Improving on estimates of the potential relative harm to health from using modern ENDS (vaping) compared to tobacco smoking

Background Although the harm to health from electronic nicotine delivery systems (ENDS) compared to smoked tobacco remains highly uncertain, society and governments still need to know the likely range of the relative harm to inform regulatory policies for ENDS and smoking. Methods We identified biomarkers with specificity of association with different disease groupings e.g., volatile organic compound (VOCs) for chronic obstructive pulmonary disease; and tobacco-specific N´-nitrosamines (TSNAs) and polycyclic aromatic hydrocarbons (PAHs) for all cancers. We conducted a review of recent studies (post January 2017) that compared these biomarkers between people exclusively using ENDS and those exclusively smoking tobacco. The percentage differences in these biomarkers, weighted by study size and adjusted for acrolein from other sources, were used as a proxy for the assumed percentage difference in disease harm between ENDS and smoking. These relative differences were applied to previously modelled estimates of smoking-related health loss (in health-adjusted life-years; HALYs). Results The respective relative biomarker levels (ENDS vs smoking) were: 28% for respiratory diseases (five results, three studies); 42% for cancers (five results, four studies); and 35% for cardiovascular (seven results, four studies). When integrated with the HALY impacts by disease, the overall harm to health from ENDS was estimated to be 33% that of smoking. Conclusions This analysis, suggests that the use of modern ENDS devices (vaping) could be a third as harmful to health as smoking in a high-income country setting. But this estimate is based on a limited number of biomarker studies and is best be considered a likely upper level of ENDS risk given potential biases in our method (i.e., the biomarkers used being correlated with more unaccounted for toxicants in smoking compared to with using ENDS).

Inequalities in population health loss by multiple deprivation: COVID-19 and pre-pandemic all-cause disability-adjusted life years (DALYs) in Scotland

Background COVID-19 has caused almost unprecedented change across health, education, the economy and social interaction. It is widely understood that the existing mechanisms which shape health inequalities have resulted in COVID-19 outcomes following this same, familiar, pattern. Our aim was to estimate inequalities in the population health impact of COVID-19 in Scotland, measured by disability-adjusted life years (DALYs) in 2020. Our secondary aim was to scale overall, and inequalities in, COVID-19 DALYs against the level of pre-pandemic inequalities in all-cause DALYs, derived from the Scottish Burden of Disease (SBoD) study. Methods National deaths and daily case data were input into the European Burden of Disease Network consensus model to estimate DALYs. Total Years of Life Lost (YLL) were estimated for each area-based deprivation quintile of the Scottish population. Years Lived with Disability were proportionately distributed to deprivation quintiles, based on YLL estimates. Inequalities were measured by: the range, Relative Index of Inequality (RII), Slope Index of Inequality (SII), and attributable DALYs were estimated by using the least deprived quintile as a reference. Results Marked inequalities were observed across several measures. The SII range was 2048 to 2289 COVID-19 DALYs per 100,000 population. The rate in the most deprived areas was around 58% higher than the mean population rate (RII = 1.16), with 40% of COVID-19 DALYs attributed to differences in area-based deprivation. Overall DALYs due to COVID-19 ranged from 7 to 20% of the annual pre-pandemic impact of inequalities in health loss combined across all causes. Conclusion The substantial population health impact of COVID-19 in Scotland was not shared equally across areas experiencing different levels of deprivation. The extent of inequality due to COVID-19 was similar to averting all annual DALYs due to diabetes. In the wider context of population health loss, overall ill-health and mortality due to COVID-19 was, at most, a fifth of the annual population health loss due to inequalities in multiple deprivation. Implementing effective policy interventions to reduce health inequalities must be at the forefront of plans to recover and improve population health.

Study of the impact of gas flaring on communities’ health: methods and participants’ demographics

