Pobreza energética y salud en población gitana y en población general de España / Energy poverty and self-rated health among Roma population and general population in Spain

Objetivo: Cuantificar la pobreza energética en población gitana y población general de España, en 2016, y observar la asociación de este fenómeno con la salud autopercibida, ajustando por los principales determinantes socioeconómicos. Método: La pobreza energética fue definida como la incapacidad económica para mantener el calor dentro del hogar, la presencia de humedad en la vivienda y tener retrasos en el pago de facturas de suministros, con datos de dos encuestas europeas para España en 2016: la Encuesta sobre Ingresos y Condiciones de Vida (EU-SILC) y la Segunda Encuesta sobre Minorías y Discriminación (EU-MIDIS II). Se calcularon modelos de regresión logística jerárquica con la salud autopercibida como variable resultado, ajustando progresivamente por variables demográficas (género y edad), ambientales (temperatura del hogar, humedad y retrasos en las facturas) y socioeconómicas (nivel educativo, estado civil y situación ocupacional). Resultados: El 45% de la población gitana mostró niveles moderados o altos de pobreza energética. La odds ratio (OR) de mala salud autopercibida era mayor en la población gitana (OR: 3,11; intervalo de confianza del 95% [IC95%]: 2,59-3,74). No poder mantener una temperatura adecuada en el interior del hogar incrementó considerablemente el riesgo de mala salud (OR: 2,10; IC95%: 1,90-2,32). Tras ajustar por variables demográficas, ambientales y socioeconómicas, no observamos asociación entre población de adscripción y salud autopercibida. Conclusiones: Considerando los principales determinantes sociales, indicadores de pobreza energética incluidos, ser una persona gitana no se asocia con declarar mala salud. Este resultado señala la relevancia de abordar los factores socioeconómicos, la pobreza energética entre ellos, para reducir las desigualdades en salud.(AU)

Objective: To quantify energy poverty in Roma population and in general population in Spain, in 2016, as well as to observe the association of this phenomenon with self-rated health, adjusted according to the main socio-economic determinants. Method: Energy poverty has been defined as the financial inability to keep a home warm, the presence of dampness in the dwelling and falling into arrears in utility bills, using data from two European surveys from Spain in 2016: the Survey on Income and Living Conditions (EU-SILC) and the Second Survey on Minorities and Discrimination (EU-MIDIS II). Hierarchical logistic regression models were estimated with self-rated health as the outcome variable, progressively adjusted according to demographic (gender and age), environmental (household temperature, humidity and arrears in utility bills) and socio-economic (level of education, marital status and employment status) variables. Results: Our results show that 45% of the Roma population had moderate or high levels of energy poverty. The odds ratio (OR) of poor self-rated health was higher in the Roma population (OR: 3.11; 95% confidence interval [95% CI]: 2.59–3.74). The inability to maintain an adequate indoor temperature significantly increased the risk of poor health (OR: 2.10; 95% CI: 1.90–2.32). After adjusting according to demographic, environmental and socio-economic variables, no association was observed between the population of ascription and self-rated health. Conclusions: Taking into account the main social determinants, including energy poverty indicators, being Roma is not associated with reporting poor health. This result points to the importance of tackling socio-economic factors, including energy poverty, to reduce health inequalities.(AU)

Estimating a social cost of carbon for global energy consumption.

