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1.
Proc Natl Acad Sci U S A ; 118(51)2021 12 21.
Artigo em Inglês | MEDLINE | ID: mdl-34903648

RESUMO

Decades of air pollution regulation have yielded enormous benefits in the United States, but vehicle emissions remain a climate and public health issue. Studies have quantified the vehicle-related fine particulate matter (PM2.5)-attributable mortality but lack the combination of proper counterfactual scenarios, latest epidemiological evidence, and detailed spatial resolution; all needed to assess the benefits of recent emission reductions. We use this combination to assess PM2.5-attributable health benefits and also assess the climate benefits of on-road emission reductions between 2008 and 2017. We estimate total benefits of $270 (190 to 480) billion in 2017. Vehicle-related PM2.5-attributable deaths decreased from 27,700 in 2008 to 19,800 in 2017; however, had per-mile emission factors remained at 2008 levels, 48,200 deaths would have occurred in 2017. The 74% increase from 27,700 to 48,200 PM2.5-attributable deaths with the same emission factors is due to lower baseline PM2.5 concentrations (+26%), more vehicle miles and fleet composition changes (+22%), higher baseline mortality (+13%), and interactions among these (+12%). Climate benefits were small (3 to 19% of the total). The percent reductions in emissions and PM2.5-attributable deaths were similar despite an opportunity to achieve disproportionately large health benefits by reducing high-impact emissions of passenger light-duty vehicles in urban areas. Increasingly large vehicles and an aging population, increasing mortality, suggest large health benefits in urban areas require more stringent policies. Local policies can be effective because high-impact primary PM2.5 and NH3 emissions disperse little outside metropolitan areas. Complementary national-level policies for NOx are merited because of its substantial impacts-with little spatial variability-and dispersion across states and metropolitan areas.


Assuntos
Saúde Pública , Meios de Transporte , Emissões de Veículos/prevenção & controle , Poluentes Atmosféricos/economia , Poluição do Ar/economia , Poluição do Ar/prevenção & controle , Causas de Morte/tendências , Mudança Climática/economia , Mudança Climática/mortalidade , Efeitos Psicossociais da Doença , Gases de Efeito Estufa/economia , Humanos , Exposição por Inalação/economia , Exposição por Inalação/prevenção & controle , Material Particulado/economia , Meios de Transporte/classificação , Estados Unidos
2.
Environ Res ; 231(Pt 3): 116211, 2023 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-37257739

RESUMO

Among infectious diseases, pneumonia is the greatest cause of mortality in children less than 5 years old. Approximately 27% of Beijing's 3-8 year-old children have had pneumonia at least once. The sole reservoir of pneumonia pathogens is the human nasopharynx. We investigated associations and interactions among two kinds of environmental risk factors: i) airborne pathogens, namely closed bedroom window and shared bedroom and ii) pollutants, namely traffic pollution and environmental tobacco smoke (ETS). We evaluated breastfeeding's (BF) protective value against childhood pneumonia. The database consists of responses to a questionnaire in a cross-sectional study. Crude and adjusted Odds Ratios were assessed independently for each risk factor. Combinations of the studied risk factors were analyzed using multivariate logistic regression. Risk factors were evaluated for interactions on the additive scale using the metrics Relative Excess Risk due to Interaction (RERI), Attributable Proportion (AP) and Synergy Index (S). All independent risk factors were significant for children's pneumonia. We also found evidence of possible synergistic interaction between pairs of risk factors that was stronger when one of the risk factors was a closed bedroom window. Remarkably, window opening was associated with reduced risk of pneumonia for children living near heavy traffic pollution. Longer duration BF was more protective than shorter, and exclusive BF was more protective than partial BF against childhood pneumonia. In conclusion, low ventilation (closed bedroom windows), shared bedroom, ETS, and traffic exposure were associated with increased risk of pneumonia. Exclusive BF for more than six months had the greatest protective value against pneumonia.


