Journal of Environmental and Public Health The latest articles from Hindawi © 2018 , Hindawi Limited . All rights reserved. A Review of Roof Harvested Rainwater in Australia Sun, 21 Jan 2018 07:53:56 +0000 To address concern regarding water sustainability, the Australian Federal Government and many state governments have implemented regulatory mechanisms and incentives to support households to purchase and install rainwater harvesting systems. This has led to an increase in rainwater harvesting in regional and urban Australia. This review examines the implementation of the regulatory mechanisms across Australia. In addition, the literature investigating the potential health consequences of rainwater consumption in Australia was explored. Studies demonstrated that although trace metals such as arsenic, cadmium, chromium, lead, and iron were present in Australian rainwater, these metallic elements were generally found below the health limit guideline, except in high industrial areas. In addition, pathogenic or indicator microorganisms that include, but are not limited to, Escherichia coli, total and faecal coliforms, Campylobacter, Salmonella, Legionella, Pseudomonas, Cryptosporidium, Enterococci, Giardia, Aeromonas, and Mycobacterium avium Complex (MAC) have been detected in rainwater collected in Australia. However, epidemiological evidence suggests that drinking rainwater does not increase the risk of gastrointestinal disease. It was also identified that there is a need for further research investigating the potential for rainwater to be a source of infection for opportunistic pathogens. Chirhakarhula E. Chubaka, Harriet Whiley, John W. Edwards, and Kirstin E. Ross Copyright © 2018 Chirhakarhula E. Chubaka et al. All rights reserved. Long-Term Effects of Environmental Lead Exposure on Blood Pressure and Plasma Soluble Cell Adhesion Molecules in Young Adults: A Follow-Up Study of a Prospective Cohort in Kosovo Mon, 08 Jan 2018 09:47:18 +0000 Background and Aims. Epidemiologic studies examining the relationship between environmental lead (Pb) exposure and blood pressure (BP) generally report small associations between blood lead concentration (BPb) and BP. However, these studies are predominantly cross-sectional. In addition, no epidemiologic studies evaluate associations between either current or past Pb exposure and serum levels of markers of systemic inflammation and endothelial dysfunction, including soluble vascular adhesion molecule (sVCAM-1) and soluble intercellular cell adhesion molecule (sICAM-1). We prospectively investigate these associations later in life. Methods. From our original prospective birth cohort study in Mitrovica (a mining town) and Prishtina (a control town), Kosovo, from 1985 to 1998, we located and assessed BPb and BP in 101 participants (mean age of 24.9 years old) in 2011. Results. We found highly statistically significant association between concurrent BPb and sVCAM-1 in men and a marginally significant association between concurrent PBb and sICAM.-1 in women. We did not find evidence of mediation. Conclusion. Current study results, along with previously reported findings on this cohort, provide evidence for the hypothesis that exposure to Pb leads to small increases in sBP and perhaps to increased circulating levels of sVCAM-1 and sICAM-1 later in life. Pashko R. Camaj, Joseph H. Graziano, Emine Preteni, Dusan Popovac, Nancy LoIacono, Olgica Balac, and Pam Factor-Litvak Copyright © 2018 Pashko R. Camaj et al. All rights reserved. Racial/Ethnic Differences in the Modifying Effect of Community Violence on the Association between Paternity Status and Preterm Birth Mon, 27 Nov 2017 09:32:49 +0000 Preterm birth (PTB) is a major public health concern in the US. Lack of established paternity has been linked with increased risk of PTB. Community violence (CV) may modify the association, and racial/ethnic differences may exist. Using a geographically defined cohort of women in Richmond, Virginia ( = 27,518), we examined racial/ethnic differences in the modifying effect of CV on the association between paternity status and PTB. Results showed that lack of established paternity was associated with incremental greater odds of PTB across CV quartiles in NH-Whites (quartile-1: AOR = 1.42, 95% CI = 0.95–2.12; quartile-2: AOR = 1.45, 95% CI = 0.57–3.71; quartile-3: AOR = 3.12, 95% CI = 2.67–6.32), NH-Blacks (quartile-1: AOR = 1.16, 95% CI = 0.85–1.58; quartile-2: AOR = 1.32, 95% CI = 0.82–2.12; quartile-3: AOR = 1.64, 95% CI = 1.24–2.16), and Hispanics (quartile-1: AOR = 1.29, 95% CI = 0.65–2.55; quartile-2: AOR = 1.34, 95% CI = 0.67–2.69). Odds of PTB were highest among NH-White women. Public health practitioners should be aware of the negative effect of lack of paternal presence on PTB in women resident in high violence rate communities and racial/ethnic differences that exist. Timothy O. Ihongbe and Saba W. Masho Copyright © 2017 Timothy O. Ihongbe and Saba W. Masho. All rights reserved. Examining the Relationship between Park Neighborhoods, Features, Cleanliness, and Condition with Observed Weekday Park Usage and Physical Activity: A Case Study Sun, 26 Nov 2017 00:00:00 +0000 Background. Little research has comprehensively explored how park features, quality indicators, and neighborhood environments are associated with observed park usage and physical activity (PA). This case study examined whether weekday park usage and PA differ by neighborhood type, across numerous categories of park features, and according to park feature condition and cleanliness. Methods. Direct observation was used to capture the number of users and PA levels within 143 park features in 6 parks (3 urban, 3 suburban) over the course of six