scholarly journals Investigating the impact of London’s Ultra Low Emission Zone on children’s health: Children’s Health in London and Luton (CHILL): Protocol for a prospective parallel cohort study

2021 ◽  
Author(s):  
Grainne Colligan ◽  
Ivelina Tsocheva ◽  
James Scales ◽  
Jasmine Chavda ◽  
Rosamund Dove ◽  
...  
Keyword(s):  
Public Health ◽  
Air Pollution ◽  
Cohort Study ◽  
Air Quality ◽  
Respiratory Health ◽  
Children's Health ◽  
Children’S Health ◽  
List Type ◽  
Low Emission ◽  
The Impact

AbstractIntroductionAir pollution harms health across the life course. Children are at particular risk of adverse effects during development, which may impact on health in later life. Interventions that improve air quality are therefore urgently needed not only to improve public health now, but to prevent longer-term increased vulnerability to chronic disease. Low Emission Zones are a public health policy intervention aimed at reducing traffic-derived contributions to urban air pollution, but evidence that they deliver clear health benefits is lacking. We established a natural experiment design study (CHILL: Children’s Health in London and Luton) to evaluate the impacts of the introduction of London’s Ultra Low Emission Zone (ULEZ) on children’s health.Methods and analysisCHILL is a prospective two-arm parallel longitudinal cohort study of children aged 6-9 years, attending primary schools in Central London (the focus of the first phase of the ULEZ) and Luton (a comparator site). The primary goal of the study is to examine the impact of changes in annual air pollutant exposures as oxides of nitrogen, nitrogen dioxide, particulate matter less than 2.5microns and 10microns (NOx, NO2, PM2.5, PM10 respectively) across the two sites on lung growth, measured as forced expiratory volume in one second (FEV1) and forced vital capacity (FVC), over four consecutive years. Secondary outcomes being investigated include a range of respiratory health indicators as well as inequality and health economic measures.Ethics and disseminationEthics approval has been given by Queen Mary University of London Research Ethics Committee (ref 2018/08). Dissemination will target audiences through a variety of channels, including research papers, conference and media presentations, web summaries and social media. CHILL is funded by National Institute for Health Research (NIHR) Public Health Research (Ref 16/139/09) with additional funding by Natural Environment Research Council, NIHR CLAHRC North Thames, NIHR ARC North Thames, and the Mayor of London. ClinicalTrials.gov: NCT04695093Strengths and limitations of this studyStrengthsCHILL uses a prospective parallel cohort design, allowing robust conclusions to be drawn on the impact of the ULEZ - a major city-wide air quality mitigation strategy - on air quality and children’s respiratory health.CHILL study cohorts include children from large and ethnically diverse populations living in urban areas characterised by poor air quality.LimitationsAttrition of study cohort population over time, although this has been accounted for in the original design of the study.Potential diminution of the ULEZ air pollution signal due to pre-compliance with ULEZ restrictions in the run up to the introduction of the scheme in Central London on the 8th April 2019, and minor impacts of other pollution mitigation measures.Added complexity of accounting for effects of COVID-19 and related lockdowns on traffic flows, air quality and children’s health.

scholarly journals Gender Differences in Association between Air Pollution and Daily Mortality in the Capital of the Green Lungs of Poland–Population-Based Study with 2,953,000 Person-Years of Follow-Up

2020 ◽  
Vol 9 (8) ◽  
pp. 2351
Author(s):  
Łukasz Kuźma ◽  
Krzysztof Struniawski ◽  
Szymon Pogorzelski ◽  
Hanna Bachórzewska-Gajewska ◽  
Sławomir Dobrzycki
Keyword(s):  
Public Health ◽  
Gender Differences ◽  
Air Pollution ◽  
Air Quality ◽  
Air Pollutant ◽  
World Health ◽  
The European Union ◽  
Daily Mortality ◽  
Male Population ◽  
The Impact

