Journal of Environmental and Public Health The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Relationship between Objectively Measured Walkability and Exercise Walking among Adults with Diabetes Wed, 26 Mar 2014 09:53:23 +0000 Little is known about the relationship between objectively measured walkability and walking for exercise among adults with diabetes. Information regarding walking behavior of adults with diabetes residing in 3 Upstate New York counties was collected through an interview survey. Walkability measures were collected through an environmental audit of a sample of street segments. Overall walkability and 4 subgroup measures of walkability were aggregated at the ZIP level. Multivariate logistic regression was used for analysis. Study participants were 61.0% female, 56.7% non-Hispanic White, and 35.1% African-American, with a mean age of 62.0 years. 108 participants (51.9%) walked for exercise on community streets, and 62 (29.8%) met the expert-recommended level of walking for ≥150 minutes/week. After adjustment for age, gender, race/ethnicity, education, BMI, physical impairment, and social support for exercise, walking any minutes/week was associated with traffic safety (OR 1.34, 95% CI 1.15–1.65). Walking ≥150 minutes/week was associated with overall walkability of the community (2.65, 1.22, and 5.74), as well as sidewalks (1.73, 1.12–2.67), street amenity (2.04, 1.12–3.71), and traffic safety (1.92, 1.02–3.72). This study suggests that walkability of the community should be an integral part of the socioecologic approach to increase physical activity among adults with diabetes. Akiko S. Hosler, Mary P. Gallant, Mary Riley-Jacome, and Deepa T. Rajulu Copyright © 2014 Akiko S. Hosler et al. All rights reserved. Risk Factors of Domestic Violence in Iran Tue, 25 Mar 2014 13:36:52 +0000 Objectives. In this study, we have evaluated the lifetime and past-year prevalence of exposure to physical violence among married women in the city of Tehran and urban and rural areas of Hashtgerd. Methods. The target population were noninstitutionalized female citizens, aged 15 years or older, who have at least one history of marriage and who resided in the capital city of Tehran or Hashtgerd County from the summer of 2008 to fall of 2010. We used a multistage sampling method. Tehran’s District Six, a central district in Tehran, was selected as a representative cluster of all municipal districts in Tehran. A total of fifty blocks were randomly selected from this district, from which 1,000 married women aged 15 years or older were interviewed using a cross-sectional design. Data was gathered face-to-face using a structured questionnaire. The lifetime prevalence, past-year prevalence, and related factors of domestic violence were measured. SPSS version 11.5 was used for the analyses. Results. Figures for lifetime prevalence and past-year prevalence were measured to be 38.7% and 6.6%, respectively. The independent effects of marital status and location and type of residency for women, along with education and smoking habits of their spouses, were statistically significant in multivariate logistic regression analysis. Conclusion. Domestic violence is a public health concern in Iran. Based on our findings, we propose that empowering women through education, and improving their ability to find employment and income, along with increasing public awareness of human rights issues through education could lower the prevalence of domestic violence. M. Rasoulian, S. Habib, J. Bolhari, M. Hakim Shooshtari, M. Nojomi, and Sh. Abedi Copyright © 2014 M. Rasoulian et al. All rights reserved. Hydraulic Fracturing: Paving the Way for a Sustainable Future? Tue, 25 Mar 2014 08:32:42 +0000 With the introduction of hydraulic fracturing technology, the United States has become the largest natural gas producer in the world with a substantial portion of the production coming from shale plays. In this review, we examined current hydraulic fracturing literature including associated wastewater management on quantity and quality of groundwater. We conclude that proper documentation/reporting systems for wastewater discharge and spills need to be enforced at the federal, state, and industrial level. Furthermore, Underground Injection Control (UIC) requirements under SDWA should be extended to hydraulic fracturing operations regardless if diesel fuel is used as a fracturing fluid or not. One of the biggest barriers that hinder the advancement of our knowledge on the hydraulic fracturing process is the lack of transparency of chemicals used in the practice. Federal laws mandating hydraulic companies to disclose fracturing fluid composition and concentration not only to federal and state regulatory agencies but also to health care professionals would encourage this practice. The full disclosure of fracturing chemicals will allow future research to fill knowledge gaps for a better understanding of the impacts of hydraulic fracturing on human health and the environment. Jiangang Chen, Mohammed H. Al-Wadei, Rebekah C. M. Kennedy, and Paul D. Terry Copyright © 2014 Jiangang Chen et al. All rights