WorldWideScience

Sample records for cumulative health risks

  1. Cumulative Risk Assessment (CRA): transforming the way we assess health risks.

    Science.gov (United States)

    Williams, Pamela R D; Dotson, G Scott; Maier, Andrew

    2012-10-16

    Human health risk assessments continue to evolve and now focus on the need for cumulative risk assessment (CRA). CRA involves assessing the combined risk from coexposure to multiple chemical and nonchemical stressors for varying health effects. CRAs are broader in scope than traditional chemical risk assessments because they allow for a more comprehensive evaluation of the interaction between different stressors and their combined impact on human health. Future directions of CRA include greater emphasis on local-level community-based assessments; integrating environmental, occupational, community, and individual risk factors; and identifying and implementing common frameworks and risk metrics for incorporating multiple stressors.

  2. Cumulative risk and developmental health: an argument for the importance of a family-wide science.

    Science.gov (United States)

    Browne, Dillon T; Plamondon, Andre; Prime, Heather; Puente-Duran, Sofia; Wade, Mark

    2015-01-01

    A substantial body of research links social disadvantage and developmental health via a cascade running from poverty, to cumulative psychosocial risk, to disrupted family dynamics, to child biological regulatory systems and neurocognitive processing, and finally to morbidity across the lifespan. Most research in this area employs single-dyad or between-family methodology. While informative, there are limitations to this approach. Specifically, it is impossible to determine how risk alters psychosocial environments that are similar for all persons within a household, versus processes that are unique to particular children. This is important in light of literature citing the primacy of child-specific environments in driving developmental health. Methodologically speaking, there are both benefits and challenges to family-wide approaches that differentiate between- and within-family environments. This review describes literature linking cumulative risk and developmental health via family process, while articulating the importance of family-wide approaches. Areas of shortcoming and recommendations for a family-wide science are provided. © 2015 John Wiley & Sons, Ltd.

  3. Cumulative health risk assessment: integrated approaches for multiple contaminants, exposures, and effects

    International Nuclear Information System (INIS)

    Rice, Glenn; Teuschler, Linda; MacDonel, Margaret; Butler, Jim; Finster, Molly; Hertzberg, Rick; Harou, Lynne

    2007-01-01

    Available in abstract form only. Full text of publication follows: As information about environmental contamination has increased in recent years, so has public interest in the combined effects of multiple contaminants. This interest has been highlighted by recent tragedies such as the World Trade Center disaster and hurricane Katrina. In fact, assessing multiple contaminants, exposures, and effects has long been an issue for contaminated sites, including U.S. Department of Energy (DOE) legacy waste sites. Local citizens have explicitly asked the federal government to account for cumulative risks, with contaminants moving offsite via groundwater flow, surface runoff, and air dispersal being a common emphasis. Multiple exposures range from ingestion and inhalation to dermal absorption and external gamma irradiation. Three types of concerns can lead to cumulative assessments: (1) specific sources or releases - e.g., industrial facilities or accidental discharges; (2) contaminant levels - in environmental media or human tissues; and (3) elevated rates of disease - e.g., asthma or cancer. The specific initiator frames the assessment strategy, including a determination of appropriate models to be used. Approaches are being developed to better integrate a variety of data, extending from environmental to internal co-location of contaminants and combined effects, to support more practical assessments of cumulative health risks. (authors)

  4. Cumulative Risk Exposure and Mental Health Symptoms among Maltreated Youth Placed in Out-of-Home Care

    Science.gov (United States)

    Raviv, Tali; Taussig, Heather N.; Culhane, Sara E.; Garrido, Edward F.

    2010-01-01

    Objective: Maltreated children placed in out-of-home care are at high risk for exhibiting symptoms of psychopathology by virtue of their exposure to numerous risk factors. Research examining cumulative risk has consistently found that the accumulation of risk factors increases the likelihood of mental health problems. The goal of the current study…

  5. Social Determinants of Health in Environmental Justice Communities: Examining Cumulative Risk in Terms of Environmental Exposures and Social Determinants of Health

    OpenAIRE

    Prochaska, John D.; Nolen, Alexandra B.; Kelley, Hilton; Sexton, Ken; Linder, Stephen H.; Sullivan, John

    2014-01-01

    Residents of environmental justice (EJ) communities may bear a disproportionate burden of environmental health risk, and often face additional burdens from social determinants of health. Accounting for cumulative risk should include measures of risk from both environmental sources and social determinants. This study sought to better understand cumulative health risk from both social and environmental sources in a disadvantaged community in Texas. Key outcomes were determining what data are cu...

  6. Cumulative risk, cumulative outcome: a 20-year longitudinal study.

    Directory of Open Access Journals (Sweden)

    Leslie Atkinson

    Full Text Available Cumulative risk (CR models provide some of the most robust findings in the developmental literature, predicting numerous and varied outcomes. Typically, however, these outcomes are predicted one at a time, across different samples, using concurrent designs, longitudinal designs of short duration, or retrospective designs. We predicted that a single CR index, applied within a single sample, would prospectively predict diverse outcomes, i.e., depression, intelligence, school dropout, arrest, smoking, and physical disease from childhood to adulthood. Further, we predicted that number of risk factors would predict number of adverse outcomes (cumulative outcome; CO. We also predicted that early CR (assessed at age 5/6 explains variance in CO above and beyond that explained by subsequent risk (assessed at ages 12/13 and 19/20. The sample consisted of 284 individuals, 48% of whom were diagnosed with a speech/language disorder. Cumulative risk, assessed at 5/6-, 12/13-, and 19/20-years-old, predicted aforementioned outcomes at age 25/26 in every instance. Furthermore, number of risk factors was positively associated with number of negative outcomes. Finally, early risk accounted for variance beyond that explained by later risk in the prediction of CO. We discuss these findings in terms of five criteria posed by these data, positing a "mediated net of adversity" model, suggesting that CR may increase some central integrative factor, simultaneously augmenting risk across cognitive, quality of life, psychiatric and physical health outcomes.

  7. Perspectives on cumulative risks and impacts.

    Science.gov (United States)

    Faust, John B

    2010-01-01

    Cumulative risks and impacts have taken on different meanings in different regulatory and programmatic contexts at federal and state government levels. Traditional risk assessment methodologies, with considerable limitations, can provide a framework for the evaluation of cumulative risks from chemicals. Under an environmental justice program in California, cumulative impacts are defined to include exposures, public health effects, or environmental effects in a geographic area from the emission or discharge of environmental pollution from all sources, through all media. Furthermore, the evaluation of these effects should take into account sensitive populations and socioeconomic factors where possible and to the extent data are available. Key aspects to this potential approach include the consideration of exposures (versus risk), socioeconomic factors, the geographic or community-level assessment scale, and the inclusion of not only health effects but also environmental effects as contributors to impact. Assessments of this type extend the boundaries of the types of information that toxicologists generally provide for risk management decisions.

  8. 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.

  9. Social Determinants of Health in Environmental Justice Communities: Examining Cumulative Risk in Terms of Environmental Exposures and Social Determinants of Health.

    Science.gov (United States)

    Prochaska, John D; Nolen, Alexandra B; Kelley, Hilton; Sexton, Ken; Linder, Stephen H; Sullivan, John

    2014-01-01

    Residents of environmental justice (EJ) communities may bear a disproportionate burden of environmental health risk, and often face additional burdens from social determinants of health. Accounting for cumulative risk should include measures of risk from both environmental sources and social determinants. This study sought to better understand cumulative health risk from both social and environmental sources in a disadvantaged community in Texas. Key outcomes were determining what data are currently available for this assessment, clarifying data needs, identifying data gaps, and considering how those gaps could be filled. Analyses suggested that the traditionally defined EJ community in Port Arthur may have a lower environmental risk from air toxics than the rest of the City of Port Arthur (although the entire city has a higher risk than the average for the state), but may have a larger burden from social determinants of health. However, the results should be interpreted in light of the availability of data, the definitions of community boundaries, and the areal unit utilized. Continued focus on environmental justice communities and the cumulative risks faced by their residents is critical to protecting these residents and, ultimately, moving towards a more equitable distribution and acceptable level of risk throughout society.

  10. Conceptual models for cumulative risk assessment.

    Science.gov (United States)

    Linder, Stephen H; Sexton, Ken

    2011-12-01

    In the absence of scientific consensus on an appropriate theoretical framework, cumulative risk assessment and related research have relied on speculative conceptual models. We argue for the importance of theoretical backing for such models and discuss 3 relevant theoretical frameworks, each supporting a distinctive "family" of models. Social determinant models postulate that unequal health outcomes are caused by structural inequalities; health disparity models envision social and contextual factors acting through individual behaviors and biological mechanisms; and multiple stressor models incorporate environmental agents, emphasizing the intermediary role of these and other stressors. The conclusion is that more careful reliance on established frameworks will lead directly to improvements in characterizing cumulative risk burdens and accounting for disproportionate adverse health effects.

  11. 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

  12. EPA Workshop on Epigenetics and Cumulative Risk ...

    Science.gov (United States)

    Agenda Download the Workshop Agenda (PDF) The workshop included presentations and discussions by scientific experts pertaining to three topics (i.e., epigenetic changes associated with diverse stressors, key science considerations in understanding epigenetic changes, and practical application of epigenetic tools to address cumulative risks from environmental stressors), to address several questions under each topic, and included an opportunity for attendees to participate in break-out groups, provide comments and ask questions. Workshop Goals The workshop seeks to examine the opportunity for use of aggregate epigenetic change as an indicator in cumulative risk assessment for populations exposed to multiple stressors that affect epigenetic status. Epigenetic changes are specific molecular changes around DNA that alter expression of genes. Epigenetic changes include DNA methylation, formation of histone adducts, and changes in micro RNAs. Research today indicates that epigenetic changes are involved in many chronic diseases (cancer, cardiovascular disease, obesity, diabetes, mental health disorders, and asthma). Research has also linked a wide range of stressors including pollution and social factors with occurrence of epigenetic alterations. Epigenetic changes have the potential to reflect impacts of risk factors across multiple stages of life. Only recently receiving attention is the nexus between the factors of cumulative exposure to environmental

  13. Single and Cumulative Relations of Social Risk Factors with Children's Dental Health and Care-Utilization Within Regions of the United States.

    Science.gov (United States)

    Yang, Alyssa J; Gromoske, Andrea N; Olson, Melissa A; Chaffin, Jeffrey G

    2016-03-01

    The purpose is to examine the relation of social risk factors, and the cumulative burden of social risk factors, on parent-reported dental health and dental care-seeking behavior. National Survey of Children's Health data (2011-2012) were analyzed for US children by Title V Block Grant regions. Multivariate logistic regressions were estimated for ten social risk factors, as well as a cumulative risk index, to find any associations with poor condition of teeth, presence of dental caries, and no dental care visits. Almost all of the risk factors were significantly associated with poor condition of teeth and presence of dental caries for the US. Models associating no dental care visits suggested that low family income (OR 1.58), poor maternal mental health (OR 1.54), high school education or less (OR 1.34), and multi-racial/other race (OR 1.18) were significant factors for the US. Regional variation existed for those risk factors and their association with the outcomes, but income, education, and poor maternal mental health consistently played a significant role in adverse outcomes. The cumulative risk index was strongly related to poor oral health outcomes, with a weaker relationship to dental care utilization. US children experiencing certain social risk factors, such as low family income, high school education or less, and poor maternal mental health, are likely to be at greater risk for poor dental health and low levels of dental-care seeking behavior. Children experiencing multiple social risks are at greater risk for poor oral outcomes than children who experience fewer social risks. An approach that involves the social determinants of health is needed to address these issues.

  14. Implications of applying cumulative risk assessment to the workplace.

    Science.gov (United States)

    Fox, Mary A; Spicer, Kristen; Chosewood, L Casey; Susi, Pam; Johns, Douglas O; Dotson, G Scott

    2018-06-01

    Multiple changes are influencing work, workplaces and workers in the US including shifts in the main types of work and the rise of the 'gig' economy. Work and workplace changes have coincided with a decline in unions and associated advocacy for improved safety and health conditions. Risk assessment has been the primary method to inform occupational and environmental health policy and management for many types of hazards. Although often focused on one hazard at a time, risk assessment frameworks and methods have advanced toward cumulative risk assessment recognizing that exposure to a single chemical or non-chemical stressor rarely occurs in isolation. We explore how applying cumulative risk approaches may change the roles of workers and employers as they pursue improved health and safety and elucidate some of the challenges and opportunities that might arise. Application of cumulative risk assessment should result in better understanding of complex exposures and health risks with the potential to inform more effective controls and improved safety and health risk management overall. Roles and responsibilities of both employers and workers are anticipated to change with potential for a greater burden of responsibility on workers to address risk factors both inside and outside the workplace that affect health at work. A range of policies, guidance and training have helped develop cumulative risk assessment for the environmental health field and similar approaches are available to foster the practice in occupational safety and health. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. 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...

  16. Cumulative Risk Assessment Toolbox: Methods and Approaches for the Practitioner

    Directory of Open Access Journals (Sweden)

    Margaret M. MacDonell

    2013-01-01

    Full Text Available The historical approach to assessing health risks of environmental chemicals has been to evaluate them one at a time. In fact, we are exposed every day to a wide variety of chemicals and are increasingly aware of potential health implications. Although considerable progress has been made in the science underlying risk assessments for real-world exposures, implementation has lagged because many practitioners are unaware of methods and tools available to support these analyses. To address this issue, the US Environmental Protection Agency developed a toolbox of cumulative risk resources for contaminated sites, as part of a resource document that was published in 2007. This paper highlights information for nearly 80 resources from the toolbox and provides selected updates, with practical notes for cumulative risk applications. Resources are organized according to the main elements of the assessment process: (1 planning, scoping, and problem formulation; (2 environmental fate and transport; (3 exposure analysis extending to human factors; (4 toxicity analysis; and (5 risk and uncertainty characterization, including presentation of results. In addition to providing online access, plans for the toolbox include addressing nonchemical stressors and applications beyond contaminated sites and further strengthening resource accessibility to support evolving analyses for cumulative risk and sustainable communities.

  17. 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

    Science.gov (United States)

    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...

  18. 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.

  19. 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...

  20. 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...

  1. 76 FR 69726 - Pyrethrins/Pyrethroid Cumulative Risk Assessment; Notice of Availability

    Science.gov (United States)

    2011-11-09

    ... exposure to multiple chemicals that have a common mechanism of toxicity when making regulatory decisions... stakeholders including environmental, human health, farm worker, and agricultural advocates; the chemical... Cumulative Risk Assessment; Notice of Availability AGENCY: Environmental Protection Agency (EPA). ACTION...

  2. 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.

  3. 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.

  4. Family Resources and Effects on Child Behavior Problem Interventions: A Cumulative Risk Approach.

    Science.gov (United States)

    Tømmerås, Truls; Kjøbli, John

    2017-01-01

    Family resources have been associated with health care inequality in general and with social gradients in treatment outcomes for children with behavior problems. However, there is limited evidence concerning cumulative risk-the accumulation of social and economic disadvantages in a family-and whether cumulative risk moderates the outcomes of evidence-based parent training interventions. We used data from two randomized controlled trials evaluating high-intensity ( n  = 137) and low-intensity ( n  = 216) versions of Parent Management Training-Oregon (PMTO) with a 50:50 allocation between participants receiving PMTO interventions or regular care. A nine-item family cumulative risk index tapping socioeconomic resources and parental health was constructed to assess the family's exposure to risk. Autoregressive structured equation models (SEM) were run to investigate whether cumulative risk moderated child behaviors at post-treatment and follow-up (6 months). Our results showed opposite social gradients for the treatment conditions: the children exposed to cumulative risk in a pooled sample of both PMTO groups displayed lower levels of behavior problems, whereas children with identical risk exposures who received regular care experienced more problems. Furthermore, our results indicated that the social gradients differed between PMTO interventions: children exposed to cumulative risk in the low-intensity (five sessions) Brief Parent Training fared equally well as their high-resource counterparts, whereas children exposed to cumulative risk in the high-intensity PMTO (12 sessions) experienced vastly better treatment effects. Providing evidence-based parent training seem to be an effective way to counteract health care inequality, and the more intensive PMTO treatment seemed to be a particularly effective way to help families with cumulative risk.

  5. 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.

  6. Aggregate Exposure and Cumulative Risk Assessment--Integrating Occupational and Non-occupational Risk Factors.

    Science.gov (United States)

    Lentz, T J; Dotson, G S; Williams, P R D; Maier, A; Gadagbui, B; Pandalai, S P; Lamba, A; Hearl, F; Mumtaz, M

    2015-01-01

    Occupational exposure limits have traditionally focused on preventing morbidity and mortality arising from inhalation exposures to individual chemical stressors in the workplace. While central to occupational risk assessment, occupational exposure limits have limited application as a refined disease prevention tool because they do not account for all of the complexities of the work and non-occupational environments and are based on varying health endpoints. To be of greater utility, occupational exposure limits and other risk management tools could integrate broader consideration of risks from multiple exposure pathways and routes (aggregate risk) as well as the combined risk from exposure to both chemical and non-chemical stressors, within and beyond the workplace, including the possibility that such exposures may cause interactions or modify the toxic effects observed (cumulative risk). Although still at a rudimentary stage in many cases, a variety of methods and tools have been developed or are being used in allied risk assessment fields to incorporate such considerations in the risk assessment process. These approaches, which are collectively referred to as cumulative risk assessment, have potential to be adapted or modified for occupational scenarios and provide a tangible path forward for occupational risk assessment. Accounting for complex exposures in the workplace and the broader risks faced by the individual also requires a more complete consideration of the composite effects of occupational and non-occupational risk factors to fully assess and manage worker health problems. Barriers to integrating these different factors remain, but new and ongoing community-based and worker health-related initiatives may provide mechanisms for identifying and integrating risk from aggregate exposures and cumulative risks from all relevant sources, be they occupational or non-occupational.

  7. 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...

  8. Childhood Psychosocial Cumulative Risks and Carotid Intima-Media Thickness in Adulthood: The Cardiovascular Risk in Young Finns Study

    Science.gov (United States)

    Hakulinen, Christian; Pulkki-Råback, Laura; Elovainio, Marko; Kubzansky, Laura D.; Jokela, Markus; Hintsanen, Mirka; Juonala, Markus; Kivimäki, Mika; Josefsson, Kim; Hutri-Kähönen, Nina; Kähönen, Mika; Viikari, Jorma; Keltikangas-Järvinen, Liisa; Raitakari, Olli T

    2015-01-01

    Objective Adverse experiences in childhood may influence cardiovascular risk in adulthood. We examined the prospective associations between types of psychosocial adversity as well as having multiple adversities (e.g., cumulative risk) with carotid intima-media thickness (IMT) and its progression among young adults. Higher cumulative risk score in childhood was expected to be associated with higher IMT and its progression. Methods Participants were 2265 men and women (age range: 24-39 years in 2001) from the on-going Cardiovascular Risk in Young Finns study whose carotid IMT were measured in 2001 and 2007. A cumulative psychosocial risk score, assessed at the study baseline in 1980, was derived from four separate aspects of the childhood environment that may impose risk (childhood stressful life-events, parental health behavior family, socioeconomic status, and childhood emotional environment). Results The cumulative risk score was associated with higher IMT in 2007 (b=.004; se=.001; padulthood, including adulthood health behavior, adulthood socioeconomic status and depressive symptoms. Among the individual childhood psychosocial risk categories, having more stressful life-events was associated with higher IMT in 2001 (b=.007; se=.003; p=.016) and poorer parental health behavior predicted higher IMT in 2007 (b=.004; se=.002; p=.031) after adjustment for age, sex and childhood cardiovascular risk factors. Conclusions Early life psychosocial environment influences cardiovascular risk later in life and considering cumulative childhood risk factors may be more informative than individual factors in predicting progression of preclinical atherosclerosis in adulthood. PMID:26809108

  9. The EPA's human exposure research program for assessing cumulative risk in communities.

    Science.gov (United States)

    Zartarian, Valerie G; Schultz, Bradley D

    2010-06-01

    Communities are faced with challenges in identifying and prioritizing environmental issues, taking actions to reduce their exposures, and determining their effectiveness for reducing human health risks. Additional challenges include determining what scientific tools are available and most relevant, and understanding how to use those tools; given these barriers, community groups tend to rely more on risk perception than science. The U.S. Environmental Protection Agency's Office of Research and Development, National Exposure Research Laboratory (NERL) and collaborators are developing and applying tools (models, data, methods) for enhancing cumulative risk assessments. The NERL's "Cumulative Communities Research Program" focuses on key science questions: (1) How to systematically identify and prioritize key chemical stressors within a given community?; (2) How to develop estimates of exposure to multiple stressors for individuals in epidemiologic studies?; and (3) What tools can be used to assess community-level distributions of exposures for the development and evaluation of the effectiveness of risk reduction strategies? This paper provides community partners and scientific researchers with an understanding of the NERL research program and other efforts to address cumulative community risks; and key research needs and opportunities. Some initial findings include the following: (1) Many useful tools exist for components of risk assessment, but need to be developed collaboratively with end users and made more comprehensive and user-friendly for practical application; (2) Tools for quantifying cumulative risks and impact of community risk reduction activities are also needed; (3) More data are needed to assess community- and individual-level exposures, and to link exposure-related information with health effects; and (4) Additional research is needed to incorporate risk-modifying factors ("non-chemical stressors") into cumulative risk assessments. The products of this

  10. 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...

  11. 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 ...

  12. 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.

  13. Cumulative childhood risk and adult functioning in abused and neglected children grown up.

    Science.gov (United States)

    Horan, Jacqueline M; Widom, Cathy Spatz

    2015-08-01

    This paper examines the relationship between childhood exposure to cumulative risk and three indicators of psychosocial adjustment in adulthood (educational attainment, mental health, and criminal behavior) and tests three different models (linear, quadratic, and interaction). Data were collected over several time points from individuals who were part of a prospective cohort design study that matched children with documented cases of abuse and/or neglect with children without such histories and followed them into adulthood. Hierarchical multiple regressions compared linear and quadratic models and then examined potential moderating effects of child abuse/neglect and gender. Exposure to a greater number of childhood risk factors was significantly related to fewer years of education, more anxiety and depression symptomatology, and more criminal arrests in adulthood. The relationship between cumulative risk and years of education demonstrated a curvilinear pattern, whereas the relationship between cumulative risk and both mental health and criminal arrests was linear. Child abuse/neglect did not moderate these relationships, although there were direct effects for both child abuse/neglect and gender on criminal arrests, with more arrests for abused/neglected individuals than controls and more for males than females. Gender interacted with cumulative risk to impact educational attainment and criminal behavior, suggesting that interventions may be more effective if tailored differently for males and females. Interventions may need to be multifaceted and designed to address these different domains of functioning.

  14. The Role of Cumulative Risk Assessment in Decisions about Environmental Justice

    Directory of Open Access Journals (Sweden)

    Ken Sexton

    2010-11-01

    Full Text Available There is strong presumptive evidence that people living in poverty and certain racial and ethnic groups bear a disproportionate burden of environmental health risk. Many have argued that conducting formal assessments of the health risk experienced by affected communities is both unnecessary and counterproductive—that instead of analyzing the situation our efforts should be devoted to fixing obvious problems and rectifying observable wrongs. We contend that formal assessment of cumulative health risks from combined effects of chemical and nonchemical stressors is a valuable tool to aid decision makers in choosing risk management options that are effective, efficient, and equitable. If used properly, cumulative risk assessment need not impair decision makers’ discretion, nor should it be used as an excuse for doing nothing in the face of evident harm. Good policy decisions require more than good intentions; they necessitate analysis of risk-related information along with careful consideration of economic issues, ethical and moral principles, legal precedents, political realities, cultural beliefs, societal values, and bureaucratic impediments. Cumulative risk assessment can provide a systematic and impartial means for informing policy decisions about environmental justice.

  15. 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...

  16. 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)

    Science.gov (United States)

    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...

  17. 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).

  18. 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.

  19. 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.

  20. 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.

  1. 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...

  2. 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...

  3. 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

  4. 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...

  5. 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,

  6. 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…

  7. 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

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

    Science.gov (United States)

    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

  9. 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…

  10. 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.

  11. 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

  12. 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...

  13. 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.

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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.

  18. 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...

  19. 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.

  20. 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...

  1. 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

  2. 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

  3. 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

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

    Directory of Open Access Journals (Sweden)

    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

  5. 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....

  6. 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

  7. 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…

  8. 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

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

    Science.gov (United States)

    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…

  10. 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...

  11. 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

  12. 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…

  13. 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

  14. 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...

  15. 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.

  16. 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.

  17. 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...

  18. 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...

  19. 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.

  20. 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.

  1. 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.

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

    Science.gov (United States)

    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

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. 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

  6. 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.

  7. 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.

  8. 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.

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

    Science.gov (United States)

    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.

  10. 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

  11. 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.

  12. 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

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

    Science.gov (United States)

    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.

  14. 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.

  15. 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.

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

    Science.gov (United States)

    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.

  17. 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.

  18. 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.

  19. 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...

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. 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.

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

    Science.gov (United States)

    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.

  7. 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…

  8. 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,

  9. 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

  10. 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.

  11. 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

  12. 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.

  13. Human biomonitoring of phthalate exposure in Austrian children and adults and cumulative risk assessment.

    Science.gov (United States)

    Hartmann, Christina; Uhl, Maria; Weiss, Stefan; Koch, Holger M; Scharf, Sigrid; König, Jürgen

    2015-07-01

    children. The execution of a cumulative risk assessment based on Hazard Indices showed cause for concern mainly for children, as well as in rare cases for adults. Although phthalate exposure seems to have decreased in previous years, the wide distribution and existing exceedances of acceptable levels indicate that phthalate exposure should be further monitored in order to identify exposure sources and enable appropriate minimisation measures. Copyright © 2015 Elsevier GmbH. All rights reserved.

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

    Science.gov (United States)

    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.

  15. 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...

  16. 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

  17. 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…

  18. 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.

  19. 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...

  20. 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

  1. 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...

