bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep learning modeling to assess surface temperature and greenery impact on emergency room access
Authors: Castellana F , Zupo R , Catino F , Ceci M , Addabbo F , Cervellera S , Mincuzzi A , Giannico O V , Sardone R
Published: October 2024

The escalating land surface temperature is a key environmental indicator with potential repercussions on human health. An artificial NN model was built to predict the number of ER accesses as a dependent variable, to establish the predictive power and interactions of land surface temperature and normalized differential vegetation index(NDVI), which is used to measure urban greenery.A map of Taranto was built by vector files on the Apulia region website and processed using R Studio 2023.06.2.The vector file containing the mapping of the city of Taranto was processed to obtain a 200mx200m grid of the entire surface.The Local Health Authority of Taranto provided indications of the residences of ER accesses, and coordinates were merged to gridded vector file to obtain the average of ER accesses and the socio demographic features per single grid unit. NDVI and surface temperature were averaged for July 2023 using images from Landsat 8(30m) and merged to the vector providing an average value of temperature and NDVI index per single quadrant. The dataset was divided into two db according to an 80/20 ratio respectively for the training and test dataset.A NN model was built on dichotomous value (above/below median) for each quadrant (6513 units) with hyperparameter tuning technique using the accuracy to select the best model.A MOC model was built to reduce the probability of NN detection by at least 40% in a randomly selected subject.A MOC model was built considering sociodemographic variables as fixed features and an epsilon of 0 for 175 generations and an ICE curves population initialization strategy. NNET accuracy value was 0.849 and 0.841 in training and testing, suggesting a good fitting of the model.Relative change plots were adopted to show the amount and the direction of generated counterfactuals, to reduce grid unit prediction to be over median.LST decreasing and NDVI score increasing were associated with a reduction of classification probability of grid unit.

Key messages

• Rising land surface temperature is a critical environmental indicator with potential impacts on human health.

• Artificial neural network models perform well in predicting the number of ER accesses with respect to land surface temperature and NDVI, which is used to measure urban greenery.
Urban burden of disease estimation for policy making
Authors: Dyer G , Khomenko S
Published: October 2024

Introduction

The Urban Burden of Disease Estimation for Policy Making (UBDPolicy) project aims to estimate the health impacts resulting from urban and transport planning related exposures in nearly 1000 European cities. So far, quantitative burden of disease assessments have estimated premature mortality attributable to the environmental stressors of air pollution, noise, urban heat islands and lack of green space for the year 2015. Regular reporting and trend monitoring of the health impacts associated with urban environments is crucial for assessing the wider impacts of urban and transport planning.

Methods

For almost 1000 European cities, quantitative Health Impact Assessments (HIAs) will be conducted that employ the comparative risk assessment methodology. Baseline exposure levels of air pollution, noise, urban heat islands and green space will be estimated and preventable health impacts modelled using counterfactual exposure scenarios. Analysis will comprise two components: firstly, the 2018 HIA will incorporate multiple environmental exposures for that year, while the second component will monitor trends at three-yearly reporting intervals covering the years of 2015, 2018, 2021 and 2024.

Results

Results are intended to shape evidence-informed urban planning and policies throughout Europe. By ranking cities according to environmental exposures and health impacts, cities are encouraged to address challenges and learn from successful urban design and planning policies in other cities.

Discussion

HIAs serve as an effective tool for identifying the health impacts of current and future urban policies. The provision of burden of disease estimates will provide policy-makers and practitioners robust data for informed decision-making, while estimates over time will allow tracking of changes from implemented policies. To fully harness the potential of cities as key drivers of sustainable and healthy living, robust evidence must be at the forefront of this change.

Key messages

• A multitude of urban and transport planning pathways contribute toward the health of urban populations.

• Compact city designs often promote health, however there are exceptions.
How to analyze multistakeholder collaboration for infectious disease outbreaks: a scoping review
Authors: Cesuroglu T , Baggen O A , Berg C R , Ong CHL , Flach R E , Fahner A G , Stein M , Swaan C
Published: October 2024

Introduction

Effective preparedness and response to infectious disease (ID) outbreaks demand collaboration among diverse stakeholders from public health and beyond. However, the organization and roles of stakeholders vary widely across countries and have evolved notably during the COVID-19 pandemic. Novel methodologies are essential to analyze and bolster collaboration in this context. We conducted a scoping review to explore methods utilized for evaluating multistakeholder collaboration in ID outbreak preparedness and response.

Methods

We comprehensively searched scientific and grey literature using keywords such as evaluation of collaboration, stakeholder analysis, (multi)stakeholder/multisectoral collaboration, and network coordination in PubMed, GoogleScholar and Google. Given the limited literature on ID outbreaks, we expanded our scope to include other public health emergencies (PHE) and related fields. Publications were analyzed to discern their aims, fields served, and methodologies employed.

