Health impacts of urban transport policy measures: A guidance note for practice

Background Urban transport related exposures and practices are associated with a significant burden of morbidity and premature mortality, which could be prevented by changing current practices. Cities now have access to an increasingly wide range of transport policy measures which continue to expand. However, the health impacts of these measures are not always explicitly defined or well understood and therefore may not be sufficiently considered when selecting policy measures. Aims The aim of this paper is to qualitatively review 64 different transport policy measures indexed in the Knowledgebase on Sustainable Urban Land use and Transport (KonSULT), and provide an indication of their potential health impacts, based on expert judgment. Results We report that key health impacts of transport occur via pathways of motor vehicle crashes, traffic-related air pollution, noise, heat islands, lack of green space, physical inactivity, climate change and social exclusion and community severance. We systematically describe the expected health impacts of transport policy measures sourced from KonSULT and find that many, but not all, can have a positive impact on health. The magnitude of both the positive and negative impacts remains largely unknown and warrants further research and synthesis. Conclusions Urban transport is responsible for a large mortality and morbidity burden and policy measures that are beneficial to health need to be implemented to reduce this burden. There are considerable differences between these policy measures in terms of potential health impacts and this should be considered in any transport planning. It is important to monitor the health impacts of all policy measures to provide further evidence on whether they work as expected or not, to ensure that the most cost-effective solutions, with the largest benefits and the smallest health risks, are being adopted

Optical Signatures of Circumstellar Interaction in Type IIP Supernovae

We propose new diagnostics for circumstellar interaction in Type IIP supernovae by the detection of high velocity (HV) absorption features in Halpha and He I 10830 A lines during the photospheric stage. To demonstrate the method, we compute the ionization and excitation of H and He in supernova ejecta taking into account time-dependent effects and X-ray irradiation. We find that the interaction with a typical red supergiant wind should result in the enhanced excitation of the outer layers of unshocked ejecta and the emergence of corresponding HV absorption, i.e. a depression in the blue absorption wing of Halpha and a pronounced absorption of He I 10830 A at a radial velocity of about -10,000 km/s. We identify HV absorption in Halpha and He I 10830 A lines of SN 1999em and in Halpha of SN 2004dj as being due to this effect. The derived mass loss rate is close to 10^{-6} Msun/yr for both supernovae, assuming a wind velocity 10 km/s. We argue that, in addition to the HV absorption formed in the unshocked ejecta, spectra of SN 2004dj and SN 1999em show a HV notch feature that is formed in the cool dense shell (CDS) modified by the Rayleigh-Taylor instability. The CDS results from both shock breakout and radiative cooling of gas that has passed through the reverse shock wave. The notch becomes dominant in the HV absorption during the late photospheric phase, ~60 d. The wind density deduced from the velocity of the CDS is consistent with the wind density found from the HV absorption produced by unshocked ejecta.Comment: 38 pages, 12 figures, ApJ, in pres

More green, less lonely? A longitudinal cohort study.

BACKGROUND: Urban greening may reduce loneliness by offering opportunities for solace, social reconnection and supporting processes such as stress relief. We (i) assessed associations between residential green space and cumulative incidence of, and relief from, loneliness over 4 years; and (ii) explored contingencies by age, sex, disability and cohabitation status. METHODS: Multilevel logistic regressions of change in loneliness status in 8049 city-dwellers between 2013 (baseline) and 2017 (follow-up) in the Household, Income and Labour Dynamics in Australia study. Associations with objectively measured discrete green-space buffers (e.g. parks) (30% green space, respectively. Compared with the 30% green space, respectively. These associations were stronger again for people living alone, with 10-20% (OR = 0.608, 95% CI = 0.448 to 0.826), 20-30% (OR = 0.649, 95% CI = 0.436 to 0.966) and >30% (OR = 0.480, 95% CI = 0.278 to 0.829) green space within 1600 m. No age, sex or disability-related contingencies, associations with green space within 400 or 800 m or relief from loneliness reported at baseline were observed. CONCLUSIONS: A lower cumulative incidence of loneliness was observed among people with more green space within 1600 m of home, especially for people living alone. Potential biopsychosocial mechanisms warrant investigation

Fourteen pathways between urban transportation and health: A conceptual model and literature review

Introduction: Transportation is an integral part of our daily lives, giving us access to people, education, jobs, services, and goods. Our transportation choices and patterns are influenced by four interrelated factors: the land use and built environment, infrastructure, available modes, and emerging technologies/disruptors. These factors influence how we can or choose to move ourselves and goods. In turn, these factors impact various exposures, lifestyles and health outcomes. / Aim and methods: We developed a conceptual model to clarify the connections between transportation and health. We conducted a literature review focusing on publications from the past seven years. We complemented this with expert knowledge and synthesized information to summarize the health outcomes of transportation, along 14 identified pathways. / Results: The pathways linking transportation to health include those that are beneficial, such as when transportation serves as means for social connectivity, independence, physical activity, and access. Some pathways link transportation to detrimental health outcomes from air pollution, road travel injuries, noise, stress, urban heat islands, contamination, climate change, community severance, and restricted green space, blue space, and aesthetics. Other possible effects may come from electromagnetic fields, but this is not definitive. We define each pathway and summarize its health outcomes. We show that transportation-related exposures and associated health outcomes, and their severity, can be influenced by inequity and intrinsic and extrinsic effect modifiers. / Conclusions: While some pathways are widely discussed in the literature, others are new or under-researched. Our conceptual model can form the basis for future studies looking to explore the transportation-health nexus. We also propose the model as a tool to holistically assess the impact of transportation decisions on public health

Effectiveness of e-learning in continuing medical education for occupational physicians

