IJERPH, Vol. 15, Pages 626: Health Impacts and Economic Costs of Air Pollution in the Metropolitan Area of Skopje

IJERPH, Vol. 15, Pages 626: Health Impacts and Economic Costs of Air Pollution in the Metropolitan Area of Skopje

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15040626

Authors: Gerardo Martinez Joseph Spadaro Dimitris Chapizanis Vladimir Kendrovski Mihail Kochubovski Pierpaolo Mudu

Background: Urban outdoor air pollution, especially particulate matter, remains a major environmental health problem in Skopje, the capital of the former Yugoslav Republic of Macedonia. Despite the documented high levels of pollution in the city, the published evidence on its health impacts is as yet scarce. Methods: we obtained, cleaned, and validated Particulate Matter (PM) concentration data from five air quality monitoring stations in the Skopje metropolitan area, applied relevant concentration-response functions, and evaluated health impacts against two theoretical policy scenarios. We then calculated the burden of disease attributable to PM and calculated the societal cost due to attributable mortality. Results: In 2012, long-term exposure to PM2.5 (49.2 μg/m3) caused an estimated 1199 premature deaths (CI95% 821–1519). The social cost of the predicted premature mortality in 2012 due to air pollution was estimated at between 570 and 1470 million euros. Moreover, PM2.5 was also estimated to be responsible for 547 hospital admissions (CI95% 104–977) from cardiovascular diseases, and 937 admissions (CI95% 937–1869) for respiratory disease that year. Reducing PM2.5 levels to the EU limit (25 μg/m3) could have averted an estimated 45% of PM-attributable mortality, while achieving the WHO Air Quality Guidelines (10 μg/m3) could have averted an estimated 77% of PM-attributable mortality. Both scenarios would also attain significant reductions in attributable respiratory and cardiovascular hospital admissions. Conclusions: Besides its health impacts in terms of increased premature mortality and hospitalizations, air pollution entails significant economic costs to the population of Skopje. Reductions in PM2.5 concentrations could provide substantial health and economic gains to the city.

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IJERPH, Vol. 15, Pages 625: Farmers’ Willingness to Pay for Health Risk Reductions of Pesticide Use in China: A Contingent Valuation Study

IJERPH, Vol. 15, Pages 625: Farmers' Willingness to Pay for Health Risk Reductions of Pesticide Use in China: A Contingent Valuation Study

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15040625

Authors: Wenyu Wang Jianjun Jin Rui He Haozhou Gong Yuhong Tian

This study aimed to estimate farmers' willingness to pay (WTP) for health risk reductions of pesticide use by applying the contingent valuation method (CVM) and to explore the factors that influence farmers' WTP in China. In total, 244 farmers were randomly selected and interviewed. The mean WTP was estimated to be $65.38 (0.94% of total household income) per household per year for a 5/10,000 reduction in morbidity risk. This study shows that farmers' socioeconomic and attitudinal factors that significantly affect their WTP include farmers' farming income, education, household size and risk perceptions. In particular, the results demonstrate that respondents' social trust, social reciprocity and social networks have significant impacts on their WTP. The findings of this study can provide useful insights for policy makers to design effective policies to address health problems related to pesticide use in the developing world.

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IJERPH, Vol. 15, Pages 627: Recurrent Renal Colic in a Patient with Munchausen Syndrome

IJERPH, Vol. 15, Pages 627: Recurrent Renal Colic in a Patient with Munchausen Syndrome

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15040627

Authors: Francesco Miconi Valentina Rapaccini Emanuela Savarese Gabriele Cabiati Augusto Pasini Giovanni Miconi Nicola Principi Susanna Esposito

Background: In most of the cases regarding children, factitious disorders (FDs) are intentionally produced by parents. Less attention is paid to FDs in which a child or adolescent intentionally induces or falsifies the disease to attain a patient's role. Case presentation: A 13-year-old immigrated and adopted boy previously underwent an operation for renal joint syndrome and was affected by recurrent episodes of renal colic. The boy was admitted reporting acute left flank pain with scars on the mucous face of his prepuce and had a recent previous hospitalization for the same reason. Laboratory tests and radiological findings did not reveal any morphological or functional alterations. Self-induced FD was suspected, and a psychiatric consultation was performed. After psychiatric consultation and remission of the symptoms with a placebo, a diagnosis of Munchausen syndrome was suspected. The patient's uncle was not initially convinced of the diagnosis. Some videos clearly showed that the boy was handling his prepuce to excrete stones, explaining the scars. A therapeutic plan with psychiatrist support was later accepted with a positive outcome. No further signs and symptoms of renal colic were reported. Conclusions: It is recommended that paediatricians include FD in the differential diagnosis of a persistent and unexplained medical condition. If suspicion arises, confirmation and long-term therapy by a group of qualified specialists, including psychiatrists, should be planned.