(1) Introduction: air pollution is considered to be one of the main risk factors for public health. According to the European Environment Agency (EEA), air pollution contributes to the premature deaths of approximately 500,000 citizens of the European Union (EU), including almost 5000 inhabitants of Poland every year. (2) Purpose: to assess the gender differences in the impact of air pollution on the mortality in the population of the city of Bialystok—the capital of the Green Lungs of Poland. (3) Materials and Methods: based on the data from the Central Statistical Office, the number—and causes of death—of Białystok residents in the period 2008–2017 were analyzed. The study utilized the data recorded by the Provincial Inspectorate for Environmental Protection station and the Institute of Meteorology and Water Management during the analysis period. Time series regression with Poisson distribution was used in statistical analysis. (4) Results: A total of 34,005 deaths had been recorded, in which women accounted for 47.5%. The proportion of cardiovascular-related deaths was 48% (n = 16,370). An increase of SO2 concentration by 1-µg/m3 (relative risk (RR) 1.07, 95% confidence interval (CI) 1.02–1.12; p = 0.005) and a 10 °C decrease of temperature (RR 1.03, 95% CI 1.01–1.05; p = 0.005) were related to an increase in the number of daily deaths. No gender differences in the impact of air pollution on mortality were observed. In the analysis of the subgroup of cardiovascular deaths, the main pollutant that was found to have an effect on daily mortality was particulate matter with a diameter of 2.5 μm or less (PM2.5); the RR for 10-µg/m3 increase of PM2.5 was 1.07 (95% CI 1.02–1.12; p = 0.01), and this effect was noted only in the male population. (5) Conclusions: air quality and atmospheric conditions had an impact on the mortality of Bialystok residents. The main air pollutant that influenced the mortality rate was SO2, and there were no gender differences in the impact of this pollutant. In the male population, an increased exposure to PM2.5 concentration was associated with significantly higher cardiovascular mortality. These findings suggest that improving air quality, in particular, even with lower SO2 levels than currently allowed by the World Health Organization (WHO) guidelines, may benefit public health. Further studies on this topic are needed, but our results bring questions whether the recommendations concerning acceptable concentrations of air pollutants should be stricter, or is there a safe concentration of SO2 in the air at all.

scholarly journals 475Machine learning approach: identifying the impact of heatwaves and air quality on children’s health

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Dimpalben Patel ◽  
Le Jian ◽  
JianGuo Xiao ◽  
Janis Jansz ◽  
Grace Yun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Air Quality ◽  
Mean Squared Error ◽  
Age Groups ◽  
Children's Health ◽  
Children’S Health ◽  
Percentage Increase ◽  
Health Events ◽  
The Impact ◽  
Geographical Locations

Abstract Background Heatwaves, air pollution and their effects on children’s health can vary temporally and spatially. With the emergence of advanced methods such as machine learning, there is an opportunity to improve prediction of children’s health events associated with those exposures. Methods Daily records on emergency department attendances (EDA) for children <15 years, heatwaves, landscape fire burns and air pollutants (CO, SO2, NO2, O3, PM10, PM2.5) were collected for Western Australia, 2006-2015. Decision tree, random forest (RF) and geographical RF (GRF) were compared to predict EDA, identify important risk factors and locations at elevated risk. Validation was performed by comparing actual and predicted EDA. Results RF was the best model with the lowest root mean squared error (MSE). The best RF validation model had an r-squared (R2) =0.95. The percentage increase in MSE indicated that PM10 and PM2.5 were important predictors of EDA for all children. Number of burns was more important in 5-9 year age group than other groups. GRF models (R2 0.90-0.98) showed that heatwave and PM2.5 were the important predictors in southern part of the study area for all age groups. Conclusions The importance of risk factors to predict EDA was varied by age groups and locations. Such differences are important when developing targeted health promotion strategies tailored to age groups and geographical locations. Key messages RF predicted EDA better than other models. Evaluation of spatial variation of heatwave and air quality effects on EDA for children by GRF modelling is useful to identify at risk geographical locations.

