Vulnerabilidade social e incidência de COVID-19 em uma metrópole brasileira / Social vulnerability and COVID-19 incidence in a Brazilian metropolis

Resumo A vulnerabilidade é um fator chave no enfrentamento da COVID-19 tendo em vista que pode influenciar no agravamento da doença. Desse modo, ela deve ser considerada no controle da COVID-19, prevenção e promoção da saúde. O objetivo deste artigo é analisar a distribuição espacial da incidência de casos de COVID-19 em uma metrópole brasileira e sua associação com indicadores de vulnerabilidade social. Estudo ecológico. Foi utilizada a análise de varredura espacial (scan) para identificar aglomerados de COVID-19. As variáveis para identificação da vulnerabilidade foram inseridas em um modelo de Regressão Espacial Geograficamente Ponderado (GWR) para identificar sua relação espacial com os casos de COVID-19. A incidência de COVID-19 em Fortaleza foi de 74,52/10 mil habitantes, com notificação de 3.554 casos, sendo pelo menos um caso registrado em cada bairro. A regressão espacial GWR mostrou relação negativa entre incidência de COVID-19 e densidade demográfica (β=-0,0002) e relação positiva entre incidência de COVID-19 e percentual de ocupados >18 anos trabalhadores autônomos (β=1,40), assim como, renda domiciliar per capita máxima do quinto mais pobre (β=0,04). A influência dos indicadores de vulnerabilidade sobre a incidência evidenciou áreas que podem ser alvo de políticas públicas a fim de impactar na incidência de COVID-19.

Abstract Vulnerability is a crucial factor in addressing COVID-19 as it can aggravate the disease. Thus, it should be considered in COVID-19 control and health prevention and promotion. This ecological study aimed to analyze the spatial distribution of the incidence of COVID-19 cases in a Brazilian metropolis and its association with social vulnerability indicators. Spatial scan analysis was used to identify COVID-19 clusters. The variables for identifying the vulnerability were inserted in a Geographically Weighted Regression (GWR) model to identify their spatial relationship with COVID-19 cases. The incidence of COVID-19 in Fortaleza was 74.52/10,000 inhabitants, with 3,554 reported cases and at least one case registered in each neighborhood. The spatial GWR showed a negative relationship between the incidence of COVID-19 and demographic density (β=-0,0002) and a positive relationship between the incidence of COVID-19 and the percentage of self-employed >18 years (β=1.40), and maximum per capita household income of the poorest fifth (β=0.04). The influence of vulnerability indicators on incidence showed areas that can be the target of public policies to impact the incidence of COVID-19.

Indoor volatile organic compounds exposures and risk of childhood acute leukemia: a case-control study in shanghai.

A case-control study was conducted to investigate the relationship between indoor air pollution and childhood acute leukemia (AL) in Shanghai. 97 cases and 148 gender-, age-, and residence-matched controls were included. Indoor air pollution was evaluated by questionnaires and quantitative measurement including 14 volatile organic compounds (VOCs) and nitrogen dioxide (NO2) in the homes of the two groups. The levels of individual VOCs, VOC families, TVOC (sum of the concentrations of the individual VOCs) and NO2 were compared between the two groups. Exposure to styrene and butyl alcohol were associated with an increased risk of childhood AL (styrene: odds ratio (OR)=2.33, 95% confidence interval (CI): 1.07-5.07; butyl alcohol: OR = 2.51, 95%CI: 1.19-5.28); 4th quartile of chlorinated hydrocarbons (OR = 2.52, 95%CI: 1.02-6.26) and 3rd quartile of TVOC (OR = 4.03, 95%CI: 1.06-6.81) had significant higher ORs for childhood AL compared with that in the lowest quartiles. Elevated levels of individual VOCs, VOC families and TVOC were also associated with self-reported risk factors. Our findings suggest that VOCs exposure was associated with an elevated risk of childhood AL, underscore that more attention should be paid to indoor air pollution as a risk factor of childhood AL.

