Environmental health, economy, and amenities interactively drive migration patterns among China's older people.

The increasing number of older adult migrants is rapidly changing regional demographic and social structures in China. There is an urgent need to understand the spatial patterns and factors that influence older adults to migrate, especially the role of environmental health. However, this issue has been under-studied. This study focused on intra-provincial and inter-provincial older adult migrants as research subjects, estimated their spatial concentration index based on the iterative proportional fitting approach, and explored the factors influencing their migration using the GeoDetector Model. The results showed the following: (1) In 2015, more than 76% of inter-provincial older adult migrants were distributed in Eastern China, and most intra-provincial older adult migrants were scattered in sub-provincial cities. (2) Compared to factors relating to economy and amenities, environmental health by itself played a relatively weak role in the migration of older adults, but the interaction among environmental health, economy, and amenities was a key driving force of older adult migration. (3) There were significant differences in the dominant environmental health factors between inter-provincial migration and intra-provincial migration, which were temperature and altitude, respectively. Our findings can help policymakers focus on the composition of older adult migrants based on urban environmental health characteristics and rationally optimize older adult care facilities to promote supply-demand matching.

Sistema de Informação de Vigilância da Qualidade da Água para Consumo Humano (Sisagua): avaliação da completitude dos dados sobre cobertura de abastecimento, 2014-2020 / Sistema de Información de Vigilancia de la Calidad del Agua para Consumo Humano (Sisagua): evaluación de la finalización de los datos de cobertura del abastecimiento de agua, Brasil, 2014-2020 / Drinking Water Quality Surveillance Information System (SISAGUA): evaluation of data completeness on water supply coverage, Brazil, 2014-2020

Objetivo: Avaliar a completitude do conjunto de dados do Sistema de Informação de Vigilância da Qualidade da Água para Consumo Humano (Sisagua) referente às informações sobre a cobertura de abastecimento de água para consumo humano no Brasil. Métodos: Estudo descritivo, sobre dados de 2014 a 2020. Foi calculada distribuição de frequência relativa de 35 variáveis. A completitude foi mensurada como excelente (≥ 95%), boa (90% a 94%), regular (70% a 89%), ruim (50% a 69%) e muito ruim (≤ 49%). Resultados: No período, foram identificados 861.250 registros de formas de abastecimento. O Sisagua, quanto à completitude dos dados, obteve uma classificação excelente para 25 variáveis, boa para duas, regular para três, ruim para uma e muito ruim para quatro. Conclusão: O sistema apresentou, em grande parte das variáveis, excelente completitude dos dados. Estudos dessa natureza contribuem para o aperfeiçoamento contínuo do Sisagua e possibilitam a identificação de inconsistências e fragilidades.

Objetivo: Evaluar la completitud del conjunto de datos del Sistema de Información para la Vigilancia de la Calidad del Agua para Consumo Humano (Sisagua), con relación a la información sobre la cobertura de abastecimiento de agua para consumo humano en Brasil. Métodos: Estudio descriptivo referido a datos de 2014 a 2020. Se calcularon distribuciones de frecuencias relativas de 35 variables. La completitud se midió como excelente (≥ 95%), buena (90% a 94%), regular (70% a 89%), mala (50% a 69%) y muy mala (≤ 49%). Resultados: En el período, hubo 861.250 registros de formas de suministro. Sisagua, en cuanto a la completitud de los datos, obtuvo una clasificación excelente para 25 variables, buena para dos, regular para tres, mala para una y muy mala para cuatro variables. Conclusión: El sistema presentó en la mayoría de las variables una excelente completitud de los datos. Estudios de esta naturaleza contribuyen a la mejoría continua de Sisagua y permiten identificar inconsistencias y debilidades.