scholarly journals The Impact of Children's Public Health Insurance Expansions on Educational Outcomes

2009 ◽  
Vol 12 (1) ◽  
Author(s):  
Phillip B Levine ◽  
Diane Schanzenbach
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
Health Status ◽  
Educational Outcomes ◽  
Test Scores ◽  
Children's Health ◽  
Public Health Insurance ◽  
Children’S Health ◽  
Percentage Point Increase ◽  
The Impact

This paper examines the impact of public health insurance expansions through both Medicaid and SCHIP on children's educational outcomes, measured by 4th and 8th grade reading and math test scores, available from the National Assessment of Educational Progress (NAEP). We use a triple difference estimation strategy, taking advantage of the cross-state variation over time and across ages in children's health insurance eligibility. Using this approach, we find that test scores in reading, but not math, increased for those children affected at birth by increased health insurance eligibility. A 50 percentage point increase in eligibility is found to increase reading test scores by 0.09 standard deviations. We also examine whether the improvements in educational outcomes can be at least partially attributed to improvements in health status itself. First, we provide further evidence that increases in eligibility are linked to improvements in health status at birth. Second, we show that better health status at birth (measured by rates of low birth-weight and infant mortality), is linked to improved educational outcomes. Although the methods used to support this last finding do not completely eliminate potentially confounding factors, we believe it is strongly suggestive that improving children's health will improve their classroom performance.

scholarly journals An overview of indoor air quality and its impact on respiratory health among Malaysian school-aged children

2014 ◽  
Vol 0 (0) ◽  
Author(s):  
Chua Poh Choo ◽  
Juliana Jalaludin
Keyword(s):  
Air Pollution ◽  
Air Quality ◽  
Indoor Air Quality ◽  
Indoor Air ◽  
Indoor Air Pollution ◽  
Prolonged Exposure ◽  
Respiratory Health ◽  
Epidemiologic Studies ◽  
School Aged Children ◽  
The Impact

AbstractThe indoor environment is a major source of human exposure to pollutants. Some pollutants can have concentrations that are several times higher indoors than outdoors. Prolonged exposure may lead to adverse biologic effects, even at low concentrations. Several studies done in Malaysia had underlined the role of indoor air pollution in affecting respiratory health, especially for school-aged children. A critical review was conducted on the quantitative literature linking indoor air pollution with respiratory illnesses among school-aged children. This paper reviews evidence of the association between indoor air quality (IAQ) and its implications on respiratory health among Malaysian school-aged children. This review summarizes six relevant studies conducted in Malaysia for the past 10 years. Previous epidemiologic studies relevant to indoor air pollutants and their implications on school-aged children’s respiratory health were obtained from electronic database and included as a reference in this review. The existing reviewed data emphasize the impact of IAQ parameters, namely, indoor temperature, ventilation rates, indoor concentration of carbon dioxide (CO

scholarly journals Fuel choice, indoor air pollution and children's health

2012 ◽  
Vol 17 (4) ◽  
pp. 379-406 ◽  
Author(s):  
John H. Y. Edwards ◽  
Christian Langpap
Keyword(s):  
Air Pollution ◽  
Developing Countries ◽  
Indoor Air ◽  
Indoor Air Pollution ◽  
Construction Materials ◽  
Children's Health ◽  
Children’S Health ◽  
Housing Construction ◽  
The Impact ◽  
Gas Stoves

AbstractMuch of the population in developing countries uses firewood for cooking. The resulting indoor air pollution has severe health consequences for children who are close to the fire while their mothers cook. We use survey data from Guatemala to examine the effects of firewood consumption on the health of children up to five years of age. We also investigate the impact of cooking inside the home, the importance of a mother cooking while caring for her children and the role played by the smoke permeability of housing construction materials. We find that children living in households that use more wood, and where exposure to indoor air pollution is higher because the mother cooks while caring for children or because cooking takes place inside, are more likely to have symptoms of respiratory infection. Simulations indicate that policies that target cooking habits in order to directly reduce exposure, particularly by reducing the number of women who simultaneously cook and care for children, may be more effective for improving young children's health than policies to accelerate the adoption of gas stoves.

