Impacts of air cleaners on indoor air quality in residences impacted by wood smoke.

Residential wood combustion is an important source of ambient air pollution, accounting for over 25% of fine particulate matter (PM2.5) emissions in Canada. In addition to these ambient contributions, wood smoke pollutants can enter the indoor environment directly when loading or stoking stoves, resulting in a high potential for human exposure. A study of the effectiveness of air cleaners at reducing wood smoke-associated PM2.5 of indoor and outdoor origin was conducted in 31 homes during winter 2009-10. Day 1, the residents' wood burning appliance operated as usual with no air cleaner. Days 2 and 3, the wood burning appliance was not operational and the air cleaner was randomly chosen to operate in "filtration" or "placebo filtration" mode. When the air cleaner was operating, total indoor PM2.5 levels were significantly lower than on placebo filtration days (p = 0.0001) resulting in a median reduction of 52%. There was also a reduction in the median PM2.5 infiltration factor from 0.56 to 0.26 between these 2 days, suggesting the air cleaner was responsible for increased PM2.5 deposition on filtration days. Our findings suggest that the use of an air cleaner reduces exposure to indoor PM2.5 resulting from both indoor and ambient wood smoke sources.

Adverse events in older patients admitted to acute care: a preliminary cost description.

The financial costs associated with Adverse Events (AEs) for older patients (> or = 65 years) in Canadian hospitals are unknown. The objective of this paper is to describe and compare costs between patients who experienced an AE and those who did not during an acute hospital admission to a tertiary care facility. Patients with an AE had twice the hospital length of stay (20.2 versus 9.8 days, p < 0.00001), resulting in 1,400 extra days at a cost of approximately $7,500/patient.

Impact of adverse events on hospital disposition in community-dwelling seniors admitted to acute care.

Older adults (> or =65 years) have been identified as a high-risk group for the occurrence of adverse events (AEs) in hospital. The purpose of this paper is to describe the association between AEs and disposition for a population of hospitalized seniors. All community-dwelling seniors admitted to an acute care in-patient unit were eligible for inclusion in this retrospective cohort study conducted at an adult tertiary care facility in Atlantic Canada between July 1, 2005, and March 31, 2006. AEs were identified from administrative data using validated screening criteria derived from the International Classification of Diseases (ICD) diagnosis and external cause of injury codes. Of the 982 eligible patients, 140 (14%) had evidence of at least one AE. There were 136 in-hospital deaths (14%). There was no significant difference in the proportion of deaths between those who experienced an AE and those who did not. However, of the 29 patients who were discharged to a long-term care facility, a significantly higher proportion had an in-hospital AE (6% versus 2%, p < .009). The potential contribution of an AE to the subsequent placement in a long-term care facility offers a compelling reason to develop prevention strategies for hospitalized seniors.

Pilot study on the impact of biogas as a fuel source on respiratory health of women on rural Kenyan smallholder dairy farms.

Biomass burning in indoor environments has been highlighted as a major cause of respiratory morbidity for women and children in low-income countries. Inexpensive technological innovations which reduce such exposures are needed. This study evaluated the impact of low tech compost digesters, which generate biogas for cooking, versus traditional fuel sources on the respiratory health of nonsmoking Kenyan farmwomen. Women from 31 farms with biogas digesters were compared to age-matched women from 31 biomass-reliant farms, in June 2010. Only 43% of the biogas group reported any breathing problems, compared to 71% in the referent group (P = 0.03). Referent women self-reported higher rates of shortness of breath (52% versus 30%), difficulty breathing (42% versus 23%), and chest pain while breathing (35% versus 17%) during the last 6 months (P = 0.09 to 0.12) compared to biogas women. Biogas women demonstrated slightly better spirometry results but differences were not statistically significant, likely due to limited latency between biogas digester installation and spirometry testing. Most biogas women reported improved personal respiratory health (87%) and improved children's health (72%) since biogas digester installation. These findings suggest that using biogas in cookhouses improves respiratory symptoms but long-term impacts on lung function are unclear.

Priority setting and policy advocacy by nursing associations: a scoping review and implications using a socio-ecological whole systems lens.

OBJECTIVE: We undertook an interpretative scoping review to examine organizational priority setting and policy advocacy and the factors that influence nursing associations' cross-sector public policy choices and actions. METHOD: Evidence was drawn from research, narrative, and theoretical sources that described priority setting and policy advocacy undertaken by non-governmental, non-profit, and nursing associations. Text was extracted from selected papers, imported into NVivo 8, coded, and analyzed using a descriptive-analytical narrative method. RESULTS: Many internal and external factors are shown to shape organizations' policy choices and actions including governance and governance structures, membership arrangements, legislative, professional, and jurisdictional mandates, perceived credibility, and external system disruptions. CONCLUSIONS: Internal and external factors are identified in the literature as critical to how organizations succeed or fail to set achievable priorities and advance their advocacy goals. Case comparisons and longitudinal research are needed to understand nursing associations' policy choices and actions for cross-sector public policy given their complex organizational structures and dynamic professional-legal-social-economic-political-ecological environments. A socio-ecological systems perspective can inform the development of theoretical frameworks and research to understand leverage points and blockages to guide nursing associations' public policy choices and actions at varying points in time.

Breast cancer risk, fungicide exposure and CYP1A1*2A gene-environment interactions in a province-wide case control study in Prince Edward Island, Canada.

Scientific certainty regarding environmental toxin-related etiologies of breast cancer, particularly among women with genetic polymorphisms in estrogen metabolizing enzymes, is lacking. Fungicides have been recognized for their carcinogenic potential, yet there is a paucity of epidemiological studies examining the health risks of these agents. The association between agricultural fungicide exposure and breast cancer risk was examined in a secondary analysis of a province-wide breast cancer case-control study in Prince Edward Island (PEI) Canada. Specific objectives were: (1) to derive and examine the level of association between estimated fungicide exposures, and breast cancer risk among women in PEI; and (2) to assess the potential for gene-environment interactions between fungicide exposure and a CYP1A1 polymorphism in cases versus controls. After 1:3 matching of 207 cases to 621 controls by age, family history of breast cancer and menopausal status, fungicide exposure was not significantly associated with an increased risk of breast cancer (OR = 0.74; 95% CI: 0.46-1.17). Moreover, no statistically significant interactions between fungicide exposure and CYP1A1*2A were observed. Gene-environment interactions were identified. Though interpretations of findings are challenged by uncertainty of exposure assignment and small sample sizes, this study does provide grounds for further research.