weeks. Audits of park environments assessed the type, condition, and cleanliness of all features and amenities. Results. Urban parks experienced greater usage, but a higher proportion of sedentary users than suburban parks. Usage and PA levels differed across types of park features, with splash pads, pools, paths, and play structures having the greatest proportion of active users. Usage did not differ by park feature condition and cleanliness, but greater condition and cleanliness were generally associated with higher PA levels. Conclusions. Factors such as neighborhood context, types of park features, and condition and cleanliness can impact park usage and PA levels and should be targets for researchers and planners aiming to foster more user-friendly and active neighborhood park environments. Kerry Hamilton, Andrew T. Kaczynski, Melissa L. Fair, and Lucie Lévesque Copyright © 2017 Kerry Hamilton et al. All rights reserved. Prevalence and Perinatal Outcomes of Singleton Term Breech Delivery in Wolisso Hospital, Oromia Region, Southern Ethiopia: A Cross-Sectional Study Thu, 23 Nov 2017 07:33:29 +0000 Background. Breech deliveries have always been topical issues in obstetrics. Neonates undergoing term breech deliveries have long-term morbidity up to the school age irrespective of mode of delivery. Objective. To determine prevalence and perinatal outcomes of singleton term breech delivery. Methods. Hospital based cross-sectional study was conducted on 384 participants retrospectively. Descriptive and analytical statistics was used. Result. A total of 384 breech deliveries were included. Prevalence of singleton breech deliveries in the hospital was 3.4%. The perinatal outcome of breech deliveries was 322 (83.9%). Adverse perinatal outcome of singleton term breech delivery was significantly associated with women’s age of greater than or equal to 35 years (AOR = 2.62, 95% CI = 1.14–6.03), fully dilated cervix (AOR = 0.48, 95% CI = 0.25–0.91), ruptured membrane (AOR = 5.11, 95% CI = 2.25–11.6), and fetal weight of <2500 g (AOR = 6.77, 95% CI = 3.22–14.25). Conclusion. Entrapment of head, birth asphyxia, and cord prolapse were the most common causes of perinatal mortality. Factors like fetal weight <2500 gm, mothers of age 35 years and above, those mothers not having a fully dilated cervix, and mothers with ruptured membrane were associated with increased perinatal mortality. Temesgen Debero Mere, Tilahun Beyene Handiso, Abera Beyamo Mekiso, Markos Selamu Jifar, Shabeza Aliye Ibrahim, and Degefe Tadele Bilato Copyright © 2017 Temesgen Debero Mere et al. All rights reserved. Estimating the Health Risk Associated with the Use of Ecological Sanitation Toilets in Malawi Wed, 08 Nov 2017 00:00:00 +0000 Use of Ecological Sanitation (EcoSan) sludge is becoming popular due to increasing price of organic fertilizers in Malawi; however, there is little evidence on the associated risks. Quantitative microbiological risk assessment (QMRA) was done to determine health risks associated with use of EcoSan. Pathogens considered included Escherichia coli (E. coli), Salmonella, and soil transmitted helminths (STHs). Exponential and Beta Poisson models were used to estimate the risk from helminthic and bacterial pathogens, respectively. Main exposure pathways were through poor storage of sludge, contamination of foods during drying, walking barefoot on the ground contaminated with sludge, pit emptying without protection, and application of sludge in the fields. Estimated annual risk for Ascaris lumbricoides, Taenia, and hookworms was approximately over 5.6 × 10−1 for both Fossa Alternas (FAs) and Urine Diverting Dry Toilet (UDDTs). Risk from E. coli and Salmonella was 8.9 × 10−2 and above. The risks were higher than WHO acceptable risk for use of faecal sludge in crops of 10−4 infections per year. Promoters and users of EcoSan latrines need to consider advocating for strict guidelines to reduce the risk. Save Kumwenda, Chisomo Msefula, Wilfred Kadewa, Bagrey Ngwira, and Tracy Morse Copyright © 2017 Save Kumwenda et al. All rights reserved. Use of Personal Protective Equipment among Building Construction Workers in Kampala, Uganda Mon, 23 Oct 2017 06:57:52 +0000 Background. 270 million workplace accidents occur annually. In Uganda, Kampala district has the highest workplace injury and fatality rates. However, information on personal protective equipment (PPE)—hand gloves, hardhats, overalls, safety boots, earplugs, safety harness with lanyard, and face shields—utilization among building construction workers remains scarce. We assessed PPE utilization and determinants among building construction workers in Kampala, Uganda. Methods. This cross-sectional study involved 385 respondents. Data collected by structured questionnaire was double-entered in EpiData and analyzed in STATA at 5% significance level. Independent determinants of PPE use were established by a stepwise backward logistic regression analysis. Results. 305 (79.2%) respondents were males, 290 (75.3%) were 18–30 years, 285 (74.0%) completed secondary education, and 197 (51.2%) were temporary employees. 