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Int. J. Environ. Res. Public Health, Volume 13, Issue 8 (August 2016) – 91 articles

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301 KiB  
Article
Well-Being and Diabetes Management in Early Pregnant Women with Type 1 Diabetes Mellitus
by Karolina Linden, Carina Sparud-Lundin, Annsofie Adolfsson and Marie Berg
Int. J. Environ. Res. Public Health 2016, 13(8), 836; https://doi.org/10.3390/ijerph13080836 - 22 Aug 2016
Cited by 16 | Viewed by 9769
Abstract
This paper explores well-being and diabetes management in women with type 1 diabetes mellitus (DM) in early pregnancy and investigates associations among perceived well-being, diabetes management, and maternal characteristics. Questionnaires were answered by 168 Swedish women. Correlation analyses were conducted with Spearman’s correlation [...] Read more.
This paper explores well-being and diabetes management in women with type 1 diabetes mellitus (DM) in early pregnancy and investigates associations among perceived well-being, diabetes management, and maternal characteristics. Questionnaires were answered by 168 Swedish women. Correlation analyses were conducted with Spearman’s correlation coefficient (rs). The women reported relatively high scores of self-efficacy in diabetes management (SWE-DES-10: 3.91 (0.51)) and self-perceived health (excellent (6.5%), very good (42.3%), good (38.7%), fair (11.3%) and poor (1.2%)). Moderate scores were reported for general well-being (WBQ-12: 22.6 (5.7)) and sense of coherence (SOC-13: 68.9 (9.7), moderate/low scores for hypoglycemia fear (SWE-HFS 26.6 (11.8)) and low scores of diabetes-distress (SWE-PAID-20 27.1 (15.9)). A higher capability of self-efficacy in diabetes management showed positive correlations with self-perceived health (rs = −0.41, p < 0.0001) and well-being (rs = 0.34, p < 0.0001) as well as negative correlations with diabetes distress (rs = −0.51, p < 0.0001) and hypoglycemia worries (rs = −0.27, p = 0.0009). Women with HbA1c levels of ≤48 mmL/mol scored higher in the subscales “goal achievement” in SWE-DES (p = 0.0028) and “comprehensibility” in SOC (p = 0.016). Well-being and diabetes management could be supported by strengthening the women’s capability to achieve glycemic goals and their comprehensibility in relation to the treatment. Further studies are needed to test this. Full article
(This article belongs to the Collection Health Care and Diabetes)
11496 KiB  
Article
USLE-Based Assessment of Soil Erosion by Water in the Nyabarongo River Catchment, Rwanda
by Fidele Karamage, Chi Zhang, Alphonse Kayiranga, Hua Shao, Xia Fang, Felix Ndayisaba, Lamek Nahayo, Christophe Mupenzi and Guangjin Tian
Int. J. Environ. Res. Public Health 2016, 13(8), 835; https://doi.org/10.3390/ijerph13080835 - 20 Aug 2016
Cited by 54 | Viewed by 10546
Abstract
Soil erosion has become a serious problem in recent decades due to unhalted trends of unsustainable land use practices. Assessment of soil erosion is a prominent tool in planning and conservation of soil and water resource ecosystems. The Universal Soil Loss Equation (USLE) [...] Read more.
Soil erosion has become a serious problem in recent decades due to unhalted trends of unsustainable land use practices. Assessment of soil erosion is a prominent tool in planning and conservation of soil and water resource ecosystems. The Universal Soil Loss Equation (USLE) was applied to Nyabarongo River Catchment that drains about 8413.75 km2 (33%) of the total Rwanda coverage and a small part of the Southern Uganda (about 64.50 km2) using Geographic Information Systems (GIS) and Remote Sensing technologies. The estimated total annual actual soil loss was approximately estimated at 409 million tons with a mean erosion rate of 490 t·ha−1·y−1 (i.e., 32.67 mm·y−1). The cropland that occupied 74.85% of the total catchment presented a mean erosion rate of 618 t·ha−1·y−1 (i.e., 41.20 mm·y−1) and was responsible for 95.8% of total annual soil loss. Emergency soil erosion control is required with a priority accorded to cropland area of 173,244 ha, which is extremely exposed to actual soil erosion rate of 2222 t·ha−1·y−1 (i.e., 148.13 mm·y−1) and contributed to 96.2% of the total extreme soil loss in the catchment. According to this study, terracing cultivation method could reduce the current erosion rate in cropland areas by about 78%. Therefore, the present study suggests the catchment management by constructing check dams, terracing, agroforestry and reforestation of highly exposed areas as suitable measures for erosion and water pollution control within the Nyabarongo River Catchment and in other regions facing the same problems. Full article
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<p>(<b>a</b>) Location map of the Nyabarongo River Catchment; and (<b>b</b>) an aerial view of the Nyabarongo River, with the water looking muddy brown due to pollution [<a href="#B26-ijerph-13-00835" class="html-bibr">26</a>].</p>
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<p>Land Cover and Land Use (LCLU) for the Nyabarongo River Catchment in 2015.</p>
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<p>Maps of the Universal Soil Loss Equation (USLE) factors for the Nyabarongo River Catchment: (<b>a</b>) rainfall erosivity; (<b>b</b>) soil erodibility; (<b>c</b>) slope length and slope steepness; (<b>d</b>) the Slope angle; (<b>e</b>) land cover management; (<b>f</b>) conservation support practice.</p>
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<p>Maps of the Nyabarongo River Catchment: (<b>a</b>) potential soil erosion; and (<b>b</b>) actual soil erosion, 2015.</p>
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<p>Maps of the agricultural land use suitability for the 2015 cropland; (<b>a</b>) agricultural land use suitability without terraces or with minor support practice (P = 0.75); and (<b>b</b>) agricultural land use suitability if terraces were applied on the cropland area.</p>
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277 KiB  
Article
The Accessibility, Usability, and Reliability of Chinese Web-Based Information on HIV/AIDS
by Lu Niu, Dan Luo, Ying Liu and Shuiyuan Xiao
Int. J. Environ. Res. Public Health 2016, 13(8), 834; https://doi.org/10.3390/ijerph13080834 - 20 Aug 2016
Cited by 14 | Viewed by 6191
Abstract
Objective: The present study was designed to assess the quality of Chinese-language Internet-based information on HIV/AIDS. Methods: We entered the following search terms, in Chinese, into Baidu and Sogou: “HIV/AIDS”, “symptoms”, and “treatment”, and evaluated the first 50 hits of each [...] Read more.
Objective: The present study was designed to assess the quality of Chinese-language Internet-based information on HIV/AIDS. Methods: We entered the following search terms, in Chinese, into Baidu and Sogou: “HIV/AIDS”, “symptoms”, and “treatment”, and evaluated the first 50 hits of each query using the Minervation validation instrument (LIDA tool) and DISCERN instrument. Results: Of the 900 hits identified, 85 websites were included in this study. The overall score of the LIDA tool was 63.7%; the mean score of accessibility, usability, and reliability was 82.2%, 71.5%, and 27.3%, respectively. Of the top 15 sites according to the LIDA score, the mean DISCERN score was calculated at 43.1 (95% confidence intervals (CI) = 37.7–49.5). Noncommercial websites showed higher DISCERN scores than commercial websites; whereas commercial websites were more likely to be found in the first 20 links obtained from each search engine than the noncommercial websites. Conclusions: In general, the HIV/AIDS related Chinese-language websites have poor reliability, although their accessibility and usability are fair. In addition, the treatment information presented on Chinese-language websites is far from sufficient. There is an imperative need for professionals and specialized institutes to improve the comprehensiveness of web-based information related to HIV/AIDS. Full article
(This article belongs to the Special Issue Health Informatics and Public Health)
2311 KiB  
Article
The Distribution and Health Risk Assessment of Metals in Soils in the Vicinity of Industrial Sites in Dongguan, China
by Chao Liu, Liwen Lu, Ting Huang, Yalin Huang, Lei Ding and Weituo Zhao
Int. J. Environ. Res. Public Health 2016, 13(8), 832; https://doi.org/10.3390/ijerph13080832 - 19 Aug 2016
Cited by 40 | Viewed by 6580
Abstract
Exponential industrialization and rapid urbanization have resulted in contamination of soil by metals from anthropogenic sources in Dongguan, China. The aims of this research were to determine the concentration and distribution of various metals (arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), mercury [...] Read more.
