Journal of Environmental and Public Health The latest articles from Hindawi © 2017 , Hindawi Limited . 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. 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. 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. 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. 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. 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. 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. Household Response to Inadequate Sewerage and Garbage Collection Services in Abuja, Nigeria Mon, 29 May 2017 09:43:06 +0000 Provision of sanitation and garbage collection services is an important and yet challenging issue in the rapidly growing cities of developing countries, with significant human health and environmental sustainability implications. Although a growing number of studies have investigated the consequences of inadequate delivery of basic urban services in developing countries, few studies have examined how households cope with the problems. Using the Exit, Voice, Loyalty, and Neglect (EVLN) model, this article explores how households respond to inadequate sewerage and garbage collection services in Abuja, Nigeria. Based on a qualitative study, data were gathered from in-depth interviews with sixty households, complemented with personal observation. The findings from grounded analysis indicated that majority (62%) and about half (55%) of the respondents have utilized the informal sector for sewerage services and garbage collection, respectively, to supplement the services provided by the city. While 68% of the respondents reported investing their personal resources to improve the delivery of existing sewerage services, half (53%) have collectively complained to the utility agency and few (22%) have neglected the problems. The paper concludes by discussing the public health and environmental sustainability implications of the findings. Ismaila Rimi Abubakar Copyright © 2017 Ismaila Rimi Abubakar. All rights reserved. Inhalation Dose and Source Term Studies in a Tribal Area of Wayanad, Kerala, India Mon, 22 May 2017 00:00:00 +0000 Among radiation exposure pathways to human beings, inhalation dose is the most prominent one. Radon, thoron, and their progeny contribute more than 50 per cent to the annual effective dose due to natural radioactivity. South west coast of India is classified as a High Natural Background Radioactivity Area and large scale data on natural radioactivity and dosimetry are available from these coastal regions including the Neendakara-Chavara belt in the south of Kerala. However, similar studies and reports from the northern part of Kerala are scarce. The present study involves the data collection and analysis of radon, thoron, and progeny concentration in the Wayanad district of Kerala. The radon concentration was found to be within a range of 12–378 Bq/m3. The thoron concentration varied from 15 to 621 Bq/m3. Progeny concentration of radon and thoron and the diurnal variation of radon were also studied. In order to assess source term, wall and floor exhalation studies have been done for the houses showing elevated concentration of radon and thoron. The average values of radon, thoron, and their progeny are found to be above the Indian average as well as the average values reported from the High Natural Background Radioactivity Areas of Kerala. Exhalation studies of the soil samples collected from the vicinity of the houses show that radon mass exhalation rate varied from below detectable limit (BDL) to a maximum of 80 mBq/kg/h. The thoron surface exhalation rate ranged from BDL to 17470 Bq/m2/h. Reshma Bhaskaran, Ravikumar C. Damodaran, Visnuprasad Ashok Kumar, Jojo Panakal John, Danalakshmi Bangaru, Chitra Natarajan, Bala Sundar Sathiamurthy, Jose Mundiyanikal Thomas, and Rosaline Mishra Copyright © 2017 Reshma Bhaskaran et al. All rights reserved. Examining the Benefits and Barriers of Instructional Gardening Programs to Increase Fruit and Vegetable Intake among Preschool-Age Children Sun, 21 May 2017 00:00:00 +0000 Research exists on using instructional gardening programs with school age children as a means of improving dietary quality and for obesity prevention. This article examines the potential use of instructional gardens in childcare settings to improving fruit and vegetable intake in young children. A qualitative study was conducted with childcare providers. Participants () were recruited via e-mails, letters, and