International journal of hygiene and environmental health最新文献

{"title":"Prevalence of antibiotic-resistant enterobacteriaceae in domestic wastewater and associated health risks in reuse practices","authors":"","doi":"10.1016/j.ijheh.2024.114478","DOIUrl":"10.1016/j.ijheh.2024.114478","url":null,"abstract":"<div><div>The use of wastewater for non-potable purposes is an important alternative for addressing water scarcity, especially in developing regions. However, minimizing the risks, particularly those associated with emerging contaminants that may induce resistance among pathogens in wastewater, is crucial. This study assessed the occurrence of antibiotic-resistant bacteria in untreated wastewater used for agricultural purposes and evaluated the quantifiable health risks associated with this practice in Tamale, Ghana. The resistance of some Enterobacteriaceae, such as <em>E. coli, Klebsiella, and Salmonella-Shigella,</em> to four commonly used antibiotics in Ghana was assessed using a conventional microbiological culture approach and the Kirby Bauer disk diffusion method. A Quantitative Microbial Risk Assessment (QMRA) was performed to estimate the health risks associated with two distinct scenarios of wastewater reuse: (1) accidental ingestion of contaminated wastewater and soil, and (2) consumption of vegetables irrigated with wastewater. This approach applied a Monte Carlo simulation based on 10,000 interactions and identified <em>E. coli</em> O157:H7 as the reference pathogen. Among Enterobacteriaceae, <em>Klebsiella pneumoniae, Salmonella-Shigella</em> and <em>E. coli</em> were isolated, in concentrations exceeding the limit recommended by the World Health Organization (10³ CFU/100 ml). All the isolated bacteria were resistant to metronidazole (5 μg). Thirty-three per cent of <em>Klebsiella pneumoniae</em> isolates were intermediate/moderately susceptible, and all other bacteria were resistant to amoxicillin (30 μg). All <em>Klebsiella pneumoniae</em> and the majority of <em>Salmonella-Shigella</em> (69.8 %) isolates were resistant to trimethoprim-sulfamethoxazole (25 μg) and tetracycline (30 μg). When assessing health risks, the mean annual probability of infection associated with consuming vegetables irrigated with wastewater varied between 5.14 × 10⁻² and 9.79 × 10⁻¹ per person per year. Conversely, for the accidental ingestion scenario, the probability was 1.00 per person per year. In these scenarios, the probability of illness ranged from 1.29 × 10⁻² to 2.4 × 10⁻¹ and 2.5 × 10⁻¹ per person per year. The health risks posed by these findings surpass the maximum threshold prescribed by the World Health Organization, thereby emphasizing the need for prompt mitigation strategies.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142383066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental, climatic, socio-economic factors and non-pharmacological interventions: A comprehensive four-domain risk assessment of COVID-19 hospitalization and death in Northern Italy","authors":"","doi":"10.1016/j.ijheh.2024.114471","DOIUrl":"10.1016/j.ijheh.2024.114471","url":null,"abstract":"<div><h3>Introduction</h3><div>Up to now, studies on environmental, climatic, socio-economic factors, and non-pharmacological interventions (NPI) show diverse associations, often contrasting, with COVID-19 spread or severity. Most studies used large-scale, aggregated data, with limited adjustment for individual factors, most of them focused on viral spread than severe outcomes. Moreover, evidence simultaneously evaluating variables belonging to different exposure domains is scarce, and none analysing their collective impact on an individual level.</div></div><div><h3>Methods</h3><div>Our population-based retrospective cohort study aimed to assess the comprehensive role played by exposure variables belonging to four different domains, environmental, climatic, socio-economic, and non-pharmacological interventions (NPI), on individual COVID-19-related risk of hospitalization and death, analysing data from all patients (no. 68472) tested positive to a SARS-CoV-2 swab in Modena Province (Northern Italy) between February 2020 and August 2021.</div><div>Using adjusted Cox proportional hazard models, we estimated the risk of severe COVID-19 outcomes, investigating dose-response relationships through restricted cubic spline modelling for hazard ratios.