Exponential industrialization and rapid urbanization have resulted in contamination of soil by metals from anthropogenic sources in Dongguan, China. The aims of this research were to determine the concentration and distribution of various metals (arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), mercury (Hg), nickel (Ni), lead (Pb) and zinc (Zn)) in soils and identify their potential health risks for local residents. A total of 106 soil samples were collected from the vicinity of industrial sites in Dongguan. Two types of samples were collected from each site: topsoil (0–20 cm, TS) and shallow soil (20–50 cm, SS). Results showed that the soils were contaminated by metals and pollution was mainly focused on TS. The geoaccumulation index (Igeo) and pollution indexes (PI) implied that there was a slight increase in the concentrations of Cd, Cu, Hg, Ni, and Pb, but the metal pollution caused by industrial activities was less severe, and elements of As and Cr exhibited non-pollution level. The risk assessment results suggested that there was a potential health risk associated with As and Cr exposure for residents because the carcinogenic risks of As and Cr via corresponding exposure pathways exceeded the safety limit of 10−6 (the acceptable level of carcinogenic risk for humans). Furthermore, oral ingestion and inhalation of soil particles are the main exposure pathways for As and Cr to enter the human body. This study may provide basic information of metal pollution control and human health protection in the vicinity of industrial regions. Full article
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<p>The location of the study area and distribution of sampling sites.</p>
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<p>Heavy metal concentrations of soil from the vicinity of industrial sites in Dongguan. TS: topsoils of 0–20 cm, SS: shallow soils of 20–50 cm. The circle symbols (○) represent outliers (mild outliers), and the cross symbols (*) represent extremes (extreme outliers). The horizontal lines at the top, middle and bottom of the box plot correspond to the 75th percentile, median and 25th percentile, respectively.</p>
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<p>Box plot of <span class="html-italic">I</span><sub>geo</sub> for heavy metals in topsoils around industrial sites in Dongguan. The <span class="html-italic">circles</span> represent outliers (mild outliers), and the <span class="html-italic">stars</span> represent extremes (extreme outliers). The <span class="html-italic">horizontal</span> lines at the top, <span class="html-italic">middle</span> and <span class="html-italic">bottom</span> of the box plot correspond to the 75th percentile, median and 25th percentile, respectively.</p>
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<p>The mean pollution index (<span class="html-italic">PI</span>) of heavy metals in topsoils in different towns of Dongguan.</p>
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<p>Carcinogenic risks of heavy metals in topsoils around industrial sites in Dongguan.</p>
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<p>Non-carcinogenic risks of heavy metals in topsoils around industrial sites in Dongguan.</p>
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10874 KiB  
Article
Spatial Distribution Characteristics of Healthcare Facilities in Nanjing: Network Point Pattern Analysis and Correlation Analysis
by Jianhua Ni, Tianlu Qian, Changbai Xi, Yikang Rui and Jiechen Wang
Int. J. Environ. Res. Public Health 2016, 13(8), 833; https://doi.org/10.3390/ijerph13080833 - 18 Aug 2016
Cited by 33 | Viewed by 7552
Abstract
The spatial distribution of urban service facilities is largely constrained by the road network. In this study, network point pattern analysis and correlation analysis were used to analyze the relationship between road network and healthcare facility distribution. The weighted network kernel density estimation [...] Read more.
The spatial distribution of urban service facilities is largely constrained by the road network. In this study, network point pattern analysis and correlation analysis were used to analyze the relationship between road network and healthcare facility distribution. The weighted network kernel density estimation method proposed in this study identifies significant differences between the outside and inside areas of the Ming city wall. The results of network K-function analysis show that private hospitals are more evenly distributed than public hospitals, and pharmacy stores tend to cluster around hospitals along the road network. After computing the correlation analysis between different categorized hospitals and street centrality, we find that the distribution of these hospitals correlates highly with the street centralities, and that the correlations are higher with private and small hospitals than with public and large hospitals. The comprehensive analysis results could help examine the reasonability of existing urban healthcare facility distribution and optimize the location of new healthcare facilities. Full article
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<p>City centers with road network in study area.</p>
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<p>(<b>a</b>) Distribution of hospitals and (<b>b</b>) pharmacy stores in main urban districts.</p>
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<p>(<b>a</b>) Unweighted NetKDE results; (<b>b</b>) weighted NetKDE results; and (<b>c</b>) weighted NetKDE results around the city center for hospitals.</p>
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<p>(<b>a</b>) Network auto K-function analysis of main urban districts and (<b>b</b>) network auto K-function analysis of downtown area.</p>
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<p>(<b>a</b>) Network auto K-function analysis of first- and second-class hospitals and (<b>b</b>) network auto K-function analysis of other hospitals in main urban districts.</p>
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<p>Network cross K-function analysis between hospitals and pharmacy stores in main urban districts.</p>
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<p>(<b>a</b>) Street betweenness; (<b>b</b>) straightness; and (<b>c</b>) closeness centrality in main urban areas.</p>
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<p>(<b>a</b>) KDE of street betweenness; (<b>b</b>) straightness; and (<b>c</b>) closeness centrality in main urban areas.</p>
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317 KiB  
Review
Co-Morbidity, Mortality, Quality of Life and the Healthcare/Welfare/Social Costs of Disordered Sleep: A Rapid Review
by Sergio Garbarino, Paola Lanteri, Paolo Durando, Nicola Magnavita and Walter G. Sannita
Int. J. Environ. Res. Public Health 2016, 13(8), 831; https://doi.org/10.3390/ijerph13080831 - 18 Aug 2016
Cited by 144 | Viewed by 10009
Abstract
Sleep disorders are frequent (18%–23%) and constitute a major risk factor for psychiatric, cardiovascular, metabolic or hormonal co-morbidity and mortality. Low social status or income, unemployment, life events such as divorce, negative lifestyle habits, and professional requirements (e.g., shift work) are often associated [...] Read more.
Sleep disorders are frequent (18%–23%) and constitute a major risk factor for psychiatric, cardiovascular, metabolic or hormonal co-morbidity and mortality. Low social status or income, unemployment, life events such as divorce, negative lifestyle habits, and professional requirements (e.g., shift work) are often associated with sleep problems. Sleep disorders affect the quality of life and impair both professional and non-professional activities. Excessive daytime drowsiness resulting from sleep disorders impairs efficiency and safety at work or on the road, and increases the risk of accidents. Poor sleep (either professional or voluntary) has detrimental effects comparable to those of major sleep disorders, but is often neglected. The high incidence and direct/indirect healthcare and welfare costs of sleep disorders and poor sleep currently constitute a major medical problem. Investigation, monitoring and strategies are needed in order to prevent/reduce the effects of these disorders. Full article
3040 KiB  
Article
Association between Natural Resources for Outdoor Activities and Physical Inactivity: Results from the Contiguous United States
by Yan Jiang, Yongping Yuan, Anne Neale, Laura Jackson and Megan Mehaffey
Int. J. Environ. Res. Public Health 2016, 13(8), 830; https://doi.org/10.3390/ijerph13080830 - 17 Aug 2016
Cited by 6 | Viewed by 6504
Abstract
Protected areas including national/state parks and recreational waters are excellent natural resources that promote physical activity and interaction with Nature, which can relieve stress and reduce disease risk. Despite their importance, however, their contribution to human health has not been properly quantified. This [...] Read more.
Protected areas including national/state parks and recreational waters are excellent natural resources that promote physical activity and interaction with Nature, which can relieve stress and reduce disease risk. Despite their importance, however, their contribution to human health has not been properly quantified. This paper seeks to evaluate quantitatively how national/state parks and recreational waters are associated with human health and well-being, taking into account of the spatial dependence of environmental variables for the contiguous U.S., at the county level. First, we describe available natural resources for outdoor activities (ANROA), using national databases that include features from the Protected Areas Database, NAVSTREETS, and ATTAINSGEO 305(b) Waters. We then use spatial regression techniques to explore the association of ANROA and socioeconomic status factors on physical inactivity rates. Finally, we use variance analysis to analyze ANROA’s influence on income-related health inequality. We found a significantly negative association between ANROA and the rate of physical inactivity: ANROA and the spatial effect explained 69%, nationwide, of the variation in physical inactivity. Physical inactivity rate showed a strong spatial dependence—influenced not only by its own in-county ANROA, but also by that of its neighbors ANROA. Furthermore, community groups at the same income level and with the highest ANROA, always had the lowest physical inactivity rate. This finding may help to guide future land use planning and community development that will benefit human health and well-being. Full article
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<p>Geographic Distributions of Contiguous U.S. Natural Resources for Outdoor Activities.</p>
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<p>Classification of ANROA for the Contiguous U.S. Counties.</p>
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<p>Geographic Distributions of Average Age-Adjusted Physical Inactivity Rate in Contiguous U.S. Counties (2008 to 2011; rates were grouped by natural breaks classification).</p>
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<p>Average Age-adjusted Rate of Physical Inactivity among ANROA and Income Groups (Group A: low income pop &lt; 20%; Group B: 20% &lt; low income pop &lt; 50%; Group C: low income pop &gt; 50%. Error bar indicates 95% confidence interval; the classification of ANROA is consistent with <a href="#ijerph-13-00830-f002" class="html-fig">Figure 2</a>).</p>
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265 KiB  
Case Report
Home Use of a Pyrethroid-Containing Pesticide and Facial Paresthesia in a Toddler: A Case Report
by Alexandra Perkins, Frederick Walters, Jennifer Sievert, Blaine Rhodes, Barbara Morrissey and Catherine J. Karr
Int. J. Environ. Res. Public Health 2016, 13(8), 829; https://doi.org/10.3390/ijerph13080829 - 17 Aug 2016
Cited by 8 | Viewed by 5768
Abstract
Paresthesias have previously been reported among adults in occupational and non-occupational settings after dermal contact with pyrethroid insecticides. In this report, we describe a preverbal 13-month-old who presented to his primary care pediatrician with approximately 1 week of odd facial movements consistent with [...] Read more.
