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Long-term exposure to green and blue space and incidence of cardiovascular disease: A Danish Nurse Cohort study 长期接触绿色和蓝色空间与心血管疾病的发病率:丹麦护士队列研究。
IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-22 DOI: 10.1016/j.ijheh.2024.114465
Yujing Li , Jiawei Zhang , Jasper Schipperijn , Stéphane Tuffier , Samuel Hyman , Marie Bergmann , Matthias Ketzel , Claus Backalarz , Zorana Jovanovic Andersen , Youn-Hee Lim , Thomas Cole-Hunter

Background

Few cohort studies have examined the associations of natural surroundings (green and blue space) with cardiovascular disease (CVD) and show mixed findings. We aimed to investigate the associations between long-term exposure to green and blue space and incidence of CVD in the Danish Nurse Cohort.

Methods

We followed 19,070 female nurses living in Denmark from 1993/1999 to 2018. The shortest Euclidian distance from a residence to three types of green space (park, woodland, and heathland) and four types of blue space (lake, river, coast, and wetland), along with total count of all types of natural surroundings within a 500 meter (m), 1000 m, and 5000 m radius from a residence, were calculated using GeoDanmark data from 2005. Distance was log-transformed to correct for a right-skewed data distribution. Residential air pollution and road traffic noise data for 2005 were estimated by the Danish air pollution modeling system (‘DEHM/UBM/AirGIS’) and Nord2000 model, respectively. Cox proportional hazards models were used to estimate associations between green and blue space and the first-ever incidence of total CVD and certain CVD subtypes after adjusting for individual factors, air pollution, and noise. We examined effect modification by age, smoking status, occupational status, household income, and urbanicity level. Hazard ratio (HR) and 95% confidence interval (95% CI) were presented per e unit (equivalent to ∼2.72 fold) increase in distance.

Results

8179 new cases of CVD were observed over 344,084 person-years. Living further from woodland was associated with higher stroke incidence (HR: 1.153; 95% CI: 1.029–1.293), while living further from heathland was associated with reduced total CVD incidence (HR: 0.975; 95% CI: 0.955–0.996). No associations were found between distance to park, woodland, lake, river, coast, or wetland and total CVD incidence. Total count of all types of green and blue spaces within a 5000 m radius was linked to a reduced risk of CVD incidence. Adjusting for air pollution or road traffic noise did not alter observed associations. Younger individuals (<50 years old) were observed to have lower HRs when living closer to all types of natural surroundings.

Conclusion

We found that proximity to woodland was associated with a reduced risk of stroke, whilst no significant or even inverse associations were observed between proximity to other types of natural surroundings and CVD incidence. Total count of all types of natural surroundings within a 5000 m radius was negatively associated with CVD incidence, suggesting cumulative benefits of these areas.
背景:很少有队列研究探讨自然环境(绿色和蓝色空间)与心血管疾病(CVD)之间的关系,研究结果也不尽相同。我们旨在调查丹麦护士队列中长期暴露于绿色和蓝色空间与心血管疾病发病率之间的关系:我们对 1993/1999 年至 2018 年期间居住在丹麦的 19070 名女护士进行了跟踪调查。我们使用 2005 年的 GeoDanmark 数据计算了居住地到三种绿地(公园、林地和荒地)和四种蓝地(湖泊、河流、海岸和湿地)的最短欧几里得距离,以及居住地半径 500 米、1000 米和 5000 米范围内所有类型自然环境的总计数。对距离进行了对数转换,以校正数据的右斜分布。2005 年的住宅空气污染和道路交通噪声数据分别由丹麦空气污染模型系统("DEHM/UBM/AirGIS")和 Nord2000 模型估算得出。在对个体因素、空气污染和噪声进行调整后,我们使用 Cox 比例危险模型来估算绿色和蓝色空间与心血管疾病总发病率和某些心血管疾病亚型的首次发病率之间的关系。我们研究了年龄、吸烟状况、职业状况、家庭收入和城市化水平对效应的影响。结果显示了距离每增加一个 e 单位(相当于 2.72 倍)的危险比(HR)和 95% 置信区间(95% CI):在 344,084 人年中观察到 8179 例心血管疾病新发病例。居住地距离林地越远,中风发病率越高(HR:1.153;95% CI:1.029-1.293),而居住地距离沼泽地越远,心血管疾病总发病率越低(HR:0.975;95% CI:0.955-0.996)。与公园、林地、湖泊、河流、海岸或湿地的距离与心血管疾病总发病率之间没有关联。半径 5000 米范围内各类绿色和蓝色空间的总计数与心血管疾病发病风险的降低有关。调整空气污染或道路交通噪音并不会改变观察到的关联。较年轻的个体(结论:我们发现,靠近林地与降低中风风险有关,而靠近其他类型的自然环境与心血管疾病发病率之间没有观察到明显的甚至是反向的联系。半径 5000 米范围内各类自然环境的总数量与心血管疾病发病率呈负相关,这表明这些区域具有累积效益。
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引用次数: 0
Aging of drinking water transmission pipes during long-term operation as a potential source of nano- and microplastics 作为纳米和微塑料潜在来源的饮用水传输管道在长期运行过程中的老化问题
IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-21 DOI: 10.1016/j.ijheh.2024.114467
Joanna Świetlik, Marta Magnucka

Microplastics (MPs) and nanoplastics (NPs) released into drinking water from transmission pipes can pose a potential health risk to consumers. This paper presents the results of a comprehensive study of PE and PVC pipes after long-term operation in drinking water distribution networks, which confirmed that degradable polymers can be a significant source of MPs. Both plastics age relatively quickly, and the degree of damage to the pipe surface depends on the time and operating conditions. During aging, polymer chains deteriorate, leading to a weakening of the structure and increased amorphousness of the plastics. As a result, the surfaces of PE and PVC crack and peel, resulting in the formation of particles with sizes corresponding to NP and MP with high potential for release into water. The magnitude of the phenomenon increases as the diameter of the pipes decreases, indicating that the most vulnerable customers are those at the ends of the network to which drinking water is supplied through small-diameter pipes. Aging PE and PVC pipes should be considered a real and very important source of MPs and NPs in drinking water, and water quality in this aspect should be monitored by manufacturers.

