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Background: In the past, deprivation has been mostly captured through simple and univariate measures such as low income or poor educational attainment in research on health and social inequalities in Belgium. This paper presents a shift towards a more complex, multidimensional measure of deprivation at the aggregate level and describes the development of the first Belgian Indices of Multiple Deprivation (BIMDs) for the years 2001 and 2011.Methods: The BIMDs are constructed at the level of the smallest administrative unit in Belgium, the statistical sector. They are a combination of six domains of deprivation: income, employment, education, housing, crime and health. Each domain is built on a suite of relevant indicators representing individuals that suffer from a certain deprivation in an area. The indicators are combined to create the domain deprivation scores, and these scores are then weighted to create the overall BIMDs scores. The domain and BIMDs scores can be ranked and assigned to deciles from 1 (the most deprived) to 10 (the least deprived).Results: We show geographical variations in the distribution of the most and least deprived statistical sectors in terms of individual domains and overall BIMDs, and we identify hotspots of deprivation. The majority of the most deprived statistical sectors are located in Wallonia, whereas most of the least deprived statistical sectors are in Flanders.Conclusion: The BIMDs offer a new tool for researches and policy makers for analyzing patterns of deprivation and identifying areas that would benefit from special initiatives and programs. This study was conducted as part of the ELLIS project (Monitoring and Mitigating Environmental Health Inequalities), funded by the Belgian Federal Science Policy (B2/191/P3/ELLIS). This work was produced using data from Statbel (Directorate-general Statistics – Statistics Belgium) – Demobel (adaptation of the National Register), Census 1991, 2001, 2011, and IPCAL. Computational resources have been provided by the supercomputing facilities of the Universit´e catholique de Louvain (CISM/UCL) and the Consortium des Equipements ´ de Calcul Intensif en F´ed´eration Wallonie Bruxelles (CECI) ´ funded by the Fond de la Recherche Scientifique de Belgique (F.R.S.-FNRS) under convention 2.5020.11 and by the Walloon Region. The authors want to thank Statbel and particularly Patrick Lusyne and Clo¨e Ost for preparing and making pseudonymized data available for research, the centre for Demographic Research (DEMO) of UCLouvain for allowing us to access the data, the CISM team for managing the statistical servers, and the Federal Police Belgium – DRI – Business Police Accounting for providing us with data on crime.

Aims: The aim of our study was to provide a synthesis of successful policies applied in the fight against malaria in African countries at different stages of intervention; Burkina Faso and Senegal. Background: Malaria is a global public health problem with many cases each year in the world (241 million cases with 247,000 deaths; 67% were under five children) in 2020. Most malaria cases occur in Sub-Saharan African countries (93%). Objective: The objective of our study was to present policies implemented against malaria (with the best results) in these two African countries (Burkina Faso and Senegal) which are at different stages of intervention. These could serve as an example to others malaria endemics countries. To achieve our purpose, we used DHS survey data and information from a literature synthesis. Methods: Data used for analysis are from Demographics and Health Surveys (DHS) 2017-2018 for Burkina Faso and DHS 2017 for Senegal. We added information from a synthesis of the literature. Linear regression models were performed with an estimation of the mean number of persons using insecticide-treated nets among groups (urban or rural areas, wealth level, highest education level in the household and age of household head) in each country. We evaluated the importance of co-factors in the relationship between the number of ITNs in a household and the number of household members by calculating the R-squared. A criteria grid used for this synthesis of literature included eight important sub-groups: funding sources, entomological monitoring, use of ITNs, use of insecticide, malaria case management, health system organization, communication and surveillance. Results: Senegal and Burkina Faso have the same proportion (51%) of households in which all children under 5 sleep under ITNs. We found R-squared (R2=0.007 in Burkina Faso and R2=0.16 in Senegal) for the relationship between the number of ITNs in a household and household size. When wealth level, age of head of household, area of residence (rural or urban), education level in the household and number of bedrooms in the household were controlled for, we found R2=0.106 for Burkina Faso and R2=0.167 for Senegal. We found that Senegal’s National Malaria Program is decentralized with entomological monitoring in all districts, which is normal considering the intervention stage in the fight against malaria. In Burkina Faso, we found centralization of routine data. Conclusion: Our study synthesized the health policies applied in African countries which are at different stages of intervention in the fight against malaria and which have succeeded in maintaining low malaria prevalence (in Senegal) or in rapidly decreasing the prevalence of the disease (in Burkina Faso). Being close to elimination, Senegal required more active malaria surveillance than passive surveillance. Burkina Faso did not require a lot of active surveillance being not close to malaria elimination. These results encourage a review in the context of each African country.