Paresthesias have previously been reported among adults in occupational and non-occupational settings after dermal contact with pyrethroid insecticides. In this report, we describe a preverbal 13-month-old who presented to his primary care pediatrician with approximately 1 week of odd facial movements consistent with facial paresthesias. The symptoms coincided with a period of repeat indoor spraying at his home with a commercially available insecticide containing two active ingredients in the pyrethroid class. Consultation by the Northwest Pediatric Environmental Health Specialty Unit and follow-up by the Washington State Department of Health included urinary pyrethroid metabolite measurements during and after the symptomatic period, counseling on home clean up and use of safer pest control methods. The child’s symptoms resolved soon after home cleanup. A diagnosis of pesticide-related illness due to pyrethroid exposure was made based on the opportunity for significant exposure (multiple applications in areas where the child spent time), supportive biomonitoring data, and the consistency and temporality of symptom findings (paresthesias). This case underscores the vulnerability of children to uptake pesticides, the role of the primary care provider in ascertaining an exposure history to recognize symptomatic illness, and the need for collaborative medical and public health efforts to reduce significant exposures in children. Full article
(This article belongs to the Special Issue Children’s Exposure to Environmental Contaminants)
850 KiB  
Review
Accessible Home Environments for People with Functional Limitations: A Systematic Review
by Hea Young Cho, Malcolm MacLachlan, Michael Clarke and Hasheem Mannan
Int. J. Environ. Res. Public Health 2016, 13(8), 826; https://doi.org/10.3390/ijerph13080826 - 17 Aug 2016
Cited by 44 | Viewed by 10494
Abstract
The aim of this review is to evaluate the health and social effects of accessible home environments for people with functional limitations, in order to provide evidence to promote well-informed decision making for policy guideline development and choices about public health interventions. MEDLINE [...] Read more.
The aim of this review is to evaluate the health and social effects of accessible home environments for people with functional limitations, in order to provide evidence to promote well-informed decision making for policy guideline development and choices about public health interventions. MEDLINE and nine other electronic databases were searched between December 2014 and January 2015, for articles published since 2004. All study types were included in this review. Two reviewers independently screened 12,544 record titles or titles and abstracts based on our pre-defined eligibility criteria. We identified 94 articles as potentially eligible; and assessed their full text. Included studies were critically appraised using the Mixed Method Appraisal Tool, version 2011. Fourteen studies were included in the review. We did not identify any meta-analysis or systematic review directly relevant to the question for this systematic review. A narrative approach was used to synthesise the findings of the included studies due to methodological and statistical heterogeneity. Results suggest that certain interventions to enhance the accessibility of homes can have positive health and social effects. Home environments that lack accessibility modifications appropriate to the needs of their users are likely to result in people with physical impairments becoming disabled at home. Full article
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<p>Flow diagram for the identification of eligible studies. (Only one reason is given per excluded study although in many cases reasons for exclusion were more than singular.)</p>
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<p>Associations between functional limitations, home accessibility features and outcomes (…. represents no significant or inconsistent associations/effects).</p>
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2325 KiB  
Article
A Well-Mixed Computational Model for Estimating Room Air Levels of Selected Constituents from E-Vapor Product Use
by Ali A. Rostami, Yezdi B. Pithawalla, Jianmin Liu, Michael J. Oldham, Karl A. Wagner, Kimberly Frost-Pineda and Mohamadi A. Sarkar
Int. J. Environ. Res. Public Health 2016, 13(8), 828; https://doi.org/10.3390/ijerph13080828 - 16 Aug 2016
Cited by 7 | Viewed by 5242
Abstract
Concerns have been raised in the literature for the potential of secondhand exposure from e-vapor product (EVP) use. It would be difficult to experimentally determine the impact of various factors on secondhand exposure including, but not limited to, room characteristics (indoor space size, [...] Read more.
Concerns have been raised in the literature for the potential of secondhand exposure from e-vapor product (EVP) use. It would be difficult to experimentally determine the impact of various factors on secondhand exposure including, but not limited to, room characteristics (indoor space size, ventilation rate), device specifications (aerosol mass delivery, e-liquid composition), and use behavior (number of users and usage frequency). Therefore, a well-mixed computational model was developed to estimate the indoor levels of constituents from EVPs under a variety of conditions. The model is based on physical and thermodynamic interactions between aerosol, vapor, and air, similar to indoor air models referred to by the Environmental Protection Agency. The model results agree well with measured indoor air levels of nicotine from two sources: smoking machine-generated aerosol and aerosol exhaled from EVP use. Sensitivity analysis indicated that increasing air exchange rate reduces room air level of constituents, as more material is carried away. The effect of the amount of aerosol released into the space due to variability in exhalation was also evaluated. The model can estimate the room air level of constituents as a function of time, which may be used to assess the level of non-user exposure over time. Full article
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<p>Model prediction and experimental data of average nicotine concentration in the indoor space for smoking machine-generated aerosol source.</p>
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<p>Modeling result for nicotine concentration in the room over time for Run 4 of study by Czogala et al. [<a href="#B26-ijerph-13-00828" class="html-bibr">26</a>].</p>
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<p>Exhaled breath condensate collection system (EBS) diagram.</p>
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<p>Fraction of inhaled nicotine that is exhaled [<a href="#B27-ijerph-13-00828" class="html-bibr">27</a>].</p>
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<p>Mobile environmental exposure chamber (mEEC) used for the controlled clinical study.</p>
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<p>Computational results for nicotine concentration in the mEEC under the described study conditions.</p>
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<p>Model predictions compared with measured nicotine concentration in the exposure chamber.</p>
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<p>Effects of (<b>a</b>) exhaled nicotine ratio; (<b>b</b>) number of puffs taken by each participant; (<b>c</b>) air exchange rate (ACH) on predicted indoor air nicotine concentration.</p>
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<p>Model predictions for exposure chamber nicotine concentration for 4 h use of e-cigarettes compared with 1 h use.</p>
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<p>Model predictions for glycerol and propylene glycol concentrations in the mEEC.</p>
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659 KiB  
Article
Surface Water Impacted by Rural Activities Induces Genetic Toxicity Related to Recombinagenic Events in Vivo
by José Lopes Soares Neto, Raíne Fogliati De Carli, Queila Susana Gambim Kotzal, Francine Bolico Latroni, Mauricio Lehmann, Johnny Ferraz Dias, Cláudia Telles De Souza, Liana Appel Boufleur Niekraszewicz, Fernanda Rabaioli Da Silva, Juliana Da Silva and Rafael Rodrigues Dihl
Int. J. Environ. Res. Public Health 2016, 13(8), 827; https://doi.org/10.3390/ijerph13080827 - 16 Aug 2016
Cited by 4 | Viewed by 4089
Abstract
This investigation assessed the interaction of surface water samples with DNA to quantitatively and qualitatively characterize their mutagenic and/or recombinagenic activity. Samples were obtained at three different sites along the Tocantins River (Tocantins State, Brazil). The area has withstood the impact mainly of [...] Read more.
This investigation assessed the interaction of surface water samples with DNA to quantitatively and qualitatively characterize their mutagenic and/or recombinagenic activity. Samples were obtained at three different sites along the Tocantins River (Tocantins State, Brazil). The area has withstood the impact mainly of rural activities, which release different chemical compounds in the environment. The Drosophila melanogaster Somatic Mutation and Recombination Test (SMART) was performed in standard (ST) and high bioactivation (HB) crosses. SMART is useful for the detection of mutational and recombinational events induced by genotoxins of direct and indirect action. Results demonstrated that samples collected in both seasons were able to induce increments on the mutant spot frequencies in the larvae of the HB cross. Genotoxicity was related to a massive recombinagenic activity. The positive responses ascribed to only the HB cross means that it is linked to pro-genotoxins requiring metabolic activation. The SMART wing test in Drosophila melanogaster was shown to be highly sensitive to detect genotoxic agents present in the aquatic environment impacted by agriculture. Full article
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<p>Geographic location of Tocantins River and the map of the collection sites.</p>
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2039 KiB  
Review
Comparison of the Ability to Predict Mortality between the Injury Severity Score and the New Injury Severity Score: A Meta-Analysis
by Qiangyu Deng, Bihan Tang, Chen Xue, Yuan Liu, Xu Liu, Yipeng Lv and Lulu Zhang
Int. J. Environ. Res. Public Health 2016, 13(8), 825; https://doi.org/10.3390/ijerph13080825 - 16 Aug 2016
Cited by 61 | Viewed by 7958
Abstract
Background: Description of the anatomical severity of injuries in trauma patients is important. While the Injury Severity Score has been regarded as the “gold standard” since its creation, several studies have indicated that the New Injury Severity Score is better. Therefore, we aimed [...] Read more.
