Suchergebnisse

For decades, many studies have linked maternal smoking to an increased risk of preterm birth. As a result, the scientific community has long hypothesized that exposure to environmental tobacco smoke (ETS), commonly referred to as second-hand smoke, is also associated with an increased risk of preterm birth. Multiple studies have examined this proposed association through different strategies and approaches. Recently, a small number of epidemiology studies have examined preterm birth trends before and after the implementation of anti-smoking legislation in various jurisdictions. We found that these studies have largely revealed a significant trend of decreasing population-level preterm birth rates after the implementation of smoking bans. However, most of the studies reviewed did not distinguish the impact of maternal smoking from ETS in their analyses, making it difficult to specifically evaluate the effects of smoking bans on ETS exposure. Other studies have taken the approach of directly measuring maternal ETS exposure and associations with preterm birth within particular study populations. In contrast to smoking ban studies, the latter group of studies had more inconclusive results. The use of a variety of exposure assessment methods ranging from different self-reporting techniques to biomarker measurements posed a challenge to compare studies. We evaluated current scientific literature for evidence of an association between maternal ETS exposure and risk of preterm birth. We also discuss the strengths and weaknesses of the different approaches to study this association, as well as methods used for ETS exposure assessment. We propose that more studies, specifically, evaluating rates of preterm birth among non-smoking women before and after smoking bans, are needed, as well as using better ETS exposure assessments methods in studies measuring maternal ETS exposure.

Abstract

Objectives
Approximately 2 billion workers globally are employed in informal settings, which are characterized by substantial risk from hazardous exposures and varying job tasks and schedules. Existing methods for identifying occupational hazards must be adapted for unregulated and challenging work environments. We designed and applied a method for objectively deriving time-activity patterns from wearable camera data and matched images with continuous measurements of personal inhalation exposure to size-specific particulate matter (PM) among workers at an informal electronic-waste (e-waste) recovery site.


Methods
One hundred and forty-two workers at the Agbogbloshie e-waste site in Accra, Ghana, wore sampling backpacks equipped with wearable cameras and real-time particle monitors during a total of 171 shifts. Self-reported recall of time-activity (30-min resolution) was collected during the end of shift interviews. Images (N = 35,588) and simultaneously measured PM2.5 were collected each minute and processed to identify activities established through worker interviews, observation, and existing literature. Descriptive statistics were generated for activity types, frequencies, and associated PM2.5 exposures. A kappa statistic measured agreement between self-reported and image-based time-activity data.


Results
Based on image-based time-activity patterns, workers primarily dismantled, sorted/loaded, burned, and transported e-waste materials for metal recovery with high variability in activity duration. Image-based and self-reported time-activity data had poor agreement (kappa = 0.17). Most measured exposures (90%) exceeded the World Health Organization (WHO) 24-h ambient PM2.5 target of 25 µg m−3. The average on-site PM2.5 was 81 µg m−3 (SD: 94). PM2.5 levels were highest during burning, sorting/loading and dismantling (203, 89, 83 µg m−3, respectively). PM2.5 exposure during long periods of non-work-related activities also exceeded the WHO standard in 88% of measured data.


Conclusions
In complex, informal work environments, wearable cameras can improve occupational exposure assessments and, in conjunction with monitoring equipment, identify activities associated with high exposures to workplace hazards by providing high-resolution time-activity data.

Extreme heat events (EHEs) are becoming more intense, more frequent and longer lasting in the 21st century. These events can disproportionately impact the health of low-income, minority, and urban populations. To better understand heat-related intervention strategies used by four U.S. cities, we conducted 73 semi-structured interviews with government and non-governmental organization leaders representing public health, general social services, emergency management, meteorology, and the environmental planning sectors in Detroit, MI; New York City, NY; Philadelphia, PA and Phoenix, AZ—cities selected for their diverse demographics, climates, and climate adaptation strategies. We identified activities these leaders used to reduce the harmful effects of heat for residents in their city, as well as the obstacles they faced and the approaches they used to evaluate these efforts. Local leaders provided a description of how local context (e.g., climate, governance and city structure) impacted heat preparedness. Despite the differences among study cities, political will and resource access were critical to driving heat-health related programming. Upon completion of our interviews, we convened leaders in each city to discuss these findings and their ongoing efforts through day-long workshops. Our findings and the recommendations that emerged from these workshops could inform other local or national efforts towards preventing heat-related morbidity and mortality.

Extreme heat events (EHEs) are becoming more intense, more frequent and longer lasting in the 21st century. These events can disproportionately impact the health of low-income, minority, and urban populations. To better understand heat-related intervention strategies used by four U.S. cities, we conducted 73 semi-structured interviews with government and non-governmental organization leaders representing public health, general social services, emergency management, meteorology, and the environmental planning sectors in Detroit, MI; New York City, NY; Philadelphia, PA and Phoenix, AZ—cities selected for their diverse demographics, climates, and climate adaptation strategies. We identified activities these leaders used to reduce the harmful effects of heat for residents in their city, as well as the obstacles they faced and the approaches they used to evaluate these efforts. Local leaders provided a description of how local context (e.g., climate, governance and city structure) impacted heat preparedness. Despite the differences among study cities, political will and resource access were critical to driving heat-health related programming. Upon completion of our interviews, we convened leaders in each city to discuss these findings and their ongoing efforts through day-long workshops. Our findings and the recommendations that emerged from these workshops could inform other local or national efforts towards preventing heat-related morbidity and mortality.