How to Evaluate Health in All Policies at the Local Level: Methodological Insights Within Municipalities From the WHO French Healthy Cities Network.

BACKGROUND: This article proposes a method for analysing the degree of maturity of Health in All Policies (HiAP) among World Health Organization-French Healthy Cities Network (WHO-FHCN) as part of the GoveRnance for Equity, EnviroNment and Health in the City (GREENH-City) project. We focused on the creation or enhancement of health-promoting environments, and more specifically, public green spaces. METHODS: We conducted a cross-sectional quantitative study guided by the evaluative framework of the HiAP maturity level developed by Storm et al mixed with a qualitative interpretation. A self-administered questionnaire was sent to elected officials and health department officers in the 85 member cities of the WHO-FHCN in 2017. Subsequently 58 cities were included in the analysis, which was based on a multiple correspondence analysis (MCA) and a hierarchical ascending classification (HAC). RESULTS: Thirty-two criteria among a total of 100 were identified and were used to organize the cities into 8 groups which was then reduced to three profiles among the cities: a less advanced HiAP profile, an established HiAP profile and an advanced HiAP profile. This process allows us to identify 4 dimensions that make it possible to evaluate the level of maturity of cities in the HiAP process, namely: (1) the consideration of social inequalities in health and/or health issues in the policies/actions of the sector studied, (2) occasional intersectoral collaboration, ie, one-off initiatives between the health department and others sectors, (3) the existence of joint projects, ie, common projects between two or more sectors, (4) the existence of intersectoral bodies, in this case on the theme of urban green spaces including an intersectoral committee and/or working groups. CONCLUSION: Four dimensions which allow to the measurement of the degree of progress in implementing health-all-policies are proposed. With a view to integrating knowledge into public action, this study carried out under real conditions offers a realistic method to evaluate HiAP.

Relationship between Urban Green Spaces and Cancer: A Scoping Review.

This scoping study aims to explore the relationships between urban green spaces (UGSs) and the onset, remission and recovery of cancer. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews (protocol published in 2018). Eligibility criteria for papers were: (1) to be concerned with UGSs, (2) reporting effects of UGSs on cancer-related outcomes including direct or indirect measures, (3) reporting randomized controlled trials, prospective cohort studies, case studies, observational studies, non-comparative studies, (4) in English or French. The search covered primary studies in the published and unpublished (grey) literatures searching by hand and electronic databases (MEDLINE, Green File, Cumulative Index to Nursing and Allied Health Literature and ScienceDirect). Among 1703 records screened by two reviewers independently, 29 were included for qualitative synthesis. We classify the cancers concerned and the effects reported i.e., protective effect, risk or without association. The most investigated cancers are bladder, breast and lung cancer. Our study also identified contributing factors and their mediating effects between UGSs and cancer. Even though the strength of the evidence of the associations between UGSs and cancer is still weak due to the low number of studies and their design, results highlight the wide variety of possible mediating factors between the use of green spaces and cancer occurrence, remission and/or prevention. Knowledge gaps and future research perspectives should be oriented to qualitative research on protective factors with an attention to equity in UGS access and use.

Mapping the links between climate change and human health in urban areas: how is research conducted? A Scoping review protocol.

INTRODUCTION: Scientists from a wide variety of fields of knowledge are increasingly interested in climate change issues. The importance given to the phenomenon is explained by the uncertainties surrounding it and its consequences not yet fully known. However, there is wide agreement that human activities are modifying the Earth's climate beyond the natural cyclical changes and that these changes impact human health. This scoping review aimed to understand how research on the links between climate change and human health in urban areas is conducted and how this research is approached holistically or not. METHODS AND ANALYSIS: This scoping review is mainly guided by the Arskey and O'Malley scoping review framework. A broad range of databases will be used, including PubMed, ScienceDirect, Web of Science Core Collection, GreenFILE and Information Science & Technology Abstracts. Predefined inclusion and exclusion criteria will be used, with a focus on climate change and human health outcome studies published between January 1990 and July 2019. An interdisciplinary team has formulated search strategies and the reviewers will independently screen eligible studies for final study selection. We will apply a thematic analysis to evaluate and categorise the study findings. We expect to map the research according to the scientific research methods, the scientific fields and the determinants of health studied. Along these lines, we will be able to understand how holistic the research is. ETHICS AND DISSEMINATION: No primary data will be collected since all data presented in this review are based on published articles and publicly available documents. Therefore, ethics committee approval is not a requirement. The findings will be disseminated through publication in a peer-reviewed journal, presentations at conferences relevant to the field of this research, as well as presentations to relevant stakeholders.

