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1.
Nature ; 631(8022): 819-825, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38843826

ABSTRACT

Horses revolutionized human history with fast mobility1. However, the timeline between their domestication and their widespread integration as a means of transport remains contentious2-4. Here we assemble a collection of 475 ancient horse genomes to assess the period when these animals were first reshaped by human agency in Eurasia. We find that reproductive control of the modern domestic lineage emerged around 2200 BCE, through close-kin mating and shortened generation times. Reproductive control emerged following a severe domestication bottleneck starting no earlier than approximately 2700 BCE, and coincided with a sudden expansion across Eurasia that ultimately resulted in the replacement of nearly every local horse lineage. This expansion marked the rise of widespread horse-based mobility in human history, which refutes the commonly held narrative of large horse herds accompanying the massive migration of steppe peoples across Europe around 3000 BCE and earlier3,5. Finally, we detect significantly shortened generation times at Botai around 3500 BCE, a settlement from central Asia associated with corrals and a subsistence economy centred on horses6,7. This supports local horse husbandry before the rise of modern domestic bloodlines.


Subject(s)
Animal Husbandry , Domestication , Horses , Transportation , Animals , Female , Male , Animal Husbandry/history , Asia , Europe , Genome/genetics , History, Ancient , Horses/classification , Horses/genetics , Reproduction , Transportation/history , Transportation/methods , Phylogeny
2.
Nature ; 631(8019): 179-188, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38926578

ABSTRACT

Encouraging routine COVID-19 vaccinations is likely to be a crucial policy challenge for decades to come. To avert hundreds of thousands of unnecessary hospitalizations and deaths, adoption will need to be higher than it was in the autumn of 2022 or 2023, when less than one-fifth of Americans received booster vaccines1,2. One approach to encouraging vaccination is to eliminate the friction of transportation hurdles. Previous research has shown that friction can hinder follow-through3 and that individuals who live farther from COVID-19 vaccination sites are less likely to get vaccinated4. However, the value of providing free round-trip transportation to vaccination sites is unknown. Here we show that offering people free round-trip Lyft rides to pharmacies has no benefit over and above sending them behaviourally informed text messages reminding them to get vaccinated. We determined this by running a megastudy with millions of CVS Pharmacy patients in the United States testing the effects of (1) free round-trip Lyft rides to CVS Pharmacies for vaccination appointments and (2) seven different sets of behaviourally informed vaccine reminder messages. Our results suggest that offering previously vaccinated individuals free rides to vaccination sites is not a good investment in the United States, contrary to the high expectations of both expert and lay forecasters. Instead, people in the United States should be sent behaviourally informed COVID-19 vaccination reminders, which increased the 30-day COVID-19 booster uptake by 21% (1.05 percentage points) and spilled over to increase 30-day influenza vaccinations by 8% (0.34 percentage points) in our megastudy. More rigorous testing of interventions to promote vaccination is needed to ensure that evidence-based solutions are deployed widely and that ineffective but intuitively appealing tools are discontinued.


Subject(s)
COVID-19 Vaccines , COVID-19 , Immunization, Secondary , Reminder Systems , Transportation , Vaccination , Adult , Female , Humans , Male , Middle Aged , COVID-19/prevention & control , COVID-19 Vaccines/administration & dosage , Evidence-Based Practice , Health Education/methods , Health Education/statistics & numerical data , Health Policy/trends , Immunization, Secondary/statistics & numerical data , Influenza Vaccines/administration & dosage , Pharmacies/statistics & numerical data , Reminder Systems/classification , Reminder Systems/statistics & numerical data , Text Messaging/statistics & numerical data , Time Factors , Transportation/economics , Transportation/methods , United States , Vaccination/statistics & numerical data
3.
Nature ; 627(8004): 612-619, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38480877

ABSTRACT

Less than 30% of people in Africa received a dose of the COVID-19 vaccine even 18 months after vaccine development1. Here, motivated by the observation that residents of remote, rural areas of Sierra Leone faced severe access difficulties2, we conducted an intervention with last-mile delivery of doses and health professionals to the most inaccessible areas, along with community mobilization. A cluster randomized controlled trial in 150 communities showed that this intervention with mobile vaccination teams increased the immunization rate by about 26 percentage points within 48-72 h. Moreover, auxiliary populations visited our community vaccination points, which more than doubled the number of inoculations administered. The additional people vaccinated per intervention site translated to an implementation cost of US $33 per person vaccinated. Transportation to reach remote villages accounted for a large share of total intervention costs. Therefore, bundling multiple maternal and child health interventions in the same visit would further reduce costs per person treated. Current research on vaccine delivery maintains a large focus on individual behavioural issues such as hesitancy. Our study demonstrates that prioritizing mobile services to overcome access difficulties faced by remote populations in developing countries can generate increased returns in terms of uptake of health services3.


