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PubMed2002

Trend of blood lead levels in children in an industrial complex and its suburban area in Ulsan, Korea.

OBJECTIVES: To study the difference in blood lead level of children living in an industrial complex and those in a suburban area in Ulsan, Korea, and to investigate the trend by age and year. METHODS: The study subjects consisted of 620 children living in an industrial complex and 298 children living in a suburban area of Ulsan, Korea. We analyzed their blood lead levels, using an atomic absorption spectrometer with a graphite furnace, bi-annually from 1997 to 2001. RESULTS: The geometric mean levels of blood lead in children living in the industrial complex were 5.10 microg/dl, 5.36 microg/dl, and 5.41 microg/dl in the years 1997, 1999, and 2001, respectively, whereas those of children living in the suburban area were 3.81 microg/dl, 4.75 microg/dl, and 4.93 microg/dl, respectively. There was an increasing trend in the blood lead levels of children, and the differences in the levels of children living in the industrial complex and in the suburban area decreased year by year. CONCLUSIONS: These results suggest that the amount of exposure to lead in children is increasing from year to year in Ulsan, Korea.

Child↗
PubMed2006

Metal contamination in urban, suburban, and country park soils of Hong Kong: a study based on GIS and multivariate statistics.

The urban environment quality is of vital importance as the majority of people now live in cities. Due to the continuous urbanisation and industrialisation in many parts of the world, metals are continuously emitted into the terrestrial environment and pose a great threat on human health. An extensive survey was conducted in the highly urbanised and commercialised Hong Kong Island area (80.3 km2) of Hong Kong using a systematic sampling strategy of five soil samples per km2 in urban areas and two samples per km2 in the suburban and country park sites (0-15 cm). The analytical results indicated that the surface soils in urban and suburban areas are enriched with metals, such as Cu, Pb, and Zn. The Pb concentration in the urban soils was found to exceed the Dutch target value. The statistical analyses using principal component analysis (PCA) and cluster analysis (CA) showed distinctly different associations among trace metals and the major elements (Al, Ca, Fe, Mg, Mn) in the urban, suburban, and country park soils. Soil pollution maps of trace metals (Cd, Co, Cr, Cu, Ni, Pb, and Zn) in the surface soils were produced based on geographical information system (GIS) technology. The hot-spot areas of metal contamination were mainly concentrated in the northern and western parts of Hong Kong Island, and closely related to high traffic conditions. The Pb isotopic composition of the urban, suburban, and country park soils showed that vehicular emissions were the major anthropogenic sources for Pb. The 206Pb/207Pb and 208Pb/207Pb ratios in soils decreased as Pb concentrations increased in a polynomial line (degree=2).

Environmental Monitoring↗
PubMed2000

Characteristics of indoor and outdoor airborne fungi at suburban and urban homes in two seasons.

Literature has suggested association between damp environments, microbial exposure, and higher prevalence of respiratory symptoms and diseases. The study began by evaluating the airborne fungal concentrations at urban and suburban areas of a typical metropolitan city in southern Taiwan for the estimation of related health risks. A group of representative homes, based on the housing characteristics questionnaires completed earlier, were selected from two parts of the city; urban and suburban. Burkard sampler (BURKARD, Rickmansworth, England) was used to collect airborne fungi onto agar plates with malt-extract. After incubation and identification, concentrations of airborne fungi were calculated as CFU/m3. The geometric mean (GM) concentration for indoors was 8946 (4372-18,306) CFU/m3 in winter and 4381 (1605-11,956) in summer. For outdoors, it was 11,464 (5767-22,788) CFU/m3 in winter and 4689 (1895-11,603) in summer. In summer, the total fungal concentration, both indoors and outdoors of suburban homes, were significantly higher than those of urban homes. The dominant fungi contributing to such a difference were indoor Cladosporium spp. and outdoor Penicillium spp. (P < 0.01). The indoor/outdoor ratio (I/O) was similar in two areas except for Penicillium spp. in winter and Aspergillus spp. in summer; both higher in the suburban area. Significantly higher levels of airborne fungi were observed in this region than those seen in northern Taiwan or other parts of the world. Future investigations are needed to further examine the effects of these exposures on the related health problems.

Air Microbiology↗
PubMedDate not supplied

Effects of air pollution on children's pulmonary function in urban and suburban areas of Wuhan, People's Republic of China.