Veterinary pharmaceutical residues from natural water to tap water: Sales, occurrence and fate.

Veterinary pharmaceuticals (VPs) increasingly used in animal husbandry have led to their presence in aquatic environments -surface water (SW) or groundwater (GW) - and even in tap water. This review focuses on studies from 2007 to 2017. Sixty-eight different veterinary pharmaceutical residues (VPRs) have been quantified worldwide in natural waters at concentrations ranging from nanograms per liter (ng L-1) to several micrograms per liter (µg L-1). An extensive up-to-date on sales and tonnages of VPs worldwide has been performed. Tetracyclines (TCs) antibiotics are the most sold veterinary pharmaceuticals worldwide. An overview of VPRs degradation pathways in natural waters is provided. VPRs can be degraded or transformed by biodegradation, hydrolysis or photolysis. Photo-degradation appears to be the major degradation pathway in SW. This review then reports occurrences of VPRs found in tap water, and presents data on VPRs removal in drinking water treatment plants (DWTPs) at each step of the process. VPRs have been quantified in tap water at ng L-1 concentration levels in four studies of the eleven studies dealing with VPRs occurrence in tap water. Overall removals of VPRs in DWTPs generally exceed 90% and advanced treatment processes (oxidation processes, adsorption on activated carbon, membrane filtration) greatly contribute to these removals. However, studies performed on full-scale DWTPs are scarce. A large majority of fate studies in DWTPs have been conducted under laboratory at environmentally irrelevant conditions (high concentration of VPRs (mg L-1), use of deionized water instead of natural water, high concentration of oxidant, high contact time etc.). Also, studies on VPRs occurrence and fate in tap water focus on antibiotics. There is a scientific gap on the occurrence and fate of antiparatic drugs in tap waters.

Direct DOC and nitrate determination in water using dual pathlength and second derivative UV spectrophotometry.

UV spectrophotometry is largely used for water and wastewater quality monitoring. The measurement/estimation of specific and aggregate parameters such as nitrate and dissolved organic carbon (DOC) is possible with UV spectra exploitation, from 2 to multi wavelengths calibration. However, if nitrate determination from UV absorbance is known, major optical interferences linked to the presence of suspended solids, colloids or dissolved organic matter limit the relevance of UV measurement for DOC assessment. A new method based on UV spectrophotometric measurement of raw samples (without filtration) coupling a dual pathlength for spectra acquisition and the second derivative exploitation of the signal is proposed in this work. The determination of nitrate concentration is carried out from the second derivative of the absorbance at 226 nm corresponding at the inflexion point of nitrate signal decrease. A short optical pathlength can be used considering the strong absorption of nitrate ion around 210 nm. For DOC concentration determination the second derivative absorbance at 295 nm is proposed after nitrate correction. Organic matter absorbing slightly in the 270-330 nm window, a long optical pathlength must be selected in order to increase the sensitivity. The method was tested on several hundred of samples from small rivers of two agricultural watersheds located in Brittany, France, taken during dry and wet periods. The comparison between the proposed method and the standardised procedures for nitrate and DOC measurement gave a good adjustment for both parameters for ranges of 2-100 mg/L NO3 and 1-30 mg/L DOC.

Microbial contamination detection in water resources: interest of current optical methods, trends and needs in the context of climate change.

Microbial pollution in aquatic environments is one of the crucial issues with regard to the sanitary state of water bodies used for drinking water supply, recreational activities and harvesting seafood due to a potential contamination by pathogenic bacteria, protozoa or viruses. To address this risk, microbial contamination monitoring is usually assessed by turbidity measurements performed at drinking water plants. Some recent studies have shown significant correlations of microbial contamination with the risk of endemic gastroenteresis. However the relevance of turbidimetry may be limited since the presence of colloids in water creates interferences with the nephelometric response. Thus there is a need for a more relevant, simple and fast indicator for microbial contamination detection in water, especially in the perspective of climate change with the increase of heavy rainfall events. This review focuses on the one hand on sources, fate and behavior of microorganisms in water and factors influencing pathogens' presence, transportation and mobilization, and on the second hand, on the existing optical methods used for monitoring microbiological risks. Finally, this paper proposes new ways of research.