Parameters for assessing the aquatic environmental impact of cosmetic products.

The cosmetic industry's growing concern about the impact of its supply chain on the environment, sustainability of raw materials, and biodiversity increases the need to ensure that the final product has a lower environmental impact. The objective of this review is to summarize and compare the information available from international organizations and legislation regarding the main criteria used to assess raw materials for aquatic toxicity, as well as the most suitable alternative methods for obtaining assessment parameters. Using the literature available in databases, a review of the scientific literature and international legislation, this work discusses and compares the parameters established by international organizations such as the Environmental Protection Agency (EPA) and Cradle to Cradle (C2C), as well as European legislation, namely, European Regulation 1272/2008, for assessing environmental impact. Defining the ecotoxicity parameters of the main classes of raw materials in rinse-off cosmetic products can enable the development of products that are more environmentally sustainable, prioritizing substances with less environmental impact.

New approach to the ecotoxicological risk assessment of artificial outdoor sporting grounds.

Artificial surfaces for outdoor sporting grounds may pose environmental and health hazards that are difficult to assess due to their complex chemical composition. Ecotoxicity tests can indicate general hazardous impacts. We conducted growth inhibition (Pseudokirchneriella subcapitata) and acute toxicity tests (Daphnia magna) with leachates obtained from batch tests of granular infill material and column tests of complete sporting ground assemblies. Ethylene propylene diene monomer rubber (EPDM) leachate showed the highest effect on Daphnia magna (EC(50) < 0.4% leachate) and the leachate of scrap tires made of styrene butadiene rubber (SBR) had the highest effect on P. subcapitata (EC(10) = 4.2% leachate; EC(50) = 15.6% leachate). We found no correlations between ecotoxicity potential of leachates and zinc and PAH concentrations. Leachates obtained from column tests revealed lower ecotoxicological potential. Leachates of column tests of complete assemblies may be used for a reliable risk assessment of artificial sporting grounds.

Identification of incident stroke in Norway: hospital discharge data compared with a population-based stroke register.

BACKGROUND AND PURPOSE: The validity of hospital discharge diagnoses is essential in improving stroke surveillance and estimating healthcare costs of stroke. The aim of this study was to assess sensitivity, positive predictive value, and accuracy of discharge diagnoses compared with a stroke register. METHODS: A record linkage was made between a population-based stroke register and the discharge records of the hospital serving the population of the stroke register (n=70 000). The stroke register (including patients aged 15 and older and with no upper age limit), applied here as a "gold standard," was used to estimate sensitivity, positive predictive value, and accuracy of the discharge diagnoses classification. The length of stay in hospital by stroke patients was measured. RESULTS: Identifying cerebrovascular diseases by hospital discharge diagnoses (International Classification of Diseases, 9th Revision [ICD-9], codes 430 to 438.9, first admission) lead to a substantial overestimation of stroke in the target population. Restricting the retrieval to acute stroke diagnoses (ICD-9 codes 430, 431, 434, and 436) gave an incidence estimate closer to the "true" incidence rate in the stroke register. Selecting ICD-9 codes 430 to 438 of cerebrovascular diseases gave the highest sensitivity (86%). The highest positive predictive value (68%) was achieved by selecting acute stroke diagnoses (ICD-9 codes 430, 431, 434, and 436), at the expense of a lower sensitivity (81%). Accuracy of ICD codes 430 to 438.9 (n=678) revealed the highest proportion of incident strokes identified by the acute stroke diagnoses (ICD-9 codes 430, 431, 434, and 436). Seventy-four percent of hospital discharge diagnoses classified as first-ever stroke kept the original diagnosis. Only 4.6% of the discharge diagnoses were classified as nonstroke diagnoses after validation. The estimation of length of stay in the hospital was improved by selection of acute stroke diagnoses from hospital discharge data (ICD-9 codes 430, 431, 434, and 436), which gave the same estimate of length of stay, a median of 8 days (2.5 percentile=0 and 97.5 percentile=56), compared with a median of 8 days (2.5 percentile=0 and 97.5 percentile=51) based on the stroke register. CONCLUSIONS: Hospital discharge data may overestimate stroke incidence and underestimate the length of stay in the hospital, unless selection routines of hospital discharge diagnoses are restricted to acute stroke diagnoses (ICD-9 codes 430, 431, 434, and 436). If supplemented by a validation procedure, including estimates of sensitivity, positive predictive value, and accuracy, hospital discharge data may provide valid information on hospital-based stroke incidence and lead to better allocation of health resources. Distinguishing subtypes of stroke from hospital discharge diagnoses should not be performed unless coding practices are improved.

Strong regional links between socio-economic background factors and disability and mortality in Oslo, Norway.

STUDY OBJECTIVE: To study geographical differences in mortality and disability and socio-economic status in Oslo, Norway. SETTING: A total of 25 local authority districts within the city of Oslo. DESIGN: Analysis of age adjusted mortality rates aged 0-74 in the period 1991-1994, and cross sectional data on disability pensioners aged 50-66 and socio-economic indicators (low education, single parenthood, unemployment, high income) in 1994. MAIN OUTCOME MEASURES: The levels of correlation between the health outcomes (mortality and disability) and socio-economic exposure variables. MAIN RESULTS: The geographical patterns of mortality and disability display substantial similarities and show strong linear correlation with area measures of socio-economic deprivation. The ratios between the highest and lowest area mortality rates were 3.3 for men and 2.1 for women, while the high-low ratios of disability were 7.0 for men and 3.8 for women. For women deprivation measures are better correlated with disability than mortality. While disability and mortality display similar correlations with deprivation measures for men. CONCLUSIONS: The social gradients in health are substantial in Oslo. Further ecological analysis of cause specific morbidity and mortality and the distribution of risk factors ought to be done to identify problem areas suitable for interventions. However, to understand the mechanisms and the relative importance of each etiological factor, studies based on individual data have to be performed.

[Physical inactivity of adults with functional disabilities and diseases]. / Fysisk inaktivitet hos voksne med funksjonshemninger og sykdom.

This article describes physical inactivity among adults in Nord-Trøndelag who suffer from or have suffered from heart infarction, angina pectoris, stroke, impaired motor ability, impaired vision, impaired hearing or impairment because of psychological complications. Information was collected by questionnaire during the Nord-Trøndelag Health Survey 1984-86. Younger men and younger women with previous heart infarction reported less inactivity than persons with no history of infarction. In contrast, young men and women suffering from impaired hearing were more inactive than people not suffering from impaired hearing. Among the disabled or sick, more women reported physical inactivity than men. This also held good when the results were controlled for age. Among healthy persons, the highest share of physically inactive was found in the oldest age groups, regardless of gender. This survey indicates that, to some degree, physical activity has become an accepted means of improving health after heart infarction in younger men and women. Physical activity has unexploited potential as a means of treating other disabilities and illness.