43 results on '"FLEMING, LORA E."'
Search Results
2. Public involvement in research about environmental change and health: A case study.
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Maguire K, Garside R, Poland J, Fleming LE, Alcock I, Taylor T, Macintyre H, Iacono GL, Green A, and Wheeler BW
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- Administrative Personnel, Health Policy, Humans, Community Participation methods, Environment Design, Health Status, Public Health, Research organization & administration
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Involving and engaging the public are crucial for effective prioritisation, dissemination and implementation of research about the complex interactions between environments and health. Involvement is also important to funders and policy makers who often see it as vital for building trust and justifying the investment of public money. In public health research, 'the public' can seem an amorphous target for researchers to engage with, and the short-term nature of research projects can be a challenge. Technocratic and pedagogical approaches have frequently met with resistance, so public involvement needs to be seen in the context of a history which includes contested truths, power inequalities and political activism. It is therefore vital for researchers and policy makers, as well as public contributors, to share best practice and to explore the challenges encountered in public involvement and engagement. This article presents a theoretically informed case study of the contributions made by the Health and Environment Public Engagement Group to the work of the National Institute for Health Research (NIHR) Health Protection Research Unit in Environmental Change and Health (HPRU-ECH). We describe how Health and Environment Public Engagement Group has provided researchers in the HPRU-ECH with a vehicle to support access to public views on multiple aspects of the research work across three workshops, discussion of ongoing research issues at meetings and supporting dissemination to local government partners, as well as public representation on the HPRU-ECH Advisory Board. We conclude that institutional support for standing public involvement groups can provide conduits for connecting public with policy makers and academic institutions. This can enable public involvement and engagement, which would be difficult, if not impossible, to achieve in individual short-term and unconnected research projects.
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- 2019
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3. Health Benefits of Physical Activity Related to an Urban Riverside Regeneration.
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Vert C, Nieuwenhuijsen M, Gascon M, Grellier J, Fleming LE, White MP, and Rojas-Rueda D
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- Adolescent, Adult, Aged, Aged, 80 and over, Cost-Benefit Analysis, Female, Health Promotion economics, Humans, Male, Middle Aged, Quality-Adjusted Life Years, Spain, Urban Renewal economics, Young Adult, Environment Design economics, Exercise, Health Promotion methods, Parks, Recreational economics, Public Health economics, Public Health methods, Urban Renewal methods
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The promotion of physical activity through better urban design is one pathway by which health and well-being improvements can be achieved. This study aimed to quantify health and health-related economic impacts associated with physical activity in an urban riverside park regeneration project in Barcelona, Spain. We used data from Barcelona local authorities and meta-analysis assessing physical activity and health outcomes to develop and apply the "Blue Active Tool". We estimated park user health impacts in terms of all-cause mortality, morbidity (ischemic heart disease; ischemic stroke; type 2 diabetes; cancers of the colon and breast; and dementia), disability-adjusted life years (DALYs) and health-related economic impacts. We estimated that 5753 adult users visited the riverside park daily and performed different types of physical activity (walking for leisure or to/from work, cycling, and running). Related to the physical activity conducted on the riverside park, we estimated an annual reduction of 7.3 deaths (95% CI: 5.4; 10.2), and 6.2 cases of diseases (95% CI: 2.0; 11.6). This corresponds to 11.9 DALYs (95% CI: 3.4; 20.5) and an annual health-economic impact of 23.4 million euros (95% CI: 17.2 million; 32.8 million). The urban regeneration intervention of this riverside park provides health and health-related economic benefits to the population using the infrastructure.
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- 2019
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4. Making the Case for "Whole System" Approaches: Integrating Public Health and Housing.
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Sharpe RA, Taylor T, Fleming LE, Morrissey K, Morris G, and Wigglesworth R
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- Housing standards, Humans, Models, Theoretical, Housing organization & administration, Public Health methods
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Housing conditions have been an enduring focus for public health activity throughout the modern public health era. However, the nature of the housing and health challenge has changed in response to an evolution in the understanding of the diverse factors influencing public health. Today, the traditional public health emphasis on the type and quality of housing merges with other wider determinants of health. These include the neighbourhood, community, and "place" where a house is located, but also the policies which make access to a healthy house possible and affordable for everyone. Encouragingly, these approaches to policy and action on housing have the potential to contribute to the "triple win" of health and well-being, equity, and environmental sustainability. However, more effective housing policies (and in public health in general) that adopt more systemic approaches to addressing the complex interactions between health, housing, and wider environment are needed. This paper illustrates some of the key components of the housing and health challenge in developed countries, and presents a conceptual model to co-ordinate activities that can deliver the "triple win." This is achieved by offering a perspective on how to navigate more effectively, inclusively and across sectors when identifying sustainable housing interventions.
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- 2018
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5. BlueHealth: a study programme protocol for mapping and quantifying the potential benefits to public health and well-being from Europe's blue spaces.
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Grellier J, White MP, Albin M, Bell S, Elliott LR, Gascón M, Gualdi S, Mancini L, Nieuwenhuijsen MJ, Sarigiannis DA, van den Bosch M, Wolf T, Wuijts S, and Fleming LE
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- Europe, Humans, Research Design, Fresh Water, Health, Public Health, Recreation, Social Planning
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Introduction: Proximity and access to water have long been central to human culture and accordingly deliver countless societal benefits. Over 200 million people live on Europe's coastline, and aquatic environments are the top recreational destination in the region. In terms of public health, interactions with 'blue space' (eg, coasts, rivers, lakes) are often considered solely in terms of risk (eg, drowning, microbial pollution). Exposure to blue space can, however, promote health and well-being and prevent disease, although underlying mechanisms are poorly understood., Aims and Methods: The BlueHealth project aims to understand the relationships between exposure to blue space and health and well-being, to map and quantify the public health impacts of changes to both natural blue spaces and associated urban infrastructure in Europe, and to provide evidence-based information to policymakers on how to maximise health benefits associated with interventions in and around aquatic environments. To achieve these aims, an evidence base will be created through systematic reviews, analyses of secondary data sets and analyses of new data collected through a bespoke international survey and a wide range of community-level interventions. We will also explore how to deliver the benefits associated with blue spaces to those without direct access through the use of virtual reality. Scenarios will be developed that allow the evaluation of health impacts in plausible future societal contexts and changing environments. BlueHealth will develop key inputs into policymaking and land/water-use planning towards more salutogenic and sustainable uses of blue space, particularly in urban areas., Ethics and Dissemination: Throughout the BlueHealth project, ethics review and approval are obtained for all relevant aspects of the study by the local ethics committees prior to any work being initiated and an ethics expert has been appointed to the project advisory board. So far, ethical approval has been obtained for the BlueHealth International Survey and for community-level interventions taking place in Spain, Italy and the UK. Engagement of stakeholders, including the public, involves citizens in many aspects of the project. Results of all individual studies within the BlueHealth project will be published with open access. After full anonymisation and application of any measures necessary to prevent disclosure, data generated in the project will be deposited into open data repositories of the partner institutions, in line with a formal data management plan. Other knowledge and tools developed in the project will be made available via the project website (www.bluehealth2020.eu). Project results will ultimately provide key inputs to planning and policy relating to blue space, further stimulating the integration of environmental and health considerations into decision-making, such that blue infrastructure is developed across Europe with both public health and the environment in mind., Competing Interests: Competing interests: All authors report grants from European Union Horizon 2020 programme (grant number 666773), during the conduct of the study., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
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- 2017
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6. An alternative approach to water regulations for public health protection at bathing beaches.
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Abdelzaher AM, Solo-Gabriele HM, Phillips MC, Elmir SM, and Fleming LE
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- Bathing Beaches legislation & jurisprudence, Florida, Humans, Public Health legislation & jurisprudence, Recreation, Seawater microbiology, Water Microbiology, Water Quality, Bathing Beaches standards, Environmental Monitoring methods, Practice Guidelines as Topic, Public Health methods, Social Control, Formal methods
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New approaches should be considered as the US Environmental Protection Agency (EPA) moves rapidly to develop new beach monitoring guidelines by the end of 2012, as these guidelines serve as the basis by which states and territories with coasts along the oceans and Great Lakes can then develop and implement monitoring programs for recreational waters. We describe and illustrate one possible approach to beach regulation termed as the "Comprehensive Toolbox within an Approval Process (CTBAP)." The CTBAP consists of three components. The first is a "toolbox" consisting of an inventory of guidelines on monitoring targets, a series of measurement techniques, and guidance to improve water quality through source identification and prevention methods. The second two components are principles of implementation. These include first, "flexibility" to encourage and develop an individualized beach management plan tailored to local conditions and second, "consistency" of this management plan to ensure a consistent national level of public health protection. The results of this approach are illustrated through a case study at a well-studied South Florida recreational marine beach. This case study explores different monitoring targets based on two different health endpoints (skin versus gastrointestinal illness) and recommends a beach regulation program for the study beach that focuses predominately on source prevention.
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- 2013
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7. Increasing rates of melanoma among nonwhites in Florida compared with the United States.
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Rouhani P, Pinheiro PS, Sherman R, Arheart K, Fleming LE, Mackinnon J, and Kirsner RS
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- Female, Florida epidemiology, Humans, Incidence, Male, Risk Factors, United States epidemiology, Black or African American, Hispanic or Latino, Melanoma ethnology, Public Health trends, Registries, SEER Program statistics & numerical data, Skin Neoplasms ethnology
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Objective: To compare melanoma trends within Florida with national melanoma trends from 1992 through 2004. An analysis of state and national melanoma trends is critical for the identification of high-risk regions of the country., Design: Data from the Florida Cancer Data System (FCDS) and Surveillance, Epidemiology, and End Results (SEER) were evaluated to determine age-adjusted and race/ethnicity- and sex-specific invasive cutaneous melanoma incidence trends for 1992 through 2004 using joinpoint regression analysis. Standardized incidence rate ratios (SIRRs) were computed to compare Florida with the United States., Patients: A population of 109 633 patients with invasive melanoma was evaluated: 73 206 (66.8%) from SEER and 36 427 (33.2%) from FCDS., Main Outcome Measures: Melanoma incidence and change in melanoma rates over time., Results: The incidence of melanoma among male Hispanic patients residing in Florida was 20% higher than that of their male counterparts in the SEER catchment areas (SIRR, 1.2; 95% confidence interval [CI], 1.1-1.4). Conversely, the incidence of melanoma among female Hispanic patients residing in Florida was significantly lower than that in SEER (SIRR, 0.7; 95% CI, 0.7-0.8). Differences in melanoma incidence were identified in female non-Hispanic black (NHB) patients in Florida who had a 60% significantly higher incidence of melanoma compared with female NHB patients in SEER (SIRR, 1.6; 95% CI, 1.3-2.0)., Conclusion: These findings suggest an emerging public health concern in race/ethnic subgroups that were previously understudied.
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- 2010
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8. Linking the oceans to public health: current efforts and future directions.
