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Objectives: Concerns on climate change are leading to the renaissance of wood burning and particulate exposures. Levoglucosan is used as a marker of woodsmoke in air and urine. Objectives: Contribution of data on urinary excretion of levoglucosan, to improve biomonitoring and source apportionment of woodsmoke. Materials and Methods: 1, 3, 5, and 7 hours after5 mg of levoglucosan had been administered orally, urinary excretion was measured by HPLC and mass spectrometry. Results: After oral intake, urine concentrations increased rapidly, reached highest values after3 hours, and after 7 hours approximately 70% of the administered dose was excreted. Conclusions: Urinary levoglucosan may be used for biomonitoring of woodsmoke exposure on the same day. [ABSTRACT FROM AUTHOR]

Summary: We performed a time series analysis in Vienna, Austria, investigating the temporal association between daily air pollution (nitrogen dioxide, NO2 and particulate matter smaller than 10 µm, PM10) concentration and risk of coronavirus disease 2019 (COVID-19) infection and death. Data covering about 2 months (March–April 2020) were retrieved from public databases. Infection risk was defined as the ratio between infected and infectious. In a separate sensitivity analysis different models were applied to estimate the number of infectious people per day. The impact of air pollution was assessed through a linear regression on the natural logarithm of infection risk. Risk of COVID-19 mortality was estimated by Poisson regression. Both pollutants were positively correlated with the risk of infection with the coefficient for NO2 being 0.032 and for PM10 0.014. That association was significant for the irritant gas (p = 0.012) but not for particles (p = 0.22). Pollutants did not affect COVID-19-related mortality. The study findings might have wider implications on an interaction between air pollution and infectious agents. [ABSTRACT FROM AUTHOR]

Summary: Background: The aim of the study was to systematically evaluate the frequency of diagnostic and interventional X‑ray procedures and the corresponding population exposure in Austria. Data and methods: A methodology based on 107 selected procedures was adopted in accordance with European Commission recommendations. Frequencies were calculated based on an Austrian nationwide standardized database for the outpatient and inpatient sectors. The collective effective dose was estimated by linking the procedure frequencies to results from previous studies on doses per procedure and correction factors from the European Commission. Results: In Austria, 1468 diagnostic and interventional X‑ray procedures per 1000 inhabitants were conducted in 2015. Plain radiography procedures were performed most frequently, with approximately 40% being dental radiographs. The estimated extrapolated collective effective dose for 2015 was approximately 12,890 man-sievert (1.5 mSv per head). Although computed tomography only constitutes about 11% of the total number of procedures, its contribution to the collective effective dose is by far the largest at 74%, followed by plain radiography at almost 10%. Conclusion: This study provides a comprehensive estimate of procedure frequencies in Austria based on annually available, routinely collected data and of the corresponding collective effective dose. The results show that the frequency of computed tomography in Austria more than doubled within the last 14 years and is high compared to Germany and Switzerland. As in other countries, computed tomography is the largest contributor to the collective effective dose, identifying it as an area that deserves special attention for dose optimization. [ABSTRACT FROM AUTHOR]

Summary: A previously presented study investigated the impact of recent pesticide exposure on cytological signs of genotoxicity and on symptoms of intoxication in 71 male coffee workers in the Dominican Republic. An unexpected finding of this study was that conventional farming workers, among other symptoms, reported fewer children than controls working in organic farms without pesticide use. This study set out to investigate possible reasons for the latter difference. One statistical problem of this analysis is that the age of the workers is a strong predictor for the number of children and available data on the exposure determinants "duration of pesticide exposure" as well as "age at first pesticide exposure" are correlated with age. To correctly control statistics for these confounding parameters, different approaches to best control for age were explored. After careful elimination of the age-related confounding factors, a reduced number of children was still observed in exposed workers. The clearest effect is seen in those workers that reported first exposure before the age of 20 years. Socioeconomic factors could still confound that finding, but a direct effect of early life pesticide exposure is the most likely explanation of the observation. [ABSTRACT FROM AUTHOR]

