A Bibliometric Analysis of Literature on Prenatal Exposure to Air Pollution: 1994–2022

Early life exposure to air pollutants during pregnancy is one of the leading causes of different health outcomes. However, few studies have provided an overview of this area of research. The aim of this study was to look at the key trends in the research on prenatal exposure to air pollution. Data were retrieved from Web of Science, and the search was conducted based on the paper title, abstract, and keywords. The relevant literature searched was from 1994 to 2022, and 952 English documents were obtained. Of the total documents, 438 documents were included in the review and 83% (n = 365) of the documents were journal articles. Type of document, annual distribution of publications, and distribution of prenatal exposure by countries were extracted. Co-authorship and keywords co-occurrence analyses were also carried out. Of all the countries that published in this field, the United States of America. had the highest number of publications, followed by China. Among the different health and environmental disciplines, 62% (n = 273) of papers came from environmental science. There were limited collaborations among researchers from different countries and institutions. In conclusion, there should be more collaboration among the researchers in this field regarding institutions, countries, and disciplines

Apparent Temperature Modifies the Effects of Air Pollution on Cardiovascular Disease Mortality in Cape Town, South Africa

Cardiovascular disease (CVD) is the top cause of mortality and a main contributor to disability globally. The evidence so far is varied on whether cold or heat modifies the CVD effects of air pollution. Weather conditions and air pollution sources and levels are different in different countries. Studies in low-and middle-income countries are lacking. Mortality data were obtained from Statistics South Africa. Air pollution and meteorological data were obtained from the South African Weather Service. A time-stratified case–crossover epidemiological design was applied. The association between air pollutants (PM10, NO2 and SO2) and CVD mortality was investigated using conditional logistic regression models. Susceptibility by sex and age groups was investigated. In total, 54,356 CVD deaths were included in the 10-year study. The daily PM10, NO2 and SO2 levels exceeded the daily WHO guidelines on 463, 421 and 8 days of the 3652 days, respectively. Higher air pollution risks were observed in this study compared to those reported in meta-analyses. In general, the elderly and females seemed to be vulnerable to air pollutants, especially at high and moderate apparent temperature levels. Harvesting effects were observed at longer lags. The results can be used to develop an early warning system for the city

Health Insurance, Socio-Economic Position and Racial Disparities in Preventive Dental Visits in South Africa

This study sought to determine the contributions of socio-economic position and health insurance enrollment in explaining racial disparities in preventive dental visits (PDVs) among South Africans. Data on the dentate adult population participating in the last South African Demographic and Health Survey conducted during 2003–2004 (n = 6,312) was used. Main outcome measure: Reporting making routine yearly PDVs as a preventive measure. Education, material wealth index and nutritional status indicated socio-economic position. Multi-level logistic regression analysis was conducted to determine the predictors of PDVs. A variant of Blinder-Oaxaca decomposition analysis was also conducted. Health insurance coverage was most common among Whites (70%) and least common among black Africans (10.1%) in South Africa. Similarly, a yearly PDV was most frequently reported by Whites (27.8%) and least frequently reported among black Africans (3.1%). Lower education and lower material wealth were associated with lower odds of making PDVs. There was significant interaction between location (urban/rural) and education (p = 0.010). The racial and socio-economic differences in PDVs observed in urban areas were not observed in rural areas. In the general dentate population, having health insurance significantly increased the odds of making PDVs (OR = 4.32; 3.04–6.14) and accounted for 40.3% of the White/non-White gap in the probability of making PDVs. Overall, socio-economic position and health insurance enrollments together accounted for 55.9% (95% CI = 44.9–67.8) of the White/non-White gap in PDVs. Interventions directed at improving both socio-economic position and insurance coverage of non-White South Africans are likely to significantly reduce racial disparities in PDVs

Socio-Environmental Factors Associated with Self-Rated Oral Health in South Africa: A Multilevel Effects Model

