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Many countries, including Indonesia, were gravely affected by the COVID-19 pandemic. While younger people were rarely severely affected by an infection, they still served as important spreaders of the disease. Therefore, the knowledge, perception and attitudes regarding COVID-19 of a mostly younger population was assessed in this study using a quantitative survey and semi-structured questionnaire. Out of 15 questions on COVID-19, males answered fewer questions (−1.26) correctly. Persons reporting more diseases in the last year (+0.49 per disease) that lived in a central area of Indonesia, and that had a better socio-economic status defined through household condition scores, had better knowledge of the symptoms, causes of and measures against COVID-19. Better knowledge independently predicted more responsible attitudes and stated behavior. Knowledge and understanding should be enhanced through information campaigns targeted specifically towards men, persons with poor socio-economic backgrounds and those living in the periphery of the state.

Zusammenfassung 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.

The Republic of Kosovo is a small country in the Balkans. The capital city of Pristina hosts most of its population and is situated in a mountain basin with poor air exchange, especially during winter. Domestic heating, road transport, industry and coal-fired power plants contribute to high levels of air pollution. We performed a time-series analysis on effects of particulate air pollution (PM2.5) on respiratory health of children and adolescents, using hospital admission and ambulatory visit numbers from the pediatric university clinic. From 2018 until 2020, daily mean concentrations of PM2.5 ranged between 2.41 and 161.03 µg/m³. On average, there were 6.7 ambulatory visits per day with lower numbers on weekends and during the first COVID-19 wave in 2020. An increase in PM2.5 led to an immediate increase in visit numbers that lasted over several days. Averaged over a full week, this amounted to about a 1% increase per 10 µg/m³. There were, on average, 1.7 hospital admissions per day. Two and three days after a rise in air pollution, there was also a rise in admission numbers, followed by a decline during the consecutive days. This might indicate that the wards were overstressed because of high admission numbers and restricted additional admissions.

In epidemiological studies, both spatial and temporal variations in nitrogen dioxide (NO2) are a robust predictor of health risks. Compared to particulate matter, the experimental evidence for harmful effects at typical ambient concentrations is less extensive and not as clear for NO2. In the wake of the &ldquo, Diesel emission scandal&mdash, Dieselgate&rdquo, the scientific basis of current limit values for ambient NO2 concentrations was attacked by industry lobbyists. It was argued that associations between NO2 levels and medical endpoints were not causal, as NO2 in older studies served as a proxy for aggressive particulate matter from incineration processes. With the introduction of particle filters in diesel cars, NO2 would have lost its meaning as a health indicator. Austria has a high percentage of diesel-powered cars (56%). If, indeed, associations between NO2 concentrations and health risks in previous studies were only due to older engines without a particle filter, we should expect a reduction in effect estimates over time as an increasing number of diesel cars on the roads were outfitted with particle filters. In previous time series studies from Vienna over shorter time intervals, we have demonstrated distributed lag effects over days up to two weeks and previous day effects of NO2 on total mortality. In a simplified model, we now assess the effect estimates for moving 5-year periods from the beginning of NO2 monitoring in Vienna (1987) until the year 2018 of same and previous day NO2 on total daily mortality. Contrary to industry claims of a spurious, no longer valid indicator function of NO2, effect estimates remained fairly stable, indicating an increase in total mortality of previous day NO2 by 0.52% (95% CI: 0.35&ndash, 0.7%) per 10 &micro, g/m3 change in NO2 concentration.

In Europe and many countries worldwide, a half-yearly changing time scheme has been adopted with the aim of optimizing the use of natural daylight during working hours and saving energy. Because the expected net economic benefit was not achieved, the discussion about the optimal solution has been reopened with a shifted focus on social and health related consequences. We set out to produce evidence for this discussion and analysed the impact of daylight saving time on total mortality of a general population in a time series study on daily total mortality for the years 1970&ndash, 2018 in the city of Vienna, Austria. Daily deaths were modelled by Poisson regression controlling for seasonal and long-term trend, same-day and 14-day average temperature, humidity, and day of week. During the week after the spring transition a significant increase in daily total mortality of about 3% per day was observed. This was not the case during the week after the fall transition. The increase in daily mortality as observed in the week after spring DST-transition is most likely causally linked to the change in time scheme.