从输水管中释放到饮用水中的微塑料(MPs)和纳米塑料(NPs)会对消费者的健康构成潜在风险。本文介绍了对饮用水输水管网中的聚乙烯(PE)和聚氯乙烯(PVC)管材长期使用后的综合研究结果,研究结果证实,可降解聚合物可能是 MPs 的重要来源。这两种塑料的老化速度相对较快,管材表面的损坏程度取决于时间和运行条件。在老化过程中,聚合物链会发生退化,从而导致塑料的结构减弱和无定形度增加。因此,聚乙烯和聚氯乙烯的表面会开裂和剥落,形成大小相当于 NP 和 MP 的颗粒,极有可能释放到水中。这种现象的严重程度随着管道直径的减小而增加,这表明最容易受到影响的用户是那些通过小直径管道供应饮用水的管网末端的用户。老化的聚乙烯和聚氯乙烯管材应被视为饮用水中 MP 和 NP 的真正且非常重要的来源,生产商应监测这方面的水质。
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引用次数: 0
Multiple mycotoxin exposure assessment through human biomonitoring in an esophageal cancer case-control study in the Arsi-Bale districts of Oromia region of Ethiopia 在埃塞俄比亚奥罗米亚地区阿尔西-巴莱区进行的一项食管癌病例对照研究中,通过人体生物监测评估多种霉菌毒素接触情况
IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-21 DOI: 10.1016/j.ijheh.2024.114466
Girma Mulisa , Roger Pero-Gascon , Valerie McCormack , Jordan E. Bisanz , Fazlur Rahman Talukdar , Tamrat Abebe , Marthe De Boevre , Sarah De Saeger

Background

Esophageal cancer (EC) is a malignancy with a poor prognosis and a five-year survival rate of less than 20%. It is the ninth most frequent cancer globally and the sixth leading cause of cancer-related deaths. The incidence of EC has been found to vary significantly by geography, indicating the importance of environmental and lifestyle factors along with genetic factors in the onset of the disease. In this work, we investigated mycotoxin exposure in a case-control study from the Arsi-Bale districts of Oromia regional state in Ethiopia, where there is a high incidence of EC while alcohol and tobacco use – two established risk factors for EC – are very rare.

Methods

Internal exposure to 39 mycotoxins and metabolites was assessed by liquid chromatography-tandem mass spectrometry in plasma samples of EC cases (n = 166) and location-matched healthy controls (n = 166) who shared similar dietary sources. Demographic and lifestyle data were collected using structured questionnaires. Principal Component Analysis and machine learning models were used to identify the most relevant demographic, lifestyle, and mycotoxin (co-)exposure variables associated with EC. Multivariate binary logistic regression analysis was used to assess EC risk.

Result

Evidence of mycotoxin exposure was observed in all plasma samples, with 10 different mycotoxins being detected in samples from EC cases, while only 6 different mycotoxins were detected in samples from healthy controls. Ochratoxin A was detected in plasma from all cases and controls, while tenuazonic acid was detected in plasma of 145 (87.3%) cases and 71 (42.8%) controls. Using multivariable logistic regression analysis, exposure to tenuazonic acid (AOR = 1.88 [95% CI: 1.68–2.11]) and to multiple mycotoxins (AOR = 2.54 [95% CI: 2.10–3.07]) were positively associated with EC.

Conclusion

All cases and controls were exposed to at least one mycotoxin. Cases were exposed to a statistically significantly higher number of mycotoxins than controls. Exposure to tenuazonic acid and to multiple mycotoxins were associated with increased risk of EC in the study population. Although aflatoxin B1-lysine and the ratio of sphinganine to sphingosine (as a biomarker of effect to fumonisin exposure) were not assessed in this study, our result emphasizes the need to characterize the effect of mycotoxin co-exposure as part of the exposome and include it in risk assessment, since the current mycotoxin safety levels do not consider the additive or synergistic effects of mycotoxin co-exposure. Moreover, a prospective study design with regular sampling should be considered in this high incidence area of EC in Ethiopia to obtain conclusive results on the role of mycotoxin exposure in the onset and development of the disease.

背景食管癌(EC)是一种预后不良的恶性肿瘤,五年生存率不到 20%。它是全球发病率第九高的癌症,也是导致癌症相关死亡的第六大原因。研究发现,EC 的发病率因地域而有显著差异,这表明环境和生活方式因素以及遗传因素在该病发病中的重要性。在这项工作中,我们在埃塞俄比亚奥罗米亚地区州阿尔西-巴莱区的一项病例对照研究中调查了霉菌毒素的暴露情况。方法通过液相色谱-串联质谱法评估了39种霉菌毒素和代谢物的内部暴露情况,这些霉菌毒素和代谢物是霉菌性心肌梗死病例(166人)和与病例地点相匹配的健康对照组(166人)的血浆样本,他们的饮食来源相似。通过结构化问卷收集了人口统计学和生活方式数据。主成分分析和机器学习模型用于确定与欧共体最相关的人口统计学、生活方式和霉菌毒素(共)暴露变量。结果在所有血浆样本中都发现了暴露于霉菌毒素的证据,在心肌梗死病例的样本中检测到10种不同的霉菌毒素,而在健康对照组的样本中仅检测到6种不同的霉菌毒素。在所有病例和对照组的血浆中都检测到赭曲霉毒素A,而在145名(87.3%)病例和71名(42.8%)对照组的血浆中则检测到了tenuazonic酸。通过多变量逻辑回归分析,暴露于十嗪酮酸(AOR = 1.88 [95% CI: 1.68-2.11])和多种霉菌毒素(AOR = 2.54 [95% CI: 2.10-3.07])与EC呈正相关。从统计学角度看,病例接触的霉菌毒素数量明显高于对照组。在研究人群中,接触替硝唑酸和多种霉菌毒素与罹患心肌梗死的风险增加有关。虽然这项研究没有评估黄曲霉毒素B1-赖氨酸和鞘氨醇与鞘氨醇的比率(鞘氨醇与伏马菌素接触影响的生物标志物),但我们的研究结果强调,由于目前的霉菌毒素安全等级没有考虑到霉菌毒素共同接触的叠加或协同效应,因此有必要将霉菌毒素共同接触的影响作为暴露体的一部分加以描述,并将其纳入风险评估。此外,应考虑在埃塞俄比亚这一氨基甲酸乙酯高发区开展定期采样的前瞻性研究,以便就霉菌毒素暴露在该疾病的发病和发展中的作用得出结论性结果。
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引用次数: 0
Trend analyses of persistent organic pollutants in human milk from first-time mothers in Norway between 2002 and 2021 2002 年至 2021 年挪威初产妇母乳中持久性有机污染物的趋势分析
IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-19 DOI: 10.1016/j.ijheh.2024.114458
Kristina R. Nermo , Kjersti S. Bakken , Jan L. Lyche , Anuschka Polder , Aina Jansen , Siri Kaldenbach , Gabrielle Haddad-Weiser , Tor A. Strand , Merete Å. Eggesbø

Introduction

Persistent organic pollutants (POPs) are stable compounds characterized by their resistance to degradation. From the 1960–70's organochlorine pesticides (OCPs), such as DDTs and polychlorinated biphenyls (PCBs) raised concerns regarding health and environmental impacts. This has led to the banning of POPs in the USA and Europe including Norway in 1980 and worldwide under the 2004 Stockholm Convention. The exposure of nursing infants to POPs has been a significant focus, prompting extensive research into the presence of these substances in human breast milk. In this study, we explored the temporal trends of POPs concentrations in breast milk sampled between 2002 and 2021 by comparing the concentration across the mother's year of birth.

