Coastal proximity, health and well-being: results from a longitudinal panel survey.

This is the author's pre print version of an article subsequently published in Health Place. The definitive published version is available from the DOI provided in this record. Copyright © 2013 Elsevier Ltd. All rights reserved.Analysis of English census data revealed a positive association between self-reported health and living near the coast. However that analysis was based on cross-sectional data and was unable to control for potential selection effects (e.g. generally healthier, personality types moving to coastal locations). In the current study we have used English panel data to explore the relationship between the proximity to the coast and indicators of generic and mental health for the same individuals over time. This allowed us to control for both time-invariant factors such as personality and compare the strength of any relationship to that of other relationships (e.g. employment vs. unemployment). In support of cross-sectional analysis, individuals reported significantly better general health and mental health when living nearer the coast, controlling for both individual (e.g. employment status) and area (e.g. green space) level factors. No coastal effect on life satisfaction was found. Although individual level coastal proximity effects for general health and mental health were small, their cumulative impact at the community level may be meaningful for policy makers.European Regional Development FundEuropean Social Fun

Radon and skin cancer in southwest England: an ecologic study

This is the author's post peer review version of the article. The final version is published in Epidemiology. 2012 Jan;23(1):44-52. doi: 10.1097/EDE.0b013e31823b6139.Radon, a naturally occurring radioactive gas, is a carcinogen that causes a small proportion of lung cancers among exposed populations. Theoretical models suggest that radon may also be a risk factor for skin cancer, but epidemiologic evidence for this relationship is weak. In this study, we investigated ecologic associations between environmental radon concentration and the incidence of various types of skin cancer

Fostering human health through ocean sustainability in the 21st century

This is the final version. Available on open access from Wiley via the DOI in this recordThe approach of the Decade of the Ocean for Sustainable Development (2021–2030) provides a time to reflect on what we know about the complex interactions between the seas, oceans, and human health and well‐being. In the past, these interactions have been seen primarily within a risk framework, for example, adverse impacts of extreme weather, chemical pollution and increasingly, climate change. However, new research is expanding our concept of the ‘health’ of the ‘Global Ocean’, with a broader recognition of its essential and beneficial contribution to the current and future health and well‐being of humans. The seas and coasts not only provide an essential source of food, opportunities for trade and access to sustainable energy, but also the chance for people to interact with high‐quality marine environments which can lead to improvements in mental and physical health and well‐being, particularly of socio‐economically deprived individuals. By going beyond this risk framework and a purely extractive anthropocentric point of view, we can capture the true benefits, value and importance of these resources. Articulating a vision of how humans might better interact with marine ecosystems in the future, is a key first step in identifying a range of policy and management actions that can deliver our goals of fostering health and well‐being through the establishment of more sustainable interconnections with the Global Ocean.European Union Horizon 2020Natural Environment Research Council (NERC)UKRI Global Challenges Research FundNational Institute for Health Research (NIHR

Coastal proximity and physical activity: Is the coast an under-appreciated public health resource?

This is the author's pre print version of an article subsequently published in Preventive Medicine. The definitive published version is available from the DOI provided in this record. Copyright © 2014 Published by Elsevier Inc.BACKGROUND: Recent findings suggest that individuals living near the coast are healthier than those living inland. Here we investigated whether this may be related to higher levels of physical activity among coastal dwellers in England, arising in part as a result of more visits to outdoor coastal settings. METHOD: Participants (n=183,755) were drawn from Natural England's Monitor of Engagement with the Natural Environment Survey (2009-2012). Analyses were based on self-reported physical activity for leisure and transport. RESULTS: A small, but significant coastal proximity gradient was seen for the likelihood of achieving recommended guidelines of physical activity a week after adjusting for relevant area and individual level controls. This effect was statistically mediated by the likelihood of having visited the coast in the last seven days. Stratification by region, however, suggested that while the main effect was relatively strong for west coast regions, it was not significant for those in the east. CONCLUSIONS: In general, our findings replicate and extend work from Australia and New Zealand. Further work is needed to explain the marked regional differences in the relationship between coastal proximity and physical activity in England to better understand the coast's potential role as a public health resource.Economic and Social Research CouncilNational Institute for Health Research Health Protection Research Unit (NIHR HPRU

Is There a Causal Association between Genotoxicity and the Imposex Effect?