</div></div><div><h3>Results</h3><div>Several significant associations emerged: long-term exposure to air pollutants (NO₂, PM₁₀, PM_2.5) was linked to hospitalization risk in a complex way and showed an increased risk for death; while humidity was inversely associated; temperature showed a U-shaped risk; wind speed showed a linear association with both outcomes. Precipitation increased hospitalization risk but decreased mortality. Socio-economic and NPI indices showed clear linear associations, respectively negative and positive, with both outcomes.</div></div><div><h3>Conclusions</h3><div>Our findings offer insights for evidence-based policy decisions, improving precision healthcare practices, and safeguarding public health in future pandemics. Refinement of pandemic response plans by healthcare authorities could benefit significantly.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the pathways linking prenatal and early childhood greenness exposure to attention-deficit/hyperactivity disorder symptoms during childhood: An approach based on robust causal inference","authors":"","doi":"10.1016/j.ijheh.2024.114475","DOIUrl":"10.1016/j.ijheh.2024.114475","url":null,"abstract":"<div><h3>Background</h3><div>Epidemiological studies suggest that exposure to greenness during childhood may protect children from developing attention-deficit hyperactivity disorder (ADHD).</div></div><div><h3>Objective</h3><div>We analyzed the effect of both prenatal (pregnancy) and early childhood (4-5-year follow-up) residential greenness exposure and green space availability on ADHD symptoms during childhood (up to the age of 12 years) and further explored the potential mediating role of PM_2.5 and physical activity in the association.</div></div><div><h3>Methods</h3><div>The study population included participants from the <em>INfancia y Medio Ambiente</em> (INMA) prospective birth cohort (Gipuzkoa, Sabadell, and Valencia). Average Normalized Difference Vegetation Index (NDVI) in buffers of 100-, 300- and 500-m around the residential addresses was used as an indicator of greenness, while green space availability was determined based on the presence of a major green space within 150-m from the residence. Childhood ADHD symptoms were assessed at the 6-8- and 10-12-year follow-ups using Conners Parents Rating Scale-Revised: Short Form.</div></div><div><h3>Results</h3><div>Although no association was found for the prenatal exposure period, increased early childhood NDVI inversely associated with the OR of clinically significant ADHD symptoms during the 6-8-year follow-up at the 100-m (OR 0.03, 95% CI: 0.003 to 0.44), 300-m (OR 0.04, 95% CI: 0.003 to 0.42) and 500-m (OR 0.08, 95% CI: 0.01 to 0.76) buffers, but exclusively in the context of direct effects. Additionally, the 10-12-year follow-up analysis found moderate to weak evidence of potential total and direct effects of NDVI at both 100- and 300-m buffers on inattention scores, as well as for NDVI at the 300-m buffer on ADHD index scores. The analysis did not reveal evidence of mediation through PM_2.5 or physical activity.</div></div><div><h3>Conclusions</h3><div>The evidence suggests that early childhood greenness exposure may reduce the risk of developing ADHD symptoms later in childhood, and that this association is not mediated through PM_2.5 and physical activity.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between metal/metalloid exposure during pregnancy and placental growth characteristics: Findings from the Hangzhou birth cohort study II","authors":"","doi":"10.1016/j.ijheh.2024.114470","DOIUrl":"10.1016/j.ijheh.2024.114470","url":null,"abstract":"<div><div>Previous studies have suggested that metal/metalloid (hereafter referred to as metal) exposure may influence placental growth by affecting gene expression in the placenta. However, no epidemiological studies have been conducted to validate the relationships between metals exposure, placental gene expression, and placental growth at the population level. This study aims to investigate these relationships based on Hangzhou birth cohort study II (HBCS-II). Totally, 1025 participants were derived from HBCS-II. Thirteen metals levels in the placenta were measured using inductively coupled plasma mass spectrometry. Placental growth characteristics were assessed, including placental weight, chorionic disc area, placental eccentricity, and distance from cord insertion site to the nearest edge of placenta (DCIEP). The relationships between metals exposure and placental growth characteristics were examined using the elastic net model combined