Aim: This study examined the influence of the social context in which people live on self-ratings of their oral health. Method: This study involved a representative sample of 2,907 South African adults (≥16 years) who participated in the 2007 South African Social Attitude Survey (SASAS). We used the 2005 General Household Survey (n = 107,987 persons from 28,129 households) to obtain living environment characteristics of SASAS participants, including sources of water and energy, and household cell-phone ownership (a proxy measure for the social network available to them). Information obtained from SASAS included socio-demographic data, respondents’ level of trust in people, oral health behaviors and self-rated oral health. Results: Of the respondents, 76.3% self-rated their oral health as good. Social context influenced women’s self-rated oral health differently from that of men. Good self-rated oral health was significantly higher among non-smokers, employed respondents and women living in areas with higher household cell-phone ownership. Furthermore, trust and higher social position were associated with good self-rated oral health among men and women respectively. Overall, 55.1% and 18.3% of the variance in self-rated oral health were explained by factors operating at the individual and community levels respectively. Conclusion: The findings highlight the potential role of social capital in improving the population’s oral health

Cigarette Smoking Trends and Social Disparities Among South African Adults, 2003–2011

INTRODUCTION : Cigarette prices have almost doubled in South Africa within the past decade due to pricing/taxation policies. Little is known about the equity impact of these price increases in concert with other tobacco control policies. This study therefore examined trends in current cigarette smoking overall and by socioeconomic status (SES) in South Africa during 2003-2011. METHODS : Data were obtained from the 2003 (n = 2,855), 2007 (n = 2,907), and 2011 (n = 3,003) South African Social Attitudes Survey. Educational attainment (> grade 12, grade 12, grade 1-11, or no education) was used as a proxy for SES, and all analyses were restricted to respondents aged ≥25 years. Trends in current cigarette smoking-defined as daily or some days use of cigarettes-during 2003-2011 were assessed with estimates of annual percentage change (APC), while smoking disparities were assessed with relative concentration index (RCI). RESULTS : Although no significant change was observed in the overall prevalence of current smoking during 2003-2011, declines were observed among those with no education (APC = -8.2; p < .05 for linear trend). However, increased smoking was observed among the most educated women (from 4.0% in 2003 to 13.1% in 2011; p < .05 for linear trend). The RCI by educational status changed significantly during the study period, from 0.80 (2003) to 1.35 (2007) to 1.94 (2011). CONCLUSIONS : The policy environment in South Africa during 2003-2011 had a significant positive equity impact by SES, even though no aggregate change in smoking prevalence was observed. Intensified implementation of taxation measures as part of a comprehensive tobacco control may further reduce smoking disparities.The South African National Research Foundation (#93093) and the American Cancer Society (NHINTLTAA02).http://ntr.oxfordjournals.org2016-10-31hb2016Community Dentistr

Evaluation of in utero exposure to arsenic in South Africa

Early life exposure to inorganic arsenic (iAs) has been shown to interfere with foetal and early childhood development, and is associated with morbidity and mortality in adulthood. The purpose of this study was to evaluate exposure to As in utero, to determine the association between maternal and cord blood of As and birth outcomes in South African populations. Total arsenic was measured in maternal blood of a total cohort (n=650) and in paired cord blood and urine of a subset cohort (n=317). Overall, the geometric mean (GM) of As in maternal blood was 0.62μg/L (n=650; 95% CI, 0.58-0.66). In the subset cohort, the GM of maternal blood As was 0.96μg/L (n=350; 95% CI, 0.91-1.02); in paired cord blood, the GM was 0.78μg/L (n=317; 95% CI, 0.74-0.83); and in urine (creatinine-corrected), the GM was 14.26μg/g creatinine (n=317; 95% CI, 12.64-16.09). A linear correlation was found between log maternal blood As and log cord blood As (rho=0.80, p<0.001). Birth outcomes showed geographical differences. in gestational age (p<0.001), birth length (p=0.019), head circumference (p<0.001), Apgar score at 5min (p<0.001) and parity (p<0.002). In a multivariate analysis, no association between maternal blood (AsB) levels and birth outcomes were found. However, the lower the gestational age, the higher the levels of maternal AsB (β=-0.054; 95% CI-0.087 to -0.020) and mothers who had had at least one child were less likely to have higher AsB if compared to those who had never had any child (β=-0.177; 95CI-0.322 to 0.031). In both univariate and multivariate analyses, being single, and drinking water from communal outdoor taps, boreholes and rivers was associated with higher As levels. The findings suggest that more research is needed to evaluate the impact of low level As exposure on postnatal development.The Research Council of Norway and the National Research Foundation (NRF), South Africa (Grant 64528); the Arctic Monitoring and Assessment Programme (AMAP); and the Norwegian Royal Ministry for Foreign Affairs.http://www.elsevier.com/locate/scitotenv2018-01-31hb2017School of Health Systems and Public Health (SHSPH