follow-up phone calls. Interviews were recorded, transcribed, and coded to identify themes within two areas childcare providers perceptions of children’s fruit and vegetable consumption and components necessary to initiate or improve instructional gardening programs. Themes associated with provider’s perceptions of child fruit and vegetable consumption included benefits of consumption, willingness to try fruits and vegetables, meeting recommendations, and influence of the home and childcare environments on child eating. Benefits, barriers, and resources needed were identified as themes related to starting or improving instructional gardening programs. Benefits to gardening with preschoolers are consistent with those found in school-age populations. While several barriers exist, resources are available to childcare providers to address these barriers. Increased knowledge and awareness of resources are necessary to improve the success of gardening programs in the childcare setting with the goal of improving child diet quality. Kristen L. Davis and Lynn S. Brann Copyright © 2017 Kristen L. Davis and Lynn S. Brann. All rights reserved. Charting Availability of Processed and Unprocessed Foods in School Neighbourhood Nutrition Environments in an Urban Australian Setting Wed, 03 May 2017 00:00:00 +0000 School Neighbourhood Nutrition Environments (SNNEs) can facilitate or impede healthy eating. This study describes the SNNEs surrounding 6 Good Start Program (GSP) schools in 5 suburbs in Logan, Queensland. Relative density of healthy and unhealthy food outlets was calculated for SNNEs surrounding GSP (6) and non-GSP (10) schools within the 5 suburbs. Relative accessibility of minimally processed and highly processed food and drink in SNNEs of the 6 GSP schools was determined using shelf measurements of snack foods. Unhealthy outlets greatly outnumber healthy outlets (mean relative density 15.6%, median 19.1%). The majority of outlets stock predominantly highly processed food and drink. Study areas are dominated by unhealthy food outlets and highly processed food. Holly Oaken, Lisa Vaughan, Nicola Fa’avale, Robert S. Ware, and Lisa Schubert Copyright © 2017 Holly Oaken et al. All rights reserved. Horizontal and Vertical Distribution of Heavy Metals in Farm Produce and Livestock around Lead-Contaminated Goldmine in Dareta and Abare, Zamfara State, Northern Nigeria Tue, 02 May 2017 08:45:19 +0000 Background. Hitherto studies in response to the June 2010 lead poisoning, Zamfara State, Nigeria, have focused on clinical interventions without information on livestock and other metals. Objective. This study has investigated the distribution of heavy metals in farm produce and livestock around lead-contaminated goldmine in Dareta and Abare, Zamfara State, Nigeria. Methods. Vegetables, soil, water, blood, and different meat samples were harvested from goat, sheep, cattle, and chicken from Dareta, Abare, and Gusau communities. The samples were digested with 10 mL of a mix of nitric and perchloric acids; the mixture was then heated to dryness. Lead, cadmium, zinc, chromium, copper, magnesium, and nickel were analysed using flame Atomic Absorption Spectrophotometer. The daily intake, bioaccumulation factor, and target hazard quotient (THQ) were calculated. Results. Chicken bone-muscles from Dareta had the highest concentrations of lead, zinc, and nickel (28.2750, 16.1650, and 4.2700 mg/kg, resp.), while chicken brain had the highest levels of cadmium, magnesium (0.3800 and 67.5400 mg/kg), and chromium (6.1650 mg/kg, kidney tissue inclusive). Conclusion. In addition to lead, cadmium may also be of concern in the contaminated mining communities of Zamfara State, Nigeria, given the high levels of cadmium in meat and vegetables samples from these areas. O. E. Orisakwe, O. O. Oladipo, G. C. Ajaezi, and N. A. Udowelle Copyright © 2017 O. E. Orisakwe et al. All rights reserved. Safety Evaluation of Potential Toxic Metals Exposure from Street Foods Consumed in Mid-West Nigeria Wed, 26 Apr 2017 09:45:25 +0000 Objective. Street-vended foods offer numerous advantages to food security; nevertheless, the safety of street food should be considered. This study has investigated the level of potential toxic metal (Pb, Cd, Hg, Sb, Mn, and Al) contamination among street-vended foods in Benin City and Umunede. Methods. Twenty street food samples were purchased from vendors at bus stops. Metals were analyzed with atomic absorption spectrophotometry. The methods developed by the US EPA