Background: There is growing interest in "Health in All Policies" approaches, aiming at promoting health through policies which are under the control of nonhealth sectors. While economic appraisal is an established practice in transport planning, health effects are rarely taken into account. An international project was carried out to develop guidance and tools for practitioners for quantifying the health effects of cycling and walking, supporting their full appraisal. Development process: A systematic review of existing approaches was carried out. Then, the products were developed with an international expert panel through an extensive consensus finding process. Products and applications: Methodological guidance was developed which addresses the main challenges practitioners encounter in the quantification of health effects from cycling and walking. A "Health Economic Assessment Tool (HEAT) for cycling" was developed which is being used in several countries. Conclusions: There is a need for a more consistent approach to the quantification of health benefits from cycling and walking. This project is providing guidance and an illustrative tool for cycling for practical application. Results show that substantial savings can be expected. Such tools illustrate the importance of considering health in transport policy and infrastructure planning, putting "Health in All Policies" into practice. [ABSTRACT FROM AUTHOR]

Green criminologists have argued that exposure to environmental pollution constitutes a serious form of green victimization of the general public and public health. This claim has not been widely assessed empirically. The present study employs data from the National Health and Nutrition Examination Survey (NHANES) over time to examine trends in exposure to environmental toxins among the U.S. population. NHANES data allow such an assessment through the collection of biological sampling used to determine exposure to environmental toxins. We examined trends for NHANES exposure estimates for biological indicators of pollutant exposure over time for 64 chemicals that have multiple measures. We divide the exposure trends into declining, stable, increasing, and unclear trajectory patterns and discuss the health consequences associated with exposure to measured chemical exposures. Discussion of the implications of this analysis and the need for future studies is provided. [ABSTRACT FROM AUTHOR]

A pumped storage power plant produces significant noise such that adjacent areas were deemed uninhabitable for the local population. In recent years, the population in the area has increased, and the noise levels are now causing significant distress to the local population. The company operating the power plant and a citizens' initiative have both commissioned noise measurements. The measurements showed that the continuous pump noise was audible over many kilometers. The A-weighted sound-pressure level of 50 dBA at the next residential area underestimates the perceived noise, given the clear tonal nature in the low frequency range. Interviews of the exposed population, together with detailed "annoyance diaries" by a sample of the residents, proved their high level of annoyance. Their reported observations on distress and sleep disturbances coincide with the time course of the pumping operation. The pumping noise leads to annoyance in a large area, and to considerable nuisance in a smaller one. For the most exposed homes, long-term exposure might be considered a health hazard due to stress and disturbances in sleep quality. Therefore, the operator committed to developing a technical noise control plan. This case shows that a scientific approach within a complex environmental noise problem can foster an agreement about noise protection measures. However, this can only be successful if all involved parties participate in the process. Pilot studies are underway to test the impact of damping material layers on the pipes, the housing of the pipes, and the kind of air vessel solutions between the pumps and the pipes. Int J Occup Med Environ Health. 2019;32(3):401-11. [ABSTRACT FROM AUTHOR]

In the planning and authorization process of industrial plants or agricultural buildings, it needs to be ensured that odor emissions do not annoy nearby residents in an unacceptable way. Previous studies have shown that odor-hour frequency is an important predictor for odor annoyance. However, odor-hour frequencies can be assessed for day and night separately. The present study relates complaint rates with different odor types and different metrics of frequency calculated via a dispersion model. Binary logistic regression analyses show that odor type and frequency of odor-hours are important predictors for complaints, while type of residential area does not increase the predictive value of the model. The combination of calculated frequency of day time odor-hours and type of odor explains complaint rates best. It is recommended to keep odor emissions as low as possible, especially for highly annoying odor types. [ABSTRACT FROM AUTHOR]

Higher rates of nuclear anomalies in buccal cells of coffee workers exposed to pesticides in comparison to their unexposed peers were detected in our field study. Here, we extend our findings by examining other exposure indicators in this sample. Occupational exposure of 38 exposed and 33 non-exposed farmworkers was assessed as exposure days in the last month (0–25 days) and as years of exposure (0–47 years). Genotoxic and cytotoxic markers in buccal cells were analysed following standard procedures for buccal micronucleus cytome assay. Both exposure markers were associated with a higher frequency of nuclear anomalies with odds ratios more than 1. After restricting the analysis to the exposed workers only, this association remained only with the marker of recent exposure. In a secondary analysis also environmental exposure defined as proximity of the home to the nearest sprayed field (distance <1000 m) was assessed. Proximity led to increased rates (with odds ratios more than 3) of genotoxic but not cytotoxic nuclear anomalies. Reported recent frequency and intensity of pesticide use and application are a valid exposure marker relevant for cytological pathologies in the buccal mucosa. The exposure metric for environmental exposure was rather crude and confounding by some unmeasured factor cannot be fully excluded. Nevertheless, simple exposure indicators that can even be obtained under rather difficult field conditions do provide health-relevant and valid information. [ABSTRACT FROM AUTHOR]

