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Introduction Inorganic arsenic in drinking water (wAs) remains an environmental exposure of concern, potentially linked to several prevalent chronic diseases in the US. (1,2) According to the American Heart Association [...], BACKGROUND: Inorganic arsenic in drinking water (wAs) is linked to atherosclerosis and cardiovascular disease. However, risk is uncertain at lower levels present in US community water supplies (CWS), currently regulated at the federal maximum contaminant level of 10 [micro]g/L. OBJECTIVES: We evaluated the relationship between long-term wAs exposure from CWS and cardiovascular disease in the California Teachers Study cohort. METHODS: Using statewide health care administrative records from enrollment through follow-up (1995-2018), we identified fatal and nonfatal cases of ischemic heart disease (IHD) and cardiovascular disease (CVD). Participants' residential addresses were linked to a network of CWS boundaries and annual wAs concentrations (1990-2020). Most participants resided in areas served by a CWS (92%). Exposure was calculated as a time-varying, 10-year moving average up to a participant's event, death, or end of follow-up. Using Cox models, we estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the risk of IHD or CVD. We evaluated wAs exposure categorized by concentration thresholds relevant to regulation standards ( RESULTS: Our analysis included 98,250 participants, 6,119 IHD cases, and 9,936 CVD cases. The HRs for IHD at concentration thresholds (reference, 55 years of age at enrollment ([p.sub.interaction] = 0:006 and 0.012 for IHD and CVD, respectively). DISCUSSION: Long-term wAs exposure from CWS, at and below the regulatory limit, may increase cardiovascular disease risk, particularly IHD. https://doi.org/10.1289/EHP14410

Introduction Thyroid hormones (THs) are essential for human growth, development, metabolism, cardiovascular homeostasis, and the immune system. (1) Their circulating levels are strictly regulated via a negative feedback loop along [...], BACKGROUND: Some pesticides have been shown to interfere with thyroid functions through changes in thyroid hormone (TH) levels. However, few human studies have explored associations between TH levels and environmental exposure to currently used pesticides, including neonicotinoids, phenylpyrazoles, phenoxy acids, and azoles. Moreover, such studies often measure biomarkers of exposure in urine or blood, and thus reveal only recent exposure. In contrast, hair has been demonstrated to be a suitable matrix for assessing chronic exposure to both persistent and nonpersistent organic pollutants. OBJECTIVES: We investigated 54 biomarkers of pollutant exposure in relation to tetraiodothyronine (T4), 3,3',5-triiodothyronine (T3), 3,3',5'-triiodothyronine (rT3), and 3,3'-diiodothyronine (T2). METHODS: In a cross-sectional study of 196 healthy Chinese women of reproductive age (25-45 years of age), concentrations of both pollutants and THs were analyzed in the first 12 cm (starting from the scalp) of the hair matrix, collected in 2016. Associations between pollutants and TH levels were explored using stability-enhanced least absolute shrinkage and selection operator (lasso) by regressing all exposures against each outcome of interest, adjusted for age, body mass index, and city. RESULTS: Each TH was associated with the mixture of at least eight of the examined pesticides. We found associations of [beta]-HCH, PCP, DMP, DETP, 3Me4NP, carbofuran, [ClCF.sub.3]CA, imidacloprid, 2,4-D, metolachlor, difenoconazole, and tebuconazole with THs. For example, a 2-standard deviation (SD) increase in [log.sub.10]-transformed hair DMP concentration was associated with lower hair T4 concentration [-15:0% (95% CI: -26:1, -2:21%)] and higher hair T3 concentration [8.16% (95% CI: 1.73, 15.0%)] in the adjusted unpenalized regression models. We also found associations of some pesticides with T3/T4, rT3/T4, and rT3/T3 molar ratios, including PCP, DMP, 2,4-D, metolachlor, difenoconazole, and tebuconazole. DISCUSSION: Our results suggest that exposure to the low levels of pesticides examined here may disrupt thyroid homeostasis in humans. Further studies are needed to confirm our results and to evaluate the long-term consequences of these subtle interferences. https://doi.org/10.1289/EHP14378