Subject(s)
COVID-19 Vaccines , Community Health Services , Mass Vaccination , Mobile Health Units , Rural Health Services , Vaccination Coverage , Child , Humans , Community Health Services/methods , Community Health Services/organization & administration , COVID-19/prevention & control , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/economics , COVID-19 Vaccines/supply & distribution , Mobile Health Units/organization & administration , Rural Health Services/organization & administration , Sierra Leone , Transportation/economics , Vaccination Coverage/economics , Vaccination Coverage/methods , Vaccination Coverage/statistics & numerical data , Vaccination Hesitancy , Mass Vaccination/methods , Mass Vaccination/organization & administration , Female , Adult , Mothers
4.
Epidemiology ; 35(2): 252-262, 2024 Mar 01.
Article in English | MEDLINE | ID: mdl-38290144

ABSTRACT

BACKGROUND: Road traffic injury contributes substantially to morbidity and mortality. Canada stands out among developed countries in not conducting a national household travel survey, leading to a dearth of national transportation mode data and risk calculations that have appropriate denominators. Since traffic injuries are specific to the mode of travel used, these risk calculations should consider travel mode. METHODS: Census data on mode of commute is one of the few sources of these data for persons aged 15 and over. This study leveraged a national data linkage cohort, the Canadian Census Health and Environment Cohorts, that connects census sociodemographic and commute mode data with records of deaths and hospitalizations, enabling assessment of road traffic injury associations by indicators of mode of travel (commuter mode). We examined longitudinal (1996-2019) bicyclist, pedestrian, and motor vehicle occupant injury and fatality risk in the Canadian Census Health and Environment Cohorts by commuter mode and sociodemographic characteristics using Cox proportional hazards models within the working adult population. RESULTS: We estimated positive associations between commute mode and same mode injury and fatality, particularly for bicycle commuters (hazard ratios for bicycling injury was 9.1 and for bicycling fatality was 11). Low-income populations and Indigenous people had increased injury risk across all modes. CONCLUSIONS: This study shows inequities in transportation injury risk in Canada and underscores the importance of adjusting for mode of travel when examining differences between population groups.


Subject(s)
Censuses , Walking , Adult , Humans , Canada/epidemiology , Walking/injuries , Transportation , Risk Factors , Bicycling/injuries , Accidents, Traffic
5.
J Natl Compr Canc Netw ; 22(5): 308-314, 2024 04 26.
Article in English | MEDLINE | ID: mdl-38670152

ABSTRACT

BACKGROUND: Recent modifications to low-dose CT (LDCT)-based lung cancer screening guidelines increase the number of eligible individuals, particularly among racial and ethnic minorities. Because these populations disproportionately live in metropolitan areas, we analyzed the association between travel time and initial LDCT completion within an integrated, urban safety-net health care system. METHODS: Using Esri's StreetMap Premium, OpenStreetMap, and the r5r package in R, we determined projected private vehicle and public transportation travel times between patient residence and the screening facility for LDCT ordered in March 2017 through December 2022 at Parkland Memorial Hospital in Dallas, Texas. We characterized associations between travel time and LDCT completion in univariable and multivariable analyses. We tested these associations in a simulation of 10,000 permutations of private vehicle and public transportation distribution. RESULTS: A total of 2,287 patients were included in the analysis, of whom 1,553 (68%) completed the initial ordered LDCT. Mean age was 63 years, and 73% were underrepresented minorities. Median travel time from patient residence to the LDCT screening facility was 17 minutes by private vehicle and 67 minutes by public transportation. There was a small difference in travel time to the LDCT screening facility by public transportation for patients who completed LDCT versus those who did not (67 vs 66 min, respectively; P=.04) but no difference in travel time by private vehicle for these patients (17 min for both; P=.67). In multivariable analysis, LDCT completion was not associated with projected travel time to the LDCT facility by private vehicle (odds ratio, 1.01; 95% CI, 0.82-1.25) or public transportation (odds ratio, 1.14; 95% CI, 0.89-1.44). Similar results were noted across travel-type permutations. Black individuals were 29% less likely to complete LDCT screening compared with White individuals. CONCLUSIONS: In an urban population comprising predominantly underrepresented minorities, projected travel time is not associated with initial LDCT completion in an integrated health care system. Other reasons for differences in LDCT completion warrant investigation.