Der Klimawandel stellt eine der größten Herausforderungen unserer Zeit dar. Er hat massive Auswirkungen auf die menschliche Gesundheit. Daher ist das Gesundheitswesen gefordert a) aktiv einen Beitrag zum Klimaschutz zu leisten und b) sich verstärkt auf die Auswirkungen des Klimawandels vorzubereiten. In Österreich wurde die Thematik im Rahmen einer „Klimamahnwoche" aufgegriffen und es wurden Schritte gesetzt, um auf Ebene des Gesundheitswesens das Bewusstsein zu schärfen. Climate change is one of the greatest challenges of our time. It has a massive impact on human health. Therefore, the health care system is called upon a) to make an active contribution to climate protection and b) to prepare more for the effects of climate change. In Austria, the topic was taken up in the context of a "climate reminder week" and steps were taken to raise awareness at the health care level. [ABSTRACT FROM AUTHOR]

Background: Vitamin K2 (VK2) belongs to the vitamin K family and comprises a number of subtypes differing in length of side chains consisting of isoprenoid groups (menaquinone-n, MK-n). It is essential for a number of physiological functions although the full spectrum of activity has not yet been elucidated. Due to its role in protection of mitochondrial damage, VK2 could be relevant in preventing disease progress in multiple sclerosis (MS).Methods: We measured VK2 serum levels by the double antibody sandwich Enzyme-linked Immunosorbent Assay (ELISA) technique in MS patients and age and sex matched controls, both under vitamin D supplementation, and related it to disease characteristics and treatment.Results: Overall, 45 MS patients (31 females and 39 of the relapsing-remitting type) and 29 healthy controls (19 females) were included in the analysis. The MS patients had vastly lower VK2 blood levels than controls (235 ± 100 ng/ml vs. 812 ± 154 ng/ml, respectively). Female patients had significantly lower VK2 levels than males and a decrease with age by approximately 10% per decade was found. The VK2 levels were lower with increasing numbers of attacks per year and were higher in patients with optic nerve lesions. No consistent relationship with medications was detected.Conclusion: The substantially lower levels of VK2 in MS patients could be due to depletion, lower production in the gut, diminished absorption or, less likely, reduced intake of precursor vitamin K1. The role of VK2 in MS development and progress deserves further study. [ABSTRACT FROM AUTHOR]

Dear editors, We want to express our thanks to Oberndorfer M, Yang L and Waldhoer T (henceforth referred to as OYW) for their letter [[1]] and comment to our recent paper [[2]]. References 1 Oberndorfer M, Yang L, Waldhoer T. Is the full moon fooling us? No matter if this finding is causal or a chance finding, we were happy realizing that lunar effects, if present, and even seasonal effects were rather weak and thus would not likely confound any air pollution effects yet to be analyzed. [Extracted from the article]

Mass concentrations PM, PM, PM, particle number concentrations of ultrafine particles and lung deposited surface area were measured during commutes with a subway, tram, bus, car and bicycle in Vienna for the first time. Obtained data were examined for significant differences in personal exposure when using various transport modalities along similar routes. Mean PM and PM mass concentrations were significantly higher in the subway when compared to buses. Mean PM, PM and PM mass concentrations were significantly higher in the subway when compared to cars using low ventilation settings. Particle number concentrations of ultrafine particles were significantly higher in trams when compared to the subway and lung deposited surface area was significantly greater on bicycles when compared to the subway. After adjusting for different vehicle speeds, exposure to PM, PM and PM along the same route length was significantly higher in the subway when compared to cars while exposure to ultrafine particles and partly also lung deposited surface area was significantly higher in bus, tram and on bicycle when compared to the subway. Car and bus passengers could be better isolated from ambient fine particulate matter than passengers in the subway, where a lot of ventilation occurs through open windows and larger doors. Tram passengers and cyclists might be exposed to increased amounts of ultrafine particles and larger lung deposited surface area due to a closer proximity to road traffic. Comparing cumulative exposure along the same route length leads to different results and favors faster traffic modes, such as the subway. [ABSTRACT FROM AUTHOR]

