46 CFR 308.104 - Additional war risk insurance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 8 2012-10-01 2012-10-01 false Additional war risk insurance. 308.104 Section 308.104 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Hull and Disbursements Insurance § 308.104 Additional war risk insurance. Owners or charterers may...

46 CFR 308.104 - Additional war risk insurance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Additional war risk insurance. 308.104 Section 308.104 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Hull and Disbursements Insurance § 308.104 Additional war risk insurance. Owners or charterers may...

46 CFR 308.104 - Additional war risk insurance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 8 2014-10-01 2014-10-01 false Additional war risk insurance. 308.104 Section 308.104 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Hull and Disbursements Insurance § 308.104 Additional war risk insurance. Owners or charterers may...

46 CFR 308.104 - Additional war risk insurance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 8 2011-10-01 2011-10-01 false Additional war risk insurance. 308.104 Section 308.104 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Hull and Disbursements Insurance § 308.104 Additional war risk insurance. Owners or charterers may...

46 CFR 308.104 - Additional war risk insurance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 8 2013-10-01 2013-10-01 false Additional war risk insurance. 308.104 Section 308.104 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Hull and Disbursements Insurance § 308.104 Additional war risk insurance. Owners or charterers may...

There is more to risk and safety planning than dramatic risks: Mental health nurses' risk assessment and safety-management practice.

PubMed

Higgins, Agnes; Doyle, Louise; Downes, Carmel; Morrissey, Jean; Costello, Paul; Brennan, Michael; Nash, Michael

2016-04-01

Risk assessment and safety planning are considered a cornerstone of mental health practice, yet limited research exists into how mental health nurses conceptualize 'risk' and how they engage with risk assessment and safety planning. The aim of the present study was to explore mental health nurses' practices and confidence in risk assessment and safety planning. A self-completed survey was administered to 381 mental health nurses in Ireland. The findings indicate that nurses focus on risk to self and risk to others, with the risk of suicide, self-harm, substance abuse, and violence being most frequently assessed. Risk from others and 'iatrogenic' risk were less frequently considered. Overall, there was limited evidence of recovery-oriented practice in relation to risk. The results demonstrate a lack of meaningful engagement with respect to collaborative safety planning, the identification and inclusion of protective factors, and the inclusion of positive risk-taking opportunities. In addition, respondents report a lack of confidence working with positive risk taking and involving family/carers in the risk-assessment and safety-planning process. Gaps in knowledge about risk-assessment and safety-planning practice, which could be addressed through education, are identified, as are the implications of the findings for practice and research. © 2015 Australian College of Mental Health Nurses Inc.

Suicide risk and mental health co-morbidities in a probationer population.

PubMed

Cardarelli, Roberto; Balyakina, Elizabeth; Malone, Kendra; Fulda, Kimberly G; Ellison, Michael; Sivernell, Ron; Shabu, Tanjina

2015-02-01

Mental health problems are disproportionately represented in the community corrections system with limited information on the epidemiology of mental health and correlated factors such as suicide among probationers. This study recruited 2,077 probationers who completed screeners for mental health and substance disorders and suicide risk. Results found 13% of probationers were at high risk of suicide. Those who screened positive for a mental health condition were between 2 and 8 times more likely to screen positive for suicide risk. Allocation of additional resources to mental health in the criminal justice system and to effectively coordinate existing mental health services is needed.

[Health risks from pest control products].

PubMed

Pieper, C; Holthenrich, D; Schneider, H

2014-05-01

According to European biocide legislation, pest control products require assessment and authorization by the responsible national or European authorities. Biocidal products can only be authorized if they have no unacceptable effects on human health. The health risk assessment performed for authorization comprises (a) the derivation of reference values for the active substances and substances of concern contained in the biocidal product and (b) an exposure assessment. These parameters are required for risk characterization. No unacceptable health risks are expected if the determined exposure is less than the relevant reference value. In addition, the toxicological information is used for classification of the biocidal product. The assessment may, where necessary, result in specific conditions for use or other restrictions aimed at minimizing risk. The risk to human health from pest control products is mainly based on the toxicological properties of their active substances. Commonly, the coformulants used in pest control products are of less concern than the active substances (e.g., food ingredients and animal feed products). For example, most rodenticides belong to the group of anticoagulants, which are also effective in humans. Regarding intoxications through insecticides, the group of pyrethroids is of particular importance. Fumigants containing metal phosphides, hydrogen cyanide, or sulfuryl difluoride are particularly toxic. This toxicity is linked to the high acute inhalation toxicity of the gaseous active substances themselves or, in the case of phosphides, of the released gas phosphane. The aim of health risk assessment for the authorization of biocidal products is to ensure their safe application for users and all other persons involved, assuming an adequate and label-compliant use.

Introducing risk adjustment and free health plan choice in employer-based health insurance: Evidence from Germany.

PubMed

Pilny, Adam; Wübker, Ansgar; Ziebarth, Nicolas R

2017-12-01

To equalize differences in health plan premiums due to differences in risk pools, the German legislature introduced a simple Risk Adjustment Scheme (RAS) based on age, gender and disability status in 1994. In addition, effective 1996, consumers gained the freedom to choose among hundreds of existing health plans, across employers and state-borders. This paper (a) estimates RAS pass-through rates on premiums, financial reserves, and expenditures and assesses the overall RAS impact on market price dispersion. Moreover, it (b) characterizes health plan switchers and investigates their annual and cumulative switching rates over time. Our main findings are based on representative enrollee panel data linked to administrative RAS and health plan data. We show that sickness funds with bad risk pools and high pre-RAS premiums lowered their total premiums by 42 cents per additional euro allocated by the RAS. Consequently, post-RAS, health plan prices converged but not fully. Because switchers are more likely to be white collar, young and healthy, the new consumer choice resulted in more risk segregation and the amount of money redistributed by the RAS increased over time. Copyright © 2017 Elsevier B.V. All rights reserved.

The impact of an integrated population health enhancement and disease management program on employee health risk, health conditions, and productivity.

PubMed

Loeppke, Ron; Nicholson, Sean; Taitel, Michael; Sweeney, Matthew; Haufle, Vince; Kessler, Ronald C

2008-12-01

This study evaluated the impact of an integrated population health enhancement program on employee health risks, health conditions, and productivity. Specifically, we analyzed changes in these measures among a cohort of 543 employees who completed a health risk assessment in both 2003 and 2005. We compared these findings with 2 different sets of employees who were not offered health enhancement programming. We found that the DIRECTV cohort showed a significant reduction in health risks after exposure to the program. Relative to a matched comparison group, the proportion of low-risk employees at DIRECTV in 2005 was 8.2 percentage points higher; the proportion of medium-risk employees was 7.1 percentage points lower; and the proportion of high-risk employees was 1.1 percentage points lower (p < 0.001). The most noticeable changes in health risk were a reduction in the proportion of employees with high cholesterol; an improvement in diet; a reduction of heavy drinking; management of high blood pressure; improved stress management; increased exercise; fewer smokers; and a drop in obesity rates. We also found that a majority of employees who improved their risk levels from 2003 to 2005 maintained their gains in 2006. Employees who improved their risks levels also demonstrated relative improvement in absenteeism. Overall, this study provides additional evidence that integrated population health enhancement positively impacts employees' health risk and productivity; it also reinforces the view that "good health is good business."

Risk analysis of sulfites used as food additives in China.

PubMed

Zhang, Jian Bo; Zhang, Hong; Wang, Hua Li; Zhang, Ji Yue; Luo, Peng Jie; Zhu, Lei; Wang, Zhu Tian

2014-02-01

This study was to analyze the risk of sulfites in food consumed by the Chinese people and assess the health protection capability of maximum-permitted level (MPL) of sulfites in GB 2760-2011. Sulfites as food additives are overused or abused in many food categories. When the MPL in GB 2760-2011 was used as sulfites content in food, the intake of sulfites in most surveyed populations was lower than the acceptable daily intake (ADI). Excess intake of sulfites was found in all the surveyed groups when a high percentile of sulfites in food was in taken. Moreover, children aged 1-6 years are at a high risk to intake excess sulfites. The primary cause for the excess intake of sulfites in Chinese people is the overuse and abuse of sulfites by the food industry. The current MPL of sulfites in GB 2760-2011 protects the health of most populations. Copyright © 2014 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Evidence That Environmental and Familial Risks for Psychosis Additively Impact a Multidimensional Subthreshold Psychosis Syndrome.

PubMed

Pries, Lotta-Katrin; Guloksuz, Sinan; Ten Have, Margreet; de Graaf, Ron; van Dorsselaer, Saskia; Gunther, Nicole; Rauschenberg, Christian; Reininghaus, Ulrich; Radhakrishnan, Rajiv; Bak, Maarten; Rutten, Bart P F; van Os, Jim

2018-06-06

The observed link between positive psychotic experiences (PE) and psychosis spectrum disorder (PSD) may be stronger depending on concomitant presence of PE with other dimensions of psychopathology. We examined whether the effect of common risk factors for PSD on PE is additive and whether the impact of risk factors on the occurrence of PE depends on the co-occurrence of other symptom dimensions (affective dysregulation, negative symptoms, and cognitive alteration). Data from the Netherlands Mental Health Survey and Incidence Study 2 were used. Risk factors included childhood adversity, cannabis use, urbanicity, foreign born, hearing impairment, and family history of affective disorders. Logistic regression models were applied to test (1) the additive effect of risk factors (4 levels) on PE and (2) the moderating effects of symptom dimensions on the association between risk factors (present/absent) and PE, using additive interaction, expressed as the interaction contrast ratio. Risk factors were additive: the greater the number of risk factors, the greater the odds of PE. Furthermore, concomitant presence of the other symptom dimensions all increased the impact of risk factors on PE. After controlling for age, sex, and education, only affective dysregulation and negative symptoms remained significant moderators; only affective dysregulation remained a significant moderator if all dimensions were adjusted for each other. Risk factors may not be directly associated with PE but additively give rise to a multidimensional subthreshold state anticipating the multidimensional clinical syndrome. Early motivational and cognitive impairments in the context of PE may be reducible to affective dysregulation.

Frequency and prioritization of patient health risks from a structured health risk assessment.

PubMed

Phillips, Siobhan M; Glasgow, Russell E; Bello, Ghalib; Ory, Marcia G; Glenn, Beth A; Sheinfeld-Gorin, Sherri N; Sabo, Roy T; Heurtin-Roberts, Suzanne; Johnson, Sallie Beth; Krist, Alex H

2014-01-01

To describe the frequency and patient-reported readiness to change, desire to discuss, and perceived importance of 13 health risk factors in a diverse range of primary care practices. Patients (n = 1,707) in 9 primary care practices in the My Own Health Report (MOHR) trial reported general, behavioral, and psychosocial risk factors (body mass index [BMI], health status, diet, physical activity, sleep, drug use, stress, anxiety or worry, and depression). We classified responses as "at risk" or "healthy" for each factor, and patients indicated their readiness to change and/or desire to discuss identified risk factors with providers. Patients also selected 1 of the factors they were ready to change as most important. We then calculated frequencies within and across these factors and examined variation by patient characteristics and across practices. On average, patients had 5.8 (SD = 2.12; range, 0-13) unhealthy behaviors and mental health risk factors. About 55% of patients had more than 6 risk factors. On average, patients wanted to change 1.2 and discuss 0.7 risks. The most common risks were inadequate fruit/vegetable consumption (84.5%) and overweight/obesity (79.6%). Patients were most ready to change BMI (33.3%) and depression (30.7%), and most wanted to discuss depression (41.9%) and anxiety or worry (35.2%). Overall, patients rated health status as most important. Implementing routine comprehensive health risk assessments in primary care will likely identify a high number of behavioral and psychosocial health risks. By soliciting patient priorities, providers and patients can better manage counseling and behavior change. © 2014 Annals of Family Medicine, Inc.

Understanding Health Risks: Improve Your Chances for Good Health

MedlinePlus

... Issues Subscribe October 2016 Print this issue Understanding Health Risks Improve Your Chances for Good Health En ... Risky Business Wise Choices Asking Your Doctor About Health Risks What are my personal health risks? Are ...

Exploration Health Risks: Probabilistic Risk Assessment

NASA Technical Reports Server (NTRS)

Rhatigan, Jennifer; Charles, John; Hayes, Judith; Wren, Kiley

2006-01-01

Maintenance of human health on long-duration exploration missions is a primary challenge to mission designers. Indeed, human health risks are currently the largest risk contributors to the risks of evacuation or loss of the crew on long-duration International Space Station missions. We describe a quantitative assessment of the relative probabilities of occurrence of the individual risks to human safety and efficiency during space flight to augment qualitative assessments used in this field to date. Quantitative probabilistic risk assessments will allow program managers to focus resources on those human health risks most likely to occur with undesirable consequences. Truly quantitative assessments are common, even expected, in the engineering and actuarial spheres, but that capability is just emerging in some arenas of life sciences research, such as identifying and minimize the hazards to astronauts during future space exploration missions. Our expectation is that these results can be used to inform NASA mission design trade studies in the near future with the objective of preventing the higher among the human health risks. We identify and discuss statistical techniques to provide this risk quantification based on relevant sets of astronaut biomedical data from short and long duration space flights as well as relevant analog populations. We outline critical assumptions made in the calculations and discuss the rationale for these. Our efforts to date have focussed on quantifying the probabilities of medical risks that are qualitatively perceived as relatively high risks of radiation sickness, cardiac dysrhythmias, medically significant renal stone formation due to increased calcium mobilization, decompression sickness as a result of EVA (extravehicular activity), and bone fracture due to loss of bone mineral density. We present these quantitative probabilities in order-of-magnitude comparison format so that relative risk can be gauged. We address the effects of

Applying the reasoned action approach to understanding health protection and health risk behaviors.

PubMed

Conner, Mark; McEachan, Rosemary; Lawton, Rebecca; Gardner, Peter

2017-12-01

The Reasoned Action Approach (RAA) developed out of the Theory of Reasoned Action and Theory of Planned Behavior but has not yet been widely applied to understanding health behaviors. The present research employed the RAA in a prospective design to test predictions of intention and action for groups of protection and risk behaviors separately in the same sample. To test the RAA for health protection and risk behaviors. Measures of RAA components plus past behavior were taken in relation to eight protection and six risk behaviors in 385 adults. Self-reported behavior was assessed one month later. Multi-level modelling showed instrumental attitude, experiential attitude, descriptive norms, capacity and past behavior were significant positive predictors of intentions to engage in protection or risk behaviors. Injunctive norms were only significant predictors of intention in protection behaviors. Autonomy was a significant positive predictor of intentions in protection behaviors and a negative predictor in risk behaviors (the latter relationship became non-significant when controlling for past behavior). Multi-level modelling showed that intention, capacity, and past behavior were significant positive predictors of action for both protection and risk behaviors. Experiential attitude and descriptive norm were additional significant positive predictors of risk behaviors. The RAA has utility in predicting both protection and risk health behaviors although the power of predictors may vary across these types of health behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

Occupational health policies on risk assessment in Japan.

PubMed

Horie, Seichi

2010-09-01

Industrial Safety and Health Law (ISH Law) of Japan requires abnormalities identified in evaluations of worker health and working environments are reported to occupational physicians, and employers are advised of measures to ensure appropriate accommodations in working environments and work procedures. Since the 1980s, notions of a risk assessment and occupational safety and health management system were expected to further prevent industrial accidents. In 2005, ISH Law stipulated workplace risk assessment using the wording "employers shall endeavor." Following the amendment, multiple documents and guidelines for risk assessment for different work procedures were developed. They require ISH Laws to be implemented fully and workplaces to plan and execute measures to reduce risks, ranking them from those addressing potential hazards to those requiring workers to wear protective articles. A governmental survey in 2005 found the performance of risk assessment was 20.4% and common reasons for not implementing risk assessments were lack of adequate personnel or knowledge. ISH Law specifies criminal penalties for both individuals and organizations. Moreover, under the Labor Contract Law promulgated in 2007, employers are obliged to make reasonable efforts to ensure employee health for foreseeable and avoidable risks. Therefore, enterprises neglecting even the non-binding provisions of guidelines are likely to suffer significant business impact if judged to be responsible for industrial accidents or occupational disease. To promote risk assessment, we must strengthen technical, financial, and physical support from public-service organizations, encourage the dissemination of good practices to reduce risks, and consider additional employer incentives, including relaxed mandatory regulations.

Assessing Your Weight and Health Risk

MedlinePlus

... Health Professional Resources Assessing Your Weight and Health Risk Assessment of weight and health risk involves using ... risk for developing obesity-associated diseases or conditions. Risk Factors for Health Topics Associated With Obesity Along ...

Risk assessment of integrated electronic health records.

PubMed

Bjornsson, Bjarni Thor; Sigurdardottir, Gudlaug; Stefansson, Stefan Orri

2010-01-01

The paper describes the security concerns related to Electronic Health Records (EHR) both in registration of data and integration of systems. A description of the current state of EHR systems in Iceland is provided, along with the Ministry of Health's future vision and plans. New legislation provides the opportunity for increased integration of EHRs and further collaboration between institutions. Integration of systems, along with greater availability and access to EHR data, requires increased security awareness since additional risks are introduced. The paper describes the core principles of information security as it applies to EHR systems and data. The concepts of confidentiality, integrity, availability, accountability and traceability are introduced and described. The paper discusses the legal requirements and importance of performing risk assessment for EHR data. Risk assessment methodology according to the ISO/IEC 27001 information security standard is described with examples on how it is applied to EHR systems.

A Framework for Assessing Health Risk of Environmental ...

EPA Pesticide Factsheets

EPA released the final report entitled, A Framework for Assessing Health Risk of Environmental Exposures to Children, which examines the impact of potential exposures during developmental lifestages and subsequent lifestages, while emphasizing the iterative nature of the analysis phase with a multidisciplinary team. Major findings and conclusions: This report outlines the framework in which mode of action(s) (MOA) can be considered across life stages. The framework is based upon existing approaches adopted in the Framework on Cumulative Risk Assessment and identifies existing guidance, guidelines and policy papers that relate to children's health risk assessment. It emphasizes the importance of an iterative approach between hazard, dose response, and exposure analyses. In addition, it includes discussion of principles for weight of evidence consideration across life stages for the hazard characterization database.Key science/assessment issues:This framework addresses the questions of why and how an improved children's health risk assessment will strengthen the overall risk assessment process across the Agency. This approach improves the scientific explanation of children's risk and will add value by: 1) providing for a more complete evaluation of the potential for vulnerability at different life stages, including a focus on the underlying biological events and critical developmental periods for incorporating MOA considerations; 2) evaluating of the potential fo

Sexual Minority Health and Health Risk Factors

PubMed Central

Hsieh, Ning; Ruther, Matt

2016-01-01

Introduction Although population studies have documented the poorer health outcomes of sexual minorities, few have taken an intersectionality approach to examine how sexual orientation, gender, and race jointly affect these outcomes. Moreover, little is known about how behavioral risks and healthcare access contribute to health disparities by sexual, gender, and racial identities. Methods Using ordered and binary logistic regression models in 2015, data from the 2013 and 2014 National Health Interview Surveys (N=62,302) were analyzed to study disparities in self-rated health and functional limitation. This study examined how gender and race interact with sexual identity to create health disparities, and how these disparities are attributable to differential exposure to behavioral risks and access to care. Results Conditional on sociodemographic factors, all sexual–gender–racial minority groups except straight white women, gay white men, and bisexual non-white men reported worse self-rated health than straight white men (p<0.05). Some of these gaps were attributable to differences in behaviors and healthcare access. All female groups, as well as gay non-white men, were more likely to report a functional limitation than straight white men (p<0.05), and these gaps largely remained when behavioral risks and access to care were accounted for. The study also discusses health disparities within sexual–gender–racial minority groups. Conclusions Sexual, gender, and racial identities interact with one another in a complex way to affect health experiences. Efforts to improve sexual minority health should consider heterogeneity in health risks and health outcomes among sexual minorities. PMID:26803358

Health Information–Seeking Behaviors, Health Indicators, and Health Risks

PubMed Central

Mays, Darren; Weaver, Stephanie Sargent; Hopkins, Gary L.; Eroğlu, Doğan; Bernhardt, Jay M.

2010-01-01

Objectives. We examined how different types of health information–seeking behaviors (HISBs)—no use, illness information only, wellness information only, and illness and wellness information combined—are associated with health risk factors and health indicators to determine possible motives for health information seeking. Methods. A sample of 559 Seattle–Tacoma area adults completed an Internet-based survey in summer 2006. The survey assessed types of HISB, physical and mental health indicators, health risks, and several covariates. Covariate-adjusted linear and logistic regression models were computed. Results. Almost half (49.4%) of the sample reported HISBs. Most HISBs (40.6%) involved seeking a combination of illness and wellness information, but both illness-only (28.6%) and wellness-only (30.8%) HISBs were also widespread. Wellness-only information seekers reported the most positive health assessments and the lowest occurrence of health risk factors. An opposite pattern emerged for illness-only information seekers. Conclusions. Our findings reveal a unique pattern of linkages between the type of health information sought (wellness, illness, and so on) and health self-assessment among adult Internet users in western Washington State. These associations suggest that distinct health motives may underlie HISB, a phenomenon frequently overlooked in previous research. PMID:20558794

46 CFR 308.204 - Additional war risk protection and indemnity insurance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 8 2013-10-01 2013-10-01 false Additional war risk protection and indemnity insurance. 308.204 Section 308.204 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Protection and Indemnity Insurance § 308.204 Additional war risk...

46 CFR 308.204 - Additional war risk protection and indemnity insurance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 8 2011-10-01 2011-10-01 false Additional war risk protection and indemnity insurance. 308.204 Section 308.204 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Protection and Indemnity Insurance § 308.204 Additional war risk...

46 CFR 308.204 - Additional war risk protection and indemnity insurance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Additional war risk protection and indemnity insurance. 308.204 Section 308.204 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Protection and Indemnity Insurance § 308.204 Additional war risk...

46 CFR 308.204 - Additional war risk protection and indemnity insurance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 8 2014-10-01 2014-10-01 false Additional war risk protection and indemnity insurance. 308.204 Section 308.204 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Protection and Indemnity Insurance § 308.204 Additional war risk...

46 CFR 308.204 - Additional war risk protection and indemnity insurance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 8 2012-10-01 2012-10-01 false Additional war risk protection and indemnity insurance. 308.204 Section 308.204 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Protection and Indemnity Insurance § 308.204 Additional war risk...

Attitude to health risk in the Canadian population: a cross-sectional survey

PubMed Central

Bansback, Nick; Harrison, Mark; Sadatsafavi, Mohsen; Stiggelbout, Anne; Whitehurst, David G.T.

2016-01-01

Background: Risk is a ubiquitous part of health care. Understanding how people respond to risks is important for predicting how populations make health decisions. Our objective was to seek preliminary descriptive insights into the attitude to health risk in the Canadian population and factors associated with heterogeneity in risk attitude. Methods: We used a large market-research panel to survey (in English and French) a representative sample of the Canadian general population that reflected the age, sex and geography of the population. The survey included the Health-Risk Attitude Scale, which predicts how a person resolves risky health decisions related to treatment, prevention of disease and health-related behaviour. In addition, we assessed participants' numeracy and risk understanding, as well as income band and level of education. We summarized the responses, and we explored the independent associations between demographics, numeracy, risk understanding and risk attitude in multivariable models. Results: Of 6780 respondents, 4949 (73.0%) were averse to health risks; however, but there was considerable heterogeneity in the magnitude of risk aversion. We found significant gradients of risk averse attitudes with increasing age and being female (p < 0.001) using the multivariable model. French-speaking participants appeared to be more risk averse than those who were English-speaking (p < 0.001), as were individuals scoring higher on the Subjective Numeracy Scale (p < 0.001). Interpreation: In general, Canadians were averse to health risks, but we found that a sizeable, identifiable group of risk takers exists. Heterogeneity in preferences for risk can explain variations in health care utilization in the context of patient-centred care. Understanding risk preference heterogeneity can help guide policy and assist in patient-physician decisions. PMID:27398375

Risk adjustment alternatives in paying for behavioral health care under Medicaid.

PubMed Central

Ettner, S L; Frank, R G; McGuire, T G; Hermann, R C

2001-01-01

OBJECTIVE: To compare the performance of various risk adjustment models in behavioral health applications such as setting mental health and substance abuse (MH/SA) capitation payments or overall capitation payments for populations including MH/SA users. DATA SOURCES/STUDY DESIGN: The 1991-93 administrative data from the Michigan Medicaid program were used. We compared mean absolute prediction error for several risk adjustment models and simulated the profits and losses that behavioral health care carve outs and integrated health plans would experience under risk adjustment if they enrolled beneficiaries with a history of MH/SA problems. Models included basic demographic adjustment, Adjusted Diagnostic Groups, Hierarchical Condition Categories, and specifications designed for behavioral health. PRINCIPAL FINDINGS: Differences in predictive ability among risk adjustment models were small and generally insignificant. Specifications based on relatively few MH/SA diagnostic categories did as well as or better than models controlling for additional variables such as medical diagnoses at predicting MH/SA expenditures among adults. Simulation analyses revealed that among both adults and minors considerable scope remained for behavioral health care carve outs to make profits or losses after risk adjustment based on differential enrollment of severely ill patients. Similarly, integrated health plans have strong financial incentives to avoid MH/SA users even after adjustment. CONCLUSIONS: Current risk adjustment methodologies do not eliminate the financial incentives for integrated health plans and behavioral health care carve-out plans to avoid high-utilizing patients with psychiatric disorders. PMID:11508640

Clinical risk management in mental health: a qualitative study of main risks and related organizational management practices.

PubMed

Briner, Matthias; Manser, Tanja

2013-02-04

A scientific understanding of clinical risk management (CRM) in mental health care is essential for building safer health systems and for improving patient safety. While evidence on patient safety and CRM in physical health care has increased, there is limited research on these issues in mental health care. This qualitative study provides an overview of the most important clinical risks in mental health and related organizational management practices. We conducted in-depth expert interviews with professionals responsible for CRM in psychiatric hospitals. Interviews were transcribed and analyzed applying qualitative content analysis to thematically sort the identified risks. The main concerns for CRM in mental health are a) violence and self-destructive behavior (i.e. protecting patients and staff from other patients, and patients from themselves), b) treatment errors, especially in the process of therapy, and c) risks associated with mental illnesses (e.g. psychosis or depression). This study identified critical differences to CRM in hospitals for physical disorder and challenges specific to CRM in mental health. Firstly, many psychiatric patients do not believe that they are ill and are therefore in hospital against their will. Secondly, staff safety is a much more prominent theme for CRM in mental health care as it is directly related to the specifics of mental illnesses. The current study contributes to the understanding of patient safety and raises awareness for CRM in mental health. The mental health specific overview of central risks and related organizational management practices offers a valuable basis for CRM development in mental health and an addition to CRM in general.

The impacts of uncertainty and variability in groundwater-driven health risk assessment. (Invited)

NASA Astrophysics Data System (ADS)

Maxwell, R. M.

2010-12-01

Potential human health risk from contaminated groundwater is becoming an important, quantitative measure used in management decisions in a range of applications from Superfund to CO2 sequestration. Quantitatively assessing the potential human health risks from contaminated groundwater is challenging due to the many coupled processes, uncertainty in transport parameters and the variability in individual physiology and behavior. Perspective on human health risk assessment techniques will be presented and a framework used to predict potential, increased human health risk from contaminated groundwater will be discussed. This framework incorporates transport of contaminants through the subsurface from source to receptor and health risks to individuals via household exposure pathways. The subsurface is shown subject to both physical and chemical heterogeneity which affects downstream concentrations at receptors. Cases are presented where hydraulic conductivity can exhibit both uncertainty and spatial variability in addition to situations where hydraulic conductivity is the dominant source of uncertainty in risk assessment. Management implications, such as characterization and remediation will also be discussed.

Health Risk Behavior and Sexual Assault Among Ethnically Diverse Women

PubMed Central

Littleton, Heather L.; Grills-Taquechel, Amie E.; Buck, Katherine S.; Rosman, Lindsey; Dodd, Julia C.

2013-01-01

Sexual assault is associated with a number of health risk behaviors in women. It has been hypothesized that these risk behaviors, such as hazardous drinking, may represent women's attempts to cope with psychological distress, such as symptoms of depression and anxiety. However, extant research has failed to evaluate these relationships among ethnic minority samples or identify the mechanisms responsible for this association. The current study examined sexual assault history and two health risk behaviors (hazardous drinking and engaging in sexual behavior to regulate negative affect) in a diverse sample of 1,620 college women. Depression and anxiety were examined as mediators of the relationship between sexual assault and health risk behaviors. There was evidence of moderated mediation, such that for European American women, but not for ethnic minority women, both forms of psychological distress were significant mediators of the sexual assault/hazardous drinking relationship. In contrast, among all ethnic groups, the relationship between sexual assault and both forms of psychological distress was mediated by the use of sexual behavior as an affect regulation strategy. Results support a need to evaluate the assault experiences of ethnically diverse women, as well as the impact of the assault on their postassault experiences including health risk behaviors and psychological adjustment. Additionally, results suggest that practitioners should carefully assess health risk behaviors among victims of sexual assault and be aware that there may be differences in the risk factors and motives for these behaviors among women of various ethnic backgrounds. PMID:24223467

Health Risk Behavior and Sexual Assault Among Ethnically Diverse Women.

PubMed

Littleton, Heather L; Grills-Taquechel, Amie E; Buck, Katherine S; Rosman, Lindsey; Dodd, Julia C

2013-03-01

Sexual assault is associated with a number of health risk behaviors in women. It has been hypothesized that these risk behaviors, such as hazardous drinking, may represent women's attempts to cope with psychological distress, such as symptoms of depression and anxiety. However, extant research has failed to evaluate these relationships among ethnic minority samples or identify the mechanisms responsible for this association. The current study examined sexual assault history and two health risk behaviors (hazardous drinking and engaging in sexual behavior to regulate negative affect) in a diverse sample of 1,620 college women. Depression and anxiety were examined as mediators of the relationship between sexual assault and health risk behaviors. There was evidence of moderated mediation, such that for European American women, but not for ethnic minority women, both forms of psychological distress were significant mediators of the sexual assault/hazardous drinking relationship. In contrast, among all ethnic groups, the relationship between sexual assault and both forms of psychological distress was mediated by the use of sexual behavior as an affect regulation strategy. Results support a need to evaluate the assault experiences of ethnically diverse women, as well as the impact of the assault on their postassault experiences including health risk behaviors and psychological adjustment. Additionally, results suggest that practitioners should carefully assess health risk behaviors among victims of sexual assault and be aware that there may be differences in the risk factors and motives for these behaviors among women of various ethnic backgrounds.

Chemical Mixture Risk Assessment Additivity-Based Approaches

EPA Science Inventory

Powerpoint presentation includes additivity-based chemical mixture risk assessment methods. Basic concepts, theory and example calculations are included. Several slides discuss the use of "common adverse outcomes" in analyzing phthalate mixtures.

Health risk assessments for alumina refineries.

PubMed

Donoghue, A Michael; Coffey, Patrick S

2014-05-01

To describe contemporary air dispersion modeling and health risk assessment methodologies applied to alumina refineries and to summarize recent results. Air dispersion models using emission source and meteorological data have been used to assess ground-level concentrations (GLCs) of refinery emissions. Short-term (1-hour and 24-hour average) GLCs and annual average GLCs have been used to assess acute health, chronic health, and incremental carcinogenic risks. The acute hazard index can exceed 1 close to refineries, but it is typically less than 1 at neighboring residential locations. The chronic hazard index is typically substantially less than 1. The incremental carcinogenic risk is typically less than 10(-6). The risks of acute health effects are adequately controlled, and the risks of chronic health effects and incremental carcinogenic risks are negligible around referenced alumina refineries.

Social capital and risk and protective behaviors: a global health perspective

PubMed Central

Kaljee, Linda M; Chen, Xinguang

2011-01-01

Social capital and health research has emerged as a focus of contemporary behavioral epidemiology, while intervention research is seeking more effective measures to increase health protective behaviors and decrease health-risk behaviors. In this review we explored current literature on social capital and health outcomes at the micro-, mesa-, and macro-levels with a particular emphasis on research that incorporates a social capital framework, and adolescent and young adult engagement in risk behaviors. These data indicate that across a broad range of socio-cultural and economic contexts, social capital can affect individuals’ risk for negative health outcomes and their engagement in risk behaviors. Further research is needed which should focus on differentiating and measuring positive and negative social capital within both mainstream and alternative social networks, assessing how social constructions of gender, ethnicity, and race – within specific cultural contexts – mediate the relationship between social capital and risk and/or protective behaviors. This new research should integrate the existing research within historical socioeconomic and political conditions. In addition, social capital scales need to be developed to be both culturally and developmentally appropriate for use with adolescents living in a diversity of settings. Despite the proliferation of social capital research, the concept remains underutilized in both assessment and intervention development for adolescents’ and young adults’ engagement in risk behaviors and their associated short- and long-term poor health outcomes. PMID:23243387

Indoor air quality investigation and health risk assessment at correctional institutions.

PubMed

Ofungwu, Joseph

2005-04-01

A comprehensive indoor air-quality (IAQ) investigation was conducted at a state correctional facility in New Jersey, USA with a lengthy history of IAQ problems. The IAQ investigation comprised preliminary indoor air screening using direct readout instrumentation, indoor air/surface wipe sampling and laboratory analysis, as well as a heating, ventilation, and air-conditioning system evaluation, and a building envelope survey. In addition to air sampling, a human health risk assessment was performed to evaluate the potential for exposure to site-related air contaminants with respect to the inmate and worker populations. The risk assessment results for the prison facility indicated the potential for significant health risks for the inmate population, possibly reflecting the effects of their confinement and extended exposure to indoor air contaminants, as compared to the prison guard and worker population. Based on the results of the risk assessment, several mitigation measures are recommended to minimize prison population health risks and improve indoor air quality at prison facilities.