60 (15.6%) respondents used PPE. Female sex (adjusted odds ratio (AOR) = 6.64; 95% CI: 1.55–28.46; ), temporary (AOR = 0.05; 95% CI: 0.01–0.27; ) and casual (AOR = 0.01; 95% CI: 0.001–0.071; ) employment, and previous knowledge of safety measures (AOR = 100.72; 95% CI: 26.00–390.16; ) were associated with PPE use. Conclusion. PPE use was low in Kampala, Uganda. Building construction companies should implement measures of the Uganda Occupational Health and Safety Act. Jonathan Izudi, Viola Ninsiima, and John Bosco Alege Copyright © 2017 Jonathan Izudi et al. All rights reserved. Malnutrition and Its Associated Factors among Rural School Children in Fayoum Governorate, Egypt Mon, 23 Oct 2017 00:00:00 +0000 Malnutrition is an increasing health problem among children in developing countries. We assessed the level of malnutrition and associated factors among school children in a rural setting in Fayoum Governorate, Egypt. A school based cross-sectional survey was conducted on children (6–17 years) in Manshit El Gamal village in Tamia district of Fayoum Governorate. Weight, height, and age data were used to calculate -scores of the three nutritional indicators using WHO anthroPlus. Sociodemographics and lifestyles Data were collected. Prevalence of stunting, underweight, and wasting was 34.2%, 3.4%, and 0.9%, respectively, while obesity was 14.9%. Prevalence of obesity was significantly higher in younger age group of 6–9 years in comparison with older age and was higher in males versus females in 10–13-year-age group. Increasing age, reduced poultry consumption, and escaping breakfast were associated factors for stunting with OR (95% CI) 1.27 (1.17–1.37), 2.19 (1.4–3.4), and 2.3 (1.07–5.03). Younger age and regular employment of the father were factors associated with obesity (OR = 0.753; 0.688–0.824 and OR = 2.217; 1.4–3.5). Malnutrition is highly prevalent in Fayoum in line with the national prevalence and associated with age, gender, regularity of father’s employment, and dietary factors. Wafaa Y. Abdel Wahed, Safaa K. Hassan, and Randa Eldessouki Copyright © 2017 Wafaa Y. Abdel Wahed et al. All rights reserved. Quality of Care of Patients with Diabetes in Primary Health Services in Southeast Brazil Tue, 10 Oct 2017 00:00:00 +0000 Background. Diabetes management involves multiple aspects that go beyond drug therapy as a way of providing high quality care. The objective of this study was to describe quality of care indicators for individuals with diabetes in southeast Brazil and to explore associations among these indicators. Methods. In this cross-sectional, observational study, health care providers filled out a questionnaire addressing health care structure and processes at 14 primary health care units (PHCUs). Clinical and laboratory data of diabetic patients attending the PHCUs and from patients referred to a secondary health care (SHC) center were collected. Results. There was a shortage of professionals in 53.8% of the PHCUs besides a high proportion of problems regarding referrals to SHC. At the PHCU, glycated hemoglobin results were available only in half of the medical records. A low rate of adequate glycemic control was also observed. An association between structure and process indicators and the outcomes analyzed was not found. Conclusion. Major deficiencies were found in the structure and processes of the PHCUs, in addition to unsatisfactory diabetes care outcomes. However, no association between structure, process, and outcomes was found. Christiane Chaves Augusto Leite Simão, Mônica Barros Costa, Fernando Antônio Basile Colugnati, Elaine Amaral de Paula, Chislene Pereira Vanelli, and Rogério Baumgratz de Paula Copyright © 2017 Christiane Chaves Augusto Leite Simão et al. All rights reserved. Influence of Water, Sanitation, and Hygiene Practices on Common Infections among Under-Five Children in Longido and Monduli Districts of Arusha, Tanzania Mon, 25 Sep 2017 00:00:00 +0000 The study aimed at assessing water, sanitation, and hygiene practices and their influence on infectious diseases among under-five children in semipastoral communities of Arusha. The study was cross-sectional in design. Prevalence of infectious diseases among under-five children was derived from patients’ attendance register. Mothers randomly sampled from households were interviewed using questionnaire. Information regarding child morbidity and sociodemographic and WASH characteristics was gathered. Hospital data revealed that 2/3 of under-five patients visited the hospitals annually were suffering from infectious diseases. Mean percentage of diarrhea prevalence for years 2013–2015 in Longido was higher than the mean of the respective years prevalence in Monduli (). Households’ survey showed that 15.5% of under-five children were suffering from diarrhea. Children who consumed foods kept in kibuyu () or used unboiled cows’ milk () or were drinking surface water () or born to uneducated mothers () had increased risk of developing diarrhea compared to their counterparts. Storing complementary foods in kibuyu was strongly associated with diarrhea among under-five children. To address the problem, communities under study need to be motivated through health education on food hygiene, proper handling of food storage containers, and domestic water treatment at the household level. Hoyce Amini Mshida, Neema Kassim, Martin Epafras Kimanya, and Emmanuel Mpolya Copyright © 2017 Hoyce Amini Mshida et al. All rights reserved. Exploration of the Risk Factors of Generalized and Central Obesity among Adolescents in North Lebanon Mon, 11 Sep 2017 07:22:40 +0000 Adolescents’ obesity is an emerging public health problem globally and in the Arab countries. Alarming rates of overweight/obesity have been rising progressively in Lebanon. However, the risk factors for the development of adolescents’ obesity have not yet been thoroughly explored in North Lebanon. To determine the dietary and lifestyle risk factors associated with generalized and central obesity among adolescents living in Tripoli, a cross-sectional survey was conducted including a representative sample of 311 students aged 11–16 years from both sexes chosen from public and private schools in Tripoli. Data were collected using a standardized questionnaire to determine sociodemographic characteristics, dietary