Method

Two Norwegian cohorts of lactating women were utilized (the HUMIS study and the “Iodine in Early Life”-Study). Concentrations of 15 different POPs, including PCBs, OCPs, and brominated diphenyl ethers (BDEs) were measured in 513 breast milk samples that had been collected over two decades in a subset of first-time mothers.

Results

Time trend analysis indicated a steady decrease in concentration levels when adjusted for maternal age. The largest reduction was observed in β-HCH, age-adjusted (−17.1%, 95% CI -18.7, −15.4), followed by ∑6BDE (−9.1%, 95% CI -10.5, −7.7), ∑6PCBs (−7.1%, 95% CI -7.7, −6.5), and ∑2DDTs (−7.0%, 95% CI -8.0, −6.0). In contrast, an increasing trend was noted in the median concentrations of β-HCH, ∑2DDTs, and ∑6BDE in the mothers born in 1990–1994 to 1995–2002.

Conclusion

Our study demonstrates a decline of most POPs in breast milk, likely attributed to international regulatory efforts like the Stockholm Convention. Notably, an increase in the 95th percentile concentrations of β-HCH, ∑2DDTs, and ∑6BDEs was noted in mothers born in 1990–1994 compared to those born in 1995–2002 suggests demographic shifts that may influence exposure levels. Further research is needed to explore and understand the underlying factors for the rise in median concentrations of ∑6BDEs.

引言 持久性有机污染物(POPs)是一种稳定的化合物,其特点是不易降解。从 20 世纪 60-70 年代开始,有机氯农药(OCPs),如滴滴涕和多氯联苯(PCBs)引起了人们对健康和环境影响的关注。因此,美国和欧洲(包括挪威)于 1980 年开始禁用持久性有机污染物,2004 年《斯德哥尔摩公约》在全球范围内也开始禁用持久性有机污染物。哺乳期婴儿接触持久性有机污染物的问题一直是人们关注的焦点,这促使人们对母乳中是否含有这些物质进行了广泛的研究。在这项研究中,我们通过比较不同母亲出生年份母乳中的持久性有机污染物浓度,探讨了 2002 年至 2021 年母乳采样中持久性有机污染物浓度的时间趋势。结果时间趋势分析表明,在对母亲年龄进行调整后,母乳中 15 种不同的持久性有机污染物(包括多氯联苯、有机氯农药和溴化二苯醚)的浓度水平稳步下降。经年龄调整后,β-HCH 的降幅最大(-17.1%,95% CI -18.7,-15.4),其次是∑6BDE(-9.1%,95% CI -10.5,-7.7)、∑6PCBs(-7.1%,95% CI -7.7,-6.5)和∑2DDTs(-7.0%,95% CI -8.0,-6.0)。与此相反,在 1990-1994 年至 1995-2002 年出生的母亲中,β-HCH、∑2DDTs 和 ∑6BDE 的中位浓度呈上升趋势。值得注意的是,1990-1994 年出生的母亲与 1995-2002 年出生的母亲相比,β-HCH、∑2DDTs 和 ∑6BDEs 的第 95 百分位数浓度有所增加,这表明人口结构的变化可能会影响暴露水平。需要进一步开展研究,探索和了解∑6BDEs 中位浓度上升的根本原因。
{"title":"Trend analyses of persistent organic pollutants in human milk from first-time mothers in Norway between 2002 and 2021","authors":"Kristina R. Nermo ,&nbsp;Kjersti S. Bakken ,&nbsp;Jan L. Lyche ,&nbsp;Anuschka Polder ,&nbsp;Aina Jansen ,&nbsp;Siri Kaldenbach ,&nbsp;Gabrielle Haddad-Weiser ,&nbsp;Tor A. Strand ,&nbsp;Merete Å. Eggesbø","doi":"10.1016/j.ijheh.2024.114458","DOIUrl":"10.1016/j.ijheh.2024.114458","url":null,"abstract":"<div><h3>Introduction</h3><p>Persistent organic pollutants (POPs) are stable compounds characterized by their resistance to degradation. From the 1960–70's organochlorine pesticides (OCPs), such as DDTs and polychlorinated biphenyls (PCBs) raised concerns regarding health and environmental impacts. This has led to the banning of POPs in the USA and Europe including Norway in 1980 and worldwide under the 2004 Stockholm Convention. The exposure of nursing infants to POPs has been a significant focus, prompting extensive research into the presence of these substances in human breast milk. In this study, we explored the temporal trends of POPs concentrations in breast milk sampled between 2002 and 2021 by comparing the concentration across the mother's year of birth.</p></div><div><h3>Method</h3><p>Two Norwegian cohorts of lactating women were utilized (the HUMIS study and the “Iodine in Early Life”-Study). Concentrations of 15 different POPs, including PCBs, OCPs, and brominated diphenyl ethers (BDEs) were measured in 513 breast milk samples that had been collected over two decades in a subset of first-time mothers.</p></div><div><h3>Results</h3><p>Time trend analysis indicated a steady decrease in concentration levels when adjusted for maternal age. The largest reduction was observed in β-HCH, age-adjusted (−17.1%, 95% CI -18.7, −15.4), followed by ∑<sub>6</sub>BDE (−9.1%, 95% CI -10.5, −7.7), ∑<sub>6</sub>PCBs (−7.1%, 95% CI -7.7, −6.5), and ∑<sub>2</sub>DDTs (−7.0%, 95% CI -8.0, −6.0). In contrast, an increasing trend was noted in the median concentrations of β-HCH, ∑<sub>2</sub>DDTs, and ∑<sub>6</sub>BDE in the mothers born in 1990–1994 to 1995–2002.</p></div><div><h3>Conclusion</h3><p>Our study demonstrates a decline of most POPs in breast milk, likely attributed to international regulatory efforts like the Stockholm Convention. Notably, an increase in the 95th percentile concentrations of β-HCH, ∑<sub>2</sub>DDTs, and ∑<sub>6</sub>BDEs was noted in mothers born in 1990–1994 compared to those born in 1995–2002 suggests demographic shifts that may influence exposure levels. Further research is needed to explore and understand the underlying factors for the rise in median concentrations of ∑<sub>6</sub>BDEs.</p></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"263 ","pages":"Article 114458"},"PeriodicalIF":4.5,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1438463924001391/pdfft?md5=86403d1d562572b0bca55e8e10f6a67b&pid=1-s2.0-S1438463924001391-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Residential proximity to conventional and unconventional wells and exposure to indoor air volatile organic compounds in the Exposures in the Peace River Valley (EXPERIVA) study 和平河谷暴露(EXPERIVA)研究中常规和非常规水井与室内空气挥发性有机化合物暴露的住宅距离
IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-17 DOI: 10.1016/j.ijheh.2024.114462
Coreen Daley , Miranda Doris , Marc-André Verner , Jad Zalzal , Romain Chesnaux , Laura Minet , Mary Kang , Heather L. MacLean , Marianne Hatzopoulou , Naomi Owens-Beek , West Moberly First Nations Chief and Council , Élyse Caron-Beaudoin