Poverty, AIDS and child health: identifying highest-risk children in South Africa.

PubMed

Cluver, Lucie; Boyes, Mark; Orkin, Mark; Sherr, Lorraine

2013-10-11

Identifying children at the highest risk of negative health effects is a prerequisite to effective public health policies in Southern Africa. A central ongoing debate is whether poverty, orphanhood or parental AIDS most reliably indicates child health risks. Attempts to address this key question have been constrained by a lack of data allowing distinction of AIDS-specific parental death or morbidity from other causes of orphanhood and chronic illness. To examine whether household poverty, orphanhood and parental illness (by AIDS or other causes) independently or interactively predict child health, developmental and HIV-infection risks. We interviewed 6 002 children aged 10 - 17 years in 2009 - 2011, using stratified random sampling in six urban and rural sites across three South African provinces. Outcomes were child mental health risks, educational risks and HIV-infection risks. Regression models that controlled for socio-demographic co-factors tested potential impacts and interactions of poverty, AIDS-specific and other orphanhood and parental illness status. Household poverty independently predicted child mental health and educational risks, AIDS orphanhood independently predicted mental health risks and parental AIDS illness independently predicted mental health, educational and HIV-infection risks. Interaction effects of poverty with AIDS orphanhood and parental AIDS illness were found across all outcomes. No effects, or interactions with poverty, were shown by AIDS-unrelated orphanhood or parental illness. The identification of children at highest risk requires recognition and measurement of both poverty and parental AIDS. This study shows negative impacts of poverty and AIDS-specific vulnerabilities distinct from orphanhood and adult illness more generally. Additionally, effects of interaction between family AIDS and poverty suggest that, where these co-exist, children are at highest risk of all.

Medication adherence, comorbidities, and health risk impacts on workforce absence and job performance.

PubMed

Loeppke, Ronald; Haufle, Vince; Jinnett, Kim; Parry, Thomas; Zhu, Jianping; Hymel, Pamela; Konicki, Doris

2011-06-01

To understand impacts of medication adherence, comorbidities, and health risks on workforce absence and job performance. Retrospective observational study using employees' medical/pharmacy claims and self-reported health risk appraisals. Statin medication adherence in individuals with Coronary Artery Disease was significant predictor (P < 0.05) of decreasing absenteeism. Insulin, oral hypoglycemic, or metformin medication adherence in type 2 diabetics was significant (P < 0.05) predictor of decreasing job performance. Number of comorbidities was found as significant (P < 0.5) predictor of absenteeism in five of nine subsamples. Significant links (P < 0.05) between high health risks and lower job performance were found across all nine subsamples. Results suggest integrated health and productivity management strategies should include an emphasis on primary and secondary prevention to reduce health risks in addition to tertiary prevention efforts of disease management and medication management.

Perceptions of health risks of cigarette smoking: A new measure reveals widespread misunderstanding

PubMed Central

Krosnick, Jon A.; Malhotra, Neil; Bruera, Eduardo F.; Chang, LinChiat; Pasek, Josh; Thomas, Randall K.

2017-01-01

Most Americans recognize that smoking causes serious diseases, yet many Americans continue to smoke. One possible explanation for this paradox is that perhaps Americans do not accurately perceive the extent to which smoking increases the probability of adverse health outcomes. This paper examines the accuracy of Americans’ perceptions of the absolute risk, attributable risk, and relative risk of lung cancer, and assesses which of these beliefs drive Americans’ smoking behavior. Using data from three national surveys, statistical analyses were performed by comparing means, medians, and distributions, and by employing Generalized Additive Models. Perceptions of relative risk were associated as expected with smoking onset and smoking cessation, whereas perceptions of absolute risk and attributable risk were not. Additionally, the relation of relative risk with smoking status was stronger among people who held their risk perceptions with more certainty. Most current smokers, former smokers, and never-smokers considerably underestimated the relative risk of smoking. If, as this paper suggests, people naturally think about the health consequences of smoking in terms of relative risk, smoking rates might be reduced if public understanding of the relative risks of smoking were more accurate and people held those beliefs with more confidence. PMID:28806420

Health Risk Assessments for Alumina Refineries

PubMed Central

Coffey, Patrick S.

2014-01-01

Objective: To describe contemporary air dispersion modeling and health risk assessment methodologies applied to alumina refineries and to summarize recent results. Methods: Air dispersion models using emission source and meteorological data have been used to assess ground-level concentrations (GLCs) of refinery emissions. Short-term (1-hour and 24-hour average) GLCs and annual average GLCs have been used to assess acute health, chronic health, and incremental carcinogenic risks. Results: The acute hazard index can exceed 1 close to refineries, but it is typically less than 1 at neighboring residential locations. The chronic hazard index is typically substantially less than 1. The incremental carcinogenic risk is typically less than 10−6. Conclusions: The risks of acute health effects are adequately controlled, and the risks of chronic health effects and incremental carcinogenic risks are negligible around referenced alumina refineries. PMID:24806721

Clinical risk management in mental health: a qualitative study of main risks and related organizational management practices

PubMed Central

2013-01-01

Background A scientific understanding of clinical risk management (CRM) in mental health care is essential for building safer health systems and for improving patient safety. While evidence on patient safety and CRM in physical health care has increased, there is limited research on these issues in mental health care. This qualitative study provides an overview of the most important clinical risks in mental health and related organizational management practices. Methods We conducted in-depth expert interviews with professionals responsible for CRM in psychiatric hospitals. Interviews were transcribed and analyzed applying qualitative content analysis to thematically sort the identified risks. Results The main concerns for CRM in mental health are a) violence and self-destructive behavior (i.e. protecting patients and staff from other patients, and patients from themselves), b) treatment errors, especially in the process of therapy, and c) risks associated with mental illnesses (e.g. psychosis or depression). This study identified critical differences to CRM in hospitals for physical disorder and challenges specific to CRM in mental health. Firstly, many psychiatric patients do not believe that they are ill and are therefore in hospital against their will. Secondly, staff safety is a much more prominent theme for CRM in mental health care as it is directly related to the specifics of mental illnesses. Conclusions The current study contributes to the understanding of patient safety and raises awareness for CRM in mental health. The mental health specific overview of central risks and related organizational management practices offers a valuable basis for CRM development in mental health and an addition to CRM in general. PMID:23379842

Maternal mental health and risk of child protection involvement: mental health diagnoses associated with increased risk.

PubMed

O'Donnell, Melissa; Maclean, Miriam J; Sims, Scott; Morgan, Vera A; Leonard, Helen; Stanley, Fiona J

2015-12-01

Previous research shows that maternal mental illness is an important risk factor for child maltreatment. This study aims to quantify the relationship between maternal mental health and risk of child maltreatment according to the different types of mental health diagnoses. The study used a retrospective cohort of children born in Western Australia between 1990 and 2005, with deidentified linked data from routine health and child protection collections. Nearly 1 in 10 children (9.2%) of mothers with a prior mental health contact had a maltreatment allegation. Alternatively, almost half the children with a maltreatment allegation had a mother with a mental health contact. After adjusting for other risk factors, a history of mental health contacts was associated with a more than doubled risk of allegations (HR=2.64, 95% CI 2.50 to 2.80). Overall, all mental health diagnostic groups were associated with an increased risk of allegations. The greatest risk was found for maternal intellectual disability, followed by disorders of childhood and psychological development, personality disorders, substance-related disorders, and organic disorders. Maltreatment allegations were substantiated at a slightly higher rate than for the general population. Our study shows that maternal mental health is an important factor in child protection involvement. The level of risk varies across diagnostic groups. It is important that mothers with mental health issues are offered appropriate support and services. Adult mental health services should also be aware and discuss the impact of maternal mental health on the family and children's safety and well-being. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Assessing knowledge and application of emergency risk communication principles among public health workers in China.

PubMed

Cope, James R; Frost, Melinda; Richun, Li; Xie, Ruiqian

2014-06-01

Since 2003, the Chinese National Health and Family Planning Commission (formerly the Ministry of Health) has implemented changes to more effectively communicate risk during public health emergencies. In spite of ongoing improvements, provincial and sub-provincial leaders face barriers, such as established modes of operation, lack of training, shortage of trained risk communicators, and limited understanding and willingness of recipients to mitigate risks. We assessed the current status of and barriers to risk communication knowledge and practice among public health practitioners in China. We designed the survey questionnaire to capture information related to the risk communication core capacities required by international health regulations and common risk communication principles. Our findings showed that risk communication training has successfully developed an awareness of risk communication principles and the ability to implement those principles in practice in China. Future efforts should focus on areas such as a dedicated risk communication workforce, requirements that public health agencies develop a risk communication plan, and additional training for public health practitioners and their partners. It is critical that the infectious diseases prevention and control law be amended to grant provincial and local public health agencies more autonomy to release information.

The common risk factor approach: a rational basis for promoting oral health.

PubMed

Sheiham, A; Watt, R G

2000-12-01

Conventional oral health education is not effective nor efficient. Many oral health programmes are developed and implemented in isolation from other health programmes. This often leads, at best to a duplication of effort, or worse, conflicting messages being delivered to the public. In addition, oral health programmes tend to concentrate on individual behaviour change and largely ignore the influence of socio-political factors as the key determinants of health. Based upon the general principles of health promotion this paper presents a rationale for an alternative approach for oral health policy. The common risk factor approach addresses risk factors common to many chronic conditions within the context of the wider socio-environmental milieu. Oral health is determined by diet, hygiene, smoking, alcohol use, stress and trauma. As these causes are common to a number of other chronic diseases, adopting a collaborative approach is more rational than one that is disease specific. The common risk factor approach can be implemented in a variety of ways. Food policy development and the Health Promoting Schools initiative are used as examples of effective ways of promoting oral health.

42 CFR 417.592 - Additional benefits requirement.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Additional benefits requirement. 417.592 Section... PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Risk Basis § 417.592 Additional benefits...) Additional benefits. Provide its Medicare enrollees with additional benefits in accordance with paragraph (c...

Risk communication, risk perception, and public health.

PubMed

Aakko, Eric

2004-01-01

Risk communication is about building trust while deploying an interactive and ongoing communication process in which audience members are active participants. This interactive participation may not solve a public health crisis, but it will help reduce unwarranted fear, anxiety and distrust. Consequently, if a government agency fails to understand how to effectively communicate about health risks, their trustworthiness and credibility may suffer, and a crisis event may go from bad to worse.

Sport participation, risk taking, and health risk behaviors.

PubMed

Patel, D R; Luckstead, E F

2000-02-01

Adolescents participate in sports for a variety of reasons. Some seem to enjoy participating in what some might consider very-high-risk or "extreme" sports activities. For some adolescents risk taking becomes pervasive and can be detrimental to normal health and development. The majority of adolescents will do well in the context of athletics, and the many positive benefits of regular physical activity and sports participation should be appropriately emphasized. However, a subset of adolescents may be at greater risk for adverse consequences. This article reviews the reasons for participation and attrition from sports, the phenomenon of thrill seeking in sports, certain risk-taking behaviors of athletes, and studies comparing health risk behaviors in athletes and non-athletes.

Hispanic Lesbians and Bisexual Women at Heightened Risk or Health Disparities

PubMed Central

Fredriksen-Goldsen, Karen I.

2012-01-01

Objectives. We investigated whether elevated risks of health disparities exist in Hispanic lesbians and bisexual women aged 18 years and older compared with non-Hispanic White lesbians and bisexual women and Hispanic heterosexual women. Methods. We analyzed population-based data from the Washington State Behavioral Risk Factor Surveillance System (2003–2009) using adjusted logistic regressions. Results. Hispanic lesbians and bisexual women, compared with Hispanic heterosexual women, were at elevated risk for disparities in smoking, asthma, and disability. Hispanic bisexual women also showed higher odds of arthritis, acute drinking, poor general health, and frequent mental distress compared with Hispanic heterosexual women. In addition, Hispanic bisexual women were more likely to report frequent mental distress than were non-Hispanic White bisexual women. Hispanic lesbians were more likely to report asthma than were non-Hispanic White lesbians. Conclusions. The elevated risk of health disparities in Hispanic lesbians and bisexual women are primarily associated with sexual orientation. Yet, the elevated prevalence of mental distress for Hispanic bisexual women and asthma for Hispanic lesbians appears to result from the cumulative risk of doubly disadvantaged statuses. Efforts are needed to address unique health concerns of diverse lesbians and bisexual women. PMID:22095348

Are smokers adequately informed about the health risks of smoking and medicinal nicotine?

PubMed

Cummings, K Michael; Hyland, Andrew; Giovino, Gary A; Hastrup, Janice L; Bauer, Joseph E; Bansal, Maansi A

2004-12-01

The present study assessed smokers' beliefs about the health risks of smoking and the benefits of smoking filtered and low-tar cigarettes, and their awareness of and interest in trying so-called reduced-risk tobacco products. Results were based on a nationally representative random-digit-dialed telephone survey of 1,046 adult (aged 18 years or older) current cigarette smokers. Data were gathered on demographic characteristics, tobacco use behaviors, awareness and use of nicotine medications, beliefs about the health risks of smoking, content of smoke and design features of cigarettes, and the safety and efficacy of nicotine medications. In addition, respondents were asked about their interest in and perceived ability to stop smoking and about their desire for more information about the health risks of smoking. Smokers were least knowledgeable about low-tar and filter cigarettes (65% of responses were incorrect or "don't know") and most knowledgeable about the health risks of smoking (39% of responses were incorrect or "don't know"). The smokers' characteristics most commonly associated with misinformation when all six indices were combined into a summary index were as follows: those aged 45 years or older, smokers of ultralight cigarettes, smokers who believe they will stop smoking before they experience a serious health problem caused by smoking, smokers who have never used a stop-smoking medication, and smokers with a lower education level. Those who believed they would stop smoking in the next year were more knowledgeable about smoking. Some 77% of respondents reported a desire for additional information from tobacco companies on the health dangers of smoking. The present findings demonstrate that smokers are misinformed about many aspects of the cigarettes they smoke and stop-smoking medications and that they want more information about ways to reduce their health risks.

Efficacy of a feed-additive antibacterial combination for improving feedlot cattle performance and health.

PubMed Central

Gallo, G F; Berg, J L

1995-01-01

The effectiveness of a feed-additive antimicrobial combination for improving feedlot performance and health was tested using 4325 high-risk feeder calves randomly allocated to a control group or an experimental group. The experimental group received the conventional ration plus a feed additive containing 700 mg per head/day of chlortetracycline and sulfamethazine from arrival at the feedlot to day 56 of the feeding period. The inclusion of the feed additive to the ration significantly improved average daily gain for days 0-28 (P = 0.0163) and 0-56 (P = 0.0001), and the feed conversion for days 0-28 (P = 0.0061) and 0-56 (P = 0.0004). Additionally, the use of the feed additive significantly reduced the rate of bovine respiratory disease morbidity for days 0-28 (P = 0.0014) and 0-56 (P = 0.0001), the rate of relapses and mortality for days 0-56 (P = 0.0151 and P = 0.0209, respectively), and the rate of animals diagnosed with chronic respiratory disease for days 0-28 and 0-56 (P = 0.0009 and P = 0.0002, respectively). Performance and health improvements produced by the use of the feed additive were cost-effective. PMID:7600512

Association of Job Insecurity with Health Risk Factors and Poorer Health in American Workers.

PubMed

Khubchandani, Jagdish; Price, James H

2017-04-01

Perceived job insecurity and health risk factors have not been well studied in the United States (US) workforce. The purpose of this study was to assess the association of specific health risk factors and morbidities with perceived job insecurity in a large national random sample of working adults in the US. The National Health Interview Survey data were analyzed for this study. We computed the prevalence of perceived job insecurity by demographic characteristics and tested the relative association between perceived job insecurity and selected health risk factors using logistic regression analysis with adjusted odds ratios (AORs). A total of 17,441 working adults were included in the study: 75 % Whites, 51.5 % females, 73.3 % worked for a private company, and 82.6 % were 25-64 years of age. One in three (33 %) workers perceived their job to be insecure. Those who reported job insecurity had significantly higher odds of: being obese, sleeping less than 6 h/day, smoking every day, having work loss days >2 weeks, and worsening of general health in the past year. Job insecure individuals had a likelihood of serious mental illness within the past 30 days almost five times higher than those who were not job insecure. In addition, job insecure individuals were significantly more likely to report pain conditions (i.e. headaches, neck pain, and low back pain), and lifetime histories of having ulcers, diabetes, hypertension, angina pectoris, and coronary heart diseases. Job insecurity is associated with poor health and health risk behaviors in American adults. Potential interventions to address job insecurity and improve the health and well-being of working adults have been discussed based on study findings.

Financial risk protection and universal health coverage: evidence and measurement challenges.

PubMed

Saksena, Priyanka; Hsu, Justine; Evans, David B

2014-09-01

Financial risk protection is a key component of universal health coverage (UHC), which is defined as access to all needed quality health services without financial hardship. As part of the PLOS Medicine Collection on measurement of UHC, the aim of this paper is to examine and to compare and contrast existing measures of financial risk protection. The paper presents the rationale behind the methodologies for measuring financial risk protection and how this relates to UHC as well as some empirical examples of the types of measures. Additionally, the specific challenges related to monitoring inequalities in financial risk protection are discussed. The paper then goes on to examine and document the practical challenges associated with measurement of financial risk protection. This paper summarizes current thinking on the area of financial risk protection, provides novel insights, and suggests future developments that could be valuable in the context of monitoring progress towards UHC.

[National health fund and morbidity-based risk structure equalization with focus on haemophilia].

PubMed

König, T

2010-11-01

The Gesundheitsfonds (national health fund) was established in Germany on January 1st, 2009, in combination with the morbidity-based risk structure equalization (RSA) in order to manage the cash flow between the statutory health insurances. The RSA equalizes income differences due to the varying levels of contributory income of the members of a health insurance (basic wage totals) and expenditure differences due to varying distribution of morbidity risks across different health insurances, as well as the varying numbers of non-contributing insured family members. Additionally, insured persons are allocated to morbidity groups according to a classification model based upon diagnoses and prescriptions anticipating medical expenses in the subsequent year. Haemophilia falls, among 80 disease entities, in the morbidity group which generates the highest risk supplement. Matching of prescribed drugs with disease entities facilitates disease grading and improves the accuracy of risk supplements.

Developing Hydrogeological Site Characterization Strategies based on Human Health Risk

NASA Astrophysics Data System (ADS)

de Barros, F.; Rubin, Y.; Maxwell, R. M.

2013-12-01

In order to provide better sustainable groundwater quality management and minimize the impact of contamination in humans, improved understanding and quantification of the interaction between hydrogeological models, geological site information and human health are needed. Considering the joint influence of these components in the overall human health risk assessment and the corresponding sources of uncertainty aid decision makers to better allocate resources in data acquisition campaigns. This is important to (1) achieve remediation goals in a cost-effective manner, (2) protect human health and (3) keep water supplies clean in order to keep with quality standards. Such task is challenging since a full characterization of the subsurface is unfeasible due to financial and technological constraints. In addition, human exposure and physiological response to contamination are subject to uncertainty and variability. Normally, sampling strategies are developed with the goal of reducing uncertainty, but less often they are developed in the context of their impacts on the overall system uncertainty. Therefore, quantifying the impact from each of these components (hydrogeological, behavioral and physiological) in final human health risk prediction can provide guidance for decision makers to best allocate resources towards minimal prediction uncertainty. In this presentation, a multi-component human health risk-based framework is presented which allows decision makers to set priorities through an information entropy-based visualization tool. Results highlight the role of characteristic length-scales characterizing flow and transport in determining data needs within an integrated hydrogeological-health framework. Conditions where uncertainty reduction in human health risk predictions may benefit from better understanding of the health component, as opposed to a more detailed hydrogeological characterization, are also discussed. Finally, results illustrate how different dose

Weekend hospitalization and additional risk of death: an analysis of inpatient data.

PubMed

Freemantle, N; Richardson, M; Wood, J; Ray, D; Khosla, S; Shahian, D; Roche, W R; Stephens, I; Keogh, B; Pagano, D

2012-02-01

To assess whether weekend admissions to hospital and/or already being an inpatient on weekend days were associated with any additional mortality risk. Retrospective observational survivorship study. We analysed all admissions to the English National Health Service (NHS) during the financial year 2009/10, following up all patients for 30 days after admission and accounting for risk of death associated with diagnosis, co-morbidities, admission history, age, sex, ethnicity, deprivation, seasonality, day of admission and hospital trust, including day of death as a time dependent covariate. The principal analysis was based on time to in-hospital death. National Health Service Hospitals in England. 30 day mortality (in or out of hospital). There were 14,217,640 admissions included in the principal analysis, with 187,337 in-hospital deaths reported within 30 days of admission. Admission on weekend days was associated with a considerable increase in risk of subsequent death compared with admission on weekdays, hazard ratio for Sunday versus Wednesday 1.16 (95% CI 1.14 to 1.18; P < .0001), and for Saturday versus Wednesday 1.11 (95% CI 1.09 to 1.13; P < .0001). Hospital stays on weekend days were associated with a lower risk of death than midweek days, hazard ratio for being in hospital on Sunday versus Wednesday 0.92 (95% CI 0.91 to 0.94; P < .0001), and for Saturday versus Wednesday 0.95 (95% CI 0.93 to 0.96; P < .0001). Similar findings were observed on a smaller US data set. Admission at the weekend is associated with increased risk of subsequent death within 30 days of admission. The likelihood of death actually occurring is less on a weekend day than on a mid-week day.

Health Risk Behavior in Foster Youth

PubMed Central

Gramkowski, Bridget; Kools, Susan; Paul, Steven; Boyer, Cherrie; Monasterio, Erica; Robbins, Nancy

2010-01-01

Problem Adolescent health problems are predominantly caused by risk behavior. Foster adolescents have disproportionately poor health; therefore identification of risk behavior is critical. Method A secondary analysis of data from a larger study investigated the health risk behavior of 56 foster youth using the CHIP-AE. Findings Foster youth had some increased risk behavior. Younger adolescents and those in kinship care had less risky behavior. Youth had more risk behavior when: in group homes, parental death, histories of physical or emotional abuse, or history of attempted suicide. Conclusions These results point to areas of strength and vulnerability in foster youth. PMID:19490278

Health Risk Management for Bioenvironmental Engineering

DTIC Science & Technology

2013-06-01

success. • Health Risk Estimate ( HRE ). HRE is the probability and severity of loss from exposure to the health threat ( HRE is a function of...probability and severity; when either or both increase the HRE increases). The HRE is also referred to as a health risk level. An HRE is a measure of the...assessments) OEH threats in populations or at locations over time (HRA = f [(health risk) “+” ( HRE ) “+” (COA)]). The HRA “product” is the validated

Cumulative Risk Assessment (CRA): Transforming the Way We Assess Health Risks

PubMed Central

Williams, Pamela R. D.; Dotson, G. Scott; Maier, Andrew

2016-01-01

Human health risk assessments continue to evolve and now focus on the need for cumulative risk assessment (CRA). CRA involves assessing the combined risk from coexposure to multiple chemical and nonchemical stressors for varying health effects. CRAs are broader in scope than traditional chemical risk assessments because they allow for a more comprehensive evaluation of the interaction between different stressors and their combined impact on human health. Future directions of CRA include greater emphasis on local-level community-based assessments; integrating environmental, occupational, community, and individual risk factors; and identifying and implementing common frameworks and risk metrics for incorporating multiple stressors. PMID:22938698

Health shocks and risk aversion.

PubMed

Decker, Simon; Schmitz, Hendrik

2016-12-01

We empirically assess whether a health shock influences individual risk aversion. We use grip strength data to obtain an objective health shock indicator. In order to account for the non-random nature of our data regression-adjusted matching is employed. Risk preferences are traditionally assumed to be constant. However, we find that a health shock increases individual risk aversion. The finding is robust to a series of sensitivity analyses and persists for at least four years after the shock. Income changes do not seem to be the driving mechanism. Copyright © 2016 Elsevier B.V. All rights reserved.

42 CFR 417.592 - Additional benefits requirement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Additional benefits requirement. 417.592 Section... HEALTH CARE PREPAYMENT PLANS Medicare Payment: Risk Basis § 417.592 Additional benefits requirement. (a... benefits. Provide its Medicare enrollees with additional benefits in accordance with paragraph (c) of this...

The present global financial and economic crisis poses an additional risk factor for mental health problems on the employees.

PubMed

Avčin, Bojana Avguštin; Kučina, Andrea Užmah; Sarotar, Brigita Novak; Radovanović, Mirjana; Plesničar, Blanka Kores

2011-09-01

The global financial and economic crisis starting in 2007 led to a deterioration of several socio-economic determinants of mental health. The aim of this cross-sectional study was to examine the impact of the present economic crisis on the depression and anxiety levels of the employed in the private and public sector in Slovenia. Altogether 1592 employees completed an internet based self-reported questionnaire. Data about perceived impact of the economic crisis, several socio-demographic, socioeconomic, and health parameters were collected. Depression symptoms were assessed by the Center for Epidemiological Studies-Depression Scale and anxiety symptoms by the Spielberger State-Inventory. Regression models were used 1) to explore the associations of the economic crisis with the level of depression and anxiety symptoms while controlling for some sociodemographic and work characteristic variables, and 2) to understand the relationship between some potentially important socioeconomic variables and the perception of the economic crisis. Depressive and anxiety scores were significantly increased among 590 (46.6%) employees being affected by the economic crisis. The level of depressive symptoms was significantly associated with perceived impact by the crisis, recent sick leave, reported injuries sustained at work, benzodiazepine and analgesic use, the lack of emotional support, and trust in crisis telephone lines. The level of anxiety symptoms yielded the robust association with the level of depression symptoms, reported injuries sustained on the way to work and education. The economic crisis poses an additional risk factor for mental health problems which clinicians should internalize and become more aware of them. Symptoms of depression and anxiety can be masked in high-utilizers of medical care with physical complaints or psychoactive drug use.

[Increased financial risks for health insurers: a challenge for providers of mental health care in the Netherlands].

PubMed

Daansen, P J; van Schilt, J

2014-01-01

As from 2014 Dutch health insurance companies will bear the full financial risk for their clients in mental health care. Over the next years the existing risk settlement shared between insurance companies will gradually be brought to a close. Municipalities and the Ministry of Justice are already responsible for or will soon become responsible for financing health care for adolescents, patients with severe psychiatric disorders and forensic psychiatric patients. As a result, the health insurance companies are beginning to impose ever stricter conditions regarding the care 'product' they are 'buying'. To study the possible consequences, for mental health care institutions, of the increased risk to be borne by health care insurers. Use was made of relevant marketing literature and literature relating to mental health care. Studies of Dutch mental health care literature indicate that in the future the purchasing procedure will no longer consider the immediate treatment outcome as the sole performance indicator but will also take into account additional factors such as long-term improvements in patients' health, customer satisfaction and degree of patient participation, patient empowerment and autonomy. In formulating the details of their health products and business strategies, health care providers will now have to take into account not only the efficacy of the treatment they provide but also the purchasing policy and strategy of the health insurance companies.

Characterizing chronic and acute health risks of residues of veterinary drugs in food: latest methodological developments by the joint FAO/WHO expert committee on food additives.

PubMed

Boobis, Alan; Cerniglia, Carl; Chicoine, Alan; Fattori, Vittorio; Lipp, Markus; Reuss, Rainer; Verger, Philippe; Tritscher, Angelika

2017-11-01

The risk assessment of residues of veterinary drugs in food is a field that continues to evolve. The toxicological end-points to be considered are becoming more nuanced and in light of growing concern about the development of antimicrobial resistance, detailed analysis of the antimicrobial activity of the residues of veterinary drugs in food is increasingly incorporated in the assessment. In recent years, the Joint FAO/WHO Expert Committee on Food Additives (JECFA) has refined its approaches to provide a more comprehensive and fit-for-purpose risk assessment. This publication describes in detail the consideration of acute and chronic effects, the estimation of acute and chronic dietary exposure, current approaches for including microbiological endpoints in the risk assessment, and JECFA's considerations for the potential effects of food processing on residues from veterinary drugs. JECFA now applies these approaches in the development of health-based guidance values (i.e. safe exposure levels) for residues of veterinary drugs. JECFA, thus, comprehensively addresses acute and chronic risks by using corresponding estimates for acute and chronic exposure and suitable correction for the limited bioavailability of bound residues by the Gallo-Torres model. On a case-by-case basis, JECFA also considers degradation products that occur from normal food processing of food containing veterinary drug residues. These approaches will continue to be refined to ensure the most scientifically sound basis for the establishment of health-based guidance values for veterinary drug residues.

Risk factors for work-related stress and health in head teachers.

PubMed

Phillips, Samantha J; Sen, Dil; McNamee, Roseanne

2008-12-01

Work-related stress (WRS) is known to cause ill-health and decreased productivity. Work in the education sector is thought to be particularly stressful. Few studies have considered risk factors for WRS and health in head teachers. To investigate health in head teachers in West Sussex. To determine personal risk factors most likely to predict cases of WRS and of poor health in head teachers. A cross-sectional study, in a population of 290 head teachers and principals of colleges of further education, using a validated questionnaire, 'a short stress evaluation tool' (ASSET) and additional questions derived from earlier studies. Results were compared with the ASSET database 'norm' groups: a general population of workers (GPN) group and a group of managers and professionals (MPN). 'Caseness' was defined as respondents who felt work was 'very or extremely stressful'. Head teachers had poor physical and mental health compared to the GPN group. Psychological well-being, particularly of females and primary head teachers was worse than a comparative group of managers and professionals. Teaching<5 h/week was a significant predictor of caseness and being female was the main risk factor for poor psychological well-being. Prevalence of self-reported stress in head teachers in West Sussex is high. Female head teachers had worse health outcomes. Our study identified possible personal risk factors predicting WRS and/or poor health in head teachers.

A review of heavy metals in indoor dust and its human health-risk implications.

PubMed

Tan, Sock Yin; Praveena, Sarva Mangala; Abidin, Emilia Zainal; Cheema, Manraj Singh

2016-12-01

Indoor dust acts as a media for heavy metal deposition. Past studies have shown that heavy metal concentration in indoor dust is affected by local human activities and atmospheric transport can have harmful effects on human health. Additionally, children are more sensitive to heavy metals due to their hand-to-mouth behaviour and rapid body development. However, limited information on health risks were found in past dust studies as these studies aimed to identify heavy metal concentrations and sources of indoor dust. The objective of this review is to discuss heavy metal concentration and sources influencing its concentration in indoor dust. Accordingly, high lead (Pb) concentration (639.10 μg/g) has been reported in heavy traffic areas. In addition, this review paper aims to estimate the health risk to children from heavy metals in indoor dust via multiple exposure pathways using the health-risk assessment (HRA). Urban areas and industrial sites have revealed high heavy metal concentration in comparison to rural areas. Hazard index (HI) values found in arsenic (As), chromium (Cr) and Pb were 21.30, 1.10 and 2.40, respectively, indicate that non-carcinogenic elements are found in children. Furthermore, most of the past studies have found that carcinogenic risks for As, cadmium (Cd), Cr and Pb were below the acceptable total lifetime cancer risk (TLCR) range (1×10-6-1×10-4). The results of health risk assessment in this review show that carcinogenic risk exists among children. Hence, this proves that future studies need to focus on children's carcinogenic risk in indoor dust studies in order to find out the sources of heavy metals in indoor dust. This review highlights the importance of having the HRA application using bioavailable heavy metal concentration as it provides more accurate health-risk estimation. Moreover, this review is also useful as a reference for policy decision making in protecting children's health.

Rural Latino adolescent health: preliminary examination of health risks and cultural correlates.

PubMed

Nelson, Timothy D; Kidwell, Katherine M; Armenta, Brian E; Crockett, Lisa J; Carlo, Gustavo; Whitbeck, Les B

2014-06-01

Latino adolescents living in rural settings may be at increased risk of health problems; however, data describing the health status of this population are limited. This study examined 60 rural Latino adolescents and found high rates of health risk, including at-risk/clinical results for hemoglobin A1C (23.3%), high-density lipoprotein cholesterol (55%), systolic blood pressure (21.7%), and overweight/obesity (55%). Time in sedentary behaviors was high and physical activity was limited. Adolescent language use was associated with health risk status, with greater use of English associated with lower risk. Health psychologists could promote improved health by providing health behavior interventions to this underserved population. © The Author(s) 2013.

Profiles of Risk: Maternal Health, Socioeconomic Status, and Child Health

PubMed Central

Hardie, Jessica Halliday; Landale, Nancy S.

2013-01-01

Child health is fundamental to well-being and achievement throughout the life course. Prior research has demonstrated strong associations between familial socioeconomic resources and children’s health outcomes, with especially poor health outcomes among disadvantaged youth who experience a concentration of risks, yet little is known about the influence of maternal health as a dimension of risk for children. This research used nationally representative U.S. data from the National Health Interview Surveys in 2007 and 2008 (N = 7,361) to evaluate the joint implications of maternal health and socioeconomic disadvantage for youth. Analyses revealed that maternal health problems were present in a substantial minority of families, clustered meaningfully with other risk factors, and had serious implications for children’s health. These findings support the development of health policies and interventions aimed at families. PMID:23794751

Chemical Risk Assessment: Traditional vs Public Health ...

