| 1. |
- Lindgren, Anna, et al.
(författare)
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Traffic exposure associated with allergic asthma and allergic rhinitis in adults. A cross-sectional study in southern Sweden.
- 2009
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Ingår i: International Journal of Health Geographics. - 1476-072X. ; 8:May 6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is conflicting evidence that traffic-related air pollution is a risk factor for allergic conditions. Few studies have investigated this in adults. In adults, a high proportion of asthma, rhinitis and eczema is triggered by non-allergic factors. We investigated traffic as a risk factor for allergic versus non-allergic asthma and rhinitis, and eczema, in adults. A questionnaire from 2000 (n = 9319, 18-77 years) provided individual data about disease outcome and self-reported traffic exposure. Additional exposure assessments were obtained using Geographical Informations Systems (GIS). Residential addresses were linked to the national Swedish Road Database and to a pollutant database with modelled annual means of NOx (Nitrogen Oxids). RESULTS: Living within 100 m from a road with a traffic intensity of >10 cars/min (24 hour mean) was associated with prevalence of current asthma reported to be triggered by allergic factors (OR = 1.83, 95% CI = 1.23-2.72) and with allergic rhinitis (OR = 1.30, 95%CI = (1.05-1.61). No relation was seen with asthma or rhinitis triggered by other factors. Living within 100 m of a road with >10 cars/min was also associated with hand-eczema during the last 12 months (OR = 1.63, 95% CI = 1.19-2.23), but not with allergic eczema or diagnosed hand-eczema. Consistent results were seen using self-reported traffic, but the associations with NOx were less consistent. CONCLUSION: Exposure to traffic was associated with a higher prevalence of allergic asthma and allergic rhinitis, but not with asthma or rhinitis triggered by non-allergic factors. This difference was suggested by the overall pattern, but only clear using GIS-measured traffic intensity as a proxy for traffic exposure. An association was also found with hand-eczema during the last 12 months. We suggest that asthma and rhinitis should not be treated as homogenous groups when estimating effects from traffic in adults.
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| 2. |
- Lindgren, Anna, et al.
(författare)
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Traffic-related air pollution associated with prevalence of asthma and COPD/chronic bronchitis. A cross-sectional study in Southern Sweden
- 2009
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Ingår i: International Journal of Health Geographics. - 1476-072X. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is growing evidence that air pollution from traffic has adverse long-term effects on chronic respiratory disease in children, but there are few studies and more inconclusive results in adults. We examined associations between residential traffic and asthma and COPD in adults in southern Sweden. A postal questionnaire in 2000 (n = 9319, 18-77 years) provided disease status, and self-reported exposure to traffic. A Geographical Information System (GIS) was used to link geocoded residential addresses to a Swedish road database and an emission database for NOx. Results: Living within 100 m of a road with > 10 cars/minute (compared with having no heavy road within this distance) was associated with prevalence of asthma diagnosis (OR = 1.40, 95% CI = 1.04-1.89), and COPD diagnosis (OR = 1.64, 95% CI = 1.11-2.4), as well as asthma and chronic bronchitis symptoms. Self-reported traffic exposure was associated with asthma diagnosis and COPD diagnosis, and with asthma symptoms. Annual average NOx was associated with COPD diagnosis and symptoms of asthma and chronic bronchitis. Conclusion: Living close to traffic was associated with prevalence of asthma diagnosis, COPD diagnosis, and symptoms of asthma and bronchitis. This indicates that traffic-related air pollution has both long-term and short-term effects on chronic respiratory disease in adults, even in a region with overall low levels of air pollution.
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| 3. |
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| 4. |
- Stroh, Emilie, et al.
(författare)
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Are associations between socio-economic characteristics and exposure to air pollution a question of study area size? An example from Scania, Sweden
- 2005
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Ingår i: International Journal of Health Geographics. - 1476-072X. ; 4:30
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Numerous studies have shown that exposure to air pollutants in the area of residence and the socio-economic status of an individual may be related. Therefore, when conducting an epidemiological study on the health effect of air pollution, socio-economy may act as a confounding factor. In this paper we examine to what extent socio-economic status and concentrations of NO2 in the county/region of Scania, southern Sweden, are associated and if such associations between these factors differ when studying them at county or city level. To perform this study we used high-resolution census data and modelled the annual exposure to NO2 using an emission database, a dispersion modelling program and a geographical information system (GIS). RESULTS: The results from this study confirm that socio-economic status and the levels of NO2 in the area of residence are associated in some cities. The associations vary considerably between cities within the same county (Scania). Even for cities of similar sizes and population bases the associations observed are different. Studying the cities together or separately yields contradictory results, especially when education is used as a socio-economic indicator. CONCLUSION: Four conclusions have been drawn from the results of this study. 1) Adjusting for socio-economy is important when investigating the health effects of air pollution. 2) The county of Scania seems to be heterogeneous regarding the association between air pollution and socio-economy. 3) The relationship between air pollution and socio-economy differs in the five cities included in our study, depending on whether they are analysed separately or together. It is therefore inadvisable to determine and analyse associations between socio-economy and exposure to air pollutants on county level. This study indicates that the size and choice of study area is of great importance. 4) The selection of socio-economic indices (in this study: country of birth and education level) is important.
