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1.
Sci Total Environ ; 805: 150242, 2022 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-34818775

RESUMO

BACKGROUND: Northeastern British Columbia (Canada) is an area of unconventional natural gas (UNG) exploitation by hydraulic fracturing, which can release several contaminants, including volatile organic compounds (VOCs). To evaluate gestational exposure to contaminants in this region, we undertook the Exposures in the Peace River Valley (EXPERIVA) study. OBJECTIVES: We aimed to: 1) measure VOCs in residential indoor air and tap water from EXPERIVA participants; 2) compare concentrations with those in the general population and explore differences related to sociodemographic and housing characteristics; and 3) determine associations between VOC concentrations and density/proximity to UNG wells. METHODS: Eighty-five pregnant women participated. Passive air samplers were analyzed for 47 VOCs, and tap water samples were analyzed for 44 VOCs. VOC concentrations were compared with those from the Canadian Health Measure Survey (CHMS). We assessed the association between different metrics of well density/proximity and indoor air and tap water VOC concentrations using multiple linear regression. RESULTS: 40 VOCs were detected in >50% of air samples, whereas only 4 VOCs were detected in >50% of water samples. We observed indoor air concentrations >95th percentile of CHMS in 10-60% of samples for several compounds (acetone, 2-methyl-2-propanol, chloroform, 1,4-dioxane, hexanal, m/p-xylene, o-xylene, styrene, decamethylcyclopentasiloxane, dodecane and decanal). Indoor air levels of chloroform and tap water levels of total trihalomethanes were higher in Indigenous participants compared to non-Indigenous participants. Indoor air levels of chloroform and acetone, and tap water levels of total trihalomethanes were positively associated with UNG wells density/proximity metrics. Indoor air BTEX (benzene, toluene, ethylbenzene, xylenes) levels were positively correlated with some well density/proximity metrics. CONCLUSION: Our results suggest higher exposure to certain VOCs in pregnant women living in an area of intense unconventional natural gas exploitation compared with the general Canadian population, and that well density/proximity is associated with increased exposure to certain VOCs.


Assuntos
Poluentes Atmosféricos , Poluição do Ar em Ambientes Fechados , Compostos Orgânicos Voláteis , Poluentes Atmosféricos/análise , Poluição do Ar em Ambientes Fechados/análise , Colúmbia Britânica , Monitoramento Ambiental , Feminino , Habitação , Humanos , Gás Natural , Gravidez , Gestantes , Compostos Orgânicos Voláteis/análise , Água
2.
J Hazard Mater ; 421: 126799, 2022 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-34396958

RESUMO

Stack aerosols are generated within vertical building drainage stacks during the discharge of wastewater containing feces and exhaled mucus from toilets and washbasins. Fifteen stack aerosol-related outbreaks of coronavirus disease 2019 (COVID-19) in high-rise buildings have been observed in Hong Kong and Guangzhou. Currently, we investigated two such outbreaks of COVID-19 in Hong Kong, identified the probable role of chimney effect-induced airflow in a building drainage system in the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We injected tracer gas (SF6) into the drainage stacks via the water closet of the index case and monitored tracer gas concentrations in the bathrooms and along the facades of infected and non-infected flats and in roof vents. The air temperature, humidity, and pressure in vertical stacks were also monitored. The measured tracer gas distribution agreed with the observed distribution of the infected cases. Phylogenetic analysis of the SARS-CoV-2 genome sequences demonstrated clonal spread from a point source in cases along the same vertical column. The stack air pressure and temperature distributions suggested that stack aerosols can spread to indoors through pipe leaks which provide direct evidence for the long-range aerosol transmission of SARS-CoV-2 through drainage pipes via the chimney effect.