In May and June of 1988, the spirometric lung function of 604 children, who were aged 7-13 y and who were free of chronic respiratory conditions, was measured in the urban core and a suburb of Wuhan, China. During 1981-1988, ambient total suspended particulate (TSP) levels averaged 481 micrograms/m3 in the urban core and 167 micrograms/m3 in the suburb. In 1988, TSP levels, measured within 500 m of the children's homes, averaged 251 micrograms/m3 in the urban core and 110 micrograms/m3 in the suburb. Levels of sulfur dioxide and nitrogen oxides were also higher in the urban core. Proportions of families who burned coal and gas domestically were similar in both areas. In linear and logarithmic regression models, height was a stronger determinant of forced vital capacity and forced expiratory volume in 1 s than was age or weight. In linear models, the proportion of variance explained by height (R-squared) ranged from 0.54 for urban females' forced expiratory volume in 1 s to 0.77 for suburban males and females. Both forced vital capacity and forced expiratory volume in 1 s were consistently lower in urban than suburban children. The average forced vital capacity and forced expiratory volume in 1 s in children 132-144 cm tall were 6.7% and 3.8% lower, respectively, in the urban core than the suburb; suburban-urban differences increased with height. Suburban-urban differences in slopes of lung function growth curves were statistically significant for forced vital capacity but not for forced expiratory volume in 1 s. Rates of clinical upper respiratory irritation were also generally elevated in urban children. These results strongly suggest that urban ambient air pollution exposure in China contributes to retardation in the growth of children's lung function. Confirmatory longitudinal studies are in progress in Wuhan and three other Chinese cities.

Adolescent↗
PubMed2002

Addressing the unique challenges of inner-city practice: a direct observation study of inner-city, rural, and suburban family practices.

Previous research on geographic variations in health care contains limited information regarding inner-city medical practice compared with suburban and rural settings. Our main objective was to compare patient characteristics and the process of providing medical care among family practices in inner-city, suburban, and rural locations. A cross-sectional multimethod study was conducted emphasizing direct observation of outpatient visits by trained research nurses involving 4,454 consecutive patients presenting for outpatient care to 138 family physicians during 2 days of observation at 84 community family practices in northeast Ohio. Time use during office visits was assessed with the Davis Observation Code; satisfaction was measured with the Medical Outcomes Study nine-item Visit Rating Scale; delivery of preventive services was as recommended by the US Preventive Services Task Force; and patient-reported domains of primary care were assessed with the Components of Primary Care Instrument. Results show that inner-city patients had more chronic medical problems, more emotional problems, more problems evaluated per visit, higher rates of health habit counseling, and longer and more frequent office visits. Rural patients were older, more likely to be established with the same physician, and had higher rates of satisfaction and patient-reported physician knowledge of the patient. Suburban patients were younger, had fewer chronic medical problems, and took fewer medications chronically. Inner-city family physicians in northeast Ohio appear to see a more challenging patient population than their rural and suburban counterparts and have more complex outpatient office visits. These findings have implications for health system organization along with the reimbursement and recruitment of physicians in medically underserved inner-city areas.

Adult↗
PubMed2000

Windows 99: a source of suburban pediatric trauma.

BACKGROUND: Falls from windows in urban areas cause a significant number of pediatric injuries. Window falls have not been well described in the nonurban setting. We describe the epidemiology of window falls from residential homes among pediatric patients at a suburban Level I trauma center. METHODS: A review of patients admitted from January 1991 through November 1999 to a center serving a rapidly growing suburban area was performed. RESULTS: A total of 2,322 children, ages 0-14 years, were admitted during the study period. Falls comprised 41% of these admissions, and 11% of falls were from windows, greater than twice the national average. More than 39% of children who fell from windows were admitted directly to the intensive care unit. Overall mortality rate was 4%. Ages 0 to 4 years comprised the largest percentage (83%), and all children who died were in this age group. Children < or = 4 years were more likely to have an Abbreviated Injury Score > or = 2 (head injury) than those ages 10 to 14 years (p = 0.032). More than 31% of all children injured in window falls seen at the study institution between 1991 and 1999 were admitted in the last 2 years. CONCLUSION: Pediatric falls from windows in this suburban area appear to be increasing, with an incidence greater than the national average. Children at greatest risk are less than 4 years old. Further research in injury prevention at the national level aimed at suburban areas may be warranted.

Accidental Falls↗
PubMedDate not supplied

Prevalence and risk factors for Chlamydia trachomatis infection in low-income rural and suburban populations of Mexico.