Background

In a previous study located in Northeastern British Columbia (Canada), we observed associations between density and proximity of oil and gas wells and indoor air concentrations of certain volatile organic compounds (VOCs). Whether conventional or unconventional well types and phases of unconventional development contribute to these associations remains unknown.

Objective

To investigate the associations between proximity-based metrics for conventional and unconventional wells and measured indoor air VOC concentrations in the Exposures in the Peace River Valley (EXPERIVA) study samples.

Methods

Eighty-four pregnant individuals participated in EXPERIVA. Passive indoor air samplers were analyzed for 47 VOCs. Oil and gas well legacy data were sourced from the British Columbia Energy Regulator. For each participant's home, 5 km, 10 km and no buffer distances were delineated, then density and Inverse Distance Square Weighted (ID2W) metrics were calculated to estimate exposure to conventional and unconventional wells during pregnancy and the VOC measurement period. Multiple linear regression models were used to test for associations between the well exposure metrics and indoor air VOCs. For exposure metrics with >30% participants having a value of 0, we dichotomized exposure (0 vs. >0) and performed ANOVAs to assess differences in mean VOCs concentrations.

Results

Analyses indicated that: 1) conventional well density and ID2W metrics were positively associated with indoor air acetone and decanal; 2) unconventional well density and ID2W metrics were positively associated with indoor air chloroform and decamethylcyclopentasiloxane, and negatively associated with decanal; 3) drilling specific ID2W metrics for unconventional wells were positively associated with indoor air chloroform.

Conclusion

Our analysis revealed that the association between the exposure metrics and indoor air acetone could be attributed to conventional wells and the association between exposure metrics and indoor air chloroform and decamethylcyclopentasiloxane could be attributed to unconventional wells.

背景在之前位于不列颠哥伦比亚省(加拿大)东北部的一项研究中,我们观察到油气井的密度和邻近程度与室内空气中某些挥发性有机化合物 (VOC) 的浓度之间存在关联。目的 研究和平河谷暴露(EXPERIVA)研究样本中常规和非常规油气井的邻近度指标与测得的室内空气挥发性有机化合物浓度之间的关系。被动式室内空气采样器分析了 47 种挥发性有机化合物。油气井遗留数据来自不列颠哥伦比亚省能源监管局。为每个参与者的家庭划定了 5 公里、10 公里和无缓冲区的距离,然后计算密度和反距离平方加权(ID2W)指标,以估计孕期和挥发性有机化合物测量期间与常规和非常规油气井的接触情况。采用多元线性回归模型来检验油井暴露指标与室内空气挥发性有机化合物之间的关联。对于 30% 参与者的暴露指标值为 0 的情况,我们对暴露指标进行了二分法处理(0 vs. 0),并进行方差分析以评估 VOCs 平均浓度的差异:1) 常规井密度和 ID2W 指标与室内空气中的丙酮和癸醛呈正相关;2) 非常规井密度和 ID2W 指标与室内空气中的氯仿和十甲基环五硅氧烷呈正相关,而与癸醛呈负相关;3) 非常规井的钻井特定 ID2W 指标与室内空气中的氯仿呈正相关。结论我们的分析表明,暴露指标与室内空气中丙酮之间的关联可归因于常规井,而暴露指标与室内空气中氯仿和十甲基环五硅氧烷之间的关联可归因于非常规井。
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引用次数: 0
Historical exposure to metals in contaminated areas and its impact on cardio- and cerebrovascular health 历史上在污染区接触金属的情况及其对心脑血管健康的影响
IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-14 DOI: 10.1016/j.ijheh.2024.114461
Louise Ekholm , Stefan Ljunggren , Ingela Helmfrid

Environmental pollution is of global concern. In Southeast Sweden, historical glass production has contaminated communities with toxic metals. Long-term residency in these communities and high consumption of local foods may constitute a risk for cardiovascular disease (CVD) or stroke.

The current study investigates if residency in these contaminated sites and long-term consumption of local foods is associated with self-reported CVD and stroke. In addition, the body burden of the toxic metals arsenic, cadmium, and lead, as well as inflammatory protein markers, were studied for association with CVD and stroke.

From an existing questionnaire cohort and biomonitoring sub cohort (n = 2290/882) of people living in the contaminated areas, self-reported CVD cases (n = 366/166) and stroke cases (n = 78/25) were identified. Individuals were grouped based on their residency within a 2 km radius of glassworks with historical high, moderate, or low air-borne lead emissions. Body burden of arsenic, cadmium, and lead was analyzed using ICP-MS. Inflammatory markers were investigated using electrochemiluminescence.

Long-term residency near glassworks with historically high levels of lead emissions, and high consumption of local foods, were associated with CVD. The risk was increasing for each year of residency in high emission areas. Increased body burden of arsenic in blood, and lead in urine, were associated with stroke. Five and two inflammatory markers, respectively, were elevated in CVD and stroke cases after adjusting for confounders.

An increased risk for CVD was found in areas with historically high emissions of lead but possibly also other toxic metals. Interestingly, there was an indication of a dose-response relationship with increasing risk for CVD per year of residency time. Inhalation and consumption of local food may constitute major pathways for this association. The study shows that long-term exposure to toxic metals in these contaminated areas is associated with CVD and that there is a need to limit exposure in the general population.