Background: Several indoor pollutants such as carbon monoxide, carbon dioxide, volatile organic compounds, particulate matter with aerodynamic diameter under 2.5μm (PM2.5) and endotoxin in house dust contribute to increasing the risk of chronic respiratory diseases. The types of dwellings and housing ventilation can affect indoor pollutant concentrations. Methods: Our study was carried out on 100 houses to define indoor air (IA) characteristics of 5 typical house types (apartment, rental, rural, slum and tube houses) in Ho Chi Minh City. Results: The measured mean concentrations reached respectively 2.37ppm for carbon monoxide, 485.10ppm (441.60-520.50) for carbon dioxide, 23.20µg/m3 for PM2.5, 70.40ppb for VOC, 300C for temperature, 60.5% for relative humidity, 107.80EU/mg for living room endotoxin, 124.50EU/mg for bedroom endotoxin and 149.10EU/mg for kitchen endotoxin. Most parameters were differently distributed among the five studied house types (p2.5, VOC, and relative humidity. Conclusion: Two house types (rental house and slum house) presented higher levels of most parameters, while the rural house presented higher PM2.5 and endotoxin levels than all the other house types. The apartment showed lower concentrations of all parameters than the other house types. In a later phase, the IA characteristics will be confronted with the prevalence of chronic respiratory diseases.

Objective: The e-waste recycling is increasing worldwide, yet there remain outstanding environmental and occupational health concerns. Most research conducted on e-waste recycling has focused on only few countries (e.g., China, Ghana), thus there is a need to increase understanding of e-waste workers’ (recyclers’) knowledge and practices in other locations, that is purpose of this study. Methods: In a cross-sectional study conducted in Cotonou, Benin, 45 e-waste recyclers were interviewed from September to November 2018. Survey data was collected concerning their demographics, professional practices, and knowledge of occupational and environmental risks associated with e-waste recycling. Results: Most participants reported the following methods of material recovery of electronic items in declining orders: dismantling (97.8%) > sorting (91.1%) > incinerating (88.9%). Only 44.2% of the recyclers reported wearing ≥ 1 piece of personal protective equipment (PPE). More than 90% of e-waste workers noted that they disposed the e-waste in natural sites. About half, 46.7% believed that e-waste can pollute water and 71.1% considered that it can pollute air and soil. Recyclers reported several diseases including respiratory (67.4%), heart (62.8%), eye (65.1%), kidney (41.9%) and cancers (30.2%) could be linked to their work, respectively. Interestingly, we also found associations between the number of electronic items dismantled per month and self-report symptoms from the e-waste recyclers such as finding blood in urine and stool, wounds, dizziness, and itchy skin. Our results also indicated associations between the number of hours worked per day and blood in urine, dizziness, itchy skin and airway obstruction. Conclusion: To our knowledge this is the first study to interview e-waste workers in Benin. Doing this increase understanding of their work practices and knowledge to help inform intervention and prevention activities.

SETTING and OBJECTIVE: Exposure to pollutants is related to the type of dwelling inhabited. Besides tobacco smoke, indoor air pollution is a significant risk factor for chronic respiratory disease (CRD). The prevalence of CRD by type of dwelling was studied in Ho Chi Minh City, Viet Nam. DESIGN: A total of 1561 people living in four type of dwellings were enrolled. Information on respiratory health, lung function, dwelling characteristics and sources of indoor pollution was obtained using a symptom and demographics questionnaire and spirometry. The two main respiratory health outcomes were clinical chronic CRD (CCRD) and chronic obstructive respiratory disease (CORD) (forced expiratory volume in 1 sec/forced vital capacity, info:eu-repo/semantics/published

Although the pandemic has caused substantial losses in economic prosperity and human lives, it has also some positive impacts on the environment. Restricted mobility, complete closure, less traffic and industry have led to improved air quality especially in urban settings. Not only is air pollution an important determinant of chronic diseases, such as heart and lung disorders, but it has also been shown that poor air quality increases the risk of COVID-19. In this article, we review some of the findings on changes in air quality during the pandemic, and its potential effects on health. We need to continue to monitor the effects of change in air quality, due to COVID-19 lockdown or other factors, but also keep all our efforts to improve air quality even faster and more persistent, bringing the pollution levels below what WHO recommends are safe to live with.