Background: Description of the anatomical severity of injuries in trauma patients is important. While the Injury Severity Score has been regarded as the “gold standard” since its creation, several studies have indicated that the New Injury Severity Score is better. Therefore, we aimed to systematically evaluate and compare the accuracy of the Injury Severity Score and the New Injury Severity Score in predicting mortality. Methods: Two researchers independently searched the PubMed, Embase, and Web of Science databases and included studies from which the exact number of true-positive, false-positive, false-negative, and true-negative results could be extracted. Quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies checklist criteria. The meta-analysis was performed using Meta-DiSc. Meta-regression, subgroup analyses, and sensitivity analyses were conducted to determine the source(s) of heterogeneity and factor(s) affecting the accuracy of the New Injury Severity Score and the Injury Severity Score in predicting mortality. Results: The heterogeneity of the 11 relevant studies (total n = 11,866) was high (I2 > 80%). The meta-analysis using a random-effects model resulted in sensitivity of 0.64, specificity of 0.93, positive likelihood ratio of 5.11, negative likelihood ratio of 0.27, diagnostic odds ratio of 27.75, and area under the summary receiver operator characteristic curve of 0.9009 for the Injury Severity Score; and sensitivity of 0.71, specificity of 0.87, positive likelihood ratio of 5.22, negative likelihood ratio of 0.20, diagnostic odds ratio of 24.74, and area under the summary receiver operating characteristic curve of 0.9095 for the New Injury Severity Score. Conclusion: The New Injury Severity Score and the Injury Severity Score have similar abilities in predicting mortality. Further research is required to determine the appropriate use of the Injury Severity Score or the New Injury Severity Score based on specific patient condition and trauma type. Full article
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<p>Flow chart showing study selection for the meta-analysis regarding the ability of the Injury Severity Score and New Injury Severity Score to predict mortality.</p>
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<p>Summary receiver operating characteristics (SROC) curve of the Injury Severity Score (ISS). AUC is the area under the receiver operator characteristic (ROC) curve.</p>
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<p>Summary receiver operating characteristics (SROC) curve of the New Injury Severity Score (NISS). AUC is the area under the receiver operator characteristic (ROC) curve.</p>
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294 KiB  
Article
Home and Work Physical Activity Environments: Associations with Cardiorespiratory Fitness and Physical Activity Level in French Women
by Jean-Michel Oppert, Marie-Aline Charles, Hélène Charreire, Mehdi Menai, Ilse De Bourdeaudhuij, Soren Brage, Blandine De Lauzon-Guillain, Guy Fagherazzi and Beverley Balkau
Int. J. Environ. Res. Public Health 2016, 13(8), 824; https://doi.org/10.3390/ijerph13080824 - 15 Aug 2016
Cited by 6 | Viewed by 5225
Abstract
The influence of the physical activity environment in the home and at work on cardiorespiratory fitness (CRF) and objectively-measured physical activity has not been extensively studied. We recruited 147 women with a (mean ± SD) age of 54 ± 7 years and without [...] Read more.
The influence of the physical activity environment in the home and at work on cardiorespiratory fitness (CRF) and objectively-measured physical activity has not been extensively studied. We recruited 147 women with a (mean ± SD) age of 54 ± 7 years and without evidence of chronic disease. The physical activity environment was assessed by self-report (Assessing Levels of PHysical Activity or ALPHA questionnaire), CRF using a submaximal step test, usual physical activity using combined heart rate and accelerometry, as well as by a validated questionnaire (Recent Physical Activity Questionnaire). Summary scores of the home environment and the work environment derived from the ALPHA questionnaire were positively correlated with CRF after adjustment for age (r = 0.18, p = 0.03 and r = 0.28, p < 0.01, respectively). Women owning a bicycle or having a garden (which may prompt physical activity) had higher CRF; those with a bicycle at home also had a higher physical activity energy expenditure. Similarly, women who had access to fitness equipment at work had higher CRF. In conclusion, these results provide new insights into potential environmental influences on physical capacity and physical activity that could inform the design of physical activity promotion strategies. Full article
287 KiB  
Article
Learning to Stand: The Acceptability and Feasibility of Introducing Standing Desks into College Classrooms
by Roberto M. Benzo, Allene L. Gremaud, Matthew Jerome and Lucas J. Carr
Int. J. Environ. Res. Public Health 2016, 13(8), 823; https://doi.org/10.3390/ijerph13080823 - 15 Aug 2016
Cited by 25 | Viewed by 7319
Abstract
Prolonged sedentary behavior is an independent risk factor for multiple negative health outcomes. Evidence supports introducing standing desks into K-12 classrooms and work settings to reduce sitting time, but no studies have been conducted in the college classroom environment. The present study explored [...] Read more.
Prolonged sedentary behavior is an independent risk factor for multiple negative health outcomes. Evidence supports introducing standing desks into K-12 classrooms and work settings to reduce sitting time, but no studies have been conducted in the college classroom environment. The present study explored the acceptability and feasibility of introducing standing desks in college classrooms. A total of 993 students and 149 instructors completed a single online needs assessment survey. This cross-sectional study was conducted during the fall semester of 2015 at a large Midwestern University. The large majority of students (95%) reported they would prefer the option to stand in class. Most students (82.7%) reported they currently sit during their entire class time. Most students (76.6%) and instructors (86.6%) reported being in favor of introducing standing desks into college classrooms. More than half of students and instructors predicted having access to standing desks in class would improve student’s “physical health”, “attention”, and “restlessness”. Collectively, these findings support the acceptability of introducing standing desks in college classrooms. Future research is needed to test the feasibility, cost-effectiveness and efficacy of introducing standing desks in college classrooms. Such studies would be useful for informing institutional policies regarding classroom designs. Full article
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Article
Role of Winter Weather Conditions and Slipperiness on Tourists’ Accidents in Finland
by Élise Lépy, Sinikka Rantala, Antti Huusko, Pentti Nieminen, Marjo Hippi and Arja Rautio
Int. J. Environ. Res. Public Health 2016, 13(8), 822; https://doi.org/10.3390/ijerph13080822 - 15 Aug 2016
Cited by 26 | Viewed by 5805
Abstract
(1) Background: In Finland, slippery snowy or icy ground surface conditions can be quite hazardous to human health during wintertime. We focused on the impacts of the variability in weather conditions on tourists’ health via documented accidents during the winter season in the [...] Read more.
(1) Background: In Finland, slippery snowy or icy ground surface conditions can be quite hazardous to human health during wintertime. We focused on the impacts of the variability in weather conditions on tourists’ health via documented accidents during the winter season in the Sotkamo area. We attempted to estimate the slipping hazard in a specific context of space and time focusing on the weather and other possible parameters, responsible for fluctuations in the numbers of injuries/accidents; (2) Methods: We used statistical distributions with graphical illustrations to examine the distribution of visits to Kainuu Hospital by non-local patients and their characteristics/causes; graphs to illustrate the distribution of the different characteristics of weather conditions; questionnaires and interviews conducted among health care and safety personnel in Sotkamo and Kuusamo; (3) Results: There was a clear seasonal distribution in the numbers and types of extremity injuries of non-local patients. While the risk of slipping is emphasized, other factors leading to injuries are evaluated; and (4) Conclusions: The study highlighted the clear role of wintery weather conditions as a cause of extremity injuries even though other aspects must also be considered. Future scenarios, challenges and adaptive strategies are also discussed from the viewpoint of climate change. Full article
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<p>Origin of non-local of Kainuu Hospital patients whose injury belongs to S40–S99 category.</p>
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<p>Number of injury cases by age and gender at Kainuu Hospital.</p>
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<p>Number of injury cases by type and gender at Kainuu Hospital.</p>
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<p>Injuries associated to weather conditions in 2006/2007.</p>
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<p>Injuries associated to weather conditions in 2007/2008.</p>
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<p>Injuries associated to weather conditions in 2008/2009.</p>
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Article
Age-Related Changes in Segmental Body Composition by Ethnicity and History of Weight Change across the Adult Lifespan
by Simiao Tian, Béatrice Morio, Jean-Baptiste Denis and Laurence Mioche
Int. J. Environ. Res. Public Health 2016, 13(8), 821; https://doi.org/10.3390/ijerph13080821 - 13 Aug 2016
Cited by 24 | Viewed by 7190
Abstract
This study assessed age-related changes in body composition (specifically in trunk fat and appendicular lean masses), with consideration of body mass index (BMI) at age 20 years (BMI reference age, “BMIref”), ethnicity and lifetime weight change history. A cross-sectional dual-energy X-ray absorptiometry-based dataset [...] Read more.