reserved. Residential Relocation by Older Adults in Response to Incident Cardiovascular Health Events: A Case-Crossover Analysis Sun, 23 Mar 2014 08:54:30 +0000 Objective. We use a case-crossover analysis to explore the association between incident cardiovascular events and residential relocation to a new home address. Methods. We conducted an ambidirectional case-crossover analysis to explore the association between incident cardiovascular events and residential relocation to a new address using data from the Cardiovascular Health Study (CHS), a community-based prospective cohort study of 5,888 older adults from four U.S. sites beginning in 1989. Relocation was assessed twice a year during follow-up. Event occurrences were classified as present or absent for the period preceding the first reported move, as compared with an equal length of time immediately prior to and following this period. Results. Older adults (65+) that experience incident cardiovascular disease had an increased probability of reporting a change of residence during the following year (OR 1.6, 95% confidence interval (CI) = 1.2–2.1). Clinical conditions associated with relocation included stroke (OR: 2.0, 95% CI: 1.2–3.3), angina (OR: 1.6, 95% CI: 1.0–2.6), and congestive heart failure (OR: 1.5, 95% CI: 1.0–2.1). Conclusions. Major incident cardiovascular disease may increase the probability of residential relocation in older adults. Case-crossover analyses represent an opportunity to investigate triggering events, but finer temporal resolution would be crucial for future research on residential relocations. Gina S. Lovasi, John M. Richardson, Carlos J. Rodriguez, Willem J. Kop, Ali Ahmed, Arleen F. Brown, Heather Greenlee, and David S. Siscovick Copyright © 2014 Gina S. Lovasi et al. All rights reserved. PFAAs in Fish and Other Seafood Products from Icelandic Waters Thu, 20 Mar 2014 17:41:32 +0000 Perfluorinatedalkyl acids (PFAAs) are of growing concern due to possible health effects on humans. Exposure assessments indicate that fish consumption is one of the major sources of perfluorooctane sulfonate (PFOS) exposure to humans, one of the major PFASs, whereas concerns of overestimation of this exposure source have been raised. Therefore, PFAAs concentrations in fish from the North Atlantic (Icelandic fishing grounds) in the flesh of different fish species were investigated along with more detailed analyses of tissue concentrations in cod (Gadus morhua) and lumpfish (Cyclopterus lumpus). Further, fish feed was investigated as a possible source of PFAAs in aquaculture by examining fish meal as feed ingredient. No PFAAs were detected in the edible part of all fish samples, except for PFOS in pollock (Pollachius virens, 0,05 ng/g wet weight). PFOS was the only PFAA detected in the fish meal samples with the exception of PFOSA in blue whiting (Micromesistius poutassou) meal (0,45 ng/g dry weight (d.w.)), where the PFOS concentration was 1,3–13 ng/g d.w. in the capelin (Mallotus villosus) and mackerel (Scomber scombrus) meal samples. The conclusions of the study are that fish commonly consumed from the Icelandic fishing grounds are unlikely to be an important source of PFAAs exposure. Hrönn Jörundsdóttir, Thorhallur I. Halldorsson, and Helga Gunnlaugsdottir Copyright © 2014 Hrönn Jörundsdóttir et al. All rights reserved. Evaluation of Trace Metal Content by ICP-MS Using Closed Vessel Microwave Digestion in Fresh Water Fish Thu, 13 Mar 2014 12:00:02 +0000 The objective of the present study was to investigate trace metal levels of different varieties of fresh water fish using Inductively Coupled Plasma Mass Spectrophotometer after microwave digestion (MD-ICPMS). Fish samples were collected from the outlets of twin cities of Hyderabad and Secunderabad. The trace metal content in different varieties of analyzed fish were ranged from 0.24 to 1.68 mg/kg for Chromium in Cyprinus carpio and Masto symbollon, 0.20 to 7.52 mg/kg for Manganese in Labeo rohita and Masto symbollon, 0.006 to 0.07 mg/kg for Cobalt in Rastrelliger kanagurta and Pampus argenteus, 0.31 to 2.24 mg/kg for Copper in Labeo rohita and Penaeus monodon, 3.25 to 14.56 mg/kg for Zinc in Cyprinus carpio and Macrobrachium rosenbergii, and 0.01 to 2.05 mg/kg for Selenium in Rastrelliger kanagurta and Pampus argenteus, respectively. Proximate composition data for the different fishes were also tabulated. Since the available data for different trace elements for fish is scanty, here an effort is made to present a precise data for the same as estimated on ICP-MS. Results were in accordance with recommended daily intake allowance by WHO/FAO. Sreenivasa Rao Jarapala, Bhaskarachary Kandlakunta, and Longvah Thingnganing Copyright © 2014 Sreenivasa Rao Jarapala et al. All rights reserved. Industrially Contaminated Sites and Health Tue, 11 Mar 2014 12:43:37 +0000 Marco Martuzzi, Roberto Pasetto, and Piedad Martin-Olmedo Copyright © 2014 World Health Organization. All rights reserved. Neonates in Ahmedabad, India, during the 2010 Heat Wave: A Climate Change Adaptation Study Mon, 10 Mar 2014 16:09:44 +0000 Health effects from climate change are an