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Kite-Powell HL, Fleming LE, Backer LC, Faustman EM, Hoagland P, Tsuchiya A, Younglove LR, Wilcox BA, and Gast RJ
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- Animals, Forecasting, Humans, Oceans and Seas, Seawater analysis, Seawater microbiology, Environmental Health methods, Public Health methods
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We review the major linkages between the oceans and public health, focusing on exposures and potential health effects due to anthropogenic and natural factors including: harmful algal blooms, microbes, and chemical pollutants in the oceans; consumption of seafood; and flooding events. We summarize briefly the current state of knowledge about public health effects and their economic consequences; and we discuss priorities for future research.We find that:* There are numerous connections between the oceans, human activities, and human health that result in both positive and negative exposures and health effects (risks and benefits); and the study of these connections comprises a new interdisciplinary area, "oceans and human health."* The state of present knowledge about the linkages between oceans and public health varies. Some risks, such as the acute health effects caused by toxins associated with shellfish poisoning and red tide, are relatively well understood. Other risks, such as those posed by chronic exposure to many anthropogenic chemicals, pathogens, and naturally occurring toxins in coastal waters, are less well quantified. Even where there is a good understanding of the mechanism for health effects, good epidemiological data are often lacking. Solid data on economic and social consequences of these linkages are also lacking in most cases.* The design of management measures to address these risks must take into account the complexities of human response to warnings and other guidance, and the economic tradeoffs among different risks and benefits. Future research in oceans and human health to address public health risks associated with marine pathogens and toxins, and with marine dimensions of global change, should include epidemiological, behavioral, and economic components to ensure that resulting management measures incorporate effective economic and risk/benefit tradeoffs.
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- 2008
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9. Overview of aerosolized Florida red tide toxins: exposures and effects.
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Fleming LE, Backer LC, and Baden DG
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- Animals, Environmental Monitoring, Eutrophication, Florida, Humans, Research trends, Aerosols, Dinoflagellida pathogenicity, Environmental Exposure, Marine Toxins adverse effects, Oxocins adverse effects, Public Health
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Florida red tide is caused by Karenia brevis, a dinoflagellate that periodically blooms, releasing its potent neurotoxin, brevetoxin, into the surrounding waters and air along the coast of the Gulf of Mexico. Exposure to Florida red tide toxins has been associated with adverse human health effects and massive fish and marine mammal deaths. The articles in this mini-monograph describe the ongoing interdisciplinary and interagency research program that characterizes the exposures and health effects of aerosolized Florida red tide toxins (brevetoxins). The interdisciplinary research program uses animal models and laboratory studies to develop hypotheses and apply these findings to in situ human exposures. Our ultimate goal is to develop appropriate prevention measures and medical interventions to mitigate or prevent adverse health effects from exposure to complex mixtures of aerosolized red tide toxins.
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- 2005
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10. Indicators of ocean health and human health: developing a research and monitoring framework.
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Knap A, Dewailly E, Furgal C, Galvin J, Baden D, Bowen RE, Depledge M, Duguay L, Fleming LE, Ford T, Moser F, Owen R, Suk WA, and Unluata U
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- Animals, Conservation of Natural Resources, Forecasting, Risk Assessment, Animal Diseases etiology, Ecosystem, Environmental Health, Models, Theoretical, Public Health, Water Pollutants adverse effects
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We need to critically assess the present quality of the marine ecosystem, especially the connection between ecosystem change and threats to human health. In this article we review the current state of indicators to link changes in marine organisms with eventual effects to human health, identify research opportunities in the use of indicators of ocean and human health, and discuss how to establish collaborations between national and international governmental and private sector groups. We present a synthesis of the present state of understanding of the connection between ocean health and human health, a discussion of areas where resources are required, and a discussion of critical research needs and a template for future work in this field. To understand fully the interactions between ocean health and human health, programs should be organized around a "models-based" approach focusing on critical themes and attributes of marine environmental and public health risks. Given the extent and complex nature of ocean and human health issues, a program networking across geographic and disciplinary boundaries is essential. The overall goal of this approach would be the early detection of potential marine-based contaminants, the protection of marine ecosystems, the prevention of associated human illness, and by implication, the development of products to enhance human well-being. The tight connection between research and monitoring is essential to develop such an indicator-based effort.
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- 2002
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11. Risk in Daily Newspaper Coverage of Red Tide Blooms in Southwest Florida
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Li, Zongchao, Garrison, Bruce, Ullmann, Steven G., Kirkpatrick, Barbara, Fleming, Lora E., and Hoagland, Porter
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This study investigated newspaper coverage of Florida red tide blooms in four metropolitan areas of Southwest Florida during a 25-year period, 1987-2012. We focused on how journalists framed red tide stories with respect to environmental risk, health risk, and economic risk. We determined risk to be a key factor in this news coverage, being an aspect of coverage of red tide itself in terms of environmental risk, tourism risk, and public health risk. The study found that red tide news coverage is most often framed as an environmental story.
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- 2015
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12. Epidemiological evidence on drinking water salinity and blood pressure: a scoping review
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Xeni, Christina, Oliva, Raymond, Jahan, Farjana, Romaina, Iqbal, Naser, Abu Mohd, Rahman, Mahbubur, Fleming, Lora E, O Gribble, Matthew, and Makris, Konstantinos C
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Hypertension ,Cardiovascular ,Generic health relevance ,Good Health and Well Being - Abstract
Abstract: In addition to diet, drinking water can be an important contributor to the total body burden of salts. Water salinity (defined as the amount of dissolved salts in a body of water) has been associated with adverse health effects. We mapped the current research on drinking water salinity and its effects on blood pressure (BP). We aimed to identify knowledge gaps in the methodology and tools used in the epidemiological literature to address water salinity effects on BP. We performed a scoping review of epidemiological studies by searching PubMed and Web of Science databases from 1980 to 2022. Reviews, study comparisons, meta-analyses, commentaries, viewpoints, correspondence, protocols, studies in clinical settings, animal or in vitro studies, or not in English, were excluded. Epidemiologic studies including systolic/diastolic BP and/or the risk of hypertension as the main health outcome and drinking water salts (sodium, potassium, calcium, magnesium, including electrical conductivity and total dissolved solids) as the main exposures were included. After screening 246 articles, 29 articles were retained. Most studies were conducted in Bangladesh and USA (n = 9 and n = 9, respectively). The majority of studies were cross-sectional (n = 18; 62%). The study populations were adults (55%) or children (35%) or both (10%). Only eight (28%) studies did not collect urine samples and only three studies (10%) did not record participant BP. About half of the studies (n = 15, 52%) reported a positive significant (p < 0.05) association between salts in drinking water and higher BP and/or risk of hypertension; while 24% and 24% reported non-significant (p > 0.05) and significant (p < 0.05) negative associations (with lower BP mainly attributed to higher Mg, Ca, and K (rather than Na) levels in drinking water). More longitudinal studies are warranted to investigate the impact of drinking water salinization on cardiovascular health and risk of hypertension. Under a changing climate, this may be particularly important for coastal populations, as sea level rise in combination with the overexploitation of groundwater would differentially perturb the salinity of their drinking water supplies.
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- 2023
13. IARC monographs: 40 years of evaluating carcinogenic hazards to humans.
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Pearce, Neil, Blair, Aaron, Vineis, Paolo, Ahrens, Wolfgang, Andersen, Aage, Anto, Josep M, Armstrong, Bruce K, Baccarelli, Andrea A, Beland, Frederick A, Berrington, Amy, Bertazzi, Pier Alberto, Birnbaum, Linda S, Brownson, Ross C, Bucher, John R, Cantor, Kenneth P, Cardis, Elisabeth, Cherrie, John W, Christiani, David C, Cocco, Pierluigi, Coggon, David, Comba, Pietro, Demers, Paul A, Dement, John M, Douwes, Jeroen, Eisen, Ellen A, Engel, Lawrence S, Fenske, Richard A, Fleming, Lora E, Fletcher, Tony, Fontham, Elizabeth, Forastiere, Francesco, Frentzel-Beyme, Rainer, Fritschi, Lin, Gerin, Michel, Goldberg, Marcel, Grandjean, Philippe, Grimsrud, Tom K, Gustavsson, Per, Haines, Andy, Hartge, Patricia, Hansen, Johnni, Hauptmann, Michael, Heederik, Dick, Hemminki, Kari, Hemon, Denis, Hertz-Picciotto, Irva, Hoppin, Jane A, Huff, James, Jarvholm, Bengt, Kang, Daehee, Karagas, Margaret R, Kjaerheim, Kristina, Kjuus, Helge, Kogevinas, Manolis, Kriebel, David, Kristensen, Petter, Kromhout, Hans, Laden, Francine, Lebailly, Pierre, LeMasters, Grace, Lubin, Jay H, Lynch, Charles F, Lynge, Elsebeth, 't Mannetje, Andrea, McMichael, Anthony J, McLaughlin, John R, Marrett, Loraine, Martuzzi, Marco, Merchant, James A, Merler, Enzo, Merletti, Franco, Miller, Anthony, Mirer, Franklin E, Monson, Richard, Nordby, Karl-Cristian, Olshan, Andrew F, Parent, Marie-Elise, Perera, Frederica P, Perry, Melissa J, Pesatori, Angela Cecilia, Pirastu, Roberta, Porta, Miquel, Pukkala, Eero, Rice, Carol, Richardson, David B, Ritter, Leonard, Ritz, Beate, Ronckers, Cecile M, Rushton, Lesley, Rusiecki, Jennifer A, Rusyn, Ivan, Samet, Jonathan M, Sandler, Dale P, de Sanjose, Silvia, Schernhammer, Eva, Costantini, Adele Seniori, Seixas, Noah, Shy, Carl, Siemiatycki, Jack, and Silverman, Debra T
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Humans ,Neoplasms ,Carcinogens ,Environmental ,Public Health ,Biomedical Research ,Publications ,International Agencies ,Environmental Sciences ,Medical and Health Sciences ,Toxicology - Abstract
BackgroundRecently, the International Agency for Research on Cancer (IARC) Programme for the Evaluation of Carcinogenic Risks to Humans has been criticized for several of its evaluations, and also for the approach used to perform these evaluations. Some critics have claimed that failures of IARC Working Groups to recognize study weaknesses and biases of Working Group members have led to inappropriate classification of a number of agents as carcinogenic to humans.ObjectivesThe authors of this Commentary are scientists from various disciplines relevant to the identification and hazard evaluation of human carcinogens. We examined criticisms of the IARC classification process to determine the validity of these concerns. Here, we present the results of that examination, review the history of IARC evaluations, and describe how the IARC evaluations are performed.DiscussionWe concluded that these recent criticisms are unconvincing. The procedures employed by IARC to assemble Working Groups of scientists from the various disciplines and the techniques followed to review the literature and perform hazard assessment of various agents provide a balanced evaluation and an appropriate indication of the weight of the evidence. Some disagreement by individual scientists to some evaluations is not evidence of process failure. The review process has been modified over time and will undoubtedly be altered in the future to improve the process. Any process can in theory be improved, and we would support continued review and improvement of the IARC processes. This does not mean, however, that the current procedures are flawed.ConclusionsThe IARC Monographs have made, and continue to make, major contributions to the scientific underpinning for societal actions to improve the public's health.
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- 2015
14. Urban Blue Spaces
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Bell, Simon, Fleming, Lora E., Grellier, James, Kuhlmann, Friedrich, Nieuwenhuijsen, Mark J., and White, Mathew P.