This study assessed age-related changes in body composition (specifically in trunk fat and appendicular lean masses), with consideration of body mass index (BMI) at age 20 years (BMI reference age, “BMIref”), ethnicity and lifetime weight change history. A cross-sectional dual-energy X-ray absorptiometry-based dataset was extracted from the U.S. National Health and Nutrition Examination Survey (NHANES) 1999–2004. Only European-American and African-American subjects were used (2705 men, 2527 women). For each gender and ethnicity, 6 analytic cases were considered, based on three BMIref categories (normal, overweight and obese, being 22, 27 and 30 kg/m2, respectively) and two weight contexts (stable weight or weight gain across the lifespan). A nonparametric model was developed to investigate age-related changes in body composition. Then, parametric modelling was developed for assessing BMIref- and ethnicity-specific effects during aging. In the stable weight, both genders’ and ethnicities’ trunk fat (TF) increased gradually; body fat (BF) remained stable until 40 years and increased thereafter; trunk lean (TL) remained stable, but appendicular lean (APL) and body lean (BL) declined from 20 years. In the weight gain context, TF and BF increased at a constant rate, while APL, TL and BL increased until 40–50 years, and then declined slightly. Compared with European-American subjects of both genders, African-American subjects had lower TF and BF masses. Ethnic differences in body composition were quantified and found to remain constant across the lifespan. Full article
(This article belongs to the Special Issue Aging and Health Promotion)
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<p>Age-related changes in segmental body composition for NHANES European-American normal men. Age is on the <span class="html-italic">x</span>-axis, and estimates of segmental body compositions from <math display="inline"> <semantics> <mrow> <mi>M</mi> <msub> <mrow> <mn>11</mn> </mrow> <mrow> <mi>B</mi> <mo>,</mo> <mi>E</mi> </mrow> </msub> <mrow> <mo>(</mo> <mi>A</mi> <mo>)</mo> </mrow> </mrow> </semantics> </math> are on the <span class="html-italic">y</span>-axis. Reference profile is represented by (o) and gain profile by (<math display="inline"> <semantics> <mo>Δ</mo> </semantics> </math>).</p>
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<p>Age-related changes in segmental body composition for NHANES European-American normal women. Age is on the <span class="html-italic">x</span>-axis, and estimates of segmental body compositions from <math display="inline"> <semantics> <mrow> <mi>M</mi> <msub> <mrow> <mn>11</mn> </mrow> <mrow> <mi>B</mi> <mo>,</mo> <mi>E</mi> </mrow> </msub> <mrow> <mo>(</mo> <mi>A</mi> <mo>)</mo> </mrow> </mrow> </semantics> </math> are on the <span class="html-italic">y</span>-axis. Reference Profile is represented by (o) and Gain Profile by (<math display="inline"> <semantics> <mo>Δ</mo> </semantics> </math>).</p>
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Article
Heavy Metal Distribution in Street Dust from Traditional Markets and the Human Health Implications
by Jin Ah Kim, Jin Hee Park and Won Ju Hwang
Int. J. Environ. Res. Public Health 2016, 13(8), 820; https://doi.org/10.3390/ijerph13080820 - 13 Aug 2016
Cited by 37 | Viewed by 6966
Abstract
Street dust is a hazard for workers in traditional markets. Exposure time is longer than for other people, making them vulnerable to heavy metals in street dust. This study investigated heavy metal concentrations in street dust samples collected from different types of markets. [...] Read more.
Street dust is a hazard for workers in traditional markets. Exposure time is longer than for other people, making them vulnerable to heavy metals in street dust. This study investigated heavy metal concentrations in street dust samples collected from different types of markets. It compared the results with heavy metal concentrations in heavy traffic and rural areas. Street dust was significantly enriched with most heavy metals in a heavy traffic area while street dust from a fish market was contaminated with cupper (Cu), lead (Pb) and zinc (Zn). Street dust from medicinal herb and fruit markets, and rural areas were not contaminated. Principal component and cluster analyses indicated heavy metals in heavy traffic road and fish market dust had different sources. Relatively high heavy metal concentration in street dust from the fish market may negatively affect worker’s mental health, as depression levels were higher compared with workers in other markets. Therefore, intensive investigation of the relationship between heavy metal concentrations in street dust and worker’s health in traditional marketplaces should be conducted to elucidate the effect of heavy metals on psychological health in humans. Full article
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<p>Sampling locations: a medicinal herb market, a fish market, two fruit markets, and a heavy traffic area in Seoul, and rural areas in Jeongeup, South Korea.</p>
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<p>Enrichment factors of heavy metals in street dust samples.</p>
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<p>Plot of loadings of the first two principal components in principal component analysis.</p>
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<p>Principal component score plot of the street dust in the projection of principal components 1 and 2.</p>
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<p>Dendrogram showing the clustering of the street dust samples. Similarities have been calculated from Euclidean distance.</p>
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Article
Using the Job Burden-Capital Model of Occupational Stress to Predict Depression and Well-Being among Electronic Manufacturing Service Employees in China
by Chao Wang, Shuang Li, Tao Li, Shanfa Yu, Junming Dai, Xiaoman Liu, Xiaojun Zhu, Yuqing Ji and Jin Wang
Int. J. Environ. Res. Public Health 2016, 13(8), 819; https://doi.org/10.3390/ijerph13080819 - 12 Aug 2016
Cited by 3 | Viewed by 6301
Abstract
Background: This study aimed to identify the association between occupational stress and depression-well-being by proposing a comprehensive and flexible job burden-capital model with its corresponding hypotheses. Methods: For this research, 1618 valid samples were gathered from the electronic manufacturing service industry [...] Read more.
Background: This study aimed to identify the association between occupational stress and depression-well-being by proposing a comprehensive and flexible job burden-capital model with its corresponding hypotheses. Methods: For this research, 1618 valid samples were gathered from the electronic manufacturing service industry in Hunan Province, China; self-rated questionnaires were administered to participants for data collection after obtaining their written consent. The proposed model was fitted and tested through structural equation model analysis. Results: Single-factor correlation analysis results indicated that coefficients between all items and dimensions had statistical significance. The final model demonstrated satisfactory global goodness of fit (CMIN/DF = 5.37, AGFI = 0.915, NNFI = 0.945, IFI = 0.952, RMSEA = 0.052). Both the measurement and structural models showed acceptable path loadings. Job burden and capital were directly associated with depression and well-being or indirectly related to them through personality. Multi-group structural equation model analyses indicated general applicability of the proposed model to basic features of such a population. Gender, marriage and education led to differences in the relation between occupational stress and health outcomes. Conclusions: The job burden-capital model of occupational stress-depression and well-being was found to be more systematic and comprehensive than previous models. Full article
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<p>Structural equation model of Job Burden-Capital-Depression-Wellbeing.</p>
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Article
Simulation-Based Prediction of Equivalent Continuous Noises during Construction Processes
by Hong Zhang and Yun Pei
Int. J. Environ. Res. Public Health 2016, 13(8), 818; https://doi.org/10.3390/ijerph13080818 - 12 Aug 2016
Cited by 9 | Viewed by 5283
Abstract
Quantitative prediction of construction noise is crucial to evaluate construction plans to help make decisions to address noise levels. Considering limitations of existing methods for measuring or predicting the construction noise and particularly the equivalent continuous noise level over a period of time, [...] Read more.
