scholarly journals A comparison of the World Health Organisation's HEAT model results using a non-linear physical activity dose response function with results from the existing tool

2022 ◽  
Vol 7 ◽  
pp. 7
Author(s):  
Robert Smith ◽  
Chloe Thomas ◽  
Hazel Squires ◽  
Elizabeth Goyder

IntroductionThe WHO-Europe’s Health Economic Assessment Tool is a tool used to estimatethe costs and benefits of changes in walking and cycling. Due to data limitationsthe tool’s physical activity module assumes a linear dose response relationship be-tween physical activity and mortality.MethodsThis study estimates baseline population physical activity distributions for 44 coun-tries included in the HEAT. It then compares, for three different scenarios, the re-sults generated by the current method, using a linear dose-response relationship,with results generated using a non-linear dose-response relationship.ResultsThe study finds that estimated deaths averted are relatively higher (lower) using thenon-linear effect in countries with less (more) active populations. This difference islargest for interventions which affect the activity levels of the least active the most.Since more active populations, e.g. in Eastern Europe, also tend to have lowerValue of a Statistical Life estimates the net monetary benefit estimated by the sce-narios are much higher in western-Europe than eastern-Europe.ConclusionsUsing a non-linear dose response function results in materially different estimateswhere populations are particularly inactive or particularly active. Estimating base-line distributions is possible with limited additional data requirements, although themethod has yet to be validated. Given the significant role of the physical activitymodule within the HEAT tool it is likely that in the evaluation of many interventionsthe monetary benefit estimates will be sensitive to the choice of the physical activitydose response function.

2015 ◽  
Vol 19 (8) ◽  
pp. 1446-1456 ◽  
Author(s):  
Nai-Hui Sun ◽  
Xuan-Zhang Huang ◽  
Shuai-Bo Wang ◽  
Yuan Li ◽  
Long-Yi Wang ◽  
...  

AbstractObjectiveThe current meta-analysis evaluated the association between vitamin B12 intake and blood vitamin B12 level and colorectal cancer (CRC) risk.DesignThe PubMed and EMBASE databases were searched. A dose–response analysis was performed with generalized least squares regression, with the relative risk (RR) and 95 % CI as effect values.SettingThe meta-analysis included seventeen studies.SubjectsA total of 10 601 patients.ResultsThe non-linear dose–response relationship between total vitamin B12 intake and CRC risk was insignificant (P=0·690), but the relationship between dietary vitamin B12 intake and CRC risk was significant (P<0·001). Every 4·5 μg/d increment in total and dietary vitamin B12 intake was inversely associated with CRC risk (total intake: RR=0·963; 95 % CI 0·928, 0·999; dietary intake: RR=0·914; 95 % CI 0·856, 0·977). The inverse association between vitamin B12 intake and CRC risk was also significant when vitamin B12 intake was over a dosage threshold, enhancing the non-linear relationship. The non-linear dose–response relationship between blood vitamin B12 level and CRC risk was insignificant (P=0·219). There was an insignificant association between every 150 pmol/l increment in blood vitamin B12 level and CRC risk (RR=1·023; 95 % CI 0·881, 1·187).ConclusionsOur meta-analysis indicates that evidence supports the use of vitamin B12 for cancer prevention, especially among populations with high-dose vitamin B12 intake, and that the association between CRC risk and total vitamin B12 intake is stronger than between CRC risk and dietary vitamin B12 intake only.


BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Qing Su ◽  
Xiaohui Sun ◽  
Liwen Zhu ◽  
Qin Yan ◽  
Peiwen Zheng ◽  
...  