international concern with urban areas at particular risk due to urban heat island effects. The burden of disease on vulnerable populations in non-climate-controlled settings has not been well studied. This study compared neonatal morbidity in a non-air-conditioned hospital during the 2010 heat wave in Ahmedabad to morbidity in the prior and subsequent years. The outcome of interest was neonatal intensive care unit (NICU) admissions for heat. During the months of April, May, and June of 2010, 24 NICU admissions were for heat versus 8 and 4 in 2009 and 2011, respectively. Both the effect of moving the maternity ward and the effect of high temperatures were statistically significant, controlling for each other. Above 42 degrees Celsius, each daily maximum temperature increase of a degree was associated with 43% increase in heat-related admissions (95% CI 9.2–88%). Lower floor location of the maternity ward within hospital which occurred after the 2010 heat wave showed a protective effect. These findings demonstrate the importance of simple surveillance measures in motivating a hospital policy change for climate change adaptation—here relocating one ward—and the potential increasing health burden of heat in non-climate-controlled institutions on vulnerable populations. Khyati Kakkad, Michelle L. Barzaga, Sylvan Wallenstein, Gulrez Shah Azhar, and Perry E. Sheffield Copyright © 2014 Khyati Kakkad et al. All rights reserved. Workplace-Related Traumatic Injuries: Insights from a Rapidly Developing Middle Eastern Country Wed, 05 Mar 2014 15:22:26 +0000 Traumatic workplace-related injuries (WRIs) carry a substantial negative impact on the public health worldwide. We aimed to study the incidence and outcomes of WRIs in Qatar. We conducted occupational injury surveillance for all WRI patients between 2010 and 2012. A total of 5152 patients were admitted to the level 1 trauma unit in Qatar, of which 1496 (29%) sustained WRI with a mean age of . Fall from height (FFH) (51%) followed by being struck by heavy objects (FHO) (18%) and motor vehicle crashes (MVC) (17%) was the commonest mechanism of injury (MOI). WRI patients were mainly laborers involved in industrial work (43%), transportation (18%), installation/repair (12%), carpentry (9%), and housekeeping (3%). Use of protective device was not observed in 64% of cases. The mean ISS was , median ICU stay was 3 days (1–64), and total hospital stay was 6 days (1–192). The overall case fatality was 3.7%. Although the incidence of WRI in Qatar is quite substantial, its mortality rate is relatively low in comparison to other countries of similar socioeconomic status. Prolonged hospital stay and treatment exert a significant socioeconomic burden on the nation’s and families’ resources. Focused and efficient injury prevention strategies are mandatory to prevent future WRI. Hassan Al-Thani, Ayman El-Menyar, Husham Abdelrahman, Ahmad Zarour, Rafael Consunji, Ruben Peralta, Mohammad Asim, Hany El-Hennawy, Ashok Parchani, and Rifat Latifi Copyright © 2014 Hassan Al-Thani et al. All rights reserved. Ambient Particulate Matter Air Pollution in Mpererwe District, Kampala, Uganda: A Pilot Study Mon, 17 Feb 2014 15:30:09 +0000 Air quality in Kampala, the capital of Uganda, has deteriorated significantly in the past two decades. We made spot measurements in Mpererwe district for airborne particulate matter PM2.5 (fine particles) and coarse particles. PM was collected on Teflon-membrane filters and analyzed for mass, 51 elements, 3 anions, and 5 cations. Both fine and coarse particle concentrations were above 100 µg/m3 in all the samples collected. Markers for crustal/soil (e.g., Si and Al) were the most abundant in the PM2.5 fraction, followed by primary combustion products from biomass burning and incinerator emissions (e.g., K and Cl). Over 90% of the measured PM2.5 mass can be explained by crustal species (41% and 59%) and carbonaceous aerosol (33%–55%). Crustal elements dominated the coarse particles collected from Kampala. The results of this pilot study are indicative of unhealthy air and suggest that exposure to ambient air in Kampala may increase the burden of environmentally induced cardiovascular, metabolic, and respiratory diseases including infections. Greater awareness and more extensive research are required to confirm our findings, to identify personal exposure and pollution sources, and to develop air quality management plans and policies to protect public health. Stephan Schwander, Clement D. Okello, Juergen Freers, Judith C. Chow, John G. Watson, Melody Corry, and Qingyu Meng Copyright © 2014 Stephan Schwander et al. All rights reserved. Comprehensive Planning for Classification and Disposal of Solid Waste at the Industrial Parks regarding Health and Environmental Impacts Thu, 13 Feb 2014 16:04:44 +0000 The aim of this study is the comprehensive planning for integrated management of solid waste at the industrial parks. The share of each industrial group including food, metal, chemical, non-metallic minerals, textile, electrical and electronical, and cellulose industries were 48.2, 14.9, 6.7, 22, 0.9, 0.6, and 6.5 