Assuntos
Aerossóis , Microbiologia do Ar , COVID-19 , Habitação , COVID-19/transmissão , Hong Kong , Humanos , Filogenia , SARS-CoV-2
3.
Artigo em Inglês | MEDLINE | ID: mdl-34769669

RESUMO

With the growth in China's economic GDP, energy consumption has increased year by year. The energy demand of rural residential buildings is 223 million tons of standard coal equivalent, accounting for 24% of the national energy demand. Therefore, an energy-saving design for rural residences is necessary. This research took the traditional residences in southern Shaanxi as the research object and combined the cooking methods in southern Shaanxi with solar heating, proposing a sunlight heating system with an additional firewall. The system is composed of a firewall system and a sunlight system. The combination of the two systems prolongs the heating time and makes up for the lack of intermittent heating. The firewall principle involves using the heat generated by cooking through the heat storage and heat release capacity of the wall, and using the principle of heat radiation and convection to increase the indoor temperature. Meanwhile, the principle of the additional sunlight room involves using the external facade of the building to establish an additional sunlight room, by absorbing the heat radiation of the sun and using the principle of heat transfer from the wall. The rapid loss of indoor hot air is avoided, the heating time is prolonged, and part of the heat is retained, thereby improving the heating efficiency. A model was established based on the typical residential model in southern Shaanxi, and the presence or absence of solar radiation on the wall was used as the research variable. Using ANSYS software to simulate the analysis, it is concluded that the firewall-sunlight system can extend the heating time and meet the continuous heating demand, and the heating effect is better than that of the firewall heating system alone. When the walls have solar radiation, the annual heat load reduction rate of the buildings under the new system is 20.21%. When the walls do not have solar radiation, the annual heat load reduction rate of the buildings under the new system is 8.56%.


Assuntos
Calefação , Energia Solar , Carvão Mineral , Habitação , Luz Solar
4.
Artigo em Inglês | MEDLINE | ID: mdl-34769749

RESUMO

Few studies have examined the combined effects of affordability, housing conditions and neighborhood characteristics on the housing stability and health of low-income homeowners. We begin to address these gaps through a mixed-method study design that evaluates the Make-it-Home program (MiH) in Detroit, Michigan, aimed at helping low-income tenants become homeowners when their landlords lose their homes to tax foreclosure. We compare the 'intervened group' of MiH homeowners to a 'comparison' group of similarly situated households whose homes experience property tax foreclosure at the same time. The comparison group represents the likely outcomes for the participants had they not participated the program. Participants will be surveyed twice (intervened group), or once (comparison group) per year over a three-year period, regarding their housing and neighborhood conditions, health, life events, and socio-economic status, including income and employment. We will use property and neighborhood census data to further examine the conditions experienced. The findings for policy and program development from this study are timely as the nation faces a chronic shortage of affordable housing for both purchasers and renters. The results suggest ways to improve the MiH program and lay out approaches for researchers to navigate some of the complexities associated with this type of research.


Assuntos
Habitação , Pobreza , Características da Família , Humanos , Renda , Características de Residência
5.
Ann Fam Med ; 19(6): 507-514, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34750125

RESUMO

PURPOSE: Clinicians and policy makers are exploring the role of primary care in improving patients' social conditions, yet little research examines strategies used in clinical settings to assist patients with social needs. METHODS: Study used semistructured interviews with leaders and frontline staff at 29 diverse health care organizations with active programs used to address patients' social needs. Interviews focused on how organizations develop and implement case management-style programs to assist patients with social needs including staffing, assistance intensity, and use of referrals to community-based organizations (CBOs). RESULTS: Organizations used case management programs to assist patients with social needs through referrals to CBOs and regular follow-up with patients. About one-half incorporated care for social needs into established case management programs and the remaining described standalone programs developed specifically to address social needs independent of clinical needs. Referrals were the foundation for assistance and included preprinted resource lists, patient-tailored lists, and warm handoffs to the CBOs. While all organizations referred patients to CBOs, some also provided more intense services such as assistance completing patients' applications for services or conducting home visits. Organizations described 4 operational challenges in addressing patients' social needs: (1) effectively engaging CBOs; (2) obtaining buy-in from clinical staff; (3) considering patients' perspectives; and (4) ensuring program sustainability. CONCLUSION: As the US health care sector faces pressure to improve quality while managing costs, many health care organizations will likely develop or rely on case management approaches to address patients' social conditions. Health care organizations may require support to address the key operational challenges.Visual abstract.


