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INTRODUCTION: Children's skin is particularly susceptible to the carcinogenic effects of ultraviolet radiation. Young children are dependent on sun protection measures taken by parents and other caregivers. OBJECTIVES: The aim of the study is to evaluate parental sun protection behavior and sun protection measures at preschool at two points in time (2010/11 and 2018/19) in Bavaria and to test for a secular trend. METHODS: Two cross-sectional surveys were carried out. For each survey, more than 4,000 parents of preschoolers completed a self-administered questionnaire about parental sun protection behavior and sun protection measures at preschool. To identify possible associations between parental sun protection behavior and sociodemographic characteristics, logistic regression analysis was carried out. RESULTS: In the survey of 2018/19, six out of eight sun protection measures are adequately applied by over two-thirds of the parents. Two out of eight sun protection measures are adequately applied by less than one-third of the parents. Those two measures are aligning sun protection to actual UV index and preschoolers wearing sunglasses. The comparison of the study population of the survey of 2010/11 and of 2018/19 shows an improvement in parental sun protection behavior for seven out of eight sun protection measures. In both surveys more than 80% of parents state that preschool staff ensures preschoolers wear sun hats and sunscreen outside on sunny days. CONCLUSIONS: Future campaigns should focus on the use of sunglasses and promote the UV index, as these sun protection measures are used very little.
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BACKGROUND: In the past, perfluorooctanoic acid (PFOA) was produced and applied as an emulsifier in a fluoropolymer production plant in the Altötting district, southern Bavaria (Germany). This chemical was released directly into the environment, resulting in the contamination of the local drinking water. During a human biomonitoring (HBM) survey in 2018, increased median PFOA blood serum levels, compared to a normally exposed control group with no known source of PFOA exposure from Munich, Germany, were detected in the resident population (23.18 µg/l in the general population, 20.71 µg/l in the children's group). The follow-up study aimed to investigate whether purification of the drinking water as the main PFOA exposure source has been successful in reducing internal PFOA exposure and to estimate the association of internal PFOA exposure with possible influencing factors. METHODS: Only individuals who had already participated in the HBM study in 2018 were included. For the determination of the PFOA serum concentration, 5 ml of blood was drawn from each participating person. Blood samples were collected in the period from June to August 2022. Furthermore, information on sociodemographic characteristics, health status, dietary behaviour and other lifestyle factors were collected by means of a self-administered questionnaire. To examine the association of PFOA blood serum levels with possible influencing factors, such as age, gender and consumption of fish and game meat, a logistic regression model with a PFOA value > 10 µg/l as outcome was used. RESULTS: A total of 764 individuals participated in the follow-up study in 2022. Analyses were performed separately for the general population (n = 559), women of reproductive age (15-49 years old) (n = 120), and children under 12 years old (n = 30). Median PFOA blood levels have decreased by 56.9% in the general population, by 59.8% in the group of women of reproductive age and by 73.4% in the group of children under 12 years old. In the general population, a higher probability of a PFOA value > 10 µg/l was found for those aged 40-59 years (Odds ratio (OR) = 2.33 (95%CI: 1.23 to 4.43, p = 0.01) and those aged 60 years and older (OR = 5.32, 95%CI: 2.78 to 10.19, p < 0.001). CONCLUSIONS: In all study groups, the median PFOA serum levels decreased as expected after a half-life of four years, which confirms that contamination via drinking water has ceased. Furthermore, our study identified age as a significant predictor of internal PFOA exposure, while no influence was found for the consumption of fish and game meat. Further investigations are needed to quantify in a more detailed way the influence of dietary habits on PFOA exposure.