percent, respectively. The results showed that nearly half of total industrial waste produced from the range of biological materials are biodegradable and discharging them without observing environmental regulations leads to short-term pollution and nuisance in the acceptor environment. Also some parts of case study waste were recyclable which is considerable from viewpoint of economical and environmental pollution. Long-term impacts will appear due to improper site selection of disposal from the spatial standpoint. In this way, an approach for site selection using several socioeconomic, physical, and environmental criteria based on multicriteria decision making model (MCDM) is introduced. Health risks and environment pollution such as soil and surface water may be done. It is essential to revise the studied industries layout, particularly those units which produce special waste which should be more cautious. Also stricter enforcement is required as an effective step in reducing the harmful impacts of it. Hassan Hashemi, Hamidreza Pourzamani, and Bahareh Rahmani Samani Copyright © 2014 Hassan Hashemi et al. All rights reserved. Blood Politics, Ethnic Identity, and Racial Misclassification among American Indians and Alaska Natives Mon, 10 Feb 2014 12:48:41 +0000 Misclassification of race in medical and mortality records has long been documented as an issue in American Indian/Alaska Native data. Yet, little has been shared in a cohesive narrative which outlines why misclassification of American Indian/Alaska Native identity occurs. The purpose of this paper is to provide a summary of the current state of the science in racial misclassification among American Indians and Alaska Natives. We also provide a historical context on the importance of this problem and describe the ongoing political processes that both affect racial misclassification and contribute to the context of American Indian and Alaska Native identity. Emily A. Haozous, Carolyn J. Strickland, Janelle F. Palacios, and Teshia G. Arambula Solomon Copyright © 2014 Emily A. Haozous et al. All rights reserved. Agent Orange Footprint Still Visible in Rural Areas of Central Vietnam Mon, 03 Feb 2014 14:28:29 +0000 Levels of polychlorinated dioxins/furans (PCDD/PCDF) in selected environmental samples (soils, sediments, fish, and farm animals) were analyzed from the area of Phong My commune (Thua Thien-Hue province, Vietnam). This area was affected by Agent Orange spraying during the Vietnam war (1968–1971). Whereas PCDD/PCDF content in soil and sediment samples is relatively low and ranges between 0.05 and 5.1 pg WHO-TEQ/g for soils and between 0.7 and 6.4 pg WHO-TEQ/g for sediments, the PCDD/PCDF content in poultry muscle and liver in most cases exceeded the maximum permissible limit of dioxin content per unit fat mass. In some cases of soil and sediments samples, 2,3,7,8-TCDD represented more than 90% of the total PCDD/PCDF, which indicates Agent Orange as the main source. Jan Banout, Ondrej Urban, Vojtech Musil, Jirina Szakova, and Jiri Balik Copyright © 2014 Jan Banout et al. All rights reserved. Urinary Polycyclic Aromatic Hydrocarbon Metabolites and Attention/Deficit Hyperactivity Disorder, Learning Disability, and Special Education in U.S. Children Aged 6 to 15 Thu, 30 Jan 2014 10:04:36 +0000 Exposure to polycyclic aromatic hydrocarbons (PAHs) adversely affects child neurodevelopment, but little is known about the relationship between PAHs and clinically significant developmental disorders. We examined the relationship between childhood measures of PAH exposure and prevalence of attention deficit/hyperactivity disorder (ADHD), learning disability (LD), and special education (SE) in a nationally representative sample of 1,257 U.S. children 6–15 years of age. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2001–2004. PAH exposure was measured by urinary metabolite concentrations. Outcomes were defined by parental report of (1) ever doctor-diagnosed ADHD, (2) ever doctor- or school representative-identified LD, and (3) receipt of SE or early intervention services. Multivariate logistic regression accounting for survey sampling was used to determine the associations between PAH metabolites and ADHD, LD, and SE. Children exposed to higher levels of fluorine metabolites had a 2-fold increased odds (95% C.I. 1.1, 3.8) of SE, and this association was more apparent in males (OR 2.3; 95% C.I. 1.2, 4.1) than in females (OR 1.8; 95% C.I. 0.6, 5.4). No other consistent pattern of developmental disorders was associated with urinary PAH metabolites. However, concurrent exposure to PAH fluorine metabolites may increase use of special education services among U.S. children. Zaynah Abid, Ananya Roy, Julie B. Herbstman, and Adrienne S. Ettinger Copyright © 2014 Zaynah Abid et al. All rights reserved. Heavy Metals in Water and Sediment: A Case Study of Tembi River Wed, 29 Jan 2014 00:00:00 +0000 This study was carried out to examine heavy metals concentration in water and sediment of upstream and downstream of the entry of the sewage to the Tembi River, Iran. Samples were collected from upstream and downstream and were analyzed