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Blue space ,Coastal management ,Coastal planning ,EU Horizon 2020 ,Landscape planning ,Planning ,Public ,Public health ,Resilient cities ,Seascapes ,Sustainability ,Sustainable design ,Urban design ,Well-being ,bic Book Industry Communication::A The arts::AM Architecture::AMV Landscape art & architecture::AMVD City & town planning - architectural aspects ,bic Book Industry Communication::A The arts::AM Architecture::AMD Architecture: professional practice ,bic Book Industry Communication::A The arts::AM Architecture::AMC Architectural structure & design::AMCR Environmentally-friendly architecture & design ,bic Book Industry Communication::R Earth sciences, geography, environment, planning::RN The environment::RNC Applied ecology - Abstract
This book presents an evidence-based approach to landscape planning and design for urban blue spaces that maximises the benefits to human health and well-being while minimising the risks. Based on applied research and evidence from primary and secondary data sources stemming from the EU-funded BlueHealth project, the book presents nature-based solutions to promote sustainable and resilient cities. Numerous cities around the world are located alongside bodies of water in the form of coastlines, lakes, rivers and canals, but the relationship between city inhabitants and these water sources has often been ambivalent. In many cities, water has been polluted, engineered or ignored completely. But, due to an increasing awareness of the strong connections between city, people, nature and water and health, this paradigm is shifting. The international editorial team, consisting of researchers and professionals across several disciplines, leads the reader through theoretical aspects, evidence, illustrated case studies, risk assessment and a series of validated tools to aid planning and design before finishing with overarching planning and design principles for a range of blue-space types. Over 200 full-colour illustrations accompany the case-study examples from geographic locations all over the world, including Portugal, the United Kingdom, China, Canada, the US, South Korea, Singapore, Norway and Estonia. With green and blue infrastructure now at the forefront of current policies and trends to promote healthy, sustainable cities, Urban Blue Spaces is a must-have for professionals and students in landscape planning, urban design and environmental design. Open Access for the book was funded by the European Union's Horizon 2020 research and innovation programme under grant agreement No 666773
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- 2022
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15. The Minderoo-Monaco Commission on Plastics and Human Health.
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Landrigan, Philip J., Raps, Hervé, Cropper, Maureen, Bald, Caroline, Brunner, Manuel, Canonizado, Elvia Maya, Charles, Dominic, Chiles, Thomas C., Donohue, Mary J., Enck, Judith, Fenichel, Patrick, Fleming, Lora E., Ferrier-Pages, Christine, Fordham, Richard, Gozt, Aleksandra, Griffin, Carly, Hahn, Mark E., Haryanto, Budi, Hixson, Richard, and Ianelli, Hannah
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ENVIRONMENTAL health ,WASTE management ,SOCIAL justice ,OCCUPATIONAL hazards ,CARBON ,WASTE recycling ,SUSTAINABILITY ,PLASTICS ,POLLUTANTS ,POLLUTION ,OCEAN ,PUBLIC health ,GREENHOUSE gases ,NANOPARTICLES - Abstract
Background: Plastics have conveyed great benefits to humanity and made possible some of the most significant advances of modern civilization in fields as diverse as medicine, electronics, aerospace, construction, food packaging, and sports. It is now clear, however, that plastics are also responsible for significant harms to human health, the economy, and the earth's environment. These harms occur at every stage of the plastic life cycle, from extraction of the coal, oil, and gas that are its main feedstocks through to ultimate disposal into the environment. The extent of these harms not been systematically assessed, their magnitude not fully quantified, and their economic costs not comprehensively counted. Goals: The goals of this Minderoo-Monaco Commission on Plastics and Human Health are to comprehensively examine plastics' impacts across their life cycle on: (1) human health and well-being; (2) the global environment, especially the ocean; (3) the economy; and (4) vulnerable populations—the poor, minorities, and the world's children. On the basis of this examination, the Commission offers science-based recommendations designed to support development of a Global Plastics Treaty, protect human health, and save lives. Report Structure: This Commission report contains seven Sections. Following an Introduction, Section 2 presents a narrative review of the processes involved in plastic production, use, and disposal and notes the hazards to human health and the environment associated with each of these stages. Section 3 describes plastics' impacts on the ocean and notes the potential for plastic in the ocean to enter the marine food web and result in human exposure. Section 4 details plastics' impacts on human health. Section 5 presents a first-order estimate of plastics' health-related economic costs. Section 6 examines the intersection between plastic, social inequity, and environmental injustice. Section 7 presents the Commission's findings and recommendations. Plastics: Plastics are complex, highly heterogeneous, synthetic chemical materials. Over 98% of plastics are produced from fossil carbon- coal, oil and gas. Plastics are comprised of a carbon-based polymer backbone and thousands of additional chemicals that are incorporated into polymers to convey specific properties such as color, flexibility, stability, water repellence, flame retardation, and ultraviolet resistance. Many of these added chemicals are highly toxic. They include carcinogens, neurotoxicants and endocrine disruptors such as phthalates, bisphenols, per- and poly-fluoroalkyl substances (PFAS), brominated flame retardants, and organophosphate flame retardants. They are integral components of plastic and are responsible for many of plastics' harms to human health and the environment. Global plastic production has increased almost exponentially since World War II, and in this time more than 8,300 megatons (Mt) of plastic have been manufactured. Annual production volume has grown from under 2 Mt in 1950 to 460 Mt in 2019, a 230-fold increase, and is on track to triple by 2060. More than half of all plastic ever made has been produced since 2002. Single-use plastics account for 35–40% of current plastic production and represent the most rapidly growing segment of plastic manufacture. Explosive recent growth in plastics production reflects a deliberate pivot by the integrated multinational fossil-carbon corporations that produce coal, oil and gas and that also manufacture plastics. These corporations are reducing their production of fossil fuels and increasing plastics manufacture. The two principal factors responsible for this pivot are decreasing global demand for carbon-based fuels due to increases in 'green' energy, and massive expansion of oil and gas production due to fracking. Plastic manufacture is energy-intensive and contributes significantly to climate change. At present, plastic production is responsible for an estimated 3.7% of global greenhouse gas emissions, more than the contribution of Brazil. This fraction is projected to increase to 4.5% by 2060 if current trends continue unchecked. Plastic Life Cycle: The plastic life cycle has three phases: production, use, and disposal. In production, carbon feedstocks—coal, gas, and oil—are transformed through energy-intensive, catalytic processes into a vast array of products. Plastic use occurs in every aspect of modern life and results in widespread human exposure to the chemicals contained in plastic. Single-use plastics constitute the largest portion of current use, followed by synthetic fibers and construction. Plastic disposal is highly inefficient, with recovery and recycling rates below 10% globally. The result is that an estimated 22 Mt of plastic waste enters the environment each year, much of it single-use plastic and are added to the more than 6 gigatons of plastic waste that have accumulated since 1950. Strategies for disposal of plastic waste include controlled and uncontrolled landfilling, open burning, thermal conversion, and export. Vast quantities of plastic waste are exported each year from high-income to low-income countries, where it accumulates in landfills, pollutes air and water, degrades vital ecosystems, befouls beaches and estuaries, and harms human health—environmental injustice on a global scale. Plastic-laden e-waste is particularly problematic. Environmental Findings: Plastics and plastic-associated chemicals are responsible for widespread pollution. They contaminate aquatic (marine and freshwater), terrestrial, and atmospheric environments globally. The ocean is the ultimate destination for much plastic, and plastics are found throughout the ocean, including coastal regions, the sea surface, the deep sea, and polar sea ice. Many plastics appear to resist breakdown in the ocean and could persist in the global environment for decades. Macro- and micro-plastic particles have been identified in hundreds of marine species in all major taxa, including species consumed by humans. Trophic transfer of microplastic particles and the chemicals within them has been demonstrated. Although microplastic particles themselves (>10 µm) appear not to undergo biomagnification, hydrophobic plastic-associated chemicals bioaccumulate in marine animals and biomagnify in marine food webs. The amounts and fates of smaller microplastic and nanoplastic particles (MNPs <10 µm) in aquatic environments are poorly understood, but the potential for harm is worrying given their mobility in biological systems. Adverse environmental impacts of plastic pollution occur at multiple levels from molecular and biochemical to population and ecosystem. MNP contamination of seafood results in direct, though not well quantified, human exposure to plastics and plastic-associated chemicals. Marine plastic pollution endangers the ocean ecosystems upon which all humanity depends for food, oxygen, livelihood, and well-being. Human Health Findings: Coal miners, oil workers and gas field workers who extract fossil carbon feedstocks for plastic production suffer increased mortality from traumatic injury, coal workers' pneumoconiosis, silicosis, cardiovascular disease, chronic obstructive pulmonary disease, and lung cancer. Plastic production workers are at increased risk of leukemia, lymphoma, hepatic angiosarcoma, brain cancer, breast cancer, mesothelioma, neurotoxic injury, and decreased fertility. Workers producing plastic textiles die of bladder cancer, lung cancer, mesothelioma, and interstitial lung disease at increased rates. Plastic recycling workers have increased rates of cardiovascular disease, toxic metal poisoning, neuropathy, and lung cancer. Residents of "fenceline" communities adjacent to plastic production and waste disposal sites experience increased risks of premature birth, low birth weight, asthma, childhood leukemia, cardiovascular disease, chronic obstructive pulmonary disease, and lung cancer. During use and also in disposal, plastics release toxic chemicals including additives and residual monomers into the environment and into people. National biomonitoring surveys in the USA document population-wide exposures to these chemicals. Plastic additives disrupt endocrine function and increase risk for premature births, neurodevelopmental disorders, male reproductive birth defects, infertility, obesity, cardiovascular disease, renal disease, and cancers. Chemical-laden MNPs formed through the environmental degradation of plastic waste can enter living organisms, including humans. Emerging, albeit still incomplete evidence indicates that MNPs may cause toxicity due to their physical and toxicological effects as well as by acting as vectors that transport toxic chemicals and bacterial pathogens into tissues and cells. Infants in the womb and young children are two populations at particularly high risk of plastic-related health effects. Because of the exquisite sensitivity of early development to hazardous chemicals and children's unique patterns of exposure, plastic-associated exposures are linked to increased risks of prematurity, stillbirth, low birth weight, birth defects of the reproductive organs, neurodevelopmental impairment, impaired lung growth, and childhood cancer. Early-life exposures to plastic-associated chemicals also increase the risk of multiple non-communicable diseases later in life. Economic Findings: Plastic's harms to human health result in significant economic costs. We estimate that in 2015 the health-related costs of plastic production exceeded $250 billion (2015 Int$) globally, and that in the USA alone the health costs of disease and disability caused by the plastic-associated chemicals PBDE, BPA and DEHP exceeded $920 billion (2015 Int$). Plastic production results in greenhouse gas (GHG) emissions equivalent to 1.96 gigatons of carbon dioxide (CO
2 e) annually. Using the US Environmental Protection Agency's (EPA) social cost of carbon metric, we estimate the annual costs of these GHG emissions to be $341 billion (2015 Int$). These costs, large as they are, almost certainly underestimate the full economic losses resulting from plastics' negative impacts on human health and the global environment. All of plastics' economic costs—and also its social costs—are externalized by the petrochemical and plastic manufacturing industry and are borne by citizens, taxpayers, and governments in countries around the world without compensation. Social Justice Findings: The adverse effects of plastics and plastic pollution on human health, the economy and the environment are not evenly distributed. They disproportionately affect poor, disempowered, and marginalized populations such as workers, racial and ethnic minorities, "fenceline" communities, Indigenous groups, women, and children, all of whom had little to do with creating the current plastics crisis and lack the political influence or the resources to address it. Plastics' harmful impacts across its life cycle are most keenly felt in the Global South, in small island states, and in disenfranchised areas in the Global North. Social and environmental justice (SEJ) principles require reversal of these inequitable burdens to ensure that no group bears a disproportionate share of plastics' negative impacts and that those who benefit economically from plastic bear their fair share of its currently externalized costs. Conclusions: It is now clear that current patterns of plastic production, use, and disposal are not sustainable and are responsible for significant harms to human health, the environment, and the economy as well as for deep societal injustices. The main driver of these worsening harms is an almost exponential and still accelerating increase in global plastic production. Plastics' harms are further magnified by low rates of recovery and recycling and by the long persistence of plastic waste in the environment. The thousands of chemicals in plastics—monomers, additives, processing agents, and non-intentionally added substances—include amongst their number known human carcinogens, endocrine disruptors, neurotoxicants, and persistent organic pollutants. These chemicals are responsible for many of plastics' known harms to human and planetary health. The chemicals leach out of plastics, enter the environment, cause pollution, and result in human exposure and disease. All efforts to reduce plastics' hazards must address the hazards of plastic-associated chemicals. Recommendations: To protect human and planetary health, especially the health of vulnerable and at-risk populations, and put the world on track to end plastic pollution by 2040, this Commission supports urgent adoption by the world's nations of a strong and comprehensive Global Plastics Treaty in accord with the mandate set forth in the March 2022 