Некоторые подходы к совершенствованию регионально-институциональной основы курортно-гостиничных услуг в Автономной республике Крым

Рассмотрены подходы (институциональный, региональный, проблемно-ориентированный и маркетинговый) к разработке регионально-институциональной модели курортно-гостиничного хозяйства как одной из важнейших составляющих институциональной модели курортно-рекреационного комплекса Автономной Республики Крым.Розглядаються підходи (інституційний, регіональний, проблемно-орієнтований і маркетинговий) до розробки регіонально-інституційної моделі курортно-готельного господарства як однієї з найважливіших складових інституційної моделі курортно-рекреаційного комплексу Автономної Республіки Крим

The MOBI-Kids Study Protocol: Challenges in Assessing Childhood and Adolescent Exposure to Electromagnetic Fields from Wireless Telecommunication Technologies and Possible Association with Brain Tumor Risk

The rapid increase in mobile phone use in young people has generated concern about possible health effects of exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF). MOBI-Kids, a multinational case-control study, investigates the potential effects of childhood and adolescent exposure to EMF from mobile communications technologies on brain tumor risk in 14 countries. The study, which aims to include approximately 1,000 brain tumor cases aged 10-24 years and two individually matched controls for each case, follows a common protocol and builds upon the methodological experience of the INTERPHONE study. The design and conduct of a study on EMF exposure and brain tumor risk in young people in a large number of countries is complex and poses methodological challenges. This manuscript discusses the design of MOBI-Kids and describes the challenges and approaches chosen to address them, including: (1) the choice of controls operated for suspected appendicitis, to reduce potential selection bias related to low response rates among population controls; (2) investigating a young study population spanning a relatively wide age range; (3) conducting a large, multinational epidemiological study, while adhering to increasingly stricter ethics requirements; (4) investigating a rare and potentially fatal disease; and (5) assessing exposure to EMF from communication technologies. Our experience in thus far developing and implementing the study protocol indicates that MOBI-Kids is feasible and will generate results that will contribute to the understanding of potential brain tumor risks associated with use of mobile phones and other wireless communications technologies among young people

Long-term exposure to elemental constituents of particulate matter and cardiovascular mortality in 19 European cohorts: Results from the ESCAPE and TRANSPHORM projects

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Assessing the waterborne risk of a norovirus infection for military personnel in the Netherlands

Norovirus (NoV) infection outbreaks are known to occur when people occupy limited space, often under poor hygienic conditions. These situations have been described for both civilians (e.g. cruise ships) or military personnel in operational situations. However, little is known regarding the NoV infection risk for military personnel during training, exercise or even recreational activities. This paper describes a quantitative analysis of the NoV infection risk potential, improving on the risk awareness of this disease under various condition

Daily changes of peak expiratory flow and respiratory symptom occurrence around a soy processing factory

Objectives. To evaluate sensitization and acute respiratory health effects in inhabitants living in the vicinity of a factory producing soy oil. Methods. Two panels of potential responders were created on the basis of a response to a short screening questionnaire sent to random samples of 1,000 exposed and 1,000 non-exposed individuals living around the factory and a control area. Individuals responding to the questionnaire were invited for a medical evaluation, including a respiratory symptom questionnaire and skin prick testing, for a panel of common allergens and a soy allergen extract. This resulted in 53 atopic and/or asthmatic inhabitants from the area surrounding the factory and 30 comparable control subjects. In these subjects, morning and evening Peak Expiratory Flow (PEF), respiratory symptoms and medication use were recorded daily during a 10-week period in the autumn. At the same time, soy allergen and endotoxin concentrations were determined in airborne dust in the exposed and the control area. The wind direction relative to the location of a subjects' house and the factory was used to determine whether an individual was exposed on a particular day. Results. Only few of the atopic subjects were sensitized to soy. PEF showed a decrease, respiratory symptoms and bronchodilator use, an increase among soy sensitized subjects after having been downwind from the factory. Airborne soy allergen was found more frequently in the area surrounding the factory and levels were higher than in the control area. Highest levels were found on the factory premises. Only a weak association was found with wind direction. Airborne endotoxin concentrations did not show a consistent pattern with distance, but levels were clearly higher on the factory premises. Conclusion. Sensitization to soy allergen was not increased among the population sample living in the vicinity of the factory. Soy sensitized individuals living in the surroundings of the factory reported more respiratory symptoms, used bronchodilators more often and had a lower PEF after having been downwind of the factory

Retrospective assessment of exposure to static magnetic fields during production and development of magnetic resonance imaging systems

At present, the relationship between chronic exposure to static magnetic fields (SMF) and health effects is unclear. We developed a task-based deterministic model for estimating historical electromagnetic field exposure from the static B-field (B0) of magnetic resonance imaging (MRI) systems, for a cohort of employees working at an MRI systems development and production facility. Technical maps describing the spatial distribution of fringe fields of B0 surrounding different types of MRI systems of various core strengths were exploited to derive estimates of static B0 exposure as a function of distance from the bore of the MRI system. Detailed information on tasks performed per exposed job and other model determinants were acquired through face-to-face interviews and used to derive base estimates of most recent exposure (2009) for each job title. The model was partially validated with actual exposure measurements. The exposure estimates from the deterministic model were used to construct a job-exposure matrix that will enable estimation of cumulative exposures for each cohort member. The generic approach described for estimating chronic MRI-related SMF exposure makes it universally applicable in other studies investigating health effects of MRI-related SMF exposure

