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PubMed2002

Arsenic contamination in Bangladesh groundwater: a major environmental and social disaster.

In attempting to eliminate disease caused by drinking polluted surface water, millions of shallow surface wells were drilled into the Ganges delta alluvium in Bangladesh. The latest statistics indicate that 80% of Bangladesh and an estimated 40 million people are at risk of arsenic poisoning-related diseases because the ground water in these wells is contaminated with arsenic. The clinical manifestations of arsenic poisoning are myriad, and the correct diagnosis depends largely on awareness of the problem. Patients with melanosis, leuco-melanosis, keratosis, hyperkeratosis, dorsum, non-petting edema, gangrene and skin cancer have been identified. The present article reviews the current arsenic contamination of ground water, hydrological systems, groundwater potential and utilization and environmental pollution in Bangladesh. This paper concludes by clarifying the main actions required to ensure the sustainable development of water resources in Bangladesh.

Arsenic↗
PubMed2003

Housing improvement projects in Indonesia: responding to local demand.

For more than three decades, environmental health programmes in Indonesia have emphasized prevention and treatment of the high incidence of disease among villagers. One of the main causes of disease is the unhygienic conditions of typical rural houses - two-room constructions with dirt floors and walls of lightly fired bricks or woven bamboo skins. While most houses have few or no windows, the occupants frequently cook, eat, sleep and even keep animals in a single room. The main objective of the housing improvement programme was to improve air circulation and introduce more sunlight to kill bacteria, avoid dampness and eliminate smoke from cooking. The programme encourages villagers to construct a permanent floor, enlarge existing windows or insert new windows for good ventilation. This presentation will share the 'success stories' of housing improvement projects in Indonesia that adopted demand-responsive approaches instead of the conventional 'supply approach'. Through exercises like Wealth Classification and Social Mapping, a demand-responsive approach lets the community decide who is eligible for assistance, resulting in higher participation and accurate information on community demand and on materials needed. In addition to the successes, the failures will be discussed at field level. This presentation will discuss the lessons learned from: the World Bank-funded Kalisemut Case Study; government's Family Welfare Movement; Plan International's project in Yogyakarta, and AusAID-funded Sustainable Development through Community Participation Project in Lombok.

Communicable Disease Control↗
PubMedDate not supplied

The International Disability Rights Movement and the ICF.

PURPOSE: To outline the thinking of disabled people about their situation and status before the formulation of the ICIDH (International Classification of Impairment, Disability and Handicap) in 1980, the growth of the international disability rights movement since 1980, its subsequent involvement in the revision process and then its hopes as to the effectiveness of the ICF (the International Classification of Functioning, Disability and Health-the revised ICIDH) in the future. METHOD: This is a personal analysis based on the author's experience as a disability rights activist and as a member of the World Council of Disabled Peoples' International (DPI), elected in 1987 to represent DPI in the revision process and who later became Chair of the Environmental Task Force. RESULTS: These are shown to be a major shift from the medical model of disability to the adoption of the interactive model and the impacts of environmental factors in all aspects of health and functioning. CONCLUSIONS: That proper use of the environmental factors within the ICF will ensure appropriate policies, systems and services for health care and support, provide measurable indicators for health status and sustainable development and underpin the recognition that disability is a human rights issue.

Activities of Daily Living↗
PubMed2006

New low-temperature applications of anaerobic wastewater treatment.

Low-temperature or psychrophilic (<20 degrees C) anaerobic biological treatment of simple industrial wastewaters has recently been proven feasible as an alternative to more expensive mesophilic (ca. 37 degrees C) technology. We implemented novel expanded granular sludge bed (EGSB)-based bioreactor designs for 27 psychrophilic anaerobic digestion (PAD) trials for the treatment of a broad range of simple and complex synthetic wastewaters representing dairy, food-processing and pharmaceutical sector effluents. A variety of operating parameters, such as hydraulic retention time, organic and volumetric loading rates and upflow velocity, were tested. Chemical oxygen demand (COD) removal efficiencies were recorded, which were comparable to previous mesophilic trials. Specific methanogenic activity, toxicity and biodegradability batch assays were employed to monitor the metabolic capabilities of microbial consortia in anaerobic reactors. The prevalence of psychrotolerant communities was observed and psychrophilic populations were detected in two of the reactors. The potential of PAD with respect to global sustainable development is discussed.

