Respiratory hospital admission risk near large composting facilities

AbstractBackgroundLarge-scale composting can release bioaerosols in elevated quantities, but there are few studies of health effects on nearby communities.MethodsA cross-sectional ecological small area design was used to examine risk of respiratory hospital admissions within 2500m of all 148 English large-scale composting facilities in 2008–10. Statistical analyses used a random intercept Poisson regression model at Census Output Area (COA) level (mean population 310). Models were adjusted for age, sex, deprivation and tobacco sales.ResultsAnalysing 34,963 respiratory hospital admissions in 4656 COAs within 250–2500m of a site, there were no significant trends using pre-defined distance bands of >250–750m, >750–1500m and >1500–2500m. Using a continuous measure of distance, there was a small non-statistically significant (p=0.054) association with total respiratory admissions corresponding to a 1.5% (95% CI: 0.0–2.9%) decrease in risk if moving from 251m to 501m. There were no significant associations for subgroups of respiratory infections, asthma or chronic obstructive pulmonary disease.ConclusionThis national study does not provide evidence for increased risks of respiratory hospital admissions in those living beyond 250m of an outdoor composting area perimeter. Further work using better measures of exposure and exploring associations with symptoms and disease prevalence, especially in vulnerable groups, is recommended to support regulatory approaches

Effects of Feeding Legume Silage With Differing Tannin Levels on Lactating Dairy Cattle

Condensed tannins (CT) bind to plant proteins in the rumen, reducing protein degradation to ammonia and increasing milk production and milk protein (e.g. Waghorn, 1987). Previous research showed that the reduced soluble non-protein nitrogen (NPN) content of red clover (Trifolium pratense) silage (RCS) was related to its greater N efficiency relative to lucerne (Medicago sativa) silage (LS) (Broderick et al., 2001). Commercial cultivars of birdsfoot trefoil (Lotus corniculatus; BFT) contain modest levels of CT which reduce NPN formation in silage (Albrecht & Muck, 1991). The objective was to compare silages made from BFT with RCS and LS for milk production and N efficiency in lactating dairy cows

Enforcing Termination of Interprocedural Analysis

Interprocedural analysis by means of partial tabulation of summary functions may not terminate when the same procedure is analyzed for infinitely many abstract calling contexts or when the abstract domain has infinite strictly ascending chains. As a remedy, we present a novel local solver for general abstract equation systems, be they monotonic or not, and prove that this solver fails to terminate only when infinitely many variables are encountered. We clarify in which sense the computed results are sound. Moreover, we show that interprocedural analysis performed by this novel local solver, is guaranteed to terminate for all non-recursive programs --- irrespective of whether the complete lattice is infinite or has infinite strictly ascending or descending chains

Protective Effects of Smoke-free Legislation on Birth Outcomes in England: A Regression Discontinuity Design

Background: Environmental tobacco smoke has an adverse impact on preterm birth and birth weight. England introduced a new law to make virtually all enclosed public places and workplaces smoke free on July 1 2007. We investigated the effect of smoke-free legislation on birth outcomes in England using Hospital Episode Statistics (HES) maternity data. Methods: We used regression discontinuity, a quasi-experimental study design, which can facilitate valid causal inference, to analyse short-term effects of smoke-free legislation on birth weight, low birth weight, gestational age, preterm birth and small for gestational age. Results: We analysed 1,800,906 pregnancies resulting in singleton live-births in England between January 1 2005 and December 31 2009. In the one to five months following the introduction of the smoking-free legislation, for those entering their third trimester, the risk of low birth weight decreased by between 8% (95% CI: 4%-12%) and 14% (95% CI: 5%-23%), very low birth weight between 28% (95% CI: 19%-36%) and 32% (95% CI: 21%-41%), preterm birth between 4% (95% CI: 1%-8%) and 9% (95% CI: 2%-16%), and small for gestational age between 5% (95% CI: 2%-8%) and 9% (95% CI: 2%-15%). The impact of the smoke-free legislation varied by maternal age, deprivation, ethnicity and region. Conclusions: The introduction of smoke-free legislation in England had an immediate beneficial impact on birth outcomes overall, although this benefit was not observed across all age, ethnic, or deprivation groups

Road traffic noise is associated with increased cardiovascular morbidity and mortality and all-cause mortality in London.