EPA Pesticide Factsheets

Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. When done efficiently and properly, chemical risk assessment enables risk management actions that minimize the incidence and impacts of environmentally-induced diseases related to chemical exposure. However, traditional chemical risk assessment is faced with multiple challenges with respect to predicting and preventing disease in human populations, and epidemiological studies increasingly report observations of adverse health effects at exposure levels predicted from animal studies to be safe for humans. This discordance reinforces concerns about the adequacy of contemporary risk assessment practices (Birnbaum, Burke, & Jones, 2016) for protecting public health. It is becoming clear that to protect public health more effectively, future risk assessments will need to use the full range of available data, draw on innovative methods to integrate diverse data streams, and consider health endpoints that also reflect the range of subtle effects and morbidities observed in human populations. Given these factors, there is a need to reframe chemical risk assessment to be more clearly aligned with the public health goal of minimizing environmental exposures associated with disease. Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. Chemical risk assessments

Financial Risk Protection and Universal Health Coverage: Evidence and Measurement Challenges

PubMed Central

Saksena, Priyanka; Hsu, Justine; Evans, David B.

2014-01-01

Financial risk protection is a key component of universal health coverage (UHC), which is defined as access to all needed quality health services without financial hardship. As part of the PLOS Medicine Collection on measurement of UHC, the aim of this paper is to examine and to compare and contrast existing measures of financial risk protection. The paper presents the rationale behind the methodologies for measuring financial risk protection and how this relates to UHC as well as some empirical examples of the types of measures. Additionally, the specific challenges related to monitoring inequalities in financial risk protection are discussed. The paper then goes on to examine and document the practical challenges associated with measurement of financial risk protection. This paper summarizes current thinking on the area of financial risk protection, provides novel insights, and suggests future developments that could be valuable in the context of monitoring progress towards UHC. PMID:25244520

Self-perceived health versus actual cardiovascular disease risks.

PubMed

Ko, Young; Boo, Sunjoo

2016-01-01

Self-perceived poor health is related to cardiovascular disease (CVD) risk perception, cardiovascular event, hospital readmission, and death from CVD. This study evaluated the associations between self-perceived health and actual CVD risk in South Koreans as well as the influence of sociodemographic and cardiovascular risk factors on self-perceived poor health. This is a secondary data analysis of the 2010 Korea National Health and Nutrition Examination Survey. The sample was 4535 South Koreans aged 30-74 years without CVD. Self-perceived health status was compared with actual cardiovascular risk separately by sex using χ(2) -tests. Logistic regressions were used to identify potential sociodemographic and cardiovascular risk factors of self-perceived poor health. Self-perceived poor health was related to higher CVD risk but there were substantial gaps between them. Among cardiovascular risk factors, dyslipidemia, obesity, smoking, and a family history of CVD did not affect self-perceived health. Gaps between perceived health and actual CVD risk should be closed to optimize cardiovascular health of South Koreans. Koreans need to increase risk perception to a level commensurate with their actual risk. Healthcare providers should try to provide individuals at increased CVD risk with better information more frequently, especially those who have favorable perceptions of their health but smoke or have elevated cholesterol levels and bodyweight. © 2015 Japan Academy of Nursing Science.

The global burden of oral diseases and risks to oral health.

PubMed Central

Petersen, Poul Erik; Bourgeois, Denis; Ogawa, Hiroshi; Estupinan-Day, Saskia; Ndiaye, Charlotte

2005-01-01

This paper outlines the burden of oral diseases worldwide and describes the influence of major sociobehavioural risk factors in oral health. Despite great improvements in the oral health of populations in several countries, global problems still persist. The burden of oral disease is particularly high for the disadvantaged and poor population groups in both developing and developed countries. Oral diseases such as dental caries, periodontal disease, tooth loss, oral mucosal lesions and oropharyngeal cancers, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)-related oral disease and orodental trauma are major public health problems worldwide and poor oral health has a profound effect on general health and quality of life. The diversity in oral disease patterns and development trends across countries and regions reflects distinct risk profiles and the establishment of preventive oral health care programmes. The important role of sociobehavioural and environmental factors in oral health and disease has been shown in a large number of socioepidemiological surveys. In addition to poor living conditions, the major risk factors relate to unhealthy lifestyles (i.e. poor diet, nutrition and oral hygiene and use of tobacco and alcohol), and limited availability and accessibility of oral health services. Several oral diseases are linked to noncommunicable chronic diseases primarily because of common risk factors. Moreover, general diseases often have oral manifestations (e.g. diabetes or HIV/AIDS). Worldwide strengthening of public health programmes through the implementation of effective measures for the prevention of oral disease and promotion of oral health is urgently needed. The challenges of improving oral health are particularly great in developing countries. PMID:16211157

The Relation between Adolescent Self Assessment of Health and Risk Behaviours: Could a Global Measure of Health Provide Indications of Health Risk Exposures?

ERIC Educational Resources Information Center

Nkansah-Amankra, Stephen; Walker, Ashley Dawn

2012-01-01

Objective: Self-rated health (SRH) has become a key organizing construct for assessing multiple dimensions of populations' physical and psychosocial health functioning. However, it is unclear how adolescents' subjective self assessment of health reflects health risk exposures, co-occurring health risks (problem behaviours) and other pre-existing…

Health Risk Assessment of Inhalable Particulate Matter in Beijing Based on the Thermal Environment

PubMed Central

Xu, Lin-Yu; Yin, Hao; Xie, Xiao-Dong

2014-01-01

Inhalable particulate matter (PM10) is a primary air pollutant closely related to public health, and an especially serious problem in urban areas. The urban heat island (UHI) effect has made the urban PM10 pollution situation more complex and severe. In this study, we established a health risk assessment system utilizing an epidemiological method taking the thermal environment effects into consideration. We utilized a remote sensing method to retrieve the PM10 concentration, UHI, Normalized Difference Vegetation Index (NDVI), and Normalized Difference Water Index (NDWI). With the correlation between difference vegetation index (DVI) and PM10 concentration, we utilized the established model between PM10 and thermal environmental indicators to evaluate the PM10 health risks based on the epidemiological study. Additionally, with the regulation of UHI, NDVI and NDWI, we aimed at regulating the PM10 health risks and thermal environment simultaneously. This study attempted to accomplish concurrent thermal environment regulation and elimination of PM10 health risks through control of UHI intensity. The results indicate that urban Beijing has a higher PM10 health risk than rural areas; PM10 health risk based on the thermal environment is 1.145, which is similar to the health risk calculated (1.144) from the PM10 concentration inversion; according to the regulation results, regulation of UHI and NDVI is effective and helpful for mitigation of PM10 health risk in functional zones. PMID:25464132

Occupational health and safety: Designing and building with MACBETH a value risk-matrix for evaluating health and safety risks

NASA Astrophysics Data System (ADS)

Lopes, D. F.; Oliveira, M. D.; Costa, C. A. Bana e.

2015-05-01

Risk matrices (RMs) are commonly used to evaluate health and safety risks. Nonetheless, they violate some theoretical principles that compromise their feasibility and use. This study describes how multiple criteria decision analysis methods have been used to improve the design and the deployment of RMs to evaluate health and safety risks at the Occupational Health and Safety Unit (OHSU) of the Regional Health Administration of Lisbon and Tagus Valley. ‘Value risk-matrices’ (VRMs) are built with the MACBETH approach in four modelling steps: a) structuring risk impacts, involving the construction of descriptors of impact that link risk events with health impacts and are informed by scientific evidence; b) generating a value measurement scale of risk impacts, by applying the MACBETH-Choquet procedure; c) building a system for eliciting subjective probabilities that makes use of a numerical probability scale that was constructed with MACBETH qualitative judgments on likelihood; d) and defining a classification colouring scheme for the VRM. A VRM built with OHSU members was implemented in a decision support system which will be used by OHSU members to evaluate health and safety risks and to identify risk mitigation actions.

Towards Improved Linkage of Disaster Risk Reduction and Climate Change Adaptation in Health: A Review.

PubMed

Banwell, Nicola; Rutherford, Shannon; Mackey, Brendan; Chu, Cordia

2018-04-18

Climate change and climate-sensitive disasters significantly impact health. Linking Disaster Risk Reduction (DRR) and Climate Change Adaptation (CCA) is essential for addressing these ever present, complex and increasing risks. Recent calls have been made to build these links in health. However, there is a need to clearly articulate why linking DRR and CCA is important in health. Furthermore, little is known about how DRR and CCA should be linked in health. By extensively examining relevant literature, this review presents the current state of knowledge of linking DRR and CCA in health. This includes the potential for maximising conceptual synergies such as building resilience, and reducing vulnerability and risk. Additionally, technical and operational synergies are identified to link DRR and CCA in health, including: policy, Early Warning Systems, vulnerability and risk assessment, health systems strengthening, infrastructure resilience, disaster preparedness and response, and health impact pathways. Public health actors have a central role in building these links due to their expertise, work functions, and experience in addressing complex health risks. The review concludes with recommendations for future research, including how to better link DRR and CCA in health; and the opportunities, challenges and enablers to build and sustain these links.

Survey of mental health nurses' attitudes towards risk assessment, risk assessment tools and positive risk.

PubMed

Downes, C; Gill, A; Doyle, L; Morrissey, J; Higgins, A

2016-04-01

WHAT IS KNOWN ON THE SUBJECT?: Risk assessment and safety planning are a core aspect of the role of the mental health nurse. Conflicting views exist on the value of risk assessment tools. Few studies have examined mental health nurses' attitudes towards risk, including use of tools and the role of positive risk in recovery. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Mental health nurses view risk assessment as a core dimension of their role and not merely an exercise to fulfil organizational clinical safety and governance obligations. The majority of nurses hold positive attitudes towards therapeutic or positive risk, and consider creative risk taking as vital to people's recovery. The majority of nurses believe that risk assessment tools facilitate professional decision making, however, some are concerned that tools may negatively impact upon therapeutic relationships. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Ongoing education on the use of risk assessment tools is required to minimize views that their use is incompatible with therapeutic engagement, and to enable nurses to develop confidence to engage with positive risk and to allow service users make decisions and take responsibility. Introduction Risk assessment and safety planning are considered core components of the role of the mental health nurse; however, little is known about nurses' attitudes towards risk assessment, use of tools to assess risk or therapeutic risk taking. Aim This study aimed to explore mental health nurses' attitudes towards completing risk assessments, use of tools as an aid, and therapeutic or positive risk. Method An anonymous survey which included 13 attitudinal statements, rated on a five-point Likert scale, was completed by 381 mental health nurses working in adult services in Ireland. Findings Findings indicate strong support for the practice of risk assessment in mental health practice. The vast majority of nurses believe that risk assessment tools facilitate professional

Clustering of risk factors for non-communicable disease and healthcare expenditure in employees with private health insurance presenting for health risk appraisal: a cross-sectional study

PubMed Central

2013-01-01

Background The global increase in the prevalence of NCD’s is accompanied by an increase in risk factors for these diseases such as insufficient physical activity and poor nutritional habits. The main aims of this research study were to determine the extent to which insufficient physical activity (PA) clustered with other risk factors for non-communicable disease (NCD) in employed persons undergoing health risk assessment, and whether these risk factors were associated with higher healthcare costs. Methods Employees from 68 companies voluntarily participated in worksite wellness days, that included an assessment of self-reported health behaviors and clinical measures, such as: blood pressure (BP), Body Mass Index (BMI), as well as total cholesterol concentrations from capillary blood samples. A risk-related age, ‘Vitality Risk Age’ was calculated for each participant using an algorithm that incorporated multiplicative pooled relative risks for all cause mortality associated with smoking, PA, fruit and vegetable intake, BMI, BP and cholesterol concentration. Healthcare cost data were obtained for employees (n = 2 789). Results Participants were 36 ± 10 years old and the most prevalent risk factors were insufficient PA (67%) and BMI ≥ 25 (62%). Employees who were insufficiently active also had a greater number of other NCD risk factors, compared to those meeting PA recommendations (chi2 = 43.55; p < 0.0001). Moreover, employees meeting PA guidelines had significantly fewer visits to their family doctor (GP) (2.5 versus 3.11; p < 0.001) than those who were insufficiently PA, which was associated with an average cost saving of ZAR100 per year (p < 0.01). Furthermore, for every additional year that the ‘Vitality Risk Age’ was greater than chronological age, there was a 3% increased likelihood of at least one additional visit to the doctor (OR = 1.03; 95% CI = 1.01 – 1.05). Conclusion Physical inactivity was associated with clustering of risk

Clustering of risk factors for non-communicable disease and healthcare expenditure in employees with private health insurance presenting for health risk appraisal: a cross-sectional study.

PubMed

Kolbe-Alexander, Tracy L; Conradie, Jaco; Lambert, Estelle V

2013-12-21

The global increase in the prevalence of NCD's is accompanied by an increase in risk factors for these diseases such as insufficient physical activity and poor nutritional habits. The main aims of this research study were to determine the extent to which insufficient physical activity (PA) clustered with other risk factors for non-communicable disease (NCD) in employed persons undergoing health risk assessment, and whether these risk factors were associated with higher healthcare costs. Employees from 68 companies voluntarily participated in worksite wellness days, that included an assessment of self-reported health behaviors and clinical measures, such as: blood pressure (BP), Body Mass Index (BMI), as well as total cholesterol concentrations from capillary blood samples. A risk-related age, 'Vitality Risk Age' was calculated for each participant using an algorithm that incorporated multiplicative pooled relative risks for all cause mortality associated with smoking, PA, fruit and vegetable intake, BMI, BP and cholesterol concentration. Healthcare cost data were obtained for employees (n = 2 789). Participants were 36±10 years old and the most prevalent risk factors were insufficient PA (67%) and BMI ≥ 25 (62%). Employees who were insufficiently active also had a greater number of other NCD risk factors, compared to those meeting PA recommendations (chi2 = 43.55; p < 0.0001). Moreover, employees meeting PA guidelines had significantly fewer visits to their family doctor (GP) (2.5 versus 3.11; p < 0.001) than those who were insufficiently PA, which was associated with an average cost saving of ZAR100 per year (p < 0.01). Furthermore, for every additional year that the 'Vitality Risk Age' was greater than chronological age, there was a 3% increased likelihood of at least one additional visit to the doctor (OR = 1.03; 95% CI = 1.01 - 1.05). Physical inactivity was associated with clustering of risk factors for NCD in SA employees. Employees with lower BMI, better

Risks associated with endotoxins in feed additives produced by fermentation.

PubMed

Wallace, R John; Gropp, Jürgen; Dierick, Noël; Costa, Lucio G; Martelli, Giovanna; Brantom, Paul G; Bampidis, Vasileios; Renshaw, Derek W; Leng, Lubomir

2016-01-15

Increasingly, feed additives for livestock, such as amino acids and vitamins, are being produced by Gram-negative bacteria, particularly Escherichia coli. The potential therefore exists for animals, consumers and workers to be exposed to possibly harmful amounts of endotoxin from these products. The aim of this review was to assess the extent of the risk from endotoxins in feed additives and to calculate how such risk can be assessed from the properties of the additive. Livestock are frequently exposed to a relatively high content of endotoxin in the diet: no additional hazard to livestock would be anticipated if the endotoxin concentration of the feed additive falls in the same range as feedstuffs. Consumer exposure will be unaffected by the consumption of food derived from animals receiving endotoxin-containing feed, because the small concentrations of endotoxin absorbed do not accumulate in edible tissues. In contrast, workers processing a dusty additive may be exposed to hazardous amounts of endotoxin even if the endotoxin concentration of the product is low. A calculation method is proposed to compare the potential risk to the worker, based on the dusting potential, the endotoxin concentration and technical guidance of the European Food Safety Authority, with national exposure limits.

Work stress and health risk behavior.

PubMed

Siegrist, Johannes; Rödel, Andreas

2006-12-01

This contribution discusses current knowledge of associations between psychosocial stress at work and health risk behavior, in particular cigarette smoking, alcohol consumption and overweight, by reviewing findings from major studies in the field published between 1989 and 2006. Psychosocial stress at work is measured by the demand-control model and the effort-reward imbalance model. Health risk behavior was analyzed in the broader context of a health-related Western lifestyle with socially and economically patterned practices of consumption. Overall, the review, based on 46 studies, only modestly supports the hypothesis of a consistent association between work stress and health risk behavior. The relatively strongest relationships have been found with regard to heavy alcohol consumption among men, overweight, and the co-manifestation of several risks. Suggestions for further research are given, and the need to reduce stressful experience in the framework of worksite health promotion programs is emphasized.

Public health and vector-borne diseases - a new concept for risk governance.

PubMed

Schmidt, K; Dressel, K M; Niedrig, M; Mertens, M; Schüle, S A; Groschup, M H

2013-12-01

Public Health is defined as an interdisciplinary multilevel approach that deals with questions of preventing diseases at the population level. In this context, this paper focuses on vector-borne diseases as an important threat with an increasing impact on human and animal health. Emphasis is laid on an integrated health approach ('One-Health' initiative) as it recognizes the interrelated nature of both human and animal health. The importance of vector-borne diseases to new and emerging diseases in Europe was demonstrated, for example, by the recent outbreak of West Nile virus infections in Greece, Northern Italy and Hungary; the spread of Crimean-Congo haemorrhagic fever virus across Turkey, south-western countries of the former USSR and the Balkans; the dramatic increase in hantavirus infections in Germany in 2012; and the dengue virus outbreak in Portugal in the same year. This paper provides a systematic approach for the analysis, assessment and governance of emerging health risks attributed to vector-borne diseases by using a holistic approach developed by the International Risk Governance Council (IRGC), called the 'IRGC Risk Governance Framework'. It can be used by decision-makers and general Public Health authorities in order to evaluate the situation regarding any specific pathogen or Public Health risk and to decide if additional measures should be implemented. © 2013 Blackwell Verlag GmbH.

Health-Based Capitation Risk Adjustment in Minnesota Public Health Care Programs

PubMed Central

Gifford, Gregory A.; Edwards, Kevan R.; Knutson, David J.

2004-01-01

This article documents the history and implementation of health-based capitation risk adjustment in Minnesota public health care programs, and identifies key implementation issues. Capitation payments in these programs are risk adjusted using an historical, health plan risk score, based on concurrent risk assessment. Phased implementation of capitation risk adjustment for these programs began January 1, 2000. Minnesota's experience with capitation risk adjustment suggests that: (1) implementation can accelerate encounter data submission, (2) administrative decisions made during implementation can create issues that impact payment model performance, and (3) changes in diagnosis data management during implementation may require changes to the payment model. PMID:25372356

Implementation of health risk assessments with family health history: barriers and benefits.

PubMed

Wu, R Ryanne; Orlando, Lori A

2015-09-01

Health risk assessments provide an opportunity to emphasise health promotion and disease prevention for individuals and populations at large. A key component of health risk assessments is the detailed collection of family health history information. This information is helpful in determining risk both for common chronic conditions and more rare diseases as well. While the concept of health risk assessments has been around since the Framingham Heart Study was launched in the 1950s, and such assessments are commonly performed in the workplace today, the US healthcare system has been slow to embrace them and the emphasis on prevention that they represent. Before wider implementation of health risk assessments within healthcare can be seen, several concerns must be addressed: (1) provider impact, (2) patient impact, (3) validity of patient-entered data and (4) health outcomes effect. Here, we describe recent developments in health risk assessment design that are helping to address these issues. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Occupational risks and pregnancy and infant health outcomes in Florida farmworkers.

PubMed

Runkle, Jennifer; Flocks, Joan; Economos, Jeannie; Tovar-Aguilar, J Antonio; McCauley, Linda

2014-08-06

The agricultural industry has some of the highest incidence rates and numbers of occupational injuries and illnesses in the United States. Injuries and illnesses in agriculture result from accidents, falls, excessive heat, repetitive motion and adverse pesticide exposure. Women working in agriculture are exposed to the same hazards and risks as their male counterparts, but can face additional adverse impacts on their reproductive health. Yet, few occupational risk assessment studies have considered the reproductive health of female farmworkers. The objective of this community-based participatory research study was to conduct a retrospective, cross-sectional survey to collect information on workplace conditions and behaviors and maternal, pregnancy and infant health outcomes among a sample of female nursery and fernery farmworkers in Central Florida. Survey results showed that nursery workers were more likely to report health symptoms during their pregnancy than fernery workers. We also observed a self-reported increased risk of respiratory illness in the first year of life for infants whose mothers worked in ferneries. Our findings confirm that agricultural work presents potential reproductive hazards for women of childbearing age.

Occupational Risks and Pregnancy and Infant Health Outcomes in Florida Farmworkers

PubMed Central

Runkle, Jennifer; Flocks, Joan; Economos, Jeannie; Tovar-Aguilar, J. Antonio; McCauley, Linda

2014-01-01

The agricultural industry has some of the highest incidence rates and numbers of occupational injuries and illnesses in the United States. Injuries and illnesses in agriculture result from accidents, falls, excessive heat, repetitive motion and adverse pesticide exposure. Women working in agriculture are exposed to the same hazards and risks as their male counterparts, but can face additional adverse impacts on their reproductive health. Yet, few occupational risk assessment studies have considered the reproductive health of female farmworkers. The objective of this community-based participatory research study was to conduct a retrospective, cross-sectional survey to collect information on workplace conditions and behaviors and maternal, pregnancy and infant health outcomes among a sample of female nursery and fernery farmworkers in Central Florida. Survey results showed that nursery workers were more likely to report health symptoms during their pregnancy than fernery workers. We also observed a self-reported increased risk of respiratory illness in the first year of life for infants whose mothers worked in ferneries. Our findings confirm that agricultural work presents potential reproductive hazards for women of childbearing age. PMID:25101767

Comparison of health risk behavior, awareness, and health benefit beliefs of health science and non-health science students: An international study.

PubMed

Peltzer, Karl; Pengpid, Supa; Yung, Tony K C; Aounallah-Skhiri, Hajer; Rehman, Rehana

2016-06-01

This study determines the differences in health risk behavior, knowledge, and health benefit beliefs between health science and non-health science university students in 17 low and middle income countries. Anonymous questionnaire data were collected in a cross-sectional survey of 13,042 undergraduate university students (4,981 health science and 8,061 non-health science students) from 17 universities in 17 countries across Asia, Africa, and the Americas. Results indicate that overall, health science students had the same mean number of health risk behaviors as non-health science university students. Regarding addictive risk behavior, fewer health science students used tobacco, were binge drinkers, or gambled once a week or more. Health science students also had a greater awareness of health behavior risks (5.5) than non-health science students (4.6). Linear regression analysis found a strong association with poor or weak health benefit beliefs and the health risk behavior index. There was no association between risk awareness and health risk behavior among health science students and an inverse association among non-health science students. © 2015 Wiley Publishing Asia Pty Ltd.

Health Risks of an Inactive Lifestyle

MedlinePlus

... may develop a hormonal imbalance What are the health risks of an inactive lifestyle? Having an inactive ... the more sedentary you are, the higher your health risks are. How can I get started with ...

Knowledge and perception about health risks of cigarette smoking among Iraqi smokers.

PubMed

Dawood, Omar Thanoon; Rashan, Mohammed Abd Ahmed; Hassali, Mohamed Azmi; Saleem, Fahad

2016-01-01

Smoking is a major public health problem, especially in Iraq. There is very little information had been documented regarding smoking risk factors and quit intention among Iraqi smokers. The main objectives of this study are to determine smokers' knowledge and perception about smoking health risks; and to determine smoking behavior and quitting intentions among Iraqi smokers; as well as to predict the factors that may associate with quit intentions. A cross-sectional study was conducted at the outpatient clinic in Tikrit Teaching Hospital, Tikrit City, Iraq. Adult smokers who are smoking cigarette everyday and able to communicate with the researcher were invited to participate in the study. A self-administered questionnaire was used to collect data from 386 participants. This study showed that smokers had low awareness about some risk effects of smoking such as lung cancer in nonsmokers (30.1%), impotence in male smokers (52.6%), premature ageing (64%), and stroke (66.3%). In addition, the high score of knowledge and perception was significantly associated with quitting intention. Smokers' knowledge and perception regarding smoking health effects were low, especially in terms of secondhand smokers. Many efforts needed from health policy-makers and health care professionals to disseminate information about the risks of smoking and health benefits of give up smoking.

45 CFR 162.930 - Additional rules for health care clearinghouses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Additional rules for health care clearinghouses. 162.930 Section 162.930 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA... Additional rules for health care clearinghouses. When acting as a business associate for another covered...

Endocrine disrupting compounds in drinking water supply system and human health risk implication.

PubMed

Wee, Sze Yee; Aris, Ahmad Zaharin

2017-09-01

To date, experimental and epidemiological evidence of endocrine disrupting compounds (EDCs) adversely affecting human and animal populations has been widely debated. Notably, human health risk assessment is required for risk mitigation. The lack of human health risk assessment and management may thus unreliably regulate the quality of water resources and efficiency of treatment processes. Therefore, drinking water supply systems (DWSSs) may be still unwarranted in assuring safe access to potable drinking water. Drinking water supply, such as tap water, is an additional and crucial route of human exposure to the health risks associated with EDCs. A holistic system, incorporating continuous research in DWSS monitoring and management using multi-barrier approach, is proposed as a preventive measure to reduce human exposure to the risks associated with EDCs through drinking water consumption. The occurrence of EDCs in DWSSs and corresponding human health risk implications are analyzed using the Needs, Approaches, Benefits, and Challenges (NABC) method. Therefore, this review may act as a supportive tool in protecting human health and environmental quality from EDCs, which is essential for decision-making regarding environmental monitoring and management purposes. Subsequently, the public could have sustainable access to safer and more reliable drinking water. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Work and mental health: risk groups].

PubMed

Vézina, M; Gingras, S

1996-01-01

Analysis of the Quebec Health survey identified those Quebec industrial sectors and professions in which workers are at risk of higher psychological distress and lower psychological well-being. Risk levels were measured by odds ratio, controlling for: health status, sex, social support and stressful life events. Results show that those at risk are blue collar workers and less qualified workers of traditional sectors. Lower job latitude could explain those results. Results show that risk of mental health problems is significantly higher in the following industrial sectors: leather, chemicals, paint and varnish industries; urban bus transport and taxi; shoe, clothing and textile retail stores; department stores; restaurant services; insurance and public administration (excluding defence). Risk of mental health problems is higher in the following professions road transport (excluding truck drivers); textile, leather, fur manufacturing and repairing; housekeeping and maintenance; painters, tapestry-workers, insulation and waterproofing, food and beverages sector; data processors; editors and university professors.

A systematic review of selected interventions for worksite health promotion. The assessment of health risks with feedback.

PubMed

Soler, Robin E; Leeks, Kimberly D; Razi, Sima; Hopkins, David P; Griffith, Matt; Aten, Adam; Chattopadhyay, Sajal K; Smith, Susan C; Habarta, Nancy; Goetzel, Ron Z; Pronk, Nicolaas P; Richling, Dennis E; Bauer, Deborah R; Buchanan, Leigh Ramsey; Florence, Curtis S; Koonin, Lisa; MacLean, Debbie; Rosenthal, Abby; Matson Koffman, Dyann; Grizzell, James V; Walker, Andrew M

2010-02-01

Many health behaviors and physiologic indicators can be used to estimate one's likelihood of illness or premature death. Methods have been developed to assess this risk, most notably the use of a health-risk assessment or biometric screening tool. This report provides recommendations on the effectiveness of interventions that use an Assessment of Health Risks with Feedback (AHRF) when used alone or as part of a broader worksite health promotion program to improve the health of employees. The Guide to Community Preventive Services' methods for systematic reviews were used to evaluate the effectiveness of AHRF when used alone and when used in combination with other intervention components. Effectiveness was assessed on the basis of changes in health behaviors and physiologic estimates, but was also informed by changes in risk estimates, healthcare service use, and worker productivity. The review team identified strong evidence of effectiveness of AHRF when used with health education with or without other intervention components for five outcomes. There is sufficient evidence of effectiveness for four additional outcomes assessed. There is insufficient evidence to determine effectiveness for others such as changes in body composition and fruit and vegetable intake. The team also found insufficient evidence to determine the effectiveness of AHRF when implemented alone. The results of these reviews indicate that AHRF is useful as a gateway intervention to a broader worksite health promotion program that includes health education lasting > or =1 hour or repeating multiple times during 1 year, and that may include an array of health promotion activities. These reviews form the basis of the recommendations by the Task Force on Community Preventive Services presented elsewhere in this supplement. Published by Elsevier Inc.

Addressing risks to advance mental health research.

PubMed

Iltis, Ana S; Misra, Sahana; Dunn, Laura B; Brown, Gregory K; Campbell, Amy; Earll, Sarah A; Glowinski, Anne; Hadley, Whitney B; Pies, Ronald; Dubois, James M

2013-12-01

Risk communication and management are essential to the ethical conduct of research, yet addressing risks may be time consuming for investigators and institutional review boards may reject study designs that seem too risky. This can discourage needed research, particularly in higher-risk protocols or those enrolling potentially vulnerable individuals, such as those with some level of suicidality. Improved mechanisms for addressing research risks may facilitate much needed psychiatric research. To provide mental health researchers with practical approaches to (1) identify and define various intrinsic research risks, (2) communicate these risks to others (eg, potential participants, regulatory bodies, and society), (3) manage these risks during the course of a study, and (4) justify the risks. As part of a National Institute of Mental Health-funded scientific meeting series, a public conference and a closed-session expert panel meeting were held on managing and disclosing risks in mental health clinical trials. The expert panel reviewed the literature with a focus on empirical studies and developed recommendations for best practices and further research on managing and disclosing risks in mental health clinical trials. No institutional review board-review was required because there were no human subjects. Challenges, current data, practical strategies, and topics for future research are addressed for each of 4 key areas pertaining to management and disclosure of risks in clinical trials: identifying and defining risks, communicating risks, managing risks during studies, and justifying research risks. Empirical data on risk communication, managing risks, and the benefits of research can support the ethical conduct of mental health research and may help investigators better conceptualize and confront risks and to gain institutional review board-approval.

Multiple health risk perception and information processing among African Americans and whites living in poverty.

PubMed

Hovick, Shelly R; Freimuth, Vicki S; Johnson-Turbes, Ashani; Chervin, Doryn D

2011-11-01

We investigated the risk-information-processing behaviors of people living at or near the poverty line. Because significant gaps in health and communication exist among high- and low-income groups, increasing the information seeking and knowledge of poor individuals may help them better understand risks to their health and increase their engagement in health-protective behaviors. Most earlier studies assessed only a single health risk selected by the researcher, whereas we listed 10 health risks and allowed the respondents to identify the one that they worried about most but took little action to prevent. Using this risk, we tested one pathway inspired by the risk information seeking and processing model to examine predictors of information insufficiency and of systematic processing and extended this pathway to include health-protective action. A phone survey was conducted of African Americans and whites living in the southern United States with an annual income of ≤$35,000 (N= 431). The results supported the model pathway: worry partially mediated the relationship between perceived risk and information insufficiency, which, in turn, increased systematic processing. In addition, systematic processing increased health-protective action. Compared with whites and better educated respondents, African Americans and respondents with little education had significantly higher levels of information insufficiency but higher levels of systematic processing and health-protective action. That systematic processing and knowledge influenced health behavior suggests a potential strategy for reducing health disparities. © 2011 Society for Risk Analysis.

Health-risk appraisal with or without disease management for worksite cardiovascular risk reduction.

PubMed

Maron, David J; Forbes, Barbara L; Groves, Jay R; Dietrich, Mary S; Sells, Patrick; DiGenio, Andres G

2008-01-01

Worksite health promotion programs use health risk appraisal (HRA) surveys to identify employees at increased risk, then provide a range of interventions to encourage high-risk individuals to improve their health. Our objective was to determine how the intensity of intervention after HRA affected cardiovascular risk after 1 year, comparing individual follow-up counseling with environmental supports. 133 employees of Vanderbilt University with cardiovascular risk factors were randomly assigned to worksite HRA plus targeted disease management (DM group) or HRA plus information about worksite health promotion programs (HRA group). The DM group received longitudinal individualized counseling for risk reduction, whereas the HRA group members received one feedback session about their risk factors and information about free worksite health promotion programs. The main outcome measure was the difference between groups in the change in average Framingham risk score from baseline to 1 year. There was no significant baseline difference between groups in the Framingham risk score. Among DM participants, the mean (SD) Framingham risk score decreased by 22.6%; among HRA participants, the mean score rose by 4.3% (P = .017 for the difference between groups). In this study of employees with cardiovascular risk factors, HRA followed by individual counseling was more effective than providing information about free worksite health promotion programs.

New approaches in human health risk assessment.

PubMed

Abass, Khaled; Carlsen, Anders; Rautio, Arja

2016-01-01

Studies on the precise impact of environmental pollutants on human health are difficult to undertake and interpret, because many genetic and environmental factors influence health at the same time and to varying degrees. Our chapter in the AMAP report was based on new approaches to describe risks and future needs. In this paper, we will introduce the issues associated with risk assessment of single chemicals, and present suggestions for future studies as well as a summary of lessons learned during the health-related parts of the European Union-funded FP7 project ArcRisk (Arctic Health Risks: Impacts on health in the Arctic and Europe owing to climate-induced changes in contaminant cycling, 2009-2014; www.arcrisk.eu).

Health Risks of Being Overweight?

MedlinePlus

... For Reporters Meetings & Workshops Follow Us Home Health Information Weight Management Health Risks of Being Overweight Related Topics Section ... at NIDDK Technology Advancement & Transfer Meetings & Workshops Health Information ... Disease Urologic Diseases Endocrine Diseases Diet & Nutrition ...

Brownfields and health risks--air dispersion modeling and health risk assessment at landfill redevelopment sites.