Estimates of global economic damage caused by carbon dioxide (CO2) emissions can inform climate policy1-3. The social cost of carbon (SCC) quantifies these damages by characterizing how additional CO2 emissions today impact future economic outcomes through altering the climate4-6. Previous estimates have suggested that large, warming-driven increases in energy expenditures could dominate the SCC7,8, but they rely on models9-11 that are spatially coarse and not tightly linked to data2,3,6,7,12,13. Here we show that the release of one ton of CO2 today is projected to reduce total future energy expenditures, with most estimates valued between -US$3 and -US$1, depending on discount rates. Our results are based on an architecture that integrates global data, econometrics and climate science to estimate local damages worldwide. Notably, we project that emerging economies in the tropics will dramatically increase electricity consumption owing to warming, which requires critical infrastructure planning. However, heating reductions in colder countries offset this increase globally. We estimate that 2099 annual global electricity consumption increases by about 4.5 exajoules (7 per cent of current global consumption) per one-degree-Celsius increase in global mean surface temperature (GMST), whereas direct consumption of other fuels declines by about 11.3 exajoules (7 per cent of current global consumption) per one-degree-Celsius increase in GMST. Our finding of net savings contradicts previous research7,8, because global data indicate that many populations will remain too poor for most of the twenty-first century to substantially increase energy consumption in response to warming. Importantly, damage estimates would differ if poorer populations were given greater weight14.

The effects on mortality and the associated financial costs of wood heater pollution in a regional Australian city.

OBJECTIVES: To estimate the annual burden of mortality and the associated health costs attributable to air pollution from wood heaters in Armidale. DESIGN: Health impact assessment (excess annual mortality and financial costs) based upon atmospheric PM2.5 measurements. SETTING: Armidale, a regional Australian city (population, 24 504) with high levels of air pollution in winter caused by domestic wood heaters, 1 May 2018 - 30 April 2019. MAIN OUTCOME MEASURES: Estimated population exposure to PM2.5 from wood heaters; estimated numbers of premature deaths and years of life lost. RESULTS: Fourteen premature deaths (95% CI, 12-17 deaths) per year, corresponding to 210 (95% CI, 172-249) years of life lost, are attributable to long term exposure to wood heater PM2.5 pollution in Armidale. The estimated financial cost is $32.8 million (95% CI, $27.0-38.5 million), or $10 930 (95% CI, $9004-12 822) per wood heater per year. CONCLUSIONS: The substantial mortality and financial cost attributable to wood heating in Armidale indicates that effective policies are needed to reduce wood heater pollution, including public education about the effects of wood smoke on health, subsidies that encourage residents to switch to less polluting home heating (perhaps as part of an economic recovery package), assistance for those affected by wood smoke from other people, and regulations that reduce wood heater use (eg, by not permitting new wood heaters and requiring existing units to be removed when houses are sold).

Automated pipeline framework for processing of large-scale building energy time series data.

Commercial buildings account for one third of the total electricity consumption in the United States and a significant amount of this energy is wasted. Therefore, there is a need for "virtual" energy audits, to identify energy inefficiencies and their associated savings opportunities using methods that can be non-intrusive and automated for application to large populations of buildings. Here we demonstrate virtual energy audits applied to large populations of buildings' time-series smart-meter data using a systematic approach and a fully automated Building Energy Analytics (BEA) Pipeline that unifies, cleans, stores and analyzes building energy datasets in a non-relational data warehouse for efficient insights and results. This BEA pipeline is based on a custom compute job scheduler for a high performance computing cluster to enable parallel processing of Slurm jobs. Within the analytics pipeline, we introduced a data qualification tool that enhances data quality by fixing common errors, while also detecting abnormalities in a building's daily operation using hierarchical clustering. We analyze the HVAC scheduling of a population of 816 buildings, using this analytics pipeline, as part of a cross-sectional study. With our approach, this sample of 816 buildings is improved in data quality and is efficiently analyzed in 34 minutes, which is 85 times faster than the time taken by a sequential processing. The analytical results for the HVAC operational hours of these buildings show that among 10 building use types, food sales buildings with 17.75 hours of daily HVAC cooling operation are decent targets for HVAC savings. Overall, this analytics pipeline enables the identification of statistically significant results from population based studies of large numbers of building energy time-series datasets with robust results. These types of BEA studies can explore numerous factors impacting building energy efficiency and virtual building energy audits. This approach enables a new generation of data-driven buildings energy analysis at scale.

Association between home insulation and hospital admission rates: retrospective cohort study using linked data from a national intervention programme.