Assuntos
Poluentes Atmosféricos , Pneumonia , Poluição por Fumaça de Tabaco , Humanos , Criança , Pré-Escolar , Pequim/epidemiologia , Estudos Transversais , Fatores de Risco , Poluição por Fumaça de Tabaco/efeitos adversos , Pneumonia/induzido quimicamente , Pneumonia/epidemiologia , Demografia , Exposição Ambiental/análise
3.
Artigo em Inglês | MEDLINE | ID: mdl-37483383

RESUMO

Prescribed nature walks frequently yield improvements to mood and cognition as observed in experimental studies. Research that uses real life settings such as self-determined time exercising outdoors for restorative health benefits may more accurately elicit effects than time-specified study protocols. This study examined in situ psycho-cognitive outcomes of routine walks in urban greenspace to test the concept that self-set exposure duration and not context alone is related to magnitude of psycho-cognitive benefit. Pre-post measurements taken on a diverse participant pool of individuals walking in urban parks and recruited on random days over a two-week period found significant associations between outdoor activity duration and cognitive and mood improvements. Greater outdoor walking duration linearly predicted stronger processing speeds but non-linearly in tests of other cognitive domains. Results of fixed effects model for mean mood change following green exercise show outdoor walking influenced mood change at highest levels of significance, even after accounting for individual level variability in duration. Mood improved for all durations of outdoor walking under a random effects model with high significance. Untethering fixed intervals of outdoor exercise from formal study design revealed briefer but more frequent nature engagement aligned with nature affinity. The influence of unmeasured factors, e.g., nature affinity or restorative conditioning, for prescriptive durations of urban green exercise merits further investigation toward designing wellbeing interventions directed at specific urban populations.

4.
Environ Sci Technol ; 56(14): 10258-10268, 2022 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-35762409

RESUMO

The presence of volatile organic compounds (VOCs) in unprocessed natural gas (NG) is well documented; however, the degree to which VOCs are present in NG at the point of end use is largely uncharacterized. We collected 234 whole NG samples across 69 unique residential locations across the Greater Boston metropolitan area, Massachusetts. NG samples were measured for methane (CH4), ethane (C2H6), and nonmethane VOC (NMVOC) content (including tentatively identified compounds) using commercially available USEPA analytical methods. Results revealed 296 unique NMVOC constituents in end use NG, of which 21 (or approximately 7%) were designated as hazardous air pollutants. Benzene (bootstrapped mean = 164 ppbv; SD = 16; 95% CI: 134-196) was detected in 95% of samples along with hexane (98% detection), toluene (94%), heptane (94%), and cyclohexane (89%), contributing to a mean total concentration of NMVOCs in distribution-grade NG of 6.0 ppmv (95% CI: 5.5-6.6). While total VOCs exhibited significant spatial variability, over twice as much temporal variability was observed, with a wintertime NG benzene concentration nearly eight-fold greater than summertime. By using previous NG leakage data, we estimated that 120-356 kg/yr of annual NG benzene emissions throughout Greater Boston are not currently accounted for in emissions inventories, along with an unaccounted-for indoor portion. NG-odorant content (tert-butyl mercaptan and isopropyl mercaptan) was used to estimate that a mean NG-CH4 concentration of 21.3 ppmv (95% CI: 16.7-25.9) could persist undetected in ambient air given known odor detection thresholds. This implies that indoor NG leakage may be an underappreciated source of both CH4 and associated VOCs.


Assuntos
Poluentes Atmosféricos , Compostos Orgânicos Voláteis , Poluentes Atmosféricos/análise , Benzeno , Monitoramento Ambiental/métodos , Gás Natural
5.
Environ Res ; 209: 112893, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35131322

RESUMO

Toxic metals such as lead, cadmium, arsenic, are present at construction worksites. From work, metals can easily, unintentionally be transported to homes of workers, contaminating living spaces and affecting others including children, known as "take-home exposure." Focus has been given to minimizing lead take-home exposure but less is known about other metals. This pilot study aims to better understand the sources and predictors of metals in the home primarily of construction workers (n = 21), but also explore other workers potentially exposed [janitorial (n = 4) and auto repair (n = 2) jobs]. Greater Boston workers were recruited in 2018-2019 through collaboration with community-based organizations and worker unions serving low-income/immigrant workers. During a home visit, a dust vacuum sample was collected, a worker questionnaire was administered, and home observations were performed to determine factors that could affect home metals concentration. Thirty elements were analyzed in the dust via inductively coupled plasma coupled to atomic emission and mass spectrometry. We performed univariable and multivariable models, potential predictive factors, and multivariable mixed-effect regression analyses combining metals. Arsenic, chromium, copper, lead, manganese, nickel, and tin, commonly found in construction, were higher in construction workers' home dust compared to other workers, although not statistically significant. Sociodemographic/work/home-related variables affected home metals dust concentrations. Various work-related factors were associated with higher metal dust levels, for example: no work locker vs. locker (nickel ratio of means or ROM = 4.2, p < 0.05); mixing vs. no mixing work/personal items (nickel ROM = 1.6, p < 0.05); dusty vs. no dusty at work (copper ROM = 3.1, p < 0.05); not washing vs. washing hands after work (manganese ROM = 1.4, p < 0.05); not changing vs. changing clothes after work (cadmium ROM = 6.9, p < 0.05; copper ROM = 3.6, p < 0.05). Mixed effect regression confirmed statistical significance, which suggests a likelihood of metal mixtures carrying a "take-home" potential. Lead home interventions should evaluate other metals exposure reduction.