Assuntos
Habitação , Atenção Primária à Saúde , Humanos , Encaminhamento e Consulta , Transportes
6.
Sci Rep ; 11(1): 22055, 2021 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-34764333

RESUMO

THE AIMS: (i) analyze connectivity between subgroups of university students, (ii) assess which bridges of relational contacts are essential for connecting or disconnecting subgroups and (iii) to explore the similarities between the attributes of the subgroup nodes in relation to the pandemic context. During the COVID-19 pandemic, young university students have experienced significant changes in their relationships, especially in the halls of residence. Previous research has shown the importance of relationship structure in contagion processes. However, there is a lack of studies in the university setting, where students live closely together. The case study methodology was applied to carry out a descriptive study. The participation consisted of 43 university students living in the same hall of residence. Social network analysis has been applied for data analysis. Factions and Girvan-Newman algorithms have been applied to detect the existing cohesive subgroups. The UCINET tool was used for the calculation of the SNA measure. A visualization of the global network will be carried out using Gephi software. After applying the Girvan-Newman and Factions, in both cases it was found that the best division into subgroups was the one that divided the network into 4 subgroups. There is high degree of cohesion within the subgroups and a low cohesion between them. The relationship between subgroup membership and gender was significant. The degree of COVID-19 infection is related to the degree of clustering between the students. College students form subgroups in their residence. Social network analysis facilitates an understanding of structural behavior during the pandemic. The study provides evidence on the importance of gender, race and the building where they live in creating network structures that favor, or not, contagion during a pandemic.


Assuntos
COVID-19/epidemiologia , Análise de Rede Social , Rede Social , Feminino , Habitação , Humanos , Masculino , Pandemias , Saúde Pública , SARS-CoV-2/isolamento & purificação , Estudantes , Universidades
7.
West J Emerg Med ; 22(6): 1360-1368, 2021 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-34787563

RESUMO

INTRODUCTION: Social emergency medicine (EM) is an emerging field that examines the intersection of emergency care and social factors that influence health outcomes. We conducted a scoping review to explore the breadth and content of existing research pertaining to social EM to identify potential areas where future social EM research efforts should be directed. METHODS: We conducted a comprehensive PubMed search using Medical Subject Heading terms and phrases pertaining to social EM topic areas (e.g., "homelessness," "housing instability") based on previously published expert consensus. For searches that yielded fewer than 100 total publications, we used the PubMed "similar publications" tool to expand the search and ensure no relevant publications were missed. Studies were independently abstracted by two investigators and classified as relevant if they were conducted in US or Canadian emergency departments (ED). We classified relevant publications by study design type (observational or interventional research, systematic review, or commentary), publication site, and year. Discrepancies in relevant publications or classification were reviewed by a third investigator. RESULTS: Our search strategy yielded 1,571 publications, of which 590 (38%) were relevant to social EM; among relevant publications, 58 (10%) were interventional studies, 410 (69%) were observational studies, 26 (4%) were systematic reviews, and 96 (16%) were commentaries. The majority (68%) of studies were published between 2010-2020. Firearm research and lesbian, gay, bisexual, transgender, and queer (LGBTQ) health research in particular grew rapidly over the last five years. The human trafficking topic area had the highest percentage (21%) of interventional studies. A significant portion of publications -- as high as 42% in the firearm violence topic area - included observational data or interventions related to children or the pediatric ED. Areas with more search results often included many publications describing disparities known to predispose ED patients to adverse outcomes (e.g., socioeconomic or racial disparities), or the influence of social determinants on ED utilization. CONCLUSION: Social emergency medicine research has been growing over the past 10 years, although areas such as firearm violence and LGBTQ health have had more research activity than other topics. The field would benefit from a consensus-driven research agenda.


Assuntos
Medicina de Emergência , Canadá , Criança , Serviço Hospitalar de Emergência , Feminino , Habitação , Humanos , Projetos de Pesquisa
8.
J Health Care Poor Underserved ; 32(4): 2233-2238, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34803072

RESUMO

The COVID-19 pandemic had a devastating impact on non-sheltered homeless and housing-insecure individuals. This report details the development of a Chicago-based isolation shelter designed for people experiencing homelessness and recovering from COVID-19. The model is informative concerning the rapid development of services for people marginalized by the health care system.


