Health outcomes of road-traffic pollution among exposed roadside workers in Rawalpindi City,Pakistan

To document ill-health effects of air pollution on the local inhabitants, we analyzed the self-reported health issues associated with the inhalation of road traffic on daily basis. For this purpose, a revised version of ALS-DLD-78S questionnaire was administered, comprising the personal information and details related to the clinical history of the surveyed population (i.e. n = 580). Five dependent (outcome) variables, including chest pain, redness of eyes, shortness of breath, eye-tearing, and skin-itching were taken into account. The results revealed that ～80% of the surveyed population were directly or indirectly exposed to road traffic, and the incidence of chest pain among exposed individuals was estimated to increase with age (odds ratio (OR) = 6.49; 95% confidence interval (CI) = 1.46–28.81), especially among cardiac patients (OR = 13.87; 95%-CI = 3.28–58.61). However, the shortness of breath was predominantly observed among those who reported to have asthmatic symptoms (OR = 32.84; 95%-CI = 15.59–69.15) and cardiovascular symptoms (OR = 13.8: 95%-CI = 3.63–52.41). In case of itching, the population along the roadside were more vulnerable to exposure (OR = 5.79; 95%-CI = 2.81–11.93). While, exposure to traffic exhaust could be attributed to ～3.13% rise in the incidences of redness of eyes among general population, the outcomes of this survey show that daily exposure to traffic pollution is an important health concern for the urban population in general, as well as for various occupational groups in particular, working in outdoor environment.     

Low-intensity workers: lessons learned from supervising primary care mental health workers and dilemmas associated with such roles

The UK government's latest primary care mental health initiative, Improving Access to Psychological Therapies (IAPT), seeks to achieve its aims partly through the extensive use of low-intensity workers (LIWs). As clinical supervisors to teams of primary care mental health workers (PCMHWs) already offering brief, evidence-based interventions in primary care mental health services, we draw on the growing body of literature and our own experience to discuss dilemmas associated with the roles of such workers. These concern clinical governance, training, supervision and integration into existing services. We discuss how IAPT service characteristics may provide solutions to some of these dilemmas. We argue that it is unlikely they will be completely resolved and that IAPT services, in addressing future challenges, could benefit from lessons learned from the PCMHW role.     

Restructuring and Health in Canadian Coastal Communities

Environmental and socioeconomic restructuring has had profound consequences for coastal communities in Canada. The decline of traditional resource-based industries—fisheries, forestry, and mining—and the emergence of new economic activities, such as tourism and aquaculture, compounded by concurrent shifts in social programs, have affected the health of environments, communities, and people. Drawing on research conducted as part of the interdisciplinary major collaborative research initiative Coasts Under Stress, we examined the implications of interactive restructuring for the health of people and communities on Canada’s east and west coasts. The research is guided by a socioecological framework that identifies the pathways from interactive restructuring through health determinants to health risks and health outcomes. The utility of the proposed framework is exemplified by a specific place-based example in Prince Rupert, British Columbia, and a case-based example from coastal communities in Newfoundland and Labrador. A focus on interactive restructuring draws our attention to the many challenges associated with promoting health in a context of rapid and often accelerating environmental and institutional change that is relevant to other areas and contexts.     

Beyond the Hazard: The Role of Beliefs in Health Risk Perception

This article addresses how beliefs about health risks cluster and how these relate to perceptions of risk among Canadians. A principal components analysis conducted on items reflecting various beliefs from the Canadian National Health Risk Perception Survey extracted four underlying dimensions: Cancer Dread, Trust in Regulators, Environmental Concern, and Personal Agency. Factor scores were then used to investigate relationships between belief factors and the perceived health risk of various hazards with gender, education, income, and province of residence as covariates. Environmental and Therapeutic health risk perceptions were significantly higher in respondents with high Cancer Dread and high Environmental Concern, but lower in respondents with high Trust in Regulators. Environmental health risk perceptions were lower in respondents with high Personal Agency, whereas Social health risk perceptions were higher in respondents with high Cancer Dread and Personal Agency. Results suggest that information about health risk–related beliefs can be useful in improving our understanding of the public's perceived risk of health hazards.     