Assuntos
Poeira , Exposição Ocupacional , Boston , Criança , Cromo/análise , Poeira/análise , Humanos , Metais/análise , Exposição Ocupacional/análise , Projetos Piloto
6.
Indoor Air ; 32(1): e12961, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34859930

RESUMO

Moderate indoor relative humidity (RH) levels (i.e., 40%-60%) may minimize transmission and viability of some viruses, maximize human immune function, and minimize health risks from mold, yet uncertainties exist about typical RH levels in offices globally and about the potential independent impacts of RH levels on workers' health. To examine this, we leveraged one year of indoor RH measurements (which study participants could view in real time) in 43 office buildings in China, India, Mexico, Thailand, the United Kingdom, and the United States, and corresponding self-report symptom data from 227 office workers in a subset of 32 buildings. In the buildings in this study, 42% of measurements during 9:00 - 17:00 on weekdays were less than 40% RH and 7% exceeded 60% RH. Indoor RH levels tended to be lower in less tropical regions, in winter months, when outdoor RH or temperature was low, and late in the workday. Furthermore, we also found statistically significant evidence that higher indoor RH levels across the range of 14%-70% RH were associated with lower odds of reporting dryness or irritation of the throat and skin among females and unusual fatigue among males in models adjusted for indoor temperature, country, and day of year.


Assuntos
Umidade , Poluição do Ar em Ambientes Fechados/análise , Poluição do Ar em Ambientes Fechados/estatística & dados numéricos , Coleta de Dados , Feminino , Humanos , Masculino , Estações do Ano , Síndrome do Edifício Doente , Temperatura , Estados Unidos
7.
Build Environ ; 219: 109186, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35599668

RESUMO

Airport transportation vehicles, such as buses, aerotrains, and shuttles, provide important passenger transfer services in airports. This study quantitatively investigated COVID-19 aerosol infection risk and identified acceptable operational conditions, such as passenger occupancy rates and duration of rides, given the performance of vehicle ventilation. The greatest risk to the largest number of passengers is from an index case whose exhaled breath would take the longest time to exit the vehicle. The study identified such a case based on ventilation patterns, and it tracked the spread of viral aerosols (5 µm) by using the Wells-Riley equation to predict aerosol infection risk distribution. These distributions allowed a definition of an imperfect mixing degree (δ) as the ratio of actual risk and the calculated risk under a perfect mixing condition, and further derived regression equations to predict δ in the far-field (FF) and near-field (NF) of each passenger. These results revealed an order of magnitude higher aerosol infection risk in NF than in FF. For example, with a ventilation rate of 58 ACH (air changes per hour) and a 45% occupancy rate, unmasked passengers should stay up to 15 min in the bus and 35 min in the shuttle to limit infection risk in NF within 10%. These also indicate that masking is an important and effective risk reduction measure in transportation vehicles, especially important in NF. Overall, the analysis of imperfect air mixing allows direct comparison of risks in different transportation vehicles and a structured approach to development of policy recommendations.