Quantitative prediction of construction noise is crucial to evaluate construction plans to help make decisions to address noise levels. Considering limitations of existing methods for measuring or predicting the construction noise and particularly the equivalent continuous noise level over a period of time, this paper presents a discrete-event simulation method for predicting the construction noise in terms of equivalent continuous level. The noise-calculating models regarding synchronization, propagation and equivalent continuous level are presented. The simulation framework for modeling the noise-affected factors and calculating the equivalent continuous noise by incorporating the noise-calculating models into simulation strategy is proposed. An application study is presented to demonstrate and justify the proposed simulation method in predicting the equivalent continuous noise during construction. The study contributes to provision of a simulation methodology to quantitatively predict the equivalent continuous noise of construction by considering the relevant uncertainties, dynamics and interactions. Full article
(This article belongs to the Special Issue Effecting a Safe and Healthy Environment in Construction)
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<p>Illustration of overlap of multiple noises. (<b>a</b>) Before summing for <span class="html-italic">T</span><sub>3</sub>; (<b>b</b>) After summing for <span class="html-italic">T</span><sub>3</sub>.</p>
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<p>An AOOS model for predicting the noise from a foundation concreting project.</p>
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<p>Flowchart of the simulation strategy incorporated with the noise-calculating models.</p>
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<p>Illustration of each period of time <span class="html-italic">T</span> for calculating <span class="html-italic">L<sub>eq-T</sub></span> along with simulation advancement.</p>
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<p>Layout of the foundation concreting project.</p>
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Article
The Impact of Human Activities on Microbial Quality of Rivers in the Vhembe District, South Africa
by Afsatou N. Traoré, Khodani Mulaudzi, Gamuchirai J.E. Chari, Stefan H. Foord, Lutendo S. Mudau, Tobias G. Barnard and Natasha Potgieter
Int. J. Environ. Res. Public Health 2016, 13(8), 817; https://doi.org/10.3390/ijerph13080817 - 12 Aug 2016
Cited by 30 | Viewed by 9744
Abstract
Background: Water quality testing is dictated by microbial agents found at the time of sampling in reference to their acceptable risk levels. Human activities might contaminate valuable water resources and add to the microbial load present in water bodies. Therefore, the effects of [...] Read more.
Background: Water quality testing is dictated by microbial agents found at the time of sampling in reference to their acceptable risk levels. Human activities might contaminate valuable water resources and add to the microbial load present in water bodies. Therefore, the effects of human activities on the microbial quality of rivers collected from twelve catchments in the Vhembe District in South Africa were investigated, with samples analyzed for total coliform (TC) and Eschericha coli (E. coli) contents. Methods: Physical parameters and various human activities were recorded for each sampling site. The Quanti-Tray® method was adopted for the assessment of TC and E. coli contents in the rivers over a two-year period. A multiplex polymerase chain (PCR) method was used to characterize the strains of E. coli found. Results: The microbial quality of the rivers was poor with both TC and E. coli contents found to be over acceptable limits set by the South African Department of Water and Sanitation (DWS). No significant difference (p > 0.05) was detected between TC and E. coli risks in dry and wet seasons. All six pathogenic E. coli strains were identified and Enteroaggregative E. coli (EAEC), atypical Enteropathogenic E. coli (a-EPEC) and Enterotoxigenic E. coli (ETEC) were the most prevalent E. coli strains detected (respectively, 87%, 86% and 83%). Conclusions: The study indicated that contamination in the majority of sampling sites, due to human activities such as car wash, animal grazing and farming, poses health risks to communities using the rivers for various domestic chores. It is therefore recommended that more education by the respective departments is done to avert pollution of rivers and prevent health risks to the communities in the Vhembe District. Full article
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<p>The Vhembe district municipality and sampling points in the Limpopo province, South Africa.</p>
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<p>(<b>a</b>) Total Dissolved Solids (TDS mg/L); (<b>b</b>) Electrical conductivity (EC μS/cm); (<b>c</b>) pH; and (<b>d</b>) Temperature (Temp °C) determined on river water samples in 2014 and 2015.</p>
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Article
The Attitudes of Chinese Cancer Patients and Family Caregivers toward Advance Directives
by Qiu Zhang, Chuanbo Xie, Shanghang Xie and Qing Liu
Int. J. Environ. Res. Public Health 2016, 13(8), 816; https://doi.org/10.3390/ijerph13080816 - 11 Aug 2016
Cited by 17 | Viewed by 5325
Abstract
Advance directives (ADs) have been legislated in many countries to protect patient autonomy regarding medical decisions at the end of life. China is facing a serious cancer burden and cancer patients’ quality at the end of life should be a concern. However, limited [...] Read more.
Advance directives (ADs) have been legislated in many countries to protect patient autonomy regarding medical decisions at the end of life. China is facing a serious cancer burden and cancer patients’ quality at the end of life should be a concern. However, limited studies have been conducted locally to gather information about attitudes toward ADs. The purpose of this study was to investigate the attitudes of Chinese cancer patients and family caregivers toward ADs and to explore the predictors that are associated with attitudes. The study indicated that although there was low awareness of ADs, most cancer patients and family caregivers had positive attitudes toward ADs after related information was explained to them. Participants preferred to discuss ADs with medical staff when they were diagnosed with a life-threatening disease. Preferences for refusing life-sustaining treatment and choosing Hospice-Palliative Care (HPC) at the end of life would increase the likelihood of agreeing with ADs. This suggests that some effective interventions to help participants better understand end-of-life treatments are helpful in promoting ADs. Moreover, the development of HPC would contribute to Chinese cancer patients and family caregivers agreeing with ADs. Full article
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Article
Barriers to Hospital Deliveries among Ethnic Minority Women with Religious Beliefs in China: A Descriptive Study Using Interviews and Survey Data
by Peige Song, Chuyun Kang, Evropi Theodoratou, Neneh Rowa-Dewar, Xuebei Liu and Lin An
Int. J. Environ. Res. Public Health 2016, 13(8), 815; https://doi.org/10.3390/ijerph13080815 - 11 Aug 2016
Cited by 15 | Viewed by 4669
Abstract
Background: China has made great progress in improving hospital delivery-the coverage of hospital delivery has increased to above 95% in most regions- some regions lag behind owing to geographic and economic inequality, particularly the poor ethnic minority areas of the Sichuan Province. This [...] Read more.
Background: China has made great progress in improving hospital delivery-the coverage of hospital delivery has increased to above 95% in most regions- some regions lag behind owing to geographic and economic inequality, particularly the poor ethnic minority areas of the Sichuan Province. This study explores factors which may influence hospital delivery from multiple perspectives, with implications for practice and policy. Methods: A framework analysis approach was used to identify and categorize the main barriers and levers to hospital delivery. Our analysis draws on basic information from the sampled counties (Butuo and Daofu). Results: The hospital delivery rate was below 50% in the two sampled areas. In both areas, the “New Rural Cooperative Medical Scheme” and “Rural hospital delivery subsidy” were introduced, but only Butuo county had a transportation subsidy policy. Socioeconomically disadvantaged women in both counties who delivered their babies in hospitals could also apply for financial assistance. A lack of transport was among the main reasons for low hospital delivery rates in these two counties. Furthermore, while the hospital delivery costs could be mostly covered by “New Rural Cooperative Medical Scheme” or “Rural Hospital Delivery Subsidy”, reimbursement was not guaranteed. People in Daofu county might be affected by their Buddhism religion for hospital delivery. Women in Butuo following the Animism religion would refuse delivery in hospitals because of language barriers. Traditional lay beliefs were the main factor that influenced hospital delivery; their understandings of reproductive health varied, and many believed that childbirth should not be watched by strangers and that a home delivery was safe. Conclusions: This study has highlighted a number of barriers and levers to hospital delivery in rural poor ethnic minority areas which could inform and improve the access and rate of hospital delivery rate; thereby reducing health inequalities in maternal and child health in China. Full article
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<p>Location of the sampled counties.</p>
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<p>The framework of the utilization of hospital delivery care.</p>
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Article
Quantitative Detection of Trace Malachite Green in Aquiculture Water Samples by Extractive Electrospray Ionization Mass Spectrometry
by Xiaowei Fang, Shuiping Yang, Konstantin Chingin, Liang Zhu, Xinglei Zhang, Zhiquan Zhou and Zhanfeng Zhao
Int. J. Environ. Res. Public Health 2016, 13(8), 814; https://doi.org/10.3390/ijerph13080814 - 11 Aug 2016
Cited by 20 | Viewed by 6581
Abstract
Exposure to malachite green (MG) may pose great health risks to humans; thus, it is of prime importance to develop fast and robust methods to quantitatively screen the presence of malachite green in water. Herein the application of extractive electrospray ionization mass spectrometry [...] Read more.