Objective: To evaluate the completeness of dataset of the Drinking Water Quality Surveillance Information System (SISAGUA) regarding information on the coverage of water supply for human consumption in Brazil. Methods: This was a descriptive study on data between 2014 and 2020. A relative frequency distribution of 35 variables was calculated. Completeness was categorized as excellent (≥ 95%), good (90% to 94%), regular (70% to 89%), poor (50% to 69%) and very poor (≤ 49%). Results: In the period, there were 861,250 records of forms of water supply. With regard to data completeness, SISAGUA obtained an excellent classification for 25 variables, good for two, regular for three, poor for one and very poor for four variables. Conclusion: The system showed excellent data completeness for most of the variables. This type of study contributes to the continuous improvement of SISAGUA and enables the identification of inconsistencies and weaknesses.

Spatial clustering patterns and regional variations for food and physical activity environments across the United States.

This study examined spatial patterns of obesogenic environments for US counties. We mapped the geographic dispersion of food and physical activity (PA) environments, assessed spatial clustering, and identified food and PA environment differences across U.S. regions and rurality categories. Substantial low food score clusters were located in the South and high score clusters in the Midwest and West. Low PA score clusters were located in the South and high score clusters in the Northeast and Midwest (p < .0001). For region, the South had significantly lower food and PA environment scores. For rurality, rural counties had significantly higher food environment scores and metropolitan counties had significantly higher PA environment scores (p < .0001). This study highlights geographic clustering and disparities in food and PA access nationwide. State and region-wide environmental inequalities may be targeted using structural interventions and policy initiatives to improve food and PA access.

Urban Emotion Sensing Beyond 'Affective Capture': Advancing Critical Interdisciplinary Methods.

The use of mobile sensor methodologies in urban analytics to study 'urban emotions' is currently outpacing the science required to rigorously interpret the data generated. Interdisciplinary research on 'urban stress' could help inform urban wellbeing policies relating to healthier commuting and alleviation of work stress. The purpose of this paper is to address-through methodological experimentation-ethical, political and conceptual issues identified by critical social scientists with regards to emotion tracking, wearables and data analytics. We aim to encourage more dialogue between the critical approach and applied environmental health research. The definition of stress is not unambiguous or neutral and is mediated by the very technologies we use for research. We outline an integrative methodology in which we combine pilot field research using biosensing technologies, a novel method for identifying 'moments of stress' in a laboratory setting, psychometric surveys and narrative interviews on workplace and commuter stress in urban environments.

Environmental health literacy and household air pollution-associated symptoms in Kenya: a cross-sectional study.

BACKGROUND: Household air pollution (HAP) is a significant source of the global burden of disease. Our objective was to evaluate the association between environmental health literacy (EHL), a domain of health literacy (HL) that describes the ability to use environmental health information to reduce health risks, and symptoms associated with HAP. METHODS: We performed a cross-sectional population-based study of 353 households in Kasarani, Kenya. One individual from each household was surveyed using our novel EHL survey tool. Baseline characteristics were compared between individuals who were symptomatic (i.e., experiencing cough, shortness of breath, phlegm production, wheeze, chest tightness, headache, eye irritation, or burns from cooking at least 5 times per month) versus individuals who were asymptomatic (i.e., experiencing none or symptoms no more than once per month). Multivariate logistic regression was used to determine the odds ratios (OR) of self-reported symptoms associated with HL, stratified by median EHL, adjusting for education, self-perceived health and solid fuel use. RESULTS: A total of 100 individuals (28%) reported experiencing one or more symptoms at least 5 times per month, including 31.2% of solid fuel users and 30.3% of non-solid fuel users. Among individuals with high EHL, higher HL was associated with lower risk of experiencing symptoms (OR = 0.26; 95% CI 0.10-0.67), however, there was no association among individuals with low EHL (OR = 0.85; 95% CI 0.34-2.13). Among solid fuel users, the association between HL and risk of experiencing symptoms was driven by individuals with high EHL (OR = 0.30; 95% CI 0.05-1.84), rather than those with low EHL (OR = 1.22; 95% CI 0.36-4.16). CONCLUSIONS: To the best of our knowledge, this was the first study to assess the association between EHL, HL, and HAP-associated symptoms. Our findings highlight the potential importance of EHL in promoting sustainable interventions to reduce symptoms associated with HAP from solid fuel use among communities in Kenya.

The healthiness and sustainability of national and global food based dietary guidelines: modelling study.