Breast cancer incidence by country of birth among immigrant women in British Columbia,Canada

IntroductionBreast cancer rates vary internationally and between immigrant and non-immigrant populations. We describe breast cancer incidence by birth region and country in British Columbia, Canada.MethodsWe linked population-based health and immigration databases for a population with >1.29 million immigrants to assess breast cancer incidence among immigrant and non-immigrant women. We report age-standardized incidence ratios (SIRs) by birth region and country using non-immigrant women as the standard.ResultsSIRs varied widely by both birth country and region. Low rates were found for South (SIR = 0.52, 95% CI: 0.47,0.59) and East Asian (SIR = 0.75, 95% CI: 0.72,0.79) women and a higher rate for Western Europeans (SIR = 1.15, 95% CI: 1.01,1.30).ConclusionThere is considerable variation in SIRs across some of British Columbia’s largest immigrant populations and several demonstrate significantly different risk profiles compared to non-immigrants. These findings provide unique data to support breast cancer prevention and control.     

Socioeconomic differences in the associations between diabetes and hospital admission and mortality among older adults in Europe

The aim of this study is to explain the trends in socioeconomic inequality and diabetes outcomes in terms of hospital admission and death in old European people. The sample includes 73,301 individuals, across 16 European countries taken from the Survey of Health, Ageing and Retirement in Europe (SHARE). People being diagnosed of diabetes were more likely to be admitted to hospital than those without diabetes, although its effect dropped after controlling for clinical and functional complications. Largest asscociations were observed in women, people aged 50–65 years old, with medium educational level and medium household income. Diabetes was significant and positively related to mortality in the whole sample. Diabetes is significantly associated with mortality risk especially in males, oldest old people, low education and medium income people. These findings have important implications for public policies to reduce socioeconomic-related health inequalities.     

Low frequency of infertility among workers in a borate processing facility

In order to rule out the possibility of omitting some individuals in the study at field visits described in previous articles, either because of the reluctance of the subject or because of his appointment elsewhere, fertility and infertility states of borate workers of the Borax and Acid Plants in Bandirma, Balikesir are given. Balikesir is one of the four provinces with large borate deposits of Turkey, and Bandirma is 1 of its 19 districts. This county is relatively far away from borate deposits, and drinking water piped out through the springs has a boron amount between 0.10 and 0.82 ppm B. That the participants are occupationally exposed to the mineral in essence is therefore conceivable. At the first phase of the investigation, 191 workers were interviewed, as detailed previously. Among these, there were six infertiles of the primary type with a rate 3.1%. Boron-unrelated infertile couples among sibs were found to be 2.6–3.6%, and 3.2% for three-generation marriages—none being higher than those revealed in different sets of controls. In the second stage of work, computerized files of all workers of the facility and all employees of the general management sharing the same location were checked without an interview. Twenty-four subjects (3.4%) out of 712 workers were childless versus 2.7% among 108 employees, and 2.2% among 91 workers of a distantly located sulfuric acid plant of the same complex. The differences were not significant, and these recent findings support the conclusion already reached almost unambiguously that boron exposure at the present levels does not interfere with human reproduction.     

Inequality among industrial workers in the late 19th century United States

This paper uses the large cross sectional survey of 8544 workers in nine industries (pig iron, bar iron, steel, coal, coke, cottons, woolens, and glass) in the United States and five European countries (Belgium, Great Britain, France, Belgium, and Switzerland) to examine inequality in the industrial working class in the late nineteenth century. The paper looks at incomes, the food budget share (estimated using the Almost Ideal Demand System), and home ownership. The results show regular gradients with the unskilled workers doing less well than semi-skilled and skilled workers. Despite the lack of proprietors, farmers, and other groups with significant income from property, such surveys can be useful in the study of the historical aspects of inequality.     

The dilemma posed by minority medical traditions in pluralistic societies: The case of China and Canada

Pluralistic societies such as China and Canada frequently find themselves pursuing potentially contradictory goals. China's contradiction results from a desire to preserve cultural diversity while eliminating ‘backward tendencies’ which work against the economic and social development of the country as a whole. Canada's contradiction results from a desire to preserve cultural diversity while maintaining an emphasis upon equality of rights and responsibilities for all Canadians. Behind these differences in ideology, however, is a more basic structural contradiction ‐ namely, that cultural pluralism, while considered an asset as long as it is restricted to preserving unique cultural traditions, is nevertheless a threat to a strong central government if interpreted to imply the power to set policy at the local level. To explore this issue, this article compares China and Canada in terms of three related topics. First, it briefly examines the multicultural policy of China and Canada. This is followed by a discussion of medical pluralism in China and Canada, with an emphasis upon the health of minority groups and the status of minority healing traditions. Finally, common perceptions of shamanic healing traditions in both China and Canada are considered. It is in relation to shamanism that the dilemma posed by cultural pluralism is most clearly delimited.     

