Estimation of lifetime cumulative incidence and mortality risk of gastric cancer.

Science.gov (United States)

Taniyama, Yukari; Katanoda, Kota; Charvat, Hadrien; Hori, Megumi; Ohno, Yuko; Sasazuki, Shizuka; Tsugane, Shoichiro

2017-11-01

To estimate cumulative incidence and mortality risk for gastric cancer by risk category. Risk was classified into four types according to the presence/absence of Helicobacter pylori infection and chronic atrophic gastritis: in order of lowest to highest risk, Group A: H. pylori(-) and atrophic gastritis(-); Group B: H. pylori(+) and atrophic gastritis(-); Group C:H. pylori(+) and atrophic gastritis(+); and, Group D: H. pylori(-) and atrophic gastritis(+). We used vital statistics for the crude all-cause and crude gastric cancer mortality rates in 2011 and data from population-based cancer registries (the Monitoring of Cancer Incidence in Japan) for gastric cancer incidence in 2011. For relative risk and prevalence, we used the results of a meta-analysis integrating previous studies and data from the Japan Public Health Center-based Prospective Study for the Next Generation, respectively (baseline survey 2011-16). We calculated the crude incidence and mortality rates and estimated the cumulative risk using a life-table method. The estimated lifetime cumulative incidence risk was 11.4% for men and 5.7% for women. The estimated risk for Groups A, B, C and D was 2.4%, 10.8%, 26.7% and 35.5% for men, and 1.2%, 5.5%, 13.5% and 18.0% for women, respectively. Similarly, the estimated lifetime cumulative mortality risk was 3.9% for men and 1.8% for women. The estimated risk of mortality for Groups A, B, C and D was 0.8%, 3.6%, 9.0% and 12.0% for men, and 0.4%, 1.7%, 4.2% and 5.7% for women, respectively. Our results may be useful for designing individually tailored prevention programs. © The Author 2017. Published by Oxford University Press.

Non-Chemical Stressors and Cumulative Risk Assessment: An Overview of Current Initiatives and Potential Air Pollutant Interactions

Science.gov (United States)

Lewis, Ari S.; Sax, Sonja N.; Wason, Susan C.; Campleman, Sharan L.

2011-01-01

Regulatory agencies are under increased pressure to consider broader public health concerns that extend to multiple pollutant exposures, multiple exposure pathways, and vulnerable populations. Specifically, cumulative risk assessment initiatives have stressed the importance of considering both chemical and non-chemical stressors, such as socioeconomic status (SES) and related psychosocial stress, in evaluating health risks. The integration of non-chemical stressors into a cumulative risk assessment framework has been largely driven by evidence of health disparities across different segments of society that may also bear a disproportionate risk from chemical exposures. This review will discuss current efforts to advance the field of cumulative risk assessment, highlighting some of the major challenges, discussed within the construct of the traditional risk assessment paradigm. Additionally, we present a summary of studies of potential interactions between social stressors and air pollutants on health as an example of current research that supports the incorporation of non-chemical stressors into risk assessment. The results from these studies, while suggestive of possible interactions, are mixed and hindered by inconsistent application of social stress indicators. Overall, while there have been significant advances, further developments across all of the risk assessment stages (i.e., hazard identification, exposure assessment, dose-response, and risk characterization) are necessary to provide a scientific basis for regulatory actions and effective community interventions, particularly when considering non-chemical stressors. A better understanding of the biological underpinnings of social stress on disease and implications for chemical-based dose-response relationships is needed. Furthermore, when considering non-chemical stressors, an appropriate metric, or series of metrics, for risk characterization is also needed. Cumulative risk assessment research will benefit

Cumulative childhood risk is associated with a new measure of chronic inflammation in adulthood.

Science.gov (United States)

Rasmussen, Line Jee Hartmann; Moffitt, Terrie E; Eugen-Olsen, Jesper; Belsky, Daniel W; Danese, Andrea; Harrington, HonaLee; Houts, Renate M; Poulton, Richie; Sugden, Karen; Williams, Benjamin; Caspi, Avshalom

2018-05-09

Childhood risk factors are associated with elevated inflammatory biomarkers in adulthood, but it is unknown whether these risk factors are associated with increased adult levels of the chronic inflammation marker soluble urokinase plasminogen activator receptor (suPAR). We aimed to test the hypothesis that childhood exposure to risk factors for adult disease is associated with elevated suPAR in adulthood and to compare suPAR with the oft-reported inflammatory biomarker C-reactive protein (CRP). Prospective study of a population-representative 1972-1973 birth cohort; the Dunedin Multidisciplinary Health and Development Study observed participants to age 38 years. Main childhood predictors were poor health, socioeconomic disadvantage, adverse childhood experiences (ACEs), low IQ, and poor self-control. Main adult outcomes were adulthood inflammation measured as suPAR and high-sensitivity CRP (hsCRP). Participants with available plasma samples at age 38 were included (N = 837, 50.5% male). suPAR (mean 2.40 ng/ml; SD 0.91) was positively correlated with hsCRP (r 0.15, p childhood risks were aggregated into a Cumulative Childhood Risk index, and controlling for sex, BMI, and smoking, Cumulative Childhood Risk was associated with higher suPAR (b 0.10; SE 0.03; p = .002). Cumulative Childhood Risk predicted elevated suPAR, after controlling for hsCRP (b 0.18; SE 0.03; p childhood risk factors was associated with higher suPAR levels, independent of CRP. suPAR is a useful addition to studies connecting childhood risk to adult inflammatory burden. © 2018 Association for Child and Adolescent Mental Health.

Childhood Cumulative Risk and Later Allostatic Load

DEFF Research Database (Denmark)

Doan, Stacey N; Dich, Nadya; Evans, Gary W

2014-01-01

State, followed for 8 years (between the ages 9 and 17). Poverty- related stress was computed using the cumulative risk approach, assessing stressors across 9 domains, including environmental, psychosocial, and demographic factors. Allostatic load captured a range of physiological responses, including......Objective: The present study investigated the long-term impact of exposure to poverty-related stressors during childhood on allostatic load, an index of physiological dysregulation, and the potential mediating role of substance use. Method: Participants (n = 162) were rural children from New York...... cardiovascular, hypothalamic pituitary adrenal axis, sympathetic adrenal medullary system, and metabolic activity. Smoking and alcohol/drug use were tested as mediators of the hypothesized childhood risk-adolescent allostatic load relationship. Results: Cumulative risk exposure at age 9 predicted increases...

Early cumulative risk predicts externalizing behavior at age 10: The mediating role of adverse parenting.

Science.gov (United States)

Gach, Emily J; Ip, Ka I; Sameroff, Arnold J; Olson, Sheryl L

2018-02-01

Multiple environmental risk factors in early childhood predict a broad range of adverse developmental outcomes. However, most prior longitudinal research has not illuminated explanatory mechanisms. Our main goals were to examine predictive associations between cumulative ecological risk factors in early childhood and children's later externalizing problems and to determine whether these associations were explained by variations in parenting quality. Participants were 241 children (118 girls) at risk for school-age conduct problems and their parents and teachers. Children were approximately 3 years old at Time 1 (T1) and 10 years old at Time 2 (T2). Reports of contextual risk at T1 were used to develop a cumulative risk index consisting of 6 singular risk variables from 3 ecological levels: social resources (low income; social isolation), family resources (marital aggression; poor total family functioning), and maternal resources (single parent status; poor maternal mental health). At T1, parenting variables were measured (corporal punishment, warm responsiveness, maternal efficacy, and negative perceptions of child behavior). At T2, mothers, fathers, and teachers reported child externalizing problems. Johnson's relative weight analysis revealed that the cumulative risk index was a more powerful predictor of age 10 years externalizing behavior than any of the singular contextual risk variables. Adverse parenting mediated the effects of cumulative risk on later child externalizing problems. Our findings have significant implications for understanding long-term effects of multiple contextual risk factors present in early childhood and for the implementation of positive parenting interventions early on. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Cumulative Trauma Among Mayas Living in Southeast Florida.

Science.gov (United States)

Millender, Eugenia I; Lowe, John

2017-06-01

Mayas, having experienced genocide, exile, and severe poverty, are at high risk for the consequences of cumulative trauma that continually resurfaces through current fear of an uncertain future. Little is known about the mental health and alcohol use status of this population. This correlational study explored t/he relationship of cumulative trauma as it relates to social determinants of health (years in the United States, education, health insurance status, marital status, and employment), psychological health (depression symptoms), and health behaviors (alcohol use) of 102 Guatemalan Mayas living in Southeast Florida. The results of this study indicated that, as specific social determinants of health and cumulative trauma increased, depression symptoms (particularly among women) and the risk for harmful alcohol use (particularly among men) increased. Identifying risk factors at an early stage before serious disease or problems are manifest provides room for early screening leading to early identification, early treatment, and better outcomes.

An analysis of cumulative risks based on biomonitoring data for six phthalates using the Maximum Cumulative Ratio

Science.gov (United States)

The Maximum Cumulative Ratio (MCR) quantifies the degree to which a single chemical drives the cumulative risk of an individual exposed to multiple chemicals. Phthalates are a class of chemicals with ubiquitous exposures in the general population that have the potential to cause ...

Mapping cumulative environmental risks: examples from the EU NoMiracle project

NARCIS (Netherlands)

Pistocchi, A.; Groenwold, J.; Lahr, J.; Loos, M.; Mujica, M.; Ragas, A.M.J.; Rallo, R.; Sala, S.; Schlink, U.; Strebel, K.; Vighi, M.; Vizcaino, P.

2011-01-01

We present examples of cumulative chemical risk mapping methods developed within the NoMiracle project. The different examples illustrate the application of the concentration addition (CA) approach to pesticides at different scale, the integration in space of cumulative risks to individual organisms

An Analysis of Cumulative Risks Indicated by Biomonitoring Data of Six Phthalates Using the Maximum Cumulative Ratio

Science.gov (United States)

The Maximum Cumulative Ratio (MCR) quantifies the degree to which a single component of a chemical mixture drives the cumulative risk of a receptor.1 This study used the MCR, the Hazard Index (HI) and Hazard Quotient (HQ) to evaluate co-exposures to six phthalates using biomonito...

Education, income and ethnic differences in cumulative biological risk profiles in a national sample of US adults: NHANES III (1988-1994).

Science.gov (United States)

Seeman, Teresa; Merkin, Sharon S; Crimmins, Eileen; Koretz, Brandon; Charette, Susan; Karlamangla, Arun

2008-01-01

Data from the nationally representative US National Health and Nutrition Examination Survey (NHANES) III cohort were used to examine the hypothesis that socio-economic status is consistently and negatively associated with levels of biological risk, as measured by nine biological parameters known to predict health risks (diastolic and systolic blood pressure, pulse, HDL and total cholesterol, glycosylated hemoglobin, c-reactive protein, albumin and waist-hip ratio), resulting in greater cumulative burdens of biological risk among those of lower education and/or income. As hypothesized, consistent education and income gradients were seen for biological parameters reflecting cardiovascular, metabolic and inflammatory risk: those with lower education and income exhibiting greater prevalence of high-risk values for each of nine individual biological risk factors. Significant education and income gradients were also seen for summary indices reflecting cumulative burdens of cardiovascular, metabolic and inflammatory risks as well as overall total biological risks. Multivariable cumulative logistic regression models revealed that the education and income effects were each independently and negatively associated with cumulative biological risks, and that these effects remained significant independent of age, gender, ethnicity and lifestyle factors such as smoking and physical activity. There were no significant ethnic differences in the patterns of association between socio-economic status and biological risks, but older age was associated with significantly weaker education and income gradients.

The MCRA model for probabilistic single-compound and cumulative risk assessment of pesticides.

Science.gov (United States)

van der Voet, Hilko; de Boer, Waldo J; Kruisselbrink, Johannes W; Goedhart, Paul W; van der Heijden, Gerie W A M; Kennedy, Marc C; Boon, Polly E; van Klaveren, Jacob D

2015-05-01

Pesticide risk assessment is hampered by worst-case assumptions leading to overly pessimistic assessments. On the other hand, cumulative health effects of similar pesticides are often not taken into account. This paper describes models and a web-based software system developed in the European research project ACROPOLIS. The models are appropriate for both acute and chronic exposure assessments of single compounds and of multiple compounds in cumulative assessment groups. The software system MCRA (Monte Carlo Risk Assessment) is available for stakeholders in pesticide risk assessment at mcra.rivm.nl. We describe the MCRA implementation of the methods as advised in the 2012 EFSA Guidance on probabilistic modelling, as well as more refined methods developed in the ACROPOLIS project. The emphasis is on cumulative assessments. Two approaches, sample-based and compound-based, are contrasted. It is shown that additional data on agricultural use of pesticides may give more realistic risk assessments. Examples are given of model and software validation of acute and chronic assessments, using both simulated data and comparisons against the previous release of MCRA and against the standard software DEEM-FCID used by the Environmental Protection Agency in the USA. It is shown that the EFSA Guidance pessimistic model may not always give an appropriate modelling of exposure. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Assessing stress-related treatment needs among girls at risk for poor functional outcomes: The impact of cumulative adversity, criterion traumas, and non-criterion events.

Science.gov (United States)

Lansing, Amy E; Plante, Wendy Y; Beck, Audrey N

2017-05-01

Despite growing recognition that cumulative adversity (total stressor exposure, including complex trauma), increases the risk for psychopathology and impacts development, assessment strategies lag behind: Adversity-related mental health needs (symptoms, functional impairment, maladaptive coping) are typically assessed in response to only one qualifying Criterion-A traumatic event. This is especially problematic for youth at-risk for health and academic disparities who experience cumulative adversity, including non-qualifying events (separation from caregivers) which may produce more impairing symptomatology. Data from 118 delinquent girls demonstrate: (1) an average of 14 adverse Criterion-A and non-Criterion event exposures; (2) serious maladaptive coping strategies (self-injury) directly in response to cumulative adversity; (3) more cumulative adversity-related than worst-event related symptomatology and functional impairment; and (4) comparable symptomatology, but greater functional impairment, in response to non-Criterion events. These data support the evaluation of mental health needs in response to cumulative adversity for optimal identification and tailoring of services in high-risk populations to reduce disparities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Considering Environmental and Occupational Stressors in Cumulative Risk Assessments

Science.gov (United States)

While definitions vary across the global scientific community, cumulative risk assessments (CRAs) typically are described as exhibiting a population focus and analyzing the combined risks posed by multiple stressors. CRAs also may consider risk management alternatives as an anal...

Cumulative Environmental Impacts: Science and Policy to Protect Communities.

Science.gov (United States)

Solomon, Gina M; Morello-Frosch, Rachel; Zeise, Lauren; Faust, John B

2016-01-01

Many communities are located near multiple sources of pollution, including current and former industrial sites, major roadways, and agricultural operations. Populations in such locations are predominantly low-income, with a large percentage of minorities and non-English speakers. These communities face challenges that can affect the health of their residents, including limited access to health care, a shortage of grocery stores, poor housing quality, and a lack of parks and open spaces. Environmental exposures may interact with social stressors, thereby worsening health outcomes. Age, genetic characteristics, and preexisting health conditions increase the risk of adverse health effects from exposure to pollutants. There are existing approaches for characterizing cumulative exposures, cumulative risks, and cumulative health impacts. Although such approaches have merit, they also have significant constraints. New developments in exposure monitoring, mapping, toxicology, and epidemiology, especially when informed by community participation, have the potential to advance the science on cumulative impacts and to improve decision making.

Potential Health Risks Posed by Plant-Derived Cumulative Neurotoxic Bufadienolides in South Africa

Directory of Open Access Journals (Sweden)

Christo Botha

2016-03-01

Full Text Available Bufadienolide-type cardiac glycosides have a worldwide distribution and are mainly synthesized by plants, but there are also animal sources. In South Africa, members of three genera of the Crassulaceae (Cotyledon, Tylecodon and Kalanchoe cause a unique chronic form of cardiac glycoside poisoning, predominantly in small stock. This paretic/paralytic condition is referred to as “krimpsiekte”, cotyledonosis or “nenta”. “Krimpsiekte” is a plant poisoning only reported from South Africa and is regarded as the most important plant poisoning of small stock in the semi-arid Little Karoo and southern fringes of the Great Karoo. The toxicosis is caused by cumulative bufadienolides which have neurotoxic properties. Four types of cumulative neurotoxic bufadienolides, namely cotyledoside, and the tyledosides, orbicusides and lanceotoxins, have been isolated. Based on the structure activity relationships and certain toxicokinetic parameters possible reasons for their accumulation are presented. Consumption of edible tissues from animals that have ingested these plants poses a potential risk to humans.

Cumulative risk hypothesis: Predicting and preventing child maltreatment recidivism.

Science.gov (United States)

Solomon, David; Åsberg, Kia; Peer, Samuel; Prince, Gwendolyn

2016-08-01

Although Child Protective Services (CPS) and other child welfare agencies aim to prevent further maltreatment in cases of child abuse and neglect, recidivism is common. Having a better understanding of recidivism predictors could aid in preventing additional instances of maltreatment. A previous study identified two CPS interventions that predicted recidivism: psychotherapy for the parent, which was related to a reduced risk of recidivism, and temporary removal of the child from the parent's custody, which was related to an increased recidivism risk. However, counter to expectations, this previous study did not identify any other specific risk factors related to maltreatment recidivism. For the current study, it was hypothesized that (a) cumulative risk (i.e., the total number of risk factors) would significantly predict maltreatment recidivism above and beyond intervention variables in a sample of CPS case files and that (b) therapy for the parent would be related to a reduced likelihood of recidivism. Because it was believed that the relation between temporary removal of a child from the parent's custody and maltreatment recidivism is explained by cumulative risk, the study also hypothesized that that the relation between temporary removal of the child from the parent's custody and recidivism would be mediated by cumulative risk. After performing a hierarchical logistic regression analysis, the first two hypotheses were supported, and an additional predictor, psychotherapy for the child, also was related to reduced chances of recidivism. However, Hypothesis 3 was not supported, as risk did not significantly mediate the relation between temporary removal and recidivism. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cumulative Risk of Bovine Mastitis Treatments in Denmark, Finland, Norway and Sweden

OpenAIRE

Valde, JP; Lawson, LG; Lindberg, A; Agger, JF; Saloniemi, H; Østerås, O

2004-01-01

Data from the national dairy cow recording systems during 1997 were used to calculate lactation-specific cumulative risk of mastitis treatments and cumulative risk of removal from the herds in Denmark, Finland Norway and Sweden. Sweden had the lowest risk of recorded mastitis treatments during 305 days of lactation and Norway had the highest risk. The incidence risk of recorded mastitis treatments during 305 days of lactation in Denmark, Finland, Norway and Sweden was 0.177, 0.139, 0.215 and...

A Review of Non-Chemical Stressors and Their Importance in Cumulative Risk Assessment

Science.gov (United States)

Cumulative exposure/risk assessments need to include non-chemical stressors as well as human activities and chemical data. Multiple stressor research can offer information on the interactions between chemical and non-chemical stressors needed for cumulative risk assessment resea...

Cumulative Risks of Foster Care Placement for Danish Children

DEFF Research Database (Denmark)

Fallesen, Peter; Emanuel, Natalia; Wildeman, Christopher

2014-01-01

children. Our results also show some variations by parental ethnicity and sex, but these differences are small. Indeed, they appear quite muted relative to racial/ethnic differences in these risks in the United States. Last, though cumulative risks are similar between Danish and American children...

Cumulative Mass and NIOSH Variable Lifting Index Method for Risk Assessment: Possible Relations.

Science.gov (United States)

Stucchi, Giulia; Battevi, Natale; Pandolfi, Monica; Galinotti, Luca; Iodice, Simona; Favero, Chiara

2018-02-01

Objective The aim of this study was to explore whether the Variable Lifting Index (VLI) can be corrected for cumulative mass and thus test its efficacy in predicting the risk of low-back pain (LBP). Background A validation study of the VLI method was published in this journal reporting promising results. Although several studies highlighted a positive correlation between cumulative load and LBP, cumulative mass has never been considered in any of the studies investigating the relationship between manual material handling and LBP. Method Both VLI and cumulative mass were calculated for 2,374 exposed subjects using a systematic approach. Due to high variability of cumulative mass values, a stratification within VLI categories was employed. Dummy variables (1-4) were assigned to each class and used as a multiplier factor for the VLI, resulting in a new index (VLI_CMM). Data on LBP were collected by occupational physicians at the study sites. Logistic regression was used to estimate the risk of acute LBP within levels of risk exposure when compared with a control group formed by 1,028 unexposed subjects. Results Data showed greatly variable values of cumulative mass across all VLI classes. The potential effect of cumulative mass on damage emerged as not significant ( p value = .6526). Conclusion When comparing VLI_CMM with raw VLI, the former failed to prove itself as a better predictor of LBP risk. Application To recognize cumulative mass as a modifier, especially for lumbar degenerative spine diseases, authors of future studies should investigate potential association between the VLI and other damage variables.

Pesticide Cumulative Risk Assessment: Framework for Screening Analysis

Science.gov (United States)

This document provides guidance on how to screen groups of pesticides for cumulative evaluation using a two-step approach: begin with evaluation of available toxicological information and, if necessary, follow up with a risk-based screening approach.

78 FR 25440 - Request for Information and Citations on Methods for Cumulative Risk Assessment

Science.gov (United States)

2013-05-01

... Citations on Methods for Cumulative Risk Assessment AGENCY: Office of the Science Advisor, Environmental... influence exposures, dose-response or risk/hazard posed by environmental contaminant exposures, and methods... who wish to receive further information about submitting information on methods for cumulative risk...

Family cumulative risk and at-risk kindergarteners' social competence: the mediating role of parent representations of the attachment relationship.

Science.gov (United States)

Sparks, Lauren A; Trentacosta, Christopher J; Owusu, Erika; McLear, Caitlin; Smith-Darden, Joanne

2018-08-01

Secure attachment relationships have been linked to social competence in at-risk children. In the current study, we examined the role of parent secure base scripts in predicting at-risk kindergarteners' social competence. Parent representations of secure attachment were hypothesized to mediate the relationship between lower family cumulative risk and children's social competence. Participants included 106 kindergarteners and their primary caregivers recruited from three urban charter schools serving low-income families as a part of a longitudinal study. Lower levels of cumulative risk predicted greater secure attachment representations in parents, and scores on the secure base script assessment predicted children's social competence. An indirect relationship between lower cumulative risk and kindergarteners' social competence via parent secure base script scores was also supported. Parent script-based representations of the attachment relationship appear to be an important link between lower levels of cumulative risk and low-income kindergarteners' social competence. Implications of these findings for future interventions are discussed.

Kaplan-Meier survival analysis overestimates cumulative incidence of health-related events in competing risk settings: a meta-analysis.

Science.gov (United States)

Lacny, Sarah; Wilson, Todd; Clement, Fiona; Roberts, Derek J; Faris, Peter; Ghali, William A; Marshall, Deborah A

2018-01-01

Kaplan-Meier survival analysis overestimates cumulative incidence in competing risks (CRs) settings. The extent of overestimation (or its clinical significance) has been questioned, and CRs methods are infrequently used. This meta-analysis compares the Kaplan-Meier method to the cumulative incidence function (CIF), a CRs method. We searched MEDLINE, EMBASE, BIOSIS Previews, Web of Science (1992-2016), and article bibliographies for studies estimating cumulative incidence using the Kaplan-Meier method and CIF. For studies with sufficient data, we calculated pooled risk ratios (RRs) comparing Kaplan-Meier and CIF estimates using DerSimonian and Laird random effects models. We performed stratified meta-analyses by clinical area, rate of CRs (CRs/events of interest), and follow-up time. Of 2,192 identified abstracts, we included 77 studies in the systematic review and meta-analyzed 55. The pooled RR demonstrated the Kaplan-Meier estimate was 1.41 [95% confidence interval (CI): 1.36, 1.47] times higher than the CIF. Overestimation was highest among studies with high rates of CRs [RR = 2.36 (95% CI: 1.79, 3.12)], studies related to hepatology [RR = 2.60 (95% CI: 2.12, 3.19)], and obstetrics and gynecology [RR = 1.84 (95% CI: 1.52, 2.23)]. The Kaplan-Meier method overestimated the cumulative incidence across 10 clinical areas. Using CRs methods will ensure accurate results inform clinical and policy decisions. Copyright © 2017 Elsevier Inc. All rights reserved.

Probabilistic cumulative risk assessment of anti-androgenic pesticides in food

DEFF Research Database (Denmark)

Müller, Anne Kirstine; Nielsen, Elsa

2008-01-01

A cumulative risk assessment of three anti-androgenic pesticides vinclozolin, procymidone and prochloraz in combination has been carried out using an Integrated Probabilistic Risk Assessment (IPRA) model. In the model, variability in both exposure and sensitivity between individuals were combined...

Probabilistic cumulative risk assessment of anti-androgenic pesticides in food.

NARCIS (Netherlands)

Müller, A.K.; Bosgra, S.; Boon, P.E.; van der Voet, H.; Nielsen, E.; Ladefoged, O.

2009-01-01

In this paper, we present a cumulative risk assessment of three anti-androgenic pesticides (vinclozolin, procymidone and prochloraz) using the relative potency factor (RPF) approach and an integrated probabilistic risk assessment (IPRA) model. RPFs for each substance were estimated for three

Probabilistic cumulative risk assessment of anti-androgenic pesticides in food

NARCIS (Netherlands)

Muller, A.K.; Bosgra, S.; Boon, P.E.; Voet, van der H.; Nielsen, E.; Ladefoged, O.

2009-01-01

In this paper, we present a cumulative risk assessment of three anti-androgenic pesticides (vinclozolin, procymidone and prochloraz) using the relative potency factor (RPF) approach and an integrated probabilistic risk assessment (IPRA) model. RPFs for each substance were estimated for three

A framework for cumulative risk assessment in the 21st century.

Science.gov (United States)

Moretto, Angelo; Bachman, Ammie; Boobis, Alan; Solomon, Keith R; Pastoor, Timothy P; Wilks, Martin F; Embry, Michelle R

2017-02-01

The ILSI Health and Environmental Sciences Institute (HESI) has developed a framework to support a transition in the way in which information for chemical risk assessment is obtained and used (RISK21). The approach is based on detailed problem formulation, where exposure drives the data acquisition process in order to enable informed decision-making on human health safety as soon as sufficient evidence is available. Information is evaluated in a transparent and consistent way with the aim of optimizing available resources. In the context of risk assessment, cumulative risk assessment (CRA) poses additional problems and questions that can be addressed using the RISK21 approach. The focus in CRA to date has generally been on chemicals that have common mechanisms of action. Recently, concern has also been expressed about chemicals acting on multiple pathways that lead to a common health outcome, and non-chemical other conditions (non-chemical stressors) that can lead to or modify a common outcome. Acknowledging that CRAs, as described above, are more conceptually, methodologically and computationally complex than traditional single-stressor risk assessments, RISK21 further developed the framework for implementation of workable processes and procedures for conducting assessments of combined effects from exposure to multiple chemicals and non-chemical stressors. As part of the problem formulation process, this evidence-based framework allows the identification of the circumstances in which it is appropriate to conduct a CRA for a group of compounds. A tiered approach is then proposed, where additional chemical stressors and/or non-chemical modulating factors (ModFs) are considered sequentially. Criteria are provided to facilitate the decision on whether or not to include ModFs in the formal quantitative assessment, with the intention to help focus the use of available resources to have the greatest potential to protect public health.

Cumulative socioeconomic status risk, allostatic load, and adjustment: a prospective latent profile analysis with contextual and genetic protective factors.

Science.gov (United States)

Brody, Gene H; Yu, Tianyi; Chen, Yi-fu; Kogan, Steven M; Evans, Gary W; Beach, Steven R H; Windle, Michael; Simons, Ronald L; Gerrard, Meg; Gibbons, Frederick X; Philibert, Robert A

2013-05-01

The health disparities literature has identified a common pattern among middle-aged African Americans that includes high rates of chronic disease along with low rates of psychiatric disorders despite exposure to high levels of cumulative socioeconomic status (SES) risk. The current study was designed to test hypotheses about the developmental precursors to this pattern. Hypotheses were tested with a representative sample of 443 African American youths living in the rural South. Cumulative SES risk and protective processes were assessed at ages 11-13 years; psychological adjustment was assessed at ages 14-18 years; genotyping at the 5-HTTLPR was conducted at age 16 years; and allostatic load (AL) was assessed at age 19 years. A latent profile analysis identified 5 profiles that evinced distinct patterns of SES risk, AL, and psychological adjustment, with 2 relatively large profiles designated as focal profiles: a physical health vulnerability profile characterized by high SES risk/high AL/low adjustment problems, and a resilient profile characterized by high SES risk/low AL/low adjustment problems. The physical health vulnerability profile mirrored the pattern found in the adult health disparities literature. Multinomial logistic regression analyses indicated that carrying an s allele at the 5-HTTLPR and receiving less peer support distinguished the physical health vulnerability profile from the resilient profile. Protective parenting and planful self-regulation distinguished both focal profiles from the other 3 profiles. The results suggest the public health importance of preventive interventions that enhance coping and reduce the effects of stress across childhood and adolescence.

Is the cluster risk model of parental adversities better than the cumulative risk model as an indicator of childhood physical abuse?: findings from two representative community surveys.

Science.gov (United States)

Fuller-Thomson, E; Sawyer, J-L

2014-01-01

Screening strategies for childhood physical abuse (CPA) need to be improved in order to identify those most at risk. This study uses two regionally representative community samples to examine whether a cluster or cumulative model of risk indicators (i.e. parental divorce, parental unemployment, and parental addictions) explains a larger proportion of the variation in CPA. Data were drawn from Statistics Canada's National Population Health Survey (1994-1995) and Canadian Community Health Survey 3.1 (2005). Response rates were greater than 80% in both samples. Each survey had approximately 13,000 respondents aged 18 and over who answered questions about the above adverse childhood experiences. A gradient was shown with similar outcomes in each data set. Only 3.4% of adults who experienced none of the three risk indicators reported they had been physically abused during childhood or adolescence. The prevalence of CPA was greater among those who experienced parental divorce alone (8.3%-10.7%), parental unemployment alone (8.9%-9.7%) or parental addictions alone (18.0%-19.5%). When all three risk indicators were present, the prevalence of CPA ranged from 36.0%-41.0% and the age-sex-race adjusted odds were greater than 15 times that of individuals with none of the three risk indicators. The cluster model explained a statistically significantly larger proportion of the variation than the cumulative model although the difference between the two models was modest. For the purposes of parsimony, the cumulative model may be the better alternative. Adults who were exposed to two or more childhood risk indicators were much more likely to report that they were physically abused during their childhood than those with only one or no risk factors. Medical professionals may use this information on cumulative risk factors to more effectively target screening for potential CPA. Future research should include prospective studies. © 2012 John Wiley & Sons Ltd.

Retooling CalEnviroScreen: Cumulative Pollution Burden and Race-Based Environmental Health Vulnerabilities in California

Science.gov (United States)

2018-01-01

The California Community Environmental Health Screening Tool (CalEnviroScreen) advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California. PMID:29659481

Retooling CalEnviroScreen: Cumulative Pollution Burden and Race-Based Environmental Health Vulnerabilities in California

Directory of Open Access Journals (Sweden)

Raoul S. Liévanos

2018-04-01

Full Text Available The California Community Environmental Health Screening Tool (CalEnviroScreen advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California.

Retooling CalEnviroScreen: Cumulative Pollution Burden and Race-Based Environmental Health Vulnerabilities in California.

Science.gov (United States)

Liévanos, Raoul S

2018-04-16

The California Community Environmental Health Screening Tool (CalEnviroScreen) advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California.

Childhood cumulative risk and obesity: the mediating role of self-regulatory ability.

Science.gov (United States)

Evans, Gary W; Fuller-Rowell, Thomas E; Doan, Stacey N

2012-01-01

We tested whether early childhood risk exposures are related to weight gain in adolescence and evaluate an underlying mechanism, self-regulatory behavior, for the risk-obesity link. Cumulative risk exposure to 9 sociodemographic (eg, poverty), physical (eg, substandard housing), and psychosocial (eg, family turmoil) stressors was assessed in 244 nine-year-old children. BMI was calculated at age 9 and then 4 years later. At age 9, children's ability to delay gratification as an index of self-regulatory behavior was assessed. Path analyses were then estimated to evaluate our mediational model (Cumulative risk → Self-regulation → BMI) over a 4-year period in a prospective, longitudinal design. Nine-year-old children exposed to a greater accumulation of multiple risk factors show larger gains in adiposity over the next four year period, net of their initial BMI. These gains in BMI during early adolescence are largely accounted for by deteriorated self-regulatory abilities among children facing more cumulative risks. Early childhood risk exposure leads to larger gains in BMI in adolescence. Given the importance of childhood adiposity to the development of obesity later in life, understanding the underlying mechanisms that link early experience to weight gain is an essential task. Deficiencies in self-regulation in response to chronic stress appears to be an important agent in the obesity epidemic.

Cumulative keyboard strokes: a possible risk factor for carpal tunnel syndrome

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Eleftheriou Andreas

2012-08-01

Full Text Available Abstract Background Contradictory reports have been published regarding the association of Carpal Tunnel Syndrome (CTS and the use of computer keyboard. Previous studies did not take into account the cumulative exposure to keyboard strokes among computer workers. The aim of the present study was to investigate the association between cumulative keyboard use (keyboard strokes and CTS. Methods Employees (461 from a Governmental data entry & processing unit agreed to participate (response rate: 84.1 % in a cross-sectional study. Α questionnaire was distributed to the participants to obtain information on socio-demographics and risk factors for CTS. The participants were examined for signs and symptoms related to CTS and were asked if they had previous history or surgery for CTS. The cumulative amount of the keyboard strokes per worker per year was calculated by the use of payroll’s registry. Two case definitions for CTS were used. The first included subjects with personal history/surgery for CTS while the second included subjects that belonged to the first case definition plus those participants were identified through clinical examination. Results Multivariate analysis used for both case definitions, indicated that those employees with high cumulative exposure to keyboard strokes were at increased risk of CTS (case definition A: OR = 2.23;95 % CI = 1.09-4.52 and case definition B: OR = 2.41; 95%CI = 1.36-4.25. A dose response pattern between cumulative exposure to keyboard strokes and CTS has been revealed (p  Conclusions The present study indicated a possible association between cumulative exposure to keyboard strokes and development of CTS. Cumulative exposure to key-board strokes would be taken into account as an exposure indicator regarding exposure assessment of computer workers. Further research is needed in order to test the results of the current study and assess causality between cumulative keyboard strokes and

Turbulent times: effects of turbulence and violence exposure in adolescence on high school completion, health risk behavior, and mental health in young adulthood.

Science.gov (United States)

Boynton-Jarrett, Renée; Hair, Elizabeth; Zuckerman, Barry

2013-10-01

Turbulent social environments are associated with health and developmental risk, yet mechanisms have been understudied. Guided by a life course framework and stress theory, this study examined the association between turbulent life transitions (including frequent residential mobility, school transitions, family structure disruptions, and homelessness) and exposure to violence during adolescence and high school completion, mental health, and health risk behaviors in young adulthood. Participants (n = 4834) from the U.S. National Longitudinal Survey of Youth, 1997 cohort were followed prospectively from age 12-14 years for 10 years. We used structural equation models to investigate pathways between turbulence and cumulative exposure to violence (CEV), and high school completion, mental health, and health risk behaviors, while accounting for early life socio-demographics, family processes, and individual characteristics. Results indicated that turbulence index was associated with cumulative exposure to violence in adolescence. Both turbulence index and cumulative exposure to violence were positively associated with higher health risk behavior, poorer mental health, and inversely associated with high school completion. These findings highlight the importance of considering the cumulative impact of turbulent and adverse social environments when developing interventions to optimize health and developmental trajectory for adolescents transitioning into adulthood. Copyright © 2012 Elsevier Ltd. All rights reserved.

Cumulative effect of reproductive factors on ideal cardiovascular health in postmenopausal women: a cross-sectional study in central south China.

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Cao, Xia; Zhou, Jiansong; Yuan, Hong; Chen, Zhiheng

2015-12-21

The American Heart Association developed the Life's Simple 7 metric for defining cardiovascular health. Little is known, however, whether co-occurring reproductive factors, which affects endogenous oestrogen levels during a woman's life, also influences ideal cardiovascular health in postmenopausal women. Using data on a cross-sectional study with a convenience sample of 1,625 postmenopausal women (median age, 60.0 years) in a medical health checkup program at a general hospital in central south China 2013-2014, we examined the association between cumulative reproductive risk and ideal cardiovascular health in postmenopausal women. A cumulative risk score (range 0 to 4) was created by summing four reproductive risk factors (age at menarche, age at menopause, number of children, and pregnancy losses) present in each individual from binary variables in which 0 stands for favorable and 1 for less-than-favorable level. Ideal levels for each component in Life's Simple 7 (blood pressure, cholesterol, glucose, BMI, smoking, physical activity, and diet) were used to create an ideal Life's Simple 7 score [0-1 (low), 2, 3, 4, 5 and 6-7 (high)]. Participants with earlier age at menarche (odds ratio [OR] =0.42 [95 % CI 0.26-0.48]), earlier age at menopause [0.46 (0.32-0.58)], who have more than three children (0.42 [0.38-0.56]) and have history of pregnancy losses [0.76 (0.66-0.92)] were more likely to attain low (0-1) ideal Life's Simple 7 after adjustment for age. Participants were more likely to attain low (0-1) ideal Life's Simple 7 as exposure to the number of reproductive risk factors increased [OR (95 % CI) of 0.52 (0.42-0.66), 0.22 (0.16-0.26), and 0.16 (0.12-0.22) for cumulative reproductive risk scores of 1, 2, and 3 or 4, respectively, each versus 0]. The postmenopausal Chinese women with an increasing number of reproductive risk factors were progressively less likely to attain ideal levels of cardiovascular health factors.

A cumulative risk factor model for early identification of academic difficulties in premature and low birth weight infants.

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Roberts, G; Bellinger, D; McCormick, M C

2007-03-01

Premature and low birth weight children have a high prevalence of academic difficulties. This study examines a model comprised of cumulative risk factors that allows early identification of these difficulties. This is a secondary analysis of data from a large cohort of premature (mathematics. Potential predictor variables were categorized into 4 domains: sociodemographic, neonatal, maternal mental health and early childhood (ages 3 and 5). Regression analysis was used to create a model to predict reading and mathematics scores. Variables from all domains were significant in the model, predicting low achievement scores in reading (R (2) of 0.49, model p-value mathematics (R (2) of 0.44, model p-value intelligence, visual-motor skill and higher behavioral disturbance scores (early childhood). Lower mathematics scores were predicted by lower maternal education, income and age and Black or Hispanic race (sociodemographic); lower birth weight and higher head circumference (neonatal); lower maternal responsivity (maternal mental health); lower intelligence, visual-motor skill and higher behavioral disturbance scores (early childhood). Sequential early childhood risk factors in premature and LBW children lead to a cumulative risk for academic difficulties and can be used for early identification.

Cumulative occupational mechanical exposures during working life and risk of sickness absence and disability pension: prospective cohort study.

Science.gov (United States)

Sundstrup, Emil; Hansen, Åse Marie; Mortensen, Erik Lykke; Poulsen, Otto Melchior; Clausen, Thomas; Rugulies, Reiner; Møller, Anne; Andersen, Lars L

2017-09-01

Objectives The aim of this study was to determine the prospective association of cumulative mechanical exposure during working life with health-related labor market outcomes. Methods This prospective cohort study combines data from 5076 older workers (age 49-63 years) from the Copenhagen Aging and Midlife Biobank with a job exposure matrix and a national register containing information on social transfer payment. By coding individual job histories from the Danish version of ISCO-codes (International Standard Classification of Occupations), we calculated cumulative occupational mechanical exposures from a JEM for ton-years (lifting 1000 kg each day in one year), lifting-years (lifting loads weighing ≥20 kg >10 times each day in one year), kneeling-years (kneeling for one hour each day in one year) and vibration-years (whole-body vibration for one hour each day in one year). Cox-regression analyses estimated the relative risk of register-based long-term sickness absence (LTSA) and disability pension with cumulative occupational mechanical exposures throughout working life. Analyses were censored for competing events and adjusted for multiple confounders. Results During the follow-up period, 970 persons (19.3%) had ≥1 episode of LTSA and 85 persons (1.7%) were granted a disability pension. Number of ton-, lifting- and kneeling-years showed an exposure-response association with increased risk of LTSA (Ppension (HR 1.75 95% CI 1.01-3.04). Conclusions Cumulative occupational mechanical exposures during working life - such as lifting and kneeling work - increased the risk of LTSA. Importantly, being exposed to lifting increased the risk of disability pension.

Cumulative Human Impacts on Coral Reefs: Assessing Risk and Management Implications for Brazilian Coral Reefs

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Rafael A. Magris

2018-04-01

Full Text Available Effective management of coral reefs requires strategies tailored to cope with cumulative disturbances from human activities. In Brazil, where coral reefs are a priority for conservation, intensifying threats from local and global stressors are of paramount concern to management agencies. Using a cumulative impact assessment approach, our goal was to inform management actions for coral reefs in Brazil by assessing their exposure to multiple stressors (fishing, land-based activities, coastal development, mining, aquaculture, shipping, and global warming. We calculated an index of the risk to cumulative impacts: (i assuming uniform sensitivity of coral reefs to stressors; and (ii using impact weights to reflect varying tolerance levels of coral reefs to each stressor. We also predicted the index in both the presence and absence of global warming. We found that 16% and 37% of coral reefs had high to very high risk of cumulative impacts, without and with information on sensitivity respectively, and 42% of reefs had low risk to cumulative impacts from both local and global stressors. Our outputs are the first comprehensive spatial dataset of cumulative impact on coral reefs in Brazil, and show that areas requiring attention mostly corresponded to those closer to population centres. We demonstrate how the relationships between risks from local and global stressors can be used to derive strategic management actions.

Cumulative risk assessment for plasticizer-contaminated food using the hazard index approach

International Nuclear Information System (INIS)

Chang, J.W.; Yan, B.R.; Chang, M.H.; Tseng, S.H.; Kao, Y.M.; Chen, J.C.; Lee, C.C.

2014-01-01

Phthalates strongly and adversely affect reproduction, development and liver function. We did a cumulative risk assessment for simultaneous exposure to nine phthalates using the hazard index (HI) and the levels of nine phthalates in 1200 foodstuff samples. DEHP (di-2-ethylhexyl phthalate) present the highest level (mean: 0.443 mg/kg) in 1200 samples, and the highest average daily dose (ADD) was found in DEHP, ΣDBP (i + n) (the sum of dibutyl phthalate [DBP] isomers [DnBP + DiBP]) posed the highest risk potential of all the phthalates. In seven phthalates, the 95th percentiles of the ADDs for ΣDBP (i + n) in 0–6-yr-old children accounted for 91% (79–107%) of the tolerable daily intake, and the 95th percentiles of the HIs for the anti-androgenic effects of five phthalates in 0–3-yr-old children and 4–6-yr-old girls were >1. We conclude that the health of younger Taiwanese may be adversely affected by overexposure of phthalate-contaminated foods. - Graphical abstract: In seven phthalates, the 95th percentile of the average daily dose (ADD) for ΣDBP (i + n) (the sum of dibutyl phthalate [DBP] isomers [DnBP + DiBP]) in 0–3-yr-old male (0–3 M) and female (0–3 F) children accounted for 97% and 84% of TDIs, respectively. For 4–6-yr-old and 7–12-yr-old males and 7–12-yr-old females, ADDs for ΣDBP (i + n) accounted for 79%, 72%, and 65% of TDIs, respectively. - Highlights: • A cumulative risk assessment of PAEs was used in a severe plasticizer-contaminated food episode. • ΣDBP (i + n) posed the highest risk potential of all the dietary phthalates. • Females 4–6 yr old had the highest risk for anti-androgenic effects. • Beverages, milk and dairy products were the major contributors to average daily dose of phthalate esters. - The health of young Taiwanese may be adversely affected by overexposure of plasticizer-contaminated food

Community Engaged Cumulative Risk Assessment of Exposure to Inorganic Well Water Contaminants, Crow Reservation, Montana

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Doyle, John T.; Lefthand, Myra J.; Young, Sara L.; Kindness, Larry; Other Medicine, Roberta; Ford, Timothy E.; Dietrich, Eric; Parker, Albert E.; Hoover, Joseph H.; Camper, Anne K.

2018-01-01

An estimated 11 million people in the US have home wells with unsafe levels of hazardous metals and nitrate. The national scope of the health risk from consuming this water has not been assessed as home wells are largely unregulated and data on well water treatment and consumption are lacking. Here, we assessed health risks from consumption of contaminated well water on the Crow Reservation by conducting a community-engaged, cumulative risk assessment. Well water testing, surveys and interviews were used to collect data on contaminant concentrations, water treatment methods, well water consumption, and well and septic system protection and maintenance practices. Additive Hazard Index calculations show that the water in more than 39% of wells is unsafe due to uranium, manganese, nitrate, zinc and/or arsenic. Most families’ financial resources are limited, and 95% of participants do not employ water treatment technologies. Despite widespread high total dissolved solids, poor taste and odor, 80% of families consume their well water. Lack of environmental health literacy about well water safety, pre-existing health conditions and limited environmental enforcement also contribute to vulnerability. Ensuring access to safe drinking water and providing accompanying education are urgent public health priorities for Crow and other rural US families with low environmental health literacy and limited financial resources. PMID:29304032

Cumulative Socioeconomic Status Risk, Allostatic Load, and Adjustment: A Prospective Latent Profile Analysis with Contextual and Genetic Protective Factors

Science.gov (United States)

Brody, Gene H.; Yu, Tianyi; Chen, Yi-Fu; Kogan, Steven M.; Evans, Gary W.; Beach, Steven R. H.; Windle, Michael; Simons, Ronald L.; Gerrard, Meg; Gibbons, Frederick X.; Philibert, Robert A.

2013-01-01

The health disparities literature has identified a common pattern among middle-aged African Americans that includes high rates of chronic disease along with low rates of psychiatric disorders despite exposure to high levels of cumulative socioeconomic status (SES) risk. The current study was designed to test hypotheses about the developmental…

Oral contraceptive use and impact of cumulative intake of estrogen and progestin on risk of ovarian cancer

DEFF Research Database (Denmark)

Faber, M T; Jensen, A; Frederiksen, K

2013-01-01

Oral contraceptive use decreases the risk of ovarian cancer, but no previous studies have assessed the impact of cumulative intake of estrogen and progestin on ovarian cancer risk.......Oral contraceptive use decreases the risk of ovarian cancer, but no previous studies have assessed the impact of cumulative intake of estrogen and progestin on ovarian cancer risk....

Cumulative occupational mechanical exposures during working life and risk of sickness absence and disability pension

DEFF Research Database (Denmark)

Sundstrup, Emil; Hansen, Åse Marie; Mortensen, Erik Lykke

2017-01-01

-regression analyses estimated the relative risk of register-based long-term sickness absence (LTSA) and disability pension with cumulative occupational mechanical exposures throughout working life. Analyses were censored for competing events and adjusted for multiple confounders. Results: During the follow-up period......Objectives: The aim of this study was to determine the prospective association of cumulative mechanical exposure during working life with health-related labor market outcomes. Methods: This prospective cohort study combines data from 5076 older workers (age 49-63 years) from the Copenhagen Aging...... from a JEM for ton-years (lifting 1000 kg each day in one year), lifting-years (lifting loads weighing ≥20 kg >10 times each day in one year), kneeling-years (kneeling for one hour each day in one year) and vibration-years (whole-body vibration for one hour each day in one year). Cox...

Comparison of cumulative false-positive risk of screening mammography in the United States and Denmark

DEFF Research Database (Denmark)

Jacobsen, Katja Kemp

2015-01-01

INTRODUCTION: In the United States (US), about one-half of women screened with annual mammography have at least one false-positive test after ten screens. The estimate for European women screened ten times biennially is much lower. We evaluate to what extent screening interval, mammogram type......=400,204), between 1991-2012 and 1993-2013, respectively. Model-based cumulative false-positive risks were computed for the entire sample, using two statistical methods (Hubbard Njor) previously used to estimate false-positive risks in the US and Europe. RESULTS: Empirical cumulative risk of at least...... one false-positive test after eight (annual or biennial) screens was 41.9% in BCSC, 16.1% in Copenhagen, and 7.4% in Funen. Variation in screening interval and mammogram type did not explain the differences by country. Using the Hubbard method, the model-based cumulative risks after eight screens...

Probabilistic cumulative risk assessment of anti-androgenic pesticides in food

DEFF Research Database (Denmark)

Müller, Anne Kirstine; Bosgra, Sieto; Boon, Polly E.

2009-01-01

In this paper, we present a cumulative risk assessment of three anti-androgenic pesticides (vinclozolin, procymidone and prochloraz) using the relative potency factor (RPF) approach and an integrated probabilistic risk assessment (IPRA) model. RPFs for each substance were estimated for three......) and the fraction of individuals with IMoEs vinclozolin, procymidone and prochloraz is not likely to be of concern for the reproductive development of their male foetuses. However...

Cumulative risk exposure moderates the association between parasympathetic reactivity and inhibitory control in preschool-age children.