OBJECTIVE: To analyse the health and environmental implications of adopting national food based dietary guidelines (FBDGs) at a national level and compared with global health and environmental targets. DESIGN: Modelling study. SETTING: 85 countries. PARTICIPANTS: Population of 85 countries. MAIN OUTCOME MEASURES: A graded coding method was developed and used to extract quantitative recommendations from 85 FBDGs. The health and environmental impacts of these guidelines were assessed by using a comparative risk assessment of deaths from chronic diseases and a set of country specific environmental footprints for greenhouse gas emissions, freshwater use, cropland use, and fertiliser application. For comparison, the impacts of adopting the global dietary recommendations of the World Health Organization and the EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems were also analysed. Each guideline's health and sustainability implications were assessed by modelling its adoption at both the national level and globally, and comparing the impacts to global health and environmental targets, including the Action Agenda on Non-Communicable Diseases, the Paris Climate Agreement, the Aichi biodiversity targets related to land use, and the sustainable development goals and planetary boundaries related to freshwater use and fertiliser application. RESULTS: Adoption of national FBDGs was associated with reductions in premature mortality of 15% on average (95% uncertainty interval 13% to 16%) and mixed changes in environmental resource demand, including a reduction in greenhouse gas emissions of 13% on average (regional range -34% to 35%). When universally adopted globally, most of the national guidelines (83, 98%) were not compatible with at least one of the global health and environmental targets. About a third of the FBDGs (29, 34%) were incompatible with the agenda on non-communicable diseases, and most (57 to 74, 67% to 87%) were incompatible with the Paris Climate Agreement and other environmental targets. In comparison, adoption of the WHO recommendations was associated with similar health and environmental changes, whereas adoption of the EAT-Lancet recommendations was associated with 34% greater reductions in premature mortality, more than three times greater reductions in greenhouse gas emissions, and general attainment of the global health and environmental targets. As an example, the FBDGs of the UK, US, and China were incompatible with the climate change, land use, freshwater, and nitrogen targets, and adopting guidelines in line with the EAT-Lancet recommendation could increase the number of avoided deaths from 78 000 (74 000 to 81 000) to 104 000 (96 000 to 112 000) in the UK, from 480 000 (445 000 to 516 000) to 585 000 (523 000 to 646 000) in the USA, and from 1 149 000 (1 095 000 to 1 204 000) to 1 802 000 (1 664 000 to 1 941 000) in China. CONCLUSIONS: This analysis suggests that national guidelines could be both healthier and more sustainable. Providing clearer advice on limiting in most contexts the consumption of animal source foods, in particular beef and dairy, was found to have the greatest potential for increasing the environmental sustainability of dietary guidelines, whereas increasing the intake of whole grains, fruits and vegetables, nuts and seeds, and legumes, reducing the intake of red and processed meat, and highlighting the importance of attaining balanced energy intake and weight levels were associated with most of the additional health benefits. The health results were based on observational data and assuming a causal relation between dietary risk factors and health outcomes. The certainty of evidence for these relations is mostly graded as moderate in existing meta-analyses.

Machine Learning Within Studies of Early-Life Environmental Exposures and Child Health: Review of the Current Literature and Discussion of Next Steps.

PURPOSE OF REVIEW: The goal of this article is to review the use of machine learning (ML) within studies of environmental exposures and children's health, identify common themes across studies, and provide recommendations to advance their use in research and practice. RECENT FINDINGS: We identified 42 articles reporting upon the use of ML within studies of environmental exposures and children's health between 2017 and 2019. The common themes among the articles were analysis of mixture data, exposure prediction, disease prediction and forecasting, analysis of complex data, and causal inference. With the increasing complexity of environmental health data, we anticipate greater use of ML to address the challenges that cannot be handled by traditional analytics. In order for these methods to beneficially impact public health, the ML techniques we use need to be appropriate for our study questions, rigorously evaluated and reported in a way that can be critically assessed by the scientific community.

Benefits of basic research from the Superfund Research Program.

