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4,511 results on '"Environmental Health"'

1. Surface ozone and population health

Author: Sun, Zhe and Archibald, Alexander
Subjects: atmospheric chemistry, Earth system model, deep learning, meta-analysis, environmental health, environmental justice
Abstract: Atmospheric ozone is attracting ever-growing research attention, as i) stratospheric ozone depletion will expose the biosphere to stronger hazardous ultraviolet radiation, which has been emphasised in the Montreal Protocol; ii) ozone as a greenhouse gas can alter the atmospheric thermodynamics; iii) ambient ozone is associated with adverse effects on ecosystem and population health through exposure; and iv) sophisticated photochemical mechanisms make the parametrisation for numerical modelling a chasing-deer challenge (Chapter 1). Original research starts from the Coupled Model Inter-comparison Project Phase 6 (CMIP6), which collates an ensemble of Earth system models to simulate the global surface ozone for the purpose of diagnosis-oriented mutual comparison. The author systematically diagnoses 8 models with supports from a collection of auxiliary features and in situ observations (Chapter 2). Interpreted from the semi-quantitative diagnosis outcomes, geographical incoherence can be ascribed to the erroneous emission inventories; incongruous longitudinal trends result from the disagreements in radical simulation; and central biases are attributable to the high uncertainties in simulating the photolysis rate and reservoir formation. Ensemble-based model diagnosis can point out possible directions for the revision of CMIP6 models. Ozone isopleths describe the non-linear responses of ozone concentrations to changes in precursors, nitrogen oxides and volatile organic compounds (VOCs), and thus are pivotal to the determination of ozone regulation requirements. The author innovatively uses the Community Multiscale Air Quality model with High-order Decoupled Direct Method (CMAQ-HDDM) to simulate surface ozone across China domain in 2017, and simultaneously derive ozone isopleths for individual cities (Chapter 3). Interpreted from the city-level isopleths, densely populated metropolitan agglomerations such as Jing-Jin-Ji, Yangtze River Delta, and Pearl River Delta follow the NOx-saturated regime, indicating NOx controlling will increase ozone. Ambient ozone in eastern China generally follows the VOC-limited regime, suggesting reducing VOCs will more effectively suppress the ozone pollution; while contrarily in western regions. Therefore, city-specific ozone isopleths are instrumental in forming differentiated strategies for ozone abatement of Chinese cities. Settling the cross-model discrepancies to achieve more accurate predictions of surface ozone is an unsolved challenge, and methods that overcome structural biases in models going beyond naïve weighted averaging of multiple models is urgently required. Building on CMIP6, a conventional aggressive ensemble-learning-based algorithm is transplanted, and also a more conservative 2-stage enhanced space-time neural network ensembler is optimised to fuse 57 simulations, both of which have revealed outstanding performances (Chapter 4). The conventional approach is computationally cheaper and achieves slightly higher accuracy, but at the expense of sacrificing the model interpretability and leaving the oceanic overestimation unsolved. The conservative approach performs better in spatial generalisation and enables perceivable interpretability, but requires heavier computational burdens, which is a prior choice in multi-model fusion when computation resources permit. Followed by the multi-model fusion, a space-time Bayesian neural network downscaler has been constructed (Chapter 5) to realise urban-rural distinguished 10 km × 10 km spatial resolution surface ozone prediction with excellent methodological reliability and fair prediction accuracy. Based on the predictions in 8-hour maximum daily average metric, the global rural-site surface ozone were 15.1±7.4 ppb higher than urban sites averaged across 30 historical years, with developing countries being of the most evident differences. The globe-wide urban surface ozone were climbing by 1.9±2.3 ppb per decade, except for the de-creasing trends in eastern United States. On the other hand, the global rural surface ozone tended to remain constant, except for the rising trends in China and India. The novel framework contributes to the deep-learning-driven environmental studies methodologically by providing a brand-new feasible way to realise data fusion and downscaling, which maintains high in-terpretability by conforming to the principles of spatial statistics without compromising the prediction accuracy. Furthermore, the spatial resolved monthly surface ozone dataset with multiple metrics has lain a solid foundation for global health impact studies. To provide more accurate estimations for the risk association between long-term ozone exposure and multi-cause mortalities, the author updates the existing systematic reviews by including recent studies and unifying the exposure metrics (Chapter 6). Cross-metric conversion factors are estimated linearly by decadal observations. A total of 25 studies involving 226,453,067 participants are included in the systematic review. The pooled relative risks associated with each 10 ppb incremental ozone exposure, by mean of the warm-season daily maximum 8-h average metric, are RR=1.014 with 95% confidence interval (CI) ranging 1.009-1.019 for all-cause mortality; 1.025 (95% CI: 1.010-1.040) for respiratory mortality; and 1.019 (95% CI: 1.004-1.035) for cardiovascular mortality. Adjustment for exposure metrics lays a more solid foundation for multi-study meta-analysis. To fill in the research gap, the author has estimated the long-term ozone exposure-associated excess mortalities in urban and rural residents globally during 1990-2019 (Chapter 7), by linking the machine-learning-generated high-resolution surface ozone concentration archives (Chapter 4 and 5) with the most up-to-date meta-analysis pooled relative risks (Chapter 6). Ozone exposure-associated all-cause excess mortality was climbing from 0.92 (95% CI: 0.58 to 1.27) million in 1990 to 1.33 (95% CI: 0.83 to 1.85) million in 2019. Rural excess mortalities kept surpassing the urban deaths over the 30 years. Ozone-attributable cardiovascular mortalities were higher than the respiratory deaths, which have been overlooked in previous studies. Urban-rural environmental inequality finally leads to population health injustice, requiring future pertinent pollution control considerations at policy-level.
Published: 2022
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2. Data, decisions, and drinking water safety : an interdisciplinary analysis of the complex adaptive response to monitoring in rural Kenya

Author: Nowicki, Saskia, Charles, Katrina, and Bradley, David
Subjects: Drinking water--Analysis, Rural poor, Environmental health, Human behavior, Water-supply, Rural development, Water quality management, Feedback control systems, Sustainable development--Africa, Sub-Saharan, Rural health, Drinking water, Interdisciplinary research
Abstract: For decades, international and national development efforts have endeavoured to improve rural drinking-water safety in Sub-Saharan Africa by focusing on infrastructure provision, devolving responsibility for operations and maintenance to the community level. Rural areas continue, however, to have severely limited access to both safe water and to water quality information for operational decision-making. This thesis argues that sustained provision of safe water is an emergent function of a complex adaptive system, and that information-response feedback mechanisms must be positioned to support decision-making at the local level if this function is to be realised. Through empirical research situated in rural Kenya, it explores how a systems-based understanding of the links between data and decision-making can elucidate leverage points for establishing an information feedback that improves water safety and thereby mitigates health risk. Guided by a structurationist systems framing and questions that align with normative, descriptive, and prescriptive modes of decision analysis, the research described in this thesis intersects with both natural and social science disciplines. Pragmatically, it draws on a diverse range of literature and methods. The empirical work is structured in three parts: 'Data uncertainty has implications for normative conceptions of risk management'. Research demonstrating growth of E. coli in the environment challenges interpretations of microbial water quality based on E. coli test results. Characterising strains using whole genome sequencing offered insight into the utility of E. coli as an indicator of microbial contamination in rural water supplies. The difficulty of interpreting health risk from grab samples, especially at the household level, is highlighted. Monitoring can be an effective feedback mechanism at supply level, informing more reliable understandings of hazard dynamics, by accounting for sanitary conditions and temporal variability in indicator concentrations. 'Data-informed understandings of risk interact with other drivers of decision-making'. An integrated fear appeal framing, which responds to key weaknesses in the behaviour change literature, is applied a) to assess user perceptions of drinking-water safety and b) to evaluate an information intervention through which monitoring data were shared with local lay water managers. The findings emphasise that data should be reported with sensitivity to self-efficacy limitations and the threatscapes that decision-makers navigate. Specific, contextualised, and repeated messaging can reinforce engagement with water safety precautions at supply level - especially if lay water manager self-efficacy is supported through infrastructure design, training, and ongoing resourcing. 'Institutional structure enables and constrains monitoring activity and data flows'. Dilemma analysis is used to synthesise views from stakeholders in bureaucratic, market-based, and community domains. The findings challenge the common practice of conceptualising water quality versus quantity as dichotomous objectives. They advance the literature on pluralistic water governance by explicitly considering quality risks, which have received less coverage than other service dimensions. Progress on securing safe water is inhibited by unclear divisions of responsibility and risks associated with not being able to respond to data, particularly at the local level. This thesis concludes that, although the health of water users is the ultimate concern, monitoring activity should focus at supply level - with research and policy developments needed to establish technical and institutional structures that support the efficacy of lay management. A structurationist systems framing was instrumental in guiding the research to evidence a range of stock and flow, feedback, and structural leverage points for implementing effective monitoring. This framing, which links international policy and local practice by recognising the interaction of agency and structure in stakeholder responses to hazards, could be applied broadly to problems of health risk management. It is useful for research that aims to contribute prescriptive decision analysis to bridge the gap between normative models and decision-making in practice.
Published: 2021

3. Combined multiscale exposures to urban greenspaces : a spatially explicit approach

Author: Labib, Sm, Lindley, Sarah, and Huck, Jonathan
Subjects: Nature and health, Health Geography, Environmental health, Remote sensing, Geographic information systems, Green space, Environmental epidemiology
Abstract: A steadily increasing number of studies have indicated the multidimensional relationships between exposure to greenspace and human health. These previous studies applied diverse, spatially explicit methods and datasets when measuring and modelling greenspace exposure. However, they often did not consider the key underlying principles of geospatial science, such as spatial scale. Potential uncertainties regarding the estimation of greenspace exposure and modelling relationships between greenspace and human health are inherent in such studies. Therefore, research to investigate the spatial dimensions (e.g., scale, data, methods) of exposure to greenspace is warranted. Previous studies measuring greenspace exposure have usually only considered individual exposure types (i.e., availability, accessibility, and visibility). Consequently, there are no existing methodological approaches that standardise and harmonise these three individual metrics to produce a composite estimate of aggregate greenspace exposure. Additional research is essential to develop metrics for greenspace exposure that can reduce the multiplicity of current heterogeneous approaches to greenspace exposure estimation. The four papers foundational to this thesis encompass different methodological approaches and used diverse spatial data to address existing challenges in greenspace exposure assessment. Greater Manchester in the UK was used as the case study area. However, the methods are intended to be transferable to other urban areas. The first paper provides a systematic review of the spatial dimensions considered in previous studies evaluating the associations between greenspace and human health. These preceding studies used a wide range of spatial data, scales of analysis, and buffer distances, resulting in the likelihood that their results were vulnerable to scale effects. Furthermore, these studies represented a heterogeneous collection of study designs. Such heterogeneity of study design may have caused ambiguities in understanding the associations between greenspace and health amongst existing studies. There is a need for new methodological solutions to overcome the existing challenges. The second paper investigated the scale effects inherent in three commonly used metrics of greenspace availability exposure (i.e., NDVI, leaf area index, and land use land cover). Applying lacunarity analysis, this paper identifies the scale sensitivity and the upper limit of the acceptable scale range beyond which these greenspace metrics are vulnerable to scale effects. Using lacunarity weightings, this study also provides a new methodological solution for measuring greenspace availability exposure that combines multiple, properly weighted metrics to reduce the scaling effect. This novel metric offers a unique solution for measuring greenspace availability at high resolutions, independent of scale. The third paper provides an innovative methodological approach to modelling eye-level greenspace visibility using a fusion of digital elevation and land use-land cover data. This study applied a classic viewshed analysis for visibility assessment to more than 86 million observer locations to achieve high resolution and granularity in eye-level exposure assessment. This paper also explores the differences between eye-level and top-down exposure metrics, and the results showed that these two exposure measures are complementary but distinct from one another. The fourth paper develops and evaluates a new methodological approach to measuring greenspaces accessibility at a high spatial resolution. This novel methodological approach allows the availability, accessibility, and visibility metrics of greenspace exposure to be combined to produce a composite greenspace exposure index (CGEI). This CGEI, in turn, introduces the possibility of standardising and harmonising greenspace exposure estimates. The paper also applies the newly developed exposure metrics to investigate variations in greenspace exposure in relation to socioeconomic inequalities and years of potential life lost (YPLL) at the neighbourhood scale. The results of this research indicate the composite greenspace exposure metric is a superior metric for green space exposure estimation and is better at explaining the variability in YPLL compared to any given single exposure metric. It also further supports previous research findings that greenspace exposure spatially co-varies with socioeconomic inequalities and that increased exposure to greenspace is significantly associated with lower YPLL. Overall, this thesis suggests that future studies should critically consider spatial dimensions in the context of exposure assessment. Further studies are required to continue to improve the current understanding of the relationships between greenspace exposure and health.
Published: 2020

4. Examination of the community food environment and the drivers affecting and impacting obesogenicity in a deprived urban neighbourhood in Scotland