Objective To describe the scale-up of cervical cancer screening and treatment for women living with human immunodeficiency virus (HIV), aged 25-49 years in Uganda, and to analyse the programme data. Methods The health ministry targeted existing HIV clinics in a 2-year scale-up of cervical cancer screening services from October 2020. In preparation, we trained health workers to assess women attending HIV clinics for screening eligibility, provided either by human papillomavirus (HPV) testing and/or visual inspection with acetic acid. Clinic staff treated women with precancerous cervical lesions with thermocoagulation or referred women with suspected cancer to external services. We analysed data reported every 6 months for the number of clinics offering screening, screening uptake, the number of positive diagnoses and the number of women who received treatment. Findings The number of HIV clinics offering cervical cancer screening services increased from 11, before the programme launch, to 1571. During the programme, screening uptake increased from 5.0% (6506/130 293) to 107.3% (151872/141 527) of targets. The cumulative proportion of positive diagnoses was 5.9% (23 970/407 323) overall, but was much lower for screening offering visual inspection only compared with clinics offering HPV testing. Although the proportion of women receiving treatment if positive increased from 12.8% (53/413) to 84.3% (8087/9592), the World Health Organization target of 90% was not reached. Conclusion We demonstrated marked increases, potentially replicable by other countries, in screening and treatment. These increases could be improved further by expanding HPV testing and same-day treatment of precancerous lesions. Objectif Decrire Intensification du depistage et du traitement du cancer du col de l'uterus chez les femmes vivant avec le virus de l'immunodeficience humaine (VIH) et agees de 25 a 49 ans en Ouganda, puis analyser les donnees du programme. Methodes Le Ministere de la Sante a cible les cliniques de prise en charge du VIH existantes dans le cadre d'un renforcement des services lies au cancer du col de l'uterus sur une periode de deux ans, a partir d'octobre 2020. En amont, nous avons forme des professionnels de la sante a examiner les femmes frequentant les cliniques du VIH afin de determiner leur admissibility au depistage, par un test de detection du papillomavirus humain (HPV) et/ou une inspection visuelle apres application d'acide acetique. Le personnel des cliniques a traite les femmes presentant des lesions precancereuses du col de l'uterus par thermocoagulation, ou les ont renvoyees vers des services externes lorsqu'elles etaient susceptibles d'etre atteintes d'un cancer. Nous avons analyse les donnees transmises tous les six mois concernant le nombre de cliniques proposant un depistage, la participation au depistage, le nombre de diagnostics positifs et le nombre de femmes ayant repu un traitement. Resultats Le nombre de cliniques du VIH disposant de services de depistage du cancer du col de l'uterus a augmente: 11 avant le lancement du programme, 1571 apres. Au cours de ce programme, la participation au depistage est passee de 5,0% (6506/130 293) a 107,3% (151 872/141 527) des cibles. Le pourcentage cumule de diagnostics positifs s'elevait a 5,9% (23 970/407 323) au total; cependant, il etait nettement moins important dans des cliniques effectuant uniquement des inspections visuelles que dans celles proposant un test de detection du HPV. Bien que le pourcentage de femmes ayant regu un traitement en cas de diagnostic positif ait progresse de 12,8% (53/413) a 84,3% (8087/9592), l'objectif de l'Organisation mondiale de la Sante, fixe a 90%, n'a pas ete atteint. Conclusion Nous avons observe des hausses considerables, susceptibles de se reproduire dans d'autres pays, en matiere de depistage et de prise en charge. Ces hausses pourraient etre accentuees par le developpement des tests de detection du HPV et de traitement des lesions precancereuses le jour meme. Objetivo Describir la ampliacion del cribado y tratamiento del cancer de cuello uterino para mujeres con el virus de la inmunodeficiencia humana (VIH) de entre 25 y 49 anos en Uganda, y analizar los datos del programa. Metodos El Ministerio de Salud se centro en las clinicas de VIH existentes en una ampliacion de dos anos de los servicios de cribado del cancer de cuello uterino a partir de octubre de 2020. Como preparacion, formamos a profesionales sanitarios para que evaluaran a las mujeres que acudian a las clinicas de VIH para determinar si cumplian los requisitos para someterse al cribado, mediante pruebas del virus del papiloma humano (VPH) o inspeccion visual con acido acetico. El personal clinico trato a las mujeres que presentaban lesiones cervicales precancerosas con termocoagulacion o derivo a las mujeres con sospecha de cancer a servicios externos. Se analizaron los datos comunicados cada seis meses sobre el numero de clinicas que ofrecian el cribado, la aceptacion del cribado, el numero de diagnosticos positivos y el numero de mujeres que recibieron tratamiento. Resultados El numero de clinicas de VIH que ofrecen servicios de cribado del cancer de cuello uterino aumento de 11, antes del lanzamiento del programa, a 1571. Durante el programa, la aceptacion del cribado aumento del 5,0% (6506/130 293) al 107,3% (151 872/141 527) de los objetivos. El porcentaje acumulado de diagnosticos positivos fue del 5,9% (23 970/407 323) en general, pero fue mucho menor en el caso de los diagnosticos en clinicas que solo ofrecian inspeccion visual en comparacion con las clinicas que ofrecian pruebas del VPH. Aunque el porcentaje de mujeres que recibieron tratamiento en caso positivo aumento del 12,8% (53/413) al 84,3% (8087/9592), no se alcanzo el objetivo del 90% que habia fijado la Organizacion Mundial de la Salud. Conclusion Se registraron aumentos notables, potencialmente reproducibles en otros paises, en el cribado y el tratamiento. Estos aumentos podrian mejorarse aun mas ampliando las pruebas del VPH y el tratamiento en el mismo dia de las lesiones precancerosas. [phrase omitted], Introduction Cervical cancer is a disease of the female reproductive tract caused primarily by oncogenic types of human papillomavirus (HPV). In 2020, it was the fourth most common cancer among [...]