patterns, and physical activity and sedentary behaviors. Body mass index (BMI) was evaluated using the Center for Disease Control BMI for age percentiles. Central obesity was assessed using both waist-to-height ratio and gender-specific waist circumference for age indices. Multiple logistic regression analysis revealed that skipping breakfast and physical inactivity were the most significant independent risk factors associated with both generalized and central obesity. In addition, higher screen time and male gender were associated with increased risk for generalized and central obesity, respectively. Intervention strategies to prevent the development of obesity should be implemented among adolescent students to encourage regular breakfast intake and adopting healthy dietary and lifestyle behaviors. Germine El-Kassas and Fouad Ziade Copyright © 2017 Germine El-Kassas and Fouad Ziade. All rights reserved. Living with Bats: The Case of Ve Golokuati Township in the Volta Region of Ghana Sun, 10 Sep 2017 06:50:49 +0000 Transmission of zoonotic pathogens from bats to humans through direct and indirect contact with bats raises public apprehension about living close to bats. In the township of Ve Golokuati in Ghana, several “camps” of Epomophorus gambianus roost in fruit trees that provide ecosystems services for residents. This study explored human-bat interaction in the township and the potential risks of disease transmission from bats to humans. Data were derived through questionnaire administration and participatory appraisal approach involving focus group discussions, participatory landscape mapping, and transect walk. The study found that most human activities within the township, such as petty-trading, domestic chores, and children’s outdoor recreation, exposed people to bats. Though there have been no reported cases of disease spillover from bats to humans from the perspective of residents and from medical records, respondents whose activities brought them closer to bats within the township were found to be more likely to experience fevers than those who do not interact with bats frequently. The study recommends education of community members about the potential risks involved in human-bat interactions and makes suggestions for reducing the frequent interactions with and exposure to bats by humans. Jesse S. Ayivor, Fidelia Ohemeng, Elaine Tweneboah Lawson, Linda Waldman, Melissa Leach, and Yaa Ntiamoa-Baidu Copyright © 2017 Jesse S. Ayivor et al. All rights reserved. Interactions between Neighbourhood Urban Form and Socioeconomic Status and Their Associations with Anthropometric Measurements in Canadian Adults Tue, 05 Sep 2017 07:15:15 +0000 Neighbourhood-level socioeconomic composition and built context are correlates of weight-related behaviours. We investigated the relations between objective measures of neighbourhood design and socioeconomic status (SES) and their interaction, in relation to self-reported waist circumference (WC), waist-to-hip ratio, and body mass index (BMI) in a sample of Canadian adults ( from 12 Calgary neighbourhoods). WC and BMI were higher among residents of disadvantaged neighbourhoods, independent of neighbourhood design (grid, warped grid, and curvilinear street patterns) and individual-level characteristics (sex, age, education, income, dog ownership, marital status, number of dependents, motor vehicle access, smoking, sleep, mental health, physical health, and past attempts to modify bodyweight). The association between neighbourhood-level SES and WC was modified by neighbourhood design; WC was higher in disadvantaged-curvilinear neighbourhoods and lower in advantaged-grid neighbourhoods. Policies making less obesogenic neighbourhoods affordable to low socioeconomic households and that improve the supportiveness for behaviours leading to healthy weight in low socioeconomic neighbourhoods are necessary. Gavin R. McCormack, Christine Friedenreich, Lindsay McLaren, Melissa Potestio, Beverly Sandalack, and Ilona Csizmadi Copyright © 2017 Gavin R. McCormack et al. All rights reserved. Urban Dog Parks as Sources of Canine Parasites: Contamination Rates and Pet Owner Behaviours in Lisbon, Portugal Wed, 30 Aug 2017 09:27:31 +0000 Dog parks represent a recent trend in western countries, enabling owners to spend quality time with their pets in a controlled environment. Despite their growing popularity, few studies have been performed to date on these parks to investigate dog intestinal parasitic infections and soil contamination. The present study examined 369 faecal and 18 soil samples collected from 3 dog parks in Greater Lisbon, Portugal. Additionally, 102 interviews were performed with dog owners to assess dog-walking behaviours and parasite risk. In total, 33% of the faecal dog samples were infected with at least one parasitic agent: hookworms (16.5%), Cryptosporidium spp. (11.9%), Giardia spp. (11.4%), Toxascaris leonina (1.1%), Cystoisospora spp. (1.1%), Toxocara spp. (0.5%), and Sarcocystis sp. (0.3%). The soil of all the parks was contaminated with hookworm eggs. This is the first study performed in a European urban area to assess canine faecal contamination and parasitic agents in dog parks. Our results highlight the potential of these parks as a source of transmission for canine parasites, including some with zoonotic potential. Public awareness and effective preventive measures should be promoted to minimise the health-risk impact to both animals and humans, under the scope of environmental and public health. Ana Ferreira, Ana Margarida Alho, David Otero, Lídia Gomes, Rolf Nijsse, Paul A. M. Overgaauw, and Luís Madeira de Carvalho Copyright © 2017 Ana Ferreira et al. All rights reserved. Assessment of Environmental Attitudes and Risk Perceptions among University Students in Mersin, Turkey Tue, 22 Aug 2017 00:00:00 +0000 Background. Environmental destruction is one of the most important problems in this century. Objective. The aim of the study was to determine the environmental attitudes and perceived risks associated with environmental factors of the students. Methods. This cross-sectional study was conducted in 7 faculties of Mersin University. The research data were collected using a questionnaire. The questionnaire included sociodemographic characteristics, the “Environmental Attitudes Scale,” and the “Environmental Risk Perception Scale.” 