BACKGROUND AND OBJECTIVES: In rural and suburban populations in developing countries, there is a lack of knowledge about the occurrence of Chlamydia trachomatis infection and the risk factors involved. Knowledge of the prevalence of infection is necessary to develop screening policies. GOALS: To estimate the prevalence of C. trachomatis infection in a rural and a suburban area of Oaxaca, Mexico, and to identify behavioral and demographic risk factors, as well as clinical findings, that may be related to this disease. STUDY DESIGN: A cross-sectional survey was conducted among 559 women attending the Rural Hospital of Tlacolula, Oaxaca in 1994. Genitourinary signs and symptoms were recorded using a structured questionnaire and a speculum examination of the cervix. Endocervical specimens were obtained for the direct immunofluorescent diagnosis of chlamydial infection. RESULTS: Results for 41 women (7.3%) were positive for chlamydia. The prevalence was the same in rural and suburban women. In a multiple logistic regression analysis, chlamydial infection was correlated highly with young age (OR, 2.3; 95% CI, 1.2 to 4.6), oral contraceptives (OR, 2.2; 95% CI, 0.7 to 6.9), number of sex partners, and genitourinary signs or symptoms. The simultaneous presence of mucopurulent cervical discharge, cervix friability, inflammatory signs of the cervix, and urinary symptoms had the highest specificity (99.6%) and positive predictive value (86.7%) for chlamydial infection detection. CONCLUSION: C. trachomatis infection is a common sexually transmitted disease in rural and suburban women in Mexico. Nearly 1 of 8 women 15 to 25 years of age may be infected. A risk factor-based screening program should be implemented in rural and urban populations in Mexico. In rural settings, women with mucopurulent cervical discharge should be treated for chlamydial infection, even without a laboratory diagnosis.

Adolescent↗
PubMed2001

Higher occurrence of asthma-related symptoms in an urban than a suburban area in adults, but not in children.

In young adults, a higher occurrence of asthma-related symptoms was found in an urban than an adjacent suburban area in a survey performed in 1991. The authors now wondered whether such differences could be established in other age groups. The present study (in 1996) included 14,299 subjects, aged 5-75 yrs, of a random sample of the general population in the same two adjacent areas: the centre of Antwerp (Belgium) and its south suburban border. The standardized European Community Respiratory Health Survey (ECRHS) and International Study of Asthma and Allergies in Childhood (ISAAC) questionnaires were used to assess the occurrence of asthma-related symptoms. Higher rates were confirmed in urban compared to suburban Antwerp in adults (20-75 yrs), but no such area differences were found in children (5-8 and 12-15 yrs). Adjustment for a number of recorded risk factors did not seem to affect the area differences in asthma-related symptoms. Comparing the survey results of 1991 and 1996 in 20-44 yr old adults, the findings suggest a slight increase in reported respiratory symptoms in both areas. A higher occurrence of asthma symptoms was observed in the urban than suburban area in adults, but not in children. This might be explained by a progressive effect of long-term exposure to the "urban environment". However, longitudinal studies are necessary to further clarify the factors accounting for these age-related area differences.

Adolescent↗
PubMed1996

The effect of consumer perceptions of quality and sacrifice on hospital choice: a suburban vs. urban competitive scenario.

The primary objective of this research was to determine how a suburban hospital located near an urban center fares when local consumers are selecting a hospital. A significant portion of the 161 suburban respondents to the study's mail survey perceive the quality of care available at alternative urban hospitals to be higher than that available at their local suburban hospital on the vast majority of quality-related attributes. Most respondents, however, select their local hospital for both major and minor medical treatment. Te greater value represented by suburban hospitals, due to their relative closeness to the consumer, represents a significant competitive advantage.

Consumer Behavior↗
PubMed1993

Malocclusion in 12-year-old suburban and rural Nigerian children.

There is little information about occlusal patterns in suburban and rural Nigerian populations. This survey was initiated to assess and compare malocclusion in 12-year-old primary school children residing in two communities of Ile-Ife (suburban) and Imesi-Ile (rural). Five hundred and seventy-four children were randomly selected comprising equal numbers of children from the two populations. They were examined using modified criteria described by Bjork, Krebs and Solow (1964). No significant differences were found between genders and in antero-posterior dental arch relationship. Crowding and spacing were more prevalent in suburban than rural children with anterior crowding significantly higher in the suburban than the rural population. Crossbite was not a common occlusal feature. There were however statistically significant differences in overjet, and overbite values in children from both populations (P < 0.001).

Child↗
PubMed1996

Vehicle occupants' exposure to aromatic volatile organic compounds while commuting on an urban-suburban route in Korea.