DOBBS V. Jackson Women's Health Organization was a great victory for the pro-life cause. Prior to the 2022 decision, dubious constitutional interpretation by the Supreme Court had impeded any effective [...]

Family planning methods have the potential to improve maternal and child health outcomes; thus, ensuring the right to family planning methods is critical in safeguarding the sexual and reproductive health rights of women. Despite the high standards of maternal and child healthcare in Kerala, a southern state in India, tribal pockets within the state such as Attappady have a high prevalence of maternal health issues and infant death rates. The present study conducted in Attappady, which focuses on an intergenerational comparison from an intersectional approach, is intended to explore the trends, practices, and experiences of tribal women regarding their awareness of, access to, and use of family planning methods. Qualitative fieldwork was carried out based on 45 in-depth, dyadic (two-subject) interviews with Attappady women (specifically mothers and grandmothers), and case studies were also used to substantiate the data. The intergenerational comparison revealed the following: a higher acceptance of sterilization among the older women; an increasing awareness and assertiveness in demanding their rights among the younger generation of mothers, who were nevertheless denied their demand for female sterilization by healthcare workers; and fear, stigma, and misconception among women due to lack of reliable information and awareness about temporary modern methods. Thus, the majority of women are opting for natural methods like abstinence to avoid unplanned/unwanted pregnancies. Other major factors determining the family planning experiences of tribal women are lack of men's engagement, lack of timely and quality family planning services, and patriarchal norms and gendered roles in families. The study proposes the need for men to be engaged in the process along with realigned efforts from the state, both of which are crucial to the fulfilment of the right to family planning among tribal women. Keywords: Family planning methods, Contraception, Sterilization, Indian tribal women, Intergenerational study, Dyadic interviews, Attappady, Introduction: Family Planning in India Of the United Nations' Sustainable Development Goals (SDGs), number 3 (Health) and number 5 (Gender equality and empowering women) are intended to safeguard universal access [...]