774 students who filled out questionnaires were evaluated. Results. The sample included 55.8% females. Environmental Attitudes Scale mean scores of students were identified as . The highest perceived risk was release of radioactive materials associated with nuclear power generation. The environmental attitudes and risk perception scores were higher in Health Sciences than in the other faculties. Females were more positive towards the environment and had higher risk perceptions than the men. There is a negative correlation between age and resource depletion risk and global environmental risk score. Conclusion. Students had a positive attitude to the environment and had moderate-level risk perception about the environment. Environmental awareness of students, especially those studying in the Social Sciences, should be increased. The environmental education curriculum should be revised throughout all the courses. Gulcin Yapici, Oya Ögenler, Ahmet Öner Kurt, Fazıl Koçaş, and Tayyar Şaşmaz Copyright © 2017 Gulcin Yapici et al. All rights reserved. Pesticide Residues in Honey from the Major Honey Producing Forest Belts in Ghana Wed, 16 Aug 2017 00:00:00 +0000 Concentrations of pesticides residues in honey sampled from the major honey producing forest belts in Ghana were determined. Samples were purposively collected and extracted using the QuEChERS (Quick, Easy, Cheap, Effective, Rugged, and Safe) method and analysed for synthetic pyrethroids, organochlorine, and organophosphate pesticide residues. Aldrin, γ-HCH, β-HCH, ∑endosulfan, cyfluthrin, cypermethrin, deltamethrin, permethrin methoxychlor, ∑DDT, chlorpyrifos, fenvalerate, malathion, dimethoate, and diazinon were all detected at the concentration of 0.01 mg/kg, while cyfluthrin and permethrin were detected at mean concentrations of 0.02 and 0.04 mg/kg, respectively. All the pesticide residues detected were very low and below their respective maximum residue limits set by the European Union. Hence, pesticide residues in honey samples analyzed do not pose any health risk to consumers. Godfred Darko, Jonah Addai Tabi, Michael Kodwo Adjaloo, and Lawrence Sheringham Borquaye Copyright © 2017 Godfred Darko et al. All rights reserved. Disinfection Byproducts in Drinking Water and Evaluation of Potential Health Risks of Long-Term Exposure in Nigeria Wed, 16 Aug 2017 00:00:00 +0000 Levels of trihalomethanes (THMs) in drinking water from water treatment plants (WTPs) in Nigeria were studied using a gas chromatograph (GC Agilent 7890A with autosampler Agilent 7683B) equipped with electron capture detector (ECD). The mean concentrations of the trihalomethanes ranged from zero in raw water samples to 950 μg/L in treated water samples. Average concentration values of THMs in primary and secondary disinfection samples exceeded the standard maximum contaminant levels. Results for the average THMs concentrations followed the order TCM > BDCM > DBCM > TBM. EPA-developed models were adopted for the estimation of chronic daily intakes (CDI) and excess cancer incidence through ingestion pathway. Higher average intake was observed in adults ( mg/kg-day), while the ingestion in children ( mg/kg-day) showed comparable values. The total lifetime cancer incidence rate was relatively higher in adults than children with median values 244 and 199 times the negligible risk level. Nsikak U. Benson, Oyeronke A. Akintokun, and Adebusayo E. Adedapo Copyright © 2017 Nsikak U. Benson et al. All rights reserved. Ambient Air Quality Classification by Grey Wolf Optimizer Based Support Vector Machine Tue, 15 Aug 2017 09:13:32 +0000 With the development of society along with an escalating population, the concerns regarding public health have cropped up. The quality of air becomes primary concern regarding constant increase in the number of vehicles and industrial development. With this concern, several indices have been proposed to indicate the pollutant concentrations. In this paper, we present a mathematical framework to formulate a Cumulative Index (CI) on the basis of an individual concentration of four major pollutants (SO2, NO2, PM2.5, and PM10). Further, a supervised learning algorithm based classifier is proposed. This classifier employs support vector machine (SVM) to classify air quality into two types, that is, good or harmful. The potential inputs for this classifier are the calculated values of CIs. The efficacy of the classifier is tested on the real data of three locations: Kolkata, Delhi, and Bhopal. It is observed that the classifier performs well to classify the quality of air. Akash Saxena and Shalini Shekhawat Copyright © 2017 Akash Saxena and Shalini Shekhawat. All rights reserved. Occupational Exposure to Needle Stick and Sharp Injuries and Associated Factors among Health Care Workers in Awi Zone, Amhara Regional State, Northwest Ethiopia, 2016 Thu, 10 Aug 2017 09:19:18 +0000 Background. Needle stick and sharp injuries were one of the major risk factors for blood and body fluid borne infections at health care facilities. Objective. To assess