  2. 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

  3. 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,…

  4. Psychobiology of cumulative trauma: hair cortisol as a risk marker for stress exposure in women.

    Science.gov (United States)

    Morris, Matthew C; Abelson, James L; Mielock, Alyssa S; Rao, Uma

    2017-07-01

    Childhood trauma (CT) is associated with long-lasting alterations of the hypothalamic-pituitary-adrenal (HPA) axis and elevated risk for stress exposure in adulthood. Although HPA alterations are present in the early aftermath of trauma, it remains unclear how initial HPA activity is associated with subsequent stress exposure and whether CT exposure influences the strength and direction of this association. The present study examined prospective associations between hair cortisol content (HCC) and stress exposure from baseline to 3-month follow-up in young adult women with recent (i.e. past 3 months) exposure to interpersonal violence (IPV; i.e. physical or sexual assault) and non-traumatized controls. History of significant CT abuse or neglect was determined based on clinical cutoffs for a self-report CT measure: 12 women had abuse or neglect and recent IPV exposure (CT + IPV); 7 women had abuse or neglect but no IPV exposure (CT); 15 women had no history of trauma (NTC). HCC was computed for 3 cm sections reflecting cortisol secretion during the 3 months preceding the baseline assessment. The interaction of cumulative trauma and HCC predicted stress exposure over 3-month follow-up, controlling for baseline stress exposure and depressive symptoms. Simple slopes analyses revealed that lower baseline HCC predicted greater stress exposure in the CT + IPV group compared to the CT group; HCC was not associated with stress exposure in the NTC group. The present findings highlight the potential utility of HCC as a predictor of stress exposure for women with a history of childhood abuse or neglect, particularly in the context of recent IPV. Lay summary Adults with a history of CT show long-lasting alterations in major stress response systems, including the HPA axis. They are also more likely to experience stressful life events in adulthood. However, it is not clear how altered HPA activity influences risk for stress exposure and whether CT affects their

  5. 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.

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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…

  11. 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

  12. 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

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

    Science.gov (United States)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  15. 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

  16. 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).

  17. 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...

  18. 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

  19. 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.

  20. 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...

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

    Science.gov (United States)

    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.

  2. Current and cumulative night shift work and subclinical atherosclerosis: results of the Gutenberg Health Study.

    Science.gov (United States)

    Jankowiak, S; Backé, E; Liebers, F; Schulz, A; Hegewald, J; Garthus-Niegel, S; Nübling, M; Blankenberg, S; Pfeiffer, N; Lackner, K J; Beutel, M; Blettner, M; Münzel, T; Wild, P S; Seidler, A; Letzel, S; Latza, U

    2016-11-01

    The study examines the association between exposure to current and cumulative night shift work and subclinical parameters of atherosclerosis. Participants of a population-based cohort study (the Gutenberg Health Study, N = 15,010) aged 35-64 years were examined at baseline (2007-2012). Investigations included measurements of arterial stiffness, vascular function [reactive hyperaemia (RH) index], and intima media thickness (IMT). Also, a complete job history (including up to 15 periods), occupational exposures, a variety of lifestyle, and dispositional variables were enquired. Night shift work was performed by 1071 out of 8065 currently employed individuals. The strongest association after adjustment for age, sex, job complexity level, being a manager, overtime work, and noise appeared for more than 660 night shifts within the last 10 years and a significantly increased arterial stiffness of 0.33 m/s. This reflects a 4 % flow velocity increase for individuals with more than 660 night shifts compared to non-night workers. Regarding the entire professional life, night shift workers showed a significantly decreased vascular function by -0.054 RH index points by using the same adjustment. IMT values did not differ statistically from non-night workers. Lifestyle and dispositional factors showed an influence on all used subclinical atherosclerosis parameters. The cross-sectional results demonstrate an association between night work and detrimental changes in the atherosclerotic process. The association is more pronounced with more years in night shift and is partly explained by lifestyle and dispositional factors. Longitudinal analyses are necessary to confirm the results.

  3. 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.

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

    Science.gov (United States)

    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.

  5. 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.

  6. 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...

  7. 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)

  8. Prevalence of Pterygia in Hawaii: Examining Cumulative Surfing Hours as a Risk Factor.

    Science.gov (United States)

    Lin, Alexander D; Miles, Ku'ulei; Brinks, Mitchel V

    2016-08-01

    To examine the association between surfing and pterygium prevalence in Hawaii. A convenience sampling was performed at four beaches on the island of Oahu, Hawaii. A total of 169 individuals were interviewed and underwent penlight examination to assess grade and extent of pterygium. Of 169 participants aged 18-80 years, 88 non-surfers, 41 occasional surfers, 15 recreational surfers and 25 surfing enthusiasts were identified based on their lifetime surfing hours. Overall, 19 participants were found to have pterygia (28 pterygia total) including two non-surfers (2.3%), five occasional surfers (12.2%), three recreational surfers (20.0%), and nine enthusiast surfers (36.0%). Variables associated with pterygium prevalence were lifetime surfing hours (p surfing hours as the primary explanatory variable. After adjustment for confounders, a significant linear relationship was observed between chord length and lifetime surfing hours (p = 0.01). Surfing was associated with an increased pterygium prevalence and trend towards an association with increased pterygium severity. Increased risk of exposure to wind, particle irritation, and ultraviolet (UV) radiation while surfing may contribute to pterygium development. Implications for public health include promoting UV protective eyewear during surfing, in addition to raising awareness about the association of pterygia and the sport of surfing.

  9. 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.

  10. 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)

  11. 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.

  12. Where buffalo and cattle meet: Modelling interspecific contact risk using cumulative resistant kernels

    Science.gov (United States)

    Zaneta Kaszta; Samuel A. Cushman; Claudio Sillero-Zubiri; Eleonore Wolff; Jorgelina Marino

    2018-01-01

    African buffalo the primary source of foot and mouth disease (FMD) infection for livestock in South Africa. Predicting the spatial drivers and patterns of buffalo–cattle contact risk is crucial for developing effective FMD mitigation strategies. Therefore, the goal of this study was to predict fine-scale, seasonal contact risk between cattle and buffaloes straying into...

  13. Cumulative Effects of Mothers' Risk and Promotive Factors on Daughters' Disruptive Behavior

    Science.gov (United States)

    van der Molen, Elsa; Hipwell, Alison E.; Vermeiren, Robert; Loeber, Rolf

    2012-01-01

    Little is known about the ways in which the accumulation of maternal factors increases or reduces risk for girls' disruptive behavior during preadolescence. In the current study, maternal risk and promotive factors and the severity of girls' disruptive behavior were assessed annually among girls' ages 7-12 in an urban community sample (N = 2043).…

  14. APPROACHES FOR INCORPORATING NON-CHEMICAL STRESSORS INTO CUMULATIVE RISK ASSESSMENTS

    Science.gov (United States)

    Over the past twenty years, the risk assessment paradigm has gradually shifted from an individual chemical approach to a community-based model. Inherent in community-based risk assessment is consideration of the totality of stressors affecting a defined population including both ...

  15. Children of Incarcerated Parents: Cumulative Risk and Children's Living Arrangements. JCPR Working Paper.

    Science.gov (United States)

    Johnson, Elizabeth Inez; Waldfogel, Jane

    This paper examines risk factors that exist in the lives of incarcerated parents and their children, focusing on the living arrangements of the children. It uses data from the 1997 Survey of Inmates in State and Federal Correctional Facilities to address three issues: risk factors present in the lives of incarcerated parents and their children,…

  16. Cumulative years in occupation and the risk of hip or knee osteoarthritis in men and women

    DEFF Research Database (Denmark)

    Andersen, Susan; Thygesen, Lau Caspar; Davidsen, Michael

    2012-01-01

    Occupational workload has been associated with an increased risk of osteoarthritis (OA), but only little research has been conducted among female workers. The objective of this study was to analyse if men and women in farming, construction or healthcare work have increased risk of developing OA...... of the hip or knee....

  17. 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

  18. 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/.

  19. 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.

  20. 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

  1. Occupational reproductive health risks.

    Science.gov (United States)

    Filkins, K; Kerr, M J

    1993-01-01

    The potentially harmful effects on women of certain workplace exposures are widely appreciated, and steps to control these have included legislative efforts such as right-to-know laws of well as corporate policies mandating selective restriction of fertile women, which are illegal under federal civil rights laws. This chapter reviews the various occupational health risks reproductive women face in the workplace but also considers the effects of other genetic, medical, social, infectious, and environmental factors which may be of even greater concern than most occupational factors.

  2. Establishing sitewide risk perspectives due to cumulative impacts from AB, EP, and NEPA hazard analyses

    International Nuclear Information System (INIS)

    Olinger, S.J.

    1998-06-01

    With the end of the Cold War in 1992, the mission for the Rocky Flats Environmental Technology Site (Site) was changed from production of nuclear weapon components to special nuclear materials (SNM) and waste management, accelerated cleanup, reuse and closure of the Site. This change in mission presents new hazards and risk management challenges. With today's shrinking DOE budget, a balance needs to be achieved between controlling those hazards related to SNM and waste management and interim storage, and those hazards related to accelerated closure of the Site involving deactivation, decontamination, and decommissioning (DD and D) of surplus nuclear facilities. This paper discusses how risk assessments of normal operations and potential accidents have provided insights on the risks of current operations and planned closure activities

  3. 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.

  4. Tsunami, War, and Cumulative Risk in the Lives of Sri Lankan Schoolchildren

    Science.gov (United States)

    Catani, Claudia; Gewirtz, Abigail H.; Wieling, Elizabeth; Schauer, Elizabeth; Elbert, Thomas; Neuner, Frank

    2010-01-01

    This study examines the impact of children's exposure to natural disaster against the backdrop of exposure to other traumatic events and psychosocial risks. One thousand three hundred ninety-eight Sri Lankan children aged 9-15 years were interviewed in 4 cross-sectional studies about exposure to traumatic life events related to the war, the…

  5. Multilevel Mediation: Cumulative Contextual Risk, Maternal Differential Treatment, and Children's Behavior within Families

    Science.gov (United States)

    Meunier, Jean Christophe; Boyle, Michael; O'Connor, Thomas G.; Jenkins, Jennifer M.

    2013-01-01

    This study tests the hypothesis that links between contextual risk and children's outcomes are partially explained by differential parenting. Using multi-informant measurement and including up to four children per family (M[subscript age] = 3.51, SD = 2.38) in a sample of 397 families, indirect effects (through maternal differential…

  6. 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.…

  7. Plastics and health risks.

    Science.gov (United States)

    Halden, Rolf U

    2010-01-01

    By 2010, the worldwide annual production of plastics will surpass 300 million tons. Plastics are indispensable materials in modern society, and many products manufactured from plastics are a boon to public health (e.g., disposable syringes, intravenous bags). However, plastics also pose health risks. Of principal concern are endocrine-disrupting properties, as triggered for example by bisphenol A and di-(2-ethylhexyl) phthalate (DEHP). Opinions on the safety of plastics vary widely, and despite more than five decades of research, scientific consensus on product safety is still elusive. This literature review summarizes information from more than 120 peer-reviewed publications on health effects of plastics and plasticizers in lab animals and humans. It examines problematic exposures of susceptible populations and also briefly summarizes adverse environmental impacts from plastic pollution. Ongoing efforts to steer human society toward resource conservation and sustainable consumption are discussed, including the concept of the 5 Rs--i.e., reduce, reuse, recycle, rethink, restrain--for minimizing pre- and postnatal exposures to potentially harmful components of plastics.

  8. 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

  9. Cumulative Effects of Several Target Organ Damages in Risk Assessment in Hypertension.

    Science.gov (United States)

    Harbaoui, Brahim; Courand, Pierre-Yves; Defforges, Alice; Khettab, Fouad; Milon, Hugues; Girerd, Nicolas; Lantelme, Pierre

    2016-02-01

    The prognostic value of screening multiple target organ damages (TODs) in hypertensive subjects has not been extensively studied. We estimated the prognostic value of considering 3 TODs in estimating the 10-year survival in hypertensive subjects. At baseline 1,848 out of a cohort of 1,963 hypertensive patients had a previous cardiovascular disease (CVD) or assessments of 3 TODs: Modification in Diet in Renal Disease (MDRD) 300mg/day, Sokolow index >3.5 mV, and advanced hypertensive retinopathy (grades 3 and 4 of Keith-Wagener-Barker classification). The cohort was divided into 5 groups: 0 TOD (N = 978), 1 TOD (N = 308), 2 TODs (N = 94), 3 TODs (N = 30), and previous CVD (N = 438). After 10 years of follow-up, we observed 418 deaths of which 254 from cardiovascular cause. The adjusted hazard ratios for the major cardiovascular risk factors showed a progressive risk associated with the number of TODs. For all-cause death, the hazard ratios [95% confidence intervals] vs. 0 TOD of the other 4 groups were 1.91 [1.39-2.63], 1.99 [1.28-3.10], 4.33 [2.42-7.72], and 3.09 [2.35-4.05], respectively. For cardiovascular death, the hazard ratios [95% confidence intervals] were of the same order of magnitude: 2.14 [1.38-3.32], 2.12 [1.15-3.89], 4.22 [1.83-9.72], and 4.24 [2.95-6.11], respectively. Our results indicate that hypertensive patients with several TODs had a worst outcome. Thus, it seems important to screen for multiple TODs in hypertension; especially check for severe hypertensive retinopathy in patients with left ventricular hypertrophy (LVH) and renal damage. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. 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

  11. 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 ...

  12. Probabilistic acute risk assessment of cumulative exposure to organophosphorus and carbamate pesticides from dietary vegetables and fruits in Shanghai populations.

    Science.gov (United States)

    Li, Fan; Yuan, Yaqun; Meng, Pai; Wu, Min; Li, Shuguang; Chen, Bo

    2017-05-01

    Organophosphorus pesticides (OPs) and carbamate pesticides (CPs) are among the most widely used pesticides in China, playing a major role in protecting agricultural commodities. In this study, we determined the cumulative acute exposure to OPs and CPs of Shanghai residents from vegetables and fruits (VFs). The food consumption data were obtained from the Shanghai Food Consumption Survey (SHFCS) of 2012-14 including a total of 1973 participants aged 2-90 years. The pesticide residue data were obtained from the Shanghai monitoring programme during 2008-11 with 34 organophosphates and 11 carbamates analysed in a total of 5335 samples of VFs. A probabilistic approach was performed as recommended by the EFSA, using the optimistic model with non-detects set as zero and with processing factors (PFs) being used and the pessimistic model with non-detects replaced by limit of detection (LOD) and without PFs. We used the relative potency factor (RPF) method to normalise the various pesticides to the index compound (IC) of methamidophos and chlorpyrifos separately. Only in the pessimistic model using methamidophos as the IC was there was small risk of exposure exceeding the ARfD (3 µg kg - 1 bw day - 1 ) in the populations of preschool children (0.029%), school-age children (0.022%) and adults (0.002%). There were no risk of exposure exceeding the ARfD of methamidophos in the optimistic model and of chlorpyrifos (100 µg kg - 1 bw day - 1 ) in both optimistic and pessimistic models in all three populations. Considering the Chinese habits of overwhelmingly eating processed food (vegetables being cooked, and fruits being washed or peeled), we conclude that little acute risk was found for the exposure to VF-sourced OPs and CPs in Shanghai.

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

    Science.gov (United States)

    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.

  14. 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.

  15. 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

  16. 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.

  17. 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)

  18. 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…

  19. 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

  20. 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

  1. Association between B vitamins supplementation and risk of cardiovascular outcomes: a cumulative meta-analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Chi Zhang

    Full Text Available BACKGROUND: Observational studies suggest that B vitamin supplementation reduces cardiovascular risk in adults, but this association remains controversial. This study aimed to summarize the evidence from randomized controlled trials (RCTs investigating B vitamin supplementation for the primary or secondary prevention of major adverse cardiovascular outcomes and to perform a cumulative meta-analysis to determine the evidence base. METHODOLOGY AND PRINCIPAL FINDINGS: In April 2013, we searched PubMed, Embase, and the Cochrane Library to identify relevant RCTs. We included RCTs investigating the effect of B vitamin supplementation on cardiovascular outcome. Relative risk (RR was used to measure the effect using a random-effect model. Statistical heterogeneity scores were assessed using the Q statistic. We included data on 57,952 individuals from 24 RCTs: 12 primary prevention trials and 12 secondary prevention trials. In 23 of these trials, 10,917 major adverse cardiovascular events (MACE occurred; in 20 trials, 7,203 deaths occurred; in 15 trials, 3,422 cardiac deaths occurred; in 19 trials, 3,623 myocardial infarctions (MI occurred; and in 18 trials, 2,465 strokes occurred. B vitamin supplementation had little or no effect on the incidence of MACE (RR, 0.98; 95% confidence interval [CI]: 0.93-1.03; P = 0.37, total mortality (RR, 1.01; 95% CI: 0.97-1.05; P = 0.77, cardiac death (RR, 0.96; 95% CI: 0.90-1.02; P = 0.21, MI (RR, 0.99; 95% CI: 0.93-1.06; P = 0.82, or stroke (RR, 0.94; 95% CI: 0.85-1.03; P = 0.18. CONCLUSION/SIGNIFICANCE: B vitamin supplementation, when used for primary or secondary prevention, is not associated with a reduction in MACE, total mortality, cardiac death, MI, or stroke.

  2. 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.

  3. Stigmatized Biologies: Examining the Cumulative Effects of Oral Health Disparities for Mexican American Farmworker Children

    OpenAIRE

    Horton, Sarah; Barker, Judith C.

    2010-01-01

    Severe early childhood caries (ECC) can leave lasting effects on children’s physical development, including malformed oral arches and crooked permanent dentition. This article examines the way that ECC sets up Mexican American farm worker children in the United States for lasting dental problems and social stigma as young adults. We examine the role of dietary and environmental factors in contributing to what we call “stigmatized biologies,” and that of market-based dental public health insur...

  4. Stigmatized biologies: Examining the cumulative effects of oral health disparities for Mexican American farmworker children.

    Science.gov (United States)

    Horton, Sarah; Barker, Judith C

    2010-06-01

    Severe early childhood caries (ECC) can leave lasting effects on children's physical development, including malformed oral arches and crooked permanent dentition. This article examines the way that the ECC of Mexican American farmworker children in the United States sets them up for lasting dental problems and social stigma as young adults. We examine the role of dietary and environmental factors in contributing to what we call "stigmatized biologies," and that of market-based dental public health insurance systems in cementing their enduring effects. We adapt Margaret Lock's term, local biology, to illustrate the way that biology differs not only because of culture, diet, and environment but also because of disparities in insurance coverage. By showing the long-term effects of ECC and disparate dental treatment on farmworker adults, we show how the interaction of immigrant caregiving practices and underinsurance can having lasting social effects. An examination of the long-term effects of farmworker children's ECC illustrates the ways that market-based health care systems can create embodied differences that in turn reproduce a system of social inequality.

  5. Hybrid capture 2 viral load and the 2-year cumulative risk of cervical intraepithelial neoplasia grade 3 or cancer.

    Science.gov (United States)

    Castle, Philip E; Schiffman, Mark; Wheeler, Cosette M

    2004-11-01

    The purpose of this study was to determine the clinical value of a semiquantitative measure of human papillomavirus viral load by the hybrid capture 2 assay for stratification of the risk of histologic cervical intraepithelial neoplasia grade 3 or carcinoma. The Atypical Cells of Unknown Significance and Low-Grade Squamous Intraepithelial Lesions Triage Study was a randomized clinical trial of 5060 women with 2 years of follow-up to evaluate treatment strategies for women with equivocal or mildly abnormal cervical cytologic condition. The usefulness of the continuous hybrid capture 2 output relative light units/positive controls that were above the positive threshold (1.0 relative light units/positive controls), which was a surrogate for human papillomavirus viral load, for distinguishing between hybrid capture 2 positive women who were diagnosed with cervical intraepithelial neoplasia grade 3 or carcinoma during the study from those who were not diagnosed with cervical intraepithelial neoplasia grade 3 or carcinoma was examined with the use of receiver-operator characteristic analyses. Relative light units/positive controls values did not further discriminate between hybrid capture 2 positive women with cervical intraepithelial neoplasia grade 3 or carcinoma from those with less than cervical intraepithelial neoplasia grade 3 or carcinoma. The use of a cervical intraepithelial neoplasia grade 2 or more severe or carcinoma case definition did not alter our findings. Among women with atypical cells of unknown significance or low-grade squamous intraepithelial lesion cervical cytologic findings, the hybrid capture 2 viral load measurement did not improve the detection of 2-year cumulative cases of cervical intraepithelial neoplasia grade 3 or carcinoma significantly.

  6. 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.

  7. Health Security and Risk Aversion.

    Science.gov (United States)

    Herington, Jonathan

    2016-09-01

    Health security has become a popular way of justifying efforts to control catastrophic threats to public health. Unfortunately, there has been little analysis of the concept of health security, nor the relationship between health security and other potential aims of public health policy. In this paper I develop an account of health security as an aversion to risky policy options. I explore three reasons for thinking risk avoidance is a distinctly worthwhile aim of public health policy: (i) that security is intrinsically valuable, (ii) that it is necessary for social planning and (iii) that it is an appropriate response to decision-making in contexts of very limited information. Striking the right balance between securing and maximizing population health thus requires a substantive, and hitherto unrecognized, value judgment. Finally, I critically evaluate the current health security agenda in light of this new account of the concept and its relationship to the other aims of public health policy. © 2016 John Wiley & Sons Ltd.

  8. 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.

  9. 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,…

  10. Pregnancy - health risks

    Science.gov (United States)

    ... to areas where viral or bacterial infections could affect the health of an unborn baby. Men need to be careful, too. Smoking and alcohol may cause problems with the unborn baby. Smoking, alcohol, and marijuana use have also been shown to lower sperm ...

  11. 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.

  12. The Use of the Kurtosis-Adjusted Cumulative Noise Exposure Metric in Evaluating the Hearing Loss Risk for Complex Noise.

    Science.gov (United States)

    Xie, Hong-Wei; Qiu, Wei; Heyer, Nicholas J; Zhang, Mei-Bian; Zhang, Peng; Zhao, Yi-Ming; Hamernik, Roger P

    2016-01-01

    To test a kurtosis-adjusted cumulative noise exposure (CNE) metric for use in evaluating the risk of hearing loss among workers exposed to industrial noises. Specifically, to evaluate whether the kurtosis-adjusted CNE (1) provides a better association with observed industrial noise-induced hearing loss, and (2) provides a single metric applicable to both complex (non-Gaussian [non-G]) and continuous or steady state (Gaussian [G]) noise exposures for predicting noise-induced hearing loss (dose-response curves). Audiometric and noise exposure data were acquired on a population of screened workers (N = 341) from two steel manufacturing plants located in Zhejiang province and a textile manufacturing plant located in Henan province, China. All the subjects from the two steel manufacturing plants (N = 178) were exposed to complex noise, whereas the subjects from textile manufacturing plant (N = 163) were exposed to a G continuous noise. Each subject was given an otologic examination to determine their pure-tone HTL and had their personal 8-hr equivalent A-weighted noise exposure (LAeq) and full-shift noise kurtosis statistic (which is sensitive to the peaks and temporal characteristics of noise exposures) measured. For each subject, an unadjusted and kurtosis-adjusted CNE index for the years worked was created. Multiple linear regression analysis controlling for age was used to determine the relationship between CNE (unadjusted and kurtosis adjusted) and the mean HTL at 3, 4, and 6 kHz (HTL346) among the complex noise-exposed group. In addition, each subject's HTLs from 0.5 to 8.0 kHz were age and sex adjusted using Annex A (ISO-1999) to determine whether they had adjusted high-frequency noise-induced hearing loss (AHFNIHL), defined as an adjusted HTL shift of 30 dB or greater at 3.0, 4.0, or 6.0 kHz in either ear. Dose-response curves for AHFNIHL were developed separately for workers exposed to G and non-G noise using both unadjusted and adjusted CNE as the exposure

  13. Children at health risks.

    Science.gov (United States)

    Sekar, H R

    1992-01-01

    In India, 69% of the children of the working class die, most of whom are child laborers. Economic pressure forces parents to make their children work. Employers want child workers because they can manipulate them and pay them low wages, thereby ensuring their viability. The caste system induces social inequality, inheritance invokes cultural inequality, and patriarchal socialization is responsible for gender inequality, all of which perpetuates exploitation of children by employers. In Sivakasi, an estimated 125,000 children make up the child labor force, comprising 30% of the entire labor force. 75% are from the lowest castes. 90% of child workers are girls because they are more obedient and accept even lower wages than boys, and girls need to save for their dowry. Girls often suffer verbal and physical abuse. Like their parents who were also child workers, child workers are illiterate and work long hours. A small rich elite in Sivakasi controls most of the trading and industrial capital, educational institutions, and voluntary organizations. Employers' agents give parents a loan and use their children's labor as security. Each day, they bring child workers to Sivakasi in factory buses from villages to work at least 12 hour days. They work under hazardous conditions, e.g., working with toxic chemicals. Coughing, sore throat, dizziness, methemoglobinemia, and anemia are common effects of ingestion or inhalation of chlorate dust. Inhalation of sulphur dust causes respiratory infections, eye infections, and chronic lung diseases (e.g., asthma). Fires and explosions are common risks for working children. Factory management seldom undertake fire prevention measures. An extensive survey of the problem of child labor is needed in Sivakasi before systematic planning to protect children could be done. Overall development, especially agricultural development, is needed. Parents, employers, enforcement authorities, trade unions, and social groups need to be sensitized to the

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. Cumulative trauma disorders in the upper extremities: reliability of the postural and repetitive risk-factors index.

    Science.gov (United States)

    James, C P; Harburn, K L; Kramer, J F

    1997-08-01

    This study addresses test-retest reliability of the Postural and Repetitive Risk-Factors Index (PRRI) for work-related upper body injuries. This assessment was developed by the present authors. A repeated measures design was used to assess the test-retest reliability of a videotaped work-site assessment of subjects' movements. Ten heavy users of video display terminals (VDTs) from a local banking industry participated in the study. The 10 subjects' movements were videotaped for 2 hours on each of 2 separate days, while working on-site at their VDTs. The videotaped assessment, which utilized known postural risk factors for developing musculoskeletal disorder, pain, and discomfort in heavy VDT users (ie, repetitiveness, awkward and static postures, and contraction time), was called the PRRI. The videotaped movement assessments were subsequently analyzed in 15-minute sessions (five sessions per 2-hour videotape, which produced a total of 10 sessions over the 2 testing days), and each session was chosen randomly from the videotape. The subjects' movements were given a postural risk score according to the criteria in the PRRI. Each subject was therefore tested a total of 10 times (ie, 10 sessions), over two days. The maximum PRRI score for both sides of the body was 216 points. Reliability coefficients (RCs) for the PRRI scores were calculated, and the reliability of any one session met the minimum criterion for excellent reliability, which was .75. A two-way analysis of variance (ANOVA) confirmed that there was no statistically significant difference between sessions (p < .05). Calculations using the standard error of measurement (SEM) indicated that an individual tested once, on one day and with a PRRI score of 25, required a change of at least 8 points in order to be confident that a true change in score had occurred. The significant results from the reliability tests indicated that the PRRI was a reliable measurement tool that could be used by occupational health

  19. 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.

  20. Health risks of energy technologies

    International Nuclear Information System (INIS)

    Travis, C.C.; Etnier, E.L.