Results

Twenty pertinent publications from Africa, Europe, North America, and Oceania were identified. These publications addressed diverse aims and fields, including stakeholder identification, network mapping in outbreak management and One Health initiatives, enhancing multistakeholder/ multisectoral collaboration for PHE response, primary care partnerships, and evaluating governance of networks in public policy. Methodologies encompassed network analysis, stakeholder mapping, and evaluative frameworks tailored to specific contexts. Common themes included trust-building, shared goals, decision-making processes, and information exchange.

Conclusions

The literature presents varied dimensions crucial for developing methodologies to evaluate multistakeholder collaboration in ID outbreak contexts. These evaluations ultimately will lead to strengthened multisectoral collaboration and coordination, and better preparedness and response for ID outbreaks.

Key messages

• Effective evaluation methodologies are crucial for enhancing multistakeholder collaboration in infectious disease outbreak preparedness and response worldwide.

• Diverse approaches from various sectors offer valuable insights for developing tailored evaluation methods to assess collaboration in specific public health contexts.
Interaction of polychlorinated biphenyls exposure, lifestyle and genetic risk in dyslipidemia
Authors: Yao Y , Ma J , Chen W
Published: October 2024

Background

Polychlorinated biphenyls (PCBs) are endocrine-disrupting chemicals that have been associated with various adverse health conditions. However, the interaction effects between PCBs, lifestyle, and/or genetic susceptibility on dyslipidemias are still unknown.

Methods

Six serum PCBs including PCB-28, 101, 118, 138, 153, and 180 were determined in 3,845 participants from the Wuhan-Zhuhai cohort. Dyslipidemias, including hyper-total cholesterol (HyperTC), hyper-triglyceride (HyperTG), hyper-low density lipoprotein cholesterol (HyperLDL-C), and hypo-high density lipoprotein cholesterol (HypoHDL-C) were classified based on serum lipids levels, which were examined by an automatic biochemical analyzer. Besides, we constructed lipid-specific polygenic risk scores (PRS) and healthy lifestyle scores, and used Logistic regression models to explore the relationships of serum PCBs, lifestyle, and PRS with dyslipidemias.

Results

We observed that all six PCB congeners were positively associated with the prevalence of dyslipidemias to varying degrees. In particular, dose-response manners were observed between ΣPCB levels and odds ratios (ORs) of HyperTC, HyperTG, and HyperLDL-C, respectively. Besides, we found that PRSs and unhealthy lifestyles were both positively associated with dyslipidemias. For the combined effect of ΣPCB, lifestyle, and PRS, participants with high ΣPCB, unfavorable lifestyle, and high genetic risk had the highest odds of HyperTC (2.285; 1.533, 3.417), HyperTG (7.944; 5.169, 12.329), and HyperLDL-C (3.523; 2.311, 5.394) when compared with those with low ΣPCB, healthy lifestyle, and low genetic risk.

Conclusions

Our study provided evidence that PCB exposure potentially increases the prevalence of dyslipidemias, which may be exacerbated by genetic susceptibility and unhealthy lifestyles.

Key messages

• Our results highlighted the importance of reducing PCB exposure, adopting healthy lifestyles for the prevention of dyslipidemia.

• Our work might facilitate the emergence of reducing or regulating PCB pollution to control blood lipids and the resultant dyslipidemia epidemic.
Long-term effects of arsenic on glucose-insulin homeostasis: A gene-environment interaction study
Authors: Yongfang Z
Published: October 2024

Background

Arsenic exposure and genetic factors are associated with an increased risk of type 2 diabetes, yet study of environment-gene interaction on glucose-insulin homeostasis remains scarce. We aimed to investigate the associations and interactions of urinary total arsenic (UTAs) and genetic susceptibility with glucose-insulin homeostasis through a longitudinal epidemiological study.

Methods

A total of 6136 observations (3063 participants) from the baseline, 3-year follow-up, and 6-year follow-up of the Wuhan-Zhuhai cohort were included in this study. In each study period, we repeatedly measured UTAs, fasting plasma glucose (FPG), fasting plasma insulin (FPI), and homeostasis model-assessed insulin resistance (HOMA-IR) and β-cell function (HOMA-β). Polygenic risk scores (PRSs) specific for all traits were constructed by corresponding genome-wide association summary statistics. Linear mixed models were used to assess associations and interactions of UTAs and PRSs with four indicators of glucose-insulin homeostasis.

Results

After adjustment for all covariates, the βs (95% CIs) for the annual growth rates of FPG, FPI, and HOMA-IR were 0.020 (0.008, 0.032), 0.007 (0.002, 0.013), and 0.011 (0.004, 0.017), respectively, associated with each ln-unit increase in UTAs. Compared to subjects with the first-quartile PRS and low UTAs, participants with the fourth-quartile PRS and high UTAs had a 0.029 (0.012, 0.047) or 0.032 (0.012, 0.051) ln-unit increase in the annual growth rate of FPI or HOMA-IR, respectively. UTAs and PRS had significant interactions on the longitudinal progressive increases of FPI and HOMA-IR (P interaction < 0.05).