unpenalized linear regression model. Placental gene expression levels were analyzed through RNA sequencing and real-time polymerase chain reaction (RT-qPCR), and mediation analysis was conducted to investigate whether placental gene expression could mediate the relationship between metal exposure and placental growth. Notably, the results showed that a unite increase in Ln-transformed cadmium (Cd) levels was associated with a reduction of 16.4 g [95% confidence interval (CI): 31.2, −1.5] in placental weight, 13.9 cm² (95%CI: 20.0, −7.8) in chorionic disc area, and 0.3 cm (95%CI: 0.55, −0.06) in DCIEP. Through RNA sequencing followed by validation, significant associations were observed between placental Cd level and increased expression of placental genes, including <em>TNFAIP2</em>, <em>OLAH</em>, <em>FLT4</em>, <em>SH3PXD2A</em>, <em>LIMCH1</em>, <em>BCL6</em>, <em>SLCO2A1</em>, and <em>CPSF1</em>. Additionally, increased placental <em>TNFAIP2</em>, <em>OLAH</em>, <em>FLT4</em>, <em>SH3PXD2A</em> and <em>LIMCH1</em> expression was linked to reduced placental weight. Moreover, <em>SH3PXD2A</em> was associated with decreased chorionic disc area. Mediation analysis showed that placental Cd level was associated with a 12.0 g (95%CI: 23.8, −2.7) decrease in placental weight mediated through the upregulation of <em>FTL4</em> gene expression. The study provides evidence of the association between placental Cd exposure and decreased placental weight, and the <em>FLT4</em> gene may play a mediating role in this relationship. Future experiment studies should be performed to validate the results.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal black carbon exposure and DNA methylation in umbilical cord blood","authors":"","doi":"10.1016/j.ijheh.2024.114464","DOIUrl":"10.1016/j.ijheh.2024.114464","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Prenatal exposure to ambient air pollution is associated with adverse cardiometabolic outcomes in childhood. We previously observed that prenatal black carbon (BC) was inversely associated with adiponectin, a hormone secreted by adipocytes, in early childhood. Changes to DNA methylation have been proposed as a potential mediator linking <em>in utero</em> exposures to lasting health impacts.</div></div><div><h3>Methods</h3><div>Among 532 mother-child pairs enrolled in the Colorado-based Healthy Start study, we performed an epigenome-wide association study of the relationship between prenatal exposure to a component of air pollution, BC, and DNA methylation in cord blood. Average pregnancy ambient BC was estimated at the mother's residence using a spatiotemporal prediction model. DNA methylation was measured using the Illumina 450K array. We used multiple linear regression to estimate associations between prenatal ambient BC and 429,246 cysteine-phosphate-guanine sites (CpGs), adjusting for potential confounders. We identified differentially methylated regions (DMRs) using DMRff and ENmix-combp. In a subset of participants (n = 243), we investigated DNA methylation as a potential mediator of the association between prenatal ambient BC and lower adiponectin in childhood.</div></div><div><h3>Results</h3><div>We identified 44 CpGs associated with average prenatal ambient BC after correcting for multiple testing. Several genes annotated to the top CpGs had reported functions in the immune system. There were 24 DMRs identified by both DMRff and ENmix-combp. One CpG (cg01123250), located on chromosome 2 and annotated to the <em>UNC80</em> gene, was found to mediate approximately 20% of the effect of prenatal BC on childhood adiponectin, though the confidence interval was wide (95% CI: 3, 84).</div></div><div><h3>Conclusions</h3><div>Prenatal BC was associated with DNA methylation in cord blood at several sites and regions in the genome. DNA methylation may partially mediate associations between prenatal BC and childhood cardiometabolic outcomes.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the impact of occupational noise exposure on workplace fatal and nonfatal injuries in the U.S. (2006–2020)","authors":"","doi":"10.1016/j.ijheh.2024.114468","DOIUrl":"10.1016/j.ijheh.2024.114468","url":null,"abstract":"<div><h3>Objectives</h3><div>This study assessed the relationship between occupational noise exposure and the incidence of workplace fatal injury (FI) and nonfatal injury (NFI) in the United States from 2006 to 2020. It also examined whether distinct occupational and industrial clusters based on noise exposure characteristics demonstrated varying risks for FI and NFI.