Science.gov (United States)

Giuliano, Ryan J; Roos, Leslie E; Farrar, Jessica D; Skowron, Elizabeth A

2018-04-01

A child's cumulative risk for early exposure to stress has been linked to alterations of self-regulation outcomes, including neurobiological correlates of inhibitory control (IC). We examined whether children's ability to engage the parasympathetic nervous system impacts how risk affects IC. Children ages 3-5 years completed two laboratory measures of IC while respiratory sinus arrhythmia (RSA) was measured, indexing parasympathetic activity. Children with greater risk demonstrated lower IC; risk also moderated associations between RSA reactivity and IC. For children with less risk, greater RSA withdrawal during IC tasks was associated with better IC. In contrast, greater risk was associated with poor IC, regardless of RSA withdrawal. Effects of risk were more pronounced for cumulative than individual measures. Results suggest that cumulative risk exposure disrupts connectivity between physiological and behavioral components of self-regulation in early childhood. Parasympathetic withdrawal to cognitive tasks may be less relevant for performance in developmental samples experiencing greater life stress. © 2018 Wiley Periodicals, Inc.

Low Fruit/Vegetable Consumption in the Home: Cumulative Risk Factors in Early Childhood

Science.gov (United States)

Ward, Wendy L.; Swindle, Taren M.; Kyzer, Angela L.; Whiteside-Mansell, Leanne

2015-01-01

Cumulative risk theory suggests that a variety of social risk factors would have an additive effect on obesity risk. Multiple studies have suggested that obesity is related to basic resources such as transportation and financial resources. Additional research points to parental engagement and parental monitoring as additional sources of risk. This…

Methodological Considerations in Screening for Cumulative Environmental Health Impacts: Lessons Learned from a Pilot Study in California

Directory of Open Access Journals (Sweden)

Lauren Zeise

2012-08-01

Full Text Available Polluting facilities and hazardous sites are often concentrated in low-income communities of color already facing additional stressors to their health. The influence of socioeconomic status is not considered in traditional models of risk assessment. We describe a pilot study of a screening method that considers both pollution burden and population characteristics in assessing the potential for cumulative impacts. The goal is to identify communities that warrant further attention and to thereby provide actionable guidance to decision- and policy-makers in achieving environmental justice. The method uses indicators related to five components to develop a relative cumulative impact score for use in comparing communities: exposures, public health effects, environmental effects, sensitive populations and socioeconomic factors. Here, we describe several methodological considerations in combining disparate data sources and report on the results of sensitivity analyses meant to guide future improvements in cumulative impact assessments. We discuss criteria for the selection of appropriate indicators, correlations between them, and consider data quality and the influence of choices regarding model structure. We conclude that the results of this model are largely robust to changes in model structure.

The impact of physical activity on cumulative cardiovascular disease risk factors among Malaysian adults.

Science.gov (United States)

Rasiah, Rajah; Thangiah, Govindamal; Yusoff, Khalid; Manikam, Rishya; Chandrasekaran, Sankara Kumar; Mustafa, Rujhan; Bakar, Najmin Binti Abu

2015-12-16

Numerous studies have shown the importance of physical activity in reducing the morbidity and mortality rates caused by cardiovascular disease (CVD). However, most of these studies emphasise little on the cumulative effect of CVD risk factors. Hence, this study investigates the association between physical exercise and cumulative CVD risk factors among adults in three different age groups. Using a sample of 7276 respondents drawn from community centers, the REDISCOVER team gathered information on physical activity, CVD risk factors (obesity, diabetes, hypertension, hypercholesterolemia, tobacco use) and socioeconomic and demographic variables in Malaysia. Because the study required medical examination, a convenience sampling frame was preferred in which all volunteers were included in the study. Fasting blood samples and anthropometric (height, weight and more) measurements were collected by trained staffs. Socio-demographic and physical activity variables were recorded through questionnaires. A Chi-square test was performed to identify the bivariate association between the covariates (socioeconomic variables, demographic variables and physical activity) and outcome variable. The association between the main exposure, physical activity, and the outcome variable, cumulative CVD risk factors, was assessed using an ordinal logistic regression model, controlling for socioeconomic status and demographic influences in three different age groups, 35-49, 50-64 and 65 and above. The mean age of participants is 51.8 (SD = 9.4). Respondents in the age groups of 35-49 (aORmoderate = 0.12; 95 % CI: 0.02 - 0.53 ) and 65 and above (aORhigh = 0.58; 95 % CI: 0.24, 0.78) showed a statistically significant inverse relationship between physical activity and cumulative CVD risk factors. However, this relationship was not significant among respondents in the 50-64 age group suggesting the possible influence of other variables, such as stress and environment. The

Cumulative Risk of Bovine Mastitis Treatments in Denmark, Finland, Norway and Sweden

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Saloniemi H

2004-12-01

Full Text Available Data from the national dairy cow recording systems during 1997 were used to calculate lactation-specific cumulative risk of mastitis treatments and cumulative risk of removal from the herds in Denmark, Finland Norway and Sweden. Sweden had the lowest risk of recorded mastitis treatments during 305 days of lactation and Norway had the highest risk. The incidence risk of recorded mastitis treatments during 305 days of lactation in Denmark, Finland, Norway and Sweden was 0.177, 0.139, 0.215 and 0.127 for first parity cows and 0.228, 0.215, 0.358 and 0.204 for parities higher than three, respectively. The risk of a first parity cow being treated for mastitis was almost 3 times higher at calving in Norway than in Sweden. The period with the highest risk for mastitis treatments was from 2 days before calving until 14 days after calving and the highest risk for removal was from calving to 10 days after calving in all countries. The study clearly demonstrated differences in bovine mastitis treatment patterns among the Nordic countries. The most important findings were the differences in treatment risks during different lactations within each country, as well as differences in strategies with respect to the time during lactation mastitis was treated.

Cumulative risk of bovine mastitis treatments in Denmark, Finland, Norway and Sweden.

Science.gov (United States)

Valde, J P; Lawson, L G; Lindberg, A; Agger, J F; Saloniemi, H; Osterås, O

2004-01-01

Data from the national dairy cow recording systems during 1997 were used to calculate lactation-specific cumulative risk of mastitis treatments and cumulative risk of removal from the herds in Denmark, Finland Norway and Sweden. Sweden had the lowest risk of recorded mastitis treatments during 305 days of lactation and Norway had the highest risk. The incidence risk of recorded mastitis treatments during 305 days of lactation in Denmark, Finland, Norway and Sweden was 0.177, 0.139, 0.215 and 0.127 for first parity cows and 0.228, 0.215, 0.358 and 0.204 for parities higher than three, respectively. The risk of a first parity cow being treated for mastitis was almost 3 times higher at calving in Norway than in Sweden. The period with the highest risk for mastitis treatments was from 2 days before calving until 14 days after calving and the highest risk for removal was from calving to 10 days after calving in all countries. The study clearly demonstrated differences in bovine mastitis treatment patterns among the Nordic countries. The most important findings were the differences in treatment risks during different lactations within each country, as well as differences in strategies with respect to the time during lactation mastitis was treated.

Predicting the cumulative risk of death during hospitalization by modeling weekend, weekday and diurnal mortality risks.

Science.gov (United States)

Coiera, Enrico; Wang, Ying; Magrabi, Farah; Concha, Oscar Perez; Gallego, Blanca; Runciman, William

2014-05-21

Current prognostic models factor in patient and disease specific variables but do not consider cumulative risks of hospitalization over time. We developed risk models of the likelihood of death associated with cumulative exposure to hospitalization, based on time-varying risks of hospitalization over any given day, as well as day of the week. Model performance was evaluated alone, and in combination with simple disease-specific models. Patients admitted between 2000 and 2006 from 501 public and private hospitals in NSW, Australia were used for training and 2007 data for evaluation. The impact of hospital care delivered over different days of the week and or times of the day was modeled by separating hospitalization risk into 21 separate time periods (morning, day, night across the days of the week). Three models were developed to predict death up to 7-days post-discharge: 1/a simple background risk model using age, gender; 2/a time-varying risk model for exposure to hospitalization (admission time, days in hospital); 3/disease specific models (Charlson co-morbidity index, DRG). Combining these three generated a full model. Models were evaluated by accuracy, AUC, Akaike and Bayesian information criteria. There was a clear diurnal rhythm to hospital mortality in the data set, peaking in the evening, as well as the well-known 'weekend-effect' where mortality peaks with weekend admissions. Individual models had modest performance on the test data set (AUC 0.71, 0.79 and 0.79 respectively). The combined model which included time-varying risk however yielded an average AUC of 0.92. This model performed best for stays up to 7-days (93% of admissions), peaking at days 3 to 5 (AUC 0.94). Risks of hospitalization vary not just with the day of the week but also time of the day, and can be used to make predictions about the cumulative risk of death associated with an individual's hospitalization. Combining disease specific models with such time varying- estimates appears to

Parenting intervention and the caregiving environment : cumulative risk and process evaluation

NARCIS (Netherlands)

Stolk, Mirjam Neeltje

2007-01-01

The objective of the research described in this thesis was to study single and cumulative family risk in relation to early childhood externalizing problems and the effectiveness of a parenting intervention program. The Video-feedback Intervention to promote Positive Parenting and Sensitive

Cumulative Risk and Impact Modeling on Environmental Chemical and Social Stressors.

Science.gov (United States)

Huang, Hongtai; Wang, Aolin; Morello-Frosch, Rachel; Lam, Juleen; Sirota, Marina; Padula, Amy; Woodruff, Tracey J

2018-03-01

The goal of this review is to identify cumulative modeling methods used to evaluate combined effects of exposures to environmental chemicals and social stressors. The specific review question is: What are the existing quantitative methods used to examine the cumulative impacts of exposures to environmental chemical and social stressors on health? There has been an increase in literature that evaluates combined effects of exposures to environmental chemicals and social stressors on health using regression models; very few studies applied other data mining and machine learning techniques to this problem. The majority of studies we identified used regression models to evaluate combined effects of multiple environmental and social stressors. With proper study design and appropriate modeling assumptions, additional data mining methods may be useful to examine combined effects of environmental and social stressors.

Volunteering and health benefits in general adults: cumulative effects and forms.

Science.gov (United States)

Yeung, Jerf W K; Zhang, Zhuoni; Kim, Tae Yeun

2017-07-11

Although the health benefits of volunteering have been well documented, no research has examined its cumulative effects according to other-oriented and self-oriented volunteering on multiple health outcomes in the general adult public. This study examined other-oriented and self-oriented volunteering in cumulative contribution to health outcomes (mental and physical health, life satisfaction, social well-being and depression). Data were drawn from the Survey of Texas Adults 2004, which contains a statewide population-based sample of adults (n = 1504). Multivariate linear regression and Wald test of parameters equivalence constraint were used to test the relationships. Both forms of volunteering were significantly related to better health outcomes (odds ratios = 3.66% to 11.11%), except the effect of self-oriented volunteering on depression. Other-oriented volunteering was found to have better health benefits than did self-volunteering. Volunteering should be promoted by public health, education and policy practitioners as a kind of healthy lifestyle, especially for the social subgroups of elders, ethnic minorities, those with little education, single people, and unemployed people, who generally have poorer health and less participation in volunteering.

Modeling the Cumulative Effects of Social Exposures on Health: Moving beyond Disease-Specific Models

Directory of Open Access Journals (Sweden)

Heather L. White

2013-03-01

Full Text Available The traditional explanatory models used in epidemiology are “disease specific”, identifying risk factors for specific health conditions. Yet social exposures lead to a generalized, cumulative health impact which may not be specific to one illness. Disease-specific models may therefore misestimate social factors’ effects on health. Using data from the Canadian Community Health Survey and Canada 2001 Census we construct and compare “disease-specific” and “generalized health impact” (GHI models to gauge the negative health effects of one social exposure: socioeconomic position (SEP. We use logistic and multinomial multilevel modeling with neighbourhood-level material deprivation, individual-level education and household income to compare and contrast the two approaches. In disease-specific models, the social determinants under study were each associated with the health conditions of interest. However, larger effect sizes were apparent when outcomes were modeled as compound health problems (0, 1, 2, or 3+ conditions using the GHI approach. To more accurately estimate social exposures’ impacts on population health, researchers should consider a GHI framework.

Evaluating Pharmacokinetic and Pharmacodynamic Interactions with Computational Models in Supporting Cumulative Risk Assessment

Science.gov (United States)

Tan, Yu-Mei; Clewell, Harvey; Campbell, Jerry; Andersen, Melvin

2011-01-01

Simultaneous or sequential exposure to multiple chemicals may cause interactions in the pharmacokinetics (PK) and/or pharmacodynamics (PD) of the individual chemicals. Such interactions can cause modification of the internal or target dose/response of one chemical in the mixture by other chemical(s), resulting in a change in the toxicity from that predicted from the summation of the effects of the single chemicals using dose additivity. In such cases, conducting quantitative cumulative risk assessment for chemicals present as a mixture is difficult. The uncertainties that arise from PK interactions can be addressed by developing physiologically based pharmacokinetic (PBPK) models to describe the disposition of chemical mixtures. Further, PK models can be developed to describe mechanisms of action and tissue responses. In this article, PBPK/PD modeling efforts conducted to investigate chemical interactions at the PK and PD levels are reviewed to demonstrate the use of this predictive modeling framework in assessing health risks associated with exposures to complex chemical mixtures. PMID:21655141

Lower cumulative stress is associated with better health for physically active adults in the community

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Stults-Kolehmainen, Matthew A.; Tuit, Keri; Sinha, Rajita

2015-01-01

Both cumulative adversity, an individual's lifetime exposure to stressors, and insufficient exercise are associated with poor health outcomes. The purpose of this study was to ascertain whether exercise buffers the association of cumulative adverse life events (CALE) with health in a community-wide sample of healthy adults (ages 18–50 years; women: n 219, 29.5 ± 9.2 years; men: n = 176, 29.4 ± 8.7 years, mean ± standard deviation). Participants underwent the Cumulative Adversity Interview, which divides life events into three subsets: major life events (MLE), recent life events (RLE) and traumatic experiences (TLE). These individuals also completed the Cornell Medical Index and a short assessment for moderate or greater intensity exercise behavior, modified from the Nurses’ Health Study. Results indicated that higher CALE was associated with greater total health problems (r = 0.431, pstress and exercise were not apparent for RLE and TLE. However, at low levels of MLE, greater exercise was related to fewer total, physical, cardiovascular and psychological health problems (p valuestress. Increased levels of exercise were related to better physical health in men, at all levels of CALE. Only women who reported both low levels of CALE and high levels of exercise had more favorable physical health outcomes. A similar pattern of results emerged for RLE. Together, these data suggest that increased exercise is related to better health, but these effects may vary by cumulative stress exposure and sex. PMID:24392966

Effects of Cumulative Family Risk Factors on American Students' Academic Performance

Science.gov (United States)

Dunst, Carl J.; Hamby, Deborah W.

2016-01-01

The relationships between cumulative family risk factors and American students' academic performance were examined in all 50 States and the District of Columbia. Data from the 2007 "American Community Survey" were used to ascertain the percent of birth to 18 year old children in the United States who experienced three or more risk…

Language Delay in Severely Neglected Children: A Cumulative or Specific Effect of Risk Factors?

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Sylvestre, Audette; Merette, Chantal

2010-01-01

Objectives: This research sought to determine if the language delay (LD) of severely neglected children under 3 years old was better explained by a cumulative risk model or by the specificity of risk factors. The objective was also to identify the risk factors with the strongest impact on LD among various biological, psychological, and…

Associations between parenting, media use, cumulative risk, and children’s executive functioning

NARCIS (Netherlands)

Linebarger, D.L.; Barr, R.; Lapierre, M.A.; Piotrowski, J.

2014-01-01

Objective: This study was designed to examine how parenting style, media exposure, and cumulative risk were associated with executive functioning (EF) during early childhood. Methods: A nationally representative group of US parents/caregivers (N = 1156) with 1 child between 2 and 8 years

Cumulative Risk Disparities in Children's Neurocognitive Functioning: A Developmental Cascade Model

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Wade, Mark; Browne, Dillon T.; Plamondon, Andre; Daniel, Ella; Jenkins, Jennifer M.

2016-01-01

The current longitudinal study examined the role of cumulative social risk on children's theory of mind (ToM) and executive functioning (EF) across early development. Further, we also tested a cascade model of development in which children's social cognition at 18 months was hypothesized to predict ToM and EF at age 4.5 through intermediary…

Genetic moderation of multiple pathways linking early cumulative socioeconomic adversity and young adults' cardiometabolic disease risk.

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Wickrama, Kandauda A S; Lee, Tae Kyoung; O'Neal, Catherine Walker

2018-02-01

Recent research suggests that psychosocial resources and life stressors are mediating pathways explaining socioeconomic variation in young adults' health risks. However, less research has examined both these pathways simultaneously and their genetic moderation. A nationally representative sample of 11,030 respondents with prospective data collected over 13 years from the National Study of Adolescent to Adult Health was examined. First, the association between early cumulative socioeconomic adversity and young adults' (ages 25-34) cardiometabolic disease risk, as measured by 10 biomarkers, through psychosocial resources (educational attainment) and life stressors (accelerated transition to adulthood) was examined. Second, moderation of these pathways by the serotonin transporter linked polymorphic region gene (5-HTTLPR) was examined. There was evidence for the association between early socioeconomic adversity and young adults' cardiometabolic disease risk directly and indirectly through educational attainment and accelerated transitions. These direct and mediating pathways were amplified by the 5-HTTLPR polymorphism. These findings elucidate how early adversity can have an enduring influence on young adults' cardiometabolic disease risk directly and indirectly through psychosocial resources and life stressors and their genetic moderation. This information suggests that effective intervention and prevention programs should focus on early adversity, youth educational attainment, and their transition to young adulthood.

The proportional odds cumulative incidence model for competing risks

DEFF Research Database (Denmark)

Eriksson, Frank; Li, Jianing; Scheike, Thomas

2015-01-01

We suggest an estimator for the proportional odds cumulative incidence model for competing risks data. The key advantage of this model is that the regression parameters have the simple and useful odds ratio interpretation. The model has been considered by many authors, but it is rarely used...... in practice due to the lack of reliable estimation procedures. We suggest such procedures and show that their performance improve considerably on existing methods. We also suggest a goodness-of-fit test for the proportional odds assumption. We derive the large sample properties and provide estimators...

Single-compound and cumulative risk assessment of mycotoxins present in breakfast cereals consumed by children from Lisbon region, Portugal.

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Assunção, Ricardo; Vasco, Elsa; Nunes, Baltazar; Loureiro, Susana; Martins, Carla; Alvito, Paula

2015-12-01

Humans can be exposed to multiple chemicals, but current risk assessment is usually carried out on one chemical at a time. Mycotoxins are commonly found in a variety of foods including those intended to consumption by children namely breakfast cereals. The present study aims to perform, the risk assessment of single and multiple mycotoxins present in breakfast cereals consumed by children (1-3 years old) from Lisbon region, Portugal. Daily exposure of children to ochratoxin A, fumonisins and trichothecenes showed no health risks to the children population considering individual mycotoxins, while exposure to aflatoxin B1 (AFB1) suggested a potential health concern for the high percentiles of intake (P90, P95 and P99). The combined exposure to fumonisins and trichothecenes are not expected to be of health concern. The combined margin of exposure (MoET) for the aflatoxins group could constitute a potential health concern and AFB1 was the main contributor for MoET. Legal limits and control strategies regarding the presence of multiple mycotoxins in foodstuffs is an urgent need. To the best of our knowledge, this is the first time a cumulative risk assessment was performed on multiple mycotoxins present in breakfast cereals consumed by children. Copyright © 2015 Elsevier Ltd. All rights reserved.

An exposure-based framework for grouping pollutants for a cumulative risk assessment approach: case study of indoor semi-volatile organic compounds.

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Fournier, Kevin; Glorennec, Philippe; Bonvallot, Nathalie

2014-04-01

Humans are exposed to a large number of contaminants, many of which may have similar health effects. This paper presents a framework for identifying pollutants to be included in a cumulative risk assessment approach. To account for the possibility of simultaneous exposure to chemicals with common toxic modes of action, the first step of the traditional risk assessment process, i.e. hazard identification, is structured in three sub-steps: (1a) Identification of pollutants people are exposed to, (1b) identification of effects and mechanisms of action of these pollutants, (1c) grouping of pollutants according to similarity of their mechanism of action and health effects. Based on this exposure-based grouping we can derive "multi-pollutant" toxicity reference values, in the "dose-response assessment" step. The approach proposed in this work is original in that it is based on real exposures instead of a limited number of pollutants from a unique chemical family, as traditionally performed. This framework is illustrated by the case study of semi-volatile organic compounds in French dwellings, providing insights into practical considerations regarding the accuracy of the available toxicological information. This case study illustrates the value of the exposure-based approach as opposed to the traditional cumulative framework, in which chemicals with similar health effects were not always included in the same chemical class. Copyright © 2014 Elsevier Inc. All rights reserved.

A case study to illustrate the utility of the Aggregate Exposure Pathway and Adverse Outcome Pathway frameworks for integrating human health and ecological data into cumulative risk assessment

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Cumulative risk assessment (CRA) methods, which evaluate the risk of multiple adverse outcomes (AOs) from multiple chemicals, promote the use of a conceptual site model (CSM) to integrate risk from relevant stressors. The Adverse Outcome Pathway (AOP) framework can inform these r...

Do risk factors for problem behaviour act in a cumulative manner? An examination of ethnic minority and majority children through an ecological perspective.

Science.gov (United States)

Atzaba-Poria, Naama; Pike, Alison; Deater-Deckard, Kirby

2004-05-01

Extensive research has identified risk factors for problem behaviour in childhood. However, most of this research has focused on isolated variables, ignoring possible additive influences. The purpose of this study was to examine whether risk factors for problem behaviour act in a cumulative manner, and to investigate whether cumulative risk stemming from distinct ecological levels (Bronfenbrenner, 1979) differentially influences the manifestation of problem behaviours in middle childhood. In addition, ethnic differences between minority (i.e., Indian) and majority (i.e., English) families were examined. The sample consisted of 125 children (59 English and 66 of Indian origin) between the ages of 7 and 9.6 (M = 8.51, SD = 0.62) and their parents. Both mothers and fathers completed questionnaires regarding the children's problem behaviour and provided reports of the children's characteristics and environment. Children were also assessed and provided reports about themselves and their relationships. Finally, parent-child mutuality and parenting behaviour were coded from a videotaped parent-child interaction task. Risk factors acted in a cumulative manner - the more risk children experienced, the more problem behaviour they exhibited. Total problem behaviour was predicted by all three levels: individual, microsystem and exosystem. However, externalising problems were mainly predicted by microsystem-level cumulative risk, whereas internalising problems were predicted by both individual-level cumulative risk and exosystem-level cumulative risk. These results were similar for both ethnic groups. The support for the cumulative hypothesis highlights the importance of having a broad picture of children's characteristics and environmental components when analysing children's adjustment. The distinct influence of risk stemming from the different ecological levels suggests that the trajectories of internalising, externalising and total problem behaviour may be different.

Impact of a health promotion program on employee health risks and work productivity.

Science.gov (United States)

Mills, Peter R; Kessler, Ronald C; Cooper, John; Sullivan, Sean

2007-01-01

Evaluate the impact of a multicomponent workplace health promotion program on employee health risks and work productivity. Quasi-experimental 12-month before-after intervention-control study. A multinational corporation headquartered in the United Kingdom. Of 618 employees offered the program, 266 (43%) completed questionnaires before and after the program. A total of 1242 of 2500 (49.7%) of a control population also completed questionnaires 12 months apart. A multicomponent health promotion program incorporating a health risk appraisal questionnaire, access to a tailored health improvement web portal, wellness literature, and seminars and workshops focused upon identified wellness issues. Outcomes were (1) cumulative count of health risk factors and the World Health Organization health and work performance questionnaire measures of (2) workplace absenteeism and (3) work performance. After adjusting for baseline differences, improvements in all three outcomes were significantly greater in the intervention group compared with the control group. Mean excess reductions of 0.45 health risk factors and 0.36 monthly absenteeism days and a mean increase of 0.79 on the work performance scale were observed in the intervention group compared with the control group. The intervention yielded a positive return on investment, even using conservative assumptions about effect size estimation. The results suggest that a well-implemented multicomponent workplace health promotion program can produce sizeable changes in health risks and productivity.

Re-conceptualising prenatal life stressors in predicting post-partum depression: cumulative-, specific-, and domain-specific approaches to calculating risk.

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Liu, Cindy H; Tronick, Ed

2013-09-01

Prenatal life stress predicts post-partum depression (PPD); however, studies generally examine individual stressors (a specific approach) or the summation of such exposure (a cumulative approach) and their associations with PPD. Such approaches may oversimplify prenatal life stress as a risk factor for PPD. We evaluated approaches in assessing prenatal life stress as a predictor of PPD diagnosis, including a domain-specific approach that captures cumulative life stress while accounting for stress across different life stress domains: financial, relational, and physical health. The Pregnancy Risk Assessment Monitoring System, a population-based survey, was used to analyse the association of prenatal life stressors with PPD diagnoses among 3566 New York City post-partum women. Specific stressors were not associated with PPD diagnosis after controlling for sociodemographic variables. Exposure to a greater number of stressors was associated with PPD diagnosis, even after adjusting for both sociodemographic variables and specific stressors [odds ratio (OR) = 3.1, 95% confidence interval (CI) = 1.5, 6.7]. Individuals reporting a moderate-to-high number of financial problems along with a moderate-to-high number of physical problems were at greater odds of PPD (OR = 4.2, 95% CI = 1.2, 15.3); those with a moderate-to-high number of problems in all three domains were at over fivefold increased odds of PPD (OR = 5.5, CI = 1.1, 28.5). In assessing prenatal stress, clinicians should consider the extent to which stressors occur across different life domains; this association appears stronger with PPD diagnosis than simple assessments of individual stressors, which typically overestimate risk or cumulative exposures. © 2013 John Wiley & Sons Ltd.

Cumulative risk assessment of phthalate exposure of Danish children and adolescents using the hazard index approach

DEFF Research Database (Denmark)

Søeborg, T; Frederiksen, H; Andersson, Anna-Maria

2012-01-01

Human risk assessment of chemicals is traditionally presented as the ratio between the actual level of exposure and an acceptable level of exposure, with the acceptable level of exposure most often being estimated by appropriate authorities. This approach is generally sound when assessing the risk...... of individual chemicals. However, several chemicals may concurrently target the same receptor, work through the same mechanism or in other ways induce the same effect(s) in the body. In these cases, cumulative risk assessment should be applied. The present study uses biomonitoring data from 129 Danish children...... and adolescents and resulting estimated daily intakes of four different phthalates. These daily intake estimates are used for a cumulative risk assessment with anti-androgenic effects as the endpoint using Tolerable Daily Intake (TDI) values determined by the European Food Safety Authorities (EFSA) or Reference...

Cumulative Risk and Continuity in Nonparental Care from Infancy to Early Adolescence.

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Colwell, Malinda J; Pettit, Gregory S; Meece, Darrell; Bates, John E; Dodge, Kenneth A

2001-04-01

Variations in amounts of nonparental care across infancy, preschool, early elementary school, and early adolescence were examined in a longitudinal sample (N = 438). Of interest was (a) continuity in use of the different arrangements, (b) whether the arrangements were additively and cumulatively associated with children's externalizing behavior problems, and (c) whether predictive relations were accounted for by social-ecological (socioeconomic status, mothers' employment status, marital status) and social-experiential (parenting quality, exposure to aggressive peers) factors. Correlations among overall amounts of care provided little evidence of cross-time continuity. Consistent with the cumulative risk perspective, Grade 1 self-care and Grade 6 unsupervised peer contact incrementally predicted Grade 6 externalizing problems. Most of the predictive associations were accounted for by family background and social relationship factors.

Cumulative risk effects for the development of behaviour difficulties in children and adolescents with special educational needs and disabilities.

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Oldfield, Jeremy; Humphrey, Neil; Hebron, Judith

2015-01-01

Research has identified multiple risk factors for the development of behaviour difficulties. What have been less explored are the cumulative effects of exposure to multiple risks on behavioural outcomes, with no study specifically investigating these effects within a population of young people with special educational needs and disabilities (SEND). Furthermore, it is unclear whether a threshold or linear risk model better fits the data for this population. The sample included 2660 children and 1628 adolescents with SEND. Risk factors associated with increases in behaviour difficulties over an 18-month period were summed to create a cumulative risk score, with this explanatory variable being added into a multi-level model. A quadratic term was then added to test the threshold model. There was evidence of a cumulative risk effect, suggesting that exposure to higher numbers of risk factors, regardless of their exact nature, resulted in increased behaviour difficulties. The relationship between risk and behaviour difficulties was non-linear, with exposure to increasing risk having a disproportionate and detrimental impact on behaviour difficulties in child and adolescent models. Interventions aimed at reducing behaviour difficulties need to consider the impact of multiple risk variables. Tailoring interventions towards those exposed to large numbers of risks would be advantageous. Copyright © 2015 Elsevier Ltd. All rights reserved.

Multi-risk infants: predicting attachment security from sociodemographic, psychosocial, and health risk among African-American preterm infants.

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Candelaria, Margo; Teti, Douglas M; Black, Maureen M

2011-08-01

Ecological and transactional theories link child outcomes to accumulated risk. This study hypothesized that cumulative risk was negatively related to attachment, and that maternal sensitivity mediated linkages between risk and attachment. One hundred and twelve high-risk African-American premature infant-mother dyads participated. Psychosocial (maternal depression, stress and self-efficacy) and sociodemographic risk (poverty, maternal education, marital status) were maternal self-report (0-4 months). Infant health risk was obtained from hospital charts. Infant-mother attachment (12 months) and maternal sensitivity (4 months) were assessed with Q-sort measures. Psychosocial and sociodemographic risk, but not infant health risk, negatively related to attachment. Both were mediated by maternal sensitivity. The impact of risk domains on attachment security was mediated by maternal sensitivity. Results emphasize the need for early intervention programs targeting premature infants to identify and address environmental and personal factors that place parenting at risk. © 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health.

Patterns of cumulative abuse among female survivors of intimate partner violence: links to women's health and socioeconomic status.

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Davies, Lorraine; Ford-Gilboe, Marilyn; Willson, Andrea; Varcoe, Colleen; Wuest, Judith; Campbell, Jacquelyn; Scott-Storey, Kelly

2015-01-01

Drawing on the Women's Health Effects Study, a community sample of women (N = 309) who recently left an abusive partner, this study examines patterns of cumulative abuse experiences over the life course, their socioeconomic correlates, and associations with a range of health outcomes. Latent class analysis identified four groups of women with differing cumulative abuse profiles: Intimate Partner Violence (IPV) Dominant, Child Abuse and IPV, All Forms, and All Forms Extreme. We find a relationship pattern between cumulative abuse and socioeconomic circumstances, and significantly worse health outcomes among women with the All Forms Extreme profile. Implications for research and practice are discussed. © The Author(s) 2014.

Cumulative Small Effect Genetic Markers and the Risk of Colorectal Cancer in Poland, Estonia, Lithuania, and Latvia

Directory of Open Access Journals (Sweden)

Pablo Serrano-Fernandez

2015-01-01

Full Text Available The continued identification of new low-penetrance genetic variants for colorectal cancer (CRC raises the question of their potential cumulative effect among compound carriers. We focused on 6 SNPs (rs380284, rs4464148, rs4779584, rs4939827, rs6983267, and rs10795668, already described as risk markers, and tested their possible independent and combined contribution to CRC predisposition. Material and Methods. DNA was collected and genotyped from 2330 unselected consecutive CRC cases and controls from Estonia (166 cases and controls, Latvia (81 cases and controls, Lithuania (123 cases and controls, and Poland (795 cases and controls. Results. Beyond individual effects, the analysis revealed statistically significant linear cumulative effects for these 6 markers for all samples except of the Latvian one (corrected P value = 0.018 for the Estonian, corrected P value = 0.0034 for the Lithuanian, and corrected P value = 0.0076 for the Polish sample. Conclusions. The significant linear cumulative effects demonstrated here support the idea of using sets of low-risk markers for delimiting new groups with high-risk of CRC in clinical practice that are not carriers of the usual CRC high-risk markers.

Cumulative incidence, distribution, and determinants of catastrophic health expenditure in Nepal: results from the living standards survey.

Science.gov (United States)

Ghimire, Mamata; Ayer, Rakesh; Kondo, Masahide

2018-02-14

Nepal has committed to the global community to achieve universal health coverage by 2030. Nevertheless, Nepal still has a high proportion of out-of-pocket health payment and a limited risk-pooling mechanism. Out-of-pocket payment for the healthcare services could result in catastrophic health expenditure (CHE). Evidence is required to effectively channel the efforts to lower those expenses in order to achieve universal health coverage. However, little is known about CHE and its determinants in a broad national context in Nepal. Therefore, this study was conducted to explore the cumulative incidence, distribution, and determinants of CHE in Nepal. Data were obtained from the nationally representative survey, the Nepal Living Standards Survey-third undertaken in 2010/11. Information from 5988 households was used for the analyses. Households were classified as having CHE when their out-of-pocket health payment was greater than or equal to 40% of their capacity to pay. Remaining households were classified as not having CHE. Logistic regression analyses were used to identify determinants of CHE. Based on household-weighted sample, the cumulative incidence of CHE was 10.3% per month in Nepal. This incidence was concentrated in the far-western region and households in the poorer expenditure quartiles. Multivariable logistic regression revealed that households were more likely to face CHE if they; consisted of chronically ill member(s), have a higher burden of acute illness and injuries, have elderly (≥60 years) member(s), belonged to the poor expenditure quartile, and were located in the far-western region. In contrast, households were less likely to incur CHE when their household head was educated. Having children (≤5 years) in households did not significantly affect catastrophic health expenditure. This study identified a high cumulative incidence of CHE. CHE was disproportionately concentrated in the poor households and households located in the far

Ecological correlates of multiple sexual partnerships among adolescents and young adults in urban Cape Town: a cumulative risk factor approach.

Science.gov (United States)

Muchiri, Evans; Odimegwu, Clifford; Banda, Pamela; Ntoimo, Lorreta; Adedini, Sunday

2017-07-01

Studies in South Africa have reported unsafe levels of risky sexual behvaiours among adolescents and young adults, with the country reporting the highest burden of HIV/AIDS globally, as well as a high rate of teenage pregnancy. While determinants of risky sexual behaviours have been investigated for factors occurring at the individual and household levels, not fully explored in the literature is the effect of community level factors. Furthermore, it is unclear whether risk factors occurring within the ecology of adolescents and young adults act cumulatively to influence their sexual practices. This article aims to address this knowledge gap using a case study of the Cape Area Panel Study of adolescents and young adults in urban Cape Town, South Africa. The ecological framework was adopted to guide the selection of risk factors at the individual, household, and community levels. Multivariate linear discriminant function analyses were used to select significant risk factors for multiple sexual partnerships and used to produce risk indices for the respondents. The cumulative risk approach was applied to test whether significant risk factors acted cumulatively. Findings point to the importance of ecological factors in influencing outcomes of multiple sexual partnerships among respondents and further demonstrate that ecological risk factors may act cumulatively. These findings are important for South Africa that is grappling with teenage pregnancy and disproportionate HIV epidemic among the youth.

Study on the cumulative impact of reclamation activities on ecosystem health in coastal waters.

Science.gov (United States)

Shen, Chengcheng; Shi, Honghua; Zheng, Wei; Li, Fen; Peng, Shitao; Ding, Dewen

2016-02-15

The purpose of this study is to develop feasible tools to investigate the cumulative impact of reclamations on coastal ecosystem health, so that the strategies of ecosystem-based management can be applied in the coastal zone. An indicator system and model were proposed to assess the cumulative impact synthetically. Two coastal water bodies, namely Laizhou Bay (LZB) and Tianjin coastal waters (TCW), in the Bohai Sea of China were studied and compared, each in a different phase of reclamations. Case studies showed that the indicator scores of coastal ecosystem health in LZB and TCW were 0.75 and 0.68 out of 1.0, respectively. It can be concluded that coastal reclamations have a historically cumulative effect on benthic environment, whose degree is larger than that on aquatic environment. The ecosystem-based management of coastal reclamations should emphasize the spatially and industrially intensive layout. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cumulative occupational mechanical exposures during working life and risk of sickness absence and disability pension

DEFF Research Database (Denmark)

Sundstrup, Emil; Hansen, Åse Marie; Mortensen, Erik Lykke

2017-01-01

and Midlife Biobank with a job exposure matrix and a national register containing information on social transfer payment. By coding individual job histories from the Danish version of ISCO-codes (International Standard Classification of Occupations), we calculated cumulative occupational mechanical exposures......-regression analyses estimated the relative risk of register-based long-term sickness absence (LTSA) and disability pension with cumulative occupational mechanical exposures throughout working life. Analyses were censored for competing events and adjusted for multiple confounders. Results: During the follow-up period......, 970 persons (19.3%) had ≥1 episode of LTSA and 85 persons (1.7%) were granted a disability pension. Number of ton-, lifting- and kneeling-years showed an exposure-response association with increased risk of LTSA (P

Effects of cumulative trauma load on perceptions of health, blood pressure, and resting heart rate in urban African American youth.

Science.gov (United States)

Conner-Warren, Rhonda

2014-04-01

This study examined relationships between cumulative trauma (CT) and urban African American (AA) adolescents' blood pressure (BP), heart rate (HR), and perceptions of health. A correlational design using secondary data analysis studied effects of CT, health outcomes, and perceptions of health. Participants were 175 urban AA youth (11-16 years) who completed structured surveys and physiological measures of HR and BP before and after exercise. AA youth were experiencing high levels of CT. Negative correlations were obtained between AA females' perceptions of their health and systolic BP with levels of trauma. No gender differences were found in HR or BP. AA females with high CT may perceive themselves as less healthy and can be at risk for health problems. © 2014, Wiley Periodicals, Inc.

The association between cumulative adversity and mental health: considering dose and primary focus of adversity.

Science.gov (United States)

Keinan, Giora; Shrira, Amit; Shmotkin, Dov

2012-09-01

The study addressed the dose-response model in the association of cumulative adversity with mental health. Data of 1,725 participants aged 50+ were drawn from the Israeli component of the Survey of Health, Ageing, and Retirement in Europe. Measures included an inventory of potentially traumatic events, distress (lifetime depression, depressive symptoms), and well-being (quality of life, optimism/hope). The maximal effect of cumulative trauma emerged in the contrast between 0-2 and 3+ events, where the higher number of events related to higher distress but also to higher well-being. While self-oriented adversity revealed no, or negative, association with well-being, other-oriented adversity revealed a positive association. The study suggests an experiential dose of cumulative adversity leading to a co-activation of distress and well-being. The source of this co-activation seems to be other-oriented adversity.

Risk of therapy-related leukaemia and preleukaemia after Hodgkin's disease. Relation to age, cumulative dose of alkylating agents, and time from chemotherapy

DEFF Research Database (Denmark)

Pedersen-Bjergaard, J.; Specht, L.; Larsen, S.O.

1987-01-01

391 patients treated intensively for Hodgkin's disease were followed for up to 15 years to evaluate the risk of therapy-related acute non-lymphocytic leukaemia (t-ANLL) and preleukaemia. Only two independent factors, patient age and cumulative dose of alkylating agents, were related to the risk...... of t-ANLL. The hazard rate of t-ANLL was roughly proportional to the square of patient age and to the total cumulative dose of alkylating agents. In 320 patients treated with alkylating agents the cumulative risk of t-ANLL increased steadily from 1 year after the start of treatment and reached 13.......0% (SE 3.0) at 10 years after which time there were no further cases. Calculated from cessation of therapy with alkylating agents, however, the cumulative risk curve increased steeply during the first 1-2 years then gradually levelled out and no new cases were observed beyond 7 years. With a 15-year...

Children neglected: Where cumulative risk theory fails.

Science.gov (United States)

O'Hara, Mandy; Legano, Lori; Homel, Peter; Walker-Descartes, Ingrid; Rojas, Mary; Laraque, Danielle

2015-07-01

Neglected children, by far the majority of children maltreated, experience an environment most deficient in cognitive stimulation and language exchange. When physical abuse co-occurs with neglect, there is more stimulation through negative parent-child interaction, which may lead to better cognitive outcomes, contrary to Cumulative Risk Theory. The purpose of the current study was to assess whether children only neglected perform worse on cognitive tasks than children neglected and physically abused. Utilizing LONGSCAN archived data, 271 children only neglected and 101 children neglected and physically abused in the first four years of life were compared. The two groups were assessed at age 6 on the WPPSI-R vocabulary and block design subtests, correlates of cognitive intelligence. Regression analyses were performed, controlling for additional predictors of poor cognitive outcome, including socioeconomic variables and caregiver depression. Children only neglected scored significantly worse than children neglected and abused on the WPPSI-R vocabulary subtest (p=0.03). The groups did not differ on the block design subtest (p=0.4). This study shows that for neglected children, additional abuse may not additively accumulate risk when considering intelligence outcomes. Children experiencing only neglect may need to be referred for services that address cognitive development, with emphasis on the linguistic environment, in order to best support the developmental challenges of neglected children. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cumulative trauma, gender discrimination and mental health in women: mediating role of self-esteem.

Science.gov (United States)

Kucharska, Justyna

2017-12-20

Evidence suggests that women show symptoms of trauma-related symptoms more often than men. Gender discrimination is also associated with the severity of symptoms in women. This study explored the relations among cumulative trauma, gender discrimination and mental health in women with a mediating role of self-esteem and emotion regulation. Two types of gender discrimination were taken into account: discrimination by parents and in the social context. Cumulative trauma over the lifetime was assessed, as well as three types of symptoms: internalising, externalising, psychoticism. A total of 277 females from Poland participated in the study. It was hypothesised that gender discrimination and cumulative trauma would be positively related to symptoms and that lowered self-esteem mediates these relations. Hypotheses received partial confirmation, as both gender discrimination and cumulative trauma have been shown to be related to three types of symptoms. Self-esteem was a partial mediator between gender discrimination in the social context and symptoms. It was also demonstrated that emotion suppression is a partial mediator between cumulative trauma and symptoms. It has been demonstrated that socio-cultural factors, such as gender discrimination, play an important role in psychiatric symptoms development.

Cumulative effective and individual organ dose levels in paediatric patients undergoing multiple catheterizations for congenital heart disease

International Nuclear Information System (INIS)

Jones, T.P.; Brennan, P.C.; Ryan, E.

2017-01-01

This study examines the cumulative radiation dose levels received by a group of children who underwent multiple cardiac catheterisation procedures during the investigation and management of congenital heart disease (CHD). The purpose is to calculate cumulative doses, identify higher dose individuals, outline the inconsistencies with risk assessment and encourage the establishment of dose databases in order to facilitate the longitudinal research necessary to better understand health risks. A retrospective review of patient records for 117 paediatric patients who have undergone two or more cardiac catheterizations for the investigation of CHD was undertaken. This cohort consisted of patients who were catheterised over a period from September 2002 to August 2014. The age distribution was from newborn to 17 y. Archived kerma-area product (P KA ) and fluoroscopy time (T) readings were retrieved and analysed. Cumulative effective and individual organ doses were determined. The cumulative P KA levels ranged from 1.8 to 651.2 Gycm 2 , whilst cumulative effective dose levels varied from 2 to 259 mSv. The cumulative fluoroscopy time was shown to vary from 8.1 to 193.5 min. Median cumulative organ doses ranged from 3 to 94 mGy. Cumulative effective dose levels are highly variable but may exceed 250 mSv. Individual organ and effective dose measurements remain useful for comparison purposes between institutions although current methodologies used for determining lifetime risks are inadequate. (authors)

Early Educational Intervention, Early Cumulative Risk, and the Early Home Environment as Predictors of Young Adult Outcomes within a High-Risk Sample

Science.gov (United States)

Pungello, Elizabeth P.; Kainz, Kirsten; Burchinal, Margaret; Wasik, Barbara H.; Sparling, Joseph J.; Ramey, Craig T.; Campbell, Frances A.

2010-01-01

The extent to which early educational intervention, early cumulative risk, and the early home environment were associated with young adult outcomes was investigated in a sample of 139 young adults (age 21) from high-risk families enrolled in randomized trials of early intervention. Positive effects of treatment were found for education attainment,…

Psychotic-spectrum symptoms, cumulative adversity exposure and substance use among high-risk girls.

Science.gov (United States)

Lansing, Amy E; Plante, Wendy Y; Fennema-Notestine, Christine; Golshan, Shahrokh; Beck, Audrey N

2018-02-01

Psychotic-spectrum symptoms are linked to trauma, substance/alcohol use (SAU), criminality/violence and poor functional outcomes, supporting the need for early detection in vulnerable populations. To better understand high-risk girls' mental health, we assessed: (1) psychotic-spectrum symptoms; (2) cumulative trauma, adversity and loss exposures (C-TALE) and adversity-indicators (symptoms, maladaptive coping, stressor-reactivity); and SAU risk-factors; and (3) relationships among psychotic-spectrum symptoms, adversity-indicators and SAU risk-factors. We administered the Structured Clinical Interviews for Psychotic Spectrum, and Trauma and Loss Spectrum to 158 adolescent delinquent girls. Girls' psychotic-spectrum profiles were similar to previously reported adult psychotic patients and characterized by typical symptoms (hallucinations/delusions, reported largely SAU-independent), interpersonal sensitivity, schizoid traits and paranoia (over-interpretation, anger over-reactivity, hypervigilance). Auditory/visual hallucinations (55.7%), delusions (92.4%), ideas of reference (96.8%) and adversity (90.0% ≥10/24 C-TALE-types) were common. Mean loss (4) and trauma (8) onset-age occurred before SAU-onset (12). Significant positive correlations were found among psychotic-spectrum symptoms, stressor-reactivity, C-TALE, adversity-indicators; and number of SAU-types; and a negative correlation occurred between psychotic-spectrum symptoms and earlier alcohol use onset. After controlling for number of SAU-types, stressor-reactivity and adversity-related numbing individually had the largest associations with total psychotic-spectrum symptoms (b = 2.6-4.3). Girls averaged more than 4 maladaptive coping strategies (e.g., 24.8% attempted suicide) in response to adversity, amplifying potential health-disparities. No racial/ethnic differences emerged on psychotic-spectrum symptoms. This symptom constellation during adolescence likely interferes with social and academic

Dietary cumulative acute risk assessment of organophosphorus, carbamates and pyrethroids insecticides for the Brazilian population.

NARCIS (Netherlands)

Jardim, Andreia Nunes Oliveira; Brito, Alessandra Page; van Donkersgoed, Gerda; Boon, Polly E; Caldas, Eloisa Dutra

Cumulative acute dietary risk assessments of organophosphorus (OPs), carbamates (CBs) and pyrethroids (PYs) were conducted for the Brazilian population. Residue data for 30786 samples of 30 foods were obtained from two national monitoring programs and one University laboratory, and consumption data

Health Risks of Diagnostic Radiology

International Nuclear Information System (INIS)

Al-Oraby, M.N.A.

2014-01-01

Exposure to ionizing radiation during diagnostic radiologic procedures carries small but real risks. Children, young adults and pregnant women are especially vulnerable. Exposure of patients to diagnostic energy levels of ionizing radiation should be kept to the minimum necessary to provide useful clinical information and allay patients concerns about radiation-related risks. Computerized Tomography (CT) accounts for two thirds of the cumulative patient dose from diagnostic radiological procedures and the cumulative dose from CT is rising as technological advances increase the number of indications and the capabilities of CT. Carcinogenesis and teratogenesis are the main concerns with ionizing radiation. The risk increases as the radiation dose increases. There is no minimum threshold and the risk is cumulative: a dose of 1 mSv once a year for 10 years is equivalent to a single dose of 10 mSv. Whenever practical, choose an imaging test that uses less radiation or no radiation and lengthen the periods between follow-up imaging tests. Some patients may avoid screening mammography because of fear of radiation-induced cancer, yet this test uses a very small radiation dose (0.6 mSv, much less than the annual dose from background radiation, 3.6 mSv). (author)

The cumulative risk of false-positive screening results across screening centres in the Norwegian Breast Cancer Screening Program

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Roman, M., E-mail: Marta.Roman@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Department of Women and Children’s Health, Oslo University Hospital, Oslo (Norway); Skaane, P., E-mail: PERSK@ous-hf.no [Department of Radiology, Oslo University Hospital Ullevaal, University of Oslo, Oslo (Norway); Hofvind, S., E-mail: Solveig.Hofvind@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Oslo and Akershus University College of Applied Sciences, Faculty of Health Science, Oslo (Norway)

2014-09-15

Highlights: • We found variation in early performance measures across screening centres. • Radiologists’ performance may play a key role in the variability. • Potential to improve the effectiveness of breast cancer screening programs. • Continuous surveillance of screening centres and radiologists is essential. - Abstract: Background: Recall for assessment in mammographic screening entails an inevitable number of false-positive screening results. This study aimed to investigate the variation in the cumulative risk of a false positive screening result and the positive predictive value across the screening centres in the Norwegian Breast Cancer Screening Program. Methods: We studied 618,636 women aged 50–69 years who underwent 2,090,575 screening exams (1996–2010. Recall rate, positive predictive value, rate of screen-detected cancer, and the cumulative risk of a false positive screening result, without and with invasive procedures across the screening centres were calculated. Generalized linear models were used to estimate the probability of a false positive screening result and to compute the cumulative false-positive risk for up to ten biennial screening examinations. Results: The cumulative risk of a false-positive screening exam varied from 10.7% (95% CI: 9.4–12.0%) to 41.5% (95% CI: 34.1–48.9%) across screening centres, with a highest to lowest ratio of 3.9 (95% CI: 3.7–4.0). The highest to lowest ratio for the cumulative risk of undergoing an invasive procedure with a benign outcome was 4.3 (95% CI: 4.0–4.6). The positive predictive value of recall varied between 12.0% (95% CI: 11.0–12.9%) and 19.9% (95% CI: 18.3–21.5%), with a highest to lowest ratio of 1.7 (95% CI: 1.5–1.9). Conclusions: A substantial variation in the performance measures across the screening centres in the Norwegian Breast Cancer Screening Program was identified, despite of similar administration, procedures, and quality assurance requirements. Differences in the

The cumulative risk of false-positive screening results across screening centres in the Norwegian Breast Cancer Screening Program

International Nuclear Information System (INIS)

Roman, M.; Skaane, P.; Hofvind, S.