Guía de vivienda 2020: sistema público de vivienda / Housing guide 2020: public housing system

En la Guía de Vivienda podés encontrar todas las posibilidades que brinda el Sistema Público de Vivienda para que puedas acceder a tener su casa.

"You Have to Keep a Roof Over Your Head": A Qualitative Study of Housing Needs Among Patients With Cancer in New York City.

PURPOSE: Housing status can become compromised in the wake of financial hardship for some patients with cancer and become a source of disparity. This qualitative study describes the types of housing issues experienced by patients with cancer and survivors of cancer in New York City. METHODS: Semistructured interviews were conducted with a volunteer sample of 21 patients with cancer or survivors of cancer treated in New York City who reported housing needs in the period after diagnosis through survivorship. Nine supplemental interviews were conducted with cancer and housing key informants. Conventional content analysis was conducted on transcripts to create a codebook describing types of housing needs. RESULTS: Patients and survivors most commonly had breast (n = 9) and blood (n = 4) cancers and ranged from recently diagnosed to many years posttreatment. Twenty-nine distinct housing-related issues were identified, which were grouped into the following six major categories: housing costs (eg, rent, mortgage), home loss, doubled up or unstable housing, housing conditions, accessibility (eg, stairs, proximity to amenities), and safety. Issues were often interrelated. Housing needs sometimes predated cancer diagnosis. Other issues newly emerged in the wake of cancer-related physical limitations and disruption to finances. Needs ranged in severity and caused patients and survivors considerable burden during a difficult period of poor health and financial strain. CONCLUSION: This study contributes depth to current understandings of housing needs among patients with cancer and survivors by providing detailed disaggregated descriptions. We recommend increasing availability of services responsive to these needs and exploring promising options such as patient navigation and legal services. Findings also highlight the importance of creative solutions addressing ecologic-level factors such as housing affordability.

Agricultural and domestic pesticides in house dust from different agricultural areas in France.

Pesticides have been associated with various pathologies, and there is growing evidence of pesticide presence in domestic environments. However, most available studies focused on a limited number of pesticides or households, and few have been conducted in Europe. We aimed to assess indoor pesticide contamination by screening the prevalence of 276 pesticides and ten pesticide metabolites, in French households from different agricultural and urban areas. We sampled indoor dust from 239 households in 2012, proximate to orchards (n = 69), cereals (n = 66) and vineyard (n = 68) crops, or from urban area (n = 36). we used cellulose wipes moistened with isopropanol and polypropylene dust traps to collect recent (7 and 30 days, respectively) and settled dust (> 6 months). Overall, 125 pesticides and piperonyl butoxide were detected at least once in households, mostly at low prevalence: 97 in recent dust, and 111 in settled dust. In recent dust, the most prevalent compounds were o-phenylphenol (168 households, 70%), pentachlorophenol (86, 36%), and piperonyl butoxide (82, 34%). In addition to agricultural pesticides, we found a high proportion of domestic and banned compounds in recent and settled house dust. Several pesticides were identified in house dust, from different pesticide groups and sources. Our results suggest that domestic usage and persistence of banned pesticides may contribute substantially to indoor pesticide contamination. Graphical abstract 97 pesticides detected in households' recent indoor dust.

Indoor phthalate concentrations in residences in Shihezi, China: implications for preschool children's exposure and risk assessment.