AIMS: Road traffic noise has been associated with hypertension but evidence for the long-term effects on hospital admissions and mortality is limited. We examined the effects of long-term exposure to road traffic noise on hospital admissions and mortality in the general population. METHODS AND RESULTS: The study population consisted of 8.6 million inhabitants of London, one of Europe's largest cities. We assessed small-area-level associations of day- (7:00-22:59) and nighttime (23:00-06:59) road traffic noise with cardiovascular hospital admissions and all-cause and cardiovascular mortality in all adults (≥25 years) and elderly (≥75 years) through Poisson regression models. We adjusted models for age, sex, area-level socioeconomic deprivation, ethnicity, smoking, air pollution, and neighbourhood spatial structure. Median daytime exposure to road traffic noise was 55.6 dB. Daytime road traffic noise increased the risk of hospital admission for stroke with relative risk (RR) 1.05 [95% confidence interval (CI): 1.02-1.09] in adults, and 1.09 (95% CI: 1.04-1.14) in the elderly in areas >60 vs. 60 vs. <55 dB]. Positive but non-significant associations were seen with mortality for cardiovascular and ischaemic heart disease, and stroke. Results were similar for the elderly. CONCLUSIONS: Long-term exposure to road traffic noise was associated with small increased risks of all-cause mortality and cardiovascular mortality and morbidity in the general population, particularly for stroke in the elderly

Prevalence and risk factors for chronic kidney disease of unknown cause in Malawi: a cross-sectional analysis in a rural and urban population.

BACKGROUND: An epidemic of chronic kidney disease of unknown cause (CKDu) is occurring in rural communities in tropical regions of low-and middle-income countries in South America and India. Little information is available from Southern African countries which have similar climatic and occupational characteristics to CKDu-endemic countries. We investigated whether CKDu is prevalent in Malawi and identified its potential risk factors in this setting. METHODS: We conducted a cross-sectional study from January-August 2018 collecting bio samples and anthropometric data in two Malawian populations. The sample comprised adults > 18 years (n = 821) without diabetes, hypertension, and proteinuria. Estimates of glomerular filtration rate (eGFR) were calculated using the CKD-EPI equation. Linear and logistic regression models were applied with potential risk factors, to estimate risk of reduced eGFR. RESULTS: The mean eGFR was 117.1 ± 16.0 ml/min per 1.73m2 and the mean participant age was 33.5 ± 12.7 years. The prevalence of eGFR< 60 was 0.2% (95% confidence interval (95% CI) 0.1, 0.9); the prevalence of eGFR< 90 was 5% (95% CI =3.2, 6.3). We observed a higher prevalence in the rural population (5% (3.6, 7.8)), versus urban (3% (1.4, 6.7)). Age and BMI were associated with reduced eGFR< 90 [Odds ratio (OR) (95%CI) =3.59 (2.58, 5.21) per ten-year increment]; [OR (95%CI) =2.01 (1.27, 3.43) per 5 kg/m2 increment] respectively. No increased risk of eGFR < 90 was observed for rural participants [OR (95%CI) =1.75 (0.50, 6.30)]. CONCLUSIONS: Reduced kidney function consistent with the definition of CKDu is not common in the areas of Malawi sampled, compared to that observed in other tropical or sub-tropical countries in Central America and South Asia. Reduced eGFR< 90 was related to age, BMI, and was more common in rural areas. These findings are important as they contradict some current hypothesis that CKDu is endemic across tropical and sub-tropical countries. This study has enabled standardized comparisons of impaired kidney function between and within tropical/subtropical regions of the world and will help form the basis for further etiological research, surveillance strategies, and the implementation and evaluation of interventions

Green walkability and physical activity in UK biobank: a cross-sectional analysis of adults in Greater London

Urban greenspace provides opportunities for outdoor exercise and may increase physical activity, with accompanying health benefits. Areas suitable for walking (walkability) are also associated with increased physical activity, but interactions with greenspace are poorly understood. We investigated associations of walkability and green walkability with physical activity in an urban adult cohort. We used cross-sectional data from Greater London UK Biobank participants (n = 57,726) and assessed walkability along roads and footpaths within 1000 m of their residential addresses. Additionally, we assessed green walkability by integrating trees and low-lying vegetation into the walkability index. Physical activity outcomes included self-reported and accelerometer-measured physical activity and active transport. We assessed associations using log-linear, logistic and linear regression models, adjusted for individual- and area-level confounders. Higher green walkability was associated with favourable International Physical Activity Questionnaire responses and achievement of weekly UK government physical activity guideline recommendations. Participants living in the highest versus lowest quintile of green walkability participated in 2.41 min (95% confidence intervals: 0.22, 4.60) additional minutes of moderate-and-vigorous physical activity per day. Higher walkability and green walkability scores were also associated with choosing active transport modes such as walking and cycling. Our green walkability approach demonstrates the utility in accounting for walkability and greenspace simultaneously to understand the role of the built environment on physical activity