PubMed

Ofungwu, Joseph; Eget, Steven

2006-07-01

Redevelopment of landfill sites in the New Jersey-New York metropolitan area for recreational (golf courses), commercial, and even residential purposes seems to be gaining acceptance among municipal planners and developers. Landfill gas generation, which includes methane and potentially toxic nonmethane compounds usually continues long after closure of the landfill exercise phase. It is therefore prudent to evaluate potential health risks associated with exposure to gas emissions before redevelopment of the landfill sites as recreational, commercial, and, especially, residential properties. Unacceptably high health risks would call for risk management measures such as limiting the development to commercial/recreational rather than residential uses, stringent gas control mechanisms, interior air filtration, etc. A methodology is presented for applying existing models to estimate residual landfill hazardous compounds emissions and to quantify associated health risks. Besides the toxic gas constituents of landfill emissions, other risk-related issues concerning buried waste, landfill leachate, and explosive gases were qualitatively evaluated. Five contiguously located landfill sites in New Jersey intended for residential and recreational redevelopment were used to exemplify the approach.

Pharmaceutical supply chain risk assessment in Iran using analytic hierarchy process (AHP) and simple additive weighting (SAW) methods.

PubMed

Jaberidoost, Mona; Olfat, Laya; Hosseini, Alireza; Kebriaeezadeh, Abbas; Abdollahi, Mohammad; Alaeddini, Mahdi; Dinarvand, Rassoul

2015-01-01

Pharmaceutical supply chain is a significant component of the health system in supplying medicines, particularly in countries where main drugs are provided by local pharmaceutical companies. No previous studies exist assessing risks and disruptions in pharmaceutical companies while assessing the pharmaceutical supply chain. Any risks affecting the pharmaceutical companies could disrupt supply medicines and health system efficiency. The goal of this study was the risk assessment in pharmaceutical industry in Iran considering process's priority, hazard and probability of risks. The study was carried out in 4 phases; risk identification through literature review, risk identification in Iranian pharmaceutical companies through interview with experts, risk analysis through a questionnaire and consultation with experts using group analytic hierarchy process (AHP) method and rating scale (RS) and risk evaluation of simple additive weighting (SAW) method. In total, 86 main risks were identified in the pharmaceutical supply chain with perspective of pharmaceutical companies classified in 11 classes. The majority of risks described in this study were related to the financial and economic category. Also financial management was found to be the most important factor for consideration. Although pharmaceutical industry and supply chain were affected by current political conditions in Iran during the study time, but half of total risks in the pharmaceutical supply chain were found to be internal risks which could be fixed by companies, internally. Likewise, political status and related risks forced companies to focus more on financial and supply management resulting in less attention to quality management.

Towards Improved Linkage of Disaster Risk Reduction and Climate Change Adaptation in Health: A Review

PubMed Central

Banwell, Nicola; Rutherford, Shannon; Mackey, Brendan; Chu, Cordia

2018-01-01

Climate change and climate-sensitive disasters significantly impact health. Linking Disaster Risk Reduction (DRR) and Climate Change Adaptation (CCA) is essential for addressing these ever present, complex and increasing risks. Recent calls have been made to build these links in health. However, there is a need to clearly articulate why linking DRR and CCA is important in health. Furthermore, little is known about how DRR and CCA should be linked in health. By extensively examining relevant literature, this review presents the current state of knowledge of linking DRR and CCA in health. This includes the potential for maximising conceptual synergies such as building resilience, and reducing vulnerability and risk. Additionally, technical and operational synergies are identified to link DRR and CCA in health, including: policy, Early Warning Systems, vulnerability and risk assessment, health systems strengthening, infrastructure resilience, disaster preparedness and response, and health impact pathways. Public health actors have a central role in building these links due to their expertise, work functions, and experience in addressing complex health risks. The review concludes with recommendations for future research, including how to better link DRR and CCA in health; and the opportunities, challenges and enablers to build and sustain these links. PMID:29670057

Associations of Health-Risk Behaviors and Health Cognition With Sexual Orientation Among Adolescents in School

PubMed Central

Lee, Dong-Yun; Kim, Seo-Hee; Woo, Sook Young; Yoon, Byung-Koo; Choi, DooSeok

2016-01-01

Abstract Homosexual adolescents may face significant health disparities. We examined health-risk behaviors and health cognition related to homosexual behavior in a representative sample of adolescents. Data were obtained from 129,900 adolescents between 2008 and 2012 over 5 cycles of the Korean Youth Risk Behavior Survey, a national survey of students in grades 7 to 12. Various health-risk behaviors and aspects of health cognition were compared between homosexual and heterosexual adolescents and analyzed with multiple logistic regression models. Compared with heterosexual adolescents (n = 127,594), homosexual adolescents (n = 2306) were more likely to engage in various health-risk behaviors and to have poor health cognition. In multiple logistic regression analysis, not living with parents, alcohol experience (adjusted odds ratio, 1.50; 95% confidence interval, 1.26–1.78 for males and 1.66; 1.33–2.07 for females), smoking experience (1.80; 1.54–2.10 for males and 3.15; 2.61–3.79 for females), and drug experience (3.65; 2.81–4.80 for males and 3.23; 2.35–4.46 for females) were associated with homosexual behavior. Homosexual adolescents were more likely to use adult internet content (2.82; 2.27–3.50 for males and 7.42; 4.19–13.15 for females), and to be depressed (1.21; 1.03–1.43 for males and 1.32; 1.06–1.64 for females). In addition, suicide ideation (1.51; 1.26–1.81 for males and 1.47; 1.16–1.86 for females) and attempts (1.67; 1.37–2.05 for males and 1.65; 1.34–2.03 for females) were significantly more prevalent among homosexual adolescents. Homosexual adolescents report disparities in various aspects of health-risk behavior and health cognition, including use of multiple substances, adult internet content and inappropriate weight loss methods, suicide ideation and attempts, and depressive mood. These factors should be addressed relevantly to develop specific interventions regarding sexual minorities. PMID:27227939

News media coverage of trans fat: health risks and policy responses.

PubMed

Jarlenski, Marian; Barry, Colleen L

2013-01-01

Prior research indicates that the news media play a critical role in transmitting information to the public about the most pressing public health problems, and framing attributions about who in society is responsible for solving these problems. In this article, we use content analysis methods to study the agenda-setting and framing functions of the news media in shaping perceptions about the health risks posed by trans fat in the U.S. diet. A census of news stories focusing on trans fat was collected from the two largest circulation U.S. newspapers and three major television networks from 1998 to 2008 (N = 156). The content of news coverage was analyzed using a 23-item instrument. Findings indicated that the news media served an important agenda-setting role in educating the public about the presence of trans fat in the U.S. diet and describing the health risks these foods pose. In addition, results indicate that news media coverage framed attributions of responsibility for solving the problem of trans fat in the food supply. News stories noting the heart disease risks of trans fat were significantly more likely to mention governmental responses aimed at curbing consumption than news coverage that did not note these health risks.

A 21st Century Roadmap for Human Health Risk Assessment ...

EPA Pesticide Factsheets

For decades human health risk assessment has depended primarily on animal testing to predict adverse effects in humans, but that paradigm has come under question because of calls for more accurate information, less use of animals, and more efficient use of resources. Moreover, the disproportionate use of hazard information has overshadowed the important role of exposure science in determinations of human safety. In addition, major risk assessments lack the clarity and transparency that hinder an understanding of the analysis and communication of key safety messages. To help answer these challenges, the HESI-managed RISK21 project was initiated to develop a scientific, transparent, and efficient approach to the evolving world of human health risk assessment. RISK21 involved over 120 participants from 12 countries, 15 government institutions, 20 universities, 2 non-governmental organizations, and 12 corporations. RISK21 developed a tiered approach that is problem formulation-based, makes maximum use of prior knowledge, and is led by exposure science to produce a highly transparent and flexible visualization of and approach to assessing human safety and risk. The general principles underlying the RISK21 approach as well as an overview of the RISK21 Roadmap are presented here. This paper will be followed by a series of publications that will articulate the details that comprise this systematic approach. The purpose of this manuscript is to provide an overview

Is health risk assessment unethical

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnson, B.L.

For persons who have followed the environmental movement in the US and in other countries, it comes as no revelation that the general public has been, and remains, quite concerned about environmental hazards. This concern has in turn led to national and local legislation that is intended to protect the environment and public health. In a parallel way, transnational public concerns have fostered international agreements on controlling such environmental hazards as shipments of hazardous wastes and ocean pollution. Over time, as governments have attempted to come to grips with controlling various environmental hazards, the development and use of health riskmore » assessment has become a well-favored practice by government and some private sector agencies. Because health risk assessment is used to ultimately manage environmental hazards that impact the well-being of people, it seems timely to raise the questions of to what extent are ethical considerations incorporated into health risk assessments and risk management actions.« less

New approaches in human health risk assessment

PubMed Central

Abass, Khaled; Carlsen, Anders; Rautio, Arja

2016-01-01

Studies on the precise impact of environmental pollutants on human health are difficult to undertake and interpret, because many genetic and environmental factors influence health at the same time and to varying degrees. Our chapter in the AMAP report was based on new approaches to describe risks and future needs. In this paper, we will introduce the issues associated with risk assessment of single chemicals, and present suggestions for future studies as well as a summary of lessons learned during the health-related parts of the European Union-funded FP7 project ArcRisk (Arctic Health Risks: Impacts on health in the Arctic and Europe owing to climate-induced changes in contaminant cycling, 2009–2014; www.arcrisk.eu). PMID:27974141

Smoking health risk. Counseling of psychiatric patients.

PubMed

Buchanan, C R; Huffman, C; Barbour, V M

1994-01-01

1. Cigarette smoking has been identified as the single most important source of preventable morbidity and premature mortality in the United States for each of the past 25 years. Despite a smoking rate of 50% to 84%, persons with psychiatric illness have not been the target of any documented smoking health risk education in current literature. 2. Most nurses view smoking health risk education as a nursing function, but few actually provide this care for patients due to perceived ineffectiveness of health risk education, belief that smoking is not a health risk, and lack of knowledge base to provide the care. 3. Data from the study reported on in the article reflected that nurses were providing smoking health risk information to less than 50% of patients. Nurses were not identifying nicotine dependence as a nursing problem and therefore were making no plans to provide nursing interventions to resolve it.

Social Determinants of Health in Environmental Justice Communities: Examining Cumulative Risk in Terms of Environmental Exposures and Social Determinants of Health

PubMed Central

Prochaska, John D.; Nolen, Alexandra B.; Kelley, Hilton; Sexton, Ken; Linder, Stephen H.; Sullivan, John

2014-01-01

Residents of environmental justice (EJ) communities may bear a disproportionate burden of environmental health risk, and often face additional burdens from social determinants of health. Accounting for cumulative risk should include measures of risk from both environmental sources and social determinants. This study sought to better understand cumulative health risk from both social and environmental sources in a disadvantaged community in Texas. Key outcomes were determining what data are currently available for this assessment, clarifying data needs, identifying data gaps, and considering how those gaps could be filled. Analyses suggested that the traditionally defined EJ community in Port Arthur may have a lower environmental risk from air toxics than the rest of the City of Port Arthur (although the entire city has a higher risk than the average for the state), but may have a larger burden from social determinants of health. However, the results should be interpreted in light of the availability of data, the definitions of community boundaries, and the areal unit utilized. Continued focus on environmental justice communities and the cumulative risks faced by their residents is critical to protecting these residents and, ultimately, moving towards a more equitable distribution and acceptable level of risk throughout society. PMID:24771993

Social Determinants of Health in Environmental Justice Communities: Examining Cumulative Risk in Terms of Environmental Exposures and Social Determinants of Health.

PubMed

Prochaska, John D; Nolen, Alexandra B; Kelley, Hilton; Sexton, Ken; Linder, Stephen H; Sullivan, John

2014-01-01

Residents of environmental justice (EJ) communities may bear a disproportionate burden of environmental health risk, and often face additional burdens from social determinants of health. Accounting for cumulative risk should include measures of risk from both environmental sources and social determinants. This study sought to better understand cumulative health risk from both social and environmental sources in a disadvantaged community in Texas. Key outcomes were determining what data are currently available for this assessment, clarifying data needs, identifying data gaps, and considering how those gaps could be filled. Analyses suggested that the traditionally defined EJ community in Port Arthur may have a lower environmental risk from air toxics than the rest of the City of Port Arthur (although the entire city has a higher risk than the average for the state), but may have a larger burden from social determinants of health. However, the results should be interpreted in light of the availability of data, the definitions of community boundaries, and the areal unit utilized. Continued focus on environmental justice communities and the cumulative risks faced by their residents is critical to protecting these residents and, ultimately, moving towards a more equitable distribution and acceptable level of risk throughout society.

Health Risks of Nuclear Power.

ERIC Educational Resources Information Center

Cohen, Bernard L.

1978-01-01

Deals with the wastes generated in nuclear power plants and the health risks involved as compared to those of wastes generated by coal-fired plants. Concludes that the risks of nuclear power plants are many times smaller than the risks from alternative energy resources. (GA)

Additive Synergism between Asbestos and Smoking in Lung Cancer Risk: A Systematic Review and Meta-Analysis

PubMed Central

Ngamwong, Yuwadee; Tangamornsuksan, Wimonchat; Lohitnavy, Ornrat; Chaiyakunapruk, Nathorn; Scholfield, C. Norman; Reisfeld, Brad; Lohitnavy, Manupat

2015-01-01

Smoking and asbestos exposure are important risks for lung cancer. Several epidemiological studies have linked asbestos exposure and smoking to lung cancer. To reconcile and unify these results, we conducted a systematic review and meta-analysis to provide a quantitative estimate of the increased risk of lung cancer associated with asbestos exposure and cigarette smoking and to classify their interaction. Five electronic databases were searched from inception to May, 2015 for observational studies on lung cancer. All case-control (N = 10) and cohort (N = 7) studies were included in the analysis. We calculated pooled odds ratios (ORs), relative risks (RRs) and 95% confidence intervals (CIs) using a random-effects model for the association of asbestos exposure and smoking with lung cancer. Lung cancer patients who were not exposed to asbestos and non-smoking (A-S-) were compared with; (i) asbestos-exposed and non-smoking (A+S-), (ii) non-exposure to asbestos and smoking (A-S+), and (iii) asbestos-exposed and smoking (A+S+). Our meta-analysis showed a significant difference in risk of developing lung cancer among asbestos exposed and/or smoking workers compared to controls (A-S-), odds ratios for the disease (95% CI) were (i) 1.70 (A+S-, 1.31–2.21), (ii) 5.65; (A-S+, 3.38–9.42), (iii) 8.70 (A+S+, 5.8–13.10). The additive interaction index of synergy was 1.44 (95% CI = 1.26–1.77) and the multiplicative index = 0.91 (95% CI = 0.63–1.30). Corresponding values for cohort studies were 1.11 (95% CI = 1.00–1.28) and 0.51 (95% CI = 0.31–0.85). Our results point to an additive synergism for lung cancer with co-exposure of asbestos and cigarette smoking. Assessments of industrial health risks should take smoking and other airborne health risks when setting occupational asbestos exposure limits. PMID:26274395

Risk segmentation in Chilean social health insurance.

PubMed

Hidalgo, Hector; Chipulu, Maxwell; Ojiako, Udechukwu

2013-01-01

The objective of this study is to identify how risk and social variables are likely to be impacted by an increase in private sector participation in health insurance provision. The study focuses on the Chilean health insurance industry, traditionally dominated by the public sector. Predictive risk modelling is conducted using a database containing over 250,000 health insurance policy records provided by the Superintendence of Health of Chile. Although perceived with suspicion in some circles, risk segmentation serves as a rational approach to risk management from a resource perspective. The variables that have considerable impact on insurance claims include the number of dependents, gender, wages and the duration a claimant has been a customer. As shown in the case study, to ensure that social benefits are realised, increased private sector participation in health insurance must be augmented by regulatory oversight and vigilance. As it is clear that a "community-rated" health insurance provision philosophy impacts on insurance firm's ability to charge "market" prices for insurance provision, the authors explore whether risk segmentation is a feasible means of predicting insurance claim behaviour in Chile's private health insurance industry.

Water- and wastewater-related disease and infection risks: what is an appropriate value for the maximum tolerable additional burden of disease?

PubMed

Mara, Duncan

2011-06-01

The maximum additional burden of water- and wastewater-related disease of 10-6 disability-adjusted life year (DALY) loss per person per year (pppy), used in the WHO Drinking-water Quality Guidelines and the WHO Guidelines for Wastewater Use in Agriculture, is based on US EPA'S acceptance of a 70-year lifetime waterborne cancer risk of 10(-5) per person, equivalent to an annual risk of 1.4x10(-7) per person which is four orders of magnitude lower than the actual all-cancer incidence in the USA in 2009 of 1.8x10(-3) pppy. A maximum additional burden of 10(-4) DALY loss pppy would reduce this risk to a more cost-effective, but still low, risk of 1.4x10(-5) pppy. It would increase the DALY loss pppy in low- and middle-income countries due to diarrhoeal diseases from the current level of 0.0119 pppy to 0.0120 pppy, and that due to ascariasis from 0.0026 pppy to 0.0027 pppy, but neither increase is of public-health significance. It is therefore recommended that the maximum additional burden of disease from these activities be increased to a DALY loss of 10(-4) pppy as this provides an adequate margin of public-health safety in relation to waterborne-cancer deaths, diarrhoeal disease and ascariasis in all countries.

[Health risks in different living circumstances of mothers. Analyses based on a population study].

PubMed

Sperlich, Stefanie

2014-12-01

The objective of this study was to determine the living circumstances ('Lebenslagen') in mothers which are associated with elevated health risks. Data were derived from a cross-sectional population based sample of German women (n = 3129) with underage children. By means of a two-step cluster analysis ten different maternal living circumstances were assessed which proved to be distinct with respect to indicators of socioeconomic position, employment status and family-related factors. Out of the ten living circumstances, one could be attributed to higher socioeconomic status (SES), while five were assigned to a middle SES and four to a lower SES. In line with previous findings, mothers with a high SES predominantly showed the best health while mothers with a low SES tended to be at higher health risk with respect to subjective health, mental health (anxiety and depression), obesity and smoking. However, there were important health differences between the different living circumstances within the middle and lower SES. In addition, varying health risks were found among different living circumstances of single mothers, pointing to the significance of family and job-related living conditions in establishing health risks. With this exploratory analysis strategy small-scale living conditions could be detected which were associated with specific health risks. This approach seemed particularly suitable to provide a more precise definition of target groups for health promotion. The findings encourage a more exrensive application of the concept of living conditions in medical sociology research as well as health monitoring.

Knowledge and perception about health risks of cigarette smoking among Iraqi smokers

PubMed Central

Dawood, Omar Thanoon; Rashan, Mohammed Abd Ahmed; Hassali, Mohamed Azmi; Saleem, Fahad

2016-01-01

Background: Smoking is a major public health problem, especially in Iraq. There is very little information had been documented regarding smoking risk factors and quit intention among Iraqi smokers. Objectives: The main objectives of this study are to determine smokers' knowledge and perception about smoking health risks; and to determine smoking behavior and quitting intentions among Iraqi smokers; as well as to predict the factors that may associate with quit intentions. Methods: A cross-sectional study was conducted at the outpatient clinic in Tikrit Teaching Hospital, Tikrit City, Iraq. Adult smokers who are smoking cigarette everyday and able to communicate with the researcher were invited to participate in the study. A self-administered questionnaire was used to collect data from 386 participants. Results: This study showed that smokers had low awareness about some risk effects of smoking such as lung cancer in nonsmokers (30.1%), impotence in male smokers (52.6%), premature ageing (64%), and stroke (66.3%). In addition, the high score of knowledge and perception was significantly associated with quitting intention. Conclusion: Smokers' knowledge and perception regarding smoking health effects were low, especially in terms of secondhand smokers. Many efforts needed from health policy-makers and health care professionals to disseminate information about the risks of smoking and health benefits of give up smoking. PMID:27134468

45 CFR 162.925 - Additional requirements for health plans.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Additional requirements for health plans. 162.925 Section 162.925 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND... requirements for health plans. (a) General rules. (1) If an entity requests a health plan to conduct a...

45 CFR 162.925 - Additional requirements for health plans.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Additional requirements for health plans. 162.925 Section 162.925 Public Welfare Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND... requirements for health plans. (a) General rules. (1) If an entity requests a health plan to conduct a...

A probabilistic assessment of health risks associated with short-term exposure to tropospheric ozone

DOE Office of Scientific and Technical Information (OSTI.GOV)

Whitfield, R.G; Biller, W.F.; Jusko, M.J.

1996-06-01

The work described in this report is part of a larger risk assessment sponsored by the U.S. Environmental Protection Agency. Earlier efforts developed exposure-response relationships for acute health effects among populations engaged in heavy exertion. Those efforts also developed a probabilistic national ambient air quality standards exposure model and a general methodology for integrating probabilistic exposure-response relation- ships and exposure estimates to calculate overall risk results. Recently published data make it possible to model additional health endpoints (for exposure at moderate exertion), including hospital admissions. New air quality and exposure estimates for alternative national ambient air quality standards for ozonemore » are combined with exposure-response models to produce the risk results for hospital admissions and acute health effects. Sample results explain the methodology and introduce risk output formats.« less

Air pollution and health risks due to vehicle traffic.

PubMed

Zhang, Kai; Batterman, Stuart

2013-04-15

Traffic congestion increases vehicle emissions and degrades ambient air quality, and recent studies have shown excess morbidity and mortality for drivers, commuters and individuals living near major roadways. Presently, our understanding of the air pollution impacts from congestion on roads is very limited. This study demonstrates an approach to characterize risks of traffic for on- and near-road populations. Simulation modeling was used to estimate on- and near-road NO2 concentrations and health risks for freeway and arterial scenarios attributable to traffic for different traffic volumes during rush hour periods. The modeling used emission factors from two different models (Comprehensive Modal Emissions Model and Motor Vehicle Emissions Factor Model version 6.2), an empirical traffic speed-volume relationship, the California Line Source Dispersion Model, an empirical NO2-NOx relationship, estimated travel time changes during congestion, and concentration-response relationships from the literature, which give emergency doctor visits, hospital admissions and mortality attributed to NO2 exposure. An incremental analysis, which expresses the change in health risks for small increases in traffic volume, showed non-linear effects. For a freeway, "U" shaped trends of incremental risks were predicted for on-road populations, and incremental risks are flat at low traffic volumes for near-road populations. For an arterial road, incremental risks increased sharply for both on- and near-road populations as traffic increased. These patterns result from changes in emission factors, the NO2-NOx relationship, the travel delay for the on-road population, and the extended duration of rush hour for the near-road population. This study suggests that health risks from congestion are potentially significant, and that additional traffic can significantly increase risks, depending on the type of road and other factors. Further, evaluations of risk associated with congestion must

Air pollution and health risks due to vehicle traffic

PubMed Central

Zhang, Kai; Batterman, Stuart

2014-01-01

Traffic congestion increases vehicle emissions and degrades ambient air quality, and recent studies have shown excess morbidity and mortality for drivers, commuters and individuals living near major roadways. Presently, our understanding of the air pollution impacts from congestion on roads is very limited. This study demonstrates an approach to characterize risks of traffic for on- and near-road populations. Simulation modeling was used to estimate on- and near-road NO2 concentrations and health risks for freeway and arterial scenarios attributable to traffic for different traffic volumes during rush hour periods. The modeling used emission factors from two different models (Comprehensive Modal Emissions Model and Motor Vehicle Emissions Factor Model version 6.2), an empirical traffic speed–volume relationship, the California Line Source Dispersion Model, an empirical NO2–NOx relationship, estimated travel time changes during congestion, and concentration–response relationships from the literature, which give emergency doctor visits, hospital admissions and mortality attributed to NO2 exposure. An incremental analysis, which expresses the change in health risks for small increases in traffic volume, showed non-linear effects. For a freeway, “U” shaped trends of incremental risks were predicted for on-road populations, and incremental risks are flat at low traffic volumes for near-road populations. For an arterial road, incremental risks increased sharply for both on- and near-road populations as traffic increased. These patterns result from changes in emission factors, the NO2–NOx relationship, the travel delay for the on-road population, and the extended duration of rush hour for the near-road population. This study suggests that health risks from congestion are potentially significant, and that additional traffic can significantly increase risks, depending on the type of road and other factors. Further, evaluations of risk associated with congestion

Semantic Interoperability of Health Risk Assessments

PubMed Central

Rajda, Jay; Vreeman, Daniel J.; Wei, Henry G.

2011-01-01

The health insurance and benefits industry has administered Health Risk Assessments (HRAs) at an increasing rate. These are used to collect data on modifiable health risk factors for wellness and disease management programs. However, there is significant variability in the semantics of these assessments, making it difficult to compare data sets from the output of 2 different HRAs. There is also an increasing need to exchange this data with Health Information Exchanges and Electronic Medical Records. To standardize the data and concepts from these tools, we outline a process to determine presence of certain common elements of modifiable health risk extracted from these surveys. This information is coded using concept identifiers, which allows cross-survey comparison and analysis. We propose that using LOINC codes or other universal coding schema may allow semantic interoperability of a variety of HRA tools across the industry, research, and clinical settings. PMID:22195174

Chemical Risk Assessment: Traditional vs Public Health Perspectives

PubMed Central

Axelrad, Daniel A.; Bahadori, Tina; Bussard, David; Cascio, Wayne E.; Deener, Kacee; Dix, David; Thomas, Russell S.; Kavlock, Robert J.; Burke, Thomas A.

2017-01-01

Preventing adverse health effects of environmental chemical exposure is fundamental to protecting individual and public health. When done efficiently and properly, chemical risk assessment enables risk management actions that minimize the incidence and effects of environmentally induced diseases related to chemical exposure. However, traditional chemical risk assessment is faced with multiple challenges with respect to predicting and preventing disease in human populations, and epidemiological studies increasingly report observations of adverse health effects at exposure levels predicted from animal studies to be safe for humans. This discordance reinforces concerns about the adequacy of contemporary risk assessment practices for protecting public health. It is becoming clear that to protect public health more effectively, future risk assessments will need to use the full range of available data, draw on innovative methods to integrate diverse data streams, and consider health endpoints that also reflect the range of subtle effects and morbidities observed in human populations. Considering these factors, there is a need to reframe chemical risk assessment to be more clearly aligned with the public health goal of minimizing environmental exposures associated with disease. PMID:28520487

Travel health risk perceptions and prevention behaviors of US study abroad students.

PubMed

Hartjes, Laurie B; Baumann, Linda C; Henriques, Jeffrey B

2009-01-01

The number of American study abroad students increased more than 150% in the past decade, along with growth in destinations with increased health risks. This study investigated travel health risk perceptions and prevention behaviors to guide interventions that address the emerging health needs of US study abroad students. A cross-sectional design was used to collect data from 318 American study abroad students using a Web-based survey. The primary source of travel health information was youth-oriented travel guidebooks (85%). The grand mean risk perception score for 18 travel health threats was 1.7 on a 1 to 4 scale, with top-rated threats being contaminated food/water, psychological distress, personal assault, and excessive sun exposure. Predeparture advice was received from primary care providers (52%) and travel health specialists (18%). Additional prevention measures were vaccines (42%) and medication (24%). Of 114 students listing their travel vaccinations, 11% described receiving a malaria vaccine and 4% a hepatitis C vaccine, although no such vaccines exist. Most respondents were confident/very confident in their ability to engage in prevention behaviors (94%). Health problems were primarily infectious disease (70%), psychological distress (10%), and injuries (8%). When asked if prior travel destinations involved areas where malaria transmission occurs, 20% responded, "Don't know." Identified gaps in travel health knowledge and prevention behaviors may produce hazardous consequences when combined with low-perceived risk, reliance on travel guidebooks for health information, and high ratings for prevention self-efficacy. Future research is needed to test the effectiveness of educational interventions designed for student travelers who would benefit from guided practice with destination-specific risk appraisal and prevention planning. Web-based educational resources are a good fit for this population because they are easily updated, available in all phases of

Is oral health a risk for malignant disease?

PubMed

Seymour, Robin A

2010-06-01

Poor oral health has been associated with a variety of systemic diseases. More recent evidence suggests that the extent and severity of periodontal disease and tooth loss may be associated with an increased risk of malignant disease. An association between poor oral health, smoking, increased alcohol consumption as a risk for oral cancer is well established. Associations between oral health and tooth loss with gastric, lung and pancreatic cancers are explored. Some of the associations need further evaluation before patients are warned about their periodontal health increasing the risk of malignant changes elsewhere in the body. The smoking factor may have a commonality linking oral health with an increased risk for malignant disease. This paper reviews the association between oral health (especially the extent and severity of periodontal disease and tooth loss) as a risk for certain malignancies.

Pathways from family disadvantage via abusive parenting and caregiver mental health to adolescent health risks in South Africa

PubMed Central

Meinck, Franziska; Cluver, Lucie Dale; Orkin, Frederick Mark; Kuo, Caroline; Sharma, Amogh Dhar; Hensels, Imca Sifra; Sherr, Lorraine

2016-01-01

Purpose Adolescent health is a major concern in LMIC but little is known about its predictors. Family disadvantage and abusive parenting may be important factors associated with adolescent psychological, behavioral and physical health outcomes. This study, based in South Africa, aimed to develop an empirically-based theoretical model of relationships between family factors such as deprivation, illness and parenting and adolescent health outcomes. Methods Cross-sectional data were collected in 2009–2010 from 2477 adolescents (aged 10–17) and their caregivers using stratified random sampling in KwaZulu-Natal, South Africa. Participants reported on socio-demographics, psychological symptoms, parenting and physical health. Multivariate regressions were conducted, confirmatory factor analysis employed to identify measurement models and a structural equation model developed. Results The final model demonstrated that family disadvantage (caregiver AIDS -illness and poverty) was associated with increased abusive parenting. Abusive parenting was in turn associated with higher adolescent health risks. Additionally, family disadvantage was directly associated with caregiver mental health distress which increased adolescent health risks. There was no direct effect of family disadvantage on adolescent health risks but indirect effects through caregiver mental health distress and abusive parenting were found. Conclusions Reducing family disadvantage and abusive parenting is essential in improving adolescent health in South Africa. Combination interventions could include poverty and violence reduction, access to health care, mental health services for caregivers and adolescents, and positive parenting support. Such combination packages can improve caregiver and child outcomes by reducing disadvantage and mitigating negative pathways from disadvantage among highly vulnerable families. PMID:27793729

New Mexico Adolescent Health Risks Survey.

ERIC Educational Resources Information Center

Antle, David

To inform students of health risks (posed by behavior, environment, and genetics) and provide schools with collective risk appraisal information as a basis for planning/evaluating health and wellness initiatives, New Mexico administered the Teen Wellness Check in 1985 to 1,573 ninth-grade students from 7 New Mexico public schools. Subjects were…

[Food additives and healthiness].

PubMed

Heinonen, Marina

2014-01-01

Additives are used for improving food structure or preventing its spoilage, for example. Many substances used as additives are also naturally present in food. The safety of additives is evaluated according to commonly agreed principles. If high concentrations of an additive cause adverse health effects for humans, a limit of acceptable daily intake (ADI) is set for it. An additive is a risk only when ADI is exceeded. The healthiness of food is measured on the basis of nutrient density and scientifically proven effects.

Ultraviolet Radiation: Human Exposure and Health Risks.

ERIC Educational Resources Information Center

Tenkate, Thomas D.

1998-01-01

Provides an overview of human exposure to ultraviolet radiation and associated health effects as well as risk estimates for acute and chronic conditions resulting from such exposure. Demonstrates substantial reductions in health risk that can be achieved through preventive actions. Also includes a risk assessment model for skin cancer. Contains 36…

Bridging Student Health Risks and Academic Achievement through Comprehensive School Health Programs.

ERIC Educational Resources Information Center

Symons, Cynthia Wolford; Cinelli, Bethann; James, Tammy C.; Groff, Patti

1997-01-01

Research confirms a direct link between student health risk behavior and education outcomes, education behaviors, and student attitudes. This article discusses barriers to comprehensive school health programming; summarizes relevant information concerning several health-risk behaviors (intentional injuries, diet, physical activity, sexual-risk…

Co-occurring mental health and substance use problems in offenders: implications for risk assessment.

PubMed

Ruiz, Mark A; Douglas, Kevin S; Edens, John F; Nikolova, Natalia L; Lilienfeld, Scott O

2012-03-01

We undertook a secondary data analysis to study issues relevant to co-occurring mental health and substance disorder in a combined sample of offenders (N = 3,197). Using the Personality Assessment Inventory, we compared the frequency of depressive, traumatic stress, and personality disorder symptom elevations across offenders with and without substance problems, identified the extent to which co-occurring problems were accompanied by risk factors for suicide and aggression, and tested for gender differences. Offenders with substance problems were more likely than others to have increased mental health problems and risk factors for suicide or aggression. Women with substance problems, compared with men, had higher depression, traumatic stress, and borderline features, in addition to lower antisocial features. The frequency with which suicide and aggression risk factors were associated with mental health problems was generally similar across men and women. Measurement issues relevant to co-occurring disorder and risk assessment are discussed.

Misrepresentation of health risks by mass media.

PubMed

Bomlitz, Larisa J; Brezis, Mayer

2008-06-01

Mass media are a leading source of health information for general public. We wished to examine the relationship between the intensity of media coverage for selected health topics and their actual risk to public health. Mass media reports in the United States on emerging and chronic health hazards (severe acute respiratory syndrome (SARS), bioterrorism, West Nile Fever, AIDS, smoking and physical inactivity) were counted for the year 2003, using LexisNexis database. The number of media reports for each health risk was correlated with the corresponding death rate as reported by the Centers for Disease Control and Prevention. The number of media reports inversely correlated with the actual number of deaths for the health risks evaluated. SARS and bioterrorism killed less than a dozen people in 2003, but together generated over 100 000 media reports, far more than those covering smoking and physical inactivity, which killed nearly a million Americans. Emerging health hazards are over-reported in mass media by comparison to common threats to public health. Since premature mortality in industrialized societies is most often due to well-known risks such as smoking and physical inactivity, their under-representation on public agendas may cause suboptimal prioritization of public health resources.