Subject(s)
Early Detection of Cancer , Health Services Accessibility , Lung Neoplasms , Safety-net Providers , Tomography, X-Ray Computed , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/epidemiology , Lung Neoplasms/diagnostic imaging , Male , Middle Aged , Female , Early Detection of Cancer/methods , Early Detection of Cancer/statistics & numerical data , Tomography, X-Ray Computed/methods , Aged , Safety-net Providers/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Health Services Accessibility/standards , Texas/epidemiology , Urban Population/statistics & numerical data , Travel/statistics & numerical data , Mass Screening/methods , Mass Screening/statistics & numerical data , Mass Screening/standards , Transportation/statistics & numerical data , Transportation/methods
6.
Int J Behav Nutr Phys Act ; 21(1): 54, 2024 May 08.
Article in English | MEDLINE | ID: mdl-38720323

ABSTRACT

BACKGROUND: Transportation policies can impact health outcomes while simultaneously promoting social equity and environmental sustainability. We developed an agent-based model (ABM) to simulate the impacts of fare subsidies and congestion taxes on commuter decision-making and travel patterns. We report effects on mode share, travel time and transport-related physical activity (PA), including the variability of effects by socioeconomic strata (SES), and the trade-offs that may need to be considered in the implementation of these policies in a context with high levels of necessity-based physical activity. METHODS: The ABM design was informed by local stakeholder engagement. The demographic and spatial characteristics of the in-silico city, and its residents, were informed by local surveys and empirical studies. We used ridership and travel time data from the 2019 Bogotá Household Travel Survey to calibrate and validate the model by SES. We then explored the impacts of fare subsidy and congestion tax policy scenarios. RESULTS: Our model reproduced commuting patterns observed in Bogotá, including substantial necessity-based walking for transportation. At the city-level, congestion taxes fractionally reduced car use, including among mid-to-high SES groups but not among low SES commuters. Neither travel times nor physical activity levels were impacted at the city level or by SES. Comparatively, fare subsidies promoted city-level public transportation (PT) ridership, particularly under a 'free-fare' scenario, largely through reductions in walking trips. 'Free fare' policies also led to a large reduction in very long walking times and an overall reduction in the commuting-based attainment of physical activity guidelines. Differential effects were observed by SES, with free fares promoting PT ridership primarily among low-and-middle SES groups. These shifts to PT reduced median walking times among all SES groups, particularly low-SES groups. Moreover, the proportion of low-to-mid SES commuters meeting weekly physical activity recommendations decreased under the 'freefare' policy, with no change observed among high-SES groups. CONCLUSIONS: Transport policies can differentially impact SES-level disparities in necessity-based walking and travel times. Understanding these impacts is critical in shaping transportation policies that balance the dual aims of reducing SES-level disparities in travel time (and time poverty) and the promotion of choice-based physical activity.


Subject(s)
Exercise , Transportation , Walking , Humans , Colombia , Transportation/methods , Walking/statistics & numerical data , Taxes , Socioeconomic Factors , Cities , Bicycling/statistics & numerical data , Female , Male , Adult
7.
Int J Behav Nutr Phys Act ; 21(1): 91, 2024 Aug 19.
Article in English | MEDLINE | ID: mdl-39160546

ABSTRACT

BACKGROUND: Greater public transport use has been linked to higher physical activity levels. However, neither the amount of physical activity associated with each daily public transport trip performed, nor the potential total physical activity gain associated with an increase in trips/day, has been determined. Using objective measures, we aimed to quantify the association between public transport use, physical activity and sedentary time. METHODS: A longitudinal study of Australian adults living in Hobart, Tasmania, who were infrequent bus users (≥ 18 years; used bus ≤ 2 times/week). The number of bus trips performed each day was determined from objective smartcard data provided by the public transportation (bus) provider across a 36-week study timeframe. Accelerometer measured steps/day (primary outcome), moderate-to-vigorous physical activity (min/day), and sedentary time (min/day) were assessed across four separate one-week periods. RESULTS: Among 73 participants across 1483 day-level observations, on days that public transport was used, participants achieved significantly more steps (ß = 2147.48; 95%CI = 1465.94, 2829.03), moderate to vigorous physical activity (ß = 22.79; 95% CI = 14.33, 31.26), and sedentary time (ß = 37.00; 95% CI = 19.80, 54.21) compared to days where no public transport trips were made. The largest increase in steps per day associated with a one-trip increase was observed when the number of trips performed each day increased from zero to one (ß = 1761.63; 95%CI = 821.38, 2701.87). The increase in the number of steps per day was smaller and non-significant when the number of trips performed increased from one to two (ß = 596.93; 95%CI=-585.16, 1779.01), and two to three or more (ß = 632.39; 95%CI=-1331.45, 2596.24) trips per day. Significant increases in sedentary time were observed when the number of trips performed increased from zero to one (ß = 39.38; 95%CI = 14.38, 64.39) and one to two (ß = 48.76; 95%CI = 25.39, 72.12); but not when bus trips increased from two to three or more (ß=-27.81; 95%CI=-76.00, 20.37). CONCLUSIONS: Greater public transport use was associated with higher physical activity and sedentary behaviour. Bus use may yield cumulative increases in steps that amount to 15-30% of the daily recommended physical activity target. A policy and public health focus on intersectoral action to promote public transport may yield meaningful increases in physical activity and subsequent health benefits.


