Associations of neighbourhood environmental attributes and socio-economic status with health-related quality of life in urban mid-aged and older adults : Mediation by physical activity and sedentary behaviour

This study examined the associations of objectively assessed physical features of the neighbourhood environment with physical and mental aspects of health-related quality of life (HRQoL) as measured by the SF-36, and the roles of physical activity and sedentary behaviour in these associations. We used data from a national sample of Australian mid-aged and older adults living in urban areas (N = 4141). Environmental attributes were computed for 1-km-radius areas surrounding participants' residential addresses. Neighbourhood socio-economic status (SES) and average annual concentrations of PM2.5 were the only attributes related to HRQoL in the expected direction in the total- and direct-effect regression models. All other environmental attributes were related to HRQoL via physical activity behaviours and leisure-time sitting. The associations of most environmental features with HRQoL mediated by physical activity and sedentary behaviours were inconsistent, positive through some pathways and negative through others. This study suggests that neighbourhood SES may in part benefit HRQoL by helping promote an active lifestyle. Neighbourhood attributes defining walkability may benefit HRQoL by providing opportunities for walking and resistance training and, through these, by helping reduce leisure-time sitting. However, the same attributes also may limit opportunities for household activities and gardening and negatively impact on HRQoL through these pathways

Room ventilation and the risk of airborne infection transmission in a tertiary hospital

Outdoor air ventilation is a key mechanism controlling the airborne spread of several diseases. However, ventilation guidelines for hospitals are not typically based on preventing infection transmission. Aim: We sought to assess the effectiveness of current ventilation rates on infection risks for influenza, tuberculosis (TB) and rhinovirus within three distinct rooms in a major tertiary hospital in Australia. Methods: The rooms targeted were a Lung Function Laboratory, negative pressure isolation room in the Emergency Department and an Outpatient Consultation Room. Air exchange measurements were performed in each by using CO2 decay, and the proportion of outdoor air supplied was determined by CO2 mass-balance at the air handling unit. Gammaitoni and Nucci's infection risk model, based on the traditional Wells-Riley model, was then employed to model scenarios typical of those experienced by patients. Results: Current outdoor air exchange rates in the Lung Function Laboratory and Isolation Room were appropriate, and infection risks for all modelled scenarios were <3.6%. Influenza risk for patients entering the OPD Room after an infectious patient departed ranged from 3.6 to 20.7% depending on the occupancy time of the susceptible and infectious patient. Conclusions: In the absence of definitive guidelines, air exchange measurements combined with modelling afford a useful means of assessing, on a case-by-case basis, the suitability of room ventilation at preventing airborne transmission

The impact of air pollution on interstitial lung disease: a systematic review and meta-analysis

IntroductionThere is a growing body of evidence suggesting a causal relationship between interstitial lung disease (ILD) and air pollution, both for the development of the disease, and driving disease progression. We aim to provide a comprehensive literature review of the association between air pollution, and ILD, including idiopathic pulmonary fibrosis (IPF).MethodsWe systematically searched from six online database. Two independent authors (DL and CF) selected studies and critically appraised the risk of bias using the Newcastle-Ottawa Scale (NOS). Findings are presented through a narrative synthesis and meta-analysis. Meta-analyses were performed exclusively when there was a minimum of three studies examining identical pollutant-health outcome pairs, all evaluating equivalent increments in pollutant concentration, using a random effects model.Results24 observational studies conducted in 13 countries or regions were identified. Pollutants under investigation encompassed ozone (O3), nitrogen dioxide (NO2), Particulate matter with diameters of 10 micrometers or less (PM10) and 2.5 micrometers or less (PM2.5), sulfur dioxide (SO2), carbon monoxide (CO), nitric oxide (NO) and nitrogen oxides (NOx). We conducted meta-analyses to assess the estimated Risk Ratios (RRs) for acute exacerbations (AE)-IPF in relation to exposure to every 10 μg/m3 increment in air pollutant concentrations, including O3, NO2, PM10, and PM2.5. The meta-analysis revealed a significant association between the increased risk of AE-IPF in PM2.5, yielding RR 1.94 (95% CI 1.30–2.90; p = 0.001). Findings across all the included studies suggest that increased exposure to air pollutants may be linked to a range of health issues in individuals with ILDs.ConclusionA scarcity of available studies on the air pollutants and ILD relationship underscores the imperative for further comprehensive research in this domain. The available data suggest that reducing levels of PM2.5 in the atmosphere could potentially reduce AE frequency and severity in ILD patients

Microbial contents of vacuum cleaner bag dust and emitted bioaerosols and their implications for human exposure indoors

Vacuum cleaners can release large concentrations of particles, both in their exhaust air and from resuspension of settled dust. However, the size, variability, and microbial diversity of these emissions are unknown, despite evidence to suggest they may contribute to allergic responses and infection transmission indoors. This study aimed to evaluate bioaerosol emission from various vacuum cleaners. We sampled the air in an experimental flow tunnel where vacuum cleaners were run, and their airborne emissions were sampled with closed-face cassettes. Dust samples were also collected from the dust bag. Total bacteria, total archaea, Penicillium/Aspergillus, and total Clostridium cluster 1 were quantified with specific quantitative PCR protocols, and emission rates were calculated. Clostridium botulinum and antibiotic resistance genes were detected in each sample using endpoint PCR. Bacterial diversity was also analyzed using denaturing gradient gel electrophoresis (DGGE), image analysis, and band sequencing. We demonstrated that emission of bacteria and molds (Penicillium/Aspergillus) can reach values as high as 1E5 cell equivalents/min and that those emissions are not related to each other. The bag dust bacterial and mold content was also consistent across the vacuums we assessed, reaching up to 1E7 bacterial or mold cell equivalents/g. Antibiotic resistance genes were detected in several samples. No archaea or C. botulinum was detected in any air samples. Diversity analyses showed that most bacteria are from human sources, in keeping with other recent results. These results highlight the potential capability of vacuum cleaners to disseminate appreciable quantities of molds and human-associated bacteria indoors and their role as a source of exposure to bioaerosols

Indigenous health and environmental risk factors: an Australian problem with global analogues?