Anaerobiosis↗
PubMed2026

Sex-stratified mortality trends in preterm birth complications in Sierra Leone: progress, persistence, and equity implications.

BACKGROUND: Preterm birth complications remain a leading cause of neonatal mortality in Sierra Leone, despite recent health system gains. Evidence on long-term sex-specific disparities in mortality due to preterm birth complications is limited, constraining equitable neonatal care planning. OBJECTIVE: To examine two&#x2011;decade trends in sex&#x2011;stratified mortality from preterm birth complications using standardized equity indicators. METHODS: We conducted a retrospective longitudinal analysis of sex-disaggregated mortality estimates from the World Health Organization (WHO) Global Health Estimates (GHE), accessed through the WHO Health Equity Assessment Toolkit (HEAT), Built-in Database Edition (Version 6.0). Mortality rates per 100,000 population were extracted for 2001, 2006, 2011, 2016, and 2021. Inequality was assessed using absolute difference (D), relative ratio (R), population attributable risk (PAR), and population attributable fraction (PAF). RESULTS: Mortality declined substantially between 2001 and 2021 for both males (85.1-49.3 per 100,000) and females (71.2-39.9 per 100,000). Male mortality remained consistently higher across all years, with relative ratios indicating approximately 20-25% excess mortality among male neonates. Absolute inequalities narrowed modestly over time, whereas relative inequalities remained largely unchanged. PAR and PAF remained close to zero throughout the study period. Wider uncertainty intervals in earlier years reflected limited empirical data availability. CONCLUSION: Although preterm mortality declined over two decades, a persistent male disadvantage remained in Sierra Leone. These findings highlight the importance of integrating sex-disaggregated equity monitoring into neonatal policies and programmes. Future research should evaluate strategies to reduce the persistent excess mortality among male neonates while sustaining overall improvements in neonatal survival and progress toward Sustainable Development Goal 3.2.

Humans↗
PubMed2004

Equity and working time: a challenge to achieve.

Equity is a humanitarian issue that gained strength during the transition from the 20th to the 21st century due to the mounting global discussion and social crisis involving human rights, health, and work. This article aims at (1) introducing the concept of equity as it applies to work environments, particularly to situations involving demanding work schedules, (2) discussing the role of science in equity issues related to work, (3) introducing a new scientific society dedicated to working-time issues, and (4) presenting an overview of new research on working time and health as addressed by the series of manuscripts published in this special issue of Chronobiology International devoted to the XVIth International Symposium on Night and Shiftwork, held in Santos, Brazil, November 2003. The concept of equity has a political as a well as a scientific dimension. Many worldwide organizations, e.g., civil society, academia, and occupational health research institutions, advocate prompt actions toward equity as a strategy to attain sustainable development and to reduce poverty. The analyses of current tendencies in work settings reveal a general situation of disrespect for equity principles, which is expressed by heavy workloads, long work hours, poor work conditions, and deregulation of established labor laws, mainly in (but not restricted to) developing countries. In spite of the great contribution of science in the past five decades, obstacles stand in the way of effectively improving good working conditions, particularly in times of precarious employment. The Working Time Society is a new scientific society that aims at promoting research into working time and health and offers practical advice on how to minimize adverse effects of working hours on workers' health and well-being. An updated view of the research on working times and health includes studies on the relationship between work schedules, worker health, and well-being; effects of night and shiftwork on the internal synchronization of circadian rhythms and laboratory and field interventions; new methods of investigation or new approaches in shift-work studies; and prediction of risks in night and shift work. Current tendencies of work organization contribute to the amplification of inequality across groups and populations, revealing that equity remains a challenge to achieve.