for Cd, Cr, Cu, Fe, Pb, Ni, and Zn by atomic absorption spectrophotometer. The results indicated that the average concentration of the metals in water and sediment on downstream was more than that of upstream. The comparison of the mean concentrations of heavy metals in water of the Tembi River with drinking water standards and those in the water used for agriculture suggests that the mean concentration of Cu and Zn lies within the standard range for drinking water and the mean concentration of Mn, Zn, and Pb lies within the standard range of agricultural water. The highest average concentration on downstream for Pb in water and for Mn in sediment was 1.95 and 820.5 ppm, respectively. Also, the lowest average concentration on upstream was identified for Cd in water and sediment 0.07 and 10 ppm, respectively. With regard to the results, it gets clear that using the water for recreational purposes, washing, and fishing is detrimental to human health and the environment. Saeed Shanbehzadeh, Marzieh Vahid Dastjerdi, Akbar Hassanzadeh, and Toba Kiyanizadeh Copyright © 2014 Saeed Shanbehzadeh et al. All rights reserved. Impact of Water, Sanitation, and Hygiene Interventions on Improving Health Outcomes among School Children Sat, 28 Dec 2013 00:00:00 +0000 Purpose. This review was done to explore the impact of water treatment, hygiene, and sanitary interventions on improving child health outcomes such as absenteeism, infections, knowledge, attitudes, and practices and adoption of point-of-use water treatment. Methods. A literature search was conducted using the databases PubMed and Google scholar for studies published between 2009 and 2012 and focusing on the effects of access to safe water, hand washing facilities, and hygiene education among school-age children. Studies included were those that documented the provision of water and sanitation in schools for children less than 18 years of age, interventions which assessed WASH practices, and English-language, full-text peer reviewed papers. Results. Fifteen studies were included in the final analysis. 73% () of the studies were conducted in developing countries and were rural based (53%, ). The child's age, gender, grade level, socioeconomic index, access to hygiene and sanitary facilities, and prior knowledge of hygiene practices were significantly associated with the outcomes. Nutrition practices which are key factors associated with the outcomes were rarely assessed. Conclusion. Further research is required to assess the long-term impact of such interventions in different settings. Ashish Joshi and Chioma Amadi Copyright © 2013 Ashish Joshi and Chioma Amadi. All rights reserved. Environment and Health in Contaminated Sites: The Case of Taranto, Italy Tue, 24 Dec 2013 09:00:12 +0000 The National Environmental Remediation programme in Italy includes sites with documented contamination and associated potential health impacts (National Priority Contaminated Sites—NPCSs). SENTIERI Project, an extensive investigation of mortality in 44 NPCSs, considered the area of Taranto, a NPCS where a number of polluting sources are present. Health indicators available at municipality level were analyzed, that is, mortality (2003–2009), mortality time trend (1980–2008), and cancer incidence (2006-2007). In addition, the cohort of individuals living in the area was followed up to evaluate mortality (1998–2008) and morbidity (1998–2010) by district of residence. The results of the study consistently showed excess risks for a number of causes of death in both genders, among them: all causes, all cancers, lung cancer, and cardiovascular and respiratory diseases, both acute and chronic. An increased infant mortality was also observed from the time trends analysis. Mortality/morbidity excesses were detected in residents living in districts near the industrial area, for several disorders including cancer, cardiovascular, and respiratory diseases. These coherent findings from different epidemiological approaches corroborate the need to promptly proceed with environmental cleanup interventions. Most diseases showing an increase in Taranto NPCS have a multifactorial etiology, and preventive measures of proven efficacy (e.g., smoking cessation and cardiovascular risk reduction programs, breast cancer screening) should be planned. The study results and public health actions are to be communicated objectively and transparently so that a climate of confidence and trust between citizens and public institutions is maintained. Roberta Pirastu, Pietro Comba, Ivano Iavarone, Amerigo Zona, Susanna Conti, Giada Minelli, Valerio Manno, Antonia Mincuzzi, Sante Minerba, Francesco Forastiere, Francesca Mataloni, and Annibale Biggeri Copyright © 2013 Roberta Pirastu et al. All rights reserved. Traditional Coping Strategies and Disaster Response: Examples from the South Pacific Region Mon, 23 Dec 2013 11:24:17 +0000 The Pacific Islands are vulnerable to climate change and increased risk of disasters not only because of their isolated and often low lying geographical setting but because of their economic status which renders them reliant on donor support. In