    1983-01-01

    This volume examines occupational, public health, and environmental risks of the coal fuel cycle, the nuclear fuel cycle, and unconventional energy technologies. The 6 chapters explore in detail the relationship between energy economics and risk analysis, assess the problems of applying traditional cost-benefit analysis to long-term environmental problems (such as global carbon dioxide levels), and consider questions about the public's perception and acceptance of risk. Also included is an examination of the global risks associated with current and proposed levels of energy production and comsumption from all major sources. A separate abstract was prepared for each of the 6 chapters; all are included in Energy Abstracts for Policy Analysis (EAPA) and four in Energy Research Abstracts

  1. Cumulative effects of negative life events and family stress on children's mental health: the Bergen Child Study.

    Science.gov (United States)

    Bøe, Tormod; Serlachius, Anna Sofia; Sivertsen, Børge; Petrie, Keith J; Hysing, Mari

    2018-01-01

    Numerous studies have documented that lower socioeconomic status (SES) is associated with increased mental health problems in children. One proposed pathway for this association has been differential exposure to accumulated risk factors in children of lower SES. The aim of the current study was to investigate the socioeconomic distribution of exposure to negative life events and family stress and to examine the direct and interactive association between lower SES and exposure to life events and family stress in relation with mental health problems. Using cross-sectional data from the second wave of the Bergen Child Study (conducted in 2006), the current study investigated the association between lower SES and exposure to negative life events, family life stressors, and mental health problems in a sample of 2043 Norwegian 11-13 years and their parents. Information about mental health was self-reported by the children using the Strengths and Difficulties Questionnaire, whereas information about SES and exposure to negative life events and family stressors were provided by their parents. The findings showed that lower SES was associated with more symptoms of emotional-, conduct-, hyperactivity/inattention-, and peer problems and that exposure to life events and family stress explained some of this association (10-29% of the total effects). Low SES and higher prevalence of negative life events and family stressors were associated with more symptoms of mental health problems. Overall, the effect sizes were smaller than previous investigations (f 2 s = 0.015-0.031), perhaps suggesting a buffering effect of the social safety net in place in Norway.

  2. 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.

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

    OpenAIRE

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

    2014-01-01

    Background 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 ...

  4. 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

  5. The excess risk of major osteoporotic fractures in hypothyroidism is driven by cumulative hyperthyroid as opposed to hypothyroid time

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Jørgensen, Henrik L; Laulund, Anne Sofie

    2015-01-01

    was not associated with an increased risk of hip fracture (HR 0.90; 95% CI, 0.80 to 1.02) or major osteoporotic fractures (HR 0.97; 95% CI, 0.90 to 1.05), nor was subsequent thyroxine prescription predictive of increased risk of fractures. The number of subsequent 6-month periods with low TSH-suggesting excessive...

  6. 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.

  7. Health risks of passive smoking.

    Science.gov (United States)

    Papier, C M; Stellman, S D

    1986-01-01

    Passive or involuntary smoking is the inhalation of smoke which escapes directly into the air from the lit end of a burning cigarette. This unfiltered smoke contains the same toxic components of the mainstream smoke inhaled directly by the smoker, including numerous carcinogens, many in greater concentrations. It has long been known that exposure to this type of smoke leads to increased respiratory and other adverse health conditions in non-smokers, especially children. During the past five years, evidence has been accumulating that risk of lung cancer is also higher, particularly in non-smoking women whose husbands smoke. Despite uncertainties and differences in interpretation of various cancer studies, there is ample justification for public health measures now in place or proposed, such as restriction or elimination of smoking in the workplace and in public places.

  8. 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...

  9. Integrating Etiological Models of Social Anxiety and Depression in Youth: Evidence for a Cumulative Interpersonal Risk Model

    Science.gov (United States)

    Epkins, Catherine C.; Heckler, David R.

    2011-01-01

    Models of social anxiety and depression in youth have been developed separately, and they contain similar etiological influences. Given the high comorbidity of social anxiety and depression, we examine whether the posited etiological constructs are a correlate of, or a risk factor for, social anxiety and/or depression at the symptom level and the…

  10. The cumulative impact of physical activity, sleep duration, and television time on adolescent obesity: 2011 Youth Risk Behavior Survey.

    Science.gov (United States)

    Laurson, Kelly R; Lee, Joey A; Eisenmann, Joey C

    2015-03-01

    Physical activity (PA), television time (TV), and sleep duration (SLP) are considered individual risk factors for adolescent obesity. Our aim was to investigate the concurrent influence of meeting PA, SLP, and TV recommendations on adolescent obesity utilizing 2011 Youth Risk Behavior Surveillance Survey (YRBSS) data. Subjects included 9589 (4874 females) high school students. PA, SLP, and TV were categorized utilizing established national recommendations and youth were cross-tabulated into 1 of 8 groups based on meeting or not meeting each recommendation. Logistic models were used to examine the odds of obesity for each group. Youth meeting the PA recommendation were not at increased odds of obesity, regardless of SLP or TV status. However, not meeting any single recommendation, in general, led to increased odds of not meeting the other two. In boys, 11.8% met all recommendations while 14.1% met 0 recommendations. In girls, only 5.0% met all recommendations while 17.8% met none. Boys and girls not meeting any of the recommendations were 4.0 and 3.8 times more likely to be obese compared with their respective referent groups. Further research considering the simultaneous influence these risk factors may have on obesity and on one another is warranted.

  11. Editorial: The effects of early trauma and deprivation on human development - from measuring cumulative risk to characterizing specific mechanisms.

    Science.gov (United States)

    Zeanah, Charles H; Sonuga-Barke, Edmund J S

    2016-10-01

    Science is not a linear process of accumulating knowledge. To the contrary, progress in understanding is most likely to occur, especially in less 'mature' disciplines, when healthy debate between opposing points of view create a dialectic in which thesis and antithesis force a new synthesis. In developmental psychopathology, such tension between opposing schools of thought continue to play a vital role in driving discovery across a wide range of topics. © 2016 Association for Child and Adolescent Mental Health.

  12. Health risks of counterfeit pharmaceuticals.

    Science.gov (United States)

    ten Ham, Martijn

    2003-01-01

    Pharmaceutical products are not exempt from the practice of counterfeiting. In recent years, many reports have become available demonstrating the presence of fake medicines on the market. Several studies have demonstrated that they are quite often of bad quality. It is estimated that 5% of all world trade in branded goods is counterfeit, leading to huge financial losses for the pharmaceutical industry. But much more important, from a public health point of view, is that history has shown that such products may lead to a great health risk. The essence of counterfeit products and the reason they are so dangerous is the complete absence of quality control, since they are often indistinguishable from the genuine product. The existence of counterfeit drugs has long been ignored both by the pharmaceutical industry and by drug regulatory authorities. At present initiatives are being taken, nationally and internationally, to curb counterfeiting. It is now realised that a strong regulatory agency is essential, but the initiatives can only be successful if all parties concerned actively co-operate.

  13. 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.

  14. 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

  15. 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

  16. 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 ...

  17. 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.

  18. 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

  19. Cumulative increased risk of incident type 2 diabetes mellitus with increasing triglyceride glucose index in normal-weight people: The Rural Chinese Cohort Study.

    Science.gov (United States)

    Zhang, Ming; Wang, Bingyuan; Liu, Yu; Sun, Xizhuo; Luo, Xinping; Wang, Chongjian; Li, Linlin; Zhang, Lu; Ren, Yongcheng; Zhao, Yang; Zhou, Junmei; Han, Chengyi; Zhao, Jingzhi; Hu, Dongsheng

    2017-03-01

    Risk of type 2 diabetes mellitus (T2DM) is increased in metabolically obese but normal-weight people. However, we have limited knowledge of how to prevent T2DM in normal-weight people. We aimed to evaluate the association between triglyceride glucose (TyG) index and incident T2DM among normal-weight people in rural China. We included data from 5706 people with normal body mass index (BMI) (18.5-23.9 kg/m 2 ) without baseline T2DM in a rural Chinese cohort followed for a median of 6.0 years. A Cox proportional-hazard model was used to assess the risk of incident T2DM by quartiles of TyG index and difference in TyG index between follow-up and baseline (TyG-D), estimating hazard ratios (HRs) and 95% confidence intervals (CIs). A generalized additive plot was used to show the nonparametric smoothed exposure-response association between risk of T2DM and TyG index as a continuous variable. TyG was calculated as ln [fasting triglyceride level (mg/dl) × fasting plasma glucose level (mg/dl)/2]. Risk of incident T2DM was increased with quartiles 2, 3 and 4 versus quartile 1 of TyG index (adjusted HR [aHR] 2.48 [95% CI 1.20-5.11], 3.77 [1.83-7.79], and 5.30 [2.21-12.71], P trend  index). Risk of incident T2DM was increased with quartile 4 versus quartile 1 of TyG-D (aHR 3.91 [2.22-6.87]). The results were consistent when analyses were restricted to participants without baseline metabolic syndrome and impaired fasting glucose level. The generalized additive plot showed cumulative increased risk of T2DM with increasing TyG index. Risk of incident T2DM is increased with increasing TyG index among rural Chinese people, so the index might be an important indicator for identifying people at high risk of T2DM.

  20. 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.

  1. 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...

  2. 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.

  3. 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

  4. 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)

  5. 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)

  6. 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.

  7. 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)

  8. Evaluating a Health Risk Reduction Program.

    Science.gov (United States)

    Nagelberg, Daniel B.

    1981-01-01

    A health risk reduction program at Bowling Green State University (Ohio) tested the efficacy of peer education against the efficacy of returning (by mail) health questionnaire results. A peer health education program did not appear to be effective in changing student attitudes or lifestyles; however, the research methodology may not have been…

  9. 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

    2011-08-01

    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.

  10. 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.

  11. 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.

  12. 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).

  13. 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.

  14. 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.

  15. Cumulative burden of comorbid mental disorders, substance use disorders, chronic medical conditions, and poverty on health among adults in the U.S.A.

    Science.gov (United States)

    Walker, Elizabeth Reisinger; Druss, Benjamin G

    2017-07-01

    The health of individuals in the U.S.A. is increasingly being defined by complexity and multimorbidity. We examined the patterns of co-occurrence of mental illness, substance abuse/dependence, and chronic medical conditions and the cumulative burden of these conditions and living in poverty on self-rated health. We conducted a secondary data analysis using publically-available data from the National Survey on Drug Use and Health (NSDUH), which is an annual nationally-representative survey. Pooled data from the 2010-2012 NSDUH surveys included 115,921 adults 18 years of age or older. The majority of adults (52.2%) had at least one type of condition (mental illness, substance abuse/dependence, or chronic medical conditions), with substantial overlap across the conditions. 1.2%, or 2.2 million people, reported all three conditions. Generally, as the number of conditions increased, the odds of reporting worse health also increased. The likelihood of reporting fair/poor health was greatest for people who reported AMI, chronic medical conditions, and poverty (AOR = 9.41; 95% CI: 7.53-11.76), followed by all three conditions and poverty (AOR = 9.32; 95% CI: 6.67-13.02). For each combination of conditions, the addition of poverty increased the likelihood of reporting fair/poor health. Traditional conceptualizations of multimorbidity should be expanded to take into account the complexities of co-occurrence between mental illnesses, chronic medical conditions, and socioeconomic factors.

  16. Health effects of risk-assessment categories

    International Nuclear Information System (INIS)

    Kramer, C.F.; Rybicka, K.; Knutson, A.; Morris, S.C.

    1983-10-01

    Environmental and occupational health effects associated with exposures to various chemicals are a subject of increasing concern. One recently developed methodology for assessing the health impacts of various chemical compounds involves the classification of similar chemicals into risk-assessment categories (RACs). This report reviews documented human health effects for a broad range of pollutants, classified by RACs. It complements other studies that have estimated human health effects by RAC based on analysis and extrapolation of data from animal research

  17. Health effects of risk-assessment categories

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, C.F.; Rybicka, K.; Knutson, A.; Morris, S.C.

    1983-10-01

    Environmental and occupational health effects associated with exposures to various chemicals are a subject of increasing concern. One recently developed methodology for assessing the health impacts of various chemical compounds involves the classification of similar chemicals into risk-assessment categories (RACs). This report reviews documented human health effects for a broad range of pollutants, classified by RACs. It complements other studies that have estimated human health effects by RAC based on analysis and extrapolation of data from animal research.

  18. 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.

  19. Health risks associated with obesity

    African Journals Online (AJOL)

    annaline

    by three factors: first is the amount of fat, second is the distribution of fat ... The negative effects of obesity on health and cardiovascular ..... second and tenth leading causes of death in South Africa, respectively. ... Slow glucose removal rate.

  20. Health risks of alcohol use

    Science.gov (United States)

    ... depressed and have problems with anxiety and low self-esteem. Have marriages that end in divorce. Drinking too ... the first to achieve this important distinction for online health information and services. Learn more about A. ...

  1. 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 ...

  2. Revised Human Health Risk Assessment on Chlorpyrifos

    Science.gov (United States)

    We have revised our human health risk assessment and drinking water exposure assessment for chlorpyrifos that supported our October 2015 proposal to revoke all food residue tolerances for chlorpyrifos. Learn about the revised analysis.

  3. Procedures for health risk assessment in Europe

    NARCIS (Netherlands)

    Seeley, M.R.; Tonner-Navarro, L.E.; Beck, B.D.; Deskin, R.; Feron, V.J.; Johanson, G.; Bolt, H.M.

    2001-01-01

    This report compares cancer classification systems, health risk assessment approaches, and procedures used for establishing occupational exposure limits (OELs), in various European countries and scientific organizations. The objectives were to highlight and compare key aspects of these processes and

  4. Health risks associated with inhaled nasal toxicants

    NARCIS (Netherlands)

    Feron, VJ; Arts, JHE; Kuper, CF; Slootweg, PJ; Woutersen, RA

    2001-01-01

    Health risks of inhaled nasal toxicants were reviewed with emphasis on chemically induced nasal lesions in humans, sensory irritation, olfactory and trigeminal nerve toxicity, nasal immunopathology and carcinogenesis, nasal responses to chemical mixtures, in vitro models, and nasal dosimetry- and

  5. 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...

  6. The emerging threats of climate change on tropical coastal ecosystem services, public health, local economies and livelihood sustainability of small islands: Cumulative impacts and synergies.

    Science.gov (United States)

    Hernández-Delgado, E A

    2015-12-15

    Climate change has significantly impacted tropical ecosystems critical for sustaining local economies and community livelihoods at global scales. Coastal ecosystems have largely declined, threatening the principal source of protein, building materials, tourism-based revenue, and the first line of defense against storm swells and sea level rise (SLR) for small tropical islands. Climate change has also impacted public health (i.e., altered distribution and increased prevalence of allergies, water-borne, and vector-borne diseases). Rapid human population growth has exacerbated pressure over coupled social-ecological systems, with concomitant non-sustainable impacts on natural resources, water availability, food security and sovereignty, public health, and quality of life, which should increase vulnerability and erode adaptation and mitigation capacity. This paper examines cumulative and synergistic impacts of climate change in the challenging context of highly vulnerable small tropical islands. Multiple adaptive strategies of coupled social-ecological ecosystems are discussed. Multi-level, multi-sectorial responses are necessary for adaptation to be successful. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. 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.

  8. Radiation. Your health at risk

    International Nuclear Information System (INIS)

    This public information pamphlet gives a simple account of the nature of ionizing radiations and their effects on human health. Sources of radiation, both natural and man-made, to which the population may be exposed and the setting of exposure limits are discussed. The need is stressed for more research into the effects of low levels of exposure over long periods of time. The aims of the Radiation and Health Information Service and a list of organizers in European countries are given. A reading list is included. (UK)

  9. Low-frequency fields - health risk assessment

    International Nuclear Information System (INIS)

    Bernhardt, J.

    1993-01-01

    The author briefly reviews the biological actions and effects of low-frequency fields, epidemiological studies and discusses health risks in detail. He describes the assessment principles of the International Commission on Non-ionizing Radiation Protection (ICNIRP), medical principles for risk assessment, determination of limits and thesholds, and aspects of prevention. This is supplemented to by several fables and literature list. (Uhe) [de

  10. 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.

  11. 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

  12. 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.

  13. 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

  14. 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)

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. 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...

  20. [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.

  1. 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.

  2. Cumulative interpersonal traumas and social support as risk and resiliency factors in predicting PTSD and depression among inner-city women.

    Science.gov (United States)

    Schumm, Jeremiah A; Briggs-Phillips, Melissa; Hobfoll, Stevan E

    2006-12-01

    This study represents one of the largest examinations of how child abuse, adult rape, and social support impact inner-city women (N = 777). Using retrospective self-report, the effects of interpersonal trauma were shown to be cumulative such that women who experienced either child abuse or adult rape were 6 times more likely to have probable posttraumatic stress disorder (PTSD), whereas women who experienced both child abuse and rape were 17 times more likely to have probable PTSD. High social support predicted lower PTSD severity for women who experienced both child abuse and adult rape, but not for women who reported one or none of these traumas. Results suggest that social support, when left intact, might buffer the cumulative impact of child and adult interpersonal traumas.

  3. 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.

  4. The role of cumulative physical work load in lumbar spine disease: risk factors for lumbar osteochondrosis and spondylosis associated with chronic complaints

    OpenAIRE

    Seidler, A; Bolm-Audorff, U; Heiskel, H; Henkel, N; Roth-Kuver, B; Kaiser, U; Bickeboller, R; Willingstorfer, W; Beck, W; Elsner, G

    2001-01-01

    OBJECTIVES—To investigate the relation with a case-control study between symptomatic osteochondrosis or spondylosis of the lumbar spine and cumulative occupational exposure to lifting or carrying and to working postures with extreme forward bending.
METHODS—From two practices and four clinics were recruited 229 male patients with radiographically confirmed osteochondrosis or spondylosis of the lumbar spine associated with chronic complaints. Of these 135 had additionally had acute lumbar disc...

  5. Study of Effectiveness of Human Factors Engineering Interference in Cumulative Trauma Disorders Rate Decreasing in the Tehran South Health Center 2005-2006

    Directory of Open Access Journals (Sweden)

    M. Noorisepehr

    2012-04-01

    Full Text Available Introduction: Up to now accomplished many investigations about cumulative trauma disorders (CTD accession. For the most part sitting pattern and unsuitable task posture has been specified reason of these complications. In the publicized stats from a foreign source ambit of 44 percent of people who worked with computer has been afflict to the CTD's. The aim of this paper is to find and measurement of CTD and ergonomic intervention and investigation rate of this intervention's effect in the Tehran south health center. This center use paperless system. Methods: In this research Nordic questionnaire distribute between 68 persons of the center to determine CTD's. By technical expert inspection specified reason of complications. Observantly to state methods reason which create more severity and frequency CTD's has been recognized and interference with human factors engineering. For the more efficiency of interference Anthropometry has been used for all of Work stations and for any person designed a significant posture. Results: results that obtained before interference indicate that were CTD's complications at more of employees which 90 percent of them suffered of up spine pain. Also 27.4 percent of them had shoulder pain and 20.4 percent had neck pain. After the interference these measures decreased. And complaint of employee decreased 40.8 percent to up spine pain. Also for the shoulder pain it reached to 22 and neck pain 17.6 percent. With state test identified that there are significant difference between CTD after and before of intervention (p<0.005. Conclusion: Being unsuitable task posture is main cause of CTD's in the Work stations. We can prevent to increasing these complications in the work place by simple approach like adjustment in the desk and chair height, correct performance working training and doing simple exercise.

  6. Health at risk in immigration detention facilities

    Directory of Open Access Journals (Sweden)

    Ioanna Kotsioni

    2013-09-01

    Full Text Available Since 2004 Médecins Sans Frontières (MSF has provided medical and psychosocial support for asylum seekers and migrants held in different immigration detention facilities across Europe (in Greece, Malta, Italy and Belgium where the life, health and human dignity of vulnerable people are being put at risk.

  7. Assessment of Cumulative Trauma Disorder (CTD) Risk for 3 Different Tasks Constructing and Repairing Multi-Layer Insulation (MLI) Blankets, Preparing the Dough for a Pizza, and Operating the Becton-Dickinson FACSAria Flow Cytometer

    Science.gov (United States)

    Gentzler, Marc; Kline, Martin; Palmer, Andrew; Terrone, Mark

    2007-01-01

    The Cumulative Trauma Disorder (CTD) risks for three different tasks using McCauley-Bell and Badiru's (1993) formula based on task, personal, and organizational factors were examined. For the Multi-Layer Insulation (MLI) blanket task, the results showed that the task, personal, and organizational risks were at about the same level. The personal risk factors for this task were evaluated using a hypothetical female employee age 52. For the pizza dough task, it was shown that the organizational risk was particularly high, with task related factors also at quite dangerous levels. On the other hand, there was a very low level of personal risk factors, based on a female age 17. The flow cytometer task was assessed with three different participants, a11 of whom had quite disparate levels of personal risk, which slightly affected the overall CTD risk. This reveals how individual difference variables certainly need to be considered. The task and organizational risks for this task were rated at about the same moderate level. The overall CTD risk averaged across the three participants was .335, indicating some risk. Compruing across the tasks revealed that the pizza dough task created the greatest overall CTD risk by far (.568), with the MLI (.325) and flow cytometer task (.335) having some risk associated with them. Future research should look into different tasks for more of a comparison

  8. Radiation risks : the ethics of health protection

    International Nuclear Information System (INIS)

    Maxey, M.N.

    1988-01-01

    Since the inception of commercial uses of nuclear technology, radiation protection standards established by regulatory agencies have reflected moral concerns based on two assumptions: (1) that the linear, zero-threshold hypothesis derives from scientific data in radiobiology which are virtually conclusive; (2) it is morally better for public health protection to assume that any radiation exposure, no matter how small, has some harmful effect which can and ought to be prevented. In the past few years these beliefs and related assumptions have received closer scrutiny, revealing hidden reasons for regulatory selection of radiation risks as objects of paramount ethical concern, with the result that greater risks to health have escaped comparison and mitigation. Based on this scrutiny this brief paper explores two questions: Are presupposed assumptions ethically justified on grounds of scientific evidence and ethical consistency? and should moral objections claiming to invalidate comparative risk assessments be accepted or rejected?

  9. Risk assessment of integrated electronic health records.

    Science.gov (United States)

    Bjornsson, Bjarni Thor; Sigurdardottir, Gudlaug; Stefansson, Stefan Orri

    2010-01-01

    The paper describes the security concerns related to Electronic Health Records (EHR) both in registration of data and integration of systems. A description of the current state of EHR systems in Iceland is provided, along with the Ministry of Health's future vision and plans. New legislation provides the opportunity for increased integration of EHRs and further collaboration between institutions. Integration of systems, along with greater availability and access to EHR data, requires increased security awareness since additional risks are introduced. The paper describes the core principles of information security as it applies to EHR systems and data. The concepts of confidentiality, integrity, availability, accountability and traceability are introduced and described. The paper discusses the legal requirements and importance of performing risk assessment for EHR data. Risk assessment methodology according to the ISO/IEC 27001 information security standard is described with examples on how it is applied to EHR systems.

  10. 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.

  11. Emerging Radiation Health-Risk Mitigation Technologies

    International Nuclear Information System (INIS)

    Wilson, J.W.; Cucinotta, F.A.; Schimmerling, W.

    2004-01-01

    Past space missions beyond the confines of the Earth's protective magnetic field have been of short duration and protection from the effects of solar particle events was of primary concern. The extension of operational infrastructure beyond low-Earth orbit to enable routine access to more interesting regions of space will require protection from the hazards of the accumulated exposures of Galactic Cosmic Rays (GCR). There are significant challenges in providing protection from the long-duration exposure to GCR: the human risks to the exposures are highly uncertain and safety requirements places unreasonable demands in supplying sufficient shielding materials in the design. A vigorous approach to future radiation health-risk mitigation requires a triage of techniques (using biological and technical factors) and reduction of the uncertainty in radiation risk models. The present paper discusses the triage of factors for risk mitigation with associated materials issues and engineering design methods

  12. Prevalence of health risk factors among fishermen

    DEFF Research Database (Denmark)

    Frantzeskou, Elpida; Jensen, Olaf; Linos, Athena

    2014-01-01

    Background Studies have shown that fishermen have a higher mortality from cardiovascular diseases, cancer and accidents. The majority of cardiovascular disease is caused by external risk factors such as the diet, tobacco, alcohol and lack of physical activity. The purpose of this paper...... was to review the available information on the prevalence of these preventable risk factors in order to strengthen the preventive strategies. Methods A search for the last decade was done via Medline, Google and Google Scholar with the keywords "diet, tobacco, alcohol, physical exercise, overweight....... Of the Danish fishermen 25%-, 34% and 37% were obese in the 18-24, 25-44 and 45-64 years age groups. Conclusion Health risk factors among fishermen need to be highlighted and further investigated as they represent occupational risks of major impact to chronic diseases prevalence with projections to quality...

  13. 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.

  14. 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

  15. The risks of innovation in health care.

    Science.gov (United States)

    Enzmann, Dieter R

    2015-04-01

    Innovation in health care creates risks that are unevenly distributed. An evolutionary analogy using species to represent business models helps categorize innovation experiments and their risks. This classification reveals two qualitative categories: early and late diversification experiments. Early diversification has prolific innovations with high risk because they encounter a "decimation" stage, during which most experiments disappear. Participants face high risk. The few decimation survivors can be sustaining or disruptive according to Christensen's criteria. Survivors enter late diversification, during which they again expand, but within a design range limited to variations of the previous surviving designs. Late diversifications carry lower risk. The exception is when disruptive survivors "diversify," which amplifies their disruption. Health care and radiology will experience both early and late diversifications, often simultaneously. Although oversimplifying Christensen's concepts, early diversifications are likely to deliver disruptive innovation, whereas late diversifications tend to produce sustaining innovations. Current health care consolidation is a manifestation of late diversification. Early diversifications will appear outside traditional care models and physical health care sites, as well as with new science such as molecular diagnostics. They warrant attention because decimation survivors will present both disruptive and sustaining opportunities to radiology. Radiology must participate in late diversification by incorporating sustaining innovations to its value chain. Given the likelihood of disruptive survivors, radiology should seriously consider disrupting itself rather than waiting for others to do so. Disruption entails significant modifications of its value chain, hence, its business model, for which lessons may become available from the pharmaceutical industry's current simultaneous experience with early and late diversifications. Copyright

  16. Risk Analysis for Environmental Health Triage

    International Nuclear Information System (INIS)

    Bogen, K T

    2005-01-01

    The Homeland Security Act mandates development of a national, risk-based system to support planning for, response to and recovery from emergency situations involving large-scale toxic exposures. To prepare for and manage consequences effectively, planners and responders need not only to identify zones of potentially elevated individual risk, but also to predict expected casualties. Emergency response support systems now define ''consequences'' by mapping areas in which toxic chemical concentrations do or may exceed Acute Exposure Guideline Levels (AEGLs) or similar guidelines. However, because AEGLs do not estimate expected risks, current unqualified claims that such maps support consequence management are misleading. Intentionally protective, AEGLs incorporate various safety/uncertainty factors depending on scope and quality of chemical-specific toxicity data. Some of these factors are irrelevant, and others need to be modified, whenever resource constraints or exposure-scenario complexities require responders to make critical trade-off (triage) decisions in order to minimize expected casualties. AEGL-exceedance zones cannot consistently be aggregated, compared, or used to calculate expected casualties, and so may seriously misguide emergency response triage decisions. Methods and tools well established and readily available to support environmental health protection are not yet developed for chemically related environmental health triage. Effective triage decisions involving chemical risks require a new assessment approach that focuses on best estimates of likely casualties, rather than on upper plausible bounds of individual risk. If risk-based consequence management is to become a reality, federal agencies tasked with supporting emergency response must actively coordinate to foster new methods that can support effective environmental health triage

  17. 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…

  18. Dose-Response Relationship between Cumulative Occupational Lead Exposure and the Associated Health Damages: A 20-Year Cohort Study of a Smelter in China.