OBJECTIVES: To investigate whether retrofitting insulation into homes can reduce cold associated hospital admission rates among residents and to identify whether the effect varies between different groups within the population and by type of insulation. DESIGN: A quasi-experimental retrospective cohort study using linked datasets to evaluate a national intervention programme. PARTICIPANTS: 994 317 residents of 204 405 houses who received an insulation subsidy through the Energy Efficiency and Conservation Authority Warm-up New Zealand: Heat Smart retrofit programme between July 2009 and June 2014. MAIN OUTCOME MEASURE: A difference-in-difference approach was used to compare the change in hospital admissions of the study population post-insulation with the change in hospital admissions of the control population that did not receive the intervention over the same two timeframes. Relative rate ratios were used to compare the two groups. RESULTS: 234 873 hospital admissions occurred during the study period. Hospital admission rates after the intervention increased in the intervention and control groups for all population categories and conditions with the exception of acute hospital admissions among Pacific Peoples (rate ratio 0.94, 95% confidence interval 0.90 to 0.98), asthma (0.92, 0.86 to 0.99), cardiovascular disease (0.90, 0.88 to 0.93), and ischaemic heart disease for adults older than 65 years (0.79, 0.74 to 0.84). Post-intervention increases were, however, significantly lower (11%) in the intervention group compared with the control group (relative rate ratio 0.89, 95% confidence interval 0.88 to 0.90), representing 9.26 (95% confidence interval 9.05 to 9.47) fewer hospital admissions per 1000 in the intervention population. Effects were more pronounced for respiratory disease (0.85, 0.81 to 0.90), asthma in all age groups (0.80, 0.70 to 0.90), and ischaemic heart disease in those older than 65 years (0.75, 0.66 to 0.83). CONCLUSION: This study showed that a national home insulation intervention was associated with reduced hospital admissions, supporting previous research, which found an improvement in self-reported health.

Impact of Urban Morphology and Climate on Heating Energy Consumption of Buildings in Severe Cold Regions.

This study aims to acquire a better understanding of the quantitative relationship between environmental impact factors and heating energy consumption of buildings in severe cold regions. We analyze the effects of five urban morphological parameters (building density, aspect ratio, building height, floor area ratio, and shape factor) and three climatic parameters (temperature, wind speed, and relative humidity) on the heating energy use intensity (EUI) of commercial and residential buildings in a severe cold region. We develop regression models using empirical data to quantitatively evaluate the impact of each parameter. A stepwise approach is used to ensure that all the independent variables are significant and to eliminate the effects of multicollinearity. Finally, a spatial cluster analysis is performed to identify the distribution characteristics of heating EUI. The results indicate that the building height, shape factor, temperature, and wind speed have a significant impact on heating EUI, and their effects vary with the type of building. The cluster analysis indicated that the areas in the north, east, and along the river exhibited high heating EUI. The findings obtained herein can be used to evaluate building energy efficiency for urban planners and heating companies and departments based on the surrounding environmental conditions.

Trends of accidental carbon monoxide poisoning in Korea, 1951-2018.

OBJECTIVES: Carbon monoxide (CO) poisoning from coal briquette combustion has been a major public health problem in Korea. In this study, we estimated the time trends of the consumption of anthracite coal and the number of CO poisoning victims over the past 7 decades, in the context of changes in heating facilities. METHODS: Using Population and Housing Census data and energy statistics, we estimated the number of houses using briquettes as heating fuel between 1951 and 2018. After estimating the incidence of CO poisoning in housing units by heating facility type, we determined the ratio of the number of household members who experienced CO poisoning to the overall number of household members. Finally, we estimated the distribution of the victims according to poisoning severity, excluding victims of intentional exposure. RESULTS: We estimated that, overall, over 26 million people experienced CO poisoning between 1951 and 2018 in Korea. The household consumption of anthracite peaked in 1986, but the number of victims of CO poisoning peaked at approximately 1 million people in 1980. From 1951 to 2018, the cumulative number of CO poisoning victims comprised approximately 22,830,000 mild cases, 3,570,000 severe cases, and 65,000 deaths. CONCLUSIONS: The peak in the number of CO poisoning victims occurred 6 years earlier than the peak in the number of people using briquettes for heating. This gap resulted from improvements in briquette heating systems. This finding provides a quantitative basis for epidemiological studies on the health outcomes of CO poisoning in the Korean population.