Introduction: We aimed to investigate the diagnostic value of International Prostate Symptom Score voiding symptom score (IPSS-VS) and Bristol Female Lower Urinary Tract Symptoms-short form voiding score (BFLUTS-VS) in female patients with urodynamically diagnosed voiding dysfunction. Methods: The medical records of female patients who underwent urodynamic examination between May 2007 and November 2021 for lower urinary tract complaints were retrospectively evaluated. A total of 1858 female patients were included in the study. Patients investigated between 2007 and 2014 were asked to fill the IPSS, and patients investigated after 2015 were asked to fill the BFLUTS-SF. Results: The mean age of the patients was 49.06 ± 0.33 in the IPSS group and 50.02 ± 0.47 in the BFLUTS group. On the pressure flow study, voiding dysfunction was found in 14.8 (n = 95) in the IPSS group and 15.1 (n = 183) in the BFLUTS group. The area under curve value was found to be 0.58 for IPSS and 0.64 for BFLUTS. Threshold values were found as >9 for IPSS-VS and >4 for BFLUTS-VS. The sensitivity, specificity, false negative, and false positive rates for IPSS-VS were 33.3, 78.8, 66.7, and 21.2, respectively. The same parameters were 45.5, 78.9, 54.5, and 21.1 for BFLUTS-VS, respectively. Conclusion: The diagnostic performance of both the questionnaires was found to be low for diagnosing voiding dysfunction in female patients according to our data. Therefore, the assessment of the voiding phase in women should not solely rely on the current questionnaires. However, further studies using questionnaires including all voiding symptoms are required., Author(s): Mehmet Erkan Erbay (corresponding author) [1]; Burcu Hanci Sevinç [2]; Fatih Tarhan [3] INTRODUCTION Female voiding dysfunction is defined as 'symptoms and urodynamic investigations as abnormally slow and/or incomplete [...]

Background: Women roll beedis from a young age and expose continuously to unburnt tobacco dust for many years. Due to poverty, ignorance, and lack of literacy, women and young individuals engage in less profitable occupation. The study was conducted in a large sample to know the occupational health morbidities in rural women. Materials and Methods: Women beedi rollers and nonbeedi rollers living in villages of Jagitial and Nizamabad districts were selected for the study. Individuals who signed consent are interviewed about their health profile using a predesigned standard questionnaire. Result: A high frequency of general health problems was observed in the present study. Hypertension, body pains, and headache are the most prevalent health issues observed in more than half of beedi rollers. Conclusion: Awareness programs must be implemented to decrease the health hazards and provide alternate job opportunities for better health. Keywords: Beedi rolling, joint pains, headache, hypertension, tobacco, women, Author(s): Penagaluru Pardhanandana Reddy (corresponding author) [1,2]; Baluka Vanitha [1]; Lakkampelly Madhuri [1]; Shehnaz Sultana [1]; Busarapu Manideep [1]; Ch. Prashanth [1,3] INTRODUCTION In Telangana, Beedi rolling is a home-based [...]

BACKGROUND: Mammographic breast density (MBD) is a strong risk factor and an intermediate phenotype for breast cancer, yet there are limited studies on how environmental pollutants are associated with MBD. OBJECTIVE: We investigated associations of perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), and perfluorohexane sulfonate (PFHxS) levels with measures of MBD and evaluated if early life factors modified any associations. METHODS: Metabolon performed metabolomics analysis using ultrahigh-performance liquid chromatography/tandem accurate mass spectrometry in fasting blood from 705 premenopausal women completing their annual screening mammogram in St. Louis, Missouri. We calculated least square means (LSM) of mammographic volumetric percent density (VPD), dense volume (DV), and nondense volume (NDV) by quartiles (Q) of PFOS, PFOA, and PFHxS from multivariable linear regression modeling overall and stratified by recruitment period, race, age at menarche, and body shape at age 10. Models were adjusted for age, age at menarche, body fat percentage, race, family history of breast cancer, oral contraceptive use, alcohol consumption, parity/age at first birth, and body shape at age 10. RESULTS: PFOS, PFOA, and PFHxS were not significantly associated with VPD or NDV. PFHxS was significantly positively associated with DV (Q1=67:64[cm.sup.3], Q2 = 69:91 [cm.sup.3], Q3 = 69:06[cm.sup.3], Q4=75:79 [cm.sup.3]; p-trend=0:03). PFOS was positively associated with DV (Q1=65:45 [cm.sup.3], Q2=70:74 [cm.sup.3], Q3=73:31[cm.sup.3], Q4 =73:52[cm.sup.3]; p-trend=0:06) with DV being 8.1%, 12%, and 12.3% higher in Q2, Q3, and Q4 compared to Q1. Among women who were underweight/normal weight at age 10, PFOS was positively associated with VPD (Q1=9:02%, Q2 = 9:11%, Q3=9:48%, Q4=9:92%; p-trend=0:04) while there was an inverse association among women who were overweight/obese at age 10 (Q1=7:46%, Q2=6:94%, Q3 =6:78%, Q4 = 5:47%; p-trend =0:005) (p-interaction = 0:04). DISCUSSION: We report novel associations of PFHxS and PFOS with DV in premenopausal women. PFOS, PFOA, and PFHxS were not associated with VPD and NDV. In addition, body shape at age 10 may modify the associations of PFOS with MBD. Further studies are needed to validate our findings and to evaluate the associations of other per- and polyfluoroalkyl substances (PFAS), as well as mixtures of PFAS, with MBD. https://doi.org/10.1289/EHP14065, Introduction Pollution is one of the biggest challenges in public health, yet associations of environmental pollutants with mammographic breast density (MBD) are not well understood. MBD is an intermediate phenotype [...]