Exposure to malachite green (MG) may pose great health risks to humans; thus, it is of prime importance to develop fast and robust methods to quantitatively screen the presence of malachite green in water. Herein the application of extractive electrospray ionization mass spectrometry (EESI-MS) has been extended to the trace detection of MG within lake water and aquiculture water, due to the intensive use of MG as a biocide in fisheries. This method has the advantage of obviating offline liquid-liquid extraction or tedious matrix separation prior to the measurement of malachite green in native aqueous medium. The experimental results indicate that the extrapolated detection limit for MG was ~3.8 μg·L−1 (S/N = 3) in lake water samples and ~0.5 μg·L−1 in ultrapure water under optimized experimental conditions. The signal intensity of MG showed good linearity over the concentration range of 10–1000 μg·L−1. Measurement of practical water samples fortified with MG at 0.01, 0.1 and 1.0 mg·L−1 gave a good validation of the established calibration curve. The average recoveries and relative standard deviation (RSD) of malachite green in lake water and Carassius carassius fish farm effluent water were 115% (6.64% RSD), 85.4% (9.17% RSD) and 96.0% (7.44% RSD), respectively. Overall, the established EESI-MS/MS method has been demonstrated suitable for sensitive and rapid (<2 min per sample) quantitative detection of malachite green in various aqueous media, indicating its potential for online real-time monitoring of real life samples. Full article
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<p>Schematic diagram of the EESI source.</p>
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<p>EESI-mass spectra of 0.1 mg·L<sup>−1</sup> malachite green obtained directly from water sample. The inset shows the MS/MS spectrum of malachite green (<span class="html-italic">m</span>/<span class="html-italic">z</span> 329).</p>
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<p>Variation of the signal intensity with the ESI voltage (<b>a</b>); sample injection rate (<b>b</b>); ion-transport capillary temperature (<b>c</b>); and nebulizing gas (N<sub>2</sub>) pressure (<b>d</b>).</p>
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<p>Dependence of the signal intensity on MG concentration in lake water.</p>
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Article
Prevailing Opinions on Connected Health in Austria: Results from an Online Survey
by Daniela Haluza, Marlene Naszay, Andreas Stockinger and David Jungwirth
Int. J. Environ. Res. Public Health 2016, 13(8), 813; https://doi.org/10.3390/ijerph13080813 - 11 Aug 2016
Cited by 27 | Viewed by 6382
Abstract
New technological developments affect almost every sector of our daily lives, including the healthcare sector. We evaluated how connected health applications, subsumed as eHealth and telemedicine, are perceived in relation to socio-demographic characteristics. The current cross-sectional, online survey collected self-reported data from a [...] Read more.
New technological developments affect almost every sector of our daily lives, including the healthcare sector. We evaluated how connected health applications, subsumed as eHealth and telemedicine, are perceived in relation to socio-demographic characteristics. The current cross-sectional, online survey collected self-reported data from a non-probability convenience sample of 562 Austrian adults (58.9% females). The concept of eHealth and telemedicine was poorly established among the study population. While most participants already used mobile devices, they expressed a quite low desirability of using various telemedicine applications in the future. Study participants perceived that the most important overall benefits for implementing connected health technology were better quality of healthcare, location-independent access to healthcare services, and better quality of life. The respective three top-ranked overall barriers were data security, lack of acceptance by doctors, and lack of technical prerequisites. With regard to aging societies, healthcare providers, and users alike could take advantage of inexpensive, consumer-oriented connected health solutions that address individual needs of specific target groups. The present survey identified issues relevant for successful implementation of ICT-based healthcare solutions, providing a compilation of several areas requiring further in-depth research. Full article
(This article belongs to the Special Issue Health Informatics and Public Health)
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Article
Parental Post-Traumatic Stress Symptoms as Predictors of Psychosocial Problems in Children Treated for Cancer
by Ryoko Nakajima-Yamaguchi, Nobuaki Morita, Tomohei Nakao, Takashi Shimizu, Yasukazu Ogai, Hideto Takahashi, Tamaki Saito, Yoji Nakatani and Takashi Fukushima
Int. J. Environ. Res. Public Health 2016, 13(8), 812; https://doi.org/10.3390/ijerph13080812 - 11 Aug 2016
Cited by 16 | Viewed by 5486
Abstract
The purpose of this study was to explore the association between psychosocial functioning of children treated for cancer and that of their parents. Factors associated with psychosocial functioning were also examined. The present study was a cross-sectional survey of 33 mothers and one [...] Read more.
The purpose of this study was to explore the association between psychosocial functioning of children treated for cancer and that of their parents. Factors associated with psychosocial functioning were also examined. The present study was a cross-sectional survey of 33 mothers and one father (mean age: 37.9), each of whom had a child that had been treated for cancer. The participants answered a package of questionnaires consisting of the Impact of Event Scale-Revised (IES-R), the Parent Experience of Child Illness (PECI), and the Child Behavior Checklist (CBCL). Information about the children’s illnesses was collected from medical records. The CBCL total problems T score was correlated with the parental IES-R total scores. Intensity of treatment independently predicted the variance of parental long-term uncertainty. In conclusion, psychosocial problems of children with cancer were associated with parental post-traumatic stress symptoms (PTSS). Provision of early, adequate support to parents who are vulnerable to PTSS will help not only the parents, but also their children with cancer. Full article
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Article
Sleep Disturbance from Road Traffic, Railways, Airplanes and from Total Environmental Noise Levels in Montreal
by Stéphane Perron, Céline Plante, Martina S. Ragettli, David J. Kaiser, Sophie Goudreau and Audrey Smargiassi
Int. J. Environ. Res. Public Health 2016, 13(8), 809; https://doi.org/10.3390/ijerph13080809 - 11 Aug 2016
Cited by 37 | Viewed by 7045
Abstract
The objective of our study was to measure the impact of transportation-related noise and total environmental noise on sleep disturbance for the residents of Montreal, Canada. A telephone-based survey on noise-related sleep disturbance among 4336 persons aged 18 years and over was conducted. [...] Read more.
The objective of our study was to measure the impact of transportation-related noise and total environmental noise on sleep disturbance for the residents of Montreal, Canada. A telephone-based survey on noise-related sleep disturbance among 4336 persons aged 18 years and over was conducted. LNight for each study participant was estimated using a land use regression (LUR) model. Distance of the respondent’s residence to the nearest transportation noise source was also used as an indicator of noise exposure. The proportion of the population whose sleep was disturbed by outdoor environmental noise in the past 4 weeks was 12.4%. The proportion of those affected by road traffic, airplane and railway noise was 4.2%, 1.5% and 1.1%, respectively. We observed an increased prevalence in sleep disturbance for those exposed to both rail and road noise when compared for those exposed to road only. We did not observe an increased prevalence in sleep disturbance for those that were both exposed to road and planes when compared to those exposed to road or planes only. We developed regression models to assess the marginal proportion of sleep disturbance as a function of estimated LNight and distance to transportation noise sources. In our models, sleep disturbance increased with proximity to transportation noise sources (railway, airplane and road traffic) and with increasing LNight values. Our study provides a quantitative estimate of the association between total environmental noise levels estimated using an LUR model and sleep disturbance from transportation noise. Full article
(This article belongs to the Special Issue The Combined Health Effects of Environmental Exposures)
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<p>Map of the study area, the island of Montreal, with potential transportation noise sources.</p>
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<p>Distance to aircraft NEF25 (<b>a</b>), major road (<b>b</b>), railways (<b>c</b>) and marginal proportions and 95% CI of sleep disturbance by railways in the weighted study sample.</p>
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<p>Marginal proportions of sleep disturbance by transportation noise according to proximity to single and combined sources of transportation noise: Airplanes (≤1000 m from NEF25 or in NEF25), roads (≤100 m from an artery or highway) and railways (≤150 m from a railway line or main line of a railroad shunting yard). See <a href="#ijerph-13-00809-t017" class="html-table">Table A16</a> for the regression model.</p>
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<p>Marginal proportions and 95% CI (confidence interval) of sleep disturbance by environmental noise (<b>a</b>); transportation noise (<b>b</b>); and road traffic in relation (<b>c</b>) to L<sub>Night</sub> estimated by the LUR noise model in the weighted study sample.</p>
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<p>Relation between predicted L<sub>Night</sub> and distance to: (<b>a</b>) NEF25; (<b>b</b>) railway; (<b>c</b>) major road.</p>
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Article
Concern about Workplace Violence and Its Risk Factors in Chinese Township Hospitals: A Cross-Sectional Study
by Kai Xing, Xue Zhang, Mingli Jiao, Yu Cui, Yan Lu, Jinghua Liu, Jingjing Zhang, Yuchong Zhao, Yanming Zhao, Ye Li, Libo Liang, Zheng Kang, Qunhong Wu and Mei Yin
Int. J. Environ. Res. Public Health 2016, 13(8), 811; https://doi.org/10.3390/ijerph13080811 - 10 Aug 2016
Cited by 39 | Viewed by 7246
Abstract
Workplace violence in Chinese township hospitals is a major public health problem. We identified the risk factors of healthcare workers’ worry about experiencing workplace violence in 90 Chinese township hospitals and determined specific measures for differing stages of violence (based on crisis management [...] Read more.