环境污染是全球关注的问题。在瑞典东南部,历史上的玻璃生产使社区受到有毒金属的污染。长期居住在这些社区并大量食用当地食物可能会构成心血管疾病(CVD)或中风的风险。本研究调查了居住在这些受污染地区并长期食用当地食物是否与自我报告的心血管疾病和中风有关。此外,还研究了有毒金属砷、镉和铅的体内负荷以及炎症蛋白标记物与心血管疾病和中风的关系。从生活在污染区的现有问卷队列和生物监测子队列(n = 2290/882)中,确定了自我报告的心血管疾病病例(n = 366/166)和中风病例(n = 78/25)。根据个人居住地在玻璃厂 2 公里半径范围内的情况进行分组,玻璃厂的空气中铅排放量历来较高、中等或较低。使用 ICP-MS 分析体内砷、镉和铅的含量。长期居住在历史上铅排放量较高的玻璃厂附近以及大量食用当地食物与心血管疾病相关。在高排放地区居住一年,风险就会增加一年。血液中砷和尿液中铅含量的增加与中风有关。在对混杂因素进行调整后,心血管疾病和中风病例中分别有五种和两种炎症标志物升高。有趣的是,有迹象表明,居住时间每增加一年,患心血管疾病的风险就会增加,这与剂量反应有关。吸入和食用当地食物可能是导致这种关联的主要途径。这项研究表明,长期暴露于这些受污染地区的有毒金属与心血管疾病有关,因此有必要限制普通人群的暴露量。
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引用次数: 0
Statistical analysis of parameters affecting Legionella and total cell growth in premise plumbing systems within buildings: A field study based on an empirical data set 对建筑物内有前提的冷热水管道系统中影响军团菌和总细胞生长的参数进行统计分析:基于经验数据集的实地研究
IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-13 DOI: 10.1016/j.ijheh.2024.114456
Marco Daniele Genuardi , Marlies Wiegand , Elisabeth Endres , Oliver Opel

During the storage and distribution of water in buildings, the excessive growth of pathogens can deteriorate the quality of drinking water. This study aims to investigate the factors influencing this growth and propose technical measures for prevention. The analysis is based on an empirical data set comprising 1361 samples from 204 domestic premise plumbing systems. In 14 systems, ultrafiltration plants were installed as microbiological barriers. Legionella cultivation and flow cytometry were used to determine microbiological properties. The study identified elevated total cell counts in tapping valves and pipe end lines in numerous premise plumbing systems, indicating prolonged water stagnation prior to sampling, which facilitates microbiological growth. Higher contamination rates were observed in these systems, with peripheral taps often being contaminated in lieu of the entire system. These systems were classified as microbiologically unstable due to the relevantly higher total cell numbers at hot water taps compared to the hot water tank (>25%). Furthermore, these systems exhibited a Legionella contamination rate that was 22.3% higher than in microbiologically stable systems. In some cases, peripheral contaminations may not accurately represent the entire premise plumbing system. Increasing the discard volume during sampling from 1 L to 3–5 L could provide more precise results during standard testing. Legionella species were primarily detected in the first 1 L of water after tap activation. Additionally, statistically significant relationships were observed between direct temperature and total cell number, as well as between the presence of ultrafiltration and total cell numbers at cold water taps.

在建筑物的储水和输水过程中,病原体的过度生长会使饮用水的质量下降。本研究旨在调查影响病原体生长的因素,并提出预防技术措施。分析基于一组经验数据,其中包括来自 204 个住宅楼冷热水管道系统的 1361 个样本。其中 14 个系统安装了超滤设备作为微生物屏障。军团菌培养和流式细胞仪用于确定微生物特性。研究发现,在许多家庭冷热水管道系统中,自来水阀门和管道末端的总细胞数升高,这表明在取样之前,水长期处于停滞状态,这有利于微生物的生长。在这些系统中观察到的污染率较高,外围的水龙头经常受到污染,而不是整个系统。这些系统被归类为微生物不稳定系统,因为与热水箱相比,热水龙头的细胞总数要高出很多(25%)。此外,这些系统的军团菌污染率比微生物稳定系统高出 22.3%。在某些情况下,外围污染可能无法准确代表整个场所的冷热水管道系统。将采样时的丢弃量从 1 升增加到 3-5 升,可以在标准测试中提供更精确的结果。军团菌主要在水龙头启动后的前 1 升水中检测到。此外,在直接温度与细胞总数之间,以及在冷水水龙头存在超滤与细胞总数之间,都观察到了显著的统计学关系。
{"title":"Statistical analysis of parameters affecting Legionella and total cell growth in premise plumbing systems within buildings: A field study based on an empirical data set","authors":"Marco Daniele Genuardi ,&nbsp;Marlies Wiegand ,&nbsp;Elisabeth Endres ,&nbsp;Oliver Opel","doi":"10.1016/j.ijheh.2024.114456","DOIUrl":"10.1016/j.ijheh.2024.114456","url":null,"abstract":"<div><p>During the storage and distribution of water in buildings, the excessive growth of pathogens can deteriorate the quality of drinking water. This study aims to investigate the factors influencing this growth and propose technical measures for prevention. The analysis is based on an empirical data set comprising 1361 samples from 204 domestic premise plumbing systems. In 14 systems, ultrafiltration plants were installed as microbiological barriers. <em>Legionella</em> cultivation and flow cytometry were used to determine microbiological properties. The study identified elevated total cell counts in tapping valves and pipe end lines in numerous premise plumbing systems, indicating prolonged water stagnation prior to sampling, which facilitates microbiological growth. Higher contamination rates were observed in these systems, with peripheral taps often being contaminated in lieu of the entire system. These systems were classified as microbiologically unstable due to the relevantly higher total cell numbers at hot water taps compared to the hot water tank (&gt;25%). Furthermore, these systems exhibited a <em>Legionella</em> contamination rate that was 22.3% higher than in microbiologically stable systems. In some cases, peripheral contaminations may not accurately represent the entire premise plumbing system. Increasing the discard volume during sampling from 1 L to 3–5 L could provide more precise results during standard testing. <em>Legionella</em> species were primarily detected in the first 1 L of water after tap activation. Additionally, statistically significant relationships were observed between direct temperature and total cell number, as well as between the presence of ultrafiltration and total cell numbers at cold water taps.</p></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"263 ","pages":"Article 114456"},"PeriodicalIF":4.5,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-term nighttime aircraft noise exposure and risk of hypertension in a prospective cohort of female nurses 前瞻性女护士队列中的长期夜间飞机噪音暴露与高血压风险
IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-12 DOI: 10.1016/j.ijheh.2024.114457
Junenette L. Peters , Stephanie T. Grady , Francine Laden , Elizabeth Nelson , Matthew Bozigar , Jaime E. Hart , JoAnn E. Manson , Tianyi Huang , Susan Redline , Joel D. Kaufman , John P. Forman , Kathryn M. Rexrode , Jonathan I. Levy