Circadian Rhythm↗
PubMed2001

Clenbuterol ingestion causing prolonged tachycardia, hypokalemia, and hypophosphatemia with confirmation by quantitative levels.

BACKGROUND: Clenbuterol is a long acting beta2-adrenergic agonist used in the treatment of pulmonary disorders. Acute clenbuterol toxicity resembles that of other beta2-adrenergic agonists. Most previously reported cases of clenbuterol toxicity describe patients who ate livestock illicitly treated with clenbuterol. CASE REPORT: We report a case of human clenbuterol toxicity confirmed and correlated with qualitative and quantitative serum clenbuterol assays. This poisoned patient, a 28-year-old woman, developed sustained sinus tachycardia at 140/min, hypokalemia (2.4 mEq/L, 2.4 mmol/L), hypophosphatemia (0.9 mg/dL, 0.29 mmol/L), and hypomagnesemia (1.52 mg/dL, 0.76 mmol/L) after ingesting a reportedly small quantity of clenbuterol. The patient received repeated doses of metoprolol to treat her cardiovascular stimulation and potassium chloride to treat her hypokalemia. She remained symptomatic for more than 20 hours after the ingestion. Analysis by enzyme-linked immunosorbent assay and liquid chromatography/mass spectrometry revealed a serum clenbuterol concentration of 2.93 mcg/L 3 hours after the ingestion and an undetectable serum concentration 20 hours after ingestion. It is noteworthy that at a serum concentration below the limit of detection by liquid chromatography/mass spectrometry, the patient remained symptomatic. Acute clenbuterol toxicity is rarely reported following illicit use in humans, and this is the first such case to provide confirmatory toxicological analysis.

Adrenergic beta-Agonists↗
PubMed2005

Cover crops and natural vegetation mulch effect achieved by mechanical management with lateral rotary mower in weed population dynamics in citrus.

The aim of this study was to obtain information on practical weed management in order to reduce the use of herbicides thereby contributing to the sustainable development of citrus crop. The experiment was carried out under field conditions at the experimental area of the Department of Vegetal Production at the College of Agriculture "Luiz de Queiroz," Piracicaba, SP, Brazil, during the season 2002-2003. Influence of mulches produced by four types of vegetations on the dynamic population of weeds in the line of citrus crop (Citrus sinensis (L.) Osbeck) was evaluated. The experimental design was of factorial randomized blocks (4 x 2), where the treatments were: (i) four types of vegetation: Dolichos lablab L., Cajanus cajan (L.) Millsp, Penisetum glaucum (L.) Leeke, and the natural infestation composed basically by Panicum maximum Jacq.; and (ii) two types of fertilization: directed under canopy and broadcast. Mechanical management of the different vegetations was accomplished using a lateral rotary mower, KAMAQ, I model NINJA MAC 260, projected to release the green cut material under crop canopy, forming a mulch layer. The studied parameters were: (i) counting of weeds per m2 in the crop line after 30, 60, 90, 180, and 210 days following the cutting of existing vegetation; (ii) percentage of covered area by weeds; and (iii) some chemical properties of the soil. It was observed that the natural infestation showed a better weed control when compared with the other treatments, and that the broadcast fertilization, regardless of coverage used, presented a lower number of weeds.

Agriculture↗
PubMed2004

Clearance of hepatitis C viremia associated with cellular immunity in the absence of seroconversion in the hepatitis C incidence and transmission in prisons study cohort.