Smoking, health, risk, and perception.

PubMed

Carbone, Jared C; Kverndokk, Snorre; Røgeberg, Ole Jørgen

2005-07-01

We provide a description of health-related incentives faced by a rational smoker by considering the role of perception in both immediate quality-of-life effects of smoking and future risk of mortality. A person who adapts psychologically to a lowered health state, smokes more early in life and shifts demands for health investments and health-complementary activities later in life. He also smokes more in total. Someone aware of the full mortality consequences of smoking, smokes less and demands less medical care than someone who believes that these effects are highly reversible. The impacts of new information on mortality risk are most valuable early in life. Lastly, someone endowed with a longer life expectancy smokes more in the first part of life but conditional on access to medical care.

How do Students Conceptualise Health and its Risk Factors? A Study among Iranian Schoolchildren

PubMed Central

Haghdoost, Ali-Akbar; Ashrafi Asgar-Abad, Ahad; Shokoohi, Mostafa; Alam, Mahin; Esmaeili, Maryam; Hojabri, Neda

2013-01-01

Background: To assess the concept of children concerning their health and its risk factors, a group of primary and middle school students were asked to draw a few relevant pictures in order to deeply explore the comprehension of this key group. Methods: In this cross-sectional study 1165 students, aged 7-15 years old, selected through random stratified sampling, were asked to draw a number of eight paintings, four paintings on health concepts, and the other four on health risk factors. The paintings were then assessed by two independent observers, and their themes and contents were abstracted and analysed. Results: The students drew a total of 2330 paintings, 1165 paintings on the concept of health, and 1165 paintings on health risk factors. The most and least expressed health concepts concerned “mental health” and “healthy diet” (73.3% and 4.8%, respectively). Considering health risk factors, “unhealthy diet” and the two concepts of “environmental hazards” and “neglected personal hygiene” had the most (95%) and least (1.4% each) frequencies. Students in public schools, primary level and girls drew more pictures about health concept or/and its risk factors (P<0.05). The association between parents’ education level and the numbers of pictures were not statistically significant. Conclusion: Although students had a broad view about health and its risk factors, generally little attention had been paid to some of the main aspects such as physical activity, healthy diet, mental and oral health, and environmental hazards. In addition, it seems that parents’ educational level, as one of the main socio-economic factors, did not have any significant impact on their concepts. PMID:24596834

Incentives and other factors associated with employee participation in health risk assessments.

PubMed

Taitel, Michael S; Haufle, Vincent; Heck, Debi; Loeppke, Ronald; Fetterolf, Donald

2008-08-01

Investigate factors associated with employee participation rates in health risk assessments. This cross-sectional study using multiple regression analyzed data from 124 employers with 882,275 eligible employees who completed 344,825 health and productivity assessments (HPAs). Incentive value and Communications and Organizational Commitment Level (Com/Org Level) were the strongest predictors of HPA completion rates. Employer size and a Gateway Model were also significant predictors. In addition, a correlation of variables showed other important relationships. To achieve a 50% HPA completion rate, employers with a low Com/Org Level will need an incentive value of approximately $120 whereas employers with a high Com/Org Level only need approximately $40--a difference of $80 dollars. This applied study offers empirical evidence to help employers increase their employees' participation in health risk assessments.

Self-esteem, self-serving cognitions, and health risk behavior.

PubMed

Gerrard, M; Gibbons, F X; Reis-Bergan, M; Russell, D W

2000-12-01

The current article reviews prospective and experimental research on the relation between self-esteem and perceptions of vulnerability. These studies demonstrate that individuals with high self-esteem who engage in risk behavior often utilize a variety of self-serving cognitive strategies that protect them from fully acknowledging their vulnerability to the potential negative consequences of their behavior; e.g., they minimize their estimates of personal risk and overestimate the prevalence of the risk behavior among their peers. The article also provides data on an additional self-serving cognitive strategy employed by adolescents with high self-esteem--alteration of perceptions of others' reactions to their own risk behavior. Finally, the article reviews the emerging literature on the relation between these cognitive strategies and maladaptive health behavior, and proposes that whether these strategies are maladaptive depends on the nature of the threat and the availability of opportunities to engage in compensatory self-enhancement.

Associations between multiple health risk behaviors and mental health among Chinese college students.

PubMed

Ye, Yong-ling; Wang, Pei-gang; Qu, Geng-cong; Yuan, Shuai; Phongsavan, Philayrath; He, Qi-qiang

2016-01-01

Although there is substantial evidence that health risk behaviors increase risks of premature morbidity and mortality, little is known about the multiple health risk behaviors in Chinese college students. Here, we investigated the prevalence of multiple health risk behaviors and its relation to mental health among Chinese college students. A cross-sectional study was conducted in Wuhan, China from May to June 2012. The students reported their health risk behaviors using self-administered questionnaires. Depression and anxiety were assessed using the self-rating depression scale and self-rating anxiety scale, respectively. A total of 2422 college students (1433 males) aged 19.7 ± 1.2 years were participated in the study. The prevalence of physical inactivity, sleep disturbance, poor dietary behavior, Internet addiction disorder (IAD), frequent alcohol use and current smoking was 62.0, 42.6, 29.8, 22.3, 11.6 and 9.3%, respectively. Significantly increased risks for depression and anxiety were found among students with frequent alcohol use, sleep disturbance, poor dietary behavior and IAD. Two-step cluster analysis identified two different clusters. Participants in the cluster with more unhealthy behaviors showed significantly increased risk for depression (odds ratio (OR): 2.21; 95% confidence interval (CI): 1.83, 2.67) and anxiety (OR: 2.32; 95% CI: 1.85, 2.92). This study indicates that a relatively high prevalence of multiple health risk behaviors was found among Chinese college students. Furthermore, the clustering of health risk behaviors was significantly associated with increased risks for depression and anxiety.

Crowdfunding our health: Economic risks and benefits.

PubMed

Renwick, Matthew J; Mossialos, Elias

2017-10-01

Crowdfunding is an expanding form of alternative financing that is gaining traction in the health sector. This article presents a typology for crowdfunded health projects and a review of the main economic benefits and risks of crowdfunding in the health market. We use evidence from a literature review, complimented by expert interviews, to extend the fundamental principles and established theories of crowdfunding to a health market context. Crowdfunded health projects can be classified into four types according to the venture's purpose and funding method. These are projects covering health expenses, fundraising health initiatives, supporting health research, or financing commercial health innovation. Crowdfunding could economically benefit the health sector by expanding market participation, drawing money and awareness to neglected health issues, improving access to funding, and fostering project accountability and social engagement. However, the economic risks of health-related crowdfunding include inefficient priority setting, heightened financial risk, inconsistent regulatory policies, intellectual property rights concerns, and fraud. Theorized crowdfunding behaviours such as signalling and herding can be observed in the market for health-related crowdfunding. Broader threats of market failure stemming from adverse selection and moral hazard also apply. Many of the discussed economic benefits and risks of crowdfunding health campaigns are shared more broadly with those of crowdfunding projects in other sectors. Where crowdfunding health care appears to diverge from theory is the negative externality inefficient priority setting may have towards achieving broader public health goals. Therefore, the market for crowdfunding health care must be economically stable, as well as designed to optimally and equitably improve public health. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Assessment of health risks of policies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ádám, Balázs, E-mail: badam@cmss.sdu.dk; Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen; Molnár, Ágnes, E-mail: MolnarAg@smh.ca

The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidancemore » and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals.« less

School Health Promotion Policies and Adolescent Risk Behaviors in Israel: A Multilevel Analysis.

PubMed

Tesler, Riki; Harel-Fisch, Yossi; Baron-Epel, Orna

2016-06-01

Health promotion policies targeting risk-taking behaviors are being implemented across schools in Israel. This study identified the most effective components of these policies influencing cigarette smoking and alcohol consumption among adolescents. Logistic hierarchical linear model (HLM) analysis of data for 5279 students in 95 Jewish public schools from the Health Behavior in School-Aged Children (HBSC) 2010-2011 survey in Israel enabled simultaneous estimation of the relationship between student- and school-level variables (health promotion policy) to alcohol consumption and smoking behavior. Principals of participating schools also were interviewed to ascertain their degree of adoption and implementation of a health promotion policy. Most of the variance in adolescent risk behaviors is explained by student-level variables: negative perceptions of school, lack of parental support for school issues, and more time spent with friends. Among the school-level policy measures, parental participation in health promotion intervention programs was repeatedly associated with lower rates of risk behaviors, over and above student characteristics. School health promotion policies should focus on parents' involvement in intervention programs and should seek to improve students' perceptions of school and their sense of well-being to promote resilience. Further research is needed to identify additional factors that may increase the effectiveness of school health promotion policies. © 2016, American School Health Association.

Trajectories of Depressive Symptoms Among Web-Based Health Risk Assessment Participants.

PubMed

Bedrosian, Richard; Hawrilenko, Matt; Cole-Lewis, Heather

2017-03-31

Health risk assessments (HRAs), which often screen for depressive symptoms, are administered to millions of employees and health plan members each year. HRA data provide an opportunity to examine longitudinal trends in depressive symptomatology, as researchers have done previously with other populations. The primary research questions were: (1) Can we observe longitudinal trajectories in HRA populations like those observed in other study samples? (2) Do HRA variables, which primarily reflect modifiable health risks, help us to identify predictors associated with these trajectories? (3) Can we make meaningful recommendations for population health management, applicable to HRA participants, based on predictors we identify? This study used growth mixture modeling (GMM) to examine longitudinal trends in depressive symptomatology among 22,963 participants in a Web-based HRA used by US employers and health plans. The HRA assessed modifiable health risks and variables such as stress, sleep, and quality of life. Five classes were identified: A "minimal depression" class (63.91%, 14,676/22,963) whose scores were consistently low across time, a "low risk" class (19.89%, 4568/22,963) whose condition remained subthreshold, a "deteriorating" class (3.15%, 705/22,963) who began at subthreshold but approached severe depression by the end of the study, a "chronic" class (4.71%, 1081/22,963) who remained highly depressed over time, and a "remitting" class (8.42%, 1933/22,963) who had moderate depression to start, but crossed into minimal depression by the end. Among those with subthreshold symptoms, individuals who were male (P<.001) and older (P=.01) were less likely to show symptom deterioration, whereas current depression treatment (P<.001) and surprisingly, higher sleep quality (P<.001) were associated with increased probability of membership in the "deteriorating" class as compared with "low risk." Among participants with greater symptomatology to start, those in the "severe

Health risk assessment of organic micropollutants in greywater for potable reuse.

PubMed

Etchepare, Ramiro; van der Hoek, Jan Peter

2015-04-01

In light of the increasing interest in development of sustainable potable reuse systems, additional research is needed to elucidate the risks of producing drinking water from new raw water sources. This article investigates the presence and potential health risks of organic micropollutants in greywater, a potential new source for potable water production introduced in this work. An extensive literature survey reveals that almost 280 organic micropollutants have been detected in greywater. A three-tiered approach is applied for the preliminary health risk assessment of these chemicals. Benchmark values are derived from established drinking water standards for compounds grouped in Tier 1, from literature toxicological data for compounds in Tier 2, and from a Threshold of Toxicological Concern approach for compounds in Tier 3. A risk quotient is estimated by comparing the maximum concentration levels reported in greywater to the benchmark values. The results show that for the majority of compounds, risk quotient values were below 0.2, which suggests they would not pose appreciable concern to human health over a lifetime exposure to potable water. Fourteen compounds were identified with risk quotients above 0.2 which may warrant further investigation if greywater is used as a source for potable reuse. The present findings are helpful in prioritizing upcoming greywater quality monitoring and defining the goals of multiple barriers treatment in future water reclamation plants for potable water production. Copyright © 2014 Elsevier Ltd. All rights reserved.

An assessment of health hazard/health risk appraisal.

PubMed Central

Wagner, E H; Beery, W L; Schoenbach, V J; Graham, R M

1982-01-01

A state-of-the-art review of a widely-used health promotion technique, the health hazard/health risk appraisal (HHA/HRA), was conducted. The review included preparing a 212-item annotated bibliography, compiling an inventory of 217 programs that have used HHA/HRA, holding discussions with HHA/HRA developers and users, conducting formal site visits to 15 HHA/HRA programs, and consultation with experts on epidemiology, biostatistics, and behavioral science as well as developers and users of HHA/HRA. Programs use HHA/HRA primarily as a promotional device, as a tool for structuring education about health-related behaviors, and as a motivational device for stimulating behavioral change. The scientific basis for HHA/HRA risk predictions is problematic, but their arithmetic imprecision is of less concern than insufficiency of the scientific evidence for certain behavioral recommendations, and inaccuracies in client-supplied data. Widely-held beliefs in HHA/HRA's efficacy for motivating behavioral change cannot be substantiated from available evidence, nor can the assumed absence of adverse effects. The importance of this particular health promotion technique appears to have been exaggerated. PMID:7065313

Effect of additional brief counselling after periodic health examination on motivation for health behavior change [corrected].

PubMed

Son, Ki Young; Lee, Cheol Min; Cho, BeLong; Lym, Youl Lee; Oh, Seung Won; Chung, Wonjoo; Lee, Jin-Seok; Park, DuShin; Kim, Han Suk

2012-11-01

This study was to evaluate the effect of additional brief counseling by a primary care physician on lifestyle modification of examinees after a periodic health examination. 1,000 participants of the 2007 Korean national health screening program were asked to note any variation in their health behavior after participating in the screening program. The degree of comprehensive motivation for lifestyle modification was assessed in terms of stages of health behavior change. We calculated odds ratio of positive change (enhanced stage of change) with multiple logistic regression analysis and age-adjusted proportion of positive changers. Of 989 respondents, 486 and 503 received the basic and additional programs, respectively. Additional group were more likely to be positive changer than basic group (adjusted OR 1.78; 95% CI 1.19-2.65), and this was more prominent in older age group (adjusted OR 2.38, 95% CI 1.23-4.58). The age-adjusted proportions of positive changers were 22.7% (95% CI, 17.9-28.3) and 36.2% (95% CI, 30.4-42.4) in the basic and additional groups, respectively (P < 0.001). The additional consultation led to improvements in the stage of health behavior change after the health examination. Thus, such a consultation should be considered when designing a health-screening program.

Pathways From Family Disadvantage via Abusive Parenting and Caregiver Mental Health to Adolescent Health Risks in South Africa.

PubMed

Meinck, Franziska; Cluver, Lucie Dale; Orkin, Frederick Mark; Kuo, Caroline; Sharma, Amogh Dhar; Hensels, Imca Sifra; Sherr, Lorraine

2017-01-01

Adolescent health is a major concern in low- and middle-income countries, but little is known about its predictors. Family disadvantage and abusive parenting may be important factors associated with adolescent psychological, behavioral, and physical health outcomes. This study, based in South Africa, aimed to develop an empirically based theoretical model of relationships between family factors such as deprivation, illness, parenting, and adolescent health outcomes. Cross-sectional data were collected in 2009-2010 from 2,477 adolescents (aged 10-17) and their caregivers using stratified random sampling in KwaZulu-Natal, South Africa. Participants reported on sociodemographics, psychological symptoms, parenting, and physical health. Multivariate regressions were conducted, confirmatory factor analysis employed to identify measurement models, and a structural equation model developed. The final model demonstrated that family disadvantage (caregiver AIDS illness and poverty) was associated with increased abusive parenting. Abusive parenting was in turn associated with higher adolescent health risks. Additionally, family disadvantage was directly associated with caregiver mental health distress which increased adolescent health risks. There was no direct effect of family disadvantage on adolescent health risks but indirect effects through caregiver mental health distress and abusive parenting were found. Reducing family disadvantage and abusive parenting is essential in improving adolescent health in South Africa. Combination interventions could include poverty and violence reduction, access to health care, mental health services for caregivers and adolescents, and positive parenting support. Such combination packages can improve caregiver and child outcomes by reducing disadvantage and mitigating negative pathways from disadvantage among highly vulnerable families. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights

The relationship between modifiable health risks and group-level health care expenditures. Health Enhancement Research Organization (HERO) Research Committee.

PubMed

Anderson, D R; Whitmer, R W; Goetzel, R Z; Ozminkowski, R J; Dunn, R L; Wasserman, J; Serxner, S

2000-01-01

To assess the relationship between modifiable health risks and total health care expenditures for a large employee group. Risk data were collected through voluntary participation in health risk assessment (HRA) and worksite biometric screenings and were linked at the individual level to health care plan enrollment and expenditure data from employers' fee-for-service plans over the 6-year study period. The setting was worksite health promotion programs sponsored by six large private-sector and public-sector employers. Of the 50% of employees who completed the HRA, 46,026 (74.7%) met all inclusion criteria for the analysis. Eleven risk factors (exercise, alcohol use, eating, current and former tobacco use, depression, stress, blood pressure, cholesterol, weight, and blood glucose) were dichotomized into high-risk and lower-risk levels. The association between risks and expenditures was estimated using a two-part regression model, controlling for demographics and other confounders. Risk prevalence data were used to estimate group-level impact of risks on expenditures. Risk factors were associated with 25% of total expenditures. Stress was the most costly factor, with tobacco use, overweight, and lack of exercise also being linked to substantial expenditures. Modifiable risk factors contribute substantially to overall health care expenditures. Health promotion programs that reduce these risks may be beneficial for employers in controlling health care costs.

Space Radiation and Risks to Human Health

NASA Technical Reports Server (NTRS)

Huff, Janice L.

2014-01-01

The radiation environment in space poses significant challenges to human health and is a major concern for long duration manned space missions. Outside the Earth's protective magnetosphere, astronauts are exposed to higher levels of galactic cosmic rays, whose physical characteristics are distinct from terrestrial sources of radiation such as x-rays and gamma-rays. Galactic cosmic rays consist of high energy and high mass nuclei as well as high energy protons; they impart unique biological damage as they traverse through tissue with impacts on human health that are largely unknown. The major health issues of concern are the risks of radiation carcinogenesis, acute and late decrements to the central nervous system, degenerative tissue effects such as cardiovascular disease, as well as possible acute radiation syndromes due to an unshielded exposure to a large solar particle event. The NASA Human Research Program's Space Radiation Program Element is focused on characterization and mitigation of these space radiation health risks along with understanding these risks in context of the other biological stressors found in the space environment. In this overview, we will provide a description of these health risks and the Element's research strategies to understand and mitigate these risks.

Health Risk Reduction Programs in Employer-Sponsored Health Plans: Part I—Efficacy

PubMed Central

Rothstein, Mark A.; Harrell, Heather L.

2011-01-01

Objective We sought to determine whether workplace health risk reduction programs (HRRPs) using health risk assessments (HRAs), individually focused risk reduction, and financial incentives succeeded in improving employee health and reducing employer health benefit costs. Methods We reviewed the proprietary HRA available to us and conducted a literature review to determine the efficacy of HRRPs using HRAs, individualized employee interventions, and financial incentives for employee participation. Results There is some evidence that HRRPs in employer-sponsored programs improve measures of employee health, but the results of these studies are somewhat equivocal. Conclusion Employer-sponsored HRRPs may have some benefits, but problems in plan design and in the studies assessing their efficacy complicate drawing conclusions. PMID:19625972

Health risk behavior of rural secondary school students in Zimbabwe.

PubMed

Gwede, C K; McDermott, R J; Westhoff, W W; Mushore, M; Mushore, T; Chitsika, E; Majange, C S; Chauke, P

2001-10-01

A socioculturally appropriate health risk behavior instrument, modeled after the U.S. Centers for Disease Control and Prevention's Youth Risk Behavior Survey (YRBS), was administered to 717 secondary school students in a rural area of Zimbabwe. Comparisons of risk behaviors by gender and school grade were made using univariate procedures and multiple logistic regression. Males were significantly more likely than females to have had sexual intercourse (odds ratio = 5.02, p < .0001) and to report drug use behaviors. Males also were significantly more likely to report early initiation (by age 13 years) of alcohol use, cigarette smoking, and marijuana use. School site violence and drug use behaviors also were prevalent in this sample. An interaction between gender and grade was evident for some behaviors. Additional research may further the understanding of these risk behaviors and facilitate development of effective, culturally relevant risk reduction programs.

Impact of a health promotion program on employee health risks and work productivity.

PubMed

Mills, Peter R; Kessler, Ronald C; Cooper, John; Sullivan, Sean

2007-01-01

Evaluate the impact of a multicomponent workplace health promotion program on employee health risks and work productivity. Quasi-experimental 12-month before-after intervention-control study. A multinational corporation headquartered in the United Kingdom. Of 618 employees offered the program, 266 (43%) completed questionnaires before and after the program. A total of 1242 of 2500 (49.7%) of a control population also completed questionnaires 12 months apart. A multicomponent health promotion program incorporating a health risk appraisal questionnaire, access to a tailored health improvement web portal, wellness literature, and seminars and workshops focused upon identified wellness issues. Outcomes were (1) cumulative count of health risk factors and the World Health Organization health and work performance questionnaire measures of (2) workplace absenteeism and (3) work performance. After adjusting for baseline differences, improvements in all three outcomes were significantly greater in the intervention group compared with the control group. Mean excess reductions of 0.45 health risk factors and 0.36 monthly absenteeism days and a mean increase of 0.79 on the work performance scale were observed in the intervention group compared with the control group. The intervention yielded a positive return on investment, even using conservative assumptions about effect size estimation. The results suggest that a well-implemented multicomponent workplace health promotion program can produce sizeable changes in health risks and productivity.

[Application of three risk assessment models in occupational health risk assessment of dimethylformamide].

PubMed

Wu, Z J; Xu, B; Jiang, H; Zheng, M; Zhang, M; Zhao, W J; Cheng, J

2016-08-20

Objective: To investigate the application of United States Environmental Protection Agency (EPA) inhalation risk assessment model, Singapore semi-quantitative risk assessment model, and occupational hazards risk assessment index method in occupational health risk in enterprises using dimethylformamide (DMF) in a certain area in Jiangsu, China, and to put forward related risk control measures. Methods: The industries involving DMF exposure in Jiangsu province were chosen as the evaluation objects in 2013 and three risk assessment models were used in the evaluation. EPA inhalation risk assessment model: HQ=EC/RfC; Singapore semi-quantitative risk assessment model: Risk= (HR×ER) 1/2 ; Occupational hazards risk assessment index=2 Health effect level ×2 exposure ratio ×Operation condition level. Results: The results of hazard quotient (HQ>1) from EPA inhalation risk assessment model suggested that all the workshops (dry method, wet method and printing) and work positions (pasting, burdening, unreeling, rolling, assisting) were high risk. The results of Singapore semi-quantitative risk assessment model indicated that the workshop risk level of dry method, wet method and printing were 3.5 (high) , 3.5 (high) and 2.8 (general) , and position risk level of pasting, burdening, unreeling, rolling, assisting were 4 (high) , 4 (high) , 2.8 (general) , 2.8 (general) and 2.8 (general) . The results of occupational hazards risk assessment index method demonstrated that the position risk index of pasting, burdening, unreeling, rolling, assisting were 42 (high) , 33 (high) , 23 (middle) , 21 (middle) and 22 (middle) . The results of Singapore semi-quantitative risk assessment model and occupational hazards risk assessment index method were similar, while EPA inhalation risk assessment model indicated all the workshops and positions were high risk. Conclusion: The occupational hazards risk assessment index method fully considers health effects, exposure, and operating conditions

Occupational Health Promotion Programs to Reduce Cardiovascular Risk.

ERIC Educational Resources Information Center

Glasgow, Russell E.; Terborg, James R.

1988-01-01

Surveys literature on worksite health promotion programs targeting cardiovascular risk factors. Reviews findings on health-risk appraisal, hypertension control, smoking cessation, weight reduction, exercise, and programs addressing multiple risk factors. Discusses current knowledge, highlights exemplary studies, and identifies problems and…

The relationship between health risks and health and productivity costs among employees at Pepsi Bottling Group.

PubMed

Henke, Rachel M; Carls, Ginger S; Short, Meghan E; Pei, Xiaofei; Wang, Shaohung; Moley, Susan; Sullivan, Mark; Goetzel, Ron Z

2010-05-01

To evaluate relationships between modifiable health risks and costs and measure potential cost savings from risk reduction programs. Health risk information from active Pepsi Bottling Group employees who completed health risk assessments between 2004 and 2006 (N = 11,217) were linked to medical care, workers' compensation, and short-term disability cost data. Ten health risks were examined. Multivariate analyses were performed to estimate costs associated with having high risk, holding demographics, and other risks constant. Potential savings from risk reduction were estimated. High risk for weight, blood pressure, glucose, and cholesterol had the greatest impact on total costs. A one-percentage point annual reduction in the health risks assessed would yield annual per capita savings of $83.02 to $103.39. Targeted programs that address modifiable health risks are expected to produce substantial cost reductions in multiple benefit categories.

[Risk Management: concepts and chances for public health].

PubMed

Palm, Stefan; Cardeneo, Margareta; Halber, Marco; Schrappe, Matthias

2002-01-15

Errors are a common problem in medicine and occur as a result of a complex process involving many contributing factors. Medical errors significantly reduce the safety margin for the patient and contribute additional costs in health care delivery. In most cases adverse events cannot be attributed to a single underlying cause. Therefore an effective risk management strategy must follow a system approach, which is based on counting and analysis of near misses. The development of defenses against the undesired effects of errors should be the main focus rather than asking the question "Who blundered?". Analysis of near misses (which in this context can be compared to indicators) offers several methodological advantages as compared to the analysis of errors and adverse events. Risk management is an integral element of quality management.

Compound risk judgment in tasks with both idiosyncratic and systematic risk: The "Robust Beauty" of additive probability integration.

PubMed

Sundh, Joakim; Juslin, Peter

2018-02-01

In this study, we explore how people integrate risks of assets in a simulated financial market into a judgment of the conjunctive risk that all assets decrease in value, both when assets are independent and when there is a systematic risk present affecting all assets. Simulations indicate that while mental calculation according to naïve application of probability theory is best when the assets are independent, additive or exemplar-based algorithms perform better when systematic risk is high. Considering that people tend to intuitively approach compound probability tasks using additive heuristics, we expected the participants to find it easiest to master tasks with high systematic risk - the most complex tasks from the standpoint of probability theory - while they should shift to probability theory or exemplar memory with independence between the assets. The results from 3 experiments confirm that participants shift between strategies depending on the task, starting off with the default of additive integration. In contrast to results in similar multiple cue judgment tasks, there is little evidence for use of exemplar memory. The additive heuristics also appear to be surprisingly context-sensitive, with limited generalization across formally very similar tasks. Copyright © 2017 Elsevier B.V. All rights reserved.

Cumulative effects of antiandrogenic chemical mixtures and their relevance to human health risk assessment.

PubMed

Howdeshell, Kembra L; Hotchkiss, Andrew K; Gray, L Earl

2017-03-01

Toxicological studies of defined chemical mixtures assist human health risk assessment by establishing how chemicals interact with one another to induce an effect. This paper reviews how antiandrogenic chemical mixtures can alter reproductive tract development in rats with a focus on the reproductive toxicant phthalates. The reviewed studies compare observed mixture data to mathematical mixture model predictions based on dose addition or response addition to determine how the individual chemicals in a mixture interact (e.g., additive, greater, or less than additive). Phthalate mixtures were observed to act in a dose additive manner based on the relative potency of the individual phthalates to suppress fetal testosterone production. Similar dose additive effects have been reported for mixtures of phthalates with antiandrogenic pesticides of differing mechanisms of action. Overall, data from these phthalate experiments in rats can be used in conjunction with human biomonitoring data to determine individual hazard indices, and recent cumulative risk assessments in humans indicate an excess risk to antiandrogenic chemical mixtures that include phthalates only or phthalates in combination with other antiandrogenic chemicals. Published by Elsevier GmbH.

Organochlorine pesticides across the tributaries of River Ravi, Pakistan: Human health risk assessment through dermal exposure, ecological risks, source fingerprints and spatio-temporal distribution.

PubMed

Baqar, Mujtaba; Sadef, Yumna; Ahmad, Sajid Rashid; Mahmood, Adeel; Li, Jun; Zhang, Gan

2018-03-15

This study monitored the human health risks through dermal exposure, hazardous risks to ecological integrity, contamination levels, spatio-temporal distribution, and congener specific analysis of organochlorine pesticides (OCPs) across River Ravi and its three northern tributaries (Nullah Bein, Nullah Basanter and Nullah Deg). The residual levels of OCPs isomers were screened for water (n=54) and surface sediment (n=54) samples from twenty seven sampling sites in two alternate seasons (pre-monsoon and post-monsoon). The ∑OCPs concentrations ranged from 13.61 to 1992.18ng/g dry weight and 12.89 to 128.16ng/L with predominance of β-endosulfan and p,p'-DDT in sediment and water matrixes, respectively. Distribution pattern revealed significantly higher concentrations in upstream and midstream, suggesting considerable transboundary OCPs pollution. Calculated ratios of α-HCH/γ-HCH, o,p'-DDT/p,p'-DDT, (DDE+DDD)/∑DDTs and cis/trans-chlordane for water and sediments identified the fresh addition of lindane, technical DDTs and chlordane in the study area. Risk quotient (RQ) based ecological risk was found to be >1 at all studied streams during both seasons and elucidates higher risks for endosulfan (α-endosulfan) and endrin. Human health risk assessment indicated absence of hazardous (non-carcinogenic) risk through bathing in studied streams; as the hazard index values ranged from 1.09E-05 to 2.48E-02 (acceptable limit; <1). However, the calculated carcinogenic risk possessed by OCPs through dermal exposure ranged from 1.39E-10 to 1.98E-05 that highlighted the considerable carcinogenic risk associated to aldrin, dieldrin, p,p'-DDT and β-endosulfan at certain studied sites. Therefore, the high levels of ecological risk and carcinogenic human health risk had emphasized an immediate elimination of ongoing OCPs addition in the studied area. Copyright © 2017 Elsevier B.V. All rights reserved.

Managing risk selection incentives in health sector reforms.

PubMed

Puig-Junoy, J

1999-01-01

The object of the paper is to review theoretical and empirical contributions to the optimal management of risk selection incentives ('cream skimming') in health sector reforms. The trade-off between efficiency and risk selection is fostered in health sector reforms by the introduction of competitive mechanisms such as price competition or prospective payment systems. The effects of two main forms of competition in health sector reforms are observed when health insurance is mandatory: competition in the market for health insurance, and in the market for health services. Market and government failures contribute to the assessment of the different forms of risk selection employed by insurers and providers, as the effects of selection incentives on efficiency and their proposed remedies to reduce the impact of these perverse incentives. Two European (Netherlands and Spain) and two Latin American (Chile and Colombia) case studies of health sector reforms are examined in order to observe selection incentives, their effects on efficiency and costs in the health system, and regulation policies implemented in each country to mitigate incentives to 'cream skim' good risks.

Is oral health a risk factor for sexual health?

PubMed

Eastham, Jane; Seymour, Robin

2015-03-01

New evidence suggests that the extent and severity of periodontal disease may be a significant risk factor for erectile dysfunction, sperm motility and time to conception. This paper reviews the evidence and informs members of the dental team when dealing with this sensitive issue. As more research is forthcoming the topic of oral and sexual health is likely to be part of regular routine medical screening. Any issue concerning oral health as a risk factor for sexual health is likely to be a sensitive subject, rarely discussed in the dental setting. However, as new evidence emerges, this topic is likely to get into the public domain. All members of the dental team should be aware of such an association. Clinical Relevance: Furthermore, the information in this paper may provide further incentive for certain patients to improve their oral health.

Familial risk for lifestyle-related chronic diseases: can family health history be used as a motivational tool to promote health behaviour in young adults?

PubMed

Prichard, I; Lee, A; Hutchinson, A D; Wilson, C

2015-08-01

Risk for colorectal cancer, breast cancer, heart disease and diabetes has both a familial and a lifestyle component. This quasi-experimental study aimed to determine whether a Family Health History (FHH) assessment and the subsequent provision of risk information would increase young adults' (17-29 years) intentions to modify health behaviours associated with the risk of these chronic diseases (i.e. alcohol consumption, fruit and vegetable intake and physical activity) and to talk to their family about their risk. After baseline measures of current and intended health-related behaviours, participants (n = 116) were randomly allocated to either a FHH assessment or control information. Based on the FHH provided, participants in the FHH condition were then classified as 'above-average risk' or 'average risk'. One week later, participants were provided with tailored health information and completed follow-up measures of intended health-related behaviours and perceived vulnerability. Participants classified as 'above-average risk' had increased perceptions of vulnerability to a chronic disease. Despite this, no group differences were found in intentions to change physical activity or fruit and vegetable consumption. Participants with above-average risk reported greater intentions to decrease the frequency of their alcohol consumption than average risk/control participants. In addition, completing a FHH assessment promoted intended communication with family members about chronic disease risk. FHH assessments may have the greatest value within the family context. SO WHAT? Future research could examine the impact of providing FHH information to different family members as a health promotion strategy.

Child Physical Abuse and Concurrence of Other Types of Child Abuse in Sweden--Associations with Health and Risk Behaviors

ERIC Educational Resources Information Center

Annerback, E. M.; Sahlqvist, L.; Svedin, C. G.; Wingren, G.; Gustafsson, P. A.