were employed to evaluate the potential health risk of toxic metals. Results. The concentrations of the toxic metals in mg/kg were in the range of Pb (0.014–1.37), Cd (0.00–0.00017), Hg (0.00–0.00014), Sb (0.00–0.021), Mn (0.00–0.012), and Al (0.00–0.22). All the toxic metals except Pb were below permissible limit set by WHO, EU, and USEPA. The daily intake, hazard quotient, and hazard index of all toxic metals except for Pb in some street foods were below the tolerable daily intake and threshold value of 1, indicating an insignificant health risk. Total cancer risk was within the priority risk level of but higher than the acceptable risk level of . Conclusion. Consumption of some of these street foods is of public health concern. O. C. Ekhator, N. A. Udowelle, S. Igbiri, R. N. Asomugha, Z. N. Igweze, and O. E. Orisakwe Copyright © 2017 O. C. Ekhator et al. All rights reserved. Risk Factors for Road Traffic Injuries among Different Road Users in the Gambia Sun, 23 Apr 2017 00:00:00 +0000 We identified risk factors for road traffic injuries among road users who received treatment at two major trauma hospitals in urban Gambia. The study includes pedestrians, bicyclists, motorcyclists, and drivers/passengers of cars and trucks. We examined distributions of injury by age, gender, collision vehicle types and vehicle category, and driver and environment factors. Two hundred and fifty-four patients were included in the study. Two-thirds were male and one-third female. Two-thirds (67%) of road traffic injuries involved pedestrians, bicyclists, and motorcyclists; and these were more common during weekdays (74%) than weekends. Nearly half (47%) of road traffic injuries involved pedestrians. One-third (34%) of injured patients were students (mean age of students was less than 14 years), more than half (51%) of whom were injured on the roadway as pedestrians. Head/skull injuries were common. Concussion/brain injuries were 3.5 times higher among pedestrians, bicyclists, and motorcyclists than vehicle occupants. Crashes involving pedestrians were more likely to involve young people (<25 years; aOR 6.36, 95% CI: 3.32–12.17) and involve being struck by a motor car (aOR 3.95, 95% CI: 2.09–7.47). Pedestrians contribute the largest proportion of hospitalizations in the Gambia. Young pedestrians are at particularly high risk. Prevention efforts should focus on not only vehicle and driver factors, but also protecting pedestrians, bicyclists, and motorcyclists. Edrisa Sanyang, Corinne Peek-Asa, Paul Bass, Tracy L. Young, Babanding Daffeh, and Laurence J. Fuortes Copyright © 2017 Edrisa Sanyang et al. All rights reserved. Human Papillomavirus Genotype Distribution among Cervical Cancer Patients prior to Brazilian National HPV Immunization Program Sun, 23 Apr 2017 00:00:00 +0000 To evaluate the impact of HPV immunization and possible changes in virus type-specific prevalence associated with cervical cancer, it is important to obtain baseline information based on socioeconomic, educational, and environmental characteristics in human populations. We describe these characteristics and the type-specific HPV distribution in 1,183 women diagnosed with cervical cancer in two Brazilian healthcare institutions located at the Southeastern (Rio de Janeiro/RJ) and the Amazonian (Belém/PA) regions. Large differences were observed between women in these regions regarding economic, educational, and reproductive characteristics. The eight most frequent HPV types found in tumor samples were the following: 16, 18, 31, 33, 35, 45, 52, and 58. Some HPV types classified as unknown or low risk were found in tumor samples with single infections, HPV 83 in RJ and HPV 11, 61, and 69 in PA. The proportion of squamous cervical cancer was lower in RJ than in PA (76.3% versus 87.3%, ). Adenocarcinoma was more frequent in RJ than in PA (13.5% versus 6.9%, ). The frequency of HPV 16 in PA was higher in younger women (). The success of a cervical cancer control program should consider HPV types, local health system organization, and sociodemographic diversity of Brazilian regions. Liz M. de Almeida, Luís Felipe L. Martins, Valéria B. Pontes, Flávia M. Corrêa, Raquel C. Montenegro, Laine C. Pinto, Bruno M. Soares, João Paulo C. B. Vidal, Shayany P. Félix, Neilane Bertoni, Moysés Szklo, and Miguel Angelo M. Moreira Copyright © 2017 Liz M. de Almeida et al. All rights reserved. Geospatial Assessment of Cholera in a Rapidly Urbanizing Environment Tue, 11 Apr 2017 00:00:00 +0000 This study mapped