8.
Environ Res ; 195: 110510, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33245888

RESUMO

Lead is a known reproductive, developmental, and neurological toxicant. Workers with a high likelihood of being exposed to lead at work may inadvertently transport lead home from work, known as "take-home exposure." This is concerning for many workers for whom a workplace intervention is not feasible because their worksites and employers often change, rendering centralized strategies insufficient. This study aimed to better understand the connection between lead in the home of workers living with children and work in construction (n = 23), while other occupations were used as a comparison group (janitorial n = 5, autobody n = 2). Thirty workers living in disadvantaged communities in the Greater Boston area were recruited in 2018-2019 through collaboration with non-profits and worker unions with expertise working with low-income or immigrant workers. Construction workers that performed renovations, bridge constructions, welding, metal work, and demolitions were prioritized during recruitment. During a visit to their residences, a worker questionnaire was administered, and observations and a dust vacuumed sample of the home were collected. Factors predicting lead in home dust were explored by a bivariate analysis and a multivariable regression model. We found lead in homes' dust in the range of 20-8,310 ppm. Homes of construction workers generally had higher and more variable lead dust concentrations (mean 775, max 8,300 ppm) than autobody and janitor worker homes combined (mean 296, max 579 ppm). Five of the construction workers' home lead dust concentrations exceeded US guidelines for yard soil in children's play areas of 400 ppm, and were similar to other studies of homes near lead smelters, superfund sites, or in the Boston area in the early 1990s, pointing to disparities relating to work. Results from the multivariable regression model suggest that lead dust in homes of workers was associated with sociodemographic-, home-, and work-related factors, and pointed to overlapping vulnerabilities; however, a larger sample size is needed to verify findings. Results provide evidence that work-related factors are important to consider when assessing home exposures, and that take-home exposures for workers in lead high-risk jobs such as construction may be an important source of exposure in the home prime for public health intervention at work, home, and community levels.


Assuntos
Poeira , Chumbo , Boston , Criança , Poeira/análise , Habitação , Humanos , Local de Trabalho
9.
J Community Health ; 46(1): 211-224, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32419079

RESUMO

Bicycling holds promise as a healthy and sustainable means of transportation and physical activity. Despite the growing interest in community-based environmental approaches to promoting physical activity, bikeability has received relatively little attention. This paper provides a scoping review of the instruments developed to measure bikeability along with practice-based analyses of the tools related to user expertise, estimated cost, and required time to implement. The review summarizes the literature, identifies research gaps, and informs stakeholders with articles from EBSCO and transportation databases published after 2003 when the previous bikeability instrument review paper was published. Data extraction included the tool name, data collection method, study location, data collection scale, type of measure, and description. Two reviewers independently reviewed articles included in the full text review, and the inter-rater agreement exceeded 90%. The database search yielded 388 unique articles, and 17 met the inclusion/exclusion criteria. Most of the studies, 11 of 17, were applied to settings outside of the U.S. Five studies employed a self-report survey, and five studies examined bikeability using geospatial data, like GIS. Seven studies used a direct observation audit tool-one specifically using a mobile app and another using virtual observation techniques with Google Street View. Bikeability tools are useful for assessing communities and their supports for bicycling. Our primary finding is that advances in technology over the past two decades have driven innovative and useful methodologies, in a variety of disciplines, for assessing the environment, but more consensus is needed to provide a universal definition of bikeability.


Assuntos
Ciclismo/normas , Planejamento em Saúde Comunitária/normas , Planejamento Ambiental/normas , Promoção da Saúde/normas , Nível de Saúde , Exercício Físico , Humanos , Inquéritos e Questionários , Meios de Transporte/normas
10.
Build Environ ; 2002021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34366550

RESUMO

Fine particulate matter (PM2.5) is an airborne pollutant associated with negative acute and chronic human health outcomes. Although the majority of PM2.5 research has focused on outdoor exposures, people spend the majority of their time indoors, where PM2.5 of outdoor origin can penetrate. In this work, we measured indoor PM2.5 continuously for one year in 37 urban commercial offices with mechanical or mixed-mode ventilation in China, India, the United Kingdom, and the United States. We found that indoor PM2.5 concentrations were generally higher when and where outdoor PM2.5 was elevated. In India and China, mean workday indoor PM2.5 levels exceeded the World Health Organization's 24-hour exposure guideline of 25 µg/m3 about 17% and 27% of the time, respectively. Our statistical models found evidence that the operation of mechanical ventilation systems could mitigate the intrusion of outdoor PM2.5: during standard work hours, a 10 µg/m3 increase in outdoor PM2.5 was associated with 19.9% increase in the expected concentration of indoor PM2.5 (p<0.0001), compared to a larger 23.4% increase during non-work hours (p<0.0001). Finally, our models found that using filters with ratings of MERV 13-14 or MERV 15+ was associated with a 30.9% (95% CI: -55.0%, +6.2%) or 39.4% (95% CI: -62.0%, -3.4%) reduction of indoor PM2.5, respectively, compared to filters with lower MERV 7-12 ratings. Our results demonstrate the potential efficacy of mechanical ventilation with efficient filtration as a public health strategy to protect workers from PM2.5 exposure, particularly where outdoor levels of PM2.5 are elevated.