Conclusions

Arsenic exposure and genetic variants are significantly synergistic risk factors for dysregulation and progressive deterioration of glucose-insulin homeostasis. Our findings emphasize the importance of reducing arsenic exposure to maintain normal glucose-insulin metabolism, especially for those at higher genetic risk.

Key messages

• Arsenic exposure was associated with annual increased rates of FPG, FPI, and HOMA-IR.

• Arsenic exposure and trait-specific PRSs are synergistic risk factors for glucose-insulin homeostasis impairment.
How characteristics of place affect multimorbidity: a systematic scoping review
Authors: Zheng C , MacRae C , Rowley-Abel L , Arakelyan S , Abubakar E , Dibben C , Guthrie B , Marshall A , Pearce J
Published: October 2024

Background

Multimorbidity has become a global public health challenge. Increasing work has identified different individual- and household-level determinants of multimorbidity; however, our understanding of how characteristics of place affect multimorbidity remains limited. This scoping review aims to identify the place-based risk factors of multimorbidity and to synthesis evidence (longitudinal in particular) on how place-based risk factors affect multimorbidity.

Methods

Following PRISMA-ScR guidelines, a predefined search strategy (https://osf.io/bf84m) was run across 7 major databases in 2023, with a double screening and data extraction process. English-language peer-reviewed studies exploring the relationship between place-based characteristics (from neighbourhood to region) and multimorbidity among the general population aged over 18 years old were included from 2010 to 2023.

Results

Out of 7761 records, 129 underwent full-text review, resulting in 76 included studies (15 longitudinal). We identified 12 types of place-based risk factors of multimorbidity, with area-level deprivation/SES, pollution, and urban/rurality most frequently examined. Fairly consistent findings suggested that people in more deprived, polluted, or urbanised areas were more likely to be multimorbid, which may further vary by multimorbidity definitions/measurements. Other place-based risk factors, such as social cohesion and greenspace availability, were linked to different single health conditions, but their associations with multimorbidity were underexplored. Finally, we proposed a potential theoretical framework that links place and multimorbidity through multiple pathways based on the synthesised evidence.

Conclusions

There remains only a partial understanding of how ‘place’ affects multimorbidity. Future studies should employ more precise measures for both place-based risk factors and multimorbidity and use longitudinal designs and analytical approaches for more causal insights.

Key messages

• This is the first scoping review that proposed a theoretical framework that demonstrates the links between place and multimorbidity.

• This study will greatly benefit local policymaking and public health intervention initiation.
How social and commercial determinants influence exclusive breastfeeding in the Philippines
Authors: Wang Z , Di Ruggiero E , Lau L , L’Abbe M
Published: October 2024

Background

The World Health Organization recommends exclusive breastfeeding (EBF) for the first six months after delivery. However, the EBF rate in the Philippines is only 29%. Existing literature suggests that the influence of infant formula marketing (IFM), communication channels, and traditional health beliefs are possible contributors to low EBF rates, but rare studies have been conducted in low-resource settings. 

Methods: 

To bridge the gap, 15 barangays in Palawan were selected; 97 interviews were conducted with lactating mothers (LM), health workers (HW), traditional healers, infant formula sellers, and community leaders (CL) to represent different perspectives. The results were coded and analyzed inductively.

Results

LM received EBF information through multiple resources. Poverty, lacking breast milk (BM), EBF education, and health benefits (HB) to infants are top contributors to EBF while maternal employment and no BM are top barriers to EBF. Elders, traditional health beliefs (THB), and the influence of COVID-19 can influence EBF in both directions. LM emphasized more on poverty and elders to EBF while HW and CL emphasized the role of EBF education and HB. Urban LM tend to have more regular EBF education, use pumps when going out, and are more influenced by IFM. LM in remote areas tend to have more THB, have more BM substitutes, and share BM. Social classes, locations, Indigeneity, migration, and poverty are intersectioned to influence EBF.

Conclusions

Multiple social and commercial determinants influenced EBF. LM is facing more challenges to EBF under globalization and capitalism. Remote LM are less benefited from new technologies and policies to promote EBF. Different stakeholders have echo chambers to perceive the determinants of EBF. To improve health equity and EBF, the situations of marginalized people in remote areas should be more considered in policy making. Community building should also be considered differently to assist in EBF. 

Key messages

• The project focuses on social and commercial determinants of exclusive breastfeeding with people in extreme poverty.

• The project includes plenty of Indigenous breastfeeding behavior that are underreported.
Estimation of Environmental Burden of Disease related to Arsenic exposure in European Populations
Authors: Benchrih R , Buekers J , Demoury C , Martins C , Purece A , Thomsen S T , Waegeneers N , De Clercq E , Devleesschauwer B
Published: October 2024

Background

Arsenic (As) exposure poses significant health risks to exposed populations, with exposure occurring predominantly via diet for the general population as recently referred by the European Food Safety Authority. This study assesses the environmental burden of disease (EBD) for three cancer types related to arsenic, across Europe.