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Monitoreo Biológico , Caprilatos , Exposición a Riesgos Ambientales , Fluorocarburos , Humanos , Caprilatos/sangre , Fluorocarburos/sangre , Alemania , Femenino , Masculino , Adulto , Persona de Mediana Edad , Niño , Adolescente , Adulto Joven , Exposición a Riesgos Ambientales/análisis , Preescolar , Anciano , Estudios de Seguimiento , Contaminantes Químicos del Agua/sangre , Contaminantes Químicos del Agua/análisis , Lactante , Contaminantes Ambientales/sangre , Agua Potable/química , Industria QuímicaRESUMEN
People can be affected by various environmental factors (e. g., odor, noise) which can lead to medical complaints or illnesses. Few adequate contact points are available for patients with suspected environmental complaints in Germany. Illustrated by the outpatient clinics for environmental medicine in Hamburg and Munich, this report shows how patients with suspected environmental medical diseases are cared for in Germany. For the exemplary presentation, the data of the environmental medicine outpatient clinics of both the university hospitals from 01.01.2019 to 31.03.2021 are presented and compared. Overall, more female than male patients were treated at both facilities. Suspected exposure to "heavy metals" was most frequently mentioned by patients as the assumed reason for their complaints. Nonetheless, the suspected exposure or "intoxication" could be ruled out in the majority of cases by appropriate examination methods in accordance to current medical guidelines. The data provided by the environmental medicine outpatient clinics show that there is a continuous demand for environmental medical care. A close cooperation between the private practice sector and the outpatient clinics for environmental medicine providing medical care to patients should therefore be sought.
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Medicina Ambiental , Humanos , Masculino , Femenino , Hospitales Universitarios , Alemania , Instituciones de Atención Ambulatoria , Atención al PacienteRESUMEN
OBJECTIVE: To examine risky leisure noise exposure from listening to music via headphones and to identify potential determinants with special focus on portable listening devices (PLDs) among adolescents over a period of 7.5-years. DESIGN: Data were collected by questionnaires at four equidistant time points (O1-O4). Music exposure via headphones was calculated based on self-reported volume setting and listening duration. Exceeding 85 dB(A) equivalent for a 40-hour working week was defined as risky noise exposure. Determinants of risky headphone and PLD exposure were investigated using generalised estimating equations and accounting for missing data by multiple imputation. STUDY SAMPLE: Closed cohort of 2148 students attending 9th grade of any secondary school type in Regensburg (Germany), during 2009 to 2011. RESULTS: Risky noise exposure from headphone usage was almost twice as high in wave O1 and O2 (at age 15 or 18) compared with 20-23-year-olds in O3 and O4. Risky exposure to headphones and PLDs were associated with younger age, low and medium education, single-parent household and smoking, whereas good self-rated hearing showed a protective effect. Additionally, not being born in Germany was associated with risky PLD exposure. CONCLUSION: Before harmful behaviours become entrenched, starting preventive efforts at a young age is essential.
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OBJECTIVE: To observe total leisure noise (TLN) exposure and to investigate determinants of risky TLN exposure among adolescents and young adults over a ten-year observation period. DESIGN: OHRKAN is a longitudinal study with five equidistantly distributed questionnaires (waves) over ten years. Risky TLN exposure was defined as exceeding ≥85dB(A) averaged over 40h per week. To identify determinants of risky TLN exposure longitudinally, generalised estimating equations were applied. STUDY SAMPLE: A subgroup (n = 661; mean age 25.6 years in the fifth wave; 58.4% female) of the closed cohort study OHRKAN was analysed. Included participants took part in the fifth wave prior to the study break due to COVID-19. RESULTS: Analysis of participants' data from all five waves showed that risky TLN exposure was highest during the second wave (72.0%), when participants were aged 17-19 years, and thereafter steadily declined. Among young adults, attendance at discotheques and private parties, especially, caused very high exposure. Determinants of risky TLN exposure were wave time point, male gender, a higher level of education, and smoking. CONCLUSIONS: As TLN exposure is highest among older adolescents, prevention programs should target younger teenagers and be tailored to the identified risk groups. The risk from private parties should be addressed.