    Science.gov (United States)

    Wu, Yue; Gu, Jun-Ming; Huang, Yun; Duan, Yan-Ying; Huang, Rui-Xue; Hu, Jian-An

    2016-03-16

    Long-term airborne lead exposure, even below official occupational limits, has been found to cause lead poisoning at higher frequencies than expected, which suggests that China's existing occupational exposure limits should be reexamined. A retrospective cohort study was conducted on 1832 smelting workers from 1988 to 2008 in China. These were individuals who entered the plant and came into continuous contact with lead at work for longer than 3 months. The dose-response relationship between occupational cumulative lead exposure and lead poisoning, abnormal blood lead, urinary lead and erythrocyte zinc protoporphyrin (ZPP) were analyzed and the benchmark dose lower bound confidence limits (BMDLs) were calculated. Statistically significant positive correlations were found between cumulative lead dust and lead fumes exposures and workplace seniority, blood lead, urinary lead and ZPP values. A dose-response relationship was observed between cumulative lead dust or lead fumes exposure and lead poisoning (p lead dust and fumes doses were 0.68 mg-year/m³ and 0.30 mg-year/m³ for lead poisoning, respectively. The BMDLs of workplace airborne lead concentrations associated with lead poisoning were 0.02 mg/m³ and 0.01 mg/m³ for occupational exposure lead dust and lead fume, respectively. In conclusion, BMDLs for airborne lead were lower than occupational exposure limits, suggesting that the occupational lead exposure limits need re-examination and adjustment. Occupational cumulative exposure limits (OCELs) should be established to better prevent occupational lead poisoning.

  19. CUMBIN - CUMULATIVE BINOMIAL PROGRAMS

    Science.gov (United States)

    Bowerman, P. N.

    1994-01-01

    The cumulative binomial program, CUMBIN, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, CUMBIN, NEWTONP (NPO-17556), and CROSSER (NPO-17557), can be used independently of one another. CUMBIN can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. CUMBIN calculates the probability that a system of n components has at least k operating if the probability that any one operating is p and the components are independent. Equivalently, this is the reliability of a k-out-of-n system having independent components with common reliability p. CUMBIN can evaluate the incomplete beta distribution for two positive integer arguments. CUMBIN can also evaluate the cumulative F distribution and the negative binomial distribution, and can determine the sample size in a test design. CUMBIN is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. The program is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. The CUMBIN program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. CUMBIN was developed in 1988.

  20. Cumulation of light nuclei

    International Nuclear Information System (INIS)

    Baldin, A.M.; Bondarev, V.K.; Golovanov, L.B.

    1977-01-01

    Limit fragmentation of light nuclei (deuterium, helium) bombarded with 8,6 GeV/c protons was investigated. Fragments (pions, protons and deuterons) were detected within the emission angle 50-150 deg with regard to primary protons and within the pulse range 150-180 MeV/c. By the kinematics of collision of a primary proton with a target at rest the fragments observed correspond to a target mass upto 3 GeV. Thus, the data obtained correspond to teh cumulation upto the third order

  1. Health risk assessment for program managers

    International Nuclear Information System (INIS)

    Jump, R.A.; Williamson, D.S.

    1994-01-01

    This paper presents the findings of a sensitivity analysis into the independent variables that determine the levels of health risks posed by buried plutonium and americium at a typical contaminated site in an arid region. Environmental Restoration Program Managers often must make decisions concerning cleanup levels, remediation alternatives, schedules, cost estimates, etc. based upon extraordinarily safe assumptions about risk assessment calculation inputs. This study reveals to the Program Manager which variables are major drivers to the calculated levels of risk posed by transuranic radionuclides and which ones have second order effects or less. The findings of this study should indicate which inputs should be the focus of attention during negotiations with regulators and of further empirical investigation

  2. Financial risk protection from social health insurance.

    Science.gov (United States)

    Barnes, Kayleigh; Mukherji, Arnab; Mullen, Patrick; Sood, Neeraj

    2017-09-01

    This paper estimates the impact of social health insurance on financial risk by utilizing data from a natural experiment created by the phased roll-out of a social health insurance program for the poor in India. We estimate the distributional impact of insurance on of out-of-pocket costs and incorporate these results with a stylized expected utility model to compute associated welfare effects. We adjust the standard model, accounting for conditions of developing countries by incorporating consumption floors, informal borrowing, and asset selling which allow us to separate the value of financial risk reduction from consumption smoothing and asset protection. Results show that insurance reduces out-of-pocket costs, particularly in higher quantiles of the distribution. We find reductions in the frequency and amount of money borrowed for health reasons. Finally, we find that the value of financial risk reduction outweighs total per household costs of the insurance program by two to five times. Copyright © 2017. Published by Elsevier B.V.

  3. Microbiological risk assessment and public health

    International Nuclear Information System (INIS)

    Roger Skinner

    1992-01-01

    Despite the advances made in risk assessment i the past twenty years, in areas as diverse as toxicology and offshore engineering, the risk assessment approach has made little impact on those addressing the microbiological aspects of public health. In this paper the advances which have been made are discussed and the difficulties preventing the wider application of microbiological risk assessment (MRA) to public health are considered. The term microbiological risk is used here to mean the probability of contracting a disease caused by a microorganism. I intend to demonstrate that the dynamic nature of microorganisms and the unique nature of the relationship between a pathogen (a microorganism which causes disease) and its host create special challenges for those involved in MRA. Although these problems are difficult they are not intractable. Indeed in some cases partial solutions have already been found and applied. It is hoped that this paper will help stimulate further thought and consideration in a variety of disciplines so that these challenges can be met, thereby allowing MRA to fulfil its potential

  4. Microbiological risk assessment and public health

    Energy Technology Data Exchange (ETDEWEB)

    Skinner, Roger

    1992-07-01

    Despite the advances made in risk assessment i the past twenty years, in areas as diverse as toxicology and offshore engineering, the risk assessment approach has made little impact on those addressing the microbiological aspects of public health. In this paper the advances which have been made are discussed and the difficulties preventing the wider application of microbiological risk assessment (MRA) to public health are considered. The term microbiological risk is used here to mean the probability of contracting a disease caused by a microorganism. I intend to demonstrate that the dynamic nature of microorganisms and the unique nature of the relationship between a pathogen (a microorganism which causes disease) and its host create special challenges for those involved in MRA. Although these problems are difficult they are not intractable. Indeed in some cases partial solutions have already been found and applied. It is hoped that this paper will help stimulate further thought and consideration in a variety of disciplines so that these challenges can be met, thereby allowing MRA to fulfil its potential.

  5. How health risk from radiation is assessed

    International Nuclear Information System (INIS)

    Rahm-Crites, L.

    1994-07-01

    The likelihood that a dose of radiation will result in death from cancer at some future time can be estimated by multiplying the dose equivalent by a risk factor, or dose-to-risk conversion factor. Conversion factors, which are based on studies of atomic bomb survivors and others, provide approximate predictions of the health effects to be expected from a given radiological exposure. Following recommendations of the Nuclear Regulatory Commission, the Department of Energy currently uses risk conversion factors of 4 x 10 -4 (0.0004 LCFs) per person-rem for workers and 5 x 10 -4 (0.0005 LCFs) per person-rem for the general public (NRC 1991; DOE 1993). The conversion factor for general public is slightly higher than that for workers because the general public includes infants and children, who are more susceptible to cancer. The current overall death rate from cancer in the United States is between 20 and 25 percent, in other words, cancer accounts for one out of nearly every four deaths. An action affecting a population of 20,000 people, with the estimated potential to induce one latent cancer fatality, should therefore be understood as adding one death from cancer to a normally expected total of 4500. Studies dedicated to improving their ability to predict radiation health effects are constantly in progress, nationally and internationally, and risk conversion factors are periodically revised to incorporate new experimental and epidemiological information

  6. CROSSER - CUMULATIVE BINOMIAL PROGRAMS

    Science.gov (United States)

    Bowerman, P. N.

    1994-01-01

    The cumulative binomial program, CROSSER, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, CROSSER, CUMBIN (NPO-17555), and NEWTONP (NPO-17556), can be used independently of one another. CROSSER can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. CROSSER calculates the point at which the reliability of a k-out-of-n system equals the common reliability of the n components. It is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. The program is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. It also lists the number of iterations of Newton's method required to calculate the answer within the given error. The CROSSER program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. CROSSER was developed in 1988.

  7. Health risk profile of prostitutes in Dublin.

    LENUS (Irish Health Repository)

    McDonnell, R J

    1998-08-01

    This study examined the health risk profile of prostitutes in Dublin. Clinical records of all 150 new prostitutes who attended a drop-in clinic for prostitutes in Dublin city during the period 1991-1997 were reviewed. Variables examined included: age, use of injectable drugs, human immunodeficiency virus (HIV) status, hepatitis B and C status, presence of sexually transmitted disease (STD), cervical cytology. Results showed the mean age of the women was 32 years. Among those tested, 2.5% were HIV positive, 5% were hepatitis B positive, 8% were hepatitis C positive and 25% had an STD. Almost 8% were injecting drug users (IDU) with higher prevalences of HIV, hepatitis B and C compared with non-IDU (P < 0.001). The clinic has been successful in providing a health-care facility for the specific health needs of this patient cohort.

  8. Cumulative environmental effects. Summary

    International Nuclear Information System (INIS)

    2012-01-01

    This report presents a compilation of knowledge about the state of the environment and human activity in the Norwegian part of the North Sea and Skagerrak. The report gives an overview of pressures and impacts on the environment from normal activity and in the event of accidents. This is used to assess the cumulative environmental effects, which factors have most impact and where the impacts are greatest, and to indicate which problems are expected to be most serious in the future. The report is intended to provide relevant information that can be used in the management of the marine area in the future. It also provides input for the identification of environmental targets and management measures for the North Sea and Skagerrak.(Author)

  9. Cumulative environmental effects. Summary

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

    This report presents a compilation of knowledge about the state of the environment and human activity in the Norwegian part of the North Sea and Skagerrak. The report gives an overview of pressures and impacts on the environment from normal activity and in the event of accidents. This is used to assess the cumulative environmental effects, which factors have most impact and where the impacts are greatest, and to indicate which problems are expected to be most serious in the future. The report is intended to provide relevant information that can be used in the management of the marine area in the future. It also provides input for the identification of environmental targets and management measures for the North Sea and Skagerrak.(Author)

  10. From Risk factors to health resources in medical practice

    DEFF Research Database (Denmark)

    Hollnagel, Hanne; Malterud, Kirsti

    2000-01-01

    autonomy, communication, empowerment, epidemiology, general practice, healing, health resources, informed consent, preventive medicine, risk factors, salutogenesis......autonomy, communication, empowerment, epidemiology, general practice, healing, health resources, informed consent, preventive medicine, risk factors, salutogenesis...

  11. Behavioural risk factors for sexually transmitted infections and health ...

    African Journals Online (AJOL)

    Behavioural risk factors for sexually transmitted infections and health ... sharing of personal effects, malnourishment and sexual harassment. ... Development of risk reduction and appropriate sexual health interventions targeted at prevention ...

  12. 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.

  13. NEWTONP - CUMULATIVE BINOMIAL PROGRAMS

    Science.gov (United States)

    Bowerman, P. N.

    1994-01-01

    The cumulative binomial program, NEWTONP, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, NEWTONP, CUMBIN (NPO-17555), and CROSSER (NPO-17557), can be used independently of one another. NEWTONP can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. NEWTONP calculates the probably p required to yield a given system reliability V for a k-out-of-n system. It can also be used to determine the Clopper-Pearson confidence limits (either one-sided or two-sided) for the parameter p of a Bernoulli distribution. NEWTONP can determine Bayesian probability limits for a proportion (if the beta prior has positive integer parameters). It can determine the percentiles of incomplete beta distributions with positive integer parameters. It can also determine the percentiles of F distributions and the midian plotting positions in probability plotting. NEWTONP is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. NEWTONP is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. It also lists the number of iterations of Newton's method required to calculate the answer within the given error. The NEWTONP program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. NEWTONP was developed in 1988.

  14. Nanomedicine and epigenome. Possible health risks.

    Science.gov (United States)

    Smolkova, Bozena; Dusinska, Maria; Gabelova, Alena

    2017-11-01

    Nanomedicine is an emerging field that combines knowledge of nanotechnology and material science with pharmaceutical and biomedical sciences, aiming to develop nanodrugs with increased efficacy and safety. Compared to conventional therapeutics, nanodrugs manifest higher stability and circulation time, reduced toxicity and improved targeted delivery. Despite the obvious benefit, the accumulation of imaging agents and nanocarriers in the body following their therapeutic or diagnostic application generates concerns about their safety for human health. Numerous toxicology studies have demonstrated that exposure to nanomaterials (NMs) might pose serious risks to humans. Epigenetic modifications, representing a non-genotoxic mechanism of toxicant-induced health effects, are becoming recognized as playing a potential causative role in the aetiology of many diseases including cancer. This review i) provides an overview of recent advances in medical applications of NMs and ii) summarizes current evidence on their possible epigenetic toxicity. To discern potential health risks of NMs, since current data are mostly based upon in vitro and animal models, a better understanding of functional relationships between NM exposure, epigenetic deregulation and phenotype is required. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. 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...

  16. Methodology of nanotechnogy's risks analysis for health and environment

    International Nuclear Information System (INIS)

    Merkulova, I.P.

    2014-01-01

    Risk assessment is a multidisciplinary field, and an important tool for understanding and managing the potential risks from nanotechnologies. As new technologies develop, a crucial task is to understand the health and environmental impacts and to identify potential risks. (authors)

  17. 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

  18. [Health risks in the biotechnological industry].

    Science.gov (United States)

    Colombi, A; Maroni, M; Foà, V

    1989-01-01

    Biotechnology has been defined as the application of biological organisms, systems or processes to manufacturing and service industries. In considering health aspects of biotechnological development it must be underlined that the use of microorganisms in traditional industries, such as the production of food, bread, beer and dairy products, has not added significantly to the more usual industrial hazards. The risk factors encountered in the biotechnology industry can be defined as general, i.e., common to other industrial activities, and specific, i.e., depending on the presence of microorganisms and/or their metabolic products. The specific health risks vary according to the type of process, but can be grouped into three main categories: immunological diseases, toxic effects; pathological effects of microorganisms. Allergic immunological diseases such as bronchial asthma, contact dermatitis, oculo-rhinitis and extrinsic allergic alveolitis are by far the most frequent and well known diseases occurring among workers employed on biotechnological production. Toxic effects were observed among workers employed on the production of antibiotics and hormones or single cell proteins, where absorption of endotoxins has been described. Infectious diseases may arise from uncontrolled dissemination of pathogenic microorganisms through aerosols, dusts, aqueous and semisolid sludge effluents from biotechnological plants. The greatest risks occur in the production of antiviral vaccines, in research laboratories and in waste-water treatment plants. Risk of pathogenic effects has also been speculated from exposure to engineered microorganisms in laboratory and environmental or agricultural applications. Safety precautions consisting of protective measures, and effective barriers of containment (both physical and biological) have to be advised according to the hazardous characteristics of the organisms.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Examining unpriced risk heterogeneity in the Dutch health insurance market

    NARCIS (Netherlands)

    Withagen-Koster, A.A. (A. A.); R.C. van Kleef (Richard); F. Eijkenaar (Frank)

    2018-01-01

    textabstractA major challenge in regulated health insurance markets is to mitigate risk selection potential. Risk selection can occur in the presence of unpriced risk heterogeneity, which refers to predictable variation in health care spending not reflected in either premiums by insurers or risk

  20. Health risk evaluation of nitrogen oxides

    Energy Technology Data Exchange (ETDEWEB)

    Berglund, M; Ewetz, L; Gustafsson, L; Moldeus, P; Pershagen, G; Victorin, K [Karolinska Inst., Stockholm (Sweden). Inst. of Environmental Medicine

    1996-12-31

    At the request of the Swedish Environmental Protection Agency a criteria document on nitrogen oxides has been prepared, and is intended to serve as a basis for revised air quality standards in Sweden. The criteria document is based on a thorough literature survey, and the health risk assessment is summarized in this presentation. The present standard for nitrogen dioxide (NO{sub 2}) is 110 {mu}g/m{sup 3} as 1-hour mean (98th percentile); 75 {mu}g/m{sup 3} as 24- hour mean (98th percentile); and 50 {mu}g/m{sup 3} as 6-month mean (arithmetic eman during winter half-year). (author)

  1. Health risk evaluation of nitrogen oxides

    Energy Technology Data Exchange (ETDEWEB)

    Berglund, M.; Ewetz, L.; Gustafsson, L.; Moldeus, P.; Pershagen, G.; Victorin, K. [Karolinska Inst., Stockholm (Sweden). Inst. of Environmental Medicine

    1995-12-31

    At the request of the Swedish Environmental Protection Agency a criteria document on nitrogen oxides has been prepared, and is intended to serve as a basis for revised air quality standards in Sweden. The criteria document is based on a thorough literature survey, and the health risk assessment is summarized in this presentation. The present standard for nitrogen dioxide (NO{sub 2}) is 110 {mu}g/m{sup 3} as 1-hour mean (98th percentile); 75 {mu}g/m{sup 3} as 24- hour mean (98th percentile); and 50 {mu}g/m{sup 3} as 6-month mean (arithmetic eman during winter half-year). (author)

  2. Uncertainties of nanotechnology: environmental and health risks

    International Nuclear Information System (INIS)

    Delgado Ramos, Giancarlo

    2007-01-01

    The nanotechnology, as any leading edge technology, develops in the border of the unknown thing and, as such, it provokes a degree of uncertainty. On having manipulated the matter to a nanometric scale (thousand millionth of a meter), the potential risks suggest to be not only relatively unpredictable, but also imperceptible to our senses. In such a tenor, evaluating the eventual implications of the nanotechnological progress is a very complex task. And even more if we take into consideration all ethic, legal, socioeconomic, environmental and health issues. The present article evaluates studies and discourses related to promises about the use of nanostructures and their environmental impact. It also treats health impact by evaluating nanotechnology to medicine application, nano make-up and new cancer treatment.

  3. Review of health risks in acrylonitrile industry

    Energy Technology Data Exchange (ETDEWEB)

    Guirguis, S S; Cohen, M B; Rajhans, G S

    1984-05-01

    The Occupational Health Branch of the Ontario Ministry of Labour began a study in 1978 for the evaluation of health risks associated with acrylonitrile (AN) exposure. Detailed hygiene and medical investigations were conducted in fourteen plants for evaluating AN exposure in various industrial processes. For companies were also studied in relation to mixed chemical exposure representing acrylic fibres, nitrile rubber, ABS-resin, and acrylic emulsions production. The possible interaction between AN and other coexisting chemical exposures was reviewed since dimethyl formamide, styrene, and butadiene have similar pharmacokinetics and possible synergistic effects. Exposure in acrylic fibre production may be synergistic and carcinogenic. Results of air monitoring indicated exposure levels to AN below 2 ppm (TWA) in most cases. Exposure to other co-existing chemicals was evaluated. Results of medical tests indicated no significant abnormalities in chest x-rays or liver function tests in currently exposed workers.

  4. Miniature Biosensor with Health Risk Assessment Feedback

    Science.gov (United States)

    Hanson, Andrea; Downs, Meghan; Kalogera, Kent; Buxton, Roxanne; Cooper, Tommy; Cooper, Alan; Cooper, Ross

    2016-01-01

    Heart rate (HR) monitoring is a medical requirement during exercise on the International Space Station (ISS), fitness tests, and extravehicular activity (EVA); however, NASA does not currently have the technology to consistently and accurately monitor HR and other physiological data during these activities. Performance of currently available HR monitor technologies is dependent on uninterrupted contact with the torso and are prone to data drop-out and motion artifact. Here, we seek an alternative to the chest strap and electrode based sensors currently in use on ISS today. This project aims to develop a high performance, robust earbud based biosensor with focused efforts on improved HR data quality during exercise or EVA. A health risk assessment algorithm will further advance the goals of autonomous crew health care for exploration missions.

  5. 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.

  6. 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.

  7. [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.

  8. 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.

  9. Cumulative radiation effect

    International Nuclear Information System (INIS)

    Kirk, J.; Gray, W.M.; Watson, E.R.

    1977-01-01

    In five previous papers, the concept of Cumulative Radiation Effect (CRE) has been presented as a scale of accumulative sub-tolerance radiation damage, with a unique value of the CRE describing a specific level of radiation effect. Simple nomographic and tabular methods for the solution of practical problems in radiotherapy are now described. An essential feature of solving a CRE problem is firstly to present it in a concise and readily appreciated form, and, to do this, nomenclature has been introduced to describe schedules and regimes as compactly as possible. Simple algebraic equations have been derived to describe the CRE achieved by multi-schedule regimes. In these equations, the equivalence conditions existing at the junctions between schedules are not explicit and the equations are based on the CREs of the constituent schedules assessed individually without reference to their context in the regime as a whole. This independent evaluation of CREs for each schedule has resulted in a considerable simplification in the calculation of complex problems. The calculations are further simplified by the use of suitable tables and nomograms, so that the mathematics involved is reduced to simple arithmetical operations which require at the most the use of a slide rule but can be done by hand. The order of procedure in the presentation and calculation of CRE problems can be summarised in an evaluation procedure sheet. The resulting simple methods for solving practical problems of any complexity on the CRE-system are demonstrated by a number of examples. (author)

  10. Cyanobacterial toxins: risk management for health protection

    International Nuclear Information System (INIS)

    Codd, Geoffrey A.; Morrison, Louise F.; Metcalf, James S.

    2005-01-01

    This paper reviews the occurrence and properties of cyanobacterial toxins, with reference to the recognition and management of the human health risks which they may present. Mass populations of toxin-producing cyanobacteria in natural and controlled waterbodies include blooms and scums of planktonic species, and mats and biofilms of benthic species. Toxic cyanobacterial populations have been reported in freshwaters in over 45 countries, and in numerous brackish, coastal, and marine environments. The principal toxigenic genera are listed. Known sources of the families of cyanobacterial toxins (hepato-, neuro-, and cytotoxins, irritants, and gastrointestinal toxins) are briefly discussed. Key procedures in the risk management of cyanobacterial toxins and cells are reviewed, including derivations (where sufficient data are available) of tolerable daily intakes (TDIs) and guideline values (GVs) with reference to the toxins in drinking water, and guideline levels for toxigenic cyanobacteria in bathing waters. Uncertainties and some gaps in knowledge are also discussed, including the importance of exposure media (animal and plant foods), in addition to potable and recreational waters. Finally, we present an outline of steps to develop and implement risk management strategies for cyanobacterial cells and toxins in waterbodies, with recent applications and the integration of Hazard Assessment Critical Control Point (HACCP) principles

  11. REDUCTION OF CUMULATIVE CARDIOVASCULAR RISK IN PATIENTS WITH ARTERIAL HYPERTENSION: THE ROLE OF ANGIOTENSIN CONVERTING ENZYME INHIBITORS ACCORDING TO THE NEW EUROPEAN RECOMMENDATIONS

    Directory of Open Access Journals (Sweden)

    M. N. Mamedov

    2015-12-01

    Full Text Available Conception of total cardio-vascular risk plays important role in defining tactics of arterial hypertension therapy according to the new European recommendations. Choice of antihypertensive therapy is based on meta-analysis of large clinical studies with hard end points. It is recommended to use five classes of antihypertensive drugs in mono- and combined therapy. Angiotensin converting enzyme (ACE inhibitors keep important place in the therapy of arterial hypertension accompanying with risk factors and associated diseases. Enalapril is one of the widely used ACE inhibitors, its efficiency was proved in prospective clinical studies. In high risk patients monotherapy with Enam (enalapril, Dr. Reddy’s decreases blood pressure and leads to positive metabolic changes. This results in significant risk reduction of cardio-vascular complications.

  12. REDUCTION OF CUMULATIVE CARDIOVASCULAR RISK IN PATIENTS WITH ARTERIAL HYPERTENSION: THE ROLE OF ANGIOTENSIN CONVERTING ENZYME INHIBITORS ACCORDING TO THE NEW EUROPEAN RECOMMENDATIONS

    Directory of Open Access Journals (Sweden)

    M. N. Mamedov

    2007-01-01

    Full Text Available Conception of total cardio-vascular risk plays important role in defining tactics of arterial hypertension therapy according to the new European recommendations. Choice of antihypertensive therapy is based on meta-analysis of large clinical studies with hard end points. It is recommended to use five classes of antihypertensive drugs in mono- and combined therapy. Angiotensin converting enzyme (ACE inhibitors keep important place in the therapy of arterial hypertension accompanying with risk factors and associated diseases. Enalapril is one of the widely used ACE inhibitors, its efficiency was proved in prospective clinical studies. In high risk patients monotherapy with Enam (enalapril, Dr. Reddy’s decreases blood pressure and leads to positive metabolic changes. This results in significant risk reduction of cardio-vascular complications.

  13. 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.

  14. Individual and cumulative effect of prostate cancer risk-associated variants on clinicopathologic variables in 5,895 prostate cancer patients.

    Science.gov (United States)

    Kader, A Karim; Sun, Jielin; Isaacs, Sarah D; Wiley, Kathleen E; Yan, Guifang; Kim, Seong-Tae; Fedor, Helen; DeMarzo, Angelo M; Epstein, Jonathan I; Walsh, Patrick C; Partin, Alan W; Trock, Bruce; Zheng, S Lilly; Xu, Jianfeng; Isaacs, William

    2009-08-01

    More than a dozen single nucleotide polymorphisms (SNPs) have been associated with prostate cancer (PCa) risk from genome-wide association studies (GWAS). Their association with PCa aggressiveness and clinicopathologic variables is inconclusive. Twenty PCa risk SNPs implicated in GWAS and fine mapping studies were evaluated in 5,895 PCa cases treated by radical prostatectomy at Johns Hopkins Hospital, where each tumor was uniformly graded and staged using the same protocol. For 18 of the 20 SNPs examined, no statistically significant differences (P > 0.05) were observed in risk allele frequencies between patients with more aggressive (Gleason scores > or =4 + 3, or stage > or =T3b, or N+) or less aggressive disease (Gleason scores < or =3 + 4, and stage < or =T2, and N0). For the two SNPs that had significant differences between more and less aggressive disease rs2735839 in KLK3 (P = 8.4 x 10(-7)) and rs10993994 in MSMB (P = 0.046), the alleles that are associated with increased risk for PCa were more frequent in patients with less aggressive disease. Since these SNPs are known to be associated with PSA levels in men without PCa diagnoses, these latter associations may reflect the enrichment of low grade, low stage cases diagnosed by contemporary disease screening with PSA. The vast majority of PCa risk-associated SNPs are not associated with aggressiveness and clinicopathologic variables of PCa. Correspondingly, they have minimal utility in predicting the risk for developing more or less aggressive forms of PCa.