Household heating associated with disability in activities of daily living among Chinese middle-aged and elderly: a longitudinal study.

BACKGROUND: The health hazards of indoor air pollution are well-established but studies of the health effects due to pollution from heating are rare. This study investigated the association of heating and disability for activities of daily living among Chinese middle-aged and elderly. METHODS: We used two consecutive surveys in a cohort of over 17,000 adults aged 45 or older, who were interviewed first in 2011-2012 and then in 2013. In these surveys, taking advantage of random survey time, we applied a random effects logit regression model that included an interaction between pollution-producing heating fuel and a dummy variable, which measured interview time based on whether or not it was heating season. RESULTS: Exposure to pollution-producing heating fuel was associated with a 39.9% (OR 1.399; 95%CI 1.227-1.594) and 71.0% (OR 1.710; 95%CI 1.523-1.920) increase in the likelihood of disability in activities of daily living (DADL) and disability in instrumental activities of daily living (DIADL), respectively. In heating season between year 2011 and 2013, moving from clean heating energy for heating to pollution-producing fuel was linked with an increase in the likelihoods having DADL and DIADL, with the OR of 2.014 (95%CI 1.126-3.600) and 1.956 (95%CI 1.186-3.226), respectively. However, disability increases due to change from clean energy to pollution-producing heating energy did not appear in advantaged education respondents. CONCLUSIONS: We found that exposure to heating by burning of coal, wood, or crop residue was associated with disability in performing daily living activities. Health policymakers should take indoor pollution due to heating into consideration as it is a major determinant of activities of daily living in elderly people; especially, such policy should focus on elderly people who have disadvantaged education.

The association of outdoor temperature with blood pressure, and its influence on future cardio-cerebrovascular disease risk in cold areas.

OBJECTIVES: To explore whether lower outdoor temperature increases cardio-cerebrovascular disease risk through regulating blood pressure and whether indoor heating in winter is beneficial to prevent cardio-cerebrovascular disease in cold areas. METHODS: We analyzed the data of 38 589 participants in Harbin from the China Kadoorie Biobank (CKB) during 2004-2008, with an average of 7.14-year follow-up. Linear regression analysis was performed to estimate the relationship between outdoor temperature and blood pressure. Cox regression analysis and logistic regression analysis were used to analyze the association of blood pressure with cardio-cerebrovascular event risk. Mediation analysis was performed to explore the role of blood pressure in the association between outdoor temperature and cardio-cerebrovascular events risk. RESULTS: There was an increase of 6.7 mmHg in SBP and 2.1 mmHg in DBP for each 10 °C decrease in outdoor temperature when outdoor temperature was higher than 5 °C. There was an inverse association between outdoor temperature and cardio-cerebrovascular event morbidity. The increases in blood pressure and cardio-cerebrovascular event morbidity were attenuated in months when central heating was fully provided. Participants with hypertension have higher risks of cardio-cerebrovascular disease (hazard ratio 1.347; 95% CI 1.281--1.415), CVD (hazard ratio 1.347; 95% CI 1.282--1.416), MACE (hazard ratio 1.670; 95% CI 1.560--1.788) and stroke (hazard ratio 1.683; 95% CI 1.571--1.803). Mediation analysis demonstrated that the association between outdoor temperature and cardio-cerebrovascular events risk was potentially mediated by blood pressure. CONCLUSION: Temperature-driven blood pressure potentially mediates the association between outdoor temperature and cardio-cerebrovascular events risk. Indoor heating in winter is probably beneficial to cardio-cerebrovascular disease prevention by inhibition of blood pressure increase.

Assessment of Ambient Air Toxics and Wood Smoke Pollution among Communities in Sacramento County.