Climate change increases heat stress exposure and occupational heat strain in tropical and subtropical regions with generally hot-humid climate conditions. The present systematic review was conducted to assess the effect of climate change on occupational heat strain among women workers. In this study, three main databases (PubMed, Scopus, and Web of Science) were searched to find relevant literature on climate change and its effects using subject headings and appropriate MeSh terms. This article has been written according to the PRISMA checklist. A total of 6,176 studies were identified for screening and 13 studies were eligible for data extraction. Scientific evidence reveals that there is an imprecise but positive relationship between climate change and occupational heat strain regarding women workers. Some complications associated with occupational heat strain among women workers include fatigue, discomfort, dehydration, reduced brain function, and loss of concentration. Climate change can lead to an increase in the occurrence of heat-related illnesses and the levels of injury risk. In addition, its adverse health effects on women workers are mentioned. This systematic study identifies key priorities for action to better characterize and understand how occupational heat strain among women workers may be associated with climate change events. Strong evidence indicates that climate change will continue to cause occupational heat strain among women workers. It is essential to implement preventive measures considering multidisciplinary strategies to reduce the adverse effects of climate change on women workers health in hot weather settings. This can limit the health risks and negative effects of climate change. Keywords: Climate change, occupational heat strain, systematic review, women workers, Author(s): Peymaneh Habibi [1]; Ahad Heydari [2]; Habibollah Dehghan [3]; Amirhossein Moradi [4]; Gholamreza Moradi (corresponding author) [5] INTRODUCTION Occupational heat exposure and heat strain responses due to climate change [...]

Women's activities within the local food system are linked to their dietary quality. Their ability to consume a nutritious diet may be influenced by socio-cultural norms; often, the influence of these norms has not been adequately studied. This study examined how socio-cultural norms linked with rural food systems can potentially exert adverse effects on women's diets. The study was conducted in two rural communities, Yilkpene and Kpachilo, in Northern Ghana, between May and July 2016. Both selected study communities were chosen because they had similar population sizes, dietary patterns, and access to social services. Using a qualitative approach, sixteen key informant interviews with community and institutional leaders, 11 focus group discussions comprising 87 community members, and forty 24-hour dietary recall interviews with women of reproductive age were used to explore the nature of the local food system linked with sociocultural norms. Transcribed interviews were coded and analyzed, thematically, using pre-determined and emerging themes. A total of 143 women and men participated in the study with women dominating the sample. The components of the food system in both communities were constructed, primarily, around men. Quantities, quality, and varieties of produce, its distribution, and intra-household allocation were dominated by male perceptions and practices that determine access and ownership of productive resources, and pre-determined roles and responsibilities of household members. Men dominated production of economic crops (cereals, and legumes); women produced vegetables, and limited quantities of legumes and cereals, mainly for home consumption. Men controlled allocation of cereals for household meal preparation; more expensive complementary ingredients were provided by women. Although women prepared household meals, men received the 'lion's share' of nutrient-dense components. Forty-five percent of women could not meet minimum dietary diversity of at least five food groups in their diets. The local food system in Northern Ghana is dominated by gender-driven socio-cultural norms, which constitutes a potential barrier to women achieving dietary adequacy. Interventions should deliberately address these culturally-established barriers, especially in contexts where subsistence farming is the main source of livelihood. Key words: Food system, Socio-cultural norms, Barriers, Women, dietary quality, INTRODUCTION Low dietary quality is a global public health challenge that exerts adverse consequences on human health and well-being with children and women of reproductive age (WRA) being the most [...]