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Due to the SARS-CoV-2 pandemic, healthcare workers worldwide faced major challenges in the form of psychological stress. The aim of this systematic literature review and meta-analysis is to identify mental health consequences and associated work-related factors in healthcare workers during a pandemic and to quantify the influence of associated work-related factors on mental health consequences. A systematic literature search according to PRISMA was conducted on 5 August 2021 using the databases PubMed Central and APA PsychInfo. The included studies investigated the mental health consequences and associated work-related factors in healthcare workers in a pandemic. In addition, we performed a risk of bias analysis to assess the study quality of the included studies using the JBI checklists. Random-effect models and pooled effect estimators were used for the meta-analysis. The Chi2 and I2 statistics were used to identify the statistical heterogeneity. Additional sensitivity analysis was performed. From a total of 3,910 publications, 43 studies met the inclusion criteria. These studies provided 15 stress consequences and 20 stress factors. The most frequently reported stress factors were 'contact with COVID-19 patients', 'no education or training in handling infectious diseases' and 'insufficient protective equipment'. Anxiety, stress, and depression were the most common outcomes identified. Analyses showed an increase in anxiety scores among HCWs who cared for COVID-19 patients, as well as a rise in depressive symptoms due to inadequate or no personal protective equipment. In this review, various pandemic-associated stress factors and stress consequences of healthcare workers were observed. With the results, criteria for effective measures and interventions can be developed to minimize the risk of stress consequences.
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COVID-19 , Salud Mental , Humanos , Pandemias , Personal de Salud/psicología , COVID-19/epidemiología , SARS-CoV-2 , Ansiedad/epidemiología , Ansiedad/psicología , DepresiónRESUMEN
OBJECTIVE: The overall objective in the study was to compare self-reported hearing based on a single question ("how good would you currently rate your hearing?") to measure hearing loss determined by audiometry in a cohort of adolescents. Prevalence of audiometrically measured hearing loss and frequencies of self-reported poor hearing as well as factors that have an impact on self-reported hearing were examined. DESIGN: Baseline and 5-year follow-up data of the Ohrkan study were used. Participants filled in a questionnaire and underwent audiometric measurements. STUDY SAMPLE: Data from 979 adolescents were analysed. Participants were 54.7% female and aged between 13 and 18 years at baseline and 17-21 years at 5-yr follow-up. RESULTS: The single question on self-reported hearing ability achieved a sensitivity of 41.9% and a positive predictive value of 7.1% at baseline. For the 5-yr follow-up, sensitivity was 40.0%, positive predictive value was 13.9%. Factors influencing self-reported poor hearing were gender, tinnitus, "muffled" ears after exposure to loud noise (e.g. after a concert) and low-frequency hearing loss. CONCLUSIONS: The single question about hearing ability used in the Ohrkan study is not sufficient to replace audiometry to detect hearing loss as defined in the study in adolescents.
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Sordera , Pérdida Auditiva , Humanos , Femenino , Adolescente , Masculino , Autoinforme , Pérdida Auditiva/diagnóstico , Pérdida Auditiva/epidemiología , Audición , Audiometría , Audiometría de Tonos PurosRESUMEN
Abandoned gold mining spoils pose socio-environmental, human, and animal health impacts and threaten sustainability of mineral extraction. Green trials and ecological solutions are required to effectively remediate these contaminated soils and mitigate the associated risks. Here, we carried out a pot experiment using a highly contaminated soil (mean total As = 5104.0 mg/kg) collected from an abandoned mine spoil in Ghana. We aimed to quantify the impacts of compost, iron oxide, and poultry manure on the mobilization, fractionation, and uptake of As by ryegrass (Lolium perenne). The soil amendments were applied at a rate of 5% (w/w) each, separately or in combination. We extracted the mine spoil soil readily-bioavailable As and specific-sorbed As, and determined the As contents in plant and the uptake after harvest. The plant transfer indices for soil-to-root (bioconcentration factor, BCF), soil-to-shoot (bioaccumulation concentration- BAC), and root-to-shoot (translocation factor- TF) were also calculated. Addition of manure increased the mining readily-bioavailable As by 243% and specific-sorbed As by 38%, as compared to the control. Manure addition further aided root As-uptake by 134%, whilst its combination with compost increased uptake by 101%. Lone addition of manure and in combination with compost resulted in BCF above 1, indicating increased As-phytostability. The presence of carbon and iron in the roots of the ryegrass sorbed or precipitated As limited its soil-to-shoot and root-to-shoot transfer. These findings indicate that manure alone and in combination with compost can be used to augment the phytoremediation efficiency of ryegrass in the As-contaminated spoil.