  15. Use of quantitative uncertainty analysis for human health risk assessment

    International Nuclear Information System (INIS)

    Duncan, F.L.W.; Gordon, J.W.; Kelly, M.

    1994-01-01

    Current human health risk assessment method for environmental risks typically use point estimates of risk accompanied by qualitative discussions of uncertainty. Alternatively, Monte Carlo simulations may be used with distributions for input parameters to estimate the resulting risk distribution and descriptive risk percentiles. These two techniques are applied for the ingestion of 1,1=dichloroethene in ground water. The results indicate that Monte Carlo simulations provide significantly more information for risk assessment and risk management than do point estimates

  16. Cumulative radiation effect

    International Nuclear Information System (INIS)

    Kirk, J.; Cain, O.; Gray, W.M.

    1977-01-01

    Cumulative Radiation Effect (CRE) represents a scale of accumulative sub-tolerance radiation damage, with a unique value of the CRE describing a specific level of radiation effect. Computer calculations have been used to simplify the evaluation of problems associated with the applications of the CRE-system in radiotherapy. In a general appraisal of the applications of computers to the CRE-system, the various problems encountered in clinical radiotherapy have been categorised into those involving the evaluation of a CRE at a point in tissue and those involving the calculation of CRE distributions. As a general guide, the computer techniques adopted at the Glasgow Institute of Radiotherapeutics for the solution of CRE problems are presented, and consist basically of a package of three interactive programs for point CRE calculations and a Fortran program which calculates CRE distributions for iso-effect treatment planning. Many examples are given to demonstrate the applications of these programs, and special emphasis has been laid on the problem of treating a point in tissue with different doses per fraction on alternate treatment days. The wide range of possible clinical applications of the CRE-system has been outlined and described under the categories of routine clinical applications, retrospective and prospective surveys of patient treatment, and experimental and theoretical research. Some of these applications such as the results of surveys and studies of time optimisation of treatment schedules could have far-reaching consequences and lead to significant improvements in treatment and cure rates with the minimum damage to normal tissue. (author)

  17. HPV genotype profile in a Norwegian cohort with ASC-US and LSIL cytology with three year cumulative risk of high grade cervical neoplasia.

    Science.gov (United States)

    Lie, A K; Tropé, A; Skare, G B; Bjørge, T; Jonassen, C M; Brusegard, K; Lönnberg, S

    2018-01-01

    To explore the HPVgenotype profile in Norwegian women with ASC-US/LSIL cytology and the subsequent risk of high-grade cervical neoplasia (CIN 3+). In this observational study delayed triage of ASC-US/LSIL of 6058 women were included from 2005 to 2010. High-risk HPV detection with Hybrid Capture 2 (HC2) was used and the HC2+ cases were genotyped with in-house nmPCR. Women were followed-up for histologically confirmed CIN3+ within three years of index HPV test by linkage to the screening databases at the Cancer Registry of Norway. HC2 was positive in 45% (2756/6058) of the women. Within 3years CIN3+ was diagnosed in 26% of womenrisk for CIN3+. Among older women, all 13 high-risk genotypes as single infection were associated with >20% risk of CIN3+. Further studies are necessary to risk stratify the individual genotypes to reduce the number of colposcopies in Norway. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. 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

  19. 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

  20. 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.

  1. Editorial: Lead Risk Assessment and Health Effects

    Directory of Open Access Journals (Sweden)

    Howard W. Mielke

    2016-06-01

    Full Text Available In 1980, Clair C. Patterson stated: “Sometime in the near future it probably will be shown that the older urban areas of the United States have been rendered more or less uninhabitable by the millions of tons of poisonous industrial lead residues that have accumulated in cities during the past century”. We live in the near future about which this quote expressed concern. This special volume of 19 papers explores the status of scientific evidence regarding Dr. Patterson’s statement on the habitability of the environments of communities. Authors from 10 countries describe a variety of lead issues in the context of large and small communities, smelter sites, lead industries, lead-based painted houses, and vehicle fuel treated with lead additives dispersed by traffic. These articles represent the microcosm of the larger health issues associated with lead. The challenges of lead risk require a concerted global action for primary prevention.

  2. Poor periodontal health: A cancer risk?

    Directory of Open Access Journals (Sweden)

    K S Rajesh

    2013-01-01

    Full Text Available Evidence indicates that chronic infections and inflammation are associated with increased risk of cancer development. There has also been considerable evidence that proves the interrelationship between bacterial and viral infections and carcinogenesis. Periodontitis is a chronic oral infection thought to be caused by gram-negative anaerobic bacteria in the dental biofilm. Periodontal bacteria and viruses may act synergistically to cause periodontitis. Many studies have shown that periodontal pockets may act as reservoirs for human papilloma virus, cytomegalovirus, Epstein Barr virus, and suspected agents associated with oral cancer. Periodontitis, characterized by epithelial proliferation and migration, results in a chronic release of inflammatory cytokines, chemokines, growth factors, prostaglandins, and enzymes, all of which are associated with cancer development. This review article intends to shed light on the association between periodontal health and carcinogenesis.

  3. Poor periodontal health: A cancer risk?

    Science.gov (United States)

    Rajesh, K S; Thomas, Deepak; Hegde, Shashikanth; Kumar, M S Arun

    2013-11-01

    Evidence indicates that chronic infections and inflammation are associated with increased risk of cancer development. There has also been considerable evidence that proves the interrelationship between bacterial and viral infections and carcinogenesis. Periodontitis is a chronic oral infection thought to be caused by gram-negative anaerobic bacteria in the dental biofilm. Periodontal bacteria and viruses may act synergistically to cause periodontitis. Many studies have shown that periodontal pockets may act as reservoirs for human papilloma virus, cytomegalovirus, Epstein Barr virus, and suspected agents associated with oral cancer. Periodontitis, characterized by epithelial proliferation and migration, results in a chronic release of inflammatory cytokines, chemokines, growth factors, prostaglandins, and enzymes, all of which are associated with cancer development. This review article intends to shed light on the association between periodontal health and carcinogenesis.

  4. 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...

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

    Science.gov (United States)

    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.

  6. Perceptions of health risk and smoking decisions of young people

    NARCIS (Netherlands)

    Gerking, S.D.; Khaddaria, R.

    2012-01-01

    Using the Annenberg Perception of Tobacco Risk Survey 2, this paper finds that perceived risk deters smoking among persons aged 14–22 years who think that it is relatively difficult to quit smoking and that onset of deleterious health effects occurs relatively quickly. Perceived health risk,

  7. Environmental health research in Japan - management of environmental risks

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Masahisa [Lake Biwa Research Institute (Japan)

    1997-12-31

    Briefly discussed the topics on emerging environmental health risks, their assessment and management, with special emphasis on groundwater management , environmental contamination, source protection, new drinking water and ambient water quality standards; and sophistication in instrumentation in environmental quality measurements, hazards and risk assessment and control, technology development in environmental health risk management.

  8. Potential human health risk assessment of heavy metals intake via ...

    African Journals Online (AJOL)

    Potential human health risk assessment of heavy metals intake via consumption of some leafy vegetables obtained from four market in Lagos Metropolis, Nigeria. ... This result reflected the risk associated with exposure for the period of life expectancy considered, and the inhabitants are highly exposed to health risks ...

  9. Environmental health research in Japan - management of environmental risks

    International Nuclear Information System (INIS)

    Masahisa Nakamura

    1996-01-01

    Briefly discussed the topics on emerging environmental health risks, their assessment and management, with special emphasis on groundwater management , environmental contamination, source protection, new drinking water and ambient water quality standards; and sophistication in instrumentation in environmental quality measurements, hazards and risk assessment and control, technology development in environmental health risk management

  10. Methodology for the assessment of human health risks associated ...

    African Journals Online (AJOL)

    Studies have shown that the aquatic environment can be polluted by contaminates that are accumulated by freshwater fish and this may pose a health risk to the ... bioaccumulation potential and health risks of analytes, sound sampling design, risk assessment procedures and performing monitoring at different scales and ...

  11. Cumulative Alendronate Dose and the Long-Term Absolute Risk of Subtrochanteric and Diaphyseal Femur Fractures: A Register-Based National Cohort Analysis

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Eiken, Pia Agnete; Eastell, Richard

    2010-01-01

    are currently the subject of a U.S. Food and Drug Administration review. Objective: Our objective was to examine the risk of subtrochanteric/diaphyseal femur fractures in long term users of alendronate. Design: We conducted an age- and gender-matched cohort study using national healthcare data. Patients...

  12. 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.

  13. Cadmium exposure and health risks: Recent findings

    Energy Technology Data Exchange (ETDEWEB)

    Elinder, C.G. [Huddinge Hospital (Sweden). Dept. of Renal Medicine; Jaerup, L. [Stockholm City Council (Sweden). Dept. of Environmental Health

    1996-08-01

    Environmental and/or occupational exposure to cadmium give rise to a tubular kidney dysfunction which may proceed to more generalized renal damage and bone disease if exposure has been high and prolonged. Recent scientific work shows that early renal effects develop at lower levels of exposure than previously anticipated. Previous risk assessments for cadmium were mainly based on studies on healthy male workers. The general population, however, also include particularly susceptible groups such as elderly and individuals with illnesses (e.g. diabetes) that may predispose to cadmium-induced health effects. A significant proportion of the general population displays early signs of toxicity already at urinary cadmium concentrations around 3 nmol mmol{sup -1} creatinine. In addition to early tubular effects, cadmium may exert direct or indirect effects on mineral metabolism and the mineralization of the skeleton at relatively low levels of exposure. This may have important health implications, as poor and easily fractured bone is a major problem among the elderly in all industrialized countries. 41 refs, 4 figs

  14. Cumulative psychosocial risk is a salient predictor of depressive symptoms among vertically HIV-infected and HIV-affected adolescents at the Kenyan coast

    NARCIS (Netherlands)

    Abubakar, A.A.; van de Vijver, Fons; Hassan, A. S.; Fischer, R.; Nyongesa, M. K.; Kabunda, B.; Berkley, J. A.; Stein, A.; Newton, C.R.

    2017-01-01

    BACKGROUND Little is known of mental health outcomes among vertically HIV-infected or HIVaffected adolescents in Africa. OBJECTIVES The current study set out to describe depressive symptoms and their correlates among vertically HIV-infected and HIV-affected adolescents at the Kenyan Coast. METHODS

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

    NARCIS (Netherlands)

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

    2017-01-01

    BACKGROUND: Little is known of mental health outcomes among vertically HIV-infected or HIV-affected adolescents in Africa. OBJECTIVES: The current study set out to describe depressive symptoms and their correlates among vertically HIV-infected and HIV-affected adolescents at the Kenyan Coast.

  16. Re: Could Testosterone Replacement Therapy in Hypogonadal Men Ameliorate Anemia, a Cardiovascular Risk Factor? An Observational, 54-week Cumulative Registry Study

    Directory of Open Access Journals (Sweden)

    Emre Bakırcıoğlu

    2016-09-01

    Full Text Available Testosterone deficiency syndrome may associate with erectile dysfunction, increased abdominal fat and reduced muscle mass. Low serum testosterone is also related with anemia, metabolic syndrome and cardiovascular disease. In this study, the authors investigated if testosterone undecanoate (TU reduces anemia and the risk of cardiovascular disease in patients with hypogonadism A total of 58 participants with a total testosterone level of less than 2.35 ng/ml received an injection of 1.000 mg TU 6 times; at initial visit, 6, 18, 30, 42 and 54 weeks. They observed that total testosterone and free testosterone levels were restored by TU. Hemoglobin and hematocrit levels significantly increased while anemia and total cholesterol levels significantly reduced. Although there are some limitations of this study e.g. it is not a randomized controlled and a long-term study, TU treatment in hypogonadal men decreased the prevalence of anemia, improved lipid profiles and lowered the risk of cardiovascular disease.

  17. Estimation of health risks from radiation exposures

    Energy Technology Data Exchange (ETDEWEB)

    Randolph, M.L.

    1983-08-01

    An informal presentation is given of the cancer and genetic risks from exposures to ionizing radiations. The risks from plausible radiation exposures are shown to be comparable to other commonly encountered risks.

  18. Estimation of health risks from radiation exposures

    International Nuclear Information System (INIS)

    Randolph, M.L.

    1983-08-01

    An informal presentation is given of the cancer and genetic risks from exposures to ionizing radiations. The risks from plausible radiation exposures are shown to be comparable to other commonly encountered risks

  19. 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...

  20. Relationship of Serum Vitamin D Concentrations and Allostatic Load as a Measure of Cumulative Biological Risk among the US Population: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Regina Frei

    Full Text Available The allostatic load (AL index is a multi-systemic measure of physiologic dysregulation known to be associated with chronic exposure to stress and adverse health outcomes. We examined the relationship between AL and serum 25-hydroxyvitamin D (25(OHD concentration in non-institutionalized US adults.Data from the Third National Health and Nutrition Examination Survey (NHANES III, 1988-94 were used to calculate two versions of AL including 9 biomarkers and another two with 14 biomarkers (systolic and diastolic blood pressure, pulse rate, serum cholesterol, serum HDL-cholesterol, glycated hemoglobin, sex-specific waist-to-hip ratio, serum albumin, and serum C-reactive protein for AL1, and, additionally body mass index, serum triglyceride, serum creatinine, and serum herpes I & II antibodies for AL2, each set defined by predefined cut-offs or by quartiles. Serum vitamin D concentration was ranked into quartiles. Logistic regression, Poisson regression and linear regression were used to examine the association of serum 25(OHD concentrations on AL, after adjusting for biological, physiological, socioeconomic, lifestyle, and health variables.Odds Ratios (OR for high AL of the lowest 25(OHD serum quartile were between 1.45 (95% CI: 1.28, 1.67 and 1.79 (95% CI: 1.39, 2.32 for the fully adjusted model, depending on AL version. Inverse relationships between vitamin D serum concentrations were observed for all AL versions and every adjustment. This relationship was consistent after stratification by sex, age or ethnic background. Sensitivity to low 25(OHD concentrations was highest among the youngest group (20-39 years with an OR of 2.11 (95% CI: 1.63, 2.73 for the lowest vitamin D quartile Q1.Vitamin D had a consistent and statistically significant inverse association with all tested models of high AL, which remained consistent after adjusting for biological, socioeconomic, lifestyle and health variables. Our study adds evidence linking low 25(OHD

  1. Proximity systems: Analysis of health risks; Varchi magneticianalysis of health risks

    Energy Technology Data Exchange (ETDEWEB)

    Barbaro, V.; Bartolini, P.; Donato, A. [Istituto Superiore di Sanita`, Rome (Italy). Lab. di Ingegneria Biomedica; Militello, C.; Polichetti, A.; Vecchia, P. [Istituto Superiore di Sanita`, Rome (Italy). Lab. di Fisica

    1996-03-01

    The results of a study on the magnetic fields generated by proximity systems for the controlled access of personnel are reported. Besides data from experimental measurements, the results are presented of theoretical calculations of induced currents inside the body. Health risks are also evaluated based on a comparison with the most advanced international standards. Finally, possible effects of interference with implanted pacemakers are analyzed in detail.

  2. No association between cumulative traumatic experiences and sex in risk for posttraumatic stress disorder among human immunodeficiency virus-positive adults.

    Science.gov (United States)

    Morris, Tanya; Naidoo, Pamela; Cloete, Karen J; Harvey, Justin; Seedat, Soraya

    2013-06-01

    This study examined the association between the type and number of traumatic experiences and the conditional risk for posttraumatic stress disorder (PTSD), stratified by sex, in human immunodeficiency virus (HIV). We evaluated 465 (114 male and 350 female) HIV-positive adults attending HIV clinics in Cape Town, South Africa. Demographic and clinical data were collected, and the participants were screened for current PTSD and traumatic event exposure using the Mini-International Neuropsychiatric Interview and the Life Events Checklist, respectively. The highest attributable risk for PTSD was derived from sexual assault (17.4%) and transport accidents (16.9%). Only sexual assault was significantly (p = 0.002) associated with current PTSD. Although sex had no effect on the prediction of current PTSD, HIV-infected men tended to experience more lifetime traumas than HIV-infected women, with the men having significantly higher rates of exposure than women to physical assault (p = 0.018) and assault with a weapon (p = 0.001). These data highlight the importance of considering trauma type in contributing to the burden of PTSD in HIV-infected adults.

  3. Methods to Quantify Uncertainty in Human Health Risk Assessment

    National Research Council Canada - National Science Library

    Aurelius, Lea

    1998-01-01

    ...) and other health professionals, such as the Bioenviroumental Engineer, to identify the appropriate use of probabilistic techniques for a site, and the methods by which probabilistic risk assessment...

  4. University of Washington Center for Child Environmental Health Risks Research

    Data.gov (United States)

    Federal Laboratory Consortium — The theme of the University of Washington based Center for Child Environmental Health Risks Research (CHC) is understanding the biochemical, molecular and exposure...

  5. 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…

  6. Measuring compliance of conducting an occupational health risk ...

    African Journals Online (AJOL)

    ... health risk assessment in the occupational health nurse's practice. ... A quantitative, descriptive design was used in this study. ... A self-developed questionnaire was distributed by mail and e-mail, and authors sent respondents reminders.

  7. 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...

  8. [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.

  9. Cold - an underrated risk factor for health

    International Nuclear Information System (INIS)

    Mercer, James B.

    2003-01-01

    Cardiovascular diseases (CVD) are responsible for around 20% of all deaths worldwide (approximately 14 million) and are the principal cause of death in all developed countries, accounting for 50% of all deaths. Variations in the annual per capita death rates in different countries are well documented. Less well known are seasonal variations in death rates, with the highest levels occurring during the colder winter months, which have been described in many countries. This phenomenon is referred to as excess winter mortality. CVD-related deaths account for the majority of excess winter deaths (up to 70% in some countries), while about half of the remaining are due to increases in respiratory diseases. Paradoxically, CVD mortality increases to a greater extent with a given fall in temperature in regions with warm winters. While much of the indirect evidence points to the notion that cold is somehow involved in explaining excess winter deaths, the mechanism by which seemingly mild exposure to cold ambient conditions can increase the risk of death remains unclear. The strong indirect epidemiological evidence coupling cold climate to mortality may be related to indoor rather than outdoor climatic conditions (e.g., cold/damp houses versus arm/dry houses) coupled with a plethora of factors including health status, ageing-related deterioration in physiological and behavioral thermoregulation, toxicology, and socioeconomic factors

  10. 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

  11. 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.

  12. 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

  13. Health risk assessment of exposure to ionizing radiation

    International Nuclear Information System (INIS)

    Ogata, Hiromitsu

    2011-01-01

    Risk assessment is an essential process for evaluating the human health effects of exposure to ionizing radiation and for determining acceptable levels of exposure. There are two major components of radiation risk assessment: a measure of exposure level and a measure of disease occurrence. For quantitative estimation of health risks, it is important to evaluate the association between exposure and disease occurrence using epidemiological or experimental data. In these approaches, statistical risk models are used particularly for estimating cancer risks related to exposure to low levels of radiation. This paper presents a summary of basic models and methods of risk assessment for studying exposure-risk relationships. Moreover, quantitative risk estimates are subject to several sources of uncertainty due to inherent limitations in risk assessment studies. This paper also discusses the limitations of radiation risk assessment. (author)

  14. Feeding and smoking habits as cumulative risk factors for early childhood caries in toddlers, after adjustment for several behavioral determinants: a retrospective study.

    Science.gov (United States)

    Majorana, Alessandra; Cagetti, Maria Grazia; Bardellini, Elena; Amadori, Francesca; Conti, Giulio; Strohmenger, Laura; Campus, Guglielmo

    2014-02-15

    Several maternal health determinants during the first period of life of the child, as feeding practice, smoking habit and socio-economic level, are involved in early childhood health problems, as caries development. The potential associations among early childhood caries, feeding practices, maternal and environmental smoking exposure, Socio-Economic Status (SES) and several behavioral determinants were investigated. Italian toddlers (n = 2395) aged 24-30 months were recruited and information on feeding practices, sweet dietary habit, maternal smoking habit, SES, and fluoride supplementation in the first year of life was obtained throughout a questionnaire administered to mothers. Caries lesions in toddlers were identified in visual/tactile examinations and classified using the International Caries Detection and Assessment System (ICDAS). Associations between toddlers' caries data and mothers' questionnaire data were assessed using chi-squared test. Ordinal logistic regression was used to analyze associations among caries severity level (ICDAS score), behavioral factors and SES (using mean housing price per square meter as a proxy). Caries prevalence and severity levels were significantly lower in toddlers who were exclusively breastfed and those who received mixed feeding with a moderate-high breast milk component, compared with toddlers who received low mixed feeding and those exclusively fed with formula (p smoked five or more cigarettes/day during pregnancy showed a higher caries severity level (p smoke. Environmental exposure to smoke during the first year of life was also significantly associated with caries severity (odds ratio =7.14, 95% confidence interval = 6.07-7.28). No association was observed between caries severity level and fluoride supplementation. More than 50% of toddlers belonging to families with a low SES, showed moderate or high severity caries levels (p smoke during pregnancy living in area with a low mean housing price per square meter.

  15. Perceived and calculated health risks: do the impacts differ

    International Nuclear Information System (INIS)

    Payne, B.A.; Williams, R.G.

    1986-01-01

    In many cases of radioactive and hazardous waste management, some members of the general public perceive that human health risks associated with the wastes are higher than the calculated risks. Calculated risks are projections that have been derived from models, and it is these risks that are usually used as the basis for waste management. However, for various reasons, the calculated risks are often considered by the public as too low or inappropriate. The reasons that calculated risks are not perceived as accurate and the factors that affect these perceptions are explored in this paper. Also discussed are the impacts related to the perceived and calculated health risks: what they are, and if and how they differ. The kinds of potential impacts examined are health effects, land value changes, and social, transportation, and economic effects. The paper concludes with a discussion of the implications of incorporating these different risk perspectives in decisions on waste management

  16. 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

  17. Risks, benefits, health and the food economy

    NARCIS (Netherlands)

    Kornelis, M.; Fischer, A.R.H.

    2007-01-01

    This report examines consumer attitudes and purchase behaviour towards risks and benefits of food products. Experimental approaches are used to analyse determinants of consumer risk and benefit perceptions regarding food products. The results suggest that perceptions and behaviour of consumers

  18. 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...

  19. Human health risks associated with asbestos abatement.

    Science.gov (United States)

    Chrostowski, P C; Foster, S A; Anderson, E L

    1991-09-01

    Upperbound lifetime excess cancer risks were calculated for activities associated with asbestos abatement using a risk assessment framework developed for EPA's Superfund program. It was found that removals were associated with cancer risks to workers which were often greater than the commonly accepted cancer risk of 1 x 10(-6), although lower than occupational exposure limits associated with risks of 1 x 10(-3). Removals had little effect in reducing risk to school populations. Risks to teachers and students in school buildings containing asbestos were approximately the same as risks associated with exposure to ambient asbestos by the general public and were below the levels typically of concern to regulatory agencies. During abatement, however, there were increased risks to both workers and nearby individuals. Careless, everyday building maintenance generated the greatest risk to workers followed by removals and encapsulation. If asbestos abatement was judged by the risk criteria applied to EPA's Superfund program, the no-action alternative would likely be selected in preference to removal in a majority of cases. These conclusions should only be interpreted within the context of an overall asbestos risk management program, which includes consideration of specific fiber types and sizes, sampling and analytical limitations, physical condition of asbestos-containing material, episodic peak exposures, and the number of people potentially exposed.

  20. 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.

  1. Television viewing, psychological positive health, health complaints and health risk behaviors in Spanish children and adolescents.

    Science.gov (United States)

    Padilla-Moledo, C; Castro-Piñero, J; Ortega, F B; Pulido-Martos, M; Sjöström, M; Ruiz, J R

    2015-06-01

    The aim of this study was to study the correlation of television viewing with positive and negative health in youth. The present cross-sectional study comprised a total of 680 children and adolescents aged 6-17.9 (46% girls) representative of the province of Cádiz (south Spain). We used the Health Behavior in School-aged Children questionnaire to assess television viewing, positive and negative health. It was found that correlations between television viewing >2 hours and several outcomes were inconsistent. No effects were found for quality of family relationships, quality of peer relationships, perceived academic performance and health risk behaviors in children, or with perceived excellent health status, excellent life satisfaction, quality of peer relationships, perceived academic performance and health risk behaviors in adolescents. However viewing >2 hours of television was correlated with lower quality family relations in adolescents, and lower perceived excellent health status, lower life satisfaction and higher health complaints index in children. Correction for multiple comparisons would render all television relationships as non-significant. Our results suggest that negative television influences on children and adolescents are minimal. However excessive television viewing may be symptomatic of other underlying mental health problems for some children.

  2. Risk assessment - a research program aimed at health risks from air pollution in the general environment

    International Nuclear Information System (INIS)

    Lindahl-Kiessling, K.; Ahlborg, U.; Bylin, G.; Ehrenberg, L.; Hemminki, K.; Lindell, B.; Nilsson, Robert; Bostroem, C.E.; Swarn, U.

    1991-01-01

    The paper presents a new research program for assessment of health risks caused by air pollutants. It is important to develop general methods for quantitative risk assessments and to improve the scientific base materials. (KAE)

  3. Mental health variables and sexual risk behaviour among young ...

    African Journals Online (AJOL)

    It becomes a great concern if mental health status has something to do with high sexual risk behaviour in this population. For a more specific and dynamic intervention in reducing cases of HIV and AIDS in Nigeria, the study therefore examines depression, anxiety and stress as mental health variables influencing sexual risk ...

  4. Application of epigenetic data in human health risk assessment.

    Science.gov (United States)

    Cote, Ila L; McCullough, Shaun D; Hines, Ronald N; Vandenberg, John J

    2017-11-06

    Despite the many recent advances in the field of epigenetics, application of this knowledge in environmental health risk assessment has been limited. In this paper, we identify opportunities for application of epigenetic data to support health risk assessment. We consider current applications and present a vision for the future.

  5. Health risk behaviours of high school learners and their perceptions ...

    African Journals Online (AJOL)

    Background: Adolescence spans nearly a decade in which young people may initiate health risk behaviours such as unsafe sexual practices and the use of alcohol, tobacco and other drugs (ATOD use). Most adolescent mortality and morbidity, attributable to such health risk behaviours, are preventable. Managing the ...