Health, justice, and the environment

In this article, we argue that the scope of bioethical debate concerning justice in health should expand beyond the topic of access to health care and cover such issues as occupational hazards, safe housing, air pollution, water quality, food and drug safety, pest control, public health, childhood nutrition, disaster preparedness, literacy, and many other environmental factors that can cause differences in health. Since society does not have sufficient resources to address all of these environmental factors at one time, it is important to set priorities for bioethical theorizing and policy formation. Two considerations should be used to set these priorities: (1) the impact of the environmental factor on health inequality, and (2) the practicality of addressing the factor.     

Effects of public health educational campaigns and the role of sex workers on the spread of HIV/AIDS among heterosexuals

This paper presents a sex-structured model for heterosexual transmission of HIV/AIDS in which the population is divided into three subgroups: susceptibles, infectives and AIDS cases. The subgroups are further divided into two classes, consisting of individuals involved in high-risk sexual activities and individuals involved in low-risk sexual activities. The model considers the movement of individuals from high to low sexual activity groups as a result of public health educational campaigns. Thus, in this case public health educational campaigns are resulting in the split of the population into risk groups. The equilibrium and epidemic threshold, which is known as the basic reproductive number (R0), are obtained, and stability (local and global) of the disease-free equilibrium is investigated. The model is extended to incorporate sex workers, and their role in the spread of HIV/AIDS in settings with heterosexual transmission is explored. Comprehensive analytic and numerical techniques are employed in assessing the possible community benefits of public health educational campaigns in controlling HIV/AIDS. From the study, we conclude that the presence of sex workers enlarges the epidemic threshold R0, thus fuels the epidemic among the heterosexuals, and that public health educational campaigns among the high-risk heterosexual population reduces R0, thus can help slow or eradicate the epidemic.     

美国、加拿大环境和健康风险管理方法

对目前美国和加拿大多个部门使用的风险评价与风险管理方法进行了全面回顾和综合分析,论述各种不同方法的特征,深入探讨各种管理方法的基础、利弊、使用经验,辨识环境、人类健康和职业健康风险综合方法中应该包含的要素,阐述风险管理目标的确定方法,以期为中国的环境风险管理提供经验。     

Effect of cotton dust on lungs among female workers in cotton industry in northern Gujarat,India

Byssinosis is a disabling occupational lung disease caused by cotton dust. It is a well-known occupational respiratory disease in cotton industry workers caused by cotton dust pollution. Many studies have been documented the effects of cotton dust on pulmonary function among workers employed in cotton-spinning mills. However, little data exist on the prevalence of this disorder in female workers particularly in western part of India. The present study was conducted to analyze the effects of exposure to cotton dust on pulmonary functions among female workers. The study was designed to assess the effects of exposure to cotton dust on lung functions among female cotton industry workers. Study group comprises 50 Female workers of cotton industry and control group comprises 50 age matched females who were neither worked in cotton industry nor exposed to cotton dust. Information was collected using standardized questionnaires, physical examination and spirometric measurements. Student''s T test was used to find the difference between spirometric parameters. All the respiratory parameters (FVC, FEV1, FEV1/FVC ratio, FEF 25-75 % PEFR and MVV) were reduced in cotton industry workers as compared with control subjects (p<0.0001) and no significant difference of SpO2 between groups. Cotton dust exposure makes huge impact on respiratory parameters of the cotton industry workers. This deterioration in respiratory health deteriorates with increasing duration of exposure. The health hazards caused by cotton dust should be controlled by creating awareness among the workers & employers.     

Effect of alternate nostril breathing on cardio respiratory parameters and muscle strength among rotating shift workers

Night shifts at work is the most frequent reasons for circadian rhythm disruption and subsequent psychological and physiological disturbances, especially increased risk of cardiovascular and respiratory ailments compared to daytime workers. Alternate nostril breathing for about 15 minutes was known to have effect over cardiac, respiratory parameters and muscle strength. Hence aim is of interest to assess the effects of alternate nostril breathing (ANB) on cardio-respiratory parameters and muscle strength among the rotating shift workers in the tertiary care hospital. This observational study was carried out in the department of Physiology after getting institutional ethical committee clearance. Around 140 rotating night shift workers of both sex of age 25-40 years with normal BMI and 140 non-shift workers age, sex and BMI matched were selected as study and control group respectively. Heart rate, blood Pressure, respiratory rate, peak expiratory flow rate, respiratory endurance, respiratory burst test, muscle strength and fatigue were recorded before and after 15 minutes of ANB. Shift workers were found to have significantly altered systolic (P=0.000) and diastolic (P=0.002) blood pressure and heart rate (P=0.010) compared to non-shift workers. Fatigue is altered significantly (P< 0.05) after ANB between both shift and non- shift workers. ANB can be used as a therapeutic module among the shift workers, to maintain their sound health and to improve their performance in the night duty.     