2012-01-01

Objective: To examine the associations between child physical abuse executed by a parent or caretaker and self-rated health problems/risk-taking behaviors among teenagers. Further to evaluate concurrence of other types of abuse and how these alone and in addition to child physical abuse were associated with bad health status and risk-taking…

Impact of the Prevention Plan on Employee Health Risk Reduction

PubMed Central

Edington, Dee W.; Bég, Sami

2010-01-01

Abstract This study evaluated the impact of The Prevention Plan™ on employee health risks after 1 year of integrated primary prevention (wellness and health promotion) and secondary prevention (biometric and lab screening as well as early detection) interventions. The Prevention Plan is an innovative prevention benefit that provides members with the high-tech/high-touch support and encouragement they need to adopt healthy behaviors. Support services include 24/7 nurse hotlines, one-on-one health coaching, contests, group events, and employer incentives. Specifically, we analyzed changes in 15 health risk measures among a cohort of 2606 employees from multiple employer groups who completed a baseline health risk appraisal, blood tests, and biometric screening in 2008 and who were reassessed in 2009. We then compared the data to the Edington Natural Flow of risks. The cohort showed significant reduction in 10 of the health risks measured (9 at P ≤ 0.01 and 1 at P ≤ 0.05). The most noticeable changes in health risks were a reduction in the proportion of employees with high-risk blood pressure (42.78%), high-risk fasting blood sugar (31.13%), and high-risk stress (24.94%). There was an overall health risk transition among the cohort with net movement from higher risk levels to lower risk levels (P < 0.01). There was a net increase of 9.40% of people in the low-risk category, a decrease of 3.61% in the moderate-risk category, and a 5.79% decrease in the high-risk category. Compared to Edington's Natural Flow model, 48.70% of individuals in the high-risk category moved from high risk to moderate risk (Natural Flow 31%), 46.35% moved from moderate risk to low risk (Natural Flow 35%), 15.65% moved from high risk to low risk (Natural Flow 6%), and 87.33% remained in the low-risk category (Natural Flow 70%) (P < 0.001). (Population Health Management 2010;13:275–284) PMID:20879909

Parent-child communication processes: preventing children's health-risk behavior.

PubMed

Riesch, Susan K; Anderson, Lori S; Krueger, Heather A

2006-01-01

Review individual, family, and environmental factors that predict health-risk behavior among children and to propose parent-child communication processes as a mechanism to mediate them. Improving parent-child communication processes may: reduce individual risk factors, such as poor academic achievement or self-esteem; modify parenting practices such as providing regulation and structure and acting as models of health behavior; and facilitate discussion about factors that lead to involvement in health-risk behaviors. Assessment strategies to identify youth at risk for health-risk behavior are recommended and community-based strategies to improve communication among parents and children need development.

Health risks, travel preparation, and illness among public health professionals during international travel.

PubMed

Balaban, Victor; Warnock, Eli; Ramana Dhara, V; Jean-Louis, Lee Ann; Sotir, Mark J; Kozarsky, Phyllis

2014-01-01

Few data currently exist on health risks faced by public health professionals (PHP) during international travel. We conducted pre- and post-travel health surveys to assess knowledge, attitudes, and practices (KAP), and illnesses among PHP international travelers. Anonymous surveys were completed by PHP from a large American public health agency who sought a pre-travel medical consult from September 1, 2009, to September 30, 2010. Surveys were completed by 122 participants; travelers went to 163 countries. Of the 122 respondents, 97 (80%) reported at least one planned health risk activity (visiting rural areas, handling animals, contact with blood or body fluids, visiting malarious areas), and 50 (41%) reported exposure to unanticipated health risks. Of the 62 travelers who visited malarious areas, 14 (23%) reported inconsistent or no use of malaria prophylaxis. Illness during travel was reported by 33 (27%) respondents. Most of the PHP travelers in our study reported at least one planned health risk activity, and almost half reported exposure to unanticipated health risks, and one-quarter of travelers to malarious areas reported inconsistent or no use of malaria chemoprophylaxis. Our findings highlight that communication and education outreach for PHP to prevent travel-associated illnesses can be improved. Published by Elsevier Ltd.

Risk adjusting community rated health plan premiums: a survey of risk assessment literature and policy applications.

PubMed

Giacomini, M; Luft, H S; Robinson, J C

1995-01-01

This paper surveys recent health care reform debates and empirical evidence regarding the potential role for risk adjusters in addressing the problem of competitive risk segmentation under capitated financing. We discuss features of health plan markets affecting risk selection, methodological considerations in measuring it, and alternative approaches to financial correction for risk differentials. The appropriate approach to assessing risk differences between health plans depends upon the nature of market risk selection allowed under a given reform scenario. Because per capita costs depend on a health plan's population risk, efficiency, and quality of service, risk adjustment will most strongly promote efficiency in environments with commensurately strong incentives for quality care.

Pathways to Health Risk Exposure in Adult Film Performers

PubMed Central

Ryan, Gery; Margold, William; Torres, Jacqueline; Gelberg, Lillian

2008-01-01

Despite being part of a large and legal industry in Los Angeles, little is known about adult film performers’ exposure to health risks and when and how these risks might occur. The objective was to identify exposure to physical, mental, and social health risks and the pathways to such risks among adult film performers and to determine how risks differ between different types of performers, such as men and women. Semi-structured in-depth interviews were conducted with 18 female and ten male performers as well as two key informants from the industry. Performers and key informants were recruited through Protecting Adult Welfare, adult film venues, and snowball sampling. Performers engaged in risky health behaviors that included high-risk sexual acts that are unprotected, substance abuse, and body enhancement. They are exposed to physical trauma on the film set. Many entered and left the industry with financial insecurity and suffered from mental health problems. Women were more likely than men to be exposed to health risks. Adult film performers, especially women, are exposed to health risks that accumulate over time and that are not limited to sexually transmitted diseases. PMID:18709554

Health benefits and risks of the Internet.

PubMed

Levy, Judith A; Strombeck, Rita

2002-12-01

The linking of the Internet with health and medicine involves all levels of society, including individuals, health care providers, professional organizations, communities, and local and federal governments. A growing body of evidence suggests that despite the benefits of the Internet, this means of communication also figures into the creation of new forms of health risk for some users. This paper examines the effects of the Internet on the promotion of both health and illness. The discussion focuses on those factors of online communication that produce positive health outcomes and also the potential for health risk. Implications for health providers and for better serving patients are analyzed together with recommendations for improving services for those who go online to access health information.

Health risks of energy systems.

PubMed

Krewitt, W; Hurley, F; Trukenmüller, A; Friedrich, R

1998-08-01

Health risks from fossil, renewable and nuclear reference energy systems are estimated following a detailed impact pathway approach. Using a set of appropriate air quality models and exposure-effect functions derived from the recent epidemiological literature, a methodological framework for risk assessment has been established and consistently applied across the different energy systems, including the analysis of consequences from a major nuclear accident. A wide range of health impacts resulting from increased air pollution and ionizing radiation is quantified, and the transferability of results derived from specific power plants to a more general context is discussed.

Health Risks of an Inactive Lifestyle - Multiple Languages

MedlinePlus

... Are Here: Home → Multiple Languages → All Health Topics → Health Risks of an Inactive Lifestyle URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Health Risks of an Inactive Lifestyle - Multiple Languages To use the sharing features on ...

TeamSTEPPS for health care risk managers: Improving teamwork and communication.

PubMed

Cooke, Marcia

2016-07-01

Ineffective communication among the health care team is a leading cause of errors in the patient care setting. Studies assessing training related to communication and teamwork in the clinical team are prevalent, however, teamwork training at the administrative level is lacking. This includes individuals in leadership positions such as health care risk managers. The purpose was to determine the impact of an educational intervention on the knowledge and attitudes related to communication and teamwork in the health care risk management population. The educational intervention was an adaptation of a national teamwork training program and incorporated didactic content as well as video vignettes and small group activities. Measurement of knowledge and attitudes were used to determine the impact of the education program. Knowledge and attitudes were assessed pre- and postcourse. Findings indicate that teamwork education tailored to the needs of the specific audience resulted in knowledge gained and improved attitudes toward the components of teamwork. The attitudes that most significantly improved were related to team structure and situation monitoring. There was no improvement in participants' attitudes toward leadership, mutual support, and communication. Team training has been shown to improve safety culture, patient satisfaction, and clinical outcomes. Including risk managers in training on teamwork, communication, and collaboration can serve to foster a common language among clinicians and management. In addition, a measurement related to implementation in the health care setting may yield insight into the impact of training. Qualitative measurement may allow the researcher to delve deeper into how these health care facilities are using team training interventions. © 2016 American Society for Healthcare Risk Management of the American Hospital Association.

Risk of Adverse Health Effects Due to Host-Microorganism Interactions

NASA Technical Reports Server (NTRS)

Ott, C. Mark; Oubre, Cherie; Castro, Sarah; Mehta, Satish; Pierson, Duane

2015-01-01

While preventive measures limit the presence of many medically significant microorganisms during spaceflight missions, microbial infection of crewmembers cannot be completely prevented. Spaceflight experiments over the past 50 years have demonstrated a unique microbial response to spaceflight culture, although the mechanisms behind those responses and their operational relevance were unclear. In 2007, the operational importance of these microbial responses was emphasized as the results of an experiment aboard STS-115 demonstrated that the enteric pathogen Salmonella enterica serovar Typhimurium (S. Typhimurium) increased in virulence in a murine model of infection. The experiment was reproduced in 2008 aboard STS-123 confirming this finding. In response to these findings, the Institute of Medicine of the National Academies recommended that NASA investigate this risk and its potential impact on the health of the crew during spaceflight. NASA assigned this risk to the Human Research Program. To better understand this risk, evidence has been collected and reported from both spaceflight analog systems and actual spaceflight. Although the performance of virulence studies during spaceflight are challenging and often impractical, additional information has been and continues to be collected to better understand the risk to crew health. Still, the uncertainty concerning the extent and severity of these alterations in host-microorganism interactions is very large and requires more investigation.

Benefits and concerns associated with biotechnology-derived foods: can additional research reduce children health risks?

PubMed

Cantani, A

2009-01-01

The development of techniques devised for the genetic manipulation of foods poses new risks for children with food allergy (FA). The introduction of foreign allergenic proteins from different foods into previously tolerated foods may trigger allergic reactions, often complicating with anaphylactic shock in a subset of allergic babies. Children with FA, even if subjected to preventative diets, always challenge the risk of developing allergic manifestations after unintentional intake of a non tolerated food in restaurant settings, with relatives or schoolmates, etc, where product labelling is necessarily lacking. The introduction of potentially allergenic proteins into foods generally considered safe for allergic children can be done deliberately, by either substantially altering the food ingredients, or by genetic manipulation which change the composition or transfer allergens, or unintentionally by qualitycontrol failures, due to contaminations in the production process, or to genetic mismanipulation. There is a controversy between multinationals often favored by governments and consumer association resistance, thus an equidistant analysis poses some unprecedented impediments. The importance of FA and the potential of transgenic plants to bring food allergens into the food supply should not be disregarded. The expression in soybeans of a Brazil nut protein resulted in a food allergen ex-pressed in widely used infant formulas, so paving the way to an often reported multinational debacle. Genetic engineering poses innovative ethical and social concerns, as well as serious challenges to the environment, human health, animal welfare, and the future of agriculture. In this paper will be emphasized practical concepts more crucial for pediatricians.

[Perception of health risks: psychological and social factors].

PubMed

Kurzenhäuser, S; Epp, A

2009-12-01

This article reviews central findings and current developments of psychological and sociological research on the perception of health risks. Risk perception is influenced by numerous psychological, social, political, and cultural factors. These factors can be categorized into (a) risk characteristics, (b) characteristics of the risk perceiving person and his/her situation, and (c) characteristics of risk communication. Thus, besides individual cognitive and affective processing of risk information, social processes of risk amplification (e.g., media effects) are also involved in the construction of individual risk perceptions. We discuss the recommendations for health risk communication that follow from these findings with regard to different communication goals.

"The Dose Makes the Poison": Informing Consumers About the Scientific Risk Assessment of Food Additives.

PubMed

Bearth, Angela; Cousin, Marie-Eve; Siegrist, Michael

2016-01-01

Intensive risk assessment is required before the approval of food additives. During this process, based on the toxicological principle of "the dose makes the poison,ˮ maximum usage doses are assessed. However, most consumers are not aware of these efforts to ensure the safety of food additives and are therefore sceptical, even though food additives bring certain benefits to consumers. This study investigated the effect of a short video, which explains the scientific risk assessment and regulation of food additives, on consumers' perceptions and acceptance of food additives. The primary goal of this study was to inform consumers and enable them to construct their own risk-benefit assessment and make informed decisions about food additives. The secondary goal was to investigate whether people have different perceptions of food additives of artificial (i.e., aspartame) or natural origin (i.e., steviolglycoside). To attain these research goals, an online experiment was conducted on 185 Swiss consumers. Participants were randomly assigned to either the experimental group, which was shown a video about the scientific risk assessment of food additives, or the control group, which was shown a video about a topic irrelevant to the study. After watching the video, the respondents knew significantly more, expressed more positive thoughts and feelings, had less risk perception, and more acceptance than prior to watching the video. Thus, it appears that informing consumers about complex food safety topics, such as the scientific risk assessment of food additives, is possible, and using a carefully developed information video is a successful strategy for informing consumers. © 2015 Society for Risk Analysis.

Impact of the prevention plan on employee health risk reduction.

PubMed

Loeppke, Ronald; Edington, Dee W; Bég, Sami

2010-10-01

This study evaluated the impact of The Prevention Plan™ on employee health risks after 1 year of integrated primary prevention (wellness and health promotion) and secondary prevention (biometric and lab screening as well as early detection) interventions. The Prevention Plan is an innovative prevention benefit that provides members with the high-tech/high-touch support and encouragement they need to adopt healthy behaviors. Support services include 24/7 nurse hotlines, one-on-one health coaching, contests, group events, and employer incentives. Specifically, we analyzed changes in 15 health risk measures among a cohort of 2606 employees from multiple employer groups who completed a baseline health risk appraisal, blood tests, and biometric screening in 2008 and who were reassessed in 2009. We then compared the data to the Edington Natural Flow of risks. The cohort showed significant reduction in 10 of the health risks measured (9 at P≤ 0.01 and 1 at P≤0.05). The most noticeable changes in health risks were a reduction in the proportion of employees with high-risk blood pressure (42.78%), high-risk fasting blood sugar (31.13%), and high-risk stress (24.94%). There was an overall health risk transition among the cohort with net movement from higher risk levels to lower risk levels (P<0.01). There was a net increase of 9.40% of people in the low-risk category, a decrease of 3.61% in the moderate-risk category, and a 5.79% decrease in the high-risk category. Compared to Edington's Natural Flow model, 48.70% of individuals in the high-risk category moved from high risk to moderate risk (Natural Flow 31%), 46.35% moved from moderate risk to low risk (Natural Flow 35%), 15.65% moved from high risk to low risk (Natural Flow 6%), and 87.33% remained in the low-risk category (Natural Flow 70%) (P<0.001).

Health risk behavior of youth in foster care.

PubMed

Gramkowski, Bridget; Kools, Susan; Paul, Steven; Boyer, Cherrie B; Monasterio, Erica; Robbins, Nancy

2009-05-01

Many adolescent health problems are predominantly caused by risk behavior. Foster adolescents have disproportionately poor health; therefore, identification of risk behavior is critical. Data from a larger study were analyzed to investigate the health risk behavior of 56 youth in foster care using the Child Health and Illness Profile-Adolescent Edition. Data indicated that youth in foster care had some increased risk behavior when compared with a normative adolescent population. Younger adolescents and those in relative placement had less risky behavior. Risk behavior was increased for youth in foster care when they were in group homes, had experienced a parental death, or had a history of physical or emotional abuse or attempted suicide. These results point to areas of strength and vulnerability for youth in foster care and suggest areas for clinicians and caregivers of these adolescents to focus interventions towards harm reduction and enhancement of resiliency.

Risk selection into consumer-directed health plans: an analysis of family choices within large employers.

PubMed

McDevitt, Roland D; Haviland, Amelia M; Lore, Ryan; Laudenberger, Laura; Eisenberg, Matthew; Sood, Neeraj

2014-04-01

To identify the degree of selection into consumer-directed health plans (CDHPs) versus traditional plans over time, and factors that influence choice and temper risk selection. Sixteen large employers offering both CDHP and traditional plans during the 2004–2007 period, more than 200,000 families. We model CDHP choice with logistic regression; predictors include risk scores, in addition to family, choice setting, and plan characteristics. Additional models stratify by account type or single enrollee versus family. Risk scores, family characteristics, and enrollment decisions are derived from medical claims and enrollment files. Interviews with human resources executives provide additional data. CDHP risk scores were 74 percent of traditional plan scores in the first year, and this difference declined over time. Employer contributions to accounts and employee premium savings fostered CDHP enrollment and reduced risk selection. Having to make an active choice of plan increased CDHP enrollment but also increased risk selection. Risk selection was greater for singles than families and did not differ between HRA and HSA-based CDHPs. Risk selection was not severe and it was well managed. Employers have effective methods to encourage CDHP enrollment and temper selection against traditional plans.

Health risk assessment of arsenic from blended water in distribution systems.

PubMed

Zhang, Hui; Zhou, Xue; Wang, Kai; Wang, Wen D

2017-12-06

In a water distribution system with different sources, water blending occurs, causing specific variations of the arsenic level. This study was undertaken to investigate the concentration and cancer risk of arsenic in blended water in Xi'an city. A total of 672 tap water samples were collected from eight sampling points in the blending zones for arsenic determination. The risk was evaluated through oral ingestion and dermal absorption, separately for males and females, as well as with respect to seasons and blending zones. Although the arsenic concentrations always fulfilled the requirements of the World Health Organization (WHO) (≤10 μg L -1 ), the total cancer risk value was higher than the general guidance risk value of 1.00 × 10 -6 . In the blending zone of the Qujiang and No.3 WTPs (Z2), the total cancer risk value was over 1.00 × 10 -5 , indicating that public health would be affected to some extent. More than 99% of the total cancer risk was from oral ingestion, and dermal absorption had a little contribution. With higher exposure duration and lower body weight, women had a higher cancer risk. In addition, due to several influential factors, the total cancer risk in the four blending zones reached the maximum in different seasons. The sensitivity analysis by the tornado chart proved that body weight, arsenic concentration and ingestion rate significantly contributed to cancer risk. This study suggests the regular monitoring of water blending zones for improving risk management.

Health risks due to radon in drinking water

USGS Publications Warehouse

Hopke, P.K.; Borak, T.B.; Doull, J.; Cleaver, J.E.; Eckerman, K.F.; Gundersen, L.C.S.; Harley, N.H.; Hess, C.T.; Kinner, N.E.; Kopecky, K.J.; Mckone, T.E.; Sextro, R.G.; Simon, S.L.

2000-01-01

Following more than a decade of scientific debate about the setting of a standard for 222Rn in drinking water, Congress established a timetable for the promulgation of a standard in the 1996 Amendments to the Safe Drinking Water Act. As a result of those Amendments, the EPA contracted with the National Academy of Sciences to undertake a risk assessment for exposure to radon in drinking water. In addition, the resulting committee was asked to address several other scientific issues including the national average ambient 222Rn concentration and the increment of 222Rn to the indoor- air concentration arising from the use of drinking water in a home. A new dosimetric analysis of the cancer risk to the stomach from ingestion was performed. The recently reported risk estimates developed by the BEIR VI Committee for inhalation of radon decay products were adopted. Because the 1996 Amendments permit states to develop programs in which mitigation of air- producing health-risk reductions equivalent to that which would be achieved by treating the drinking water, the scientific issues involved in such 'multimedia mitigation programs' were explored.

Integrating Behavioral Health Risk Assessment into Centralized Intake for Maternal and Child Health Services.

PubMed

Price, Sarah Kye; Coles, D Crystal; Wingold, Tracey

2017-11-01

Effectively promoting women's health during and around the time of pregnancy requires early, nonstigmatizing identification and assessment of behavioral health risks (such as depression, substance use, smoking, and interpersonal violence) combined with timely linkage to community support and specialized interventions. This article describes an integrated approach to behavioral health risk screening woven into a point of first contact with the health care delivery system: centralized intake for maternal and child health home visiting programs. Behavioral Health Integrated Centralized Intake is a social work-informed, community-designed approach to screening, brief intervention, and service linkage targeting communities at high risk for fetal and infant mortality. Women enrolled in this study were receptive to holistic risk screening as well as guided referral for both home visiting support and specialized mental health interventions. Results from this multi-community study form the foundation for strengths-based, social work-informed enhancements to community health promotion programs. © 2017 National Association of Social Workers.

45 CFR 162.925 - Additional requirements for health plans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... clearinghouse to receive, process, or transmit a standard transaction may not charge fees or costs in excess of... RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS General Provisions for Transactions § 162.925 Additional... transaction as a standard transaction, the health plan must do so. (2) A health plan may not delay or reject a...

The effect of risk perception on public preferences and willingness to pay for reductions in the health risks posed by toxic cyanobacterial blooms.

PubMed

Hunter, Peter D; Hanley, Nick; Czajkowski, Mikołaj; Mearns, Kathryn; Tyler, Andrew N; Carvalho, Laurence; Codd, Geoffrey A

2012-06-01

Mass populations of toxin-producing cyanobacteria are an increasingly common occurrence in inland and coastal waters used for recreational purposes. These mass populations pose serious risks to human and animal health and impose potentially significant economic costs on society. In this study, we used contingent valuation (CV) methods to elicit public willingness to pay (WTP) for reductions in the morbidity risks posed by blooms of toxin-producing cyanobacteria in Loch Leven, Scotland. We found that 55% of respondents (68% excluding protest voters) were willing to pay for a reduction in the number of days per year (from 90, to either 45 or 0 days) that cyanobacteria pose a risk to human health at Loch Leven. The mean WTP for a risk reduction was UK£9.99-12.23/household/year estimated using a logistic spike model. In addition, using the spike model and a simultaneous equations model to control for endogeneity bias, we found the respondents' WTP was strongly dependent on socio-demographic characteristics, economic status and usage of the waterbody, but also individual-specific attitudes and perceptions towards health risks. This study demonstrates that anticipated health risk reductions are an important nonmarket benefit of improving water quality in recreational waters and should be accounted for in future cost-benefit analyses such as those being undertaken under the auspices of the European Union's Water Framework Directive, but also that such values depend on subjective perceptions of water-related health risks and general attitudes towards the environment. Copyright © 2012 Elsevier B.V. All rights reserved.

Community Health Risk Assessment of Primary Aluminum Smelter Emissions

PubMed Central

Larivière, Claude

2014-01-01

Objective: Primary aluminum production is an industrial process with high potential health risk for workers. We consider in this article how to assess community health risks associated with primary aluminum smelter emissions. Methods: We reviewed the literature on health effects, community exposure data, and dose–response relationships of the principal hazardous agents emitted. Results: On the basis of representative measured community exposure levels, we were able to make rough estimates on health risks associated with specific agents and categorize these as none, low, medium, or high. Conclusions: It is possible to undertake a rough-estimate community Health Risk Assessment for individual smelters on the basis of information available in the epidemiological literature and local community exposure data. PMID:24806724

The role of health-risk appraisals in disease management.

PubMed

Hudson, Laurel R; Pope, James E

2006-02-01

Managed care organizations and disease management vendors often find themselves in the position of responding to employers who want to administer a health-risk appraisal (HRA) without committing to implementation of a comprehensive health promotion program. The assumption appears to be that information on health risks is sufficient to motivate employees to change their health behaviors in order to reduce estimated health risks. A review of the relevant literature does not substantiate the efficacy of a stand-alone HRA for motivating behavior change. The challenge is to engage employers in informed conversations on what works in health promotion and achieve cost-effective benefits.

The family health, functioning, social support and child maltreatment risk of families expecting a baby.

PubMed

Lepistö, Sari; Ellonen, Noora; Helminen, Mika; Paavilainen, Eija

2017-08-01

To describe the family health, functioning, social support and child maltreatment risk and associations between them in families expecting a baby. Finland was one of the first countries in banning corporal punishment against children over 30 years ago. Despite of this, studies have shown that parents physically abuse their children. In addition, professionals struggle in intervention of this phenomenon. Abusive parents should be recognised and helped before actual violent behaviour. A follow-up case-control study, with a supportive intervention in the case group (families with a heightened risk) in maternity and child welfare clinics. The baseline results of families are described here. Child maltreatment risk in families expecting a baby was measured by Child Abuse Potential Inventory. The health and functioning was measured by Family Health, Functioning and Social Support Scale. Data included 380 families. A total of 78 families had increased risk for child maltreatment. Heightened risk was associated with partners' age, mothers' education, partners' father's mental health problems, mothers' worry about partners' drinking and mothers' difficulties in talking about the family's problems. Risk was associated with family functioning and health. Families with risk received a less support from maternity clinics. Families with child maltreatment risk and related factors were found. This knowledge can be applied for supporting families both during pregnancy and after the baby is born. Professionals working with families in maternity clinics need tools to recognise families with risk and aid a discussion with them about the family life situation. The Child Abuse Potential, as a part of evaluating the family life situation, seems to prove a useful tool in identifying families at risk. The results offer a valid and useful tool for recognising families with risk and provide knowledge about high-risk family situations. © 2016 John Wiley & Sons Ltd.

Assessing Human Health Risk from Pesticides

EPA Pesticide Factsheets

EPA protects human health and the environment by evaluating the risk associated with pesticides before allowing them to be used in the United States. Learn about the tools and processes used in risk assessment for pesticides.

A Real-World Community Health Worker Care Coordination Model for High-Risk Children.

PubMed

Martin, Molly A; Perry-Bell, Kenita; Minier, Mark; Glassgow, Anne Elizabeth; Van Voorhees, Benjamin W

2018-04-01

Health care systems across the United States are considering community health worker (CHW) services for high-risk patients, despite limited data on how to build and sustain effective CHW programs. We describe the process of providing CHW services to 5,289 at-risk patients within a state-run health system. The program includes 30 CHWs, six care coordinators, the Director of Care Coordination, the Medical Director, a registered nurse, mental health specialists, and legal specialists. CHWs are organized into geographic and specialized teams. All CHWs receive basic training that includes oral and mental health; some receive additional disease-specific training. CHWs develop individualized care coordination plans with patients. The implementation of these plans involves delivery of a wide range of social service and coordination support. The number of CHW contacts is determined by patient risk. CHWs spend about 60% of their time in an office setting. To deliver the program optimally, we had to develop multiple CHW job categories that allow for CHW specialization. We created new technology systems to manage operations. Field issues resulted in program changes to improve service delivery and ensure safety. Our experience serves as a model for how to integrate CHWs into clinical and community systems.

Risk management assessment of Health Maintenance Organisations participating in the National Health Insurance Scheme

PubMed Central

Campbell, Princess Christina; Korie, Patrick Chukwuemeka; Nnaji, Feziechukwu Collins

2014-01-01

Background: The National Health Insurance Scheme (NHIS), operated majorly in Nigeria by health maintenance organisations (HMOs), took off formally in June 2005. In view of the inherent risks in the operation of any social health insurance, it is necessary to efficiently manage these risks for sustainability of the scheme. Consequently the risk-management strategies deployed by HMOs need regular assessment. This study assessed the risk management in the Nigeria social health insurance scheme among HMOs. Materials and Methods: Cross-sectional survey of 33 HMOs participating in the NHIS. Results: Utilisation of standard risk-management strategies by the HMOs was 11 (52.6%). The other risk-management strategies not utilised in the NHIS 10 (47.4%) were risk equalisation and reinsurance. As high as 11 (52.4%) of participating HMOs had a weak enrollee base (less than 30,000 and poor monthly premium and these impacted negatively on the HMOs such that a large percentage 12 (54.1%) were unable to meet up with their financial obligations. Most of the HMOs 15 (71.4%) participated in the Millennium development goal (MDG) maternal and child health insurance programme. Conclusions: Weak enrollee base and poor monthly premium predisposed the HMOs to financial risk which impacted negatively on the overall performance in service delivery in the NHIS, further worsened by the non-utilisation of risk equalisation and reinsurance as risk-management strategies in the NHIS. There is need to make the scheme compulsory and introduce risk equalisation and reinsurance. PMID:25298605

Multiple health behaviors in an ethnically diverse sample of adults with risk factors for cardiovascular disease.

PubMed

Heinrich, Katie M; Maddock, Jay

2011-01-01

Health behaviors of adults living with cardiovascular disease (CVD) risk factors affect additional risk, where lifestyle behavioral choices become even more important in controlling disease and preventing additional negative health outcomes. In addition, both lifestyle behaviors and CVD risk factor prevalence can vary by ethnicity. We compared multiple health behaviors of adults with diabetes, hypertension, high cholesterol, and obesity to the behaviors of adults without those conditions in a diverse ethnic sample to determine if significant differences existed between groups. Data were obtained from 30-minute random-digit-dial telephone surveys in 2007 (n = 3607). All data were self-reports. Healthy behaviors included meeting recommendations for intake of fruits and vegetables; consuming low or very low amounts of dietary fat; eating breakfast six or seven days per week; having a healthy diet; and meeting recommendations for walking, moderate, and vigorous physical activity. Unhealthy behaviors included frequent consumption of soda and fast food, smoking, binge drinking, and high stress. More than 6% of respondents had diabetes, 15.9% had hypertension, 16.4% had high cholesterol, and 18.5% were obese. Significantly fewer healthy and more unhealthy behaviors were reported for those who had CVD risk factors than were reported by those who did not have such conditions. Ethnic differences in CVD risk factor prevalence and health behaviors existed as well (p < 0.001). Logistic regression models indicated that not eating a healthy diet (odds ratio [OR] = 1.82) was a significant predictor for diabetes; not eating a healthy diet (OR = 1.52) and not doing vigorous physical activity (OR = 1.79) were significant predictors for hypertension; consumption of high amounts of dietary fat (OR = 1.70) and of fast food (OR = 1.51) were significant predictors for high cholesterol levels; and not eating a healthy diet (OR = 1.52), high consumption of dietary fat (OR = 2.20), not

SEMIPARAMETRIC ADDITIVE RISKS REGRESSION FOR TWO-STAGE DESIGN SURVIVAL STUDIES

PubMed Central

Li, Gang; Wu, Tong Tong

2011-01-01

In this article we study a semiparametric additive risks model (McKeague and Sasieni (1994)) for two-stage design survival data where accurate information is available only on second stage subjects, a subset of the first stage study. We derive two-stage estimators by combining data from both stages. Large sample inferences are developed. As a by-product, we also obtain asymptotic properties of the single stage estimators of McKeague and Sasieni (1994) when the semiparametric additive risks model is misspecified. The proposed two-stage estimators are shown to be asymptotically more efficient than the second stage estimators. They also demonstrate smaller bias and variance for finite samples. The developed methods are illustrated using small intestine cancer data from the SEER (Surveillance, Epidemiology, and End Results) Program. PMID:21931467

Primary health care reform, dilemmatic space and risk of burnout among health workers.

PubMed

Freeman, Toby; Baum, Fran; Labonté, Ronald; Javanparast, Sara; Lawless, Angela

2018-05-01

Health system changes may increase primary health care workers' dilemmatic space, created when reforms contravene professional values. Dilemmatic space may be a risk factor for burnout. This study partnered with six Australian primary health care services (in South Australia: four state government-managed services including one Aboriginal health team and one non-government organisation and in Northern Territory: one Aboriginal community-controlled service) during a period of change and examined workers' dilemmatic space and incidence of burnout. Dilemmatic space and burnout were assessed in a survey of 130 staff across the six services (58% response rate). Additionally, 63 interviews were conducted with practitioners, managers, regional executives and health department staff. Dilemmatic space occurred across all services and was associated with higher rates of self-reported burnout. Three conditions associated with dilemmatic space were (1) conditions inherent in comprehensive primary health care, (2) stemming from service provision for Aboriginal and Torres Strait Islander peoples and (3) changes wrought by reorientation to selective primary health care in South Australia. Responses to dilemmatic space included ignoring directives or doing work 'under the radar', undertaking alternative work congruent with primary health care values outside of hours, or leaving the organisation. The findings show that comprehensive primary health care was contested and political. Future health reform processes would benefit from considering alignment of changes with staff values to reduce negative effects of the reform and safeguard worker wellbeing.

[Health risk assessment of coke oven PAHs emissions].

PubMed

Bo, Xin; Wang, Gang; Wen, Rou; Zhao, Chun-Li; Wu, Tie; Li, Shi-Bei

2014-07-01

Polycyclic aromatic hydrocarbons (PAHs) produced by coke oven are with strong toxicity and carcinogenicity. Taken typical coke oven of iron and steel enterprises as the case study, the dispersion and migration of 13 kinds of PAHs emitted from coke oven were analyzed using AERMOD dispersion model, the carcinogenic and non-carcinogenic risks at the receptors within the modeling domain were evaluated using BREEZE Risk Analyst and the Human Health Risk Assessment Protocol for Hazardous Waste Combustion (HHRAP) was followed, the health risks caused by PAHs emission from coke oven were quantitatively evaluated. The results indicated that attention should be paid to the non-carcinogenic risk of naphthalene emission (the maximum value was 0.97). The carcinogenic risks of each single pollutant were all below 1.0E-06, while the maximum value of total carcinogenic risk was 2.65E-06, which may have some influence on the health of local residents.

Health insurance in South Africa: an empirical analysis of trends in risk-pooling and efficiency following deregulation.