Windows in a classroom are particularly necessary to ventilate the room, provide fresh air to maintain the indoor air quality and thermal comfort, and provide natural light and an outside view. Several health issues related to the inappropriate use of windows in school classrooms have been reported, such as distracting student concentration; affecting learning performances; and causing headaches, asthma, cough, and eye irritation, also known as the symptoms of sick building syndrome. Therefore, the type of windows used in school classrooms must be analyzed to inquire whether the window type appropriately achieves good indoor air quality, thermal comfort, natural light, and access to an outside view. Thus, this study aims to identify the typology of the windows used in public elementary schools in Indonesia. This study employed the qualitative method via field observations on the fifty-eight school classrooms of forty-four chosen public elementary schools in Indonesia that use natural cross ventilation. Three types of windows were used in the selected classrooms, namely, casement top hung, casement side hung, and louver types. All the window types come with additional permanent ventilation, which is the wooden horizontal louver on the upper side. The windows located on the corridor sidewall and the opposite side are generally at the height of 1.0 to 1.4 m above the floor level. Most of the school classrooms use the same type of window on both sides of the wall: the casement top hung (24) and the louver window (12). One school classroom uses only permanent ventilation at the height of more than 2 m from the floor on both sides of the wall. Other school classrooms use different window types on each side of the wall. The results are necessary for further investigation to ensure that the performance of a window type achieves a healthy indoor environment in public elementary school classrooms in Indonesia. [ABSTRACT FROM AUTHOR]

In 2013-2015, a consortium of European scientists - NEWDANUBE - was established to prepare a birth cohort in the Danube region, including most of the countries with the highest air pollution in Europe, the area being one-fifth of the European Union's (EU's) territory, including 14 countries (nine EU member states), over 100 million inhabitants, with numerous challenges: big socioeconomic disparities, and a region-specific environmental pollution. The consortium reflects the EU Strategy for the Danube Region Strategy (2010), which identified 11 thematic Priority Areas - one of which is the environmental risks. Birth cohorts have been established in all other areas of Europe and collaborative efforts in promoting maternal and fetal health by minimizing the environmental exposures have been initiated with national, European, and international financial support. A birth cohort in the Danube area could apply the established methodologies for prenatal exposure and birth outcome measurements and establish a platform for targeted health promotion in couples planning pregnancies. The consortium included a strong socioeconomic part focusing on the participant's active registration of exposures to environmental toxicants and health indicators of disease and wellbeing, combined with investigation of their risk-reducing behavior and interventions to change their lifestyle to avoid the adverse health risks. Willingness to pay for reducing the health risks in children is also proposed to be estimated. Further collaboration and networking is encouraged as the Danube region has several decades of experience and expertise in biomonitoring adult populations exposed environmentally or occupationally. Additionally, some countries in the Danube region launched small-scale birth cohorts encouraged by participation in several ongoing research projects. [ABSTRACT FROM AUTHOR]

In climbing halls, high levels of dust are found because magnesia powder is used to dry hands. Concerns have been raised about possible health effects after reports from asthmatics experiencing worsening of symptoms while or after climbing. We investigated acute and sub-acute effects of climbing in dusty halls on lung function in two pilot studies. The first study examined 109 climbers before and after a climbing activity that lasted at least 1 h. In the second study, 25 climbers from different age classes participated in a 2-day climbing competition. Of these, 24 agreed to take part in our investigation, but only 22 provided valid lung function tests on both days. The climbers underwent lung function tests before the first round of the competition (in the morning), after the second round approximately 3 h later and in the morning of the second day before the competition started again. In the first study, we found acute effects, a decline in lung function immediately after the exposure, likely due to protective reflexes of the bronchial muscles and stronger declines in persons with higher exhaled nitric oxide (NO) pre-climbing. In the second study, we also expected sub-acute effects on the next day due to inflammation. On the first day of the competition (second study), dust levels at a central monitor increased over time in a linear manner. Most of the dust was in the size range between 2.5 and 10 μm and dust levels of particulate matter (PM10) reached 0.5 mg/m3. There was a decline in lung function over 24 h in persons with higher exhaled NO levels pre-exposure. All spirometric parameters were affected though the effects were not statistically significant in all cases. Younger age classes started earlier in the morning. Because of the increasing trend in dust levels we expected stronger effects with higher numbers but for the acute effects the reverse was true, possibly because younger climbers use magnesia more or with less experience thus causing higher individual exposure. No differences by age or by time of the first climb were observed for the 24-h lung function change. [ABSTRACT FROM AUTHOR]