Subject(s)
Accelerometry , Exercise , Sedentary Behavior , Transportation , Humans , Transportation/methods , Male , Female , Adult , Longitudinal Studies , Middle Aged , Tasmania , Australia
8.
Int J Behav Nutr Phys Act ; 21(1): 55, 2024 May 10.
Article in English | MEDLINE | ID: mdl-38730407

ABSTRACT

BACKGROUND: The purpose of this study was to investigate the effects of a walking school bus intervention on children's active commuting to school. METHODS: We conducted a randomized controlled trial (RCT) in Houston, Texas (Year 1) and Seattle, Washington (Years 2-4) from 2012 to 2016. The study had a two-arm, cluster randomized design comparing the intervention (walking school bus and education materials) to the control (education materials) over one school year October/November - May/June). Twenty-two schools that served lower income families participated. Outcomes included percentage of days students' active commuting to school (primary, measured via survey) and moderate-to-vigorous physical activity (MVPA, measured via accelerometry). Follow-up took place in May or June. We used linear mixed-effects models to estimate the association between the intervention and outcomes of interest. RESULTS: Total sample was 418 students [Mage=9.2 (SD = 0.9) years; 46% female], 197 (47%) in the intervention group. The intervention group showed a significant increase compared with the control group over time in percentage of days active commuting (ß = 9.04; 95% CI: 1.10, 16.98; p = 0.015) and MVPA minutes/day (ß = 4.31; 95% CI: 0.70, 7.91; p = 0.02). CONCLUSIONS: These findings support implementation of walking school bus programs that are inclusive of school-age children from lower income families to support active commuting to school and improve physical activity. TRAIL REGISTRATION: This RCT is registered at clinicaltrials.gov (NCT01626807).


Subject(s)
Schools , Transportation , Walking , Humans , Walking/statistics & numerical data , Female , Male , Child , Transportation/methods , Health Promotion/methods , Washington , Texas , Students , Exercise , Motor Vehicles , Accelerometry , Poverty , Program Evaluation , Cluster Analysis
9.
J Surg Res ; 296: 281-290, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38301297

ABSTRACT

INTRODUCTION: Transportation databases have limited data regarding injury severity of pedestrian versus automobile patients. To identify opportunities to reduce injury severity, transportation and trauma databases were integrated to examine the differences in pedestrian injury severity at street crossings that were signalized crossings (SCs) versus nonsignalized crossings (NSCs). It was hypothesized that trauma database integration would enhance safety analysis and pedestrians struck at NSC would have greater injury severity. METHODS: Single-center retrospective review of all pedestrian versus automobile patients treated at a level 1 trauma center from 2014 to 2018 was performed. Patients were matched to the transportation database by name, gender, and crash date. Google Earth Pro satellite imagery was used to identify SC versus NSC. Injury severity of pedestrians struck at SC was compared to NSC. RESULTS: A total of 512 patients were matched (median age = 41 y [Q1 = 26, Q3 = 55], 74% male). Pedestrians struck at SC (n = 206) had a lower injury severity score (ISS) (median = 9 [4, 14] versus 17 [9, 26], P < 0.001), hospital length of stay (median = 3 [0, 7] versus 6 [1, 15] days, P < 0.001), and mortality (21 [10%] versus 52 [17%], P = 0.04), as compared to those struck at NSC (n = 306). The transportation database had a sensitivity of 63.4% (55.8%-70.4%) and specificity of 63.4% (57.7%-68.9%) for classifying severe injuries (ISS >15). CONCLUSIONS: Pedestrians struck at SC were correlated with a lower ISS and mortality compared to those at NSC. Linkage with the trauma database could increase the transportation database's accuracy of injury severity assessment for nonfatal injuries. Database integration can be used for evidence-based action plans to reduce pedestrian morbidity, such as increasing the number of SC.


Subject(s)
Pedestrians , Wounds and Injuries , Humans , Male , Adult , Female , Accidents, Traffic/prevention & control , Transportation , Trauma Centers , Databases, Factual , Wounds and Injuries/diagnosis , Wounds and Injuries/epidemiology
10.
Environ Sci Technol ; 58(33): 14608-14617, 2024 Aug 20.
Article in English | MEDLINE | ID: mdl-39105763

ABSTRACT

We present methods and insights for the design of CO2 capture, transport, and storage systems for industrial facilities with a case study focus on Louisiana. Our analytical framework includes (1) evaluating the scale and concentration of capturable CO2 emissions at individual facilities for the purpose of estimating the cost of CO2 capture retrofits that utilize various energy supply sources to meet parasitic demands; (2) screening to identify potential CO2 storage sites and estimate their capacities, injectivities, and costs; and (3) designing cost-minimized trucking or pipeline infrastructure connecting CO2 capture plants with storage sites, considering existing land uses, demographics, and a variety of social and environmental justice factors. Estimated levelized costs of capture at Louisiana's 190 industrial facilities range from below $50/tCO2 to above $500/tCO2, depending on facility-specific features. We identified 98 potential storage sites with storage costs ranging from $8 to $17/tCO2. We find that in most situations, pipelines are the least-costly mode of CO2 transport. When industrial facilities in a region share pipelines, aggregate pipeline mileage and average transport costs are dramatically lower than without sharing. Shared pipeline networks designed to avoid disadvantaged communities require right-of-way areas compared to those for networks that transect such communities, but result in 25% higher average per-tonne transport cost.