There is growing interest in cardiometabolic outcomes associated with nighttime noise, given that noise can disturb sleep and sleep disturbance can increase cardiometabolic risk such as hypertension. However, there is little empirical research evaluating the association between nighttime aircraft noise and hypertension risk. In this study, we expand on previous work to evaluate associations between nighttime aircraft noise exposure and self-reported hypertension incidence in the Nurses' Health Studies (NHS/NHSII), two US-wide cohorts of female nurses. Annual nighttime average aircraft sound levels (Lnight) surrounding 90 airports for 1995–2015 (in 5-year intervals) were modeled using the Aviation Environmental Design Tool and assigned to participants’ geocoded addresses over time. Hypertension risk was estimated for each cohort using time-varying Cox proportional-hazards models for Lnight dichotomized at 45 dB (dB), adjusting for individual-level hypertension risk factors, area-level socioeconomic status, region, and air pollution. Random effects meta-analysis was used to combine cohort results. Among 63,229 NHS and 98,880 NHSII participants free of hypertension at study baseline (1994/1995), we observed 33,190 and 28,255 new hypertension cases by 2014/2013, respectively. Although ∼1% of participants were exposed to Lnight ≥45 dB, we observed an adjusted hazard ratio (HR) of 1.10 (95% CI: 0.96, 1.27) in NHS and adjusted HR of 1.12 (95% CI: 0.98, 1.28) in NHSII, comparing exposure to Lnight ≥45 versus <45 dB(A). In meta-analysis, we observed an adjusted HR of 1.11 (95% CI: 1.01, 1.23). These results were attenuated with adjustment for additional variables such as body mass index. Our findings support a modest positive association between nighttime aircraft noise and hypertension risk across NHS/NHSII, which may reinforce the concept that sleep disturbance contributes to noise-related disease burden.

鉴于噪声会干扰睡眠,而睡眠障碍会增加高血压等心脏代谢风险,人们对夜间噪声相关的心脏代谢结果越来越感兴趣。然而,很少有实证研究评估夜间飞机噪音与高血压风险之间的关系。在本研究中,我们在先前工作的基础上,评估了护士健康研究(NHS/NHSII)中夜间飞机噪音暴露与自我报告的高血压发病率之间的关系。使用航空环境设计工具(Aviation Environmental Design Tool)对 1995-2015 年(以 5 年为间隔)90 个机场周围的年夜间平均飞机声级(Lnight)进行建模,并随时间推移将其分配给参与者的地理编码地址。使用时间变化的 Cox 比例危害模型对每个队列的高血压风险进行估算,并将 Lnight 二分为 45 dB (dB),同时对个人水平的高血压风险因素、地区水平的社会经济状况、地区和空气污染进行调整。随机效应荟萃分析用于合并队列结果。在研究基线(1994/1995 年)时无高血压的 63,229 名 NHS 和 98,880 名 NHSII 参与者中,到 2014/2013 年,我们分别观察到 33,190 例和 28,255 例新的高血压病例。虽然有 1% 的参与者暴露于 Lnight ≥45 dB,但在 NHS 中,我们观察到调整后的危险比 (HR) 为 1.10(95% CI:0.96, 1.27),而在 NHSII 中,比较暴露于 Lnight ≥45 与 <45 dB(A) 的调整后的危险比为 1.12(95% CI:0.98, 1.28)。在荟萃分析中,我们观察到调整后的 HR 为 1.11(95% CI:1.01,1.23)。在对体重指数等其他变量进行调整后,这些结果有所减弱。我们的研究结果表明,夜间飞机噪声与高血压风险之间存在适度的正相关,这可能会加强睡眠障碍会导致噪声相关疾病负担的概念。
{"title":"Long-term nighttime aircraft noise exposure and risk of hypertension in a prospective cohort of female nurses","authors":"Junenette L. Peters ,&nbsp;Stephanie T. Grady ,&nbsp;Francine Laden ,&nbsp;Elizabeth Nelson ,&nbsp;Matthew Bozigar ,&nbsp;Jaime E. Hart ,&nbsp;JoAnn E. Manson ,&nbsp;Tianyi Huang ,&nbsp;Susan Redline ,&nbsp;Joel D. Kaufman ,&nbsp;John P. Forman ,&nbsp;Kathryn M. Rexrode ,&nbsp;Jonathan I. Levy","doi":"10.1016/j.ijheh.2024.114457","DOIUrl":"10.1016/j.ijheh.2024.114457","url":null,"abstract":"<div><p>There is growing interest in cardiometabolic outcomes associated with nighttime noise, given that noise can disturb sleep and sleep disturbance can increase cardiometabolic risk such as hypertension. However, there is little empirical research evaluating the association between nighttime aircraft noise and hypertension risk. In this study, we expand on previous work to evaluate associations between nighttime aircraft noise exposure and self-reported hypertension incidence in the Nurses' Health Studies (NHS/NHSII), two US-wide cohorts of female nurses. Annual nighttime average aircraft sound levels (L<sub>night</sub>) surrounding 90 airports for 1995–2015 (in 5-year intervals) were modeled using the Aviation Environmental Design Tool and assigned to participants’ geocoded addresses over time. Hypertension risk was estimated for each cohort using time-varying Cox proportional-hazards models for L<sub>night</sub> dichotomized at 45 dB (dB), adjusting for individual-level hypertension risk factors, area-level socioeconomic status, region, and air pollution. Random effects meta-analysis was used to combine cohort results. Among 63,229 NHS and 98,880 NHSII participants free of hypertension at study baseline (1994/1995), we observed 33,190 and 28,255 new hypertension cases by 2014/2013, respectively. Although ∼1% of participants were exposed to L<sub>night</sub> ≥45 dB, we observed an adjusted hazard ratio (HR) of 1.10 (95% CI: 0.96, 1.27) in NHS and adjusted HR of 1.12 (95% CI: 0.98, 1.28) in NHSII, comparing exposure to L<sub>night</sub> ≥45 versus &lt;45 dB(A). In meta-analysis, we observed an adjusted HR of 1.11 (95% CI: 1.01, 1.23). These results were attenuated with adjustment for additional variables such as body mass index. Our findings support a modest positive association between nighttime aircraft noise and hypertension risk across NHS/NHSII, which may reinforce the concept that sleep disturbance contributes to noise-related disease burden.</p></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"263 ","pages":"Article 114457"},"PeriodicalIF":4.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prenatal exposure to perfluoroalkyl and polyfluoroalkyl substances and childhood bone mineral density: A prospective birth cohort study 产前接触全氟烷基和多氟烷基物质与儿童骨矿物质密度:一项前瞻性出生队列研究
IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-12 DOI: 10.1016/j.ijheh.2024.114459
Wei Wei , Qian Chen , Jun Zhang , Hui Wang

Background and aim

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) have demonstrated potential toxicity in skeletal development. However, the relationship between prenatal PFAS exposure and offspring bone health remains unclear in epidemiological studies. Therefore, we aim to investigate whether prenatal exposure to PFAS is associated with bone mineral density (BMD) in offspring.