Substantial knowledge is available on the association of the indoor school environment and its effect among schoolchildren. In the same context, the SINPHONIE (School indoor pollution and health: Observatory network in Europe) conducted a study to collect data and determine the distribution of several indoor air pollutants (IAPs), physical and thermal parameters and their association with eye, skin, upper-, lower respiratory and systemic disorder symptoms during the previous three months. Finally, data from 115 schools in 54 European cities from 23 countries were collected and included 5175 schoolchildren using a harmonized and standardized protocol. The association between exposures and the health outcomes were examined using logistic regression models on the environmental stressors assessed in classroom while adjusting for several confounding factors; a VOC (volatile organic compound) score defined as the sum of the number of pollutants to which the children were highly exposed (concentration > median of the distribution) in classroom was also introduced to evaluate the mul tiexposu re - outcome association. Schoolchildren while adjusting for several confounding factors. Schoolchildren exposed to above or equal median concentration of PM2.5, benzene, limonene, ozone and radon were at significantly higher odds of suffering from upper, lower airways, eye and systemic disorders. Increased odds were also observed for any symptom (sick school syndrome) among schoolchildren exposed to concentrations of limonene and ozone above median values. Furthermore, the risks for upper and lower airways and systemic disorders significantly increased with the VOCs score. Results also showed that increased ventilation rate was significantly associated with decreased odds of suffering from eye and skin disorders whereas similar association was observed between temperature and upper airways symptoms. The present study provides evidence that exposure to IAPs in schools is associated with various health problems in children. Further investigations are needed to confirm our findings. (C) 2020 Elsevier B.V. All rights reserved.

Clinical research aiming at objectively identifying and characterizing diseases via clinical observations and biological and radiological findings is a critical initial research step when establishing objective diagnostic criteria and treatments. Failure to first define such diagnostic criteria may lead research on pathogenesis and etiology to serious confounding biases and erroneous medical interpretations. This is particularly the case for electrohypersensitivity (EHS) and more particularly for the so-called “provocation tests”, which do not investigate the causal origin of EHS but rather the EHS-associated particular environmental intolerance state with hypersensitivity to man-made electromagnetic fields (EMF). However, because those tests depend on multiple EMF-associated physical and biological parameters and have been conducted in patients without having first defined EHS objectively and/or endpoints adequately, they cannot presently be considered to be valid pathogenesis research methodologies. Consequently, the negative results obtained by these tests do not preclude a role of EMF exposure as a symptomatic trigger in EHS patients. Moreover, there is no proof that EHS symptoms or EHS itself are caused by psychosomatic or nocebo effects. This international consensus report pleads for the acknowledgement of EHS as a distinct neuropathological disorder and for its inclusion in the WHO International Classification of Diseases.

Banana farming represents an important segment of agricultural production in Ecuador. The health of farmworkers might be compromised by the extensive use of pesticides in plantations applied under poorly regulated conditions. Due to an increased awareness of pesticide-related problems for nature, as well as for worker and consumer health, ecological farming has been established in some plantations of Ecuador. We set out to investigate the occupational health of workers in both conventional and ecological farming. Nuclear anomalies in buccal epithelial cells were used as short-term indicators for genotoxicity and a potentially increased cancer risk in the two groups of farmworkers. By application of the Buccal Micronucleus Cytome Assay (BMCA), we found the frequency of micronuclei in conventional pesticide using farmworkers significantly increased by 2.6-fold, and other nuclear anomalies significantly increased by 24% to 80% (except pyknosis with a non-significant increase of 11%) compared to the farmworkers on ecological plantations. These results demonstrate that ecological farming may provide an alternative to extensive pesticide use with significantly reduced indicators of cancer risk. In conventional farming, improvements in education and instruction regarding the safe handling of pesticides and protective equipment, as well as regulatory measures, are urgently needed.