Despite the risks associated with phthalate exposure, there are few studies emphasizing preschool children's exposure to phthalates in residences in Northwest China. In this study, seven phthalates from indoor dust samples were measured in 50 residences in Shihezi, China. Preschool children's exposure doses via non-dietary intake were calculated by Monte Carlo simulation. Risk assessment was conducted by comparing the simulated exposure dose with benchmarks for reproductive toxicity and cancer specified in Proposition 65 of California. The detection frequencies for all selected phthalates were more than 75%, with the exception of benzyl butyl phthalate (BBP) and di-n-octyl phthalate (DNOP). Bis(2-ethylhexyl) phthalate (DEHP) was the most principal compound in the dust samples (median = 455 µg/g and 462 µg/g in the bedroom and living room, respectively). The simulation displayed that the median DBP daily intake was 1.5-1.9 µg/day/kg for preschool children in Shihezi, which was considered a high level compared with similar studies around the world. The risk assessment indicated that almost all preschool children face potential reproductive risk due to dibutyl phthalate (DBP) exposure, with medians of hazard index (HI) from 9.6 to 12.4 for all age groups. Therefore, from a children's health perspective, attention should be paid to reducing indoor phthalate pollution and exposure in this area.

Semi-volatile organic compounds in infant homes: Levels, influence factors, partitioning, and implications for human exposure.

While infants are developing, they are easily affected by toxic chemicals existing in their environments, such as semi-volatile organic compounds (SVOCs): phthalates, polycyclic aromatic hydrocarbons (PAHs), polybrominated diphenyl ethers (PBDEs), and organophosphate esters (OPEs). However, the specific living environment of infants, including increased plastic products and foam floor mats, may increase the presence of these chemicals. In this study, 68 air, dust, and window film samples were collected from homes, with 3- to 6-month-old infant occupants, to analyze phthalates, PAHs, PBDEs, and OPEs. High detection rates and concentrations suggest that these SVOCs are widespread in infant environments and are associated with cooking methods, smoking habits, the period of time after decoration, and room floors. The partitioning behavior of SVOCs indicates that the logarithms of the dust/gas-phase air partition coefficient (logKD) and the window film/gas-phase air partition coefficient (logKF) in homes are not at an equilibrium state when the logarithm of the octanol/air partition coefficient (logKOA) is less than 8 or greater than 11. Considering the 3 exposure routes, ingestion and dermal absorption have become the main routes of infant exposure to phthalates and OPEs, and ingestion and inhalation have become the dominant routes of exposure to PAHs and PBDEs. The total carcinogenic risk of SVOCs, which have carcinogenic toxicities, via ingestion and dermal absorption for infants in homes exceeds the acceptable value, suggesting that the current levels of these SVOCs in homes might pose a risk to infant health.

Sources of isocyanic acid (HNCO) indoors: a focus on cigarette smoke.

The sources and sinks of isocyanic acid (HNCO), a toxic gas, in indoor environments are largely uncharacterized. In particular, cigarette smoke has been identified as a significant source. In this study, controlled smoking of tobacco cigarettes was investigated in both an environmental chamber and a residence in Toronto, Canada using an acetate-CIMS. The HNCO emission ratio from side-stream cigarette smoke was determined to be 2.7 (±1.1) × 10-3 ppb HNCO/ppb CO. Side-stream smoke from a single cigarette introduced a large pulse of HNCO to the indoor environment, increasing the HNCO mixing ratio by up to a factor of ten from background conditions of 0.15 ppb. Although there was no evidence for photochemical production of HNCO from cigarette smoke in the residence, it was observed in the environmental chamber via oxidation by the hydroxyl radical (1.1 × 107 molecules per cm3), approximately doubling the HNCO mixing ratio after 30 minutes of oxidation. Oxidation of cigarette smoke by O3 (15 ppb = 4.0 × 1017 molecules per cm3) and photo-reaction with indoor fluorescent lights did not produce HNCO. By studying the temporal profiles of both HNCO and CO after smoking, it is inferred that gas-to-surface partitioning of HNCO acts as an indoor loss pathway. Even in the absence of smoking, the indoor HNCO mixing ratios in the Toronto residence were elevated compared to concurrent outdoor measurements by approximately a factor of two.

Screening for Housing Instability: Providers' Reflections on Addressing a Social Determinant of Health.