Methods

A literature review was conducted to 1) identify the dose-response function (DRF) to assess the cancer risk in European populations, and 2) define EBD approaches applicable to the available data. Country-specific data (Belgium, Denmark, Portugal) for EBD calculation (exposure, socioeconomic status, health outcomes) were gathered. Disability-Adjusted Life Years (DALY) estimations were performed by calculating attributable cases (AC).

Results

Two main references are used for DRF: the United States Food and Drug Administration DRF for assessing bladder and lung cancer risks, and the United States Environmental Protection Agency DRF for skin cancer. Preliminary results for Belgium indicate that inorganic arsenic dietary exposure ranges from 0.084 [0.080 - 0.088] to 0.102 [0.097 - 0.107] µg/kg body weight per day, varying with education level. Stratified estimates suggest that individuals with higher educational attainment (ISCED levels 5 & 6) have a marginally higher average daily intake of arsenic compared to those with lower educational attainment (ISCED levels 0, 1 & 2). DALY attributable to inorganic arsenic exposure follow the same trend as exposure levels, i.e. individuals with a higher education level bear a higher burden of disease than individuals of the low education stratum. This concerns the three studied cancers.

Conclusions

This study quantifies DALY related to inorganic arsenic from dietary exposure for different European countries. Our findings will contribute to better target public health policies and interventions for arsenic risk mitigation.

Key messages

• Exposure to inorganic arsenic is confirmed in European countries.

• EBD studies guide action priorities to tackle chemical risk factors.
Flatbreads in Kazakh, Kyrgyz, and Uighur Groups and its Role in Sustainable Food System
Authors: Wang Z , Sultan A , Feruza S , Asanaliev A , Maimaiti G
Published: October 2024

Background

Flatbreads are various types of comparably thin bread and are widespread in a large region. People embed flatbreads with special cultural meanings and adapted local ingredients for baking flatbreads. More attention has been focused on flatbreads in recent years. However, how the cross-border Kazakh, Kyrgyz, and Uighur groups use flatbreads is understudied.

Methods

To understand how the cross-border Kazakh, Kyrgyz, and Uighur groups use flatbreads, the current paper reviews existing English, Mandarin, and some Russian literature to summarize how the Kazakh, Kyrgyz, and Uighur groups use flatbreads.

Results

The results show that these three ethnic groups prepare and use flatbreads in multiple aspects. The Kazakh, Kyrgyz, and Uighur people use 23, 9, and 17 types of flatbreads respectively. The flatbreads used by the Kazakh and Kyrgyz people have more overlapping than those of the Uighur people while the relevant studies of Kyrgyz people are more understudied. This resemblance may be because of the closer nomadic lifestyle and the similar influences of Russia and the USSR. The ingredients of flatbreads are aligned with the local ecosystems and have been evolving consistently in the past centuries because of the changes in technology, politics, lifestyles, health perceptions, acculturation, and globalization.

Conclusions

Because of the eco-friendly features of flatbreads and the widespread use of these foods, flatbreads have a high potential to support a regional strategy for sustainable food system transformation and planetary health along the Silk Road countries. To achieve this goal, more studies should be conducted to contribute missing information about ingredients, cooking methods, features, and regional differences in using flatbreads; more nutritious and bio-diverse recipes of flatbreads and the most eco-friendly cooking energy resources for baking flatbread should be identified; new meanings should be given to flatbreads to promote the use.

Key messages

• The first study to summarize how Kazakh, Uighur, and Kyrgyz peoples use flatbread.

• Justify a potential to use flatbread for sustainable food system transformation.
Oxidative stress and cytotoxicity of co-formulants of glyphosate-based herbicides in HMWB cells
Authors: Makame K , Masese S , Ádám B , Nagy K
Published: October 2024

Background

Glyphosate-based herbicides (GBHs) are widely used worldwide because of their effectiveness and low cost. However, there is a growing concern regarding the potential health risks associated with glyphosate exposure. Glyphosate is always marketed in formulations containing ingredients other than the active substance. These co-formulants may have toxic effects on humans and animals. Although several studies have assessed the health risks related to glyphosate, the toxicological effects of the co-formulants must be analysed in more detail to ensure the health and safety of pesticide users and the general population. This study aimed to characterize and compare the cytotoxic effects of co-formulants with those of the active substance and GBH formulations.

Methods

Human mononuclear white blood (HMWB) cells were exposed to varying concentrations (0.1 µM, 1µM, 10 µM, 100 µM, 1 mM, 10 mM) of glyphosate, three GBHs (Fozat 480, Roundup, and Glyfos), and two co-formulants for 4- and 20-hours. Cytotoxicity was assessed using the CCK-8 assay, and oxidative stress levels in HMWB cells were evaluated using the superoxide dismutase (SOD) assay. Cell viability and SOD activity were analysed using a spectrophotometer at 460 nm absorbance.