Land Use Regression Models for Ultrafine Particles and Black Carbon Based on Short-Term Monitoring Predict Past Spatial Variation

Health effects of long-term exposure to ultrafine particles (UFP) have not been investigated in epidemiological studies because of the lack of spatially resolved UFP exposure data. Short-term monitoring campaigns used to develop land use regression (LUR) models for UFP typically had moderate performance. The aim of this study was to develop and evaluate spatial and spatiotemporal LUR models for UFP and Black Carbon (BC), including their ability to predict past spatial contrasts. We measured 30 min at each of 81 sites in Amsterdam and 80 in Rotterdam, The Netherlands in three different seasons. Models were developed using traffic, land use, reference site measurements, routinely measured pollutants and weather data. The percentage explained variation (R(2)) was 0.35-0.40 for BC and 0.33-0.42 for UFP spatial models. Traffic variables were present in every model. The coefficients for the spatial predictors were similar in spatial and spatiotemporal models. The BC LUR model explained 61% of the spatial variation in a previous campaign with longer sampling duration, better than the model R(2). The UFP LUR model explained 36% of UFP spatial variation measured 10 years earlier, similar to the model R(2). Short-term monitoring campaigns may be an efficient tool to develop LUR models

Validation of a questionnaire on hand hygiene in the construction industry

INTRODUCTION: Construction workers are at risk of developing occupational contact dermatitis. Gloves, when used properly, may protect against chemicals and coarse materials. We investigated the prevalence and determinants of contact dermatitis in a population of Dutch construction workers and aimed at validating questionnaire items on hand hygiene. METHODS: A cross-sectional study was conducted at 13 construction sites, yielding data of 177 subjects (95% response rate). A questionnaire covering questions on hand hygiene and contact dermatitis symptoms was used. Agreement between workplace observations and a number of questionnaire items was assessed by calculating Cohen's kappa. Log-binomial regression analysis was used to assess the association between contact dermatitis and various hand hygiene-related determinants. RESULTS: The 1-year prevalence of self-reported contact dermatitis in our study sample was 46.9%. Multiple regression analysis showed a positive association with difficulties with hand cleaning (prevalence ratio [PR]: 1.26, 95% confidence interval [CI]: 1.05-1.52), hand contamination at the end of the working day (PR: 2.30, 95% CI: 1.14-4.65), and intensive hand cream use (PR: 2.07, 95% CI: 1.42-3.01). Observations of hand contamination, glove use, and glove types were found to agree well with the self-reported data from the questionnaire (Cohen's kappa's 0.75, 0.97, and 0.88). CONCLUSIONS: Self-reported contact dermatitis prevalence in construction workers was high and related to hand hygiene. A strong agreement was found between workplace observations and self-reported questionnaire data

Milieudossier: Koppeling NO2-blootstelling aan enquête biedt inzicht in gezondheidseffecten.

Blootstelling aan vooral fijnstof en stikstofdioxide (NO2) gaat gepaard met een aanzienlijke ziektelast, ook bij de huidige in Nederland voorkomende concentraties. Met name NO2 is geschikt voor lokaal onderzoek naar mogelijke associaties tussen luchtkwaliteit en gezondheid. In de stad Utrecht wordt sinds januari 2011 op ongeveer vijftig punten NO2 gemeten. Op basis van deze meetgegevens is een ‘Land Use Regression’ (LUR)- model ontwikkeld. De modeluitkomsten zijn vervolgens gekoppeld aan de gemeentelijke gezondheidsenquête. Hierdoor konden mogelijke associaties tussen NO2 en een aantal sociaaleconomische factoren en ziekten worden geanalyseer

'Relieved working' study: systematic development and design of an intervention to decrease occupational quartz exposure at construction worksites

Occupational quartz exposure continues to be a serious hazard in the construction industry. Until now, evidence-based interventions aimed at reducing quartz exposure are scarce. The aim of this study was to systematically develop an intervention and to describe the study to evaluate its effectiveness. Methods/Design. The intervention was developed according to the principles of the Intervention Mapping protocol, meaning that evidence from the literature was combined with information collected from stakeholders (e.g., construction workers, managers and researchers). The intervention aimed to integrate technical, behavioural and organizational factors. The intervention consists of two plenary meetings for all employers within the company, and individual visits at construction worksites, including specific intervention materials. Additionally, a demonstration session regarding control measures was organized for all managers. The effectiveness of the intervention will be evaluated in a cluster randomized controlled trial among eight construction companies, with measurements at baseline and follow-up. Outcome measures are personal respirable dust and quartz exposure by means of exposure assessment, and behavioural and organizational determinants which will be assessed by means of questionnaires. Additionally, a process evaluation will shed light on whether the intervention (does not) works, and, if so, the reasons for this. Discussion. Applying Intervention Mapping in the development of an intervention to reduce occupational quartz exposure was useful, as different stakeholders provided input for the intervention as well as the implementation strategy. Therefore, the feasibility of the intervention has been enhanced, as it appeals to construction workers and managers and will not unduly interfere with the ongoing construction work. Trial registration number. NTR4586 (May 7th 2014)