BACKGROUND: The Veterans Health Administration (VHA) has a long history of addressing social determinants of health, including housing. In 2012, the VA integrated a two-question Homelessness Screening Clinical Reminder (HSCR) into the electronic medical record in outpatient clinics to identify Veterans experiencing housing instability and ensure referral to appropriate services. OBJECTIVE: This study explores perspectives of VA clinical providers regarding administration of the HSCR, their role in addressing housing status, and how a patient's housing status impacts clinical decision-making. DESIGN: We conducted a qualitative study using in-depth semi-structured interviewing. PARTICIPANTS: Twenty-two providers were interviewed (20 physicians and two nurse practitioners) between March and September 2016. APPROACH: Interviews were conducted with Veterans Health Administration (VHA) physician and non-physician practitioners who had administered the HSCR and documented at least five positive screens between 2013 and 2015. Our interview guide investigated provider experiences with administering the HSCR and addressing affirmative responses. The guide also elicited details about how patients' housing instability was identified (if at all) prior to implementation of the screening reminder, and how practices changed following implementation of the HSCR. Transcripts were analyzed using a modified grounded theory approach. KEY RESULTS: Providers reported that the HSCR prompted them to incorporate patient housing status into routine assessment, which they typically did not do prior to its implementation. Providers discussed adverse impacts of housing instability on patients' overall health and described how they factored patients' housing instability into clinical decision-making. Although providers viewed the health system as having an important role in addressing housing concerns, there were mixed opinions on whether it was the role of providers to directly administer the screening. CONCLUSIONS: Integration of a screener for housing instability into the electronic medical record increased provider attention to housing instability into the social history, and positive responses commonly impacted plans of care.

Examining the role of total organic carbon and black carbon in the fate of legacy persistent organic pollutants (POPs) in indoor dust from Nepal: Implication on human health.

Despite the fact that the consumption and import of legacy persistent organic pollutants (POPs) have been stopped in Nepal since 2001, they are still of worry for human prosperity and the environment because of their persistence behavior and constant release from sources that are presently being used. The essential objective of this study was to assess the concentration and spatial distribution of organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) in residential dust from Nepal keeping in mind the end goal to evaluate the importance of total organic carbon (TOC) and black carbon (BC) in the fate of legacy POPs. Additionally, health risk exposure via dust ingestion and dermal absorption was estimated to evaluate the significance of dust media for human exposure. Results demonstrated that ∑OCPs in dust was 37 times greater than ∑PCBs. DDT was mostly dominated in the dust, and contributed 90% of the ∑OCPs, while hexa-CBs predominated among PCBs and represented 34% of ∑PCBs. Birgunj and Biratnagar had a relatively higher level of ∑OCPs and ∑PCBs than those of Kathmandu and Pokhara. TOC and BC showed a poor connection with OCPs, recommending little or no role. However, PCB in the dust, especially low congeners was strongly linked with TOC but not BC indicating the significant role of TOC. The daily risk exposure estimation indicated dermal absorption through dust as the principal means of OCPs/PCBs intake to both adult and children population. These estimated exposures were 2-4 orders of magnitude inferior to their corresponding reference dose showing insignificant risk.

A Technological Scenario for a Healthier, More Equitable and Sustainable Europe in 2040: Citizen Perceptions and Policy Implications.

This article aims at exploring, understanding and comparing European citizens' insights and perceptions towards "My life between realities", a positive future scenario which depicts a narrative of reaching healthier, more equitable and sustainable societies by 2040 with the support of technology and technological solutions. It responds to the need for gathering and incorporating more citizen insights into future policy developments and strategic actions to tackle the global challenge of unsustainable development. Citizens of five European countries-the Czech Republic, Germany, North Macedonia, Spain and the United Kingdom-have been consulted through focus groups. The exercise has uncovered citizens' preferences and attitudes towards four main lifestyle areas; namely, green spaces, energy efficient housing, active mobility and (food) consumption. The technological attributes of the scenario led to citizens expressing diametrically opposed and critical perceptions and attitudes. Given the prospects of technology in driving sustainable development, based on these insights, policy recommendations for the better integration and acceptance of technological advances by the public are discussed herein.