a qualitative study exploring the adaptive capacity of Pacific Island Countries (PICs) across four countries, Cook Islands, Fiji, Samoa, and Vanuatu, it was clear that traditional coping strategies are consistently being applied as part of response to disasters and climate changes. This paper describes five common strategies employed in PICs as understood through this research: recognition of traditional methods; faith and religious beliefs; traditional governance and leadership; family and community involvement; and agriculture and food security. While this study does not trial the efficacy of these methods, it provides an indication of what methods are being used and therefore a starting point for further research into which of these traditional strategies are beneficial. These findings also provide important impetus for Pacific Island governments to recognise traditional approaches in their disaster preparedness and response processes. Stephanie M. Fletcher, Jodi Thiessen, Anna Gero, Michele Rumsey, Natasha Kuruppu, and Juliet Willetts Copyright © 2013 Stephanie M. Fletcher et al. All rights reserved. Exposure to Celebrity-Endorsed Small Cigar Promotions and Susceptibility to Use among Young Adult Cigarette Smokers Sun, 24 Nov 2013 15:18:00 +0000 Small cigar smoking among young adult cigarette smokers may be attributed to their exposure to its advertisements and promotions. We examined the association between exposure to a celebrity music artist’s endorsement of a specific brand of small cigars and young adult cigarette smokers’ susceptibility to smoking that brand. Venue-based sampling procedures were used to select and survey a random sample of 121 young adult cigarette smokers, aged 18–35. Fourteen percent reported exposure to the artist’s endorsement of the small cigar and 45.4% reported an intention to smoke the product in the future. The odds of small cigar smoking susceptibility increased threefold for those who reported exposure to the endorsement compared to those not exposed (OR = 3.64, 95% CI 1.06 to 12.54). Past 30-day small cigar use (OR = 3.30, 95% CI 1.24 to 8.74) and past 30-day cigar use (OR = 5.08, 95% CI 1.23, 21.08) were also associated with susceptibility to smoke a small cigar. An association between young adult cigarette smokers’ exposure to the music artist’s small cigar endorsement and their susceptibility to smoke small cigars was found. This association underscores the importance of monitoring small cigar promotions geared toward young people and their impact on small cigar product smoking. Kymberle L. Sterling, Roland S. Moore, Nicole Pitts, Melissa Duong, Kentya H. Ford, and Michael P. Eriksen Copyright © 2013 Kymberle L. Sterling et al. All rights reserved. The Attitudes and Intention to Participate in Hemoglobinopathy Carrier Screening in The Netherlands among Individuals from Turkish, Moroccan, and Surinamese Descent Sun, 17 Nov 2013 17:14:06 +0000 Objective. To explore factors that influence intention to participate in hemoglobinopathy (HbP) carrier screening under Dutch subjects at risk, since HbP became more common in The Netherlands. Method. Structured interviews with 301 subjects from Turkish, Moroccan, or Surinamese ethnicity. Results. Half of the participants were familiar with HbP, 27% with carrier screening. Only 55% correctly answered basic knowledge items. After balanced information, 83% percent of subjects express intention to participate in HbP carrier screening. Intention to participate was correlated with (1) anticipated negative feelings, (2) valuing a physician's advice, and (3) beliefs on significance of carrier screening. Risk perception was a significant determinant, while respondents were unaware of HbP as endemic in their country of birth. Respondents preferred screening before pregnancy and at cost < 50€. Conclusion. These findings show the importance of informing those at risk by tailored health education. We propose easy access at no costs for those willing to participate in HbP carrier screening. Sylvia M. van der Pal, Nicole M. C. van Kesteren, Jacobus P. van Wouwe, Paula van Dommelen, and Symone B. Detmar Copyright © 2013 Sylvia M. van der Pal et al. All rights reserved. Lung Cancer Risk and Past Exposure to Emissions from a Large Steel Plant Wed, 13 Nov 2013 17:25:47 +0000 We studied the spatial distribution of cancer incidence rates around a large steel plant and its association with historical exposure. The study population was close to 600,000. The incidence data was collected for 1995–2006. From historical emission data the air pollution concentrations for polycyclic aromatic hydrocarbons (PAH) and metals were modelled. Data were analyzed using Bayesian hierarchical Poisson regression models. The standardized incidence ratio (SIR) for lung cancer was up to 40% higher than average in postcodes located in two municipalities adjacent to the industrial area. Increased incidence rates could partly be explained by differences in socioeconomic status (SES). In the highest exposure category (approximately 45,000 inhabitants) a statistically significant increased relative risk (RR) of 1.21 (1.01–1.43) was