There is a growing body of evidence that indicates common environmental pollutants are capable of disrupting reproductive and developmental processes by interfering with the actions of endogenous hormones. Many reports of endocrine disruption describe changes in the normal development of organs and tissues that are consistent with genetic damage, and recent studies confirm that many chemicals classified to have hormone-modulating effects also possess carcinogenic and mutagenic potential. To date, however, there have been no conclusive examples linking genetic damage with perturbation of endocrine function and adverse effects in vivo. Here, we provide the first evidence of DNA damage associated with the development of imposex (the masculinization of female gastropods considered to be the result of alterations to endocrine-mediated pathways) in the dog-whelk Nucella lapillus. Animals (n = 257) that displayed various stages of tributyltin (TBT)-induced imposex were collected from sites in southwest England, and their imposex status was determined by physical examination. Linear regression analysis revealed a very strong relationship (correlation coefficient of 0.935, p < 0.0001) between the degree of imposex and the extent of DNA damage (micronucleus formation) in hemocytes. Moreover, histological examination of a larger number of dog-whelks collected from sites throughout Europe confirmed the presence of hyperplastic growths, primarily on the vas deferens and penis in both TBT-exposed male snails and in females that exhibited imposex. A strong association was found between TBT body burden and the prevalence of abnormal growths, thereby providing compelling evidence to support the hypothesis that environmental chemicals that affect reproductive processes do so partly through DNA damage pathways

Potential changes in disease patterns and pharmaceutical use in response to climate change

This is the final version of the article. Available from Taylor & Francis via the DOI in this record.As climate change alters environmental conditions, the incidence and global patterns of human diseases are changing. These modifications to disease profiles and the effects upon human pharmaceutical usage are discussed. Climate-related environmental changes are associated with a rise in the incidence of chronic diseases already prevalent in the Northern Hemisphere, for example, cardiovascular disease and mental illness, leading to greater use of associated heavily used Western medications. Sufferers of respiratory diseases may exhibit exacerbated symptoms due to altered environmental conditions (e.g., pollen). Respiratory, water-borne, and food-borne toxicants and infections, including those that are vector borne, may become more common in Western countries, central and eastern Asia, and across North America. As new disease threats emerge, substantially higher pharmaceutical use appears inevitable, especially of pharmaceuticals not commonly employed at present (e.g., antiprotozoals). The use of medications for the treatment of general symptoms (e.g., analgesics) will also rise. These developments need to be viewed in the context of other major environmental changes (e.g., industrial chemical pollution, biodiversity loss, reduced water and food security) as well as marked shifts in human demographics, including aging of the population. To identify, prevent, mitigate, and adapt to potential threats, one needs to be aware of the major factors underlying changes in the use of pharmaceuticals and their subsequent release, deliberately or unintentionally, into the environment. This review explores the likely consequences of climate change upon the use of medical pharmaceuticals in the Northern Hemisphere.The European Centre for Environment and Human Health (part of the University of Exeter Medical School) is partly financed by the European Regional Development Fund Programme 2007 to 2013 and European Social Fund Convergence Programme for Cornwall and the Isles of Scilly

The Weight-of-Evidence Approach and the Need for Greater International Acceptance of Its Use in Tackling Questions of Chemical Harm to the Environment

© 2021 The Authors. As we attempt to manage chemicals in the environment we need to be sure that our research efforts are being directed at the substances of greatest threat. All too often we focus on a chemical of concern and then cast around for evidence of its effects in an unstructured way. Risk assessment based on laboratory ecotoxicity studies, combined with field chemical measurements, can only take us so far. Uncertainty about the range and sufficiency of evidence required to take restorative action often puts policymakers in a difficult situation. We review this conundrum and reflect on how the “Hill criteria,” used widely by epidemiologists, have been applied to a weight-of-evidence approach (a term sometimes used interchangeably with ecoepidemiology) to build a case for causation. While using a set of such criteria to address sites of local environmental distress has been embraced by the US Environmental Protection Agency, we urge a wider adoption of weight-of-evidence approaches by policymakers, regulators, and scientists worldwide. A simplified series of criteria is offered. Progress will require a sustained commitment to long-term wildlife and chemical monitoring over a sufficient geographic spread. Development of a comprehensive monitoring network, coupled with assembling evidence of harm in a structured manner, should be the foundation for protecting our ecosystems and human health. This will enable us to not only judge the success or failure of our efforts but also diagnose underlying causes. Environ Toxicol Chem 2021;00:1–10. © 2021 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.Natural Environment Research Council. Grant Number: NE/S000100/