occupational exposure to needle stick and sharp injuries and associated factors among health care workers in Awi zone, 2016. Methods. institutional based cross-sectional study was conducted among 193 health care workers. Study participants were selected using systematic random sampling technique. Result. When queried, 18.7% of the respondents’ encountered needle stick and sharp injury in the last 1 year. Participants who practiced needle recapping and had job related stress were 21.3 and 7.3 times more likely to face needle stick and sharp injury, respectively. However, those who apply universal precautions and acquire the required skill were 99% and 96% times less likely to face needle stick and sharp injury, respectively, than their counterparts. Conclusion and Recommendation. The prevalence of needle stick and sharp injury was relatively low as compared to previous studies. Recapping of needle after use, job related stress, not applying universal precautions, and lack of the required skill were associated with needle stick and sharp injuries. Therefore, health care providers should apply universal precaution. Abebe Dilie, Desalegn Amare, and Tenaw Gualu Copyright © 2017 Abebe Dilie et al. All rights reserved. Opportunities for Promoting Physical Activity in Rural Communities by Understanding the Interests and Values of Community Members Tue, 08 Aug 2017 06:56:25 +0000 Purpose. Physical activity (PA) has well-established health benefits, but most Americans do not meet national guidelines. In southeastern Missouri, trails have been developed to increase rates of PA. Although this has had success, broad-scale interventions will be needed to improve rates further. In this study, we surveyed residents of southeastern Missouri to identify ways to improve rates of PA. Methods. We conducted a telephone survey in 2015 of adults () from eight rural Missouri towns that had walking trails, regarding their activities and interests. Findings. Forty percent of respondents reported both walking and meeting PA recommendations, 29% reported walking but not meeting PA recommendations, and the remainder did not walk or did not answer. Respondents who used the trails were significantly more likely to meet PA recommendations (odds ratio = 2.7; 95% confidence interval = 1.7, 4.5). Certain values and interests that may encourage PA or draw people to trails were common. Conclusions. The group that walked but did not meet PA recommendations would be the ideal group to target for intervention, which could focus on their reported values and interests (e.g., personal relationships, being outdoors). Use of walking trails was associated with meeting PA recommendations. Thomas Park, Amy A. Eyler, Rachel G. Tabak, Cheryl Valko, and Ross C. Brownson Copyright © 2017 Thomas Park et al. All rights reserved. Does Survival Vary for Breast Cancer Patients in the United States? A Study from Six Randomly Selected States Wed, 26 Jul 2017 08:02:56 +0000 Background. Breast cancer is the most common cancer in women. Disparities in some characteristics of breast cancer patients and their survival data for six randomly selected states in the US were examined. Materials and Methods. A probability random sampling method was used to select the records of 2,000 patients from each of six randomly selected states. Demographic and disease characteristics were extracted from the Surveillance Epidemiology and End Results (SEER) database. To evaluate relationships between variables, we employed a Cox Proportional Regression to compare survival times in the different states. Results. Iowa had the highest mean age of diagnosis at 64.14 years () and Georgia had the lowest at 57.97 years (). New Mexico had the longest mean survival time of 189.09 months () and Hawaii the shortest at 119.01 () months, a 70.08-month difference (5.84 years). Analysis of stage of diagnosis showed that the highest survival times for Whites and American Indians/Alaska Natives were for stage I cancers. The highest survival times for Blacks varied. Stage IV cancer consistently showed the lowest survival times. Conclusions. Differences in breast cancer characteristics across states highlight the need to understand differences between the states that result in variances in breast cancer survival. Hafiz M. R. Khan, Lisaann S. Gittner, Abhilash Perisetti, Anshul Saxena, Aamrin Rafiq, Kemesha Gabbidon, Sarah Mende, and Maria Lyuksyutova Copyright © 2017 Hafiz M. R. Khan et al. All rights reserved. Uses, Limitations, and Validity of a Registry of Congenital Anomalies in Iran: A Critical Review Tue, 11 Jul 2017 08:19:26 +0000 Background and Aims. Preventive strategies of congenital anomalies are basically relying on the systematic ongoing collection and analysis of data and timely dissemination of information. The aim of this paper is to briefly report a critical review of a surveillance system of congenital anomalies in a developing country, by describing the challenges and experience of the registry since it began. Methods. Tabriz Registry of Congenital Anomalies (TRoCA) was mainly set up based on the guidelines provided by the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR) for data collection, coding, process, analysis, use, and evaluation of the system. Findings. TRoCA has successfully achieved its main objective as a pilot model for setting up a nationwide registry of congenital anomalies in the country. The programme has too succeeded in relation to its regional objectives: epidemiological rates and data have been produced consistently for etiological investigations, methodological studies, service provision, and preventive measures for selected anomalies. Conclusions. Our successful experience, as a small