Evaluation of Occupational Injuries among Young Workers in West Virginia

We compared workplace injuries between young (16 to 19 years of age) and adult workers using West Virginia Workers' Compensation database. All workers injured between January 1 and December 31, 1995 were included in the analysis. The industry-specific injury incidence rates between young and adults workers were significantly different with lower rates of injury in young workers in all sectors except service sector. In the service sector the young workers had significantly higher injury rates than adults (rate ratios for young workers were 2.28, 1.92, and 2.94 when compared with age groups 20-24, 25-34, and >34, respectively). Estimates of the proportional injury ratio (PIR) indicated significantly greater risk of finger (PIR 1.62) and hand (PIR 1.66) injuries and burns (PIR 3.27) and lacerations (PIR 1.69) in the young workers. The proportion of injuries occurring in the summer months was higher in the young than in the adults (35.2% vs. 27.0%), particularly in the service sector (79.6% vs. 25.9%). Higher injury rates in young workers compared to adults in the service sector may be explained by the seasonal employment of young workers in West Virginia.     

Oral health behind bars: a study of oral disease and its impact on the life quality of an older prison population

Objective: The principal aims of this study were to report on the prevalence of oral disease and its impact on the life quality of older (aged 60 and above) prisoners at Hong Kong SAR's elderly detention centre, China. Design: A cross‐sectional epidemiological survey involving clinical oral examinations and face‐to‐face interviews with 64 older prisoners at the centre. Clinical oral examinations were carried out following WHO criteria. The impact of oral health on life quality was assessed using the 14‐item Oral Health Impact Profile measure, OHIP‐14 Results: The prevalence of oral disease was high, the mean DMFT was 22.5 (SD 10.6) and 40% (18) of the dentate prisoners had shallow or deep periodontal pockets. Most (75%, 48) were in need of prosthetic treatment. Over half the prisoners experienced one or more oral health impacts on life quality during the previous year. This was associated with socio‐demographic factors: employment status prior to incarceration (P<0.01), oral health behaviour: smoking habits (P<0.01) and clinical oral health status: DMFT (P<0.05) and prosthetic need (P<0.05). Conclusion: Among inmates at Hong Kong's elderly detention centre, the prevalence of oral disease was high and the impact of oral health on their life quality was substantial. The impact of oral health on the life quality of the older prisoners was associated with prisoners socio‐demographic background, oral health behaviour and oral health status.     

Everything and nothing: regulating embryo research in Canada

This article examines how medical and scientific professionals experience and engage with the governance of embryo research in Canada. Drawing on the history of embryo regulation in Canada and the findings of a survey conducted with lab directors in Canadian fertility clinics, we identify a disjuncture between the rules established by legislation, regulations, and research ethics guidelines and the real-life experiences of professionals in the field. This disjuncture, we argue, is the result of both the absence of implementation mechanisms that would give substance to the governing framework, as well as an inability on the part of medical and scientific professionals to engage in robust self-regulation. Overall, we demonstrate that in an ethically charged and highly technical area of policy-making like embryonic research, clarity about the roles and responsibilities of government and professionals in policy-making and implementation is critical to effective governance.     

Bringing class back in: class consciousness and solidarity among Chinese migrant workers in Italy and the UK

The growing literature on international migration has a tendency to emphasize homogenous elements such as shared ethnic background, social network and cultural similarities in shaping immigrants' identity. We argue that this underestimates the differences (and sometimes conflicts) of interests between ethnic employers and migrant workers and that class needs to be brought back into the studies of ethnic relationship. Based upon findings from a series of fieldwork in Veneto, Italy and East Midlands, UK, this article contends that class consciousness has co-existed, sometimes uneasily, alongside co-ethnic and cultural relationships among Chinese migrant workers and has played an important part in the making of new Chinese communities. By analysing the perspectives of Chinese migrant workers and their relationship with co-ethnic entrepreneurs, this article illustrates complex factors behind the formation, diffusion and development of class consciousness among Chinese migrant workers.