11.
Epidemiology ; 31(4): 490-498, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32243276

RESUMO

BACKGROUND: In April 2016, Chile enacted the Law 20,900, which restricted electoral publicity on public roads. It established two important regulations: first, candidates were allowed, 30 days before any election, to publicize their campaigns in specific street locations. Second, roadside publicity must follow strict size standards to avoid visual contamination. This article examines the impact of this regulation in reducing road traffic crashes. METHODS: We obtained a number of traffic injuries and fatalities per population from public records. A time-series difference-in-difference study, using generalized linear models with an interaction between time-period and intervention, compared a municipal election period before the introduction of Law 20,900 (2012) to the first municipal election affected by the law (2016). We adjusted for precipitation and temperature, and applied models to three cities: Santiago, Gran-Valparaíso, and Concepción. We assessed the overall impact of the intervention using random effects meta-analyses. RESULTS: The law was associated with a decrease of 0.01 (95% confidence interval [CI]: -0.02, -0.00) in Santiago, a decrease of 0.01 (95% CI: -0.03, -0.00) in Valparaíso and an increase of 0.09 (95% CI: 0.06, 0.13) in Concepción, in all daily injuries and fatalities per 100,000 population. After 40 days of its implementation, the intervention was associated with a mild absolute reduction of 34 (95% reduction interval: -270, 67) traffic injuries and fatalities. CONCLUSIONS: This study estimates that the regulation of public road publicity had an overall mild effect on reducing traffic injuries and fatalities in three large cities in Chile.


Assuntos
Acidentes de Trânsito , Jurisprudência , Política , Ferimentos e Lesões , Acidentes de Trânsito/prevenção & controle , Acidentes de Trânsito/estatística & dados numéricos , Chile/epidemiologia , Cidades/epidemiologia , Humanos , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/prevenção & controle
12.
Am J Public Health ; 110(5): 662-668, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32191522

RESUMO

Objectives. To examine the impact of extreme heat on emergency services in Boston, MA.Methods. We conducted relative risk and time series analyses of 911 dispatches of the Boston Police Department (BPD), Boston Emergency Medical Services (BEMS), and Boston Fire Department (BFD) from November 2010 to April 2014 to assess the impact of extreme heat on emergency services.Results. During the warm season, there were 2% (95% confidence interval [CI] = 0%, 5%) more BPD dispatches, 9% (95% CI = 7%, 12%) more BEMS dispatches, and 10% (95% CI = 5%, 15%) more BFD dispatches on days when the maximum temperature was 90°F or higher, which remained consistent when we considered multiple days of heat. A 10°F increase in daily maximum temperature, from 80° to 90°F, resulted in 1.016, 1.017, and 1.002 times the expected number of daily BPD, BEMS, and BFD dispatch calls, on average, after adjustment for other predictors.Conclusions. The burden of extreme heat on local emergency medical and police services may be agency-wide, and impacts on fire departments have not been previously documented.Public Health Implications. It is important to account for the societal burden of extreme heat impacts to most effectively inform climate change adaptation strategies and planning.


Assuntos
Serviços Médicos de Emergência/estatística & dados numéricos , Bombeiros/estatística & dados numéricos , Temperatura Alta , Polícia/estatística & dados numéricos , Boston/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Humanos , Risco , Medição de Risco , Estações do Ano
13.
Health Promot Pract ; 21(6): 926-933, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-31030563

RESUMO

Background and Purpose. The American Heart Association recommends community-based research on shared use of physical activity (PA) spaces. Pasadena, a community in southeast Houston, Texas with lower socioeconomic status and racial/ethnic diversity, was the setting for our study. Efforts to increase access to PA in Pasadena include building the evidence on PA resources. The purpose of this research was to utilize survey data in a community setting to inform and target efforts around sharing PA spaces. Method. An online survey was administered to K-12 school (n = 25) and park (n = 30) administrators, church leaders (n = 10), community organizations (n = 2), a health care center, and a local business. Results. Park facilities in Pasadena shared by agreement with two high schools and three baseball/softball leagues were ballfields, tennis courts, and jogging paths. No park facilities were shared with faith-based organizations. Four parks communicated daily, and five schools communicated with parks quarterly about providing opportunities for PA. Key facilitators to sharing facilities were building relationships and collaboration, service to the community, and improving health. Key barriers were cost, maintenance, staffing, and prioritizing use with limited time, facilities, and resources. Conclusions. This study is the first of its kind to address shared use at the community level and suggests opportunities to improve communication and partnerships between parks, schools, and churches. This research will inform ongoing efforts to promote access by identifying barriers and motivators among stakeholder groups to help facilitate shared use agreements.