</div></div><div><h3>Methods</h3><div>An ecological study design was utilized, employing data from the U.S. Bureau of Labor Statistics for FI and NFI and demographic data, the U.S. Census Bureau for occupation/industry classification code lists, and the U.S./Canada Occupational Noise Job Exposure Matrix for noise measurements. We examined four noise metrics as predictors of FI and NFI rates: mean Time-Weighted Average (TWA), maximum TWA, standard deviation of TWA, and percentage of work shifts exceeding 85 or 90 dBA for 619 occupation-years and 591 industry-years. K-means clustering was used to identify clusters of noise exposure characteristics. Mixed-effects negative binomial regression examined the relationship between the noise characteristics and FI/NFI rates separately for occupation and industry.</div></div><div><h3>Results</h3><div>Among occupations, we found significant associations between increased FI rates and higher mean TWA (IRR: 1.06, 95% CI: 1.01–1.12) and maximum TWA (IRR: 1.10, 95% CI: 1.07–1.14), as well as TWA exceedance (IRR: 1.04, 95% CI: 1.01–1.07). Increased rates of NFI were found to be significantly associated with maximum TWA (IRR: 1.06, 95% CI: 1.04–1.09) and TWA exceedance (IRR: 1.03, 95% CI: 1.01–1.05). In addition, occupations with both higher exposure variability (IRR with FI rate: 1.49, 95% CI: 1.23–1.80; IRR with NFI rate: 1.40, 95% CI: 1.14–1.73) and higher level of sustained exposure (IRR with FI rate: 1.27, 95% CI: 1.12–1.44; IRR with NFI rate: 1.21, 95% CI: 1.05–1.39) were associated with higher rates of FI and NFI compared to occupations with low noise exposure. Among industries, significant associations between increased NFI rates and higher mean TWA (IRR: 1.05, 95% CI: 1.02–1.08) and maximum TWA (IRR: 1.06, 95% CI: 1.04–1.08) were observed. Unlike the occupation-specific analysis, industries with higher exposure variability and higher sustained exposures did not display significantly higher FI/NFI rates compared to industries with low exposure.</div></div><div><h3>Conclusions</h3><div>The results suggest that occupational noise exposure may be an independent risk factor for workplace FIs/NFIs, particularly for workplaces with highly variable noise exposures. The study highlights the importance of comprehensive occupational noise assessments.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of impacts of occupational exposure to wildfire smoke on respiratory function, symptoms, measures and diseases","authors":"","doi":"10.1016/j.ijheh.2024.114463","DOIUrl":"10.1016/j.ijheh.2024.114463","url":null,"abstract":"<div><h3>Background</h3><div>Wildfire smoke contains numerous hazardous air pollutants which pose serious health risks to humans. Despite this, there has been a limited focus on the assessment of the acute physiological and longer-term respiratory effects of wildfire exposure on firefighters and other emergency workers. Therefore, we undertook a systematic review of the evidence about the respiratory impacts of occupational wildfire smoke exposure among wildfire fighters (WFF).</div></div><div><h3>Methods</h3><div>Eligible studies from Medline, Embase and Scopus databases were included if they described the relationship between wildfire exposure and respiratory function, symptoms, measures and diseases amongst emergency personnel or firefighters who had responded to wildfires.</div></div><div><h3>Results</h3><div>Twenty-six articles met the inclusion criteria. 24 out of 26 (22 out of 23 moderate/high quality) studies provided evidence of adverse respiratory effects, including reduced lung function, increased airway dysfunction and airway inflammation, upper and lower respiratory tract symptoms and increased asthma incidence related to wildfires or prescribed burns exposure among WFF and police responders. Fourteen out of 19 studies showed statistically significant declines in spirometry measures of lung function (mostly short-term studies). Two studies using complex lung function tests showed a significant effect on peripheral airway function.</div></div><div><h3>Discussion</h3><div>This review found a convincing body of evidence that occupational exposure to wildfires or prescribed burns has both acute and possibly longer-term respiratory effects among WFFs and some other emergency personnel. Given that these events are increasing, more needs to be done to identify those most at risk and mitigate these risks.