2014-01-01

Highlights: • We found variation in early performance measures across screening centres. • Radiologists’ performance may play a key role in the variability. • Potential to improve the effectiveness of breast cancer screening programs. • Continuous surveillance of screening centres and radiologists is essential. - Abstract: Background: Recall for assessment in mammographic screening entails an inevitable number of false-positive screening results. This study aimed to investigate the variation in the cumulative risk of a false positive screening result and the positive predictive value across the screening centres in the Norwegian Breast Cancer Screening Program. Methods: We studied 618,636 women aged 50–69 years who underwent 2,090,575 screening exams (1996–2010. Recall rate, positive predictive value, rate of screen-detected cancer, and the cumulative risk of a false positive screening result, without and with invasive procedures across the screening centres were calculated. Generalized linear models were used to estimate the probability of a false positive screening result and to compute the cumulative false-positive risk for up to ten biennial screening examinations. Results: The cumulative risk of a false-positive screening exam varied from 10.7% (95% CI: 9.4–12.0%) to 41.5% (95% CI: 34.1–48.9%) across screening centres, with a highest to lowest ratio of 3.9 (95% CI: 3.7–4.0). The highest to lowest ratio for the cumulative risk of undergoing an invasive procedure with a benign outcome was 4.3 (95% CI: 4.0–4.6). The positive predictive value of recall varied between 12.0% (95% CI: 11.0–12.9%) and 19.9% (95% CI: 18.3–21.5%), with a highest to lowest ratio of 1.7 (95% CI: 1.5–1.9). Conclusions: A substantial variation in the performance measures across the screening centres in the Norwegian Breast Cancer Screening Program was identified, despite of similar administration, procedures, and quality assurance requirements. Differences in the

Setting the stage for chronic health problems: cumulative childhood adversity among homeless adults with mental illness in Vancouver, British Columbia.

Science.gov (United States)

Patterson, Michelle L; Moniruzzaman, Akm; Somers, Julian M

2014-04-12

It is well documented that childhood abuse, neglect and household dysfunction are disproportionately present in the backgrounds of homeless adults, and that these experiences adversely impact child development and a wide range of adult outcomes. However, few studies have examined the cumulative impact of adverse childhood experiences on homeless adults with mental illness. This study examines adverse events in childhood as predictors of duration of homelessness, psychiatric and substance use disorders, and physical health in a sample of homeless adults with mental illness. This study was conducted using baseline data from a randomized controlled trial in Vancouver, British Columbia for participants who completed the Adverse Childhood Experiences (ACE) scale at 18 months follow-up (n=364). Primary outcomes included current mental disorders; substance use including type, frequency and severity; physical health; duration of homelessness; and vocational functioning. In multivariable regression models, ACE total score independently predicted a range of mental health, physical health, and substance use problems, and marginally predicted duration of homelessness. Adverse childhood experiences are overrepresented among homeless adults with complex comorbidities and chronic homelessness. Our findings are consistent with a growing body of literature indicating that childhood traumas are potent risk factors for a number of adult health and psychiatric problems, particularly substance use problems. Results are discussed in the context of cumulative adversity and self-trauma theory. This trial has been registered with the International Standard Randomized Control Trial Number Register and assigned ISRCTN42520374.

Optimization of the cumulative risk assessment of pesticides and biocides using computational techniques: Pilot project

DEFF Research Database (Denmark)

Jonsdottir, Svava Osk; Reffstrup, Trine Klein; Petersen, Annette

This pilot project is intended as the first step in developing a computational strategy to assist in refining methods for higher tier cumulative and aggregate risk assessment of exposure to mixture of pesticides and biocides. For this purpose, physiologically based toxicokinetic (PBTK) models were...

Nonparametric Estimation of Cumulative Incidence Functions for Competing Risks Data with Missing Cause of Failure

DEFF Research Database (Denmark)

Effraimidis, Georgios; Dahl, Christian Møller

In this paper, we develop a fully nonparametric approach for the estimation of the cumulative incidence function with Missing At Random right-censored competing risks data. We obtain results on the pointwise asymptotic normality as well as the uniform convergence rate of the proposed nonparametric...

Cumulative burden of lifetime adversities: Trauma and mental health in low-SES African Americans and Latino/as.

Science.gov (United States)

Myers, Hector F; Wyatt, Gail E; Ullman, Jodie B; Loeb, Tamra B; Chin, Dorothy; Prause, Nicole; Zhang, Muyu; Williams, John K; Slavich, George M; Liu, Honghu

2015-05-01

This study examined the utility of a lifetime cumulative adversities and trauma model in predicting the severity of mental health symptoms of depression, anxiety, and posttraumatic stress disorder. We also tested whether ethnicity and gender moderate the effects of this stress exposure construct on mental health using multigroup structural equation modeling. A sample of 500 low-socioeconomic status African American and Latino men and women with histories of adversities and trauma were recruited and assessed with a standard battery of self-report measures of stress and mental health. Multiple-group structural equation models indicated good overall model fit. As hypothesized, experiences of discrimination, childhood family adversities, childhood sexual abuse, other childhood trauma, and chronic stresses all loaded on the latent cumulative burden of adversities and trauma construct (CBAT). The CBAT stress exposure index in turn predicted the mental health status latent variable. Although there were several significant univariate ethnic and gender differences, and ethnic and gender differences were observed on several paths, there were no significant ethnic differences in the final model fit of the data. These findings highlight the deleterious consequences of cumulative stress and trauma for mental health and underscore a need to assess these constructs in selecting appropriate clinical interventions for reducing mental health disparities and improving human health. (c) 2015 APA, all rights reserved).

Repeated exposure to high-frequency spanking and child externalizing behavior across the first decade: a moderating role for cumulative risk.

Science.gov (United States)

MacKenzie, Michael J; Nicklas, Eric; Brooks-Gunn, Jeanne; Waldfogel, Jane

2014-12-01

This study used the Fragile Families and Child Well-Being Study to examine the effects of repeated exposure to harsh parenting on child externalizing behavior across the first decade of life, and a moderating role for cumulative ecological risk. Maternal report of harsh parenting, defined as high frequency spanking, was assessed at age 1, 3, 5, and 9, along with child externalizing at age 9 (N=2,768). Controlling for gender, race, maternal nativity, and city of residence, we found a cumulative risk index to significantly moderate the effects of repeated harsh parenting on child behavior, with the effects of repeated high-frequency spanking being amplified for those experiencing greater levels of cumulative risk. Harsh parenting, in the form of high frequency spanking, remains a too common experience for children, and results demonstrate that the effects of repeated exposure to harsh parenting across the first decade are amplified for those children already facing the most burden. Copyright © 2014. Published by Elsevier Ltd.

Acrylamide in Romanian food using HPLC-UV and a health risk assessment.

Science.gov (United States)

Oroian, Mircea; Amariei, Sonia; Gutt, Gheorghe

2015-01-01

The aim of this study was to investigate the level of acrylamide from coffee, potato chips and French fries in Romanian food. According to the European Food Safety Authority, coffee beans, potato chips and French fries have the highest levels of acrylamide. For this survey, 50 samples of coffee beans, 50 samples of potato chips and 25 samples of French fries were purchased from different producers from the Romanian market. Acrylamide levels have been quantified using high-performance liquid chromatography with a diode array detector (HPLC-DAD) method, using water as mobile phase. Health risk assessment was achieved by computing the average daily intake, hazard quotient, cumulative risk, carcinogenic risk and cancer risk. For coffee, potato chips and French fries, acrylamide was not shown to pose a health risk in Romanian food.

Introducing risk adjustment and free health plan choice in employer-based health insurance: Evidence from Germany.

Science.gov (United States)

Pilny, Adam; Wübker, Ansgar; Ziebarth, Nicolas R

2017-12-01

To equalize differences in health plan premiums due to differences in risk pools, the German legislature introduced a simple Risk Adjustment Scheme (RAS) based on age, gender and disability status in 1994. In addition, effective 1996, consumers gained the freedom to choose among hundreds of existing health plans, across employers and state-borders. This paper (a) estimates RAS pass-through rates on premiums, financial reserves, and expenditures and assesses the overall RAS impact on market price dispersion. Moreover, it (b) characterizes health plan switchers and investigates their annual and cumulative switching rates over time. Our main findings are based on representative enrollee panel data linked to administrative RAS and health plan data. We show that sickness funds with bad risk pools and high pre-RAS premiums lowered their total premiums by 42 cents per additional euro allocated by the RAS. Consequently, post-RAS, health plan prices converged but not fully. Because switchers are more likely to be white collar, young and healthy, the new consumer choice resulted in more risk segregation and the amount of money redistributed by the RAS increased over time. Copyright © 2017 Elsevier B.V. All rights reserved.

Life course socioeconomic position and C-reactive protein: mediating role of health-risk behaviors and metabolic alterations. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil.

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Lidyane V Camelo

Full Text Available BACKGROUND: Chronic inflammation has been postulated to be one mediating mechanism explaining the association between low socioeconomic position (SEP and cardiovascular disease (CVD. We sought to examine the association between life course SEP and C-reactive protein (CRP levels in adulthood, and to evaluate the extent to which health-risk behaviors and metabolic alterations mediate this association. Additionally, we explored the possible modifying influence of gender. METHODS AND FINDINGS: Our analytical sample comprised 13,371 participants from ELSA-Brasil baseline, a multicenter prospective cohort study of civil servants. SEP during childhood, young adulthood, and adulthood were considered. The potential mediators between life course SEP and CRP included clusters of health-risk behaviors (smoking, low leisure time physical activity, excessive alcohol consumption, and metabolic alterations (obesity, hypertension, low HDL, hypertriglyceridemia, and diabetes. Linear regression models were performed and structural equation modeling was used to evaluate mediation. Although lower childhood SEP was associated with higher levels of CRP in adult life, this association was not independent of adulthood SEP. However, CRP increased linearly with increasing number of unfavorable social circumstances during the life course (p trend <0.001. The metabolic alterations were the most important mediator between cumulative SEP and CRP. This mediation path accounted for 49.5% of the total effect of cumulative SEP on CRP among women, but only 20.2% among men. In consequence, the portion of the total effect of cumulative SEP on CRP that was mediated by risk behaviors and metabolic alterations was higher among women (55.4% than among men (36.8%. CONCLUSIONS: Cumulative SEP across life span was associated with elevated systemic inflammation in adulthood. Although health-risk behaviors and metabolic alterations were important mediators of this association, a sizable

Observed Sensitivity during Family Interactions and Cumulative Risk: A Study of Multiple Dyads per Family

Science.gov (United States)

Browne, Dillon T.; Leckie, George; Prime, Heather; Perlman, Michal; Jenkins, Jennifer M.

2016-01-01

The present study sought to investigate the family, individual, and dyad-specific contributions to observed cognitive sensitivity during family interactions. Moreover, the influence of cumulative risk on sensitivity at the aforementioned levels of the family was examined. Mothers and 2 children per family were observed interacting in a round robin…

The effects of cumulative risks and promotive factors on urban adolescent alcohol and other drug use: a longitudinal study of resiliency.

Science.gov (United States)

Ostaszewski, Krzysztof; Zimmerman, Marc A

2006-12-01

Resiliency theory provides a conceptual framework for studying why some youth exposed to risk factors do not develop the negative behaviors they predict. The purpose of this study was to test compensatory and protective models of resiliency in a longitudinal sample of urban adolescents (80% African American). The data were from Years 1 (9th grade) and 4 (12th grade). The study examined effects of cumulative risk and promotive factors on adolescent polydrug use including alcohol, tobacco and marijuana. Cumulative measures of risk/promotive factors represented individual characteristics, peer influence, and parental/familial influences. After controlling for demographics, results of multiple regression of polydrug use support the compensatory model of resiliency both cross-sectionally and longitudinally. Promotive factors were also found to have compensatory effects on change in adolescent polydrug use. The protective model of resiliency evidenced cross-sectionally was not supported in longitudinal analysis. The findings support resiliency theory and the use of cumulative risk/promotive measures in resiliency research. Implications focused on utilizing multiple assets and resources in prevention programming are discussed.

Gender disparities among the association between cumulative family-level stress & adolescent weight status.

Science.gov (United States)

Hernandez, Daphne C; Pressler, Emily

2015-04-01

To investigate precursors to gender-related obesity disparities by examining multiple family-level stress indices. Analyses was based on adolescents born between 1975 and 1991 to women from the 1979 National Longitudinal Study of Youth data set (N=4762). Three types of family-level stressors were captured from birth to age 15: family disruption and conflict, financial strain, and maternal risky health behaviors, along with a total cumulative risk index. Body mass index was constructed on reference criteria for children outlined by the Centers for Disease Control. Multivariate logistic regressions were conducted for the three types of family stressors and for the total cumulative index. The accumulation of family disruption and conflict and financial stress was positively related to female adolescents being overweight/obese. Childhood exposure to maternal risky health behaviors was positively associated with higher weight status for male adolescents. Total cumulative stress was related to overweight/obesity for females, but not males. Different family-level stress indices are associated with the weight status of female and male adolescents. Combining types of family-level stress into one cumulative index appears to mask these differences. Copyright © 2015 Elsevier Inc. All rights reserved.

Serious, Minor, and Non-Delinquents in Early Adolescence : The Impact of Cumulative Risk and Promotive Factors. The TRAILS Study

NARCIS (Netherlands)

van der Laan, A.M.; Veenstra, R.; Bogaerts, S.; Verhulst, F.C.; Ormel, J.

This study uses a social-ecological approach to the development of delinquency. The authors emphasize that a balance between eliminating risk and enhancing protection across domains is essential in reducing problems and promoting competence. The cumulative risk and promotive effects of temperament,

Serious, minor, and non-delinquents in early adolescence: The impact of cumulative risk and promotive factors. The TRAILS study

NARCIS (Netherlands)

A.M. van der Laan (André); R. Veenstra (René); S. Bogaerts (Stefan); F.C. Verhulst (Frank); J. Ormel (Johan Hans)

2010-01-01

textabstractThis study uses a social-ecological approach to the development of delinquency. The authors emphasize that a balance between eliminating risk and enhancing protection across domains is essential in reducing problems and promoting competence. The cumulative risk and promotive effects of

A Case Study Application of the Aggregate Exposure Pathway (AEP) and Adverse Outcome Pathway (AOP) Frameworks to Facilitate the Integration of Human Health and Ecological End Points for Cumulative Risk Assessment (CRA)

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Cumulative risk assessment (CRA) methods promote the use of a conceptual site model (CSM) to apportion exposures and integrate risk from multiple stressors. While CSMs may encompass multiple species, evaluating end points across taxa can be challenging due to data availability an...

Serious, Minor, and Non-Delinquents in Early Adolescence: The Impact of Cumulative Risk and Promotive Factors. The TRAILS Study

Science.gov (United States)

van der Laan, Andre M.; Veenstra, Rene; Bogaerts, Stefan; Verhulst, Frank C.; Ormel, Johan

2010-01-01

This study uses a social-ecological approach to the development of delinquency. The authors emphasize that a balance between eliminating risk and enhancing protection across domains is essential in reducing problems and promoting competence. The cumulative risk and promotive effects of temperament, family and school factors in preadolescence were…

Health Impact Assessment: Linking Public Health to ...

Science.gov (United States)

The goal of this presentation is to explore how HIA can help inform hazardous waste permitting regulations and incorporate community vulnerability and cumulative impacts to their potential health risks into permitting decision making by the California Department of Toxic Substances Control. Presented the Health Impact Assessment (HIA) at the State of California Cumulative Impacts and Community Vulnerability Symposium on July 27 in Diamond Bar, CA.

Estimating a population cumulative incidence under calendar time trends

DEFF Research Database (Denmark)

Hansen, Stefan N; Overgaard, Morten; Andersen, Per K

2017-01-01

BACKGROUND: The risk of a disease or psychiatric disorder is frequently measured by the age-specific cumulative incidence. Cumulative incidence estimates are often derived in cohort studies with individuals recruited over calendar time and with the end of follow-up governed by a specific date....... It is common practice to apply the Kaplan-Meier or Aalen-Johansen estimator to the total sample and report either the estimated cumulative incidence curve or just a single point on the curve as a description of the disease risk. METHODS: We argue that, whenever the disease or disorder of interest is influenced...

Estimating a population cumulative incidence under calendar time trends

DEFF Research Database (Denmark)

Hansen, Stefan N; Overgaard, Morten; Andersen, Per K

2017-01-01

BACKGROUND: The risk of a disease or psychiatric disorder is frequently measured by the age-specific cumulative incidence. Cumulative incidence estimates are often derived in cohort studies with individuals recruited over calendar time and with the end of follow-up governed by a specific date...... by calendar time trends, the total sample Kaplan-Meier and Aalen-Johansen estimators do not provide useful estimates of the general risk in the target population. We present some alternatives to this type of analysis. RESULTS: We show how a proportional hazards model may be used to extrapolate disease risk...... estimates if proportionality is a reasonable assumption. If not reasonable, we instead advocate that a more useful description of the disease risk lies in the age-specific cumulative incidence curves across strata given by time of entry or perhaps just the end of follow-up estimates across all strata...

Toward the breast screening balance sheet: cumulative risk of false positives for annual versus biennial mammograms commencing at age 40 or 50.

Science.gov (United States)

Winch, Caleb J; Sherman, Kerry A; Boyages, John

2015-01-01

This study aimed to: (1) Estimate cumulative risk of recall from breast screening where no cancer is detected (a harm) in Australia; (2) Compare women screened annually versus biennially, commencing age 40 versus 50; and (3) Compare with international findings. At the no-cost metropolitan program studied, women attended biennial screening, but were offered annual screening if regarded at elevated risk for breast cancer. The cumulative risk of at least one recall was estimated using discrete-time survival analysis. Cancer detection statistics were computed. In total, 801,636 mammograms were undertaken in 231,824 women. Over 10 years, cumulative risk of recall was 13.3 % (95 % CI 12.7-13.8) for those screened biennially, and 19.9 % (CI 16.6-23.2) for those screened annually from age 50-51. Cumulative risk of complex false positive involving a biopsy was 3.1 % (CI 2.9-3.4) and 5.0 % (CI 3.4-6.6), respectively. From age 40-41, the risk of recall was 15.1 % (CI 14.3-16.0) and 22.5 % (CI 17.9-27.1) for biennial and annual screening, respectively. Corresponding rates of complex false positive were 3.3 % (CI 2.9-3.8) and 6.3 % (CI 3.4-9.1). Over 10 mammograms, invasive cancer was detected in 3.4 % (CI 3.3-3.5) and ductal carcinoma in situ in 0.7 % (CI 0.6-0.7) of women, with a non-significant trend toward a larger proportion of Tis and T1N0 cancers in women screened annually (74.5 %) versus biennially (70.1 %), χ (2) = 2.77, p = 0.10. Cancer detection was comparable to international findings. Recall risk was equal to European estimates for women screening from 50 and lower for screening from 40. Recall risk was half of United States' rates across start age and rescreening interval categories. Future benefit/harm balance sheets may be useful for communicating these findings to women.

Cumulative Risk and Adolescent's Internalizing and Externalizing Problems: The Mediating Roles of Maternal Responsiveness and Self-Regulation

Science.gov (United States)

Doan, Stacey N.; Fuller-Rowell, Thomas E.; Evans, Gary W.

2012-01-01

The purpose of the present study was to examine longitudinal associations among maternal responsiveness, self-regulation, and behavioral adjustment in adolescents. The authors used structural equation modeling to test a model that demonstrates that the effects of early cumulative risk on behavioral problems is mediated by maternal responsiveness…

Health risk characterization for exposure to benzene in service stations and petroleum refineries environments using human adverse response data.

Science.gov (United States)

Edokpolo, Benjamin; Yu, Qiming Jimmy; Connell, Des

2015-01-01

Health risk characterization of exposure to benzene in service stations and petroleum refineries has been carried out in previous studies using guideline values set by various agencies. In this work, health risk was characterized with the exposure data as cumulative probability distribution (CPD) plots but using human epidemiological data. This was achieved by using lowest observable adverse effects levels (LOAEL) data plotted as cumulative probability lowest effects distribution (CPLED). The health risk due to benzene was characterized by using probabilistic methods of hazard quotient (HQ 50/50 and HQ 95/5 ), Monte-Carlo simulation (MCS) and overall risk probability (ORP). CPD relationships of adverse health effects relationships and exposure data were in terms of average daily dose (ADD) and lifetime average daily dose (LADD) for benzene. For service station environments HQ 50/50 and HQ 95/5 were in a range of 0.000071-0.055 and 0.0049-21, respectively. On the other hand, the risk estimated for petroleum refinery environments suggests higher risk with HQ 50/50 and HQ 95/5 values ranging from 0.0012 to 77 and 0.17 to 560, respectively. The results of Monte-Carlo risk probability (MRP) and ORP indicated that workers in petroleum refineries (MRP of 2.9-56% and ORP of 4.6-52% of the affected population) were at a higher risk of adverse health effects from exposure to benzene as compared to exposure to benzene in service station environments (MRP of 0.051 -3.4% and ORP of 0.35-2.7% affected population). The adverse effect risk probabilities estimated by using the Monte-Carlo simulation technique and the ORP method were found to be generally consistent.

Cumulative Effect of Racial Discrimination on the Mental Health of Ethnic Minorities in the United Kingdom.

Science.gov (United States)

Wallace, Stephanie; Nazroo, James; Bécares, Laia

2016-07-01

To examine the longitudinal association between cumulative exposure to racial discrimination and changes in the mental health of ethnic minority people. We used data from 4 waves (2009-2013) of the UK Household Longitudinal Study, a longitudinal household panel survey of approximately 40 000 households, including an ethnic minority boost sample of approximately 4000 households. Ethnic minority people who reported exposure to racial discrimination at 1 time point had 12-Item Short Form Health Survey (SF-12) mental component scores 1.93 (95% confidence interval [CI] = -3.31, -0.56) points lower than did those who reported no exposure to racial discrimination, whereas those who had been exposed to 2 or more domains of racial discrimination, at 2 different time points, had SF-12 mental component scores 8.26 (95% CI = -13.33, -3.18) points lower than did those who reported no experiences of racial discrimination. Controlling for racial discrimination and other socioeconomic factors reduced ethnic inequalities in mental health. Cumulative exposure to racial discrimination has incremental negative long-term effects on the mental health of ethnic minority people in the United Kingdom. Studies that examine exposure to racial discrimination at 1 point in time may underestimate the contribution of racism to poor health.

Low Birth Weight, Cumulative Obesity Dose, and the Risk of Incident Type 2 Diabetes

OpenAIRE

Feng, Cindy; Osgood, Nathaniel D.; Dyck, Roland F.

2018-01-01

Background. Obesity history may provide a better understanding of the contribution of obesity to T2DM risk. Methods. 17,634 participants from the 1958 National Child Development Study were followed from birth to 50 years. Cumulative obesity dose, a measure of obesity history, was calculated by subtracting the upper cut-off of the normal BMI from the actual BMI at each follow-up and summing the areas under the obesity dose curve. Hazard ratios (HRs) for diabetes were calculated using Cox regre...

Human Health Risk from Metals in Fish from Saudi Arabia: Consumption Patterns for Some Species Exceed Allowable Limits

KAUST Repository

Burger, Joanna

2014-10-06

ABSTRACT: Fish are a healthful source of protein, but contaminants in some fish pose a risk. While there are multiple risk assessments from Europe and North America, there are far fewer for other parts of the world. We examined the risks from mercury, arsenic, lead, and other metals in fish consumed by people in Jeddah area, Saudi Arabia, using site-specific data on consumption patterns and metal levels in fish. The U.S. Environmental Protection Agency\\'s Hazard Quotient (HQ) and cumulative Hazard Index (HI) for non-cancer endpoints and Carcinogenic Index for cancer were used to determine the health risk based on fish consumption rates. Of the 13 fish species examined, HQ was greater than 1 (indicating elevated risk) in two species for arsenic, and seven species for methylmercury. The cumulative HI for all metals was above 1 for all but three species of fish at the mean consumption rates. Generally, fish species with HI above 1 for one sampling location, had HI above 1 for all sampling locations. The implications of these findings are discussed in the light of strategies for reducing risk from fish consumption while encouraging dietary intakes of fish with low mercury and arsenic levels.

Prospective weight change and colon cancer risk in male US health professionals

DEFF Research Database (Denmark)

Thygesen, Lau Caspar; Grønbaek, Morten; Johansen, Christoffer

2008-01-01

Epidemiological studies are remarkably consistent, especially among men, in showing that overweight and obesity [body mass index (BMI) >25] are associated with increased risk of colon cancer. However, no prospective studies address the influence of weight change in adulthood on subsequent colon...... cancer risk. In this study, we investigated whether weight change influences colon cancer risk utilizing prospectively collected weight data. We included 46,349 men aged 40-75 participating in the Health Professionals Follow-Up Study. Questionnaires including items on weight were completed every second......-year period, we documented 765 cases of colon cancer. Cumulative mean BMI >22.5 was associated with significantly increased risk of colon cancer. The short-term weight change in the prior 2 to 4 years was positively and significantly associated with risk [HR = 1.14 (95% confidence interval, 1...

Cumulative Effect of Depression on Dementia Risk

OpenAIRE

Olazarán, J.; Trincado, R.; Bermejo-Pareja, F.

2013-01-01

Objective. To analyze a potential cumulative effect of life-time depression on dementia and Alzheimer's disease (AD), with control of vascular factors (VFs). Methods. This study was a subanalysis of the Neurological Disorders in Central Spain (NEDICES) study. Past and present depression, VFs, dementia status, and dementia due to AD were documented at study inception. Dementia status was also documented after three years. Four groups were created according to baseline data: never depression (n...

Cumulative risk on the oxytocin receptor gene (OXTR) underpins empathic communication difficulties at the first stages of romantic love.

Science.gov (United States)

Schneiderman, Inna; Kanat-Maymon, Yaniv; Ebstein, Richard P; Feldman, Ruth

2014-10-01

Empathic communication between couples plays an important role in relationship quality and individual well-being and research has pointed to the role of oxytocin in providing the neurobiological substrate for pair-bonding and empathy. Here, we examined links between genetic variability on the oxytocin receptor gene (OXTR) and empathic behaviour at the initiation of romantic love. Allelic variations on five OXTR single nucleotide polymorphisms (SNPs) previously associated with susceptibility to disorders of social functioning were genotyped in 120 new lovers: OXTRrs13316193, rs2254298, rs1042778, rs2268494 and rs2268490. Cumulative genetic risk was computed by summing risk alleles on each SNP. Couples were observed in support-giving interaction and behaviour was coded for empathic communication, including affective congruence, maintaining focus on partner, acknowledging partner's distress, reciprocal exchange and non-verbal empathy. Hierarchical linear modelling indicated that individuals with high OXTR risk exhibited difficulties in empathic communication. OXTR risk predicted empathic difficulties above and beyond the couple level, relationship duration, and anxiety and depressive symptoms. Findings underscore the involvement of oxytocin in empathic behaviour during the early stages of social affiliation, and suggest the utility of cumulative risk and plasticity indices on the OXTR as potential biomarkers for research on disorders of social dysfunction and the neurobiology of empathy. © The Author (2013). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Cumulative Burden of Lifetime Adversities: Trauma and Mental Health in Low-SES African Americans and Latino/as

OpenAIRE

Myers, Hector F.; Wyatt, Gail E.; Ullman, Jodie B.; Loeb, Tamra B.; Chin, Dorothy; Prause, Nicole; Zhang, Muyu; Williams, John K.; Slavich, George M.; Liu, Honghu

2015-01-01

© 2014 American Psychological Association. All rights reserved. This study examined the utility of a lifetime cumulative adversities and trauma model in predicting the severity of mental health symptoms of depression, anxiety, and posttraumatic stress disorder. We also tested whether ethnicity and gender moderate the effects of this stress exposure construct on mental health using multigroup structural equation modeling. A sample of 500 low-socioeconomic status African American and Latino men...

Health risk assessment of ambient air concentrations of benzene, toluene and xylene (BTX) in service station environments.

Science.gov (United States)

Edokpolo, Benjamin; Yu, Qiming Jimmy; Connell, Des

2014-06-18

A comprehensive evaluation of the adverse health effects of human exposures to BTX from service station emissions was carried out using BTX exposure data from the scientific literature. The data was grouped into different scenarios based on activity, location and occupation and plotted as Cumulative Probability Distributions (CPD) plots. Health risk was evaluated for each scenario using the Hazard Quotient (HQ) at 50% (CEXP50) and 95% (CEXP95) exposure levels. HQ50 and HQ95 > 1 were obtained with benzene in the scenario for service station attendants and mechanics repairing petrol dispensing pumps indicating a possible health risk. The risk was minimized for service stations using vapour recovery systems which greatly reduced the benzene exposure levels. HQ50 and HQ95 service station attendants than any other scenario.

Maintenance hemodialysis patients have high cumulative radiation exposure.

LENUS (Irish Health Repository)

Kinsella, Sinead M

2010-10-01

Hemodialysis is associated with an increased risk of neoplasms which may result, at least in part, from exposure to ionizing radiation associated with frequent radiographic procedures. In order to estimate the average radiation exposure of those on hemodialysis, we conducted a retrospective study of 100 patients in a university-based dialysis unit followed for a median of 3.4 years. The number and type of radiological procedures were obtained from a central radiology database, and the cumulative effective radiation dose was calculated using standardized, procedure-specific radiation levels. The median annual radiation dose was 6.9 millisieverts (mSv) per patient-year. However, 14 patients had an annual cumulative effective radiation dose over 20 mSv, the upper averaged annual limit for occupational exposure. The median total cumulative effective radiation dose per patient over the study period was 21.7 mSv, in which 13 patients had a total cumulative effective radiation dose over 75 mSv, a value reported to be associated with a 7% increased risk of cancer-related mortality. Two-thirds of the total cumulative effective radiation dose was due to CT scanning. The average radiation exposure was significantly associated with the cause of end-stage renal disease, history of ischemic heart disease, transplant waitlist status, number of in-patient hospital days over follow-up, and death during the study period. These results highlight the substantial exposure to ionizing radiation in hemodialysis patients.

Process monitoring in intensive care with the use of cumulative expected minus observed mortality and risk-adjusted P charts.

Science.gov (United States)

Cockings, Jerome G L; Cook, David A; Iqbal, Rehana K

2006-02-01

A health care system is a complex adaptive system. The effect of a single intervention, incorporated into a complex clinical environment, may be different from that expected. A national database such as the Intensive Care National Audit & Research Centre (ICNARC) Case Mix Programme in the UK represents a centralised monitoring, surveillance and reporting system for retrospective quality and comparative audit. This can be supplemented with real-time process monitoring at a local level for continuous process improvement, allowing early detection of the impact of both unplanned and deliberately imposed changes in the clinical environment. Demographic and UK Acute Physiology and Chronic Health Evaluation II (APACHE II) data were prospectively collected on all patients admitted to a UK regional hospital between 1 January 2003 and 30 June 2004 in accordance with the ICNARC Case Mix Programme. We present a cumulative expected minus observed (E-O) plot and the risk-adjusted p chart as methods of continuous process monitoring. We describe the construction and interpretation of these charts and show how they can be used to detect planned or unplanned organisational process changes affecting mortality outcomes. Five hundred and eighty-nine adult patients were included. The overall death rate was 0.78 of predicted. Calibration showed excess survival in ranges above 30% risk of death. The E-O plot confirmed a survival above that predicted. Small transient variations were seen in the slope that could represent random effects, or real but transient changes in the quality of care. The risk-adjusted p chart showed several observations below the 2 SD control limits of the expected mortality rate. These plots provide rapid analysis of risk-adjusted performance suitable for local application and interpretation. The E-O chart provided rapid easily visible feedback of changes in risk-adjusted mortality, while the risk-adjusted p chart allowed statistical evaluation. Local analysis of

Childhood Violence Exposure: Cumulative and Specific Effects on Adult Mental Health

OpenAIRE

Hooven, Carole; Nurius, Paula S.; Logan-Greene, Patricia; Thompson, Elaine A.

2012-01-01

Childhood exposure to violence and victimization is a significant public health problem, with potentially long-lasting, deleterious effects on adult mental health. Using a longitudinal study design, 123 young adults—identified in adolescence as at-risk for high school dropout—were examined for the effects of multi-domain childhood victimization on emotional distress and suicide risk, net of adolescent risk and protective factors, including family dysfunction. The hypothesis that higher levels...

Long-term cumulative depressive symptom burden and risk of cognitive decline and dementia among very old women.

Science.gov (United States)

Zeki Al Hazzouri, Adina; Vittinghoff, Eric; Byers, Amy; Covinsky, Ken; Blazer, Dan; Diem, Susan; Ensrud, Kristine E; Yaffe, Kristine

2014-05-01

Depressive symptoms and cognitive outcomes are strongly interrelated. Despite that rates of depressive symptoms fluctuate during late life, little is known about the impact of long-term cumulative depressive symptom burden on cognitive decline and dementia in older adults. This study examines the association of nearly 20 years of cumulative depressive symptoms with cognitive outcomes in a cohort of older women. We assessed depressive symptoms in 7,240 women using the Geriatric Depression scale (GDS) at serial visits. We used a Poisson model with random slopes to estimate GDS trajectories for each participant from baseline to death or end of follow-up, and then characterized depressive symptom burden by quartile of the area under the curve. We assessed cognitive outcomes using repeated measures of the Mini-Mental State Examination (MMSE) and Trails B score over 20 years, Year-20 neuropsychological test battery, and adjudicated dementia and mild cognitive impairment (MCI). Adjusting for potential confounders, compared with women in the lowest quartile of cumulative depressive symptoms burden, women in the highest quartile had 21% more MMSE errors over time (95% CI = 17%, 26%), 20% worse Trails B score over time (95% CI = 17%, 23%), worse scores on most of the Year-20 cognitive tests, and a twofold greater likelihood of developing dementia or MCI (95% CI = 1.48, 3.11). Long-term cumulative depressive symptom burden was associated with cognitive decline and risk of dementia or MCI. Older adults with a history of depression should be closely monitored for recurrent episodes or unresolved depressive symptoms as well as any cognitive deficits.

Multi-Risk Infants: Predicting Attachment Security from Sociodemographic, Psychosocial, and Health Risk among African-American Preterm Infants

Science.gov (United States)

Candelaria, Margo; Teti, Douglas M.; Black, Maureen M.

2011-01-01

Background: Ecological and transactional theories link child outcomes to accumulated risk. This study hypothesized that cumulative risk was negatively related to attachment, and that maternal sensitivity mediated linkages between risk and attachment. Methods: One hundred and twelve high-risk African-American premature infant-mother dyads…

Cumulative effective dose and cancer risk for pediatric population in repetitive full spine follow-up imaging: How micro dose is the EOS microdose protocol?

Science.gov (United States)

Law, Martin; Ma, Wang-Kei; Lau, Damian; Cheung, Kenneth; Ip, Janice; Yip, Lawrance; Lam, Wendy

2018-04-01

To evaluate and to obtain analytic formulation for the calculation of the effective dose and associated cancer risk using the EOS microdose protocol for scoliotic pediatric patients undergoing full spine imaging at different age of exposure; to demonstrate the microdose protocol capable of delivering lesser radiation dose and hence of further reducing cancer risk induction when compared with the EOS low dose protocol; to obtain cumulative effective dose and cancer risk for both genders scoliotic pediatrics of US and Hong Kong population using the microdose protocol. Organ absorbed doses of full spine exposed scoliotic pediatric patients have been simulated with the use of EOS microdose protocol imaging parameters input to the Monte Carlo software PCXMC. Gender and age specific effective dose has been calculated with the simulated organ absorbed dose using the ICRP-103 approach. The associated radiation induced cancer risk, expressed as lifetime attributable risk (LAR), has been estimated according to the method introduced in the Biological Effects of Ionizing Radiation VII report. Values of LAR have been estimated for scoliotic patients exposed repetitively during their follow up period at different age for US and Hong Kong population. The effective doses of full spine imaging with simultaneous posteroanterior and lateral projection for patients exposed at the age between 5 and 18 years using the EOS microdose protocol have been calculated within the range of 2.54-14.75 μSv. The corresponding LAR for US and Hong Kong population was ranged between 0.04 × 10 -6 and 0.84 × 10 -6 . Cumulative effective dose and cancer risk during follow-up period can be estimated using the results and are of information to patients and their parents. With the use of computer simulation and analytic formulation, we obtained the cumulative effective dose and cancer risk at any age of exposure for pediatric patients of US and Hong Kong population undergoing repetitive

Consideration of the FQPA Safety Factor and Other Uncertainty Factors in Cumulative Risk Assessment of Chemicals Sharing a Common Mechanism of Toxicity

Science.gov (United States)

This guidance document provides OPP's current thinking on application of the provision in FFDCA about an additional safety factor for the protection of infants and children in the context of cumulative risk assessments.

Applicability of the tissue stem cell turnover concept on the validity of cumulative dose based radiation risk evaluation

International Nuclear Information System (INIS)

Otsuka, Kensuke; Hamada, Nobuyuki; Iwasaki, Toshiyasu; Yoshida, Kazuo

2011-01-01

The radiation protection system adopts the linear no-threshold model to achieve proper radiation protection for considering cancer risks resulting from radiation exposure. This model uses cumulative dose to a tissue for risk evaluation in which cumulative dose is related to the amount of DNA damage and consequential induction of gene mutation. In this concept, gene mutation accumulates in tissue stem cells, the putative target of carcinogenesis, with total dose given to the tissue. Unlike high-dose-rate exposure, epidemiological studies in high radiation background areas, such as Kerala in India, revealed that cancer risks is not elevated by the dose to the inhabitants, suggesting that there exists some mechanisms to eliminate the damage/mutation in the exposed tissue under extremely low-dose-rate exposure situations. In this report, the dynamics of tissue stem cell turnover is evaluated as a possible mechanism under extremely low-dose-rate exposure situations. To this end, we reviewed recent literatures studying tissue stem cell turnover, and found that great advances in stem cell research have made it possible to trace a fate of stem cells in tissues. Furthermore, turnover of tissue stem cells is found to occur after irradiation, due to competition of stem cells within tissues. This raises a possibility that radiation effects may not accumulate in a tissue depending on the dose-rate and duration of exposure period. (author)

Cumulative radiation exposure in children with cystic fibrosis.

LENUS (Irish Health Repository)

O'Reilly, R

2010-02-01

This retrospective study calculated the cumulative radiation dose for children with cystic fibrosis (CF) attending a tertiary CF centre. Information on 77 children with a mean age of 9.5 years, a follow up time of 658 person years and 1757 studies including 1485 chest radiographs, 215 abdominal radiographs and 57 computed tomography (CT) scans, of which 51 were thoracic CT scans, were analysed. The average cumulative radiation dose was 6.2 (0.04-25) mSv per CF patient. Cumulative radiation dose increased with increasing age and number of CT scans and was greater in children who presented with meconium ileus. No correlation was identified between cumulative radiation dose and either lung function or patient microbiology cultures. Radiation carries a risk of malignancy and children are particularly susceptible. Every effort must be made to avoid unnecessary radiation exposure in these patients whose life expectancy is increasing.

Failure-To-Thrive, Maltreatment and the Behavior and Development of 6-Year-Old Children from Low-Income, Urban Families: A Cumulative Risk Model.

Science.gov (United States)

Kerr, Mia A.; Black, Maureen M.; Krishnakumar, Ambika

2000-01-01

A cumulative risk model was used to examine the relationship among failure-to-thrive (FIT), maltreatment, and four aspects of children's development (cognitive performance, adaptive functioning at school, classroom behavior, and behavior at home) in 193 6-year-olds. Risk status was negatively associated with the four developmental outcomes.…

Longitudinal patterns of poverty and health in early childhood: exploring the influence of concurrent, previous, and cumulative poverty on child health outcomes

Science.gov (United States)

2012-01-01

Background Although the links between poverty and health have often been studied , the dynamics of poverty and physical health in early childhood remain under-investigated. In particular, it is not known whether the health of young children is affected differently from that of adults by patterns of poverty unique to them. Methods We examined patterns of health from 5 to 41 months of age as a function of concurrent, lagged, and chronic exposure to insufficient income. Using data from the first four rounds of the Quebec Longitudinal Study of Child Development, we performed multilevel logistic and multilevel Poisson regressions and latent growth curve analyses to explore associations between exposure to poverty and mother-reported asthma-like attacks, and maternal perception of health status controlling for neonatal, maternal, and environmental characteristics. Results The mean number of mother-reported asthma-like attacks significantly decreased as children aged. The likelihood of being perceived in a poorer health status also decreased across time. Concurrent poverty was associated with more mother-reported asthma-like attacks and with a higher risk of being perceived in poorer health status. One-period-lagged poverty was associated with more mother-reported asthma-like attacks and this remained significant after controlling for concurrent poverty. The number of mother-reported asthma-like attacks was significantly higher among children in the chronic poverty class compared to those in the never-poor class, particularly at 17 and 29 months. Perceived health status at 5-months was significantly poorer among chronically poor children compared to never-poor children. Conclusion Exposure to poverty negatively affects two major health indicators in early childhood – maternal perception of child health and mother-reported asthma-like attacks. Patterns of the effects vary according to timing and duration of poverty exposure. Further longitudinal research is warranted

Sovereign default risk assessment

NARCIS (Netherlands)

Rijken, H.A.; Altman, E.I.

2013-01-01

We propose a new approach toward assessing sovereign risk by examining rigorously the health and aggregate default risk of a nation's private corporate sector. Models can be utilised to measure the probability of default of the non-financial sector cumulatively for five years, both as an absolute

Development of a risk prediction model for lung cancer: The Japan Public Health Center-based Prospective Study.

Science.gov (United States)

Charvat, Hadrien; Sasazuki, Shizuka; Shimazu, Taichi; Budhathoki, Sanjeev; Inoue, Manami; Iwasaki, Motoki; Sawada, Norie; Yamaji, Taiki; Tsugane, Shoichiro

2018-03-01

Although the impact of tobacco consumption on the occurrence of lung cancer is well-established, risk estimation could be improved by risk prediction models that consider various smoking habits, such as quantity, duration, and time since quitting. We constructed a risk prediction model using a population of 59 161 individuals from the Japan Public Health Center (JPHC) Study Cohort II. A parametric survival model was used to assess the impact of age, gender, and smoking-related factors (cumulative smoking intensity measured in pack-years, age at initiation, and time since cessation). Ten-year cumulative probability of lung cancer occurrence estimates were calculated with consideration of the competing risk of death from other causes. Finally, the model was externally validated using 47 501 individuals from JPHC Study Cohort I. A total of 1210 cases of lung cancer occurred during 986 408 person-years of follow-up. We found a dose-dependent effect of tobacco consumption with hazard ratios for current smokers ranging from 3.78 (2.00-7.16) for cumulative consumption ≤15 pack-years to 15.80 (9.67-25.79) for >75 pack-years. Risk decreased with time since cessation. Ten-year cumulative probability of lung cancer occurrence estimates ranged from 0.04% to 11.14% in men and 0.07% to 6.55% in women. The model showed good predictive performance regarding discrimination (cross-validated c-index = 0.793) and calibration (cross-validated χ 2 = 6.60; P-value = .58). The model still showed good discrimination in the external validation population (c-index = 0.772). In conclusion, we developed a prediction model to estimate the probability of developing lung cancer based on age, gender, and tobacco consumption. This model appears useful in encouraging high-risk individuals to quit smoking and undergo increased surveillance. © 2018 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

The Relationship between Gender, Cumulative Adversities and ...

African Journals Online (AJOL)

The Relationship between Gender, Cumulative Adversities and Mental Health of Employees in ... CAs were measured in three forms (family adversities (CAFam), personal adversities ... Age of employees ranged between 18-65 years.

Collaboration, Participation and Technology: The San Joaquin Valley Cumulative Health Impacts Project

Directory of Open Access Journals (Sweden)

Jonathan K. London

2011-11-01

Full Text Available Community-university partnerships have been shown to produce significant value for both sets of partners by providing reciprocal learning opportunities, (rebuilding bonds of trust, and creating unique venues to formulate and apply research that responds to community interests and informs collaborative solutions to community problems. For such partnerships to be mutually empowering, certain design characteristics are necessary. These include mutual respect for different modes and expressions of knowledge, capacity-building for all parties, and an environment that promotes honest and constructive dialogue about the inevitable tensions associated with the interplay of power/knowledge. This article explores an innovative case of community-university partnerships through participatory action research involving a coalition of environmental justice and health advocates, the San Joaquin Valley Cumulative Health Impacts Project, and researchers affiliated with the University of California, Davis. In particular, we examine how participatory GIS and community mapping can promote co-learning and interdependent science. Keywords Community-based participatory research, environmental justice, Public Participation Geographic Information System

Changes in corneal endothelial cell density and the cumulative risk of corneal decompensation after Ahmed glaucoma valve implantation.

Science.gov (United States)

Kim, Kyoung Nam; Lee, Sung Bok; Lee, Yeon Hee; Lee, Jong Joo; Lim, Hyung Bin; Kim, Chang-Sik

2016-07-01

To evaluate changes in the corneal endothelial cell density (ECD) and corneal decompensation following Ahmed glaucoma valve (AGV) implantation. This study was retrospective and observational case series. Patients with refractory glaucoma who underwent AGV implantation and were followed >5 years were consecutively enrolled. We reviewed the medical records, including the results of central corneal specular microscopy. Of the 127 enrolled patients, the annual change in ECD (%) was determined using linear regression for 72 eyes evaluated at least four times using serial specular microscopic examination and compared with 31 control eyes (fellow glaucomatous eyes under medical treatment). The main outcome measures were cumulative risk of corneal decompensation and differences in the ECD loss rates between subjects and controls. The mean follow-up after AGV implantation was 43.1 months. There were no cases of postoperative tube-corneal touch. The cumulative risk of corneal decompensation was 3.3%, 5 years after AGV implantation. There was a more rapid loss of ECD in the 72 subject eyes compared with the 31 controls (-7.0% and -0.1%/year, respectively; p<0.001). However, the rate of loss decreased over time and statistical significance compared with control eyes disappeared after 2 years postoperatively: -10.7% from baseline to 1 year (p<0.01), -7.0% from 1 year to 2 years (p=0.037), -4.2% from 2 years to 3 years (p=0.230) and -2.7% from 3 years to the final follow-up (p=0.111). In case of uncomplicated AGV implantation, the cumulative risk of corneal decompensation was 3.3%, 5 years after the operation. The ECD loss was statistically greater in eyes with AGV than in control eyes without AGV, but the difference was significant only up to 2 years post surgery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Health care worker decompression sickness: incidence, risk and mitigation.

Science.gov (United States)

Clarke, Richard

2017-01-01

Inadvertent exposure to radiation, chemical agents and biological factors are well recognized hazards associated with the health care delivery system. Less well appreciated yet no less harmful is risk of decompression sickness in those who accompany patients as inside attendants (IAs) during provision of hyperbaric oxygen therapy. Unlike the above hazards where avoidance is practiced, IA exposure to decompression sickness risk is unavoidable. While overall incidence is low, when calculated as number of cases over number of exposures or potential for a case during any given exposure, employee cumulative risk, defined here as number of cases over number of IAs, or risk that an IA may suffer a case, is not. Commonly, this unique occupational environmental injury responds favorably to therapeutic recompression and a period of recuperation. There are, however, permanent and career-ending consequences, and at least two nurses have succumbed to their decompression insults. The intent of this paper is to heighten awareness of hyperbaric attendant decompression sickness. It will serve as a review of reported cases and reconcile incidence against largely ignored individual worker risk. Mitigation strategies are summarized and an approach to more precisely identify risk factors that might prompt development of consensus screening standards is proposed. Copyright© Undersea and Hyperbaric Medical Society.

Cumulative risk effect of household dysfunction for child maltreatment after intensive intervention of the child protection system in Japan: a longitudinal analysis.

Science.gov (United States)

Ohashi, Hirotsuna; Wada, Ichiro; Yamaoka, Yui; Nakajima-Yamaguchi, Ryoko; Ogai, Yasukazu; Morita, Nobuaki

2018-04-20

Building an effective casework system for child maltreatment is a global issue. We estimated the effect of household dysfunction (i.e., interparental violence, caregiver mental health problems, and caregiver substance abuse) on child maltreatment to understand how to advance the current framework of child welfare. The sample comprised 759 children (1- to 17-year-old; mean age was 10.6; 404 boys and 355 girls) placed in temporary custody units (one of the strongest intervention of the Japanese child protection system). Caseworkers from 180 units across 43 prefectures completed questionnaires on children and their family and were asked whether a child maltreatment report had been made after cancelation of custody in a 15-month follow-up period. The relations of household dysfunction and maltreatment reports were assessed using the Cox proportional hazard model. About half (48.4%) of the children had been placed in the unit because of maltreatment, and 88.3% had a history of victimization. Seventy-six cases had maltreatment reports after cancelation. We entered household dysfunction variables individually into the model, and each had a significant relationship with maltreatment reports (hazard ratios for interparental violence, caregiver mental health problem, and substance abuse were 1.69, 1.69, and 2.19, respectively) after covariate adjustment. When treating these three variables as cumulative risk score model of household dysfunction, the hazard ratio increased with increasing number of score (1.96 for score two; 2.35 for score three; score 0 as reference). Greater household dysfunction score is a risk of maltreatment after intensive intervention. It is imperative to construct systems facilitating cooperation between child and adult service sectors and to deliver seamless services to children and families. Our findings provide child protect services with risk-stratified interventions for children at victimization risk and promote adult-focused services to be

An Axiomatization of Cumulative Prospect Theory for Decision under Risk

NARCIS (Netherlands)

Wakker, P.P.; Chateauneuf, A.