  6. Risk Analysis: Risk Communication: Diet, Nutrition, and Health

    NARCIS (Netherlands)

    Kleef, van E.; Verkooijen, K.T.; Frewer, L.J.

    2014-01-01

    Nutrition and food safety related diseases such as foodborne illnesses, some cancers, and obesity belong to the most challenging health concerns of our time. As a consequence, the provision of information about diet, health, and nutrition is increasing, spread rapidly by the (mass) media, including

  7. 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.

  8. Ergogenic risks elevate health risks in young athletes.

    Science.gov (United States)

    Giesemer, Bernard A

    2003-11-01

    Young athletes may use many products and techniques in an attempt to increase competitive edge in sports. The doping techniques that were previously seen in elite adult athletes are now being noted in increasingly competitive elementary, middle, and high school male and female athletes. The risk of significant morbidity and mortality associated with the use of these products is substantially increased when other risk factors are present. The risk for heat-related illness and possible heat-related mortality is higher in physiologically immature, overweight, and poorly conditioned young athletes. These are the same athletes who may be more likely to use stimulant or anabolic steroid products in attempts to catch up on training and conditioning regimens, improve their competitive advantage, or improve their physiques. The risk for heat-related incidents is higher in young athletes who are predisposed to these events because of a family trait or a previous heat-related adverse event in their own medical histories. Combinations of these factors (eg, high osmotic dietary supplements, stimulants, pre-existing medical factors, adverse ambient conditions) may significantly increase a young athlete's chances of a serious, potentially fatal event. Similarly, the risk of cardiac-related sudden death in a young athlete is significantly increased by the use of stimulants such as methamphetamine. As is the case with heat-related adverse events, the risk of cardiac-related morbidity and mortality may be significantly increased when other variables are present, such as the presence of other medications and pre-existing medical factors. As athletic competition becomes increasingly intense for younger athletes, pediatricians need to be aware of the possibility that their young patients are using ergogenic aids that may increase the risk for sudden death significantly. Pediatricians should be aware of the products available to these young competitors, and of the co-factors that

  9. Risk distribution across multiple health insurance funds in rural Tanzania

    DEFF Research Database (Denmark)

    Chomi, Eunice Nahyuha; Mujinja, Phares Gamba; Enemark, Ulrika

    2014-01-01

    cross-subsidisation across the funds. This paper analyses whether the risk distribution varies across the Community Health Fund (CHF) and National Health Insurance Fund (NHIF) in two districts in Tanzania. Specifically we aim to 1) identify risk factors associated with increased utilisation of health...... services and 2) compare the distribution of identified risk factors among the CHF, NHIF and non-member households. METHODS: Data was collected from a survey of 695 households. A multivariate logisitic regression model was used to identify risk factors for increased health care utilisation. Chi-square tests...... were performed to test whether the distribution of identified risk factors varied across the CHF, NHIF and non-member households. RESULTS: There was a higher concentration of identified risk factors among CHF households compared to those of the NHIF. Non-member households have a similar wealth status...

  10. Perceptions of health risk and smoking decisions of young people.

    Science.gov (United States)

    Gerking, Shelby; Khaddaria, Raman

    2012-07-01

    Using the Annenberg Perception of Tobacco Risk Survey 2, this paper finds that perceived risk deters smoking among persons aged 14-22 years who think that it is relatively difficult to quit smoking and that onset of deleterious health effects occurs relatively quickly. Perceived health risk, however, does not affect the smoking status of young people who hold the opposite beliefs. These results are consistent with predictions of rational addiction models and suggest that young people, who view smoking as more addictive and health effects as more immediate, may have greater incentive to consider long-term health effects in their decision to smoke. Copyright © 2011 John Wiley & Sons, Ltd.

  11. A cross-cultural longitudinal examination of the effect of cumulative adversity on the mental and physical health of older adults.

    Science.gov (United States)

    Palgi, Yuval; Shrira, Amit

    2016-03-01

    Self-oriented adversity refers to traumatic events that primarily inflict the self, whereas other-oriented adversity refers to events that affect the self by primarily targeting others. The present study aimed to examine whether cultural background moderates the effects of self-oriented and other-oriented adversity on mental and physical health of older adults. Using longitudinal data from the Israeli component of the Survey of Health and Retirement, we focused on 370 Jews and 239 Arabs who reported their exposure to various adversities across the life span, and completed questionnaires regarding mental and physical health. Results showed that the effect of self-oriented adversity on health did not differ among Jews and Arabs. However, other-oriented adversity showed a stronger effect on Arabs' mental and physical health than on Jews' health. Our findings suggest that the accumulation of adverse events that affect the self by primarily targeting others may have a stronger impact in collectivist cultures than in individualist cultures. (c) 2016 APA, all rights reserved).

  12. Occupational safety and health management and risk governance

    NARCIS (Netherlands)

    Dijkman, A.; Terwoert, J.

    2014-01-01

    The advancement in new technologies, substances and new ways of working make it necessary to look beyond traditional methods of risk management. General drivers to emerging occupational safety and health (OSH) risks are: globalisation; demographic changes; technical innovations; changes in risk

  13. Mental health and HIV sexual risk behaviour among University of ...

    African Journals Online (AJOL)

    To determine the association between mental health, substance use and HIV sexual risk behaviour among a sample of university ... analysis, HIV risk behaviour was associated with, among men, hazardous or harmful alcohol use and having screened positive for PTSD, and ..... risk behaviors among U.S. adolescents.

  14. Pathways to Health Risk Exposure in Adult Film Performers

    OpenAIRE

    Grudzen, Corita R.; Ryan, Gery; Margold, William; Torres, Jacqueline; Gelberg, Lillian

    2008-01-01

    Despite being part of a large and legal industry in Los Angeles, little is known about adult film performers’ exposure to health risks and when and how these risks might occur. The objective was to identify exposure to physical, mental, and social health risks and the pathways to such risks among adult film performers and to determine how risks differ between different types of performers, such as men and women. Semi-structured in-depth interviews were conducted with 18 female and ten male pe...

  15. Health effects and risks of radon exposure

    International Nuclear Information System (INIS)

    Cross, F.T.

    1990-01-01

    In view of the current widespread concern about the risks associated with indoor radon exposures, this paper explores the evidence on risk from human epidemiology studies, particularly in reference to EPA's 4-pCi/L action level value and from animal studies. While the EPA 4-pCi/L level has no legal force and is not a standard per se, it is becoming a de facto standard as several states are considering the level in pending legislation. Although risk can also be related to radiation dose from radon exposure, this perspective on risk is not treated in this chapter

  16. 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

  17. 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

  18. 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.

  19. Motivators and Barriers to Incorporating Climate Change-Related Health Risks in Environmental Health Impact Assessment

    OpenAIRE

    Turner, Lyle R.; Alderman, Katarzyna; Connell, Des; Tong, Shilu

    2013-01-01

    Climate change presents risks to health that must be addressed by both decision-makers and public health researchers. Within the application of Environmental Health Impact Assessment (EHIA), there have been few attempts to incorporate climate change-related health risks as an input to the framework. This study used a focus group design to examine the perceptions of government, industry and academic specialists about the suitability of assessing the health consequences of climate change within...

  20. Risks and health effects in operating room personnel

    NARCIS (Netherlands)

    van den Berg-Dijkmeijer, Marleen L.; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

    2011-01-01

    The objective was to find the factors that pose a possible health risk to OR personnel. Work-related health problems of operating room (OR) personnel were signalled by an occupational physician and preparations for the development of new Worker's Health Surveillance (WHS) were started with a

  1. Social Security Rulings on Federal Old-Age, Survivors, Disability, Health Insurance, Supplemental Security Income, and Black Lung Benefits. Cumulative Bulletin 1976.

    Science.gov (United States)

    Social Security Administration (DHEW), Washington, DC.

    The purpose of this publication is to make available to the public official rulings relating to the Federal old-age, survivors, disability, health insurance, supplemental security income, and miners' benefit programs. The rulings contain precedential case decisions, statements of policy and interpretations of the law and regulations. Included is a…

  2. Mental Health and Health Risk Behaviours of Homeless Adolescents and Youth: A Mixed Methods Study

    Science.gov (United States)

    Oppong Asante, Kwaku; Meyer-Weitz, Anna; Petersen, Inge

    2016-01-01

    Background: Homeless youth, as a vulnerable population are susceptible to various mental and health risk behaviours. However, less is known of the mental health status of these homeless youth and its role in risky sexual behaviours; neither do we understand the reasons homeless youth give for their engagement in various health risk behaviour.…

  3. 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.

  4. An economic assessment of population health risk in region

    Directory of Open Access Journals (Sweden)

    Nina Vladimirovna Zaytseva

    2012-06-01

    Full Text Available This paper proposes a method of economic assessment of population health risk as a tool of life qualitymanagement and qualityof labor resources in the region (as factors of a region’s economic security. The technique is based on the cost of reducing the period of disability in the implementation of population health risk and takes into account the effects of risk prevention on levels of the budgetary system of the Russian Federation. The method intends to support making decisions on planning measures to reduce population health risk at the level of regions, territories and separate objects to assess their cost-performance, optimization of investment and operating costs to reduce the population health risk and sustainable development of the territory

  5. Health risks of atomic bomb survivors

    International Nuclear Information System (INIS)

    Yoshimoto, Y.; Soda, M.; Mabuchi, K.

    1992-01-01

    At the Atomic Bomb Casualty Commission and its successor organization, the Radiation Effects Research Foundation, mortality and morbidity surveys have been continually carried out on about 1,800 persons exposed in utero to the atomic bombings of Hiroshima and Nagasaki. Although the effect of radiation exposure was marked enough to permit observation of a dose-response relationship in the 30 known cases of severe mental retardation among the in utero-exposed, the association between in utero exposure and cancer risk is still uncertain. Based on data for all cancers from 1950 through 1984 for the in utero-exposed, the excess risk per 10,000 person-year-Gy was 6.57 and the relative risk at 1 Gy was 3.77. For the recent years 1985-89, there was no evident excess of cancer risk. During the remaining lifetime, it seems unlikely that any great excess of leukemia will appear. As for the risk of solid tumors, further follow up is in progress. The 1950-89 findings for cancer risk among the in utero-exposed will be compared with cancer risk among A-bomb survivors who were less than 10 years old at the time of the bombings. (author)

  6. 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.

  7. Sources of uncertainty in characterizing health risks from flare emissions

    International Nuclear Information System (INIS)

    Hrudey, S.E.

    2000-01-01

    The assessment of health risks associated with gas flaring was the focus of this paper. Health risk assessments for environmental decision-making includes the evaluation of scientific data to identify hazards and to determine dose-response assessments, exposure assessments and risk characterization. Gas flaring has been the cause for public health concerns in recent years, most notably since 1996 after a published report by the Alberta Research Council. Some of the major sources of uncertainty associated with identifying hazardous contaminants in flare emissions were discussed. Methods to predict human exposures to emitted contaminants were examined along with risk characterization of predicted exposures to several identified contaminants. One of the problems is that elemental uncertainties exist regarding flare emissions which places limitations of the degree of reassurance that risk assessment can provide, but risk assessment can nevertheless offer some guidance to those responsible for flare emissions

  8. Physical Health Risk Behaviours in Young People with Mental Illness.

    Science.gov (United States)

    McCloughen, Andrea; Foster, Kim; Marabong, Nikka; Miu, David; Fethney, Judith

    2015-01-01

    Comorbid physical health conditions, commonly associated with mental illness, contribute to increased morbidity and reduced life expectancy. The trajectory to poorer health begins with the onset of mental illness. For young people with mental illness, health risk behaviours and poor physical health can progress to adulthood with long-term detrimental impacts. Using a cross-sectional survey design, self-reported health risk behaviours were gathered from 56 young (16-25 years) Australians who had been hospitalised for mental illness and taking psychotropic medication. Smoking, alcohol use, minimal physical activity, and lack of primary health care were evident. While these behaviours are typical of many young people, those with mental illness have substantially increased vulnerability to poor health and reduced life expectancy. Priority needs to be given to targeted health promotion strategies for young people with mental illness to modify their risky long-term health behaviours and improve morbidity and mortality outcomes. Nurses in mental health settings play a vital role in promoting young peoples' well-being and preventing poorer physical health outcomes. Implementation of a cardiometabolic health nurse role in inpatient settings for young people with mental illness could facilitate prevention and early intervention for health risk behaviours.

  9. Health risks for students on overseas placements.

    Science.gov (United States)

    Driver, Carolyn

    Health profession students are encouraged to take an elective during training and many do this overseas in tropical, low-income countries. Higher education institutions should offer advice and support on organising these placements but this varies and students may present for pre-travel health advice at their general practice or travel clinic. This article discusses how they should be advised.

  10. HEALTH RISK ASSESSMENT OF HEAVY METALS VIA ...

    African Journals Online (AJOL)

    runoff to the rivers is a major threat for human health that consumes ... spinach were analyzed for Fe, Zn, Cu, Pb, Cr and Cd using FAAS. Based on ... health due to their toxicity, accumulative tendencies and persistence in the environment with.

  11. 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...

  12. Risk - a symposium on the assessment and perception of risk to human health in Canada. Proceedings

    International Nuclear Information System (INIS)

    Rogers, J.T.; Bates, D.V.

    1983-04-01

    The central concern in this Symposium is with risk to human health and life. Health risk includes the possibility of deaths (mortality), either immediate or delayed, and less severe health effects due to injury and illness (morbidity). Risk is defined as the product of the magnitude and the probability so that where it may be expressed quantitatively it is stated in units of harm per unit time (e.g. deaths per year or deaths per year per million of population). The 15 papers presented at this conference discuss the measurement, analysis perception, and management of risk. Six papers judged to be in scope were indexed for INIS

  13. Mental health, stress and risk perception: insights from psychological research

    International Nuclear Information System (INIS)

    Renn, Ortwin

    1997-01-01

    Risk perceptions are only slightly correlated with the expected values of a probability distribution for negative health impacts. Psychometric studies have documented that context variables such as dread or personal control are important predictors for the perceived seriousness of risk. Studies about cultural patterns of risk perceptions emphasize different response set to risk information, depending on cultural priorities such as social justice versus personal freedom. This chapter reports the major psychological research pertaining to the factors that govern individual risk perception and discusses the psychometric effects due to people's risk perception and the experience of severe stress. The relative importance of the psychometric content variables, the signals pertaining to each health risks and symbolic beliefs are explained. (Author)

  14. 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.

  15. 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.

    Directory of Open Access Journals (Sweden)

    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

  16. Neighborhood Perceptions and Cumulative Impacts of Low Level Chronic Exposure to Fine Particular Matter (PM2.5 on Cardiopulmonary Health

    Directory of Open Access Journals (Sweden)

    Kristen M. C. Malecki

    2018-01-01

    Full Text Available Adverse perceptions of neighborhood safety, aesthetics and quality including access to resources can induce stress and may make individuals more sensitive to cardiopulmonary effects of air pollution exposure. Few studies have examined neighborhood perceptions as important and modifiable non-chemical stressors of the built environment that may exacerbate effects of air pollution on cardiopulmonary health outcomes, particularly among general population based cohorts. This study examined associations between low-level chronic exposure to fine particulate matter (PM2.5 and cardiopulmonary health, and the potential mediating or modifying effects of adverse neighborhood perceptions. Using data from the Survey of the Health of Wisconsin (SHOW, 2230 non-asthmatic adults age 21–74 were included in the analyses. The overall goals of this study were to assess if individuals who experience stress from neighborhood environments in which they live were more sensitive to low levels of fine particular matter (PM2.5 μg/m3. Demographic predictors of air pollution exposure included younger age, non-White race, lower education and middle class income. After adjustments, objective lung function measures (FEV1 and FEV1 to FVC ratio were the only cardiopulmonary health indicators significantly associated with chronic three-year annual averages of PM2.5. Among all non-asthmatics, a ten unit increase in estimated three year annual average PM2.5 exposure was significantly associated with lower forced expiratory volume (L in one second FEV1 (β = −0.40 μg/L; 95% CI −0.45, −0.06. Among all individuals, adverse perceptions of the neighborhood built environment did not appear to statistically moderate or mediate associations. However, stratified analysis did reveal significant associations between PM2.5 and lung function (FEV1 only among individuals with negative perceptions and increased reports of neighborhood stressors. These findings included individuals who

  17. Neighborhood Perceptions and Cumulative Impacts of Low Level Chronic Exposure to Fine Particular Matter (PM2.5) on Cardiopulmonary Health.

    Science.gov (United States)

    Malecki, Kristen M C; Schultz, Amy A; Bergmans, Rachel S

    2018-01-06

    Adverse perceptions of neighborhood safety, aesthetics and quality including access to resources can induce stress and may make individuals more sensitive to cardiopulmonary effects of air pollution exposure. Few studies have examined neighborhood perceptions as important and modifiable non-chemical stressors of the built environment that may exacerbate effects of air pollution on cardiopulmonary health outcomes, particularly among general population based cohorts. This study examined associations between low-level chronic exposure to fine particulate matter (PM 2.5 ) and cardiopulmonary health, and the potential mediating or modifying effects of adverse neighborhood perceptions. Using data from the Survey of the Health of Wisconsin (SHOW), 2230 non-asthmatic adults age 21-74 were included in the analyses. The overall goals of this study were to assess if individuals who experience stress from neighborhood environments in which they live were more sensitive to low levels of fine particular matter (PM 2.5 μg/m³). Demographic predictors of air pollution exposure included younger age, non-White race, lower education and middle class income. After adjustments, objective lung function measures (FEV1 and FEV1 to FVC ratio) were the only cardiopulmonary health indicators significantly associated with chronic three-year annual averages of PM 2.5 . Among all non-asthmatics, a ten unit increase in estimated three year annual average PM 2.5 exposure was significantly associated with lower forced expiratory volume (L) in one second FEV1 (β = -0.40 μg/L; 95% CI -0.45, -0.06). Among all individuals, adverse perceptions of the neighborhood built environment did not appear to statistically moderate or mediate associations. However, stratified analysis did reveal significant associations between PM 2.5 and lung function (FEV1) only among individuals with negative perceptions and increased reports of neighborhood stressors. These findings included individuals who felt their

  18. 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.

  19. Mental Health Professionals' Suicide Risk Assessment and Management Practices.

    Science.gov (United States)

    Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Mitchell, Sean M; Taylor, Nathanael J; Quinnett, Paul; Ries, Richard

    2018-01-01

    Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. The study utilized a cross-sectional design and self-report questionnaires. Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

  20. Updated Human Health Risk Analyses for Chlorpyrifos

    Science.gov (United States)

    EPA has revised the human health hazard assessment and drinking water exposure assessment for chlorpyrifos that supported our October 2015 proposal to revoke all food residue tolerances for chlorpyrifos.

  1. Behavioral Risk Factors - Vision & Eye Health

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2005-2016. In 2013 and subsequently, one question in the core of BRFSS asks about vision: Are you blind or do you have serious difficulty seeing, even when wearing...

  2. Behavioral Risk Factors - Vision & Eye Health

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2005-2015. In 2013 and subsequently, one question in the core of BRFSS asks about vision: Are you blind or do you have serious difficulty seeing, even when wearing...

  3. EO2HEAVEN: mitigating environmental health risks

    CSIR Research Space (South Africa)

    Le Rouw, Wouter J

    2013-01-01

    Full Text Available EO2HEAVEN has the primary objective to contribute to a better understanding of the complex relationships between environmental changes and their impact on human health. To achieve this, the project followed a multidisciplinary and user...

  4. Health Risk Management for Bioenvironmental Engineering

    Science.gov (United States)

    2013-06-01

    with mission objectives. Decisions that include differing objectives, knowledge, and perceptions of those affected by the decision (e.g., workplace ...factors, controlling health care costs, predicting employee absenteeism , encouraging individuals to take a proactive stance concerning personal

  5. Occupational health policies on risk assessment in Japan.

    Science.gov (United States)

    Horie, Seichi

    2010-09-01

    Industrial Safety and Health Law (ISH Law) of Japan requires abnormalities identified in evaluations of worker health and working environments are reported to occupational physicians, and employers are advised of measures to ensure appropriate accommodations in working environments and work procedures. Since the 1980s, notions of a risk assessment and occupational safety and health management system were expected to further prevent industrial accidents. In 2005, ISH Law stipulated workplace risk assessment using the wording "employers shall endeavor." Following the amendment, multiple documents and guidelines for risk assessment for different work procedures were developed. They require ISH Laws to be implemented fully and workplaces to plan and execute measures to reduce risks, ranking them from those addressing potential hazards to those requiring workers to wear protective articles. A governmental survey in 2005 found the performance of risk assessment was 20.4% and common reasons for not implementing risk assessments were lack of adequate personnel or knowledge. ISH Law specifies criminal penalties for both individuals and organizations. Moreover, under the Labor Contract Law promulgated in 2007, employers are obliged to make reasonable efforts to ensure employee health for foreseeable and avoidable risks. Therefore, enterprises neglecting even the non-binding provisions of guidelines are likely to suffer significant business impact if judged to be responsible for industrial accidents or occupational disease. To promote risk assessment, we must strengthen technical, financial, and physical support from public-service organizations, encourage the dissemination of good practices to reduce risks, and consider additional employer incentives, including relaxed mandatory regulations.

  6. 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.

  7. [Health alert management and emerging risk].

    Science.gov (United States)

    Pillonel, J

    2010-12-01

    Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  8. Health risk reduction programs in employer-sponsored health plans: Part II-law and ethics.

    Science.gov (United States)

    Rothstein, Mark A; Harrell, Heather L

    2009-08-01

    We sought to examine the legal and ethical implications of workplace health risk reduction programs (HRRPs) using health risk assessments, individually focused risk reduction, and financial incentives to promote compliance. We conducted a literature review, analyzed relevant statutes and regulations, and considered the effects of these programs on employee health privacy. A variety of laws regulate HRRPs, and there is little evidence that employer-sponsored HRRPs violate these provisions; infringement on individual health privacy is more difficult to assess. Although current laws permit a wide range of employer health promotion activities, HRRPs also may entail largely unquantifiable costs to employee privacy and related interests.

  9. Health Risk Reduction Programs in Employer-Sponsored Health Plans: Part II—Law and Ethics

    Science.gov (United States)

    Rothstein, Mark A.; Harrell, Heather L.

    2011-01-01

    Objective We sought to examine the legal and ethical implications of workplace health risk reduction programs (HRRPs) using health risk assessments, individually focused risk reduction, and financial incentives to promote compliance. Methods We conducted a literature review, analyzed relevant statutes and regulations, and considered the effects of these programs on employee health privacy. Results A variety of laws regulate HRRPs, and there is little evidence that employer-sponsored HRRPs violate these provisions; infringement on individual health privacy is more difficult to assess. Conclusion Although current laws permit a wide range of employer health promotion activities, HRRPs also may entail largely unquantifiable costs to employee privacy and related interests. PMID:19625971

  10. Health risk behaviours of high school learners and their perceptions ...

    African Journals Online (AJOL)

    their interaction with their GP in dealing with these health risk behaviours. Results: The research .... It also assisted in the layout and phrasing of the final ... The Committee for Research on Human Subjects issued a clearance certificate number ...

  11. Framework for Human Health Risk Assessment to Inform Decision Making

    Science.gov (United States)

    The purpose of this document is to describe a Framework for conducting human health risk assessments that are responsive to the needs of decision‐making processes in the U.S. Environmental Protection Agency (EPA).

  12. Mental health and HIV sexual risk behaviour among University of ...

    African Journals Online (AJOL)

    Mental health and HIV sexual risk behaviour among University of Limpopo students. ... Methods. A cross-sectional survey was conducted among undergraduate ... positive for post-traumatic stress disorder (PTSD), 22% reported hazardous or ...

  13. Wastewater Irrigation and Health: Assessing and Mitigating Risk in ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2009-12-18

    Dec 18, 2009 ... In most developing countries wastewater treatment systems have very low ... from a practical and realistic perspective, addressing the issues of health risk ... at the International Water Management Institute ( IWMI ), Sri Lanka.

  14. Human Health Toxicity Values in Superfund Risk Assessments

    Science.gov (United States)

    This memorandum revises the hierarchy of human health toxicity values generally recommended for use inr isk assessments, originally presented in Risk Assessment Guidance for Superfund Volume I, Part A.

  15. 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.

  16. 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.

  17. Communicating health risks to the public: a global perspective

    National Research Council Canada - National Science Library

    Hillier, Dawn

    2006-01-01

    ... under the Copyright, Designs and Patents Act, 1988, to be identified as the author of this work. British Library Cataloguing in Publication Data Communicating health risks to the public : a global perspective 1. Health risk communication I. Hillier, Dawn, 1950- 614.4'4 ISBN-13: 978-0-566-08672-4 ISBN-10: 0 566 08672 7 Library of Congress Cataloging-in-Publ...

  18. 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.

  19. Relative and absolute risk in epidemiology and health physics

    International Nuclear Information System (INIS)

    Goldsmith, R.; Peterson, H.T. Jr.

    1983-01-01

    The health risk from ionizing radiation commonly is expressed in two forms: (1) the relative risk, which is the percentage increase in natural disease rate and (2) the absolute or attributable risk which represents the difference between the natural rate and the rate associated with the agent in question. Relative risk estimates for ionizing radiation generally are higher than those expressed as the absolute risk. This raises the question of which risk estimator is the most appropriate under different conditions. The absolute risk has generally been used for radiation risk assessment, although mathematical combinations such as the arithmetic or geometric mean of both the absolute and relative risks, have also been used. Combinations of the two risk estimators are not valid because the absolute and relative risk are not independent variables. Both human epidemiologic studies and animal experimental data can be found to illustrate the functional relationship between the natural cancer risk and the risk associated with radiation. This implies that the radiation risk estimate derived from one population may not be appropriate for predictions in another population, unless it is adjusted for the difference in the natural disease incidence between the two populations

  20. The differential impacts of episodic, chronic, and cumulative physical bullying and cyberbullying: the effects of victimization on the school experiences, social support, and mental health of rural adolescents.

    Science.gov (United States)

    Smokowski, Paul R; Evans, Caroline B R; Cotter, Katie L

    2014-01-01

    Few studies have examined the impacts of past, current, and chronic physical bullying and cyberbullying on youth, especially in rural settings. This study augments this scant literature by exploring the school experiences, social support, and mental health outcomes for rural, middle school youth. The participants for this 2-year longitudinal study were 3,127 youth from 28 middle schools. Participants were classified as nonvictims, past victims (i.e., victimized during Year 1 but not Year 2), current victims (i.e., victimized during Year 2 but not Year 1), and chronic victims (i.e., victimized during both Year 1 and Year 2). Findings illustrated that chronic victimization resulted in the lowest levels of school satisfaction, social support, future optimism, and self-esteem. Chronic victims also reported the highest levels of school hassles, perceived discrimination, peer rejection, anxiety, depression, and externalizing behaviors. In terms of episodic victimization, current year victimization was associated with worse outcomes than past year victimization. Implications and limitations were discussed.