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Arsénico , Lolium , Contaminantes del Suelo , Animales , Biodegradación Ambiental , Oro , Humanos , Estiércol , Minería , SueloRESUMEN
PURPOSE: The aim of this study was to analyze the association of total leisure noise exposure and hearing threshold shifts over 5 years among adolescents enrolled in the Ohrkan cohort study. METHOD: The Ohrkan cohort of 2,148 students aged 13-19 years was recruited from 2009 to 2011 and followed up 5 years later. Complete baseline and follow-up reports on exposure and outcome were available for 989 participants. Leisure noise exposure was assessed by questionnaires, and clinical audiometric examinations were performed. Two outcomes were defined: occurrence of the Niskar notch pattern and audiometry showing maximum hearing threshold values at 3, 4, and 6 kHz (both ears). Longitudinal analysis using generalized estimating equations was performed. RESULTS: High total leisure noise exposure, defined as an energy equivalent of a 40-hr week of > 85 dBA, was estimated for 32.7% of students at baseline and 63.8% at follow-up. A noise notch was observed in 1.1% of adolescents at baseline and 3.3% at follow-up. At baseline, the maximum measured threshold shift was 55 dB, which increased to 85 dB at the follow-up. Longitudinal analysis did not reveal an association between leisure noise exposure and hearing thresholds. Hearing threshold shifts or noise notches were associated with sex, school type, and time point of measurement. CONCLUSIONS: No relationship was found between leisure noise and hearing thresholds. Male adolescents and those attending secondary general schools, with graduation following completion of ninth or 10th grade, had a greater likelihood of developing hearing threshold shifts. Prevention programs should focus on these risk groups. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.19233462.
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Pérdida Auditiva Provocada por Ruido , Adolescente , Adulto , Umbral Auditivo , Estudios de Cohortes , Audición , Pérdida Auditiva Provocada por Ruido/epidemiología , Pérdida Auditiva Provocada por Ruido/prevención & control , Humanos , Actividades Recreativas , Masculino , Ruido/efectos adversos , Adulto JovenRESUMEN
Heavy metal (HM) pollution and the need to preserve the environment have gathered increasing scientific attention. The immobilization of HMs into less-soluble, less mobile, and less toxic forms in addition to the improvement of Medicago sativa L. growth and HMs accumulation were evaluated after the application of marble waste (MW) and/or beneficial PGP rhizobacteria and mycorrhizae to the mining soil compost. A greenhouse assay was conducted to elucidate the influence of both amendment and beneficial microorganisms. The application of marble waste to the soil-compost resulted in decreasing the bioavailability of metals (Cu, Zn, Pb, and Cd), thus ameliorating the installation of the vegetal cover for 6 months of culture. Cultivation of M. sativa under 5% MW-amended soil for 6 months increased the shoot dry weight by almost twofold, while the inoculation with rhizobacteria-mycorrhizae combined with the application of 15% MW resulted in an improvement of 3.5-fold in case of shoot dry weight. In addition, the application of marble waste amendment or their combination with metallo-resistant bacteria resulted in decreasing HM accumulation leading to HM content below the threshold recommended for animal grazing. Thus, the application of amendments and beneficial microorganisms appeared to guarantee the safe cultivation of alfalfa for 6 months of culture. The dual combination amendments and beneficial microorganisms showed the good potential to restore HM polluted soils and could stand as a novel approach for restoration of HM-contaminated soils.