1999-01-01

Cumulative prospect theory was introduced by Tversky and Kahneman so as to combine the empirical realism of their original prospect theory with the theoretical advantages of Quiggin's rank-dependent utility. Preference axiomatizations were provided in several papers. All those axiomatizations,

[Risks and health problems caused by the use of video terminals].

Science.gov (United States)

Tamez González, Silvia; Ortiz-Hernández, Luis; Martínez-Alcántara, Susana; Méndez-Ramírez, Ignacio

2003-01-01

To evaluate the association between video display terminal (VDT) use and health hazards, occupational risks, and psychosocial factors, in newspaper workers. A cross-sectional study was conducted in 1998 in a representative sample (n = 68) drawn from a population of 218 VDT operators in Mexico City. Data were collected using a self-administered questionnaire. Data were confirmed by performing physical examinations. The research hypothesis was that both the current and cumulative use of VDT are associated with visual, musculoskeletal system, and skin illnesses, as well as with fatigue and mental or psychosomatic disorders. Occupational health hazards were assessed (visual problems, postural risks, sedentary work, computer mouse use, excessive heat, and overcrowding), as well as psychosocial factors related to work organization (psychological demands, work control, and social support). Prevalence ratios were adjusted for confounding variables like age, sex and schooling. Women were more likely than men to have upper extremity musculoskeletal disorders (MSD), dermatitis, and seborrheic eczema. VDT use was associated with neuro-visual fatigue, upper extremity MSD, dermatitis, and seborrheic eczema. Computer mouse use and postural risks were significantly associated with health problems. Psychosocial factors were mainly associated with mental problems, psychosomatic disorders, and fatigue. Intense use of video screens has been found to cause musculoskeletal disorders of the hand. The diversification of tasks and control of labor processes itself had a protective effect against psychosomatic disorders and pathological fatigue.

Dynamic prediction of cumulative incidence functions by direct binomial regression.

Science.gov (United States)

Grand, Mia K; de Witte, Theo J M; Putter, Hein

2018-03-25

In recent years there have been a series of advances in the field of dynamic prediction. Among those is the development of methods for dynamic prediction of the cumulative incidence function in a competing risk setting. These models enable the predictions to be updated as time progresses and more information becomes available, for example when a patient comes back for a follow-up visit after completing a year of treatment, the risk of death, and adverse events may have changed since treatment initiation. One approach to model the cumulative incidence function in competing risks is by direct binomial regression, where right censoring of the event times is handled by inverse probability of censoring weights. We extend the approach by combining it with landmarking to enable dynamic prediction of the cumulative incidence function. The proposed models are very flexible, as they allow the covariates to have complex time-varying effects, and we illustrate how to investigate possible time-varying structures using Wald tests. The models are fitted using generalized estimating equations. The method is applied to bone marrow transplant data and the performance is investigated in a simulation study. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores Among Urban Youth in the United States*

Science.gov (United States)

Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

2014-01-01

Background The Institute of Medicine (2012) concluded that we must “strengthen schools as the heart of health.” To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement, and (2) examine cumulative effects of these assets on academic achievement. Methods Participants include 940 students (grades 5 and 6) from 12 schools randomly selected from an urban district. Data include physical assessments, fitness testing, surveys, and district records. Fourteen health indicators were gathered including physical health (eg, body mass index [BMI]), health behaviors (eg, meeting recommendations for fruit/vegetable consumption), family environment (eg, family meals), and psychological well-being (eg, sleep quality). Data were collected 3-6 months prior to standardized testing. Results On average, students reported 7.1 health assets out of 14. Those with more health assets were more likely to be at goal for standardized tests (reading/writing/mathematics), and students with the most health assets were 2.2 times more likely to achieve goal compared with students with the fewest health assets (both p student health may also improve academic achievement, closing equity gaps in both health and academic achievement. PMID:24320151

Exploring the Life Course Perspective in Maternal and Child Health through Community-Based Participatory Focus Groups: Social Risks Assessment.

Science.gov (United States)

Salinas-Miranda, Abraham A; King, Lindsey M; Salihu, Hamisu M; Berry, Estrellita; Austin, Deborah; Nash, Susan; Scarborough, Kenneth; Best, Evangeline; Cox, Lillian; King, Georgette; Hepburn, Carrie; Burpee, Conchita; Richardson, Eugene; Ducket, Marlo; Briscoe, Richard; Baldwin, Julie

2017-01-01

Little is known about the patterns of risk factors experienced by communities of color and how diverse community contexts shape the health trajectory of women from the early childhood period to the time of their pregnancies. Thus, we conducted a focus group study to identify social risks over the life course that contribute to maternal and child health from the perspective of community members residing in low income urban areas. Ten community-based participatory focus groups were conducted with residents from selected communities in Tampa, Florida, from September to November 2013. We used the life course perspective to illuminate and explain the experiences reported by the interviewees. A total of 78 residents participated in the focus groups. Children and adolescents' health risks were childhood obesity, lack of physical activity, and low self-esteem. Women's health risks were low self-esteem, low educational level, low health literacy, inadequate parenting skills, and financial problems. Risks during pregnancy included stress, low self-esteem, inadequate eating patterns, lack of physical activity, healthcare issues, lack of social support, and lack of father involvement during pregnancy. Multiple risk factors contribute to maternal and child health in low income communities in Tampa Bay. The intersection of risk factors in different life periods suggest possible pathways, cumulative, and latent effects, which must be considered in future longitudinal studies and when developing effective maternal and child health programs and policies.

Projected lifetime risks and hospital care expenditure for traumatic injury.

Science.gov (United States)

Chang, David C; Anderson, Jamie E; Kobayashi, Leslie; Coimbra, Raul; Bickler, Stephen W

2012-08-01

The lifetime risk and expected cost of trauma care would be valuable for health policy planners, but this information is currently unavailable. The cumulative incidence rates methodology, based on a cross-sectional population analysis, offers an alternative approach to prohibitively costly prospective cohort studies. Retrospective analysis of the California Office of Statewide Health Planning and Development (OSHPD) database was performed for 2008. Trauma admissions were identified by ICD-9 primary diagnosis codes 800-959, with certain exclusions. Cumulative incidence rates were calculated as the cumulative summation of incidence risks sequentially across age groups. A total of 2.2 million admissions were identified, with mean age of 63.8 y, 49.6% men, 82.8% Whites, 5.7% Blacks, 11.3% Hispanics, and 3.1% Asians. The cumulative incidence rate for patients older than age 85 y was 1119 per 10,000 people, with the majority of risk in the elderly, compared with 24,325 per 10,000 people for all-cause hospitalizations. The rates were 946 for men, 1079 for women, 999 for non-Hispanic Whites, 568 for Blacks, 577 for Hispanics, and 395 for Asians, per 10,000 population. The cumulative expected hospital charge was $6538, compared with $81,257 for all-cause hospitalizations. The cumulative lifetime risk of trauma/injury requiring hospitalization for a person living to age 85 y in California is 11.2%, accounting for 4.6% of expected lifetime hospitalizations, but accounting for 8.0% of expected lifetime hospital expenditures. Risk of trauma is significant in the elderly. The total expenditure for all trauma hospitalizations in California was $7.62 billion in 2008. Copyright © 2012 Elsevier Inc. All rights reserved.

Examining cumulative victimization, community violence exposure, and stigma as contributors to PTSD symptoms among high-risk young women.

Science.gov (United States)

Kennedy, Angie C; Bybee, Deborah; Greeson, Megan R

2014-05-01

This study examines patterns of lifetime victimization within the family, community violence exposure, and stigma as contributors to posttraumatic stress disorder (PTSD) symptoms within a sample of 198 high-risk young women who are pregnant or parenting. We used cluster analysis to identify 5 profiles of cumulative victimization, based on participants' levels of witnessing intimate partner violence (IPV), physical abuse by an adult caregiver, and sexual victimization, all beginning by age 12. Hierarchical regression was used to examine these 5 clusters (ranging from a High All Victimization cluster characterized by high levels of all 3 forms of violence, to a Low All Victimization cluster characterized by low levels of all 3 forms), along with community violence exposure and stigma, as predictors of PTSD symptoms. We found that 3 of the cumulative victimization clusters, in comparison with Low All Victimization, were significant predictors of PTSD symptoms, as was stigma, while community violence exposure was not a significant predictor. PsycINFO Database Record (c) 2014 APA, all rights reserved

Strategy for an assessment of cumulative ecological impacts

International Nuclear Information System (INIS)

Boucher, P.; Collins, J.; Nelsen, J.

1995-01-01

The US Department of Energy (DOE) has developed a strategy to conduct an assessment of the cumulative ecological impact of operations at the 300-square-mile Savannah River Site. This facility has over 400 identified waste units and contains several large watersheds. In addition to individual waste units, residual contamination must be evaluated in terms of its contribution to ecological risks at zonal and site-wide levels. DOE must be able to generate sufficient information to facilitate cleanup in the immediate future within the context of a site-wide ecological risk assessment that may not be completed for many years. The strategy superimposes a more global perspective on ecological assessments of individual waste units and provides strategic underpinnings for conducting individual screening-level and baseline risk assessments at the operable unit and zonal or watershed levels. It identifies ecological endpoints and risk assessment tools appropriate for each level of the risk assessment. In addition, it provides a clear mechanism for identifying clean sites through screening-level risk assessments and for elevating sites with residual contamination to the next level of assessment. Whereas screening-level and operable unit-level risk assessments relate directly to cleanup, zonal and site-wide assessments verity or confirm the overall effectiveness of remediation. The latter assessments must show, for example, whether multiple small areas with residual pesticide contamination that have minimal individual impact would pose a cumulative risk from bioaccumulation because they are within the habitat range of an ecological receptor

Fuzzy set theory for cumulative trauma prediction

OpenAIRE

Fonseca, Daniel J.; Merritt, Thomas W.; Moynihan, Gary P.

2001-01-01

A widely used fuzzy reasoning algorithm was modified and implemented via an expert system to assess the potential risk of employee repetitive strain injury in the workplace. This fuzzy relational model, known as the Priority First Cover Algorithm (PFC), was adapted to describe the relationship between 12 cumulative trauma disorders (CTDs) of the upper extremity, and 29 identified risk factors. The algorithm, which finds a suboptimal subset from a group of variables based on the criterion of...

Cumulative stress and autonomic dysregulation in a community sample.

Science.gov (United States)

Lampert, Rachel; Tuit, Keri; Hong, Kwang-Ik; Donovan, Theresa; Lee, Forrester; Sinha, Rajita

2016-05-01

Whether cumulative stress, including both chronic stress and adverse life events, is associated with decreased heart rate variability (HRV), a non-invasive measure of autonomic status which predicts poor cardiovascular outcomes, is unknown. Healthy community dwelling volunteers (N = 157, mean age 29 years) participated in the Cumulative Stress/Adversity Interview (CAI), a 140-item event interview measuring cumulative adversity including major life events, life trauma, recent life events and chronic stressors, and underwent 24-h ambulatory ECG monitoring. HRV was analyzed in the frequency domain and standard deviation of NN intervals (SDNN) calculated. Initial simple regression analyses revealed that total cumulative stress score, chronic stressors and cumulative adverse life events (CALE) were all inversely associated with ultra low-frequency (ULF), very low-frequency (VLF) and low-frequency (LF) power and SDNN (all p accounting for additional appreciable variance. For VLF and LF, both total cumulative stress and chronic stress significantly contributed to the variance alone but were not longer significant after adjusting for race and health behaviors. In summary, total cumulative stress, and its components of adverse life events and chronic stress were associated with decreased cardiac autonomic function as measured by HRV. Findings suggest one potential mechanism by which stress may exert adverse effects on mortality in healthy individuals. Primary preventive strategies including stress management may prove beneficial.

Cumulative exposure to shift work and sickness absence: associations in a five-year historic cohort

Directory of Open Access Journals (Sweden)

Alwin van Drongelen

2017-01-01

Full Text Available Abstract Background Exposure to shift work has been associated with negative health consequences, although the association between shift work and sickness absence remains unclear. The aim of this study is to investigate associations between cumulative exposure to shift work and sickness absence among ground staff employees of an airline company. Methods This study used data from the MORE (Monitoring Occupational Health Risks in Employees cohort, which is a 5-year historic cohort. The population of the present study consisted of 7562 ground staff employees. For each employee, work schedules and sickness absence days between 2005 and 2009 were obtained from company records. For the exposure to different shift schedule types and to the cumulative number of night shifts, the association with long-term sickness absence (>7 consecutive sickness absence days and the number of sickness absence episodes during 2009, was calculated using logistic and Poisson regression analyses. Socio-demographic variables, work-related variables, job classification variables, and previous sickness absence days were regarded as confounders. Results After adjusting for previous sickness absence and job classification variables, only the group of employees that switched into working in a three-shift schedule, showed a significantly increased risk for long-term sickness absence (OR = 1.31, 95%CI 1.02–1.69. Night shift exposure was not significantly associated with long-term sickness absence. Exposure to shift work was negatively associated with more sickness absence episodes. Employees who were exposed to more than 46 night shifts also showed a lower risk for more sickness absence episodes. Subgroup analyses showed that single employees and employees without children had an increased risk for long-term sickness absence when exposed to a three-shift schedule, and when they had changed between shift schedule types. Conclusions Cumulative exposure to shift work proved to

Cumulative exposure to shift work and sickness absence: associations in a five-year historic cohort.

Science.gov (United States)

van Drongelen, Alwin; Boot, Cécile R L; Hlobil, Hynek; van der Beek, Allard J; Smid, Tjabe

2017-01-11

Exposure to shift work has been associated with negative health consequences, although the association between shift work and sickness absence remains unclear. The aim of this study is to investigate associations between cumulative exposure to shift work and sickness absence among ground staff employees of an airline company. This study used data from the MORE (Monitoring Occupational Health Risks in Employees) cohort, which is a 5-year historic cohort. The population of the present study consisted of 7562 ground staff employees. For each employee, work schedules and sickness absence days between 2005 and 2009 were obtained from company records. For the exposure to different shift schedule types and to the cumulative number of night shifts, the association with long-term sickness absence (>7 consecutive sickness absence days) and the number of sickness absence episodes during 2009, was calculated using logistic and Poisson regression analyses. Socio-demographic variables, work-related variables, job classification variables, and previous sickness absence days were regarded as confounders. After adjusting for previous sickness absence and job classification variables, only the group of employees that switched into working in a three-shift schedule, showed a significantly increased risk for long-term sickness absence (OR = 1.31, 95%CI 1.02-1.69). Night shift exposure was not significantly associated with long-term sickness absence. Exposure to shift work was negatively associated with more sickness absence episodes. Employees who were exposed to more than 46 night shifts also showed a lower risk for more sickness absence episodes. Subgroup analyses showed that single employees and employees without children had an increased risk for long-term sickness absence when exposed to a three-shift schedule, and when they had changed between shift schedule types. Cumulative exposure to shift work proved to be negatively associated with more sickness absence episodes, and

Air toxics concentrations, source identification, and health risks: An air pollution hot spot in southwest Memphis, TN

Science.gov (United States)

Jia, Chunrong; Foran, Jeffery

2013-12-01

Southwest Memphis is a residential region surrounded by fossil fuel burning, steel, refining, and food processing industries, and considerable mobile sources whose emissions may pose adverse health risks to local residents. This study characterizes cancer and non-cancer risks resulting from exposure to ambient air toxics in southwest Memphis. Air toxics samples were collected at a central location every 6 days from June 5, 2008 to January 8, 2010. Volatile organic compounds (VOCs) were collected in evacuated stainless-steel canisters and aldehydes by DNPH cartridges, and samples were analyzed for 73 target compounds. A total of 60 compounds were detected and 39 were found in over 86% of the samples. Mean concentrations of many compounds were higher than those measured in many industrial communities throughout the U.S. The cumulative cancer risk associated with exposure to 13 carcinogens found in southwest Memphis air was 2.3 × 10-4, four times higher than the national average of 5.0 × 10-5. Three risk drivers were identified: benzene, formaldehyde, and acrylonitrile, which contributed 43%, 19%, and 14% to the cumulative risk, respectively. This is the first field study to confirm acrylonitrile as a potential risk driver. Mobile, secondary, industrial, and background sources contributed 57%, 24%, 14%, and 5% of the risk, respectively. The results of this study indicate that southwest Memphis, a region of significant income, racial, and social disparities, is also a region under significant environmental stress compared with surrounding areas and communities.

Rainfall Intensity and Frequency Explain Production Basis Risk in Cumulative Rain Index Insurance

Science.gov (United States)

Muneepeerakul, Chitsomanus P.; Muneepeerakul, Rachata; Huffaker, Ray G.

2017-12-01

With minimal moral hazard and adverse selection, weather index insurance promises financial resilience to farmers struck by harsh weather conditions through swift compensation at affordable premium. Despite these advantages, the very nature of indexing gives rise to production basis risk as the selected weather indexes do not sufficiently correspond to actual damages. To address this problem, we develop a stochastic yield model, built upon a stochastic soil moisture model driven by marked Poisson rainfall. Our analysis shows that even under similar temperature and rainfall amount yields can differ significantly; this was empirically supported by a 2-year field experiment in which rain-fed maize was grown under very similar total rainfall. Here, the year with more intense, less-frequent rainfall produces a better yield—a rare counter evidence to most climate change projections. Through a stochastic yield model, we demonstrate the crucial roles of rainfall intensity and frequency in determining the yield. Importantly, the model allows us to compute rainfall pattern-related basis risk inherent in cumulative rain index insurance. The model results and a case study herein clearly show that total rainfall is a poor indicator of yield, imposing unnecessary production basis risk on farmers and false-positive payouts on insurers. Incorporating rainfall intensity and frequency in the design of rain index insurance can offer farmers better protection, while maintaining the attractive features of the weather index insurance and thus fulfilling its promise of financial resilience.

Hierarchical Bayesian parameter estimation for cumulative prospect theory

NARCIS (Netherlands)

Nilsson, H.; Rieskamp, J.; Wagenmakers, E.-J.

2011-01-01

Cumulative prospect theory (CPT Tversky & Kahneman, 1992) has provided one of the most influential accounts of how people make decisions under risk. CPT is a formal model with parameters that quantify psychological processes such as loss aversion, subjective values of gains and losses, and

Playing It Safe: Assessing Cumulative Impact and Social Vulnerability through an Environmental Justice Screening Method in the South Coast Air Basin, California

Directory of Open Access Journals (Sweden)

Justin Scoggins

2011-05-01

Full Text Available Regulatory agencies, including the U.S. Environmental Protection Agency (US EPA and state authorities like the California Air Resources Board (CARB, have sought to address the concerns of environmental justice (EJ advocates who argue that chemical-by-chemical and source-specific assessments of potential health risks of environmental hazards do not reflect the multiple environmental and social stressors faced by vulnerable communities. We propose an Environmental Justice Screening Method (EJSM as a relatively simple, flexible and transparent way to examine the relative rank of cumulative impacts and social vulnerability within metropolitan regions and determine environmental justice areas based on more than simply the demographics of income and race. We specifically organize 23 indicator metrics into three categories: (1 hazard proximity and land use; (2 air pollution exposure and estimated health risk; and (3 social and health vulnerability. For hazard proximity, the EJSM uses GIS analysis to create a base map by intersecting land use data with census block polygons, and calculates hazard proximity measures based on locations within various buffer distances. These proximity metrics are then summarized to the census tract level where they are combined with tract centroid-based estimates of pollution exposure and health risk and socio-economic status (SES measures. The result is a cumulative impacts (CI score for ranking neighborhoods within regions that can inform diverse stakeholders seeking to identify local areas that might need targeted regulatory strategies to address environmental justice concerns.

Consumption of fruits and vegetables and probabilistic assessment of the cumulative acute exposure to organophosphorus and carbamate pesticides of schoolchildren in Slovenia.

Science.gov (United States)

Blaznik, Urška; Yngve, Agneta; Eržen, Ivan; Hlastan Ribič, Cirila

2016-02-01

Adequate consumption of fruits and vegetables is a part of recommendations for a healthy diet. The aim of the present study was to assess acute cumulative dietary exposure to organophosphorus and carbamate pesticides via fruit and vegetable consumption by the population of schoolchildren aged 11-12 years and the level of risk for their health. Cumulative probabilistic risk assessment methodology with the index compound approach was applied. Slovenia, primary schools. Schoolchildren (n 1145) from thirty-one primary schools in Slovenia. Children were part of the PRO GREENS study 2009/10 which assessed 11-year-olds' consumption of fruit and vegetables in ten European countries. The cumulative acute exposure amounted to 8.3 (95% CI 7.7, 10.6) % of the acute reference dose (ARfD) for acephate as index compound (100 µg/kg body weight per d) at the 99.9th percentile for daily intake and to 4.5 (95% CI 3.5, 4.7) % of the ARfD at the 99.9th percentile for intakes during school time and at lunch. Apples, bananas, oranges and lettuce contributed most to the total acute pesticides intake. The estimations showed that acute dietary exposure to organophosphorus and carbamate pesticides is not a health concern for schoolchildren with the assessed dietary patterns of fruit and vegetable consumption.

Risk

Science.gov (United States)

Cole, Stephen R.; Hudgens, Michael G.; Brookhart, M. Alan; Westreich, Daniel

2015-01-01

The epidemiologist primarily studies transitions between states of health and disease. The purpose of the present article is to define a foundational parameter for such studies, namely risk. We begin simply and build to the setting in which there is more than 1 event type (i.e., competing risks or competing events), as well as more than 1 treatment or exposure level of interest. In the presence of competing events, the risks are a set of counterfactual cumulative incidence functions for each treatment. These risks can be depicted visually and summarized numerically. We use an example from the study of human immunodeficiency virus to illustrate concepts. PMID:25660080

Environmental injustice and sexual minority health disparities: A national study of inequitable health risks from air pollution among same-sex partners.

Science.gov (United States)

Collins, Timothy W; Grineski, Sara E; Morales, Danielle X

2017-10-01

factors may together exacerbate health disparities, we call for a shift toward interdisciplinary research on LGBT health that takes into account cumulative risks, including the role of environmental exposures. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cumulative Poisson Distribution Program

Science.gov (United States)

Bowerman, Paul N.; Scheuer, Ernest M.; Nolty, Robert

1990-01-01

Overflow and underflow in sums prevented. Cumulative Poisson Distribution Program, CUMPOIS, one of two computer programs that make calculations involving cumulative Poisson distributions. Both programs, CUMPOIS (NPO-17714) and NEWTPOIS (NPO-17715), used independently of one another. CUMPOIS determines cumulative Poisson distribution, used to evaluate cumulative distribution function (cdf) for gamma distributions with integer shape parameters and cdf for X (sup2) distributions with even degrees of freedom. Used by statisticians and others concerned with probabilities of independent events occurring over specific units of time, area, or volume. Written in C.

Towards personalized screening: Cumulative risk of breast cancer screening outcomes in women with and without a first-degree relative with a history of breast cancer.

Science.gov (United States)

Ripping, Theodora Maria; Hubbard, Rebecca A; Otten, Johannes D M; den Heeten, Gerard J; Verbeek, André L M; Broeders, Mireille J M

2016-04-01

Several reviews have estimated the balance of benefits and harms of mammographic screening in the general population. The balance may, however, differ between individuals with and without family history. Therefore, our aim is to assess the cumulative risk of screening outcomes; screen-detected breast cancer, interval cancer, and false-positive results, in women screenees aged 50-75 and 40-75, with and without a first-degree relative with a history of breast cancer at the start of screening. Data on screening attendance, recall and breast cancer detection were collected for each woman living in Nijmegen (The Netherlands) since 1975. We used a discrete time survival model to calculate the cumulative probability of each major screening outcome over 19 screening rounds. Women with a family history of breast cancer had a higher risk of all screening outcomes. For women screened from age 50-75, the cumulative risk of screen-detected breast cancer, interval cancer and false-positive results were 9.0, 4.4 and 11.1% for women with a family history and 6.3, 2.7 and 7.3% for women without a family history, respectively. The results for women 40-75 followed the same pattern for women screened 50-75 for cancer outcomes, but were almost doubled for false-positive results. To conclude, women with a first-degree relative with a history of breast cancer are more likely to experience benefits and harms of screening than women without a family history. To complete the balance and provide risk-based screening recommendations, the breast cancer mortality reduction and overdiagnosis should be estimated for family history subgroups. © 2015 UICC.

A longitudinal study of the impact of cumulative violence victimization on comorbid posttraumatic stress and depression among female nurses and nursing personnel.

Science.gov (United States)

Cavanaugh, Courtenay; Campbell, Jacquelyn; Messing, Jill T

2014-06-01

This study examined the impact of cumulative violence victimization on health care workers' subsequent posttraumatic stress-depression comorbidity. Female nurses and nursing personnel (N = 1,044) answered questions about lifetime violence victimization (e.g., childhood abuse, intimate partner violence, and workplace violence) at baseline and completed the Primary Care Posttraumatic Stress (PTS) Disorder screen and Center for Epidemiologic Studies Depression Scale 6 months later. Seven percent screened positive for comorbid posttraumatic stress-depression at 6-month monitoring. Workers who reported one, two, or three or more types of violence victimization at baseline had 2.41 (p .05), and 6.44 (p violence victimization at baseline. These results suggest the need to provide female nurses and nursing personnel with information about (1) the risk cumulative violence victimization poses for poorer mental health and functioning, and (2) evidence-based trauma informed treatment options outside their place of employment for those affected by violence victimization who develop mental health symptoms. Copyright 2014, SLACK Incorporated.

Effects of cumulative risk on behavioral and psychological well-being in first grade: moderation by neighborhood context.

Science.gov (United States)

Lima, Julie; Caughy, Margaret; Nettles, Saundra M; O'Campo, Patricia J

2010-10-01

This study builds upon existing research by examining whether risk indices for child psychological well-being behave in the same way in different types of neighborhoods. Specifically, we sought to determine if neighborhood characteristics acted to exacerbate or, alternatively, to buffer risk factors at the family and/or child level. Families with a child entering first grade in Fall 2002 were recruited from Baltimore City neighborhoods, defined as census block groups. This study included 405 children, and data came from an interview with the primary caregiver and an assessment of the first grader. The dependent variables were externalizing behavior and internalizing problems. A family risk index consisting of 13 measures, and a child risk index consisting of three measures were the main independent variables of interest. We examined the effects of these indices on child psychological well-being and behavior across two neighborhood characteristics: neighborhood potential for community involvement with children and neighborhood negative social climate. Results of multivariate analyses indicated that cumulative family risk was associated with an increase in both internalizing and externalizing behavior problems. Perceived negative social climate moderated the effect of family risks on behavior problems such that more risk was associated with a larger increment in both externalizing behavior problems and psychological problems for children living in high versus low risk neighborhoods. These findings further emphasize the importance of considering neighborhood context in the study of child psychological well-being. Copyright © 2010 Elsevier Ltd. All rights reserved.

Towards personalized screening: Cumulative risk of breast cancer screening outcomes in women with and without a first-degree relative with a history of breast cancer

NARCIS (Netherlands)

Ripping, Theodora Maria; Hubbard, Rebecca A.; Otten, Johannes D. M.; den Heeten, Gerard J.; Verbeek, André L. M.; Broeders, Mireille J. M.

2016-01-01

Several reviews have estimated the balance of benefits and harms of mammographic screening in the general population. The balance may, however, differ between individuals with and without family history. Therefore, our aim is to assess the cumulative risk of screening outcomes; screen-detected

A comparison of a novel time-based summary measure of dairy cow health against cumulative disease frequency.

Science.gov (United States)

McConnel, Craig S; McNeil, Ashleigh A; Hadrich, Joleen C; Lombard, Jason E; Heller, Jane; Garry, Franklyn B

2018-01-01

There is an increasing push for dairy production to be scientifically grounded and ethically responsible in the oversight of animal health and well-being. Addressing underlying challenges affecting the quality and length of productive life necessitates novel assessment and accountability metrics. Human medical epidemiologists developed the Disability-Adjusted Life Year metric as a summary measure of health addressing the complementary nature of disease and death. The goal of this project was to develop and implement a dairy Disease-Adjusted Lactation (DALact) summary measure of health, as a comparison against cumulative disease frequency. A total of 5694 cows were enrolled at freshening from January 1st, 2014 through May 26th, 2015 on 3 similarly managed U.S. Midwestern Plains' region dairies. Eleven health categories of interest were tracked from enrollment until culling, death, or the study's completion date. The DALact accounted for the days of life lost due to illness, forced removal, and death relative to the average lactation length across the participating farms. The DALact consistently identified mastitis as the primary disease of concern on all 3 dairies (19,007-23,955 days lost). Secondary issues included musculoskeletal injuries (19,559 days), pneumonia (11,034 days), or lameness (8858 days). By comparison, cumulative frequency measures pointed to mastitis (31-50%) and lameness (25-54%) as the 2 most frequent diseases. Notably, the DALact provided a robust accounting of health events such as musculoskeletal injuries (5010-19,559 days) and calving trauma (2952-5868 days) otherwise overlooked by frequency measures (0-3%). The DALact provides a time-based method for assessing the overall burden of disease on dairies. It is important to emphasize that a summary measure of dairy health goes beyond simply linking morbidity to culling and mortality in a standardized fashion. A summary measure speaks to the burden of disease on both the well-being and

Cumulative effects of planned industrial development and climate change on marine ecosystems

Directory of Open Access Journals (Sweden)

Cathryn Clarke Murray

2015-07-01

Full Text Available With increasing human population, large scale climate changes, and the interaction of multiple stressors, understanding cumulative effects on marine ecosystems is increasingly important. Two major drivers of change in coastal and marine ecosystems are industrial developments with acute impacts on local ecosystems, and global climate change stressors with widespread impacts. We conducted a cumulative effects mapping analysis of the marine waters of British Columbia, Canada, under different scenarios: climate change and planned developments. At the coast-wide scale, climate change drove the largest change in cumulative effects with both widespread impacts and high vulnerability scores. Where the impacts of planned developments occur, planned industrial and pipeline activities had high cumulative effects, but the footprint of these effects was comparatively localized. Nearshore habitats were at greatest risk from planned industrial and pipeline activities; in particular, the impacts of planned pipelines on rocky intertidal habitats were predicted to cause the highest change in cumulative effects. This method of incorporating planned industrial development in cumulative effects mapping allows explicit comparison of different scenarios with the potential to be used in environmental impact assessments at various scales. Its use allows resource managers to consider cumulative effect hotspots when making decisions regarding industrial developments and avoid unacceptable cumulative effects. Management needs to consider both global and local stressors in managing marine ecosystems for the protection of biodiversity and the provisioning of ecosystem services.

Mechanisms and risk of cumulative impacts to coastal ecosystem services: An expert elicitation approach.

Science.gov (United States)

Singh, Gerald G; Sinner, Jim; Ellis, Joanne; Kandlikar, Milind; Halpern, Benjamin S; Satterfield, Terre; Chan, Kai M A

2017-09-01

Coastal environments are some of the most populated on Earth, with greater pressures projected in the future. Managing coastal systems requires the consideration of multiple uses, which both benefit from and threaten multiple ecosystem services. Thus understanding the cumulative impacts of human activities on coastal ecosystem services would seem fundamental to management, yet there is no widely accepted approach for assessing these. This study trials an approach for understanding the cumulative impacts of anthropogenic change, focusing on Tasman and Golden Bays, New Zealand. Using an expert elicitation procedure, we collected information on three aspects of cumulative impacts: the importance and magnitude of impacts by various activities and stressors on ecosystem services, and the causal processes of impact on ecosystem services. We assessed impacts to four ecosystem service benefits - fisheries, shellfish aquaculture, marine recreation and existence value of biodiversity-addressing three main research questions: (1) how severe are cumulative impacts on ecosystem services (correspondingly, what potential is there for restoration)?; (2) are threats evenly distributed across activities and stressors, or do a few threats dominate?; (3) do prominent activities mainly operate through direct stressors, or do they often exacerbate other impacts? We found (1) that despite high uncertainty in the threat posed by individual stressors and impacts, total cumulative impact is consistently severe for all four ecosystem services. (2) A subset of drivers and stressors pose important threats across the ecosystem services explored, including climate change, commercial fishing, sedimentation and pollution. (3) Climate change and commercial fishing contribute to prominent indirect impacts across ecosystem services by exacerbating regional impacts, namely sedimentation and pollution. The prevalence and magnitude of these indirect, networked impacts highlights the need for approaches

Mechanisms and risk of cumulative impacts to coastal ecosystem services: An expert elicitation approach

KAUST Repository

Singh, Gerald G.

2017-05-23

Coastal environments are some of the most populated on Earth, with greater pressures projected in the future. Managing coastal systems requires the consideration of multiple uses, which both benefit from and threaten multiple ecosystem services. Thus understanding the cumulative impacts of human activities on coastal ecosystem services would seem fundamental to management, yet there is no widely accepted approach for assessing these. This study trials an approach for understanding the cumulative impacts of anthropogenic change, focusing on Tasman and Golden Bays, New Zealand. Using an expert elicitation procedure, we collected information on three aspects of cumulative impacts: the importance and magnitude of impacts by various activities and stressors on ecosystem services, and the causal processes of impact on ecosystem services. We assessed impacts to four ecosystem service benefits — fisheries, shellfish aquaculture, marine recreation and existence value of biodiversity—addressing three main research questions: (1) how severe are cumulative impacts on ecosystem services (correspondingly, what potential is there for restoration)?; (2) are threats evenly distributed across activities and stressors, or do a few threats dominate?; (3) do prominent activities mainly operate through direct stressors, or do they often exacerbate other impacts? We found (1) that despite high uncertainty in the threat posed by individual stressors and impacts, total cumulative impact is consistently severe for all four ecosystem services. (2) A subset of drivers and stressors pose important threats across the ecosystem services explored, including climate change, commercial fishing, sedimentation and pollution. (3) Climate change and commercial fishing contribute to prominent indirect impacts across ecosystem services by exacerbating regional impacts, namely sedimentation and pollution. The prevalence and magnitude of these indirect, networked impacts highlights the need for

Contextual risk and child psychopathology.

Science.gov (United States)

Flouri, Eirini

2008-10-01

In developmental psychopathology it almost goes without saying that contextual risk factors do not occur in isolation and that it is the combination of various risk factors that portends numerous negative child outcomes. Despite this, the body of literature that examines the relation between multiple risk exposure and child psychopathology using a cumulative risk approach is still relatively small. Even when studies use a cumulative risk approach they rarely test properly whether the relation between cumulative risk and child psychopathology is linear or nonlinear, with consequences for both theory development and intervention design: if cumulative risk impacts problem behavior in a positively accelerated exponential manner, for instance, it means that exposure to multiple risk is especially difficult to manage as problem behavior accelerates at a critical level of risk. Furthermore, few studies have actually examined factors that protect from negative outcomes in those exposed to cumulative risk and even fewer have explored cumulative protection in relation to cumulative risk. On the other hand, there is the view that a cumulative risk approach at least implicitly assumes that risk factors are, in essence, interchangeable. According to this view, the importance of testing for specificity should not be underestimated. Finally, the renewed interest in the role of neighborhood risk in child development has initiated a lively debate as to whether contextual risk should be operationalized at the family or the area level. In this letter I discuss these issues, and offer some suggestions as to how future research can address them.

CUMULATIVE TRAUMAS AND RISK THRESHOLDS: 12-MONTH PTSD IN THE WORLD MENTAL HEALTH (WMH) SURVEYS

Science.gov (United States)

Karam, Elie G.; Friedman, Matthew J.; Hill, Eric D.; Kessler, Ronald C.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C.; Bromet, Evelyn J.; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E.; Haro, Josep Maria; He, Yanling; Karam, Aimee N.; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne, Mark A. Oakley; Posada-Villa, José A.; Shalev, Arieh Y.; Stein, Dan J.; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C.

2014-01-01

Background Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Methods Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. Results 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyper-arousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. Conclusions A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more “complex” clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. Depression and Anxiety 31:130–142, 2014. PMID:23983056

Frequency and prioritization of patient health risks from a structured health risk assessment.

Science.gov (United States)

Phillips, Siobhan M; Glasgow, Russell E; Bello, Ghalib; Ory, Marcia G; Glenn, Beth A; Sheinfeld-Gorin, Sherri N; Sabo, Roy T; Heurtin-Roberts, Suzanne; Johnson, Sallie Beth; Krist, Alex H

2014-01-01

To describe the frequency and patient-reported readiness to change, desire to discuss, and perceived importance of 13 health risk factors in a diverse range of primary care practices. Patients (n = 1,707) in 9 primary care practices in the My Own Health Report (MOHR) trial reported general, behavioral, and psychosocial risk factors (body mass index [BMI], health status, diet, physical activity, sleep, drug use, stress, anxiety or worry, and depression). We classified responses as "at risk" or "healthy" for each factor, and patients indicated their readiness to change and/or desire to discuss identified risk factors with providers. Patients also selected 1 of the factors they were ready to change as most important. We then calculated frequencies within and across these factors and examined variation by patient characteristics and across practices. On average, patients had 5.8 (SD = 2.12; range, 0-13) unhealthy behaviors and mental health risk factors. About 55% of patients had more than 6 risk factors. On average, patients wanted to change 1.2 and discuss 0.7 risks. The most common risks were inadequate fruit/vegetable consumption (84.5%) and overweight/obesity (79.6%). Patients were most ready to change BMI (33.3%) and depression (30.7%), and most wanted to discuss depression (41.9%) and anxiety or worry (35.2%). Overall, patients rated health status as most important. Implementing routine comprehensive health risk assessments in primary care will likely identify a high number of behavioral and psychosocial health risks. By soliciting patient priorities, providers and patients can better manage counseling and behavior change. © 2014 Annals of Family Medicine, Inc.

Adaptive strategies for cumulative cultural learning.

Science.gov (United States)

Ehn, Micael; Laland, Kevin

2012-05-21

The demographic and ecological success of our species is frequently attributed to our capacity for cumulative culture. However, it is not yet known how humans combine social and asocial learning to generate effective strategies for learning in a cumulative cultural context. Here we explore how cumulative culture influences the relative merits of various pure and conditional learning strategies, including pure asocial and social learning, critical social learning, conditional social learning and individual refiner strategies. We replicate the Rogers' paradox in the cumulative setting. However, our analysis suggests that strategies that resolved Rogers' paradox in a non-cumulative setting may not necessarily evolve in a cumulative setting, thus different strategies will optimize cumulative and non-cumulative cultural learning. Copyright © 2012 Elsevier Ltd. All rights reserved.

Exploration Health Risks: Probabilistic Risk Assessment

Science.gov (United States)

Rhatigan, Jennifer; Charles, John; Hayes, Judith; Wren, Kiley

2006-01-01

Maintenance of human health on long-duration exploration missions is a primary challenge to mission designers. Indeed, human health risks are currently the largest risk contributors to the risks of evacuation or loss of the crew on long-duration International Space Station missions. We describe a quantitative assessment of the relative probabilities of occurrence of the individual risks to human safety and efficiency during space flight to augment qualitative assessments used in this field to date. Quantitative probabilistic risk assessments will allow program managers to focus resources on those human health risks most likely to occur with undesirable consequences. Truly quantitative assessments are common, even expected, in the engineering and actuarial spheres, but that capability is just emerging in some arenas of life sciences research, such as identifying and minimize the hazards to astronauts during future space exploration missions. Our expectation is that these results can be used to inform NASA mission design trade studies in the near future with the objective of preventing the higher among the human health risks. We identify and discuss statistical techniques to provide this risk quantification based on relevant sets of astronaut biomedical data from short and long duration space flights as well as relevant analog populations. We outline critical assumptions made in the calculations and discuss the rationale for these. Our efforts to date have focussed on quantifying the probabilities of medical risks that are qualitatively perceived as relatively high risks of radiation sickness, cardiac dysrhythmias, medically significant renal stone formation due to increased calcium mobilization, decompression sickness as a result of EVA (extravehicular activity), and bone fracture due to loss of bone mineral density. We present these quantitative probabilities in order-of-magnitude comparison format so that relative risk can be gauged. We address the effects of

Using Information on Exposure to Characterizing Risks to Human Health from Concurrent Exposures to Multiple Chemicals

NARCIS (Netherlands)

Mr Price, PSP

2012-01-01

This thesis explores the concept of using exposure information to understand, organize, and manage the risks associated with cumulative exposures to chemicals (exposures to multiple chemicals from multiple sources). The issue of cumulative exposures was identified in more than 30 years ago, but in

10-year cumulative and bidirectional associations of domain-specific physical activity and sedentary behaviour with health-related quality of life in French adults: Results from the SU.VI.MAX studies.

Science.gov (United States)

Omorou, Abdou Y; Vuillemin, Anne; Menai, Medhi; Latarche, Clotilde; Kesse-Guyot, Emmanuelle; Galan, Pilar; Hercberg, Serge; Oppert, Jean-Michel; Briançon, Serge

2016-07-01

The directionality of the associations of domain-specific physical activity (PA) and sedentary behaviour (SB) with health-related quality of life (HRQoL) in adults remain insufficiently known. This study investigated the longitudinal associations of 10-year cumulative levels of PA and SB with HRQoL and the reverse associations. A sample of 2093 (47.8% men) participants from a cohort of French adult (SU.VI.MAX) was included. Data were collected at 3 time points (1998, 2001 and 2007) using the Modifiable Activity Questionnaire (MAQ) for PA (leisure-time and occupational) and SB (screen-viewing, reading and total sitting time) and the DUKE Health Profile for HRQoL. The cumulative level (from 0 to 3) referred to the number of time points where a high PA level, high SB or good HRQoL was reported. Regression models examined the 10-year cumulative level of PA, SB as predictors of HRQoL and reverse associations. The 10-year cumulative level of high PA, both leisure-time and occupational, predicted a higher HRQoL while the 10-year cumulative level of high screen-viewing time and high total sitting time was associated with lower HRQoL. For the reverse association, cumulative level of good HRQoL predicted more leisure-time PA, less screen-viewing time and less total sitting time but was not related to occupational PA. Relationships between PA, SB and HRQoL are complex and should not be oversimplified in one or the other direction. Taking into account domain-specific PA and SB in health promotion programs appears of prime importance to design interventions aiming at improving HRQoL. Copyright © 2016 Elsevier Inc. All rights reserved.

Health risks in perspective: Judging health risks of energy technologies

Energy Technology Data Exchange (ETDEWEB)

Rowe, M.D.

1992-09-18

Almost daily, Americans receive reports from the mass news media about some new and frightening risk to health and welfare. Most such reports emphasize the newsworthiness of the risks -- the possibility of a crisis, disagreements among experts, how things happened, who is responsible for fixing them, how much will it cost, conflict among parties involved, etc. As a rule, the magnitudes of the risks, or the difficulty of estimating those magnitudes, have limited newsworthiness, and so they are not mentioned. Because of this emphasis in the news media, most people outside the risk assessment community must judge the relative significance of the various risks to which we all are exposed with only that information deemed newsworthy by reporters. This information is biased and shows risks in isolation. There is no basis for understanding and comparing the relative importance of risks among themselves, or for comparing one risk, perhaps a new or newly-discovered one, in the field of all risks. The purpose of this report is to provide perspective on the various risks to which we are routinely exposed. It serves as a basis for understanding the meaning of quantitative risk estimates and for comparing new or newly-discovered risks with other, better-understood risks. Specific emphasis is placed on health risks of energy technologies.

Probabilistic framework for assessing the arsenic exposure risk from cooked fish consumption.

Science.gov (United States)

Ling, Min-Pei; Wu, Chiu-Hua; Chen, Szu-Chieh; Chen, Wei-Yu; Chio, Chia-Pin; Cheng, Yi-Hsien; Liao, Chung-Min

2014-12-01

Geogenic arsenic (As) contamination of groundwater is a major ecological and human health problem in southwestern and northeastern coastal areas of Taiwan. Here, we present a probabilistic framework for assessing the human health risks from consuming raw and cooked fish that were cultured in groundwater As-contaminated ponds in Taiwan by linking a physiologically based pharmacokinetics model and a Weibull dose-response model. Results indicate that As levels in baked, fried, and grilled fish were higher than those of raw fish. Frying resulted in the greatest increase in As concentration, followed by grilling, with baking affecting the As concentration the least. Simulation results show that, following consumption of baked As-contaminated fish, the health risk to humans is fish is unlikely to pose a significant risk to human health. However, contaminated fish cooked by frying resulted in significant health risks, showing the highest cumulative incidence ratios of liver cancer. We also show that males have higher cumulative incidence ratio of liver cancer than females. We found that although cooking resulted in an increase for As levels in As-contaminated fish, the risk to human health of consuming baked fish is nevertheless acceptable. We suggest the adoption of baking as a cooking method and warn against frying As-contaminated fish. We conclude that the concentration of contaminants after cooking should be taken into consideration when assessing the risk to human health.

CTD Information Guide. Preventing Cumulative Trauma Disorders in the Workplace

National Research Council Canada - National Science Library

1992-01-01

The purpose of this report is to provide Army occupational safety and health (OSH) professionals with a primer that explains the basic principles of ergonomic-hazard recognition for common cumulative trauma disorders...

Assessing Your Weight and Health Risk

Science.gov (United States)

... Health Professional Resources Assessing Your Weight and Health Risk Assessment of weight and health risk involves using ... risk for developing obesity-associated diseases or conditions. Risk Factors for Health Topics Associated With Obesity Along ...

Cumulative Human Impacts on Coral Reefs: Assessing Risk and Management Implications for Brazilian Coral Reefs

OpenAIRE

Rafael A. Magris; Alana Grech; Robert L. Pressey

2018-01-01

Effective management of coral reefs requires strategies tailored to cope with cumulative disturbances from human activities. In Brazil, where coral reefs are a priority for conservation, intensifying threats from local and global stressors are of paramount concern to management agencies. Using a cumulative impact assessment approach, our goal was to inform management actions for coral reefs in Brazil by assessing their exposure to multiple stressors (fishing, land-based activities, coastal de...

Health risk assessment of chemical pollutants in a petrochemical complex

Directory of Open Access Journals (Sweden)

F Golbabaie

2012-12-01

Full Text Available   Background and Aims: workers in petrochemical industries are exposed to various contaminants and are facing to serious hazards, therefore a comprehensive risk assessment program for identification of hazardous chemicals that affect human health and also determination of hazardous tasks and processes is necessary.     Methods : This descriptive cross-sectional study was conducted in three stages. First stage consisted of identifying hazardous chemicals and determination of chemicals risk ratio, the second stage included the evaluation of worker's exposure to hazardous chemicals, and the third stage was estimating the relative risk of blood cancer caused by exposure to benzene through epidemiological studies.     Results: With regard to risk assessment method, 40 chemicals were identified in this Petrochemical Company. Among them, Benzene introduced as the most hazardous chemical. The results of the second stage showed that site man workers in noon shift work and in aromatic site with mean exposure 4.29 ppm had the highest exposure to benzene. The results of estimated leukemia relative risk stage in benzene exposure, the highest relative risk in workers related to site man workers in aromatic units with cumulative benzene exposure of 4.149 ppm. Years that obtained the relative risk of 2.3. The statistical test results showed that the relationship between worker's exposure to benzene and their job was significant(p<0/001     Conclusion : This study showed that benzene with a risk ratio of 4.5 -5 have 5th rank in risk levels and this indicates that preventative actions regarding to this hazardous and carcinogenic chemical must be started as soon as possible.

Understanding the Relation of Low Income to HPA-Axis Functioning in Preschool Children: Cumulative Family Risk and Parenting as Pathways to Disruptions in Cortisol

Science.gov (United States)

Zalewski, Maureen; Lengua, Liliana J.; Kiff, Cara J.; Fisher, Philip A.

2012-01-01

This study examined the relation of low income and poverty to cortisol levels, and tested potential pathways from low income to disruptions in cortisol through cumulative family risk and parenting. The sample of 306 mothers and their preschool children included 29 % families at or near poverty, 27 % families below the median income, and the…

Cumulative childhood stress and autoimmune diseases in adults.