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| 5. |
- Wennerholm, Carina, et al.
(författare)
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Cardiovascular disease occurrence in two close but different social environments
- 2011
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Ingår i: International Journal of Health Geographics. - : BioMed Central. - 1476-072X. ; 10:5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cardiovascular diseases estimate to be the leading cause of death and loss of disability-adjusted life years globally. Conventional risk factors for cardiovascular diseases only partly account for the social gradient. The purpose of this study was to compare the occurrence of the most frequent cardiovascular diseases and cardiovascular mortality in two close cities, the Twin cities. Methods: We focused on the total population in two neighbour and equally sized cities with a population of around 135 000 inhabitants each. These twin cities represent two different social environments in the same Swedish county. According to their social history they could be labelled a "blue-collar" and a "white-collar" city. Morbidity data for the two cities was derived from an administrative health care register based on medical records assigned by the physicians at both hospitals and primary care. The morbidity data presented are cumulative incidence rates and the data on mortality for ischemic heart diseases is based on official Swedish statistics. Results: The cumulative incidence of different cardiovascular diagnoses for younger and also elderly men and women revealed significantly differences for studied cardiovascular diagnoses. The occurrence rates were in all aspects highest in the population of the "blue-collar" twin city for both sexes. Conclusions: This study revealed that there are significant differences in risk for cardiovascular morbidity and mortality between the populations in the studied different social environments. These differences seem to be profound and stable over time and thereby give implication for public health policy to initiate a community intervention program in the "blue-collar" twin city.
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| 6. |
- Dambach, Peter, et al.
(författare)
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Utilization of combined remote sensing techniques to detect environmental variables influencing malaria vector densities in rural West Africa
- 2012
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Ingår i: International Journal of Health Geographics. - London : BioMed Central (BMC). - 1476-072X. ; 11, s. 8-
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The use of remote sensing has found its way into the field of epidemiology within the last decades. With the increased sensor resolution of recent and future satellites new possibilities emerge for high resolution risk modeling and risk mapping. Methods: A SPOT 5 satellite image, taken during the rainy season 2009 was used for calculating indices by combining the image's spectral bands. Besides the widely used Normalized Difference Vegetation Index (NDVI) other indices were tested for significant correlation against field observations. Multiple steps, including the detection of surface water, its breeding appropriateness for Anopheles and modeling of vector imagines abundance, were performed. Data collection on larvae, adult vectors and geographic parameters in the field, was amended by using remote sensing techniques to gather data on altitude (Digital Elevation Model = DEM), precipitation (Tropical Rainfall Measurement Mission = TRMM), land surface temperatures (LST). Results: The DEM derived altitude as well as indices calculations combining the satellite's spectral bands (NDTI = Normalized Difference Turbidity Index, NDWI Mac Feeters = Normalized Difference Water Index) turned out to be reliable indicators for surface water in the local geographic setting. While Anopheles larvae abundance in habitats is driven by multiple, interconnected factors - amongst which the NDVI - and precipitation events, the presence of vector imagines was found to be correlated negatively to remotely sensed LST and positively to the cumulated amount of rainfall in the preceding 15 days and to the Normalized Difference Pond Index (NDPI) within the 500 m buffer zone around capture points. Conclusions: Remotely sensed geographical and meteorological factors, including precipitations, temperature, as well as vegetation, humidity and land cover indicators could be used as explanatory variables for surface water presence, larval development and imagines densities. This modeling approach based on remotely sensed information is potentially useful for counter measures that are putting on at the environmental side, namely vector larvae control via larviciding and water body reforming.
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| 7. |
- Grodzinsky, Ewa, et al.
(författare)
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Could gastrointestinal disorders differ in two close but divergent social environments?
- 2012
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Ingår i: International Journal of Health Geographics. - : BioMed Central. - 1476-072X. ; 11:5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Many public health problems in modern society affect the gastrointestinal area. Knowledge of the disease occurrence in populations is better understood if viewed in a psychosocial context including indicators of the social environment where people spend their lives. The general aim of this study was to estimate the occurrence in the population and between sexes of common gastrointestinal conditions in two neighborhood cities representing two different social environments defined as a "white-collar" and a "blue-collar" city. less thanbrgreater than less thanbrgreater thanMethods: We conducted a retrospective register study using data of diagnosed gastrointestinal disorders (cumulative incidence rates) derived from an administrative health care register based on medical records assigned by the physicians at hospitals and primary care. less thanbrgreater than less thanbrgreater thanResults: Functional gastrointestinal diseases and peptic ulcers were more frequent in the white-collar city, while diagnoses in the gallbladder area were significantly more frequent in the blue-collar city. Functional dyspepsia, irritable bowel syndrome, and unspecified functional bowel diseases, and celiac disease, were more frequent among women while esophageal reflux, peptic ulcers, gastric and rectal cancers were more frequent among men regardless of social environment. less thanbrgreater than less thanbrgreater thanConclusions: Knowledge of the occurrence of gastrointestinal problems in populations is better understood if viewed in a context were the social environment is included. Indicators of the social environment should therefore also be considered in future studies of the occurrence of gastrointestinal problems.
