Methodological aspects of a GIS-based environmental health inspection program used in the Athens 2004 Olympic and Para Olympic Games

BACKGROUND: The use of geographical information system (GIS) technologies in public health surveillance is gradually gaining momentum around the world and many applications have already been reported in the literature. In this study, GIS technology was used to help county departments of Public Health to implement environmental health surveillance for the Athens 2004 Olympic and Para Olympic Games. METHODS: In order to assess the workload in each Olympic county, 19 registry forms and 17 standardized inspection forms were developed to register and inspect environmental health items requiring inspection (Hotels, restaurants, swimming pools, water supply system etc), respectively. Furthermore, related databases were created using Epi Info 2002 and a geographical information system (GIS) were used to implement an integrated Environmental Health inspection program. The project was conducted in Athens by the Olympic Planning Unit (OPU) of the National School of Public Health, in close cooperation with the Ministry of Health and Social Solidarity and the corresponding departments of Public Health in all municipalities that were scheduled to host events during the Athens 2004 Olympic and Para Olympic games. RESULTS: A total of 44,741 premises of environmental health interest were geocoded into GIS databases and several electronic maps were developed. Using such maps in association with specific criteria, we first identified the maximum workload required to execute environmental health inspections in all premises within the eleven Olympic County Departments of Public Health. Six different scenarios were created for each county, based on devised algorithms in order to design the most effective and realistic inspection program using the available inspectors from each municipality. Furthermore, GIS applications were used to organize the daily inspection program for the Olympic games, provide coloured displays of the inspection results and link those results with the public health surveillance of specific cases or outbreak investigation. CONCLUSION: Our computerised program exhibited significant efficiency in facilitating the prudent use of public health resources in implementing environmental health inspections in densely populated urban areas as well as in rural counties. Furthermore, the application of simple algorithms in integrating human and other resources provided tailored and cost-effective applications to different public health agencies

Mapping temporally-variable exposure to flooding in small Mediterranean basins using land-use indicators

This article deals with mapping exposure (or external vulnerability) to flood risk in two typical Mediterranean ephemeral streams: the Barranco de Carraixet and the Rambla de Poyo. The floodplains of both streams are within the metropolitan area of the city of Valencia (Spain"s third largest city). Following the Mediterranean model, they are very fertile areas (with intense periurban and highly productive agriculture) which have recently absorbed the great urban expansion of the metropolis. Hydrologically these basins remain dry for most of the year, but become particularly dangerous during flash-flood events. They generate a risk pattern highly dependent on exposure since, in general, the hazard factor is very difficult to map, given the unpredictable nature of flash-floods. This work constitutes a proof of concept based on simple estimators obtained from land uses. External vulnerability or exposure is evaluated as a function of economic land value and human exposure to hazard. Land value is directly taken from the cadastre whilst human exposure is indirectly estimated from the location of population in relation to timeeactivity profiles. The temporal dimension is introduced and three exposure scenarios have been mapped, related to different time periods: working days, nights, weekends and holidays. The results show different patterns of exposure for each plain. In Carraixet floodplain exposure is greater at night and on weekends and holidays than during working hours, on account of the dominant agricultural and residential land uses. In the Poyo plain there are no major contrasts in absolute terms between day and night time, although spatial patterns of exposure vary from day to night: during the day, exposure is higher in industrial and commercial areas (around communication routes) whilst at night residential areas show more exposure

Flood risk assessment and mapping in peri-urban Mediterranean environments using hydrogeomorphology. Application to ephemeral streams in the Valencia region (eastern Spain)

This paper proposes a methodology for mapping flood risk in ephemeral streams, based on assessing flood hazards and global exposure. The method has been applied to the peri-urban area of Valencia, extended over the floodplains of the Barranco del Carraixet and Rambla de Poyo catchments. Hazard was assessed using hydrogeomorphological methods. Global exposure was estimated as a combination between the economic value of land use and human exposure, following a previous study carried out by Camarasa, A.M., López, M.J. and Soriano, J., 2011. Mapping temporally variable exposure to flooding in small Mediterranean basins using land-use indicators, Applied Geography 31 (19), 136¿145. Synthesis mapping was elaborated to spatially rank flood risks, in terms of their hazard and exposure components. The method is simple, effective and easily comparable. The results reveal diverse risk configurations for each floodplain, even though both are in the vicinity of Valencia city (metropolitan area). This flood risk mapping method is very useful for land use planning because it enables swift diagnosis of the nature of risks and can supports decision making by risk managers and urban planners

Air Pollution, Urgent Asthma Medical Visits and the Modifying Effect of Neighborhood Asthma Prevalence

Background: Social and environmental stressors, may modify associations between environmental pollutants and asthma symptoms. We examined if neighborhood asthma prevalence (higher: HAPN vs. lower: LAPN), a surrogate for underlying risk factors for asthma, modified the relationship between pollutants and urgent asthma visits. Methods: Through zip code, home addresses were linked to New York City Community Air Survey’s land use regression model for street-level, annual average nitrogen dioxide (NO2), particulate matter (PM2.5), elemental carbon (EC); summer average ozone (O3); winter average sulfur dioxide (SO2) concentrations. Poisson regression models were fit to estimate the association (prevalence ratio, PR) between pollutant exposures and seeking urgent asthma care. Results: All pollutants, except O3 were higher in HAPN than LAPN (P0.05). Conclusions: Relationships between modeled street-level pollutants and urgent asthma were stronger in LAPN compared to HAPN. Social stressors that may be more prevalent in HAPN than LAPN, could play a greater role in asthma exacerbations in HAPN versus pollutant exposure alone