Assuntos
COVID-19 , Pessoas em Situação de Rua , Habitação , Humanos , Pandemias , SARS-CoV-2
9.
J Health Care Poor Underserved ; 32(4): 1978-1994, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34803054

RESUMO

Objectives . We investigated the association of pre-existing economic variables with COVID-19 infections and mortality in New York City. Methods . We combined ZIP code-level data from New York City's Department of Health with five-year American Community Survey data. We estimated ordinary least squares models of the prevalence of positive COVID-19 test results and deaths per 100,000 population. Results . We found ZIP codes with higher concentrations of residents living in crowded living quarters, employees in high-risk occupations, and employees commuting more than half an hour were positively and significantly associated with higher infection rates. Higher rates of crowded housing were also significantly and positively related to mortality rates, though the positive point estimates for the other two economic variables were not statistically significant. Conclusions . Economic factors such as working and living conditions beyond common measures such as poverty generate significant public health effects. Policymakers should consider these associations while designing and modifying public health policies.


Assuntos
COVID-19 , Habitação , Humanos , Cidade de Nova Iorque/epidemiologia , Pobreza , SARS-CoV-2
10.
Environ Sci Technol ; 55(22): 15051-15062, 2021 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-34738808

RESUMO

Currently, there is a lack of understanding on the variations of the indoor airborne microbiotas of different building types within a city, and how operational taxonomic unit (OTU)- and amplicon sequence variant (ASV)-based analyses of the 16S rRNA gene sequences affect interpretation of the indoor airborne microbiota results. Therefore, in this study, the indoor airborne bacterial microbiotas between commercial buildings, residences, and subways within the same city were compared using both OTU- and ASV-based analytic methods. Our findings suggested that indoor airborne bacterial microbiota compositions were significantly different between building types regardless of the bioinformatics method used. The processes of ecological drift and random dispersal consistently played significant roles in the assembly of the indoor microbiota across building types. Abundant taxa tended to be more centralized in the correlation network of each building type, highlighting their importance. Taxonomic changes between the microbiotas of different building types were also linked to changes in their inferred metabolic function capabilities. Overall, the results imply that customized strategies are necessary to manage indoor airborne bacterial microbiotas for each building type or even within each specific building.


Assuntos
Microbiota , Bactérias/genética , Cidades , Habitação , RNA Ribossômico 16S/genética
11.
Harm Reduct J ; 18(1): 112, 2021 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-34749744

RESUMO

Young adults experiencing homelessness are at high risk of opioid and other substance use, poor mental health outcomes, exposure to trauma, and other risks. Providing access to stable housing has the potential to act as a powerful preventive intervention, but supportive housing programs have been studied most often among chronically homeless adults or adults with serious mental illness. The Housing First model, which does not precondition supportive housing on sobriety, may reduce drug use in homeless adults. In the present study, we piloted an adapted model of Housing First plus prevention services that was tailored to the needs of young adults (18-24 years) experiencing homelessness in the USA. Preventive services were added to the Housing First model and included youth-centered advocacy services, motivational interviewing, and HIV risk prevention services. This model was piloted in a single-arm study (n = 21) to assess the feasibility, acceptability, and initial efficacy of a Housing First model over a 6-month period in preparation for a larger randomized trial. We use repeated measures ANOVA to test for changes in alcohol and drug use (percent days of use; alcohol or drug use consequences), housing stability, social network support, and cognitive distortions over 6 months of follow-up. A total of 17 youth completed the study (85% retention), and a high proportion of youth were stably housed at 6-month follow-up. Participation in intervention services was high with an average of 13.57 sessions for advocacy, 1.33 for MI, and 0.76 for HIV prevention. Alcohol use did not change significantly over time. However, drug use, drug use consequences, and cognitive distortions, and the size of youths' social networks that were drug using individuals decreased significantly. The Housing First model appeared to be feasible to deliver, and youth engaged in the supportive intervention services. The study demonstrates the potential for an adapted Housing First model to be delivered to youth experiencing homelessness and may improve outcomes, opening the way for larger randomized trials of the intervention.