<p class="abstract">The exploration and production of oil and gas in Nigeria have resulted in gas flaring. This has led to the release of excessive amounts of harmful pollutants possibly leading to ill-health, loss of lives and damage to properties in communities where gas is flared. This has resulted in various studies on the impact of gas flaring on the health of communities. This article described the methodology and demographics of respondents of research in Delta State Nigeria. This research was designed to be a cross-sectional mixed method study. About 500 self-administered questionnaires were distributed to individuals of 18 years and above and the response rate 97.4%. The questionnaire comprised six sections with closed and open-ended questions to ensure objectivity and accuracy of data. Demographic analysis showed that participants comprised 40.1% women, 99.1% reside in 12 oil-producing local government areas (LGA) across Delta State and 69.4% have lived in region for 3-20 years. On occupation, 97.7% work in communities distributed across oil-producing 11 LGAs and 68.2% have worked in the region for 3-20 years. Other participants lived and/or worked in neighbouring communities and states. Participants were well distributed in age groups with 89% consisting of 20-70 years old. Further, respondents comprised 96% who completed secondary or higher and 61.7% classified themselves as middle or upper-class socioeconomic status. The proposal has provision to generate nuanced perspectives of stakeholders. The distribution of respondents indicates satisfactory selection criteria for valid responses to survey questions.</p>

Unhealthy lifestyles, environment, well-being and health capability in rural neighbourhoods: a community-based cross-sectional study

Background Non-communicable diseases are a leading cause of health loss worldwide, in part due to unhealthy lifestyles. Metabolic-based diseases are rising with an unhealthy body-mass index (BMI) in rural areas as the main risk factor in adults, which may be amplified by wider determinants of health. Changes in rural environments reflect the need of better understanding the factors affecting the self-ability for making balanced decisions. We assessed whether unhealthy lifestyles and environment in rural neighbourhoods are reflected into metabolic risks and health capability. Methods We conducted a community-based cross-sectional study in 15 Portuguese rural neighbourhoods to describe individuals’ health functioning condition and to characterize the community environment. We followed a qualitatively driven mixed-method design to gather information about evidence-based data, lifestyles and neighbourhood satisfaction (incorporated in eVida technology), within a random sample of 270 individuals, and in-depth interviews to 107 individuals, to uncover whether environment influence the ability for improving or pursuing heath and well-being. Results Men showed to have a 75% higher probability of being overweight than women (p-value = 0.0954); and the reporting of health loss risks was higher in women (RR: 1.48; p-value = 0.122), individuals with larger waist circumference (RR: 2.21; IC: 1.19; 4.27), overweight and obesity (RR: 1.38; p-value = 0.293) and aged over 75 years (RR: 1.78; p-value = 0.235; when compared with participants under 40 years old). Metabolic risks were more associated to BMI and physical activity than diet (or sleeping habits). Overall, metabolic risk linked to BMI was higher in small villages than in municipalities. Seven dimensions, economic development, built (and natural) environment, social network, health care, demography, active lifestyles, and mobility, reflected the self-perceptions in place affecting the individual ability to make healthy choices. Qualitative data exposed asymmetries in surrounding environments among neighbourhoods and uncovered the natural environment and natural resources specifies as the main value of rural well-being. Conclusions Metabolic risk factors reflect unhealthy lifestyles and can be associated with environment contextual-dependent circumstances. People-centred approaches highlight wider socioeconomic and (natural) environmental determinants reflecting health needs, health expectations and health capability. Our community-based program and cross-disciplinary research provides insights that may improve health-promoting changes in rural neighbourhoods.

The Economic Impacts of Climate Change

Quantifiability of the pecuniary change regarding the climatic change is foreseen yet the ignorable fact of the century. This did not lead to a catastrophic change; however, it paved the path to the change in the governance of the conditions which led to moderate methodologies. This research contrasts directly with the immediate public discussion and greenhouse gas reduction expenditures. These forecasts demonstrate that climate change initially improves economic stability. But these advantages are declining. In the later century, the effects will be more negative. The global average effects will be equivalent in poorer economies to the health loss of a few percent of income. The marginal cost of carbon dioxide pollution is estimated at over two hundred. The social costs of carbon are quite elusive. The estimated price of $50/tc is somewhat lower than in the EU but far higher than the price for carbon elsewhere for a normal discount rate. Current forecasts are incomplete, with optimistic and negative prejudices on harm costs from climate change. The indirect consequences of climate change on economic growth, large-scale destruction of habitats, low chance, the effects of global change on violence and war are among the most important of the lost impacts. The effect of climate change is troublesome from the welfare point of view because it has an endogenous population, and because policy assessments can divide impatience, risk aversion, and inequality within and within nations.