Subject(s)
Carbon Dioxide , Louisiana , Transportation , Industry , Air Pollutants
11.
J Urban Health ; 101(3): 439-450, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38683420

ABSTRACT

The occupational health burden and mechanisms that link gig work to health are understudied. We described injury and assault prevalence among food delivery gig workers in New York City (NYC) and assessed the effect of job dependence on injury and assault through work-related mechanisms and across transportation modes (electric bike and moped versus car). Data were collected through a 2022 survey commissioned by the NYC Department of Consumer and Worker Protection among delivery gig workers between October and December 2021 in NYC. We used modified Poisson regression models to estimate the adjusted prevalence rate ratio associations between job dependence and injury and assault. Of 1650 respondents, 66.9% reported that food delivery gig work was their main or only job (i.e., fully dependent). About 21.9% and 20.8% of respondents reported being injured and assaulted, respectively. Injury and assault were more than twice as prevalent among two-wheeled drivers, in comparison to car users. Fully dependent respondents had a 1.61 (95% confidence interval (CI) 1.20, 2.16) and a 1.36 (95% CI 1.03, 1.80) times greater prevalence of injury and assault, respectively, than partially dependent respondents after adjusting for age, sex, race and ethnicity, language, employment length, transportation mode, and weekly work hours. These findings suggest that fully dependent food delivery gig workers, especially two-wheeled riders, are highly vulnerable to the negative consequences of working conditions under algorithmic management by the platforms. Improvements to food delivery gig worker health and safety are urgently needed, and company narratives surrounding worker autonomy and flexibility need to be revisited.


Subject(s)
Occupational Injuries , Humans , New York City/epidemiology , Female , Adult , Male , Middle Aged , Occupational Injuries/epidemiology , Young Adult , Prevalence , Food Services/statistics & numerical data , Workplace Violence/statistics & numerical data , Adolescent , Transportation/statistics & numerical data
12.
J Appl Microbiol ; 135(4)2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38637309

ABSTRACT

AIMS: To monitor severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA contamination in vehicles operating in England during the pandemic, to better understand transmission risk of SARS-CoV-2 on public transport. METHODS AND RESULTS: We collected 1314 surface samples between December 2020 and April 2022 on trains and buses managed by five different transport operators. The presence of SARS-CoV-2 RNA was investigated through reverse transcription polymerase chain reaction (RT-PCR). SARS-CoV-2 RNA was found on 197 (15%) of the 1314 surfaces sampled, including seat head rests, handholds, and air extract grilles, but the levels of RNA recovered on those samples (median value of 23.4, interquartile range: 14.3-35.4, N gene copies per extraction) made the presence of infectious virus at the time of sampling extremely unlikely. However, detection rates varied over time with peaks broadly coinciding with times of high community transmission, when it was more likely that people infected with SARS-CoV-2 were travelling on public transport. CONCLUSION: During the pandemic, and as in other public spaces, low levels of SARS-CoV-2 RNA were found on surfaces associated with public transport.


Subject(s)
COVID-19 , RNA, Viral , SARS-CoV-2 , COVID-19/transmission , COVID-19/virology , COVID-19/epidemiology , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification , England/epidemiology , RNA, Viral/genetics , RNA, Viral/analysis , RNA, Viral/isolation & purification , Humans , Longitudinal Studies , Motor Vehicles , Transportation
13.
Occup Environ Med ; 81(3): 163-166, 2024 Mar 08.
Article in English | MEDLINE | ID: mdl-38360725