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Metales Pesados , Micorrizas , Contaminantes del Suelo , Animales , Biodegradación Ambiental , Carbonato de Calcio , Análisis Costo-Beneficio , Medicago sativa , Metales Pesados/análisis , Micorrizas/química , Suelo , Contaminantes del Suelo/análisisRESUMEN
BACKGROUND: After decades of rising prevalence of atopic and airway-related diseases, studies showed stagnating prevalence in western industrialised countries. Objective of this study is to analyse the time trend of prevalence of atopic diseases and airway-related symptoms among Bavarian children before starting primary school. MATERIALS AND METHODS: Five cross-sectional studies from 2004/2005, 2006/2007, 2012/2013, 2014/2015 and 2016/2017 took place in urban and rural regions in Bavaria, Germany. Using standardized parent questionnaires children's atopic diseases and airway-related symptoms were surveyed. Logistic regression analysis (Bonferroni correction: adjusted significance level 0.005) was performed to analyse prevalence of symptoms and diseases from 2004 to 2017 for time trends. RESULTS: The surveys included 27384 Bavarian children aged 5-6 years (52.6% male). In all children the calculated 12-month prevalence of symptoms '≥four episodes of wheeze' (p-value = .0880) and 'rhinoconjunctivitis' (p-value = .3994) reported by parents stagnated, whereas 'wheeze' (p-value<.0001; OR = 0.97; CI = [0.96-0.98]) and 'rhinitis' (p-value = .0007; OR = 0.98; CI = [0.97-0.99]) decreased. In all children the calculated lifetime prevalence of physician-diagnosed 'asthma' (p-value = .5337), and 'hay fever' (p-value = .8206) stagnated, whereas of 'bronchitis' (p-value<.0001; OR = 0.98; CI = [0.98-0.99]) decreased over time. The calculated lifetime prevalence of physician-diagnosed 'atopic eczema' (p-value = .0002; OR = 0.98; CI = [0.97-0.99]) decreased in all children, whereas the calculated 12-month prevalence of the symptom 'itchy rash' increased (p-value = .0033; OR = 1.07; CI = [1.05-1.08]) over time. CONCLUSIONS: Several calculated prevalence of children's atopic diseases and airway-related symptoms reported by parents stagnated in a subgroup of Bavarian children before starting primary school between 2004 and 2017. The time trend of prevalence in 'wheeze', 'rhinitis' and 'bronchitis' decreased. Prevalence of 'atopic eczema' decreased over time, whereas 'itchy rash' increased.
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Dermatitis Atópica , Rinitis Alérgica Estacional , Niño , Preescolar , Estudios Transversales , Dermatitis Atópica/epidemiología , Femenino , Humanos , Masculino , Prevalencia , Ruidos Respiratorios/etiología , Rinitis Alérgica Estacional/epidemiología , Instituciones Académicas , Encuestas y CuestionariosRESUMEN
Introduction: Asthma is among the most common chronic conditions in children. The aim of this publication is to describe prevalence rates and factors associated with asthmatic or wheezing preschoolers and to evaluate medical care and treatment with regard to urban-rural differences.Methods: Data for this cross-sectional study were collected through a questionnaire, which was distributed to parents within the Health Monitoring Units in Bavaria (HMU), Germany. Data from 4767 children were available (2016/17). Those children were classified into four diagnostic groups: Unremitting Wheeze, International Study of Asthma and Allergies in Children (ISAAC) Asthma, Physician-diagnosed Asthma, and healthy control group. Urban-rural differences were tested by Pearson's chi-squared test or by Fisher's exact test. Independent variables were factors associated with health outcomes, for example, residency or migrant status. To examine associations between independent and outcome variables multivariate logistic regression analysis was performed.Results: Prevalence rates were 6.3% for 'Unremitting Wheeze', 5.2% for 'ISAAC Asthma', and 1.2% for 'Physician-diagnosed Asthma'. Factors associated with health outcomes were the occurrence of asthma in first-degree relatives, male sex, and migrant status. Generally, higher rates of doctor's visits, positive allergy tests, and corticosteroids intake in the diagnostic groups in rural compared to urban areas were observed. Rates of performed allergy tests were 55.6% for 'ISAAC Asthma' and 74.6% for 'Physician-diagnosed Asthma'.Conclusions: Prevalence rates of the diagnostic groups decreased compared to the HMU 2014/15. According to previous studies, factors associated with asthmatic or wheezing health outcomes could be confirmed. Children in rural areas generally received more medical care.Key pointsChildren's prevalence rates of asthma or wheezing disorders decreased in the past 2 years within Bavaria.This study is consistent with risk factors for asthma from the literature: asthma in the family, male gender, and migrant status.Children in rural areas receive more medical care than children in urban areas.There should me more allergy tests among children with medical diagnosis in Bavaria as low rates indicate gaps in care.