Science.gov (United States)

Dube, Shanta R; Fairweather, DeLisa; Pearson, William S; Felitti, Vincent J; Anda, Robert F; Croft, Janet B

2009-02-01

To examine whether childhood traumatic stress increased the risk of developing autoimmune diseases as an adult. Retrospective cohort study of 15,357 adult health maintenance organization members enrolled in the Adverse Childhood Experiences (ACEs) Study from 1995 to 1997 in San Diego, California, and eligible for follow-up through 2005. ACEs included childhood physical, emotional, or sexual abuse; witnessing domestic violence; growing up with household substance abuse, mental illness, parental divorce, and/or an incarcerated household member. The total number of ACEs (ACE Score range = 0-8) was used as a measure of cumulative childhood stress. The outcome was hospitalizations for any of 21 selected autoimmune diseases and 4 immunopathology groupings: T- helper 1 (Th1) (e.g., idiopathic myocarditis); T-helper 2 (Th2) (e.g., myasthenia gravis); Th2 rheumatic (e.g., rheumatoid arthritis); and mixed Th1/Th2 (e.g., autoimmune hemolytic anemia). Sixty-four percent reported at least one ACE. The event rate (per 10,000 person-years) for a first hospitalization with any autoimmune disease was 31.4 in women and 34.4 in men. First hospitalizations for any autoimmune disease increased with increasing number of ACEs (p or=2 ACEs were at a 70% increased risk for hospitalizations with Th1, 80% increased risk for Th2, and 100% increased risk for rheumatic diseases (p Childhood traumatic stress increased the likelihood of hospitalization with a diagnosed autoimmune disease decades into adulthood. These findings are consistent with recent biological studies on the impact of early life stress on subsequent inflammatory responses.

Prevalence and Risk Factors Associated with Low Back Pain Among Health Care Providers in a District Hospital

Directory of Open Access Journals (Sweden)

TS Wong

2010-07-01

Full Text Available STUDY DESIGN: A cross-sectional study among health care providers working at one hospital. OBJECTIVE: To investigate the prevalence, the consequences and the risk factors associated with low back pain (LBP among hospital staff. MATERIALS AND METHODS: The study sample consisted of 931 health care providers who answered a pre-established questionnaire including 30 items in two languages. RESULTS: The cumulative life-prevalence of LBP was 72.5% and the yearly prevalence was 56.9%. Chronic LBP prevalence was noted 5.1% of the cases. Treatment was sought in 34.1% of LBP sufferers and 7.3% required sick leave or absence from work due to LBP. Risk factors associated with LBP were professional categories, bad body posture, lifting objects or patients and the increased levels of lifting, levels of job satisfaction and stressful job demands. CONCLUSION: There was a high prevalence of LBP among hospital staff, resulting in significant medical and socio-professional consequences. Many risk factors were identified that would necessitate multidisciplinary involvement to reduce the LBP incidence and related costs.

Can the Air Pollution Index be used to communicate the health risks of air pollution?

International Nuclear Information System (INIS)

Li, Li; Lin, Guo-Zhen; Liu, Hua-Zhang; Guo, Yuming; Ou, Chun-Quan; Chen, Ping-Yan

2015-01-01

The validity of using the Air Pollution Index (API) to assess health impacts of air pollution and potential modification by individual characteristics on air pollution effects remain uncertain. We applied distributed lag non-linear models (DLNMs) to assess associations of daily API, specific pollution indices for PM 10 , SO 2 , NO 2 and the weighted combined API (APIw) with mortality during 2003–2011 in Guangzhou, China. An increase of 10 in API was associated with a 0.88% (95% confidence interval (CI): 0.50, 1.27%) increase of non-accidental mortality at lag 0–2 days. Harvesting effects appeared after 2 days’ exposure. The effect estimate of API over lag 0–15 days was statistically significant and similar with those of pollutant-specific indices and APIw. Stronger associations between API and mortality were observed in the elderly, females and residents with low educational attainment. In conclusion, the API can be used to communicate health risks of air pollution. - Highlights: • The cumulative effects of API on mortality over lag 0–15 days remained significant. • The indices for three specific pollutants had similar associations with mortality. • The effects of API were modified by age, gender and educational attainment. • Our findings can help to communicate health risks of air pollution to the public. - The Air Pollution Index communicates health risks of air pollution

Complete cumulative index (1963-1983)

International Nuclear Information System (INIS)

1983-01-01

This complete cumulative index covers all regular and special issues and supplements published by Atomic Energy Review (AER) during its lifetime (1963-1983). The complete cumulative index consists of six Indexes: the Index of Abstracts, the Subject Index, the Title Index, the Author Index, the Country Index and the Table of Elements Index. The complete cumulative index supersedes the Cumulative Indexes for Volumes 1-7: 1963-1969 (1970), and for Volumes 1-10: 1963-1972 (1972); this Index also finalizes Atomic Energy Review, the publication of which has recently been terminated by the IAEA

Do Holocaust survivors show increased vulnerability or resilience to post-Holocaust cumulative adversity?

Science.gov (United States)

Shrira, Amit; Palgi, Yuval; Ben-Ezra, Menachem; Shmotkin, Dov

2010-06-01

Prior trauma can hinder coping with additional adversity or inoculate against the effect of recurrent adversity. The present study further addressed this issue by examining whether a subsample of Holocaust survivors and comparison groups, drawn from the Israeli component of the Survey of Health, Ageing, and Retirement in Europe, were differentially affected by post-Holocaust cumulative adversity. Post-Holocaust cumulative adversity had a stronger effect on the lifetime depression of Holocaust survivors than on that of comparisons. However, comparisons were more negatively affected by post-Holocaust cumulative adversity when examining markers of physical and cognitive functioning. Our findings suggest that previous trauma can both sensitize and immunize, as Holocaust survivors show general resilience intertwined with specific vulnerability when confronted with additional cumulative adversity.

Family Income, Cumulative Risk Exposure, and White Matter Structure in Middle Childhood

Directory of Open Access Journals (Sweden)

Alexander J. Dufford

2017-11-01

Full Text Available Family income is associated with gray matter morphometry in children, but little is known about the relationship between family income and white matter structure. In this paper, using Tract-Based Spatial Statistics, a whole brain, voxel-wise approach, we examined the relationship between family income (assessed by income-to-needs ratio and white matter organization in middle childhood (N = 27, M = 8.66 years. Results from a non-parametric, voxel-wise, multiple regression (threshold-free cluster enhancement, p < 0.05 FWE corrected indicated that lower family income was associated with lower white matter organization [assessed by fractional anisotropy (FA] for several clusters in white matter tracts involved in cognitive and emotional functions including fronto-limbic circuitry (uncinate fasciculus and cingulum bundle, association fibers (inferior longitudinal fasciculus, superior longitudinal fasciculus, and corticospinal tracts. Further, we examined the possibility that cumulative risk (CR exposure might function as one of the potential pathways by which family income influences neural outcomes. Using multiple regressions, we found lower FA in portions of these tracts, including those found in the left cingulum bundle and left superior longitudinal fasciculus, was significantly related to greater exposure to CR (β = -0.47, p < 0.05 and β = -0.45, p < 0.05.

Environmental modeling and health risk analysis (ACTS/RISK)

National Research Council Canada - National Science Library

Aral, M. M

2010-01-01

... presents a review of the topics of exposure and health risk analysis. The Analytical Contaminant Transport Analysis System (ACTS) and Health RISK Analysis (RISK) software tools are an integral part of the book and provide computational platforms for all the models discussed herein. The most recent versions of these two softwa...

Using Marginal Structural Modeling to Estimate the Cumulative Impact of an Unconditional Tax Credit on Self-Rated Health.

Science.gov (United States)

Pega, Frank; Blakely, Tony; Glymour, M Maria; Carter, Kristie N; Kawachi, Ichiro

2016-02-15

In previous studies, researchers estimated short-term relationships between financial credits and health outcomes using conventional regression analyses, but they did not account for time-varying confounders affected by prior treatment (CAPTs) or the credits' cumulative impacts over time. In this study, we examined the association between total number of years of receiving New Zealand's Family Tax Credit (FTC) and self-rated health (SRH) in 6,900 working-age parents using 7 waves of New Zealand longitudinal data (2002-2009). We conducted conventional linear regression analyses, both unadjusted and adjusted for time-invariant and time-varying confounders measured at baseline, and fitted marginal structural models (MSMs) that more fully adjusted for confounders, including CAPTs. Of all participants, 5.1%-6.8% received the FTC for 1-3 years and 1.8%-3.6% for 4-7 years. In unadjusted and adjusted conventional regression analyses, each additional year of receiving the FTC was associated with 0.033 (95% confidence interval (CI): -0.047, -0.019) and 0.026 (95% CI: -0.041, -0.010) units worse SRH (on a 5-unit scale). In the MSMs, the average causal treatment effect also reflected a small decrease in SRH (unstabilized weights: β = -0.039 unit, 95% CI: -0.058, -0.020; stabilized weights: β = -0.031 unit, 95% CI: -0.050, -0.007). Cumulatively receiving the FTC marginally reduced SRH. Conventional regression analyses and MSMs produced similar estimates, suggesting little bias from CAPTs. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Risk management frameworks for human health and environmental risks.

Science.gov (United States)

Jardine, Cindy; Hrudey, Steve; Shortreed, John; Craig, Lorraine; Krewski, Daniel; Furgal, Chris; McColl, Stephen

2003-01-01

A comprehensive analytical review of the risk assessment, risk management, and risk communication approaches currently being undertaken by key national, provincial/state, territorial, and international agencies was conducted. The information acquired for review was used to identify the differences, commonalities, strengths, and weaknesses among the various approaches, and to identify elements that should be included in an effective, current, and comprehensive approach applicable to environmental, human health and occupational health risks. More than 80 agencies, organizations, and advisory councils, encompassing more than 100 risk documents, were examined during the period from February 2000 until November 2002. An overview was made of the most important general frameworks for risk assessment, risk management, and risk communication for human health and ecological risk, and for occupational health risk. In addition, frameworks for specific applications were reviewed and summarized, including those for (1)contaminated sites; (2) northern contaminants; (3) priority substances; (4) standards development; (5) food safety; (6) medical devices; (7) prescription drug use; (8) emergency response; (9) transportation; (10) risk communication. Twelve frameworks were selected for more extensive review on the basis of representation of the areas of human health, ecological, and occupational health risk; relevance to Canadian risk management needs; representation of comprehensive and well-defined approaches; generalizability with their risk areas; representation of "state of the art" in Canada, the United States, and/or internationally; and extent of usage of potential usage within Canada. These 12 frameworks were: 1. Framework for Environmental Health Risk Management (US Presidential/Congressional Commission on Risk Assessment and Risk Management, 1997). 2. Health Risk Determination: The Challenge of Health Protection (Health and Welfare Canada, 1990). 3. Health Canada Decision

Association Between Cumulative Psychosocial Risk and Cervical Human Papillomavirus Infection Among Female Adolescents in a Free Vaccination Program.

Science.gov (United States)

Linares, Lourdes Oriana; Shankar, Viswanathan; Diaz, Angela; Nucci-Sack, Anne; Strickler, Howard D; Peake, Ken; Weiss, Jocelyn; Burk, Robert D; Schlecht, Nicolas F

2015-10-01

This study investigated the association of cervical human papillomavirus (HPV) infection with cumulative psychosocial risk reflecting family disadvantage, psychological distress, and unhealthy lifestyle. The sample (N = 745) comprised sexually active female adolescent patients (12-19 yr), primarily ethnic minorities, enrolled in a free HPV vaccination program. Subjects completed questionnaires and provided cervical swabs for HPV DNA testing. Unweighted and weighted principal component analyses for categorical data were used to derive multisystemic psychosocial risk indices using 9 indicators: low socioeconomic status, lack of adult involvement, not attending high school/college, history of treatment for depression/anxiety, antisocial/delinquent behavior, number of recent sexual partners, use of alcohol, use of drugs, and dependency risk for alcohol/drugs. The association between cervical HPV (any type, high-risk types, vaccine types) assayed by polymerase chain reaction and self-reported number of psychosocial risk indicators was estimated using multivariable logistic regression. Subjects had a median of 3 psychosocial risk indicators. Multiple logistic regression analyses showed associations with unweighted and weighted number of psychosocial indicators for HPV any type (adjusted odds ratio [aOR] = 1.1; 95% confidence interval [CI], 1.0-1.2), with the strongest associations between weighted drug/alcohol use, drug/alcohol dependency risk, and antisocial/delinquent behavior and detection of HPV vaccine types (aOR = 1.5; 95% CI, 1.1-2.0) independent of number of recent sexual partners and vaccine dose (0-3). Increased HPV infections including HPV vaccine types were associated with greater number of psychosocial risk indicators even after controlling for demographics, sexual behavior, history of chlamydia, and vaccine dose.

Heavy metal content and potential health risk of geophagic white clay from the Kumasi Metropolis in Ghana

Directory of Open Access Journals (Sweden)

Marian Asantewah Nkansah

Full Text Available Geophagia is the craving for non-food substances and commonly practiced among pregnant women and children. Consumption of geophagic clay samples can have serious implications on the health of the consumers as a result of the presence of toxic metals such as Pb, As, Hg and Cd. This study sought to determine the levels of heavy metals in the studied geophagic clay samples and to determine the potential risks of heavy metals as cumulative carcinogenic and non-carcinogenic risks to the health of the consumers via oral (ingestion and dermal exposure routes. A total of thirty (30 white clay samples were analysed using Niton Thermo scientific XRF Analyser (Mobile Test S, NDTr-XL3t-86956, com 24. The clay samples were found to contain essential elements such as Ca, Fe, K and Zn as well as toxic metals such as As and Pb. There were isolated cases of the presence of Hg and all samples had Cd levels below detection. Health risk indices such as hazard quotient and cancer risk were calculated and the results indicated that consumers are likely to suffer from cancer through ingestion of geophagic clay. Bioaccessibility studies were done on zinc and it did not indicate any potential toxicity due to zincs essential nature. The levels of heavy metals in some of the geophagic clay consumed by some residents in the Kumasi were high compared to the Permitted Maximum Tolerable Daily Intake (PMTDI by (WHO/FAO and may pose potential health threat over time. Keywords: Geophagia, White clay, Heavy metals, Health risk assessment, Permitted maximum tolerable daily intake

Cumulative absolute breast cancer risk for young women treated for Hodgkin lymphoma

NARCIS (Netherlands)

Travis, L.B.; Hill, D.A.; Dores, G.M.; Gospodarowicz, M.; Leeuwen, van F.E.; Holowaty, E.; Glimelius, B.; Andersson, M.; Pukkala, E.; Lynch, C.F.; Pee, D.; Smith, S.A.; Veer, van 't M.B.; Joensuu, T.; Storm, H.; Stovall, M.; Boice, J.D.,Jr.; Gilbert, E.; Gail, M.H.

2005-01-01

or = 40 Gy) and use of alkylating agents (yes or no) were estimated from a case-control study conducted within an international population-based cohort of 3817 female 1-year survivors of HL diagnosed at age 30 years or younger from January 1, 1965, through December 31, 1994. To compute cumulative

Cumulative childhood risk is associated with a new measure of chronic inflammation in adulthood

DEFF Research Database (Denmark)

Rasmussen, Line Jee Hartmann; Moffitt, Terrie E; Eugen-Olsen, Jesper

2018-01-01

BACKGROUND: Childhood risk factors are associated with elevated inflammatory biomarkers in adulthood, but it is unknown whether these risk factors are associated with increased adult levels of the chronic inflammation marker soluble urokinase plasminogen activator receptor (suPAR). We aimed to test...... the hypothesis that childhood exposure to risk factors for adult disease is associated with elevated suPAR in adulthood and to compare suPAR with the oft-reported inflammatory biomarker C-reactive protein (CRP). METHODS: Prospective study of a population-representative 1972-1973 birth cohort; the Dunedin...... Multidisciplinary Health and Development Study observed participants to age 38 years. Main childhood predictors were poor health, socioeconomic disadvantage, adverse childhood experiences (ACEs), low IQ, and poor self-control. Main adult outcomes were adulthood inflammation measured as suPAR and high...

Cumulative effects of wind turbines. A guide to assessing the cumulative effects of wind energy development

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-07-01

This guidance provides advice on how to assess the cumulative effects of wind energy developments in an area and is aimed at developers, planners, and stakeholders interested in the development of wind energy in the UK. The principles of cumulative assessment, wind energy development in the UK, cumulative assessment of wind energy development, and best practice conclusions are discussed. The identification and assessment of the cumulative effects is examined in terms of global environmental sustainability, local environmental quality and socio-economic activity. Supplementary guidance for assessing the principle cumulative effects on the landscape, on birds, and on the visual effect is provided. The consensus building approach behind the preparation of this guidance is outlined in the annexes of the report.

The challenge of cumulative impacts

Energy Technology Data Exchange (ETDEWEB)

Masden, Elisabeth

2011-07-01

Full text: As governments pledge to combat climate change, wind turbines are becoming a common feature of terrestrial and marine environments. Although wind power is a renewable energy source and a means of reducing carbon emissions, there is a need to ensure that the wind farms themselves do not damage the environment. There is particular concern over the impacts of wind farms on bird populations, and with increasing numbers of wind farm proposals, the concern focuses on cumulative impacts. Individually, a wind farm, or indeed any activity/action, may have minor effects on the environment, but collectively these may be significant, potentially greater than the sum of the individual parts acting alone. Cumulative impact assessment is a legislative requirement of environmental impact assessment but such assessments are rarely adequate restricting the acquisition of basic knowledge about the cumulative impacts of wind farms on bird populations. Reasons for this are numerous but a recurring theme is the lack of clear definitions and guidance on how to perform cumulative assessments. Here we present a conceptual framework and include illustrative examples to demonstrate how the framework can be used to improve the planning and execution of cumulative impact assessments. The core concept is that explicit definitions of impacts, actions and scales of assessment are required to reduce uncertainty in the process of assessment and improve communication between stake holders. Only when it is clear what has been included within a cumulative assessment, is it possible to make comparisons between developments. Our framework requires improved legislative guidance on the actions to include in assessments, and advice on the appropriate baselines against which to assess impacts. Cumulative impacts are currently considered on restricted scales (spatial and temporal) relating to individual development assessments. We propose that benefits would be gained from elevating cumulative

An Integrated Approach to Assess Exposure and Health-Risk from Polycyclic Aromatic Hydrocarbons (PAHs in a Fastener Manufacturing Industry

Directory of Open Access Journals (Sweden)

Hsin-I Hsu

2014-09-01

Full Text Available An integrated approach was developed to assess exposure and health-risk from polycyclic aromatic hydrocarbons (PAHs contained in oil mists in a fastener manufacturing industry. One previously developed model and one new model were adopted for predicting oil mist exposure concentrations emitted from metal work fluid (MWF and PAHs contained in MWF by using the fastener production rate (Pr and cumulative fastener production rate (CPr as predictors, respectively. By applying the annual Pr and CPr records to the above two models, long-term workplace PAH exposure concentrations were predicted. In addition, true exposure data was also collected from the field. The predicted and measured concentrations respectively served as the prior and likelihood distributions in the Bayesian decision analysis (BDA, and the resultant posterior distributions were used to determine the long-term exposure and health-risks posed on workers. Results show that long term exposures to PAHs would result in a 3.1%, 96.7%, and 73.4% chance of exceeding the PEL-TWA (0.2 mg/m3, action level (0.1 mg/m3, and acceptable health risk (10−3, respectively. In conclusion, preventive measures should be taken immediately to reduce workers’ PAH exposures.

Quantitative Relationship Between Cumulative Risk Alleles Based on Genome-Wide Association Studies and Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis

Directory of Open Access Journals (Sweden)

Satoru Kodama

2018-01-01

Full Text Available Many epidemiological studies have assessed the genetic risk of having undiagnosed or of developing type 2 diabetes mellitus (T2DM using several single nucleotide polymorphisms (SNPs based on findings of genome-wide association studies (GWAS. However, the quantitative association of cumulative risk alleles (RAs of such SNPs with T2DM risk has been unclear. The aim of this meta-analysis is to review the strength of the association between cumulative RAs and T2DM risk. Systematic literature searches were conducted for cross-sectional or longitudinal studies that examined odds ratios (ORs for T2DM in relation to genetic profiles. Logarithm of the estimated OR (log OR of T2DM for 1 increment in RAs carried (1-ΔRA in each study was pooled using a random-effects model. There were 46 eligible studies that included 74,880 cases among 249,365 participants. In 32 studies with a cross-sectional design, the pooled OR for T2DM morbidity for 1-ΔRA was 1.16 (95% confidence interval [CI], 1.13–1.19. In 15 studies that had a longitudinal design, the OR for incident T2DM was 1.10 (95% CI, 1.08–1.13. There was large heterogeneity in the magnitude of log OR (P < 0.001 for both cross-sectional studies and longitudinal studies. The top 10 commonly used genes significantly explained the variance in the log OR (P = 0.04 for cross-sectional studies; P = 0.006 for longitudinal studies. The current meta-analysis indicated that carrying 1-ΔRA in T2DM-associated SNPs was associated with a modest risk of prevalent or incident T2DM, although the heterogeneity in the used genes among studies requires us to interpret the results with caution.

Cumulative reproductive effects of in utero administration of mixtures of antiandrogens in male SD rats: synergy or additivity?

Science.gov (United States)

In 1996 the USEPA was charged under the FQPA to consider the cumulative effects of chemicals in their risk assessments. Our studies were conducted to provide a framework for assessing the cumulative effects of antiandrogens. Toxicants were administered individually or as mixtures...

The Association between Cumulative Psychosocial Risk and Cervical HPV Infection Among Female Adolescents in a Free Vaccination Program

Science.gov (United States)

Linares, Lourdes Oriana; Shankar, Viswanathan; Diaz, Angela; Nucci-Sack, Anne; Strickler, Howard D.; Peake, Ken; Weiss, Jocelyn; Burk, Robert D.; Schlecht, Nicolas F.

2016-01-01

Objective This study investigated the association of cervical Human Papillomavirus (HPV) infection with cumulative psychosocial risk reflecting family disadvantage, psychological distress, and unhealthy life style. Methods The sample (N=745) was comprised of sexually-active female adolescent patients (12-19 years), primarily ethnic minorities, enrolled in a free HPV vaccination program. Subjects completed questionnaires and provided cervical swabs for HPV DNA testing. Unweighted and weighted Principal Component Analyses (PCA) for categorical data were used to derive multi-systemic psychosocial risk indices using nine indicators: low socioeconomic status, lack of adult involvement, not attending high-school/college, history of treatment for depression/anxiety, antisocial/delinquent behavior, number of recent sexual partners, use of alcohol, use of drugs, and dependency risk for alcohol/drugs. The association between cervical HPV (any-type, high risk-types, vaccine-types) assayed by polymerase chain reaction and self-reported number of psychosocial risk indicators was estimated using multivariable logistic regression. Results Subjects had a median of three psychosocial risk indicators. Multiple logistic regression analyses showed associations with unweighted and weighted number of psychosocial indicators for HPV any-type (adjusted odds ratio [aOR]=1.1; 95% confidence interval [CI]: 1.0-1.2 ); with the strongest associations between weighted drug/alcohol use, drug/alcohol dependency risk, and antisocial/delinquent behavior and detection of HPV vaccine-types (aOR=1.5; 95%CI: 1.1-2.0) independent of number of recent sexual partners and vaccine dose (0-3). Conclusion Increased HPV infections including HPV vaccine-types were associated with greater number of psychosocial risk indicators even after controlling for demographics, sexual behavior, history of chlamydia, and vaccine dose. PMID:25985216

Risk tradeoffs and public health protection

International Nuclear Information System (INIS)

Charnley, G.

1998-01-01

Full text of publication follows: over the last 25 years, the traditional command-and-control, chemical-by-chemical environmental medium-by-environmental medium, risk-by-risk approach to protecting public health from environmental risks has worked well to greatly improve the quality of our food, air, water, and workplaces, but we are now left with the more complex problems, like urban air pollution or personal dietary behavior, that a chemical-by-chemical approach is not going to solve. Because current environmental regulatory programs have curbed the 'low-hanging fruit' and because of today's emphasis on achieving risk reductions cost-effectively, new and creative public health-based approaches to risk management are needed. Since public concern about pollution-related disease become serious in the 1960's and 1970's and regulatory agencies and laws began to proliferate, the public health goals of environmental protection have been obscured. As a society, we have made a tradeoff between environmental health and public health. The public health foundation of environmental health protection has been obscured by legalistic, technical, centralized decision-making processes that have often mistaken hazard for risk. A greater focus on public health would help us to assess aggregate risks and to target risk management resources by focusing on a problem and then identifying what is causing the problem as a guide to determining how best to solve it. Most of our current approaches start with a cause and then try to eliminate it without determining the extent to which it actually may contribute to a problem, making it difficult to set priorities among risks or to evaluate the impact of risk management actions on public health. (author)

Prospective associations of psychosocial adversity in childhood with risk factors for cardiovascular disease in adulthood: the MRC National Survey of Health and Development.

Science.gov (United States)

Anderson, Emma L; Caleyachetty, Rishi; Stafford, Mai; Kuh, Diana; Hardy, Rebecca; Lawlor, Debbie A; Fraser, Abigail; Howe, Laura D

2017-09-07

Studies assessing associations of childhood psychosocial adversity (e.g. sexual abuse, physical neglect, parental death), as opposed to socioeconomic adversity, with cardiovascular disease (CVD) risk factors in adulthood are scarce. We aimed to assess associations of various forms of psychosocial adversity and cumulative adversity in childhood, with multiple CVD risk factors in mid-life. Participants were from the MRC National Survey of Health and Development. Childhood psychosocial risk factors were reported prospectively by parents from 1950-1957, and retrospectively by participants at mean age 43 years in 1989. CVD risk factors were assessed at mean age 60-64 years in 2006-2011. Associations of a summary score of total psychosocial adversity and CVD risk in adulthood were assessed. There was no consistent evidence that cumulative psychosocial adversity, nor any specific form of psychosocial adversity in childhood, was associated with CVD risk factors in late adulthood. There was some evidence that parental death in the first 15 years was associated with higher SBP (Beta: 0.23, 95% confidence interval: 0.06 to 0.40, P=0.01) and DBP (Beta: 0.15, 95% confidence interval: -0.01 to 0.32, P=0.07). We found no evidence that exposure to greater psychosocial adversity, or specific forms of psychosocial adversity during childhood is associated with adult CVD risk factors. Further large population studies are needed to clarify whether parental death is associated with higher systolic and diastolic blood pressure.

32 CFR 651.16 - Cumulative impacts.

Science.gov (United States)

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Cumulative impacts. 651.16 Section 651.16... § 651.16 Cumulative impacts. (a) NEPA analyses must assess cumulative effects, which are the impact on the environment resulting from the incremental impact of the action when added to other past, present...

The impact of risk communications on public understanding

International Nuclear Information System (INIS)

O'Connor, R.E.; Bord, R.J.

1992-01-01

This paper assesses the impact of different modes of communicating information about risks that are cumulative, uncertain, and long-term (CULT). Do communications that emphasize potential ecological problems have a different impact from messages that discuss health concerns? Is a more emotional style more effective than a traditional standard approach? CULT risks, including those commonly associated with high-level radioactive waste, pose particular problems for risk communicators. nevertheless, the research shows that relatively simple risk communications can effectively lower risk estimates and reduce fears of negative consequences from CULT risks

Rotating Night-Shift Work and the Risk of Breast Cancer in the Nurses' Health Studies.

Science.gov (United States)

Wegrzyn, Lani R; Tamimi, Rulla M; Rosner, Bernard A; Brown, Susan B; Stevens, Richard G; Eliassen, A Heather; Laden, Francine; Willett, Walter C; Hankinson, Susan E; Schernhammer, Eva S

2017-09-01

In 2007, the International Agency for Research on Cancer declared shift work that involved circadian disruption to be a "probable" carcinogen (group 2A), noting that human evidence was limited. Using data from 2 prospective cohort studies, the Nurses' Health Study (1988-2012; n = 78,516) and Nurses' Health Study II (1989-2013; n = 114,559), we examined associations between rotating night-shift work and breast cancer risk. In the 2 cohorts, there were a total of 9,541 incident invasive breast malignancies and 24 years of follow-up. In the Nurses' Health Study, women with 30 years or more of shift work did not have a higher risk of breast cancer (hazard ratio (HR) = 0.95, 95% confidence interval (95% CI): 0.77, 1.17; P for trend = 0.63) compared with those who never did shift work, although follow-up occurred primarily after retirement from shift work. Among participants in the Nurses' Health Study II, who were younger than participants in the other cohort, the risk of breast cancer was significantly higher in women with 20 years or more of shift work at baseline, reflecting young-adult exposure (HR = 2.15, 95% CI: 1.23, 3.73; P for trend = 0.23), and was marginally significantly higher for women with 20 years or more of cumulative shift work when we used updated exposure information (HR = 1.40, 95% CI: 1.00, 1.97; P for trend = 0.74). In conclusion, long-term rotating night-shift work was associated with a higher risk of breast cancer, particularly among women who performed shift work during young adulthood. Further studies should explore the role of shift work timing on breast cancer risk. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Health risks in perspective: Judging health risks of energy technologies. Revision 5/94

Energy Technology Data Exchange (ETDEWEB)

Rowe, M.D.

1992-09-01

The purpose of this report is to provide perspective on the various risks to which man is routinely exposed. It serves as a basis for understanding the meaning of quantitative risk estimates and for comparing new or newly-discovered risks with other, better-understood risks. Specific emphasis is placed on health risks of energy technologies. This report is not a risk assessment; nor does it contain instructions on how to do a risk assessment. Rather, it provides background information on how most of us think about risks and why it is difficult to do it rationally, it provides a philosophy and data with which to do a better job of judging risks more rationally, and it provides an overview of where risks of energy technologies fit within the spectrum of all risks. Much of the quantitative information provided here is on relative risk of dying of various causes. This is not because risk of dying is seen as the most important kind of risk, but because the statistics on mortality rates by cause are the highest quality data available on health risks in the general population.

Social Relationships and Health: A Flashpoint for Health Policy

Science.gov (United States)

Umberson, Debra; Montez, Jennifer Karas

2011-01-01

Social relationships—both quantity and quality—affect mental health, health behavior, physical health, and mortality risk. Sociologists have played a central role in establishing the link between social relationships and health outcomes, identifying explanations for this link, and discovering social variation (e.g., by gender and race) at the population level. Studies show that social relationships have short- and long-term effects on health, for better and for worse, and that these effects emerge in childhood and cascade throughout life to foster cumulative advantage or disadvantage in health. This article describes key research themes in the study of social relationships and health, and it highlights policy implications suggested by this research. PMID:20943583

High cumulative insulin exposure : a risk factor of atherosclerosis in type 1 diabetes?

NARCIS (Netherlands)

Muis, MJ; Bots, ML; Bilo, HJG; Hoogma, RPLM; Hoekstra, JBL; Grobbee, DE; Stolk, RP

Background: Since insulin therapy might have an atherogenic effect, we studied the relationship between cumulative insulin dose and atherosclerosis in type 1 diabetes. We have focused on patients with type 1 diabetes instead of type 2 diabetes to minimise the effect of insulin resistance as a

High cumulative insulin exposure: a risk factor of atherosclerosis in type 1 diabetes?

NARCIS (Netherlands)

Muis, Marian J.; Bots, Michiel L.; Bilo, Henk J. G.; Hoogma, Roel P. L. M.; Hoekstra, Joost B. L.; Grobbee, Diederick E.; Stolk, Ronald P.

2005-01-01

Background: Since insulin therapy might have an atherogenic effect, we studied the relationship between cumulative insulin dose and atherosclerosis in type 1 diabetes. We have focused on patients with type 1 diabetes instead of type 2 diabetes to minimise the effect of insulin resistance as a

Adolescent mental health and academic functioning: empirical support for contrasting models of risk and vulnerability.

Science.gov (United States)

Lucier-Greer, Mallory; O'Neal, Catherine W; Arnold, A Laura; Mancini, Jay A; Wickrama, Kandauda K A S

2014-11-01

Adolescents in military families contend with normative stressors that are universal and exist across social contexts (minority status, family disruptions, and social isolation) as well as stressors reflective of their military life context (e.g., parental deployment, school transitions, and living outside the United States). This study utilizes a social ecological perspective and a stress process lens to examine the relationship between multiple risk factors and relevant indicators of youth well-being, namely depressive symptoms and academic performance, as well as the mediating role of self-efficacy (N = 1,036). Three risk models were tested: an additive effects model (each risk factor uniquely influences outcomes), a full cumulative effects model (the collection of risk factors influences outcomes), a comparative model (a cumulative effects model exploring the differential effects of normative and military-related risks). This design allowed for the simultaneous examination of multiple risk factors and a comparison of alternative perspectives on measuring risk. Each model was predictive of depressive symptoms and academic performance through persistence; however, each model provides unique findings about the relationship between risk factors and youth outcomes. Discussion is provided pertinent to service providers and researchers on how risk is conceptualized and suggestions for identifying at-risk youth. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Cumulative Risk and Continuity in Nonparental Care from Infancy to Early Adolescence

OpenAIRE

Colwell, Malinda J.; Pettit, Gregory S.; Meece, Darrell; Bates, John E.; Dodge, Kenneth A.

2001-01-01

Variations in amounts of nonparental care across infancy, preschool, early elementary school, and early adolescence were examined in a longitudinal sample (N = 438). Of interest was (a) continuity in use of the different arrangements, (b) whether the arrangements were additively and cumulatively associated with children’s externalizing behavior problems, and (c) whether predictive relations were accounted for by social-ecological (socioeconomic status, mothers’ employment status, marital stat...

Divergent Cumulative Cultural Evolution

OpenAIRE

Marriott, Chris; Chebib, Jobran

2016-01-01

Divergent cumulative cultural evolution occurs when the cultural evolutionary trajectory diverges from the biological evolutionary trajectory. We consider the conditions under which divergent cumulative cultural evolution can occur. We hypothesize that two conditions are necessary. First that genetic and cultural information are stored separately in the agent. Second cultural information must be transferred horizontally between agents of different generations. We implement a model with these ...

A Collaborative Study of Disproportionate Chemical Risks in Seven Delaware Communities

Science.gov (United States)

Dryden, O.; Goldman, G. T.; White, R.; Moore, D.; Roberts, M.; Thomas, J.; Johnson, C.

2017-12-01

Studies have found that, compared to national averages, a significantly greater percentage of Blacks (African-Americans), Latinos (Hispanics), and people at or near poverty levels tend to live near industrial facilities that use large quantities of toxic chemicals and present a risk of major chemical disasters with potentially severe consequences for nearby communities. The Union of Concerned Scientists, the Environmental Justice Health Alliance for Chemical Policy Reform, and Delaware Concerned Residents for Environmental Justice collaborated on a study to examine the potential for cumulative impacts from health and safety risks for seven Delaware communities with a percentage of people of color and/or poverty levels greater than the Delaware average located along an industrial corridor in the northern portion of Delaware's New Castle County. These risks include close proximity to major industrial sources, as well as facilities that use large quantities of toxic, flammable or explosive chemicals and pose a high risk of a major chemical release or catastrophic incident. Additionally, proximity to contaminated waste sites was assessed, as well as the risk of cancer and potential for respiratory disease impacts from exposure to toxic air pollution. We found that people in these seven communities face a substantial cumulative health risk from exposure to toxic air pollution, proximity to polluting industrial facilities and hazardous chemical facilities, as well as contaminated waste sites. These health risks are substantially greater when compared to a wealthier and predominantly White Delaware community and for Delaware as a whole. Significant and expedited improvements in regulatory and public policy are needed at the national, state, and municipal levels to address the health and well-being of at-risk communities in Delaware and elsewhere.

Direct comparison of risk-adjusted and non-risk-adjusted CUSUM analyses of coronary artery bypass surgery outcomes.

Science.gov (United States)

Novick, Richard J; Fox, Stephanie A; Stitt, Larry W; Forbes, Thomas L; Steiner, Stefan

2006-08-01

We previously applied non-risk-adjusted cumulative sum methods to analyze coronary bypass outcomes. The objective of this study was to assess the incremental advantage of risk-adjusted cumulative sum methods in this setting. Prospective data were collected in 793 consecutive patients who underwent coronary bypass grafting performed by a single surgeon during a period of 5 years. The composite occurrence of an "adverse outcome" included mortality or any of 10 major complications. An institutional logistic regression model for adverse outcome was developed by using 2608 contemporaneous patients undergoing coronary bypass. The predicted risk of adverse outcome in each of the surgeon's 793 patients was then calculated. A risk-adjusted cumulative sum curve was then generated after specifying control limits and odds ratio. This risk-adjusted curve was compared with the non-risk-adjusted cumulative sum curve, and the clinical significance of this difference was assessed. The surgeon's adverse outcome rate was 96 of 793 (12.1%) versus 270 of 1815 (14.9%) for all the other institution's surgeons combined (P = .06). The non-risk-adjusted curve reached below the lower control limit, signifying excellent outcomes between cases 164 and 313, 323 and 407, and 667 and 793, but transgressed the upper limit between cases 461 and 478. The risk-adjusted cumulative sum curve never transgressed the upper control limit, signifying that cases preceding and including 461 to 478 were at an increased predicted risk. Furthermore, if the risk-adjusted cumulative sum curve was reset to zero whenever a control limit was reached, it still signaled a decrease in adverse outcome at 166, 653, and 782 cases. Risk-adjusted cumulative sum techniques provide incremental advantages over non-risk-adjusted methods by not signaling a decrement in performance when preoperative patient risk is high.

Risk factors for child maltreatment in an Australian population-based birth cohort.

Science.gov (United States)

Doidge, James C; Higgins, Daryl J; Delfabbro, Paul; Segal, Leonie

2017-02-01

Child maltreatment and other adverse childhood experiences adversely influence population health and socioeconomic outcomes. Knowledge of the risk factors for child maltreatment can be used to identify children at risk and may represent opportunities for prevention. We examined a range of possible child, parent and family risk factors for child maltreatment in a prospective 27-year population-based birth cohort of 2443 Australians. Physical abuse, sexual abuse, emotional abuse, neglect and witnessing of domestic violence were recorded retrospectively in early adulthood. Potential risk factors were collected prospectively during childhood or reported retrospectively. Associations were estimated using bivariate and multivariate logistic regressions and combined into cumulative risk scores. Higher levels of economic disadvantage, poor parental mental health and substance use, and social instability were strongly associated with increased risk of child maltreatment. Indicators of child health displayed mixed associations and infant temperament was uncorrelated to maltreatment. Some differences were observed across types of maltreatment but risk profiles were generally similar. In multivariate analyses, nine independent risk factors were identified, including some that are potentially modifiable: economic disadvantage and parental substance use problems. Risk of maltreatment increased exponentially with the number of risk factors experienced, with prevalence of maltreatment in the highest risk groups exceeding 80%. A cumulative risk score based on the independent risk factors allowed identification of individuals at very high risk of maltreatment, while a score that incorporated all significant risk and protective factors provided better identification of low-risk individuals. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cumulative environmental risk in substance abusing women: early intervention, parenting stress, child abuse potential and child development.

Science.gov (United States)

Nair, Prasanna; Schuler, Maureen E; Black, Maureen M; Kettinger, Laurie; Harrington, Donna

2003-09-01

To assess the relationship between cumulative environmental risks and early intervention, parenting attitudes, potential for child abuse and child development in substance abusing mothers. We studied 161 substance-abusing women, from a randomized longitudinal study of a home based early intervention, who had custody of their children through 18 months. The intervention group received weekly home visits in the first 6 months and biweekly visits from 6 to 18 months. Parenting stress and child abuse potential were assessed at 6 and 18 months postpartum. Children's mental and motor development (Bayley MDI and PDI) and language development (REEL) were assessed at 6, 12, and 18 months postpartum. Ten maternal risk factors were assessed: maternal depression, domestic violence, nondomestic violence, family size, incarceration, no significant other in home, negative life events, psychiatric problems, homelessness, and severity of drug use. Level of risk was recoded into four categories (2 or less, 3, 4, and 5 or more), which had adequate cell sizes for repeated measures analysis. Repeated measures analyses were run to examine how level of risk and group (intervention or control) were related to parenting stress, child abuse potential, and children's mental, motor and language development over time. Parenting stress and child abuse potential were higher for women with five risks or more compared with women who had four or fewer risks; children's mental, motor, and language development were not related to level of risk. Children in the intervention group had significantly higher scores on the PDI at 6 and 18 months (107.4 vs. 103.6 and 101.1 vs. 97.2) and had marginally better scores on the MDI at 6 and 12 months (107.7 vs. 104.2 and 103.6 vs. 100.1), compared to the control group. Compared to drug-abusing women with fewer than five risks, women with five or more risks found parenting more stressful and indicated greater inclination towards abusive and neglectful behavior

NON-EXPECTED UTILITY THEORIES: WEIGHTED EXPECTED, RANK DEPENDENT, AND CUMULATIVE PROSPECT THEORY UTILITY

OpenAIRE

Tuthill, Jonathan W.; Frechette, Darren L.

2002-01-01

This paper discusses some of the failings of expected utility including the Allais paradox and expected utility's inadequate one dimensional characterization of risk. Three alternatives to expected utility are discussed at length; weighted expected utility, rank dependent utility, and cumulative prospect theory. Each alternative is capable of explaining Allais paradox type problems and permits more sophisticated multi dimensional risk preferences.

Health and ecological risk-based characterization of soil and sediment contamination in shipyard with long-term use of DDT-containing antifouling paint

Energy Technology Data Exchange (ETDEWEB)

Guo, Guanlin; Zhang, Chao [State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); Wu, Guanglong; Ding, Qiong [Foreign Economic Cooperation Office, Ministry of Environmental Protection of China, Beijing, 100035 (China); Wang, Shijie [State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); Li, Fasheng, E-mail: Lifs@craes.org.cn [State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012 (China)

2013-04-15

Dichlorodiphenyltrichloroethane (DDT) was a frequently occurring type of persistent organic environmental pollutant in China and DDT-containing antifouling paint could be the main contributor of DDT to shipyards and fishing harbors. A field survey was conducted in a shipyard in southern China to investigate the content and distribution of DDT in soil and sediments. Human health and screening-level ecological risk assessments were conducted for DDT contamination in soil and sediments and the results indicated that total DDT in all samples tested exceeded present advisory safe limits. Analysis of the composition and distribution implicated DDT-containing antifouling paint used for ship maintenance as an important source of DDT. Individual and cumulative health risks for residents exceeded the extra lifetime cancer risks of 10{sup −6} and 10{sup −5}, mainly from exposure to soil, ingestion and dermal contact. DDT in sediments is associated with a high level of toxicity for the benthic community when > 99% of samples exceed the threshold concentration likely to be responsible for effects and severe effects. Further risk control for DDT is required to ensure safety for human health, the benthic community and the environment. - Highlights: ► DDT ranked high concentration both in sediments and soil in a shipyard. ► Composition analysis indicated DDT antifouling paint was the main source. ► High loading DDT in sediments resulted in high probability of ecological risks. ► Potential health risks for residents were mainly from the exposure of ingestion.

Health and ecological risk-based characterization of soil and sediment contamination in shipyard with long-term use of DDT-containing antifouling paint

International Nuclear Information System (INIS)

Guo, Guanlin; Zhang, Chao; Wu, Guanglong; Ding, Qiong; Wang, Shijie; Li, Fasheng

2013-01-01

Dichlorodiphenyltrichloroethane (DDT) was a frequently occurring type of persistent organic environmental pollutant in China and DDT-containing antifouling paint could be the main contributor of DDT to shipyards and fishing harbors. A field survey was conducted in a shipyard in southern China to investigate the content and distribution of DDT in soil and sediments. Human health and screening-level ecological risk assessments were conducted for DDT contamination in soil and sediments and the results indicated that total DDT in all samples tested exceeded present advisory safe limits. Analysis of the composition and distribution implicated DDT-containing antifouling paint used for ship maintenance as an important source of DDT. Individual and cumulative health risks for residents exceeded the extra lifetime cancer risks of 10 −6 and 10 −5 , mainly from exposure to soil, ingestion and dermal contact. DDT in sediments is associated with a high level of toxicity for the benthic community when > 99% of samples exceed the threshold concentration likely to be responsible for effects and severe effects. Further risk control for DDT is required to ensure safety for human health, the benthic community and the environment. - Highlights: ► DDT ranked high concentration both in sediments and soil in a shipyard. ► Composition analysis indicated DDT antifouling paint was the main source. ► High loading DDT in sediments resulted in high probability of ecological risks. ► Potential health risks for residents were mainly from the exposure of ingestion

Effectiveness of Health Promotion Programmes for Truck Drivers: A Systematic Review

Science.gov (United States)

Ng, Mandy K.; Yousuf, Bilal; Bigelow, Philip Lloyd; Van Eerd, Dwayne

2015-01-01

Objective: To review the characteristics of effective health promotion interventions for reducing chronic diseases and their risk factors in truck drivers. Methods: MEDLINE (PubMed), SCOPUS, Web of Science Conference Proceedings, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and the National Transportation Library were…

Parental perception of psychophysical health, nutritional status and oral health in relation to sociodemographic characteristics in children in Bariloche, Argentina: an epidemiological study.

Science.gov (United States)

Garibotti, Gilda; Vasconi, Cecilia; Ferrari, Alejandra; Giannini, Gabriela; Comar, Haydeé; Schnaiderman, Diego

2015-10-01

There is evidence of an association between social determinants and child health. To identify sociodemographic characteristics related to child health inequalities and to analize the cumulative effect on health of risk factors based on these characteristics. We evaluated 4-13 year-old children in Bariloche between June 2008 and May 2009. The following sociodemographic characteristics were taken into account: socioeconomic level, maternal education, adolescent pregnancy, medical coverage, unsafeness, and family habits. We assessed parental perception of physical, and social and emotional health, nutritional status and oral health in relation to these characteristics and the accumulation of risk factors. We used survey, anthropometry and oral examination. One hundred and eighty students participated. The level of maternal education was associated with the child's physical, social and emotional, and oral health. The percentage of children with missing teeth or cavities reached 77% among those whose mothers had, at most, completed primary school, compared to 13% among those whose mothers had completed tertiary school or university. The possibility of perceiving a non-optimal physical, and social and emotional health increased 1.8 and 1.4 times with each risk factor, respectively, and the possibility of having missing teeth or cavities was twice as much with each additional risk factor. Overweight and obesity was observed in 27.3% and 8.7% of students, respectively, and no relationship was found with sociodemographic characteristics. A low family socioeconomic level and a low maternal education level were associated with a higher prevalence of unfavorable health outcomes. Multiple risk factors have an cumulative effect on parental perception of physical, social and emotional, and oral health.

Cumulative Effect of Depression on Dementia Risk

Directory of Open Access Journals (Sweden)

J. Olazarán

2013-01-01

Full Text Available Objective. To analyze a potential cumulative effect of life-time depression on dementia and Alzheimer’s disease (AD, with control of vascular factors (VFs. Methods. This study was a subanalysis of the Neurological Disorders in Central Spain (NEDICES study. Past and present depression, VFs, dementia status, and dementia due to AD were documented at study inception. Dementia status was also documented after three years. Four groups were created according to baseline data: never depression (nD, past depression (pD, present depression (prD, and present and past depression (prpD. Logistic regression was used. Results. Data of 1,807 subjects were investigated at baseline (mean age 74.3, 59.3% women, and 1,376 (81.6% subjects were evaluated after three years. The prevalence of dementia at baseline was 6.7%, and dementia incidence was 6.3%. An effect of depression was observed on dementia prevalence (OR [CI 95%] 1.84 [1.01–3.35] for prD and 2.73 [1.08–6.87] for prpD, and on dementia due to AD (OR 1.98 [0.98–3.99] for prD and OR 3.98 [1.48–10.71] for prpD (fully adjusted models, nD as reference. Depression did not influence dementia incidence. Conclusions. Present depression and, particularly, present and past depression are associated with dementia at old age. Multiple mechanisms, including toxic effect of depression on hippocampal neurons, plausibly explain these associations.

Challenges in risk estimation using routinely collected clinical data: The example of estimating cervical cancer risks from electronic health-records.

Science.gov (United States)

Landy, Rebecca; Cheung, Li C; Schiffman, Mark; Gage, Julia C; Hyun, Noorie; Wentzensen, Nicolas; Kinney, Walter K; Castle, Philip E; Fetterman, Barbara; Poitras, Nancy E; Lorey, Thomas; Sasieni, Peter D; Katki, Hormuzd A

2018-06-01

Electronic health-records (EHR) are increasingly used by epidemiologists studying disease following surveillance testing to provide evidence for screening intervals and referral guidelines. Although cost-effective, undiagnosed prevalent disease and interval censoring (in which asymptomatic disease is only observed at the time of testing) raise substantial analytic issues when estimating risk that cannot be addressed using Kaplan-Meier methods. Based on our experience analysing EHR from cervical cancer screening, we previously proposed the logistic-Weibull model to address these issues. Here we demonstrate how the choice of statistical method can impact risk estimates. We use observed data on 41,067 women in the cervical cancer screening program at Kaiser Permanente Northern California, 2003-2013, as well as simulations to evaluate the ability of different methods (Kaplan-Meier, Turnbull, Weibull and logistic-Weibull) to accurately estimate risk within a screening program. Cumulative risk estimates from the statistical methods varied considerably, with the largest differences occurring for prevalent disease risk when baseline disease ascertainment was random but incomplete. Kaplan-Meier underestimated risk at earlier times and overestimated risk at later times in the presence of interval censoring or undiagnosed prevalent disease. Turnbull performed well, though was inefficient and not smooth. The logistic-Weibull model performed well, except when event times didn't follow a Weibull distribution. We have demonstrated that methods for right-censored data, such as Kaplan-Meier, result in biased estimates of disease risks when applied to interval-censored data, such as screening programs using EHR data. The logistic-Weibull model is attractive, but the model fit must be checked against Turnbull non-parametric risk estimates. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Health Risk Behavior in Foster Youth

Science.gov (United States)

Gramkowski, Bridget; Kools, Susan; Paul, Steven; Boyer, Cherrie; Monasterio, Erica; Robbins, Nancy

2010-01-01

Problem Adolescent health problems are predominantly caused by risk behavior. Foster adolescents have disproportionately poor health; therefore identification of risk behavior is critical. Method A secondary analysis of data from a larger study investigated the health risk behavior of 56 foster youth using the CHIP-AE. Findings Foster youth had some increased risk behavior. Younger adolescents and those in kinship care had less risky behavior. Youth had more risk behavior when: in group homes, parental death, histories of physical or emotional abuse, or history of attempted suicide. Conclusions These results point to areas of strength and vulnerability in foster youth. PMID:19490278

Cumulative emission budgets and their implications: the case for SAFE carbon

Science.gov (United States)

Allen, Myles; Bowerman, Niel; Frame, David; Mason, Charles

2010-05-01

The risk of dangerous long-term climate change due to anthropogenic carbon dioxide emissions is predominantly determined by cumulative emissions over all time, not the rate of emission in any given year or commitment period. This has profound implications for climate mitigation policy: emission targets for specific years such as 2020 or 2050 provide no guarantee of meeting any overall cumulative emission budget. By focusing attention on short-term measures to reduce the flow of emissions, they may even exacerbate the overall long-term stock. Here we consider how climate policies might be designed explicitly to limit cumulative emissions to, for example, one trillion tonnes of carbon, a figure that has been estimated to give a most likely warming of two degrees above pre-industrial, with a likely range of 1.6-2.6 degrees. Three approaches are considered: tradable emission permits with the possibility of indefinite emission banking, carbon taxes explicitly linked to cumulative emissions and mandatory carbon sequestration. Framing mitigation policy around cumulative targets alleviates the apparent tension between climate protection and short-term consumption that bedevils any attempt to forge global agreement. We argue that the simplest and hence potentially the most effective approach might be a mandatory requirement on the fossil fuel industry to ensure that a steadily increasing fraction of fossil carbon extracted from the ground is artificially removed from the active carbon cycle through some form of sequestration. We define Sequestered Adequate Fraction of Extracted (SAFE) carbon as a source in which this sequestered fraction is anchored to cumulative emissions, increasing smoothly to reach 100% before we release the trillionth tonne. While adopting the use of SAFE carbon would increase the cost of fossil energy much as a system of emission permits or carbon taxes would, it could do so with much less explicit government intervention. We contrast this proposal

Health shocks and risk aversion.

