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1.
Health Place ; 63: 102355, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32543438

RESUMO

INTRODUCTION: There is some evidence that exam results are worse when students are acutely exposed to air pollution. Studies investigating the association between air pollution and academic attainment have been constrained by small sample sizes. METHODS: Cross sectional educational attainment data (2009-2015) from students aged 15-16 years in Cardiff, Wales were linked to primary health care data, modelled air pollution and measured pollen data, and analysed using multilevel linear regression models. Annual cohort, school and individual level confounders were adjusted for in single and multi-pollutant/pollen models. We stratified by treatment of asthma and/or Seasonal Allergic Rhinitis (SAR). RESULTS: A unit (10µg/m3) increase of short-term exposure to NO2 was associated with 0.044 (95% CI: -0.079, -0.008) reduction of standardised Capped Point Score (CPS) after adjusting for individual and household risk factors for 18,241 students. This association remained statistically significant after controlling for other pollutants and pollen. There was no association of PM2.5, O3, or Pollen with standardised CPS remaining after adjustment. We found no evidence that treatment for asthma or SAR modified the observed NO2 effect on educational attainment. CONCLUSION: Our study showed that short-term exposure to traffic-related air pollution, specifically NO2, was associated with detrimental educational attainment for students aged 15-16. Longitudinal investigations in different settings are required to confirm this possible impact and further work may uncover the long-term economic implications, and degree to which impacts are cumulative and permanent.

2.
Curr Opin Urol ; 30(4): 496-500, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32453000

RESUMO

PURPOSE OF REVIEW: The aim of this article is to look into recent updates on the management of neurogenic stress urinary incontinence (NSUI) in adult females. RECENT FINDINGS: Recently, a small number of studies have investigated different surgical modalities in treatment of NSUI in adult females including artificial urinary sphincter (AUS), suburethral tapes (SUT) and adjustable slings and urethral bulking agents. Up to 70% of neurogenic patients who received AUS implants are continent and have not required surgical revision over a 20-year follow-up period. However, the risk for explantation of AUS may be twice as high in neurogenic patients compared with nonneurogenic patients. SUT have success and improvement in quality of life rates of up to 52 and 68%, respectively. However, complications may be as high as 24%. Early data on adjustable slings may suggest up to 80% continence with low complication rates. SUMMARY: AUS can provide satisfactory continence levels with acceptable rates of revision and explantation. SUT are effective but more than half of patients may require additional procedures. Adjustable slings could be a promising option. Further high-quality studies with careful attention to methodology and standardization of both definitions used and outcome reporting are required to help us reach safe conclusions.

3.
Environ Health Perspect ; 126(10): 107004, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30392403

RESUMO

BACKGROUND: Asthma is the most prevalent chronic respiratory disease worldwide, affecting 358 million people in 2015. Ambient air pollution exacerbates asthma among populations around the world and may also contribute to new-onset asthma. OBJECTIVES: We aimed to estimate the number of asthma emergency room visits and new onset asthma cases globally attributable to fine particulate matter ([Formula: see text]), ozone, and nitrogen dioxide ([Formula: see text]) concentrations. METHODS: We used epidemiological health impact functions combined with data describing population, baseline asthma incidence and prevalence, and pollutant concentrations. We constructed a new dataset of national and regional emergency room visit rates among people with asthma using published survey data. RESULTS: We estimated that 9­23 million and 5­10 million annual asthma emergency room visits globally in 2015 could be attributable to ozone and [Formula: see text], respectively, representing 8­20% and 4­9% of the annual number of global visits, respectively. The range reflects the application of central risk estimates from different epidemiological meta-analyses. Anthropogenic emissions were responsible for [Formula: see text] and 73% of ozone and [Formula: see text] impacts, respectively. Remaining impacts were attributable to naturally occurring ozone precursor emissions (e.g., from vegetation, lightning) and [Formula: see text] (e.g., dust, sea salt), though several of these sources are also influenced by humans. The largest impacts were estimated in China and India. CONCLUSIONS: These findings estimate the magnitude of the global asthma burden that could be avoided by reducing ambient air pollution. We also identified key uncertainties and data limitations to be addressed to enable refined estimation. https://doi.org/10.1289/EHP3766.