ABSTRACT

BACKGROUND: Certain workers are at increased risk for acquiring Legionnaires' disease compared with other workers. This study aims to identify occupations at increased risk for acquiring Legionnaires' disease. METHODS: Using data from the US Centers for Disease Control and Prevention's Supplemental Legionnaires' Disease Surveillance System, this study identified Legionnaires' disease confirmed patients ≥16 years of age in 39 states with reported symptom onset during 2014-2016. Age-adjusted and sex-adjusted incidence rate ratios (IRR) stratified by occupation group were calculated by comparing Legionnaires' disease patients in an occupation group (eg, transportation) to those in all other occupation groups (eg, non-transportation). RESULTS: A total of 2553 patients had a known occupation group. The two occupations with the highest burden were transportation (N=287; IRR=2.11) and construction (N=269; IRR=1.82). Truck drivers comprised the majority (69.7%) of the transportation occupation group and construction labourers comprised almost half (49%) of the construction occupation group. The healthcare support occupation had the highest IRR (N=75; IRR=2.16). CONCLUSION: Transportation and construction workers, who are generally not covered by guidance related to building water systems, have increased risk of Legionnaires' disease compared with other workers. One hypothesised risk factor for truck drivers is the use of non-genuine windshield cleaner in their vehicles. A simple intervention is to use genuine windshield cleaner with bactericidal properties (ie, includes isopropanol/methanol) which can reduce the risk of Legionella growth and transmission. To improve surveillance of Legionnaires' disease and identification of similar exposures, the authors encourage the collection of occupation and industry information for all patients with Legionnaires' disease.


Subject(s)
Legionnaires' Disease , Humans , Legionnaires' Disease/diagnosis , Legionnaires' Disease/epidemiology , Legionnaires' Disease/etiology , Occupations , Risk Factors , Transportation , Industry , Disease Outbreaks
14.
Support Care Cancer ; 32(5): 317, 2024 Apr 29.
Article in English | MEDLINE | ID: mdl-38684580

ABSTRACT

Transportation is an underrecognized, but modifiable barrier to accessing cancer care, especially for clinical trials. Clinicians, insurers, and health systems can screen patients for transportation needs and link them to transportation. Direct transportation services (i.e., ride-sharing, insurance-provided transportation) have high rates of patient satisfaction and visit completion. Patient financial reimbursements provide necessary funds to counteract the effects of transportation barriers, which can lead to higher trial enrollment, especially for low socioeconomic status and racially and ethnically diverse patients. Expanding transportation interventions to more cancer patients, and addressing knowledge, service, and system gaps, can help more patients access needed cancer care.


Subject(s)
Health Services Accessibility , Neoplasms , Humans , Clinical Trials as Topic , Medical Oncology/organization & administration , Medical Oncology/methods , Neoplasms/therapy , Patient Satisfaction , Transportation/methods , Transportation of Patients/methods , Transportation of Patients/organization & administration , Transportation of Patients/economics
15.
Environ Res ; 257: 119324, 2024 Sep 15.
Article in English | MEDLINE | ID: mdl-38844028

ABSTRACT

BACKGROUND: As the world becomes increasingly urbanised, there is recognition that public and planetary health relies upon a ubiquitous transition to sustainable cities. Disentanglement of the complex pathways of urban design, environmental exposures, and health, and the magnitude of these associations, remains a challenge. A state-of-the-art account of large-scale urban health studies is required to shape future research priorities and equity- and evidence-informed policies. OBJECTIVES: The purpose of this review was to synthesise evidence from large-scale urban studies focused on the interaction between urban form, transport, environmental exposures, and health. This review sought to determine common methodologies applied, limitations, and future opportunities for improved research practice. METHODS: Based on a literature search, 2958 articles were reviewed that covered three themes of: urban form; urban environmental health; and urban indicators. Studies were prioritised for inclusion that analysed at least 90 cities to ensure broad geographic representation and generalisability. Of the initially identified studies, following expert consultation and exclusion criteria, 66 were included. RESULTS: The complexity of the urban ecosystem on health was evidenced from the context dependent effects of urban form variables on environmental exposures and health. Compact city designs were generally advantageous for reducing harmful environmental exposure and promoting health, with some exceptions. Methodological heterogeneity was indicative of key urban research challenges; notable limitations included exposure and health data at varied spatial scales and resolutions, limited availability of local-level sociodemographic data, and the lack of consensus on robust methodologies that encompass best research practice. CONCLUSION: Future urban environmental health research for evidence-informed urban planning and policies requires a multi-faceted approach. Advances in geospatial and AI-driven techniques and urban indicators offer promising developments; however, there remains a wider call for increased data availability at local-levels, transparent and robust methodologies of large-scale urban studies, and greater exploration of urban health vulnerabilities and inequities.


Subject(s)
Cities , Humans , Environmental Exposure , Transportation , Urban Health , Environmental Health/methods
16.
Environ Res ; 245: 118092, 2024 Mar 15.
Article in English | MEDLINE | ID: mdl-38163540