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Increasing water productivity, nitrogen economy, and grain yield of rice by water saving irrigation and fertilizer-N management

Abstract

The looming water resources worldwide necessitate the development of water-saving technologies in rice production. An open greenhouse experiment was conducted on rice during the summer season of 2016 at Huazhong Agricultural University, Wuhan, China, in order to study the influence of irrigation methods and nitrogen (N) inputs on water productivity, N economy, and grain yield of rice. Two irrigation methods, viz. conventional irrigation (CI) and "thin-shallow-moist-dry" irrigation (TSMDI), and three levels of nitrogen, viz. 0 kg N ha⁻¹ (N₀), 90 kg N ha⁻¹ (N₁), and 180 kg N ha⁻¹ (N₂), were examined with three replications. Study data indicated that no significant water by nitrogen interaction on grain yield, biomass, water productivity, N uptake, NUE, and fertilizer N balance was observed. Results revealed that TSMDI method showed significantly higher water productivity and irrigation water applications were reduced by 17.49% in TSMDI compared to CI. Thus, TSMDI enhanced root growth and offered significantly greater water saving along with getting more grain yield compared to CI. Nitrogen tracer (¹⁵N) technique accurately assessed the absorption and distribution of added N in the soil crop environment and divulge higher nitrogen use efficiency (NUE) influenced by TSMDI. At the same N inputs, the TSMDI was the optimal method to minimize nitrogen leaching loss by decreasing water leakage about 18.63%, which are beneficial for the ecological environment.

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A new approach to the renewable energy-growth nexus: evidence from the USA

Abstract

The climate change is one of the leading problems in the today's world. The rise of the renewable energy meets the sustainable growth objectives since it can decelerate the climate change. For this purpose, this paper investigates the relationship between the renewable energy consumption and the economic growth in the United States (USA). Theoretically, the paper constructs the growth model that captures the effects of the economic complexity indicator as a measure of capabilities and productivity for exporting the "complex" (high value-added) products. Empirically, the paper uses the Autoregressive Distributed Lag (ARDL) estimations and observes that both the economic complexity and the renewable energy consumption lead to a higher rate of economic growth in the USA for the period from 1965 to 2016. The paper also discusses the potential policy implications of the results for achieving the sustainable growth objectives.

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IJERPH, Vol. 15, Pages 624: Patient as a Partner in Healthcare-Associated Infection Prevention

IJERPH, Vol. 15, Pages 624: Patient as a Partner in Healthcare-Associated Infection Prevention

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15040624

Authors: Marta Wałaszek Małgorzata Kołpa Zdzisław Wolak Anna Różańska Jadwiga Wójkowska-Mach

Objectives: The objective of the study was getting to know the knowledge and attitudes towards hand hygiene (HH) among Polish patients and healthcare workers (HCWs). Methods: 459 respondents replied to the survey: 173 (37.6%) patients and 286 (62.3%) HCWs; 57 HCWs were additionally interviewed. Results: Few HCWs knew and used the "5 moments for HH" in the required situations. Both patients and HCWs rated HH of other HCWs poorly: only 75% of patients and 54% of HCWs noticed the application of HH before blood sample collection, but 1/2 of interviewed HCWs did not encounter a request for HH from a patient. According to interviews, 23 (40%) HCWs did not admonish others when they did not use HH. Seventy-five percent of patients and HCWs claimed that, in the past, in schools the toilets were poorly stocked, but the situation improved with the passage of time. Conclusions: There are barriers with resspect to treating patients as partners in HH in Polish hospitals and HCWs' lack of compliance with the "5 moments for HH" significantly reduces patients' safety. Practice implications: Education regarding HH should be conducted for the whole society from an early age: lack of proper supplies in school bathrooms impedes the development of positive HH habits.

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Explaining the accelerated degradation of ciprofloxacin, sulfamethazine, and erythromycin in different soil exposure scenarios by their aqueous extractability

Abstract

Antibiotics are frequently introduced into agricultural soils with the application of sewage sludge or farm organic fertilizers. Repeated exposure of soils to a pollutant can enrich for microbial populations that metabolize the chemical, reducing its environmental persistence. In London, Canada, soils from a long-term field experiment have received different concentrations of antibiotics annually for several years. The purpose of the present study was to assess the bioavailability of sulfamethazine, erythromycin, or ciprofloxacin through aqueous extractions with borax or EDTA solutions and their biodegradation following different soil exposure scenarios. Control soils and soils treated annually in the field with 10 mg antibiotics per kg were sampled, supplemented in the laboratory with radiolabeled antibiotic either added directly or carried in dairy manure. Sulfamethazine and erythromycin were initially more bioavailable than ciprofloxacin, with aqueous extractabilities representing 60, 36, and 8%, respectively. Sulfamethazine and erythromycin were degraded in soils, with a larger fraction mineralized in the long-term exposed soil (20 and 65%, respectively) than in control soil (0.4 and 3%, respectively) after 7 days of incubation. In contrast, ciprofloxacin was not mineralized neither in control nor long-term exposed soils. The mineralized fractions were similar for antibiotics added directly to soil or carried in dairy manure.

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