Assuntos
Poluição do Ar/efeitos adversos , Asma/epidemiologia , Dióxido de Nitrogênio/efeitos adversos , Ozônio/efeitos adversos , Material Particulado/efeitos adversos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Exposição Ambiental/efeitos adversos , Humanos , Incidência , Ozônio/química , Tamanho da Partícula , Fatores de Risco
4.
Br Dent J ; 225(10): 919-921, 2018 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-30468181
6.
Br Dent J ; 225(2): 110-112, 2018 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-30050187
8.
Environ Health ; 16(Suppl 1): 118, 2017 12 05.
Artigo em Inglês | MEDLINE | ID: mdl-29219103

RESUMO

This review examines the current literature on the effects of future emissions and climate change on particulate matter (PM) and O3 air quality and on the consequent health impacts, with a focus on Europe. There is considerable literature on the effects of climate change on O3 but fewer studies on the effects of climate change on PM concentrations. Under the latest Intergovernmental Panel on Climate Change (IPCC) 5th assessment report (AR5) Representative Concentration Pathways (RCPs), background O3 entering Europe is expected to decrease under most scenarios due to higher water vapour concentrations in a warmer climate. However, under the extreme pathway RCP8.5 higher (more than double) methane (CH4) abundances lead to increases in background O3 that offset the O3 decrease due to climate change especially for the 2100 period. Regionally, in polluted areas with high levels of nitrogen oxides (NOx), elevated surface temperatures and humidities yield increases in surface O3 - termed the O3 climate penalty - especially in southern Europe. The O3 response is larger for metrics that represent the higher end of the O3 distribution, such as daily maximum O3. Future changes in PM concentrations due to climate change are much less certain, although several recent studies also suggest a PM climate penalty due to high temperatures and humidity and reduced precipitation in northern mid-latitude land regions in 2100.A larger number of studies have examined both future climate and emissions changes under the RCP scenarios. Under these pathways the impact of emission changes on air quality out to the 2050s will be larger than that due to climate change, because of large reductions in emissions of O3 and PM pollutant precursor emissions and the more limited climate change response itself. Climate change will also affect climate extreme events such as heatwaves. Air pollution episodes are associated with stagnation events and sometimes heat waves. Air quality during the 2003 heatwave over Europe has been examined in numerous studies and mechanisms for enhancing O3 have been identified.There are few studies on health effects associated with climate change impacts alone on air quality, but these report higher O3-related health burdens in polluted populated regions and greater PM2.5 health burdens in these emission regions. Studies that examine the combined impacts of climate change and anthropogenic emissions change under the RCP scenarios report reductions in global and European premature O3-respiratory related and PM mortalities arising from the large decreases in precursor emissions. Under RCP 8.5 the large increase in CH4 leads to global and European excess O3-respiratory related mortalities in 2100. For future health effects, besides uncertainty in future O3 and particularly PM concentrations, there is also uncertainty in risk estimates such as effect modification by temperature on pollutant-response relationships and potential future adaptation that would alter exposure risk.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Mudança Climática , Ozônio/efeitos adversos , Material Particulado/efeitos adversos , Saúde Pública , Europa (Continente) , Humanos
10.
Environ Health ; 16(1): 104, 2017 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-28985761