Assuntos
Exercício Físico , Instituições Acadêmicas , Etnicidade , Humanos , Logradouros Públicos , Inquéritos e Questionários , Texas
14.
Indoor Air ; 29(6): 1028-1039, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31418925

RESUMO

Biophilia hypothesis suggests humans have an innate connection to nature which may affect our health and productivity. Yet we currently live in a world that is rapidly urbanizing with people spending most of their time indoors. We designed a randomized crossover study to let 30 participants experience three versions of biophilic design in simulated open and enclosed office spaces in virtual reality (VR). Throughout the VR session, we measured blood pressure, heart rate, heart rate variability, and skin conductance level and administered cognitive tests to measure their reaction time and creativity. Compared to the base case, participants in three spaces with biophilic elements had consistently lower level of physiological stress indicators and higher creativity scores. In addition, we captured the variation in the intensity of virtual exposure to biophilic elements by using eye-tracking technology. These results suggest that biophilic interventions could help reduce stress and improve creativity. Moreover, those effects are related to both the types of biophilic elements and may be different based on the workspace type (open vs enclosed). This research demonstrates that VR-simulated office spaces are useful in differentiating responses to two configurations and among biophilic elements.


Assuntos
Cognição , Arquitetura de Instituições de Saúde/métodos , Saúde Ocupacional , Estresse Fisiológico , Local de Trabalho/psicologia , Adolescente , Adulto , Poluição do Ar em Ambientes Fechados/efeitos adversos , Poluição do Ar em Ambientes Fechados/análise , Estudos Cross-Over , Saúde Ambiental/métodos , Feminino , Humanos , Masculino , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/análise , Realidade Virtual , Adulto Jovem
15.
Nurs Res ; 68(6): 453-463, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31693551

RESUMO

BACKGROUND: Evidence suggests that behavioral, social, and environmental factors may modify the effects of life stress on health and performance of new nurses as they transition to hospitals. OBJECTIVES: The aim of this study was to describe the methods of a project designed to investigate the role of social, behavioral, and environmental factors in modifying the adverse effects of stress on new nurses and to discuss demographic, health, and life stress characteristics of the cohort at baseline. METHODS: A prospective cohort design was used to conduct a comprehensive assessment of health endpoints, life stress, behaviors, personal traits, social factors, indicators of engagement and performance, and environmental exposures in nursing students. Adjusted odds ratios and analyses of covariance were used to examine associations between these factors at baseline. RESULTS: Health indicators in the cohort were comparable or better than in the broader United States population, and lifetime stress exposure was lower than among students from other majors. Exposure to more lifetime stressors was associated with greater risk for various health conditions, including hypertension, diabetes, and depression. Conversely, better social, environmental, behavioral, and personal profiles were associated with protective effects for the same health conditions. DISCUSSION: These data comprehensively summarize the lives of predominately Hispanic nursing students and highlight risk and resilience factors associated with their health and well-being. The findings are timely, as the nursing field diversifies in preparation to care for a diverse and aging population. Comprehensively assessing stress-health relationships among student nurses ought to inform the policies, practices, and curricula of nursing schools to better prepare nurses to thrive in the often-strenuous healthcare environment.


Assuntos
Estresse Psicológico/epidemiologia , Estudantes de Enfermagem/psicologia , Adolescente , Adulto , Estudos de Coortes , Feminino , Comportamentos Relacionados com a Saúde , Nível de Saúde , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Estados Unidos , Adulto Jovem
16.
PLoS Med ; 15(7): e1002605, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29990359