  1. Health-based risk neutralization in private disability insurance

    NARCIS (Netherlands)

    Wijnvoord, Elisabeth C.; Buitenhuis, Jan; Brouwer, Sandra; van der Klink, Jac J. L.; de Boer, Michiel R.

    2016-01-01

    Background: Exclusions are used by insurers to neutralize higher than average risks of sickness absence (SA). However, differentiating risk groups according to one's medical situation can be seen as discrimination against people with health problems in violation of a 2006 United Nations convention.

  2. Health-based risk neutralization in private disability insurance

    NARCIS (Netherlands)

    Wijnvoord, Elisabeth C; Buitenhuis, Jan; Brouwer, Sandra; van der Klink, Jac J L; de Boer, Michiel R

    2016-01-01

    BACKGROUND: Exclusions are used by insurers to neutralize higher than average risks of sickness absence (SA). However, differentiating risk groups according to one's medical situation can be seen as discrimination against people with health problems in violation of a 2006 United Nations convention.

  3. Incorporating Human Interindividual Biotransformation Variance in Health Risk Assessment

    Science.gov (United States)

    The protection of sensitive individuals within a population dictates that measures other than central tendencies be employed to estimate risk. The refinement of human health risk assessments for chemicals metabolized by the liver to reflect data on human variability can be accom...

  4. Substance abuse and HIV risk behaviours amongst primary health ...

    African Journals Online (AJOL)

    Substance abuse and HIV risk behaviours amongst primary health care service users in Cape Town. ... African Journal of Psychiatry ... We assessed substance use with the Alcohol, Smoking and Substance Involvement Screening Test, and HIV risk with items addressing injection drug use, blood-sharing rituals, and sexual ...

  5. Health risks associated with swimming at an inland river

    Science.gov (United States)

    Swimming exposure to fecally-contaminated oceans and lakes has been associated with an increased risk of gastrointestinal (GI) illness. Although treated and untreated sewage are often discharged to rivers, the health risks of swimming exposure on rivers has been less frequently ...

  6. Health risk behaviours among adolescent girls: A questionnaire ...

    African Journals Online (AJOL)

    Health risk behaviours among adolescent girls: A questionnaire versus the timeline follow-back procedure. ... E Africa, K van Deventer ... These risk behaviours include violence, cigarette smoking, alcohol and drug use and abuse, irresponsible sexual behaviours, unhealthy eating habits and non-physical activity. The main ...

  7. Assessment of health risks caused by air pollutants

    International Nuclear Information System (INIS)

    Nilsson, Robert.

    1991-02-01

    This report is a support document to an other report from the Swedish Environmental Protection Agency 'Risk assessment - a research programme aimed at health risks from air pollution in the general environment', report 3890, 1991 and is a survey of the scientific 'state of the art' in the different parts of risk assessment. Furthermore certain proposals are made concerning the scientific content of the future research in this area. (au)

  8. Assessing human health risk in the USDA forest service

    Energy Technology Data Exchange (ETDEWEB)

    Hamel, D.R. [Department of Agriculture-Forest Service, Washington, DC (United States)

    1990-12-31

    This paper identifies the kinds of risk assessments being done by or for the US Department of Agriculture (USDA) Forest Service. Summaries of data sources currently in use and the pesticide risk assessments completed by the agency or its contractors are discussed. An overview is provided of the agency`s standard operating procedures for the conduct of toxicological, ecological, environmental fate, and human health risk assessments.

  9. 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.

  10. Potential health risks due to telecommunications radiofrequency ...

    African Journals Online (AJOL)

    Background: The global system mobile telecommunications system (GSM) which was recently introduced in Nigeria is now being used by over 40 million people in Nigeria. The use of GSM is accompanied with exposure of the users to radiofrequency radiation (RFR), which if significant, may produce health hazards. This is ...

  11. Understanding Health Risks: Improve Your Chances for Good Health

    Science.gov (United States)

    ... raise your risk for catching the flu. Obesity boosts the odds you’ll get diabetes. Smoking increases ... They can say, ‘Tell me what’s on your mind. Do you have any questions?’” Such open conversations ...

  12. Health risk assessment for chemical exposures of military interest

    NARCIS (Netherlands)

    Langenberg, J.P.; Polhuijs, M.; Sijbranda, T.

    2016-01-01

    Participation in military operations is accompanied by health hazards resulting from exposure to chemical substances from natural and anthropogenic sources. Historically, focus on toxicological risks has been on the health effects of exposure to chemical warfare agents (CW A). In recent years the

  13. Do the health benefits of cycling outweigh the risks?

    NARCIS (Netherlands)

    de Hartog, J.J.; Boogaard, H.; Nijland, H.; Hoek, G.

    2012-01-01

    Although from a societal point of view a modal shift from car to bicycle may have beneficial health effects due to decreased air pollution emissions and increased levels of physical activity, shifts in individual adverse health effects such as higher exposure to air pollution and risk of a traffic

  14. Risk sharing between competing health plans and sponsors

    NARCIS (Netherlands)

    E.M. van Barneveld (Erik); W.P.M.M. van de Ven (Wynand); R.C.J.A. van Vliet (René)

    2001-01-01

    textabstractIn many countries, competing health plans receive capitation payments from a sponsor, whether government or a private employer. All capitation payment methods are far from perfect and have raised concerns about risk selection. Paying health plans partly on the basis

  15. 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.

  16. Radiological protection, environmental implications, health and risk management: forum

    International Nuclear Information System (INIS)

    2008-01-01

    Topics related to the radioactivity or radiation are presented. The importance of protection and security measures that are required both for public health, occupational health and the medical radiation is analyzed. In addition, it emphasizes the risks faced by professionals who work with radioactivity. Issues that confront the serious environmental implications of such activities are also showed [es

  17. A score for measuring health risk perception in environmental surveys.

    Science.gov (United States)

    Marcon, Alessandro; Nguyen, Giang; Rava, Marta; Braggion, Marco; Grassi, Mario; Zanolin, Maria Elisabetta

    2015-09-15

    In environmental surveys, risk perception may be a source of bias when information on health outcomes is reported using questionnaires. Using the data from a survey carried out in the largest chipboard industrial district in Italy (Viadana, Mantova), we devised a score of health risk perception and described its determinants in an adult population. In 2006, 3697 parents of children were administered a questionnaire that included ratings on 7 environmental issues. Items dimensionality was studied by factor analysis. After testing equidistance across response options by homogeneity analysis, a risk perception score was devised by summing up item ratings. Factor analysis identified one latent factor, which we interpreted as health risk perception, that explained 65.4% of the variance of five items retained after scaling. The scale (range 0-10, mean ± SD 9.3 ± 1.9) had a good internal consistency (Cronbach's alpha 0.87). Most subjects (80.6%) expressed maximum risk perception (score = 10). Italian mothers showed significantly higher risk perception than foreign fathers. Risk perception was higher for parents of young children, and for older parents with a higher education, than for their counterparts. Actual distance to major roads was not associated with the score, while self-reported intense traffic and frequent air refreshing at home predicted higher risk perception. When investigating health effects of environmental hazards using questionnaires, care should be taken to reduce the possibility of awareness bias at the stage of study planning and data analysis. Including appropriate items in study questionnaires can be useful to derive a measure of health risk perception, which can help to identify confounding of association estimates by risk perception. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Focus on CSIR research in water resources: CSIR’S environmental human health risk assessment

    CSIR Research Space (South Africa)

    Genthe, Bettina

    2007-08-01

    Full Text Available Environmental health risk assessment deals with risks associated with manmade and natural environmental hazards. Environmental health risk assessment provides a means of estimating the probability of adverse health effects associated with hazards...

  19. Scripts, animal health and biosecurity : The moral accountability of farmers' talk about animal health risks

    NARCIS (Netherlands)

    Enticott, Gareth; Vanclay, Frank

    2011-01-01

    This paper explores the contribution of script theory to understandings of animal health risks. Script theory has long played an important role in studies of health and risk, yet the application of script theories is often vague and confused. Theories from different ontological perspectives are

  20. Do the health benefits of cycling outweigh the risks?

    OpenAIRE

    Hartog,Jeroen Johan de; Boogaard,Hanna; Nijland,Hans; Hoek,Gerard

    2011-01-01

    BACKGROUND: Although from a societal point of view a modal shift from car to bicycle may have beneficial health effects due to decreased air pollution emissions, decreased greenhouse gas emissions, and increased levels of physical activity, shifts in individual adverse health effects such as higher exposure to air pollution and risk of a traffic accident may prevail.Objective: We describe whether the health benefits from the increased physical activity of a modal shift for urban commutes outw...

  1. Impact of the Prevention Plan on Employee Health Risk Reduction

    OpenAIRE

    Loeppke, Ronald; Edington, Dee W.; Bég, Sami

    2010-01-01

    This study evaluated the impact of The Prevention Plan™ on employee health risks after 1 year of integrated primary prevention (wellness and health promotion) and secondary prevention (biometric and lab screening as well as early detection) interventions. The Prevention Plan is an innovative prevention benefit that provides members with the high-tech/high-touch support and encouragement they need to adopt healthy behaviors. Support services include 24/7 nurse hotlines, one-on-one health coach...

  2. A computerized program to educate adults about environmental health risks

    International Nuclear Information System (INIS)

    Adams, M.; Dewey, J.; Schur, P.

    1993-01-01

    A computerized program called Environmental Risk Appraisal (ERA) has been developed to educate adults about environmental health risks and to motivate positive behavior change. A questionnaire addresses issues such as radon, environmental tobacco smoke, pesticides, lead, air and water pollution, and work-site risks. Responses are computer processed in seconds to produce an individualized computer printout containing a score, educational messages, and phone numbers to call for more information. A variety of audiences including environmental groups, worksites, women's organizations and health professionals were represented in this study of 269 participants. Many respondents indicated they were exposed to important environmental hazards and nearly 40 percent reported they had, or might have had, an environmental related illness at some time. Preliminary evaluation indicates the program is effective as an educational tool in raising awareness of environmental health risks

  3. Health risk assessment of groundwater arsenic pollution in southern Taiwan.

    Science.gov (United States)

    Liang, Ching-Ping; Wang, Sheng-Wei; Kao, Yu-Hsuan; Chen, Jui-Sheng

    2016-12-01

    Residents of the Pingtung Plain, Taiwan, use groundwater for drinking. However, monitoring results showed that a considerable portion of groundwater has an As concentration higher than the safe drinking water regulation of 10 μg/L. Considering residents of the Pingtung Plain continue to use groundwater for drinking, this study attempted to evaluate the exposure and health risk from drinking groundwater. The health risk from drinking groundwater was evaluated based on the hazard quotient (HQ) and target risk (TR) established by the US Environmental Protection Agency. The results showed that the 95th percentile of HQ exceeded 1 and TR was above the safe value of threshold value of 10 -6 . To illustrate significant variability of the drinking water consumption rate and body weight of each individual, health risk assessments were also performed using a spectrum of daily water intake rate and body weight to reasonably and conservatively assess the exposure and health risk for the specific subgroups of population of the Pingtung Plain. The assessment results showed that 0.01-7.50 % of the population's HQ levels are higher than 1 and as much as 77.7-93.3 % of the population being in high cancer risk category and having a TR value >10 -6 . The TR estimation results implied that groundwater use for drinking purpose places people at risk of As exposure. The government must make great efforts to provide safe drinking water for residents of the Pingtung Plain.

  4. Dynamical tendencies of health consequences caused by competitive risk factors

    International Nuclear Information System (INIS)

    Bykov, A.A.; Pronina, I.A.; Kudriavtsev, G.I.

    2000-01-01

    The paper deals with the generalized probabilistic approach for analyzing health consequences caused by various exposure factors. Formally basing on the competitive risk theory, it is introduced a general risk model for analysis the influence of environmental risk factors to human health. The usefulness of the model approach is in the opportunity of taking into account: time delay of impact and consequence manifestation; easy comparisons of exposure factors with different nature and various consequences (morbidity and mortality, carcinogenic and genetic); social and environmental components in overall mortality. Preliminary examples of comparative risk analysis are demonstrated on the Russian demography and environmental data with the attempt of characterizing the dynamical tendencies and evolution of introduced risk index. The prospects of the probabilistic approach and the results obtaining on this basis are discussed. (author)

  5. Human health risk assessment of trichloroethylene from industrial complex a.

    Science.gov (United States)

    Sin, Saemi; Byeon, Sang-Hoon

    2012-09-01

    This study investigated the human health risks of trichloroethylene from Industrial Complex A. The excessive carcinogenic risks for central tendency exposure were 1.40 × 10(?5) for male and female residents in the vicinity of Industrial Complex A. The excessive cancers risk for reasonable maximum exposure were 2.88 × 10(?5) and 1.97 × 10(?5) for males and females, respectively. These values indicate that there are potential cancer risks for exposure to these concentrations. The hazard index for central tendency exposure to trichloroethylene was 1.71 for male and female residents. The hazard indexes for reasonable maximum exposure were 3.27 and 2.41 for males and females, respectively. These values were over one, which is equivalent to the threshold value. This result showed that adverse cancer and non-cancer health effects may occur and that some risk management of trichloroethylene from Industrial Complex A was needed.

  6. 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.

  7. Radiation and health. Benefit and risks

    International Nuclear Information System (INIS)

    Kiefer, Juergen

    2012-01-01

    The book on radiation and health covers the following topics: The world of radiation and waves; a sight into biology; if radiation hits the body; a sight into the internal radiation diagnostics; radiation hazards; the not always beloved sun; mobile phones, microwave ovens and power poles; healing with and due to radiation; radiation and food; radiation in the environment; generation and interactions of radiation in more detail; radiation effects in the cell - closer insight; radiation doses and measurement; epidemiology and its pitfalls; the system of radiation protection radiation accidents.

  8. Nanoparticles – known and unknown health risks

    Directory of Open Access Journals (Sweden)

    Brüske-Hohlfeld Irene

    2004-12-01

    Full Text Available Abstract Manmade nanoparticles range from the well-established multi-ton production of carbon black and fumed silica for applications in plastic fillers and car tyres to microgram quantities of fluorescent quantum dots used as markers in biological imaging. As nano-sciences are experiencing massive investment worldwide, there will be a further rise in consumer products relying on nanotechnology. While benefits of nanotechnology are widely publicised, the discussion of the potential effects of their widespread use in the consumer and industrial products are just beginning to emerge. This review provides comprehensive analysis of data available on health effects of nanomaterials.

  9. Self-rated health and cancer risk

    DEFF Research Database (Denmark)

    Roelsgaard, Ida Kristiane; Olesen, Anne Marie; Simonsen, Mette Kildevæld

    2016-01-01

    BACKGROUND: Self-rated health (SRH) has been shown to be a strong predictor of mortality from a number of major chronic diseases, however, the association with cancer remains unclear. The aim of this study was to investigate a possible association between change in SRH and cancer incidence...... proportional hazards model with adjustment for age, smoking, alcohol, marital status, physical activity, body mass index and estrogen replacement therapy. RESULTS: No significant association was found between SRH and overall cancer incidence in the age-adjusted Cox proportional hazards model (1.04; 95% CI 0...

  10. 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.

  11. Human Health Risk Assessment of Trichloroethylene from Industrial Complex A

    OpenAIRE

    Sin, Saemi; Byeon, Sang-Hoon

    2012-01-01

    This study investigated the human health risks of trichloroethylene from Industrial Complex A. The excessive carcinogenic risks for central tendency exposure were 1.40 ? 10?5 for male and female residents in the vicinity of Industrial Complex A. The excessive cancers risk for reasonable maximum exposure were 2.88 ? 10?5 and 1.97 ? 10?5 for males and females, respectively. These values indicate that there are potential cancer risks for exposure to these concentrations. The hazard index for cen...

  12. Developing Hydrogeological Site Characterization Strategies based on Human Health Risk

    Science.gov (United States)

    de Barros, F.; Rubin, Y.; Maxwell, R. M.

    2013-12-01

    In order to provide better sustainable groundwater quality management and minimize the impact of contamination in humans, improved understanding and quantification of the interaction between hydrogeological models, geological site information and human health are needed. Considering the joint influence of these components in the overall human health risk assessment and the corresponding sources of uncertainty aid decision makers to better allocate resources in data acquisition campaigns. This is important to (1) achieve remediation goals in a cost-effective manner, (2) protect human health and (3) keep water supplies clean in order to keep with quality standards. Such task is challenging since a full characterization of the subsurface is unfeasible due to financial and technological constraints. In addition, human exposure and physiological response to contamination are subject to uncertainty and variability. Normally, sampling strategies are developed with the goal of reducing uncertainty, but less often they are developed in the context of their impacts on the overall system uncertainty. Therefore, quantifying the impact from each of these components (hydrogeological, behavioral and physiological) in final human health risk prediction can provide guidance for decision makers to best allocate resources towards minimal prediction uncertainty. In this presentation, a multi-component human health risk-based framework is presented which allows decision makers to set priorities through an information entropy-based visualization tool. Results highlight the role of characteristic length-scales characterizing flow and transport in determining data needs within an integrated hydrogeological-health framework. Conditions where uncertainty reduction in human health risk predictions may benefit from better understanding of the health component, as opposed to a more detailed hydrogeological characterization, are also discussed. Finally, results illustrate how different dose

  13. WHO's health risk assessment of extremely low frequency electric fields

    International Nuclear Information System (INIS)

    Repacholi, M.H.

    2003-01-01

    The World Health Organization (WHO), the International Commission on Non-Ionizing Radiation Protection (ICNIRP), WHOs scientific collaborating centres (including the UKs National Radiological Protection Board (NRPB) and over 50 participating Member States are participants of WHOs International EMF Project. As part of WHOs health risk assessment process for extremely low frequency fields (ELFs), this workshop was convened by NRPB to assist WHO in evaluating potential health impacts of electrical currents and fields induced by ELF in molecules, cells, tissues and organs of the body. This paper describes the process by which WHO will conduct its health risk assessment. WHO is also trying to provide information on why exposure to ELF magnetic fields seems to be associated with an increased incidence of childhood leukaemia. Are there mechanisms that could lead to this health outcome or does the epidemiological evidence incorporate biases or other factors that need to be further explored? (author)

  14. 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.

  15. Public Health Risk Conditioned by Chemical Composition of Ground Water

    Science.gov (United States)

    Yankovich, E.; Osipova, N.; Yankovich, K.; Matveenko, I.

    2016-03-01

    The article studies the public health potential risk originated from water consumption and estimated on the basis of the groundwater chemical composition. We have processed the results of chemical groundwater analysis in different aquifers of Tomsk district (Tomsk Oblast, Russia). More than 8400 samples of chemical groundwater analyses were taken during long-term observation period. Human health risk assessment of exposure to contaminants in drinking water was performed in accordance with the risk assessment guidance for public health concerning chemical pollution of the environment (Russian reference number: 2.1.10.1920-04-M, 2004). Identified potential risks were estimated for consuming water of each aquifer. The comparative analysis of water quality of different aquifers was performed on the basis of the risk coefficient of the total non-carcinogenic effects. The non-carcinogenic risk for the health of the Tomsk district population due to groundwater consumption without prior sanitary treatment was admitted acceptable. A rather similar picture is observed for all aquifers, although deeper aquifers show lower hazard coefficients.

  16. Urban flooding and health risk analysis by use of quantitative microbial risk assessment

    DEFF Research Database (Denmark)

    Andersen, Signe Tanja

    D thesis is to identify the limitations and possibilities for optimising microbial risk assessments of urban flooding through more evidence-based solutions, including quantitative microbial data and hydrodynamic water quality models. The focus falls especially on the problem of data needs and the causes......, but also when wading through a flooded area. The results in this thesis have brought microbial risk assessments one step closer to more uniform and repeatable risk analysis by using actual and relevant measured data and hydrodynamic water quality models to estimate the risk from flooding caused...... are expected to increase in the future. To ensure public health during extreme rainfall, solutions are needed, but limited knowledge on microbial water quality, and related health risks, makes it difficult to implement microbial risk analysis as a part of the basis for decision making. The main aim of this Ph...

  17. Chemical cycles and health risks of some crustal nuclides

    International Nuclear Information System (INIS)

    McKone, T.E.

    1981-01-01

    This dissertation describes and utilizes an approach for assessing long term health risks due to dispersion of naturally occurring radionuclide series and chemical toxins by normal and altered landscape chemical cycles. In particular, the health risks resulting from geochemical mobilizations of arsenic, lead, uranium and radium are considered. Based on a review of toxic waste hazard-measures and risk assessment studies, a general expression is developed for quantifying health risks imposed by the introduction of toxic materials to components of the total environment. This general measure deals with long term interactions within and between the internal human environment and the external biogeochemical environment. Health hazards are expressed as dose factors which convert environmental concentrations into a corresponding dose field (organ doses in rad for radionuclides; daily intake for toxic elements). The dose field is translated into population health risk expressed as lifetime cancer risk for carcinogens and average blood levels for other toxins. The landscape cell (or prism) is presented as a tool for visualizing and mapping toxic material cycles near the crustal surface. The overall process is incorporated in the GEOTOX code which is a geochemical systems model for describing the dynamics of crustal toxins within a landscape and the resulting health risks. GEOTOX is used to investigate the response of regional landscapes to increased soil and rock inventories of 238 U, 226 Ra, arsenic and lead. It is found that each decay series of element imposes a hazard by its behavior in the total environment that can not be quantified by a similar measure of toxicity

  18. Online reporting and assessing new occupational health risks in SIGNAAL.

    Science.gov (United States)

    Lenderink, A F; Keirsbilck, S; van der Molen, H F; Godderis, L

    2015-11-01

    Changes in work and working conditions continuously give rise to new work-related health risks. Without sufficient knowledge of these, opportunities for prevention and intervention may be missed. To develop, implement and evaluate an online tool called SIGNAAL for reporting and assessment of new work-related health risks by occupational health physicians and experts in the Netherlands and Belgium. Development and implementation of SIGNAAL to allow both easy and sufficient detailed reporting by occupational health physicians and structured and transparent assessment by occupational health experts. A new work-related health risk is defined as a work-related disease due to specific exposure in a specific work setting not described in the literature before. The online reporting and assessment tool proved to be a feasible means of reporting possible new combinations of health problems and exposures in the work situation. Eleven of the 15 cases reported until October 2014 were fully assessed: one was an entirely new work-related disease, four were known but uncommon work-related diseases, five were known but new in the reported work situation and one was a well-known work-related disease. An online reporting system used in an occupational health setting can provide insight into new work-related health risks by creating a structured way to gather, report and assess new combinations of health problems and exposure in the workplace. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. The risk ogf high-risk jobs : psychological health consequences in forensic physicians and ambulance workers

    NARCIS (Netherlands)

    Ploeg, E. van der

    2003-01-01

    The risk of high-risk jobs: Psychological health consequences in forensic doctors and ambulance workers This thesis has shown that forensic physicians and ambulance personnel frequently suffer from psychological complaints as a result of dramatic events and sources of chronic work stress. A

  20. 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)

  1. 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.

  2. Occupational Health Policies on Risk Assessment in Japan

    Directory of Open Access Journals (Sweden)

    Seichi Horie

    2010-09-01

    Full Text Available Industrial Safety and Health Law (ISH Law of Japan requires abnormalities identifi ed in evaluations of worker health and working environments are reported to occupational physicians, and employers are advised of measures to ensure appropriate accommodations in working environments and work procedures. Since the 1980s, notions of a risk assessment and occupational safety and health management system were expected to further prevent industrial accidents. In 2005, ISH Law stipulated workplace risk assessment using the wording “employers shall endeavor.” Following the amendment, multiple documents and guidelines for risk assessment for different work procedures were developed. They require ISH Laws to be implemented fully and workplaces to plan and execute measures to reduce risks, ranking them from those addressing potential hazards to those requiring workers to wear protective articles. A governmental survey in 2005 found the performance of risk assessment was 20.4% and common reasons for not implementing risk assessments were lack of adequate personnel or knowledge. ISH Law specifi es criminal penalties for both individuals and organizations. Moreover, under the Labor Contract Law promulgated in 2007, employers are obliged to make reasonable efforts to ensure employee health for foreseeable and avoidable risks. Therefore, enterprises neglecting even the non-binding provisions of guidelines are likely to suffer signifi cant business impact if judged to be responsible for industrial accidents or occupational disease. To promote risk assessment, we must strengthen technical, fi nancial, and physical support from public-service organizations, encourage the dissemination of good practices to reduce risks, and consider additional employer incentives, including relaxed mandatory regulations.

  3. Latino Solo Grandparents Raising Grandchildren: Health Risks and Behaviors.

    Science.gov (United States)

    Whitley, Deborah M; Fuller-Thomson, Esme

    2018-03-01

    The purpose of this descriptive report is to provide the first representative information on the sociodemographic profile and the prevalence of mental and physical health conditions of two "at-risk" groups of Latino caregivers: solo grandparent caregivers and single parents. The 2012 Behavior Risk Factor Surveillance System was used to compare five dimensions of health on a sample of Latino solo grandparents and Latino single parents, raising their grandchildren/children alone. Bivariate and logistic regression comparative analyses were conducted on study measures. Latino solo grandparents have a high prevalence of chronic health conditions, including arthritis (51%), depression (40%), diabetes (34%), and asthma (34%). Latino single parents have lower but troubling health risks, including depression (22%), diabetes (14%), and asthma (14%). Differences between the two groups were largely due to the grandparents older age. Latino solo grandparents have a high prevalence of several chronic medical conditions. The prevalence of disorders is much lower for Latino single parents, although they too have disturbing health risks. Latino solo grandparents perform their parenting role under intense physical and emotional strain. Health professionals can be instrumental in facilitating interventions that affect the well-being of this expanding family group.

  4. 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.

  5. Risk assessment and management approaches on mental health units.

    Science.gov (United States)

    Woods, P

    2013-11-01

    This exploratory and descriptive study took place in one Canadian province. The study aimed to: (1) to identify and describe the nature and extent of current risk assessment and management approaches used in the adult inpatient mental health and forensic units; and (2) to identify good practice and shortfalls in the nature and extent of the approaches currently utilized. Data were collected from 48 participants through nine focus groups. Participants reported that they used a clinical approach to risk assessment. They had also not considered risk assessment and management as a proactive structured process. Education and training was also limited and skills were developed over time through practice. Five keys issues are discussed as important: reliance on clinical judgement alone is not the best choice to make; the need to consider risk as a whole concept; risk management being more reactive than proactive; education and training; and client involvement in risk assessment. © 2012 John Wiley & Sons Ltd.

  6. Health risk communication--a view from within industry.

    Science.gov (United States)

    Spivey, G H

    1991-01-01

    Health risk communication is discussed in respect to four principles of biomedical ethics: (1) autonomy, the need to protect confidentiality and provide decision-making information; (2) beneficence, an obligation to inform and to develop trust; (3) non-maleficence, not covering up study findings, not over- or underinterpreting data; and (4) justice, helping place risk in proper perspective. The epidemiologist's role in risk communication includes responsible interpretation of data, balanced and non-judgemental risk communication and careful attention to the biologic and population significance of study findings. Potential problem areas for epidemiologists which are discussed include deciding when risk is significant, working for an agency which does not want a communication to take place and the occasional need to violate confidentiality for overriding societal goals. The paper concludes with an example risk communication which illustrates some of the principles covered in the paper.