RESUMO

BACKGROUND: Socioeconomically disadvantaged populations often have higher exposures to particulate air pollution, which can be expected to contribute to differentials in life expectancy. We examined socioeconomic differentials in exposure and air pollution-related mortality relating to larger scale (5 km resolution) variations in background concentrations of selected pollutants across England. METHODS: Ozone and particulate matter (sub-divided into PM10, PM2.5, PM2.5-10, primary, nitrate and sulphate PM2.5) were simulated at 5 km horizontal resolution using an atmospheric chemistry transport model (EMEP4UK). Annual mean concentrations of these pollutants were assigned to all 1,202,578 residential postcodes in England, which were classified by urban-rural status and socioeconomic deprivation based on the income and employment domains of the 2010 English Index of Multiple Deprivation for the Lower-level Super Output Area of residence. We used life table methods to estimate PM2.5-attributable life years (LYs) lost in both relative and absolute terms. RESULTS: Concentrations of the most particulate fractions, but not of nitrate PM2.5 or ozone, were modestly higher in areas of greater socioeconomic deprivation. Relationships between pollution level and socioeconomic deprivation were non-linear and varied by urban-rural status. The pattern of PM2.5 concentrations made only a small contribution to the steep socioeconomic gradient in LYs lost due to PM2.5 per 103 population, which primarily was driven by the steep socioeconomic gradient in underlying mortality rates. In rural areas, the absolute burden of air pollution-related LYs lost was lowest in the most deprived deciles. CONCLUSIONS: Air pollution shows modest socioeconomic patterning at 5 km resolution in England, but absolute attributable mortality burdens are strongly related to area-level deprivation because of underlying mortality rates. Measures that cause a general reduction in background concentrations of air pollution may modestly help narrow socioeconomic differences in health.


Assuntos
Poluição do Ar/análise , Exposição Ambiental/análise , Modelos Teóricos , Mortalidade , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Poluentes Atmosféricos/análise , Inglaterra/epidemiologia , Feminino , Humanos , Masculino , Nitratos/análise , Ozônio/análise , Material Particulado/análise , Fatores Socioeconômicos , Sulfatos/análise
13.
Br Dent J ; 221(11): 692-695, 2016 12 09.
Artigo em Inglês | MEDLINE | ID: mdl-27932819

Assuntos
Odontólogos , Política
14.
Br Dent J ; 221(5): 231, 2016 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-27608571

RESUMO

Socioeconomic disadvantage and oral-health-related hospital admissions: a 10-year analysis.


Assuntos
Saúde Bucal , Fatores Socioeconômicos , Hospitalização , Humanos
15.
Open Heart ; 3(2): e000429, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27621827

RESUMO

OBJECTIVES: To investigate associations between daily concentrations of air pollution and myocardial infarction (MI), ST-elevation MI (STEMI) and non-ST-elevation MI (NSTEMI). METHODS: Modelled daily ground-level gaseous, total and speciated particulate pollutant concentrations and ground-level daily mean temperature, all at 5 km×5 km horizontal resolution, were linked to 202 550 STEMI and 322 198 NSTEMI events recorded on the England and Wales Myocardial Ischaemia National Audit Project (MINAP) database. The study period was 2003-2010. A case-crossover design was used, stratified by year, month and day of the week. Data were analysed using conditional logistic regression, with pollutants modelled as unconstrained distributed lags 0-2 days. Results are presented as percentage change in risk per 10 µg/m(3) increase in the pollutant relevant metric, having adjusted for daily mean temperature, public holidays, weekly influenza consultation rates and a sine-cosine annual cycle. RESULTS: There was no evidence of an association between MI or STEMI and any of O3, NO2, PM2.5, PM10 or selected PM2.5 components (sulfate and elemental carbon). For NSTEMI, there was a positive association with daily maximum 1-hour NO2 (0.27% (95% CI 0.01% to 0.54%)), which persisted following adjustment for O3 and adjustment for PM2.5. The association appeared to be confined to the midland and southern regions of England and Wales. CONCLUSIONS: The study found no evidence of an association between the modelled pollutants (including components) investigated and STEMI but did find some evidence of a positive association between NO2 and NSTEMI. Confirmation of this association in other studies is required.