RESUMO

BACKGROUND: In many regions globally, buildings designed for harnessing heat during the cold exacerbate thermal exposures during heat waves (HWs) by maintaining elevated indoor temperatures even when high ambient temperatures have subdued. While previous experimental studies have documented the effects of ambient temperatures on cognitive function, few have observed HW effects on indoor temperatures following subjects' habitual conditions. The objective was to evaluate the differential impact of having air conditioning (AC) on cognitive function during a HW among residents of AC and non-AC buildings using a prospective observational cohort study. METHODS: We followed 44 students (mean age = 20.2 years; SD = 1.8 years) from a university in the Greater Boston area, Massachusetts in the United States living in AC (n = 24) and non-AC (n = 20) buildings before, during, and after a HW. Two cognition tests were self-administered daily for a period of 12 days (July 9-July 20, 2016), the Stroop color-word test (STROOP) to assess selective attention/processing speed and a 2-digit, visual addition/subtraction test (ADD) to evaluate cognitive speed and working memory. The effect of the HW on cognitive function was evaluated using difference-in-differences (DiD) modelling. FINDINGS: Mean indoor temperatures in the non-AC group (mean = 26.3°C; SD = 2.5°C; range = 19.6-30.4°C) were significantly higher (p < 0.001) than in the AC group (mean = 21.4°C; SD = 1.9°C; range = 17.5-25.0°C). DiD estimates show an increase in reaction time (STROOP = 13.4%, p < 0001; ADD = 13.3%, p < 0.001) and reduction in throughput (STROOP = -9.9%, p < 0.001; ADD = -6.3%, p = 0.08) during HWs among non-AC residents relative to AC residents at baseline. While ADD showed a linear relationship with indoor temperatures, STROOP was described by a U-shaped curve with linear effects below and above an optimum range (indoor temperature = 22°C-23°C), with an increase in reaction time of 16 ms/°C and 24 ms/°C for STROOP and ADD, respectively. Cognitive tests occurred right after waking, so the study is limited in that it cannot assess whether the observed effects extended during the rest of the day. Although the range of students' ages also represents a limitation of the study, the consistent findings in this young, healthy population might indicate that greater portions of the population are susceptible to the effects of extreme heat. CONCLUSIONS: Cognitive function deficits resulting from indoor thermal conditions during HWs extend beyond vulnerable populations. Our findings highlight the importance of incorporating sustainable adaptation measures in buildings to preserve educational attainment, economic productivity, and safety in light of a changing climate.


Assuntos
Ar Condicionado , Transtornos Cognitivos/epidemiologia , Cognição , Arquitetura de Instituições de Saúde , Temperatura Alta/efeitos adversos , Estações do Ano , Adolescente , Adulto , Fatores Etários , Atenção , Boston/epidemiologia , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/prevenção & controle , Transtornos Cognitivos/psicologia , Feminino , Humanos , Masculino , Memória de Curto Prazo , Estudos Prospectivos , Fatores de Risco , Teste de Stroop , Estudantes/psicologia , Fatores de Tempo , Adulto Jovem
18.
Environ Res ; 164: 212-220, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29501831

RESUMO

Polycyclic aromatic hydrocarbons (PAHs) are widespread in the environment and can adversely affect human health. The aim of the present study is to describe the level of PAHs exposure in children living in Kraków, one of the most polluted cities in Poland, and to determine the relationship of urinary biomarkers with environmental PAHsexposure. Urinary monohydroxy metabolites (OH-PAHs) of 20 PAHs were assessed in 218 three-year old children, of which only 10 were present in nearly all the samples: monohydroxy metabolites of naphthalene, fluorene, phenantrene and pyrene. Of the metabolites analyzed, hydroxynaphthalenes were predominant and constituted almost 73% of total excreted OH-PAHs, while 1-OH-PYRene was the least abundant (2.3% of total OH-PAHs). All measured urinary OH-PAHs were statistically significantly correlated with each other (R = 0.165-0.880) but the highest correlation coefficients with other individual OH-PAHs and with total OH-PAHs were observed for 2-OH-FLUOR. Children exposed at home to environmental tobacco smoke (ETS) had higher concentrations of fluorene and pyrene urinary metabolites compared to those without ETS exposure; and those exposed to gas-based appliances used for cooking or heating water had higher levels of fluorene and phenanthrene metabolites than children not exposed. The use of coal, wood or oil for heating was associated with elevated levels of 1-OH-PYRene. Urinary PAHs metabolites only modestly reflect high molecular weight carcinogenic PAHs exposures such as those monitored in air in the present study. None of the measured PAHs metabolites was correlated with airborne PM2.5 and only two were slightly correlated with measured higher molecular mass airborne PAHs. The average concentrations of these specific metabolites in Polish children were much higher than observed in other pediatric populations living in developed countries. Our findings suggest that to capture various sources of PAHs, in addition to 1-OH-PYRene, biomonitoring of PAHs exposure should include 2-OH-NAP and 2-OH-FLUOR.