found after adjustment for SES. The elevated RRs were similar for men and women. Additional analyses in a subsample of the population with personal smoking data from a recent survey suggested that the observed association between lung cancer and plant emission, after adjustment for SES, could still be caused by residual confounding. Therefore, we cannot indisputably conclude that past emissions from the steel plant have contributed to the increased risk of lung cancer. Oscar Breugelmans, Caroline Ameling, Marten Marra, Paul Fischer, Jan van de Kassteele, Johannes Lijzen, Arie Oosterlee, Rinske Keuken, Otto Visser, Danny Houthuijs, and Carla van Wiechen Copyright © 2013 Oscar Breugelmans et al. All rights reserved. The Effect of Active Transport, Transport Systems, and Urban Design on Population Health Mon, 04 Nov 2013 14:01:06 +0000 Li Ming Wen, Chris Rissel, and Hua Fu Copyright © 2013 Li Ming Wen et al. All rights reserved. Pollutants Source Control and Health Effects Thu, 31 Oct 2013 11:02:04 +0000 Roya Kelishadi, Mohammad Mehdi Amin, Ali Akbar Haghdoost, Ajay K. Gupta, and Tuula Anneli Tuhkanen Copyright © 2013 Roya Kelishadi et al. All rights reserved. Relationship between Lighting and Noise Levels and Productivity of the Occupants in Automotive Assembly Industry Tue, 22 Oct 2013 15:52:35 +0000 Work environment affects human productivity and his performance. The aims of this study were to investigate the effects of lighting and noise levels on human productivity in the automotive assembly industry. Method. Subjects were 181 workers from different parts of an automobile assembly industry. Illuminance (Lx) at the height of 30 inches from the surface of work station and noise (dBA) were locally measured. Also human productivity by the Goldsmith and Hersey scale (1980) was measured. Data were analyzed by using SPSS v20 Pearson correlation coefficient. Results. The results showed that the relationship between noise level and human productivity is negative and significant (, ), but there was no significant relationship between lighting and human productivity (). Conclusion. Based on the results, in assembly tasks, noise has a negative impact on human productivity, and lighting does not affect this. So, in order to increase employee productivity, noise control and reduction to less than the standard values (less than 85 dB) is necessary. Jafar Akbari, Habibollah Dehghan, Hiva Azmoon, and Farhad Forouharmajd Copyright © 2013 Jafar Akbari et al. All rights reserved. Water, Sanitation, and Public Health Tue, 24 Sep 2013 11:50:30 +0000 Niyi Awofeso, Boo Kwa, and Stephen Peckham Copyright © 2013 Niyi Awofeso et al. All rights reserved. Assessment of Lead and Cadmium Levels in Frequently Used Cosmetic Products in Iran Mon, 23 Sep 2013 08:32:03 +0000 This study aims to investigate the content of lead and cadmium in most frequently used brands of cosmetic products (lipstick and eye shadow) in Iran. Fifty samples of lipstick (5 colors in 7 brands) and eye shadow (3 colors in 5 brands) were selected taken from large cosmetic stores in Isfahan (Iran) and lead and cadmium of them were analyzed. The results showed that the concentration of lead and cadmium in the lipsticks was within the range of 0.08–5.2 µg/g and 4.08–60.20 µg/g, respectively. The eye shadow samples had a lead level of 0.85–6.90 µg/g and a cadmium level of 1.54–55.59 µg/g. The content range of the heavy metals in the eye shadows was higher than that of the lipsticks. There was significant difference between the average of the lead content in the different brands of the lipsticks and eye shadows. Thus, the continuous use of these cosmetics can increase the absorption of heavy metals, especially Cd and Pb, in the body when swallowing lipsticks or through dermal cosmetic absorption. The effects of heavy metals such as lead can be harmful, especially for pregnant women and children. Therefore, effort must be made to inform the users and the general public about the harmful consequences of cosmetics. H. Nourmoradi, M. Foroghi, M. Farhadkhani, and M. Vahid Dastjerdi Copyright © 2013 H. Nourmoradi et al. All rights reserved. Food Marketing Targeting Youth and Families: What Do We Know about Stores Where Moms Actually Shop? Mon, 16 Sep 2013 10:47:49 +0000 Although efforts are underway to examine marketing that targets the youth and families in the retail food store environment, few studies have specifically focused on stores that families identify as their primary sites for food shopping. Between November 2011 and April 2012, we examined the frequency and types of marketing techniques of 114 packaged and nonpackaged items in 24 food stores that mothers of young children in Champaign County, IL, said they commonly frequented. Chi-square tests were used to determine whether significant differences existed between items with regard to marketing by store type, store food-assistance-program acceptance (i.e., WIC), and claims. Overall, stores accepting WIC and convenience stores had higher frequencies of marketing compared to non-WIC and grocery stores. Fruits and vegetables had the lowest frequency of any marketing