ABSTRACT

BACKGROUND: Previous studies have linked noise exposure with adverse cardiovascular events. However, evidence remains inconsistent, and most previous studies only focused on traffic noise, excluding other anthropogenic sources like constructions, industrial process and commercial activities. Additionally, few studies have been conducted in the U.S. or evaluated the non-linear exposure-response relationships. METHODS: We conducted a relative incidence analysis study using all cardiovascular diseases mortality as cases (n = 936,019) and external causes mortality (n = 232,491) as contrast outcomes. Mortality records geocoded at residential addresses were obtained from five U.S. states (Indiana, 2007; Kansas, 2007-2009, Missouri, 2010-2019, Ohio, 2007-2013, Texas, 2007-2016). Time-invariant long-term noise exposure was obtained from a validated model developed based on acoustical measurements across 2000-2014. Noises from both natural sources (natural activities, including animals, insects, winds, water flows, thunder, etc.) and anthropogenic sources (human activities, including transportation, industrial activities, community facilities & infrastructures, commercial activities, entertainments, etc.) were included. We used daytime and nighttime total anthropogenic noise & day-night average sound pressure level combining natural and anthropogenic sources as exposures. Logistic regression models were fit controlling for Census tract-level & individual-level characteristics. We examined potential modification by sex by interaction terms and potential non-linear associations by thin plate spline terms. RESULTS: We observed positive associations for daytime anthropogenic L50 (sound level exceeded 50% of time) noise (10-dBA OR = 1.047, 95%CI 1.025-1.069), nighttime anthropogenic L50 noise (10-dBA OR = 1.061, 95%CI 1.033-1.091) in a two-exposure-term model, and overall Ldn (day-night average) sound pressure level (10-dBA OR = 1.064, 95%CI 1.040-1.089) in single-exposure-term model. Females were more susceptible to all three exposures. All exposures showed monotonic positive associations with cardiovascular mortality up to certain thresholds around 45-55 dBA, with a generally flattened or decreasing trend beyond those thresholds. CONCLUSIONS: Both daytime anthropogenic and nighttime anthropogenic noises were associated with cardiovascular disease mortality, and associations were stronger in females.


Subject(s)
Cardiovascular Diseases , Humans , Female , Cardiovascular Diseases/epidemiology , Environmental Exposure/analysis , Noise , Transportation , Cohort Studies
17.
Environ Res ; 247: 118174, 2024 Apr 15.
Article in English | MEDLINE | ID: mdl-38244968

ABSTRACT

BACKGROUND: Exposure to air pollution during childhood has been linked with adverse effects on cognitive development and motor function. However, limited research has been done on the associations of air pollution exposure in different microenvironments such as home, school, or while commuting with these outcomes. OBJECTIVE: To analyze the association between childhood air pollution exposure in different microenvironments and cognitive and fine motor function from six European birth cohorts. METHODS: We included 1301 children from six European birth cohorts aged 6-11 years from the HELIX project. Average outdoor air pollutants concentrations (NO2, PM2.5) were estimated using land use regression models for different microenvironments (home, school, and commute), for 1-year before the outcome assessment. Attentional function, cognitive flexibility, non-verbal intelligence, and fine motor function were assessed using the Attention Network Test, Trail Making Test A and B, Raven Colored Progressive Matrices test, and the Finger Tapping test, respectively. Adjusted linear regressions models were run to determine the association between each air pollutant from each microenvironment on each outcome. RESULTS: In pooled analysis we observed high correlation (rs = 0.9) between air pollution exposures levels at home and school. However, the cohort-by-cohort analysis revealed correlations ranging from low to moderate. Air pollution exposure levels while commuting were higher than at home or school. Exposure to air pollution in the different microenvironments was not associated with working memory, attentional function, non-verbal intelligence, and fine motor function. Results remained consistently null in random-effects meta-analysis. CONCLUSIONS: No association was observed between outdoor air pollution exposure in different microenvironments (home, school, commute) and cognitive and fine motor function in children from six European birth cohorts. Future research should include a more detailed exposure assessment, considering personal measurements and time spent in different microenvironments.


Subject(s)
Air Pollutants , Air Pollution , Child , Humans , Air Pollutants/toxicity , Air Pollution/analysis , Cognition , Cohort Studies , Environmental Exposure/analysis , Particulate Matter/analysis , Transportation
18.
Environ Res ; 252(Pt 2): 118901, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38609068

ABSTRACT

Transmission of fungi in the air and its impact on health are regarded as important public health issues. Bioaerosols play an important role in causing or exacerbating infectious diseases, acute toxic effects, allergies, and cardiopulmonary symptoms. As many people use the public transportation system daily, it is necessary to determine the type and manner of dispersal and abundance of airborne fungi in public transport places. Three public transportation systems including a bus station, a train station, and an airport in Ahvaz city (Iran) were examined. At each of these stations, the air samples were taken from inside and outside the hall stations, and in-vehicle. A bio-stage Anderson sampler was used by suctioning air and passing it over a Petri dish containing culture medium Sabouraud Dextrose Agar (SDA). Relative humidity (RH, %), temperature (T, ◦C), and mass concentration of particulate matter (PM1, PM2.5, and PM10, µg/m3) at the sampling points were measured. The highest concentration of airborne fungi was observed in the airport. The concentration of fungi in the ambient air was higher than that in the indoor air of halls and in-vehicle. In all sampling points, the ambient predominant airborne fungi were Cladosporium and Alternaria, while the indoor predominant airborne fungi were Cladosporium, Aspergillus, and Penicillium. The indoor to outdoor ratio showed that the fungi were of an external origin. Due to the influence of the ambient air on indoor air, it is recommended to use proper ventilation and enhance the hygiene level of vehicles in public transportation systems to reduce exposure to environmentally pathogenic bioaerosols.