Chronic diseases and illnesses associated with non-specific symptoms are on the rise. In addition to chronic stress in social and work environments, physical and chemical exposures at home, at work, and during leisure activities are causal or contributing environmental stressors that deserve attention by the general practitioner as well as by all other members of the health care community. It seems necessary now to take "new exposures" like electromagnetic fields (EMF) into account. Physicians are increasingly confronted with health problems from unidentified causes. Studies, empirical observations, and patient reports clearly indicate interactions between EMF exposure and health problems. Individual susceptibility and environmental factors are frequently neglected. New wireless technologies and applications have been introduced without any certainty about their health effects, raising new challenges for medicine and society. For instance, the issue of so-called non-thermal effects and potential long-term effects of low-dose exposure were scarcely investigated prior to the introduction of these technologies. Common electromagnetic field or EMF sources: Radio-frequency radiation (RF) (3 MHz to 300 GHz) is emitted from radio and TV broadcast antennas, Wi-Fi access points, routers, and clients (e.g. smartphones, tablets), cordless and mobile phones including their base stations, and Bluetooth devices. Extremely low frequency electric (ELF EF) and magnetic fields (ELF MF) (3 Hz to 3 kHz) are emitted from electrical wiring, lamps, and appliances. Very low frequency electric (VLF EF) and magnetic fields (VLF MF) (3 kHz to 3 MHz) are emitted, due to harmonic voltage and current distortions, from electrical wiring, lamps (e.g. compact fluorescent lamps), and electronic devices. On the one hand, there is strong evidence that long-term exposure to certain EMFs is a risk factor for diseases such as certain cancers, Alzheimer's disease, and male infertility. On the other hand, the emerging electromagnetic hypersensitivity (EHS) is more and more recognized by health authorities, disability administrators and case workers, politicians, as well as courts of law. We recommend treating EHS clinically as part of the group of chronic multisystem illnesses (CMI), but still recognizing that the underlying cause remains the environment. In the beginning, EHS symptoms occur only occasionally, but over time they may increase in frequency and severity. Common EHS symptoms include headaches, concentration difficulties, sleep problems, depression, a lack of energy, fatigue, and flu-like symptoms. A comprehensive medical history, which should include all symptoms and their occurrences in spatial and temporal terms and in the context of EMF exposures, is the key to making the diagnosis. The EMF exposure is usually assessed by EMF measurements at home and at work. Certain types of EMF exposure can be assessed by asking about common EMF sources. It is very important to take the individual susceptibility into account. The primary method of treatment should mainly focus on the prevention or reduction of EMF exposure, that is, reducing or eliminating all sources of high EMF exposure at home and at the workplace. The reduction of EMF exposure should also be extended to public spaces such as schools, hospitals, public transport, and libraries to enable persons with EHS an unhindered use (accessibility measure). If a detrimental EMF exposure is reduced sufficiently, the body has a chance to recover and EHS symptoms will be reduced or even disappear. Many examples have shown that such measures can prove effective. To increase the effectiveness of the treatment, the broad range of other environmental factors that contribute to the total body burden should also be addressed. Anything that supports homeostasis will increase a person's resilience against disease and thus against the adverse effects of EMF exposure. There is increasing evidence that EMF exposure has a major impact on the oxidative and nitrosative regulation capacity in affected individuals. This concept also may explain why the level of susceptibility to EMF can change and why the range of symptoms reported in the context of EMF exposures is so large. Based on our current understanding, a treatment approach that minimizes the adverse effects of peroxynitrite - as has been increasingly used in the treatment of multisystem illnesses - works best. This EMF Guideline gives an overview of the current knowledge regarding EMF-related health risks and provides recommendations for the diagnosis, treatment and accessibility measures of EHS to improve and restore individual health outcomes as well as for the development of strategies for prevention. [ABSTRACT FROM AUTHOR]

Purpose Lifetime risk for melanoma skin cancer is enlarged by sunlight exposure and reduced by sun protection. Austrian melanoma incidence and mortality rates are constantly rising with higher rates in males. Thus, we aimed at investigating gender-specific recreational sun exposure habits among the Austrian population. Methods We conducted a telephone survey among 1500 adults (50.5% females) representing sociodemographic characteristics of the Austrian population. Using a structured questionnaire, we studied gender-specific sun exposurerelated knowledge, motives to tan, and behavior. Results Overall, using sunscreen, wearing sunglasses, and seeking shade were among the three most frequent sun safe measures. Basic skin health knowledge and tanning motives were similar among genders, although females protected themselves more. In general, sunburn occurrence (odds ratio [OR] = 1.4, 95% confidence interval [CI] = 1.0-1.8), skin type IV (OR = 2.4, 95% CI = 1.3-4.5), ex-/non-smoking (OR = 1.4-1.6, 95% CI = 1.0-2.1), low motives to tan (both OR = 1.3, 95% CI = 1.0-1.7), no outdoor sport (OR = 1.3, 95% CI = 1.0-1.7), all P < 0.05, as well as the use of sunscreen with lower SPF values (OR = 1.0-3.0, 95% CI = 1.4-4.3) and male gender (OR = 1.6, 95% CI = 1.2-2.0), both P < 0.001, increased the odds of practicing low sun protection. Conclusion The results of this investigation suggest considering gender specificity when planning Public (Skin) Health-related educative campaigns and programs, for example, by highlighting the appearance-related benefits of sun light avoidance. [ABSTRACT FROM AUTHOR]