The National Institutes of Health (NIH), National Institute of Environmental Health Sciences (NIEHS) Hazardous Substances Basic Research and Training Program [Superfund Research Program (SRP)] funds transdisciplinary research projects spanning the biomedical and environmental sciences to address issues related to potentially hazardous substances. We used a case study approach to identify how SRP-funded basic biomedical research has had an impact on society. We examined how transdisciplinary research projects from the SRP have advanced knowledge and led to additional clinical, public health, policy, and economic benefits. SRP basic biomedical research findings have contributed to the body of knowledge and influenced a broad range of scientific disciplines. It has informed the development of policies and interventions to reduce exposure to environmental contaminants to improve public health. Research investments by the SRP have had a significant impact on science, health, and society. Documenting the benefits of these investments provides insight into how basic research is translated to real-world applications.

Reaching the sustainable development goals through healthy environments: are we on track?

The adoption of the 2030 Agenda for Sustainable Development in 2015 opened new opportunities to work towards healthy environments through 'whole of government' and 'whole of society' approaches. It created a strong policy platform that acknowledges health as a result and an enabler of sustainable policies across all sectors of government. Five years into the process, an initial analysis of emerging trends indicates that, despite some encouraging developments in policy as well as overall progress in economy and technology, there remains a gap between rhetoric, ambition and reality. In particular, the monitoring system for environment and health-related sustainable development goals (SDGs) and targets requires further development; inequalities in environment and health persist and in some areas have increased; equity is not yet a central element of implementation and reporting on the achievement of the SDGs; and, most worrying of all, trends in key environmental indicators that are vital to the survival of the human species, such as those related to climate change and biodiversity, are still on an overall negative path. In summary, governments must significantly and rapidly increase action to secure the habitability and safety of planet Earth. The public health community assumes an unprecedented role in placing and maintaining health and equity at the heart of the political agenda. This demands new governance models conferring on the health sector a clear mandate and legitimacy to operate across sectors. It also requires enhancing capacities among health professionals to embrace this new level of complexity, understand the multiple links between sectoral policies and health, and successfully engage with other government sectors and stakeholders.

Sharing SRP data to reduce environmentally associated disease and promote transdisciplinary research.

The National Institute of Environmental Health Sciences (NIEHS) Superfund Basic Research and Training Program (SRP) funds a wide range of projects that span biomedical, environmental sciences, and engineering research and generate a wealth of data resulting from hypothesis-driven research projects. Combining or integrating these diverse data offers an opportunity to uncover new scientific connections that can be used to gain a more comprehensive understanding of the interplay between exposures and health. Integrating and reusing data generated from individual research projects within the program requires harmonization of data workflows, ensuring consistent and robust practices in data stewardship, and embracing data sharing from the onset of data collection and analysis. We describe opportunities to leverage data within the SRP and current SRP efforts to advance data sharing and reuse, including by developing an SRP dataset library and fostering data integration through Data Management and Analysis Cores. We also discuss opportunities to improve public health by identifying parallels in the data captured from health and engineering research, layering data streams for a more comprehensive picture of exposures and disease, and using existing SRP research infrastructure to facilitate and foster data sharing. Importantly, we point out that while the SRP is in a unique position to exploit these opportunities, they can be employed across environmental health research. SRP research teams, which comprise cross-disciplinary scientists focused on similar research questions, are well positioned to use data to leverage previous findings and accelerate the pace of research. Incorporating data streams from different disciplines addressing similar questions can provide a broader understanding and uncover the answers to complex and discrete research questions.

Symposium report: emerging threats for human health - impact of socioeconomic and climate change on zooanthroponosis in the Republic of Sakha (Yakutia), Russia.

Population growth, socio-cultural and economic changes as well as technological progress have an immediate impact on the environment and human health in particular. Our steadily rising needs of resources increase the pressure on the environment and narrow down untainted habitats for plants and wild animals. Balance and resilience of ecosystems are further threatened by climate change, as temperature and seasonal shifts increase the pressure for all species to find successful survival strategies. Arctic and subarctic regions are especially vulnerable to climate change, as thawing of permafrost significantly transforms soil structures, vegetation and habitats. With rising temperature, the risk of zoonotic diseases in the Republic of Sakha (Yakutia) has also increased. As vegetation periods prolong and habitats broaden, zoonotic pathogens and their vectors find more favourable living conditions. Moreover, permafrost degradation may expose historic burial grounds and allow for reviving the vectors of deadly infections from the past. To assess the current state of knowledge and emerging risks in the light of the "One Health" concept, a German-Russian Symposium took place on 13 August 2018 in Yakutsk, Russian Federation. This symposium report presents the main findings generated from presentations and discussions.