Assuntos
Pessoas em Situação de Rua , Transtornos Mentais , Transtornos Relacionados ao Uso de Opioides , Adolescente , Estudos de Viabilidade , Habitação , Humanos , Transtornos Mentais/prevenção & controle , Motivação , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Adulto Jovem
12.
Acad Pediatr ; 21(8S): S184-S193, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34740427

RESUMO

If ZIP code is more important than genetic code in determining one's health and opportunities, how can pediatricians enable healthy and opportunity-rich environments for all children? This paper introduces a broad network of organizations, policies, and financial resources that are working to improve ZIP codes by tackling poverty at the neighborhood level. The mission-driven US community development sector began with the War on Poverty in the 1960s and 70s and comprises a network of finance, real estate, and community-based organizations working together to overturn decades of racially motivated disinvestment, revitalize persistently marginalized, low-income communities, and enhance the lives of the people who live in them. Across the country, thousands of community development corporations, community development financial institutions, affordable housing developers, and regulated for-profit banks together invest over $300 billion annually in affordable housing, childcare and early learning facilities, recreation centers, community clinics, grocery stores, small businesses, and financial services for low-income families and neighborhoods. We present successful examples of community development efforts targeting child health and opportunity and highlight opportunities for pediatricians to advise, collaborate, and partner in order to accelerate and maximize the impact of billions of dollars invested in support of healthier neighborhoods where all children can grow and thrive.


Assuntos
Saúde da Criança , Pobreza , Criança , Cuidado da Criança , Habitação , Humanos , Características de Residência
13.
Acad Pediatr ; 21(8S): S194-S199, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34740428

RESUMO

Understanding how housing inequities among families with children are rooted in structural racism is important for identifying opportunities to engage in ongoing and collective work as pediatricians to lift children out of poverty. This article discusses the complex mechanisms between housing and child and family health outcomes, and offers potential solutions linking housing, health programs, and policy solutions. Beginning with a review of historical antecedents of housing policy and their impact on health inequities, the authors outlines policies and structures directly linked to disproportionate housing instability and inequities in health outcomes among children. This article examines four key domains of housing - affordability, stability, quality, and neighborhood - and their relationship to child and family health. Finally, the authors present multidimensional solutions for advancing health equity.


Assuntos
Habitação , Racismo , Criança , Saúde da Família , Humanos , Pobreza , Características de Residência
14.
Artigo em Inglês | MEDLINE | ID: mdl-34770160

RESUMO

Older public housing tenants experience various factors associated with physical inactivity and are locally dependent on their environment to support their physical activity. A better understanding of the person-environment fit for physical activity could highlight avenues to improve access to physical activity for this subgroup of the population. The aim of this study was to evaluate older public housing tenants' capabilities for physical activity in their residential environment using a socioecological approach. We conducted individual semi-structured walk-along interviews with 26 tenants (female = 18, male = 8, mean age = 71.96 years old). Living in housing developments exclusively for adults aged 60 years or over in three neighborhoods in the city of Montreal, Canada. A hybrid thematic analysis produced five capabilities for physical activity: Political, financial, social, physical, and psychological. Themes spanned across ecological levels including individual, public housing, community, and government. Tenant committees appear important to physical activity promotion. Participants called for psychosocial interventions to boost their capability for physical activity as well as greater implication from the housing authority and from government. Results further support a call for intersectoral action to improve access to physical activity for less affluent subgroups of the population such as older public housing tenants.


Assuntos
Habitação , Habitação Popular , Adulto , Idoso , Canadá , Exercício Físico , Feminino , Humanos , Masculino , Meio Social , Caminhada
15.
Front Public Health ; 9: 772236, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34778197

RESUMO

Background: The mental health of racial/ethnic minorities in the U.S. has been disproportionately impacted by the COVID-19 pandemic. This study examined the extent to which disruptions in employment and housing, coronavirus-specific forms of victimization and racial bias independently and conjointly contributed to mental health risk among Asian, Black, and Latinx adults in the United States during the pandemic. Methods: This study reports on data from 401 Asian, Black, and Latinx adults (age 18-72) who participated in a larger national online survey conducted from October 2020-June 2021, Measures included financial and health information, housing disruptions and distress in response to employment changes, coronavirus related victimization distress and perceived increases in racial bias, depression and anxiety. Results: Asian participants had significantly higher levels of COVID-related victimization distress and perceived increases in racial bias than Black and Latinx. Young adults (<26 years old) were more vulnerable to depression, anxiety, and coronavirus victimization distress than older respondents. Having at least one COVID-related health risk, distress in response to changes in employment and housing disruptions, pandemic related victimization distress and perceived increases in racial bias were positively and significantly related to depression and anxiety. Structural equation modeling indicated COVID-related increases in racial bias mediated the effect of COVID-19 related victimization distress on depression and anxiety. Conclusions: COVID-19 has created new pathways to mental health disparities among racial/ethnic minorities in the U.S. by exacerbating existing structural and societal inequities linked to race. Findings highlight the necessity of mental health services sensitive to specific challenges in employment and housing and social bias experienced by people of color during the current and future health crises.