PubMed

Söderlund, N; Hansl, B

2000-12-01

This paper reports an empirical investigation into the pattern of private health insurance coverage in South Africa before and after deregulation of the health insurance industry. More specifically, we sought to measure trends in risk-pooling over the period 1985-95, and to assess the impact of risk pooling on the costs of health insurance cover over this period. South African mutual health insurers (Medical Schemes) have existed for over 100 years, and have been regulated under a specific Act since 1967. Up until 1989, health insurers were required by law to community rate their premiums, and were not allowed to exclude high-risk enrolees from cover. In 1989 these regulations were removed, effectively allowing health insurers to risk-rate the cover which they provided, and exclude 'medically uninsurables'. Data were obtained from the office of the health insurance regulator (the Registrar of Medical Schemes) for the period 1985-95, and consisted of the statutory returns from all registered medical schemes for each year during the study period. Multiple regression methods were used to assess the determinants of changes in the risk pools of insurers, and their costs. Both cross-sectional and longitudinal models were estimated. Unadjusted data suggest changes in risk-pooling since the deregulation period after 1985. Health insurers with open enrolment had worse than average risk profiles in the 1980s, but this reversed by the early 1990s, leaving them with significantly better risk profiles by 1995. Worsening risk profiles were associated with decreasing fund size, higher loss-ratios and past premium increases. Most models showed that risk rating of premiums was consistently associated with higher premiums, after adjustment for risk, quality, scale and other environmental differences between insurers. Likely explanations include the additional costs required for marketing and underwriting risk-rated policies, insufficient incentives to use cost-control techniques

A new approach to criteria for health risk assessment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Spickett, Jeffery, E-mail: J.Spickett@curtin.edu.au; Faculty of Health Sciences, School of Public Health, Curtin University, Perth, Western Australia; Katscherian, Dianne

2012-01-15

Health Impact Assessment (HIA) is a developing component of the overall impact assessment process and as such needs access to procedures that can enable more consistent approaches to the stepwise process that is now generally accepted in both EIA and HIA. The guidelines developed during this project provide a structured process, based on risk assessment procedures which use consequences and likelihood, as a way of ranking risks to adverse health outcomes from activities subjected to HIA or HIA as part of EIA. The aim is to assess the potential for both acute and chronic health outcomes. The consequences component alsomore » identifies a series of consequences for the health care system, depicted as expressions of financial expenditure and the capacity of the health system. These more specific health risk assessment characteristics should provide for a broader consideration of health consequences and a more consistent estimation of the adverse health risks of a proposed development at both the scoping and risk assessment stages of the HIA process. - Highlights: Black-Right-Pointing-Pointer A more objective approach to health risk assessment is provided. Black-Right-Pointing-Pointer An objective set of criteria for the consequences for chronic and acute impacts. Black-Right-Pointing-Pointer An objective set of criteria for the consequences on the health care system. Black-Right-Pointing-Pointer An objective set of criteria for event frequency that could impact on health. Black-Right-Pointing-Pointer The approach presented is currently being trialled in Australia.« less

Chemical Risk Assessment: Traditional vs Public Health Perspectives

EPA Science Inventory

Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. When done efficiently and properly, chemical risk assessment enables risk management actions that minimize the incidence and impacts of environme...

Ozone Health Risk Assessment for Selected Urban Areas

EPA Pesticide Factsheets

The health risk assessment described in this report estimated various health effects associated with O3 exposures as well as the reduced risks for one O3 season associated with just meeting the current O3 NAAQS.

Mental Health Professionals' Suicide Risk Assessment and Management Practices.

PubMed

Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Mitchell, Sean M; Taylor, Nathanael J; Quinnett, Paul; Ries, Richard

2018-01-01

Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. The study utilized a cross-sectional design and self-report questionnaires. Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

Evaluating a Health Risk Reduction Program.

ERIC Educational Resources Information Center

Nagelberg, Daniel B.

1981-01-01

A health risk reduction program at Bowling Green State University (Ohio) tested the efficacy of peer education against the efficacy of returning (by mail) health questionnaire results. A peer health education program did not appear to be effective in changing student attitudes or lifestyles; however, the research methodology may not have been…

Health Risk Taking and Human Immunodeficiency Virus Risk in Collegiate Female Athletes.

ERIC Educational Resources Information Center

Kokotailo, Patricia K.; Koscik, Rebecca E.; Henry, Bill C.; Fleming, Michael F.; Landry, Gregory L.

1998-01-01

A human immunodeficiency virus risk-scale compared risky health behaviors of female college athletes and their nonathlete peers. Both groups reported several risk behaviors. Athletes had significantly lower proportions of risk behaviors in several categories than nonathletes, though high levels of risk behavior overall indicated a need for…

Examining relationships between multiple health risk behaviors, well-being, and productivity.

PubMed

Evers, Kerry E; Castle, Patricia H; Prochaska, James O; Prochaska, Janice M

2014-06-01

Traditionally, the concept of health promotion has emphasized the reduction of health risk behaviors to reduce disease and impairment. Well-being research expands this focus to include positive constructs such as thriving, productivity, life-evaluation, and emotional and physical health. The objective of the present study was to examine the relationships between health risk behaviors and specific measures of individual well-being. Participants (N = 790) from 49 states completed a one-time online assessment that included the Life-Evaluation Index, Emotional and Physical Health Ladders, the Health Risk Intervention Assessment, and the Work Productivity and Activity Improvement Questionnaire for General Health. Life Evaluation and physical and emotional health were all inversely related to the number of health risk behaviors, with higher well-being scores associated with lower number of risk behaviors. Across the three Life Evaluation categories (Suffering, Struggling, and Thriving) the number of health risk behaviors decreased, productivity loss decreased, and emotional and physical health increased. The results add to previous research on how reducing multiple health risk behaviors can be combined with well-being, i.e., an emphasis on increasing life-evaluation, emotional and physical health, better functioning, and productivity.

Health risk appraisals in Swedish occupational health services

PubMed Central

Grooten, Wilhelmus Johannes Andreas; Müller, Mira; Forsman, Mikael; Kjellberg, Katarina; Toomingas, Allan; Björn Olov, Ång; Svartengren, Magnus

2016-01-01

BACKGROUND: Health risk appraisals (HRAs) in occupational health services (OHS) in Sweden are very commonly used for health promotion issues, but not much research has explored the extent and nature of individual feedback that is provided. OBJECTIVES: This study aimed to describe and explore HRAs in OHS regarding the content of the feedback in relation to the individual status and overall employee satisfaction. METHODS: Feedback (evaluation and advice) and employee satisfaction with HRA were studied in employees that participated in health risk appraisals with a specific feedback session (HRA-F) (n = 272) and employees that participated in a single session (HRA-S) (n = 104). Associations between feedback and individual status concerning life style were assessed with Cohen’s kappa (k). RESULTS: The employees received mainly information and advice for improvement on health and lifestyle issues (89–100%), while advice for improvement of working conditions was less common (15–59%). The feedback provided on life style was not based on individual status (k < 0.4), except for smoking and risky alcohol consumption (k > 0.55). A great majority of employees reported good overall satisfaction with their HRAs. CONCLUSIONS: The evaluation and feedback given to employees after HRAs should be based more on HRA-results and advice could be focused more on work-related factors. PMID:28059808

Risk behaviours and self rated health in Russia 1998

PubMed Central

Carlson, P

2001-01-01

OBJECTIVES—As self rated health and mortality represent different dimensions of public health and as risk behaviours have been closely related to mortality, we wanted to examine whether (poor) self rated health on the one hand and risk behaviours on the other can be attributed to different causes.
METHODS—The Taganrog household survey (1998) was conducted in the form of face to face interviews and included 1009 people and their families. To estimate health differences and differences in risk behaviours between groups, logistic regressions were performed.
RESULTS—In Taganrog between 1993/94 and 1998, changes in self rated health seem to have been much more dramatic than changes in smoking and different in direction from changes in heavy alcohol consumption. Moreover, self rated "poor" health was especially common among those whose economic situation was worse in 1998 than 10 years before. However, having a poorer economy during the period 1988-1998, does not seem to have affected drinking or smoking habits significantly.
CONCLUSIONS—Self rated health seems to be closely related to three indicators of economic circumstances. Risk behaviours are probably important for the poor state of public health in Russia, but may be less sensitive to the economic aspects of the transition than is self rated health.


Keywords: self rated health; risk behaviours PMID:11604437

Ethical Dilemmas in Protecting Susceptible Subpopulations From Environmental Health Risks: Liberty, Utility, Fairness, and Accountability for Reasonableness

PubMed Central

Resnik, David B.; MacDougall, D. Robert; Smith, Elise M.

2018-01-01

Various U.S. laws, such as the Clean Air Act and the Food Quality Protection Act, require additional protections for susceptible subpopulations who face greater environmental health risks. The main ethical rationale for providing these protections is to ensure that environmental health risks are distributed fairly. In this article, we (1) consider how several influential theories of justice deal with issues related to the distribution of environmental health risks; (2) show that these theories often fail to provide specific guidance concerning policy choices; and (3) argue that an approach to public decision making known as accountability for reasonableness can complement theories of justice in establishing acceptable environmental health risks for the general population and susceptible subpopulations. Since accountability for reasonableness focuses on the fairness of the decision-making process, not the outcome, it does not guarantee that susceptible subpopulations will receive a maximum level of protection, regardless of costs or other morally relevant considerations. PMID:29466133

Health Risk Behaviors and Mental Health Problems as Mediators of the Relationship Between Childhood Abuse and Adult Health

PubMed Central

Walker, John R.; Naimark, Barbara

2009-01-01

Objectives. We examined the relationship between childhood abuse and adult health risk behaviors, and we explored whether adult health risk behaviors or mental health problems mediated the relationship between childhood abuse and adult health problems and health care utilization. Methods. We used logistic regression to analyze data from the Mental Health Supplement of the Ontario Health Survey, a representative population sample (N = 8116) of respondents aged 15 to 64 years. Results. We found relationships between childhood sexual abuse and smoking (odds ratio [OR] = 1.52; 95% confidence interval [CI] = 1.16, 1.99), alcohol problems (OR = 2.44; 95% CI = 1.74, 3.44), obesity (OR = 1.61; 95% CI = 1.14, 2.27), having more than 1 sexual partner in the previous year (OR = 2.34; 95% CI = 1.44, 3.80), and mental health problems (OR = 2.26; 95% CI = 1.78. 2.87). We also found relationships between these factors (with the exception of obesity) and childhood physical abuse. Mediation analysis suggested that health risk behaviors and particularly mental health problems are partial mediators of the relationship between childhood abuse and adult health. Conclusions. Public health approaches that aim to decrease child abuse by supporting positive parent–child relationships, reducing the development of health risk behaviors, and addressing children's mental health are likely to improve long-term population health. PMID:18703446

Intensified food production and correlated risks to human health in the Greater Mekong Subregion: a systematic review.

PubMed

Richter, Carsten H; Custer, Benjamin; Steele, Jennifer A; Wilcox, Bruce A; Xu, Jianchu

2015-05-26

Intensified food production, i.e. agricultural intensification and industrialized livestock operations may have adverse effects on human health and promote disease emergence via numerous mechanisms resulting in either direct impacts on humans or indirect impacts related to animal and environmental health. For example, while biodiversity is intentionally decreased in intensive food production systems, the consequential decrease in resilience in these systems may in turn bear increased health risks. However, quantifying these risks remains challenging, even if individual intensification measures are examined separately. Yet, this is an urgent task, especially in rapidly developing areas of the world with few regulations on intensification measures, such as in the Greater Mekong Subregion (GMS). We systematically searched the databases PubMed and Scopus for recent studies conducted on the association between agricultural (irrigation, fertilization, pesticide application) and livestock (feed additives, animal crowding) intensification measures and human health risks in the GMS. The search terms used were iteratively modified to maximize the number of retrieved studies with relevant quantitative data. We found that alarmingly little research has been done in this regard, considering the level of environmental contamination with pesticides, livestock infection with antibiotic resistant pathogens and disease vector proliferation in irrigated agroecosystems reported in the retrieved studies. In addition, each of the studies identified focused on specific aspects of intensified food production and there have been no efforts to consolidate the health risks from the simultaneous exposures to the range of hazardous chemicals utilized. While some of the studies identified already reported environmental contamination bearing considerable health risks for local people, at the current state of research the actual consolidated risk from regional intensification measures cannot be

Cardiovascular risk assessment: addition of CKD and race to the Framingham equation

PubMed Central

Drawz, Paul E.; Baraniuk, Sarah; Davis, Barry R.; Brown, Clinton D.; Colon, Pedro J.; Cujyet, Aloysius B.; Dart, Richard A.; Graumlich, James F.; Henriquez, Mario A.; Moloo, Jamaluddin; Sakalayen, Mohammed G.; Simmons, Debra L.; Stanford, Carol; Sweeney, Mary Ellen; Wong, Nathan D.; Rahman, Mahboob

2012-01-01

Background/Aims The value of the Framingham equation in predicting cardiovascular risk in African Americans and patients with chronic kidney disease (CKD) is unclear. The purpose of the study was to evaluate whether the addition of CKD and race to the Framingham equation improves risk stratification in hypertensive patients. Methods Participants in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) were studied. Those randomized to doxazosin, age greater than 74 years, and those with a history of coronary heart disease (CHD) were excluded. Two risk stratification models were developed using Cox proportional hazards models in a two-thirds developmental sample. The first model included the traditional Framingham risk factors. The second model included the traditional risk factors plus CKD, defined by eGFR categories, and stratification by race (Black vs. Non-Black). The primary outcome was a composite of fatal CHD, nonfatal MI, coronary revascularization, and hospitalized angina. Results There were a total of 19,811 eligible subjects. In the validation cohort, there was no difference in C-statistics between the Framingham equation and the ALLHAT model including CKD and race. This was consistent across subgroups by race and gender and among those with CKD. One exception was among Non-Black women where the C-statistic was higher for the Framingham equation (0.68 vs 0.65, P=0.02). Additionally, net reclassification improvement was not significant for any subgroup based on race and gender, ranging from −5.5% to 4.4%. Conclusion The addition of CKD status and stratification by race does not improve risk prediction in high-risk hypertensive patients. PMID:23194494

Communication about environmental health risks: a systematic review.

PubMed

Fitzpatrick-Lewis, Donna; Yost, Jennifer; Ciliska, Donna; Krishnaratne, Shari

2010-11-01

Using the most effective methods and techniques for communicating risk to the public is critical. Understanding the impact that different types of risk communication have played in real and perceived public health risks can provide information about how messages, policies and programs can and should be communicated in order to be most effective. The purpose of this systematic review is to identify the effectiveness of communication strategies and factors that impact communication uptake related to environmental health risks. A systematic review of English articles using multiple databases with appropriate search terms. Data sources also included grey literature. Key organization websites and key journals were hand searched for relevant articles. Consultation with experts took place to locate any additional references.Articles had to meet relevance criteria for study design [randomized controlled trials, clinical controlled trials, cohort analytic, cohort, any pre-post, interrupted time series, mixed methods or any qualitative studies), participants (those in community-living, non-clinical populations), interventions (including, but not limited to, any community-based methods or tools such as Internet, telephone, media-based interventions or any combination thereof), and outcomes (reported measurable outcomes such as awareness, knowledge or attitudinal or behavioural change). Articles were assessed for quality and data was extracted using standardized tools by two independent reviewers. Articles were given an overall assessment of strong, moderate or weak quality. There were no strong or moderate studies. Meta-analysis was not appropriate to the data. Data for 24 articles were analyzed and reported in a narrative format. The findings suggest that a multi-media approach is more effective than any single media approach. Similarly, printed material that offers a combination of information types (i.e., text and diagrams) is a more effective than just a single type, such

Biomarkers: Dynamic "Tools" for Health and Safety Risk Assessment

EPA Science Inventory

Today informational flow from biomarkers contributes importantly to various types of health effects research, risk assessment and risk management decisions that impact, or have the potential to impact, public health and safety. Therefore, dependent upon the nature of the health r...

[Health risk among workers employed in rubber footwear plant].

PubMed

Szubert, Z; Wilczyńska, U; Sobala, W

2001-01-01

The aim of the study was to assess the health risk of workers performing specific jobs in the process of the rubber footwear production by defining the cause and length of temporary work disability, as well as mortality causes and level. The analysis was carried out in the groups of workers performing the following jobs: mixing, mill operation, pressing and vulcanizing (A); semi-product preparation and calendaring (B); finishing and sorting (C); production of polyvinyl chloride footwear (D); and auxiliary works (E). The sickness absence study covered all workers (208 men and 315 women) employed in a large rubber footwear company and performing all above-listed jobs in 1995. Standardized sick days ratio was used to analyze the risk of temporary work disability. Mortality rate was estimated on the basis of the results of the cohort study performed in the same company among workers who had worked at least three months during the years 1945-1985. The follow-up continued until 31 December 1997. The present study included sub-cohorts composed of 5628 men and 7197 women, performing jobs listed above. The results of both studies indicated the enhanced risk of cardiovascular diseases among workers employed in the basic phases of the production process. The increased risk of the diseases of the digestive system was observed in men and women employed in: finishing, sorting and packing of the products (group C); in men involved in mixing, pressing and vulcanizing (group A); and in women engaged in auxiliary works (group E). In addition, the enhanced risk of sickness absence due to the diseases of the respiratory, digestive, or genitourinary systems was related to the enhanced risk of death from malignant neoplasms in a given site. The analysis showed that the temporary work disability may be regarded as a parameter useful in early assessment of health effects of the work environmental hazards.

Health Risk Reduction Programs in Employer-Sponsored Health Plans: Part II—Law and Ethics

PubMed Central

Rothstein, Mark A.; Harrell, Heather L.

2011-01-01

Objective We sought to examine the legal and ethical implications of workplace health risk reduction programs (HRRPs) using health risk assessments, individually focused risk reduction, and financial incentives to promote compliance. Methods We conducted a literature review, analyzed relevant statutes and regulations, and considered the effects of these programs on employee health privacy. Results A variety of laws regulate HRRPs, and there is little evidence that employer-sponsored HRRPs violate these provisions; infringement on individual health privacy is more difficult to assess. Conclusion Although current laws permit a wide range of employer health promotion activities, HRRPs also may entail largely unquantifiable costs to employee privacy and related interests. PMID:19625971

Tobacco use and cancer risk in the Agricultural Health Study

PubMed Central

Andreotti, Gabriella; Freedman, Neal D.; Silverman, Debra T.; Lerro, Catherine C.; Koutros, Stella; Hartge, Patricia; Alavanja, Michael C.; Sandler, Dale P.; Freeman, Laura Beane

2017-01-01

Background Cigarettes are well known to cause cancer, but less is known about the risks of other tobacco products and use of more than one product. Methods We examined cancer incidence in relation to exclusive use of six tobacco products (cigarettes, other combustibles (pipe, cigar, cigarillo), and smokeless tobacco (chewing tobacco, snuff)) in the Agricultural Health Study. We also examined the added cancer risks associated with use of cigarettes and other tobacco products. Results In our study population of 84,015, ever use of smokeless tobacco was higher than the general United States population, while cigarette use was lower and other combustible product use was about the same. The strongest associations for exclusive ever use were for lung cancer (cigarettes hazard ratio (HR)=15.48, 95% confidence interval (CI): 11.95, 20.06; other combustible tobacco HR=3.44, 95% CI: 1.53, 7.71; smokeless tobacco HR=2.21, 95% CI: 1.11, 4.42). Compared to exclusive cigarette smokers, cigarette smokers who additionally ever-used another combustible product had higher risks of smoking related cancers (HR=1.16, 95% CI: 1.04, 1.30), especially among those who smoked cigarettes for more than 15 years. Conclusion and Impact Cigarette smokers who additionally ever used smokeless tobacco had cancer risks similar to exclusive cigarette smokers. Users of cigarettes and other combustible tobacco may have higher risks of certain cancers than exclusive cigarette users. PMID:28035020

Discrimination of health risk by combined body mass index and waist circumference.

PubMed

Ardern, Christopher I; Katzmarzyk, Peter T; Janssen, Ian; Ross, Robert

2003-01-01

NIH Clinical Guidelines (1998) recommend the measurement of waist circumference (WC, centimeters) within body mass index (BMI, kilograms per square meter) categories as a screening tool for increased health risk. The Canada Heart Health Surveys (1986 through 1992) were used to describe the prevalence of the metabolic syndrome in Canada and to test the use of the NIH guidelines for predicting metabolic risk factors. The sample included 7981 participants ages 20 to 74 years who had complete data for WC, BMI, high-density lipoprotein-cholesterol, triglycerides, diabetic status, and systolic and diastolic blood pressures. National Cholesterol Education Program Adult Treatment Panel III risk categories were used to identify the metabolic syndrome and associated risk factors. Logistic regression was used to test the hypothesis that WC improves the prediction of the metabolic syndrome, within overweight (25 to 29.9 kg/m(2)) and obese I (30 to 34.9 kg/m(2)) BMI categories. The prevalence of the metabolic syndrome was 17.0% in men and 13.2% in women. The odds ratios (OR) for the prediction of the metabolic syndrome were elevated in overweight [OR, 1.85; 95% confidence interval (95%CI), 1.02 to 3.35] and obese (OR, 2.35; 95%CI, 1.25 to 4.42) women with a high WC compared with overweight and obese women with a low WC, respectively. On the other hand, WC was not predictive of the metabolic syndrome or component risk factors in men, within BMI categories. In women already at increased health risk because of an elevated BMI, the additional measurement of WC may help identify cardiovascular risk.

Risk Selection into Consumer-Directed Health Plans: An Analysis of Family Choices within Large Employers

PubMed Central

McDevitt, Roland D; Haviland, Amelia M; Lore, Ryan; Laudenberger, Laura; Eisenberg, Matthew; Sood, Neeraj

2014-01-01

Objective To identify the degree of selection into consumer-directed health plans (CDHPs) versus traditional plans over time, and factors that influence choice and temper risk selection. Data Sources/Study Setting Sixteen large employers offering both CDHP and traditional plans during the 2004–2007 period, more than 200,000 families. Study Design We model CDHP choice with logistic regression; predictors include risk scores, in addition to family, choice setting, and plan characteristics. Additional models stratify by account type or single enrollee versus family. Data Collection/Extraction Methods Risk scores, family characteristics, and enrollment decisions are derived from medical claims and enrollment files. Interviews with human resources executives provide additional data. Principal Findings CDHP risk scores were 74 percent of traditional plan scores in the first year, and this difference declined over time. Employer contributions to accounts and employee premium savings fostered CDHP enrollment and reduced risk selection. Having to make an active choice of plan increased CDHP enrollment but also increased risk selection. Risk selection was greater for singles than families and did not differ between HRA and HSA-based CDHPs. Conclusions Risk selection was not severe and it was well managed. Employers have effective methods to encourage CDHP enrollment and temper selection against traditional plans. PMID:24800305

Public risk perception of food additives and food scares. The case in Suzhou, China.

PubMed

Wu, Linhai; Zhong, Yingqi; Shan, Lijie; Qin, Wei

2013-11-01

This study examined the factors affecting public risk perception of food additive safety and possible resulting food scares using a survey conducted in Suzhou, Jiangsu Province, China. The model was proposed based on literature relating to the role of risk perception and information perception of public purchase intention under food scares. Structural equation modeling (SEM) was used for data analysis. The results showed that attitude towards behavior, subjective norm and information perception exerted moderate to high effect on food scares, and the effects were also mediated by risk perceptions of additive safety. Significant covariance was observed between attitudes toward behavior, subjective norm and information perception. Establishing an effective mechanism of food safety risk communication, releasing information of government supervision on food safety in a timely manner, curbing misleading media reports on public food safety risk, and enhancing public knowledge of the food additives are key to the development and implementation of food safety risk management policies by the Chinese government. Copyright © 2013 Elsevier Ltd. All rights reserved.

Health Risks and Adverse Reactions to Functional Foods.

PubMed

Ameratunga, Rohan; Crooks, Christine; Simmons, Greg; Woon, See-Tarn

2016-01-01

Functional foods have become increasingly popular with consumers anxious to mitigate the effects of an unhealthy lifestyle or aging. In spite of attractive health claims, these products do not have legal or regulatory status in most countries and are regulated through their health claims. Regulation of functional foods by health claims does not address health risks and adverse effects of these products. In this essay regulatory aspects of functional foods are reviewed along with adverse effects published in the peer-reviewed literature. We detail why the lack of an internationally accepted definition of functional foods places consumers at risk of adverse outcomes. Our review will assist regulatory agencies, manufacturers and consumer groups to assess the benefits and reduce the risks associated with these products.

Health-risk behaviour in Croatia.

PubMed

Bécue-Bertaut, Mónica; Kern, Josipa; Hernández-Maldonado, Maria-Luisa; Juresa, Vesna; Vuletic, Silvije

2008-02-01

To identify the health-risk behaviour of various homogeneous clusters of individuals. The study was conducted in 13 of the 20 Croatian counties and in Zagreb, the Croatian capital. In the first stage, general practices were selected in each county. The second-stage sample was created by drawing a random subsample of 10% of the patients registered at each selected general practice. The sample was divided into seven homogenous clusters using statistical methodology, combining multiple factor analysis with a hybrid clustering method. Seven homogeneous clusters were identified, three composed of males and four composed of females, based on statistically significant differences between selected characteristics (P<0.001). Although, in general, self-assessed health declined with age, significant variations were observed within specific age intervals. Higher levels of self-assessed health were associated with higher levels of education and/or socio-economic status. Many individuals, especially females, who self-reported poor health were heavy consumers of sleeping pills. Males and females reported different health-risk behaviours related to lifestyle, diet and use of the healthcare system. Heavy alcohol and tobacco use, unhealthy diet, risky physical activity and non-use of the healthcare system influenced self-assessed health in males. Females were slightly less satisfied with their health than males of the same age and educational level. Even highly educated females who took preventive healthcare tests and ate a healthy diet reported a less satisfactory self-assessed level of health than expected. Sociodemographic characteristics, life style, self-assessed health and use of the healthcare system were used in the identification of seven homogeneous population clusters. A comprehensive analysis of these clusters suggests health-related prevention and intervention efforts geared towards specific populations.

Linking family economic pressure and supportive parenting to adolescent health behaviors: two developmental pathways leading to health promoting and health risk behaviors.

PubMed

Kwon, Josephine A; Wickrama, K A S

2014-07-01

Adolescent health behaviors, especially health risk behaviors, have previously been linked to distal (i.e., family economic pressure) and proximal (i.e., parental support) contributors. However, few studies have examined both types of contributors along with considering health promoting and health risk behaviors separately. The present study investigated the influences of family economic hardship, supportive parenting as conceptualized by self-determination theory, and individual psychosocial and behavioral characteristics (i.e., mastery and delinquency, respectively) on adolescents' health promoting and health risk behaviors. We used structural equation modeling to analyze longitudinal data from a sample of Caucasian adolescent children and their mothers and fathers (N = 407, 54 % female) to examine direct and indirect effects, as well as gender symmetry and asymmetry. Findings suggest that family economic pressure contributed to adolescent mastery and delinquency through supportive parenting. Further, supportive parenting indirectly affected adolescent health risk behaviors only through delinquency, whereas supportive parenting indirectly influenced health promoting behaviors only through mastery, suggesting different developmental pathways for adolescent health risk and health promoting behaviors. Testing for gender symmetry of the full model showed that maternal and paternal parenting contributed to females' health risk behaviors directly, while maternal and paternal parenting contributed to males' health risk behaviors through delinquency. Gender symmetry was largely unsupported. The study highlights key direct and indirect pathways to adolescent health risk and health promoting behaviors within a family stress model and self-determination theory framework, and also highlights important gender differences in these developmental pathways.

Degrees of difference among minority female juvenile offenders' psychological functioning, risk behavior engagement, and health status: a latent profile investigation.

PubMed

Guthrie, Barbara J; Cooper, Shauna M; Brown, Charity; Metzger, Isha

2012-02-01

Given the increase in the number of female youth who come in contact with the juvenile justice system, particularly those from ethnic minority backgrounds, concerns have been raised about the health status of this population. Using a latent profile analysis, we identified health profiles using indicators of psychological well-being, health risk behaviors, and health status. Participants included 153 minority adolescent females (M=15.13, SD=1.70) who were currently in a juvenile diversion program. Results indicated that a three-class solution fit the data optimally. Profiles included girls with low to moderate health risks (n=35; 22.9%), higher mental health symptoms (n=68; 44.4%), and a combination of multiple health risks (n=50; 32.7%). Additionally, demographic, contextual and offense-related variation existed across health profiles. Treatment and policy implications are discussed.

Review of NASA's Evidence Reports on Human Health Risks. 2015 Letter Report

NASA Technical Reports Server (NTRS)

Scott-Conner, Carol E. H.; Masys, Daniel R.; Liverman, Catharyn T.

2016-01-01

NASA has requested a study from the Institute of Medicine (IOM) to provide an independent review of more than 30 evidence reports on human health risks for long duration and exploration spaceflight. The evidence reports, which are publicly available, are categorized into five broad categories: (1) behavioral health and performance; (2) human health countermeasures (with a focus on bone metabolism and orthopedics, nutrition, immunology, and cardiac and pulmonary physiology); (3) radiation; (4) human factors issues; and (5) exploration medical capabilities. The reports are revised on an ongoing basis to incorporate new scientific information. In conducting this study, an IOM ad hoc committee will build on the 2008 IOM report Review of NASA's Human Research Program Evidence Books. That report provided an assessment of the process used for developing the evidence reports and provided an initial review of the evidence reports that had been completed at that time. Each year, NASA staff will identify a set of evidence reports for committee review. Over the course of the study all evidence reports will be reviewed. The committee will hold an annual scientific workshop to receive input on the evidence reports it is reviewing that year and an update on the recent literature. The committee will issue an annual letter report that addresses the following questions relevant to each evidence report: 1. Does the evidence report provide sufficient evidence, as well as sufficient risk context, that the risk is of concern for long-term space missions? 2. Does the evidence report make the case for the research gaps presented? 3. Are there any additional gaps in knowledge or areas of fundamental research that should be considered to enhance the basic understanding of this specific risk? 4. Does the evidence report address relevant interactions among risks? 5. Is input from additional disciplines needed? 6. Is the breadth of the cited literature sufficient? 7. What is the overall

Health Risk Behaviors and Academic Achievement

MedlinePlus

... 2009 † Health-Risk Behaviors Percentage of U.S. high school students who engaged in each risk behavior, by type of grades mostly earned A’s B’s C’s D’s/F’s Unintentional Injury and Violence-Related Behaviors Rarely or never wore a seat ...

Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Sex

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2011

2011-01-01

The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

Assessment of potential health risk of fluoride consumption through rice, pulses, and vegetables in addition to consumption of fluoride-contaminated drinking water of West Bengal, India.

PubMed

Bhattacharya, Piyal; Samal, Alok Chandra; Banerjee, Suman; Pyne, Jagadish; Santra, Subhas Chandra

2017-09-01

A study was conducted in fluoride-affected Bankura and Purulia districts of West Bengal to assess the potential health risk from fluoride exposure among children, teenagers, and adults due to consumption of rice, pulses, and vegetables in addition to drinking water and incidental ingestion of soil by children. Higher mean fluoride contents (13-63 mg/kg dry weight) were observed in radish, carrot, onion bulb, brinjal, potato tuber, cauliflower, cabbage, coriander, and pigeon pea. The combined influence of rice, pulses, and vegetables to cumulative estimated daily intake (EDI) of fluoride for the studied population was found to be 9.5-16%. Results also showed that intake of ivy gourd, broad beans, rice, turnip, fenugreek leaves, mustard, spinach, and amaranth grown in the study area is safe at least for time being. The cumulative EDI values of fluoride (0.06-0.19 mg/kg-day) among different age group of people of the study area were evaluated to be ~10 4 times higher than those living in the control area; the values for children (0.19 and 0.52 mg/kg-day for CTE and RME scenarios, respectively) were also greater than the "Tolerable Upper Intake Level" value of fluoride. The estimated hazard index (HI) for children (3.2 and 8.7 for CTE and RME scenarios, respectively) living in the two affected districts reveals that they are at high risk of developing dental fluorosis due to the consumption of fluoride-contaminated rice, pulses, and vegetables grown in the study area in addition to the consumption of contaminated drinking water.

Concentrations and Potential Health Risks of Metals in Lip Products

PubMed Central

Liu, Sa; Rojas-Cheatham, Ann

2013-01-01

Background: Metal content in lip products has been an issue of concern. Objectives: We measured lead and eight other metals in a convenience sample of 32 lip products used by young Asian women in Oakland, California, and assessed potential health risks related to estimated intakes of these metals. Methods: We analyzed lip products by inductively coupled plasma optical emission spectrometry and used previous estimates of lip product usage rates to determine daily oral intakes. We derived acceptable daily intakes (ADIs) based on information used to determine public health goals for exposure, and compared ADIs with estimated intakes to assess potential risks. Results: Most of the tested lip products contained high concentrations of titanium and aluminum. All examined products had detectable manganese. Lead was detected in 24 products (75%), with an average concentration of 0.36 ± 0.39 ppm, including one sample with 1.32 ppm. When used at the estimated average daily rate, estimated intakes were > 20% of ADIs derived for aluminum, cadmium, chromium, and manganese. In addition, average daily use of 10 products tested would result in chromium intake exceeding our estimated ADI for chromium. For high rates of product use (above the 95th percentile), the percentages of samples with estimated metal intakes exceeding ADIs were 3% for aluminum, 68% for chromium, and 22% for manganese. Estimated intakes of lead were < 20% of ADIs for average and high use. Conclusions: Cosmetics safety should be assessed not only by the presence of hazardous contents, but also by comparing estimated exposures with health-based standards. In addition to lead, metals such as aluminum, cadmium, chromium, and manganese require further investigation. PMID:23674482

Health Security and Risk Aversion.