Chronic diseases and illnesses associated with unspecific symptoms are on the rise. In addition to chronic stress in social and work environments, physical and chemical exposures at home, at work, and during leisure activities are causal or contributing environmental stressors that deserve attention by the general practitioner as well as by all other members of the health care community. It seems certainly necessary now to take "new exposures" like electromagnetic field (EMF) into account. Physicians are increasingly confronted with health problems from unidentified causes. Studies, empirical observations, and patient reports clearly indicate interactions between EMF exposure and health problems. Individual susceptibility and environmental factors are frequently neglected. New wireless technologies and applications have been introduced without any certainty about their health effects, raising new challenges for medicine and society. For instance, the issue of so-called non-thermal effects and potential long-term effects of low-dose exposure were scarcely investigated prior to the introduction of these technologies. Common EMF sources include Wi-Fi access points, routers and clients, cordless and mobile phones including their base stations, Bluetooth devices, ELF magnetic fields from net currents, ELF electric fields from electric lamps and wiring close to the bed and office desk. On the one hand, there is strong evidence that long-term-exposure to certain EMF exposures is a risk factor for diseases such as certain cancers, Alzheimer's disease and male infertility. On the other hand, the emerging electromagnetic hypersensitivity (EHS) is more and more recognized by health authorities, disability administrators and case workers, politicians, as well as courts of law. We recommend treating EHS clinically as part of the group of chronic multisystem illnesses (CMI) leading to a functional impairment (EHS), but still recognizing that the underlying cause remains the environment. In the beginning, EHS symptoms often occur only occasionally, but over time they may increase in frequency and severity. Common EHS symptoms include headaches, concentration difficulties, sleeping problems, depression, lack of energy, fatigue and flu-like symptoms. A comprehensive medical history, which should include all symptoms and their occurrences in spatial and temporal terms and in the context of EMF exposures, is the key to the diagnosis. The EMF exposure can be assessed by asking for typical sources like Wi-Fi access points, routers and clients, cordless and mobile phones and measurements at home and at work. It is very important to take the individual susceptibility into account. The primary method of treatment should mainly focus on the prevention or reduction of EMF exposure, that is, reducing or eliminating all sources of EMF at home and in the workplace. The reduction of EMF exposure should also be extended to public spaces such as schools, hospitals, public transport, and libraries to enable persons with EHS an unhindered use (accessibility measure). If a detrimental EMF exposure is reduced sufficiently, the body has a chance to recover and EHS symptoms will be reduced or even disappear. Many examples have shown that such measures can prove effective. Also the survival rate of children with leukemia depends on ELF magnetic field exposure at home. To increase the effectiveness of the treatment, the broad range of other environmental factors that contribute to the total body burden should also be addressed. Anything that supports a balanced homeostasis will increase a person's resilience against disease and thus against the adverse effects of EMF exposure. There is increasing evidence that EMF exposure has a major impact on the oxidative and nitrosative regulation capacity in affected individuals. This concept also may explain why the level of susceptibility to EMF can change and why the number of symptoms reported in the context of EMF exposures is so large. Based on our current understanding, a treatment approach that minimizes the adverse effects of peroxynitrite - as has been increasingly used in the treatment of multisystem disorders - works best. This EMF Guideline gives an overview of the current knowledge regarding EMF-related health risks and provides concepts for the diagnosis and treatment and accessibility measures of EHS to improve and restore individual health outcomes as well as for the development of strategies for prevention. [ABSTRACT FROM AUTHOR]