Results

Glyphosate alone did not significantly affect the cell viability. However, notable cytotoxic effects were observed in response to GBHs and adjuvants at concentrations as low as 100 µM. Furthermore, the Oxidative stress levels in cells treated with GBHs or adjuvants were significantly higher than those treated with glyphosate alone.

Conclusions

These findings suggest that the cytotoxic effects of GBHs are likely attributed to the adjuvants present in the formulations, which promote oxidative stress. Further studies are necessary to evaluate the health risks associated with using glyphosate-based herbicides, and co-formulants should be considered when assessing their safety.

Key messages

• The safety of GBHs cannot be solely attributed to glyphosate itself but also to the other components in the formulation.

• Toxicity evaluation should take into account not only glyphosate but also the co-formulants present in these herbicides when assessing their safety.
Artificial sport surfaces and adverse effects for human health. A literature review
Authors: Ghelli F , El Sherbiny S , Squillacioti G , Bellisario V , Panizzolo M , Bono R
Published: October 2024

The management of the Post-Consumer Tyres (PCTs) is still a hot topic. In 2021, the 27 EU Member States plus Norway, Switzerland, and the UK discarded 4,200 Ktons of PCTs. The main application of the rubber granules obtained from their recycling is represented by infill material in synthetic turf playgrounds. These widespread installations have become fundamental tools for the promotion of physical activity, especially among children. However, this material is in the spotlight for the presence in its composition of hazardous substances and for the small size of granules, which the European Commission classified as “microplastics”. This review aims to clarify the scientific knowledge, focusing on the assessment of the bio-accessibility/availability of hazardous chemicals and the risk assessment for users. Eligible articles reporting original data were identified in CAB Direct, Embase, PubMed, Scopus, and Web of Science. The included articles (preliminary results) variously demonstrated the presence of PAHs, metals, volatile organic compounds, and phthalates in artificial biofluids (n = 9 articles). The risk assessment for these toxicants and the potential cancer risk induction (n = 19), revealed a risk for users from absent or negligible to potential, according to the exposure scenario considered and the relative assumptions, the contaminants, the exposure route, the age of the pitch, and characteristics of the rubber granules such as origin, concentration of the different toxicants, and particle size. The assessment of the potential hazard due to the exposure to artificial sports surfaces is anything but simple. Indeed, the crumb rubber compositions may vary in different settings and over time and can be variously influenced by the climate and environmental conditions, making it difficult to quantify the possible health effects, as well as the specific mixture, the quantities, and sources responsible for them (Funded by LIFE20 GIE FR 282 - RE-PLAN CITY LIFE).

Key messages

• The bioccessibility of PAHs, metals, volatile organic compounds, and phthalates included in the infill material composition was variously demonstrated in literature.

• The assessment of the potential risks due to the exposure to synthetic turf, revealed a risk from negligible to potential, according to the exposure scenario considered and the relative assumptions.
School canteens healthier for children and the planet in the Valencian Region
Authors: Muelas H , Quiles J , Boned-Ombuena A , Vicent P , Hernández P , Taut P , Sánchez-González R , Navarro E , García A , Garcia-Sierra M
Published: October 2024

Issue

SchoolFood4Change (SF4C), an EU Horizon 2020 project in 12 EU countries, aims at making school meals healthier for children and the planet through innovative and sustainable food procurement, promotion of planetary health diets and cooking, and a Whole School Food Approach. In the Valencian Region two subsequent market dialogues (MDs) were organised to explore a new school food procurement and feeding model.

Description

In our context, most children have lunch at school daily. SF4C sees schools as catalysts for a systemic change. Two intersectoral MDs were conducted with the participation of public authorities, food procurers, cooks and schools. The first one MD1, 23 attendees, used a gamification dynamic through building blocks. MD2, 58 participants, used a World Cafe methodology to analyse nutritional, environmental, educational, social and economic determinants.

Results

MD1 highlighted the need to increase food education in the curricula, value regional products and cuisine, improve culinary training and reduce food waste. It suggested establishing percentages of local and organic products in tenders and improving communication between the public administration and the educational community. MD2 emphasised the objective of promoting the Mediterranean diet and sustainability in canteens. To that end, participants identified the importance of establishing requirements in public tenders, annual planning of procurement, optimising logistics and integrating the canteen into the educational project. This would enhance predictability, economic sustainability, and social support for a new innovative model.

Lessons

Structured interaction between stakeholders was essential to devise innovative and sustainable solutions. The creation and dynamization of intersectoral working groups is an effective public health strategy to build networks for the co-creation of viable alternatives to achieve a healthier and more environmentally sustainable school feeding.

Key messages

• Structured interaction in intersectoral working groups is an effective public health strategy for the co-creation of viable alternatives to make school feeding healthier for children and the planet.