registry in a developing country, might be of interest and useful to practitioners, policymakers of birth defects control programmes, and mainly those willing to set up a monitoring system of congenital anomalies in similar areas. David H. Stone, Saeed Dastgiri, Mohammad Heidarzadeh, Hossein M. Abdollahi, Shahin Imani, and Mohammad H. K. Maher Copyright © 2017 David H. Stone et al. All rights reserved. Investigation of Some Metals in Leaves and Leaf Extracts of Lippia javanica: Its Daily Intake Tue, 11 Jul 2017 00:00:00 +0000 Consumption of plant extracts can be a source of essential elements or a route of human exposure to toxicants. Metal concentrations in leaves, leaf brew, and infusion of L. javanica collected from five sites were determined by atomic absorption spectrometry after acid and aqueous extraction. Estimated daily intakes of metals in extracts were compared with recommended dietary allowances. Total metal concentrations in leaves varied with sampling sites (): Mn > Fe > Cu > Cr > Pb for sites SS2–SS5. The highest metal concentrations in leaves were recorded for SS3 (Cu: and Mn: ), SS5 (Fe: ), SS2 (Pb: ), and SS4 (Cr:  mg/kg). Leaf infusion appeared to release higher Cu and Mn concentrations in leaves across sites (Cu: 21.65; Mn: 28.01%) than leaf brew (Cu: 11.95; Mn: 19.74%). Lead was not detected in leaf extracts. Estimated dietary intakes of Cr, Cu, Fe, and Mn were below recommended dietary allowances. A 250 ml cup of leaf infusion contributed 0.30–1.18% Cu and 4.46–13.83% Mn to the recommended dietary allowances of these elements per day. Lead did not pose any potential hazard when consumed in tea beverage made from brew and infusion of leaves of L. javanica. Kanda Artwell, Ncube France, and Kunsamala Florence Copyright © 2017 Kanda Artwell et al. All rights reserved. Haematological Profile and Intensity of Urogenital Schistosomiasis in Ghanaian Children Wed, 21 Jun 2017 00:00:00 +0000 Background. Urogenital schistosomiasis is a widely contracted parasitic helminth infection often associated with haematological abnormalities. Aim. We investigated the relationship between the haematological profile and the intensity of schistosomiasis among children in the Yeji district. Materials and Methods. A total of 100 participants comprising 50 Schistosoma haematobium (S. haematobium) infected and 50 noninfected controls aged 6–17 years matched for age and sex were recruited into the study. Blood and urine samples were collected and haematological profile and presence of S. haematobium eggs were assessed using standard protocols. Results. Haemoglobin (HGB) (), haematocrit (HCT) (), mean cell volume (MCV) (), mean cell haemoglobin (MCH) (), and mean cell haemoglobin concentration (MCHC) () levels were reduced in cases compared to controls. Mixed cell percentage (MXD) () and red blood cell distribution width (RDW-CV) () were significantly elevated among cases as compared to controls. Haematuria was a clinical characteristic of heavy infection. Conclusion. S. haematobium infection creates an imbalance in the haematological profile. We found low HGB, HCT, MCV, MCH, and MCHC levels coupled with increased % MXD count and RDW-CV. Also, low MCV, MCH, and MCHC and high % MXD count are independently associated with S. haematobium infection among our study participants. Justice Afrifa, Desmond Gyedu, Eric Ofori Gyamerah, Samuel Essien-Baidoo, and Isaac Mensah-Essilfie Copyright © 2017 Justice Afrifa et al. All rights reserved. Black Tea Source, Production, and Consumption: Assessment of Health Risks of Fluoride Intake in New Zealand Wed, 21 Jun 2017 00:00:00 +0000 In countries with fluoridation of public water, it is imperative to determine other dietary sources of fluoride intake to reduce the public health risk of chronic exposure. New Zealand has one of the highest per capita consumption rates of black tea internationally and is one of the few countries to artificially fluoridate public water; yet no information is available to consumers on the fluoride levels in tea products. In this study, we determined the contribution of black tea as a source of dietary fluoride intake by measuring the fluoride content in 18 brands of commercially available products in New Zealand. Fluoride concentrations were measured by potentiometric method with a fluoride ion-selective electrode and the contribution of black tea to Adequate Intake (AI) and Tolerable Upper Intake Level (UL) was calculated for a range of consumption scenarios. We examined factors that influence the fluoride content in manufactured tea and tea infusions, as well as temporal changes in fluoride exposure from black tea. We review the international evidence regarding chronic fluoride intake and its association with chronic pain, arthritic disease, and musculoskeletal disorders and provide insights into possible association between fluoride intake and the high prevalence of these disorders in New Zealand. Declan T. Waugh, Michael Godfrey, Hardy Limeback, and William Potter Copyright © 2017 Declan T. Waugh et al. All rights reserved. Physical Trauma among Refugees: Comparison between Refugees and Local Population Who Were Admitted to Emergency Department—Experience of a State Hospital in Syrian Border District Wed, 14 Jun 2017 07:21:50 +0000 Background. Hundreds of thousands of people have fled to Turkey since the civil war started in Syria in 2011. Refugees and local residents have been facing various challenges such as sociocultural and economic ones and access to health services. Trauma exposure is one of the most important and underestimated health problems of refugees settling in camps. Aims. We aimed to evaluate refugee admissions to emergency department because of trauma in