Author: Fuentes Pacheco, Andrea Carolina, Grant, Liz, and Skafida, Valeria
Subjects: obesity, environmental health, foodscapes
Abstract: Introduction: The condition of obesity has been classified as a pandemic , given that it is negatively impacted health in almost every country in the world (1). Scotland has one of the worst obesity records in the world and one of the highest rates of all OECD countries (2). Scottish men and women in the most deprived areas had higher rates of obesity in 2016 in comparison with less deprived areas (3,4). Its alarming increasing trend year on year and the magnitude of the level of obesity over the last 30 years, coupled with the causality network which appears to be rooted in health inequities has been made obesity a titan challenge of the 21st century (1,5,6). No country in the world has reversed the challenge of obesity. The community food environment has been identified as one of the environmental causes of obesity (7-9). The high presence and accessibility of less healthy food sources appears to determine an increased availability of high-energy dense food, and the lower presence and accessibility of healthier food outlets also decreases the availability and shopping possibilities for more nutritious products (7-9). Both scenarios encourage a more frequent consumption of obesogenic food, promoting a rapid and sustained weight increase in all age groups, but especially among adults and elders (6,7,10). This thesis is the first study in Scotland that has mapped a complete foodscape or food map in a deprived neighbourhood and identify some key contributors that promote obesity. Methodology and methods: the study was conducted in a Scottish urban neighbourhood, which is low-income with high levels of poverty and obesity and poor dietary patterns. Data collection made use of a combination of different databases and approaches, including ethnographic fieldwork and online validation. Predominance, proximity and density of all type food sources, and healthier and less healthy food sources were calculated, using the Quantum Geographic Information System (QGIS) software. Food sources were categorised using 15-point classification tool, proposed by Lake et al (11). Accessibility to these sources was assessed separately for general stores and healthier and less healthy categories. Results: Findings reported a wide range of outlet types and confirmed an obesogenic food environment in the neighbourhood. Food sources related to deprivation were also present, such as food banks, whereas others such as organic food outlets which are related to more affluent areas were absent. A set of ready-made food at a low price, easy to collect or delivery at home preparations was present in over 30% of the establishments and are described in the thesis. These preparations were highly popular among the residents, and almost all the menu options were served in extra-large portions. The food outlets' showcases were often in a deteriorated state with a preponderance of special cheap offers. Most of the establishments had a small sit-in area, while promotion of food delivery and takeaway was high. A higher proportion of less healthy food sources (27.7%) than healthy food sources (5.5%) were present within the neighbourhood. Less healthy food sources, such as fast-food outlets, takeaways, and convenience stores, were highly accessible and offered a wide range of high-energy dense foods. This scenario is known as food swamp. On the opposite side, the few healthier food sources, such as supermarkets, and fruit and vegetable stores, were located further away from households than the less healthy food sources. This scenario is known as a food desert, and alongside a food swamp, they confirmed that the geographical area mapped, anonymised to Whitewood has a highly obesogenic food environment. This environment appeared to be encouraging unhealthy eating patterns among residents and people working and studying in the area. Conclusions: This complete food exposure mapping showed for the first time in an area of intense deprivation, the features of a low-income food environment. Regarding the obesogenic characteristics of the food environment, results resonated with previous investigations. The presence of a food swamp and a food desert and the high accessibility of less healthy food in comparison with healthier establishments, is a scenario described previously in literature in other countries, including the US and Canada (12,13). According to Glanz et al. and Story et al. there are common drivers related to deprivation that influence a less healthy food shopping behaviour among residents, contributing to the weight gain process (7,8,14). Although the obesity causality network is hugely complex and several determinants can potentially influence eating patterns, the community food environments quality and accessibility may be part of the factors that encourage inhabitants to eat less healthy food regularly. Obesity causes are potentiated by health inequities, and there is an urgent need to tackle the obesity problem from the roots, using a multilevel approach (5,6,15). Intervening within the food environments in deprived neighbourhoods is part of the Scottish government new food policy; however, more articulated initiatives are needed to fight against obesity, starting from tackling the roots of poverty (16,17).
Published: 2020
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5. Formulating and managing neighbourhood complaints : a comparative study of service provision

Author: Alexander, Marc
Subjects: 363.2, Language, Communication and Culture not elsewhere classified, Studies in Human Society not elsewhere classified, Agency, Antisocial behaviour, Comparative analysis, Complaints, Conversation analysis, Discursive psychology, Environmental health, Identity, Institutions, Mediation, Neighbour disputes, Noise, Recipient design
Abstract: This thesis investigates how members of the public report neighbourhood problems in telephone inquiry calls to antisocial behaviour, environmental health, and mediation services in the United Kingdom (UK). It provides the first comparative analysis of how similar kinds of concerns (e.g., noise, smells, property access) are designed for different organizations that, in their own way, have a remit to provide service. Despite neighbourhood problems, and neighbour disputes, being such a widespread and pervasive concern in the UK, little is known about the service provided by the somewhat diverse organisations that exist to remedy them. This research examines actual interactions that take place in these institutional settings, focusing on the ways in which people formulate complaints about their neighbours conduct, and how different services offer (or reject) assistance. In so doing, the thesis contributes in new ways to our understanding of how institutional identities, relationships, actions, and activities are shaped in these encounters. Further, it enriches our knowledge of the organisational features of social interaction. The empirical basis for the research comprises a corpus of over 340 telephone recordings of interactions between members of the public and antisocial behaviour, environmental health, and mediation services. The data were transcribed and analysed using the approach of discursive psychology (DP), as embedded within the methodological framework of conversation analysis (CA). The four analytic chapters are organised around different aspects of service provision, and in their own way, address the two core CA concepts of comparative analysis (i.e., comparing interactional features in or across environments) and recipient design (i.e., formulating talk designed to display an orientation to co-present others). The first analytic chapter examines how noise disturbance is initially recipient designed and establishes two predominant formulations callers use - agentive (neighbours are invoked) and agent-free (neighbours are omitted). In mediation calls, the agentive formulation is always used, whilst in environmental health calls, agent-free design is predominantly used. The second analytic chapter investigates the emergence of service-side business and demonstrates how concomitant shifts (i.e. from caller experience to institutional concern) by call-takers treat certain information as adequate, and how callers are given interactional space (or not) to complain in various ways. The third analytic chapter comparatively examines how third-party agencies (TPAs) are recipient designed when making the case for aid specifically, as service-referrals and service-mentions , and brings into focus, the interconnectedness of organisations that manage similar problems. The final analytic chapter investigates call outcomes through offers and signposting to TPAs. Offers might recruit callers in future courses of action or may only be treated as offers by next-turn-proof-procedure. Signposting typically involves rejecting the case for assistance sometimes in normative terms, or in the vehicle of an offer. Through comparative analysis, this thesis contributes significantly to our understanding of the interconnectedness of services and underscores the flexible ways in which neighbourhood problems are recipient designed for, and managed by, call-takers in organisations. This thesis lays the groundwork for future research by introducing new institutional environments for service provision antisocial behaviour and environmental health agencies.
Published: 2019

6. Exploring the socio-environmental context in the prevalence and management of asthma at Scottish General Practices

Author: Sheriff, Shiraz, Hall, Edward, and Kroll, Thilo
Subjects: 616.2, Asthma, Health inequalities, Deprivation, Socio-environmental contexts, Environmental health
Abstract: Worldwide, asthma is a chronic condition which is prevalent and neglected and Scotland has a high prevalence of asthma compared to the rest of the world. In their report on the global burden of asthma, the Global Initiative for Asthma (GINA) Program ranks Scotland as having the highest asthma prevalence in the world, with almost one in every five people affected and 6.3 % of the population in Scotland are seeking treatment at General Practices. The aetiology of asthma is complex and it remains a persistent and chronic problem affecting many people, and prevention and treatment are not working. This thesis makes a unique contribution utlising an interdisciplinary approach from Geography and Public Health to explore the nature and role of the socio-environmental context in relation to the prevalence and management of asthma at Scottish General Practices located in areas of dissimilar deprivation levels. The key focus of the research is the way that health professionals (and related stakeholders) understand the factors that shape the causation and prevalence of asthma (including social and environmental contexts), and how this in turn shapes their management of the condition in their practice. Aim: The overall aim of this research is identify, understand and interpret the nature and role of the socio-environmental context in relation to asthma prevalence and management at the Scottish primary care setting. Methods: The research employed quantitative analysis of a secondary dataset on asthma and a case study analysis of two General Practices located in areas of dissimilar deprivation levels in Scotland. Practices were selected after quantitative data analysis comparing the deprivation scores (SIMD) against crude prevalence rates of asthma. The case study employed in-depth semi-structured interviews with stakeholders involved in asthma care. The results of the study contributed to the understanding of what a conventional deprivation measure does/ does not reveal about asthma–place contexts. It also gave insights on how health professionals perceived their area, patient population and how they integrated these perceptions it into their practice as their understanding or lack of understanding or their inability to act upon their understanding on the importance of the socio-environmental context was one of key factors that shape their management of asthma. The study concluded imparting policy implications and renewed approaches to asthma care and management practices within the Health Services.
Published: 2016

7. Exploring how Health and Wellbeing Boards are tackling health inequalities with particular reference to the role of environmental health

Author: Dhesi, Surindar, Harrison, Stephen, Coleman, Anna, and Checkland, Katherine
Subjects: 616.9, Health and Wellbeing Boards, Health Inequalities, Environmental Health, Public health policy
Abstract: Health and Wellbeing Boards (HWBs) are new local government (LG) sub-committees tasked with assessing local health and social care needs, and developing strategies for promoting integration and tackling health inequalities; yet they have no statutory authority to compel action. This research explored how they approached tackling health inequalities, focussing on the role of environmental health (EH), the LG public health occupation, in the pre-shadow and shadow stages and as they went live in April 2013. Four case study sites (based around individual HWBs) were purposively sampled to ensure that a variety of HWBs were included, including unitary and two-tier authorities and urban, suburban and rural areas. Data collection at each case study site included semi-structured interviews, observation of HWB meetings, and documentary analysis and extended for 18 months from early 2012. In addition, EH practitioners and managers were interviewed from each of the English regions to provide a wider context. The data was analysed thematically both inductively and deductively using Atlas.ti. and conclusions drawn. HWBs were varied in their structures, practices and intentions and some changed considerably during the research, as would be expected at a time of new policy development and implementation. There was evident commitment and enthusiasm from HWB members to improve the health of local populations. However it is unclear what ‘success’ will be or how it will be measured and attributed to the work of the HWB, and there were some tensions between the various parties involved. There was an espoused commitment to the principles of Marmot, in particular to children, however much of the focus during HWB meetings was on integrating health and social care. Taking action on many of the social determinants of health is outside the core sphere of HWB control, however they did not generally appear to be utilising some of the readily available tools, such as EH work to improve local living and working conditions. EH was found to be largely ‘invisible’ within its own public health community and does not have a tradition of evidence based practice needed to secure funding in the new system. This, along with the decline of the regulatory role, has led to a period of reflection and adaptation. The research findings are linked by the policy approaches of ‘doodle’ and localism, including the shrinking of the state, and in particular the retreat of statutory and regulatory roles and the introduction of overt political values in policy making; shifting the focus to relationships, partnership-building, integration and the impact of individuals. The contexts in which the research has taken place, both at local and national levels, including financial austerity, major health restructuring, and high national and local expectations are all significant factors which have shaped the findings.
Published: 2014