Ambient air monitoring and phone survey data were collected in three environmental justice (EJ) and three non-EJ communities in Sacramento County during winter 2016-2017 to understand the differences in air toxics and in wood smoke pollution among communities. Concentrations of six hazardous air pollutants (HAPs) and black carbon (BC) from fossil fuel (BCff) were significantly higher at EJ communities versus non-EJ communities. BC from wood burning (BCwb) was significantly higher at non-EJ communities. Correlation analysis indicated that the six HAPs were predominantly from fossil fuel combustion sources, not from wood burning. The HAPs were moderately variable across sites (coefficient of divergence (COD) range of 0.07 for carbon tetrachloride to 0.28 for m- and p-xylenes), while BCff and BCwb were highly variable (COD values of 0.46 and 0.50). The BCwb was well correlated with levoglucosan (R2 of 0.68 to 0.95), indicating that BCwb was a robust indicator for wood burning. At the two permanent monitoring sites, wood burning comprised 29-39% of the fine particulate matter (PM2.5) on nights when PM2.5 concentrations were forecasted to be high. Phone survey data were consistent with study measurements; the only significant difference in the survey results among communities were that non-EJ residents burn with indoor devices more often than EJ residents.

Relationship Between Housing Components and Development of Eosinophilic Esophagitis.

BACKGROUND: While the environment contributes to EoE pathogenesis, few environmental risk factors for EoE have been identified. AIM: To determine whether housing components such as exterior materials, heating systems, and house age are associated with EoE. METHODS: This case-control study used the UNC EoE clinicopathologic database to identify newly diagnosed EoE patients. Controls were patients without EoE who underwent endoscopy during the study time frame. Housing data were collected from publicly available online sources, and cases and controls were compared. The primary analysis was restricted to those living at their provided address at the time of diagnostic endoscopy. Multivariable logistical regression estimated associations after adjusting for potential confounders. RESULTS: Of 451 EoE cases and 2421 controls identified, the primary analysis included 158 cases and 769 controls. Compared to controls, EoE cases were more likely to have a house with a brick exterior (35% vs 26%; p = 0.04), gas heating (14% vs 8%; p = 0.06), or forced air (57% vs 45%; p = 0.009). In adjusted analysis, brick exterior was positively associated with EoE diagnosis [aOR 1.83 (95% CI 1.11-3.02)]. The average duration a patient lived in their house before EoE diagnosis was 7.2 ± 5.9 years, while symptom duration prior to diagnosis was 6.8 ± 8.4 years. CONCLUSION: EoE patients were more likely to have houses with a brick exterior, forced air, or gas heating, and brick exteriors were independently associated with EoE. Since symptoms generally started after moving into a house, housing-related environmental exposures may contribute to EoE disease development.

The Relationship Between Social Risks and the Mental Health of School-Age Children in Primary Care.

BACKGROUND AND OBJECTIVE: The study's goal was to measure the association between social risks and the mental health of school-age children in primary care. METHODS: We conducted a cross-sectional study in an urban safety-net hospital-based pediatric clinic using data collected from 2 standardized screening tools administered at well-child care visits for children age 6 to 11. Psychosocial dysfunction was measured with the Pediatric Symptom Checklist-17 (PSC-17), and 6 social risks (caregiver education, employment, child care, housing, food security, and household heat) were measured with the WE CARE screener. Multivariable linear and logistic regression analyses were conducted to measure the association between scores while controlling for sociodemographic characteristics. RESULTS: Among N = 943 patients, cumulative social risks were significantly associated with a positive PSC-17 total score (adjusted odds ratio [aOR] 1.2; 95% confidence interval [CI] 1.1-1.5; P = .02), indicating psychosocial dysfunction. Children with ≥3 social risks were 2.4 times more likely to have a positive PSC-17 total score compared to children with <3 social risks (95% CI 1.5-3.9; P < .001). Of the individual social risks measured, only food insecurity significantly predicted a positive PSC-17 total score (aOR 1.9; 95% CI 1.1-3.2; P = .02) and attention score (aOR 1.9; 95% CI 1.1-3.4; P = .03). CONCLUSION: Number of risks on a social risk screener was associated with psychosocial dysfunction in school-age children. Food insecurity was the only individual risk associated with psychosocial dysfunction, in particular attention problems. Screening tools for social risks could be used to identify at-risk children whose mental health may be adversely impacted by their social conditions.