Workplace violence in Chinese township hospitals is a major public health problem. We identified the risk factors of healthcare workers’ worry about experiencing workplace violence in 90 Chinese township hospitals and determined specific measures for differing stages of violence (based on crisis management theory). Participants were 440 general practitioners and 398 general nurses from Heilongjiang Province, China (response rate 84.6%). One hundred and six (12.6%) respondents reported being physically attacked in their workplace in the previous 12 months. Regarding psychological violence, the most common type reported was verbal abuse (46.0%). While most (85.2%) respondents had some degree of worry about suffering violence, 22.1% were worried or very worried. Ordinal regression analysis revealed that being ≤35 years of age, having a lower educational level, having less work experience, and working night shifts were all associated with worry about workplace violence. Furthermore, those without experience of such violence were more likely to worry about it. Respondents’ suggested measures for controlling violence included “widening channels on medical dispute solutions,” “improving doctor-patient communication,” and “advocating for respect for medical workers via the media.” Results suggest the target factors for reducing healthcare workers’ worry by according to the type of education and training and possible measures for limiting workplace violence in township hospitals. Full article
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Article
Fuel for Life: Domestic Cooking Fuels and Women’s Health in Rural China
by Peng Nie, Alfonso Sousa-Poza and Jianhong Xue
Int. J. Environ. Res. Public Health 2016, 13(8), 810; https://doi.org/10.3390/ijerph13080810 - 10 Aug 2016
Cited by 39 | Viewed by 6577
Abstract
Background: There is evidence that household air pollution is associated with poor health in China, and that this form of air pollution may even be more of a health concern in China than the much-publicized outdoor air pollution. However, there is little [...] Read more.
Background: There is evidence that household air pollution is associated with poor health in China, and that this form of air pollution may even be more of a health concern in China than the much-publicized outdoor air pollution. However, there is little empirical evidence on the relationship between household air pollution and health in China based on nationally representative and longitudinal data. This study examines the association between the type of domestic cooking fuel and the health of women aged ≥16 in rural China. Methods: Using longitudinal and biomarker data from the China Family Panel Studies (n = 12,901) and the China Health and Nutrition Survey (n = 15,539), we investigate the impact of three major domestic cooking fuels (wood/straw, coal, liquefied petroleum gas (LPG)) on health status using both cross-sectional and panel approaches. Results: Compared to women whose households cook with dirty fuels like wood/straw, women whose households cook with cleaner fuels like LPG have a significantly lower probability of chronic or acute diseases and are more likely to report better health. Cooking with domestic coal instead of wood or straw is also associated with elevated levels of having certain risks (such as systolic blood pressure) related to cardiovascular diseases. Conclusions: Our study provides evidence that using cleaner fuels like LPG is associated with better health among women in rural China, suggesting that the shift from dirty fuels to cleaner choices may be associated with improved health outcomes. Full article
(This article belongs to the Special Issue Indoor Air Quality and Health 2016)
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<p>Temporal change of domestic cooking fuels from 1991 to 2009, China Health and Nutrition Survey. Note: LPG denotes liquefied petroleum gas and others represent electricity, kerosene, natural gas, charcoal and other unspecified fuels for cooking.</p>
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Article
Prevalence of Pre-Diabetes and Its Associated Risk Factors in Rural Areas of Ningbo, China
by Ming Zhao, Hongbo Lin, Yanyan Yuan, Fuyan Wang, Yang Xi, Li Ming Wen, Peng Shen and Shizhong Bu
Int. J. Environ. Res. Public Health 2016, 13(8), 808; https://doi.org/10.3390/ijerph13080808 - 10 Aug 2016
Cited by 34 | Viewed by 6771
Abstract
Objective: The aims of the study were to investigate the prevalence of pre-diabetes and explore its associated risk factors in rural areas of Ningbo, China. Methods: A cross-sectional survey was conducted with 4583 adult residents in rural areas of Ningbo, China [...] Read more.
Objective: The aims of the study were to investigate the prevalence of pre-diabetes and explore its associated risk factors in rural areas of Ningbo, China. Methods: A cross-sectional survey was conducted with 4583 adult residents in rural areas of Ningbo, China between March and May 2013. The survey used a multi-stage, stratified, cluster sampling method. Data collected included demographics and medical history, anthropometric measurements, blood pressure, blood lipid, and plasma glucose. After at least 10 h of overnight fasting, participants underwent an oral glucose tolerance test (OGTT) to identify pre-diabetes. Univariate and multivariate logistic regression analyses were used to evaluate the associated risk factors for pre-diabetes, and to estimate the effect of interaction between the factors. Results: There were 1307 survey participants having pre-diabetes (28.52%) and the age-standardized prevalence was 30.53%. Multivariate logistic regression results showed that overweight/obesity, hypertension, and higher triglycerides were the risk factors for developing pre-diabetes. There were positive interactions between overweight/obesity and triglycerides, and also between hypertension and triglycerides on the multiplicative scale, suggesting that they synergistically influenced the development of pre-diabetes. Conclusions: The rural areas in Ningbo had a high prevalence of pre-diabetes. Overweight and obesity, hypertension, and elevated triglycerides were the major risk factors. There is a need of early intervention for preventing pre-diabetes. Full article
(This article belongs to the Collection Health Care and Diabetes)
5111 KiB  
Article
Characteristics of Fine Particles in an Urban Atmosphere—Relationships with Meteorological Parameters and Trace Gases
by Tianhao Zhang, Zhongmin Zhu, Wei Gong, Hao Xiang and Ruimin Fang
Int. J. Environ. Res. Public Health 2016, 13(8), 807; https://doi.org/10.3390/ijerph13080807 - 10 Aug 2016
Cited by 14 | Viewed by 5143
Abstract
Atmospheric fine particles (diameter < 1 μm) attract a growing global health concern and have increased in urban areas that have a strong link to nucleation, traffic emissions, and industrial emissions. To reveal the characteristics of fine particles in an industrial city of [...] Read more.
Atmospheric fine particles (diameter < 1 μm) attract a growing global health concern and have increased in urban areas that have a strong link to nucleation, traffic emissions, and industrial emissions. To reveal the characteristics of fine particles in an industrial city of a developing country, two-year measurements of particle number size distribution (15.1 nm–661 nm), meteorological parameters, and trace gases were made in the city of Wuhan located in central China from June 2012 to May 2014. The annual average particle number concentrations in the nucleation mode (15.1 nm–30 nm), Aitken mode (30 nm–100 nm), and accumulation mode (100 nm–661 nm) reached 4923 cm−3, 12193 cm−3 and 4801 cm−3, respectively. Based on Pearson coefficients between particle number concentrations and meteorological parameters, precipitation and temperature both had significantly negative relationships with particle number concentrations, whereas atmospheric pressure was positively correlated with the particle number concentrations. The diurnal variation of number concentration in nucleation mode particles correlated closely with photochemical processes in all four seasons. At the same time, distinct growth of particles from nucleation mode to Aitken mode was only found in spring, summer, and autumn. The two peaks of Aitken mode and accumulation mode particles in morning and evening corresponded obviously to traffic exhaust emissions peaks. A phenomenon of “repeated, short-lived” nucleation events have been created to explain the durability of high particle concentrations, which was instigated by exogenous pollutants, during winter in a case analysis of Wuhan. Measurements of hourly trace gases and segmental meteorological factors were applied as proxies for complex chemical reactions and dense industrial activities. The results of this study offer reasonable estimations of particle impacts and provide references for emissions control strategies in industrial cities of developing countries. Full article
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Graphical abstract

Graphical abstract
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<p>Geographic location of experimental area and sampling site: (<b>a</b>) location of Hubei Province in China; (<b>b</b>) location of Wuhan in Hubei Province; and (<b>c</b>) location of experimental site and three air quality monitoring stations in Wuhan.</p>
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<p>Monthly variation in particle number concentrations for the three modes and monthly total precipitation, where the blank, gridded, and <b>black</b> areas represent the nucleation, Aitken, and accumulation modes, respectively, and the <b>blue</b> hollow squares represent the monthly total precipitation.</p>
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<p>Seasonal variations in wind speed (<b>a</b>); mixing layer height (<b>b</b>); temperature (<b>c</b>); and relative humidity (<b>d</b>) in Wuhan during the two-year experiment. The upper and lower edges of the boxes represent the 25th and 75th percentiles; the horizontal line and square in the box show the median and mean values, respectively; the lower and upper whiskers of each box represent the 5th and 95th percentiles, respectively; and the lower and upper crosses represent the 1st and 99th percentiles, respectively.</p>
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<p>Diurnal variations in averaged particle number concentrations in the nucleation, Aitken, and accumulation modes during the four seasons.</p>
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<p>Contour plot of the size distribution of number concentration, <math display="inline"> <semantics> <mrow> <mtext>d</mtext> <mi>N</mi> <mo>/</mo> <mi>dlog</mi> <msub> <mi>D</mi> <mi>p</mi> </msub> </mrow> </semantics> </math> in cm<sup>−3</sup> on three consecutive winter days from 3 January to 5 January 2014.</p>
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<p>Concentration of trace gases averaged from three sites and black carbon with meteorological parameters on three consecutive winter days from 3 January to 5 January 2014: (<b>a</b>) hourly variations of wind speed and mixing layer height; (<b>b</b>) hourly variations in mass concentrations of CO and black carbon; (<b>c</b>) hourly variations in mass concentrations of NO<sub>2</sub>, SO<sub>2</sub>, and O<sub>3</sub>.</p>
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