scholarly journals The Impact of the COVID-19 Pandemic on Child Health and Well-Being: Are Children “Slipping through the Net”? A Qualitative Study of Frontline Emergency Care Staff

2021 ◽  
Author(s):  
Ciara Conlon ◽  
Thérèse McDonnell ◽  
Michael Barrett ◽  
Fergal Cummins ◽  
Conor Deasy ◽  
...  
Keyword(s):  
Public Health ◽  
Qualitative Study ◽  
Children's Health ◽  
Care Staff ◽  
Children’S Health ◽  
Frontline Staff ◽  
Health And Wellbeing ◽  
Paediatric Emergency ◽  
Health And Social Care ◽  
The Impact

Abstract BackgroundThe COVID-19 pandemic and subsequent public health guidance to reduce the spread of the disease have wide-reaching implications for children’s health and wellbeing. Furthermore, paediatric emergency departments (EDs) have rapidly adapted provision of care in response to the pandemic. This qualitative study utilized insight from multidisciplinary frontline staff to understand 1) the changes in paediatric emergency healthcare utilization during COVID-19 2) the experiences of working within the restructured health system. MethodsFifteen semi-structured interviews were conducted with frontline staff working in two paediatric EDs and two mixed adult and children EDs. Participants included emergency medicine clinicians (n = 5), nursing managerial staff (n=6), social workers (n=2) and nursing staff (n = 2). Thematic Analysis (TA) was applied to the data to identify key themes. ResultsThe pandemic and public health restrictions have had an adverse impact on children’s health and psychosocial wellbeing, compounded by difficulty in accessing primary and community services. The impact may have been more acute for children with disabilities and chronic health conditions and has raised child protection issues for vulnerable children. EDs have shown innovation and agility in the structural and operational changes they have implemented to continue to deliver care to children, however resource limitations and other challenges must be addressed to ensure high quality care delivery and protect the wellbeing of those tasked with delivering this care.Conclusions The spread of COVID-19 and subsequent polices to address the pandemic has had wide-reaching implications for children’s health and wellbeing. The interruption to health and social care services is manifesting in myriad ways in the ED, such as a rise in psychosocial presentations. As the pandemic continues to progress, policy makers and service providers must ensure the continued provision of essential health and social services, including targeted responses for those with existing conditions.

Study on the Relationship between Indoor Air Quality and Children's Health in Beijing

2013 ◽  
Vol 368-370 ◽  
pp. 525-530 ◽  
Author(s):  
Na Cui ◽  
Jing Chao Xie ◽  
Wen Yue Bian ◽  
Hiroshi Yoshino ◽  
U Yanagi ◽  
...  
Keyword(s):  
Air Pollution ◽  
Health Status ◽  
Air Quality ◽  
Indoor Air Quality ◽  
Indoor Air ◽  
Indoor Environment ◽  
General Information ◽  
Living Environment ◽  
Children's Health ◽  
Children’S Health

Indoor air quality (IAQ) has been concerned since 1970s in some western countries. Many researchers have studied the effects of air pollution on children's health and evidence suggested that it did contribute significantly to the risk of adverse health in children. Children spend the majority of their time indoors, mostly at home. To study health effects of long-term exposure to indoor air, we conducted a questionnaire survey about indoor environment and children's health status in 2012 on the 4-5 grades children of a primary school in Beijing. The questionnaire was used to collect data on general information of children, living environment, residential equipments and lifestyle and children's health status. We classified the investigated families into several categories according to residential surrounding air pollution, decoration and smoking. Then we observed respiratory symptoms like cough, dyspnea with phlegm, nasal obstruction, asthma and some allergy symptoms in different categories. The results of this survey suggest that indoor air quality is associated with children's health. Morbidity of children's respiratory system symptoms and some allergy symptoms is higher in relatively poor indoor environment.