Cotton workers in small weaving household factories (power looms) in Pakistan are typically exposed to high levels of cotton dusts. Working in the textile manufacturing industry has been classified as a possible human carcinogen (group 2B) by the International Agency for Research on Cancer. The study set out to determine potential cytotoxic and genotoxic effects of occupational exposure to cotton dusts in exfoliated buccal cells of exposed cotton workers. Nuclear anomalies reflecting cytotoxic and genotoxic effects were evaluated in a representative sample of 51 exposed male cotton weavers and in the same number of age-matched male non-exposed subjects applying the micronucleus cytome assay. Nuclear anomalies reflecting cytotoxicity (karyolysis, karyorrhexis, condensed chromatin and pyknosis) were significantly elevated in exposed cotton workers. The frequency of micronucleated cells increased significantly with increasing years of work in power looms (odds ratio = 1.043 per year; 95% confidence interval: 1.012-1.076, P = 0.007). Results were consistent with the typical inflammatory pattern and injury in epithelia due to unprotected occupational exposure to cotton dusts and other toxic, allergic and infectious substances in the working areas of the cotton industry. Occupational exposure in power looms induces cytotoxic effects and, upon chronic exposure, DNA damage. This may eventually result in typical obstructive patterns of pulmonary symptoms and in a clinical condition called byssinosis in exposed cotton workers. Long exposure may lead to chronic inflammation and cumulative damage of DNA in buccal stem cells that may indicate an increased risk of oropharyngeal cancer. [ABSTRACT FROM AUTHOR]

Objectives: In the cotton industry of Pakistan, 15 million people are employed and exposed to cotton dust, toxic chemicals, noise and physical hazards. The aim of this study was to determine the prevalence of health symptoms, particularly respiratory symptoms, and to measure cotton dust and endotoxin levels in different textile factories of Faisalabad, Pakistan. Methods: A cross-sectional investigation was performed in a representative sample of 47 cotton factories in the Faisalabad region in Punjab, Pakistan. Respiratory symptoms of 800 workers were documented by questionnaire. Occupational safety in the factories was assessed by a trained expert following a checklist, and dust and endotoxin levels in different work areas were measured. Results: Prevalence of respiratory disease symptoms (fever, shortness of breath, chest tightness and cough) was generally high and highest in the weaving section of the cotton industry (20-40% depending on symptoms). This section also displayed the poorest occupational safety ratings and the highest levels of inhalable cotton dust (mean±SD 4.6±2.5 vs 0.95 ±0.65 mg/m³ in compact units). In contrast, endotoxin levels were highest in the spinning section (median 1521 EU/m³), where high humidity is maintained. Conclusions: There are still poor working conditions in the cotton industry in Pakistan where workers are exposed to different occupational hazards. More health symptoms were reported from small weaving factories (power looms). There is a dire need for improvements in occupational health and safety in this industrial sector with particular focus on power looms. [ABSTRACT FROM AUTHOR]

Objective Occupationally acquired noise-induced hearing loss (NIHL) is the most prevalent occupational disease in Austria and among the most common in many other countries. Because of the wide variation in hearing loss after equivalent exposures it has long been assumed that some individuals are more vulnerable to occupational NIHL than others. Earlier attempts to define predictors of NIHL before starting occupational noise exposure have largely failed. We present results of a prospective study evaluating the potential of temporary threshold shift (TTS) after a test exposure to predict NIHL. Methods Between 1982 and 1989, overall 311 apprentices were included into a prospective study during their initial health screening visit. At this occasion, a standardised noise exposure was applied (20 min, 200-500 Hz, 100 dBA) and the TTS at 4 kHz was determined during at least 10 min after exposure. Hearing loss was monitored at follow-up visits every 3-5 years. Follow-up was 13 years on average. Results Permanent threshold shift was predicted by duration of noise exposure, frequency of wearing noise protectors and especially by the initial TTS at 4 kHz. Using 14 dB TTS as a cut-off had 82% sensitivity and 53% specificity to predict 20 dB or higher levels of NIHL. Conclusions The TTS model can be successfully applied as a method to detect individuals at greater risk of occupational NIHL. It is recommended to routinely include such a procedure into initial workers' examinations for suitability to work under occupational noise conditions and for counselling on the use of hearing protectors. [ABSTRACT FROM AUTHOR]