Comparing Forced-Air to Resistive-Polymer Warming for Perioperative Temperature Management: A Retrospective Study.

PURPOSE: Compare perioperative temperature management between forced-air warming (FAW) and resistive-polymer heating blankets (RHBs). DESIGN: A retrospective, quasi-experimental study. METHODS: Retrospective data analysis of nonspine orthopedic cases (N = 426) over a one-year period including FAW (n = 119) and RHBs (n = 307). FINDINGS: FAW was associated with a significantly higher final intraoperative temperature (P = .001, d = 0.46) than the RHB. The incidence of hypothermia was not found to be significantly different at the end (P = .102) or anytime throughout surgery (P = .270). Of all patients who started hypothermic, the FAW group had a lower incidence of hypothermia at the end of surgery (P = .023). CONCLUSIONS: FAW was associated with higher final temperatures and a greater number of normothermic patients than RHBs. However, no causal relationship between a warming device and hypothermia incidence should be assumed.

Control of NOx emissions by air staging in small- and medium-scale biomass pellet boilers.

The effect of air staging strategies on NOx control was investigated on a 210-kW small-scale biomass boiler (SBB) and a 1.4-MW medium-scale biomass boiler (MBB). Considering the de-NOx effect, as well as the convenience and economy for future wide use, the structures of the secondary air duct and the fuel feed tube were innovatively designed to solve the problems of the traditional prototype. The preliminary experiment showed that the lowest NOx emission was achieved when the air excess (ε) was equal to 2.04. Then, additional operating modes were conducted on the MBB to further optimize the air staging strategies. The optimal air staging strategy of the MBB (the secondary to primary air flow ratio (λ) and the ε were equal to 0.13 and 0.76, respectively) could decrease the NOx emission from 338.12 to 148.14 mg/m3. Furthermore, the SO2 emissions and the lowest NOx emission of the SBB and the MBB could meet most emission standards of China and some developed countries. The thermogravimetric analysis (TG) and combustion characteristics of the wood fuel showed that the air staging was a suitable de-NOx technology for wood combustion, and the slagging was less likely to occur under the selected condition. Hence, the air staging technology was an effective and low-cost method for the emission reduction of biomass boilers. This study provided a practical basis for future research on the gas emission control of biomass boilers.

Household Fuel Use for Heating and Cooking and Respiratory Health in a Low-Income, South African Coastal Community.

In low-income communities, non-electric fuel sources are typically the main cause of Household Air Pollution (HAP). In Umlazi, a South African coastal, informal settlement, households use electric- and non-electric (coal, wood, gas, paraffin) energy sources for cooking and heating. The study aimed to determine whether respiratory ill health status varied by fuel type use. Using a questionnaire, respondents reported on a range of socio-demographic characteristics, dwelling type, energy use for cooking and heating as well as respiratory health symptoms. Multivariate Poisson regression was used to obtain the adjusted Odds Ratios (ORs) for the effects of electric and non-electric energy sources on prevalence of respiratory infections considering potential confounding factors. Among the 245 households that participated, Upper Respiratory Tract Infections (URTI, n = 27) were prevalent in respondents who used non-electric sources compared to electric sources for heating and cooking. There were statistically significant effects of non-electric sources for heating (adjusted OR = 3.6, 95% CI (confidence interval): 1.2⁻10.1, p < 0.05) and cooking (adjusted OR = 2.9, 95% CI: 1.1⁻7.9, p < 0.05) on prevalence of URTIs. There was a statistically significant effect of electric sources for heating (adjusted OR = 2.7, 95% CI: 1.1⁻6.4, p < 0.05) on prevalence of Lower Respiratory Tract Infections (LRTIs) but no evidence for relations between non-electric sources for heating and LRTIs, and electric or non-electric fuel use type for cooking and LRTIs. Energy switching, mixing or stacking could be common in these households that likely made use of multiple energy sources during a typical month depending on access to and availability of electricity, funds to pay for the energy source as well as other socio-economic or cultural factors. The importance of behaviour and social determinants of health in relation to HAP is emphasized.