8. Developing an understanding of greenspace as a resource for physical activity of adolescents in Scotland

Author: Geyer, Justine, Currie, Candace, Higgins, Pete, and Inchley, Joanna
Subjects: 333.78, greenspace, physical activity, adolescents, environmental health
Abstract: This thesis explores the potential role of greenspace to promote physical activity in young adolescents in Scotland through an examination of physical activity behaviour associated with greenspace use and adolescents motivations to use greenspace, and experiences, attitudes and perceptions of greenspace. This is in light of political interest in promoting physical activity in all populations, especially in young people, as one way to help prevent obesity and promote health and well-being, and recognition that a link between greenspace provision and greenspace has been suggested by research, however, the evidence base is currently limited, particularly within Scotland. Research into greenspace links to physical activity are usually framed within an overarching socio-ecological perspective, however, additional theoretical perspectives are discussed which can add to understanding of adolescents’ use of greenspace. An argument is made for the use of Gibson’s Theory of Affordances and this is further developed to make the links between greenspace design, provision and use. The research included two studies. Study one involved the design, testing and placement of greenspace use questions into a survey of a nationally representative sample of 13 and 15 year-olds across Scotland (n=4697). This was done in collaboration with the Scotland team for the Health Behaviour in School-aged Children (HBSC) survey. The second study used a mixed methods design which employed GPS (global positioning system), accelerometry and GIS (geographical information system), referred to in this research as the GAG method, as an objective measure of physical activity location, timing and duration for a sample of n=35 13 and 15 year-olds. This is a relatively new method used in environment and physical activity research and the present study makes a contribution to understanding this method in practice. The GAG study also included semi-structured interviews with participants at the end of the period of monitoring physical activity. The two studies combined demonstrated a positive association between use of greenspace and higher quantity of and intensity of physical activity. Logistic regression on the survey data revealed that an adolescent who used greenspace more than three times per week was 42% more likely to achieve 60 minutes of moderate physical activity daily. The GAG study demonstrated that, when in greenspace, a lower proportion of time was spent being sedentary compared to when not in greenspace (48.6% vs. 81.7%). In interviews, the adolescents described a wide variety of physical activities taking place in greenspace, many incidental to being in greenspace as opposed to planned beforehand, although this was also encountered. Four types of greenspace user were identified and helped highlight how social motivations to use greenspace were paramount suggesting that the impact of greenspace on physical activity is both a result of motivation to be active, but also a benefit of going to greenspace for social reasons. This bi-directional relationship complicates endeavours to demonstrate cause and effect and suggests the requirement for more research to understand the interaction between psycho-social and environmental factors. Greenspace use appeared to be relatively high. The HBSC survey found that a large majority of young adolescents in Scotland (71%) reported using greenspace at least once per week in the summer months, and may well be one of the most frequent users groups. However, scope remains to further increase use aimed at increasing physical activity and it is argued that more flexibility exists for this possibility than within other domains for physical activity, such as school PE classes. The interviews revealed that motivations and influences on use of greenspace were found to closely reflect the a priori model (based on previous mainly public space research) with clear evidence of interplay between factors influencing intention and opportunity. Developmental attributes of the adolescent stage were indicated to be strongly influential in motivating greenspace use, however, the relative impact of the range of factors was uncertain with decisions to use greenspace complex and dynamic. Despite this complexity, improvements in the physical condition of greenspace, safety and greenspace quality are likely to be universally welcomed. From a theoretical perspective, the findings supported the existence of design, normative and individual affordances which have relevance for how greenspace and the facilities within them are designed and used and how exclusionary practices can arise. Political endorsement of the importance of greenspace to health and well-being is evident and this research supports continued protection, investment and improvement, particularly in greenspace quality. There is, however, a need to further develop policy to incorporate consideration of the role of youth and community services and park management aimed at facilitating positive use of and experiences in parks and other greenspace for all users.
Published: 2013

9. Physical and chemical composition of particulate pollutants in an urban area of Cardiff, Wales

Author: Mohamed, Guma E. T., Karani, George, and Mitchell, David J.
Subjects: 363.738, environmental health
Abstract: The issue of particulate matter (PM) and associated health and environmental problems has been subjected to extensive research in a number of countries. However, there are no recent studies concerning the physical and chemical properties of PM from urban Cardiff. Measurements were made to study particulate matter, their sources, chemical compositions, gaseous precursors and their seasonal variations in urban Cardiff (latitude: 51° 28´ 59.47¨N and longitude: 03° 09´ 58.08¨W) from December 2009 to November 2010. A low volume air sampler for PM10 and PM2.5 particles, and real-time air samplers for TSP, PM10, PM2.5, PM1, NO, NO2, NOx, SO2 and VOCs were used during sampling. The collected ambient air suspended particles were analysed for seven major ions (Cl−, NO3−, SO42−, Ca²⁺, Mg²⁺, K⁺ and Na⁺) and 12 elements (Na, Mg, Al, K, Ca, Cr, Fe, Ni, Cu, Zn, Cd and Pb) by using an ion chromatography and atomic absorption spectrometer respectively. Cl⁻, SO42− and NO3− were generally the major ions in fractions of PM10 and PM2.5, while the elements Na, Mg, Ca, Al, K, and Fe were the most abundant elements. A good correlation was observed between PM10 and PM2.5 indicating that PM10 and PM2.5 contribute significantly to PM levels in urban Cardiff. Most of the ions and elements in both PM fractions were abundant in the winter season. Natural sources were the highest contributors followed by anthropogenic sources for the analysed elements in PM10 and PM2.5. Enrichment factor (EF) analysis showed the enrichment factor was higher in PM10 and PM2.5 elements such as Zn, Pb, Cu, Cr and Cd. The high enrichment factor of these elements in urban Cardiff suggested that the dominant sources for these elements were non-crustal. Real-time measurements of PM precursor gases did not exceed the standard concentrations given by the Air Quality Strategy (AQS) for these pollutants.
Published: 2012
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10. Adverse Childhood Experiences, Job Strain, Social Isolation, and Risk of Cardiovascular Disease in U.S. Workers: a Multi-Cohort Study with a Life-Course Perspective

Author: Matthews, Timothy Alan and Matthews, Timothy Alan
Abstract: Cardiovascular disease (CVD, including heart disease and stroke) is the leading cause of death in the United States and worldwide, making CVD a key priority in epidemiological and public health research. The utility of current exposure and risk assessment models utilizing traditional risk factors such as sociodemographic characteristics and health behaviors in CVD prevention efforts has plateaued, with a large proportion of excess CVD morbidity and mortality risk remaining unexplained. In recent years, psychosocial stressors have gained prominence as important drivers of CVD etiology, with stressful exposures such as adverse childhood experiences (ACEs), social isolation, and job strain emerging as novel CVD risk factors. The objective of this project was to conduct a systematic epidemiological investigation of ACEs, social isolation, job strain, cardiometabolic biomarkers implicated in allostatic load, and their associations with risk of CVD mortality using data from three large, population-based, nationally representative cohort studies characterizing the health and disease profiles of childhood, mid-life, and old age in the United States. This project implemented a secondary data analysis of the based National Longitudinal Study of Adolescent to Adult Health (Add Health), Mid-life in the United States (MIDUS), and the Health and Retirement Study (HRS) cohort studies, examining the contribution of psychosocial stressors at different life stages (childhood and adulthood), in different life domains (working life and non-working life) to the development and progression of CVD. The primary aim of the study was to examine the associations of ACEs, social isolation, and job strain with CVD mortality risk in the Add Health, MIDUS, and HRS cohorts, implementing a comprehensive exposure assessment of work and nonwork related psychosocial factors across the life-course. The secondary aim of the study was to identify psycho-physiological pathways reflecting allostatic load
Published: 2023

11. Air Pollution, Health, and Environmental Justice in Southern California’s Salton Sea Region

Author: Miao, Yaning and Miao, Yaning
Abstract: Ambient air pollutants including aerosols and gas phase pollutants has caused concerns for both air quality and public health, especially in environmental justice region. The Salton Sea region located in southern California, is one such region characterized by high air pollution levels, asthma rates but low socioeconomic status. My dissatisfaction centers around evaluating and comparing the adverse health impacts of ambient air pollution exposure including PM2.5, ozone and windblown dust, as well as characterizing ammonia emissions in the Salton Sea region. In the first study, I examine disparities in air pollution exposure and associated health outcomes in the Coachella Valley. Two different measures of the health outcomes are used to investigate the connections between air pollution exposure and human health. I further investigate whether such relationships vary with socioeconomic status metrics. This research showed that more vulnerable communities are associated with higher levels of PM2.5 and higher emergency room visits, possibly indicating that high exposure, high vulnerability families are less likely to self-report diagnoses relative to more affluent communities. In the second study, I developed a model to separate windblown dust observed in the Salton Sea region by their potential source regions and compare the health impacts of those different dust coming with a case crossover design. Results show increases in both respiratory and cardiovascular hospital admissions with increasing concentrations of dust arriving from over the Salton Sea. Even stronger associations were observed for Salton Sea dust with algae events. These findings are important for air quality mitigation efforts in the region, as they point to the possible significance of water surface sources of toxic particulates alongside the windblown dust sources that currently receive the most attention. In the third study, I characterize potential sources and emission patterns of ammonia in the Sal
Published: 2023

12. Participatory environmental health research: A tool to explore the socio-exposome in a major european industrial zone

Author: Jeanjean, Maxime and Jeanjean, Maxime
Abstract: ObjectivesWe show that participatory research approaches can be a useful tool across disciplines and data collection methods to explore the socio-exposome near one of the largest industrial harbors in Europe. We analyzed resident involvement in each project and their capacity to affect structural changes.MethodsLongitudinal participatory environmental monitoring studies on lichens, petunias, aquatic systems and groundwater were conducted under the program VOCE (Volunteers for the Citizens' Observation of the Environment), which mobilized nearly 100 volunteers to collect and report data. A community-based participatory health survey, Fos EPSEAL was also carried out during the same period. We describe citizens' involvement in each study following Davis and Ramirez-Andreotta's (2021) 'best practice' grid. We also use residents' insights to refine understanding of the socio-exposome.ResultsThe region is significantly impacted by industrial pollution and fenceline communities are disproportionately exposed. The community-based participatory health survey documented negative health outcomes among the residents, including a higher prevalence of chronic symptoms and diabetes (e.g., 11.9%) in the Fos-Berre Lagoon region than in other communities. This methodology shows the benefits of the co-production of knowledge in environmental health: not only does it enable epistemological transformations favorable to the vulnerable population, but it also triggered public action (i.e., media and public authorities' attention leading to official expertise reports, filing of collective complaints before the courts).ConclusionThis body of multiple participatory research studies over time is a useful approach to better understand the socio-exposome and health issues in an industrial zone.
Published: 2023

13. Estudi de riscos higiènics a les oficines de l'edifici singular del Museu de Badalona.

Abstract: L’objectiu d’aquest treball consisteix en realitzar un estudi de la qualitat de l’ambient interior a les oficines del Museu de Badalona, i proposar un pla d’actuació per aquelles situacions de risc detectades per tal d’eliminar-les o reduir-les. El treball està dividit en 3 parts. La primera és la part teòrica on es defineixen els agents d’origen físic, químic i biològic d’aquest estudi, així com les afectacions principals en la salut dels treballadors. En aquesta part també es descriu la metodologia utilitzada així com els criteris de valoració segons la normativa vigent i els aparells utilitzats. La segona part d’aquest treball consisteix en l’estudi de la qualitat de l’ambient interior de les oficines del Museu de Badalona. Per a realitzar-lo es segueix el procés de diagnòstic descrit en la UNE 171330 «Qualitat ambiental a interiors» i es poden diferenciar en les fases resumides tot seguit: Fase 1. Identificació: s’identifica els aspectes que interaccionen amb la qualitat ambiental d’interiors. Es recopila tota la informació relacionada amb l’edifici (ubicació, usos, any de construcció, materials de construcció, instal·lacions, plànols, reformes realitzades....) Fase 2. Valoració quantitativa: un cop coneguts els factors que tenen una probabilitat d’afectar negativament a la qualitat de l’ambient interior, es realitzen les medicions directes per quantificar les condicions de risc real i verificar la seva afectació negativa. Fase 3. Valoració qualitativa: a partir dels resultats obtinguts per cada factor, es determina si compleix o no amb la normativa que en regula els valors límits que no es poden sobrepassar. Fase 4. Accions correctores: si els resultats no compleixen amb la normativa, s’identifiquen les causes i es defineixen les accions correctores que permetrien mantenir-se en uns valors òptims. Finalment, la tercera part del treball consisteix en tota la documentació gràfica realitzada per tal de dur a terme l’estudi així com totes les accions correctores pr
Published: 2023

14. NEUROINFLAMMATORY AND METABOLOMIC TEMPORAL DYNAMICS FROM INHALED WILDFIRE SMOKE WITH ATTENUATION VIA PHARMACOLOGICAL INTERVENTION

Subjects: Willdfire
Abstract: Wildfire smoke is a global issue affecting nearly all humans on the surface of this Earth. Smoke dispersion from wildfires can span continents and cross oceans with amazing ease. Furthermore, total acres of land burned per year in the United States has roughly doubled since 1980, meaning this issue will persist for an indeterminate amount of time. Exposure to wildfire smoke is hazardous and promotes aging-associated events in the cardiopulmonary systems. Yet long- and short-term effects on the brain remain relatively unknown. From these, it is critically important to understand the neurological impacts from wildfire smoke exposure; to compare these effects to a more replicable woodsmoke exposure systems in a lab setting; and to endeavor mitigation strategies. In our first study, we serendipitously exposed mice to wildfire smoke at a distance >1,000 km from the fire source (California, 2020). The exposure quantification revealed an ebb and flow of PM2.5 (particulate matter 2.5 µM diameter)concentration intensities, and variations in the levoglucosan abundance (measure of woodsmoke content). Upon sacrifice, we found markers of blood brain barrier (BBB) permeability, neuronal damage, inflammation, peripheral immune infiltration, and markers that indicated an acceleration of brain aging. Initial follow-up studies utilized an in-lab woodchip smoldering exposure system to determine the neuroinflammatory temporal dynamics and metabolomic effects of inhaled wildfire smoke. We attempted to model our exposure paradigm based on a lower concentration than millions of Americans receive during yearly wildfires. Our results revealed that vascular inflammation resolved before our experimental cutoff timepoint of 28 days. However, peripheral immune infiltration increased 14 days post exposure, and inflammation persisted in the brain until our final timepoint of 28 days. Slightly more alarming, markers of brain aging and damage were observed at the 28-day
Published: 2023