16.
Br Dent J ; 221(3): 123, 2016 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-27514342

RESUMO

Conscious sedation: is this provision equitable? Analysis of sedation services provided within primary dental care in England, 2012-2014.


Assuntos
Sedação Consciente , Assistência Odontológica , Anestesia Dentária , Inglaterra , Humanos
18.
Br Dent J ; 221(1): 16, 2016 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-27388079

RESUMO

The ultrastructure of subgingival dental plaque, revealed by high-resolution field emission scanning electron microscopy.


Assuntos
Biofilmes , Placa Dentária
19.
Br Dent J ; 221(1): 17, 2016 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-27388080

RESUMO

Antimicrobial prescribing by dentists in Wales, UK: findings of the first cycle of a clinical audit.


Assuntos
Antibacterianos , Odontólogos , Padrões de Prática Odontológica , Anti-Infecciosos , Auditoria Clínica , Humanos , País de Gales
20.
Faraday Discuss ; 189: 589-616, 2016 07 18.
Artigo em Inglês | MEDLINE | ID: mdl-27121106

RESUMO

Air pollution is the environmental factor with the greatest impact on human health in Europe. Understanding the key processes driving air quality across the relevant spatial scales, especially during pollution exceedances and episodes, is essential to provide effective predictions for both policymakers and the public. It is particularly important for policy regulators to understand the drivers of local air quality that can be regulated by national policies versus the contribution from regional pollution transported from mainland Europe or elsewhere. One of the main objectives of the Coupled Urban and Regional processes: Effects on AIR quality (CUREAIR) project is to determine local and regional contributions to ozone events. A detailed zero-dimensional (0-D) box model run with the Master Chemical Mechanism (MCMv3.2) is used as the benchmark model against which the less explicit chemistry mechanisms of the Generic Reaction Set (GRS) and the Common Representative Intermediates (CRIv2-R5) schemes are evaluated. GRS and CRI are used by the Atmospheric Dispersion Modelling System (ADMS-Urban) and the regional chemistry transport model EMEP4UK, respectively. The MCM model uses a near-explicit chemical scheme for the oxidation of volatile organic compounds (VOCs) and is constrained to observations of VOCs, NOx, CO, HONO (nitrous acid), photolysis frequencies and meteorological parameters measured during the ClearfLo (Clean Air for London) campaign. The sensitivity of the less explicit chemistry schemes to different model inputs has been investigated: Constraining GRS to the total VOC observed during ClearfLo as opposed to VOC derived from ADMS-Urban dispersion calculations, including emissions and background concentrations, led to a significant increase (674% during winter) in modelled ozone. The inclusion of HONO chemistry in this mechanism, particularly during wintertime when other radical sources are limited, led to substantial increases in the ozone levels predicted (223%). When the GRS and CRIv2-R5 schemes are run with the equivalent model constraints to the MCM, they are able to reproduce the level of ozone predicted by the near-explicit MCM to within 40% and 20% respectively for the majority of the time. An exception to this trend was observed during pollution episodes experienced in the summer, when anticyclonic conditions favoured increased temperatures and elevated O3. The in situ O3 predicted by the MCM was heavily influenced by biogenic VOCs during these conditions and the low GRS [O3] : MCM [O3] ratio (and low CRIv2-R5 [O3] : MCM [O3] ratio) demonstrates that these less explicit schemes under-represent the full O3 creation potential of these VOCs. To fully assess the influence of the in situ O3 generated from local emissions versus O3 generated upwind of London and advected in, the time since emission (and, hence, how far the real atmosphere is from steady state) must be determined. From estimates of the mean transport time determined from the NOx : NOy ratio observed at North Kensington during the summer and comparison of the O3 predicted by the MCM model after this time, ∼60% of the median observed [O3] could be generated from local emissions. During the warmer conditions experienced during the easterly flows, however, the observed [O3] may be even more heavily influenced by London's emissions.

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