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Asma , Hipersensibilidad , Asma/diagnóstico , Asma/epidemiología , Asma/terapia , Niño , Estudios Transversales , Humanos , Hipersensibilidad/complicaciones , Masculino , Evaluación de Resultado en la Atención de Salud , Prevalencia , Ruidos Respiratorios/diagnóstico , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
BACKGROUND: The prevalence of antimicrobial-resistant bacteria and methicillin-sensitive Staphylococcus aureus (MSSA) in healthy newborns and the role of maternal transmission are scarcely discussed. OBJECTIVES: The objective of this study was to evaluate the prevalence of MSSA, MRSA, and ESBL among healthy newborns. Additionally, mother-to-newborn transmission rates were investigated as well as antibiotic susceptibility of MSSA, MRSA, and ESBL isolates. METHODS: Swabs of 658 newborns and their mothers were collected to investigate the presence of MSSA, MRSA, and ESBL. Swabs were taken from the nose and umbilicus immediately after birth. Additional swabs were taken from the nose, perianal area, and umbilicus 3 days after birth. Samples were screened and further characterized using culture and molecular methods. RESULTS: Prevalence of MSSA, MRSA, and ESBL colonization was 10.9, 0.5, and 2.6%, respectively. There was no association between the colonization status of the newborn and infections at any time point. Mother-to-newborn transmission rates (confirmed by PFGE) were 53.6% for MSSA/MRSA and 100% for ESBL. Maternal carriage of MSSA, MRSA, or ESBL was a risk factor for colonization of the newborn. Some isolates were resistant to the antibiotics recommended for therapy, including clindamycin and daptomycin for MSSA/MRSA isolates and ertapenem, fosfomycin, and tigecyclin for ESBL isolates. CONCLUSION: No association between infections and the newborns' colonization status could be detected. Maternal colonization played an important role in newborn colonization, but not every case of colonization could be explained by mother-to-newborn transmission. General screening of pregnant women and healthy newborns in the absence of other risk factors is not necessary. To prevent the possibility of transmission in the healthcare setting, professionals, pregnant women, parents, hospital visitors, and obstetricians should receive regular training on appropriate hygiene measures. With regard to the emergence of resistance to recommended antibiotics, an antibiogram should be conducted before treating MSSA/MRSA/ESBL infections to ensure the efficacy of the antibiotics.
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Staphylococcus aureus Resistente a Meticilina , Infecciones Estafilocócicas , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Estudios Transversales , Escherichia coli , Femenino , Humanos , Recién Nacido , Meticilina , Pruebas de Sensibilidad Microbiana , Embarazo , Prevalencia , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus , beta-LactamasasRESUMEN
BACKGROUND: Allergic diseases pose a health problem worldwide. Pollen are widespread aeroallergens which can cause symptoms like shortness of breath, cough, itchy eyes, or rhinitis. Apart from preventive measures and pharmacological treatment, also non-pharmacological interventions have been suggested to reduce symptoms. The objective of this work was to review studies investigating the effectiveness of non-pharmacologic interventions to reduce allergic symptoms. METHODS: PubMed, EMBASE, and CENTRAL were systematically reviewed in July 2018 and April 2020. Several authors worked on the screening of titles, abstracts, and full texts. One author for each literature search performed the data extraction and the risk of bias assessment. Studies were included if they met the inclusion criteria defined by the PECOs. Studies which investigating the effect of non-pharmacologic interventions on patients with allergic rhinitis were included. RESULTS: Twenty-nine studies investigating eleven types of non-pharmacologic interventions to avoid and reduce allergic symptoms due to pollen exposure were included in this review. Out of all studies, seven studies addressed nasal rinsing and 22 included acupuncture, air filtering, artisanal tears, individual allergen avoidance advice, various nasal applications, self-hypnosis, rhinophototherapy, and wraparound sunglasses. CONCLUSION: Most studies had a high risk of bias and small sample sizes. There were only a few high-quality studies that give hints about the effectiveness of non-pharmacological interventions. For future research, more high-quality studies are required to confirm the effectiveness of simple, safe, and cost-effective interventions.