Fungal spores and pollen are correlated with meteorological variables: effects in human health at Hermosillo, Sonora, Mexico.

We conducted the first study of air pollen and fungal spores for Hermosillo, Sonora, where the human population is exposed to high temperatures and high levels of dust and suffers from diseases related to air quality. We sampled pollen and fungal spores daily in the air during 2016 using a volumetric spore trap Hirst-type sampler. We used simple linear correlation to investigate the association between pollen and spore counts and daily weather conditions. We found an Annual Pollen Integral of 16,243 pollen day/m3 and an Annual Spore Integral higher 222,365 spore day/m3. We identified 32 pollen taxa and 15 different spores. We found two periods of higher pollen and spore concentrations: March to May and August to October, the latter was the most severe. Spore and pollen concentrations in the air increased at higher temperature and higher relative humidity but decreased at higher precipitation. We detected negative impacts during summer and fall on population health, with 13,454 cases of people who presented diseases related to allergies. A peak in allergies is centered during October and correlates well with our peaks in pollen and spore concentrations; it seems that pollen of Poaceae is the one that generates most effects in allergic people.

Neighborhood air pollution and household environmental health as it relates to respiratory health and healthcare utilization among elderly persons with asthma.

Objective: The study investigated the associations between fine particulate matter (PM2.5; <2.5 µm in diameter), indoor environment, pulmonary function, and healthcare utilization in a vulnerable group of elderly persons with asthma. We hypothesized that environmental conditions were associated with adverse pulmonary health outcomes. Methods: The study involved elderly (n = 76; mean age 64.6 years; 48 women) vulnerable persons in Detroit, Michigan, USA, with physician-diagnosed asthma. Exposure variables included measured outdoor PM2.5, self-rated outdoor and household environmental pollutants. Outcome variables were self-rated and measured pulmonary function, and asthma-related healthcare utilization. Results: Mean ambient PM2.5 concentrations during the study was 14.14 ± (S.D. 6.36) µg/m3 during the summer and 14.20 (6.33) during the winter (p = 0.95). In multiple regression analyses, adjusting for age and gender, mean 6-month concentration of PM2.5 was related to shortness of breath (SHOB; standardized ß = 0.26, p = 0.02) and inversely with self-rated respiratory health (SRRH; ß = 0.28, p = 0.02). However, PM2.5 did not predict lung function (FEV1% predicted and FEV1/FVC). However, PM2.5 was related to use of asthma controller drugs (ß = 0.38, p = 0.001). Participants' air pollution ratings predicted total healthcare utilization (ß = 0.33, p = 0.01). Conclusions: In elderly persons with asthma, living near heavy industry and busy highways, objective and perceived environmental pollution relate to participants' respiratory health and healthcare utilization. Importantly, air pollution might increase use of asthma controller drugs containing corticosteroids with implication for elderly persons' risk to develop osteoporosis and cardiovascular disease.

Assessing the national capacity for disaster research response (DR2) within the NIEHS Environmental Health Sciences Core Centers.