* Context.--Unsatisfactory Papanicolaou (Pap) tests pose a unique set of challenges to the laboratory with regard to their processing, review, reporting, and performance of human papillomavirus (HPV) testing. There are no standardized guidelines for the review process and handling of unsatisfactory Pap tests. Objective.--To assess the current practice patterns regarding various aspects of the unsatisfactory Pap test, from processing to reporting, across laboratories worldwide. Design.--A supplemental questionnaire was mailed to laboratories participating in the 2020 College of American Pathologists (CAP) Gynecologic Cytopathology (PAP Education) Program, requesting data regarding the unsatisfactory Pap test. Results.--Of 1520 participating laboratories, 619 (40.7%) responded, and the responses of 577 laboratories were included for further analysis. Only 64.6% (373 of 577) laboratories used the unsatisfactory Pap test criteria as specified by the 2014 Bethesda System. About three-quarters of the respondents (433 of 576; 75.2%) routinely rescreened unsatisfactory Pap tests. Routine repreparation of such Pap tests was performed by 54.9% (316 of 576) of laboratories, and 52.0% (293 of 563) used glacial acetic acid for repreparing excessively bloody specimens. HPV test results were reported for unsatisfactory Pap tests, always or sometimes, by 62.4% (353 of 566) of respondents. Conclusions.--This CAP survey reveals important information regarding the practice patterns pertaining to several aspects of the unsatisfactory Pap test. It also provides valuable insight into the quality assurance measures that can be implemented for such tests. Future studies can further aid in the standardization of all components of the handling of unsatisfactory Pap tests for overall quality improvement. doi: 10.5858/arpa.2022-0330-CP, The assessment of specimen adequacy or satisfactoriness is a key component of a Papanicolaou (Pap) test interpretation. The criteria for specimen adequacy were initially established under the Bethesda System (TBS) [...]

Bu calismada kadin calisan istihdaminin yogun oldugu tehlikeli ve emek yogun bir sektor olan tekstil sektorunde kadin calisanlarin Is Sagligi ve Guvenligi (ISG) uygulamalarina bakis acisini ortaya koyabilmek amaclanmistir. Calisma kapsaminda bir tekstil fabrikasindaki 180 kadin calisana 35 soruluk 5'li Likert tipi olcekle hazirlanan anket uygulanmistir. Kadin calisanlarin ISG konusundaki bilgi ve tecrubeleri degerlendirilerek, ISG kulturunun gunumuz calisma kosullarindaki durumu kadin calisanlarin bakis acisiyla ortaya konmaya calisilmistir. Yapilan anket neticesinde, calisanlarinin %54'unun 'Kadin calisanlara yonelik cikarilan kanunlarin iyilestirilmesi gerektigini dusundugu', bununla birlikte %49'luk kisminin ise 'Kadin calisanlar acisindan gece vardiyasinin erkek calisanlara kiyasla daha zorlayici oldugunu dusundugu' tespit edilmistir. Genel olarak degerlendirildiginde ise kadin calisanlarin guvenlik kulturu ve ISG farkindaliklarinin yetersiz oldugu ortaya konmustur. Anahtar Kelimeler: Calisan kadin, guvenlik kulturu, tekstil sektoru, is guvenligi, ISG Bilinci In this study, it is aimed to reveal the perspective of women employees on Occupational Health and Safety (OHS) practices in the textile sector where there is intense women employment, a dangerous and labor-intensive sector. In this context, a questionnaire prepared with a 5-point Likert type scale with 35 questions was applied to 180 women employees in a textile factory. By evaluating the knowledge and experience of women employees in terms of OHS, the state of OHS culture in today's working conditions has been tried to be revealed from the perspective of female employees. As a result of the study, it was determined that 54% of the employees think that 'the laws enacted for female employees should be improved', while 49% of them think that 'night shifts are more challenging for female employees compared to male employees'. When evaluated in general, it has been revealed that the safety culture and OHS awareness of female employees are insufficient. Keywords: Women employees, safety culture, textile industry, occupational safety, OHS Awareness, Giris Calisma ihtiyaci insanlarin temel gereksinimlerini karsilayabilmesi noktasinda oldukca onemli bir aractir. Insanlarin hayatlarinin devami icin gereksinim duydugu calisma ihtiyaci onlari olumsuz calisma kosullari ve calisma ortamlarinda is gormeye mecbur [...]