Method

This study population included 182 mother-child pairs in the Shanghai Obesity and Allergy Cohort, enrolled during 2012–2013. 10 PFAS were measured by liquid chromatography-mass spectrometry (LC-MS) in cord plasma. The child's spinal BMD was measured using a dual-energy X-ray absorptiometry (DXA) scanner at the age of 8. Multivariable linear regression models were used to estimate the associations between individual PFAS concentrations (as a continuous variable or categorized into quartiles) and child BMD. Bayesian kernel machine regression (BKMR) was employed to explore the joint effects of PFAS mixtures on BMD.

Results

Among the 10 PFAS, 8 of them had a detection rate >90% and were included in the subsequent analysis. We observed no significant associations between individual PFAS (as a continuous variable) and spinal BMD in 8-year-old children using the multivariable linear regression model. When treated as quartile categories, the second and fourth quartiles of perfluorobutane sulfonate (PFBS) was associated with higher BMD in the first lumbar vertebra, compared with the lowest quartile. BKMR analysis revealed no association between the PFAS mixture and child BMD.

Conclusion

We observed no associations of prenatal PFAS exposure with child BMD at 8 years of age. Given the inconsistent epidemiological evidence, further research is needed to confirm these findings from other studies or elucidate the potentially toxic effects of PFAS on bone.

背景和目的全氟烷基和多氟烷基物质(PFAS)已被证明对骨骼发育具有潜在毒性。然而,在流行病学研究中,产前接触 PFAS 与后代骨骼健康之间的关系仍不清楚。因此,我们旨在研究产前暴露于 PFAS 是否与后代的骨矿物质密度(BMD)有关。采用液相色谱-质谱法(LC-MS)测定了脐带血浆中的 10 种 PFAS。采用多变量线性回归模型来估计单个 PFAS 浓度(作为连续变量或分为四分位)与儿童 BMD 之间的关系。结果在 10 种 PFAS 中,8 种的检出率为 90%,被纳入后续分析。在多变量线性回归模型中,我们观察到单个 PFAS(作为连续变量)与 8 岁儿童脊柱 BMD 之间没有明显关联。与最低四分位数相比,全氟丁烷磺酸盐(PFBS)的第二和第四四分位数与第一腰椎较高的 BMD 相关。BKMR分析表明,PFAS混合物与儿童BMD之间没有关联。鉴于流行病学证据的不一致性,我们需要进一步的研究来证实其他研究的这些发现,或阐明 PFAS 对骨骼的潜在毒性影响。
{"title":"Prenatal exposure to perfluoroalkyl and polyfluoroalkyl substances and childhood bone mineral density: A prospective birth cohort study","authors":"Wei Wei ,&nbsp;Qian Chen ,&nbsp;Jun Zhang ,&nbsp;Hui Wang","doi":"10.1016/j.ijheh.2024.114459","DOIUrl":"10.1016/j.ijheh.2024.114459","url":null,"abstract":"<div><h3>Background and aim</h3><p>Perfluoroalkyl and polyfluoroalkyl substances (PFAS) have demonstrated potential toxicity in skeletal development. However, the relationship between prenatal PFAS exposure and offspring bone health remains unclear in epidemiological studies. Therefore, we aim to investigate whether prenatal exposure to PFAS is associated with bone mineral density (BMD) in offspring.</p></div><div><h3>Method</h3><p>This study population included 182 mother-child pairs in the Shanghai Obesity and Allergy Cohort, enrolled during 2012–2013. 10 PFAS were measured by liquid chromatography-mass spectrometry (LC-MS) in cord plasma. The child's spinal BMD was measured using a dual-energy X-ray absorptiometry (DXA) scanner at the age of 8. Multivariable linear regression models were used to estimate the associations between individual PFAS concentrations (as a continuous variable or categorized into quartiles) and child BMD. Bayesian kernel machine regression (BKMR) was employed to explore the joint effects of PFAS mixtures on BMD.</p></div><div><h3>Results</h3><p>Among the 10 PFAS, 8 of them had a detection rate &gt;90% and were included in the subsequent analysis. We observed no significant associations between individual PFAS (as a continuous variable) and spinal BMD in 8-year-old children using the multivariable linear regression model. When treated as quartile categories, the second and fourth quartiles of perfluorobutane sulfonate (PFBS) was associated with higher BMD in the first lumbar vertebra, compared with the lowest quartile. BKMR analysis revealed no association between the PFAS mixture and child BMD.</p></div><div><h3>Conclusion</h3><p>We observed no associations of prenatal PFAS exposure with child BMD at 8 years of age. Given the inconsistent epidemiological evidence, further research is needed to confirm these findings from other studies or elucidate the potentially toxic effects of PFAS on bone.</p></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"263 ","pages":"Article 114459"},"PeriodicalIF":4.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142173600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Post-war status of water supply, sanitation, hygiene and related reported diseases in Tigray, Ethiopia: A community-based cross-sectional study 埃塞俄比亚提格雷地区战后供水、环境卫生、个人卫生及相关疾病的状况:一项基于社区的横断面研究
IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-12 DOI: 10.1016/j.ijheh.2024.114460
Akeza Awealom Asgedom , Gebru Hailu Redae , Hailay Gebretnsae , Mengistu Hagazi Tequare , Hagos Degefa Hidru , Gebregziabher Berihu Gebrekidan , Abadi Kidanemariam Berhe , Mohamedawel Mohamedniguss Ebrahim , Mulugeta Cherinet , Gebremedhin Gebreegziabher Gebretsadik , Haftom Gebrehiwot Woldearegay , Yemane Berhane Tesfau , Tedros Bereket , Muzey Gebremichael Berhe , Meresa Gebremedhin Weldu , Gebrekiros Gebremichael Meles , Micheale Hagos Debesay , Rieye Esayas , Mache Tsadik

Water, sanitation and hygiene (WASH) associated diseases remain a global public health issue and linked with Sustainable Development Goal 6. In November 2020, a war broke out in Tigray, Ethiopia, resulting in a negative health consequence. The post war status of WASH and its associated diseases are not documented. The aim of this study was to assess the status of drinking water, sanitation and hygiene practices and the prevalence of WASH-associated diseases in Tigray, Ethiopia following the war. A community-based cross-sectional study was conducted in 24 randomly selected accessible districts of Tigray, Ethiopia. A standardized questionnaire was used to collect data from households in the study. Data was collected from 2338 households. Descriptive statistics and binary logistic regression were used to analyze the data. The average age of respondents was 28.7 years (SD = 6.2). The majority of respondents 2030 (86.8%) were married and 1698 (72.6%) were rural residents. Nearly one third of the respondents were uneducated and around 40% have either radio or TV as means of communication. More than half (55.2%) of the respondents had a family size of over 5.