This study identified in-auto and in-bus exposures to six selected aromatic volatile organic compounds (VOCs) for commutes on an urban-suburban route in Korea. A bus-service route was selected to include three segments of Taegu and one suburban segment (Hayang) to satisfy the criteria specified for this study. This study indicates that motor vehicle exhaust and evaporative emissions are major sources of both auto and bus occupants' exposures to aromatic VOCs in both Taegu and Hayang. A nonparametric statistical test (Wilcoxon test) showed that in-auto benzene levels were significantly different from in-bus benzene levels for both urban-segment and suburban-segment commutes. The test also showed that the benzene-level difference between urban-segment and suburban-segment commutes was significant for both autos and buses. An F-test showed the same statistical results for the comparison of the summed in-vehicle concentration of the six target VOCs (benzene, toluene, ethylbenzene, and o,m,p-xylenes) as those for the comparison of the in-vehicle benzene concentration. On the other hand, the in-vehicle benzene level only and the sum were not significantly different among the three urban-segment commutes and between the morning and evening commutes. The in-auto VOC concentrations were intermediate between the results for the Los Angeles and Boston. The in-bus VOC concentrations were about one-tenth of the Taipei, Taiwan results.

Air Pollutants↗
PubMed2006

Chloride effects on nitrogen dynamics in forested and suburban stream debris dams.

Organic debris dams (accumulations of organic material) can function as "hotspots" of nitrogen (N) processing in streams. Suburban streams are often characterized by high flows that prevent the accumulation of organic debris and by elevated concentrations of solutes, especially nitrate (NO(3)(-)) and chloride (Cl(-)). In this study we (1) studied the effects of urbanization on the extent and characteristics of debris dams in large and small streams and (2) evaluated the effects of NO(3)(-) and Cl(-) on rates of N cycle processes in these debris dams. In some suburban streams debris dams were small and rare, but in others factors that reduce the effects of high stream flows fostered the maintenance of debris dams. Ambient denitrification enzyme activity (DEA) in these suburban and forested streams was positively correlated with stream NO(3)(-) concentrations. In laboratory microcosms, DEA in debris dam material from a forested reference stream was increased by NO(3)(-) additions. Chloride additions constrained the response of DEA to NO(3)(-) additions in material from the forested stream, but had no effect on DEA in material from streams with a history of high Cl(-) levels. Chloride additions changed the sign of net N mineralization from negative (consumption of inorganic N) to positive in debris dam material from the forested reference stream, but had no effect on net mineralization in material from streams with a history of exposure to Cl(-). Understanding the factors regulating the maintenance and N cycling activity of organic debris, and incorporating them into urban stream management plans could have important effects on N dynamics in suburban watersheds.

Chlorides↗
PubMed1975

Differentials in characteristics between city and suburban admissions to a state clinic for retarded children.

Characteristics of city and suburban admissions to a state-operated outpatient clinic for mentally retarded children were reported. City admissions tended to be overrepresented among lower socioeconomic groups and minorities. Suburban admissions tended to approximate the characteristics of the population of suburbia as a whole. A stepwise discriminant-function analysis between city and suburban admissions showed race to be the best predictor. Employment and occupational status, type of family structure, and certain referral agents also discriminated city and suburban admissions to varying degrees.

Adolescent↗
PubMed1998

U.S. suburbanization in the 1980s.

"This paper measures and analyzes differences in rates of suburbanization during the 1980s among U.S. metropolitan areas which fit a monocentric urban model. Three findings are of interest: (1) the average rate of suburbanization for U.S. metropolitan areas was the same in the 1980s and the 1970s; (2) the monocentric urban model provides a good description of population distribution for a diminishing number of urban areas; and (3) variables that characterize the entire metropolitan area as well as those that measure disparities between the central city and its suburban ring are important in explaining differences in rates of decentralization."

Americas↗
PubMed1995

Screening for lead poisoning by fingerstick in suburban pediatric practices.