Assuntos
COVID-19 , Vítimas de Crime , Racismo , Adolescente , Adulto , Idoso , Emprego , Habitação , Humanos , Saúde Mental , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2 , Estados Unidos/epidemiologia , Adulto Jovem
16.
Environ Health Prev Med ; 26(1): 104, 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34641787

RESUMO

BACKGROUND: Excess winter mortality caused by cardiovascular disease is particularly profound in cold houses. Consistent with this, accumulating evidence indicates that low indoor temperatures at home increase blood pressure. However, it remains unclear whether low indoor temperatures affect other cardiovascular biomarkers. In its latest list of priority medical devices for management of cardiovascular diseases, the World Health Organization (WHO) included electrocardiography systems as capital medical devices. We therefore examined the association between indoor temperature and electrocardiogram findings. METHODS: We collected electrocardiogram data from 1480 participants during health checkups. We also measured the indoor temperature in the living room and bedroom for 2 weeks in winter, and divided participants into those living in warm houses (average exposure temperature ≥ 18 °C), slightly cold houses (12-18 °C), and cold houses (< 12 °C) in accordance with guidelines issued by the WHO and United Kingdom. The association between indoor temperature (warm vs. slightly cold vs. cold houses) and electrocardiogram findings was analyzed using multivariate logistic regression models, with adjustment for confounders such as demographics (e.g., age, sex, body mass index, household income), lifestyle (e.g., eating habit, exercise, smoking, alcohol drinking), and region. RESULTS: The average temperature at home was 14.7 °C, and 238, 924, and 318 participants lived in warm, slightly cold, and cold houses, respectively. Electrocardiogram abnormalities were observed in 17.6%, 25.4%, and 30.2% of participants living in warm, slightly cold, and cold houses, respectively (p = 0.003, chi-squared test). Compared to participants living in warm houses, the odds ratio of having electrocardiogram abnormalities was 1.79 (95% confidence interval: 1.14-2.81, p = 0.011) for those living in slightly cold houses and 2.18 (95% confidence interval: 1.27-3.75, p = 0.005) for those living in cold houses. CONCLUSIONS: In addition to blood pressure, living in cold houses may have adverse effects on electrocardiogram. Conversely, keeping the indoor thermal environment within an appropriate range through a combination of living in highly thermal insulated houses and appropriate use of heating devices may contribute to good cardiovascular health. TRIAL REGISTRATION: The trial was retrospectively registered on 27 Dec 2017 to the University hospital Medical Information Network Clinical Trials Registry (UMIN-CTR, https://www.umin.ac.jp/ctr/ , registration identifier number UMIN000030601 ).


Assuntos
Temperatura Baixa/efeitos adversos , Eletrocardiografia , Habitação , Temperatura , Idoso , Doenças Cardiovasculares/prevenção & controle , Estudos Transversais , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade
17.
Int J Hyg Environ Health ; 238: 113862, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34673354

RESUMO

Childhood lead exposure affects over 500,000 children under 6 years old in the US; however, only 14 states recommend regular universal blood screening. Several studies have reported on the use of predictive models to estimate lead exposure of individual children, albeit with limited success: lead exposure can vary greatly among individuals, individual data is not easily accessible, and models trained in one location do not always perform well in another. We report on a novel approach that uses machine learning to accurately predict elevated Blood Lead Levels (BLLs) in large groups of children, using aggregated data. To that end, we used publicly available zip code and city/town BLL data from the states of New York (n = 1642, excluding New York City) and Massachusetts (n = 352), respectively. Five machine learning models were used to predict childhood lead exposure by using socioeconomic, housing, and water quality predictive features. The best-performing model was a Random Forest, with a 10-fold cross validation ROC AUC score of 0.91 and 0.85 for the Massachusetts and New York datasets, respectively. The model was then tested with New York City data and the results compared to measured BLLs at a borough level. The model yielded predictions in excellent agreement with measured data: at a city level it predicted elevated BLL rates of 1.72% for the children in New York City, which is close to the measured value of 1.73%. Predictive models, such as the one presented here, have the potential to help identify geographical hotspots with significantly large occurrence of elevated lead blood levels in children so that limited resources may be deployed to those who are most at risk.