resolution of the United Nations Environment Assembly (UNEA). International measures such as a Global Plastics Treaty are needed to curb plastic production and pollution, because the harms to human health and the environment caused by plastics, plastic-associated chemicals and plastic waste transcend national boundaries, are planetary in their scale, and have disproportionate impacts on the health and well-being of people in the world's poorest nations. Effective implementation of the Global Plastics Treaty will require that international action be coordinated and complemented by interventions at the national, regional, and local levels. This Commission urges that a cap on global plastic production with targets, timetables, and national contributions be a central provision of the Global Plastics Treaty. We recommend inclusion of the following additional provisions: The Treaty needs to extend beyond microplastics and marine litter to include all of the many thousands of chemicals incorporated into plastics. The Treaty needs to include a provision banning or severely restricting manufacture and use of unnecessary, avoidable, and problematic plastic items, especially single-use items such as manufactured plastic microbeads. The Treaty needs to include requirements on extended producer responsibility (EPR) that make fossil carbon producers, plastic producers, and the manufacturers of plastic products legally and financially responsible for the safety and end-of-life management of all the materials they produce and sell. The Treaty needs to mandate reductions in the chemical complexity of plastic products; health-protective standards for plastics and plastic additives; a requirement for use of sustainable non-toxic materials; full disclosure of all components; and traceability of components. International cooperation will be essential to implementing and enforcing these standards. The Treaty needs to include SEJ remedies at each stage of the plastic life cycle designed to fill gaps in community knowledge and advance both distributional and procedural equity. This Commission encourages inclusion in the Global Plastic Treaty of a provision calling for exploration of listing at least some plastic polymers as persistent organic pollutants (POPs) under the Stockholm Convention. This Commission encourages a strong interface between the Global Plastics Treaty and the Basel and London Conventions to enhance management of hazardous plastic waste and slow current massive exports of plastic waste into the world's least-developed countries. This Commission recommends the creation of a Permanent Science Policy Advisory Body to guide the Treaty's implementation. The main priorities of this Body would be to guide Member States and other stakeholders in evaluating which solutions are most effective in reducing plastic consumption, enhancing plastic waste recovery and recycling, and curbing the generation of plastic waste. This Body could also assess trade-offs among these solutions and evaluate safer alternatives to current plastics. It could monitor the transnational export of plastic waste. It could coordinate robust oceanic-, land-, and air-based MNP monitoring programs. This Commission recommends urgent investment by national governments in research into solutions to the global plastic crisis. This research will need to determine which solutions are most effective and cost-effective in the context of particular countries and assess the risks and benefits of proposed solutions. Oceanographic and environmental research is needed to better measure concentrations and impacts of plastics <10 µm and understand their distribution and fate in the global environment. Biomedical research is needed to elucidate the human health impacts of plastics, especially MNPs. Summary: This Commission finds that plastics are both a boon to humanity and a stealth threat to human and planetary health. Plastics convey enormous benefits, but current linear patterns of plastic production, use, and disposal that pay little attention to sustainable design or safe materials and a near absence of recovery, reuse, and recycling are responsible for grave harms to health, widespread environmental damage, great economic costs, and deep societal injustices. These harms are rapidly worsening. While there remain gaps in knowledge about plastics' harms and uncertainties about their full magnitude, the evidence available today demonstrates unequivocally that these impacts are great and that they will increase in severity in the absence of urgent and effective intervention at global scale. Manufacture and use of essential plastics may continue. However, reckless increases in plastic production, and especially increases in the manufacture of an ever-increasing array of unnecessary single-use plastic products, need to be curbed. Global intervention against the plastic crisis is needed now because the costs of failure to act will be immense. [ABSTRACT FROM AUTHOR]- Published
- 2023
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16. Correction: The Minderoo-Monaco Commission on Plastics and Human Health.
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Landrigan, Philip J., Raps, Hervé, Cropper, Maureen, Bald, Caroline, Brunner, Manuel, Canonizado, Elvia Maya, Charles, Dominic, Chiles, Thomas C., Donohue, Mary J., Enck, Judith, Fenichel, Patrick, Fleming, Lora E., Ferrier-Pages, Christine, Fordham, Richard, Gozt, Aleksandra, Griffin, Carly, Hahn, Mark E., Haryanto, Budi, Hixson, Richard, and Ianelli, Hannah
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POLLUTION ,PLASTICS ,PUBLIC health ,COMMITTEES - Abstract
This article details a correction to: Landrigan PJ, Raps H, Cropper M, et al. The Minderoo-Monaco Commission on Plastics and Human Health. Annals of Global Health. 2023; 89(1): 23. DOI: https://doi.org/10.5334/aogh.4056. [ABSTRACT FROM AUTHOR]
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- 2023
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17. Healthcare provider smoking cessation advice among US worker groups
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Lee, David J, Fleming, Lora E, McCollister, Kathryn E, Caban, Alberto J, Arheart, Kristopher L, LeBlanc, William G, Chung-Bridges, Katherine, Christ, Sharon L, Dietz, Noella, and Clark, John D
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- 2007
18. Outbreak Bias in Illness Reporting and Case Confirmation in Ciguatera Fish Poisoning Surveillance in South Florida
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Begier, Elizabeth M., Backer, Lorraine C., Weisman, Richard S., Hammond, Roberta M., Fleming, Lora E., and Blythe, Donna
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- 2006
19. Knowledge Sharing to Reduce Toxin Exposure Risks from Harmful Algal Blooms: Global Networks and Political Barriers.
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Roland, Hugh B., Whitehead, Christopher, Fleming, Lora E., Berdalet, Elisa, Enevoldsen, Henrik Oksfeldt, and Gribble, Matthew O.
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ALGAL blooms ,PARALYTIC shellfish poisoning ,SEAFOOD poisoning ,DOMOIC acid ,PARALYTIC shellfish toxins ,GLOBAL environmental change ,FOOD poisoning prevention ,PHENOMENOLOGICAL biology ,RESEARCH evaluation ,WORLD health ,PUBLIC health ,IMPACT of Event Scale - Abstract
Harmful algal blooms (HABs) are a significant global environmental management challenge, especially with respect to microalgae that produce dangerous natural toxins. Examples of HAB toxin diseases with major global health impact include: ciguatera poisoning, paralytic shellfish poisoning (PSP), amnesic shellfish poisoning (ASP), diarrhetic shellfish poisoning (DSP), and neurotoxic (brevetoxin) shellfish poisoning (NSP). Such diseases affect communities globally and contribute to health inequalities within the United States and beyond. Sharing data and lessons learned about the factors determining bloom occurrence and associated exposure to contaminated seafood across locations can reduce public health risks. Knowledge sharing is particularly important as ongoing global environmental changes seem to alter the intensity, location, and timing of toxic HAB events, reducing the reliability of conventional guidance where toxin risks have been endemic and leading to emerging challenges in new settings. Political changes that disrupt membership in knowledge-sharing networks may impede efforts to share scientific expertise and best practices. In this commentary, we stress the importance of community and expert knowledge sharing for reducing HAB risks, both for vulnerable communities in the United States and globally. Considering the impacts of political changes, we note the indirect engagement sometimes required for continued participation in international coordination programs. As an example, we highlight how lessons learned from a Native-led toxin monitoring and testing program (the Southeast Alaska Tribal Ocean Research partnership) can inform programs in other settings. We also describe how international knowledge is mutually valuable for this program in Southeast Alaska. [ABSTRACT FROM AUTHOR]
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- 2022
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20. The Ocean Decade—Opportunities for Oceans and Human Health Programs to Contribute to Public Health
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Fleming, Lora E., Depledge, Michael, Bouley, Timothy, Britton, Easkey, Dupont, Sam, Eatock, Claire, Garside, Ruth, Heymans, Johanna J., Kellett, Paula, Lloret, Josep, Maycock, Bruce, Bus(Man), GDip, Pahl, Sabine, Philippart, Catharina J. M., Roberts, Bethany R., Thiele, Torsten, White, Mathew P., and Wuijts, Susanne
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Economic growth ,Government ,medicine.medical_specialty ,Conservation of Natural Resources ,business.industry ,Social Determinants of Health ,Public health ,Oceans and Seas ,Public Health, Environmental and Occupational Health ,Town council ,Mental health ,Global governance ,Food Supply ,Political science ,Opinions, Ideas, & Practice ,Health care ,Per capita ,medicine ,media_common.cataloged_instance ,Humans ,Public Health ,European union ,business ,media_common - Abstract
For more than 4 5 billion people, approximately 15% of their daily per capita intake of animal protein comes from marine products 5 Seafood provides a source of micronutrients and omega-3 fatty acids essential for good physical and mental health Studies over the past 10 years have demonstrated that spending time in highquality "blue" spaces (through leisure activities or living in a coastal environment) directly supports and enhances health and well-being, combatting obesity and mental health problems, particularly in deprived populations 6 This highlights an enormous potential for these well-being promotion initiatives and healthcare interventions to address both preexisting and emerging health issues beyond the lifetime of the pandemic There is now a tremendous opportunity and public momentum for health professionals to join with ocean researchers to help policymakers, the business community, and the wider public to address systemic global challenges in a new way (http://bit ly/2ZDFMS3) 7 We need international alliances, transdisciplinary collaborations, and global governance that support innovative, systemic ways of managing ocean resources ACKNOWLEDGMENTS The research was supported in part by the European Union's Horizon 2020 research and innovation programme (grants 774567 [H2020 SOPHIE Project] and 666773 [H2020 BlueHealth Project]);the UK Natural Environment Research Council and the UK Research and Innovation's Global Challenges Research Fund for the Blue Communities Project;the Blue Climate Initiative Health and Wellbeing Subgroup (https://www blueclimateinitiative org);the University of Girona;the City Council of Roses;the Catalan Fishmonger's Association;the Roses Fishers' Association;the Town Council of Tossa de Mar;and the government of Catalonia (the sponsors of the Roses Oceans and Human Health Chair)
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- 2021
21. The Roses Ocean and Human Health Chair: a new way to engage the public in oceans and human health challenges
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Lloret, Josep, Abós-Herràndiz, Rafael, Alemany, Sílvia, Allué, Rosario, Bartra, Joan, Basagaña, Maria, Berdalet, Elisa, Campàs i Homs, Mònica, Carreño, Arnau, Demestre, Montserrat, Diogène, Jorge, Fontdecaba, Eva, Gascon, Mireia, Gómez Mestres, Sílvia, Izquierdo, Angel, Mas, Lluïsa, Marquès, Montse, Pedro-Botet, Juan, Pery, Maria, Peters, Francesc, Pintó, Xavier, Planas, Marta, Sabatés, Ana, San, Joan, Sanchez-Vidal, Anna, Trepat, Martí, Vendrell, Cristina, Fleming, Lora E., Hospital del Mar, Agrosistemes i Medi Ambient, Aigües Marines i Continentals, Instituto de Salud Carlos III, European Commission, Natural Environment Research Council (UK), UK Research and Innovation, Ajuntament de Tossa de Mar, Agencia Estatal de Investigación (España), and Producció Animal
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Marine conservation ,medicine.medical_specialty ,010504 meteorology & atmospheric sciences ,Marine habitat conservation ,Health, Toxicology and Mutagenesis ,Oceans and Seas ,Stakeholder engagement ,lcsh:Medicine ,Context (language use) ,Marine Biology ,010501 environmental sciences ,Citizen science ,01 natural sciences ,Ecologia marina ,Article ,Marine ecology ,Goods and services ,Participatory process ,Stakeholder Participation ,Political science ,medicine ,Animals ,Humans ,14. Life underwater ,Environmental planning ,Conservació de l’hàbitat marí ,Ecosystem ,0105 earth and related environmental sciences ,Public health ,lcsh:R ,Public Health, Environmental and Occupational Health ,Ciència ciutadana ,Salut pública ,3. Good health ,13. Climate action ,Spain ,General partnership ,Environmental Health ,Tourism - Abstract
Involving and engaging stakeholders is crucial for studying and managing the complex interactions between marine ecosystems and human health and wellbeing. The Oceans and Human Health Chair was founded in the town of Roses (Catalonia, Spain, NW Mediterranean) in 2018, the fruit of a regional partnership between various stakeholders, and for the purpose of leading the way to better health and wellbeing through ocean research and conservation. The Chair is located in an area of the Mediterranean with a notable fishing, tourist, and seafaring tradition and is close to a marine reserve, providing the opportunity to observe diverse environmental conditions and coastal and maritime activities. The Chair is a case study demonstrating that local, collaborative, transdisciplinary, trans-sector, and bottom-up approaches offer tremendous opportunities for engaging coastal communities to help support long-lasting solutions that benefit everyone, and especially those living by the sea or making their living from the goods and services provided by the sea. Furthermore, the Chair has successfully integrated most of its experts in oceans and human health from the most prestigious institutions in Catalonia. The Chair focuses on three main topics identified by local stakeholders: Fish and Health, Leisure, Health, and Wellbeing, and Medicines from the Sea. Led by stakeholder engagement, the Chair can serve as a novel approach within the oceans and human health field of study to tackle a variety of environmental and public health challenges related to both communicable and non-communicable diseases, within the context of sociocultural issues. Drawing on the example provided by the Chair, four principles are established to encourage improved participatory processes in the oceans and human health field: bottom-up, &ldquo, think local&rdquo, transdisciplinary and trans-sectorial, and &ldquo, balance the many voices&rdquo
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- 2020
22. Pathogen seasonality and links with weather in England and Wales: A big data time series analysis
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Cherrie, Mark P. C., Nichols, Gordon, Iacono, Gianni Lo, Sarran, Christophe, Hajat, Shakoor, and Fleming, Lora E.
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0301 basic medicine ,medicine.medical_specialty ,Ground frost ,Time Factors ,Epidemiology ,Big data ,Climate change ,Communicable Diseases ,Wind speed ,03 medical and health sciences ,0302 clinical medicine ,Laboratory surveillance ,Salmonella ,medicine ,Humans ,030212 general & internal medicine ,Time series ,Weather ,Models, Statistical ,Wales ,business.industry ,Pathogen ,Incidence ,Public health ,lcsh:Public aspects of medicine ,Statistics ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,Seasonality ,medicine.disease ,030104 developmental biology ,England ,Climatology ,Seasons ,Time-series ,Weather patterns ,business ,Research Article - Abstract
Background Many infectious diseases of public health importance display annual seasonal patterns in their incidence. We aimed to systematically document the seasonality of several human infectious disease pathogens in England and Wales, highlighting those organisms that appear weather-sensitive and therefore may be influenced by climate change in the future. Methods Data on infections in England and Wales from 1989 to 2014 were extracted from the Public Health England (PHE) SGSS surveillance database. We conducted a weekly, monthly and quarterly time series analysis of 277 pathogen serotypes. Each organism’s time series was forecasted using the TBATS package in R, with seasonality detected using model fit statistics. Meteorological data hosted on the MEDMI Platform were extracted at a monthly resolution for 2001–2011. The organisms were then clustered by K-means into two groups based on cross correlation coefficients with the weather variables. Results Examination of 12.9 million infection episodes found seasonal components in 91/277 (33%) organism serotypes. Salmonella showed seasonal and non-seasonal serotypes. These results were visualised in an online Rshiny application. Seasonal organisms were then clustered into two groups based on their correlations with weather. Group 1 had positive correlations with temperature (max, mean and min), sunshine and vapour pressure and inverse correlations with mean wind speed, relative humidity, ground frost and air frost. Group 2 had the opposite but also slight positive correlations with rainfall (mm, > 1 mm, > 10 mm). Conclusions The detection of seasonality in pathogen time series data and the identification of relevant weather predictors can improve forecasting and public health planning. Big data analytics and online visualisation allow the relationship between pathogen incidence and weather patterns to be clarified. Electronic supplementary material The online version of this article (10.1186/s12889-018-5931-6) contains supplementary material, which is available to authorized users.
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- 2018
23. IARC Monographs : 40 Years of Evaluating Carcinogenic Hazards to Humans
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Pearce, Neil E, Blair, Aaron, Vineis, Paolo, Ahrens, Wolfgang, Andersen, Aage, Anto, Josep M, Armstrong, Bruce K, Baccarelli, Andrea A, Beland, Frederick A, Berrington, Amy, Bertazzi, Pier A, Birnbaum, Linda S, Brownson, Ross C, Bucher, John R, Cantor, Kenneth P, Cardis, Elisabeth, Cherrie, John W, Christiani, David C, Cocco, Pierluigi, Coggon, David, Comba, Pietro, Demers, Paul A, Dement, John M, Douwes, Jeroen, Eisen, Ellen A, Engel, Lawrence S, Fenske, Richard A, Fleming, Lora E, Fletcher, Tony, Fontham, Elizabeth, Forastiere, Francesco, Frentzel-Beyme, Rainer, Fritschi, Lin, Gerin, Michel, Goldberg, Marcel, Grandjean, Philippe, Grimsrud, Tom K, Gustavsson, Per, Haines, Andy, Hartge, Patricia, Hansen, Johnni, Hauptmann, Michael, Heederik, Dick, Hemminki, Kari, Hemon, Denis, Hertz-Picciotto, Irva, Hoppin, Jane A, Huff, James, Jarvholm, Bengt, Kang, Daehee, Karagas, Margaret R, Kjaerheim, Kristina, Kjuus, Helge, Kogevinas, Manolis, Kriebel, David, Kristensen, Petter, Kromhout, Hans, Laden, Francine, Lebailly, Pierre, LeMasters, Grace, Lubin, Jay H, Lynch, Charles F, Lynge, Elsebeth, 't Mannetje, Andrea, McMichael, Anthony J, McLaughlin, John R, Marrett, Loraine, Martuzzi, Marco, Merchant, James A, Merler, Enzo, Merletti, Franco, Miller, Anthony, Mirer, Franklin E, Monson, Richard, Nordby, Karl-Kristian, Olshan, Andrew F, Parent, Marie-Elise, Perera, Frederica P, Perry, Melissa J, Pesatori, Angela C, Pirastu, Roberta, Porta, Miquel, Pukkala, Eero, Rice, Carol, Richardson, David B, Ritter, Leonard, Ritz, Beate, Ronckers, Cecile M, Rushton, Lesley, Rusiecki, Jennifer A, Rusyn, Ivan, Samet, Jonathan M, Sandler, Dale P, de Sanjose, Silvia, Schernhammer, Eva, Seniori Constantini, Adele, Seixas, Noah, Shy, Carl, Siemiatycki, Jack, Silvermann, Debra T, Simonato, Lorenzo, Smith, Allan H, Smith, Martyn T, Spinelli, John J, Spitz, Margaret R, Stallones, Lorann, Stayner, Leslie T, Steenland, Kyle, Stenzel, Mark, Stewart, Bernard W, Stewart, Patricia A, Symanski, Elaine, Terracini, Benedetto, Tolbert, Paige E, Vainio, Harri, Vena, John, Vermeulen, Roel, Victora, Cesar G, Ward, Elizabeth M, Weinberg, Clarice R, Weisenburger, Dennis, Wesseling, Catharina, Weiderpass, Elisabete, Zahm, Shelia H, Risk Assessment, Infection & Immunity, dIRAS RA-I&I RA, dIRAS RA-2, LS IRAS EEPI GRA (Gezh.risico-analyse), LS IRAS EEPI EXAS (Arb.hyg+bl.st.kar.), CCA -Cancer Center Amsterdam, APH - Amsterdam Public Health, Paediatric Oncology, The University of Sydney, CIBER de Epidemiología y Salud Pública (CIBERESP), Universita degli Studi di Cagliari [Cagliari], Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Paris (UP), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Université de Caen Normandie (UNICAEN), Normandie Université (NU), Institut Armand Frappier (INRS-IAF), Réseau International des Instituts Pasteur (RIIP)-Institut National de la Recherche Scientifique [Québec] (INRS), Movement Disorders and Tourette Centre, Rockefeller University [New York], Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM), Plymouth University, Siemens [New York], Siemens AG [Munich], Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet [Stockholm], Population-Based Epidemiological Cohorts, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital Paul Brousse, Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Universitat Pompeu Fabra [Barcelona]-Catalunya ministerio de salud, Institut National de la Recherche Scientifique [Québec] (INRS)-Réseau International des Instituts Pasteur (RIIP), Rockefeller University, Risk Assessment, Infection & Immunity, dIRAS RA-I&I RA, dIRAS RA-2, LS IRAS EEPI GRA (Gezh.risico-analyse), LS IRAS EEPI EXAS (Arb.hyg+bl.st.kar.), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), The University of Sydney [Sydney], Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AP-HP Hôpital Paul Brousse, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité ( CRESS (U1153 / UMR_A 1125) ), Institut National de la Recherche Agronomique ( INRA ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Center for Research in Environmental Epidemiology ( CREAL ), Université de Caen Normandie ( UNICAEN ), Normandie Université ( NU ), Institut Armand Frappier ( INRS-IAF ), Institut National de la Recherche Scientifique [Québec] ( INRS ) -Réseau International des Instituts Pasteur ( RIIP ) -Institut Armand Frappier, Rockefeller University, New York, Centre de recherche du Centre Hospitalier de l'Université de Montréal ( CRCHUM ), and Department of Medical Epidemiology and Biostatistics ( MEB )
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Pathology ,Biomedical Research ,Health, Toxicology and Mutagenesis ,[SDV]Life Sciences [q-bio] ,05 Environmental Sciences ,Toxicology ,MESH: Carcinogens, Environmental ,0302 clinical medicine ,CANCER-EPIDEMIOLOGY ,Neoplasms ,Epidemiology of cancer ,PLEA ,PROGRAM ,Medicine ,MESH: Neoplasms ,Càncer ,health care economics and organizations ,Public, Environmental & Occupational Health ,Cancer ,0303 health sciences ,Publications ,11 Medical And Health Sciences ,MESH : Publications ,POLICY ,030220 oncology & carcinogenesis ,PUBLIC-HEALTH ,Public Health ,MESH: Public Health ,MESH : Biomedical Research ,Life Sciences & Biomedicine ,International agency ,medicine.medical_specialty ,MESH : Public Health ,education ,MESH : International Agencies ,Environmental Sciences & Ecology ,macromolecular substances ,MESH: Publications ,MESH : Carcinogens, Environmental ,MESH: International Agencies ,03 medical and health sciences ,Arbetsmedicin och miljömedicin ,ADHERENCE ,Environmental health ,Humans ,VDP::Medisinske Fag: 700 ,030304 developmental biology ,Science & Technology ,MESH: Humans ,[ SDV ] Life Sciences [q-bio] ,business.industry ,MESH: Biomedical Research ,MESH : Humans ,Public Health, Environmental and Occupational Health ,RECIPE ,International Agencies ,PRINCIPLES UNDERLYING SCIENCE ,Occupational Health and Environmental Health ,MESH : Neoplasms ,Carcinogens, Environmental ,VDP::Medical disciplines: 700 ,Commentary ,business ,FALSE ,Cancerígens ,Environmental Sciences ,EPIDEMIOLOGIC ENTERPRISE - Abstract
BACKGROUND: Recently, the International Agency for Research on Cancer (IARC) Programme for the Evaluation of Carcinogenic Risks to Humans has been criticized for several of its evaluations, and also for the approach used to perform these evaluations. Some critics have claimed that failures of IARC Working Groups to recognize study weaknesses and biases of Working Group members have led to inappropriate classification of a number of agents as carcinogenic to humans.OBJECTIVES: The authors of this Commentary are scientists from various disciplines relevant to the identification and hazard evaluation of human carcinogens. We examined criticisms of the IARC classification process to determine the validity of these concerns. Here, we present the results of that examination, review the history of IARC evaluations, and describe how the IARC evaluations are performed.DISCUSSION: We concluded that these recent criticisms are unconvincing. The procedures employed by IARC to assemble Working Groups of scientists from the various disciplines and the techniques followed to review the literature and perform hazard assessment of various agents provide a balanced evaluation and an appropriate indication of the weight of the evidence. Some disagreement by individual scientists to some evaluations is not evidence of process failure. The review process has been modified over time and will undoubtedly be altered in the future to improve the process. Any process can in theory be improved, and we would support continued review and improvement of the IARC processes. This does not mean, however, that the current procedures are flawed.CONCLUSIONS: The IARC Monographs have made, and continue to make, major contributions to the scientific underpinning for societal actions to improve the public's health.CITATION: Pearce N, Blair A, Vineis P, Ahrens W, Andersen A, Anto JM, Armstrong BK, Baccarelli AA, Beland FA, Berrington A, Bertazzi PA, Birnbaum LS, Brownson RC, Bucher JR, Cantor KP, Cardis E, Cherrie JW, Christiani DC, Cocco P, Coggon D, Comba P, Demers PA, Dement JM, Douwes J, Eisen EA, Engel LS, Fenske RA, Fleming LE, Fletcher T, Fontham E, Forastiere F, Frentzel-Beyme R, Fritschi L, Gerin M, Goldberg M, Grandjean P, Grimsrud TK, Gustavsson P, Haines A, Hartge P, Hansen J, Hauptmann M, Heederik D, Hemminki K, Hemon D, Hertz-Picciotto I, Hoppin JA, Huff J, Jarvholm B, Kang D, Karagas MR, Kjaerheim K, Kjuus H, Kogevinas M, Kriebel D, Kristensen P, Kromhout H, Laden F, Lebailly P, LeMasters G, Lubin JH, Lynch CF, Lynge E, 't Mannetje A, McMichael AJ, McLaughlin JR, Marrett L, Martuzzi M, Merchant JA, Merler E, Merletti F, Miller A, Mirer FE, Monson R, Nordby KC, Olshan AF, Parent ME, Perera FP, Perry MJ, Pesatori AC, Pirastu R, Porta M, Pukkala E, Rice C, Richardson DB, Ritter L, Ritz B, Ronckers CM, Rushton L, Rusiecki JA, Rusyn I, Samet JM, Sandler DP, de Sanjose S, Schernhammer E, Seniori Costantini A, Seixas N, Shy C, Siemiatycki J, Silverman DT, Simonato L, Smith AH, Smith MT, Spinelli JJ, Spitz MR, Stallones L, Stayner LT, Steenland K, Stenzel M, Stewart BW, Stewart PA, Symanski E, Terracini B, Tolbert PE, Vainio H, Vena J, Vermeulen R, Victora CG, Ward EM, Weinberg CR, Weisenburger D, Wesseling C, Weiderpass E, Zahm SH. 2015. IARC Monographs: 40 years of evaluating carcinogenic hazards to humans. Environ Health Perspect 123:507-514; http://dx.doi.org/10.1289/ehp.1409149.
- Published
- 2015
24. Recreational visits to marine and coastal environments in England: Where, what, who, why, and when?.
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Elliott, Lewis R., White, Mathew P., Grellier, James, Rees, Siân E., Waters, Ruth D., and Fleming, Lora E.
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COASTAL ecosystem health ,DEMOGRAPHIC surveys ,RECREATION ,PUBLIC health ,COMPARATOR circuits - Abstract
Abstract Health and economic benefits may accrue from marine and coastal recreation. In England, few national-level descriptive analyses exist which examine predictors of recreation in these environments. Data from seven waves (2009–2016) of a representative survey of the English population (n = 326,756) were analysed to investigate how many recreational visits were made annually to coastal environments in England, which activities were undertaken on these visits, and which demographic, motivational, temporal, and regional factors predict them. Inland environments are presented for comparison. Approximately 271 million recreational visits were made to coastal environments in England annually, the majority involving land-based activities such as walking. Separately, there were around 59 million instances of water-based recreation undertaken on recreational visits (e.g. swimming, water sports). Visits to the coast involving walking were undertaken by a wide spectrum of the population: compared to woodland walks, for instance, coastal walks were more likely to be made by females, older adults, and individuals from lower socioeconomic classifications, suggesting the coast may support reducing activity inequalities. Motivational and temporal variables showed distinct patterns between visits to coastal and inland comparator environments. Regional variations existed too with more visits to coastal environments made by people living in the south-west and north-east compared to London, where more visits were made to urban open spaces. The results provide a reference for current patterns of coastal recreation in England, and could be considered when making policy-level decisions with regard to coastal accessibility and marine plans. Implications for future public health and marine plans are discussed. [ABSTRACT FROM AUTHOR]
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- 2018
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25. The economic burden of disease by industry: Differences in quality-adjusted life years and associated costs
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Tolbert, Davina V., McCollister, Kathryn E., LeBlanc, William G., Lee, David J., Fleming, Lora E., and Muennig, Peter A.
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Public health ,Economics ,Industrial safety ,Income distribution--Health aspects ,Working class--Health and hygiene - Abstract
Background: This study compares differences in quality-adjusted life expectancy across the eight original National Occupational Research Agenda (NORA) industry sectors. Methods: Data from the 1997 to 2012 National Health Interview Survey (NHIS) were used to estimate quality-adjusted life years (QALYs) for all workers and by NORA sector. Differences in QALYs were calculated and translated into economic values using estimates of the societal willingness-to-pay per QALY. Results: Mean QALYs across workers was 29.17 years. Among NORA sectors, wholesale, and retail trade workers had the highest average QALYs remaining (35.88), while mining workers had the lowest QALYs (31.4). The economic value of this difference ranges from $604,843 to $1,155,287 per worker depending on the societal willingness-to-pay per QALY. Conclusion: The value of life lost within some industries is very high relative to others. Additional investments in occupational safety, benefits, and health promotion initiatives may reduce these losses, but experimental research is needed to assess the effectiveness of such programs.
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- 2014
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26. The effects of a psychosocial dimension of socioeconomic position on survival: occupational prestige and mortality among US working adults
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Christ, Sharon L., Fleming, Lora E., Lee, David J., Muntaner, Carlos, Muennig, Peter A., and Caban-Martinez, Alberto J.
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FOS: Psychology ,Public health ,Psychology ,Occupational prestige ,Mortality--Economic aspects ,Social status--Psychological aspects ,Occupational prestige--Psychological aspects ,Mortality--Social aspects ,Education - Abstract
The association between education or income and mortality has been explored in great detail. These measures capture both the effects of material disadvantage on health and the psychosocial impacts of a low socioeconomic position on health. When explored independently of educational attainment and income, occupational prestige – a purely perceptual measure – serves as a measure of the impact of a psychosocial phenomenon on health. For instance, a fire-fighter, academician or schoolteacher may carry the social benefits of a higher social status without actually having the income (in all cases) or the educational credentials (in the case of the fire-fighter) to match. We explored the independent influence of occupational prestige on mortality. We applied Cox proportional hazards models to a nationally representative sample of over 380,000 US workers who had worked at any time between 1986 and 1994 with mortality follow up through 2002. We found that occupational prestige is associated with a decrease in the risk of all-cause, cancer, cardiovascular and respiratory-related mortality after controlling for household income and educational attainment. We further investigated the question of whether the effects of prestige are moderated by sex and broader occupational groupings. Prestige effects operate in white-collar occupations for men only and within service occupations for all workers.
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- 2012
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27. Effect of Childhood Victimization on Occupational Prestige and Income Trajectories.
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Fernandez, Cristina A., Christ, Sharon L., LeBlanc, William G., Arheart, Kristopher L., Dietz, Noella A., McCollister, Kathyrn E., Fleming, Lora E., Muntaner, Carles, Muennig, Peter, and Lee, David J.
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CHILD victims ,OCCUPATIONAL prestige ,CRIME victims ,INCOME ,WELL-being ,PUBLIC health - Abstract
Background: Violence toward children (childhood victimization) is a major public health problem, with long-term consequences on economic well-being. The purpose of this study was to determine whether childhood victimization affects occupational prestige and income in young adulthood. We hypothesized that young adults who experienced more childhood victimizations would have less prestigious jobs and lower incomes relative to those with no victimization history. We also explored the pathways in which childhood victimization mediates the relationships between background variables, such as parent’s educational impact on the socioeconomic transition into adulthood. Methods: A nationally representative sample of 8,901 young adults aged 18–28 surveyed between 1999–2009 from the National Longitudinal Survey of Youth 1997 (NLSY) were analyzed. Covariate-adjusted multivariate linear regression and path models were used to estimate the effects of victimization and covariates on income and prestige levels and on income and prestige trajectories. After each participant turned 18, their annual 2002 Census job code was assigned a yearly prestige score based on the 1989 General Social Survey, and their annual income was calculated via self-reports. Occupational prestige and annual income are time-varying variables measured from 1999–2009. Victimization effects were tested for moderation by sex, race, and ethnicity in the multivariate models. Results: Approximately half of our sample reported at least one instance of childhood victimization before the age of 18. Major findings include 1) childhood victimization resulted in slower income and prestige growth over time, and 2) mediation analyses suggested that this slower prestige and earnings arose because victims did not get the same amount of education as non-victims. Conclusions: Results indicated that the consequences of victimization negatively affected economic success throughout young adulthood, primarily by slowing the growth in prosperity due to lower education levels. [ABSTRACT FROM AUTHOR]
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- 2015
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28. Potential Changes in Disease Patterns and Pharmaceutical Use in Response to Climate Change.
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Redshaw, Clare H., Stahl-Timmins, Will M., Fleming, Lora E., Davidson, Iain, and Depledge, Michael H.
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CLIMATE change ,CHRONIC diseases ,PUBLIC health ,MENTAL health - Abstract
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.© Clare H. Redshaw, Will M. Stahl-Timmins, Lora E. Fleming, Iain Davidson, and Michael H. Depledge [ABSTRACT FROM AUTHOR]
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- 2013
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29. Ciguatera Fish Poisoning in the Pacific Islands (1998 to 2008).
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Skinner, Mark P., Brewer, Tom D., Johnstone, Ron, Fleming, Lora E., and Lewis, Richard J.
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TOXICOLOGY of poisonous fishes ,STATISTICAL correlation ,QUESTIONNAIRES ,CHRONIC diseases ,PUBLIC health ,T-test (Statistics) - Abstract
Background: Ciguatera is a type of fish poisoning that occurs throughout the tropics, particularly in vulnerable island communities such as the developing Pacific Island Countries and Territories (PICTs). After consuming ciguatoxin-contaminated fish, people report a range of acute neurologic, gastrointestinal, and cardiac symptoms, with some experiencing chronic neurologic symptoms lasting weeks to months. Unfortunately, the true extent of illness and its impact on human communities and ecosystem health are still poorly understood. Methods: A questionnaire was emailed to the Health and Fisheries Authorities of the PICTs to quantify the extent of ciguatera. The data were analyzed using t-test, incidence rate ratios, ranked correlation, and regression analysis. Results: There were 39,677 reported cases from 17 PICTs, with a mean annual incidence of 194 cases per 100,000 people across the region from 1998-2008 compared to the reported annual incidence of 104/100,000 from 1973-1983. There has been a 60% increase in the annual incidence of ciguatera between the two time periods based on PICTs that reported for both time periods. Taking into account under-reporting, in the last 35 years an estimated 500,000 Pacific islanders might have suffered from ciguatera. Conclusions: This level of incidence exceeds prior ciguatera estimates locally and globally, and raises the status of ciguatera to an acute and chronic illness with major public health significance. To address this significant public health problem, which is expected to increase in parallel with environmental change, well-funded multidisciplinary research teams are needed to translate research advances into practical management solutions. [ABSTRACT FROM AUTHOR]
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- 2011
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30. Review of Florida red tide and human health effects
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Fleming, Lora E., Kirkpatrick, Barbara, Backer, Lorraine C., Walsh, Cathy J., Nierenberg, Kate, Clark, John, Reich, Andrew, Hollenbeck, Julie, Benson, Janet, Cheng, Yung Sung, Naar, Jerome, Pierce, Richard, Bourdelais, Andrea J., Abraham, William M., Kirkpatrick, Gary, Zaias, Julia, Wanner, Adam, Mendes, Eliana, Shalat, Stuart, and Hoagland, Porter
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RED tide , *TOXIC algae , *EFFECT of environment on human beings , *PUBLIC health , *POISONOUS shellfish , *COASTS - Abstract
Abstract: This paper reviews the literature describing research performed over the past decade on the known and possible exposures and human health effects associated with Florida red tides. These harmful algal blooms are caused by the dinoflagellate, Karenia brevis, and similar organisms, all of which produce a suite of natural toxins known as brevetoxins. Florida red tide research has benefited from a consistently funded, long-term research program, that has allowed an interdisciplinary team of researchers to focus their attention on this specific environmental issue—one that is critically important to Gulf of Mexico and other coastal communities. This long-term interdisciplinary approach has allowed the team to engage the local community, identify measures to protect public health, take emerging technologies into the field, forge advances in natural products chemistry, and develop a valuable pharmaceutical product. The review includes a brief discussion of the Florida red tide organisms and their toxins, and then focuses on the effects of these toxins on animals and humans, including how these effects predict what we might expect to see in exposed people. [Copyright &y& Elsevier]
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- 2011
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31. Obesity in US Workers: The National Health Interview Survey, 1986 to 2002.
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Caban, Alberto J., Lee, David J., Fleming, Lora E., Gómez-Marín, Orlando, LeBlanc, William, and Pitman, Terry
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OBESITY ,INDUSTRIAL hygiene ,PUBLIC health ,HEALTH surveys - Abstract
Objectives. Obesity has emerged as one of the most important public health issues in the United States. We assessed obesity prevalence rates and their trends among major US occupational groups. Methods. Self-reported weight and height were collected annually on US workers, aged 18 years or older, from the 1986 to 1995 and the 1997 to 2002 National Health Interview Surveys. Overall, occupation-, race-, and gender-specific rates of obesity (defined as a body mass index>30.0 kg/m²) were calculated with data pooled from both study periods (n > 600000). Annual occupation-specific prevalence rates were also calculated, and their time trends were assessed. Results. Obesity rates increased significantly over time among employed workers, irrespective of race and gender. The average yearly change increased from 0.61% (±.04) during the period from 1986 to 1995 to 0.95% (±.11) during the period from 1997 to 2002. Average obesity prevalence rates and corresponding trends varied considerably across occupational groups; pooled obesity prevalence rates were highest in motor vehicle operators (31.7% in men; 31.0% in women). Conclusions. Weight loss intervention programs targeting workers employed in occupational groups with high or increasing rates of obesity are urgently needed. [ABSTRACT FROM AUTHOR]
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- 2005
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32. Acute and Chronic Disability Among U.S. Farmers and Pesticide Applicators: The National Health Interview Survey (NHIS).
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Gómez-Marín, Orlando, Fleming, Lora E., Lee, David J., LeBlanc, William, Zheng, Diane, Jané, Dulce, Pitman, Terry, Caban Jr., Alberto, and Fangchao Ma
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HOUSEHOLD surveys ,PUBLIC health ,HEALTH education ,POPULATION ,DISABILITIES - Abstract
Reports that the National Health Interview Survey is a multipurpose household survey of the United States civilian non-institutionalized population. Participation of workers in the probability sampling; Range of the measures of acute and chronic disability; Assessment of the predictors of health status.
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- 2004
33. Effect of Childhood Victimization on Occupational Prestige and Income Trajectories
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Fernandez, Cristina A., Christ, Sharon L., LeBlanc, William G., McCollister, Kathyrn E., Arheart, Kristopher L., Dietz, Noella A., Fleming, Lora E., Muntaner, Carles, Muennig, Peter A., and Lee, David J.
- Subjects
Public health ,Sociology ,4. Education ,education ,8. Economic growth ,Statistics ,FOS: Mathematics ,social sciences ,health care economics and organizations ,FOS: Sociology - Abstract
Background Violence toward children (childhood victimization) is a major public health problem, with long-term consequences on economic well-being. The purpose of this study was to determine whether childhood victimization affects occupational prestige and income in young adulthood. We hypothesized that young adults who experienced more childhood victimizations would have less prestigious jobs and lower incomes relative to those with no victimization history. We also explored the pathways in which childhood victimization mediates the relationships between background variables, such as parent’s educational impact on the socioeconomic transition into adulthood. Methods A nationally representative sample of 8,901 young adults aged 18–28 surveyed between 1999–2009 from the National Longitudinal Survey of Youth 1997 (NLSY) were analyzed. Covariate-adjusted multivariate linear regression and path models were used to estimate the effects of victimization and covariates on income and prestige levels and on income and prestige trajectories. After each participant turned 18, their annual 2002 Census job code was assigned a yearly prestige score based on the 1989 General Social Survey, and their annual income was calculated via self-reports. Occupational prestige and annual income are time-varying variables measured from 1999–2009. Victimization effects were tested for moderation by sex, race, and ethnicity in the multivariate models. Results Approximately half of our sample reported at least one instance of childhood victimization before the age of 18. Major findings include 1) childhood victimization resulted in slower income and prestige growth over time, and 2) mediation analyses suggested that this slower prestige and earnings arose because victims did not get the same amount of education as non-victims. Conclusions Results indicated that the consequences of victimization negatively affected economic success throughout young adulthood, primarily by slowing the growth in prosperity due to lower education levels.
34. Health Status of Older US Workers and Nonworkers, National Health Interview Survey, 1997–2011
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Kachan, Diana, Fleming, Lora E., Christ, Sharon L., Muennig, Peter A., Prado, Guillermo, Tannenbaum, Stacey L., Yang, Xuan, Caban-Martinez, Alberto J., and Lee, David J.
- Subjects
Retirement ,Public health ,8. Economic growth ,Occupational diseases ,Working poor ,Industrial safety ,National Health Interview Survey (U.S.) ,Working class--Health and hygiene - Abstract
Introduction Many US workers are increasingly delaying retirement from work, which may be leading to an increase in chronic disease at the workplace. We examined the association of older adults’ health status with their employment/occupation and other characteristics. Methods National Health Interview Survey data from 1997 through 2011 were pooled for adults aged 65 or older (n = 83,338; mean age, 74.6 y). Multivariable logistic regression modeling was used to estimate the association of socioeconomic factors and health behaviors with 4 health status measures: 1) self-rated health (fair/poor vs good/very good/excellent); 2) multimorbidity (≤1 vs ≥2 chronic conditions); 3) multiple functional limitations (≤1 vs ≥2); and 4) Health and Activities Limitation Index (HALex) (below vs above 20th percentile). Analyses were stratified by sex and age (young–old vs old–old) where interactions with occupation were significant. Results Employed older adults had better health outcomes than unemployed older adults. Physically demanding occupations had the lowest risk of poor health outcomes, suggesting a stronger healthy worker effect: service workers were at lowest risk of multiple functional limitations (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.71–0.95); and blue-collar workers were at lowest risk of multimorbidity (OR, 0.84; 95% CI, 0.74–0.97) and multiple functional limitation (OR, 0.84; 95% CI, 0.72–0.98). Hispanics were more likely than non-Hispanic whites to report fair/poor health (OR, 1.62; 95% CI, 1.52–1.73) and lowest HALex quintile (OR, 1.21; 95% CI, 1.13–1.30); however, they were less likely to report multimorbidity (OR, 0.78; 95% CI, 0.73–0.83) or multiple functional limitations (OR, 0.82; 95% CI, 0.77–0.88). Conclusion A strong association exists between employment and health status in older adults beyond what can be explained by socioeconomic factors (eg, education, income) or health behaviors (eg, smoking). Disability accommodations in the workplace could encourage employment among older adults with limitations.
35. Beyond Climate Change and Health: Integrating Broader Environmental Change and Natural Environments for Public Health Protection and Promotion in the UK.
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Fleming, Lora E., Leonardi, Giovanni S., White, Mathew P., Medlock, Jolyon, Alcock, Ian, Macintyre, Helen L., Maguire, Kath, Nichols, Gordon, Wheeler, Benedict W., Morris, George, Taylor, Tim, Hemming, Deborah, Iacono, Gianni Lo, Gillingham, Emma L., Hansford, Kayleigh M., Heaviside, Clare, Bone, Angie, and Duarte-Davidson, Raquel
- Subjects
- *
CLIMATE change , *GLOBAL environmental change , *PUBLIC health , *ENVIRONMENTAL impact analysis , *PARTICULATE matter , *TROPOSPHERE - Abstract
Increasingly, the potential short and long-term impacts of climate change on human health and wellbeing are being demonstrated. However, other environmental change factors, particularly relating to the natural environment, need to be taken into account to understand the totality of these interactions and impacts. This paper provides an overview of ongoing research in the Health Protection Research Unit (HPRU) on Environmental Change and Health, particularly around the positive and negative effects of the natural environment on human health and well-being and primarily within a UK context. In addition to exploring the potential increasing risks to human health from water-borne and vector-borne diseases and from exposure to aeroallergens such as pollen, this paper also demonstrates the potential opportunities and co-benefits to human physical and mental health from interacting with the natural environment. The involvement of a Health and Environment Public Engagement (HEPE) group as a public forum of “critical friends” has proven useful for prioritising and exploring some of this research; such public involvement is essential to minimise public health risks and maximise the benefits which are identified from this research into environmental change and human health. Research gaps are identified and recommendations made for future research into the risks, benefits and potential opportunities of climate and other environmental change on human and planetary health. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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36. Risk of Hospitalization Among Firefighters: The National Health Interview Survey, 1986-1994.
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Lee, David J., Fleming, Lora E., Gomez-Marín, Orlando, and LeBlanc, William
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HEALTH risk assessment , *HOSPITAL care , *FIRE fighters , *RISK management in business , *OCCUPATIONS , *PUBLIC health - Abstract
This study assessed the risk of hospitalization among firefighters. Data were derived from a nationally representative sample of 235897 employed men from the National Health Interview Survey. Firefighters aged 30 to 39 years were at significantly increased risk for hospitalization relative to other employed men in the same age group (odds ratio=1.93; 95% confidence interval=1.21, 3.09). Findings from this study and others support the call for longitudinal studies to monitor the health of this high-risk occupational group. (Am J Public Health. 2004;94:1938-1939). [ABSTRACT FROM AUTHOR]
- Published
- 2004
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37. Temporal dynamics of drinking water sodium levels in coastal areas, Cyprus 2009–2020.
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Xeni, Christina, Gribble, Matthew O., Oude Essink, Gualbert H.P., Fleming, Lora E., and Makris, Konstantinos C.
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- 2024
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38. Valuing the health benefits of nature-based recreational physical activity in England.
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Grellier, James, White, Mathew P., de Bell, Siân, Brousse, Oscar, Elliott, Lewis R, Fleming, Lora E, Heaviside, Clare, Simpson, Charles, Taylor, Tim, Wheeler, Benedict W, and Lovell, Rebecca
- Subjects
- *
PHYSICAL activity , *NON-communicable diseases , *ECONOMIC aspects of diseases , *MENTAL depression , *ISCHEMIC stroke - Abstract
• In 2019, 22 million adults in England visited natural environments at least weekly. • Physical activity on these visits prevented 12,763 cases of non-communicable disease. • Annual societal costs of the disease avoided were estimated at £108.7 million. • Strategies increasing visitor activity or volume may prevent more cases of disease. Physical activity (PA) reduces the risk of several non-communicable diseases (NCDs). Natural environments support recreational PA. Using data including a representative cross-sectional survey of the English population, we estimated the annual value of nature-based PA conducted in England in 2019 in terms of avoided healthcare and societal costs of disease. Population-representative data from the Monitor of Engagement with the Natural Environment (MENE) survey (n = 47,580; representing 44,386,756) were used to estimate the weekly volume of nature-based recreational PA by adults in England in 2019. We used epidemiological dose–response data to calculate incident cases of six NCDs (ischaemic heart disease (IHD), ischaemic stroke (IS), type 2 diabetes (T2D), colon cancer (CC), breast cancer (BC) and major depressive disorder (MDD)) prevented through nature-based PA, and estimated associated savings using published costs of healthcare, informal care and productivity losses. We investigated additional savings resulting from hypothetical increases in: (a) visitor PA and (b) visitor numbers. In 2019, 22 million adults > 16 years of age in England visited natural environments at least weekly. At reported volumes of nature-based PA, we estimated that 550 cases of IHD, 168 cases of IS, 1,410 cases of T2D, 41 cases of CC, 37 cases of BC and 10,552 cases of MDD were prevented, creating annual savings of £108.7million (95 % uncertainty interval: £70.3million; £150.3million). Nature-based recreational PA in England results in reduced burden of disease and considerable annual savings through prevention of priority NCDs. Strategies that increase nature-based PA could lead to further reductions in the societal burden of NCDs. [ABSTRACT FROM AUTHOR]
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- 2024
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39. Trends in U.S. Smoking Rates in Occupational Groups: The National Health Interview Survey 1987-1994.
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Lee, David J., LeBlanc, William, Fleming, Lora E., Gómez-Marín, Orlando, and Pitman, Terry
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- *
SMOKING , *PROFESSIONAL employees , *PUBLIC health , *SMOKING cessation , *WHITE collar workers - Abstract
It is unknown if reductions in U.S. adult smoking rates are uniform across occupational groups. The National Health Interview Survey (NHIS) is a multistage area probability cross-sectional survey of the U.S. civilian population. Data on occupational and smoking status were collected on 141,122 adult participants from the 1987, 1988, and 1990-1994 NHIS annual surveys. Overall smoking rates ranged from 58% in roofers to 4% in physicians, with higher rates found among blue collar professions. There were reductions in smoking from 1987-1994 within 72% of occupational groups; 19 of these downward trends were significant and occurred exclusively within white collar professions. Blue collar workers continue to smoke in large numbers, whereas white collar workers report lower rates along with corresponding significant downward trends in rates among selected occupational groups. The development of effective smoking prevention strategies targeting blue collar groups is needed. [ABSTRACT FROM AUTHOR]
- Published
- 2004
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40. The human health effects of Florida Red Tide (FRT) blooms: An expanded analysis.
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Hoagland, Porter, Jin, Di, Beet, Andrew, Kirkpatrick, Barbara, Reich, Andrew, Ullmann, Steve, Fleming, Lora E., and Kirkpatrick, Gary
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PUBLIC health , *RED tide , *ALGAL blooms , *RESPIRATORY diseases , *DIGESTION , *BREVETOXINS - Abstract
Abstract: Human respiratory and digestive illnesses can be caused by exposures to brevetoxins from blooms of the marine alga Karenia brevis, also known as Florida red tide (FRT). K. brevis requires macro-nutrients to grow; although the sources of these nutrients have not been resolved completely, they are thought to originate both naturally and anthropogenically. The latter sources comprise atmospheric depositions, industrial effluents, land runoffs, or submerged groundwater discharges. To date, there has been only limited research on the extent of human health risks and economic impacts due to FRT. We hypothesized that FRT blooms were associated with increases in the numbers of emergency room visits and hospital inpatient admissions for both respiratory and digestive illnesses. We sought to estimate these relationships and to calculate the costs of associated adverse health impacts. We developed environmental exposure–response models to test the effects of FRT blooms on human health, using data from diverse sources. We estimated the FRT bloom-associated illness costs, using extant data and parameters from the literature. When controlling for resident population, a proxy for tourism, and seasonal and annual effects, we found that increases in respiratory and digestive illnesses can be explained by FRT blooms. Specifically, FRT blooms were associated with human health and economic effects in older cohorts (≥55years of age) in six southwest Florida counties. Annual costs of illness ranged from $60,000 to $700,000 annually, but these costs could exceed $1.0million per year for severe, long-lasting FRT blooms, such as the one that occurred during 2005. Assuming that the average annual illness costs of FRT blooms persist into the future, using a discount rate of 3%, the capitalized costs of future illnesses would range between $2 and 24million. [Copyright &y& Elsevier]
- Published
- 2014
- Full Text
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41. Longitudinal Effects on Mental Health of Moving to Greener and Less Green Urban Areas.
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Alcock, Ian, White, Mathew P., Wheeler, Benedict W., Fleming, Lora E., and Depledge, Michael H.
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MENTAL health , *PUBLIC health , *SUSTAINABLE development , *CITIES & towns , *METROPOLITAN areas - Abstract
Despite growing evidence of public health benefits from urban green space there has been little longitudinal analysis. This study used panel data to explore three different hypotheses about how moving to greener or less green areas may affect mental health over time. The samples were participants in the British Household Panel Survey with mental health data (General Health Questionnaire scores) for five consecutive years, and who relocated to a different residential area between the second and third years (n = 1064; observations = 5320). Fixed-effects analyses controlled for time-invariant individual level heterogeneity and other area and individual level effects. Compared to premove mental health scores, individuals who moved to greener areas (n = 594) had significantly better mental health in all three postmove years (P = .015; P = .016; P = .008), supporting a "shifting baseline" hypothesis. Individuals who moved to less green areas (n = 470) showed significantly worse mental health in the year preceding the move (P = .031) but returned to baseline in the postmove years. Moving to greener urban areas was associated with sustained mental health improvements, suggesting that environmental policies to increase urban green space may have sustainable public health benefits. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
42. Sustained low influenza vaccination rates in US healthcare workers
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Caban-Martinez, Alberto J., Lee, David J., Davila, Evelyn P., LeBlanc, William G., Arheart, Kristopher L., McCollister, Kathryn E., Christ, Sharon L., Clarke, Tainya, and Fleming, Lora E.
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INFLUENZA vaccines , *MORTALITY , *INFLUENZA viruses , *VIRAL disease prevention , *INDUSTRIAL hygiene , *HEALTH surveys , *PUBLIC health , *EPIDEMIOLOGY , *MEDICAL care - Abstract
Abstract: Introduction: A substantial morbidity and mortality burden attributable to the influenza virus is observed annually in the United States. Healthcare workers are an occupational group at increased risk of exposure, demonstrated to transmit influenza to their patient populations, and vital to the care of these patient populations. The prevention of the spread of the flu is a significant public health concern. In the present study, we examined influenza vaccination rates and their 5-year trends within the major occupational healthcare worker groups and compared them to non-Healthcare Workers. Methods: Using data from the nationally representative 2004–2008 National Health Interview Survey (NHIS), US healthcare workers (n =6349) were analyzed. Results: Seasonal influenza vaccination coverage estimates remain low among all healthcare workers, highest among the health diagnosing and treating practitioners (52.3%), and lowest among other healthcare support occupations (32.0%). Among all other occupational groups, pooled influenza vaccination rates were highest for white collar workers (24.7%), and lowest for farm workers (11.7%). There were no significant upward or downward trends in influenza vaccination rates for any healthcare or other occupational worker group during the 5-year survey period. Conclusion: Improving these low vaccination rates among healthcare workers warrants a comprehensive national approach to influenza prevention that includes education and strong encouragement of routine annual vaccination among healthcare workers. Policy enhancements such as free provision of seasonal influenza vaccine, coverage for treatment and workers compensation for vaccine-related complications are needed. [Copyright &y& Elsevier]
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- 2010
- Full Text
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43. The health implications of fracking.
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Kovats, Sari, Depledge, Michael, Haines, Andy, Fleming, Lora E., Wilkinson, Paul, Shonkoff, Seth B., and Scovronick, Noah
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HYDRAULIC fracturing , *PUBLIC health , *GAS wells , *POLLUTION , *SHALE gas industry , *EPIDEMIOLOGY , *HEALTH impact assessment - Abstract
The article offers observations on the health impacts of hydraulic fracturing. Particular focus is given to status of fracking in Great Britain. Key factors that contribute to environmental contamination in U.S. gas wells are discussed. Also mentioned are the need for exposure and epidemiological studies along the shale gas supply chain, contribution of shale gas extraction to climate change, and important issues surrounding health impact assessments on fracking.
- Published
- 2014
- Full Text
- View/download PDF
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