Assuntos
Exposição Ambiental , Hidrocarbonetos Policíclicos Aromáticos , Poluição por Fumaça de Tabaco , Biomarcadores , Criança , Pré-Escolar , Cidades , Monitoramento Ambiental , Humanos , Polônia , Hidrocarbonetos Policíclicos Aromáticos/urina
19.
Environ Res ; 166: 150-157, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29886391

RESUMO

BACKGROUND: Patterns of lung function development during childhood can be helpful in understanding the pathogenesis of respiratory diseases. A variety of environmental and lifestyle factors, present from the prenatal period to adulthood, may affect or modulate lung function growth. The aim of this study was to investigate, the associations between individual growth trajectories of children's lung function during childhood and prenatal exposure to airborne fine particulate matter (PM2.5) and polycyclic aromatic hydrocarbons (PAH), which were hypothesized to adversely affect spirometry parameters. MATERIAL AND METHODS: The study group comprised 294 non-asthmatic, full term children from the Krakow birth cohort, who underwent annual spirometry testing at the ages of 4-9 years. Individual personal air monitoring of PM2.5 and PAH were performed over 48 h in the second trimester of pregnancy. Possible confounders or modifiers such as child's gender, height, atopic status and exposure to environmental tobacco smoke (ETS) were considered. Polynomial multilevel mixed models were used to assess the growth rates of children's lung functions. RESULTS: Lung function trajectories differed significantly for boys and girls for FVC, FEV1 and FEF25-75. Girls had lower rates of increase than boys: - 20.5 (95%CI: - 32.4; - 8.6) ml/year (FVC); - 19.9 (95%CI: -30.7;-9.0) ml/year (FEV1); and - 32.5 (95%CI: - 56.9; - 8.2) ml/year (FEF25-75). Spirometry functions increased with age; however the growth rate decelerated over time. Significant lung function impairment (lower FVC and FEV1 levels) was observed from 4 to 9 years among subjects prenatally exposed to higher levels of PM2.5 as well as PAH, but not in the case of FEF25-75. No significant differences were observed in the rates of increase over time in relation to prenatal PM2.5 and PAH exposure. CONCLUSION: Our results indicate that in non-asthmatic children high prenatal exposure to airborne PM2.5 and PAH is associated with lower trajectories of FVC and FEV1, but not the rate of increase over time, suggesting that the initial effect is not diminishing in time.


Assuntos
Pulmão/fisiopatologia , Material Particulado/análise , Hidrocarbonetos Policíclicos Aromáticos/análise , Efeitos Tardios da Exposição Pré-Natal , Testes de Função Respiratória , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Masculino , Parto , Polônia , Gravidez
20.
Environ Sci Technol ; 51(9): 4860-4869, 2017 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-28406624

RESUMO

Furniture flammability standards are typically met with chemical flame retardants (FRs). FRs can migrate out of products into dust and are linked to cancer, neurological impairment, and endocrine disruption. We collected 95 dust samples from dormitory common areas and student rooms on two U.S. college campuses adhering to two different furniture flammability standards: Technical Bulletin 117 (TB117) and Technical Bulletin 133 (TB133). Because TB133 requires furniture to withstand a much-more-demanding test flame than TB117, we hypothesized that spaces with TB133 furniture would have higher levels of FRs in dust. We found all 47 targeted FRs, including 12 polybrominated diphenyl ether (PBDE) congeners, 19 other brominated FRs, 11 phosphorus FRs (PFRs), 2 Dechlorane-Plus (DP) isomers, and 3 hexabromocyclododecane (HBCDD) isomers in the 95 dust samples. We measured the highest reported U.S. concentrations for a number of FRs, including BDE 209 (up to 990 000 ng/g), which may be used to meet the TB133 standard. We prioritized 16 FRs and analyzed levels in relation to flammability standard as well as presence and age of furniture and electronics. Adherence to TB133 was associated with higher concentrations of BDE 209, decabromodiphenylethane (DBDPE), DPs, and HBCDD compared to adherence to TB117 in univariate models (p < 0.05). Student dormitory rooms tended to have higher levels of some FRs compared to common rooms, likely a result of the density of furniture and electronics. As flammability standards are updated, it is critical to understand their impact on exposure and health risks.


Assuntos
Poeira , Retardadores de Chama , Monitoramento Ambiental , Éteres Difenil Halogenados , Habitação , Humanos , Decoração de Interiores e Mobiliário , Padrões de Referência
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