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Rinitis Alérgica , Rinitis , Alérgenos , Humanos , PolenRESUMEN
OBJECTIVE: Investigating determinants of total leisure noise (TLN) exposure among adolescents over 7.5 years and compensating for missing data due to loss to follow-up. DESIGN: In the OHRKAN cohort study, data were collected by questionnaires at four waves. TLN was calculated from self-reported duration spent participating in 18 leisure activities. High exposure was defined as exceeding 85 dB(A) of equivalent continuous average sound pressure level (SPL) during a 40-h week. Multiple imputation (MI) and generalised estimating equations (GEE) were used to analyse odds ratios (OR) of determinants of TLN exposure and compared to complete-case analysis. STUDY SAMPLE: Closed cohort of 2148 students enrolled in grade 9 of any school in Regensburg (Germany), recruited from 2009 to 2011. RESULTS: Up to 74% of adolescents had risky TLN exposure, depending on wave. The most significant sources were discotheques, portable listening devices (PLD) and stereo systems. Higher TLN exposure was associated with time point, education, single-parent households and gender. MI under MAR assumption changed results only slightly compared to complete-case analysis. CONCLUSIONS: Prevalence of risky TLN is high during adolescence. MI reinforced trends detected in former results of OHRKAN. Preventive measures should consider the main drivers of noise exposure including changes by age and high risks groups.
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Pérdida Auditiva Provocada por Ruido , Adolescente , Estudios de Cohortes , Alemania/epidemiología , Pérdida Auditiva Provocada por Ruido/epidemiología , Pérdida Auditiva Provocada por Ruido/etiología , Pérdida Auditiva Provocada por Ruido/prevención & control , Humanos , Actividades Recreativas , Ruido/efectos adversosRESUMEN
OBJECTIVE: The aims of this work were the systematic and evidence-based generation and answering of frequently asked questions (FAQ) regarding contact with multi-drug resistant pathogens (MDR) including aspects of veterinary and human medicine for the public health service (PHS) and the general population. METHODS: In order to determine the information needs of the population, guideline-based expert interviews with veterinarians and physicians were conducted in five surveys. In addition, information about the project was published in two journals and the participants were asked to submit open questions from their daily routine with respect to MDR. The results of the interviews and project calls were divided into categories, and frequently mentioned topics were prepared as FAQ. For answering the FAQ, a systematic literature search in the databases Pubmed and Wiley Online Library was conducted. A panel of experts subsequently evaluated the FAQ drafts, and a consensus was reached in case of conflicting results. Thereafter, the FAQs were evaluated by physicians and veterinarians of the PHS. RESULTS: Nine FAQs were generated in total. In addition to a survey of the current state of research, recommendations were made for private dealing with non-medical contact with MDR at the interface of human and veterinary medicine. The recommendations depended on the respective setting and the type of animal contact. Different recommendations were given for the handling of MDR in pets, farm animals, animals in communal facilities and animals used for animal-assisted therapies. The most important measure against the spread of MDR between humans and animals proved to be regular and careful handwashing. CONCLUSION: Mixed methods were used to ensure the quality of the FAQ. Limitations were found in the literature search. Not all submitted questions could be answered with the available literature. In the future, the FAQ should be continuously updated and extended.
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Medicina , Animales , Humanos , Alemania , Encuestas y CuestionariosRESUMEN
OBJECTIVES: To investigate the association between total leisure noise exposure and intermittent tinnitus among young adults. DESIGN: Data were obtained from the Ohrkan study, an ongoing prospective cohort study conducted in South Germany since 2009. Information about exposure to impulse and leisure noise, tinnitus occurrences, sociodemographic variables, and self-rated hearing ability were analysed at four time points over a period of seven and a half years. STUDY SAMPLE: Participants of the Ohrkan cohort study, who provided data about the occurrence of tinnitus for all surveys (n = 1028). RESULTS: Intermittent tinnitus was reported in the majority of the sample (60%). The risk for intermittent tinnitus increased with higher sound pressure levels from exposure to leisure noise (full model (Odds Ratio, 95%CI): 80-<85dB(A): 1.41 [1.13-1.78], 85-<90dB(A): 1.73 [1.38-2.16], >90dB(A): 2.04 [1.59-2.61]). Visiting nightclubs was a major contributor to this relationship. Of the considered covariables, self-rated hearing as "poor", and growing up in a single-parent household were significantly associated with intermittent tinnitus. CONCLUSION: Intermittent tinnitus is very frequent among young adults and is associated with high levels of leisure noise exposure. To prevent intermittent tinnitus, reduced sound pressure levels and the use of hearing protection are necessary.