15. Determinants of Disposal of Disposable Diapers Among Caregivers in Kisumu City, Kenya

Abstract: Background: A disposable diaper harbor feces and hazardous chemicals that if improperly handled and disposed, can lead to diseases and pollution. Objective: To assess determinants for disposal of disposable diapers in Kisumu city. Methods: A cross-section design was used. 246 Caregivers with children < 3 years were selected and ata was collected using a semi-structured questionnaire. Data was analysed in SPSS and both descriptive and inferential statistics were performed with significance level set at 0.05. Results: Majority (86.5%) of the caregivers were women. The mean age of caregivers was 29.3 years (±= 6.86). mean household size was 5, most (92.3%) households were male headed with an average monthly income of KES 21,833; Majority of mothers (73.1%) and fathers (93.2%) had attained secondary level of education. The usage of disposal diapers was 95.93% with appropriate disposal at 41.3%. Variables significantly (P<0.05) associated with appropriate disposal of diapers were: Sex of the household head; Mother with high school education; father with high school education; home ownership status; and availability of onsite sanitation. Conclusions: Maternal literacy and household income are key determinants for disposal of diapers. Knowledge on risks posed by diapers is high but it has not translated into proper disposal practice.
Published: 2023

16. Machine learning-based data correlation between scanning electron microscopy images and energy-dispersive X-ray spectroscopy profiles

Abstract: Characterisation of organic and inorganic microparticles has long been an important topic in the field of environmental health sciences. Especially, combined analytical method of scanning electron microscopy (SEM) associated with energy-dispersive X-ray spectroscopy (EDX) is a commonly exploited approach to obtain extensive data on the size, morphological, and elemental information from the particulate specimens. Particulate matter (PM) is a representative atmospheric pollutant that may exert adverse effects on the human respiratory system, and SEM-EDX is a widely used tool for extracting PM analysis data, which can be subsequently utilised as physicochemical features for toxicological predictions. In this presentation, we show a machine learning-based automation of SEM-EDX correlation of environmental PM data. First, we segment SEM images using WEKA trainable segmentation which is based on a random forest algorithm to classify pixels as foreground and background groups, followed by finding connected components (pixels that are foreground and connected vertically or horizontally). These regions are used to calculate PM shape parameters. Next, element maps are obtained from EDX using curve fitting with HyperSpy Python package. PM regions from SEM images are utilised to sum intensities in the same spatial location for the element maps to obtain elemental profiles. We finally build two models to predict PM elements: (1) Element maps from SEMEDX data using image-to-image translation, and (2) regression to predict PM element percentages from shape features. Results from model 1 and 2 are then applied to extract PM elemental profiles associated with PM morphology information. Our results show how to efficiently predict EDX and element maps from SEM images with a high degree of accuracy. This method has a potential to significantly reduce time and labour required for environmental PM monitoring.
Published: 2023

17. Adaptation to Climate Change, Health Promotion and Sustainability: the Pyramid of Healthy and Sustainable Mobility

Abstract: Mobility, the processes and actions of displacement of people, have great consequences in the social, economic, environmental or urban sphere. The means of motorized transport that are used for the mobility of people generate risks for the population’s health, through polluting emissions, noise, greenhouse gases or accidents. In addition, they influence the degree of physical activity and sedentary lifestyle. Together, they affect mental and physical health, and cause the development of diseases. It is for all these reasons that people and citizens must be able to choose sustainable and healthy forms of mobility, for themselves and for the population. To this end, we developed this “the pyramid of healthy and sustainable mobility” whose purpose is to provide guidelines on how to improve this behavior in daily commuting, for an improvement in environmental health. To do this, it orders and graphically graduates the forms of mobility into two main objectives, to improve sustainability and health. In addition, transcendental factors for improvement in both axes are specifically indicated., La movilidad, los procesos y acciones de desplazamiento de las personas, tienen grandes consecuencias en el ámbito social, económico, ambiental o urbanístico. Los medios de transporte motorizado que se utilizan para la movilidad de las personas generan riesgos para la salud poblacional, a través de emisiones contaminantes, ruido, gases de efecto invernadero o accidentes. Además, influyen en el grado de actividad física y del sedentarismo. En conjunto, afectan la salud mental y física, y causan el desarrollo de enfermedades. Es por todo ello que las personas y la ciudadanía debe poder elegir formas sostenibles y saludables de movilidad, para sí y para el conjunto de la población. Con este fin desarrollamos esta “pirámide de la movilidad saludable y sostenible” cuyo fin es aportar pautas sobre cómo mejorar este comportamiento en los desplazamientos diarios, para una mejora de la salud ambiental. Para ello ordena y gradúa gráficamente las formas de movilidad en dos grandes objetivos, mejorar la sostenibilidad y la salud. Además, se señalan específicamente factores trascendentes para la mejora en ambos ejes., A mobilidade, os processos e ações de deslocamento de pessoas, tem grandes consequências na esfera social, econômica, ambiental ou urbana. Os meios de transporte motorizados que são utilizados para a locomoção de pessoas geram riscos à saúde da população, por meio de emissões poluentes, ruídos, gases de efeito estufa ou acidentes. Além disso, influenciam o grau de atividade física e o sedentarismo. Juntos, eles afetam a saúde mental e física e causam o desenvolvimento de doenças. É por todas estas razões que as pessoas e os cidadãos devem poder optar por formas de mobilidade sustentáveis e saudáveis, para si e para a população em geral. Para tal, desenvolvemos esta “pirâmide de mobilidade saudável e sustentável” cujo objetivo é fornecer orientações sobre como melhorar este comportamento nas deslocações diárias, para uma melhoria da saúde ambiental. Para isso, ordena e gradua graficamente as formas de mobilidade em dois objetivos principais, melhorar a sustentabilidade e a saúde. Além disso, são especificamente indicados fatores transcendentais para melhoria em ambos os eixos.
Published: 2023

18. A bibliometric analysis on a new approach: the ecopharmacovigilance

Abstract: The entry of pharmaceutical into the environment can have numerous ecological consequences. For this reason, a new science proposes to mitigate and manage the possible effects of these substances on the environmental scenario, Ecopharmacovigilance. Considering all the approach around this area, the present article aims to carry out a bibliometric analysis of the literature contemplating this theme. A bibliometric survey was carried out, using only the descriptor “Ecopharmacovigilance”, to verify which research trends in this subject. Four databases were selected, and searches were performed in three languages: Portuguese, English and Spanish. The time window assigned in the present study was 2007-2020. Inclusion and exclusion criteria were designated. After refinement, the content of the articles was analyzed and briefly described. The affiliation of the researchers, typology of articles, year the articles were published, thematic areas, impact factor and number of citations were also verified. Data analysis was performed using Excel software for quantitative analysis and Nvivo for qualitative analysis. 27 articles were identified based on the established criteria. There was an increase in publications between 2015-2019. Most of the articles evaluated were literature review, described in English with predominantly Asian affiliations. The keywords most used in the studies were “Ecopharmacovigilance”, “Environment”, “Pharmaceutical”, “Residues” indicating a link between this new science and the impacts around drugs on the environment. Based on the results obtained, we encourage researchers to dedicate themselves to carrying out studies in this area., La entrada de drogas en el medio ambiente puede tener numerosas consecuencias ecológicas. Por ello, una nueva ciencia propone mitigar y gestionar los posibles efectos de estas sustancias en el escenario ambiental, la Ecofarmacovigilancia. Considerando todo el abordaje en torno a esta área, el presente artículo tiene como objetivo realizar un análisis bibliométrico de la literatura que contempla este tema. Se realizó un levantamiento bibliométrico, utilizando únicamente el descriptor “Ecofarmacovigilancia”, para verificar cuáles son las tendencias de investigación en este tema. Se seleccionaron cuatro bases de datos y se realizaron búsquedas en tres idiomas: portugués, inglés y español. La ventana de tiempo asignada en el presente estudio fue 2007-2020. Se designaron criterios de inclusión y exclusión. Después del refinamiento, se analizó y describió brevemente el contenido de los artículos. También se verificó la afiliación de los investigadores, tipología de artículos, año de publicación de los artículos, áreas temáticas, factor de impacto y número de citaciones. El análisis de datos se realizó utilizando el software Excel para el análisis cuantitativo y Nvivo para el análisis cualitativo. Se identificaron 27 artículos en base a los criterios establecidos. Hubo un aumento en las publicaciones entre 2015-2019. La mayoría de los artículos evaluados fueron revisión de literatura, descritos en inglés con afiliaciones predominantemente asiáticas. Las palabras clave más utilizadas en los estudios fueron “Ecofarmacovigilancia”, “Medio ambiente”, “Farmacéutica”, “Residuos” que indican un vínculo entre esta nueva ciencia y los impactos en torno a las drogas en el medio ambiente. En base a los resultados obtenidos, animamos a los investigadores a dedicarse a realizar estudios en esta área., A entrada de fármacos no ambiente pode ter inúmeras consequências ecológicas. Por esse motivo, uma nova ciência se propõe a mitigar e gerir os possíveis efeitos dessas substâncias no cenário ambiental, a Ecofarmacovigilância. Considerando toda a abordagem em torno dessa área, o presente artigo tem como objetivo realizar uma análise bibliométrica da literatura contemplando essa temática. Foi realizado um levantamento bibliométrico, utilizando somente o descritor “Ecofarmacovigilância”, para verificar quais tendências de pesquisa nesse assunto. Foram selecionados quatro bancos de dados, e as buscas foram realizadas em três idiomas: português, inglês e espanhol. A janela temporal atribuída no presente estudo foi de 2007-2020. Foram designados critérios de inclusão e exclusão. Após o refinamento, os conteúdos dos artigos foram analisados e descritos de forma resumida. Também foi verificado a filiação dos pesquisadores, tipologia dos artigos, ano que os artigos foram publicados, áreas temáticas, fator de impacto e quantidade de citações. A análise de dados foi realizada utilizando o software Excel para análise quantitativa e o Nvivo para análise qualitativa. Foram identificados 27 artigos com base nos critérios estabelecidos. Verificou-se um aumento das publicações entre 2015-2019. A maioria dos artigos avaliados eram de revisão bibliográficas, descritos em inglês com as filiações predominantemente da Ásia. As palavras-chaves mais utilizadas nos estudos foram “Ecopharmacovigilance”, “Environment”, “Pharmaceutical”,“Residues”indicando uma ligação entre essa nova ciência e os impactos em torno de medicamentos no ambiente. Com base nos resultados obtidos encorajamos que pesquisadores se dediquem na realização de estudos nessa área.
Published: 2023

19. “Why would you release fish into a body of water that can’t sustain them?” A community-based experience on the environmental health impacts of hydro dams in O-Pipon-Na-Piwin Cree Nation, Manitoba

Abstract: This project emerged as an opportunity to document Indigenous knowledge and strength-based solutions to address the environmental and health impacts of hydroelectric dam projects in the O-Pipon-Na-Piwin Cree Nation. As documented in the pages that follow, Hydro dams adversely affected local food production in these communities in particular traditional hunting and trapping grounds, fisheries were devasted, water quality was impaired, and shorelines were eroded. Members of OPCN have shared stories and narratives about the ways they have experienced the health impacts of hydro dams such as diabetes, cancer, heart attacks and skin diseases that emerged when hydroelectric projects entered the OPCN territory. This thesis was a collaborative research with a hydroelectric dam-impacted community, OPCN. The research objective was to provide an opportunity for the O-Pipon-Na-Piwin Cree Nation (OPCN) community members to document their hydro dam experiences. The research aimed to understand the spatial temporal implications of hydroelectric dam projects in Northern Cree communities before and after hydroelectric dam operations, and how communities experienced the changes in their environment. The research used qualitative research methods to achieve the research goals. Qualitative methods are used here as narrative-based methods and in this thesis, they were undertaken through interviews with Elders, Knowledge Keepers and Users, Fishers, Hunters and Trappers in OPCN. According to OPCN community members' experiences, the cumulative impacts of hydroelectric dams’ increased health and well-being problems. These cumulative impacts have been voiced by the OPCN community through different platforms such as social media, newspapers, conferences and recently at the United Nations Permanent Forum on Indigenous Issues (UNPFII) held on the 17th of April up to the 28th of April 2023 in New York, USA. The 2023 UNPFII theme was focused on “Indigenous Peoples, human health, planetary and ter
Published: 2023

20. Scientific research and environmental education: the participatory approach of the MAPS-MI projects in schools of Milan, Italy [Ricerca scientifica ed educazione ambientale: l'approccio partecipativo dei progetti MAPS-MI nelle scuole di Milano]