'My blood pressure is low today, do you have the heating on?' The association between indoor temperature and blood pressure.

OBJECTIVES: The independent association of indoor temperature with blood pressure (BP) is poorly understood and is not routinely considered in hypertension diagnosis or research. Questions remain as to whether the effect of indoor temperature on BP is confounded or modified by other factors. METHODS: This study used data from the Health Survey for England 2014, consisting of 4659 community-dwelling adults aged 16 years and over, interviewed from January to December. Multivariable regression models were used to determine whether indoor temperature was related to levels of BP, and whether these relationships were confounded by other factors, including mean monthly outdoor temperature. RESULTS: After controlling for confounding variables, a 1°C decrease in indoor temperature was associated with rises of 0.48 mmHg (95% confidence interval: -0.72 to -0.25) in SBP and 0.45 mmHg (95% confidence interval: -0.63 to -0.27) in DBP. The magnitude of association of indoor temperature with DBP and SBP was modified by physical activity. The indoor temperature-BP relationship was stronger in people who do not take physical activity regularly than people who exercise regularly. CONCLUSION: The size of the independent association between indoor temperature and BP suggests it should be considered in the clinical management of hypertension and in hypertension research. Room temperature should also be considered as a modifiable risk factor in hypertension-related mortality and morbidity.

Types and factors affecting injury rates of mechanical contractors.

BACKGROUND: In the United States, about 38,000 cases of nonfatal workplace injuries were reported in 2015, in the category of 'mechanical work' (plumbing, heating, and air conditioning); this is nearly identical to the number of cases reported under 'building construction'. OBJECTIVE: This paper analyzes the types and rates of injuries and illnesses of mechanical contractors of southern Nevada, including the nature of the injuries and illnesses, body parts affected by injuries, causes of injuries, and factors affecting the injury rates. METHODS: To obtain data, a survey consisting of questions regarding the number of injuries and types of injuries was conducted with 31 mechanical contractors of southern Nevada involved in plumbing, piping, heating, refrigeration, and air conditioning. RESULTS: The injury rate for larger mechanical contractors (n = 16), in terms of number of employees and annual revenue, was significantly lower than for smaller mechanical contractors (n = 15). Mechanical contractors who worked on residential buildings (n = 13) had significantly higher rates of injuries than those involved with industrial (n = 7) or commercial buildings (n = 10). Results showed that sprains and strains (31%) were dominant injuries, and the major causes were from parts and materials (39%), hand tools (16%), contact with objects (14%), and falls (7%). CONCLUSIONS: The study concluded that the injury rate for these mechanical contractors was found to be higher than that reported by the Occupational Safety and Health Administration for specialty trade contractors.

Investigating the environmental quality deterioration and human health hazard caused by heating emissions.

By analyzing the status quo of the district heating energy consumption and air quality in China, it was found that with the environmental quality degradation, the previous assessment method using energy efficiency as the index cannot consider the impact on the environmental quality and human health simultaneously. Hence, to analyze the environmental quality deterioration and human health hazard due to the heating emissions, a novel assessment method was proposed and can be used to guide the improvement strategies. In this study, based on the quantitative influence of the heating emissions, urban population density and pollution duration, heating impact index (HII) as a new comprehensive evaluation index was introduced. It can be used to assess the urgency of the heating improvement in the studied regions. To estimate the air pollution status quo caused by heating emissions, 66 main heating cities in China were selected as the studied objects. The results showed that the calculated average heating emission-contributed air quality index (AQI) was 45% and polluted time percentage was 39%. The industrial emissions in 19 cities were the main reason to deteriorate the environmental quality during the heating season. While in the remaining 47 cities (71.2% of total studied cities), heating emissions dominated the deterioration of environmental quality. Subsequently, the cities with HII larger than 0.1 were divided into six levels to provide a guide for the Chinese government and relevant departments to improve the heating system and reduce human health hazard. This study can also be used as a reference for other polluted cities to investigate the environmental quality deterioration and human health hazard degrees due to the heating emissions.