Understanding the earliest virological and immunological events in acute hepatitis C virus (HCV) infection may provide insight into the determinants of protective immunity. Four cases of HCV viremia with subsequent viral clearance, but without biochemical hepatitis or anti-HCV seroconversion, are reported from a prospective cohort study of prison inmates. Two of the subjects who developed sustained viremia were assessed for production of interferon (IFN)- gamma, by use of the enzyme-linked immunospot (ELISPOT) method and by assessment of HCV cytotoxic T lymphocyte (CTL) activity, CD4 lymphocyte proliferative responses, HCV load, and genotype. After 2-6 months of viremia, all 4 subjects cleared serum HCV RNA. Specific cellular responses were detected in both of the subjects who were assessed, and production of IFN- gamma was demonstrated in one subject. All subjects had weak, but consistent, serological reactivity against HCV nonstructural proteins on immunoblot testing, despite repeatedly nonreactive HCV ELISA tests. These cases highlight the potential for cellular immune responses against HCV to facilitate viral clearance, responses that may model those required for effective HCV vaccination.

Adult↗
PubMed2006

Lessons learned from reconstructing the 1918 influenza pandemic.

The "Spanish influenza" pandemic of 1918 was the most devastating influenza epidemic reported in history and killed >30 million people worldwide. The factors contributing to the severe pathogenicity of this influenza virus are of great interest, because avian influenza viruses circulating today pose the threat of a new pandemic if they develop sustained human-to-human transmissibility. Recent characterization of the 1918 virus has illuminated which determinants may be the cause of virulence. Here, we wish to shed light on what has been learned to date about the 1918 virus with regard to pathogenicity and transmissibility, to supplement our understanding of the determinants of human virulence and transmission of pandemic influenza viruses. Monitoring the sequences of avian influenza viruses for genetic changes and diversity may help us to predict the risks that these viruses pose of causing a new pandemic.

Animals↗
PubMed2004

Visceral leishmaniasis: consequences to women in a Bangladeshi community.

Visceral leishmaniasis (VL) or kala-azar (KA) affects the rural poor, causing significant morbidity and mortality. We examined the epidemiological and social impact of KA in an affected village in Bangladesh. A population-based survey of the village residents showed a case fatality rate of 14.7% among females and 5.3% among males. Before initiation of the study, female patients were ill longer than males before they received treatment. Future work needs to focus on understanding the implications of KA on women and to develop sustainable strategies for appropriate and timely access to treatment.

Adolescent↗
PubMed2002

Partnership for sustainable healthy workplaces: Warner Lecture, British Occupational Hygiene Society, Sheffield 9 April 2002.

The paper sets out a fresh approach to healthy workplaces, laying foundations to meet the demands of the new millennium. Professionals such as occupational hygienists deal with issues at the heart of the economy and society, which are beginning to attract the attention of politicians. Old disciplinary barriers must be crossed and communication improved so that healthy work is accepted as a mainstream concern, integral to sustainable development. This presents challenges both to professionals and to those with responsibilities for policy. As a first step, we need to develop an understanding of how conclusions from research can inform responsible decision making. We will not be able to design and build perfectly safe environments, but real progress can be made in the field of 'workplace health defence', using available human, technical and financial resources. A vital ingredient is partnership in the workplace, involving social partners and professionals working in collaboration.

Employment↗
PubMed1982

Coronary circulatory failure and thromboxane A2 release during coronary occlusion and reperfusion in anaesthetised dogs.

Attempts were made to demonstrate release of vasoactive substances from the heart during coronary occlusion (for 60 min) and reperfusion (for 60 min), and to clarify the pathophysiological significance of them. Vasoactive substances were detected by superfusion of rabbit aortic and dog coronary arterial strips with great coronary venous blood. Plasma thromboxane (TX) B2 was radioimmunologically assayed. Gradually developing, sustained contraction of both vascular strips was noted during coronary occlusion and reperfusion, while a transient contraction in rabbit aortic and relaxation in dog coronary arterial strips were seen immediately after reperfusion. The TXB2 released into the great coronary venous blood significantly increased during occlusion and reperfusion. Indomethacin treatment of the dog abolished the sustained contraction of both vascular strips and TXB2 release. The transient contraction of rabbit aorta after reperfusion was inhibited by phenoxybenzamine. Reactive hyperaemia following a 60 min occlusion was significantly depressed, as compared with that following 30 s to 30 min occlusion, and the depression was alleviated by indomethacin and imidazole. These results suggest that catecholamine(s) and TXA2 are released during coronary occlusion and reperfusion, and that the latter might be responsible for the coronary circulatory failure during reperfusion of irreversibly damaged myocardium.