Abstract Background The aim of this study was to quantitatively summarize the available evidence on the association of breastfeeding with the risk of childhood cancer. Methods A literature search of PubMed and Embase databases was performed to identify eligible observational studies published from inception to July 17, 2020. The categorical and dose-response meta-analysis was conducted by pooling relative risk (RR) or odds ratio (OR) estimates with 95% confidence intervals (CIs). Potential sources of heterogeneity were detected by meta-regression and stratification analysis. Sensitivity analysis and publication bias test were also carried out. Results Forty-five articles involving 475,579 individuals were included in the meta-analysis. Among the thirty-three studies on the association between breastfeeding and risk of childhood leukemia, the pooled risk estimates were 0.77 (95% CI, 0.65–0.91) and 0.77 (95% CI 0.63–0.94) for ever versus non/occasional breastfeeding and longest versus shortest breastfeeding duration group, respectively. There was clear indication for non-linear dose-response relationship between breastfeeding duration and the risk of childhood leukemia (P non-linear < 0.001). The most protective effect (OR, 0.66, 95% CI 0.62–0.70) was observed at a breastfeeding duration of 9.6 months. Four studies examined, the association between breastfeeding and risk of childhood neuroblastoma, and significant inverse associations were consistently observed in both the comparisons of ever breastfeeding versus non/occasional breastfeeding (OR = 0.59, 95% CI 0.44–0.81) and longest versus shortest breastfeeding (OR = 0.61, 95% CI 0.44–0.83). However, no associations of breastfeeding with risk of other cancers were found. Conclusions Our study supports a protective role of breastfeeding on the risk of childhood leukemia, also suggesting a non-linear dose-response relationship. Further studies are warranted to confirm the association between breastfeeding and risk of childhood neuroblastoma.


2021 ◽  
Vol 2 ◽  
Author(s):  
Li Li ◽  
Dingsheng Li

Current life cycle impact assessment (LCIA) practices use a characterization factor to linearly scale chemical emission to human health impact assuming a homogeneous exposure and toxicological susceptibility for the entire population. However, both exposure and toxicological susceptibility may vary within the population, making the same emission elicit disproportionate impacts. Here we explore how inter-individual variabilities in human exposure and toxicological susceptibility interact to affect the estimated overall health impacts on the population level. For exemplification, we use the PROTEX model to simulate the exposure of the general American population to dieldrin and heptachlor, two organochlorine pesticides that tend to accumulate in food items. Using a Monte-Carlo analysis, we characterize inter-individual variabilities in exposure by considering variations in anthropometrics and dietary patterns between ages, sexes, and racial groups. We assess the overall health impact on the population level in five scenarios with different combinations of assumptions in exposure (homogeneous/heterogeneous) and the dose-response relationship (linear/non-linear, homogeneous/heterogeneous susceptibility). Our results indicate human exposure can vary by a factor of six among the different demographic groups. Combined with a non-linear dose-response relationship with heterogeneous susceptibility, the estimated overall health impact is substantially higher than the results using homogeneous susceptibility. However, the current LCIA practice of using a linear dose-response relationship produces even higher results that may overestimate the health impacts.


2014 ◽  
Vol 7 (5) ◽  
pp. 701-708 ◽  
Author(s):  
Kasper Andersen ◽  
Daniela Mariosa ◽  
Hans-Olov Adami ◽  
Claes Held ◽  
Erik Ingelsson ◽  
...  

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Dan-Hong Wei ◽  
Qi-Qi Mao

Abstract Background Nutrients involved in one-carbon metabolism may play a key role in pancreatic carcinogenesis. The aim of this study was to examine the association between pancreatic cancer risk and intake or blood levels of vitamins B6, B12 and methionine via meta-analysis. Methods A systematic search was performed in PubMed, Web of Knowledge and Chinese National Knowledge Infrastructure (CNKI) up to April 2020 to identify relevant studies. Risk estimates and their 95% confidence intervals (CIs) were retrieved from the studies and combined by a random-effect model. Results A total of 18 studies were included in this meta-analysis on the association of vitamin B6, B12 and methionine with pancreatic cancer risk. The combined risk estimate (95% CI) of pancreatic cancer for the highest vs lowest category of vitamin B6 intake and blood pyridoxal 5′-phosphate (PLP, active form of vitamin B6) levels was 0.63 (0.48–0.79) and 0.65 (0.52–0.79), respectively. The results indicated a non-linear dose-response relationship between vitamin B6 intake and pancreatic risk. Linear dose–response relationship was found, and the risk of pancreatic cancer decreased by 9% for every 10 nmol/L increment in blood PLP levels. No significant association were found between pancreatic cancer risk and vitamin B12 intake, blood vitamin B12 levels, methionine intake and blood methionine levels. Conclusion Our study suggests that high intake of vitamin B6 and high concentration of blood PLP levels may be protective against the development of pancreatic cancer. Further research are warranted to confirm the results.


2018 ◽  
Vol 269 ◽  
pp. 258-263 ◽  
Author(s):  
Sun-Young Kim ◽  
Sang-Won Jeon ◽  
Dong-Won Shin ◽  
Kang-Seob Oh ◽  
Young-Chul Shin ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document