The WB Green Agenda (WB GA) aims to implement the GD principles in this region and has defined five priority areas: climate, energy, mobility; circular economy, pollution reduction, sustainable agricultural and food production, and biodiversity. Some of the WB GA goals are strongly related to health: e.g. the continent's carbon neutrality by 2050, the ambitious climate policy, the reform of energy and transport sectors. The launch of the EU CP is an important opportunity for the WB to promote action in this area. For instance, promoting energy efficiency and supporting building renovation are directly related to the quality of life and hygiene of housing. Reduction or cancellation of coal subsidies as well as the region's withdrawal from the use of coal is of great importance for reducing externalities. In the WB, citizens are concerned about their health due to air, water and soil pollution and their reduction is in the common interest. To that end, it is necessary, inter alia, to: ratify the Convention on Long-range Transboundary Air Pollution and its protocols in each of the WB economies; to implement air quality strategies; and to strengthen air quality monitoring systems (and network accreditation). Appropriate processes are needed to reduce water and soil pollution, as well as to ensure the transformation of the agricultural sector. It is also necessary to harmonize the agricultural and food sector with EU standards for food safety, plant and animal health and environmental protection. To achieve the WB GA goals it is important to develop policy strategies based on the most up-to-date scientific studies for this region (JRC, 2020). On the basis of the analysis presented in this study we conclude that the processes associated with the GD and the CP will be of benefit for both individual and public health in the EU and in the WB.

The COVID-19 pandemic has brought a renewed interest in urban environment and healthy living and the changes in urban environments which can make for a healthier living. Today, more than 50% of the global population lives in urban areas, and in Europe the number is 75%. We present a narrative review to explore considerations and necessary requirements to achieve health and well-being within strategies for healthy design and urban planning whilst rethinking urban spaces for a post-COVID-19 and carbon-neutral future. The achievement of health and well-being demands healthy design strategies, namely, (1) moving from the concept of infrastructure for processes to the infrastructure for healthy living—requirements for healthy places, cycling, walking, disintegrating the role of polluting traffic from the urban environments, social vulnerability and equality; (2) physical space that will achieve standards of ‘liveable communities’—open, green space requirements and standards for any built environment; (3) mainstreaming ‘in-the-walking distance’ cities and neighbourhoods for healthy physical activities for daily living; (4) exploring any of the new concepts that connect the nexus of urban spaces and public health and improving of the population’s well-being. Public health needs to be prioritised systematically in planning of built environments, energy generations, sustainable food production, and nutrition.

Background: Malaria is a global public health problem with many cases each year (228 million cases in 2018 with 405,000 deaths). Most malaria cases occur in Africa. Methods: Data used for analysis are from Demographics and Health Surveys (DHS) 2017-2018 for Burkina Faso and DHS 2017 for Senegal. We added information from a synthesis of literature. Linear regression models were performed with an estimation of the mean number of persons using ITNs among groups (urban or rural areas, wealth level, highest education level in the household and age of household head) in each country. We evaluated the importance of co-factors in the relationship between the number of ITNs (insecticide-treated nets) in a household and the number of household members by calculating the R-squared. A criteria grid used for this synthesis of literature included eight important sub-groups: funding sources, entomological monitoring, use of ITNs, use of insecticide, malaria case management, health system organization, communication and surveillance. Results: Senegal and Burkina Faso have the same proportion (51%) of households in which all children under 5 sleep under ITNs. We found R-squared (R2=0.007 in Burkina Faso and R2=0.16 in Senegal) for the relationship between the number of ITNs in a household and household size. When wealth level, age of head of household, area of residence (rural or urban), highest education level in the household and number of bedrooms in the household were controlled for, we found R2=0.106 for Burkina Faso and R2=0.167 for Senegal. We found that Senegal’s national malaria program is decentralized with entomological monitoring in all districts, which is normal considering the intervention stage in the fight against malaria. In Burkina Faso, we found centralization of routine data.Conclusion: Our study synthesized the health policies applied in African countries which are at different stages of intervention in the fight against malaria and which have succeeded in maintaining low malaria prevalence (in Senegal) or in rapidly decreasing the prevalence of the disease (in Burkina Faso). Being close to elimination, Senegal required more active malaria surveillance than passive surveillance. Burkina Faso did not require a lot of active surveillance being not close to malaria elimination. These results merit a review in the context of each African country.