Science.gov (United States)

Decker, Simon; Schmitz, Hendrik

2016-12-01

We empirically assess whether a health shock influences individual risk aversion. We use grip strength data to obtain an objective health shock indicator. In order to account for the non-random nature of our data regression-adjusted matching is employed. Risk preferences are traditionally assumed to be constant. However, we find that a health shock increases individual risk aversion. The finding is robust to a series of sensitivity analyses and persists for at least four years after the shock. Income changes do not seem to be the driving mechanism. Copyright © 2016 Elsevier B.V. All rights reserved.

Cumulative effects of cascade hydropower stations on total dissolved gas supersaturation.

Science.gov (United States)

Ma, Qian; Li, Ran; Feng, Jingjie; Lu, Jingying; Zhou, Qin

2018-03-01

Elevated levels of total dissolved gas (TDG) may occur downstream of dams during the spill process. These high levels would increase the incidence of gas bubble disease in fish and cause severe environmental impacts. With increasing numbers of cascade hydropower stations being built or planned, the cumulative effects of TDG supersaturation are becoming increasingly prominent. The TDG saturation distribution in the downstream reaches of the Jinsha River was studied to investigate the cumulative effects of TDG supersaturation resulting from the cascade hydropower stations. A comparison of the effects of the joint operation and the single operation of two hydropower stations (XLD and XJB) was performed to analyze the risk degree to fish posed by TDG supersaturation. The results showed that water with supersaturated TDG generated at the upstream cascade can be transported to the downstream power station, leading to cumulative TDG supersaturation effects. Compared with the single operation of XJB, the joint operation of both stations produced a much higher TDG saturation downstream of XJB, especially during the non-flood discharge period. Moreover, the duration of high TDG saturation and the lengths of the lethal and sub-lethal areas were much higher in the joint operation scenario, posing a greater threat to fish and severely damaging the environment. This work provides a scientific basis for strategies to reduce TDG supersaturation to the permissible level and minimize the potential risk of supersaturated TDG.

RISKIND: A computer program for calculating radiological consequences and health risks from transportation of spent nuclear fuel

Energy Technology Data Exchange (ETDEWEB)

Yuan, Y.C. [Square Y Consultants, Orchard Park, NY (US); Chen, S.Y.; Biwer, B.M.; LePoire, D.J. [Argonne National Lab., IL (US)

1995-11-01

This report presents the technical details of RISKIND, a computer code designed to estimate potential radiological consequences and health risks to individuals and the collective population from exposures associated with the transportation of spent nuclear fuel. RISKIND is a user-friendly, interactive program that can be run on an IBM or equivalent personal computer under the Windows{trademark} environment. Several models are included in RISKIND that have been tailored to calculate the exposure to individuals under various incident-free and accident conditions. The incident-free models assess exposures from both gamma and neutron radiation and can account for different cask designs. The accident models include accidental release, atmospheric transport, and the environmental pathways of radionuclides from spent fuels; these models also assess health risks to individuals and the collective population. The models are supported by databases that are specific to spent nuclear fuels and include a radionuclide inventory and dose conversion factors. In addition, the flexibility of the models allows them to be used for assessing any accidental release involving radioactive materials. The RISKIND code allows for user-specified accident scenarios as well as receptor locations under various exposure conditions, thereby facilitating the estimation of radiological consequences and health risks for individuals. Median (50% probability) and typical worst-case (less than 5% probability of being exceeded) doses and health consequences from potential accidental releases can be calculated by constructing a cumulative dose/probability distribution curve for a complete matrix of site joint-wind-frequency data. These consequence results, together with the estimated probability of the entire spectrum of potential accidents, form a comprehensive, probabilistic risk assessment of a spent nuclear fuel transportation accident.

RISKIND: A computer program for calculating radiological consequences and health risks from transportation of spent nuclear fuel

International Nuclear Information System (INIS)

Yuan, Y.C.; Chen, S.Y.; Biwer, B.M.; LePoire, D.J.

1995-11-01

This report presents the technical details of RISKIND, a computer code designed to estimate potential radiological consequences and health risks to individuals and the collective population from exposures associated with the transportation of spent nuclear fuel. RISKIND is a user-friendly, interactive program that can be run on an IBM or equivalent personal computer under the Windows trademark environment. Several models are included in RISKIND that have been tailored to calculate the exposure to individuals under various incident-free and accident conditions. The incident-free models assess exposures from both gamma and neutron radiation and can account for different cask designs. The accident models include accidental release, atmospheric transport, and the environmental pathways of radionuclides from spent fuels; these models also assess health risks to individuals and the collective population. The models are supported by databases that are specific to spent nuclear fuels and include a radionuclide inventory and dose conversion factors. In addition, the flexibility of the models allows them to be used for assessing any accidental release involving radioactive materials. The RISKIND code allows for user-specified accident scenarios as well as receptor locations under various exposure conditions, thereby facilitating the estimation of radiological consequences and health risks for individuals. Median (50% probability) and typical worst-case (less than 5% probability of being exceeded) doses and health consequences from potential accidental releases can be calculated by constructing a cumulative dose/probability distribution curve for a complete matrix of site joint-wind-frequency data. These consequence results, together with the estimated probability of the entire spectrum of potential accidents, form a comprehensive, probabilistic risk assessment of a spent nuclear fuel transportation accident

Secant cumulants and toric geometry

NARCIS (Netherlands)

Michalek, M.; Oeding, L.; Zwiernik, P.W.

2012-01-01

We study the secant line variety of the Segre product of projective spaces using special cumulant coordinates adapted for secant varieties. We show that the secant variety is covered by open normal toric varieties. We prove that in cumulant coordinates its ideal is generated by binomial quadrics. We

Chemical Risk Assessment: Traditional vs Public Health ...

Science.gov (United States)

Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. When done efficiently and properly, chemical risk assessment enables risk management actions that minimize the incidence and impacts of environmentally-induced diseases related to chemical exposure. However, traditional chemical risk assessment is faced with multiple challenges with respect to predicting and preventing disease in human populations, and epidemiological studies increasingly report observations of adverse health effects at exposure levels predicted from animal studies to be safe for humans. This discordance reinforces concerns about the adequacy of contemporary risk assessment practices (Birnbaum, Burke, & Jones, 2016) for protecting public health. It is becoming clear that to protect public health more effectively, future risk assessments will need to use the full range of available data, draw on innovative methods to integrate diverse data streams, and consider health endpoints that also reflect the range of subtle effects and morbidities observed in human populations. Given these factors, there is a need to reframe chemical risk assessment to be more clearly aligned with the public health goal of minimizing environmental exposures associated with disease. Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. Chemical risk assessments

Cumulative Culture and Future Thinking: Is Mental Time Travel a Prerequisite to Cumulative Cultural Evolution?

Science.gov (United States)

Vale, G. L.; Flynn, E. G.; Kendal, R. L.

2012-01-01

Cumulative culture denotes the, arguably, human capacity to build on the cultural behaviors of one's predecessors, allowing increases in cultural complexity to occur such that many of our cultural artifacts, products and technologies have progressed beyond what a single individual could invent alone. This process of cumulative cultural evolution…

Perceived Interpersonal Discrimination and Older Women’s Mental Health: Accumulation Across Domains, Attributions, and Time

Science.gov (United States)

Bécares, Laia; Zhang, Nan

2018-01-01

Abstract Experiencing discrimination is associated with poor mental health, but how cumulative experiences of perceived interpersonal discrimination across attributes, domains, and time are associated with mental disorders is still unknown. Using data from the Study of Women’s Health Across the Nation (1996–2008), we applied latent class analysis and generalized linear models to estimate the association between cumulative exposure to perceived interpersonal discrimination and older women’s mental health. We found 4 classes of perceived interpersonal discrimination, ranging from cumulative exposure to discrimination over attributes, domains, and time to none or minimal reports of discrimination. Women who experienced cumulative perceived interpersonal discrimination over time and across attributes and domains had the highest risk of depression (Center for Epidemiologic Studies Depression Scale score ≥16) compared with women in all other classes. This was true for all women regardless of race/ethnicity, although the type and severity of perceived discrimination differed across racial/ethnic groups. Cumulative exposure to perceived interpersonal discrimination across attributes, domains, and time has an incremental negative long-term association with mental health. Studies that examine exposure to perceived discrimination due to a single attribute in 1 domain or at 1 point in time underestimate the magnitude and complexity of discrimination and its association with health. PMID:29036550

Environmental health risk assessment: Energy systems

International Nuclear Information System (INIS)

Krewski, D.; Somers, E.; Winthrop, S.O.

1984-01-01

Most industrialized nations have come to rely on a variety of systems for energy production, both of a conventional and non-conventional nature. In the paper, the spectrum of energy systems currently in use in Canada is outlined along with their potential health risks. Several examples of environmental health studies involving both outdoor and indoor air pollution related to energy production in Canada are reported. The limitations of current technologies for assessing health risks are discussed and possible approaches to managing energy related health risks are indicated. (author)

The Relation between Adolescent Self Assessment of Health and Risk Behaviours: Could a Global Measure of Health Provide Indications of Health Risk Exposures?

Science.gov (United States)

Nkansah-Amankra, Stephen; Walker, Ashley Dawn

2012-01-01

Objective: Self-rated health (SRH) has become a key organizing construct for assessing multiple dimensions of populations' physical and psychosocial health functioning. However, it is unclear how adolescents' subjective self assessment of health reflects health risk exposures, co-occurring health risks (problem behaviours) and other pre-existing…

Occupational health and safety: Designing and building with MACBETH a value risk-matrix for evaluating health and safety risks

Science.gov (United States)

Lopes, D. F.; Oliveira, M. D.; Costa, C. A. Bana e.

2015-05-01

Risk matrices (RMs) are commonly used to evaluate health and safety risks. Nonetheless, they violate some theoretical principles that compromise their feasibility and use. This study describes how multiple criteria decision analysis methods have been used to improve the design and the deployment of RMs to evaluate health and safety risks at the Occupational Health and Safety Unit (OHSU) of the Regional Health Administration of Lisbon and Tagus Valley. ‘Value risk-matrices’ (VRMs) are built with the MACBETH approach in four modelling steps: a) structuring risk impacts, involving the construction of descriptors of impact that link risk events with health impacts and are informed by scientific evidence; b) generating a value measurement scale of risk impacts, by applying the MACBETH-Choquet procedure; c) building a system for eliciting subjective probabilities that makes use of a numerical probability scale that was constructed with MACBETH qualitative judgments on likelihood; d) and defining a classification colouring scheme for the VRM. A VRM built with OHSU members was implemented in a decision support system which will be used by OHSU members to evaluate health and safety risks and to identify risk mitigation actions.

Age and gender differences in health risk perception.

Science.gov (United States)

Kim, YoungHo; Park, InKyoung; Kang, SooJin

2018-03-01

The current study investigated how adolescents perceive their own health risks and compare their own likelihood of health risks with that of others of the same age. Moreover, the study identified the differences in health risk perceptions between males and females. A total of 625 adolescents (314 males and 311 females) from the Nowon district, geographically located in northern Seoul, voluntarily participated. In order to measure health risk perceptions a Korean version of self-other risk judgments profile was used. The findings indicated that study participants, regardless of gender and age, tend to underestimate their vulnerability to majority of health risk events. Furthermore, there were significant gender and age differences in health risk perception and perception bias in all health risk domains. The present study suggests that further research is needed to identify realistic and unrealistic perception mechanism for a large number of people from different demographic and socioeconomic backgrounds. Copyright© by the National Institute of Public Health, Prague 2018.

System-Reliability Cumulative-Binomial Program

Science.gov (United States)

Scheuer, Ernest M.; Bowerman, Paul N.

1989-01-01

Cumulative-binomial computer program, NEWTONP, one of set of three programs, calculates cumulative binomial probability distributions for arbitrary inputs. NEWTONP, CUMBIN (NPO-17555), and CROSSER (NPO-17557), used independently of one another. Program finds probability required to yield given system reliability. Used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. Program written in C.

Cumulative human impacts on marine predators.

Science.gov (United States)

Maxwell, Sara M; Hazen, Elliott L; Bograd, Steven J; Halpern, Benjamin S; Breed, Greg A; Nickel, Barry; Teutschel, Nicole M; Crowder, Larry B; Benson, Scott; Dutton, Peter H; Bailey, Helen; Kappes, Michelle A; Kuhn, Carey E; Weise, Michael J; Mate, Bruce; Shaffer, Scott A; Hassrick, Jason L; Henry, Robert W; Irvine, Ladd; McDonald, Birgitte I; Robinson, Patrick W; Block, Barbara A; Costa, Daniel P

2013-01-01

Stressors associated with human activities interact in complex ways to affect marine ecosystems, yet we lack spatially explicit assessments of cumulative impacts on ecologically and economically key components such as marine predators. Here we develop a metric of cumulative utilization and impact (CUI) on marine predators by combining electronic tracking data of eight protected predator species (n=685 individuals) in the California Current Ecosystem with data on 24 anthropogenic stressors. We show significant variation in CUI with some of the highest impacts within US National Marine Sanctuaries. High variation in underlying species and cumulative impact distributions means that neither alone is sufficient for effective spatial management. Instead, comprehensive management approaches accounting for both cumulative human impacts and trade-offs among multiple stressors must be applied in planning the use of marine resources.

Assessment of the health risks and odor concentration of volatile compounds from a municipal solid waste landfill in China.

Science.gov (United States)

Wu, Chuandong; Liu, Jiemin; Liu, Shihua; Li, Wenhui; Yan, Luchun; Shu, Mushui; Zhao, Peng; Zhou, Peng; Cao, Wenbin

2018-07-01

Municipal solid waste (MSW) landfills are a source of odorous and toxic compounds. In this work, we present an integrated assessment of the odor concentration and human health risks of volatile compounds to evaluate the environmental quality at a MSW landfill. Air samples were collected seasonally from six areas of the landfill with different functions. The total concentrations of the compounds ranged from 204.0 to 7426.7 μg m -3 , and the concentrations in temporarily and permanently capped areas were 50.3 and 83.4% lower than those in the tipping area, respectively. The odor concentration was greatest at the leachate collection tank (1732-6254 ou E m -3 ) and tipping area (1573-4113 ou E m -3 ) and was mainly caused by hydrogen sulfide (57.9 and 49.1%, respectively). Moreover, the odor concentration was positively correlated with the temperature (r = 0.500, p waste areas exceeded acceptable levels. Moreover, the cumulative HI (2.5-5.7) and R (1.0E-04 to 3.4E-04) in the waste areas should receive special attention since they were above acceptable levels during all of the seasons. Aromatic and halogenated compounds dominated the cumulative R, accounting for 79 and 21% of the total, on average, while for the cumulative HI, sulfur compounds contributed the most (67%). Copyright © 2018 Elsevier Ltd. All rights reserved.

Healthful dietary patterns and type 2 diabetes mellitus risk among women with a history of gestational diabetes mellitus.

Science.gov (United States)

Tobias, Deirdre K; Hu, Frank B; Chavarro, Jorge; Rosner, Bernard; Mozaffarian, Dariush; Zhang, Cuilin

2012-11-12

Type 2 diabetes mellitus (T2DM) has reached epidemic proportions. Women with gestational diabetes mellitus (GDM) are at high risk for T2DM after pregnancy. Adherence to healthful dietary patterns has been inversely associated with T2DM in the general population; however, whether these dietary patterns are associated with progression to T2DM among a susceptible population is unknown. Four thousand four hundred thirteen participants from the Nurses' Health Study II cohort with prior GDM were followed up from 1991 to 2005. We derived the alternate Mediterranean diet (aMED), Dietary Approaches to Stop Hypertension (DASH), and alternate Healthy Eating Index (aHEI) dietary pattern adherence scores from a post-GDM validated food-frequency questionnaire, with cumulative average updating every 4 years. Multivariable Cox proportional hazards models estimated the relative risk (hazard ratios) and 95% confidence intervals. We observed 491 cases of incident T2DM during 52 743 person-years. All 3 patterns were inversely associated with T2DM risk with adjustment for age, total calorie intake, age at first birth, parity, ethnicity, parental diabetes, oral contraceptive use, menopause, and smoking. When we compared participants with the highest adherence (quartile 4) vs lowest (quartile 1), the aMED pattern was associated with 40% lower risk of T2DM (hazard ratio, 0.60 [95% CI, 0.44-0.82; P=.002]); the DASH pattern, with 46% lower risk (0.54 [0.39-0.73; P.001]); and the aHEI pattern, with 57% lower risk (0.43 [0.31-0.59; P.001]). Adjustment for body mass index moderately attenuated these findings. Adherence to healthful dietary patterns is associated with lower T2DM risk among women with a history of GDM. The inverse associations are partly mediated by body mass index.

Acute and Cumulative Effects of Unmodified 50-nm Nano-ZnO on Mice.

Science.gov (United States)

Kong, Tao; Zhang, Shu-Hui; Zhang, Ji-Liang; Hao, Xue-Qin; Yang, Fan; Zhang, Cai; Yang, Zi-Jun; Zhang, Meng-Yu; Wang, Jie

2018-01-02

Nanometer zinc oxide (nano-ZnO) is widely used in diverse industrial and agricultural fields. Due to the extensive contact humans have with these particles, it is crucial to understand the potential effects that nano-ZnO have on human health. Currently, information related to the toxicity and mechanisms of nano-ZnO is limited. The aim of the present study was to investigate acute and cumulative toxic effects of 50-nm unmodified ZnO in mice. This investigation will seek to establish median lethal dose (LD50), a cumulative coefficient, and target organs. The acute and cumulative toxicity was investigated by Karber's method and via a dose-increasing method, respectively. During the experiment, clinical signs, mortality, body weights, hematology, serum biochemistry, gross pathology, organ weight, and histopathology were examined. The LD50 was 5177-mg/kg·bw; the 95% confidence limits for the LD50 were 5116-5238-mg/kg·bw. It could be concluded that the liver, kidney, lung, and gastrointestinal tract were target organs for the 50-nm nano-ZnO acute oral treatment. The cumulative coefficient (K) was 1.9 which indicated that the cumulative toxicity was apparent. The results also indicated that the liver, kidney, lung, and pancrea were target organs for 50-nm nano-ZnO cumulative oral exposure and might be target organs for subchronic and chronic toxicity of oral administered 50-nm ZnO.

Work stress and health risk behavior.

Science.gov (United States)

Siegrist, Johannes; Rödel, Andreas

2006-12-01

This contribution discusses current knowledge of associations between psychosocial stress at work and health risk behavior, in particular cigarette smoking, alcohol consumption and overweight, by reviewing findings from major studies in the field published between 1989 and 2006. Psychosocial stress at work is measured by the demand-control model and the effort-reward imbalance model. Health risk behavior was analyzed in the broader context of a health-related Western lifestyle with socially and economically patterned practices of consumption. Overall, the review, based on 46 studies, only modestly supports the hypothesis of a consistent association between work stress and health risk behavior. The relatively strongest relationships have been found with regard to heavy alcohol consumption among men, overweight, and the co-manifestation of several risks. Suggestions for further research are given, and the need to reduce stressful experience in the framework of worksite health promotion programs is emphasized.

CUMULATIVE REPRODUCTIVE EFFECTS OF IN UTERO ADMINISTRATION OF A MIXTURE OF TEN “ANTIANDROGENS” IN MALE SD RATS: SYNERGY OR ADDITIVITY?

Science.gov (United States)

In 1996, the USEPA was charged under FQPA to consider the cumulative effects of chemicals in their risk assessments. We are conducting studies to provide a framework for assessing the cumulative effects of antiandrogens. In the current study, ten “antiandrogenic” chemicals were a...

Health-Based Capitation Risk Adjustment in Minnesota Public Health Care Programs

Science.gov (United States)

Gifford, Gregory A.; Edwards, Kevan R.; Knutson, David J.

2004-01-01

This article documents the history and implementation of health-based capitation risk adjustment in Minnesota public health care programs, and identifies key implementation issues. Capitation payments in these programs are risk adjusted using an historical, health plan risk score, based on concurrent risk assessment. Phased implementation of capitation risk adjustment for these programs began January 1, 2000. Minnesota's experience with capitation risk adjustment suggests that: (1) implementation can accelerate encounter data submission, (2) administrative decisions made during implementation can create issues that impact payment model performance, and (3) changes in diagnosis data management during implementation may require changes to the payment model. PMID:25372356

Lack of evidence for a harmful effect of sodium-glucose co-transporter 2 (SGLT2) inhibitors on fracture risk among type 2 diabetes patients: a network and cumulative meta-analysis of randomized controlled trials.

Science.gov (United States)

Tang, H L; Li, D D; Zhang, J J; Hsu, Y H; Wang, T S; Zhai, S D; Song, Y Q

2016-12-01

To evaluate the comparative effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors on risk of bone fracture in patients with type 2 diabetes mellitus (T2DM). PubMed, EMBASE, CENTRAL and ClinicalTrials.gov were systematically searched from inception to 27 January 2016 to identify randomized controlled trials (RCTs) reporting the outcome of fracture in patients with T2DM treated with SGLT2 inhibitors. Pairwise and network meta-analyses, as well as a cumulative meta-analysis, were performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). A total of 38 eligible RCTs (10 canagliflozin, 15 dapagliflozin and 13 empagliflozin) involving 30 384 patients, with follow-ups ranging from 24 to 160 weeks, were included. The fracture event rates were 1.59% in the SGLT2 inhibitor groups and 1.56% in the control groups. The incidence of fracture events was similar among these three SGLT2 inhibitor groups. Compared with placebo, canagliflozin (OR 1.15; 95% CI 0.71-1.88), dapagliflozin (OR 0.68; 95% CI 0.37-1.25) and empagliflozin (OR 0.93; 95% CI 0.74-1.18) were not significantly associated with an increased risk of fracture. Our cumulative meta-analysis indicated the robustness of the null findings with regard to SGLT2 inhibitors. Our meta-analysis based on available RCT data does not support the harmful effect of SGLT2 inhibitors on fractures, although future safety monitoring from RCTs and real-world data with detailed information on bone health is warranted. © 2016 John Wiley & Sons Ltd.

A comparison of alternative methods of calculating complementary cumulative distribution functions of health effects following an atmospheric radioactive release

International Nuclear Information System (INIS)

Ponting, A.C.; Nair, S.

1984-04-01

A concept extensively used in studying the consequences of accidental atmospheric radioactive releases is that of the Complementary Cumulative Distribution Function, CCDF. Various methods of calculating CCDFs have been developed with particular applications in putting degraded core accidents in perspective and in identifying release sequences leading to high risks. This note compares three methods with specific reference to their accuracy and computational efficiency. For two of the methods (that used in the US Reactor Safety Study code CRAC2 and extended version of that method), the effects of varying the sector width and considering site-specific population distributions have been determined. For the third method it is only necessary to consider the effects of site-specific population distributions. (author)

Increased risk of ischemic stroke in cervical cancer patients: a nationwide population-based study

International Nuclear Information System (INIS)

Tsai, Shiang-Jiun; Su, Yu-Chieh; Hung, Shih-Kai; Huang, Yung-Sung; Tung, Chien-Hsueh; Lee, Ching-Chih; Lee, Moon-Sing; Chiou, Wen-Yen; Lin, Hon-Yi; Hsu, Feng-Chun; Tsai, Chih-Hsin

2013-01-01

Increased risk of ischemic stroke has been validated for several cancers, but limited study evaluated this risk in cervical cancer patients. Our study aimed to evaluate the risk of ischemic stroke in cervical cancer patients. The study analyzed data from the 2003 to 2008 National Health Insurance Research Database (NHIRD) provided by the National Health Research Institutes in Taiwan. Totally, 893 cervical cancer patients after radiotherapy and 1786 appendectomy patients were eligible. The Kaplan-Meier method and the Cox proportional hazards model were used to assess the risk of ischemic stroke. The 5-year cumulative risk of ischemic stroke was significantly higher for the cervical cancer group than for the control group (7.8% vs 5.1%; p <0.005). The risk of stroke was higher in younger (age <51 years) than in older (age ≥51 years) cervical cancer patients (HR = 2.73, p = 0.04; HR = 1.37, p = 0.07) and in patients with more than two comorbid risk factors (5 years cumulative stroke rate of two comorbidities: 15% compared to no comorbidities: 4%). These study demonstrated cervical cancer patients had a higher risk of ischemic stroke than the general population, especially in younger patients. Strategies to reduce this risk should be assessed

The health risk of the agricultural production in potentially contaminated sites: an environmental-health risk analysis

Directory of Open Access Journals (Sweden)

Giovanni Russo

2012-12-01

Full Text Available Rural areas are often interested by pollution phenomena generated by agricultural activities with a high use of pesticides and/or by anthropic activities, such as industrial plants or illegal waste disposal sites, which may cause even long-range contamination. The risk for human health from the pollutants present in the environment can be quantitatively evaluated by the environmental health risk analysis set out in the Italian Legislative Decree no. 152/2006 (Italian Regulation, 2006. This analysis is the best technical-normative tool to estimate the health risks linked to the pollutants present in the environment but it does not consider the specificity of agricultural soils or the contamination of agricultural products. This study aims to provide this missing technical-normative data by identifying and applying a suitable methodology to evaluate the health risk caused by the ingestion of agricultural products grown in contaminated soils. The risk analysis was applied to two contaminated areas in southern Italy using an innovative methodology based on widely accepted parameters for the determination of polycyclic aromatic hydrocarbons (PAHs soil-plant bio-transfer factor in the case of horticultural crops. In addition, some concentration limits of PAHs in agricultural soils are proposed that may be of help to the competent authorities (health agencies, local authorities in delineating the areas requiring strict health surveillance of the food products cultivated.

Comparison of health risk behavior, awareness, and health benefit beliefs of health science and non-health science students: An international study.

Science.gov (United States)

Peltzer, Karl; Pengpid, Supa; Yung, Tony K C; Aounallah-Skhiri, Hajer; Rehman, Rehana

2016-06-01

This study determines the differences in health risk behavior, knowledge, and health benefit beliefs between health science and non-health science university students in 17 low and middle income countries. Anonymous questionnaire data were collected in a cross-sectional survey of 13,042 undergraduate university students (4,981 health science and 8,061 non-health science students) from 17 universities in 17 countries across Asia, Africa, and the Americas. Results indicate that overall, health science students had the same mean number of health risk behaviors as non-health science university students. Regarding addictive risk behavior, fewer health science students used tobacco, were binge drinkers, or gambled once a week or more. Health science students also had a greater awareness of health behavior risks (5.5) than non-health science students (4.6). Linear regression analysis found a strong association with poor or weak health benefit beliefs and the health risk behavior index. There was no association between risk awareness and health risk behavior among health science students and an inverse association among non-health science students. © 2015 Wiley Publishing Asia Pty Ltd.

Common-Reliability Cumulative-Binomial Program

Science.gov (United States)

Scheuer, Ernest, M.; Bowerman, Paul N.

1989-01-01

Cumulative-binomial computer program, CROSSER, one of set of three programs, calculates cumulative binomial probability distributions for arbitrary inputs. CROSSER, CUMBIN (NPO-17555), and NEWTONP (NPO-17556), used independently of one another. Point of equality between reliability of system and common reliability of components found. Used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. Program written in C.

Cumulative effects assessment: Does scale matter?

International Nuclear Information System (INIS)

Therivel, Riki; Ross, Bill

2007-01-01

Cumulative effects assessment (CEA) is (or should be) an integral part of environmental assessment at both the project and the more strategic level. CEA helps to link the different scales of environmental assessment in that it focuses on how a given receptor is affected by the totality of plans, projects and activities, rather than on the effects of a particular plan or project. This article reviews how CEAs consider, and could consider, scale issues: spatial extent, level of detail, and temporal issues. It is based on an analysis of Canadian project-level CEAs and UK strategic-level CEAs. Based on a review of literature and, especially, case studies with which the authors are familiar, it concludes that scale issues are poorly considered at both levels, with particular problems being unclear or non-existing cumulative effects scoping methodologies; poor consideration of past or likely future human activities beyond the plan or project in question; attempts to apportion 'blame' for cumulative effects; and, at the plan level, limited management of cumulative effects caused particularly by the absence of consent regimes. Scale issues are important in most of these problems. However both strategic-level and project-level CEA have much potential for managing cumulative effects through better siting and phasing of development, demand reduction and other behavioural changes, and particularly through setting development consent rules for projects. The lack of strategic resource-based thresholds constrains the robust management of strategic-level cumulative effects

Health risks maps. Modelling of air quality as a tool to map health risks

International Nuclear Information System (INIS)

Van Doorn, R.; Hegger, C.

2000-01-01

Environmental departments consider geographical maps with information on air quality as the final product of a complicated process of measuring, modelling and presentation. Municipal health departments consider such maps a useful starting point to solve the problem whether air pollution causes health risks for citizens. The answer to this question cannot be reduced to checking if threshold limit values are exceeded. Based on the results of measurements and modelling of concentrations of nitrogen dioxide in air, the health significance of air pollution caused by nitrogen dioxide is illuminated. A proposal is presented to map health risks of air pollution by using the results of measurements and modelling of air pollution. 7 refs

Cumulative cultural learning: Development and diversity

Science.gov (United States)

2017-01-01

The complexity and variability of human culture is unmatched by any other species. Humans live in culturally constructed niches filled with artifacts, skills, beliefs, and practices that have been inherited, accumulated, and modified over generations. A causal account of the complexity of human culture must explain its distinguishing characteristics: It is cumulative and highly variable within and across populations. I propose that the psychological adaptations supporting cumulative cultural transmission are universal but are sufficiently flexible to support the acquisition of highly variable behavioral repertoires. This paper describes variation in the transmission practices (teaching) and acquisition strategies (imitation) that support cumulative cultural learning in childhood. Examining flexibility and variation in caregiver socialization and children’s learning extends our understanding of evolution in living systems by providing insight into the psychological foundations of cumulative cultural transmission—the cornerstone of human cultural diversity. PMID:28739945

Cumulative cultural learning: Development and diversity.

Science.gov (United States)

Legare, Cristine H

2017-07-24

The complexity and variability of human culture is unmatched by any other species. Humans live in culturally constructed niches filled with artifacts, skills, beliefs, and practices that have been inherited, accumulated, and modified over generations. A causal account of the complexity of human culture must explain its distinguishing characteristics: It is cumulative and highly variable within and across populations. I propose that the psychological adaptations supporting cumulative cultural transmission are universal but are sufficiently flexible to support the acquisition of highly variable behavioral repertoires. This paper describes variation in the transmission practices (teaching) and acquisition strategies (imitation) that support cumulative cultural learning in childhood. Examining flexibility and variation in caregiver socialization and children's learning extends our understanding of evolution in living systems by providing insight into the psychological foundations of cumulative cultural transmission-the cornerstone of human cultural diversity.

Risk Assessment of Fluoride Intake from Tea in the Republic of Ireland and its Implications for Public Health and Water Fluoridation

Science.gov (United States)

Waugh, Declan T.; Potter, William; Limeback, Hardy; Godfrey, Michael

2016-01-01

The Republic of Ireland (RoI) is the only European Country with a mandatory national legislation requiring artificial fluoridation of drinking water and has the highest per capita consumption of black tea in the world. Tea is a hyperaccumulator of fluoride and chronic fluoride intake is associated with multiple negative health outcomes. In this study, fifty four brands of the commercially available black tea bag products were purchased and the fluoride level in tea infusions tested by an ion-selective electrode method. The fluoride content in all brands tested ranged from 1.6 to 6.1 mg/L, with a mean value of 3.3 mg/L. According to our risk assessment it is evident that the general population in the RoI is at a high risk of chronic fluoride exposure and associated adverse health effects based on established reference values. We conclude that the culture of habitual tea drinking in the RoI indicates that the total cumulative dietary fluoride intake in the general population could readily exceed the levels known to cause chronic fluoride intoxication. Evidence suggests that excessive fluoride intake may be contributing to a wide range of adverse health effects. Therefore from a public health perspective, it would seem prudent and sensible that risk reduction measures be implemented to reduce the total body burden of fluoride in the population. PMID:26927146

Unraveling the Link between Trauma and Male Delinquency: The Cumulative Versus Differential Risk Perspectives

Science.gov (United States)

Maschi, Tina

2006-01-01

This study examined how the cumulative (additive) versus differential (individual) effects of trauma influenced male delinquency. Using a comprehensive measure of trauma, a secondary data analysis was conducted on a nationally representative sample of male youths between the ages of 12 and 17. Logistic regression analyses revealed that all three…

Cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome: a nationwide Danish cohort study.

Science.gov (United States)

Dalbøge, Annett; Frost, Poul; Andersen, Johan Hviid; Svendsen, Susanne Wulff

2014-11-01

The primary aim was to examine exposure-response relationships between cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome (SIS), and to compare sex-specific exposure-response relationships. The secondary aim was to examine the time window of relevant exposures. We conducted a nationwide register study of all persons born in Denmark (1933-1977), who had at least 5 years of full-time employment. In the follow-up period (2003-2008), we identified first-time events of surgery for SIS. Cumulative exposure estimates for a 10-year exposure time window with a 1-year lag time were obtained by linking occupational codes with a job exposure matrix. The exposure estimates were expressed as, for example, arm-elevation-years in accordance with the pack-year concept of tobacco consumption. We used a multivariable logistic regression technique equivalent to discrete survival analysis. The adjusted OR (ORadj) increased to a maximum of 2.1 for arm-elevation-years, repetition-years and force-years, and to 1.5 for hand-arm-vibration-years. Sex-specific exposure-response relationships were similar for men and women, when assessed using a relative risk scale. The ORadj increased gradually with the number of years contributing to the cumulative exposure estimates. The excess fraction was 24%. Cumulative occupational shoulder exposures carried an increase in risk of surgery for SIS with similar exposure-response curves for men and women. The risk of surgery for SIS increased gradually, when the period of exposure assessment was extended. In the general working population, a substantial fraction of all first-time operations for SIS could be related to occupational exposures. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

New approaches in human health risk assessment.

Science.gov (United States)

Abass, Khaled; Carlsen, Anders; Rautio, Arja

2016-01-01

Studies on the precise impact of environmental pollutants on human health are difficult to undertake and interpret, because many genetic and environmental factors influence health at the same time and to varying degrees. Our chapter in the AMAP report was based on new approaches to describe risks and future needs. In this paper, we will introduce the issues associated with risk assessment of single chemicals, and present suggestions for future studies as well as a summary of lessons learned during the health-related parts of the European Union-funded FP7 project ArcRisk (Arctic Health Risks: Impacts on health in the Arctic and Europe owing to climate-induced changes in contaminant cycling, 2009-2014; www.arcrisk.eu).

Latino children’s autonomic nervous system reactivity moderates the relations between cumulative socioeconomic adversity in the first five years and externalizing behavior problems at seven years

Directory of Open Access Journals (Sweden)

Abbey Alkon

2016-05-01

Full Text Available Background: Thirty-seven percent of Hispanic and Latino children under 5 years of age are living in poverty in the United States. Children growing up under conditions of cumulative adversity are at much greater risk for compromised psychosocial adjustment with long-lasting ramifications for mental and physical health. This study assessed whether the relations between adversity early in life and later externalizing behaviors was moderated by children’s autonomic nervous system (ANS reactivity for immigrant, poor, MexicanAmerican children. Methods: A cumulative socioeconomic adversity index of children’s exposure to poverty, father’s absence, household crowding, mothers speaking Spanish, and poor housing condition at 6 months and 1, 3.5, and 5 years of age was calculated. At 5 years, ANS profiles during resting and social- and emotion-evoking challenges were calculated as combined parasympathetic and sympathetic difference scores. At 7 years, parents assessed children’s externalizing behavior problems. Results: Multiple regression models (n=220 showed that the relations between cumulative socioeconomic adversity and externalizing behaviors were moderated by children’s ANS profiles of coactivation during a social, not emotion-evoking, challenge, controlling for relevant covariates. Conclusions: Children living in adverse conditions early in life with specific psychobiologic responses to social challenges may be at risk for developing externalizing behavior problems later in life.

Calculating Cumulative Binomial-Distribution Probabilities

Science.gov (United States)

Scheuer, Ernest M.; Bowerman, Paul N.

1989-01-01

Cumulative-binomial computer program, CUMBIN, one of set of three programs, calculates cumulative binomial probability distributions for arbitrary inputs. CUMBIN, NEWTONP (NPO-17556), and CROSSER (NPO-17557), used independently of one another. Reliabilities and availabilities of k-out-of-n systems analyzed. Used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. Used for calculations of reliability and availability. Program written in C.

Cumulative Environmental Management Association : Wood Buffalo Region

International Nuclear Information System (INIS)

Friesen, B.

2001-01-01

The recently announced oil sands development of the Wood Buffalo Region in Alberta was the focus of this power point presentation. Both mining and in situ development is expected to total $26 billion and 2.6 million barrels per day of bitumen production. This paper described the economic, social and environmental challenges facing the resource development of this region. In addition to the proposed oil sands projects, this region will accommodate the needs of conventional oil and gas production, forestry, building of pipelines and power lines, municipal development, recreation, tourism, mining exploration and open cast mining. The Cumulative Environmental Management Association (CEMA) was inaugurated as a non-profit association in April 2000, and includes 41 members from all sectors. Its major role is to ensure a sustainable ecosystem and to avoid any cumulative impacts on wildlife. Other work underway includes the study of soil and plant species diversity, and the effects of air emissions on human health, wildlife and vegetation. The bioaccumulation of heavy metals and their impacts on surface water and fish is also under consideration to ensure the quality and quantity of surface water and ground water. 3 figs

Cumulative human impacts on marine predators

DEFF Research Database (Denmark)

Maxwell, Sara M; Hazen, Elliott L; Bograd, Steven J

2013-01-01

Stressors associated with human activities interact in complex ways to affect marine ecosystems, yet we lack spatially explicit assessments of cumulative impacts on ecologically and economically key components such as marine predators. Here we develop a metric of cumulative utilization and impact...

Occupational risk involving students of health

Directory of Open Access Journals (Sweden)

Éder Oliveira Rocha

2014-01-01

Full Text Available Objective: To analyze the social representations of occupational risks involving students in the area of health. Method: Exploratory research with 160 students from nursing, medicine and dentistry, through interviews. The data were processed in ALCESTE 4.8 and lexical analysis done by descending hierarchical classification. Results: In four semantic classes, namely: occupational risks involving students in the area of health, the work environment and occupational risks, exposure to accidents with sharps and adoption of standard precautions as biosecurity measures. Conclusion: Students healthcare represent occupational risks, such as a concern for the prevention of cross infection in the workplace, should both professionals and students of health, adopt standard precautions and biosecurity measures in the environment work.

2007 TOXICOLOGY AND RISK ASSESSMENT ...

Science.gov (United States)

EPA has announced The 2007 Toxicology and Risk Assessment Conference Cincinnati Marriott North, West Chester (Cincinnati), OHApril 23- 26, 2007 - Click to register!The Annual Toxicology and Risk Assessment Conference is a unique meeting where several Government Agencies come together to discuss toxicology and risk assessment issues that are not only of concern to the government, but also to a broader audience including academia and industry. The theme of this year's conference is Emerging Issues and Challenges in Risk Assessment and the preliminary agenda includes: Plenary Sessions and prominent speakers (tentative) include: Issues of Emerging Chemical ContaminantsUncertainty and Variability in Risk Assessment Use of Mechanistic data in IARC evaluationsParallel Sessions:Uncertainty and Variability in Dose-Response Assessment Recent Advances in Toxicity and Risk Assessment of RDX The Use of Epidemiologic Data for Risk Assessment Applications Cumulative Health Risk Assessment:

New approaches in human health risk assessment

Directory of Open Access Journals (Sweden)

Khaled Abass

2016-12-01

Full Text Available Studies on the precise impact of environmental pollutants on human health are difficult to undertake and interpret, because many genetic and environmental factors influence health at the same time and to varying degrees. Our chapter in the AMAP report was based on new approaches to describe risks and future needs. In this paper, we will introduce the issues associated with risk assessment of single chemicals, and present suggestions for future studies as well as a summary of lessons learned during the health-related parts of the European Union-funded FP7 project ArcRisk (Arctic Health Risks: Impacts on health in the Arctic and Europe owing to climate-induced changes in contaminant cycling, 2009–2014; www.arcrisk.eu.

The impact and cumulative effects of intimate partner abuse during pregnancy on health-related quality of life among Hong Kong Chinese women.

Science.gov (United States)

Lau, Ying; Keung Wong, Daniel Fu; Chan, Kin Sin

2008-03-01

to explore the prevalence of intimate partner abuse during pregnancy and to examine the effect and cumulative effects of different types of intimate partner abuse on health-related quality of life. a retrospective, cross-sectional, comparative design. three postnatal wards of a university-affiliated regional public hospital in Hong Kong. a community-based sample (n=1200) of postnatal women. the women were identified as abused or non-abused using the Abuse Assessment Screen Questionnaire (AAS), and various types of abuse were elaborated using the Revised Conflict Tactics Scale (CTS-2). The Medical Outcomes Study Short-form 36 Health Survey (SF-36) measured the health-related quality of life. the prevalence rate of intimate partner abuse during pregnancy was 134 out of 1200 (11.2%, 95% confidence interval [CI] 9.4-13.0%). They consisted of an only psychologically abused group (32.1%, 95% CI 24.2-40.0%), an only physically abused group (20.9%, 95% CI 14.0-27.8%), and a combined psychological and physically abused group (47.0%, 95% CI 38.5-55.5%). Over half of the women (53.0%, 95% CI 44.5-61.5%) experienced more than one type of abuse. Women who had experienced different types of intimate partner abuse were associated with lower scores in the majority of domains and the subscales of the SF-36 (pquality of life of the women. the problem of intimate partner abuse during pregnancy is similar to most Western countries, and the negative effect of different types of such abuse on the health-related quality of life over time seems to be cumulative. the relatively poor health-related quality of life of the abused women highlights the necessity of developing a checklist or a structured questionnaire that will assist in the detection of different types and combinations of intimate partner abuse, and that will be helpful in the development of more effective preventive interventions or programmes.

Risk segmentation in Chilean social health insurance.

Science.gov (United States)

Hidalgo, Hector; Chipulu, Maxwell; Ojiako, Udechukwu

2013-01-01

The objective of this study is to identify how risk and social variables are likely to be impacted by an increase in private sector participation in health insurance provision. The study focuses on the Chilean health insurance industry, traditionally dominated by the public sector. Predictive risk modelling is conducted using a database containing over 250,000 health insurance policy records provided by the Superintendence of Health of Chile. Although perceived with suspicion in some circles, risk segmentation serves as a rational approach to risk management from a resource perspective. The variables that have considerable impact on insurance claims include the number of dependents, gender, wages and the duration a claimant has been a customer. As shown in the case study, to ensure that social benefits are realised, increased private sector participation in health insurance must be augmented by regulatory oversight and vigilance. As it is clear that a "community-rated" health insurance provision philosophy impacts on insurance firm's ability to charge "market" prices for insurance provision, the authors explore whether risk segmentation is a feasible means of predicting insurance claim behaviour in Chile's private health insurance industry.

Chapter 19. Cumulative watershed effects and watershed analysis

Science.gov (United States)

Leslie M. Reid

1998-01-01

Cumulative watershed effects are environmental changes that are affected by more than.one land-use activity and that are influenced by.processes involving the generation or transport.of water. Almost all environmental changes are.cumulative effects, and almost all land-use.activities contribute to cumulative effects

Insomnia as a risk factor for ill health: results from the large population-based prospective HUNT Study in Norway.

Science.gov (United States)

Sivertsen, Børge; Lallukka, Tea; Salo, Paula; Pallesen, Ståle; Hysing, Mari; Krokstad, Steinar; Simon Øverland

2014-04-01

Insomnia co-occurs with many health problems, but less is known about the prospective associations. The aim of the current study was to investigate if insomnia predicts cumulative incidence of mental and physical conditions. Prospective population-based data from the two last Nord-Trøndelag Health Studies (HUNT2 in 1995–97 and HUNT3 in 2006–08), comprising 24 715 people in the working population, were used to study insomnia as a risk factor for incidence of physical and mental conditions. Insomnia was defined according to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Insomnia at HUNT2 was a significant risk factor for incidence of a range of both mental and physical conditions at HUNT3 11 years later. Most effects were only slightly attenuated when adjusting for confounding factors, and insomnia remained a significant risk factor for the following conditions in the adjusted analyses: depression [odds ratio (OR): 2.38, 95% confidence interval (CI): 1.91–2.98], anxiety (OR: 2.08, 95% CI: 1.63–2.64), fibromyalgia (OR: 2.05, 95% CI: 1.51–2.79), rheumatoidarthritis (OR: 1.87, 95% CI: 1.29–2.52), whiplash (OR: 1.71, 95% CI: 1.21–2.41), arthrosis (OR: 1.68, 95% CI: 1.43–1.98), osteoporosis (OR:1.52, 95% CI: 1.14–2.01, headache (OR: 1.50, 95% CI: 1.16–1.95,asthma (OR: 1.47, 95% CI: 1.16–1.86 and myocardial infarction (OR:1.46, 95% CI: 1.06–2.00). Insomnia was also associated significantly with incidence of angina, hypertension, obesity and stroke in the crude analyses, but not after adjusting for confounders. We conclude that insomnia predicts cumulative incidence of several physical and mental conditions. These results may have important clinical implications, and whether or not treatment of insomnia would have a preventive value for both physical and mental conditions should be studied further.

Cumulative trauma and partner conflict predict post-traumatic stress disorder in postpartum African-American women.

Science.gov (United States)

Hauff, Nancy J; Fry-McComish, Judith; Chiodo, Lisa M

2017-08-01

To describe relationships between cumulative trauma, partner conflict and post-traumatic stress in African-American postpartum women. Cumulative trauma exposure estimates for women in the USA range from 51-69%. During pregnancy, most trauma research has focused on physical injury to the mother. Post-traumatic stress disorder (PTSD) is associated with trauma and more prevalent in African-American women than women of other groups. Knowledge about both the rate and impact of cumulative trauma on pregnancy may contribute to our understanding of women seeking prenatal care, and disparities in infant morbidity and mortality. This retrospective, correlational, cross-sectional study took place on postpartum units of two Detroit hospitals. Participants were 150 African-American women aged between 18-45 who had given birth. Mothers completed the Cumulative Trauma Scale, Conflict Tactics Scale, Clinician Administered Post-traumatic Stress Scale, Edinburgh Postnatal Depression Scale and a Demographic Data form. Descriptive statistics, correlations and multiple regressions were used for data analysis. All participants reported at least one traumatic event in their lifetime. Cumulative trauma and partner conflict predicted PTSD, with the trauma of a life-threatening event for a loved one reported by 60% of the sample. Nearly, one-fourth of the women screened were at risk for PTSD. Increased cumulative trauma, increased partner conflict and lower level of education were related to higher rates of PTSD symptoms. Both cumulative trauma and partner conflict in the past year predict PTSD. Reasoning was used most often for partner conflict resolution. The results of this study offer additional knowledge regarding relationships between cumulative trauma, partner conflict and PTSD in African-American women. Healthcare providers need to be sensitive to patient life-threatening events, personal failures, abuse and other types of trauma. Current evidence supports the need to assess for

Managing the total cost of risk exposures through risk mapping techniques

International Nuclear Information System (INIS)

Unione, A.J.; Rode, D.M.