Abstract: The accumulated scientific evidence regarding the effects of air pollution on health calls for urgent and effective action to protect the most vulnerable part of the population, such as children and the elderly. In this context, the participatory approach represents a viable option to empower citizens and increase their level of awareness and participation. The involvement of civil society is a potential ally in tackling the still open research challenges. The MAPS-MI 2018-2019 Mapping air pollution in the catchment area of an elementary school of Milan and MAPS-MI 2022-2023 Mobility, environment and participation in the schools of Milan projects are here presented.The main targets of the projects are primary and middle school children, their parents and teachers, with some activities extended to the entire citizenship. Starting from the survey on parents' habits and opinions about mobility and air pollution, to the air quality and personal exposure assessment, and the field-testing and development of an environmental education module, the MAPS-MI approach aims to increase knowledge and awareness about air pollution and to involve stakeholders in experimenting practices towards change. The first results suggest that adopting a participatory approach in the fields of exposure science and environmental epidemiology is a winning choice in terms of quality research, participation and community impact.
Published: 2023

21. Exploring Mitochondrial Activities in Murine Brain as a Potential Mechanism for Normal Tissue Protection by FLASH Radiotherapy

Author: Kim, Rachel Youn Kyung and Kim, Rachel Youn Kyung
Abstract: Purpose: FLASH radiotherapy's enhanced normal tissue protective effect without compromising cancer treatment efficacy has stimulated investigations exploring its mechanisms. To this date, mitochondrial endpoints after FLASH radiotherapy have not been explored. This master’s thesis aims to narrate the in vivo accounts of the normal tissue-sparing FLASH effect observed across organ systems and report the findings in ATP production and mitochondrial dynamics in the murine brain as possible explanations for the FLASH effect.Methods: Two cohorts received 10 Gy whole-brain FLASH and conventional dose rate irradiations at two different facilities. Stanford FLASH dose rate per pulse was 5.3 × 10^5 Gy/s Gy/s, with mean dose rate of 225 Gy/s. CHUV FLASH dose rate was 5.6 × 10^6 Gy/s, where a single 1.8 microsecond pulse was used to administer the total dose. The conventional dose rate was 0.1 Gy/s at both locations. At 4 months post-irradiation, ATP concentration and OPA-1 mitochondrial fusion protein levels were measured from the hippocampus and frontal cortex tissues and compared across the treatment groups via one-way ANOVA and Pearson's correlation analyses. Results: The hippocampus tissues from Stanford FLASH- and CHUV conventional-irradiated groups had significantly different associations between long and short OPA-1 isoforms compared to the control (p=0.005 and p=0.012, respectively). Although the strengths of associations in the hippocampal tissues were weaker than their cortex counterparts across the cohorts, only the Stanford CONV and FLASH irradiated groups showed significant and marginally significant differences between the brain regions (p=0.0496 and 0.057, respectively). These differences indicate that the mitochondrial dynamics may be dysregulated in the hippocampus at 4 months post-irradiation. The individual levels of ATP, L-OPA1, S-OPA1, and the ratios of isoforms did not significantly differ across the treatment groups. Conclusion: Despite the low sample s
Published: 2023

22. Legally Speaking : A Podcast from the Utah Attorney General's Office : Exposure to Forever Chemicals : A First Look Into the Emerging Issue (March 31, 2023)

Abstract: The Utah Attorney General’s Office is investigating the potential harm that so-called ‘forever chemicals’ pose to Utah citizens’ health. Detected in everyday places like drinking water, Teflon pans, microwave popcorn bags, water, fire-resistant clothing, carpeting, and much more, these PFOA and PFOS chemicals are everywhere. Legally Speaking consults Health and Environment Division Chief Craig Anderson for more information.
Published: 2023

23. Análisis de interacciones de los actores de la red deconocimiento en salud ambiental del Observatorio Nacional de Salud de Colombia

Abstract: Introduction: Positive and negative interactions between the human beings and the environment have an impact on the general health of the population. Therefore, it is necessary to use knowledge management and social transformation, in order to limit exposure to environmental risk factorsby creating a favorable environment for healthcare. This should be carried out through multidisciplinary and intersectorial actions, such as the collaborative work of knowledge networks. Objective: To describe the interactions between the actors within the Environmental Health Knowledge Network Colombia's National Observatory of Health (ONS acronym in Spanish), in order to promote, improve and strengthen collaboration, information exchange and planning ofcollaborative actions. Methodology: Cross-sectional descriptive study to analyze social interactions through text mining tools by R, programmer language. Categories analyzed: Water and sanitation, climate, air quality, electromagnetic radiation and chemical poisoning. Data source: a documentary corpus of 99 texts done by actors of Environmental Health Knowledge Network of Colombia's ONS. We calculated centrality and prestige measures. We used Power BI in order to plot multi-layered directed networks. Results: Actors with greatest centrality in the network: Ministry of Health and Social Protection, Health Superintendency, Profamilia, Antioquia and La Salle universities, National Health Observatory, Bogotá's Observatory of Environmental Health, the Pan American Health Organization and the World Health Organization. The five categories analyzed provides a low centrality degree, and water and climate categoriespresented greater participation by actors (more nodes and links). Conclusions: Social interactions analysis provides the identification of relevant environmental health issues in Colombia and key actors in order to develop interaction spaces for knowledge management. The analysis had limitations that suggest the inclusion of biblio, Introducción: las interrelaciones positivas y negativas entre el hombre y el medioambiente impactan en la salud general de la población, por esto, la gestión del conocimiento y la transformación social, orientadas a la prevención de la exposición a factores de riesgo ambiental y a la creación de ambientes propicios, deben realizarse a través de acciones multidisciplinares intersectoriales, como el trabajo colaborativo de redes del conocimiento. Objetivo:describir las interacciones entre los actores de la Red de Conocimiento de Salud Ambiental del Observatorio Nacional de Salud de Colombia (ONS), con el fin de promover, mejorar y fortalecer la colaboración, intercambio de información y planificación conjunta de acciones. Metodología: estudio descriptivo transversal de análisis de redes sociales mediante herramientas de minería de texto del lenguaje de programación R. Se analizaron las categorías de agua y saneamiento, clima, calidad del aire, radiaciones electromagnéticas e intoxicaciones químicas de un corpus documental de 99 textos de los actores de la red general de conocimiento en salud pública del ONS. Se calcularon medidas de centralidad y prestigio y se graficaron redes dirigidas multicapa con Power BI. Resultados: los actores con mayor centralidad en la red fueron: Ministerio de Salud y Protección Social, Superintendencia de Salud, Profamilia, universidades de Antioquia y La Salle, ONS, Observatorio de Salud Ambiental de Bogotá, Organización Panamericana de la Salud y Organización Mundial de la Salud. Las cinco categorías analizadas presentaron bajas centralidades de grado, y las categorías de agua y clima mostraron mayor participación de los actores (más nodos e interacciones). Conclusiones: el análisis de redes sociales permitió identificar temas relevantes de salud ambiental entre los actores de la red del ONS, además de actores clave para desarrollar espacios de interacción y gestión del conocimiento. Acorde con las limitaciones del análisis, se sugiere l
Published: 2023

24. Protecting Children's Environmental Health in a Changing Climate: A Model Collaboration of the Maternal and Child Health Section and the Environment Section of APHA.

Author: Trousdale, Kristie and Trousdale, Kristie
Abstract: PurposeThe complexities of modern civilization, coupled with challenges including systemic racism and climate change-related impacts, compel public health professionals to break down silos and collaborate towards the shared goals of protecting the wellbeing of current and future generations. This article highlights the growing collaboration between the Maternal and Child Health (MCH) and the Environment (ENV) Sections of the American Public Health Association (APHA) as members bring their collective focus to the protection of children's and pregnant people's environmental health.DescriptionThe MCH Section and the Children's Environmental Health (CEH) Committee of the ENV Section are collaborating on efforts to: inform key stakeholders?including public health and health care professionals, child care professionals, families, and youth?about environmental hazards and climate change impacts to children's and pregnant people's health and wellbeing; and provide tools and guidance about how to best protect these groups and how to advocate for climate action. The CEH Committee embraces a health equity paradigm and intentionally centers environmental, racial, and social justice as integral to effective children's health and climate change initiatives.AssessmentProjects to date include multiple joint sessions about children's environmental health and climate change at APHA's annual meetings, publications and various children's environmental health tools and resources, including a toolkit and lesson plan that equips public health professionals to provide guest lectures at their local high schools on climate change and health, and educational materials for caregivers on extreme heat, wildfires, and ticks and mosquitos.ConclusionThis collaboration could serve as a replicable model that can be applied to other interdisciplinary efforts seeking strategic partnerships to address complex health issues.
Published: 2023

25. Determinants of Disposal of Disposable Diapers Among Caregivers in Kisumu City, Kenya

Abstract: Background: A disposable diaper harbor feces and hazardous chemicals that if improperly handled and disposed, can lead to diseases and pollution. Objective: To assess determinants for disposal of disposable diapers in Kisumu city. Methods: A cross-section design was used. 246 Caregivers with children < 3 years were selected and ata was collected using a semi-structured questionnaire. Data was analysed in SPSS and both descriptive and inferential statistics were performed with significance level set at 0.05. Results: Majority (86.5%) of the caregivers were women. The mean age of caregivers was 29.3 years (±= 6.86). mean household size was 5, most (92.3%) households were male headed with an average monthly income of KES 21,833; Majority of mothers (73.1%) and fathers (93.2%) had attained secondary level of education. The usage of disposal diapers was 95.93% with appropriate disposal at 41.3%. Variables significantly (P<0.05) associated with appropriate disposal of diapers were: Sex of the household head; Mother with high school education; father with high school education; home ownership status; and availability of onsite sanitation. Conclusions: Maternal literacy and household income are key determinants for disposal of diapers. Knowledge on risks posed by diapers is high but it has not translated into proper disposal practice.
Published: 2023

26. Determinants of Disposal of Disposable Diapers Among Caregivers in Kisumu City, Kenya

Abstract: Background: A disposable diaper harbor feces and hazardous chemicals that if improperly handled and disposed, can lead to diseases and pollution. Objective: To assess determinants for disposal of disposable diapers in Kisumu city. Methods: A cross-section design was used. 246 Caregivers with children < 3 years were selected and ata was collected using a semi-structured questionnaire. Data was analysed in SPSS and both descriptive and inferential statistics were performed with significance level set at 0.05. Results: Majority (86.5%) of the caregivers were women. The mean age of caregivers was 29.3 years (±= 6.86). mean household size was 5, most (92.3%) households were male headed with an average monthly income of KES 21,833; Majority of mothers (73.1%) and fathers (93.2%) had attained secondary level of education. The usage of disposal diapers was 95.93% with appropriate disposal at 41.3%. Variables significantly (P<0.05) associated with appropriate disposal of diapers were: Sex of the household head; Mother with high school education; father with high school education; home ownership status; and availability of onsite sanitation. Conclusions: Maternal literacy and household income are key determinants for disposal of diapers. Knowledge on risks posed by diapers is high but it has not translated into proper disposal practice.
Published: 2023

27. An Evaluation of Methods and Technology to Estimate Localized Environmental and Health Impacts from Air Pollution and Pesticide Use

Author: Isied, Margaret and Isied, Margaret
Abstract: Humans are a product of their environment – the air we breathe, the water we drink, the food we eat, are all in one way or another our “environment”, which in turn, impacts our health. Air pollution has been a long-standing issue, from the time humans innovated cooking over fire stoves, to our present-day reliance on transportation, technology, and industry. Exposure to air pollution has been linked to premature deaths, respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), and bronchitis, total body inflammation, and cancer. We are exposed to environmental contaminants everywhere and every day. For example, pesticides are used for farming practices to increase crop yield. With the advancements in commercial farming, any number of highly toxic, highly volatile pesticides are ubiquitously used within the same area. Many communities living near major sources of air pollution, such as freeways, industrial sites, and agricultural areas, have been demonstrated to be disproportionately burdened by these environmental contaminants. While environmental conditions have improved drastically since the 1970s, there is high variability of what communities are experiencing at the local level. Recently, there has been a rise in environmental concerns locally; communities are concerned that current environmental monitoring and assessment methods are flawed in two ways. First, these methods are focused on regional impacts not capturing local environmental conditions within smaller communities. Since the 1970s, environmental agencies have evaluated environmental contaminant levels using monitoring and modeling techniques that demonstrate how pollutant concentrations are impacting a region. Many of these methods were developed to demonstrate compliance with state and federal standards. For example, monitoring equipment is strategically placed to understand the impacts of air quality on a region, rather than a local community, and air dispersion modeling ha
Published: 2023