Indigenous people experience poorer health than non-Indigenous people, and this well-described inequality has been observed in many countries. The contribution of different risk factors to the health ‘gap’ has understandably focussed on those factors for which there are sufficient data. However, this has precluded environmental risk factors – those present in air, water, food, and soil – due to a lack of data describing exposures and outcomes. These risk factors are demonstrably important at the global scale, as highlighted by the 2010 Global Burden of Disease study. Here, we describe how a greater focus on environmental risk factors is required in order to define their role in the Indigenous health gap. We use the Australian context as a case study of an issue we feel has global analogues and relevance. Suggestions for how and why this situation should be remedied are presented and discussed

In-vehicle nitrogen dioxide concentrations in road tunnels

There is a lack of knowledge regarding in-vehicle concentrations of nitrogen dioxide (NO) during transit through road tunnels in urban environments. Furthermore, previous studies have tended to involve a single vehicle and the range of in-vehicle NO concentrations that vehicle occupants may be exposed to is not well defined. This study describes simultaneous measurements of in-vehicle and outside-vehicle NO concentrations on a route through Sydney, Australia that included several major tunnels, minor tunnels and busy surface roads. Tests were conducted on nine passenger vehicles to assess how vehicle characteristics and ventilation settings affected in-vehicle NO concentrations and the in-vehicle-to-outside vehicle (I/O) concentration ratio. NO was measured directly using a cavity attenuated phase shift (CAPS) technique that gave a high temporal and spatial resolution. In the major tunnels, transit-average in-vehicle NO concentrations were lower than outside-vehicle concentrations for all vehicles with cabin air recirculation either on or off. However, markedly lower I/O ratios were obtained with recirculation on (0.08–0.36), suggesting that vehicle occupants can significantly lower their exposure to NO in tunnels by switching recirculation on. The highest mean I/O ratios for NO were measured in older vehicles (0.35–0.36), which is attributed to older vehicles having higher air exchange rates. The results from this study can be used to inform the design and operation of future road tunnels and modelling of personal exposure to NO

Seeing and experiencing nature – factors that affect health and wellbeing in health care facilities

Several studies indicate that seeing and experiencing nature play a vital role in human health and well-being

The neighbourhood environment and profiles of the metabolic syndrome

Background There is a dearth of studies on how neighbourhood environmental attributes relate to the metabolic syndrome (MetS) and profiles of MetS components. We examined the associations of interrelated aspects of the neighbourhood environment, including air pollution, with MetS status and profiles of MetS components. Methods We used socio-demographic and MetS-related data from 3681 urban adults who participated in the 3rd wave of the Australian Diabetes, Obesity and Lifestyle Study. Neighbourhood environmental attributes included area socio-economic status (SES), population density, street intersection density, non-commercial land use mix, percentages of commercial land, parkland and blue space. Annual average concentrations of NO2 and PM2.5 were estimated using satellite-based land-use regression models. Latent class analysis (LCA) identified homogenous groups (latent classes) of participants based on MetS components data. Participants were then classified into five metabolic profiles according to their MetS-components latent class and MetS status. Generalised additive mixed models were used to estimate relationships of environmental attributes with MetS status and metabolic profiles. Results LCA yielded three latent classes, one including only participants without MetS (“Lower probability of MetS components” profile). The other two classes/profiles, consisting of participants with and without MetS, were “Medium-to-high probability of high fasting blood glucose, waist circumference and blood pressure” and “Higher probability of MetS components”. Area SES was the only significant predictor of MetS status: participants from high SES areas were less likely to have MetS. Area SES, percentage of commercial land and NO2 were associated with the odds of membership to healthier metabolic profiles without MetS, while annual average concentration of PM2.5 was associated with unhealthier metabolic profiles with MetS. Conclusions This study supports the utility of operationalising MetS as a combination of latent classes of MetS components and MetS status in studies of environmental correlates. Higher socio-economic advantage, good access to commercial services and low air pollution levels appear to independently contribute to different facets of metabolic health. Future research needs to consider conducting longitudinal studies using fine-grained environmental measures that more accurately characterise the neighbourhood environment in relation to behaviours or other mechanisms related to MetS and its components

Independent and Combined Effects of Heatwaves and PM2.5 on Preterm Birth in Guangzhou, China: A Survival Analysis.

BACKGROUND: Both extreme heat and air pollution exposure during pregnancy have been associated with preterm birth; however, their combined effects are unclear. OBJECTIVES: Our goal was to estimate the independent and joint effects of heatwaves and fine particulate matter [PM 0) for less extreme heatwaves (i.e., shorter or with relatively low temperature thresholds) but were less than additive (RERIs<0) for more intense heatwaves. CONCLUSIONS: Our research strengthens the evidence that exposure to heatwaves during the final gestational week can independently trigger preterm birth. Moderate heatwaves may also act synergistically with PM2.5 exposure to increase risk of preterm birth, which adds new evidence to the current understanding of combined effects of air pollution and meteorological variables on adverse birth outcomes. https://doi.org/10.1289/EHP5117