Acute and sub-acute effects of pesticide use in coffee farmers have rarely been investigated. In the present field study, self-reported health symptoms from 38 male pesticide users were compared to those of 33 organic farmers. Results of cytological findings have been reported in an accompanying paper in this issue. The present second part of the study comprises a questionnaire based survey for various, potentially pesticide related symptoms among the coffee farmers. Symptom rates were generally higher in exposed workers, reaching significance in nine out of 19 assessed symptoms. Significantly increased symptom frequencies were related to neurotoxicity, parasympathic effects and acetylcholine esterase inhibition, with the highest differences found for excessive salivation, dizziness and stomach ache. We revealed a lack of precautionary measures in the majority of farmers. Better education, regulations, and safety equipment are urgently needed.

Individual skin health attitudes are influenced by various factors, including public education campaigns, mass media, family, and friends. Evidence-based, educative information materials assist communication and decision-making in doctor-patient interactions. The present study aims at assessing the prevailing use of skin health information material and sources and their impact on skin health knowledge, motives to tan, and sun protection. We conducted a questionnaire survey among a representative sample of Austrian residents. Print media and television were perceived as the two most relevant sources for skin health information, whereas the source physician was ranked third. Picking the information source physician increased participants’ skin health knowledge (p = 0.025) and sun-protective behavior (p &lt, 0.001). The study results highlight the demand for targeted health messages to attain lifestyle changes towards photo-protective habits. Providing resources that encourage pro-active counseling in every-day doctor-patient communication could increase skin health knowledge and sun-protective behavior, and thus, curb the rise in skin cancer incidence rates.

Connectedness to nature (CN) influences motivation to have contact with outdoor natural environments. Spending leisure time in natural environments is beneficial for human health and well-being. Besides these positive effects, health risks of open-air activities are mainly related to unprotected sun light exposure-associated acute and chronic skin hazards. Thus, we conducted a cross-sectional, representative telephone survey among Austrian residents to study the association of perceived CN level with sun-exposure knowledge, tanning habits, and sun protective behaviour. In total, 1,500 study subjects (50.5% females) participated in this questionnaire survey. Although knowledge about tanning and motives to tan were similar among genders, females performed more photoprotective measures and were more connected to nature (all p < 0.001) compared to males. Older age and outdoor sport were significant gender-independent predictor variables influencing perceived CN level. Additionally, level of education was relevant in male CN, whereas non-smoking and higher knowledge were predictive of female CN. This survey provides so far unreported empirical data on the relationship between nature connectedness and skin health-relevant recreational habits of Austrian residents. The findings suggest to integrate hitherto neglected gender-specific Public (Skin) Health promotion when counselling on the manifold health advantages of outdoor activities.

Objectives: WHO's Children's Environment and Health Action Plan for Europe (CEHAPE) focuses on improvements of indoor environments where children spend most of their time. To investigate the relationship between school indoor air pollutants and cognitive performance in elementary school children, a multidisciplinary study was planned in all-day schools in Austria. Materials and Methods: In a cross-sectional study (LuKi study: Air and Children) indoor air pollutants were monitored in nine elementary all-day schools in urban and rural regions of Austria. In addition, school dust and suspended particulates (PM10, PM2.5) were measured, focusing on semivolatile compounds (e.g. phthalates, phosphororganic compounds [POC]). Health status and environmental conditions were determined by parents' questionnaire, cognitive function was measured by Standard Progressive Matrices (SPM). Results: Overall, 596 children (6-8 years of age) were eligible for the study. Cognitive tests were performed in 436 children. Analysis showed significant correlations of tris(2-chlorethyl)-phosphate (TCEP) in PM10 and PM2.5 and school dust samples with cognitive performance. Cognitive performance decreased with increasing concentrations of TCEP. Furthermore, cognitive function decreased significantly with increasing CO2 levels. Conclusions: POC are widely used as plasticizers, flame retardants and floor sealing. This is the first report of a correlation between TCEP in indoor air samples and impairment of cognitive performance in school children. As a precautionary measure, it is recommended to prohibit the use of toxic chemicals and those suspected of a toxic potential in children's environments such as schools.