28. Data-Driven Approaches to Evaluating Traffic-Related Air Pollution Exposure and Health Impacts in California, USA

Author: Liu, Jonathan Zhong and Liu, Jonathan Zhong
Abstract: Automobile traffic has been a longstanding source of air pollution in human communities. The target of major regulations in the past few decades, the transportation sector has gone through significant changes, ranging from shifts in vehicle fleet composition to natural and artificial disruptions to traffic patterns. Both an essential form of transportation as well as a major source of air pollution, traffic, to this day, remains a human necessity and a public health challenge. As such, measuring and modeling the temporal and spatial distribution of traffic related air pollution (TRAP) is a critical necessity for exposure scientists, epidemiologists, and other public health professionals.In this dissertation, we investigate methods to measure TRAP in response to recent trends and disruptions in traffic patterns and composition, with a particular focus on California State. To this end, we employ novel combinations of big data, including regulatory air quality data in addition to traffic, land-use, and internet-of-things network data. It is divide into five chapters: an introduction (chapter 1), three chapters of original research (chapters 2-4), and a discussion of the conclusions of the work (chapter 5).Chapter 2 evaluates the near-road air quality impacts of traffic disruptions associated with the COVID-19 pandemic. Following global activity stoppages associated with stay-at-home measures, studies reported improved air quality in several cities and countries around the world. While widely observed, many studies could not properly attribute the decline of traffic in this chapter evaluates the relationship between traffic volume as reported by the California Department of Transportation and near-road NO and NO2 emissions at seven EPA monitoring sites in California state: four in Northern California and three in Southern California.Chapter 3 models the spatial distribution of non-tailpipe emissions-related PM2.5 chemical species and oxidative potential in Southern Cali
Published: 2023

29. Guidelines for Improving Household Indoor Air Quality: A Narrative Review and Scenario Testing Report

Author: Dixon, Kiera Alexandra and Dixon, Kiera Alexandra
Abstract: As most individuals within the United States spend the majority of their time indoors at home, residential indoor air quality is an important area for mitigating exposure to toxic air pollutants. This is especially important for low-income communities who are more likely to live in polluted areas with poor housing quality and lack the resources to obtain and maintain effective mechanical and exhaust ventilation within the home. The main research objective is to provide guidelines backed by current research and modeling to determine optimal window-opening behavior for reducing overall exposure to pollutants in different residential scenarios. Available literature was used to inform the majority of scenarios in which there are predominantly indoor-only, outdoor-only, or minimal indoor and outdoor sources. However, for a complex scenario in which there are both elevated levels of indoor and outdoor pollutants and where natural ventilation or exhaust-only ventilation are the only options, the Contaminant Transport Analysis Method (CONTAM) indoor air quality model program was used to determine pollutant exposure levels under three different window-opening strategies (windows closed, windows open, and windows open temporarily). Results indicate that strategic ventilation (temporarily opening windows during and shortly after indoor source pollutant generation) can be a low-cost option for low-income residential buildings without working exhaust fans. However, the use of well-maintained and efficient exhaust fans should be prioritized while cooking. Using electric appliances can also reduce indoor pollutants and offer more flexibility in ventilation options.
Published: 2023

30. The Environmental Conditions, Treatments, and Exposures Ontology (ECTO): connecting toxicology and exposure to human health and beyond.

Author: Chan, Lauren E and Chan, Lauren E
Abstract: BackgroundEvaluating the impact of environmental exposures on organism health is a key goal of modern biomedicine and is critically important in an age of greater pollution and chemicals in our environment. Environmental health utilizes many different research methods and generates a variety of data types. However, to date, no comprehensive database represents the full spectrum of environmental health data. Due to a lack of interoperability between databases, tools for integrating these resources are needed. In this manuscript we present the Environmental Conditions, Treatments, and Exposures Ontology (ECTO), a species-agnostic ontology focused on exposure events that occur as a result of natural and experimental processes, such as diet, work, or research activities. ECTO is intended for use in harmonizing environmental health data resources to support cross-study integration and inference for mechanism discovery.Methods and findingsECTO is an ontology designed for describing organismal exposures such as toxicological research, environmental variables, dietary features, and patient-reported data from surveys. ECTO utilizes the base model established within the Exposure Ontology (ExO). ECTO is developed using a combination of manual curation and Dead Simple OWL Design Patterns (DOSDP), and contains over 2700 environmental exposure terms, and incorporates chemical and environmental ontologies. ECTO is an Open Biological and Biomedical Ontology (OBO) Foundry ontology that is designed for interoperability, reuse, and axiomatization with other ontologies. ECTO terms have been utilized in axioms within the Mondo Disease Ontology to represent diseases caused or influenced by environmental factors, as well as for survey encoding for the Personalized Environment and Genes Study (PEGS).ConclusionsWe constructed ECTO to meet Open Biological and Biomedical Ontology (OBO) Foundry principles to increase translation opportunities between environmental health and other areas of bio
Published: 2023

31. The Devil they Knew: Chemical Documents Analysis of Industry Influence on PFAS Science.

Author: Gaber, Nadia and Gaber, Nadia
Abstract: BackgroundPer-and polyfluoroalkyl substances (PFAS) are a class of widely-used chemicals that persist in the environment and bioaccumulate in humans and animals, becoming an increasing cause for global concern. While PFAS have been commercially produced since the 1940s, their toxicity was not publicly established until the late 1990s. The objective of this paper is to evaluate industry documents on PFAS and compare them to the public health literature in order to understand this consequential delay.MethodsWe reviewed a collection of previously secret industry documents archived at the UCSF Chemical Industry Documents Library, examining whether and how strategies of corporate manipulation of science were used by manufacturers of PFAS. Using well-established methods of document analysis, we developed deductive codes to assess industry influence on the conduct and publication of research. We also conducted a literature review using standard search strategies to establish when scientific information on the health effects of PFAS became public.ResultsOur review of industry documents shows that companies knew PFAS was "highly toxic when inhaled and moderately toxic when ingested" by 1970, forty years before the public health community. Further, the industry used several strategies that have been shown common to tobacco, pharmaceutical and other industries to influence science and regulation - most notably, suppressing unfavorable research and distorting public discourse. We did not find evidence in this archive of funding favorable research or targeted dissemination of those results.ConclusionsThe lack of transparency in industry-driven research on industrial chemicals has significant legal, political and public health consequences. Industry strategies to suppress scientific research findings or early warnings about the hazards of industrial chemicals can be analyzed and exposed, in order to guide prevention.
Published: 2023

32. Climate knows no borders: Assessing the role of extreme weather events in driving adverse health outcomes in a binational United States-Mexico border region

Author: Schwarz, Lara and Schwarz, Lara
Abstract: Background: While the detrimental health effects of extreme heat and wildfire smoke are well established in high-income countries, there is substantially less evidence in low and middle-income settings. This dissertation research aimed to quantify the effects of extreme heat and wildfire smoke through a social vulnerability approach, using the San Diego-Tijuana border as a context to study differential impacts.Methods: This dissertation includes three studies examining the differential impacts of extreme heat and wildfire smoke in a binational context. The first study evaluates the spatial variation in the effect of extreme heat across municipalities in Mexico using a within-community-matched design with a Bayesian Hierarchical model extension and meta-regression to explore socioeconomic drivers. In the second study, we used the San Diego-Tijuana region as a unique context to study the differential effects of wildfire smoke on cardio-respiratory hospitalizations across the border using synthetic control methods (SCM). The third study also used SCM to explore the potential role of wildfire smoke in driving COVID-19 mortality in the San Diego-Tijuana border region. Results: In the first study, we found substantial spatial heterogeneity in the effects of heat across Mexico at the municipality level, and disadvantaged social conditions such as low education, poor housing conditions, and higher marginalization were important predictors of these differences. In the second study, wildfire smoke increased cardio-respiratory hospitalizations in the San Diego-Tijuana border region, with a higher, albeit imprecise, relative change in Tijuana likely driven by a higher poverty rate and increased social vulnerability. Lastly, in the third study, no strong effect of wildfire smoke on COVID-19 mortality was observed in either San Diego or Tijuana. Conclusion: The results of this dissertation indicate that social vulnerability is an important factor in understanding the health risks
Published: 2023

33. An applied environmental justice framework for exposure science.

Author: Van Horne, Yoshira Ornelas and Van Horne, Yoshira Ornelas
Abstract: On the 30th anniversary of the Principles of Environmental Justice established at the First National People of Color Environmental Leadership Summit in 1991 (Principles of Environmental Justice), we continue to call for these principles to be more widely adopted. We propose an environmental justice framework for exposure science to be implemented by all researchers. This framework should be the standard and not an afterthought or trend dismissed by those who believe that science should not be politicized. Most notably, this framework should be centered on the community it seeks to serve. Researchers should meet with community members and stakeholders to learn more about the community, involve them in the research process, collectively determine the environmental exposure issues of highest concern for the community, and develop sustainable interventions and implementation strategies to address them. Incorporating community "funds of knowledge" will also inform the study design by incorporating the knowledge about the issue that community members have based on their lived experiences. Institutional and funding agency funds should also be directed to supporting community needs both during the "active" research phase and at the conclusion of the research, such as mechanisms for dissemination, capacity building, and engagement with policymakers. This multidirectional framework for exposure science will increase the sustainability of the research and its impact for long-term success.
Published: 2023

34. Industrial Hygiene Aspects of Swimming Pool Service Workers

Author: Mackey, Thomas Rafael and Mackey, Thomas Rafael
Abstract: Swimming pool cleaners are a common sight for swimming pool users across the U.S. These workers do a variety of jobs surrounding pools and spas. Unfortunately, pool worker occupational hazards are not well researched in existing literature. This thesis presents pilot study findings on pool worker hazards. It features two sections: a review of data on the pool industry and a survey of pool service workers in Southern California. The goal was to gather information on workplace hazards for future research. The survey involved 10 respondents and revealed a variety of hazards, including the role of varied work processes, which translated to exposure to different types of hazards. Additionally, workers and their bosses often faced similar hazards, potentially due to the common occurrence of small businesses. The study serves as a blueprint for further research and recommends partnering with pool supply companies to recruit pool workers. Swimming pool cleaners are a common sight for swimming pool users across the U.S. These workers do a variety of jobs surrounding pools and spas. Unfortunately, pool worker occupational hazards are not well researched in existing literature. This thesis presents pilot study findings on pool worker hazards. It features two sections: a review of data on the pool industry and a survey of pool service workers in Southern California. The goal was to gather information on workplace hazards for future research. The survey involved 10 respondents and revealed a variety of hazards, including the role of varied work processes, which translated to exposure to different types of hazards. Additionally, workers and their bosses often faced similar hazards, potentially due to the common occurrence of small businesses. The study serves as a blueprint for further research and recommends partnering with pool supply companies to recruit pool workers.
Published: 2023

35. Socio-Demographic Patterning of Phthalate Burden in the U.S. (2001-2016)

Author: Benoit, Gabrielle Eva and Benoit, Gabrielle Eva
Abstract: For most humans, environmental exposure to toxicants begins as early as the moment of conception and accrues differently based on where a person lives, the nature of their work, and a variety of other socio-economically linked behaviors. A toxicant of particular interest are phthalates – the chemicals used to make plastics flexible and durable. They are found in clothes, furniture varnishes, toys, pharmaceuticals, food containers, and personal care products - to name just a few sources of exposure. Phthalates can make their way into bodies through ingestion, inhalation, and dermal absorption, and the breakdown of them within bodies can be measured as phthalate metabolites in urine. The specific physiological mechanisms linking phthalate exposure to health outcomes are still being deciphered, although it is abundantly clear that they pervade all aspects of the environment and our bodies, resulting in negative health outcomes. We study the level of the metabolite, mono-ethyl phthalate (MEP), in urine samples of children and adult participants in the National Health and Nutrition Examination Survey (NHANES), years 2001-2016. We have chosen mono-ethyl phthalate as our biomarker indicating exposure to phthalates because it is one of the most abundant phthalate metabolites present in human urine; it is the primary metabolite of diethyl phthalates (DEP). We ask which socio-demographic characteristics are associated with higher phthalate levels in urine within children and adults. Socio-demographic characteristics we examine include: age, gender, education, race/ethnicity, family income to poverty level, citizenship status. We expect that socio-demographically disadvantaged groups will have the highest levels of phthalate exposure. Factors such as education, SES, and gender influence where people live, (and their built environment exposures), their time-use patterns, their occupation, their treatment at healthcare facilities, and their purchasing patterns. Those factors (wh
Published: 2023

36. Predicting Ecological Risks of Pharmaceuticals and Personal Care Products in Central and Southern California Aquatic Environments using Modeling

Author: Desgens-Martin, Violaine and Desgens-Martin, Violaine
Abstract: Pharmaceuticals and personal care products (PPCPs) are anthropogenic compounds that are ubiquitously found in the environment due to their continued release from various sources such as wastewater treatment plants (WWTPs). Given their chronic input into the environment, continued monitoring of their environmental loads and ecotoxicity risks is warranted, especially for novel compounds for which there is little to no environmental data available. However, field sampling efforts can be time consuming and costly, leading to gaps in providing a complete and continuous picture on the presence of these PPCPs in the environment, and their ecotoxicity risks. In this dissertation, the ChemFate modeling tool was used to accurately predict the environmental load of selected PPCPs, such as ones used for the treatment of COVID-19. In combination with detected concentrations resulting from a monthly field sampling effort, we also contributed data on the factors driving per- and polyfluoroalkyl substances (PFAS) and PPCP loads to WWTPs. Results from the freshwater samples were also used to assess the ecorisks of PPCPs and PFAS by comparing these with toxicity thresholds reported in the United States Environmental Protection Agency (EPA)’s ECOTOXicology Knowledgebase (ECOTOX), or using predicted values determined using structure activity relationship tools such as EPA’s Ecological Structure Activity Relationships (ECOSAR). ChemFate was accurate in predicting PPCP influent loads when compared to results obtained using pharmaceutical prescription information. The predicted PFAS influent loads correlated well with factors such as population size and urban landscape, while population size correlated well with most of the selected PPCPs. Factors such as predicted versus actual removal efficiency in the WWTPs are a likely explanation into the discrepancies observed, which warrants obtaining real-world data on the removal efficiency of certain compounds. We found that most of the evaluate
Published: 2023

37. Adverse effect propensity: A new feature of Gulf War illness predicted by environmental exposures.

Author: Han, Jun and Han, Jun
Abstract: A third of 1990-1 Gulf-deployed personnel developed drug/chemical-induced multisymptom illness, Gulf War illness (GWI). Veterans with GWI (VGWI) report increased drug/exposure adverse effects (AEs). Using previously collected data from a case-control study, we evaluated whether the fraction of exposures that engendered AEs (AE Propensity) is increased in VGWI (it was); whether AE Propensity is related to self-rated chemical sensitivity (it did); and whether specific exposures predicted AE Propensity (they did). Pesticides and radiation exposure were significant predictors, with copper significantly protective-in the total sample (adjusted for GWI-status) and separately in VGWI and controls, on multivariable regression. Mitochondrial impairment and oxidative stress (OS) underlie AEs from many exposures irrespective of nominal specific mechanism. We hypothesize that mitochondrial toxicity and interrelated OS from pesticides and radiation position people on the steep part of the curve of mitochondrial impairment and OS versus symptom/biological disruption, amplifying impact of new exposures. Copper, meanwhile, is involved in critical OS detoxification processes.
Published: 2023

38. Developing a National-Scale Exposure Index for Combined Environmental Hazards and Social Stressors and Applications to the Environmental Influences on Child Health Outcomes (ECHO) Cohort.