Factors associated with parent-reported wheeze and cough in children living in an industrial area of Gauteng, South Africa.

We examined the factors associated with mother-reported wheeze and dry cough in children living in Tembisa, a residential and industrial community in South Africa. A cross-sectional sample of parents reported wheezing and dry cough in children (aged 1 to 26 months) by completing the standardised International Study of Asthma and Allergies in Childhood questionnaire with additional questions concerning tobacco use, income, living conditions, and mothers' educational level. Data were analysed using chi-square, univariate, and multivariable logistic regressions. Of the 493 children who participated, 81 (16.4%) had wheeze ever and 186 (37.7%) had dry cough ever. We observed that children had a higher probability of wheezing if mothers had lived in the area for longer periods (aOR 1.05; 95% CI 1.01-1.08). Children who had trucks passing on their streets frequently were more likely to have had dry cough ever compared to those with no trucks passing on their streets (aOR 3.88; 95% CI 2.29-6.57). In Tembisa, dry cough in a child was associated with the frequency of trucks passing in front of the child's home. Children were also more likely have wheeze if their mothers had been living in the community for longer times.

The Importance of Using Public Health Impact Criteria to Develop Environmental Health Indicators: The Example of the Indoor Environment in New Zealand.

Developing environmental health indicators is challenging and applying a conceptual framework and indicator selection criteria may not be sufficient to prioritise potential indicators to monitor. This study developed a new approach for prioritising potential environmental health indicators, using the example of the indoor environment for New Zealand. A three-stage process of scoping, selection, and design was implemented. A set of potential indicators (including 4 exposure indicators and 20 health indicators) were initially identified and evaluated against indicator selection criteria. The health indicators were then further prioritised according to their public health impact and assessed by the five following sub-criteria: number of people affected (based on environmental burden of disease statistics); severity of health impact; whether vulnerable populations were affected and/or large inequalities were apparent; whether the indicator related to multiple environmental exposures; and policy relevance. Eight core indicators were ultimately selected, as follows: living in crowded households, second-hand smoke exposure, maternal smoking at two weeks post-natal, asthma prevalence, asthma hospitalisations, lower respiratory tract infection hospitalisations, meningococcal disease notifications, and sudden unexpected death in infancy (SUDI). Additionally, indicators on living in damp and mouldy housing and children's injuries in the home, were identified as potential indicators, along with attributable burden indicators. Using public health impact criteria and an environmental burden of disease approach was valuable in prioritising and selecting the most important health impacts to monitor, using robust evidence and objective criteria.

Associations between household air pollution and reduced lung function in women and children in rural southern India.

Half of the world's population still relies on solid fuels to fulfill its energy needs for cooking and space heating, leading to high levels of household air pollution (HAP), adversely affecting human health and the environment. A cross-sectional cohort study was conducted to investigate any associations between: (1) HAP metrics (mass concentration of particulate matter of aerodynamic size less than 2.5 µm (PM2.5 ), lung-deposited surface area (LDSA) and carbon monoxide (CO)); (2) a range of household and socio-demographic characteristics; and (3) lung function for women and children exposed daily to biomass cookstove emissions, in rural southern India. HAP measurements were collected inside the kitchen of 96 households, and pulmonary function tests were performed for the women and child in each enrolled household. Detailed questionnaires captured household characteristics, health histories and various socio-demographic parameters. Simple linear and logistic regression analysis was performed to examine possible associations between the HAP metrics, lung function and all household/socio-demographic variables. Obstructive lung defects (forced vital capacity (FVC) ≥ lower limit of normal (LLN) and forced expiratory volume in 1 second (FEV1 )/FVC < LLN) were found in 8% of mothers and 9% of children, and restrictive defects (FVC < LLN and FEV1 /FVC ≥ LLN) were found in 17% of mothers and 15% of children. A positive association between LDSA, included for the first time in this type of epidemiological study, and lung function was observed, indicating LDSA is a superior metric compared to PM2.5 to assess effects of PM on lung function. HAP demonstrated a moderate association with subnormal lung function in children. The results emphasize the need to look beyond mass-based PM metrics to assess fully the association between HAP and lung function.