  7. Speciation and Health Risks of Atmospheric Nanoparticulates

    Science.gov (United States)

    Nguyen, Kennedy

    Exposure to air pollution causes several adverse health effects such as asthma, respiratory disease, cardiovascular disease, cancer, and premature death; and the San Joaquin Valley is one of the most heavily polluted regions in the US. The mountains that surround the valley allow air pollution, including particulate matter, to remain stagnant, prolonging the exposure of valley populations to it. The primary sources of particulate matter for this region are aluminosilicate dust from agricultural activities, and soot emissions from diesel trucks and vehicular traffic. A substantial fraction of emitted material is nanoparticulate matter (testing in cell culture studies, and correlation of particulate properties and sources with their negative health impacts. These results can help identify the sources of air pollution to prioritize for mitigation for the greatest health benefit. In addition, further chemical speciation can help monitor the results of such mitigation efforts. Here, natural particulate matter samples from Merced and Fresno, two cities in the San Joaquin Valley, were analyzed. Ultrafine particles present were 40 to 50 nm in diameter and mostly composed of aluminum, silicon, oxygen, and iron hydroxide. XAS data confirmed the presence of the aluminosilicate as smectite clay and the iron hydroxide as ferrihydrite. Furthermore, a chemical speciation study investigated industrial emissions of air particulate matter. Samples were analyzed using electron microscopy for elemental composition and size distribution, and found to contain fine metal particulates (lead and iron) that can lead to lung inflammation. From characterization data, in order to create a simplified proxy particle system for cell culture studies, amorphous silica particles were synthesized using a modified Stober Synthesis and coated with iron hydroxide. A range of iron hydroxide concentrations (0.06 to 1.63 mmol of iron per gram of silica) were used to test the effect of iron contamination on

  8. Child Social Exclusion Risk and Child Health Outcomes in Australia.

    Directory of Open Access Journals (Sweden)

    Itismita Mohanty

    Full Text Available This paper studies the relationship between the risk of child social exclusion, as measured by the Child Social Exclusion (CSE index and its individual domains, and child health outcomes at the small area level in Australia. The CSE index is Australia's only national small-area index of the risk of child social exclusion. It includes five domains that capture different components of social exclusion: socio-economic background, education, connectedness, housing and health services.The paper used data from the National Centre for Social and Economic Modelling (NATSEM, University of Canberra for the CSE Index and its domains and two key Australian Institute of Health and Welfare (AIHW data sources for the health outcome measures: the National Hospital Morbidity Database and the National Mortality Database.The results show positive associations between rates of both of the negative health outcomes: potentially preventable hospitalisations (PPH and avoidable deaths, and the overall risk of child social exclusion as well as with the index domains. This analysis at the small-area level can be used to identify and study areas with unexpectedly good or bad health outcomes relative to their estimated risk of child social exclusion. We show that children's health outcomes are worse in remote parts of Australia than what would be expected solely based on the CSE index.The results of this study suggest that developing composite indices of the risk of child social exclusion can provide valuable guidance for local interventions and programs aimed at improving children's health outcomes. They also indicate the importance of taking a small-area approach when conducting geographic modelling of disadvantage.

  9. Health risks of genetically modified foods.

    Science.gov (United States)

    Dona, Artemis; Arvanitoyannis, Ioannis S

    2009-02-01

    As genetically modified (GM) foods are starting to intrude in our diet concerns have been expressed regarding GM food safety. These concerns as well as the limitations of the procedures followed in the evaluation of their safety are presented. Animal toxicity studies with certain GM foods have shown that they may toxically affect several organs and systems. The review of these studies should not be conducted separately for each GM food, but according to the effects exerted on certain organs it may help us create a better picture of the possible health effects on human beings. The results of most studies with GM foods indicate that they may cause some common toxic effects such as hepatic, pancreatic, renal, or reproductive effects and may alter the hematological, biochemical, and immunologic parameters. However, many years of research with animals and clinical trials are required for this assessment. The use of recombinant GH or its expression in animals should be re-examined since it has been shown that it increases IGF-1 which may promote cancer.

  10. 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.

  11. Examining Residence Status as a Risk Factor for Health Risk Behaviors among College Students

    Science.gov (United States)

    DiBello, Angelo M.; Benz, Madeline B.; Miller, Mary Beth; Merrill, Jennifer E.; Carey, Kate B.

    2018-01-01

    Objective: The current study is aimed to evaluate college student residence as a unique risk factor for a range of negative health behaviors. Participants: We examined data from 63,555 students (66% females) from 157 campuses who completed the National College Health Assessment Survey in Spring 2011. Methods: Participants answered questions about…

  12. 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

  13. A 21st century roadmap for human health risk assessment.

    Science.gov (United States)

    Pastoor, Timothy P; Bachman, Ammie N; Bell, David R; Cohen, Samuel M; Dellarco, Michael; Dewhurst, Ian C; Doe, John E; Doerrer, Nancy G; Embry, Michelle R; Hines, Ronald N; Moretto, Angelo; Phillips, Richard D; Rowlands, J Craig; Tanir, Jennifer Y; Wolf, Douglas C; Boobis, Alan R

    2014-08-01

    The Health and Environmental Sciences Institute (HESI)-coordinated Risk Assessment in the 21st Century (RISK21) project was initiated to develop a scientific, transparent, and efficient approach to the evolving world of human health risk assessment, and involved over 120 participants from 12 countries, 15 government institutions, 20 universities, 2 non-governmental organizations, and 12 corporations. This paper provides a brief overview of the tiered RISK21 framework called the roadmap and risk visualization matrix, and articulates the core principles derived by RISK21 participants that guided its development. Subsequent papers describe the roadmap and matrix in greater detail. RISK21 principles include focusing on problem formulation, utilizing existing information, starting with exposure assessment (rather than toxicity), and using a tiered process for data development. Bringing estimates of exposure and toxicity together on a two-dimensional matrix provides a clear rendition of human safety and risk. The value of the roadmap is its capacity to chronicle the stepwise acquisition of scientific information and display it in a clear and concise fashion. Furthermore, the tiered approach and transparent display of information will contribute to greater efficiencies by calling for data only as needed (enough precision to make a decision), thus conserving animals and other resources.

  14. Women at risk: Gender inequality and maternal health.

    Science.gov (United States)

    Banda, Pamela C; Odimegwu, Clifford O; Ntoimo, Lorretta F C; Muchiri, Evans

    2017-04-01

    Gender inequality has been documented as a key driver of negative health outcomes, especially among women. However, studies have not clearly examined the role of gender inequality in maternal health in an African setting. Therefore, the authors of this study examined the role of gender inequality, indicated by lack of female autonomy, in exposing women to maternal health risk. Data were obtained from the 2007 Zambia Demographic and Health Survey on a weighted sample of 3,906 married or partnered women aged 15-49 years. Multivariable analyses revealed that low autonomy in household decision power was associated with maternal health risk (Odds Ratio (OR) = 1.52, p < .001). Autonomy interacted with household wealth showed that respondents who were in the wealthier households and had low autonomy in household decision power (OR = 2.03, p < .05) were more likely to be exposed to maternal health risk than their counterparts who had more autonomy. Efforts to lower women's exposure to maternal mortality and morbidity in Zambia should involve interventions to alter prevailing gender norms that limit women's active participation in decisions about their own health during pregnancy and delivery.

  15. 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...

  16. 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.

  17. Perceived risk of mental health problems in primary care

    Directory of Open Access Journals (Sweden)

    Constança ePaúl

    2015-11-01

    Full Text Available In the face of limited resources and an ageing population with increasingly care needs, healthcare systems must identify community-dwelling older adults with mental health problems at higher risk of adverse outcomes such as institutionalisation, hospitalisation and death, in order to deliver timely and efficient care. The objectives of this study were to assess the prevalence of mental health concerns and the associated perceived risk of adverse outcomes in a large sample of older patients in primary care. We trained general practitioners and nurses to use the Risk Instrument for Screening in the Community (RISC to rank perceived risk of mental health concerns (including neurocognitive and mood disorders from 1 (mild to 3 (Severe. The mean age of the 4499 people assessed was 76.3 years (sd=7.3 and 2645 (58.8% were female. According to the primary care team 1616 (35.9% were perceived to have mental health concerns of whom 847 (52.4% were mild, 559 (34.6% were moderate and 210 (13% were severe. Patients with mental health concerns had higher odds of perceived risk of adverse outcomes (OR=2.22, 95% CI 1.83-2.69 for institutionalisation; OR=1.66, 95% CI 1.41-1.94 for hospitalisation; OR=1.69, 95% CI 1.42-2.01 for death. These results suggest a high prevalence of mental health concerns among older adults and supports the need for early identification of patients at high-risk of adverse healthcare outcomes.

  18. Perceived risk of mental health problems in primary care.

    LENUS (Irish Health Repository)

    2015-01-01

    In the face of limited resources and an aging population with increasingly care needs, healthcare systems must identify community-dwelling older adults with mental health problems at higher risk of adverse outcomes such as institutionalization, hospitalization and death, in order to deliver timely and efficient care. The objectives of this study were to assess the prevalence of mental health concerns and the associated perceived risk of adverse outcomes in a large sample of older patients in primary care (PC). We trained general practitioners and nurses to use the Risk Instrument for Screening in the Community to rank perceived risk of mental health concerns (including neurocognitive and mood disorders) from 1 (mild) to 3 (severe). The mean age of the 4499 people assessed was 76.3 years (SD = 7.3) and 2645 (58.8%) were female. According to the PC team 1616 (35.9%) were perceived to have mental health concerns of whom 847 (52.4%) were mild, 559 (34.6%) were moderate and 210 (13%) were severe. Patients with mental health concerns had higher odds of perceived risk of adverse outcomes (OR = 2.22, 95% CI 1.83-2.69 for institutionalization; OR = 1.66, 95% CI 1.41-1.94 for hospitalization; OR = 1.69, 95% CI 1.42-2.01 for death). These results suggest a high prevalence of mental health concerns among older adults and supports the need for early identification of patients at high-risk of adverse healthcare outcomes.

  19. 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

  20. Strategic management of health risks posed by buried transuranic wastes

    International Nuclear Information System (INIS)

    Jump, R.A.

    1994-01-01

    A strategy is presented for reducing health risks at sites contaminated with buried transuranic (TRU) wastes by first taking measures to immobilize the contaminants until the second step, final action, becomes cost-effective and poses less risk to the remediation workers. The first step of this strategy does not preclude further action if it is warranted and is in harmony with environmental laws and regulations

  1. Impact of actinide recycle on nuclear fuel cycle health risks

    International Nuclear Information System (INIS)

    Michaels, G.E.

    1992-06-01

    The purpose of this background paper is to summarize what is presently known about potential impacts on the impacts on the health risk of the nuclear fuel cycle form deployment of the Advanced Liquid Metal Reactor (ALMR) 1 and Integral Fast Reactor (IF) 2 technology as an actinide burning system. In a companion paper the impact on waste repository risk is addressed in some detail. Therefore, this paper focuses on the remainder of the fuel cycle

  2. 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.

  3. 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.

  4. A paradox of cumulative culture.

    Science.gov (United States)

    Kobayashi, Yutaka; Wakano, Joe Yuichiro; Ohtsuki, Hisashi

    2015-08-21

    Culture can grow cumulatively if socially learnt behaviors are improved by individual learning before being passed on to the next generation. Previous authors showed that this kind of learning strategy is unlikely to be evolutionarily stable in the presence of a trade-off between learning and reproduction. This is because culture is a public good that is freely exploited by any member of the population in their model (cultural social dilemma). In this paper, we investigate the effect of vertical transmission (transmission from parents to offspring), which decreases the publicness of culture, on the evolution of cumulative culture in both infinite and finite population models. In the infinite population model, we confirm that culture accumulates largely as long as transmission is purely vertical. It turns out, however, that introduction of even slight oblique transmission drastically reduces the equilibrium level of culture. Even more surprisingly, if the population size is finite, culture hardly accumulates even under purely vertical transmission. This occurs because stochastic extinction due to random genetic drift prevents a learning strategy from accumulating enough culture. Overall, our theoretical results suggest that introducing vertical transmission alone does not really help solve the cultural social dilemma problem. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Health risk perception, optimistic bias, and personal satisfaction.

    Science.gov (United States)

    Bränström, Richard; Brandberg, Yvonne

    2010-01-01

    To examine change in risk perception and optimistic bias concerning behavior-linked health threats and environmental health threats between adolescence and young adulthood and how these factors related to personal satisfaction. In 1996 and 2002, 1624 adolescents responded to a mailed questionnaire. Adolescents showed strong positive optimistic bias concerning behaviorlinked risks, and this optimistic bias increased with age. Increase in optimistic bias over time predicted increase in personal satisfaction. The capacity to process and perceive potential threats in a positive manner might be a valuable human ability positively influencing personal satisfaction and well-being.

  6. Historical perspectives on the uses and health risks of beryllium

    International Nuclear Information System (INIS)

    Preuss, O.P.

    1985-01-01

    Unawareness of the health risks of beryllium resulted in a decade of unmitigated exposure of several thousand workers and numerous cases of beryllium disease in employees and nearby residents. Subsequent adoption of exposure limits and their implementation with effective technical controls reduced the occurrence of new cases, which were mainly due to accidental exposures, to a minimum. The fact that continuously growing production and consumption did not alter this trend demonstrates the effectiveness of the present threshold limit value. It shows that the potential health hazard can be well contained and that beryllium can be produced and fabricated without undue risk to employees or the general public

  7. Global health risks and cosmopolitisation: from emergence to interference.

    Science.gov (United States)

    Figuié, Muriel

    2013-02-01

    According to Beck's 'World at Risk' theory, global risks push nations towards a cosmopolitisation of their health policy and open opportunities for a democratic turn. This article provides an empirical analysis of Beck's theory, based on the experience of Vietnamese authorities from 2003 to 2007 in managing the emerging avian flu virus. It shows how Vietnam's framing of avian flu has shifted, under the pressure from international organisations and the US administration, from an epizootic and zoonotic risk (or a classic risk) to a pandemic threat (or a late modern risk). Vietnam's response was part of its overall strategy to join the World Trade Organization and it was limited by Vietnam's defence of its sovereignty. This strategy has been successful for Vietnam but has limited the possibility of cosmopolitan and democratic transformations. The case study highlights the constructed dimension of risks of late modernity and their possible instrumentalisation: it minimises the role of a community of fear relative to a community of trade. © 2013 The Author. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  8. Criteria for risk acceptance: a health physicist's view

    International Nuclear Information System (INIS)

    Hull, A. P.

    1977-01-01

    While energy need (or demand) and the risks of energy production and use may be objectively quantified, risk acceptance embodies a subjective element of preferences and values. Yet, as demonstrated by the nuclear controversy in the United States, public acceptance is essential to the beneficial uses of radiation. The statement of the objectives and purposes of the Health Physics Society and our application of it are proposed as offering useful criteria for risk acceptance. The principle of comparing risk with a number of those regularly accepted in everyday life is emphasized. On this basis, it is concluded that the expenditures to attain currently applicable or proposed 'as low as practicable' (or 'as low as readily achievable') levels for the nuclear fuel cycle are disproportionate to those addressed to other sources of general public exposure to radiation. They are also disproportionate compared to those addressed to a variety of public health risks. It is suggested that sensible priorities for radiation and public health protection might be achieved by the application of a de minimus negligible (but nonzero) level of probable risk. (Research supported by the U.S. Energy Research and Development Administration.)

  9. A prevalência cumulativa de fatores de risco para doença cardiovascular em adolescentes iranianos: IHHP-HHPC Cumulative prevalence of risk factors for atherosclerotic cardiovascular diseases in Iranian adolescents: IHHP-HHPC

    Directory of Open Access Journals (Sweden)

    Roya Kelishadi

    2005-12-01

    Full Text Available OBJETIVO: Avaliar a prevalência cumulativa dos fatores de risco para a doença cardiovascular aterosclerótica numa amostra de adolescentes iranianos. MÉTODOS: Foi realizado um estudo transversal com 1000 meninas e 1000 meninos, com idade entre 11 e 18 anos, selecionados através de uma amostragem aleatória multietapas à base de conglomerados das áreas urbana e rural de três cidades iranianas. RESULTADOS: As taxas de prevalência de inatividade física, dislipidemia, tabagismo, pressão arterial alta e obesidade (índice de massa corporal >P95 foram 66,6, 23,7, 8,7, 5,7 e 2,2%, respectivamente. Dentre os indivíduos estudados, 79,1% apresentaram pelo menos um e 24,6% tiveram dois fatores de risco para doença cardiovascular. A prevalência de inatividade física foi significativamente menor entre os meninos que entre as meninas [53,9 contra 79,3%, respectivamente, OR IC95%, 0,44 (0,39-0,51]. A prevalência de tabagismo foi maior nos meninos que nas meninas [13,1 contra 4,2%, respectivamente, OR IC95%, 3,4 (2,4-4,9]. CONCLUSÃO: Considerando a alta prevalência de fatores de risco para doença cardiovascular em adolescentes, deve-se garantir intervenções que sejam adequadas à idade e sensíveis a aspectos culturais para que medidas preventivas possam ser tomadas em tempo hábil.OBJECTIVE: To evaluate the cumulative prevalence of atherosclerotic cardiovascular disease risk factors in a representative sample of Iranian adolescents. METHODS: The subjects of this cross-sectional study were 1,000 girls and 1,000 boys, ages 11-18 years, selected by multi stage-random cluster sampling from urban and rural areas of three cities in Iran. RESULTS: The prevalence of physical inactivity, dyslipidemia, smoking, high blood pressure and obesity (body mass index >95th percentile were 66.6, 23.7, 8.7, 5.7 and 2.2%, respectively. Of subjects studied, 79.1% had at least one and 24.6% had two cardiovascular disease risk factors. The prevalence of physical

  10. 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.

  11. 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

  12. Human and animal sentinels for shared health risks

    Directory of Open Access Journals (Sweden)

    Peter Rabinowitz, MD, MPH

    2009-03-01

    Full Text Available The tracking of sentinel health events in humans in order to detect and manage disease risks facing a larger population is a well accepted technique applied to influenza, occupational conditions and emerging infectious diseases. Similarly, animal health professionals routinely track disease events in sentinel animal colonies and sentinel herds. The use of animals as sentinels for human health threats, or of humans as sentinels for animal disease risk, dates back at least to the era when coal miners brought caged canaries into mines to provide early warning of toxic gases. Yet the full potential of linking animal and human health information to provide warning of such ‘shared risks’ from environmental hazards has not been realised. Reasons appear to include the professional segregation of human and animal health communities, the separation of human and animal surveillance data and evidence gaps in the linkages between human and animal responses to environmental health hazards. The ‘One Health initiative’ and growing international collaboration in response to pandemic threats, coupled with development in the fields of informatics and genomics, hold promise for improved sentinel event coordination in order to detect and reduce environmental health threats shared between species.

  13. Practical consequences of the assessment of different energy health risks

    International Nuclear Information System (INIS)

    Hamilton, L.D.

    1984-01-01

    Public authorities must make decisions about energy, and the risks of alternative strategies need to be calculated including health and environmental costs. Information from various sources must be organized into a logical framework for comparing impacts. This must include the widest practicable range of health and environmental damage - public health impact of pollution, role of accidents, disease and hazardous materials in the workplace, and odds for catastrophes. It must put each part of the energy cycle into perspective - giving particular attention to uncertainties in knowledge - to convey what is known, what is uncertain, and the importance of each factor in the overall picture. This paper gives examples of the use of health-impact assessment by decision-makers: (1) comparative risk assessment of the health effects of coal and nuclear fuel cycles used in nuclear power plant siting and licensing hearings, and (2) health risks of acid deposition and other air-transported pollutants, carried out as part of an assessment for the U.S. Congress Office of Technology Assessment. (author)

  14. Principles for decisions involving environmental and health risks

    International Nuclear Information System (INIS)

    Bengtsson, B.

    1989-01-01

    Decision making with respect to safety is becoming more and more complex. The risk involved must be taken into account together with numerous other factors such as the benefits, the uncertainties and the public perception. Can the decision maker be aided by some kind of system, general rules of thumb, or broader perspective on similar decisions? This question has been addressed in a joint Nordic project relating to nuclear power. Modern techniques for risk assessment and management have been studied and parallels drawn to such areas as offshore safety and management of genotoxic chemicals in the environment. The topics include synoptic vs. incrementalistic approaches to decision making, health hazards from radiation and genotoxic chemicals, value judgments in decision making, definitions of low risks, risk comparisons, and principles for decision making when risks are involved. (author) 47 refs

  15. Health risk behavior of rural secondary school students in Zimbabwe.

    Science.gov (United States)

    Gwede, C K; McDermott, R J; Westhoff, W W; Mushore, M; Mushore, T; Chitsika, E; Majange, C S; Chauke, P

    2001-10-01

    A socioculturally appropriate health risk behavior instrument, modeled after the U.S. Centers for Disease Control and Prevention's Youth Risk Behavior Survey (YRBS), was administered to 717 secondary school students in a rural area of Zimbabwe. Comparisons of risk behaviors by gender and school grade were made using univariate procedures and multiple logistic regression. Males were significantly more likely than females to have had sexual intercourse (odds ratio = 5.02, p < .0001) and to report drug use behaviors. Males also were significantly more likely to report early initiation (by age 13 years) of alcohol use, cigarette smoking, and marijuana use. School site violence and drug use behaviors also were prevalent in this sample. An interaction between gender and grade was evident for some behaviors. Additional research may further the understanding of these risk behaviors and facilitate development of effective, culturally relevant risk reduction programs.

  16. 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.

  17. Environmental health risk assessment and management for global climate change

    Science.gov (United States)

    Carter, P.

    2014-12-01

    This environmental health risk assessment and management approach for atmospheric greenhouse gas (GHG) pollution is based almost entirely on IPCC AR5 (2014) content, but the IPCC does not make recommendations. Large climate model uncertainties may be large environmental health risks. In accordance with environmental health risk management, we use the standard (IPCC-endorsed) formula of risk as the product of magnitude times probability, with an extremely high standard of precaution. Atmospheric GHG pollution, causing global warming, climate change and ocean acidification, is increasing as fast as ever. Time is of the essence to inform and make recommendations to governments and the public. While the 2ºC target is the only formally agreed-upon policy limit, for the most vulnerable nations, a 1.5ºC limit is being considered by the UNFCCC Secretariat. The Climate Action Network International (2014), representing civil society, recommends that the 1.5ºC limit be kept open and that emissions decline from 2015. James Hansen et al (2013) have argued that 1ºC is the danger limit. Taking into account committed global warming, its millennial duration, multiple large sources of amplifying climate feedbacks and multiple adverse impacts of global warming and climate change on crops, and population health impacts, all the IPCC AR5 scenarios carry extreme environmental health risks to large human populations and to the future of humanity as a whole. Our risk consideration finds that 2ºC carries high risks of many catastrophic impacts, that 1.5ºC carries high risks of many disastrous impacts, and that 1ºC is the danger limit. IPCC AR4 (2007) showed that emissions must be reversed by 2015 for a 2ºC warming limit. For the IPCC AR5 only the best-case scenario RCP2.6, is projected to stay under 2ºC by 2100 but the upper range is just above 2ºC. It calls for emissions to decline by 2020. We recommend that for catastrophic environmental health risk aversion, emissions decline

  18. [NIGHT SHIFT WORK AND HEALTH DISORDER RISK IN FEMALE WORKERS].

    Science.gov (United States)

    Kukhtina, E G; Solionova, L G; Fedichkina, T P; Zykova, I E

    2015-01-01

    There was evaluated the risk to health in females employed in shift work, including night shifts. According to the data of periodical medical examinations health indices of 403 females employed in shift work, including night shifts, were compared with indices of 205 females--workers of administrative units of the same enterprise. Overall relative risk (RR) for the health disorder associated with the night shift was 1.2 (95%; confidence interval (CI): 1.09-1.28). A statistically significant increase in risk was observed in relation to uterine fibroids (OR 1.3; 95% CI: 1.06-1.54), mastopathy (OR 1.4; 95% CI: 1.2-1.6), inorganic sleep disorders (OR 8.8; 95% CI 2.6-29.8). At the boundary of the statistical significance there was the increase in the risk for obesity (OR 1.2; 95% C: 0.97-1.39), hypertension (OR 1.2; 95% CI, 0.9-1.5) and endometriosis (OR 1.5; 95% CI: 0.98-2.16). There was revealed an adverse effect of night shifts on the gestation course: ectopic pregnancy in the experimental group occurred 6.6 times more frequently than in the control group (95% CI: 0.87-50.2), and spontaneous abortion--1.7 times (95% CI: 0.95-3.22). The performed study has once again confirmed the negative impact of smoking on women's reproductive health: smoking women in the experimental group compared with the control group smokers had 2.7 times increased risk of uterine fibroids (within 1.06-7.0), the risk in non-smokers was significantly lower--1.2 (0.98-1.4). The findings suggest about a wide range of health problems related to employment on shift work, including night shifts, which indicates to the need for adoption of regulatory and preventive measures aimed to this professional group.

  19. Melanoma risk prediction using a multilocus genetic risk score in the Women's Health Initiative cohort.

    Science.gov (United States)

    Cho, Hyunje G; Ransohoff, Katherine J; Yang, Lingyao; Hedlin, Haley; Assimes, Themistocles; Han, Jiali; Stefanick, Marcia; Tang, Jean Y; Sarin, Kavita Y

    2018-07-01

    Single-nucleotide polymorphisms (SNPs) associated with melanoma have been identified though genome-wide association studies. However, the combined impact of these SNPs on melanoma development remains unclear, particularly in postmenopausal women who carry a lower melanoma risk. We examine the contribution of a combined polygenic risk score on melanoma development in postmenopausal women. Genetic risk scores were calculated using 21 genome-wide association study-significant SNPs. Their combined effect on melanoma development was evaluated in 19,102 postmenopausal white women in the clinical trial and observational study arms of the Women's Health Initiative dataset. Compared to the tertile of weighted genetic risk score with the lowest genetic risk, the women in the tertile with the highest genetic risk were 1.9 times more likely to develop melanoma (95% confidence interval 1.50-2.42). The incremental change in c-index from adding genetic risk scores to age were 0.075 (95% confidence interval 0.041-0.109) for incident melanoma. Limitations include a lack of information on nevi count, Fitzpatrick skin type, family history of melanoma, and potential reporting and selection bias in the Women's Health Initiative cohort. Higher genetic risk is associated with increased melanoma prevalence and incidence in postmenopausal women, but current genetic information may have a limited role in risk prediction when phenotypic information is available. Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  20. 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