Levoglucosan is a sugar anhydride produced by combustion of carbohydrates. In ambient monitoring it serves as an indicator for wood smoke. Its use in human biomonitoring, however, is not yet widespread. This study investigated whether levoglucosan in urine is a suitable biomarker for regional differences in wood smoke exposure in the winter season. Within the first Austrian biomonitoring survey, pooled urine samples from mothers as well as children of five communities of different size (two-stage random stratified sampling) were analysed by HPLC. As an indicator of exposure to polycyclic aromatic hydrocarbons (PAH) that are also prevalent in wood smoke, 1-hydroxypyrene was determined. In each town levoglucosan was found in higher levels in the pooled children's samples than in the pooled mothers’ samples. It correlated well with the agrarian quota. 1-Hydroxypyrene concentrations were higher in areas with higher population density. Correlation of urinary levoglucosan concentrations with the agrarian quota may be explained by higher wood smoke exposure in communities with higher agrarian quota. To our knowledge this study is the first investigation on this issue in Europe. It indicates that human biomonitoring of levoglucosan may be suitable to detect differences in regional exposure to wood smoke.

Fine particles in hospitality venues with insufficient smoking bans indicate health risks from passive smoking. In a random sample of Viennese inns (restaurants, cafes, bars, pubs and discotheques) effects of partial smoking bans on indoor air quality were examined by measurement of count, size and chargeable surface of ultrafine particles (UFPs) sized 10-300 nm, simultaneously with mass of particles sized 300-2500 nm (PM2.5). Air samples were taken in 134 rooms unannounced during busy hours and analyzed by a diffusion size classifier and an optical particle counter. Highest number concentrations of particles were found in smoking venues and smoking rooms (median 66,011 pt/cm(3)). Even non-smoking rooms adjacent to smoking rooms were highly contaminated (median 25,973 pt/cm(3)), compared with non-smoking venues (median 7408 pt/cm(3)). The particle number concentration was significantly correlated with the fine particle mass (P0.001). We conclude that the existing tobacco law in Austria is ineffective to protect customers in non-smoking rooms of hospitality premises. Health protection of non-smoking guests and employees from risky UFP concentration is insufficient, even in rooms labeled "non-smoking". Partial smoking bans with separation of smoking rooms failed.

It is well known that ozone concentration is associated with daily cause specific mortality. But which ozone metric is the best predictor of the daily variability in mortality? We performed a time series analysis on daily deaths (all causes, respiratory and cardiovascular causes as well as death in elderly 65+) in Vienna for the years 1991–2009. We controlled for seasonal and long term trend, day of the week, temperature and humidity using the same basic model for all pollutant metrics. We found model fit was best for same day variability of ozone concentration (calculated as the difference between daily hourly maximum and minimum) and hourly maximum. Of these the variability displayed a more linear dose–response function. Maximum 8 h moving average and daily mean value performed not so well. Nitrogen dioxide (daily mean) in comparison performed better when previous day values were assessed. Same day ozone and previous day nitrogen dioxide effect estimates did not confound each other. Variability in daily ozone levels or peak ozone levels seem to be a better proxy of a complex reactive secondary pollutant mixture than daily average ozone levels in the Middle European setting. If this finding is confirmed this would have implications for the setting of legally binding limit values.