Author: Martenies, Sheena and Martenies, Sheena
Abstract: Tools for assessing multiple exposures across several domains (e.g., physical, chemical, and social) are of growing importance in social and environmental epidemiology because of their value in uncovering disparities and their impact on health outcomes. Here we describe work done within the Environmental influences on Child Health Outcomes (ECHO)-wide Cohort Study to build a combined exposure index. Our index considered both environmental hazards and social stressors simultaneously with national coverage for a 10-year period. Our goal was to build this index and demonstrate its utility for assessing differences in exposure for pregnancies enrolled in the ECHO-wide Cohort Study. Our unitless combined exposure index, which collapses census-tract level data into a single relative measure of exposure ranging from 0-1 (where higher values indicate higher exposure to hazards), includes indicators for major air pollutants and air toxics, features of the built environment, traffic exposures, and social determinants of health (e.g., lower educational attainment) drawn from existing data sources. We observed temporal and geographic variations in index values, with exposures being highest among participants living in the West and Northeast regions. Pregnant people who identified as Black or Hispanic (of any race) were at higher risk of living in a high exposure census tract (defined as an index value above 0.5) relative to those who identified as White or non-Hispanic. Index values were also higher for pregnant people with lower educational attainment. Several recommendations follow from our work, including that environmental and social stressor datasets with higher spatial and temporal resolutions are needed to ensure index-based tools fully capture the total environmental context.
Published: 2023

39. Role of air pollution and socioeconomic position on cognition over six years in older adults in the United States

Author: Dang, Kristina Van and Dang, Kristina Van
Abstract: As our population ages, mounting interest lies in alleviating the illnesses of our older populations. Alzheimer’s Disease and related dementias affect 5.8 million Americans as of 2019, and this figure is set to grow to 7.1 million by 2050. This translates to current annual healthcare costs in excess of $1 trillion. There are 12 identified modifiable risk factors for dementia that could prevent up to 40% of dementia incidence, including air pollution, which was added in 2020. This objective of this dissertation was to examine the role of air pollution and socioeconomic position on cognition over six years in the National Health and Aging Trends Study (NHATS). As air pollution is socially patterned, there is a need to evaluate its interaction with social factors on cognition and cognitive decline. Chapter 1 of this dissertation compares racial and socioeconomic measures, from 2000 to 2015, across the conterminous US in exposure to outdoor nitrogen dioxide (NO2) and fine particulate matter (PM2.5). Chapter 2 builds upon Chapter 1 by using the individual and area-level metrics at the census tract level to examine their interaction with air pollution exposure on cognition in NHATS. Finally, the temporal pattern of air pollution exposure may be relevant to risk of cognitive decline in older adulthood. In Chapter 3, we characterized 10-year trajectories of PM2.5 and NO2 exposure at the census-tract level using sequence analysis and cluster analysis, and evaluated their association with cognition among a cohort of older adults.
Published: 2023

40. Particulate Matter-Related Reactive Oxygen Species Chemistry in Surrogate Lung Fluid and in Cloud Droplets

Author: Shen, Jiaqi and Shen, Jiaqi
Abstract: When air pollution particles encounter water, whether in clouds or in the lungs, they partly dissolve, which starts a cascade of reactions. In clouds, this chemistry can change the mass concentration, chemical composition, and size distribution of particulate matter (PM) left behind when the cloud re-evaporates, making it an important process impacting the earth’s climate. In the lungs, particles induce health impacts via mechanisms that are areas of active research. While these two environments are distinct, both are mediated by the reactions of reactive oxygen species (ROS). Excess amounts of ROS formation triggered by the inhalation of PM is believed to be one of the causes of PM-induced diseases. I utilized different oxidative potential (OP) metrics in my research to quantify aerosol particles’ ability to generate ROS. I further combined lab measurements with statistical analysis and kinetics models to determine the most toxic components in PM and dominant emission sources contributing to OP. In this dissertation, I first delved into the chemistry of ascorbate, one of the most abundant antioxidants in the lung. Ascorbate plays a vital role in the mechanism by which particulate air pollution initiates biological responses. I synthesized the literature on ascorbate, trace metals, and ROS interactions. Recognizing the large disagreements on the ascorbate reactions with iron or copper, I developed a chemical kinetics model to constrain the mechanisms and derive key rate constants. The modeling results suggest trace metals iron and copper are efficient sinks for ascorbate. Secondly, I investigated the interactions of PM and ROS with two other OP metrics – the hydroxyl radical (OH) and dithiothreitol (DTT) assays. The source apportionment analysis on OP indicates that vehicular exhaust and brake and tire wear are primary contributors to OP. I further linked the measured PM mass and OP with the CalEnviroScreen database. This is the first study in the US to uncover a di
Published: 2023

41. Threats of compound wildfire smoke and extreme heat in California

Author: Jones-Ngo, Caitlin Greer and Jones-Ngo, Caitlin Greer
Abstract: Wildfires and extreme heat events are inherently linked; shared climatic drivers are simultaneously worsening both hazardous events in California. Populations likely experience exposure to a combination of these hazards, i.e., compound hazards; yet there is little known about this public health threat. Studies indicate wildfire smoke and extreme heat, independently, elevate risks for morbidity and mortality. In addition, epidemiologic evidence gives reason to suspect compound wildfire smoke and extreme heat could exacerbate health outcomes and present a greater threat to public health.This dissertation aims to examine multiple facets of compound wildfire smoke and extreme heat in California. Chapter one assesses the distribution of compound wildfire smoke and extreme heat exposures in California from 2011-2020. The exposure assessment uses a clinically meaningful definition of exposure to estimate populations with disproportionate vulnerabilities. Chapter two then estimates the joint effects of exposure to wildfire smoke and extreme heat within a short-term exposure lag window. Chapters two and three both utilize a statewide payer’s database to examine all-natural cause, cardiovascular, cerebrovascular, renal, and respiratory morbidity impacts. In Chapter three, exposures are examined at different time periods to evaluate temporally compounding wildfire smoke and extreme heat in two ways; that is, effect modification of extreme heat-related morbidity by wildfire smoke exposure weeks to months prior, and vice versa. Methods include descriptive mapping and exposure assessment to identify disproportionately exposed populations. Joint effects and effect modification are estimated using time-stratified case crossover design with conditional logistic regression models. Each chapter investigates different periods of exposure and characterizes findings by individual or community level factors, such as race and ethnicity, income, education, and rural and urban classification
Published: 2023

42. Epidemiology and Pedagogy: Approaches to examining disease dynamics and developing anti-racist teaching practices.

Author: Mgbara, Whitney Ijeoma and Mgbara, Whitney Ijeoma
Abstract: My dissertation integrates theories and methods from pathogen ecology, infectious disease epidemiology and anti-racist pedagogy. For the first part of my dissertation, I focus on two environmentally- mediated, infectious diseases impacting the respiratory system, COVID-19 and coccidioidomycosis. My first chapter reviews key environmental features that characterize the soil niche of the two known fungal species in the Coccidioides genus, the etiologic agents for coccidioidomycosis. In this chapter, I aim to understand the environmental biology of Coccidioides species, C. immitis and C. posadasii, and factors that influence the pathogens’ life history. My second chapter explores the most important health, social, and environmental factors impacting transmission and mortality rates in US counties to determine the sectors of society most vulnerable to infection and mortality during the COVID-19 pandemic. For the last part of my dissertation, I outline a pedagogical framework which integrates social theories in methods for anti-racist praxis. In my third chapter I present a pedagogical framework with anti-racist principles for developing a course centered on uplifting racially minoritized groups in higher education.
Published: 2023

43. Translating community-based participatory research into broadscale sociopolitical change: insights from a coalition of women firefighters, scientists, and environmental health advocates.

Author: Ohayon, Jennifer and Ohayon, Jennifer
Abstract: BACKGROUND: We report on community-based participatory research (CBPR) initiated by women firefighters in order to share successful elements that can be instructive for other community-engaged research. This CBPR initiative, known as the Women Worker Biomonitoring Collaborative (WWBC) is the first we are aware of to investigate links between occupational exposures and health outcomes, including breast cancer, for a cohort of exclusively women firefighters. METHODS: In order to be reflective of the experiences and knowledge of those most intimately involved, this article is co-authored by leaders of the research initiative. We collected leaders input via recorded meeting sessions, emails, and a shared online document. We also conducted interviews (N = 10) with key research participants and community leaders to include additional perspectives. RESULTS: Factors contributing to the initiatives success in enacting broadscale social change and advancing scientific knowledge include (1) forming a diverse coalition of impacted community leaders, labor unions, scientists, and advocacy organizations, (2) focusing on impacts at multiple scales of action and nurturing different, yet mutually supportive, goals among partners, (3) adopting innovative communication strategies for study participants, research partners, and the broader community, (4) cultivating a prevention-based ethos in the scientific research, including taking early action to reduce community exposures based on existing evidence of harm, and (5) emphasizing co-learning through all the study stages. Furthermore, we discuss external factors that contribute to success, including funding programs that elevate scientist-community-advocacy partnerships and allow flexibility to respond to emerging science-policy opportunities, as well as institutional structures responsive to worker concerns. CONCLUSIONS: While WWBC shares characteristics with other successful CBPR partnerships, it also advances approaches that increas
Published: 2023

44. Health and Safety Effects of Airborne Soil Dust in the Americas and Beyond

Author: Tong, Daniel Q. and Tong, Daniel Q.
Abstract: Risks associated with dust hazards are often underappreciated, a gap between the knowledge pool and public awareness that can be costly for impacted communities. This study reviews the emission sources and chemical, physical, and biological characteristics of airborne soil particles (dust) and their effects on human and environmental health and safety in the Pan-American region. American dust originates from both local sources (western United States, northern Mexico, Peru, Bolivia, Chile, and Argentina) and long-range transport from Africa and Asia. Dust properties, as well as the trends and interactions with criteria air pollutants, are summarized. Human exposure to dust is associated with adverse health effects, including asthma, allergies, fungal infections, and premature death. In the Americas, a well-documented and striking effect of soil dust is its association with Coccidioidomycosis, commonly known as Valley fever, an infection caused by inhalation of soil-dwelling fungi unique to this region. Besides human health, dust affects environmental health through nutrients that increase phytoplankton biomass, contaminants that diminish water supply and affect food (crops/fruits/vegetables and ready-to-eat meat), spread crop and marine pathogens, cause Valley fever among domestic and wild animals, transport heavy metals, radionuclides and microplastics, and reduce solar and wind power generation. Dust is also a safety hazard to road transportation and aviation, in the southwestern US where blowing dust is one of the deadliest weather hazards. To mitigate the harmful effects, coordinated regional and international efforts are needed to enhance dust observations and prediction capabilities, soil conservation measures, and Valley fever and other disease surveillance. © 2023. The Authors.
Published: 2023

45. Influence of synoptic meteorology on airborne allergenic pollen and spores in an urban environment in Northeastern Iberian Peninsula