claim, while salty snacks and soda had the highest frequency of marketing claims. Nutrition claims were the most common across all items, followed by taste, suggested use, fun, and convenience. Television tie-ins and cartoons were observed more often than movie tie-ins and giveaways. Our results suggest an opportunity to promote healthful items more efficiently by focusing efforts on stores where mothers actually shop. Diana S. Grigsby-Toussaint and Mary R. Rooney Copyright © 2013 Diana S. Grigsby-Toussaint and Mary R. Rooney. All rights reserved. A Preliminary Assessment of Dispersion Level of SO2 in Fars Industrial Region, South of Iran, by GIS Thu, 12 Sep 2013 11:20:06 +0000 The city of Zarghan is located 25 km northeast of Shiraz, southern Iran. Zarghan is affected by numerous pollution sources such as oil refinery, an industrial park, and Shiraz-Tehran highway. The numerous contaminating sources around Zarghan can cause serious local air pollution. Sulfur dioxide gas is an important index of air pollution in cities. Therefore, in order to control and manage Zarghan air quality, it is important to monitor sulfur dioxide concentration in the surrounding area. It is also essential to know about the contribution level of other sources of pollution as well as dispersion radius of pollutants in the area. In this study, the concentration of sulfur dioxide was measured by passive sampling at 10 different stations. These values were interpolated in other parts of the city using ArcGIS software. The results of sampling showed that the concentration of the gas was 60 µgm−3 around oil refinery. The level was 19 µgm−3 in region located about 3 km from the oil refinery. It was also demonstrated that the gas concentration was not higher than the standard limit within residential area. On the other hand, the role of the local highway and industrial park was not significant in contaminating air in urban areas. Mansooreh Dehghani, Mohammad Mehdi Taghizadeh, Hassan Hashemi, and Ebrahim Rastgoo Copyright © 2013 Mansooreh Dehghani et al. All rights reserved. Active Commuting among K-12 Educators: A Study Examining Walking and Biking to Work Sun, 08 Sep 2013 10:09:43 +0000 Background. Walking and biking to work, active commuting (AC) is associated with many health benefits, though rates of AC remain low in the US. K-12 educators represent a significant portion of the workforce, and employee health and associated costs may have significant economic impact. Therefore, the purpose of this study was to examine the current rates of AC and factors associated with AC among K-12 educators. Methods. A volunteer sample of K-12 educators () was recruited to participate in an online survey. Participants responded about AC patterns and social ecological influences on AC (individual, interpersonal, institutional, community, and environmental factors). -tests and ANOVAs examined trends in AC, and Pearson correlations examined the relationship between AC and dependent variables. Multiple regression analysis determined the relative influence of individual, interpersonal, institutional, community, and environmental levels on AC. Results. Participants actively commuted times/week. There were several individual, interpersonal, institutional, community, and environmental factors significantly related to AC. The full model explained 60.8% of the variance in AC behavior. Conclusions. This study provides insight on the factors that determine K-12 educators mode of commute and provide some insight for employee wellness among this population. Melissa Bopp, Tanis J. Hastmann, and Alyssa N. Norton Copyright © 2013 Melissa Bopp et al. All rights reserved. Efficiency of Constructed Wetland Vegetated with Cyperus alternifolius Applied for Municipal Wastewater Treatment Tue, 20 Aug 2013 14:03:11 +0000 The treatment of municipal wastewater from Yazd city (center of Iran) by constructed wetland vegetated with Cyperus alternifolius was assessed. Two identical wetlands with a total working volume of 60 L and 10 cm sandy layer at the bottom were used. First wetland (W1) was control and had no Cyperus alternifolius plant. Second wetland (W2) had 100 Cyperus alternifolius shrubs with 40 cm height. Influent wastewater was provided from Yazd's septic tanks effluents and after a 4-day retention time in wetlands, reactors effluent was sampled for parameters analysis. Results show that chemical oxygen demand (COD), –N, –N, and –P in W1 were reduced to 72%, 88%, 32%, and 0.8%, and in W2, these parameters were removed in values of 83%, 81%, 47%, and 10%, respectively. In both wetlands, the highest and lowest removal efficiencies were related to COD and phosphorus, respectively. Also, the removed phosphorus can be released to stream when the soil saturated or influent phosphorus decreased and when the plant died. After a 4-day-retention time, the W2 wetland showed a statistically significantly lower COD and –N in comparison with W2 wetland. Asghar Ebrahimi, Ensiyeh Taheri, Mohammad Hassan Ehrampoush, Sara Nasiri, Fatemeh Jalali, Rahele Soltani, and Ali Fatehizadeh Copyright © 2013 Asghar Ebrahimi et al. All rights reserved.