scholarly journals Public health services: implementation of healthcare technologies

2020 ◽  
Vol 1 (1) ◽  
pp. 84-92
Author(s):  
Andrii Shipko ◽  
Serhii Shklyar ◽  
Oleksii Demikhov ◽  
Henryk Dzwigol
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Primary Prevention ◽  
Health Services ◽  
Health Management ◽  
Significant Risk ◽  
Children's Health ◽  
Children’S Health ◽  
Public Health Services ◽  
The Impact

This paper summarizes the arguments and counterarguments within the scientific discussion on the factors that influence public health service. The main purpose of this research is to determine the expected indicators of pathogenic and sanogenic effects on significant risk factors of pathology among children. For achieving the research goal, the authors substantiated the models of final results for the modification of risk factors. Investigation of antenatal and genealogical factors in healthy and ill children groups was performed using a specially compiled expert assessment card and parents’ interviews. The systemic population modeling methods were applied to develop and substantiate population health management models (early diagnosis and primary prevention). Evaluation of the expected effectiveness of the N-factor program of primary prevention was carried out on a set of genealogical and antenatal factors. Conducted logical analysis of the methodology of quantitative and qualitative determination of health and the gathered experience in that respect were taken into account in developing population models of preventive effects. This study provides the identified priority directions for realizing the regional and population programs to implement them further. The authors presented the example of calculating the expected effectiveness of children’s health management by eliminating the investigated factors. The authors determine the priority directions for realizing the regional and population programs pathology based on the influence on the various elements to improve the public health services system. An example of calculating the expected effectiveness of children’s health management by eliminating these factors is given. The obtained results could be used to further research the issues associated with a prospective assessment of the program’s effectiveness in reducing the impact of antenatal and genealogical factors on children’s health.

scholarly journals The impact of the COVID-19 pandemic on child health and the provision of Care in Paediatric Emergency Departments: a qualitative study of frontline emergency care staff

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ciara Conlon ◽  
Thérèse McDonnell ◽  
Michael Barrett ◽  
Fergal Cummins ◽  
Conor Deasy ◽  
...  
Keyword(s):  
Public Health ◽  
Qualitative Study ◽  
Emergency Departments ◽  
Children's Health ◽  
Children’S Health ◽  
Frontline Staff ◽  
Health And Wellbeing ◽  
Paediatric Emergency ◽  
Provision Of Care ◽  
The Impact

Abstract Background The COVID-19 pandemic and subsequent public health guidance to reduce the spread of the disease have wide-reaching implications for children’s health and wellbeing. Furthermore, paediatric emergency departments (EDs) have rapidly adapted provision of care in response to the pandemic. This qualitative study utilized insight from multidisciplinary frontline staff to understand 1) the changes in paediatric emergency healthcare utilization during COVID-19 2) the experiences of working within the restructured health system. Methods Fifteen semi-structured interviews were conducted with frontline staff working in two paediatric EDs and two mixed adult and children EDs. Participants included emergency medicine clinicians (n = 5), nursing managerial staff (n = 6), social workers (n = 2) and nursing staff (n = 2). Thematic Analysis (TA) was applied to the data to identify key themes. Results The pandemic and public health restrictions have had an adverse impact on children’s health and psychosocial wellbeing, compounded by difficulty in accessing primary and community services. The impact may have been more acute for children with disabilities and chronic health conditions and has raised child protection issues for vulnerable children. EDs have shown innovation and agility in the structural and operational changes they have implemented to continue to deliver care to children, however resource limitations and other challenges must be addressed to ensure high quality care delivery and protect the wellbeing of those tasked with delivering this care. Conclusions The spread of COVID-19 and subsequent policies to address the pandemic has had wide-reaching implications for children’s health and wellbeing. The interruption to health and social care services is manifesting in myriad ways in the ED, such as a rise in psychosocial presentations. As the pandemic continues to progress, policy makers and service providers must ensure the continued provision of essential health and social services, including targeted responses for those with existing conditions.

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