• Tailored innovative and sustainable solutions entail a framework for structured discussions, specific context analysis, negotiations between stakeholders and locally adaptation of good practices.
Distribution of the Culex pipiens mosquito in mainland Portugal: a geospatial modelling study
Authors: Martinho J , Osório H , Amaro F , Silva M , Zé-Zé L , Alves M J , Nunes B , Soares P
Published: October 2024

Background

The mosquito Culex pipiens is a vector for several pathogens, such as the West Nile virus. As the most abundant mosquito in Portugal, understanding its spatial distribution can support vector-borne diseases control and robust public health planning, given the mainland’s favourable climate for this vector. Information on its spatial distribution at a national level is limited, especially its association with climate variables. Thus we aimed to predict the suitability of Culex pipiens distribution in mainland Portugal, considering climate factors.

Methods

We used presence records for adult and larvae of Culex pipiens mosquitoes sampled across mainland Portugal from January 2017 to October 2023, as part of the Portuguese Vector Surveillance Network program (REVIVE). Between May-October, in random locations and throughout the year in point-of-entry sites, adult mosquito collection used CDC light traps and BG-Sentinel traps, and larvae collection used dippers in breeding sites. Sampling bias was corrected by filtering presence sites, retaining one record per each cell grid of 1 km2. Climatic data (including temperature, precipitation and elevation) were used as predictors in a maximum entropy (MaxEnt) model of the Culex pipiens geographical distribution.

Results

From the dataset of 6859 records, 1416 unique sites were obtained after filtering. Suitable habitats seem to be mainly distributed on the coast, particularly in Minho, Porto and Lisbon metropolitan areas, and Tagus Valley, with precipitation as the most important predictor.

Conclusions

Most West Nile Virus case reports come from the south of Portugal, but the potential distribution of Culex pipiens covers the whole mainland territory, with seemingly higher distribution on the north coast. However, bias due to convenience sampling could be present. West Nile vector surveillance should be a priority across all regions to accurately assess transmission risk and implement effective control measures.

Key messages

• The suitability of Culex pipiens distribution covers the entire mainland of Portugal, with higher presence in the north.

• The distribution of Culex pipiens in the country points towards a need for developing region-specific strategies regarding West Nile Virus prevention and control.
Mercury contamination of soil and Matricaria chamomilla in selected regions of the Slovak Republic
Authors: Kimáková T , Ruszkiewicz K , Poračová J , Bednarski A , Yip C , Sieradzka Uchnár K
Published: October 2024

Background

The aim of our study was to determine the amount of mercury in Chamomile. In certain parts of Slovakia, such as Middle Spiš region in Eastern Slovakia, there has been reports of higher concentration of mercury in the soil. Heavy metals, including mercury, can enter human organism by ingestion. In case of using Chamomile infusions orally there is a risk of administration of mercury into the organism through digestive system.

Methods

We monitored mercury presence in Chamomile (Matricaria chamomilla) (n = 20) and the soil. We determined the mercury concentration by using the flameless atomic absorption spectrometer - Advanced Mercury Analyzer (AMA-254).

Results

Chamomile: The lowest concentration was in the roots (0.513 mg.kg-1). The second lowest was in the flower stem samples (1.105 mg.kg-1). The concentration of mercury was higher in the leaves (2.205 mg.kg-1). The highest was measured in the flower (2.541 mg.kg-1). Soil: The mercury content in soil in the entire territory of Slovakia is higher compared to the soil in the world. During our measurements, the concentration of mercury in the soil samples in the territory of Middle Spiš ranged from 100 to 500 mg.kg-1.

Conclusions

We have to take into account that the quality and contents of the soil are important for the crops, as it will entail their contents. With the knowledge of exceeded norms of mercury content in Slovak soils, it is crucial to monitor the mercury concentration in plants that are harvested there.

Key messages

• In the examined samples of Chamomile we found mercury, with its highest concentration in flowers and lowest in roots.

• In the regions with significant mercury contamination it is crucial to monitor mercury content in harvested plants and to be cautious in regards of their consumption.
Monitoring of mosquito breeding sites in the municipality of Cascais, Portugal
Authors: Costa e Silva R , Duarte da Silva J , Nunes R , Quelhas C , Lopes M , Fernandes M
Published: October 2024

Culex pipiens is the primary West Nile Virus vector in Portugal. Additionally, in 2017, Aedes albopictus, vector of various arboviruses, was detected in Northern Portugal. To mitigate viral transmission risks, effective surveillance is crucial, including monitoring egg, larva, and pupa stages. Located on the west of Lisbon, Cascais implemented a surveillance based on monitoring invasive species at Points of Entry and, complementarily, on detecting and intervening in breeding sites. Active searches for new breeding sites and monitoring those that were already identified are conducted weekly during the peak mosquito season (May to October) and biweekly during the colder season (November to April), following the methodology outlined below: • Upon detection, samples of immature stages are collected for submission to the National Institute of Health (INSA); • Corrective measures are requested to the managing entities of the locations where the sites are found; • Date of action, location, collection point, date of report, and status (pending or intervened) are recorded on a database; • Locations with pending status undergo continuous monitoring.