OBJECTIVE: To assess the false-positive rate of blood lead determinations on samples obtained by fingerstick from children screened in private suburban and rural practices. METHODS: Screening capillary lead samples were obtained by fingerstick; children with capillary lead levels of 0.7 mumol/L (15 micrograms/dL) or greater were recalled for a confirmatory venous lead test that served as the criterion standard. Parents completed a five-question risk assessment questionnaire at the time of initial screening. SETTING: Four private suburban to rural practices that serve predominantly white, middle-class populations. PARTICIPANTS: Children seen for routine care between August 1992 and February 1993 (N = 1085; 98% between 6 months and 6 years of age). RESULTS: Capillary lead level was 0.7 mumol/L (15 micrograms/dL) or greater in 35 children (3% of total sample); venous lead samples were obtained in 30 patients. Nine of the elevated capillary lead results were true-positives (venous lead = 0.7, 0.8, 0.8, 0.9, 0.9, 0.9, 1.1, 1.1, and 1.7 mumol/L [15, 17, 17, 18, 18, 18, 22, 22, and 35 micrograms/dL]); parents of only two of these children answered yes to any question on the risk assessment questionnaire. Although the false-positive rate of the capillary lead screening test was 70% (21/30) in this setting, only 2% of the total sample had a false-positive screening test (an average of fewer than one false-positive per month per practice). Screening by fingerstick allowed phlebotomy to be avoided for 97% of the children. CONCLUSION: Fingerstick screening for lead poisoning is a reasonable alternative to direct venous testing within private suburban and rural practices, provided that care is taken to avoid specimen contamination, that appropriate caution is used in the interpretation of screening test results, and that medical and environmental interventions are based on the results of confirmatory venous testing.

Blood Specimen Collection↗
PubMed1991

Screening rural and suburban children with the Preschool Language Scale.

A population of 528 Nebraska 4- and 5-year-old boys and girls, 214 rural children and 214 suburban children residing in the same school district in the rural-suburban interface west of metropolitan Omaha, were administered the Preschool Language Scale (PLS) to help determine future eligibility for kindergarten placement and possible remedial services. Rural and suburban cultures led to significantly different performance profiles on the PLS. Language ability was overestimated as both groups scored above age level using the age equivalency tables and performance quotients published for the Preschool Language Scale. Also, a significantly higher percentage of rural children failed a wide age range of Verbal Ability and Auditory Comprehension items. Differences were disproportionately due to Verbal Ability test items requiring the rural child to use responsive verbalized language. The PLS did not consistently satisfy criteria for culturally nonbiased, ecologically valid assessment.

Bias↗
PubMed2005

Comparison of caregiver otitis media risk factor knowledge in suburban and urban primary care environments.

OBJECTIVE: There are many risk factors for otitis media. Some of these, such as passive tobacco smoke exposure and childcare arrangements; have the potential to be modified. The purpose of this study is to assess caregiver knowledge deficits about risk factors associated with otitis media and their willingness to modify behaviors associated with those risks. RESEARCH DESIGN AND METHODS: This study is a prospective survey study investigating knowledge deficits of parents or guardians of children ages 6-36 months about the risk factors of otitis media. The patients were consecutively drawn from a suburban and an urban pediatric practice. Any difference in survey results between these two groups was also assessed. Participants completed a survey of 21 questions with content including demographic and OM risk factor data. RESULTS: A total of 401 caregivers completed surveys, with 213 from an urban pediatric practice and 188 from a suburban practice. There was a significant difference in the ethnic distributions of the two populations. The suburban population had a significantly greater family history of ear infections, number of ear infections in the past 12 months, and number of previous ventilation tubes placed. The urban population had a significantly greater number of smokers in the household and decreased knowledge about day care as a risk for OM. The urban population's question responses suggested a greater willingness to change day care arrangements to reduce the risk of otitis media. CONCLUSIONS: Both populations demonstrated knowledge deficits regarding risk factors associated with OM and both populations exhibited willingness to modify behaviors to reduce risk. These findings demonstrate that there are opportunities for improving education regarding OM risk factors and that this education could potentially reduce risk for OM and in turn reduce the incidence of OM in children.

Adult↗
PubMed2005

Modelling of light pollution in suburban areas using remotely sensed imagery and GIS.

This paper describes a methodology for modelling light pollution using geographical information systems (GIS) and remote sensing (RS) technology. The proposed approach attempts to address the issue of environmental assessment in sensitive suburban areas. The modern way of life in developing countries is conductive to environmental degradation in urban and suburban areas. One specific parameter for this degradation is light pollution due to intense artificial night lighting. This paper aims to assess this parameter for the Athens metropolitan area, using modern analytical and data capturing technologies. For this purpose, night-time satellite images and analogue maps have been used in order to create the spatial database of the GIS for the study area. Using GIS advanced analytical functionality, visibility analysis was implemented. The outputs for this analysis are a series of maps reflecting direct and indirect light pollution around the city of Athens. Direct light pollution corresponds to optical contact with artificial night light sources, while indirect light pollution corresponds to optical contact with the sky glow above the city. Additionally, the assessment of light pollution in different periods allows for dynamic evaluation of the phenomenon. The case study demonstrates high levels of light pollution in Athens suburban areas and its increase over the last decade.

Air Pollutants↗