Association between health risks and frailty in relation to the degree of housing damage among elderly survivors of the great East Japan earthquake.

BACKGROUND: Many survivors of the Great East Japan Earthquake that occurred in 2011 were at risk of deteriorating health, especially elderly people living in disaster-stricken areas. The objectives of this prospective study were: a) to clarify the different lifestyle and psychosocial factors associated with frailty by sex among the non-disabled elderly survivors, and b) to describe the differences in characteristics stratified by the degree of disaster-related housing damage. METHODS: We followed 2261 Japanese survivors aged ≥65 years (45.3% male; mean age, 71.7 years) without disability or frailty who completed a self-administered questionnaire at baseline. All participants completed a baseline questionnaire in 2011 and at least one identical follow-up questionnaire between 2012 and 2015 regarding lifestyle (smoking status, alcohol intake, physical activity, sedentary lifestyle, and dietary intake) and psychosocial factors (self-rated health, standard of living, psychological distress, and social networks). Frailty was defined as a score of ≥5 on the Kihon Checklist, which is used by the Japanese government to certify the need for long-term care insurance. Adjusted odds ratios and 95% confidence intervals with frailty as the dichotomous dependent variable and health factors as the independent variables were calculated using a multilevel model for repeated measures by sex, followed by stratification analyses by the degree of housing damage. RESULTS: Over the 4-year study period, 510 participants (22.6%) developed frailty. In the post-disaster setting, many of the psychosocial factors remained more prevalent 4 years later among survivors with extensive housing damage. The presence of risk factors regarding the development of frailty differed by the degree of housing damage. Among men, psychological distress, in parallel with a poor social network, was related to frailty among only the participants with extensive housing damage and those living in temporary housing, whereas among women, worsening psychological distress was associated only with no damage and no displaced survivors. Among women with extensive damage and displacement, health outcomes such as overweight and diabetes and poor social networks were strongly related to frailty. CONCLUSIONS: Lifestyle and psychosocial factors associated with the risk of frailty differ by sex and the degree of housing damage.

Cessation and reduction in smoking behavior: impact of creating a smoke-free home on smokers.

The aim of this study was to assess the effect of a creating a smoke-free home (SFH) on cessation and reduction of cigarette smoking on low-income smokers. This secondary data analysis uses data from study participants who were originally recruited through 2-1-1 information and referral call centers in Atlanta (Georgia, 2013), North Carolina (2014) and the Texas Gulf Coast (2015) across three randomized controlled trials testing an intervention aimed at creating SFHs, pooling data from 941 smokers. Participants who reported adopting a SFH were more likely to report quitting smoking than those who did not adopt a SFH. This was true at 3-month follow-up and even more pronounced at 6-month follow-up and persisted when considering only those who consistently reported no smoking at 3 and 6 months. Among those who did not stop smoking, the number of cigarettes per day declined significantly more and quit attempts were more frequent for those who created a SFH compared with those who did not. Findings suggest that creating a SFH facilitates cessation, reduces cigarette consumption and increases quit attempts. Future studies should assess the long-term impact of SFHs on sustaining cessation.

Currently used organophosphate flame retardants determined in the settled dust of masjids and hotels of Saudi Arabia, a new insight into human health implications of dust exposure.