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal exposure to PFAS and the association with neurobehavioral and social development during childhood","authors":"","doi":"10.1016/j.ijheh.2024.114469","DOIUrl":"10.1016/j.ijheh.2024.114469","url":null,"abstract":"<div><div>Exposure to per- and polyfluoroalkyl substances (PFAS) is ubiquitous and may be associated with neurodevelopmental toxicity. However, epidemiological studies report mixed results on the risks of gestational PFAS exposure for children's neurobehavioral impairment. We aimed to examine the associations between prenatal PFAS exposure and children's neurobehavioral and social problems.</div><div>We measured plasma concentrations of perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), and perfluorohexane sulphonate (PFHxS) in first-trimester blood from 757 women from the Canadian Maternal-Infant Research on Environmental Chemicals (MIREC) study. Children were assessed at 3–4 years with the Behavior Assessment System for Children-2 (BASC-2) and the Social Responsiveness Scale-2 (SRS-2) (n = 756 and 496, respectively). We used multivariable linear regression to examine associations between individual and summed log₂-transformed PFAS and scores on these assessments. Effect modification by sex was evaluated through interaction terms and stratified analyses.</div><div>In the sample combining both sexes, a doubling of maternal PFOA was significantly associated with lower T-scores on the following SRS-2 scales: Social Motivation, DSM-Social Communication, and SRS Total score (B ranging from -1.08 to -0.78), suggesting lesser impairments with higher exposure. In sex-stratified analysis, PFOA was related to significantly lower T-scores in boys for these BASC-2 scales: Behavioral Symptoms Index, Externalizing Problems, Aggression, and Hyperactivity (B ranging from -1.32 to -1.03). In girls, however, PFAS were significantly associated more problem behaviors, but most associations were small and the CIs included the null, with the exception of PFOA being significantly associated with higher T-scores for the BASC-2Anxiety scale (B = 1.84, 95% CI: 0.36, 3.32).</div><div>In conclusion, we did not observe strong associations between prenatal exposure to the PFAS evaluated and children's neurobehavioral and social development in this population with low exposure levels. The results show mixed findings, depending on children's sex, neurodevelopmental outcome, and specific PFAS.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term exposure to green and blue space and incidence of cardiovascular disease: A Danish Nurse Cohort study","authors":"","doi":"10.1016/j.ijheh.2024.114465","DOIUrl":"10.1016/j.ijheh.2024.114465","url":null,"abstract":"<div><h3>Background</h3><div>Few cohort studies have examined the associations of natural surroundings (green and blue space) with cardiovascular disease (CVD) and show mixed findings. We aimed to investigate the associations between long-term exposure to green and blue space and incidence of CVD in the Danish Nurse Cohort.</div></div><div><h3>Methods</h3><div>We followed 19,070 female nurses living in Denmark from 1993/1999 to 2018. The shortest Euclidian distance from a residence to three types of green space (park, woodland, and heathland) and four types of blue space (lake, river, coast, and wetland), along with total count of all types of natural surroundings within a 500 meter (m), 1000 m, and 5000 m radius from a residence, were calculated using GeoDanmark data from 2005. Distance was log-transformed to correct for a right-skewed data distribution. Residential air pollution and road traffic noise data for 2005 were estimated by the Danish air pollution modeling system (‘DEHM/UBM/AirGIS’) and Nord2000 model, respectively. Cox proportional hazards models were used to estimate associations between green and blue space and the first-ever incidence of total CVD and certain CVD subtypes after adjusting for individual factors, air pollution, and noise. We examined effect modification by age, smoking status, occupational status, household income, and urbanicity level. Hazard ratio (HR) and 95% confidence interval (95% CI) were presented per <em>e</em> unit (equivalent to ∼2.72 fold) increase in distance.