The dependency on carbon-based fossil energy and growing awareness of climate change issues has induced ambitious policy initiatives to promote renewable energy sources for indoor heating. Combustion of regionally available material such as wood is considered a carbon-neutral alternative for oil and gas, but unregulated revival of wood stoves may cause detrimental health effects. For the prognosis of the health impact of air pollution due to the use of wood stoves, Upper Austria served for a case study. On the basis of recent measurements of particulate matter10 μm in aerodynamic diameter (PM10) and nitrous gases (NO(x)), we compared the air pollution attributable to present energy mix (termed scenario 1) with two alternatives: For scenario 2, we assumed replacement of light fuel oil by either fossil gas or biomass, and for scenario 3, replacement of light fuel oil by biomass only. Compared with the current exposure from scenario 1, the increased annual mean PM10 levels are estimated to lead to 101 (95% CI 56;146) and 174 (95% CI 92;257) additional deaths among 1.4 million inhabitants per year for scenarios 2 and 3, respectively. Without adequate strategies for reducing the emissions of domestic heating facilities, replacement of fossil energy sources could lead to an increased health risk.

Humans are exposed to a broad variety of man-made chemicals. Human biomonitoring (HBM) data reveal the individual body burden irrespective of sources and routes of uptake. A first population-based study was started in Austria in 2008 and was finished at the end of May 2011. This cross sectional study aims at documenting the extent, the distribution and the determinants of human exposure to industrial chemicals as well as proving the feasibility of a representative HBM study. Overall, 150 volunteers (50 families) were selected by stratified random sampling. Exposure to phthalates, trisphosphates, polybrominated diphenyl ethers (PBDE), bisphenol A (along with nonyl- and octyl phenol) and methyl mercury was assessed. Sixteen of 18 PBDE determined were detected above the limit of quantification (LOQ) in blood samples with #153 and #197 the most abundant species. Bisphenol A in urine was measured in a subsample of 25 with only 4 samples found above the LOQ. In 3 of 100 urine samples at least one of 8 trisphosphate compounds assessed was above the LOQ. These first analytical results of the human biomonitoring data show that the body burden of the Austrian population with respect to the assessed compounds is comparable to or even lower than in other European countries. Overall, the study revealed that in order to develop a feasible protocol for representative human biomonitoring studies procedures have to be optimized to allow for non-invasive sampling of body tissues in accordance with the main metabolic pathways. Procedures of participants’ recruitment were, however, labor intensive and have to be improved.

Workers exposed to dust have to undergo medical check-ups every 2 years including lung function testing. Here we report on the routine lung function data (FVC, FEV1, MEF50) of 994 workers from Austria. Lung function data were compared to the Austrian standard values that are based on routine testing of healthy volunteers. For all parameters the workers' values were significantly poorer than the Austrian standards (FVC: – 0.4 l; FEV1: – 0.5 l; MEF50: – 0.9 l/s). The difference from the standard increased with increasing duration of the dust exposure. This increase was significant for the total group for MEF50 even after controlling for smoking. About half of the workers were exposed to quartz dust and had poorer lung function values (p = 0.02 for MEF50) than the other workers. Smoking significantly reduced all 3 lung function parameters with a significant interaction between strong smoking (compared to non-smokers) and quartz exposure (compared to all other exposures). Current Austrian limit values are not protective against chronic damage of the respiratory system. The combined impact of cigarette smoke and high concentration of mineral dust (quartz) is especially dangerous.

In a cross-sectional study on 433 schoolchildren (aged 6&ndash, 9 years) from 9 schools in Austria, we observed associations between housing factors like passive smoking and lung function as well as improved lung function in children who had been breast-fed. The latter findings urged the question of whether the protective effects of breast-feeding act on environmental stressors or if they act independently. Therefore, the effect of passive smoking on lung function was stratified by breast-feeding. The detrimental effects of passive smoking were significant but restricted to the group of 53 children without breast-feeding. Breast-feeding counteracts the effect of environmental stressors on the growing respiratory organs.