1998-01-01

In a competitive power market, power producers are exposed to an increasingly broad spectrum of financial risks. The cumulative impact of these financial risks is known collectively as the Total of Cost of Risk. The concept of Total of Cost of Risk presents the business reality of a company's exposure to potentially devastating financial consequences in an integrated and useful way. In this way, a strategy of managing Total Cost of Risk in the most cost effective way can become a means of ensuring long term business health and security. This paper will examine the use of risk mapping as a tool for visually understanding Total Cost of Risk, thus creating an enhanced situational awareness and an integrated basis for risk management decision. The evaluation process, available through the use of risk maps allows the power producers to pro-actively implement prudent business decisions concerning the design, operation and maintenance of power plants. Risk mapping is thus a means for harmonizing operational objectives, such as improved plant reliability, with corporate strategies and goals in terms of an effective risk management program

Cumulative exposure to childhood stressors and subsequent psychological distress. An analysis of US panel data.

Science.gov (United States)

Björkenstam, Emma; Burström, Bo; Brännström, Lars; Vinnerljung, Bo; Björkenstam, Charlotte; Pebley, Anne R

2015-10-01

Research has shown that childhood stress increases the risk of poor mental health later in life. We examined the effect of childhood stressors on psychological distress and self-reported depression in young adulthood. Data were obtained from the Child Development Supplement (CDS) to the national Panel Study of Income Dynamics (PSID), a survey of US families that incorporates data from parents and their children. In 2005 and 2007, the Panel Study of Income Dynamics was supplemented with two waves of Transition into Adulthood (TA) data drawn from a national sample of young adults, 18-23 years old. This study included data from participants in the CDS and the TA (n = 2128), children aged 4-13 at baseline. Data on current psychological distress was used as an outcome variable in logistic regressions, calculated as odds ratios (OR) with 95% confidence intervals (CI). Latent Class Analyses were used to identify clusters based on the different childhood stressors. Associations were observed between cumulative exposure to childhood stressors and both psychological distress and self-reported depression. Individuals being exposed to three or more stressors had the highest risk (crude OR for psychological distress: 2.49 (95% CI: 1.16-5.33), crude OR for self-reported depression: 2.07 (95% CI: 1.15-3.71). However, a large part was explained by adolescent depressive symptoms. Findings support the long-term negative impact of cumulative exposure to childhood stress on psychological distress. The important role of adolescent depression in this association also needs to be taken into consideration in future studies. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cumulative Psychosocial Risk is a Salient Predictor of Depressive Symptoms among Vertically HIV-Infected and HIV-Affected Adolescents at the Kenyan Coast.

Science.gov (United States)

Abubakar, Amina; Van de Vijver, Fons J R; Hassan, Amin S; Fischer, Ronald; Nyongesa, Moses K; Kabunda, Beatrice; Berkley, James A; Stein, Alan; Newton, Charles R

Little is known of mental health outcomes among vertically HIV-infected or HIV-affected adolescents in Africa. The current study set out to describe depressive symptoms and their correlates among vertically HIV-infected and HIV-affected adolescents at the Kenyan Coast. 130 adolescents (vertically HIV-infected [n = 44], HIV-affected [n = 53], and unexposed [n = 33]) and their caregivers participated in this cross-sectional study. An adapted version of the Beck Depression Inventory-11 (BDI) was administered to examine depressive symptoms in both adolescents and caregivers, together with measures of sociodemographic, medical, and anthropometric characteristics. Our analysis indicated a main effect of HIV status on mean BDI scores in HIV-infected (18.4 [SD = 8.3) and HIV-affected (16.8 [SD = 7.3]) adolescents compared to the community controls (12.0 [SD = 7.9]), F (2, 127) = 6.704, P = .002, η 2  = .095. Post hoc analysis showed that BDI scores of HIV-infected adolescents were higher than those of community controls (P HIV-affected adolescents had BDI scores that were higher than those of community controls (P = .007). However, there was no difference in BDI scores between HIV-infected and HIV-affected adolescents (P = .304). A path analytic model indicated that cumulative psychosocial risk (orphanhood, family poverty, and caregiver depressive symptoms) were positive predictors of BDI scores among adolescents, while nutritional status had a limited role. Both HIV-infected and HIV-affected adolescents are at a high risk of experiencing depressive symptoms, largely due to the multiple psychosocial risk factors in their environment. The provision of adequate psychosocial support and counseling needs to become an integral part of the care program for adolescents from families living with HIV/AIDS at the Kenyan coast and other similar settings. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Health risk in nuclear power plants

International Nuclear Information System (INIS)

Bliznakov, V.

1997-01-01

Worked out are the health risk indices for NPP personnel that could be used in normal operation and in case of accident. These indices concern temporary incapacity for work, invalidity, lethality, cancer, etc. Risk estimation is based on produced energy in NPP or on the collective dose of personnel exposure. Assessed are the specific risk values for NPP ''Kozloduy'', which show that the risk in normal operation is significantly low (of the order of 2.3 ./. 7.2 x 10 -4 for invalidity, lethality and cancer). Health risk indices can be used when comparing various alternative energy sources, as well as for determination of the power strategy of a country. (author)

Managing risk: clinical decision-making in mental health services.

Science.gov (United States)

Muir-Cochrane, Eimear; Gerace, Adam; Mosel, Krista; O'Kane, Debra; Barkway, Patricia; Curren, David; Oster, Candice

2011-01-01

Risk assessment and management is a major component of contemporary mental health practice. Risk assessment in health care exists within contemporary perspectives of management and risk aversive practices in health care. This has led to much discussion about the best approach to assessing possible risks posed by people with mental health problems. In addition, researchers and commentators have expressed concern that clinical practice is being dominated by managerial models of risk management at the expense of meeting the patient's health and social care needs. The purpose of the present study is to investigate the risk assessment practices of a multidisciplinary mental health service. Findings indicate that mental health professionals draw on both managerial and therapeutic approaches to risk management, integrating these approaches into their clinical practice. Rather than being dominated by managerial concerns regarding risk, the participants demonstrate professional autonomy and concern for the needs of their clients.

Ecosystem assessment methods for cumulative effects at the regional scale

International Nuclear Information System (INIS)

Hunsaker, C.T.

1989-01-01

Environmental issues such as nonpoint-source pollution, acid rain, reduced biodiversity, land use change, and climate change have widespread ecological impacts and require an integrated assessment approach. Since 1978, the implementing regulations for the National Environmental Policy Act (NEPA) have required assessment of potential cumulative environmental impacts. Current environmental issues have encouraged ecologists to improve their understanding of ecosystem process and function at several spatial scales. However, management activities usually occur at the local scale, and there is little consideration of the potential impacts to the environmental quality of a region. This paper proposes that regional ecological risk assessment provides a useful approach for assisting scientists in accomplishing the task of assessing cumulative impacts. Critical issues such as spatial heterogeneity, boundary definition, and data aggregation are discussed. Examples from an assessment of acidic deposition effects on fish in Adirondack lakes illustrate the importance of integrated data bases, associated modeling efforts, and boundary definition at the regional scale

A Conceptual Framework for the Assessment of Cumulative Exposure to Air Pollution at a Fine Spatial Scale

Directory of Open Access Journals (Sweden)

Kihal-Talantikite Wahida

2016-03-01

Full Text Available Many epidemiological studies examining long-term health effects of exposure to air pollutants have characterized exposure by the outdoor air concentrations at sites that may be distant to subjects’ residences at different points in time. The temporal and spatial mobility of subjects and the spatial scale of exposure assessment could thus lead to misclassification in the cumulative exposure estimation. This paper attempts to fill the gap regarding cumulative exposure assessment to air pollution at a fine spatial scale in epidemiological studies investigating long-term health effects. We propose a conceptual framework showing how major difficulties in cumulative long-term exposure assessment could be surmounted. We then illustrate this conceptual model on the case of exposure to NO2 following two steps: (i retrospective reconstitution of NO2 concentrations at a fine spatial scale; and (ii a novel approach to assigning the time-relevant exposure estimates at the census block level, using all available data on residential mobility throughout a 10- to 20-year period prior to that for which the health events are to be detected. Our conceptual framework is both flexible and convenient for the needs of different epidemiological study designs.

A Conceptual Framework for the Assessment of Cumulative Exposure to Air Pollution at a Fine Spatial Scale

Science.gov (United States)

Wahida, Kihal-Talantikite; Padilla, Cindy M.; Denis, Zmirou-Navier; Olivier, Blanchard; Géraldine, Le Nir; Philippe, Quenel; Séverine, Deguen

2016-01-01

Many epidemiological studies examining long-term health effects of exposure to air pollutants have characterized exposure by the outdoor air concentrations at sites that may be distant to subjects’ residences at different points in time. The temporal and spatial mobility of subjects and the spatial scale of exposure assessment could thus lead to misclassification in the cumulative exposure estimation. This paper attempts to fill the gap regarding cumulative exposure assessment to air pollution at a fine spatial scale in epidemiological studies investigating long-term health effects. We propose a conceptual framework showing how major difficulties in cumulative long-term exposure assessment could be surmounted. We then illustrate this conceptual model on the case of exposure to NO2 following two steps: (i) retrospective reconstitution of NO2 concentrations at a fine spatial scale; and (ii) a novel approach to assigning the time-relevant exposure estimates at the census block level, using all available data on residential mobility throughout a 10- to 20-year period prior to that for which the health events are to be detected. Our conceptual framework is both flexible and convenient for the needs of different epidemiological study designs. PMID:26999170

Managing cumulative impacts: A key to sustainability?

Energy Technology Data Exchange (ETDEWEB)

Hunsaker, C.T.

1994-12-31

This paper addresses how science can be more effectively used in creating policy to manage cumulative effects on ecosystems. The paper focuses on the scientific techniques that we have to identify and to assess cumulative impacts on ecosystems. The term ``sustainable development`` was brought into common use by the World Commission on Environment and Development (The Brundtland Commission) in 1987. The Brundtland Commission report highlighted the need to simultaneously address developmental and environmental imperatives simultaneously by calling for development that ``meets the needs of the present generation without compromising the needs of future generations.`` We cannot claim to be working toward sustainable development until we can quantitatively assess cumulative impacts on the environment: The two concepts are inextricibally linked in that the elusiveness of cumulative effects likely has the greatest potential of keeping us from achieving sustainability. In this paper, assessment and management frameworks relevant to cumulative impacts are discussed along with recent literature on how to improve such assessments. When possible, examples are given for marine ecosystems.

Stagewise pseudo-value regression for time-varying effects on the cumulative incidence

DEFF Research Database (Denmark)

Zöller, Daniela; Schmidtmann, Irene; Weinmann, Arndt

2016-01-01

In a competing risks setting, the cumulative incidence of an event of interest describes the absolute risk for this event as a function of time. For regression analysis, one can either choose to model all competing events by separate cause-specific hazard models or directly model the association...... for time-varying effects. This is implemented by coupling variable selection between the grid times, but determining estimates separately. The effect estimates are regularized to also allow for model fitting with a low to moderate number of observations. This technique is illustrated in an application...

Assessment of health risks of policies

International Nuclear Information System (INIS)

Ádám, Balázs; Molnár, Ágnes; Ádány, Róza; Bianchi, Fabrizio; Bitenc, Katarina; Chereches, Razvan; Cori, Liliana; Fehr, Rainer; Kobza, Joanna; Kollarova, Jana

2014-01-01

The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals

Assessment of health risks of policies

Energy Technology Data Exchange (ETDEWEB)

Ádám, Balázs, E-mail: badam@cmss.sdu.dk [Unit for Health Promotion Research, Faculty of Health Sciences, University of Southern Denmark, Niels Bohrs Vej 9, DK-6700 Esbjerg (Denmark); Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Molnár, Ágnes, E-mail: MolnarAg@smh.ca [Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Centre for Research on Inner City Health, Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael' s Hospital, Victoria 209, Rm. 3-26.22, M5B 1C6 Toronto, Ontario (Canada); Ádány, Róza, E-mail: adany.roza@sph.unideb.hu [Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Bianchi, Fabrizio, E-mail: Fabriepi@ifc.cnr.it [Unit of Environmental Epidemiology, Institute of Clinical Physiology, National Council of Research, Moruzzi 1, 56124 Pisa (Italy); Bitenc, Katarina, E-mail: katarina.bitenc@ivz-rs.si [National Institute of Public Health, Trubarjeva 2, SI-1000 Ljubljana (Slovenia); Chereches, Razvan, E-mail: razvan.m.chereches@gmail.com [Faculty of Political, Administrative and Communication Sciences, Babes-Bolyai University, Strada Mihail Kogalniceanu 1, 3400 Cluj (Romania); Cori, Liliana, E-mail: liliana.cori@ifc.cnr.it [Unit of Environmental Epidemiology, Institute of Clinical Physiology, National Council of Research, Moruzzi 1, 56124 Pisa (Italy); Fehr, Rainer, E-mail: rainer.fehr@uni-bielefeld.de [NRW Centre for Health, Westerfeldstr. 35-37, 33611 Bielefeld (Germany); Kobza, Joanna, E-mail: koga1@poczta.onet.pl [Public Health Department, Silesian Medical University, 18 Medykow Street, 40-752 Katowice (Poland); Kollarova, Jana, E-mail: janakollarova@yahoo.com [Department of Health Promotion, Regional Public Health Authority, Ipelska 1, 04011 Kosice (Slovakia); and others

2014-09-15

The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals.

Young people's perspectives on health-related risks

Directory of Open Access Journals (Sweden)

Grace Elisabeth Spencer

2008-07-01

Full Text Available Drawing upon current socio-cultural understandings of risk, this study highlights the disjunction between the expert risk discourses that permeate official public health policy and practice, and young people’s own perspectives on health and risk. Data were collected from young people aged 14-16 years through the use of group and individual interviews in a school and community youth centre setting. Findings from this study question the saliency of expert-defined health-related risks to young people’s everyday lives. Young people in this study saw health as closely linked to ‘being happy’. Friendships and a sense of personal achievement were particularly important to participants’ health and well-being. When accounting for their participation in health-related practices identified as ‘risky’ in government policy – such as smoking, alcohol and substance use – young people emphasised the levels of pressure they experienced. Sources of pressure included arguments and bullying, school work, and negative stereotypes of young people in general. These areas indicated young people’s concerns that reach beyond the official prescriptions permeating current health policy.

Cumulative dosages of antipsychotic drugs are associated with increased mortality rate in patients with Alzheimer's dementia

DEFF Research Database (Denmark)

Nielsen, R E; Lolk, A; Valentin, J B

2016-01-01

OBJECTIVE: We wished to investigate the effects of cumulative dosages of antipsychotic drug in Alzheimer's dementia, when controlling for known risk factors, including current antipsychotic exposure, on all-cause mortality. METHOD: We utilized a nationwide, population-based, retrospective cohort...... study design with mortality as outcome in individual patients diagnosed with Alzheimer's dementia. RESULTS: We included a total of 45 894 patients and followed them for 3 803 996 person-years in total, presenting 27 894 deaths in the study population. Cumulative antipsychotic exposure increased...... or equal to 730 DDDs: HR 1.06, 95% CI (0.95-1.18), P = 0.322, when controlling for proxy markers of severity, somatic and mental comorbid disorders. CONCLUSION: In this nationwide cohort study of 45 894 patients diagnosed with Alzheimer's dementia, we found that cumulative dosages of antipsychotic drugs...

On the Health Risk of the Lumbar Spine due to Whole-Body VIBRATION—THEORETICAL Approach, Experimental Data and Evaluation of Whole-Body Vibration

Science.gov (United States)

Seidel, H.; Blüthner, R.; Hinz, B.; Schust, M.

1998-08-01

The guidance on the effects of vibration on health in standards for whole-body vibration (WBV) does not provide quantitative relationships between WBV and health risk. The paper aims at the elucidation of exposure-response relationships. An analysis of published data on the static and dynamic strength of vertebrae and bone, loaded with various frequencies under different conditions, provided the basis for a theoretical approach to evaluate repetitive loads on the lumbar spine (“internal loads”). The approach enabled the calculation of “equivalent”—with respect to cumulative fatigue failure—combinations of amplitudes and numbers of internal cyclic stress. In order to discover the relation between external peak accelerations at the seat and internal peak loads, biodynamic data of experiments (36 subjects, three somatotypes, two different postures—relaxed and bent forward; random WBV,aw, r.m.s. 1·4 ms-2, containing high transients) were used as input to a biomechanical model. Internal pressure changes were calculated using individual areas of vertebral endplates. The assessment of WBV was based on the quantitative relations between peak accelerations at the seat and pressures predicted for the disk L5/S1. For identical exposures clearly higher rates of pressure rise in the bent forward compared to the relaxed posture were predicted. The risk assessment for internal forces considered the combined internal static and dynamic loads, in relation to the predicted individual strength, and Miner's hypothesis. For exposure durations between 1 min and 8 h, energy equivalent vibration magnitudes (formula B.1, ISO 2631-1, 1997) and equivalent vibration magnitudes according to formula B.2 (time dependence over-energetic) were compared with equivalent combinations of upward peak accelerations and exposure durations according to predicted cumulative fatigue failures of lumbar vertebrae. Formula B.1 seems to underestimate the health risk caused by high magnitudes

Not so Black and White: environmental justice and cumulative impact assessments

International Nuclear Information System (INIS)

Krieg, Eric J.; Faber, Daniel R.

2004-01-01

not typically identified as meeting EJ criteria (in demographic terms) also face more significant ecological hazards. Thus, the strict bifurcation of communities into categories of Environmental Justice and Non-Environmental Justice is problematic, and poses a serious dilemma for policy makers, public health officials, and community activists. To overcome this challenge requires the adoption of a cumulative environmental justice impact assessment (CEJIA), which in addition to the demographic characteristics of a community, also takes into account the total environmental burden and related health impacts upon residents. Furthermore, through the adoption of the precautionary principle, source reduction, and alternative forms of ''cleaner'' production, environmental justice advocates must work for policies which reduce the environmental threat for the full range of communities, as well as their own

Cumulative contextual and individual disadvantages over the life course and adult functional somatic symptoms in Sweden.

Science.gov (United States)

Gustafsson, Per E; Hammarström, Anne; San Sebastian, Miguel

2015-08-01

Disadvantage, originating in one's residential context or in one's past life course, has been shown to impact on health in adulthood. There is however little research on the accumulated health impact of both neighbourhood and individual conditions over the life course. This study aims to examine whether the accumulation of contextual and individual disadvantages from adolescence to middle-age predicts functional somatic symptoms (FSS) in middle-age, taking baseline health into account. The sample is the age 16, 21, 30 and 42 surveys of the prospective Northern Swedish Cohort, with analytical sample size n = 910 (85% of the original cohort). FSS at age 16 and 42, and cumulative socioeconomic disadvantage, social adversity and material adversity between 16 and 42 years were operationalized from questionnaires, and cumulative neighbourhood disadvantage between 16 and 42 years from register data. Results showed accumulation of disadvantages jointly explained 9-12% of FSS variance. In the total sample, cumulative neighbourhood and socioeconomic disadvantage significantly predicted FSS at age 42 in the total sample. In women, neighbourhood disadvantage but not socioeconomic disadvantage contributed significantly, whereas in men, socioeconomic but not neighbourhood disadvantage contributed significantly. In all analyses, associations were largely explained by the parallel accumulation of social and material adversities, but not by symptoms at baseline. In conclusion, the accumulation of diverse forms of disadvantages together plays an important role for somatic complaints in adulthood, independently of baseline health. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

El Carreto o Cumulá - Aspidosperma Dugandii Standl El Carreto o Cumulá - Aspidosperma Dugandii Standl

Directory of Open Access Journals (Sweden)

Dugand Armando

1944-03-01

Full Text Available Nombres vulgares: Carreto (Atlántico, Bolívar, Magdalena; Cumulá, Cumulá (Cundinamarca, ToIima. Según el Dr. Emilio Robledo (Lecciones de Bot. ed. 3, 2: 544. 1939 el nombre Carreto también es empleado en Puerto Berrío (Antioquia. El mismo autor (loc. cit. da el nombre Comulá para una especie indeterminada de Viburnum en Mariquita (Tolima y J. M. Duque, refiriendose a la misma planta y localidad (en Bot. Gen. Colomb. 340, 356. 1943 atribuye este nombre vulgar al Aspidosperma ellipticum Rusby.  Sin embargo, las muestras de madera de Cumulá o Comulá que yo he examinado, procedentes de la región de Mariquita -una de las cuales me fue recientemente enviada por el distinguido ictiólogo Sr. Cecil Miles- pertenecen sin duda alguna al A. Dugandii StandI. Por otra parte, Santiago Cortés (FI. Colomb. 206. 1898; ed, 2: 239. 1912 cita el Cumulá "de Anapoima y otros lugares del (rio Magdalena" diciendo que pertenece a las Leguminosas, pero la brevísima descripción que este autor hace de la madera "naranjada y notable por densidad, dureza y resistencia a la humedad", me induce a creer que se trata del mismo Cumula coleccionado recientemente en Tocaima, ya que esta población esta situada a pocos kilómetros de Anapoima. Nombres vulgares: Carreto (Atlántico, Bolívar, Magdalena; Cumulá, Cumulá (Cundinamarca, ToIima. Según el Dr. Emilio Robledo (Lecciones de Bot. ed. 3, 2: 544. 1939 el nombre Carreto también es empleado en Puerto Berrío (Antioquia. El mismo autor (loc. cit. da el nombre Comulá para una especie indeterminada de Viburnum en Mariquita (Tolima y J. M. Duque, refiriendose a la misma planta y localidad (en Bot. Gen. Colomb. 340, 356. 1943 atribuye este nombre vulgar al Aspidosperma ellipticum Rusby.  Sin embargo, las muestras de madera de Cumulá o Comulá que yo he examinado, procedentes de la región de Mariquita -una de las cuales me fue recientemente enviada por el distinguido ictiólogo Sr. Cecil Miles- pertenecen sin

Associations between multiple health risk behaviors and mental health among Chinese college students.

Science.gov (United States)

Ye, Yong-ling; Wang, Pei-gang; Qu, Geng-cong; Yuan, Shuai; Phongsavan, Philayrath; He, Qi-qiang

2016-01-01

Although there is substantial evidence that health risk behaviors increase risks of premature morbidity and mortality, little is known about the multiple health risk behaviors in Chinese college students. Here, we investigated the prevalence of multiple health risk behaviors and its relation to mental health among Chinese college students. A cross-sectional study was conducted in Wuhan, China from May to June 2012. The students reported their health risk behaviors using self-administered questionnaires. Depression and anxiety were assessed using the self-rating depression scale and self-rating anxiety scale, respectively. A total of 2422 college students (1433 males) aged 19.7 ± 1.2 years were participated in the study. The prevalence of physical inactivity, sleep disturbance, poor dietary behavior, Internet addiction disorder (IAD), frequent alcohol use and current smoking was 62.0, 42.6, 29.8, 22.3, 11.6 and 9.3%, respectively. Significantly increased risks for depression and anxiety were found among students with frequent alcohol use, sleep disturbance, poor dietary behavior and IAD. Two-step cluster analysis identified two different clusters. Participants in the cluster with more unhealthy behaviors showed significantly increased risk for depression (odds ratio (OR): 2.21; 95% confidence interval (CI): 1.83, 2.67) and anxiety (OR: 2.32; 95% CI: 1.85, 2.92). This study indicates that a relatively high prevalence of multiple health risk behaviors was found among Chinese college students. Furthermore, the clustering of health risk behaviors was significantly associated with increased risks for depression and anxiety.

Crowdfunding our health: Economic risks and benefits.

Science.gov (United States)

Renwick, Matthew J; Mossialos, Elias

2017-10-01

Crowdfunding is an expanding form of alternative financing that is gaining traction in the health sector. This article presents a typology for crowdfunded health projects and a review of the main economic benefits and risks of crowdfunding in the health market. We use evidence from a literature review, complimented by expert interviews, to extend the fundamental principles and established theories of crowdfunding to a health market context. Crowdfunded health projects can be classified into four types according to the venture's purpose and funding method. These are projects covering health expenses, fundraising health initiatives, supporting health research, or financing commercial health innovation. Crowdfunding could economically benefit the health sector by expanding market participation, drawing money and awareness to neglected health issues, improving access to funding, and fostering project accountability and social engagement. However, the economic risks of health-related crowdfunding include inefficient priority setting, heightened financial risk, inconsistent regulatory policies, intellectual property rights concerns, and fraud. Theorized crowdfunding behaviours such as signalling and herding can be observed in the market for health-related crowdfunding. Broader threats of market failure stemming from adverse selection and moral hazard also apply. Many of the discussed economic benefits and risks of crowdfunding health campaigns are shared more broadly with those of crowdfunding projects in other sectors. Where crowdfunding health care appears to diverge from theory is the negative externality inefficient priority setting may have towards achieving broader public health goals. Therefore, the market for crowdfunding health care must be economically stable, as well as designed to optimally and equitably improve public health. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Health and environmental risks of energy systems

International Nuclear Information System (INIS)

Hamilton, L.D.

1984-01-01

The paper gives four examples of health risk assessments of energy systems: (1) Comparative risk assessment of the health effects of the coal and nuclear fuel cycles. Estimates differ from previous values chiefly by inclusion of ranges of uncertainty, but some coal-cycle numbers were re-estimated. Upper-boundary public disease risks of air pollution from coal-fired plants dominate. Reactors probably account for most of the potential effect of major nuclear accidents. Accidental death rates in electricity generation are low for reactors and higher for coal. (2) Upper-boundary air pollution health risks of existing fossil-fuel-based energy technologies in the United States of America. Preliminary mortality estimates were obtained combining potential impacts of three index pollutants - SO 4 , NO 2 , and CO - as independent measures of risk. Four fuel cycle trajectories leading to three end-uses were analysed. (3) Health risks of acid deposition and other transported air pollutants, carried out as part of an assessment of the US Congress Office of Technology Assessment (OTA) 'Acid Rain and Transported Air Pollutants. (4) Health effects of uranium mill tailings piles. Mortality risk is estimated to be minuscule (8.7x10 -9 average individual lifetime cancer risk from a model mill, compared with 9.5x10 -4 for background radiation). Methods that sum risks over the indefinite future are shown to be unrealistic. As a final example of risk analysis, the cost-effectiveness analysis for proposed EPA standards for radionuclides is shown to be deficient by an analysis concluding that the cost per potential cancer avoided could range from US $70 million to US $140 billion

The relation of risk assessment and health impact assessment

DEFF Research Database (Denmark)

Ádám, Balázs; Gulis, Gabriel

2013-01-01

than assessing a present situation. As part of this process, however, methods applied in risk assessment are used. Risk assessment typically characterises relation of a well-defined risk factor to a well-defined health outcome. Within HIA usually several individual risk assessments are needed...... of the causal chain from the proposal through related health determinants and risk factors to health outcomes. The stepwise analysis, systematic prioritization and consideration of horizontal interactions between the causal pathways make it feasible to use widely recognized risk assessment methods in the HIA......The level and distribution of health risks in a society is substantially influenced by measures of various policies, programmes or projects. Risk assessment can evaluate the nature, likelihood and severity of an adverse effect. Health impact assessment (HIA) provides similar function when used...

Predicting Cumulative Incidence Probability by Direct Binomial Regression

DEFF Research Database (Denmark)

Scheike, Thomas H.; Zhang, Mei-Jie

Binomial modelling; cumulative incidence probability; cause-specific hazards; subdistribution hazard......Binomial modelling; cumulative incidence probability; cause-specific hazards; subdistribution hazard...

Health psychology and health promotion

Directory of Open Access Journals (Sweden)

Ali Delshad Noghabi

2017-11-01

Full Text Available Health psychology is the defined as studying of psychological and behavioral processes in health, illness, and healthcare. It contributes to is concerned with the understanding of how psychological, behavioral, and cultural factors contribute role to in physical health and illness. Psychological factors can affect health directly. For example, health is hurt by the chronically occurring environmental stressors which cumulatively affecting the hypothalamic–pituitary–adrenal axis, cumulatively, can harm health. On the other hand, a person's health is also interwoven with the Behavioral behavioral factors can also affect a person's health. For exampleinstance, certain behaviors behaviors, including smoking and excessive alcohol consumption can, over time, harm (smoking, excessive alcohol consumption health but exercise and diet low in saturated fat or can enhance health (exercise, diet low in saturated fat.

7 CFR 42.132 - Determining cumulative sum values.

Science.gov (United States)

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Determining cumulative sum values. 42.132 Section 42... Determining cumulative sum values. (a) The parameters for the on-line cumulative sum sampling plans for AQL's... 3 1 2.5 3 1 2 1 (b) At the beginning of the basic inspection period, the CuSum value is set equal to...

The Algebra of the Cumulative Percent Operation.

Science.gov (United States)

Berry, Andrew J.

2002-01-01

Discusses how to help students avoid some pervasive reasoning errors in solving cumulative percent problems. Discusses the meaning of ."%+b%." the additive inverse of ."%." and other useful applications. Emphasizes the operational aspect of the cumulative percent concept. (KHR)

Standing Posture at Work Does Not Increase the Risk of Varicose Veins among Health Care Providers in Taiwan

Science.gov (United States)

Huang, Hsin-Kai; Weng, Shih-Feng; Su, Shih-Bin; Wang, Jhi-Joung; Guo, How-Ran; Hsu, Chien-Chin; Huang, Chien-Cheng; Lin, Hung-Jung

2017-01-01

Objective This study compared the risk of varicose veins (VV) among physicians, nonphysician health care providers (HCP), and the general population. Subjects and Methods The Taiwan National Health Insurance Research Database was used to identify 28,844 physicians and 26,099 nonphysician HCP and an identical number of age- and sex-matched patients from the general population. Using logistic regression analyses, VV risks between physicians and the general population, nonphysician HCP and the general population, and physicians and nonphysician HCP, and among physician specialists were compared by tracing their medical histories between 2007 and 2011. Results Physicians and nonphysician HCP had cumulative VV incidences of 0.12% (34/28,844) and 0.13% (33/26,099), respectively, during the 5-year period, compared to that of the general population within the same 5-year period. Physicians and nonphysician HCP did not have a higher VV risk than the general population after adjusting for deep vein thrombosis (DVT) history (adjusted odds ratio [AOR] 0.86; 95% confidence interval [CI] 0.53–1.40, and AOR 1.43; 95% CI 0.82–2.50, respectively). Physicians did not a have higher VV risk than nonphysician HCP (AOR 0.80; 95% CI 0.43–1.51) after adjusting for age, sex, and DVT history. Surgery had the highest incidence (0.22%) while pediatrics and emergency medicine had the lowest incidence (0%) of VV risk among physician specialists; however, the difference was not significant (all p values >0.05). Conclusion In this study, VV risk did not differ among physicians, nonphysician HCP, and the general population. PMID:28249260

Who comes to a workplace health risk assessment?

Science.gov (United States)

Dobbins, T A; Simpson, J M; Oldenburg, B; Owen, N; Harris, D

1998-01-01

Workplace health promotion initiatives have proliferated, but there are difficulties in recruiting employees of lower socioeconomic status and at higher risk of disease. A survey of health behaviors and attitudes was administered in 20 worksites and the opportunity to attend a health risk assessment promoted. Those more likely to attend were women, those of higher occupational prestige, and those from a non-English-speaking background. After adjustment for these variables, the only health behavior associated with attendance was smoking status. Perceived risk of lung cancer was significant, even after adjustment for smoking status. Stage of readiness to change health behaviors was associated with attendance, with those in the preparation stage being more likely to attend than those in the precontemplation stage. However, this association was statistically significant only for fruit and vegetable consumption. There was no relation between attendance and support for health promotion, perceived general health, or other perceived risk of disease. These findings suggest that additional risk communication strategies and environmental support are required to involve those with less prestigious occupations.

[Health risks from pest control products].

Science.gov (United States)

Pieper, C; Holthenrich, D; Schneider, H

2014-05-01

According to European biocide legislation, pest control products require assessment and authorization by the responsible national or European authorities. Biocidal products can only be authorized if they have no unacceptable effects on human health. The health risk assessment performed for authorization comprises (a) the derivation of reference values for the active substances and substances of concern contained in the biocidal product and (b) an exposure assessment. These parameters are required for risk characterization. No unacceptable health risks are expected if the determined exposure is less than the relevant reference value. In addition, the toxicological information is used for classification of the biocidal product. The assessment may, where necessary, result in specific conditions for use or other restrictions aimed at minimizing risk. The risk to human health from pest control products is mainly based on the toxicological properties of their active substances. Commonly, the coformulants used in pest control products are of less concern than the active substances (e.g., food ingredients and animal feed products). For example, most rodenticides belong to the group of anticoagulants, which are also effective in humans. Regarding intoxications through insecticides, the group of pyrethroids is of particular importance. Fumigants containing metal phosphides, hydrogen cyanide, or sulfuryl difluoride are particularly toxic. This toxicity is linked to the high acute inhalation toxicity of the gaseous active substances themselves or, in the case of phosphides, of the released gas phosphane. The aim of health risk assessment for the authorization of biocidal products is to ensure their safe application for users and all other persons involved, assuming an adequate and label-compliant use.

The relationship between modifiable health risks and group-level health care expenditures. Health Enhancement Research Organization (HERO) Research Committee.

Science.gov (United States)

Anderson, D R; Whitmer, R W; Goetzel, R Z; Ozminkowski, R J; Dunn, R L; Wasserman, J; Serxner, S

2000-01-01

To assess the relationship between modifiable health risks and total health care expenditures for a large employee group. Risk data were collected through voluntary participation in health risk assessment (HRA) and worksite biometric screenings and were linked at the individual level to health care plan enrollment and expenditure data from employers' fee-for-service plans over the 6-year study period. The setting was worksite health promotion programs sponsored by six large private-sector and public-sector employers. Of the 50% of employees who completed the HRA, 46,026 (74.7%) met all inclusion criteria for the analysis. Eleven risk factors (exercise, alcohol use, eating, current and former tobacco use, depression, stress, blood pressure, cholesterol, weight, and blood glucose) were dichotomized into high-risk and lower-risk levels. The association between risks and expenditures was estimated using a two-part regression model, controlling for demographics and other confounders. Risk prevalence data were used to estimate group-level impact of risks on expenditures. Risk factors were associated with 25% of total expenditures. Stress was the most costly factor, with tobacco use, overweight, and lack of exercise also being linked to substantial expenditures. Modifiable risk factors contribute substantially to overall health care expenditures. Health promotion programs that reduce these risks may be beneficial for employers in controlling health care costs.

Space Radiation and Risks to Human Health

Science.gov (United States)

Huff, Janice L.; Patel, Zarana S.; Simonsen, Lisa C.

2014-01-01

The radiation environment in space poses significant challenges to human health and is a major concern for long duration manned space missions. Outside the Earth's protective magnetosphere, astronauts are exposed to higher levels of galactic cosmic rays, whose physical characteristics are distinct from terrestrial sources of radiation such as x-rays and gamma-rays. Galactic cosmic rays consist of high energy and high mass nuclei as well as high energy protons; they impart unique biological damage as they traverse through tissue with impacts on human health that are largely unknown. The major health issues of concern are the risks of radiation carcinogenesis, acute and late decrements to the central nervous system, degenerative tissue effects such as cardiovascular disease, as well as possible acute radiation syndromes due to an unshielded exposure to a large solar particle event. The NASA Human Research Program's Space Radiation Program Element is focused on characterization and mitigation of these space radiation health risks along with understanding these risks in context of the other biological stressors found in the space environment. In this overview, we will provide a description of these health risks and the Element's research strategies to understand and mitigate these risks.

EXAFS cumulants of CdSe

International Nuclear Information System (INIS)

Diop, D.

1997-04-01

EXAFS functions had been extracted from measurements on the K edge of Se at different temperatures between 20 and 300 K. The analysis of the EXAFS of the filtered first two shells has been done in the wavevector range laying between 2 and 15.5 A -1 in terms of the cumulants of the effective distribution of distances. The cumulants C 3 and C 4 obtained from the phase difference and the amplitude ratio methods have shown the anharmonicity in the vibrations of atoms around their equilibrium position. (author). 13 refs, 3 figs

Risk policies and risk perceptions: a comparative study of environmental health risk policy and perception in six European countries

NARCIS (Netherlands)

Bröer, C.; Moerman, G.; Spruijt, P.; van Poll, R.

2014-01-01

This paper explores the influence that health risk policies have on the citizens’ perceptions of those health risks. Previously, detailed mixed methods research revealed that noise annoyance policies shaped noise perception. This idea is now applied to nine different environmental health risks in

Lifetime stress cumulatively programs brain transcriptome and impedes stroke recovery: benefit of sensory stimulation.

Directory of Open Access Journals (Sweden)

Fabíola C R Zucchi

Full Text Available Prenatal stress (PS represents a critical variable affecting lifetime health trajectories, metabolic and vascular functions. Beneficial experiences may attenuate the effects of PS and its programming of health outcomes in later life. Here we investigated in a rat model (1 if PS modulates recovery following cortical ischemia in adulthood; (2 if a second hit by adult stress (AS exaggerates stress responses and ischemic damage; and (3 if tactile stimulation (TS attenuates the cumulative effects of PS and AS. Prenatally stressed and non-stressed adult male rats underwent focal ischemic motor cortex lesion and were tested in skilled reaching and skilled walking tasks. Two groups of rats experienced recurrent restraint stress in adulthood and one of these groups also underwent daily TS therapy. Animals that experienced both PS and AS displayed the most severe motor disabilities after lesion. By contrast, TS promoted recovery from ischemic lesion and reduced hypothalamic-pituitary-adrenal axis activity. The data also showed that cumulative effects of adverse and beneficial lifespan experiences interact with disease outcomes and brain plasticity through the modulation of gene expression. Microarray analysis of the lesion motor cortex revealed that cumulative PS and AS interact with genes related to growth factors and transcription factors, which were not affected by PS or lesion alone. TS in PS+AS animals reverted these changes, suggesting a critical role for these factors in activity-dependent motor cortical reorganization after ischemic lesion. These findings suggest that beneficial experience later in life can moderate adverse consequences of early programming to improve cerebrovascular health.

Development of a cumulative risk assessment for the Idaho National Engineering Laboratory's waste area group 2

International Nuclear Information System (INIS)

Burns, D.E.

1995-01-01

In 1989, the Idaho National Engineering Laboratory (INEL) was added to the Environmental Protection Agency's (EPA) National Priorities List of Superfund sites. A Federal Facility Agreement and Consent Order (FFA/CO) for the INEL was signed by the Department of Energy, Idaho Operations Office (DOE-ID), EPA, and the State of Idaho in December 1991. The goal of this agreement is to ensure that potential or actual INEL releases of hazardous substances to the environment are thoroughly investigated in accordance with the National Contingency Plan (NCP) and that appropriate response actions are taken as necessary to protect human health and the environment. The Test Reactor Area (TRA) is included as Waste Area Group (WAG) 2 of ten INEL WAGs identified in the FFA/CO. WAG 2 consists of 13 operable units (OUs) which include pits, tanks, rubble piles, ponds, cooling towers, wells, french drains, perched water and spill areas. OU 2-13 is the Comprehensive Remedial Investigation/Feasibility Study (RI/FS) for WAG 2. The study presented here is a preliminary evaluation of the comprehensive risk for WAG-2. This investigation will be used as the basis of the WAG-2 comprehensive baseline risk assessment (BRA), and it will serve as a model for other INEL comprehensive risk assessments. The WAG-2 preliminary risk evaluation consisted of two broad phases. These phases were (1) a site and contaminant screening that was intended to support the identification of COPCs and risk assessment data gaps, and (2) an exposure pathway analysis that evaluated the comprehensive human health risks associated with WAG-2. The primary purposes of the investigation were to screen WAG-2 release sites and contaminants, and to identify risk assessment data gaps, so the investigation will be referred to as the WAG-2 Screening and Data Gap Analysis (SDGA) for the remainder of this report

Spatiotemporal variability of drinking water quality and the associated health risks in southwestern towns of Ethiopia.

Science.gov (United States)

Sisay, Tadesse; Beyene, Abebe; Alemayehu, Esayas

2017-10-18

The failure to provide safe drinking water services to all people is the greatest development setback of the twenty-first century including Ethiopia. Potential pollutants from various sources are deteriorating drinking water quality in different seasons, and associated health risks were not clearly known. We determined seasonal and spatial variations of urban drinking water characteristics and associated health risks in Agaro, Jimma, and Metu towns, Southwest Ethiopia. Seventy-two samples were collected during dry and rainy seasons of 2014 and 2015. The majority (87.4%) of physicochemical parameters was found within the recommended limits. However, free residual chlorine in Jimma and Agaro town water sources was lower than the recommended limit and negatively correlated with total and fecal coliform counts (r = - 0.585 and - 0.638). Statistically significant differences were observed at pH, turbidity, and total coliform between dry and rainy seasons (p water source was the highest in fluoride concentration (3.15 mg/l). The daily exposure level for high fluoride concentration in Agaro town was estimated between 0.19 and 0.41 mg/kg day, and the average cumulative hazard index of fluoride was > 3.13 for all age groups. Water quality variations were observed in all conventional water treatment systems in the rainy season, and further research should focus on its optimization to safeguard the public.

The relationship between health risks and health and productivity costs among employees at Pepsi Bottling Group.

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Henke, Rachel M; Carls, Ginger S; Short, Meghan E; Pei, Xiaofei; Wang, Shaohung; Moley, Susan; Sullivan, Mark; Goetzel, Ron Z

2010-05-01

To evaluate relationships between modifiable health risks and costs and measure potential cost savings from risk reduction programs. Health risk information from active Pepsi Bottling Group employees who completed health risk assessments between 2004 and 2006 (N = 11,217) were linked to medical care, workers' compensation, and short-term disability cost data. Ten health risks were examined. Multivariate analyses were performed to estimate costs associated with having high risk, holding demographics, and other risks constant. Potential savings from risk reduction were estimated. High risk for weight, blood pressure, glucose, and cholesterol had the greatest impact on total costs. A one-percentage point annual reduction in the health risks assessed would yield annual per capita savings of $83.02 to $103.39. Targeted programs that address modifiable health risks are expected to produce substantial cost reductions in multiple benefit categories.

Risk assessment in support of plant health

DEFF Research Database (Denmark)

Jeger, Michael; Schans, Jan; Lövei, Gabor L.

2012-01-01

environmental risk assessment and the evaluation of risk reducing options. Quantitative approaches have become increasingly important during this time. The Panel has developed such methods in climatic mapping (in association with the Joint Research Councils), application of spatial spread models, re......With the establishment of the Plant Health Panel in 2006, EFSA became the body responsible for risk assessment in the plant health area for the European Union (EU). Since then more than 70 outputs have been produced dealing with the full range of organisms harmful to plant health across all crop...... types and plants in the environment. There has been an increasing trend towards producing scientific opinions which are full pest risk assessments for the whole EU territory. In its work, and as a contribution to the wider development of risk assessment methodology, the Panel has developed a series...

Health and environmental risks of energy systems

International Nuclear Information System (INIS)

Hamilton, L.D.

1984-01-01

This paper gives four examples of health risk assessments of energy systems: (1) Comparative risk assessment of the health effects of the coal and nuclear fuel cycles. Estimates differ from previous values chiefly by inclusion of ranges of uncertainty, but some coal-cycle numbers were re-estimated. Upper-boundary public disease risks of air pollution from coal-fired plants dominate. Reactors probably account for most of the potential effect of major nuclear accidents. Accidental death rates in electricity generation are low for reactors and higher for coal. (2) Upper boundary air pollution health risks of existing fossil-based energy technologies in the United States. Preliminary mortality estimates were obtained combining potential impacts of three index pollutants - SO 4 , NO 2 , and CO - as independent measures of risk. Four fuel cycle trajectories leading to three end-uses were analyzed. Example results: domestic wood burning has substantial potential impact, with an upper boundary exceeding that of coal; upper-boundary air pollution impacts of gas can exceed those of oil, because of NO 2 . (3) Health risks of acid deposition and other transported air pollutants, carried out as part of an assessment of the US Congress Office of Technology Assessment (OTA) Acid Rain and Transported Air Pollutants - Implications for Public Policy. Three scenarios were examined, leading to estimates of 40,000 to 50,000 annual premature deaths, depending on year (1978 vs 2000) and scenario (holding total emissions constant vs 30% reduction). (4) health effects of uranium mill tailings piles. Mortality risk is estimated to be minuscule (8.7 x 10 -9 average individual lifetime cancer risk from a model mill, compared with 9.5 x 10 -4 for background radiation). Methods that sum risks over the indefinite future are shown to be to be unrealistic. 39 references, 7 figures, 15 tables

The Cumulative Lifting Index (CULI) for the Revised NIOSH Lifting Equation: Quantifying Risk for Workers With Job Rotation.

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Garg, Arun; Kapellusch, Jay M

2016-08-01

The objectives were to: (a) develop a continuous frequency multiplier (FM) for the Revised NIOSH Lifting Equation (RNLE) as a function of lifting frequency and duration of a lifting task, and (b) describe the Cumulative Lifting Index (CULI), a methodology for estimating physical exposure to workers with job rotation. The existing FM for the RNLE (FME) does not differentiate between task duration >2 hr and <8 hr, which makes quantifying physical exposure to workers with job rotation difficult and presents challenges to job designers. Using the existing FMs for 1, 2, and 8 hr of task durations, we developed a continuous FM (FMP) that extends to 12 hr per day. We simulated 157,500 jobs consisting of two tasks each and, using different combinations of Frequency Independent Lifting Index, lifting frequency and duration of lifting. Biomechanical stresses were estimated using the CULI, time-weighted average (TWA), and peak exposure. The median difference between FME and FMP was ±1% (range: 0%-15%). Compared to CULI, TWA underestimated risk of low-back pain (LBP) for 18% to 30% of jobs, and peak exposure for an assumed 8-hr work shift overestimated risk of LBP for 20% to 25% of jobs. Peak task exposure showed 90% agreement with CULI but ignored one of two tasks. The CULI partially addressed the underestimation of physical exposure using the TWA approach and overestimation of exposure using the peak-exposure approach. The proposed FM and CULI may provide more accurate physical exposure estimates, and therefore estimated risk of LBP, for workers with job rotation. © 2016, Human Factors and Ergonomics Society.

About the cumulants of periodic signals

Science.gov (United States)

Barrau, Axel; El Badaoui, Mohammed

2018-01-01

This note studies cumulants of time series. These functions originating from the probability theory being commonly used as features of deterministic signals, their classical properties are examined in this modified framework. We show additivity of cumulants, ensured in the case of independent random variables, requires here a different hypothesis. Practical applications are proposed, in particular an analysis of the failure of the JADE algorithm to separate some specific periodic signals.

Health risk among asbestos cement sheet manufacturing workers in Thailand.

Science.gov (United States)

Phanprasit, Wantanee; Sujirarat, Dusit; Chaikittiporn, Chalermchai

2009-12-01

To assess asbestos exposure and calculate the relative risks of lung cancer among asbestos cement roof sheet workers and to predict the incidence rate of lung cancer caused by asbestos in Thailand. A cross-sectional study was conducted in four asbestos cement roof factories. Both area and personal air samples were collected and analyzed employing NIOSH method # 7400 and counting rule A for all procesess and activities. The time weight average exposures were calculated for each studied task using average area concentrations of the mill and personal concentrations. Then, cumulative exposures were estimated based on the past nation-wide air sampling concentrations and those from the present study. The relative risk (RR) of lung cancer among asbestos cement sheet workers was calculated and the number of asbestos related lung cancer case was estimated. The roof fitting polishers had the highest exposure to airborne asbestos fiber (0.73 fiber/ml). The highest average area concentration was at the conveyor to the de-bagger areas (0.02 fiber/ml). The estimated cumulative exposure for the workers performed studied-tasks ranged in between 90.13-115.65 fiber-years/ml while the relative risk of lung cancer calculated using US. EPA's model were 5.37-5.96. Based on the obtained RR, lung cancer among AC sheet in Thailand would be 2 case/year. In case that AC sheet will not be prohibited from being manufactured, even though only chrysotile is allowed, the surveillance system should be further developed and more seriously implemented. The better control measures for all processes must be implemented. Furthermore, due to the environmental persistence of asbestos fiber, its life cycle analysis should be conducted in order to control environmental exposure of general population.

Severe occupational hand eczema, job stress and cumulative sickness absence.