In 2023, 16 artificial breeding sites were identified. These findings resulted from 23 actions conducted across 8 locations. 35 samples of immatures were collected, followed by their submission and notification to the respective managing entities. Recurrent detections were noted in 9 breeding sites. The managing entities implemented measures at 13 of the identified sites, leaving 3 with pending intervention. The identification of breeding sites demands continuous monitoring efforts and requires an effective coordination between the Public Health services and the management entities. Based on the achieved outcomes, it is evident that the implementation of corrective measures has been successful, making a significant contribution to reducing mosquito density.

Key messages

• Effective surveillance and intervention strategies are crucial in mitigating West Nile Virus and arbovirus transmission risks in Portugal.

• Continuous monitoring and coordination between public health services and management entities are key for maintaining effective vector control measures.
Development of an air quality communication strategy with underserved groups
Authors: Tolley C , Wilson S , Hassan N , de Nazelle A J , Slight R , Slight S
Published: October 2024

Air quality is the greatest environmental health threat. Effective communication can support individuals to take actions to protect themselves, however, we know some groups are less likely to engage with exposure reducing behaviours than others. We aimed to explore what information individuals want to receive about raised air pollution levels, when, where and how they would like to receive it. In this qualitative study individuals participated in either semi-structured interviews (n = 6) or focus groups (n = 8) in North East England between Oct23-Feb24. We used purposive sampling underpinned by extensive community-based engagement to ensure inclusion of those who were underserved and/ or at risk of digital exclusion. The Capability Opportunity Motivation-Behaviour model was used to help guide discussions and the data thematically analysed using an inductive approach. Fifty individuals participated, many of whom were of non-white ethnicity (n = 23, 46%), spoke English as an additional language (n = 12, 24%), and had lower educational attainment levels (i.e., no-qualifications n = 7, 14%). Participants discussed four aspects that they deemed important to include in air quality communication: (1) the risk and harms of air pollution should be stated, and be tailored because “what’s a dangerous level for one person isn’t a dangerous level for another”(P41) (2) Participants felt detail about the pollutants should be included such as: “what is causing the air pollution?”(P15) to “avoid the exposure to this source”(P21). (3) Messages should also include actionable recommendations about how to protect oneself and, (4) various ways to communicate these messages (text-message-based approaches being the most popular) were suggested. Our findings indicated using a combined communication strategy including text messages and community-based approaches. This work can inform the development of inclusive future air quality information communication

Key messages

• Effective communication can support individuals to take actions to protect themselves from air pollution.

• A combined communication strategy including text messages and community-based approaches were suggested as being effective communication strategies.
Cancer mortality attributable to air pollution in Slovakia
Authors: Pekarcikova J
Published: October 2024

Introduction

Air pollution is considered one of the most significant global environmental health risks. According to the Global Burden of Disease estimates, fine particulate matter, a key component of ambient air pollution, was the fifth leading risk factor for mortality worldwide in 2015, contributing to 4.2 million deaths (7.6% of total global deaths). In 2019, ambient air pollution was responsible for 4.5 million deaths. This rise is attributed to the growing levels of air pollution and the increasing incidence of NCDs associated with air pollution.

Aim

This contribution aims to clarify the possible association between environmental air pollution and cancer in Slovakia in the years 2015-2019 overall and by gender and age.

Methodology

This ecological study focuses on the population of Slovakia from 2015 to 2019. The data used are from the Global Burden of Disease study (IHME, 2019), the Statistical Office of the Slovak Republic and the Slovak Hydrometeorological Institute.

Results

In 2019, mortality from NCDs related to environmental pollution accounted for 6.6% of total mortality in Slovakia, which is lower than the global average of 8.3%. Cancer mortality attributable to ambient particulate matter pollution (APMP) was lower in 2019 (2.97 per 100,000, CI 95% 4.43-1.76) than in 2015. Higher cancer mortality rates attributable to APMP, were observed mainly in men (7.18 per 100,950, CI % 10.67-4.31 in 2015) and especially in the 80-84 age group (59.49 per 100,000; CI 95 % 94.60-32.20) in 2015 and in men aged 75-79 (510.76 per 510.76 per 100,000) in 2019.

Conclusions

While Slovakia has experienced a long-term decline in cancer mortality, bucking the global trend, challenges persist due to the country’s relatively poorer outcomes associated with environmental pollution. Addressing environmental pollution remains a critical aspect of ongoing efforts to enhance population health through targeted strategies and policies.

Key messages

• The significant impact of environmental pollution on cancer mortality underscores the urgent need for targeted interventions and policies to improve public health outcomes in Slovakia.