In the course of the COVID-19 pandemic, it has become clear that primary healthcare systems play a critical role in clinical care, such as patient screening, triage, physical and psychological support and also in promoting good community advice and awareness in coordination with secondary healthcare and preventive care. Because of the role of social and environmental factors in COVID-19 transmission and burden of disease, it is essential to ensure that there is adequate coordination of population-based health services and public health interventions. The COVID-19 pandemic has shown the primary and community healthcare (PCHC) system's weaknesses worldwide. In many instances, PCHC played only a minor role, the emphasis being on hospital and intensive care beds. This was compounded by political failures, in supporting local community resilience. Placing community building, social cohesion and resilience at the forefront of dealing with the COVID-19 crisis can help align solutions that provide a vision of a € planetary health'. This can be achieved by involving local well-being and participation in the face of any pervasive health and environmental crisis, including other epidemics and large-scale ecological crises. This paper proposes that PCHC should take on two critical roles: first, to support local problem-solving efforts and to serve as a partner in innovative approaches to safeguarding community well-being; and second, to understand the local environment and health risks in the context of the global health perspective. We see this as an opportunity of immediate value and broad consequence beyond the control of the COVID-19 pandemic., SCOPUS: ar.j, info:eu-repo/semantics/published

The recycling of electronic waste (e-waste) contaminates ecosystems with metals, though a compilation of data from across sites worldwide is lacking, without which evidence-based compar-isons and conclusions cannot be realized. As such, here, a systematic review of the literature was conducted to identify peer-reviewed studies concerning e-waste sites (published between 2005 and 2017) that reported on the concentration of heavy metals (Cd, Hg, As, Pb and Cr) in soil, water and sediment. From 3063 papers identified, 59 studies from 11 countries meeting predefined criteria were included. Reported metal concentrations were summarized, and a narrative synthesis was performed. This review summarized 8286 measurements of the aforementioned metals in soils (5836), water (1347) and sediment (1103). More than 70% of the studies were conducted in Asia. In nearly all cases, the average metal concentrations in a particular medium from a given site were above guideline values; suggesting soils, water and sediment at, or near, e-waste recycling sites are contaminated. Across all media, concentrations of Pb were generally highest, followed by Cr, As, Cd and Hg. The synthesized information demonstrates that e-waste sites worldwide are contaminated with metals, that geographic data gaps exist, that the quality of most studies can be improved and that action is needed to help reduce such levels to protect human health and the environment., SCOPUS: re.j, info:eu-repo/semantics/published

BACKGROUND: According to the WHO, chronic obstructive pulmonary disease (COPD) will become the third leading cause of death by 2030. In sub-Saharan Africa, the burden of the disease is unknown. We assessed the prevalence and the factors associated with COPD and chronic bronchitis among women in charge of household cooking. METHODS: A cross-sectional population survey was conducted. We randomly selected women aged ≥18 years in charge of cooking in their household. COPD was defined as post-bronchodilator FEV 1 /FVC (forced expiratory volume in 1 sec/forced vital capacity) ratio of 40 years, those had been cooking or had been exposed to toxic gases for more than 30 years. After adjustment, only biomass fuel use and exposure to toxic products were found to be associated with COPD. CONCLUSION: Urgent action is need to accelerate the transition to the other sources of energy., info:eu-repo/semantics/published

Public health professionals (PHP) have a dual task in climate change. They should persuade their colleagues in clinical medicine of the importance of all the issues covered by the GD. The fact that the health sector contributes to the overall emissions of 4.4% speaks to the lack of awareness within the health sector itself. The issue of providing adequate infrastructure for the health sector is essential. Strengthening the opportunities and development of the circular economy within healthcare is more than just a current issue. The second task of PHP is targeting the broader population. The public health mission is being implemented, inter alia, through numerous activities related to environmental monitoring and assessment of the impact on health. GD should be a roadmap for priorities and actions in public health, bearing in mind: an ambitious goal of climate neutrality, an insistence on clean, affordable and safe energy, a strategy for a clean and circular economy. GD provides a framework for the development of sustainable and smart transport, the development of green agriculture and policies from field to table. It also insists on biodiversity conservation and protection actions. The pursuit of zero pollution and an environment free of toxic chemicals, as well as incorporating sustainability into all policies, is also an indispensable part of GD. GD represents a leadership step in the global framework towards a healthier future and comprises all the non-EU members as well. The public health sector should consider the GD as an argument for achieving goals at national levels, and align national public health policies with the goals of this document. There is a need for stronger advocacy of health and public-health interests along with incorporating sustainability into all policies. Achieving goals requires the education process for healthcare professionals covering all of topics of climate change, energy and air pollution to a much greater extent than before.