Methodology Assessment of Working Environment Factors on Health Status of Workers of Radiation Hazardous Productions

Purpose: Development of methodology and criteria for establishing causal relationships between the health status of workers in radiation-hazardous industries with factors of the working environment. Results: A methodology and criteria have been developed for assessing the cause-and-effect relationships of the health of workers in radiation-hazardous industries with the factors of the working environment. The assessment is carried out in three stages. At the 1st stage, according to the data of periodic medical examinations and psychophysiological examinations, the level of the employee’s health loss is assessed, at the 2nd stage (using the risk matrix) – the level of occupational risk. At the 3rd stage, according to the relative risk of a specific disease (or its etiological share) and the level of occupational risk, a decision is made on the causation of the disease by unfavorable factors of the working environment.

Disability-adjusted life years associated with population ageing in China, 1990-2017

Background The Chinese population has aged significantly in the last few decades. Comprehensive health losses including both fatal and non-fatal health outcomes associated with ageing in China have not been detailed. Methods Based on freely accessible disability adjusted life years (DALYs) estimated by the Global Burden of Diseases (GBD) 2017, we adopted a robust decomposition method that ascribes changes in DALYs in any given country across two time points to changes resulting from three sources: population size, age structure, and age-specific DALYs rate per 100,000 population. Using the method, we calculated DALYs associated with population ageing in China from 1990 to 2017 and examined the counteraction between the effects of DALYs rate change and population ageing. This method extends previous work through attributing the change in DALYs to the three sources. Results Population ageing was associated with 92.8 million DALYs between 1990 and 2017 in China, of which 65.8% (61.1 million) were years of life lost (YLLs). Males had comparatively more DALYs associated with population ageing than females in the study period. The five leading causes of DALYs associated with population ageing between 1990 and 2017 were stroke (23.6 million), chronic obstructive pulmonary disease (COPD) (18.3 million), ischemic heart disease (13.0 million), tracheal, bronchus, and lung cancer (6.1 million) and liver cancer (5.0 million). Between 1990 and 2017, changes in DALYs associated with age-specific DALY rate reductions far exceeded those related to population ageing (− 196.2 million versus 92.8 million); 57.5% (− 112.8 million) of DALYs were caused by decreases in rates attributed to 84 modifiable risk factors. Conclusion Population ageing was associated with growing health loss in China from 1990 to 2017. Despite the recent progress in alleviating health loss associated with population ageing, the government should encourage scientific research on effective and affordable prevention and control strategies and should consider investment in resources to implement strategies nationwide to address the future challenge of population ageing.

Inequalities in population health loss by multiple deprivation: COVID-19 and pre-pandemic all-cause disability-adjusted life years (DALYs) in Scotland

Background: COVID-19 has caused almost unprecedented change across health, education, the economy and social interaction. It is widely understood that the existing mechanisms which shape health inequalities have resulted in COVID-19 outcomes following this same, familiar, pattern. Our aim was to estimate inequalities in the population health impact of COVID-19 in Scotland, measured by disability-adjusted life years (DALYs) in 2020. These were scaled against pre-pandemic inequalities in DALYs combined across all causes, derived from the Scottish Burden of Disease (SBoD) study.Methods: National deaths and daily case data were input into the European Burden of Disease Network consensus model to estimate DALYs. Total Years of Life Lost (YLL) were estimated for each area-based deprivation quintile of the Scottish population. Years Lived with Disability were proportionately distributed to deprivation quintiles, based on YLL estimates. Inequalities were measured by: the range, Relative Index of Inequality (RII), Slope Index of Inequality (SII), and attributable DALYs were estimated by using the least deprived quintile as a reference. Overall, and inequalities in, COVID-19 DALYs were scaled against pre-pandemic estimates of inequalities across all causes from the SBoD study.Results: Marked inequalities were observed across several measures. The SII was 2,048–2,289 COVID-19 DALYs per 100,000 population. The RII was 1.16, meaning that the rate in the most deprived areas was around 58% higher than the mean population rate, with 40% of COVID-19 DALYs attributed to differences in area-based deprivation. Overall DALYs due to COVID-19 ranged from 7–20% of the annual pre-pandemic impact of inequalities in health loss combined across all causes.Conclusion: The substantial population health impact of COVID-19 in Scotland was not shared equally across areas experiencing different levels of deprivation. The extent of inequality due to COVID-19 was similar to averting all annual DALYs due to diabetes. In the wider context of population health loss, overall ill-health and mortality due to COVID-19 was, at most, a fifth of the annual population health loss due to inequalities in multiple deprivation. Implementing effective policy interventions to reduce health inequalities must be at the forefront of plans to recover and improve population health.