Subject(s)
Air Microbiology , Fungi , Particulate Matter , Fungi/isolation & purification , Particulate Matter/analysis , Air Pollution, Indoor/analysis , Transportation , Iran , Environmental Monitoring/methods , Air Pollutants/analysis
19.
Environ Health ; 23(1): 39, 2024 Apr 13.
Article in English | MEDLINE | ID: mdl-38609941

ABSTRACT

BACKGROUND: Physical inactivity is a global public health problem. A practical solution would be to build physical activity into the daily routine by using active modes of transport. Choice of transport mode can influence cancer risk through their effects on levels of physical activity, sedentary time, and environmental pollution. This review synthesizes existing evidence on the associations of specific transport modes with risks of site-specific cancers. METHODS: Relevant literature was searched in PubMed, Embase, and Scopus from 1914 to 17th February 2023. For cancer sites with effect measures available for a specific transport mode from two or more studies, random effects meta-analyses were performed to pool relative risks (RR) comparing the highest vs. lowest activity group as well as per 10 Metabolic Equivalent of Task (MET) hour increment in transport-related physical activity per week (∼150 min of walking or 90 min of cycling). RESULTS: 27 eligible studies (11 cohort, 15 case-control, and 1 case-cohort) were identified, which reported the associations of transport modes with 10 site-specific cancers. In the meta-analysis, 10 MET hour increment in transport-related physical activity per week was associated with a reduction in risk for endometrial cancer (RR: 0.91, 95% CI: 0.83-0.997), colorectal cancer (RR: 0.95, 95% CI: 0.91-0.99) and breast cancer (RR: 0.99, 95% CI: 0.89-0.996). The highest level of walking only or walking and cycling combined modes, compared to the lowest level, were significantly associated with a 12% and 30% reduced risk of breast and endometrial cancers respectively. Cycling, compared to motorized modes, was associated with a lower risk of overall cancer incidence and mortality. CONCLUSION: Active transport appears to reduce cancer risk, but evidence for cancer sites other than colorectum, breast, and endometrium is currently limited.


Subject(s)
Neoplasms , Humans , Neoplasms/epidemiology , Transportation , Exercise , Walking
20.
BMC Vet Res ; 20(1): 158, 2024 Apr 26.
Article in English | MEDLINE | ID: mdl-38671444

ABSTRACT

BACKGROUND: Studies on equine air transport practices and consequences are scarce. This prospective study aimed to describe horse and air journey details and practices, document how horse behavior and health changed during the air transport phases, quantify the occurrence of welfare issues, and identify possible associations between horse and journey details, air transport practices, and welfare issues. RESULTS: Data were collected from before departure to five days after arrival on 118/597 horses traveling on 32 commercial air journeys on different routes, varying in duration and conditions. Most horses were middle-aged warmblood females, 26% of which were pregnant, and being moved by air for sales. Before flying, most were quarantined (median: 18; IQR: 9-53 days), and their fitness for travel was certified by veterinarians. At the departure airports, external temperatures varied from - 6 °C to 33 °C, and horses were loaded by experienced flight grooms (median: 35; IQR: 15-40 years) into jet stalls (three-horse: 87%, two-horse: 13%). During the flights, horses were regularly watered (water intake median: 14 L) and fed ad libitum (feed consumption median: 8 kg). At the arrival airport, horses were unloaded from the jet stalls, and external temperatures ranged from - 5 °C to 32 °C. Then, all horses were transported to arrival quarantine by road. Air transport phases affected horses' health status and behavior; increased heart and respiratory rates and behaviors, such as pawing, head tossing, and vocalization, were mainly identified at departure and arrival. Horse interaction, nasal discharge, increased capillary refill time (CRT), and abnormal demeanor were observed more often one hour before landing while resting and normal capillary refill time were more often displayed five days after arrival (all P < 0.01). One hour before landing, horses with bad temperament and horses of unknown temperament were more likely to develop nasal discharge when transported in winter and autumn (P < 0.001). The likelihood of an increased CRT was associated with shorter flights in horses of unknown travel experience (P < 0.001). Ten horses were injured, and 11 developed pleuropneumonias (i.e., shipping fever). CONCLUSIONS: Air transport is a complex procedure with several different phases affecting horse health and behavior. Therefore, experienced staff should carefully manage each horse before, during, and after air journeys to minimize welfare hazards.


Subject(s)
Animal Welfare , Transportation , Animals , Horses/physiology , Female , Male , Prospective Studies , Aircraft , Pregnancy
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