Animals↗
PubMed1982

Relationship between conductivity and functional refractoriness of atrioventricular node in man.

Eighty-one consecutive patients representing a wide clinical spectrum were studied to assess the degree of limitation of the atrial extrastimulus technique for measurement of atrioventricular node refractoriness; and, to determine the relationship between conductivity and functional refractoriness of the atrioventricular node (AVN). Four patients developed sustained atrial fibrillation and a total of 277 basic cycle lengths (BCLs) were evaluated in the remaining 77. Four different patterns of AVN conduction were defined on the basis of plots of H1H2 versus A2A2 and discontinuity in the plot was observed for some of each of the three major patterns. No functional refractory period (FRP) of AVN could be determined in 10/77 patients (13%) and in 127/277 BCLs (46%). A mathematical formula relating measurements of conductivity (A2H2 interval) to FRP which was derived from the canine heart was applied to the data for those BCLs where FRP was known. Optimal agreement between measured and calculated FRP (y = x + 3, r = 0.97, n = 38) was obtained when subsets of data were selected according to an algorithm derived from repetetive computer analysis of the parent data base. The calculation is independent of patient variables (medication, impaired AVN conduction, pattern of AVN conduction). These results demonstrate that the atrial extrastimulus technique often will not permit measurement of AVN refractoriness in the human heart but conductivity and FRP are related in a fashion similar to that determined for the canine heart. This relationship permits calculation of FRP from measurements of conductivity. Calculation of FRP is recommended for brevity and greater yield of data.

Adolescent↗
PubMed1992

Effects of exogenous oxygen derived free radicals on myocardial capillary permeability, vascular tone, and incidence of ventricular arrhythmias in the canine heart.

OBJECTIVE: The aim was to examine the effects of exogenous oxygen derived free radicals on myocardial capillary permeability for a small hydrophilic indicator, postischaemic vascular tone, and the occurrence of arrhythmias in the canine heart in vivo. METHODS: Free radicals were generated by simultaneous intracoronary infusion of hypoxanthine and xanthine oxidase into normally perfused myocardium, and at reperfusion following five minutes of coronary occlusion, respectively, in 20 anaesthetised open chest dogs. Myocardial capillary extraction for 99mTc-DTPA, plasma flow rate, and the interstitial washout rate constant were measured by the single injection, residue detection method, and the capillary permeability-surface area product (PS) was calculated. The maximum plasma flow during reactive hyperaemia was measured by the local 133Xe washout method. RESULTS: Hypoxanthine and xanthine oxidase infusion into normally perfused myocardium induced a 15% decrease in capillary extraction (p = 0.05), a 24% decrease in PS (p < 0.01), and a 23% decrease in the interstitial washout rate constant (NS) two minutes after the end of the infusion. When hypoxanthine and xanthine oxidase were infused into postischaemic myocardium, 86% of animals developed sustained ventricular arrhythmias, in contrast to none in control experiments (p < 0.05). The maximum plasma flow was 363% of preocclusive values in control experiments v 268% in hypoxanthine + xanthine oxidase experiments (p < 0.05). CONCLUSIONS: In normally perfused hearts, intracoronary infusion of hypoxanthine and xanthine oxidase induce a decreased capillary extraction, suggesting a reduced capillary surface area. In postischaemic myocardium these substances cause a decreased vasodilatation in the initial phase of reactive hyperaemia, and induce ventricular arrhythmias.

Animals↗
PubMed1994

Increase in rat aortic endothelial free calcium mediated by metabolically sensitive calcium release from endoplasmic reticulum.