The Future of the Weight‐of‐Evidence Approach: A Response to Suter's Comments

© 2021 The Authors. Authors’ Response: We are grateful to Suter (2021) for noting our effort (Johnson et al., 2021) and for the role that he and his co-workers have played (and continue to play) in championing the weight-of-evidence (WoE) approach. As Suter has pointed out, the field is far from stagnant and enjoys continuing debate within parts of the community (Suter, 2021). With regard to his response to our article, we see no reason to criticize the Hill criteria (Hill, 1965) but find that, while agreeing with Suter that they are not a perfect fit for our field, they are of enduring value and are readily adaptable. We consider that there remain a number of issues that both hinder the take-up of WoE and have yet to be resolved in the decision-making process over whether a chemical is a threat or not. We suggest reasons behind the worldwide poor take-up of WoE.NERC grant NE/S000100/1 for the ChemPop project

Future of the Sea: Health and Wellbeing of Coastal Communities

This is the final version of the report. Available from the Government Office for Science via the link in this recordThis review has been commissioned as part of the UK government’s Foresight Future of the Sea project. The views expressed do not represent policy of any government or organisationApproximately 17 per cent of the UK population live in coastal communities; some are prosperous and commercially successful, others experiencing socio- economic decline. Regardless, evidence suggests growing risks for the health and wellbeing of coastal communities. Communities along the coast are on the front line in facing climate change and marine pollution impacts, furthermore their economies are deeply embedded with coastal and other marine activities, making these communities particularly affected. Sea-level rise and extreme weather events, driven by climate change and ecosystem damage, expose coastal communities to flooding events now and in the future, damaging local economies, and threatening health and wellbeing. Continuing pollution of the sea has been underestimated as a threat to the health of coastal dwellers.Governtment Office for Scienc

High urinary tungsten concentration is associated with stroke in the National Health and Nutrition Examination Survey 1999-2010.

Published onlineClinical TrialMulticenter StudyResearch Support, Non-U.S. Gov'tBACKGROUND: In recent years there has been an exponential increase in tungsten demand, potentially increasing human exposure to the metal. Currently, the toxicology of tungsten is poorly understood, but mounting evidence suggests that both the elemental metal and its alloys have cytotoxic effects. Here, we investigate the association between tungsten and cardiovascular disease (CVD) or stroke using six waves of the National Health and Nutrition Examination Survey (NHANES). METHODS: We investigated associations using crude and adjusted logistic regression models in a cohort of 8614 adults (18-74 years) with 193 reported stroke diagnoses and 428 reported diagnoses of CVD. We also stratified our data to characterize associations in a subset of younger individuals (18-50 years). RESULTS: Elevated tungsten concentrations were strongly associated with an increase in the prevalence of stroke, independent of typical risk factors (Odds Ratio (OR): 1.66, 95% Confidence Interval (95% CI): 1.17, 2.34). The association between tungsten and stroke in the young age category was still evident (OR: 2.17, 95% CI: 1.33, 3.53). CONCLUSION: This study represents the most comprehensive analysis of the human health effects of tungsten to date. Individuals with higher urinary tungsten concentrations have double the odds of reported stroke. We hypothesize that the pathological pathway resulting from tungsten exposure may involve oxidative stress.This work was supported by funding from University of Exeter Medical School. No funding organization or sponsor played any part in the design or conduct of the study, in the analysis or interpretation of the data, or preparation, review, or approval of the manuscript. The European Centre for the Environment and Human Health (part of the University of Exeter Medical School) is supported by investment from the ERDF (European Regional Development Fund) and ESF (European Social Fund) Convergence Programmed for Cornwall and the Isles of Scilly. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript