Health Risk Assessment of Employees Exposed to Chlorination By-products of Recreational Water in Large Amusement Parks in Shanghai

Objective Chlorination is often used to disinfect recreational water in large amusement parks;however,the health hazards of chlorination disinfection by-products(DBPs)to occupational populations are unknown.This study aimed to assess the exposure status of chlorinated DBPs in recreational water and the health risks to employees of large amusement parks.Methods Exposure parameters of employees of three large amusement parks in Shanghai were investigated using a questionnaire.Seven typical chlorinated DBPs in recreational water and spray samples were quantified by gas chromatography,and the health risks to amusement park employees exposed to chlorinated DBPs were evaluated according to the WHO's risk assessment framework.Results Trichloroacetic acid,dibromochloromethane,bromodichloromethane,and dichloroacetic acid were detected predominantly in recreational water.The carcinogenic and non-carcinogenic risks of the five DBPs did not exceed the risk thresholds.In addition,the carcinogenic and non-carcinogenic risks of mixed exposure to DBPs were within the acceptable risk limits.Conclusion Typical DBPs were widely detected in recreational water collected from three large amusement parks in Shanghai;however,the health risks of DBPs and their mixtures were within acceptable limits.

Assessment of Breast Cancer Prevention Practices among Women Attending Primary Health Care in Abha City, Aseer Region, Saudi Arabia

Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices.

Health risk assessment of trace metal(loid)s in agricultural soils based on Monte Carlo simulation coupled with positive matrix factorization model in Chongqing, southwest China

This study aimed to investigate the pollution characteristics, source apportionment, and health risks associated with trace metal(loid)s(TMs) in the major agricultural producing areas in Chongqing, China. We analyzed the source apportionment and assessed the health risk of TMs in agricultural soils by using positive matrix factorization(PMF) model and health risk assessment(HRA) model based on Monte Carlo simulation. Meanwhile, we combined PMF and HRA models to explore the health risks of TMs in agricultural soils by different pollution sources to determine the priority control factors. Results showed that the average contents of cadmium(Cd), arsenic (As), lead(Pb), chromium(Cr), copper(Cu), nickel(Ni), and zinc(Zn) in the soil were found to be 0.26, 5.93, 27.14, 61.32, 23.81, 32.45, and 78.65 mg/kg, respectively. Spatial analysis and source apportionment analysis revealed that urban and industrial sources, agricultural sources, and natural sources accounted for 33.0%, 27.7%, and 39.3% of TM accumulation in the soil, respectively. In the HRA model based on Monte Carlo simulation, noncarcinogenic risks were deemed negligible(hazard index <1), the carcinogenic risks were at acceptable level(10^(-6)<total carcinogenic risk ≤ 10^(-4)), with higher risks observed for children compared to adults. The relationship between TMs, their sources, and health risks indicated that urban and industrial sources were primarily associated with As, contributing to 75.1% of carcinogenic risks and 55.7% of non-carcinogenic risks, making them the primary control factors. Meanwhile, agricultural sources were primarily linked to Cd and Pb, contributing to 13.1% of carcinogenic risks and 21.8% of non-carcinogenic risks, designating them as secondary control factors.

Assessment of Satisfaction in the Reception and Emergency Department of a Health Center

Introduction The main objective of any healthcare establishment must be to ensure the quality of patient care and customer satisfaction. It is necessary to regularly assess patient satisfaction. The aim of this study was to assess the level of satisfaction of customers aged over 18 years attending the emergency department of the health center. Methodology This was a descriptive and analytical cross-sectional study of patients aged 18 years and over, who attended the Samu Municipal emergency department between 02 and 30 May 2023. The satisfaction index was determined using the adapted 2009 SAPHORA-MCO questionnaire and the Likert satisfaction scale. Results A total of 400 patients were surveyed. The average age was 35 years, with a standard deviation of 14.7. Of those surveyed, 51% were women, 87% were educated, 50% lived in Grand Yoff and 59.5% were unemployed. Satisfaction levels linked to perception of the cost of care (72%), waiting time (64.3%), information given to patients (69.1%) and pain management (74 .5%) are fair. On the other hand, the levels of satisfaction linked to administrative procedures (82.5%), staff attitudes towards patients (84%), staff availability (86.4%), patient privacy (89.2%), general atmosphere (87.2%), staff competence (87.3%), and the effectiveness of care (89.4%) were satisfactory. The average waiting time was 38 minutes. However, 32% of patients waited less than 30 minutes and 92% less than an hour. The satisfaction index linked to administration and reception was 72.9% and 79.85%, respectively. The satisfaction index linked to the administration and technical quality of care is equal to 85.8% and 83.7%, respectively. The overall satisfaction index is equal to 80.6%;the level of satisfaction of users of the health structure is satisfactory. Conclusion Patient satisfaction is an essential part of quality care. Patient satisfaction must be based on effective communication from the healthcare team and the creation of a patient-caregiver relationship.

Health Assessment of Typical Reservoirs in Eastern Jilin: A Case Study of Niligou Reservoir

Niligou Reservoir,a typical reservoir in the eastern region of Jilin Province,is subordinate to Niligou River,which is located in the Changbai Mountains in eastern Jilin,with abundant plant and animal resources and well protected biodiversity in the basin,but there are also some related problems such as fragile ecosystem of forest wetland.This paper carried out a health assessment of Niligou River,including water quality monitoring,aquatic organism monitoring,and riparian zone investigation.According to the requirements of the Technical Guidelines for River and Lake Health Assessment,13 assessment indexes were selected to build a river and lake health assessment index system.By sorting and analyzing the monitoring and investigation data,we got a clear picture of the ecological environment status and existing problems of Niligou Res-ervoir.Based on the actual situation of Niligou River,we evaluated the hydrologic integrity,chemical integrity,morphological and structural integrity,biological integrity and sustainability of social service function,and put forward corresponding countermeasures according to the re-sults,in order to provide a technical support for the health treatment of rivers and lakes in Jilin Province.

Assessment of Rainwater Quality in Warri and Environ, Southern Nigeria for Domestic Purposes

The study aimed at assessing the physiochemical characteristics of rainwater in Warri and it environ was investigated. Pb, Zn, Cd, Cu and Cr concentrations in rainwater from roof and non-roof sources were determined using Atomic Absorption Spectrophotometry. Three geospatial locations comprising Jakpa, Udu, and Ubeji were selected based on prevailing anthropogenic activities. The rainwater samples were systematically collected from (aluminum) roof and non-roof sources for the months of April, June, and August and October 2022, treated and analyzed in the laboratory for sixteen physicochemical parameters. Results were statistically analyzed using ANOVA, and T-test for the determination of the level of relationships and variations across geospatial locations. Significant correlations (r = 0.72) exist between Cr in rainwater from roof and non-roof sources. Implying point-source contaminations and may be emanating from the influence of roof materials. Furthermore, high concentrations of Cd and Pb in roof source above WHO standards were mostly in Jakpa and Ubeji. Calculated Health Risk Index (HRI) for children and adult is greater than 1. The results showed that most samples from the locations are considered not safe (HRI > 1) especially for Cd, which means that there are potential health risks consuming rainwater from Jakpa, Udu and Ubeji. Therefore, there is need for prompt sensitization program to dissuade people from directly drinking rainwater from these locations.

Implications of Dynamic Interactions between Meteorological Patterns and Surface Water Quality on Environmental Health—A Case Study of the Nairobi River

Urban areas face significant challenges in maintaining water quality amidst increasing urbanization and changing climatic patterns. This study investigates the complex interplay between meteorological variables and water quality parameters in Nairobi City, focusing on the impacts of rainfall and temperature on surface water quality. Data from multiple sources, including the Water Resources Authority, Nairobi Water and Sewerage Company, and the World Bank’s Climate Change Knowledge Portal, were analyzed to assess the relationships between meteorological variables (rainfall and temperature) and water quality parameters (such as electroconductivity, biochemical oxygen demand, chloride, and pH). The analysis reveals varying impacts of rainfall and temperature on different water quality parameters. While parameters like iron and pH show strong relationships with both rainfall and temperature, others such as ammonia and nitrate exhibit moderate relationships. Additionally, the study highlights the influence of runoff, urbanization, and industrial activities on water quality, emphasizing the need for holistic management approaches. Recommendations encompass the establishment of annual publications on Nairobi River water quality, online accessibility of water quality data, development of hydrological models, spatial analysis, and fostering cross-disciplinary research collaborations. Implementing these recommendations can enhance water quality management practices, mitigate risks, and safeguard environmental integrity in Nairobi City.

Ecosystem health: ecological sustainability target of strategic environment assessment

Strategic environment assessment (SEA) and ecosystem health are two new ideas on environmental management. On the basis of reviewing some relevant literature, this paper made discussions on the ecological sustainability target of SEA, the content of ecosystem health as well as the interrelations between SEA and ecosystem health. For a good SEA, its ecological sustainability principles should be provided with distinct content and a general assessment system. A framework for ecosystem health assessment was established according to the content of ecosystem health, and combined into SEA as SEA抯 ecological sustainability target, we can effectively guide decision-makers to make suitable indigenous means and local solutions. , The basic principles and procedure of SEA for ecosystem health are also discussed in the paper.

Assessment of first-order-moment-based sample reconstruction method for design flood estimation in changing environment

Estimating the design flood under nonstationary conditions is challenging. In this study, a sample reconstruction approach was developed to transform a nonstationary series into a stationary one in a future time window (FTW). In this approach, the first-order moment (EFTW) of an extreme flood series in the FTW was used, and two possible methods of estimating EFTW values in terms of point values and confidence intervals were developed. Three schemes were proposed to analyze the uncertainty of design flood estimation in terms of sample representativeness, uncertainty from EFTW estimation, and both factors, respectively. To investigate the performance of the sample reconstruction approach, synthesis experiments were designed based on the annual peak series of the Little Sugar Creek in the United States. The results showed that the sample reconstruction approach performed well when the high-order moment of the series did not change significantly in the specified FTW. Otherwise, its performance deteriorated. In addition, the uncertainty of design flood estimation caused by sample representativeness was greater than that caused by EFTW estimation.

Driving risk assessment under the connected vehicle environment:a CNN-LSTM modeling approach

Connected vehicle(CV)is regarded as a typical feature of the future road transportation system.One core benefit of promoting CV is to improve traffic safety,and to achieve that,accurate driving risk assessment under Vehicle-to-Vehicle(V2V)communications is critical.There are two main differences concluded by comparing driving risk assessment under the CV environment with traditional ones:(1)the CV environment provides high-resolution and multi-dimensional data,e.g.,vehicle trajectory data,(2)Rare existing studies can comprehensively address the heterogeneity of the vehicle operating environment,e.g.,the multiple interacting objects and the time-series variability.Hence,this study proposes a driving risk assessment framework under the CV environment.Specifically,first,a set of time-series top views was proposed to describe the CV environment data,expressing the detailed information on the vehicles surrounding the subject vehicle.Then,a hybrid CNN-LSTM model was established with the CNN component extracting the spatial interaction with multiple interacting vehicles and the LSTM component solving the time-series variability of the driving environment.It is proved that this model can reach an AUC of 0.997,outperforming the existing machine learning algorithms.This study contributes to the improvement of driving risk assessment under the CV environment.

Exposure Level, Toxicity Effects and Health Risk Assessment of Organophosphorus Flame Retardants in Water Environment

Organophosphorus flame retardants(OPFRs) are gradually replacing brominated flame retardants(BFRs), which are widely used in the world. The increasing output of OPFRs and the increasing detection of OPFRs in environmental media have attracted wide attention of scholars at home and abroad. OPFRs are generally semi-volatile, easy to enter the environment and accumulate in organisms,causing potential hazards to the environment and human health. In this paper, the pollution status and toxic effects of OPFRs in aquatic environment were introduced,and the research progress of human health risk caused by them was summarized.The existing problems were pointed out, and the future research was prospected. In the future, the analytical methods of various environmental and biological media should be improved, and comprehensive and in-depth environmental investigation and ecological and health risk assessment should be carried out. Attention should be paid to the effects of combined pollution on organisms and the study of biological acceptability.

Environmental Assessment for Health Tourism in Baños de Agua Santa, Ecuador

The aim of this study is to apply the methodology for assessment of environmental impact of the heritage town with health tourism interest that is assessed. Health tourism is based on the appropriate employment of natural resources, landscapes and the natural and cultural heritage of a place. In order to carry out the study, a set of both theoretical and empirical methods were used to analyze the case of Ba?os de Agua Santa. The theoretical methods include the analysis and synthesis employed throughout the research process, as well as in the bibliographic study and the evaluation of the information obtained. In addition, the inductive-deductive method was employed to analyze, process, and treat the information and data that were used frequently in this work. As for the empirical methods, the researchers employed participatory techniques with community stakeholders, in order to gather information through interviews. Also, researchers conducted direct observation of community activities. The automated method software is used which requires a baseline study of the environment assessment in Tungurahua, Ecuador, to be prepared. In addition, the analysis of the social perception on tourism of the local people from the course work of students at the UIDE shall be applied. The conclusions of the case studies undertaken allow for strategic proposals and recommendations to be prepared so that they can be incorporated into the management plans for health tourism in the town with natural heritage value.

Regional comprehensive assessment on environment-health of China

The aim of the study was to assess the environment-health development in different regions of China. 175 indicators, such as average life expectancy at birth, emission intensity of waste gas, GDP etc. were chosen to describe various aspects of the environment, health and development of China. Of all the indicators, life expectancy can sufficiently reflect health situation of population. Consequently, life expectancy was identified as key indicator, and 42 out of 175 indicators were selected for establishing the environment-health indicator framework with three grades of integrative indices to assess the development of environment-health of China. Based on the hierarchical relation between various grades of indices, the comprehensive environment-health index was calculated and contributed to classify the environment-health situation of 30 provinces, municipalities and autonomous regions in China which were divided into five grades by four predefined limits. Comprehensive assessment indicates that the environment-health situation of the eastern and coastal areas is superior to that of inland which is the western regions with underdeveloped economy and rigorous natural condition. Especially, the Qinghai-Tibet and Yunnan-Guizhou plateaus in southwestern China are most vulnerable in the environment and population health. These fit in with the pattern of national socio-economic development, which fully shows that socio-economic context plays a dominant role in the improvement of environment-health in China.

Health risk assessment of heavy metals in soils and crops in a mining area(Au-Ag-Cutrona-oil et al.) of the Nanyang Basin, Henan Province, China

Heavy metal distribution in mining areas has always been a hot research topic due to the special environment of these areas. This study aims to explore the impact of heavy metal pollution on soils and crops in the study area, ensure the safety of local crops and the health of local residents, and provide a basis for the subsequent environmental restoration and the prevention and control of environmental pollution. Based on the analysis of the heavy metal concentrations in local soils and crops, the study investigated the spatial distribution, pollution degrees, and potential ecological risks of heavy metals in the farmland of a mining area in the southeastern Nanyang Basin, Henan province, China explored the sources of heavy metals and assessed the health risks caused by crop intake. The results of this study are as follows. The root soils of crops in the study area suffered heavy metal pollution to varying degrees. The degree of heavy metal pollution in maize fields is higher than that in wheat fields, and both types of fields suffer the most severe Cd pollution. Moreover, the root soils of different crops suffer compound pollution.The root soils in the maize fields suffer severe compound pollution at some sampling positions, whose distribution is similar to that of the mining area. Cd poses the highest potential ecological risks among all heavy metals, and the study area mainly suffers low and moderate comprehensive potential ecological risks. The principal component analysis(PCA) shows that the distribution of Zn, Cd, Pb, and As in soils of the study area is mainly affected by anthropogenic factors such as local mining activities;the distribution of Cr and Ni is primarily controlled by the local geological background;the distribution of Hg is mainly affected by local vehicle exhaust emissions, and the distribution of Cu is influenced by both human activities and the geological background. Different cereal crops in the study area are polluted with heavy metals dominated by Cd and Ni to varying degrees, especially wheat. As indicated by the health risk assessment results, the intake of maize in the study area does not pose significant human health risks;however, Cu has high risks to human health, and the compound heavy metal pollution caused by the intake of wheat in the study area poses risks to the health of both adults and children. Overall, the soils and crops in the study area suffer a high degree of heavy metal pollution, for which mining activities may be the main reason.

A Comparative Study of Different Methods on Quality Assessment of Soil Environment Polluted by Zinc in Agricultural Production Areas——A Case Study in Shulan City of Jilin Province

[Objective] The aim was to explore evaluated precision on quality of soil environment polluted with zinc in agricultural production areas and to provide references for verification of production area.[Method] In Shulan City in Jilin Province,soils were sampled and analyzed in a laboratory using single-factor pollution index and GIS based spatial interpolation.The quality of environment polluted with zinc was assessed and related methods were compared according to Environment Quality Standard of Green Food Production Area.[Result] Spatial interpolation of zinc in soils based on GIS proved more precise than traditional methods;cokriging method with co-factors was higher in precision than common cokriging;cokriging method with zinc and organic matter was higher in precision than cokriging with zinc alone.[Conclusion] Quality assessment on environment polluted with zinc based on GIS interpolation is more scientific and reasonable than traditional methods.

Shaoma Zhijing granule for children with tic disorders: A rapid health technology assessment

Objective:To rapidly assess the effectiveness,safety,economy,and applicability of Shaoma Zhijing granule(SZG)for the treatment of children with tic disorders(TD),and provide currently available best evidence for decision-makers of health policies.Methods:We conducted a rapid health technology assessment(RHTA)to explore the value of SZG.A systematic literature search in eight literature databases and on three clinical trial registration platforms was performed.The literature was screened according to eligibility criteria.The screening process and data extraction were conducted by two reviewers,and the quality of the literature was also assessed.The results were summarized,analyzed,and presented in tables or figures.Results:A total of five randomized controlled trials(RCTs)were included in this study,of which one was published in English(in the Journal of Child Psychology and Psychiatry)and four in Chinese journals.The overall risk of bias for the five RCTs was evaluated as“some concerns.”SZG monotherapy or in combi-nation with tiapride was better than tiapride alone in improving traditional Chinese medicine(TCM)syndromes and tic symptoms,with a daily cost of¥67.50e107.22.Adverse events were mainly related to the digestive,respiratory,and neurological systems,but all were mild.Conclusion:Overall,the current RHTA of published,peer-reviewed literature has located a small body of evidence evaluating the use of SZG for the treatment of TD in children.SZG has effects on improving TCM syndromes and tic symptoms;the daily cost is¥67.50e107.22;and all adverse events are mild.High-quality studies with long-term follow-up should be conducted,so as to provide local evidence and consistently guide and improve scientific decision-making.

Development and validation of an instrument to assess knowledge,attitudes,and practices on digital health among nursing officers

Objective:Validation is an important aspect of an instrument,and it ensures the confidence of researchers to employ the instrument in their studies.This study was conducted to develop and validate an instrument to assess knowledge,attitudes,and practices(KAP) on digital health among nurses since digital health capacity is a major concern in health care that needs to be assessed.Methods:We conducted a methodological study to assess the content validity and reliability of the instrument.First,items were generated through a comprehensive literature review and by obtaining an expert opinion.Second,content and face validity were assessed by a panel of 7 experts.Both the item-level content validity index(I-CVI) and the scale-level content validity index(S-CVI) were established.Moreover,test–retest reliability and internal consistency of the instrument were assessed.Data were analyzed using SPSS version 25.Results:The initial pool consisted of 60 items and after obtaining content,face,and construct validity,51 items remained.Items with an I-CVI <0.78 were considered relevant.The S-CVI for relevancy,clarity,ambiguity,and simplicity were 0.93,0.91,0.94,and 0.92,respectively.Five subcomponents were constructed in each knowledge and attitudes domain,and the test–retest reliability test revealed that the instrument has good reliability,showing correlation coefficient values for the KAP domains and the total questionnaire of 0.76,0.98,0.99,and 0.99,respectively.The independent Cronbach's α for all items was 0.76,indicating good internal consistency.Conclusions:The present study established the acceptable validity and ensured the good reliability and internal consistency of the instrument,which can serve as an assessment tool of KAP on digital health among healthcare professionals.

Socio-Economic and Health Indicators’ Relation to Self-Assessed Health: A Case Study of Phai Tha Pho, Phichit Province, Thailand

Background: Self-assessed health (SAH) is used as a common method of sociology research to understand the implications of self-reported health and the link to social factors like education, income, and occupation. The paper explores the impact of socio-economic and health indicators on self-assessed health in the middle-aged to the senior population in a rural community in Thailand. Methods: Primary data were collected after conducting a randomized sampling for 100 people using direct interviews in two locations within the sub-district of Phai Tha Pho, Thailand. The target demographic was the middle-age to elderly population. A logit model was applied to the collected samples. Results: The study highlights that higher education, income, and sleep are high predictors for positive SAH while high blood sugar level has significant adverse effects on SAH. Detection of metabolic syndrome further indicates degraded overall health perception over time. Conclusion: The study demonstrated the relationship between socio-economic indicators and illnesses alongside individual SAH in rural Thailand. Accordingly, policies have been proposed that include targeted subsidies for healthy food alternatives, promoting work-rest balance at all levels, and an expansion of sub-district education up to secondary school. SAH can be performed regularly and expanded across communities including areas of low-income living due to its low implementation costs. It could also be used as a tool to support the government’s public health initiatives complementing the existing five-year direct health check-up programme. A comparative study of SAH across regions is recommended for future research.

Seasonal variations and health risk assessment of trace elements in the Badigad River,lesser Himalayas,Nepal

The consumption of contaminated river water can have severe effects on human health.This study aims to investigate the trace elements(TEs)content and their health risk assessment in the Badigad River Basin in the lesser Himalayas of Nepal.In total,44 water samples were collected from 22 different sites during the pre-monsoon and monsoon seasons,and 25 TEs were analyzed.Correlation matrix and principal component analysis(PCA)were used to analyze the potential relationship between the measured TEs and their source tracking.Furthermore,the water quality index(WQI),metal index(MI),and cancer index(CI)were evaluated.The TEs content in all samples were found to be within the WHO recommended guideline for drinking and domestic purposes.The dominancy order of the TEs was observed as Sr>Ba>Li>Rb>Zn>Cr>Sc>Mn>Ti>Cu>As>Ni>Co>U>V>Pb>Cs>Ga>Y>Tl>Th>Zr>Bi>Cd>Nb.The PCA analysis suggested that TEs could have natural,anthropogenic,and mixed origins.The WQI indicated that the river water is safe from a human health perspective.The MI suggested that Badigad River can be considered safer for drinking purposes,and the cancer index(CI)showed that all the reported TEs are at low-risk levels.The findings of this study could be useful for government agencies in developing more sustainable water management policies in the region.However,it is suggested that further investigations should be conducted in terms of other hydrogeochemical variables,including major ions,at spatiotemporal levels for the sustainability of the river basin.