Abstract: The influence of the most frequent patterns of synoptic circulation on the dynamics of airborne pollen/spores recorded at the Barcelona Aerobiological Station (BCN) was analysed. Six pollen types (Platanus, Cupressaceae, Olea, Poaceae, Urticaceae and Amaranthaceae), and one fungal spore (Alternaria) were selected for their high allergenic effect in sensitive people. Six synoptic meteorological patterns were identified through cluster analysis of sea level pressure fields as the main responsible of the weather conditions in the Iberian Peninsula. The local meteorological conditions in Barcelona associated with each one of the synoptic types were also stablished. Different statistical methods were applied to analyse possible relationships between concentrations and timing of the recorded aerobiological particles and specific synoptic types. The study, focused in the 19-year period 2001–2019, shows that one of the scenarios, frequent in winter and linked to high stability and air-mass blockage, registered the highest mean and median values for Platanus and Cupressaceae, but it was not very relevant for the other taxa. It was also this scenario that turned out to be the most influent on the pollination timing showing a significant influence on the start occurrence of Urticaceae flowering and on the peak date of Platanus. On the other hand, the most frequent synoptic type in the period, relevant in spring and summer, was linked to sporadic episodes of levels considered to be of high risk of allergy to Platanus, Poaceae, and Urticaceae pollen, and Alternaria fungal spore. This synoptic pattern, characterized by the presence of the Azores anticyclone and the Atlantic low located in the north of the United Kingdom, was associated with high temperatures, low relative humidity and moderate winds from the NW in Barcelona. The identification of an interaction between synoptic meteorology and pollen/spore dynamics will allow better abatement measures, reducing adverse health eff, Peer Reviewed, Postprint (published version)
Published: 2023

46. Climate change and health in international medical education - a narrative review

Abstract: Objective: Climate change is a key threat to human health worldwide. Accordingly, medical education should prepare future physicians for climate-associated hazards and corresponding professional challenges. Currently, this is not yet implemented across the board. The aim of this review is to present (I) the knowledge and (II) the attitudes of medical students and physicians towards climate change and (III) the expectations of medical education as formulated by medical students. In addition, the available literature will be used to look at (IV) global teaching activities, (V) international learning goals and learning goal catalogues, and (VI) applied teaching methods and formats. This review should simplify and, considering the urgency of the topic, accelerate the design of future teaching activities.Methodology: The paper is based on a selective literature search supplemented by a topic-guided internet search.Results: Knowledge about the causes and concrete health consequences of climate change seems to be incomplete. The majority of medical students consider human health to be at risk from climate change and the health sector to be inadequately prepared. A majority of surveyed medical students would like to see teaching about climate change. It is evident that internationally, teaching projects on climate change and climate health, as well as topic-specific learning objectives and learning goal catalogues, have been developed and integrated into medical education.Conclusion: There is a need for and acceptance of teaching climate change in the medical curriculum. This literature review can assist in the development and implementation of new teaching formats., Zielsetzung: Der Klimawandel stellt eine zentrale Bedrohung für die Gesundheit der Menschen weltweit dar. Entsprechend sollte die medizinische Ausbildung zukünftige Ärzt*innen auf klimaassoziierte Gefahren und entsprechende berufliche Herausforderungen vorbereiten. Aktuell wird dies noch nicht flächendeckend umgesetzt. Ziel dieser Übersichtsarbeit ist es, (I) das Wissen und (II) die Haltungen von Medizinstudierenden und Ärzt*innen zum Klimawandel sowie (III) die von den Medizinstudierenden formulierten Erwartungen an die medizinische Lehre darzustellen. Darüber hinaus wird anhand der verfügbaren Literatur ein Blick auf (IV) globale Lehraktivitäten gelenkt, (V) internationale Lernziele und Lernzielkataloge werden dargestellt sowie (VI) angewandte Lehrmethoden und -formate beleuchtet. Hierdurch soll die Gestaltung künftiger Lehrveranstaltung vereinfacht und - in Anbetracht der Dringlichkeit des Themas - beschleunigt werden.Methodik: Dem Beitrag liegt eine selektive Literaturrecherche, ergänzt durch eine themengeleitete Internetsuche, zugrunde.Ergebnisse: Das Wissen um die Ursachen und konkrete gesundheitliche Folgen des Klimawandels scheint unvollständig zu sein. Mehrheitlich betrachten Medizinstudierende die menschliche Gesundheit als durch den Klimawandel gefährdet und den Gesundheitssektor als inadäquat vorbereitet. Eine Mehrheit befragter Medizinstudierender wünscht Lehre zum Themenkomplex Klimawandel. Es zeigt sich, dass international Lehrprojekte zu Klimawandel und Klimagesundheit sowie themenspezifische Lernziele und Lernzielkataloge entwickelt und in die medizinische Ausbildung integriert wurden. Schlussfolgerung: Es besteht der Bedarf und eine Akzeptanz für Lehre zum Klimawandel im medizinischen Curriculum. Die vorliegende Literaturübersicht kann bei der Entwicklung und Implementierung neuer Lehrformate unterstützen.
Published: 2023

47. DETERMINING THE IMPACT OF WELL MAINTENANCE, CONDITION, TYPE, AND LOCATION FACTORS ON E. COLI AND TOTAL COLIFORMS IN MARYLAND FARM PRIVATE DRINKING WATER WELLS

Abstract: Even with the establishment of the Safe Drinking Water Act in 1974, private wells are still not regulated or monitored for drinking water quality or the presence of contaminants such as total coliform bacteria and Escherichia coli. The presence of microbiological contaminants in private wells poses a public health risk. With Agricultural Agents from the University of Maryland Extension, we collected 67 water samples from Maryland farms with private wells located in seven regions and 19 counties of Maryland. We evaluated water samples for total coliforms and E. coli to understand the risk of contamination for Maryland private well owners. We also analyzed the impact of well factors, location, and climate on the presence of total coliforms and E. coli in well water by analyzing participant survey responses and climate data. Our results found that 39% (26/67) of the well water samples were positive for total coliforms and 10% (7/67) were positive for E. coli. Region (p<0.01), county (p=0.03), previously testing for pH (p<0.01), and ambient temperature (p=0.05) were significant factors impacting total coliform concentration. Region (p<0.01) and precipitation in the last 24 hours of collection (p<0.01) were the only significant factors impacting E. coli concentration. These findings emphasize the importance of well water testing for private well owners.
Published: 2023

48. Examining Consumer Product Use And Phthalate Exposure Among Vulnerable Populations

Abstract: One in 13 Americans have asthma, and higher rates have been reported among women and Black children.1 In addition, hairdressers who are exposed to chemicals through products used on themselves and their clients frequently report respiratory symptoms and conditions.2–10 Limited studies indicate that chemicals in personal care and consumer products (PCP) may impact respiratory health.11–14 The goal of this dissertation is to describe PCP use and exposures to recognized and suspected respiratory irritants (phthalates) among vulnerable populations who may experience disparate exposures. The aims are to: 1) characterize PCP use among 110 children with asthma, 2) examine associations between PCP use and asthma morbidity among 110 children with asthma, and 3) characterize concentrations and exposure determinants to phthalate metabolites in post-shift urine samples among 23 female hairdressers and 17 female office workers. In aim 1, participants were majority Black (87%), males (56%), and aged 8-11 years (66%). Adolescents (12-17 years) and females reported more frequent use of hair, face, and body products compared to children (8-11 years) and males. Participants used chemical treatments on their hair as young as 4 years and females 11-16 years used feminine wipes, spray, and regular deodorant in the genital area. For aim 2, use of aerosol products, hair products, and nail polish were positively associated with maximal symptom days [number of aerosol products (aOR: 1.36; CI: 1.17, 1.59), hairspray (aOR: 1.63; CI: 1.14, 2.33), perfume (aOR: 1.40; CI: 1.11,1.77); shampoo (aOR: 1.34; CI: 1.05,1.73), hair sheen (aOR: 1.41; CI: 1.00, 2.00), nail polish (aOR: 2.42; CI: 1.72, 3.41)] among children with asthma. For Aim 3, the geometric mean (GM) for monoethyl phthalate (MEP) was 10 times higher among hairdressers (161.4 ng/mL) than office workers (15.3 ng/mL). Hairdressers who provided chemical services had higher GM MEP concentrations than those who did not: texturizing (200.2 vs
Published: 2023

49. Legally Speaking : A Podcast from the Utah Attorney General's Office : Exposure to Forever Chemicals : A First Look Into the Emerging Issue (March 31, 2023)

Abstract: The Utah Attorney General’s Office is investigating the potential harm that so-called ‘forever chemicals’ pose to Utah citizens’ health. Detected in everyday places like drinking water, Teflon pans, microwave popcorn bags, water, fire-resistant clothing, carpeting, and much more, these PFOA and PFOS chemicals are everywhere. Legally Speaking consults Health and Environment Division Chief Craig Anderson for more information.
Published: 2023

50. Maimonides’ Health Regime and Its Prevalence Today

Abstract: Until the middle of the last century, health was expressed as a mere opposition to disease, and the general perspective to improve it was focused on the advancement of medicine as the main tool for progress, but currently the need for other strategies beyond biomedical ones is recognized . From the report of the Canadian Minister of Health Marc Lalonde (Isla Perrot, Canada, 1935), A New Perspective on the Health of Canadians (1974), the notion of «health field» is introduced, in which it is considered that being healthy is the result of four determinants: 1st) human biology, 2nd) environment, 3rd) health care systems and 4th) lifestyle. For Maimonides (Córdoba, Spain, 1138; Fustat, Egypt, 1204) health is not only the absence of illness, but the result of the conjunction of three balances: the humoral (physiological), the psychic (psychological) and the cosmic (ecological). Likewise, within the historical context, the nomenclature and the theoretical-scientific framework of medicine in the Middle Ages, in its texts on the «health regimen» or hygiene of life, the four components that make up the current idea of health can be recognized, with the equivalent terms: 1st) human nature, 2nd) local habitat, 3rd) continuous medical care for life and 4th) things necessary for the body, respectively. It can therefore be considered that Maimonides' doctrine on health was the most advanced of its time and that it survives over time, since it is based on concepts similar to those of the current Lalonde model. &nbsp, Hasta mediados del siglo pasado la salud se expresa como mera oposición a la enfermedad, y la perspectiva general para mejorarla se centra en el avance de la medicina como principal herramienta de progreso, pero actualmente se reconoce la necesidad de otras estrategias más allá de las biomédicas. A partir del informe del ministro de sanidad canadiense Marc Lalonde (Isla Perrot, Canadá, 1935), A New Perspective on the Health of Canadians (1974), se introduce la noción de «campo de salud», en el cual se considera que estar sano es el resultado de cuatro determinantes: 1o) biología humana, 2o) medio ambiente, 3o) sistemas de atención sanitaria y 4o) estilo de vida. Para Maimónides (Córdoba, España, 1138; Fustat, Egipto, 1204) la salud tampoco es solo la ausencia de dolencia, sino el fruto de la conjunción de tres equilibrios: el humoral (fisiológico), el anímico (psicológico) y el cósmico (ecológico). Asimismo, dentro del contexto histórico, la nomenclatura y el marco teórico-científico de la medicina del Medioevo, en sus textos sobre el «régimen de salud» o higiene de vida se pueden reconocer los cuatros componentes que conforman la idea actual de salud, con los términos equiparables: 1o) naturaleza humana, 2o) hábitat local, 3o) cuidados médicos continuados de por vida y 4o) «cosas» necesarias para el cuerpo, respectivamente. Se puede considerar, pues, que la doctrina de Maimónides sobre la salud fue la más avanzada de su época y que pervive en el tiempo, ya que se fundamenta en conceptos similares a los del vigente modelo de Lalonde., Até meados do século passado, a saúde se expressava como mera oposição à doença, e a perspectiva geral de melhorá-la estava voltada para o avanço da medicina como principal ferramenta para o progresso, mas atualmente a necessidade de outras estratégias além das biomédicas é reconhecido. A partir do relatório do Ministro da Saúde canadense Marc Lalonde (Isla Perrot, Canadá, 1935), A New Perspective on the Health of Canadians (1974), introduz-se a noção de «campo da saúde», no qual se considera que ser saudável é o resultado de quatro determinantes: 1º) biologia humana, 2º) meio ambiente, 3º) sistemas de saúde e 4º) estilo de vida. Para Maimônides (Córdoba, Espanha, 1138; Fustat, Egito, 1204) a saúde não é apenas a ausência de doença, mas o resultado da conjunção de três equilíbrios: o humoral (fisiológico), o psíquico (psicológico) e o cósmico (ecológico). ). Da mesma forma, dentro do contexto histórico, da nomenclatura e do arcabouço teórico-científico da medicina na Idade Média, em seus textos sobre o «regime de saúde» ou higiene da vida, os quatro componentes que compõem a ideia atual de saúde podem ser reconhecidos, com os termos equivalentes: 1º) natureza humana, 2º) habitat local, 3º) cuidados médicos contínuos para a vida e 4º) coisas necessárias ao corpo, respectivamente. Pode-se, portanto, considerar que a doutrina de Maimônides sobre a saúde foi a mais avançada de seu tempo e que sobrevive ao longo do tempo, pois se baseia em conceitos semelhantes aos do atual modelo Lalonde. &nbsp
Published: 2023

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