Residential exposure to motor vehicle emissions and the risk of wheezing among 7-8 year-old schoolchildren: a city-wide cross-sectional study in Nicosia, Cyprus

<p>Abstract</p> <p>Background</p> <p>Several studies have reported associations between respiratory outcomes in children and a range of self-reported, administrative or geographical indicators of traffic pollution. First-time investigation into the frequency of asthmatic symptoms among 7-8 year-old Cypriot children in 1999-2000 showed increased prevalence in the capital Nicosia compared to other areas. Geographical differences on an island the size of Cyprus may reflect environmental and/or lifestyle factors. This study investigates the relationship between self-reported symptoms and residential exposure to motor vehicle emissions among Nicosia schoolchildren.</p> <p>Methods</p> <p>The addresses of children in the metropolitan area of Nicosia who participated in the original survey (N = 1,735) were geo-coded and the level of exposure of each child was assessed using distance- and emission-based indicators (i.e. estimated levels of particulate matter and nitrogen oxides emissions due to motor vehicles on main roads around the residence). Odds ratios of wheezing and asthma diagnosis in relation to levels of exposure were estimated in logistic regression models adjusting for person-based factors, co-morbidity and intra-school clustering.</p> <p>Results</p> <p>We found an increased risk of wheezing at distances less than 50 m from a main road and/or only among those experiencing the highest levels of exposure. The strongest effect estimates were observed when exposure was defined in terms of the cumulative burden at all roads around the residence. Adjusted odds ratios for current wheezing were 2.33 (95% CI 1.27, 4.30) amongst the quartile of participants exposed to the highest levels of PM at all roads 50 m of their residence and 2.14 (95% CI 1.05, 4.35) for NOx, with no effect at intermediate levels of exposure. While the direction of effect was apparent at longer distances, differences were generally not statistically significant.</p> <p>Conclusions</p> <p>Children experiencing the highest burden of emissions in Nicosia seem to be at a higher risk of reporting asthmatic symptoms. Due to the small number of children residing at close proximity to main roads and lack of evidence of risk at intermediate levels of exposure or longer distances, the observed pattern alone does not explain the generally higher prevalence observed in urban Nicosia compared to other areas.</p

Emerging Strategies for Healthy Urban Governance

Urban health promotion is not simply a matter of the right interventions, or even the necessary resources. Urban (and indeed global) health depends to an important extent on governance, the institutions and processes through which societies manage the course of events. This paper describes the concept of governance, distinguishing between reforms aimed at improving how government works and innovations that more fundamentally reinvent governance by developing new institutions and processes of local stakeholder control. The paper highlights strategies urban governors can use to maximize their influence on the national and international decisions that structure urban life. It concludes with some observations on the limitations of local governance strategies and the importance of establishing a “virtuous circuit” of governance through which urban dwellers play a greater role in the formation and implementation of policy at the national and global levels

Green qualities in the neighbourhood and mental health - results from a longitudinal cohort study in Southern Sweden

Background: Poor mental health is a major issue worldwide and causality is complex. For diseases with multifactorial background synergistic effects of person-and place-factors can potentially be preventive. Nature is suggested as one such positive place-factor. In this cohort study we tested the effect of defined green qualities (Serene, Space, Wild, Culture, Lush) in the environment at baseline on mental health at follow-up. We also studied interaction effects on mental health of those place factors and varied person factors (financial stress, living conditions, and physical activity). Methods: Data on person factors were extracted from a longitudinal (years 1999/2000 and 2005) population health survey (n = 24945). The participants were geocoded and linked to data on green qualities from landscape assessments, and stored in the Geographical Information System (GIS). Crude odds ratios (OR) and 95% confidence intervals (CI) were calculated, and multivariate logistic analyses were performed. Results: Mental health was not affected by access to the chosen green qualities, neither in terms of amount nor in terms of any specific quality. However, we found a reduced risk for poor mental health at follow-up among women, through a significant interaction effect between physical activity and access to the qualities Serene or Space. For men the tendencies were similar, though not significant. Regarding the other three green qualities, as well as amount of qualities, no statistically certain synergistic effects were found. Likewise, no significant synergies were detected between green qualities and the other person-factors. Only advanced exercise significantly reduced the risk for poor mental health among women, but not for men, compared to physical inactivity. Conclusions: The results do not directly support the hypothesis of a preventive mental health effect by access to the green qualities. However, the additive effect of serene nature to physical activity contributed to better mental health at follow-up. This tendency was equal for both sexes, but statistically significant only for women. Objective landscape assessments may be important in detangling geographic determinants of health. This study stresses the importance of considering interaction effects when dealing with disorders of multifactorial background

Superfund, Hedonics, and the Scales of Environmental Justice

Environmental justice (EJ) is prominent in environmental policy, yet EJ research is plagued by debates over methodological procedures. A well-established economic approach, the hedonic price method, can offer guidance on one contentious aspect of EJ research: the choice of the spatial unit of analysis. Environmental managers charged with preventing or remedying inequities grapple with these framing problems. This article reviews the theoretical and empirical literature on unit choice in EJ, as well as research employing hedonic pricing to assess the spatial extent of hazardous waste site impacts. The insights from hedonics are demonstrated in a series of EJ analyses for a national inventory of Superfund sites. First, as evidence of injustice exhibits substantial sensitivity to the choice of spatial unit, hedonics suggests some units conform better to Superfund impacts than others. Second, hedonic estimates for a particular site can inform the design of appropriate tests of environmental inequity for that site. Implications for policymakers and practitioners of EJ analyses are discussed