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Biofuels have become an alternative to fossil fuel, but consequences on human health from changes to emissions compositions are not well understood. By combining information on composition of vehicle exhaust, dispersion models, and relationship between exposure to air contaminants and health, the authors determined expected mortality outcomes in 2 scenarios: a blend of 10% biodiesel and 90% standard diesel (B10) and biodiesel only (B100), for a rural and an urban environment. Vehicle exhaust for both fuel compositions contained lower fine particle mass but higher NO2levels. Ambient air concentrations in scenario B10 were almost unchanged. In scenario B100, PM2.5(particulate matter with an aerodynamic diameter <2.5 μm) levels decreased by 4–8% and NO2levels increased 7–11%. Reduction of PM2.5is expected to reduce mortality rate by 5 × 10−6and 31 × 10−6per year, whereas NO2increase adds 17 × 10−6and 30 × 10−6to mortality rate for B10 and B100, respectively. Since effects of PM2.5and NO2are not independent, a positive net effect is possible. [ABSTRACT FROM PUBLISHER]

Objectives: The World Health Organization (WHO) provides data on national indices of health, environment and economy. When we were asked, why air pollution is negatively correlated with cancer mortality, our first response (presumably the mortality data are not age-adjusted) was not sufficient to explain the paradox. Material and Methods: A table including all-cause, cancer and childhood mortality, life expectancy, gross national product per person, smoking prevalence, physician density and particulate matter (PM) per country (N = 193) was developed. For explorative purposes weighted cross-sectional multiple linear regressions models were built. Results: Air pollution is positively correlated with infant and overall mortality and negatively with life expectancy. This might not only depict a true causal effect of PM because air quality is also an indicator of a country's prosperity and general state of environment. Cancer mortality is negatively correlated with PM. However, this association turns positive when economic or health system indicators are controlled. Conclusions: The World Health Organization's world-wide data sets demonstrate the large disparity of our world. A careful and professional approach is needed as interpretation is difficult, especially for lay persons. Therefore, with publicly available data WHO should also provide interpretation and guidance. [ABSTRACT FROM AUTHOR]

Objectives: There is increasing evidence that smoking is associated with abdominal obesity and other risk factors for the metabolic syndrome. The aim of this study is to investigate these associations in a sample of healthy Austrian adults. Setting and participants: Data of 986 employees of an Austrian company (405 men and 581 women; participation rate approximately 80%) obtained during their annual medical check-up at the workplace were analysed. Primary and secondary outcome measures: Information on smoking status, education level, physical activity, diet, body weight, height, body mass index (BMI), waist circumference and biochemical parameters was obtained. The influence of smoking on health and anthropometric measures was investigated. Results: No differences in total body fat and/or body fat distribution were found between non-smokers, smokers and former smokers; however, among daily smokers, the number of cigarettes smoked per day was significantly associated with higher body weight (p=0.001) and BMI (p=0.009). Male and female smokers had significantly higher white cell count than non-smokers and former smokers. Heavy smokers also had an unhealthier lipid profile (lower high-density lipoprotein cholesterol) and higher fasting glucose levels even after controlling for physical activity and calorie intake. Conclusions: Contrary to the beliefs of many smokers, heavy smoking is associated with higher body weight and unfavourable metabolic changes. [ABSTRACT FROM AUTHOR]

Purpose: Adverse health effects of work-related contact with respirable hazardous substances are of great public interest. Because related prospective and long-term follow-up studies are rare, the extent of acute and chronic pulmonary health risks of occupational exposure to welding fumes is discussed controversially in the scientific literature. The objective of the present longitudinal study during a 9-year period was to investigate the annual changes of lung function in welders. Methods: Anthropometric measures and smoking behaviour, and spirometric tests (FVC, FEV1, and MEF50) obtained during routine occupational health checkups of female and male workers ( n = 1,982) in Austria during the years 2002-2010 were analyzed. Results: The study participants displayed average lung function values lower than the age- and sex-specific norm. Decrease in respiratory capacity was dependent on smoking habits and duration of occupational exposure. Specifically for welders ( n = 1,326), decrease of pulmonary function was significantly associated with heavy smoking (FVC −70.7 ml, p = 0.07; FEV1 −167.4 ml, p < 0.001; MEF50 −356.2 ml/s, p < 0.001), but not with moderate smoking habits, and also with duration of occupational exposure to welding fumes per year (FVC −0.89 ml, p = 0.36; FEV1 −2.91 ml, p < 0.001; MEF50 −4.7 ml/s, p = 0.047). Conclusions: Individual smoking habits as well as duration of occupational exposure to welding fumes showed a negative impact on lung function parameters. To reduce the risk of work-associated respiratory morbidity, smoking cessation is highly recommended to personnel engaged in welding fumes- and dust-exposed occupations. [ABSTRACT FROM AUTHOR]