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| 9. |
- Huerta Munoz, Ulises, 1981-, et al.
(författare)
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Geographical accessibility and spatial coverage modeling of the primary health care network in the Western Province of Rwanda
- 2012
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Ingår i: International Journal of Health Geographics. - 1476-072X. ; 11:1, s. 40-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Primary health care is essential in improving and maintaining the health of populations. It has the potential to accelerate achievement of the Millennium Development Goals and fulfill the "Health for All" doctrine of the Alma-Ata Declaration. Understanding the performance of the health system from a geographic perspective is important for improved health planning and evidence-based policy development. The aims of this study were to measure geographical accessibility, model spatial coverage of the existing primary health facility network, estimate the number of primary health facilities working under capacity and the population underserved in the Western Province of Rwanda.METHODS:This study uses health facility, population and ancillary data for the Western Province of Rwanda. Three different travel scenarios utilized by the population to attend the nearest primary health facility were defined with a maximum travelling time of 60 minutes: Scenario 1 - waking; Scenario 2 - walking and cycling; and Scenario 3 - walking and public transportation. Considering these scenarios, a raster surface of travel time between primary health facilities and population was developed. To model spatial coverage and estimate the number of primary health facilities working under capacity, the catchment area of each facility was calculated by taking into account population coverage capacity, the population distribution, the terrain topography and the travelling modes through the different land categories.RESULTS: Scenario 2 (walking and cycling) has the highest degree of geographical accessibility followed by Scenario 3 (walking and public transportation). The lowest level of accessibility can be observed in Scenario 1 (walking). The total population covered differs depending on the type of travel scenario. The existing primary health facility network covers only 26.6 % of the population in Scenario 1. In Scenario 2, the use of a bicycle greatly increases the population being served to 58 % of inhabitants. When considering Scenario 3, the total population served is 34.3 %.CONCLUSIONS: Significant spatial variations in geographical accessibility and spatial coverage were observed across the three travel scenarios. The analysis demonstrates that regardless of which travel scenario is used, the majority of the population in the Western Province does not have access to the existing primary health facility network. Our findings also demonstrate the usefulness of GIS methods to leverage multiple datasets from different sources in a spatial framework to provide support to evidence-based planning and resource allocation decision-making in developing countries.
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| 10. |
- Louis, Valérie R, et al.
(författare)
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Modeling tools for dengue risk mapping - a systematic review
- 2014
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Ingår i: International Journal of Health Geographics. - 1476-072X. ; 13
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Forskningsöversikt (refereegranskat)abstract
- INTRODUCTION: The global spread and the increased frequency and magnitude of epidemic dengue in the last 50 years underscore the urgent need for effective tools for surveillance, prevention, and control. This review aims at providing a systematic overview of what predictors are critical and which spatial and spatio-temporal modeling approaches are useful in generating risk maps for dengue.METHODS: A systematic search was undertaken, using the PubMed, Web of Science, WHOLIS, Center for Disease Control (CDC) and OvidSP databases for published citations, without language or time restrictions. A manual search of the titles and abstracts was carried out using predefined criteria, notably the inclusion of dengue cases. Data were extracted for pre-identified variables, including the type of predictors and the type of modeling approach used for risk mapping.RESULTS: A wide variety of both predictors and modeling approaches was used to create dengue risk maps. No specific patterns could be identified in the combination of predictors or models across studies. The most important and commonly used predictors for the category of demographic and socio-economic variables were age, gender, education, housing conditions and level of income. Among environmental variables, precipitation and air temperature were often significant predictors. Remote sensing provided a source of varied land cover data that could act as a proxy for other predictor categories. Descriptive maps showing dengue case hotspots were useful for identifying high-risk areas. Predictive maps based on more complex methodology facilitated advanced data analysis and visualization, but their applicability in public health contexts remains to be established.CONCLUSIONS: The majority of available dengue risk maps was descriptive and based on retrospective data. Availability of resources, feasibility of acquisition, quality of data, alongside available technical expertise, determines the accuracy of dengue risk maps and their applicability to the field of public health. A large number of unknowns, including effective entomological predictors, genetic diversity of circulating viruses, population serological profile, and human mobility, continue to pose challenges and to limit the ability to produce accurate and effective risk maps, and fail to support the development of early warning systems.
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