out and investigated the spatial relationship between cholera incidences and environmental risk factors in the study area. The study area was stratified into eight zones. Water samples from each zone were collected and analyzed to determine the colony forming units. GIS layers including housing density, digitized roads, rivers, buildings, and cholera incidence data from hospital archives were also collected and analyzed using ArcGIS 10.1. It was observed that there was an association between the ERFs (). Similarly, 18 out of the 44 waste dump sites, seven out of 18 markets, and two out of 36 abattoirs were found near the historical cholera cases. Similarly, 4 (21.1%) locations were traced to be predominantly close to rivers and waste dump site. All the historical cholera cases were found adjoining to roads and buildings. Highest CFU count was found in the wells and streams of areas with a cluster of all the environmental risk factors and high housing density. This study revealed that waste dump sites and market had the highest predisposing attribute while the least was abattoir. The uniqueness of the study lies in the combination of mapping and microbial analyses to identify and assess the pattern of cholera risk and also to provide clear information for development of strategies for environmental supervision. Olajumoke Esther Olanrewaju and Kayode Adewale Adepoju Copyright © 2017 Olajumoke Esther Olanrewaju and Kayode Adewale Adepoju. All rights reserved. Increased Sensitization to Mold Allergens Measured by Intradermal Skin Testing following Hurricanes Sun, 09 Apr 2017 07:14:39 +0000 Objective. To report on changes in sensitivity to mold allergens determined by changes in intradermal skin testing reactivity, after exposure to two severe hurricanes. Methods. A random, retrospective allergy charts review divided into 2 groups of 100 patients each: Group A, patients tested between 2003 and 2010 prior to hurricanes, and Group B, patients tested in 2014 and 2015 following hurricanes. Reactivity to eighteen molds was determined by intradermal skin testing. Test results, age, and respiratory symptoms were recorded. Chi-square test determined reactivity/sensitivity differences between groups. Results. Posthurricane patients had 34.6 times more positive results () at weaker dilutions, all tested molds were found to be more reactive, and 95% had at least one positive test versus only 62% before the hurricanes (); average mold reactivity was 55% versus 16% while 17% of patients reacted to the entire panel versus none before the hurricanes (). The posthurricane population was younger () and included more patients with asthma or lower respiratory symptoms (). Conclusion. Reactivity and sensitization to mold allergens increased compared to patients before the hurricanes. This supports climatologists’ hypothesis that environmental changes resulting from hurricanes can be a health risk as reflected in increased allergic sensitivities and symptoms and has significant implications for physicians treating patients from affected areas. Diego Saporta and David Hurst Copyright © 2017 Diego Saporta and David Hurst. All rights reserved. Self-Medication in University Students from the City of Mansoura, Egypt Wed, 05 Apr 2017 00:00:00 +0000 Background. Self-medication is a common practice in developed and developing countries. Objectives. To explore the prevalence of self-medication practices among university students, probable reasons, symptoms requiring self-medication, and sources of advice. Methods. A descriptive cross-sectional study was carried out in Mansoura University, Egypt, and included 1st and last year students of both medical and nonmedical faculties. Results. Prevalence of self-medication was 62.9%. Younger age, female, medical, and ever-married students and those having home pharmacy tended to self-medicate more than their peers with significant difference between them. Being medical student, being from urban area, having good current health condition, being careless about health, and having drugs stored at home pharmacy were independently associated with the likelihood of self-medicating. Conclusion. Prevalence of self-medication among university students is high which constitutes a health problem that needs intervention. R. M. Helal and H. S. Abou-ElWafa Copyright © 2017 R. M. Helal and H. S. Abou-ElWafa. All rights reserved. Environmental, Spatial, and Sociodemographic Factors Associated with Nonfatal Injuries in Indonesia Mon, 03 Apr 2017 08:18:06 +0000 Background. The determinants of injuries and their reoccurrence in Indonesia are not well understood, despite their importance in the prevention of injuries. Therefore, this study seeks to investigate the environmental, spatial, and sociodemographic factors associated with the reoccurrence of injuries among Indonesian people. Methods. Data from the 2013 round of the Indonesia Baseline Health Research (IBHR 2013) were analysed using a two-part hurdle regression model. A logit regression model was chosen for the zero-hurdle part, while a zero-truncated negative binomial regression model was selected for the counts part. Odds ratio (OR) and incidence rate ratio (IRR) were the measures of association, respectively. Results. The results suggest that living in a household with distant drinking water source, residing in slum areas, residing in Eastern Indonesia, having low educational attainment, being men, and being poorer are positively related to the likelihood of experiencing injury. Moreover, being a farmer or fishermen, having low educational attainment, and being men are positively associated with the frequency of injuries. Conclusion. This study would be useful to prioritise injury prevention programs in Indonesia based on the environmental, spatial, and sociodemographic characteristics. Sri Irianti and Puguh Prasetyoputra Copyright © 2017 Sri Irianti and Puguh Prasetyoputra. All rights reserved. Epidemic of Vitamin D Deficiency and Its Management: Awareness among Indian Medical Undergraduates Mon, 03 Apr 2017 00:00:00 +0000 Vitamin D deficiency is prevalent across all age groups in epidemic proportions. The purpose of this study was to acquire a baseline assessment and create awareness among medical students regarding vitamin D. A cross-sectional, voluntary survey was conducted among undergraduate medical students. Data were collected using a questionnaire which assessed the level of knowledge students had with regard to where vitamin D comes from, what it does for health, how much is recommended, factors that affect its levels, and deficiency management. Majority of students were unaware that vitamin D deficiency has attained epidemic proportions. Though bone and skeletal disorders as a complication of vitamin D deficiency were known, a large number were unaware of systemic consequences (diabetes mellitus, cardiovascular diseases, and cancers). Only one-third of respondents were aware of duration and timing of sun exposure required for adequate serum vitamin D levels. However, we observed lack of awareness among students regarding the various biochemical forms, dose, and duration of vitamin D supplementation for treatment of nutritional deficiency. Our study highlighted a lack of knowledge about the importance of vitamin D, worldwide prevalence of vitamin D deficiency, and its management among medical students. Promoting vitamin D health awareness, if replicated across populations, could lead to positive health outcomes globally. Yangshen Lhamo, Preeta Kaur Chugh, Sandhya R. Gautam, and C. D. Tripathi Copyright © 2017 Yangshen Lhamo et al. All rights reserved. Understanding Public Views about Air Quality and Air Pollution Sources in the San Joaquin Valley, California Sun, 02 Apr 2017 08:44:21 +0000 The San Joaquin Valley of California has poor air quality and high rates of asthma. Surveys were collected from 744 residents of the San Joaquin Valley from November 2014 to January 2015 to examine the public’s views about air quality. The results of this study suggest that participants exposed to high PM2.5 (particulate matter less than 2.5 microns in size) concentrations perceived air pollution to be of the worst quality. Air quality in the San Joaquin Valley was primarily perceived as either moderate or unhealthy for sensitive groups. Females perceived air pollution to be of worse quality compared to males. Participants perceived unemployment, crime, and obesity to be the top three most serious community problems in the San Joaquin Valley. Participants viewed cars and trucks, windblown dust, and factories as the principle contributors to air pollution in the area. There is a need to continue studying public perceptions of air quality in the San Joaquin Valley with a more robust survey with more participants over several years and seasons. Ricardo Cisneros, Paul Brown, Linda Cameron, Erin Gaab, Mariaelena Gonzalez, Steven Ramondt, David Veloz, Anna Song, and Don Schweizer Copyright © 2017 Ricardo Cisneros et al. All rights reserved.