Background Within a clinical context e-learning is comparable to traditional approaches of continuing medical education (CME). However, the occupational health context differs and until now the effect of postgraduate e-learning among occupational physicians (OPs) has not been evaluated

Heterogeneous dermatitis complaints after change in drinking water treatment: a case report

BACKGROUND: The disinfectant monochloramine minimizes the formation of potentially hazardous and regulated byproducts, and many drinking water utilities are shifting to its use. CASE PRESENTATION: After a drinking water utility serving 2.4 million people switched to monochloramine for residual disinfection, a small number of residents complained of dermatitis reactions. We interviewed 17 people about their symptoms. Skin appearance, symptoms, and exposures were heterogeneous. Five respondents had history of hives or rash that preceded the switch to monochloramine. CONCLUSION: The complaints described were heterogeneous, and many of the respondents had underlying or preexisting conditions that would offer plausible alternative explanations for their symptoms. We did not recommend further study of these complaints

Exploring factors relevant in the assessment of the return-to-work process of employees on long-term sickness absence due to a depressive disorder: a focus group study

Background: Efforts undertaken during the Return-to-Work (RTW) process need to be sufficient in order to optimize the quality of the RTW process. The purpose of this study was to explore factors relevant to Return-to-Work Effort Sufficiency (RTW-ES) in cases of sick-listed employees with a Depressive Disorder (DD). Method: A case of a long-term sick-listed employee with a DD applying for disability benefits was used to gather arguments and grounds relevant to the assessment of RTW-ES. Two focus group meetings were held, consisting of Labor Experts working at the Dutch Social Insurance Institute. Factors were collected and categorized using the International Classification of Functioning, Disability and Health (ICF model). Results: Sixteen factors relevant to RTW-ES assessment in a case of DD were found, categorized in the ICF-model under activities (e. g. functional capacity), personal (e. g. competencies, attitude) and environmental domain (e. g. employer-employee relationship), or categorized under interventions, job accommodations and measures. Conclusions: This study shows that 16 factors are relevant in the assessment of RTW-ES in employees sick-listed due to DD. Further research is necessary to expand this knowledge to other health conditions, and to investigate the impact of these results on the quality of the RTW-ES assessment

Associations between park features, park satisfaction and park use in a multi-ethnic deprived urban area

Parks are increasingly understood to be key community resources for public health, particularly for ethnic minority and low socioeconomic groups. At the same time, research suggests parks are underutilised by these groups. In order to design effective interventions to promote health, the determinants of park use for these groups must be understood.This study examines the associations between park features, park satisfaction and park use in a deprived and ethnically diverse sample in Bradford, UK. 652 women from the Born in Bradford cohort completed a survey on park satisfaction and park use. Using a standardised direct observation tool, 44 parks in the area were audited for present park features. Features assessed were: access, recreational facilities, amenities, natural features, significant natural features, non-natural features, incivilities and usability. Size and proximity to the park were also calculated. Multilevel linear regressions were performed to understand associations between park features and (1) park satisfaction and (2) park use. Interactions between park features, ethnicity and socioeconomic status were explored, and park satisfaction was tested as a mediator in the relationship between park features and park use.More amenities and greater usability were associated with increased park satisfaction, while more incivilities were negatively related to park satisfaction. Incivilities, access and proximity were also negatively associated with park use. Ethnicity and socioeconomic status had no moderating role, and there was no evidence for park satisfaction as a mediator between park features and park use.Results suggest diverse park features are associated with park satisfaction and park use, but this did not vary by ethnicity or socioeconomic status. The reduction of incivilities should be prioritised where the aim is to encourage park satisfaction and park use

Exposure to low-level ambient air pollution and the relationship with lung and bladder cancer in older men, in Perth, Western Australia

Background: Air pollution is a cause of lung cancer and is associated with bladder cancer. However, the relationship between air pollution and these cancers in regions of low pollution is unclear. We investigated associations between fine particulate matter (PM2.5), nitrogen dioxide, and black carbon (BC), and both these cancers in a low-pollution city. Methods: A cohort of 11,679 men ≥65 years old in Perth (Western Australia) were followed from 1996–1999 until 2018. Pollutant concentrations, as a time-varying variable, were estimated at participants’ residential addresses using land use regression models. Incident lung and bladder cancer were identified through the Western Australian Cancer Registry. Risks were estimated using Cox proportional-hazard models (age as the timescale), adjusting for smoking, socioeconomic status, and co-pollutants. Results: Lung cancer was associated with PM2.5 and BC in the adjusted single-pollutant models. A weak positive association was observed between ambient air pollution and squamous cell lung carcinoma but not lung adenocarcinoma. Positive associations were observed with bladder cancer, although these were not statistically significant. Associations were attenuated in two-pollutant models. Conclusion: Low-level ambient air pollution is associated with lung, and possibly bladder, cancer among older men, suggesting there is no known safe level for air pollution as a carcinogen

Circumstellar Na I and Ca II lines in type IIP supernovae and SN 1998S

We study a possibility of detection of circumstellar absorption lines of Na I D$_{1,2}$ and Ca II H,K in spectra of type IIP supernovae at the photospheric epoch. The modelling shows that the circumstellar lines of Na I doublet will not be seen in type IIP supernovae for moderate wind density, e.g., characteristic of SN 1999em, whereas rather pronounced Ca II lines with P Cygni profile should be detectable. A similar model is used to describe Na I and Ca II circumstellar lines seen in SN 1998S, type IIL with a dense wind. We show that line intensities in this supernova are reproduced, if one assumes an ultraviolet excess, which is caused primarily by the comptonization of supernova radiation in the shock wave.Comment: To be published in Astronomy Letter