As technology progresses, social inequality grows, the gap widens, and the environment continues to suffer. Furthermore, the social environment in societies is “ruffled” and does not appear to be constructive toward well-being. New inequalities are emerging in the availability of technology, climate change, education. The achievement reports on the Sustainable Development Goals (SDGs), also point out to the need of reviewing individual indicators. The UN Human Development Report estimates that children in highly developed countries have a 55% chance of obtaining high education, as opposed to children born in underdeveloped countries where only 3% of them have a chance of high education. In underdeveloped countries, according to the UN data, 17% of them die by the age of 20, while in developed countries this is 1%. The gap in the opportunities of young people in different living environments is quite pronounced nowadays. If this process does not get stopped, it can be irreversible. The directions of transformation necessary to achieve the SDGs, while respecting the principles of equality, quality of life preservation and improvement, are divided into six groups. Transformations should aim at: an educated workforce, an innovative economy, gender equality and social protection, health and wellbeing for all, universal health care and support for healthy lifestyles. Transformation is also a prerequisite for: climate neutrality, circular economy, decarbonisation, renewable energy and industrial development. Sustainable agriculture and food production, conservation and restoration of natural resources, as well as sustainable, green urban environments and support for small communities also require radical changes. An indispensable factor for transformation is that both digital and modern technologies align with sustainable development, respecting human rights privacy and social inclusion.

Background: Endotoxin exposure may cause asthma exacerbations and contribute to non-atopic respiratory diseases. Viet Nam, a country with multiple house types, is lacking data on indoor contamination by endotoxin in regard with house types.Objectives: The comparison of measured settled dust endotoxin levels among house types in Ho Chi Minh city will allow to classify the house types regarding health risks.Methods: This study is a cross-sectional study. Five identified house types were selected: apartment (APA), rental (REN), rural (RUR), slum (SLU) and tube house (TUB). One hundred house’s endotoxin contamination was evaluated by ques- tionnaire and dust sampling. Endotoxin concentration was measured by kinetic chromogenic Limulus assay.Results: Endotoxin concentration (geometric mean 126.0 EU/mg, 95%CI 118.3-133.7) is particularly high in settled house dust compared to western countries and is significantly associated with the house type. The highest level was found in RUR in each room (p = 0.002 for living room; p < 0.0001 for bedrooms and for kitchens). Concerning levels in the different rooms, APA and TUB form a low group while REN and SLU (p < 0.001) form a median group and RUR the highest (p < 0.001). Differences in endotoxin levels were associated to the presence of dog, chicken and farm animals, wood cooking, air-conditioning usage.Conclusions: Further understanding of the relevant factors to endotoxin levels would contribute to prevent asthma exacerbations and chronic respiratory diseases. Public health interventions to reduce exposure to endotoxin include improving housing conditions, eliminating risk factors and a priority to high-risk house types., info:eu-repo/semantics/published

The hypothesis of an electromagnetic origin of idiopathic environmental intolerance (IEI) attributed to electromagnetic fields (EMF) has been widely investigated by provocation studies, which consist of deliberately exposing people with IEI‐EMF in laboratory settings to particular EMF to observe volunteers’ reactions. In the majority of these studies, reactions have been found to be independent of exposure. However, most of these studies suffer from design and methodological limitations that might bias their findings or reduce their precision. As provocation studies are best suited for isolating the effects of EMF, innovative protocols should be applied. In the ExpoComm project (PNREST Anses, EST/2017/2 RF/19), several innovations have been introduced: the involvement of people with IEI‐EMF in the development of the protocol, the attenuation of the anxiogenic nature of the tests, the individualization of the protocol, the validation of the neutral or normal reactivity state before the test, and the use of a cocktail of real, rather than artificially generated, sources. The objective of involving people with IEI‐EMF was to increase the relevance and acceptability of the protocol, while respecting technical constraints and scientific quality requirements. This paper describes the protocol resulting from the collaborative process., info:eu-repo/semantics/published

The Climate Pact was launched in December 2020, with hope that the upcoming vaccine would help us overcome the COVID-19 pandemic “storm”. Even though humans are in the canter of the Covid pandemic storm, it is still important not to forget the climate change challenge, as it is a highly active “factory”. Unfortunately, there is no vaccine for the climate change process and biodiversity crises. The Climate Pact is an opportunity to create a European-wide movement that supports, encourages and acknowledges individual climate achievements. According to SDG 13 (climate action), Climate Pact encourages actions such as: green areas, green transport, green buildings and green skills. Also, it is important to expand sustainable consumption and production, the quality of soil, healthy food and sustainable diets, oceans, and rural and coastal areas. Therefore, Climate Pact is a driver for Sustainable Development Goals, and it is based on the ideas and contributions of all interested individuals and various organisations. Climate Pact Ambassadors are representatives of civil society and citizens with the strength for action (despite the Covid 19 pandemic “storm”) and collaboration among themselves as well as with researchers, academic citizens and policy makers to beat climate change and give contribution to SDG 13.

Objective About 40% of new cancer diagnoses are detected among working age individuals. Cancer diagnosis and treatment have high impact on the work ability of workers and represent a real challenge for the healthcare and social security systems but also for employers and the labour market. This review aims at investigating the legal frameworks set up in EU Member States that support the retention and integration of workers with disability. Furthermore, we look at these initiatives or measures to see whether they fit the specific needs of workers with cancer. Methods We searched the PubMed database combining 4 key words: cancer, labour market, labour law and disability insurance or disability benefits. A total of 1.185 articles were found of which 10 were used for this review. In addition, grey literature, reports from the European Commission, the OECD and the WHO were searched and included in the material used for this review. Results Few peer reviewed articles discuss the impact of labor market law on the (re)integration of cancer survivors. Most measures and initiatives support workers with chronic diseases but present important limits when considering workers with cancer. Collaboration and coordination among health providers, social workers and employment decision makers is the mostly required and effective. Conclusion More research efforts should be made to systematically assess the impact of labor market and employment measures and initiatives on the (re)integration of workers with chronic diseases, with specific attention for workers with cancer. Legal frameworks need to be rethought for a better balance between productivity and equity, inclusion and social justice.

Background Environmental risk factors such as air pollution, contaminated water, climate change, soil pollution, chemical exposures, ultraviolet radiation, noise pollution and others potentially contribute to diseases and mental disorders, such as depressive and anxiety disorders. Taken together mental, behavioral and neurological disorders accounted for 10% of the global disease burden in 2015 and is expected to increase to 15% by the year 2020. Methods We will identify health promoting factors on the background of the changing disorders spectrum. Based on a narrative review we identified as potentially environmental mental health promoting factors quality green areas, e urban planning, sanitation and public transportation, and decrease in noise pollution. Results Using the sustainable development goals (SDGs) as a benchmarking tool in national, regional and local development plans, citizens are empowered to improve their mental health through improved environment. Discussion: Mental health is an underresearched area in the field of environmental health. Intersectoral and interdsiciplinary collaboration can contribute to overcome boudnaries of specific disciplines and build bridges to support the overall goal of promoting and supporting mnetal health and reducing the burden of mental and neurological disorders.

Globalization and modern economic trends bring enormous changes to civilization. The human health pattern also changes and the overall system becomes more complex. Exponential growth in demographic, in economic and in human activities alters the natural global environment beyond safe or sustainable borders, which refers to energy for the future, as well as climate change in the broadest sense. These changes pose threats to human health and with the rise in temperature the most visible symptoms are seen in the difficulty of securing sufficient energy amount, as well as the appropriate supply of health-safe food and water. Global influences on the health of the population require changes in different sectors (economy, health, economy, etc). Even though, World Meteorological Organization data show that the five-year average global temperature from 2013 to 2017 was at a record level, and that in 2017 it was one of the three hottest years. Today, about 3 billion people have no access to safe food and/or water and are also exposed to significant air pollution. Nearly one billion people have no electricity in the household, and 13% of the world’s population has no access to modern electricity. Air pollution indoors by using combustible fuels for domestic energy caused 4.3 million deaths in 2012 (women and girls accounted for 6 out of 10). Energy has a dominant contribution to climate changes and accounts for about 60% of overall global greenhouse gas emissions. Overall progress made through the use of renewable energy sources should reduce risks and allow for the improvement of basic living conditions. However, a significant shift in reducing inequalities and improving global quality of life and health indicators requires transformation of many sectors. Energy, therefore, is crucial for almost every challenge the world is facing today (climate change, food production, health systems, etc.). SDG 7 is particularly important and is linked to other SDGs.

Many studies have highlighted the link between indoor air pollution from the burning of solid fuels for cooking and heating and the occurrence of various health problems particularly in women and children under 5 years. In developing countries, solid fuels remain the main sources of energy. The purpose of this study aims to describe the distribution of household cooking fuel types and to analyze the factors influencing household cooking energy choice in Ouagadougou. A cross-sectional survey was conducted in 2017 in 3 neighborhoods of Ouagadougou. A total of 1734 household were randomly selected. We performed a multivariable logistic regression and a multinomial logistic regression to measure the relationship between selected determinants and households’ primary cooking fuel. 59.53% of the households of Ouagadougou reported using solid fuels as the main cooking fuel. Wood is the most common primary cooking fuel used (43.93%), followed by LPG (40.41%) and then charcoal (15.60%). About 84% combine at least 2 types of energy for cooking. Cooking fuel choice is strongly influenced by the socioeconomic status, the family size, and also by the woman’s educational attainment, her age and the main cooking fuel used in her parents’ house. Actions aimed at reducing the impact of solid fuel use in the environment or health must consider these factors.

Summary Introduction Defects reconstruction after oncologic resection is challenging and complex in head and neck tumors. The aim of this retrospective study is to evaluate the use of the supraclavicular artery island flap (SCAIF) in head and neck reconstruction, in particular, when traditional free flaps is not recommended. Methods We reviewed our two years’ experience of the use of SCAIF on a total of 15 cases. In 10 cases, it was used as an alternative to free flaps after head and neck tumors resection. In 5 cases, SCAIF was used for revision surgery after a free flap failure. The indications for flap use have been defects due to resection of stage II–IV cancer in the head and neck region. The operative site, time, complications and functional outcomes were assessed. Results We identified 15 patients with a total of 16 SCAIF. One patient had received bilateral SCAIF. Out of the patients, 10 were men and 5 were women. Head and neck oncologic patients underwent tumor resection followed by immediate reconstruction using SCAIF. Among those 15 patients, 10 received previous radiotherapy in the head and neck region. All the patients had undergone multiple surgical procedures. Mean flap dimensions were 6.0 cm (range, 5–7 cm) wide and 22.0 cm (range, 14–26 cm) long. The proximal part of the flap was de-epithelialized to match the defect, resulting in a mean skin paddle length of 8.0 cm (range, 5–12 cm). After an average follow-up duration of 13 months (range 3–20 months), the flap survival rate was 90%. Two patients had had a partial loss of the flap. All the flaps were harvested in less than one hour. The donor sites were closed primarily and did not require any additional surgery. No donor site wound dehiscence had been reported. No infection or cellulitis were observed. None of the patients reported any functional donor site morbidity. Conclusions The supraclavicular flap provides a safe option for head and neck reconstruction of oncologic defects when traditional free flap is not recommended. It is also an excellent alternative to radial forearm free flap (RFFF) in head and neck soft tissue reconstruction, especially in vessel-depleted neck.

Background: The improvements in cancer control led to an increase in the number of cancer survivors, notably, in the working age population (16-64 years). There is a strong need to assess and understand their reintegration on the labour market, which underlines and ensures their social integration and quality of life. The objectives of the EMPCAN study is therefore to measure the scale of return-to-work after cancer and to identify the determining factors, allowing for the implementation of an adequate socio-professional support. Methods: We requested data from the Belgian Cancer Registry and the Crossroad Bank for Social Security. We included all socially insured Belgian workers diagnosed between 2004 and 2011 with colorectal, breast, head & neck, prostate, testis, lung and corpus uteri cancer. The end of (administrative) follow-up was 31st December 2012. We include demographic, health-related and work-related factors in the analysis and observed how these factors interplay to determine the working status. After having solved legal, ethical and technical issues for the coupling, we will perform survival analysis with competing risks using the Fine and Gray model; we will also perform a multistate model using transitions probabilities; and finally, a group-based modeling for longitudinal data using the 'proc traj' package in SAS. Discussion: The results of the EMPCAN study will allow the provision of an evidence-based support to professional reintegration policies. It will also bring some key features for the prediction of the cancer-related social security needs. Besides the raise of awareness among health professionals and policy makers, this study could lead to a better planning and organization of vocational rehabilitation programs., SCOPUS: ar.j, info:eu-repo/semantics/published

Background: Approximately 3 billion people, worldwide, rely primarily on biomass for cooking. This study aimed to investigate the association between respiratory symptoms among women in charge of household cooking and the type of fuel used for cooking. Methods: A community-based cross-sectional survey was conducted. A total of 1705 women that were randomly selected, completed the survey. We also performed a bivariate and a multivariate analysis to verify the possible associations between respiratory symptoms in women in charge of household cooking and the type of cooking fuel used. Results: Dry cough, breathing difficulties, and throat irritation frequencies were statistically high in biomass fuel users when compared to liquefied petroleum gas (LPG) users. It was also the case for some chronic respiratory symptoms, such as sputum production, shortness of breath, wheezing, wheezing with dyspnea, wheezing without a cold, waking up with shortness of breath, waking up with coughing attacks, and waking up with breathing difficulty. After adjustment for the respondents&rsquo, and households&rsquo, characteristics, dry cough, breathing difficulties, sneezing, nose tingling, throat irritation, chronic sputum production, wheezing, wheezing with dyspnea, wheezing without a cold, waking up with shortness of breath, waking up with coughing attacks, and waking up with breathing difficulty were symptoms that remained associated to biomass fuel compared to LPG. Women who used charcoal reported the highest proportion of all the chronic respiratory symptoms compared to the firewood users. However, this difference was not statistically significant except for the wheezing, waking up with coughing attacks, and waking up with breath difficulty, after adjustment. Conclusion: Exposure to biomass smoke is responsible for respiratory health problems in women. Charcoal, which is often considered as a clean fuel compared to other biomass fuels and often recommended as an alternative to firewood, also presents health risks, including increased respiratory morbidity in women. Effective and efficient energy policies are needed to accelerate the transition to clean and sustainable energies.