Der Klimawandel stellt das Gesundheitswesen vor neue Herausforderungen. Im Auftrag des osterreichischen Bundesministeriums fur Land- und Forstwirtschaft, Umwelt und Wasserwirtschaft (Lebensministerium) wurden Beitrage zur nationalen Anpassungsstrategie fur das Aktivitatsfeld Gesundheit erarbeitet. Dies erfolgte mittels breit angelegter Expertenbefragung und vertiefender Workshops. Als prioritar wurden Anpassungsmasnahmen hinsichtlich der direkten und mit groser Sicherheit vorhersagbaren Auswirkungen des Klimawandels identifiziert – dies sind Gefahren fur die Gesundheit durch extreme Temperaturereignisse, insbesondere Hitzeperioden im urbanen Umfeld, und Gefahren durch Uberschwemmungen und Vermurungen. Speziell bei den letztgenannten Katastrophen sind auch langfristige Folgen wie posttraumatische Belastungsstorungen, Schaden an Infrastruktur und Bausubstanz mit entsprechenden Auswirkungen auf die Gesundheit sowie erhohter Migrationsdruck zu berucksichtigen.

Intensive agrochemical use in coffee production in the Global South has been documented. The aim of this study was to investigate cytotoxic and genotoxic effects of pesticide exposure in male farmworkers in the Dominican Republic comparing conventional farming using pesticides to organic farming. Furthermore, feasibility of the buccal micronucleus cytome assay (BMCA) for field studies under difficult local conditions was tested. In a cross-sectional field study, pesticide exposed (sprayers) and non-exposed male workers on coffee plantations were interviewed about exposure history, and pesticide application practices. Buccal cells were sampled, and BMCA was applied to assess potential effects on cell integrity. In total, 38 pesticide-exposed and 33 non-exposed workers participated. Eighty-four and 87%, respectively, of the pesticide-exposed respondents did not use masks or gloves at all. All biomarkers from the BMCA were significantly more frequent among exposed workers&mdash, odds ratio for micronucleated cells: 3.1 (95% confidence interval: 1.3&ndash, 7.4) or karyolysis: 1.3 (1.1&ndash, 1.5). Buccal cells as sensitive markers of toxic oral or respiratory exposures proved feasible for challenging field studies. Our findings indicate that the impact of pesticide use is not restricted to acute effects on health and wellbeing, but also points to long-term health risks. Therefore, occupational safety measures including training and protective clothing are needed, as well as encouragement towards minimal application of pesticides and more widespread use of organic farming.

In response to the World Health Organization Children's Environment and Health Action Plan for Europe (CEHAPE), a town near Vienna initiated a health survey of schoolchildren. To create recommendations for the community's decision makers, the health survey tried to identify the environmental factors influencing the respiratory health of children. The survey consisted of a questionnaire and spirometry. For 186 of 207 children of first and second grade, parents consented to include their children and answered a questionnaire. Spirometry was performed in 177 children. Results of lung function testing revealed that lung function was significantly reduced in children with visible mould infestation at home and living on a street with frequent lorry traffic. Larger family size and living in a rural area had positive effects on lung function. Our study provides an example for a feasible strategy to provide local decision makers with recommendations based on scientific evidence and actual observations and to help them implement measures in accordance with CEHAPE.

BACKGROUND: Living in a damp or mouldy home reportedly damages children's respiratory health, yet mould appears not to be a prominent risk factor in the public's perception. Analyses of data on over 58,000 children from the Pollution and the Young (PATY) study are presented. In this collaboration, researchers from 12 cross-sectional studies pooled their data to assess the effects of air quality on a spectrum of children's respiratory disorders. METHOD: Original studies were conducted in Russia, North America and 10 countries in Eastern and Western Europe. Pooled analyses were restricted to children aged 6-12 years. Associations between visible mould reported in the household and a spectrum of eight respiratory and allergic symptoms were estimated within each study. Logistic regressions were used, controlling for individual risk factors and for study area. Heterogeneity between study-specific results and mean effects (allowing for heterogeneity) were estimated using meta-analysis. RESULTS: Visible mould was reported by 13.9% of respondents in Russia, increasing to 39.1% in North America. Positive associations between exposure to mould and children's respiratory health were seen with considerable consistency across studies and across outcomes. Confounder-adjusted combined ORs ranged from 1.30 (95% CI 1.22 to 1.39) for "nocturnal cough" to 1.50 (1.31 to 1.73) for "morning cough". Evidence of stronger effects in more crowded households was statistically significant for only asthma and sensitivity to inhaled allergens. No consistent interactions between mould and age, sex or parental smoking were found. CONCLUSION: Indoor mould exposure was consistently associated with adverse respiratory health outcomes in children living in these diverse countries.