Indoor settled dust particles are considered as an important source of human exposure to chemicals such as organophosphate flame retardants (PFRs). In recent decades the Kingdom of Saudi Arabia (KSA) has experienced tremendous growth in population, as a result the number of masjids has also increased significantly to provide sufficient space for the public to offer prayers. The hospitality industry in KSA is also expanding to cater for the ever-increasing number of pilgrims visiting the two holy cities of the kingdom. However, limited data are available on the indoor pollution of masjids and hotels. In this study, PFRs were analyzed in the settled dust collected from various hotels and masjids of Jeddah, KSA. Tris(1,3-dichloro-2-propyl) phosphate (TDCPP) and tris(1-chloro-2-propyl) phosphate (TCPP) were the major PFRs in masjid (median = 2490 and 2055 ngg-1) and hotel (median = 2360 and 3315 ngg-1) dust, respectively. A public health risk assessment was carried out by determining the incremental lifetime cancer risk (ILCR), and daily exposure via dust ingestion, inhalation, and dermal contact of PFRs. The calculated daily exposure via dust ingestion was well below the reference dose (RfD) values, and also the calculated hazardous quotient (HQ) and carcinogenic risk were well below the risk mark. However, the ILCR for PFRs was below the reference values of USEPA, which suggested that long-term exposure to these chemicals has a limited cause for concern. The study showed that the general public is exposed to PFRs in the studied microenvironments and the major exposure routes are dermal contact and ingestion.

Assessment of progeny concentrations of 222Rn/220Rn and their related doses using deposition-based direct progeny sensors.

Indoor radon and thoron concentrations in the domestic environment result in natural radiation exposure to the public due to the inhalation of their short-lived decay products. Keeping this in view, the annual effective dose and other radiation risks due to radon/thoron progenies have been calculated. In this study, newly developed time deposition-based progeny sensors (DTPS/DRPS) were used for long-term passive determination of progeny concentrations in the environment of Jammu and Kashmir, Himalayas, India. The total equilibrium equivalent radon (EECRA + U) and thoron (EECTA + U) concentrations ("A" and "U" referring to attached and unattached fractions) were found to vary from 5 to 38 Bq m-3 with an average value of 18 Bq m-3 and from 0.48 to 5.49 Bq m-3 with an average value of 1.69 Bq m-3, respectively. The aerosol concentration, equilibrium factors, and unattached fractions for radon and thoron progeny have been estimated in normal living conditions and their dependence on each others have also been studied. The annual equilibrium factor for radon and thoron progeny has been determined from the calculated data. The estimated annual effective dose due to radon progeny (0.34 to 2.42 mSv y-1) and thoron progeny (0.13 to 1.54 mSv y-1) is found to be below the world's recommended level. Based on measurements of mean values of the unattached fraction, dose conversion factors (DCFs) in units of mSv per working level month (WLM) has been calculated and the average calculated values of DCFs are 24, 10, and 13 mSv WLM-1. The variability of equilibrium factor and radon/thoron progeny with different seasons, ventilation conditions, and types of houses were also analyzed.

Prevalence and Indicators of Household Smoking Bans Among American Indians.

More than 58 million nonsmokers in the U.S. encounter secondhand smoke that leads to tobacco-related diseases and deaths every year, making voluntary household smoking bans an important public health goal. American Indians/Alaska Natives are rarely included in research related to household smoking bans. Further, most studies dichotomize household smoking bans into complete bans versus partial/no bans, rendering it impossible to determine if partial and no bans are associated with different or similar risk factors. Using the 2014 Cherokee Nation American Indian Adult Tobacco Survey, our study sought to identify prevalence of household smoking bans, their extent, and their correlates in an American Indian population. This cross-sectional analysis used multinomial logistic regression to determine correlates of complete, partial, and no household smoking bans. Results indicated that approximately 84% of Cherokee households have a complete ban. Younger age, female gender, higher education, higher household income, respondent's nonsmoking status, good health, better awareness of harms related to secondhand smoke, visits with a healthcare provider within the past year, and children in the home were positively and significantly associated with complete household smoking bans. Additionally, there were notable differences between correlates related to partial bans and no bans. These results provide insight for the development of more appropriate interventions for American Indian households that do not have a complete household smoking ban.