Science.gov (United States)

Böhm, D; Stock Gissendanner, S; Finkeldey, F; John, S M; Werfel, T; Diepgen, T L; Breuer, K

2014-10-01

Stress is known to activate or exacerbate dermatoses, but the relationships between chronic stress, job-related stress and sickness absence among occupational hand eczema (OHE) patients are inadequately understood. To see whether chronic stress or burnout symptoms were associated with cumulative sickness absence in patients with OHE and to determine which factors predicted sickness absence in a model including measures of job-related and chronic stress. We investigated correlations of these factors in employed adult inpatients with a history of sickness absence due to OHE in a retrospective cross-sectional explorative study, which assessed chronic stress (Trier Inventory for the Assessment of Chronic Stress), burnout (Shirom Melamed Burnout Measure), clinical symptom severity (Osnabrück Hand Eczema Severity Index), perceived symptom severity, demographic characteristics and cumulative days of sickness absence. The study group consisted of 122 patients. OHE symptoms were not more severe among patients experiencing greater stress and burnout. Women reported higher levels of chronic stress on some measures. Cumulative days of sickness absence correlated with individual dimensions of job-related stress and, in multiple regression analysis, with an overall measure of chronic stress. Chronic stress is an additional factor predicting cumulative sickness absence among severely affected OHE patients. Other relevant factors for this study sample included the 'cognitive weariness' subscale of the Shirom Melamed Burnout Measure and the physical component summary score of the SF-36, a measure of health-related life quality. Prevention and rehabilitation should take job stress into consideration in multidisciplinary treatment strategies for severely affected OHE patients. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Congener specific distribution and health risk assessment of polychlorinated biphenyls in urban soils

Directory of Open Access Journals (Sweden)

Bhupander Kumar

2012-10-01

Full Text Available Polychlorinated biphenyls (PCBs were primarily used in transformers and capacitors, lubricants, flame retardants, plasticizers, paint, carbonless papers, etc. These are capable of long-range atmospheric transport and have been designated as persistent organic pollutants by the Stockholm Convention. Due to their characteristic properties, PCBs are found worldwide in all environmental matrices (including human and biota. Soils are usually considered to be the source as well as sink for environmental pollutants, with cumulative effects of long-range atmospheric transport and local sources. Around the world, comparatively higher concentrations of PCBs have been reported in urban soils than suburban or rural soils. Higher amount of PCBs in urban soils may cause toxicological health risks to urban residents through ingestion, inhalation and skin contact. This paper presents the PCB distribution in soils from Delhi, India, and exposure risk estimates for human health through soil ingestion. The concentration of ΣPCBs ranged between 1.08-100.67 ng g^–1 (mean 21.16 ng g^–1±5.24 ng g^–1, which was much lower than the Canadian soil quality guideline value of 1.3 mg/kg or 1300 ng g^–1. Human health risk estimates through the soil ingestion pathway were made in terms of lifetime average daily dose (LADD, incremental lifetime cancer risks and non-carcinogenic hazard quotient (HQ. The LADD for Delhi adults and children was 3.02x10^–8 mg kg^–1 d^–1 and 1.57x10^–7 mg kg^–1 d^–1, respectively, which corresponds to toxic equivalent quotients (TEQ intake of 0.105 pg TEQ kg^–1 d^–1 (0.735 pg TEQ kg^–1 week^–1 and 0.543 pg TEQ kg^–1 d^–1 (3.801 pg TEQ kg^–1 week^–1, respectively. The estimated LADD for Delhi residents was lower than the acceptable

Clean Slate transportation and human health risk assessment

International Nuclear Information System (INIS)

1997-02-01

Public concern regarding activities involving radioactive material generally focuses on the human health risk associated with exposure to ionizing radiation. This report describes the results of a risk analysis conducted to evaluate risk for excavation, handling, and transport of soil contaminated with transuranics at the Clean Slate sites. Transportation risks were estimated for public transport routes from the Tonopah Test Range (TTR) to the Envirocore disposal facility or to the Area 3 Radioactive Waste Management Site (RWMS) at the Nevada Test Site (NTS) for both radiological risk and risk due to traffic accidents. Human health risks were evaluated for occupational and radiation-related health effects to workers. This report was generated to respond to this public concern, to provide an evaluation of the risk, and to assess feasibility of transport of the contaminated soil for disposal

Managing risk selection incentives in health sector reforms.

Science.gov (United States)

Puig-Junoy, J

1999-01-01

The object of the paper is to review theoretical and empirical contributions to the optimal management of risk selection incentives ('cream skimming') in health sector reforms. The trade-off between efficiency and risk selection is fostered in health sector reforms by the introduction of competitive mechanisms such as price competition or prospective payment systems. The effects of two main forms of competition in health sector reforms are observed when health insurance is mandatory: competition in the market for health insurance, and in the market for health services. Market and government failures contribute to the assessment of the different forms of risk selection employed by insurers and providers, as the effects of selection incentives on efficiency and their proposed remedies to reduce the impact of these perverse incentives. Two European (Netherlands and Spain) and two Latin American (Chile and Colombia) case studies of health sector reforms are examined in order to observe selection incentives, their effects on efficiency and costs in the health system, and regulation policies implemented in each country to mitigate incentives to 'cream skim' good risks.

Is oral health a risk factor for sexual health?

Science.gov (United States)

Eastham, Jane; Seymour, Robin

2015-03-01

New evidence suggests that the extent and severity of periodontal disease may be a significant risk factor for erectile dysfunction, sperm motility and time to conception. This paper reviews the evidence and informs members of the dental team when dealing with this sensitive issue. As more research is forthcoming the topic of oral and sexual health is likely to be part of regular routine medical screening. Any issue concerning oral health as a risk factor for sexual health is likely to be a sensitive subject, rarely discussed in the dental setting. However, as new evidence emerges, this topic is likely to get into the public domain. All members of the dental team should be aware of such an association. Clinical Relevance: Furthermore, the information in this paper may provide further incentive for certain patients to improve their oral health.

Recurrence of Subdural Haematoma in a Population-Based Cohort - Risks and Predictive Factors

DEFF Research Database (Denmark)

Schmidt, Linnea; Gørtz, Sanne; Wohlfahrt, Jan

2015-01-01

OBJECTIVES: To estimate the risks of and identify predictors for recurrent subdural haematoma in surgically and conservatively treated patients. METHODS: The cohort comprised all individuals diagnosed with a first-time subdural hematoma in Denmark 1996-2011. Information on potential predictors...... was retrieved from the Danish health registers. Cumulative recurrence risks were estimated using the Aalen-Johansen estimator. Rate ratios (RR) were estimated using Poisson regression. RESULTS: Among 10,158 individuals with a subdural hematoma, 1,555 had a recurrent event. The cumulative risk of recurrent...... subdural hematoma was 9% at 4 weeks after the primary bleeding, increasing to and stabilising at 14% after one year. Predictors associated with recurrence were: Male sex (RR 1.60, 95% CI:1.43-1.80), older age (>70 years compared to 20-49 years; RR 1.41, 95% CI: 1.21-1.65), alcohol addiction (RR 1.20, 95...

Cumulative effects analysis of the water quality risk of herbicides used for site preparation in the Central North Island, New Zealand

Science.gov (United States)

Dan Neary; Brenda R. Baillie

2016-01-01

Herbicide use varies both spatially and temporally within managed forests. While information exists on the effects of herbicide use on water quality at the site and small catchment scale, little is known about the cumulative effects of herbicide use at the landscape scale. A cumulative effects analysis was conducted in the upper Rangitaiki catchment (118,345...

High cumulative incidence of urinary tract transitional cell carcinoma after kidney transplantation in Taiwan.

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Wu, Ming-Ju; Lian, Jong-Da; Yang, Chi-Rei; Cheng, Chi-Hung; Chen, Cheng-Hsu; Lee, Wen-Chin; Shu, Kuo-Hsiung; Tang, Ming-Jer

2004-06-01

Cancer is a well-documented complication after kidney transplantation. Increased incidence of bladder cancer had been reported in long-term hemodialysis patients in Taiwan. Herein, the authors report a very high cumulative incidence of transitional cell carcinoma (TCC) of the urinary tract after kidney transplantation in Taiwan. The authors retrospectively reviewed the clinical data, medical records, and outcome of 730 kidney transplant (KT) recipients. The cumulative incidence of TCC was computed. The Cox regression method was used to analysis the role of potential risk factors. After a mean follow-up duration of 72.2 +/- 54.4 months, 69 cancers were diagnosed in 63 (8.6%) KT recipients. Of them, 30 cases (4.1%) were TCC. The cumulative incidence for TCC was 3.0% after 3 years of graft survival, increasing to 7.2% at 6 years and 17.5% at 10 years. Compared with the general population in Taiwan, the standardized mortality ratio was 398.4 (male, 192.6; female, 875.6). Painless gross hematuria was the cardinal initial symptom in 22 (73.3%) of the 30 KT recipients with TCC. Another 4 (13.3%) KT recipients with TCC presented with chronic urinary tract infection (UTI). Bilateral nephroureterectomy with removal of bladder cuffs was performed in 18 (60%) patients. Synchronous TCC in bilateral upper urinary tracts was confirmed in 11 (36.7%) of KT recipients with TCC. The age at the time of KT, female sex, compound analgesics usage, Chinese herb usage, and underground water intake had statistical significance as risk factors (P Taiwan, with an incidence of 4.1%. This study indicates that hematuria and chronic UTI are the initial presentation of TCC in KT recipients. Carefully urologic screening is indicated for patients with high risk for TCC, including those with older age, compound analgesics usage, Chinese herbs usage, and underground water intake as well as women.

The role of cumulative physical work load in symptomatic knee osteoarthritis – a case-control study in Germany

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Abolmaali Nasreddin

2008-07-01

Full Text Available Abstract Objectives To examine the dose-response relationship between cumulative exposure to kneeling and squatting as well as to lifting and carrying of loads and symptomatic knee osteoarthritis (OA in a population-based case-control study. Methods In five orthopedic clinics and five practices we recruited 295 male patients aged 25 to 70 with radiographically confirmed knee osteoarthritis associated with chronic complaints. A total of 327 male control subjects were recruited. Data were gathered in a structured personal interview. To calculate cumulative exposure, the self-reported duration of kneeling and squatting as well as the duration of lifting and carrying of loads were summed up over the entire working life. Results The results of our study support a dose-response relationship between kneeling/squatting and symptomatic knee osteoarthritis. For a cumulative exposure to kneeling and squatting > 10.800 hours, the risk of having radiographically confirmed knee osteoarthritis as measured by the odds ratio (adjusted for age, region, weight, jogging/athletics, and lifting or carrying of loads is 2.4 (95% CI 1.1–5.0 compared to unexposed subjects. Lifting and carrying of loads is significantly associated with knee osteoarthritis independent of kneeling or similar activities. Conclusion As the knee osteoarthritis risk is strongly elevated in occupations that involve both kneeling/squatting and heavy lifting/carrying, preventive efforts should particularly focus on these "high-risk occupations".

Parent-child communication processes: preventing children's health-risk behavior.

Science.gov (United States)

Riesch, Susan K; Anderson, Lori S; Krueger, Heather A

2006-01-01

Review individual, family, and environmental factors that predict health-risk behavior among children and to propose parent-child communication processes as a mechanism to mediate them. Improving parent-child communication processes may: reduce individual risk factors, such as poor academic achievement or self-esteem; modify parenting practices such as providing regulation and structure and acting as models of health behavior; and facilitate discussion about factors that lead to involvement in health-risk behaviors. Assessment strategies to identify youth at risk for health-risk behavior are recommended and community-based strategies to improve communication among parents and children need development.

Health risks, travel preparation, and illness among public health professionals during international travel.

Science.gov (United States)

Balaban, Victor; Warnock, Eli; Ramana Dhara, V; Jean-Louis, Lee Ann; Sotir, Mark J; Kozarsky, Phyllis

2014-01-01

Few data currently exist on health risks faced by public health professionals (PHP) during international travel. We conducted pre- and post-travel health surveys to assess knowledge, attitudes, and practices (KAP), and illnesses among PHP international travelers. Anonymous surveys were completed by PHP from a large American public health agency who sought a pre-travel medical consult from September 1, 2009, to September 30, 2010. Surveys were completed by 122 participants; travelers went to 163 countries. Of the 122 respondents, 97 (80%) reported at least one planned health risk activity (visiting rural areas, handling animals, contact with blood or body fluids, visiting malarious areas), and 50 (41%) reported exposure to unanticipated health risks. Of the 62 travelers who visited malarious areas, 14 (23%) reported inconsistent or no use of malaria prophylaxis. Illness during travel was reported by 33 (27%) respondents. Most of the PHP travelers in our study reported at least one planned health risk activity, and almost half reported exposure to unanticipated health risks, and one-quarter of travelers to malarious areas reported inconsistent or no use of malaria chemoprophylaxis. Our findings highlight that communication and education outreach for PHP to prevent travel-associated illnesses can be improved. Published by Elsevier Ltd.

Cardiorespiratory fitness not sedentary time or physical activity is associated with cardiometabolic risk in active older adults.

Science.gov (United States)

Pollock, R D; Duggal, N A; Lazarus, N R; Lord, J M; Harridge, S D R

2018-02-10

Sedentary time (ST) and moderate-to-vigorous physical activity (MVPA) are associated with cardiometabolic health. Cardiorespiratory fitness (CRF) is also implicated but often overlooked in health recommendations. This study assessed the relationships between ST, MVPA, CRF, and cardiometabolic health in highly active older individuals. 125 healthy amateur cyclists aged 55 to 79 years had their ST and MVPA levels assessed by actigraphy over a 7-day period. CRF was assessed using a maximal effort cycle ergometry test to determine VO 2max with results normalized to both body mass and fat-free mass measured by DXA. Markers of cardiometabolic risk (blood glucose, triglycerides, cholesterol, HDL, LDL, Insulin, HOMA IR, blood pressure, and body fat) were assessed and used to determine cumulative cardiometabolic risk. Multiple linear regression was used to assess ST, MVPA, and CRF associations with cardiometabolic health with the relationship between activity levels and CRF determined. CRF was associated with training volume (P = .003), but not ST or MVPA. A high CRF was associated with lower cumulative cardiometabolic risk, body fat percentage, triglyceride, and HDL levels (P < .05 in all cases). MVPA was negatively associated with body fat percentage, while ST was not associated with any marker of cardiometabolic risk when adjusting for activity levels. An association between CRF and cardiometabolic risk even in a group of older individuals with high fitness levels highlights the importance that CRF may have in maintaining health. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Cumulative Student Loan Debt in Minnesota, 2015

Science.gov (United States)

Williams-Wyche, Shaun

2016-01-01

To better understand student debt in Minnesota, the Minnesota Office of Higher Education (the Office) gathers information on cumulative student loan debt from Minnesota degree-granting institutions. These data detail the number of students with loans by institution, the cumulative student loan debt incurred at that institution, and the percentage…

The Cumulative Effect of Gene-Gene and Gene-Environment Interactions on the Risk of Prostate Cancer in Chinese Men

Directory of Open Access Journals (Sweden)

Ming Liu

2016-01-01

Full Text Available Prostate cancer (PCa is a multifactorial disease involving complex genetic and environmental factors interactions. Gene-gene and gene-environment interactions associated with PCa in Chinese men are less studied. We explored the association between 36 SNPs and PCa in 574 subjects from northern China. Body mass index (BMI, smoking, and alcohol consumption were determined through self-administered questionnaires in 134 PCa patients. Then gene-gene and gene-environment interactions among the PCa-associated SNPs were analyzed using the generalized multifactor dimensionality reduction (GMDR and logistic regression methods. Allelic and genotypic association analyses showed that six variants were associated with PCa and the cumulative effect suggested men who carried any combination of 1, 2, or ≥3 risk genotypes had a gradually increased PCa risk (odds ratios (ORs = 1.79–4.41. GMDR analysis identified the best gene-gene interaction model with scores of 10 for both the cross-validation consistency and sign tests. For gene-environment interactions, rs6983561 CC and rs16901966 GG in individuals with a BMI ≥ 28 had ORs of 7.66 (p = 0.032 and 5.33 (p = 0.046, respectively. rs7679673 CC + CA and rs12653946 TT in individuals that smoked had ORs of 2.77 (p = 0.007 and 3.11 (p = 0.024, respectively. rs7679673 CC in individuals that consumed alcohol had an OR of 4.37 (p = 0.041. These results suggest that polymorphisms, either individually or by interacting with other genes or environmental factors, contribute to an increased risk of PCa.

Weighted cumulative exposure models helped identify an association between early knee-pain consultations and future knee OA diagnosis.

Science.gov (United States)

Yu, Dahai; Peat, George; Bedson, John; Edwards, John J; Turkiewicz, Aleksandra; Jordan, Kelvin P

2016-08-01

To establish the association between prior knee-pain consultations and early diagnosis of knee osteoarthritis (OA) by weighted cumulative exposure (WCE) models. Data were from an electronic health care record (EHR) database (Consultations in Primary Care Archive). WCE functions for modeling the cumulative effect of time-varying knee-pain consultations weighted by recency were derived as a predictive tool in a population-based case-control sample and validated in a prospective cohort sample. Two WCE functions ([i] weighting of the importance of past consultations determined a priori; [ii] flexible spline-based estimation) were comprehensively compared with two simpler models ([iii] time since most recent consultation; total number of past consultations) on model goodness of fit, discrimination, and calibration both in derivation and validation phases. People with the most recent and most frequent knee-pain consultations were more likely to have high WCE scores that were associated with increased risk of knee OA diagnosis both in derivation and validation phases. Better model goodness of fit, discrimination, and calibration were observed for flexible spline-based WCE models. WCE functions can be used to model prediagnostic symptoms within routine EHR data and provide novel low-cost predictive tools contributing to early diagnosis. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Risk Factors, Processes and Risk Management within a Public Health Context

Directory of Open Access Journals (Sweden)

Tamás Szentes

2016-06-01

Full Text Available Besides clinical medicine, which is in the process of constant and fast development, the focus is increasingly on public health services, which should be well prepared for reducing or keeping under control the dangers induced by the growing social burden of disease. Continuous risk management is represented by these services that are specially designed to prevent diseases and health damages. The grounds for the planning and implementation of public health services are constituted by risk factor management and assessment by means of adopting a unified approach.

[Perception of health risks: psychological and social factors].

Science.gov (United States)

Kurzenhäuser, S; Epp, A

2009-12-01

This article reviews central findings and current developments of psychological and sociological research on the perception of health risks. Risk perception is influenced by numerous psychological, social, political, and cultural factors. These factors can be categorized into (a) risk characteristics, (b) characteristics of the risk perceiving person and his/her situation, and (c) characteristics of risk communication. Thus, besides individual cognitive and affective processing of risk information, social processes of risk amplification (e.g., media effects) are also involved in the construction of individual risk perceptions. We discuss the recommendations for health risk communication that follow from these findings with regard to different communication goals.

Health risks from uranium mill tailings

International Nuclear Information System (INIS)

Russell, J.L.

1992-01-01

This paper reviews the risk to public health and the environment from uranium mill tailings. The steps taken by the Environmental Protection Agency (EPA) to reduce this risk from tailing are summarized

Health effects of ionizing radiation

International Nuclear Information System (INIS)

Radford, E.P.

1980-01-01

This presentation is restricted to the health effects of low doses of ionizing radiation. In general, these cumulative exposures are well below 100 rem, or about 50 times background or less. The two effects of interest in this dose range are genetic mutations and cancer production. The genetic effects will not be discussed in detail. The chief reason for the rise in risk estimates for cancer is the longer follow-up of exposed populations

Cumulative ionizing radiation exposure in patients with end stage kidney disease: a 6-year retrospective analysis.

LENUS (Irish Health Repository)

Coyle, Joe

2011-08-13

OBJECTIVE: To quantify cumulative exposure to ionizing radiation in patients with end stage kidney disease (ESKD). To investigate factors which may be independently associated with risk of high cumulative effective dose (CED). MATERIALS AND METHODS: The study had local institutional review board ethical approval. We conducted a retrospective study of 394 period prevalent ESKD patients attending a single tertiary referral centre between 2004 and 2009. Patient demographics were obtained from case records. Details of radiological investigations were obtained from the institutional radiology computerized database. CED was calculated using standard procedure specific radiation levels. High exposure was defined as CED > 50 mSv, an exposure which has been reported to increase cancer mortality by 5%. Data were compared using Pearson χ(2) and Mann-Whitney U test or Kruskal-Wallis tests. RESULTS: 394 patients were followed for a median of 4 years (1518 patient years follow-up). Of these 63% were male. Seventeen percent of patients had a CED of >50 mSv. Computed tomography (CT) accounted for 9% of total radiological studies\\/procedures while contributing 61.4% of total study dose. Median cumulative dose and median dose per patient year were significantly higher in the hemodialysis (HD) group (15.13 and 5.79 mSv, respectively) compared to the post-transplant group (2.9 and 0.52 mSv, respectively) (P < 0.001). CONCLUSION: ESKD patients are at risk of cumulative exposure to significant levels of diagnostic radiation. The majority of this exposure is imparted as a result of CT examinations to patients in the HD group.

Risk factors for fishermen's health and safety in Greece

DEFF Research Database (Denmark)

Frantzeskou, Elpida; Kastania, Anastasia N; Riza, Elena

2012-01-01

Background: This is, to the best of our knowledge, the first occupational health study in Greek fishing. Aim: The aim of the study is to determine the risks for health and safety in Greek fisheries workers by exploring their health status and the health risk factors present in their occupational...... injury, of which half caused more than one day absence, while 14% had a near drowning experience. The health risks factors studied include excessive weight, cardiovascular incidents and dermatological, musculoskeletal, respiratory, hearing, stress, and anxiety problems. The occupational health risk...... factors include alcohol, fatty food consumption, smoking, and lack of physical exercise. Conclusions: The health effects observed are causally related to diet, smoking, and exercise, which in turn relate to the specific working conditions and culture in small-scale fishing that need to be taken...

Systematic review of interventions to increase the provision of care for chronic disease risk behaviours in mental health settings: review protocol.

Science.gov (United States)

Fehily, Caitlin; Bartlem, Kate; Wiggers, John; Wolfenden, Luke; Regan, Timothy; Dray, Julia; Bailey, Jacqueline; Bowman, Jenny

2018-04-30

People with a mental illness experience a higher morbidity and mortality from chronic diseases relative to the general population. A higher prevalence of risk behaviours, including tobacco smoking, poor nutrition, harmful alcohol consumption and physical inactivity, is a substantial contributor to this health inequity. Clinical practice guidelines recommend that mental health services routinely provide care to their clients to address these risk behaviours. Such care may include the following elements: ask, assess, advise, assist and arrange (the '5As'), which has been demonstrated to be effective in reducing risk behaviours. Despite this potential, the provision of such care is reported to be low internationally and in Australia, and there is a need to identify effective strategies to increase care provision. The proposed review will examine the effectiveness of interventions which aimed to increase care provision (i.e. increase the proportion of clients receiving or clinicians providing the 5As) for the chronic disease risk behaviours of clients within the context of mental health service delivery. Eligible studies will be any quantitative study designs with a comparison group and which report on the effectiveness of an intervention strategy (including delivery arrangements, financial arrangements, governance arrangements and implementation strategies) to increase care provision specifically for chronic disease risk behaviours (tobacco smoking, poor nutrition, harmful alcohol consumption and physical inactivity). Screening for studies will be conducted across seven electronic databases: PsycINFO, MEDLINE, Excerpta Medica database (EMBASE), Psychology and Behavioural Sciences Collection, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL) and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Two authors will independently screen studies for eligibility and extract data from included studies. Where studies are sufficiently homogenous

Health and Self-Regulation among School-Age Children Experiencing Family Homelessness

Directory of Open Access Journals (Sweden)

Andrew J. Barnes

2017-08-01

Full Text Available Children in homeless families have high levels of adversity and are at risk for behavior problems and chronic health conditions, however little is known about the relationship between cognitive-emotional self-regulation and health among school-aged homeless children. Children (n = 86; mean age 10.5 living in shelters were assessed for health, family stress/adversity, emotional-behavioral regulation, nonverbal intellectual abilities, and executive function. Vision problems were the most prevalent health condition, followed by chronic respiratory conditions. Cumulative risk, child executive function, and self-regulation problems in children were uniquely related to child physical health. Homeless children experience problems with cognitive, emotional, and behavioral regulation as well as physical health, occurring in a context of high psychosocial risk. Several aspects of children’s self-regulation predict physical health in 9- to 11-year-old homeless children. Health promotion efforts in homeless families should address individual differences in children’s self-regulation as a resilience factor.

Effects of lifetime stress exposure on mental and physical health in young adulthood: How stress degrades and forgiveness protects health.

Science.gov (United States)

Toussaint, Loren; Shields, Grant S; Dorn, Gabriel; Slavich, George M

2016-06-01

To examine risk and resilience factors that affect health, lifetime stress exposure histories, dispositional forgiveness levels, and mental and physical health were assessed in 148 young adults. Greater lifetime stress severity and lower levels of forgiveness each uniquely predicted worse mental and physical health. Analyses also revealed a graded Stress × Forgiveness interaction effect, wherein associations between stress and mental health were weaker for persons exhibiting more forgiveness. These data are the first to elucidate the interactive effects of cumulative stress severity and forgiveness on health, and suggest that developing a more forgiving coping style may help minimize stress-related disorders. © The Author(s) 2014.

Health risk behavior of youth in foster care.

Science.gov (United States)

Gramkowski, Bridget; Kools, Susan; Paul, Steven; Boyer, Cherrie B; Monasterio, Erica; Robbins, Nancy

2009-05-01

Many adolescent health problems are predominantly caused by risk behavior. Foster adolescents have disproportionately poor health; therefore, identification of risk behavior is critical. Data from a larger study were analyzed to investigate the health risk behavior of 56 youth in foster care using the Child Health and Illness Profile-Adolescent Edition. Data indicated that youth in foster care had some increased risk behavior when compared with a normative adolescent population. Younger adolescents and those in relative placement had less risky behavior. Risk behavior was increased for youth in foster care when they were in group homes, had experienced a parental death, or had a history of physical or emotional abuse or attempted suicide. These results point to areas of strength and vulnerability for youth in foster care and suggest areas for clinicians and caregivers of these adolescents to focus interventions towards harm reduction and enhancement of resiliency.

The association of health risks with on-the-job productivity.

Science.gov (United States)

Burton, Wayne N; Chen, Chin-Yu; Conti, Daniel J; Schultz, Alyssa B; Pransky, Glenn; Edington, Dee W

2005-08-01

Decreased on-the-job productivity represents a large yet poorly characterized indirect cost to employers. We studied the impact of employee health risk factors on self-reported worker productivity (presenteeism). Using a brief version of the Work Limitation Questionnaire incorporated into a Health Risk Appraisal, 28,375 employees of a national company responded to the survey. The association between health risks and work limitation and each of the four domains was examined. Percentage of lost productivity also was estimated. Ten of 12 health risk factors studied were significantly associated with self-reported work limitations. The strength of the associations varied between risks and the four domains of work limitation. Perception-related risk factors such as life dissatisfaction, job dissatisfaction, poor health, and stress showed the greatest association with presenteeism. As the number of self-reported health risk factors increased, so did the percentage of employees reporting work limitations. Each additional risk factor was associated with 2.4% excess productivity reduction. Medium and high-risk individuals were 6.2% and 12.2% less productive than low-risk individuals, respectively. The annual cost of lost productivity in this corporation was estimated at between 99Mdollars and 185Mdollars or between 1392dollars and 2592dollars per employee. Health risk factors represent additional causes of lost productivity.

High cumulants of conserved charges and their statistical uncertainties

Science.gov (United States)

Li-Zhu, Chen; Ye-Yin, Zhao; Xue, Pan; Zhi-Ming, Li; Yuan-Fang, Wu

2017-10-01

We study the influence of measured high cumulants of conserved charges on their associated statistical uncertainties in relativistic heavy-ion collisions. With a given number of events, the measured cumulants randomly fluctuate with an approximately normal distribution, while the estimated statistical uncertainties are found to be correlated with corresponding values of the obtained cumulants. Generally, with a given number of events, the larger the cumulants we measure, the larger the statistical uncertainties that are estimated. The error-weighted averaged cumulants are dependent on statistics. Despite this effect, however, it is found that the three sigma rule of thumb is still applicable when the statistics are above one million. Supported by NSFC (11405088, 11521064, 11647093), Major State Basic Research Development Program of China (2014CB845402) and Ministry of Science and Technology (MoST) (2016YFE0104800)

Health Inequalities Among Korean Employees

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Eunsuk Choi

2017-12-01

Full Text Available Background: Social status might be a determinant of occupational health inequalities. This study analyzed the effects of social status on both work environments and health outcomes. Methods: The study sample consisted of 27,598 wage employees aged 15 years and older from among the Korean Working Condition Survey participants in 2011. Work environments included atypical work, physical risks, ergonomic risks, work demands, work autonomy, social supports, and job rewards. Health outcomes comprised general health, health and safety at risk because of work, the World Health Organization-5 Well-being Index, work-related musculoskeletal disease, and work-related injury. Multivariable logistic-regression models were used to identify the associations between social status and work environments and health outcomes. Results: Employees in the demographically vulnerable group had lower occupational status compared with their counterparts. Low social status was largely related to adverse work environments. Especially, precarious employment and manual labor occupation were associated with both adverse work environments and poor health outcomes. Conclusion: Precarious and manual workers should take precedence in occupational health equity policies and interventions. Their cumulative vulnerability, which is connected to demographics, occupational status, adverse work environments, or poor health outcomes, can be improved through a multilevel approach such as labor market, organizations, and individual goals. Keywords: employee health, health equity, social status

Military service absences and family members' mental health: A timeline followback assessment.

Science.gov (United States)

Rodriguez, Aubrey J; Margolin, Gayla

2015-08-01

Although military service, and particularly absence due to deployment, has been linked to risk for depression and anxiety among some spouses and children of active duty service members, there is limited research to explain the heterogeneity in family members' reactions to military service stressors. The current investigation introduces the Timeline Followback Military Family Interview (TFMFI) as a clinically useful strategy to collect detailed time-linked information about the service member's absences. Two dimensions of parent absence--the extent to which absences coincide with important family events and cumulative time absent--were tested as potential risks to family members' mental health. Data from 70 mother-adolescent pairs revealed that the number of important family events missed by the service member was linked to elevated youth symptoms of depression, even when accounting for the number of deployments and cumulative duration of the service member's absence. However, youth who reported more frequent contact with the service member during absences were buffered from the effects of extensive absence. Mothers' symptoms were associated with the cumulative duration of the service members' time away, but not with family events missed by the service member. These results identify circumstances that increase the risk for mental health symptoms associated with military family life. The TFMFI provides an interview-based strategy for clinicians wishing to understand military family members' lived experience during periods of service-member absence. (c) 2015 APA, all rights reserved).

A new approach to criteria for health risk assessment

International Nuclear Information System (INIS)

Spickett, Jeffery; Katscherian, Dianne; Goh, Yang Miang

2012-01-01

Health Impact Assessment (HIA) is a developing component of the overall impact assessment process and as such needs access to procedures that can enable more consistent approaches to the stepwise process that is now generally accepted in both EIA and HIA. The guidelines developed during this project provide a structured process, based on risk assessment procedures which use consequences and likelihood, as a way of ranking risks to adverse health outcomes from activities subjected to HIA or HIA as part of EIA. The aim is to assess the potential for both acute and chronic health outcomes. The consequences component also identifies a series of consequences for the health care system, depicted as expressions of financial expenditure and the capacity of the health system. These more specific health risk assessment characteristics should provide for a broader consideration of health consequences and a more consistent estimation of the adverse health risks of a proposed development at both the scoping and risk assessment stages of the HIA process. - Highlights: ► A more objective approach to health risk assessment is provided. ► An objective set of criteria for the consequences for chronic and acute impacts. ► An objective set of criteria for the consequences on the health care system. ► An objective set of criteria for event frequency that could impact on health. ► The approach presented is currently being trialled in Australia.

An integrated framework for health and ecological risk assessment

International Nuclear Information System (INIS)

Suter, Glenn W.; Vermeire, Theo; Munns, Wayne R.; Sekizawa, Jun

2005-01-01

The worldHealth Organization's (WHO's) International Program for Chemical Safety has developed a framework for performing risk assessments that integrate the assessment of risks to human health and risks to nonhuman organisms and ecosystems. The WHO's framework recognizes that stakeholders and risk managers have their own processes that are parallel to the scientific process of risk assessment and may interact with the risk assessment at various points, depending on the context. Integration of health and ecology provides consistent expressions of assessment results, incorporates the interdependence of humans and the environment, uses sentinel organisms, and improves the efficiency and quality of assessments relative to independent human health and ecological risk assessments. The advantage of the framework to toxicologists lies in the opportunity to use understanding of toxicokinetics and toxicodynamics to inform the integrated assessment of all exposed species

Cumulative processes and quark distribution in nuclei

International Nuclear Information System (INIS)

Kondratyuk, L.; Shmatikov, M.

1984-01-01

Assuming existence of multiquark (mainly 12q) bags in nuclei the spectra of cumulative nucleons and mesons produced in high-energy particle-nucleus collisions are discussed. The exponential form of quark momentum distribution in 12q-bag (agreeing well with the experimental data on lepton-nucleus interactions at large q 2 ) is shown to result in quasi-exponential distribution of cumulative particles over the light-cone variable αsub(B). The dependence of f(αsub(B); psub(perpendicular)) (where psub(perpendicular) is the transverse momentum of the bag) upon psub(perpendicular) is considered. The yields of cumulative resonances as well as effects related to the u- and d-quark distributions in N > Z nuclei being different are dicscussed

Health Risks of an Inactive Lifestyle

Science.gov (United States)

... develop a hormonal imbalance What are the health risks of an inactive lifestyle? Having an inactive lifestyle ... By not getting regular exercise, you raise your risk of Obesity Heart diseases, including coronary artery disease ...

Recurrence of Subdural Haematoma in a Population-Based Cohort - Risks and Predictive Factors.

Directory of Open Access Journals (Sweden)

Linnea Schmidt

Full Text Available To estimate the risks of and identify predictors for recurrent subdural haematoma in surgically and conservatively treated patients.The cohort comprised all individuals diagnosed with a first-time subdural hematoma in Denmark 1996-2011. Information on potential predictors was retrieved from the Danish health registers. Cumulative recurrence risks were estimated using the Aalen-Johansen estimator. Rate ratios (RR were estimated using Poisson regression.Among 10,158 individuals with a subdural hematoma, 1,555 had a recurrent event. The cumulative risk of recurrent subdural hematoma was 9% at 4 weeks after the primary bleeding, increasing to and stabilising at 14% after one year. Predictors associated with recurrence were: Male sex (RR 1.60, 95% CI:1.43-1.80, older age (>70 years compared to 20-49 years; RR 1.41, 95% CI: 1.21-1.65, alcohol addiction (RR 1.20, 95% CI:1.04-1.37, surgical treatment (RR 1.76, 95% CI:1.58-1.96, trauma diagnoses (RR 1.14, 95% CI:1.03-1.27, and diabetes mellitus (RR 1.40, 95% CI:1.11-1.74. Out of a selected combination of risk factors, the highest cumulative 1-year recurrence risks for subdural hematoma of 25% (compared to 14% for all patients was found in surgically treated males with diabetes mellitus.The recurrence risk of subdural hematoma is largely limited to the first year. Patient characteristics including co-morbidities greatly influence the recurrence risk of SDH, suggesting that individualized prognostic guidance and follow-up is needed.

Predicting Cumulative Incidence Probability: Marginal and Cause-Specific Modelling

DEFF Research Database (Denmark)

Scheike, Thomas H.; Zhang, Mei-Jie

2005-01-01

cumulative incidence probability; cause-specific hazards; subdistribution hazard; binomial modelling......cumulative incidence probability; cause-specific hazards; subdistribution hazard; binomial modelling...

Assessment of radon-induced health risk for occupants of a house built on uranium ore residue

International Nuclear Information System (INIS)

Clero, E.; Marie, L.; Challeton-De Vathaire, C.; Laurier, D.; Rannou, A.

2016-01-01

At the request of French public authorities, the Institute of Radiological Protection and Nuclear Safety has assessed the radiological situation of a house built on uranium ore residues in Haute-Vienne and the health risks induced from exposure to radon for all occupants. Classified as a lung carcinogen by the World Health Organization, radon is a proven cause of lung cancer in case of regular inhalation over a long period, and the risk increases with cumulative exposure. Radon exposure was reconstructed for various standard profiles of house occupancy. A risk model derived from a European epidemiological study was used to calculate the lifetime probability of death from lung cancer according to these standard profiles. Risk assessment of the occupants of the house highlighted the following main findings. For a resident school child having been exposed to radon from birth to the age of 7, the lifetime relative risk (LRR) was estimated at 5. For last adult and young adult residents having lived more than 10 years in the house, the probability of death from lung cancer was in the same order of magnitude as that of a regular cigarette smoker, with a LRR from 10 to 13 and a lifetime probability of death from lung cancer between 3 and 4%. If these individuals smoked regularly, in addition to being exposed to radon, this probability would be between 6 and 32% (supposing an additive or multiplicative interaction). For former occupants (non-smokers) having been exposed 10 years during childhood, the LRR was two-fold lower. For children having been in day care in the house, the increased probability of death from lung cancer was low, with a LRR lower than 2. Supposing, as in adults, that the risk decreases beyond 30 years after the end of radon exposure, the increase was almost zero for former occupants exposed during childhood and during day care, with a LRR close to 1. (authors)

Synergistic effect of cumulative corticosteroid dose and immunosuppressants on avascular necrosis in patients with systemic lupus erythematosus.

Science.gov (United States)

Kwon, H H; Bang, S Y; Won, S; Park, Y; Yi, J H; Joo, Y B; Lee, H S; Bae, S C

2018-01-01

Objectives Avascular necrosis (AVN) is one of the most common causes of organ damage in patients with systemic lupus erythematosus (SLE) and often causes serious physical disability. The aims of this study were to investigate clinical risk factors associated with symptomatic AVN and to analyze their synergistic effects in a large SLE cohort in Korea. Methods Patients with SLE were enrolled and followed from 1998 to 2014 in the Hanyang BAE Lupus cohort, and damage was measured annually according to the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). AVN was confirmed by imaging study if patients had symptoms. To determine risk factors for AVN, clinical, laboratory and therapeutic variables were analyzed by logistic regression. Relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S) were calculated to measure interactions between significant variables. Results Among 1219 SLE patients, symptomatic AVN was the most common type of musculoskeletal damage (10.8%, n = 132). SLE patients with AVN showed an earlier onset age, demonstrated AVN more commonly in conjunction with certain other clinical manifestations such as renal and neuropsychiatric disorders, and received significantly higher total cumulative corticosteroid dose and immunosuppressive agents than did patients without AVN. However, in multivariable analysis, only two variables including use of a cumulative corticosteroid dose greater than 20 g (odds ratio (OR) 3.62, p = 0.015) and use of immunosuppressants including cyclophosphamide or mycophenolate mofetil (OR 4.51, p AVN. Patients with cumulative corticosteroid dose > 20 g and immunosuppressant use had a 15.44-fold increased risk for AVN, compared with patients without these risk factors ( p AVN in our Korean lupus cohort. Conclusions An individual risk assessment for AVN development should be made prior to and during treatment for SLE

Subjective Effect of September 11, 2001 among Pregnant Women: Is Cumulative History of Interpersonal Violence Important?

Science.gov (United States)

Lewis, Marilyn W.; Cavanagh, Paul K.; Ahn, Grace; Yoshioka, Marianne R.

2008-01-01

Prior history of trauma may sensitize individuals to subsequent trauma, including terrorist attacks. Using a convenience sample of secondary, cross-sectional data, pregnant women were grouped based on lifetime interpersonal violence history. Cumulative risk theory was used to evaluate the association of lifetime interpersonal violence history and…

Comparative risk analysis for the Rocky Flats Plant integrated project planning

International Nuclear Information System (INIS)

Jones, M.E.; Shain, D.I.

1994-01-01

The Rocky Flats Plant is developing, with active stakeholder participation, a comprehensive planning strategy that will support transition of the Rocky Flats Plant from a nuclear weapons production facility to site cleanup and final disposition. Consideration of the interrelated nature of sitewide problems, such as material movement and disposition, facility and land use endstates, costs, relative risks to workers and the public, and waste disposition are all needed. Comparative Risk Analysis employs both incremental risk and cumulative risk evaluations to compare risks from postulated options or endstates and is an analytical tool for the Rocky Flats Plant Integrated Project Planning which can assist a decision-maker in evaluating relative risks among proposed remediation activity. However, risks from all of the remediation activities, decontamination and decommissioning activities, and normal ongoing operations are imposed upon the Rocky Flats workers, the surrounding public, and the environment. Comparative Risk Analysis will provide risk information, both human health and ecological, to aid in reducing unnecessary resource and monetary expenditures by focusing these resources on the largest risks first. Comparative Risk Analysis has been developed to aggregate various incremental risk estimates to develop a site cumulative risk estimate. The Comparative Risk Analysis methodology Group, consisting of community stakeholders, was established. Early stakeholder involvement in the risk analysis methodology development provides an opportunity for stakeholders to influence the risk information delivered to a decision-maker. This paper discusses development of the Comparative Risk Analysis methodology, stakeholder participation and lessons learned from these challenges

Decision analysis with cumulative prospect theory.

Science.gov (United States)

Bayoumi, A M; Redelmeier, D A

2000-01-01

Individuals sometimes express preferences that do not follow expected utility theory. Cumulative prospect theory adjusts for some phenomena by using decision weights rather than probabilities when analyzing a decision tree. The authors examined how probability transformations from cumulative prospect theory might alter a decision analysis of a prophylactic therapy in AIDS, eliciting utilities from patients with HIV infection (n = 75) and calculating expected outcomes using an established Markov model. They next focused on transformations of three sets of probabilities: 1) the probabilities used in calculating standard-gamble utility scores; 2) the probabilities of being in discrete Markov states; 3) the probabilities of transitioning between Markov states. The same prophylaxis strategy yielded the highest quality-adjusted survival under all transformations. For the average patient, prophylaxis appeared relatively less advantageous when standard-gamble utilities were transformed. Prophylaxis appeared relatively more advantageous when state probabilities were transformed and relatively less advantageous when transition probabilities were transformed. Transforming standard-gamble and transition probabilities simultaneously decreased the gain from prophylaxis by almost half. Sensitivity analysis indicated that even near-linear probability weighting transformations could substantially alter quality-adjusted survival estimates. The magnitude of benefit estimated in a decision-analytic model can change significantly after using cumulative prospect theory. Incorporating cumulative prospect theory into decision analysis can provide a form of sensitivity analysis and may help describe when people deviate from expected utility theory.

Multiple imputation for estimating the risk of developing dementia and its impact on survival.

Science.gov (United States)

Yu, Binbing; Saczynski, Jane S; Launer, Lenore

2010-10-01

Dementia, Alzheimer's disease in particular, is one of the major causes of disability and decreased quality of life among the elderly and a leading obstacle to successful aging. Given the profound impact on public health, much research has focused on the age-specific risk of developing dementia and the impact on survival. Early work has discussed various methods of estimating age-specific incidence of dementia, among which the illness-death model is popular for modeling disease progression. In this article we use multiple imputation to fit multi-state models for survival data with interval censoring and left truncation. This approach allows semi-Markov models in which survival after dementia depends on onset age. Such models can be used to estimate the cumulative risk of developing dementia in the presence of the competing risk of dementia-free death. Simulations are carried out to examine the performance of the proposed method. Data from the Honolulu Asia Aging Study are analyzed to estimate the age-specific and cumulative risks of dementia and to examine the effect of major risk factors on dementia onset and death.

An inferential and descriptive statistical examination of the relationship between cumulative work metrics and injury in Major League Baseball pitchers.

Science.gov (United States)

Karakolis, Thomas; Bhan, Shivam; Crotin, Ryan L

2013-08-01

In Major League Baseball (MLB), games pitched, total innings pitched, total pitches thrown, innings pitched per game, and pitches thrown per game are used to measure cumulative work. Often, pitchers are allocated limits, based on pitches thrown per game and total innings pitched in a season, in an attempt to prevent future injuries. To date, the efficacy in predicting injuries from these cumulative work metrics remains in question. It was hypothesized that the cumulative work metrics would be a significant predictor for future injury in MLB pitchers. Correlations between cumulative work for pitchers during 2002-07 and injury days in the following seasons were examined using regression analyses to test this hypothesis. Each metric was then "binned" into smaller cohorts to examine trends in the associated risk of injury for each cohort. During the study time period, 27% of pitchers were injured after a season in which they pitched. Although some interesting trends were noticed during the binning process, based on the regression analyses, it was found that no cumulative work metric was a significant predictor for future injury. It was concluded that management of a pitcher's playing schedule based on these cumulative work metrics alone could not be an effective means of preventing injury. These findings indicate that an integrated approach to injury prevention is required. This approach will likely involve advanced cumulative work metrics and biomechanical assessment.

NIOSH (National Institute for Occupational Safety and Health) testimony to Department of Labor on the Mine Safety and Health Administration proposed rule: ionizing radiation standards for metal and nonmetal mines, August 13, 1987 by R. Niemeier

International Nuclear Information System (INIS)

1987-01-01

Recommendations were offered for protecting workers against the health effects of ionizing radiation in metal and nonmetal mines. Available data demonstrating such health effects was reviewed and evidence supporting the technical feasibility of reducing the current Mine Safety and Health Administration (MSHA) standard was presented. Five recent studies indicated a significant increase in lung cancer rates associated with radon progeny exposure in underground mines. Additional studies indicated an exposure/response relationship in uranium miners. The influence of smoking on the association between radon progeny exposure and lung cancer was cited. Evidence has indicated that exposure to radon progeny carries a potential risk of developing occupationally induced lung cancer. Risk-assessment data supported the conclusion that miners with the same characteristics as the United States Public Health Service uranium miners cohort and who accrue a cumulative occupational exposure of 120 working level months, would have a lung cancer excess lifetime risk of about 35 to 40 lung cancer deaths per 1000 exposed miners. Modern mining methods using dilution ventilation as well as bulkheading and backfilling techniques make it possible to achieve substantial reductions in the cumulative exposure to radon progeny. Information was provided on sampling strategy, control technology, ventilation systems, respirators, and medical surveillance programs

Original and cumulative prospect theory: a discussion of empirical differences

NARCIS (Netherlands)

Wakker, P.P.; Fennema, H.

1997-01-01

This note discusses differences between prospect theory and cumulative prospect theory. It shows that cumulative prospect theory is not merely a formal correction of some theoretical problems in prospect theory, but it also gives different predictions. Experiments are described that favor cumulative

Cumulative incidence and prevalence of childhood autism in children in Japan.

Science.gov (United States)

Honda, H; Shimizu, Y; Misumi, K; Niimi, M; Ohashi, Y

1996-08-01

An epidemiological survey of childhood autism as defined in ICD-10 Research Criteria was conducted in the northern part of Yokohama, Japan. The routine health checkup for 18-month-old children served as the initial mass-screening, and all facilities which provide child care services function to detect all cases with childhood autism and refer them to the Yokohama Rehabilitation Centre. Cumulative incidence of childhood autism up to 5 years of age among the birth cohort of 1988, and prevalence on 1 January 1994, among residents born in 1988 were estimated Cumulative incidence and prevalence were 16.2 per 10,000 and 21.1 per 10,000, respectively. Children with high-functioning autism who had IQs of 70 and over constituted approximately half of all the children with childhood autism. CONCLUSION. It was confirmed through better detection of high-functioning cases that childhood autism in Japan is more common than formerly estimated.

Cumulative radiation dose of multiple trauma patients during their hospitalization

International Nuclear Information System (INIS)

Wang Zhikang; Sun Jianzhong; Zhao Zudan

2012-01-01

Objective: To study the cumulative radiation dose of multiple trauma patients during their hospitalization and to analyze the dose influence factors. Methods: The DLP for CT and DR were retrospectively collected from the patients during June, 2009 and April, 2011 at a university affiliated hospital. The cumulative radiation doses were calculated by summing typical effective doses of the anatomic regions scanned. Results: The cumulative radiation doses of 113 patients were collected. The maximum,minimum and the mean values of cumulative effective doses were 153.3, 16.48 mSv and (52.3 ± 26.6) mSv. Conclusions: Multiple trauma patients have high cumulative radiation exposure. Therefore, the management of cumulative radiation doses should be enhanced. To establish the individualized radiation exposure archives will be helpful for the clinicians and technicians to make decision whether to image again and how to select the imaging parameters. (authors)

Cumulative particle production in the quark recombination model

International Nuclear Information System (INIS)

Gavrilov, V.B.; Leksin, G.A.

1987-01-01

Production of cumulative particles in hadron-nuclear inteactions at high energies is considered within the framework of recombination quark model. Predictions for inclusive cross sections of production of cumulative particles and different resonances containing quarks in s state are made

Patents, Drug Delivery and Public Health Protection: Health Risk Management for Nanopharmaceuticals

Directory of Open Access Journals (Sweden)

Leonardo da Silva Sant`Anna

2013-05-01

Full Text Available The present article discusses the general risks associated with nanotechnology applications and the defcits of the risk management of engineered nanopharmaceutical particles. An evaluation of the possible health or environmental risks of nanoparticles must systematically be carried out and it is important to ensure that particle size and chemistry are taken into account when investigating possible adverse effects. It has been a goal subsidizes the policy-makers to adapt and modernize the regulatory framework on nanotechnology and risks involving health as a strategic area in the politics of Science. It is essential that health and environment be always directly or indirectly involved in various researches to understand the causes of affections and to develop control procedures in order to avoid them, providing results achievable, reliable and secure.

Growth of Korean preterm infants in a family-centered tradition during early infancy: the influence of health risks, maternal employment, and the sex of infants.

Science.gov (United States)

Ahn, Youngmee; Sohn, Min; Lee, Sangmi

2014-10-01

The physical growth of mild preterm infants (maternal employment status, and the infant sex. There were four noteworthy findings on growth variation in Korean mild preterm infants during early infancy: (i) the secular trend of intrauterine growth; (ii) the cumulative adverse effects of four risk factors; (iii) the possible burden of maternal employment if insufficient support; and (iv) the possibility of the cultural favoritism to male infants regardless of the modern industrialized society. The study suggests that, in a modern society, while mild preterm infants could sustain typical fetal growth, the early postnatal growth may vary based on health risks and sociocultural circumstances related to child-bearing and -rearing practices surrounding them. © 2013 The Authors. Japan Journal of Nursing Science © 2013 Japan Academy of Nursing Science.

Safety of Weightlifting Among Women with or at Risk for Breast Cancer–Related Lymphedema: Musculoskeletal Injuries and Health Care Use in a Weightlifting Rehabilitation Trial