Assuntos
Intoxicação por Chumbo , Chumbo , Criança , Pré-Escolar , Exposição Ambiental , Habitação , Humanos , Intoxicação por Chumbo/epidemiologia , Aprendizado de Máquina , Cidade de Nova Iorque
19.
PLoS One ; 16(10): e0258641, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34648584

RESUMO

The assessment of the suitability of existing buildings for implementation of green roofs is an important research issue, especially in the context of Urban Heat Island (UHI), the negative impacts of which are locally exacerbated by the global warming. The studies carried out so far have covered a variety of buildings and have taken into account a range of different conditions. Relatively little attention has been paid to the possibilities of greening the roofs of prefabricated apartment blocks from the second half of the 20th century in the context of the potential climate effect. Yet, these buildings are found in many cities around the world, and seem in fact attractive for greening. In view of the above, we proposed a three-stage investigatory procedure to: (I) identify and classify buildings based on the number of floors and the rooftop available area; (II) select buildings by designating priority areas depending on the highest UHI intensity and roof density; (III) analyse the roof load capacity to develop retrofit scenarios. The procedure was applied to prefabricated housing estates built in the 1970s and 1980s in Wroclaw, Poland. The research shows that there are 1962 buildings of different heights and roof area of 722405 m2, of which 480 buildings with a roof area of 122749.1 m2 were selected for greening within priority areas. The structure of the studied roofs was not designed to carry additional loads, which requires the application of complementary solutions. Scenario 1 assumes extensive greening provided that the existing ventilated roof is strengthened, scenario 2 -semi-intensive greening, which however requires the conversion of the ventilated roof to a non-ventilated one. The presented procedure can be applied in any other city with prefabricated apartment blocks and available UHI data, and serve to support the decision to implement green roofs to mitigate UHI.


Assuntos
Materiais de Construção , Cidades , Aquecimento Global , Temperatura Alta , Habitação , Polônia
20.
Pediatrics ; 148(5)2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34663680

RESUMO

BACKGROUND: To determine the association between states' total spending on benefit programs and child maltreatment outcomes. METHODS: This was an ecological study of all US states during federal fiscal years 2010-2017. The primary predictor was states' total annual spending on local, state, and federal benefit programs per person living ≤100% federal poverty limit, which was the sum of (1) cash, housing, and in-kind assistance, (2) housing infrastructure, (3) child care assistance, (4) refundable Earned Income Tax Credit, and (5) Medical Assistance Programs. The main outcomes were rates of maltreatment reporting, substantiations, foster care placements, and fatalities after adjustment for relevant confounders. Generalized estimating equations adjusted for federal spending and estimated adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs). RESULTS: States' total spending was inversely associated with all maltreatment outcomes. For each additional $1000 states spent on benefit programs per person living in poverty, there was an associated -4.3% (adjusted IRR: 0.9573 [95% CI: 0.9486 to 0.9661]) difference in reporting, -4.0% (adjusted IRR: 0.903 [95% CI: 0.9534 to 0.9672]) difference in substantiations, -2.1% (adjusted IRR: 0.9795 [95% CI: 0.9759 to 0.9832]) difference in foster care placements, and -7.7% (adjusted IRR: 0.9229 [95% CI: 0.9128 to 0.9330]) difference in fatalities. In 2017, extrapolating $1000 of additional spending for each person living in poverty ($46.5 billion nationally, or 13.3% increase) might have resulted in 181 850 fewer reports, 28 575 fewer substantiations, 4168 fewer foster care placements, and 130 fewer fatalities. CONCLUSIONS: State spending on benefit programs was associated with reductions in child maltreatment, which might offset some benefit program costs.


Assuntos
Maus-Tratos Infantis/estatística & dados numéricos , Assistência Pública/economia , Despesas Públicas , Adolescente , Criança , Maus-Tratos Infantis/mortalidade , Intervalos de Confiança , Cuidados no Lar de Adoção/economia , Habitação/economia , Humanos , Incidência , Assistência Médica/economia , Pobreza/economia , Fatores de Tempo , Estados Unidos
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