Dual Food and Energy Hardship and Associated Child Behavior Problems.

OBJECTIVE: To examine dual food and energy hardship and internalizing and externalizing behavior problems in 9-year-old children. METHODS: We conducted a cross-sectional analysis of the Fragile Families and Child Wellbeing Study, a prospective national urban birth cohort, when the children were 9 years old. Maternal-reported "food hardship" (ever hungry and/or ever received free food) and "energy hardship" (ever unable to pay utility bill and/or utility shutoff) within the past year, and child behavior using the Child Behavior Checklist for Ages 6-18 were assessed. Multiple logistic regression analyses estimated associations between individual and dual food and energy hardship and child behavior problems, adjusting for a priori covariates (ie, child sex, health insurance, maternal sociodemographic characteristics, poverty, reported health, attention deficit hyperactivity disorder, depressive symptoms, smoking, and substance and alcohol abuse). RESULTS: Approximately 10% of households reported dual food and energy hardship. Children experiencing dual food and energy hardship had 3 times greater odds of withdrawn/depressed behaviors (adjusted odds ratio [AOR], 2.8; 95% confidence interval [CI], 1.4-5.5), threefold greater odds of somatic complaints (AOR, 3.2; 95% CI, 1.5-6.9), and 4 times greater odds of rule-breaking behavior (AOR, 3.7; 95% CI, 1.5-9.2) in the borderline/clinical range than children with no hardship, and had fourfold greater odds of borderline/clinical range somatic complaints (AOR, 4.2; 95% CI, 1.7-10.3) than children with only energy hardship. CONCLUSIONS: Children experiencing dual food and energy hardship have greater odds of coexisting internalizing and externalizing behaviors after controlling for possible confounders. Providers can consider screening and resource referrals for these addressable hardships alongside behavior assessments in the clinical setting.

Characterization and cytotoxicity of PAHs in PM2.5 emitted from residential solid fuel burning in the Guanzhong Plain, China.

The emission factors (EFs) of polycyclic aromatic hydrocarbons (PAHs) in PM2.5 were measured from commonly used stoves and fuels in the rural Guanzhong Plain, China. The toxicity of the PM2.5 also was measured using in vitro cellular tests. EFs of PAHs varied from 0.18 mg kg-1 (maize straw charcoal burning in a clean stove) to 83.3 mg kg-1 (maize straw burning in Heated Kang). The two largest influencing factors on PAH EFs were air supply and volatile matter proportion in fuel. Improvements in these two factors could decrease not only EFs of PAHs but also the proportion of 3-ring to 5-ring PAHs. Exposure to PM2.5 extracts caused a concentration-dependent decline in cell viability but an increase in reactive oxygen species (ROS), tumor necrosis factor a (TNF-α) and interleukin 6 (IL-6). PM2.5 emitted from maize burning in Heated Kang showed the highest cytotoxicity, and EFs of ROS and inflammatory factors were the highest as well. In comparison, maize straw charcoal burning in a clean stove showed the lowest cytotoxicity, which indicated a clean stove and fuel treatment were both efficient methods for reducing cytotoxicity of primary PM2.5. The production of these bioreactive factors were highly correlated with 3-ring and 4-ring PAHs. Specifically, pyrene, anthracene and benzo(a)anthracene had the highest correlations with ROS production (R = 0.85, 0.81 and 0.80, respectively). This study shows that all tested stoves emitted PM2.5 that was cytotoxic to human cells; thus, there may be no safe levels of exposure to PM2.5 emissions from cooking and heating stoves using solid fuels. The study may also provide a new approach for evaluating the cytotoxicity of primary emitted PM2.5 from solid fuel burning as well as other PM2.5 sources.