means of demographics of patients and mechanism of trauma and compare the results with the local population. Methods. Retrospective evaluation of results and comparison with the results of local population. Results. We determined that the ratio of emergency admission of refugee patients because of trauma was significantly higher than the local population for most types of trauma. Conclusion. Further studies with more refugee participants are needed to fully understand the underlying reasons for this high ratio to protect refugees as well as for planning to take caution to attenuate the burden on healthcare systems. Yigit Duzkoylu, Salim Ilksen Basceken, and Emrullah Cem Kesilmez Copyright © 2017 Yigit Duzkoylu et al. All rights reserved. Riverbed Sediments as Reservoirs of Multiple Vibrio cholerae Virulence-Associated Genes: A Potential Trigger for Cholera Outbreaks in Developing Countries Wed, 31 May 2017 10:50:12 +0000 Africa remains the most cholera stricken continent in the world as many people lacking access to safe drinking water rely mostly on polluted rivers as their main water sources. However, studies in these countries investigating the presence of Vibrio cholerae in aquatic environments have paid little attention to bed sediments. Also, information on the presence of virulence-associated genes (VAGs) in environmental ctx-negative V. cholerae strains in this region is lacking. Thus, we investigated the presence of V. cholerae VAGs in water and riverbed sediment of the Apies River, South Africa. Altogether, 120 samples (60 water and 60 sediment samples) collected from ten sites on the river (January and February 2014) were analysed using PCR. Of the 120 samples, 37 sediment and 31 water samples were positive for at least one of the genes investigated. The haemolysin gene (hlyA) was the most isolated gene. The cholera toxin (ctxAB) and non-O1 heat-stable (stn/sto) genes were not detected. Genes were frequently detected at sites influenced by human activities. Thus, identification of V. cholerae VAGs in sediments suggests the possible presence of V. cholerae and identifies sediments of the Apies River as a reservoir for potentially pathogenic V. cholerae with possible public health implications. Akebe Luther King Abia, Eunice Ubomba-Jaswa, and Maggy Ndombo Benteke Momba Copyright © 2017 Akebe Luther King Abia et al. All rights reserved. Water and Sanitation Hygiene Practices for Under-Five Children among Households of Sugali Tribe of Chittoor District, Andhra Pradesh, India Wed, 31 May 2017 09:00:58 +0000 Background. Increased mortality is associated with poor household water, sanitation, and hygiene (WaSH) practices. The objective was to study the WaSH practices for under-five children among households of Sugali Tribe, Chittoor district, Andhra Pradesh, India. Methods. A community-based cross-sectional study was conducted in four mandals in 2012. A total of 500 households with under-five children were identified. Data was collected from mothers/caregivers. A summary WaSH score was generated from four specific indices, water, sanitation, hygiene, and hand washing practices, and determinants were identified. Results. Of the total households, 69% reported doing nothing at home to make the water safe for drinking. Over 90% of the households reported storing water in a utensil covered with a lid and retrieving water by dipping glass in the vessels. Open defecation was a commonly reported practice (84.8%). About three-fifths of the study’s households reported using water and soap for cleaning dirty hands and one-third (37.4%) reported using water and soap after defecation. The median WaSH score was 15. In the hierarchical stepwise multiple linear regression, only socioeconomic variables were significantly associated with WaSH score. Conclusion. WaSH related practices were generally poor in people of the Sugali Tribe in Andhra Pradesh, India. Venkatashiva Reddy B, Yadlapalli S. Kusuma, Chandrakant S. Pandav, Anil Kumar Goswami, and Anand Krishnan Copyright © 2017 Venkatashiva Reddy B et al. All rights reserved. Why Do the Youths in Northeast India Use Tobacco? Wed, 31 May 2017 08:08:32 +0000 This study is an assessment of the influence of parent’s tobacco use on prospective tobacco use trajectories among young offspring. The study is based on unit level data from District Level Household and Facility Survey-4 (2012-2013) comprising 27,706 youths in 15–24 years’ age group from northeastern states of India and used multilevel regression to identify the potential risk factors of tobacco consumption. The likelihood of using tobacco was found to be 3.4 and 1.14 times more, respectively, for the youths coresiding with mothers who use tobacco and fathers who use tobacco, in comparison to youths staying with parents not taking tobacco. The significant effect of peers on tobacco consumption among youths was also observed. School-going youths had significantly lower risk of tobacco use. The estimated likelihood of a young person from a household to use any tobacco, use smokeless tobacco, and smoke was found to be 28, 12, and 17 percent, respectively. There is an urgent need to extend National Tobacco Control Programme (NTCP) to the community level involving civil societies and young and adult generations for spreading awareness about the health hazards of tobacco use, providing support and facilitating quitting tobacco use. Laishram Ladusingh, Preeti Dhillon, and Pralip Kumar Narzary Copyright © 2017 Laishram Ladusingh et al. All rights reserved. Corrigendum to “Physiologic Conditions Affect Toxicity of Ingested Industrial Fluoride” Tue, 30 May 2017 00:00:00 +0000 Richard Sauerheber Copyright © 2017 Richard Sauerheber. All rights reserved.