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Pérdida Auditiva Provocada por Ruido , Acúfeno , Estudios de Cohortes , Pérdida Auditiva Provocada por Ruido/diagnóstico , Pérdida Auditiva Provocada por Ruido/epidemiología , Pérdida Auditiva Provocada por Ruido/etiología , Humanos , Actividades Recreativas , Estudios Prospectivos , Factores de Riesgo , Encuestas y Cuestionarios , Acúfeno/diagnóstico , Acúfeno/epidemiología , Acúfeno/etiología , Adulto JovenRESUMEN
BACKGROUND: Concerns about smoking displacement from public places to private amenities aroused following smoking ban implementation in Bavaria in 2008. We analysed children's exposure to second-hand smoke (SHS) before and after the ban, its effect on children's health and prevalence of active smoking in adults. METHODS: Six cross-sectional surveys (n = 32,443) on pre-school children in Bavaria were analysed, two surveys before the smoking ban in years 2004 and 2005 (S1 and S2) and four after the ban in 2008, 2012, 2014 and 2016 (S4, S6, S7 and S8). Using multivariable logistic regression, we analysed change in children's intra- and extrauterine SHS exposure and its adverse health effects (Asthma, wheezing, bronchitis and neurodermatitis) as well as change in parental active smoking. RESULTS: The response rates were 78% for S1, 73% for S2, 61% for S4, 62% for S6, 56% for S7 and 54% for S8. Odds of parents never smoked at home in presence of children increased significantly from before to after the ban with odds ratios (OR) 1.17 (CI95% 1.01-1.35), 1.65 (CI95% 1.39-1.95), 2.85 (CI95% 2.32-3.51), 2.24 (CI95% 1.84-2.72) and 3.66 (CI95% 2.89-4.63) for S2, S4, S6, S7 and S8, respectively with S1 as reference. Compared to S4, odds of parents who were not actively smoking is significantly higher in S7 (OR = 1.13 (CI95% 1.03-1.24)) and S8 (OR = 1.24 (CI95% 1.13-1.36)). The odds of mothers who never smoked during pregnancy increased over time with OR = 1.22 (CI95% 1.06-1.40) for S2 and 1.57 (CI95% 1.33-1.86) for S8 compared to S1. Adverse health effects related to children's exposure to SHS are significantly less in S8 compared to S1. CONCLUSION: After 11 years of smoking ban in Bavaria, smoking displacement to homes was disproved. Exposure of children to SHS intrauterine and at home is decreasing. Number of parents who are not actively smoking is increasing over time. Prevalence of health problems in children related to exposure to SHS is decreasing.
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Política para Fumadores , Contaminación por Humo de Tabaco , Adulto , Niño , Salud Infantil , Preescolar , Estudios Transversales , Exposición a Riesgos Ambientales/análisis , Exposición a Riesgos Ambientales/estadística & datos numéricos , Femenino , Humanos , Padres , Fumar/epidemiología , Contaminación por Humo de Tabaco/efectos adversos , Contaminación por Humo de Tabaco/estadística & datos numéricosRESUMEN
The soil microbial community fulfils various functions, such as nutrient cycling and carbon (C) sequestration, therefore contributing to maintenance of soil fertility and mitigation of global warming. In this context, a major focus of research has been on C, nitrogen (N) and phosphorus (P) cycling. However, from aquatic and other environments, it is well known that other elements beyond C, N, and P are essential for microbial functioning. Nonetheless, for soil microorganisms this knowledge has not yet been synthesised. To gain a better mechanistic understanding of microbial processes in soil systems, we aimed at summarising the current knowledge on the function of a range of essential or beneficial elements, which may affect the efficiency of microbial processes in soil. This knowledge is discussed in the context of microbial driven nutrient and C cycling. Our findings may support future investigations and data evaluation, where other elements than C, N, and P affect microbial processes.