The management of hospital waste is a high-risk practice in the hospitals of Kinshasa, the largest city of the Democratic Republic of the Congo, from the point of view of public health and the environment. A multi-criteria study carried out in 4 hospitals assessed the situation and put forward solutions.

In the EU-FP7 project APPRAISAL the current practice for integrated assessment modelling (IAM) of air quality in the EU was reviewed, limitations were identified and guidance for improvements was provided. In this article we present the guidance proposed by APPRAISAL. This guidance takes into account that a single IAM solution does not exist but that the different elements of the IAM methodology can be addressed in more or less detail taking into account the available data, the regional/local specificities, the financial resources and the actual purpose of the assessment.

Background: Rapid urbanization combined with rural migration to urban areas in southern Vietnam could be risk factors for allergen sensitization, contributing to chronic respiratory diseases (CRD). We aimed to evaluate the prevalence of mite sensitization and its relation to house dust characteristics among rural and urban native and migrating populations with CRD. Methods: Rural (n = 19) and urban (n = 46) dwellings were defined on the basis of a home typology. Controls were western Belgian houses (n = 14). Besides the house characteristics, both endotoxin and mite allergens were measured in the settled dusts. The sensitization to mite allergens was defined by positive skin prick test (SPT) and concentration of specific IgE (sIgE)≥ 0.7 U/mL. The prevalence of mite sensitization was evaluated among 610 patients with CRD and compared according to both their home types and places of birth and residences. Results: The concentration of endotoxin (but not mite allergen) was higher in rural compared to urban dusts (440 (95%CI: 314–566) versus 170 (95%CI: 115–226) EU/mg; p

The introduction of early cancer detection and the improvement in treatment efficacy have led to a significant increase in the survival and the prevalence of (ex) cancer patients. Approximately 40 % of new cancer cases are diagnosed every year in the working age population (20-64 years). Maintaining their quality of life results, among others, in their retain on the labour market. Even though it is necessary to realize the scale of the phenomenon and to plan interventions, no measure allows assessing the rate of return to work among of (ex) cancer patients in Belgium nowadays.We observe during a five-year period the socio-professional status (inability, disability, unemployment or death) of 645 workers identified in the permanent sample (EPS), having had an oncological multidisciplinary consultation (MOC) in 2011.By the end of follow-up, 24 % of the workers were deceased. Among those who survived 26 % are unable to work, 12 % are unemployed and 63 % do not receive any social benefit. Women and young workers (20-44 years) seemed to have encountered difficulties the most.The results of this study allow giving a prudent first estimation of the return to work of socially insured Belgian citizens of almost 40 %, five years after the first MOC. Nevertheless, the structure of the EPS presents many limitations to the interpretation and reliability of results. We suggest some modifications of the EPS that might offer scientists better opportunities to improve the performance and reliability of such cohort studies.L’introduction de la détection précoce des cancers et l’amélioration de l’efficacité des traitements ont mené à une augmentation significative de la prévalence d’(ex) patients. A peu près 40 % des nouveaux cancers sont diagnostiqués chaque année dans la population active (20-64 ans). Le maintien de leur qualité de vie passe, notamment, par leur maintien sur le marché du travail. Bien que nécessaire pour évaluer l’ampleur du phénomène et planifier des interventions spécifiques, aucune mesure ne permet actuellement d’établir avec précision le taux de réinsertion professionnelle des travailleurs atteints de cancer en Belgique. Matériel et Méthodes : Nous observons durant cinq ans le statut socioprofessionnel (incapacité de travail, invalidité, chômage ou décès) de 645 travailleurs identifiés dans l’échantillon permanent (EPS) ayant eu une première consultation oncologique multidisciplinaire (COM) en 2011. Résultats : Au terme du suivi, 24 % des travailleurs sont décédés. Parmi les travailleurs ayant survécu, 26 % sont en incapacité de travail, 12 % sont au chômage et 63 % ne bénéficient d’aucun revenu de remplacement. Les femmes et les jeunes travailleurs (20-44 ans) semblent rencontrer le plus de difficultés pour le retour au travail.Les résultats de cette étude permettent d’avancer une première estimation du retour au travail des assurés sociaux belges atteints de cancer à un peu moins de 40 %, cinq ans après la première COM. Toutefois, la structure et les données de l’EPS présentent de nombreuses limites pour l’interprétation et la fiabilité des résultats. Nous suggérons quelques modifications des données de l’EPS qui offriront aux scientifiques des opportunités pour améliorer la réalisation et la fiabilité de telles études de cohorte.