OBJECTIVE: The aim was to examine the relationship between cellular metabolism and intracellular [Ca2+] in vascular endothelial cells, focusing on the timing, mechanism, and reversibility of intracellular [Ca2+] changes resulting from ATP depletion. METHODS: Cultured rat aortic endothelial monolayers were loaded with indo-1 and exposed for 30 min to: (1) glucose-free buffer, (2) 10 mM deoxyglucose or iodoacetic acid (0.1 or 2.5 mM) to inhibit glycolysis, or (3) 2 mM NaCN to inhibit oxidative phosphorylation with or without glucose. In other experiments, the pH sensitive fluorescent indicator SNARF-1 was used to assess the relationship between observed changes in [Ca2+] and pH. RESULTS: While glucose deprivation resulted in a minor increase in [Ca2+], glycolytic inhibition resulted in a larger, slowly developing, sustained increase in [Ca2+]. Endothelial [Ca2+] was not affected by inhibition of oxidative phosphorylation alone, whereas a rapid, sustained, and largely reversible increase (approximately 102 nM) occurred when NaCN exposure was combined with glucose deprivation. The increase in [Ca2+] during glucose-free NaCN exposure was not altered when calcium influx was prevented by removal of extracellular calcium, but was abolished following depletion of an intracellular calcium store by the endoplasmic reticular Ca(2+)-ATPase inhibitor thapsigargin. In SNARF-1 loaded monolayers, inhibition of glycolysis with iodoacetic acid decreased intracellular pH by 0.33(SEM 0.10) units whereas inhibition of oxidative phosphorylation in the absence of glucose increased intracellular pH by 0.17(0.05) units. While these divergent pH changes were noted, [Ca2+] increased in both groups. CONCLUSIONS: A metabolically sensitive endoplasmic reticular calcium store is rapidly and reversibly released in vascular endothelial cells. Endothelial [Ca2+] is shown to be dependent on glycolytic energy production. In the endothelial cell, brief periods of inhibition of oxidative phosphorylation in the absence of glucose rapidly affect intracellular calcium pools rather than leading to calcium influx due to non-specific cellular damage. Effects on intracellular pH alone cannot account for the changes in [Ca2+].

Adenosine Triphosphate↗
PubMed2006

Building public health associations in the transition countries of south-eastern Europe: the example of Albania.

The Albanian Forum of Public Health (AFPH), an umbrella organization including different public health associations operating in Albania, was established in March 2004 with the support of the European Public Health Association (EUPHA) and the Open Society Institute (OSI). Ever since its establishment the AFPH has been an open arena wherein opinions and options for rational health policies comprising all relevant issues of the New Public Health are discussed, formulated, and documented near the Albanian Ministry of Health. Notwithstanding the laudable mission of the AFPH, there is an emerging need to establish a regional Public Health Forum in south-east Europe as a basic prerequisite for sustainable development of public health in these countries. Most conveniently, this regional umbrella organization should have a supporting Secretariat based in one of the south-east European countries. Nevertheless, there is a clear call for international funding with participation of different agencies and bodies (OSI, EUPHA, Canadian International Development Agency, and the Stability Pact). A regional association in the south-east Europe would enable the organization of annual conferences in the most renowned institutions in the region. Also, a regional collaboration among public health associations would be a suitable start for the development of research in south-east Europe. Furthermore, the existence of a regional public health association would make feasible the establishment of a scientific public health journal for south-east Europe in the English language.

Adolescent↗
PubMed1994

Donor funding for health reform in Africa: is non-project assistance the right prescription?

During the past 10 years, donors have recognized the need for major reforms to achieve sustainable development. Using non-project assistance they have attempted to leverage reforms by offering financing conditioned on the enactment of reform. The experience of USAID's health reform programmes in Niger and Nigeria suggest these programmes have proved more difficult to implement than expected. When a country has in place a high level of fiscal accountability and high institutional capacity, programmes of conditioned non-project assistance may be more effective in achieving reforms than traditional project assistance. However, when these elements are lacking, as they were in Niger, non-project assistance offers nothing inherently superior than traditional project assistance. Non-project assistance may be most effective for assisting the implementation of policy reforms adopted by the host government.

Cost-Benefit Analysis↗