A quarter (25%, 95% CI: 23.3, 26.8) of study participants had access to a basic water supply. Less than a tenth (7.7%, 95% CI: 6.6, 8.8) of households had access to basic sanitation. Basic hand washing was available in 2% of households. Malaria, diarrhoea, skin infection and eye infection were the common reported disease in the community. Marital status, family size, place of residence and liquid waste management were the most important predictors of reported diseases.

Access to basic water, sanitation and hygiene services was low, and the prevalence of malaria, diarrhoea and skin infections was higher. There were differences in WASH services and reported diseases according to zone and place of residence (urban-rural). Post war, improved access to basic water, sanitation and hygiene services is recommended to prevent WASH-associated diseases in Tigray, Ethiopia. Furthermore, the prevention oriented policy of the country needs better implementation to reduce preventable diseases and ensure better health status in the community.

与水、环境卫生和个人卫生(WASH)相关的疾病仍然是一个全球公共卫生问题,并与可持续发展目标 6 相关联。2020 年 11 月,埃塞俄比亚提格雷爆发了一场战争,造成了不良的健康后果。关于战后讲卫生运动及其相关疾病的状况并无记载。本研究旨在评估埃塞俄比亚提格雷地区战后饮用水、环境卫生和个人卫生习惯的状况以及与水、环境卫生和个人卫生相关疾病的发病率。我们在埃塞俄比亚提格雷随机选取的 24 个可到达的地区开展了一项基于社区的横断面研究。研究采用标准化问卷向家庭收集数据。共收集了 2338 户家庭的数据。数据分析采用了描述性统计和二元逻辑回归。受访者的平均年龄为 28.7 岁(SD = 6.2)。大多数受访者为已婚,2030 人(86.8%),1698 人(72.6%)为农村居民。近三分之一的受访者未受过教育,约 40% 的受访者有收音机或电视作为通讯工具。超过半数(55.2%)的受访者家庭人口超过 5 人。四分之一(25%,95% CI:23.3, 26.8)的研究参与者能够获得基本供水。不到十分之一(7.7%,95% CI:6.6, 8.8)的家庭拥有基本的卫生设施。2%的家庭可以进行基本的洗手。疟疾、腹泻、皮肤感染和眼部感染是社区报告的常见疾病。婚姻状况、家庭规模、居住地和液体废物管理是预测报告疾病的最重要因素。获得基本水、环境卫生和个人卫生服务的比例较低,疟疾、腹泻和皮肤感染的发病率较高。不同地区和居住地(城市-农村)在讲卫生运动服务和报告疾病方面存在差异。战后,建议改善基本水、环境卫生和个人卫生服务,以预防埃塞俄比亚提格雷地区与水、环境卫生和个人卫生有关的疾病。此外,该国以预防为导向的政策需要更好地实施,以减少可预防的疾病,确保改善社区的健康状况。
{"title":"Post-war status of water supply, sanitation, hygiene and related reported diseases in Tigray, Ethiopia: A community-based cross-sectional study","authors":"Akeza Awealom Asgedom ,&nbsp;Gebru Hailu Redae ,&nbsp;Hailay Gebretnsae ,&nbsp;Mengistu Hagazi Tequare ,&nbsp;Hagos Degefa Hidru ,&nbsp;Gebregziabher Berihu Gebrekidan ,&nbsp;Abadi Kidanemariam Berhe ,&nbsp;Mohamedawel Mohamedniguss Ebrahim ,&nbsp;Mulugeta Cherinet ,&nbsp;Gebremedhin Gebreegziabher Gebretsadik ,&nbsp;Haftom Gebrehiwot Woldearegay ,&nbsp;Yemane Berhane Tesfau ,&nbsp;Tedros Bereket ,&nbsp;Muzey Gebremichael Berhe ,&nbsp;Meresa Gebremedhin Weldu ,&nbsp;Gebrekiros Gebremichael Meles ,&nbsp;Micheale Hagos Debesay ,&nbsp;Rieye Esayas ,&nbsp;Mache Tsadik","doi":"10.1016/j.ijheh.2024.114460","DOIUrl":"10.1016/j.ijheh.2024.114460","url":null,"abstract":"<div><p>Water, sanitation and hygiene (WASH) associated diseases remain a global public health issue and linked with Sustainable Development Goal 6. In November 2020, a war broke out in Tigray, Ethiopia, resulting in a negative health consequence. The post war status of WASH and its associated diseases are not documented. The aim of this study was to assess the status of drinking water, sanitation and hygiene practices and the prevalence of WASH-associated diseases in Tigray, Ethiopia following the war. A community-based cross-sectional study was conducted in 24 randomly selected accessible districts of Tigray, Ethiopia. A standardized questionnaire was used to collect data from households in the study. Data was collected from 2338 households. Descriptive statistics and binary logistic regression were used to analyze the data. The average age of respondents was 28.7 years (SD = 6.2). The majority of respondents 2030 (86.8%) were married and 1698 (72.6%) were rural residents. Nearly one third of the respondents were uneducated and around 40% have either radio or TV as means of communication. More than half (55.2%) of the respondents had a family size of over 5.</p><p>A quarter (25%, 95% CI: 23.3, 26.8) of study participants had access to a basic water supply. Less than a tenth (7.7%, 95% CI: 6.6, 8.8) of households had access to basic sanitation. Basic hand washing was available in 2% of households. Malaria, diarrhoea, skin infection and eye infection were the common reported disease in the community. Marital status, family size, place of residence and liquid waste management were the most important predictors of reported diseases.</p><p>Access to basic water, sanitation and hygiene services was low, and the prevalence of malaria, diarrhoea and skin infections was higher. There were differences in WASH services and reported diseases according to zone and place of residence (urban-rural). Post war, improved access to basic water, sanitation and hygiene services is recommended to prevent WASH-associated diseases in Tigray, Ethiopia. Furthermore, the prevention oriented policy of the country needs better implementation to reduce preventable diseases and ensure better health status in the community.</p></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"263 ","pages":"Article 114460"},"PeriodicalIF":4.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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