Recreational sun exposure accounts for a large number of acute and chronic dermatological diseases, including skin cancer. This study aimed at estimating the one-year prevalence of sun exposure and skin health-associated knowledge and attitudes among Austrian citizens. The population-based UVSkinRisk survey investigated a representative sample of Austrian adults using a structured questionnaire. In total, 1500 study subjects (median age 33.0 years, 50.5% females) participated in this questionnaire survey. Among study participants, prevalence of sun exposure was 47%, with slightly higher rates in males (48%) compared to females (46%). Younger age, lower professional category, darker skin type, motives to tan, sunbed use, sunburn, and outdoor sport activity increased the odds for prevalent sun exposure. This is the first population-based study evaluating the prevailing sun exposure and recreational habits influencing skin health among Austrian citizens. Despite public media campaigns educating on the harmful effects of sunlight exposure, we found a high prevalence of self-reported sunlight exposure. The results suggest that multifaceted socio-cultural characteristics stimulate recreational sun exposure and tanning habits. Communicating individualized Public (Skin) Health messages might be the key to prevent photo-induced skin health hazards in light-skinned populations. The practical and theoretical implications of these findings are discussed.

The objective of this longitudinal (3 year) study was to determine predictors of abstinence in 515 employees of a steel plant (28% female, age 18-67 years) after participation in Allen Carr seminars (intensive group counselling in a single session of 6 h). Answers given in computer aided phone interviews were analysed by stepwise and Cox regression. Of 510 responding persons 262 (51.4%) reported continuing abstinence. In a random sample of 61 respondents cotinine concentration in urine was measured, showing high agreement with smoking history. Social support increased abstinence, which was more persistent in males and office workers. Also in female participants the non-smoking spouse was a significant predictor for abstinence while a higher body weight predicted relapse. Relapsed female smokers did not show a sustainable reduction of cigarette consumption. Compared to cessation clinics higher population coverage would be achievable by workplace seminars. Every second smoker motivated to participate seems to be able to quit even without medication and to stay abstinent. Especially in females these seminars should be followed by physical exercise and continued support of gender specific occupational health care.

Both prenatal and postnatal passive smoking have been linked with respiratory symptoms and asthma in childhood. Their differential contributions to lung function growth in the general children's population are less clear.To study the relative impact of pre- and postnatal exposure on respiratory functions of primary school children in a wide range of geographic settings, we analyzed flow and volume data of more than 20,000 children (aged 6-12 yr) from nine countries in Europe and North America.Exposure information had been obtained by comparable questionnaires, and spirometry followed a protocol of the American Thoracic Society/European Respiratory Society. Linear and logistic regressions were used, controlling for individual risk factors and study area. Heterogeneity between study-specific results and mean effects were estimated using meta-analytic tools.Smoking during pregnancy was associated with decreases in lung function parameters between -1% (FEV1) and -6% maximal expiratory flow at 25% of vital capacity left (MEF25). A 4% lower maximal midexpiratory flow (MMEF) corresponded to a 40% increase in the risk of poor lung function (MMEF75% of expected). Associations with current passive smoking were weaker though still measurable, with effects ranging from -0.5% (FEV1) to -2% maximal expiratory flow (MEF50).Considering the high number of children exposed to maternal smoking in utero and the even higher number exposed to passive smoking after birth, this risk factor for reduced lung function growth remains a serious pediatric and public health issue.