INTRODUCTION: Disaster research response (DR2) is necessary to answer scientific questions about the environmental health impacts of disasters and the effectiveness of response and recovery strategies. This research explores the preparedness and capacity of National Institute of Environmental Health Sciences (NIEHS) P30 Core Centers (CCs) to conduct DR2 and engage with communities in the context of disasters. METHODS: In early 2018, we conducted an online survey of CC Directors (n = 16, 69.5% response rate) to identify their DR2 relevant scientific assets, capabilities, and activities. Summary statistics were calculated. We also conducted in-depth, semi-structured interviews with 16 (69.5%) CC Community Engagement Core directors to identify facilitators and barriers of DR2 community engagement. Interview notes were coded and thematically analyzed. RESULTS: Survey: While 56% of responding CCs reported prior participation in DR2 and preparedness to repurpose funding to support DR2, less than one third reported development of a disaster-specific data collection protocol, deployment plan, or concept of operations plan, participation in an exercise to test DR2 capacity, development of academic partnerships to conduct DR2, development of a process for fast-tracking institutional review board approvals for DR2, or maintenance of formal agreements with state, local, or community-based partner(s). A number of CCs reported developing or considering developing capacity in these areas. Barriers to, and tools and resources to enhance, CC engagement in DR2 were identified. Interviews: Four key components for community engaged DR2 were identified: pre-existing community relationships, responsive research that benefits communities, coordination among researchers, and coordination with community response partners. Several roles for, benefits of, and barriers to Community Engagement Rapid Response Teams (CERRT) were described. CONCLUSIONS: CCs have significant scientific assets and community partnerships that can be leveraged for DR2; however, additional planning is necessary to ensure that these scientific assets and community partnerships are leveraged when disasters strike.

Using machine learning to examine the relationship between asthma and absenteeism.

In this study, we found that machine learning was able to effectively estimate student learning outcomes geo-spatially across all the campuses in a large, urban, independent school district. The machine learning showed that key factors in estimating the student learning outcomes included the number of days students were absent from school. In turn, one of the most important factors in estimating the number of days a student was absent was whether or not the student had asthma. This highlights the importance of environmental public health for student learning outcomes.

[Systematic review of the impact of chlordecone on human health in the French West Indies]. / Revue systématique de l'impact du chlordécone sur la santé humaine aux Antilles françaises.

INTRODUCTION: Several publications have highlighted the adverse effects of chlordecone on human and animal species. The possible long-term consequences continue to be explored as chlordecone still contaminates Caribbean soils. The objective of this literature review is to determine the long-term effects of chlordecone on human health. MATERIAL AND METHOD: We searched for the keyword "chlordecone" on different scientific databases: Medline®, ISI Web of Knowledge, Google Scholar, EM Premium. We have enriched our research with first degree references, related articles on PubMed and grey literature. RESULTS: Of the 192 articles analyzed, 12 responded to the impact of chlordecone on human health in the French West Indies. In obstetrics, exposure to chlordecone was associated with a lower incidence of gestational hypertension. In pediatrics, these studies have shown an association between prenatal exposure to chlordecone and increased risk of prematurity, decreased birth weight (especially when the mother gained excessive weight during pregnancy), decreased fine cognitive and motor acquisition, and changes in circulating concentrations of certain thyroid hormones. In oncology, exposure was associated with an increased risk of prostate cancer, particularly if there was a family history of prostate cancer. CONCLUSION: While the effects of acute exposure to chlordecone at high doses are well described (Kepone Shake syndrome at the time of the Hopewell accident), the effects at environmental doses are becoming clearer even if they remain complex to identify.

The need for community-led, integrated and innovative monitoring programmes when responding to the health impacts of climate change.

In Northern Canada, climate change has led to many acute and interrelated health and environmental impacts experienced among Inuit populations. Community-based monitoring, in which community members participate in monitoring initiatives using various forms of technology, is a key strategy increasingly used to detect, monitor and respond to climate change impacts. To better understand the landscape of existing environmental and health monitoring programmes mobilising different technologies and operating in the North we conducted a review that used environmental scan methodologies to explore and contextualise these programmes. We consulted with academic researchers with experience in community-led monitoring, conducted systematic searches of grey and peer-reviewed literature, and conducted a secondary search for environment-health mobile-phone applications. Following specific criteria, we identified 18 monitoring programmes using information and communication technologies in the North, and three global monitoring mobile-phone applications, which cumulatively monitored 74 environment and health indicators. Several themes emerged, including the need for: (1) community leadership, (2) indicators of environment and/or human health and (3) innovative technology. This synthesis supports the development of community-led, environment-health monitoring programmes that use innovative technology to monitor and share information related to the health implications of climate change in and around Indigenous communities throughout the Circumpolar North.