• Cancer mortality attributable to air pollution differs by gender.
Environmental Public Health Tracking in England- support for Health Impact Assessments
Authors: Zeka A , Crabbe H , Leonardi G
Published: October 2024

Environmental epidemiology is a key function for the public health service with regards to investigating the public health effects of environmental hazards, monitoring the public health efforts to control the environmental risks, and providing the evidence that informs decisions making and preparedness. At the United Kingdom Health Security Agency (UKHSA), the Environmental Public Health Tracking (EPHT) Programme, initiated in 2010, has developed a number of data streams to help link environment and health data, to support Health Impact Assessment (HIA). The main aims of the EPHT programme in England are to:

1. Identify populations at risk from exposure to significant environmental and chemical hazards

2. Investigate relationships between hazard and disease

3. Inform public health policy making

4. Optimise intervention and prevention strategies

5. Generate hypotheses for further research.

Such EPHT functions are based on three key components: a) by building a national EPHT program that integrates surveillance of environmental hazards, exposures and related health outcomes, to allow data linkage and assessment of environmental and health information; b) strengthening the epidemiology science, by conducting research and training of the workforce and c) developing strategies for response to immediate risks, incidents and preparing for future risks. Examples to support HIA include a) developing an air pollution exposure surveillance work programme, that has designed a pilot population vulnerability indicator; b) developing indicators for climate change impacts for public health, c) reporting regularly on the health impacts of public fluoridation water supply schemes (as mandated by Government) and d) exploring risk factors associated with elevated blood lead concentration in children, through laboratory reporting to surveillance systems. The talk will highlight some examples of practice and outline how the EPHT programme in England has supported HIA practices.
Income transfer and COVID-19 pandemic in Brazil: wrong and right at the same time
Authors: Castro M , Souza A , Silva G , Oliveira G , Paes-Sousa R
Published: October 2024

To alleviate the effects of socioeconomic inequalities and of the fall in economic activity on vulnerable populations during the COVID-19 pandemic, many countries have implemented or expanded income distribution programs. Brazil, amid the political and economic 2020 crisis, exacerbated by the pandemic, established Emergency Aid (EA). This longitudinal ecological study aimed to analyze whether the availability of EA contributed to the reduction of morbidity and mortality due to COVID-19 in the Brazilian 5,570 municipalities, from March 2020 to December 2021. The theoretical model considered as control covariates socioeconomic, sociodemographic and morbidity characteristics and access to health services, including COVID-19 testing availability and vaccination. Classical variable selection methods were applied considering the theoretical model, culminating in the adjustment of Bayesian hierarchical models with the inclusion of spatial and temporal effects. First dose COVID-19 vaccine coverage and EA had a protective effect against hospitalization (RR = 0.982 and RR = 0.986) and mortality (RR = 0.978 and RR = 0.976) due to COVID-19 in Brazil, when controlled by socioeconomic variables, access to health services and spatial-temporal effects. The results highlight the important role of income transfer in morbidity and mortality due to the disease, however, the way in which EA was implemented in Brazil presented a series of problems, the main ones being discontinued payment of aid, reduction in values throughout the duration of the benefit, in addition to the use of public resources to pay people who did not meet the eligibility criteria. Such problems might not have happened if the federal government had maintained the registration structure of Bolsa Familia Program (BFP), which did not happen. Furthermore, vaccination was started late for several reasons, that is, its role in reducing morbidity and mortality could have been even greater if started as soon as it become available.

Key messages

• Even with planning and execution problems, income transfer and specific vaccination were important in reducing COVID-19 morbidity and mortality in Brazil during the COVID-19 pandemic.

• Income transfer during the COVID-19 pandemic in Brazil was not done in the best way possible, due to discontinued payment, reduction in values and payment to not eligible people.
Did the COVID-19 Pandemic Affect Suicide Rates Differently in Urban and Rural South Korea?
Authors: Kweon S , Baek M , Choi Y
Published: October 2024

Background

The influence of the COVID-19 pandemic on suicide rates remains a subject of debate. Despite increases in suicidal ideation and attempts reported during the pandemic, several recent meta-analyses have not demonstrated corresponding rises in suicide rates. Given the potential for substantial regional and demographic variability in the psychological consequences of COVID-19-related restrictions, this study explores differential suicide rates in urban versus rural contexts within South Korea subsequent to the pandemic outbreak.

Methods

This investigation employed age-standardized suicide rates from two periods, 2015-2019 and 2020-2022, across 234 administrative divisions (152 urban, 82 rural). A difference-in-differences approach was utilized to evaluate the pandemic’s impact on suicide rates, segmented by urban and rural classifications. A linear regression model was developed to examine the interaction between location (urban/rural) and time period, controlled for annual variations, perceived stress, and health status within each locale.

Results

Analysis revealed higher suicide rates in rural areas compared to urban counterparts (β = 1.247, p = 0.003), although no significant changes were observed during the pandemic period itself (β=-0.425, p = 0.682). Furthermore, the interaction between urban/rural status and the pandemic period did not reach statistical significance (p = 0.367).

Conclusions

The findings indicate no significant contribution of the COVID-19 pandemic to increased suicide rates, irrespective of the urban or rural setting. Further research is warranted to dissect the impact of more direct socioeconomic factors on this dynamic.

Key messages

• There in no evidence of increased suicide rates during the COVID-19 pandemic in South Korea.

• The impact of the COVID-19 pandemic on suicide rates did not significantly different between urban and rural areas.