</div></div><div><h3>Results</h3><div>8179 new cases of CVD were observed over 344,084 person-years. Living further from woodland was associated with higher stroke incidence (HR: 1.153; 95% CI: 1.029–1.293), while living further from heathland was associated with reduced total CVD incidence (HR: 0.975; 95% CI: 0.955–0.996). No associations were found between distance to park, woodland, lake, river, coast, or wetland and total CVD incidence. Total count of all types of green and blue spaces within a 5000 m radius was linked to a reduced risk of CVD incidence. Adjusting for air pollution or road traffic noise did not alter observed associations. Younger individuals (&lt;50 years old) were observed to have lower HRs when living closer to all types of natural surroundings.</div></div><div><h3>Conclusion</h3><div>We found that proximity to woodland was associated with a reduced risk of stroke, whilst no significant or even inverse associations were observed between proximity to other types of natural surroundings and CVD incidence. Total count of all types of natural surroundings within a 5000 m radius was negatively associated with CVD incidence, suggesting cumulative benefits of these areas.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1438463924001469/pdfft?md5=e33cac815fcb8035a318a8e0fe7d95e3&pid=1-s2.0-S1438463924001469-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple mycotoxin exposure assessment through human biomonitoring in an esophageal cancer case-control study in the Arsi-Bale districts of Oromia region of Ethiopia","authors":"","doi":"10.1016/j.ijheh.2024.114466","DOIUrl":"10.1016/j.ijheh.2024.114466","url":null,"abstract":"<div><h3>Background</h3><p>Esophageal cancer (EC) is a malignancy with a poor prognosis and a five-year survival rate of less than 20%. It is the ninth most frequent cancer globally and the sixth leading cause of cancer-related deaths. The incidence of EC has been found to vary significantly by geography, indicating the importance of environmental and lifestyle factors along with genetic factors in the onset of the disease. In this work, we investigated mycotoxin exposure in a case-control study from the Arsi-Bale districts of Oromia regional state in Ethiopia, where there is a high incidence of EC while alcohol and tobacco use – two established risk factors for EC – are very rare.</p></div><div><h3>Methods</h3><p>Internal exposure to 39 mycotoxins and metabolites was assessed by liquid chromatography-tandem mass spectrometry in plasma samples of EC cases (n = 166) and location-matched healthy controls (n = 166) who shared similar dietary sources. Demographic and lifestyle data were collected using structured questionnaires. Principal Component Analysis and machine learning models were used to identify the most relevant demographic, lifestyle, and mycotoxin (co-)exposure variables associated with EC. Multivariate binary logistic regression analysis was used to assess EC risk.</p></div><div><h3>Result</h3><p>Evidence of mycotoxin exposure was observed in all plasma samples, with 10 different mycotoxins being detected in samples from EC cases, while only 6 different mycotoxins were detected in samples from healthy controls. Ochratoxin A was detected in plasma from all cases and controls, while tenuazonic acid was detected in plasma of 145 (87.3%) cases and 71 (42.8%) controls. Using multivariable logistic regression analysis, exposure to tenuazonic acid (AOR = 1.88 [95% CI: 1.68–2.11]) and to multiple mycotoxins (AOR = 2.54 [95% CI: 2.10–3.07]) were positively associated with EC.</p></div><div><h3>Conclusion</h3><p>All cases and controls were exposed to at least one mycotoxin. Cases were exposed to a statistically significantly higher number of mycotoxins than controls. Exposure to tenuazonic acid and to multiple mycotoxins were associated with increased risk of EC in the study population. Although aflatoxin B1-lysine and the ratio of sphinganine to sphingosine (as a biomarker of effect to fumonisin exposure) were not assessed in this study, our result emphasizes the need to characterize the effect of mycotoxin co-exposure as part of the exposome and include it in risk assessment, since the current mycotoxin safety levels do not consider the additive or synergistic effects of mycotoxin co-exposure. Moreover, a prospective study design with regular sampling should be considered in this high incidence area of EC in Ethiopia to obtain conclusive results on the role of mycotoxin exposure in the onset and development of the disease.</p></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1438463924001470/pdfft?md5=2e339520117dba3c1bd3fa78e7ce1ce4&pid=1-s2.0-S1438463924001470-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}