and 2% from other sources. Forty-seven per cent attended swimming pools during pregnancy. Using method 1, the geometric mean of total THM uptake was 0.93 microg/day. Showering contributed 64%, swimming in pools 23%, bathing 12%, and drinking water 1% to the total THM uptake. In a setting with low geographical variability and limited environmental measurements, individual data is highly relevant to determine personal THM exposure and uptake. In a population that mainly drinks bottled water (e.g., pregnant women), individual THM uptakes are dominated by inhalation and dermal absorption during, showering, swimming in pools, and bathing.  相似文献   

16.
An experiment was designed to determine whether the respiratory retention of sytrene vapor, as estimated from measurements of end-exhaled air, was the same during periods of both constant and fluctuating exposure. Six human subjects were exposed to styrene inside an experimental chamber. A computer-controlled system was used to generate time-varying air concentrations of styrene over 4–5 h in both multistep sequences of constant exposure (four subjects exposed to 15–99 ppm. of styrene in 100-min steps) and fluctuating patterns representative of occupational exposures (two subjects exposed to mean concentrations of styrene of 50 ppm). In the latter case, lognormally distributed exposures, which fit one of two first-order autoregressive models, were generated at intervals of 2.5 min. It was found that the concentration of styrene in end-exhaled air was reduced by about half if the subject inhaled one to three breaths of clean air prior to sampling. This suggests that significant amounts of styrene were desorbed from the lining of the lungs during the initial exhalation. The retention of styrene vapor during constant exposures was 0.935 and was independent of the level. During each of the two sets of fluctuating exposure the retention of sytrene was also constant and was independent of both the variance and the autocorrelation coefficient. However, the retention of styrene during fluctuating exposure (estimates ranged from 0.957 to 0.973) was significantly higher than that observed during the constant exposures. It is speculated that the difference in retention between the constant and the fluctuating exposure regimens is related to non-steady-state behavior of styrene in the richly perfused tissues, as suggested by Opdam and Smolders (1986) regarding tetrachloroethylene exposure.  相似文献   

17.
This study aimed to assess educational differences in adolescents’ exposure to tobacco outlets. Data were collected among 312 13-17-year-old non-smoking secondary school students in four Dutch cities. In a smartphone app, exposure (≤10 m from outlet) was measured using GPS and participants reported their educational track (pre-vocational vs. pre-university). Associations were estimated in negative binomial regression models. Mean exposure to tobacco outlet was 16.6 times in 14 days. Pre-vocational education was associated with higher exposure compared to pre-university education (IRR:1.46, 95%CI:1.08–1.98), especially around school (IRR:2.61,95%CI:1.50–4.55). These differences may contribute to socioeconomic inequalities in smoking.  相似文献   

18.
Objectives: To compare blood toluene (TOL-B) and urinary toluene (TOL-U) as biomarkers of occupational exposure to toluene, and to set a suitable procedure for collection and handling of specimens. Method: An assay based on headspace solid-phase microextraction (SPME) was used both for the determination of toluene urine/air partition coefficient (λurine/air) and for the biological monitoring of exposure to toluene in 31 workers (group A) and in 116 non-occupationally exposed subjects (group B). Environmental toluene (TOL-A) was sampled during the work shift (group A) or during the 24 h before specimen collection (group B). Blood and urine specimens were collected at the end of the shift (group A) or in the morning (group B) and toluene was measured. Results: Toluene λurine/air was 3.3 ± 0.9. Based on the specimen/air partition coefficient, it was calculated that the vial in which the sample is collected had to be filled up to 85% of its volume with urine and 50% with blood in order to limit the loss of toluene in the air above the specimen to less than 5%. Environmental and biological monitoring of workers showed that the median personal exposure to toluene (TOL-A) during the work-shift was 80 mg/m3, the corresponding TOL-B was 82 μg/l and TOL-U was 13 μg/l. Personal exposure to toluene in environmentally exposed subjects was 0.05 mg/m3, TOL-B was 0.36 μg/l and TOL-U was 0.20 μg/l. A significant correlation (P < 0.05) was observed between TOL-B or TOL-U and TOL-A (Pearson's r=0.782 and 0.754) in workers, but not in controls. A significant correlation was found between TOL-U and TOL-B both in workers and in controls (r=0.845 and 0.681). Conclusion: The comparative evaluation of TOL-B and TOL-U showed that they can be considered to be equivalent biomarkers as regards their capacity to distinguish workers and controls and to correlate with exposure. However, considering that TOL-U does not require an invasive specimen collection, it appears to be a more convenient tool for the biological monitoring of exposure to toluene. Received: 20 October 1999 / Accepted: 4 March 2000  相似文献   

19.
Few studies characterizing trihalomethane (THM) exposure or examining potential health effects were conducted in children. The present study describes patterns of water use in children as a source of THM exposure, and estimates the daily THM uptake and the relative contribution of each pathway of exposure.A cross-sectional population-based study was conducted in children 9-12 years of age in Sabadell, Catalonia, Spain (N=2037). We collected individual information on ingestion, frequency and duration of showering, bathing and swimming, source of drinking water, age, sex and parental education. Chloroform, dibromochloroform, bromodichloroform and bromoform in tap, bottled and swimming pool water were measured. The daily chloroform and brominated THM uptakes were estimated combining environmental levels with individual water activities using algorithms reported in the literature.Among the studied group, 80% of children drank bottled water and 20% regularly attended swimming pools. Mean THM concentration in bottled, tap and chlorinated pool water were, respectively, 0.3, 117 and 92 μg/L. Brominated THM predominated in the tap water (84% of total THM) and chloroform predominated in the swimming pool (84% of total THM). Children attending swimming pools had four times higher THM uptake compared to non-swimmers (p-value<0.05). Showering was the main pathway of exposure for non-swimmers. Girls and children with low parental education had a higher THM uptake (p-value<0.05) as they reported taking longer showers and more frequent baths.In conclusion, total and specific THM uptake varied considerably with the personal water uses among children. As drinking water was mainly bottled and bathing was infrequent, showering and swimming in pools were the main pathways of THM exposure. Specific water uses among children slightly differed by sociodemographic characteristics.  相似文献   

20.
Context: Raising public awareness of the importance of social determinants of health (SDH) and health disparities presents formidable communication challenges. Methods: This article reviews three message strategies that could be used to raise awareness of SDH and health disparities: message framing, narratives, and visual imagery. Findings: Although few studies have directly tested message strategies for raising awareness of SDH and health disparities, the accumulated evidence from other domains suggests that population health advocates should frame messages to acknowledge a role for individual decisions about behavior but emphasize SDH. These messages might use narratives to provide examples of individuals facing structural barriers (unsafe working conditions, neighborhood safety concerns, lack of civic opportunities) in efforts to avoid poverty, unemployment, racial discrimination, and other social determinants. Evocative visual images that invite generalizations, suggest causal interpretations, highlight contrasts, and create analogies could accompany these narratives. These narratives and images should not distract attention from SDH and population health disparities, activate negative stereotypes, or provoke counterproductive emotional responses directed at the source of the message. Conclusions: The field of communication science offers valuable insights into ways that population health advocates and researchers might develop better messages to shape public opinion and debate about the social conditions that shape the health and well‐being of populations. The time has arrived to begin thinking systematically about issues in communicating about SDH and health disparities. This article offers a broad framework for these efforts and concludes with an agenda for future research to refine message strategies to raise awareness of SDH and health disparities.  相似文献   

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