PubMed

Herington, Jonathan

2016-09-01

Health security has become a popular way of justifying efforts to control catastrophic threats to public health. Unfortunately, there has been little analysis of the concept of health security, nor the relationship between health security and other potential aims of public health policy. In this paper I develop an account of health security as an aversion to risky policy options. I explore three reasons for thinking risk avoidance is a distinctly worthwhile aim of public health policy: (i) that security is intrinsically valuable, (ii) that it is necessary for social planning and (iii) that it is an appropriate response to decision-making in contexts of very limited information. Striking the right balance between securing and maximizing population health thus requires a substantive, and hitherto unrecognized, value judgment. Finally, I critically evaluate the current health security agenda in light of this new account of the concept and its relationship to the other aims of public health policy. © 2016 John Wiley & Sons Ltd.

The Effect of Genetic Risk Information and Health Risk Assessment on Compliance with Preventive Behaviors.

ERIC Educational Resources Information Center

Bamberg, Richard; And Others

1990-01-01

Results from a study of 82 males provide no statistical support and limited encouragement that genetic risk information may motivate persons to make positive changes in preventive health behaviors. Health risk assessments were used to identify subjects at risk for coronary heart disease or lung cancer because of genetic factors. (IAH)

Risky music-listening behaviors and associated health-risk behaviors.

PubMed

Vogel, Ineke; van de Looij-Jansen, Petra M; Mieloo, Cathelijne L; Burdorf, Alex; de Waart, Frouwkje

2012-06-01

To examine, among adolescents and emerging adults attending inner-city lower education, associations between risky music-listening behaviors (from MP3 players and in discotheques and at pop concerts) and more traditional health-risk behaviors: substance use (cigarettes, alcohol, cannabis, and hard drugs) and unsafe sexual intercourse. A total of 944 students in Dutch inner-city senior-secondary vocational schools completed questionnaires about their music-listening and traditional health-risk behaviors. Multiple logistic regression analyses were used to examine associations between music-listening and traditional health-risk behaviors. Risky MP3-player listeners used cannabis more often during the past 4 weeks. Students exposed to risky sound levels during discotheque and pop concert attendance used cannabis less often during the past 4 weeks, were more often binge drinkers, and reported inconsistent condom use during sexual intercourse. The coexistence of risky music-listening behaviors with other health-risk behaviors provides evidence in support of the integration of risky music-listening behaviors within research on and programs aimed at reducing more traditional health-risk behaviors, such as substance abuse and unsafe sexual intercourse.

Workers' knowledge and beliefs about cardiometabolic health risk.

PubMed

Damman, Olga C; van der Beek, Allard J; Timmermans, Danielle R M

2014-01-01

Investigate workers' knowledge and beliefs about cardiometabolic risk. A survey on the risks of diabetes, cardiovascular disease, and chronic kidney disease was disseminated among Dutch construction workers and employees from the general working population. We had 482 respondents (26.8%) among construction workers and 738 respondents (65.1%) among the general working population. Employees showed reasonable basic knowledge, especially about cardiovascular disease risk factors and risk reduction. Nevertheless, they also had knowledge gaps (eg, specific dietary intake) and showed misconceptions of what elevated risk entails. Employees having lower education, being male, and having lower health literacy demonstrated less adequate knowledge and beliefs. To improve the potential effect of health risk assessments in the occupational setting, physicians should explain what it means to be at elevated cardiometabolic risk and target their messages to employee subgroups.

Health Risks Associated with Exposure to Filamentous Fungi

PubMed Central

Egbuta, Mary Augustina; Mwanza, Mulunda

2017-01-01

Filamentous fungi occur widely in the environment, contaminating soil, air, food and other substrates. Due to their wide distribution, they have medical and economic implications. Regardless of their use as a source of antibiotics, vitamins and raw materials for various industrially important chemicals, most fungi and filamentous fungi produce metabolites associated with a range of health risks, both in humans and in animals. The association of filamentous fungi and their metabolites to different negative health conditions in humans and animals, has contributed to the importance of investigating different health risks induced by this family of heterotrophs. This review aims to discuss health risks associated with commonly occurring filamentous fungal species which belong to genera Aspergillus, Penicillium and Fusarium, as well as evaluating their pathogenicity and mycotoxic properties. PMID:28677641

What should the African health workforce know about disasters? Proposed competencies for strengthening public health disaster risk management education in Africa.

PubMed

Olu, Olushayo; Usman, Abdulmumini; Kalambay, Kalula; Anyangwe, Stella; Voyi, Kuku; Orach, Christopher Garimoi; Azazh, Aklilu; Mapatano, Mala Ali; Nsenga, Ngoy; Manga, Lucien; Woldetsadik, Solomon; Nguessan, Francois; Benson, Angela

2018-04-02

As part of efforts to implement the human resources capacity building component of the African Regional Strategy on Disaster Risk Management (DRM) for the health sector, the African Regional Office of the World Health Organization, in collaboration with selected African public health training institutions, followed a multistage process to develop core competencies and curricula for training the African health workforce in public health DRM. In this article, we describe the methods used to develop the competencies, present the identified competencies and training curricula, and propose recommendations for their integration into the public health education curricula of African member states. We conducted a pilot research using mixed methods approaches to develop and test the applicability and feasibility of a public health disaster risk management curriculum for training the African health workforce. We identified 14 core competencies and 45 sub-competencies/training units grouped into six thematic areas: 1) introduction to DRM; 2) operational effectiveness; 3) effective leadership; 4) preparedness and risk reduction; 5) emergency response and 6) post-disaster health system recovery. These were defined as the skills and knowledge that African health care workers should possess to effectively participate in health DRM activities. To suit the needs of various categories of African health care workers, three levels of training courses are proposed: basic, intermediate, and advanced. The pilot test of the basic course among a cohort of public health practitioners in South Africa demonstrated their relevance. These competencies compare favourably to the findings of other studies that have assessed public health DRM competencies. They could provide a framework for scaling up the capacity development of African healthcare workers in the area of public health DRM; however further validation of the competencies is required through additional pilot courses and follow up of

The impact of using visual images of the body within a personalized health risk assessment: an experimental study.

PubMed

Hollands, Gareth J; Marteau, Theresa M

2013-05-01

To examine the motivational impact of the addition of a visual image to a personalized health risk assessment and the underlying cognitive and emotional mechanisms. An online experimental study in which participants (n = 901; mean age = 27.2 years; 61.5% female) received an assessment and information focusing on the health implications of internal body fat and highlighting the protective benefits of physical activity. Participants were randomized to receive this in either (a) solely text form (control arm) or (b) text plus a visual image of predicted internal body fat (image arm). Participants received information representing one of three levels of health threat, determined by how physically active they were: high, moderate or benign. Main outcome measures were physical activity intentions (assessed pre- and post-intervention), worry, coherence and believability of the information. Intentions to undertake recommended levels of physical activity were significantly higher in the image arm, but only amongst those participants who received a high-threat communication. Believability of the results received was greater in the image arm and mediated the intervention effect on intentions. The addition of a visual image to a risk assessment led to small but significant increases in intentions to undertake recommended levels of physical activity in those at increased health risk. Limitations of the study and implications for future research are discussed. What is already known on this subject? Health risk information that is personalized to the individual may more strongly motivate risk-reducing behaviour change. Little prior research attention has been paid specifically to the motivational impact of personalized visual images and underlying mechanisms. What does this study add? In an experimental design, it is shown that receipt of visual images increases intentions to engage in risk-reducing behaviour, although only when a significant level of threat is presented. The

Health effects of risk-assessment categories

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kramer, C.F.; Rybicka, K.; Knutson, A.

Environmental and occupational health effects associated with exposures to various chemicals are a subject of increasing concern. One recently developed methodology for assessing the health impacts of various chemical compounds involves the classification of similar chemicals into risk-assessment categories (RACs). This report reviews documented human health effects for a broad range of pollutants, classified by RACs. It complements other studies that have estimated human health effects by RAC based on analysis and extrapolation of data from animal research.

Patterns of Health-Risk Behavior among Japanese High School Students.

ERIC Educational Resources Information Center

Takakura, Minoru; Nagayama, Tomoko; Sakihara, Seizo; Willcox, Craig

2001-01-01

Surveyed Japanese high school students' health risk behavior patterns, examining clustering and accumulation of health risk behaviors. Physical inactivity and alcohol use were the most common risk behaviors. Prevalence rates for most risk behaviors varied by demographic variables. Smoking, drinking, and sexual intercourse clustered among both…

Incidence of online health information search: a useful proxy for public health risk perception.

PubMed

Liang, Bo; Scammon, Debra L

2013-06-17

Internet users use search engines to look for information online, including health information. Researchers in medical informatics have found a high correlation of the occurrence of certain search queries and the incidence of certain diseases. Consumers' search for information about diseases is related to current health status with regard to a disease and to the social environments that shape the public's attitudes and behaviors. This study aimed to investigate the extent to which public health risk perception as demonstrated by online information searches related to a health risk can be explained by the incidence of the health risk and social components of a specific population's environment. Using an ecological perspective, we suggest that a population's general concern for a health risk is formed by the incidence of the risk and social (eg, media attention) factors related with the risk. We constructed a dataset that included state-level data from 32 states on the incidence of the flu; a number of social factors, such as media attention to the flu; private resources, such as education and health insurance coverage; public resources, such as hospital beds and primary physicians; and utilization of these resources, including inpatient days and outpatient visits. We then explored whether online information searches about the flu (seasonal and pandemic flu) can be predicted using these variables. We used factor analysis to construct indexes for sets of social factors (private resources, public resources). We then applied panel data multiple regression analysis to exploit both time-series and cross-sectional variation in the data over a 7-year period. Overall, the results provide evidence that the main effects of independent variables-the incidence of the flu (P<.001); social factors, including media attention (P<.001); private resources, including life quality (P<.001) and health lifestyles (P=.009); and public resources, such as hospital care utilization (P=.008

Incidence of Online Health Information Search: A Useful Proxy for Public Health Risk Perception

PubMed Central

Scammon, Debra L

2013-01-01

Background Internet users use search engines to look for information online, including health information. Researchers in medical informatics have found a high correlation of the occurrence of certain search queries and the incidence of certain diseases. Consumers’ search for information about diseases is related to current health status with regard to a disease and to the social environments that shape the public’s attitudes and behaviors. Objective This study aimed to investigate the extent to which public health risk perception as demonstrated by online information searches related to a health risk can be explained by the incidence of the health risk and social components of a specific population’s environment. Using an ecological perspective, we suggest that a population’s general concern for a health risk is formed by the incidence of the risk and social (eg, media attention) factors related with the risk. Methods We constructed a dataset that included state-level data from 32 states on the incidence of the flu; a number of social factors, such as media attention to the flu; private resources, such as education and health insurance coverage; public resources, such as hospital beds and primary physicians; and utilization of these resources, including inpatient days and outpatient visits. We then explored whether online information searches about the flu (seasonal and pandemic flu) can be predicted using these variables. We used factor analysis to construct indexes for sets of social factors (private resources, public resources). We then applied panel data multiple regression analysis to exploit both time-series and cross-sectional variation in the data over a 7-year period. Results Overall, the results provide evidence that the main effects of independent variables—the incidence of the flu (P<.001); social factors, including media attention (P<.001); private resources, including life quality (P<.001) and health lifestyles (P=.009); and public

Changes in Risk Perception of the Health Effects of Radiation and Mental Health Status: The Fukushima Health Management Survey.

PubMed

Suzuki, Yuriko; Takebayashi, Yoshitake; Yasumura, Seiji; Murakami, Michio; Harigane, Mayumi; Yabe, Hirooki; Ohira, Tetsuya; Ohtsuru, Akira; Nakajima, Satomi; Maeda, Masaharu

2018-06-10

After the Fukushima nuclear power plant accident, numerous evacuees reported poor mental health status and high-risk perceptions of the health effects of radiation. However, the temporal associations between these variables have not yet been examined. Using data from the Fukushima Health Survey, we examined changes in risk perception of the health effects of radiation over time and assessed the effects of mental health on such changes using logistic regression analysis. Risk perception for delayed effect pertains a brief on health effect in later life (delayed effect), whereas that of genetic effect pertains a brief on health effect of future children and grandchildren (genetic effect). We found that many participants showed consistently high or low-risk perceptions over all three study years (2011⁻2013) (for delayed effect: 59% and 41% of participants were in the low and high-risk perception groups, respectively; for genetic effect: 47% and 53%, respectively). Stronger traumatic reactions (≥50 on the PTSD Checklist⁻Specific) significantly affected the odds of being in the high-risk perception group for the delayed and genetic effects, with the associations being strongest soon after the disaster: The adjusted ORs (95%CIs) were 2.05 (1.82⁻2.31), 1.86 (1.61⁻2.15), and 1.88 (1.62⁻2.17) for the delayed effect in 2011, 2012, and 2013, respectively, and 2.18 (1.92⁻2.48), 2.05 (1.75⁻2.40), and 1.82 (1.55⁻2.15) for the genetic effect. As initial mental health status had the strongest impact on later risk perceptions of radiation, it should be considered in early response and communication efforts.

Unraveling Health Risk and Speciation of Arsenic from Groundwater in Rural Areas of Punjab, Pakistan.

PubMed

Shakoor, Muhammad Bilal; Niazi, Nabeel Khan; Bibi, Irshad; Rahman, Mohammad Mahmudur; Naidu, Ravi; Dong, Zhaomin; Shahid, Muhammad; Arshad, Muhammad

2015-10-05

This study determined the total and speciated arsenic (As) concentrations and other health-related water quality parameters for unraveling the health risk of As from drinking water to humans. Groundwater samples (n = 62) were collected from three previously unexplored rural areas (Chichawatni, Vehari, Rahim Yar Khan) of Punjab in Pakistan. The mean and median As concentrations in groundwater were 37.9 and 12.7 µg·L(-1) (range = 1.5-201 µg·L(-1)). Fifty three percent groundwater samples showed higher As value than WHO safe limit of 10 µg·L(-1). Speciation of As in groundwater samples (n = 13) showed the presence of inorganic As only; arsenite (As(III)) constituted 13%-67% of total As and arsenate (As(V)) ranged from 33% to 100%. For As health risk assessment, the hazard quotient and cancer risk values were 11-18 and 46-600 times higher than the recommended values of US-EPA (i.e., 1.00 and 10(-6), respectively). In addition to As, various water quality parameters (e.g., electrical conductivity, Na, Ca, Cl(-), NO₃(-), SO₄(2-), Fe, Mn, Pb) also enhanced the health risk. The results show that consumption of As-contaminated groundwater poses an emerging health threat to the communities in the study area, and hence needs urgent remedial and management measures.

Unraveling Health Risk and Speciation of Arsenic from Groundwater in Rural Areas of Punjab, Pakistan

PubMed Central

Shakoor, Muhammad Bilal; Niazi, Nabeel Khan; Bibi, Irshad; Rahman, Mohammad Mahmudur; Naidu, Ravi; Dong, Zhaomin; Shahid, Muhammad; Arshad, Muhammad

2015-01-01

This study determined the total and speciated arsenic (As) concentrations and other health-related water quality parameters for unraveling the health risk of As from drinking water to humans. Groundwater samples (n = 62) were collected from three previously unexplored rural areas (Chichawatni, Vehari, Rahim Yar Khan) of Punjab in Pakistan. The mean and median As concentrations in groundwater were 37.9 and 12.7 µg·L−1 (range = 1.5–201 µg·L−1). Fifty three percent groundwater samples showed higher As value than WHO safe limit of 10 µg·L−1. Speciation of As in groundwater samples (n = 13) showed the presence of inorganic As only; arsenite (As(III)) constituted 13%–67% of total As and arsenate (As(V)) ranged from 33% to 100%. For As health risk assessment, the hazard quotient and cancer risk values were 11–18 and 46–600 times higher than the recommended values of US-EPA (i.e., 1.00 and 10−6, respectively). In addition to As, various water quality parameters (e.g., electrical conductivity, Na, Ca, Cl−, NO3−, SO42−, Fe, Mn, Pb) also enhanced the health risk. The results show that consumption of As-contaminated groundwater poses an emerging health threat to the communities in the study area, and hence needs urgent remedial and management measures. PMID:26445051

Motivators and barriers to incorporating climate change-related health risks in environmental health impact assessment.

PubMed

Turner, Lyle R; Alderman, Katarzyna; Connell, Des; Tong, Shilu

2013-03-22

Climate change presents risks to health that must be addressed by both decision-makers and public health researchers. Within the application of Environmental Health Impact Assessment (EHIA), there have been few attempts to incorporate climate change-related health risks as an input to the framework. This study used a focus group design to examine the perceptions of government, industry and academic specialists about the suitability of assessing the health consequences of climate change within an EHIA framework. Practitioners expressed concern over a number of factors relating to the current EHIA methodology and the inclusion of climate change-related health risks. These concerns related to the broad scope of issues that would need to be considered, problems with identifying appropriate health indicators, the lack of relevant qualitative information that is currently incorporated in assessment and persistent issues surrounding stakeholder participation. It was suggested that improvements are needed in data collection processes, particularly in terms of adequate communication between environmental and health practitioners. Concerns were raised surrounding data privacy and usage, and how these could impact on the assessment process. These findings may provide guidance for government and industry bodies to improve the assessment of climate change-related health risks.

Alerting the general population to genetic risks: the value of health messages communicating the existence of genetic risk factors for public health promotion.

PubMed

Smerecnik, Chris M R; Mesters, Ilse; de Vries, Nanne K; de Vries, Hein

2009-11-01

Health messages alerting the public to previously unknown genetic risk factors for multifactorial diseases are a potentially useful strategy to create public awareness, and may be an important first step in promoting public health. However, there is a lack of evidence-based insight into its impact on individuals who were unaware of the existence of genetic risk factors at the moment of information exposure. The authors conducted 3 experimental studies with health messages communicating information about genetic risk factors for salt sensitivity (Studies 1A and 1B) and heightened cholesterol (Study 2) compared with general information without reference to genetic risk factors as a between-subjects variable and risk perception and intention to engage in preventive behavior as dependent variables. All 3 studies revealed lower perceived susceptibility among participants who received information on genetic risk factors, which was associated with lowered intentions to engage in preventive behavior. In Studies 1A and 1B, these effects were observed only for previously unaware individuals, whereas in Study 2, they were observed for the entire sample. Alerting the public to the existence of genetic risk factors may not necessarily be beneficial to public health. Public health promoters should be aware of the possible adverse effects of alerting the general population to genetic risk factors, and should simultaneously educate the public about the meaning and consequences of such factors. PsycINFO Database Record (c) 2009 APA, all rights reserved.

Risk factors for fishermen's health and safety in Greece.

PubMed

Frantzeskou, Elpida; Kastania, Anastasia N; Riza, Elena; Jensen, Olaf C; Linos, Athena

2012-01-01

This is, to the best of our knowledge, the first occupational health study in Greek fishing. The aim of the study is to determine the risks for health and safety in Greek fisheries workers by exploring their health status and the health risk factors present in their occupational environment, thus providing a current baseline for further research in the future and for documentation of the needs for prevention. A questionnaire pilot study was carried out in a random sample of 100 Greek fishermen. Twenty-eight per cent (28%) had experienced at least one injury, of which half caused more than one day absence, while 14% had a near drowning experience. The health risks factors studied include excessive weight, cardiovascular incidents and dermatological, musculoskeletal, respiratory, hearing, stress, and anxiety problems. The occupational health risk factors include alcohol, fatty food consumption, smoking, and lack of physical exercise. The health effects observed are causally related to diet, smoking, and exercise, which in turn relate to the specific working conditions and culture in small-scale fishing that need to be taken into consideration in prevention programmes. The results are comparable with international fisheries experience, mainly from Poland, Denmark, and Turkey.

Women at risk: Gender inequality and maternal health.

PubMed

Banda, Pamela C; Odimegwu, Clifford O; Ntoimo, Lorretta F C; Muchiri, Evans

2017-04-01

Gender inequality has been documented as a key driver of negative health outcomes, especially among women. However, studies have not clearly examined the role of gender inequality in maternal health in an African setting. Therefore, the authors of this study examined the role of gender inequality, indicated by lack of female autonomy, in exposing women to maternal health risk. Data were obtained from the 2007 Zambia Demographic and Health Survey on a weighted sample of 3,906 married or partnered women aged 15-49 years. Multivariable analyses revealed that low autonomy in household decision power was associated with maternal health risk (Odds Ratio (OR) = 1.52, p < .001). Autonomy interacted with household wealth showed that respondents who were in the wealthier households and had low autonomy in household decision power (OR = 2.03, p < .05) were more likely to be exposed to maternal health risk than their counterparts who had more autonomy. Efforts to lower women's exposure to maternal mortality and morbidity in Zambia should involve interventions to alter prevailing gender norms that limit women's active participation in decisions about their own health during pregnancy and delivery.

Australian fitness professionals' level of interest in engaging with high health-risk population subgroups: findings from a national survey.

PubMed

Bennie, J A; Thomas, G; Wiesner, G H; van Uffelen, J G Z; Khan, A; Kolbe-Alexander, T; Vergeer, I; Biddle, S J H

2018-07-01

Fitness industry professionals (personal trainers, group instructors) may have a role in health promotion, particularly when working with subgroups with known health risks (e.g. older adults, obese). The aim of this study is to examine fitness professionals' level of interest in engaging with high-risk populations. Cross-sectional evaluation of a national survey. In 2014, 9100 Australian registered exercise professionals were invited to complete an online survey. Respondents reported their level of interest in engaging with nine health-risk population subgroups. A multivariable logistic regression analysis assessed the odds of being classified as having a 'low level' of interest in training high health-risk subgroups, adjusting for demographic and fitness industry-related factors. Of 1185 respondents (aged 17-72 years), 31.1% reported having a 'high level' of interest in training high health-risk subgroups. The highest level of interest was among 'obese clients' and 'adults (18-64 years) with chronic health conditions'. In the adjusted analysis, males (odds ratio [OR], 1.55, 95% confidence interval [CI]: 1.06-2.25) and those in urban settings (OR, 2.26, 95% CI: 1.54-3.37) were more likely to have a 'low level' of interest. Fitness professionals have a modest level of interest in training high health-risk subgroups. In addition to the development of strategies to increase interest, research should examine whether fitness professionals are able to safely prescribe exercise to high health-risk subgroups. Copyright © 2018. Published by Elsevier Ltd.

Health Risk Assessment of Cyanobacterial (Blue-green Algal) Toxins in Drinking Water

PubMed Central

Falconer, Ian R.; Humpage, Andrew R.

2005-01-01

Cyanobacterial toxins have caused human poisoning in the Americas, Europe and Australia. There is accumulating evidence that they are present in treated drinking water supplies when cyanobacterial blooms occur in source waters. With increased population pressure and depleted groundwater reserves, surface water is becoming more used as a raw water source, both from rivers and lakes/reservoirs. Additional nutrients in water which arise from sewage discharge, agricultural run-off or storm water result in overabundance of cyanobacteria, described as a ‘water bloom’. The majority of cyanobacterial water-blooms are of toxic species, producing a diversity of toxins. The most important toxins presenting a risk to the human population are the neurotoxic alkaloids (anatoxins and paralytic shellfish poisons), the cyclic peptide hepatotoxins (microcystins) and the cytotoxic alkaloids (cylindrospermopsins). At the present time the only cyanobacteral toxin family that have been internationally assessed for health risk by the WHO are the microcystins, which cause acute liver injury and are active tumour promoters. Based on sub-chronic studies in rodents and pigs, a provisional Guideline Level for drinking water of 1μg/L of microcystin-LR has been determined. This has been adopted in legislation in countries in Europe, South America and Australasia. This may be revised in the light of future teratogenicity, reproductive toxicity and carcinogenicity studies. The other cyanobacterial toxin which has been proposed for detailed health risk assessment is cylindrospermopsin, a cytotoxic compound which has marked genotoxicity, probable mutagenicity, and is a potential carcinogen. This toxin has caused human poisoning from drinking water, and occurs in water supplies in the USA, Europe, Asia, Australia and South America. An initial health risk assessment is presented with a proposed drinking water Guideline Level of 1μg/L. There is a need for both increased monitoring data for

Chemical Mixtures Health Risk Assessment of Environmental Contaminants: Concepts, Methods, Applications

EPA Science Inventory

This problems-based, introductory workshop focuses on methods to assess health risks posed by exposures to chemical mixtures in the environment. Chemical mixtures health risk assessment methods continue to be developed and evolve to address concerns over health risks from multic...

Assessing health risks of synthetic vitreous fibers: an integrative approach.

PubMed

McClellan, R O

1994-12-01

This paper reviews a tiered approach to acquiring information from multiple experimental systems to understand and assess the potential human health risks of exposure to airborne synthetic fibers. The approach is grounded in the now widely accepted research-risk assessment-risk management paradigm. It involves the acquisition of information that will provide mechanistic linkages within the exposure-dose-response paradigm. It advocates the use of the inhalation route of exposure for developing relevant information for assessing human health risks and calls attention to serious problems encountered using nonphysiologic routes of administration to assess human health risks.

The risks of innovation in health care.

PubMed

Enzmann, Dieter R

2015-04-01

Innovation in health care creates risks that are unevenly distributed. An evolutionary analogy using species to represent business models helps categorize innovation experiments and their risks. This classification reveals two qualitative categories: early and late diversification experiments. Early diversification has prolific innovations with high risk because they encounter a "decimation" stage, during which most experiments disappear. Participants face high risk. The few decimation survivors can be sustaining or disruptive according to Christensen's criteria. Survivors enter late diversification, during which they again expand, but within a design range limited to variations of the previous surviving designs. Late diversifications carry lower risk. The exception is when disruptive survivors "diversify," which amplifies their disruption. Health care and radiology will experience both early and late diversifications, often simultaneously. Although oversimplifying Christensen's concepts, early diversifications are likely to deliver disruptive innovation, whereas late diversifications tend to produce sustaining innovations. Current health care consolidation is a manifestation of late diversification. Early diversifications will appear outside traditional care models and physical health care sites, as well as with new science such as molecular diagnostics. They warrant attention because decimation survivors will present both disruptive and sustaining opportunities to radiology. Radiology must participate in late diversification by incorporating sustaining innovations to its value chain. Given the likelihood of disruptive survivors, radiology should seriously consider disrupting itself rather than waiting for others to do so. Disruption entails significant modifications of its value chain, hence, its business model, for which lessons may become available from the pharmaceutical industry's current simultaneous experience with early and late diversifications. Copyright

Cities without cavities: democracy, risk, and public health.

PubMed

Carstairs, Catherine

2010-01-01

This essay examines the history of fluoride debates in four Canadian cities. It argues that fluoride's opponents were primarily motivated by what they saw as the health and environmental risks of adding fluoride to the water supply. They also believed that fluoridating the public water supply was a fundamental violation of civil liberties. The fluoride debates have much to teach us about how people evaluate potential health risks and how they respond to state interventions in the field of public health.

The Impact of an Incentive-Based Worksite Health Promotion Program on Modifiable Health Risk Factors.

ERIC Educational Resources Information Center

Poole, Kathleen; Kumpfer, Karol; Pett, Marjorie

2001-01-01

Examined the impact of participating in an incentive-based employee health promotion program on modifiable health risk factors over 4 years. Data from physiological and self-report measures indicated that modifiable health risks improved over time (smoking, physical activity, systolic and diastolic blood pressure, and seat belt use). Cholesterol…

Risk of Adverse Health Outcomes and Decrements in Performance Due to In-flight Medical Conditions

NASA Technical Reports Server (NTRS)

Antonsen,Erik

2017-01-01

The drive to undertake long-duration space exploration missions at greater distances from Earth gives rise to many challenges concerning human performance under extreme conditions. At NASA, the Human Research Program (HRP) has been established to investigate the specific risks to astronaut health and performance presented by space exploration, in addition to developing necessary countermeasures and technology to reduce risk and facilitate safer, more productive missions in space (NASA Human Research Program 2009). The HRP is divided into five subsections, covering behavioral health, space radiation, habitability, and other areas of interest. Within this structure is the ExMC Element, whose research contributes to the overall development of new technologies to overcome the challenges of expanding human exploration and habitation of space. The risk statement provided by the HRP to the ExMC Element states: "Given that medical conditions/events will occur during human spaceflight missions, there is a possibility of adverse health outcomes and decrements in performance in mission and for long term health" (NASA Human Research Program 2016). Within this risk context, the Exploration Medical Capabilities (ExMC) Element is specifically concerned with establishing evidenced-based methods of monitoring and maintaining astronaut health. Essential to completing this task is the advancement in techniques that identify, prevent, and treat any health threats that may occur during space missions. The ultimate goal of the ExMC Element is to develop and demonstrate a pathway for medical system integration into vehicle and mission design to mitigate the risk of medical issues. Integral to this effort is inclusion of an evidence-based medical and data handling system appropriate for long-duration, exploration-class missions. This requires a clear Concept of Operations, quantitative risk metrics or other tools to address changing risk throughout a mission, and system scoping and system

Real Time Radiation Exposure And Health Risks

NASA Technical Reports Server (NTRS)

Hu, Shaowen; Barzilla, Janet E.; Semones, Edward J.

2015-01-01

Radiation from solar particle events (SPEs) poses a serious threat to future manned missions outside of low Earth orbit (LEO). Accurate characterization of the radiation environment in the inner heliosphere and timely monitoring the health risks to crew are essential steps to ensure the safety of future Mars missions. In this project we plan to develop an approach that can use the particle data from multiple satellites and perform near real-time simulations of radiation exposure and health risks for various exposure scenarios. Time-course profiles of dose rates will be calculated with HZETRN and PDOSE from the energy spectrum and compositions of the particles archived from satellites, and will be validated from recent radiation exposure measurements in space. Real-time estimation of radiation risks will be investigated using ARRBOD. This cross discipline integrated approach can improve risk mitigation by providing critical information for risk assessment and medical guidance to crew during SPEs.

Health risk assessment of China's main air pollutants.

PubMed

Sun, Jian; Zhou, Tiancai

2017-02-20

With the rapid development of China's economy, air pollution has attracted public concern because of its harmful effects on health. The source apportioning of air pollution, the spatial distribution characteristics, and the relationship between atmospheric contamination, and the risk of exposure were explored. The in situ daily concentrations of the principal air pollutants (PM 2.5 , PM 10 , SO 2 , NO 2 , CO and O 3 ) were obtained from 188 main cities with many continuous air-monitoring stations across China (2014 and 2015). The results indicate positive correlations between PM 2.5 and SO 2 (R 2  = 0.395/0.404, P < 0.0001), CO (R 2  = 0.187/0.365, P < 0.0001), and NO 2 (R 2  = 0.447/0.533, P < 0.0001), but weak correlations with O 3 (P > 0.05) for both 2014 and 2015. Additionally, a significant relationship between SO 2 , NO 2, and CO was discovered using regression analysis (P < 0.0001), indicating that the origin of air pollutants is likely to be vehicle exhaust, coal consumption, and biomass open-burning. For the spatial pattern of air pollutants, we found that the highest concentration of SO 2 , NO 2, and CO were mainly distributed in north China (Beijing-Tianjin-Hebei regions), Shandong, Shanxi and Henan provinces, part of Xinjiang and central Inner Mongolia (2014 and 2015). The highest concentration and risk of PM 2.5 was observed in the Beijing-Tianjin-Hebei economic belts, and Shandong, Henan, Shanxi, Hubei and Anhui provinces. Nevertheless, the highest concentration of O 3 was irregularly distributed in most areas of China. A high-risk distribution of PM 10 , SO 2 and NO 2 was also observed in these regions, with the high risk of PM 10 and NO 2 observed in the Hebei and Shandong province, and high-risk of PM 10 in Urumchi. The high-risk of NO 2 distributed in Beijing-Yangtze River Delta region-Pearl River Delta region-central. Although atmospheric contamination slightly improved in 2015 compared to 2014, humanity faces the

Sleep Disturbances, Psychosocial Difficulties, and Health Risk Behavior in 16,781 Dutch Adolescents.

PubMed

Verkooijen, Sanne; de Vos, Nelleke; Bakker-Camu, Betty J W; Branje, Susan J T; Kahn, René S; Ophoff, Roel A; Plevier, Carolien M; Boks, Marco P M

2018-03-09

To investigate the prevalence of adolescent sleep disturbances and their relation to psychosocial difficulties and health risk behaviors with the use of data from a province-wide health survey (n = 16,781). Psychosocial difficulties were measured with the Strength and Difficulties Questionnaire. Additional assessments included self-reported sleep disturbances, suicidality, and health risk behaviors including current use of tobacco, alcohol, and drugs, physical inactivity, and compulsive use of multimedia. We used multilevel analyses to investigate the relationhips, including differences, between boys and girls, as well as the mediating role of emotional problems. Just under 20% of adolescents reported sleep disturbances in the previous month. These sleep disturbances were associated with psychosocial problems (odds ratio [OR], 6.42; P < .001), suicidality (OR, 3.90-4.14; P < .001), and all health risk behaviors (OR, 1.62-2.66; P < .001), but not with physical inactivity. We found moderation by gender for the relations between sleep and suicide attempts (OR, 0.38; P < .002) and between sleep and cannabis use (OR, 0.52; P = .002), indicating attenuated relationships in girls compared with boys. Emotional problems partially mediated the relationships between sleep disturbances and multimedia use. This study reiterates the high prevalence of sleep disturbances during adolescence. These sleep disturbances were strongly related to psychosocial problems and a wide range of health risk behaviors. Although the direction of causality cannot be inferred, this study emphasizes the need for awareness of impaired sleep in adolescents. Moreover, the gender differences in associated suicide attempts and cannabis use call for further research into tailored intervention strategies. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Education-based disparities in knowledge of novel health risks: The case of knowledge gaps in HIV risk perceptions.

PubMed

Kiviniemi, Marc T; Orom, Heather; Waters, Erika A; McKillip, Megan; Hay, Jennifer L

2018-05-01

Risk perception is a key determinant of preventive health behaviour, but when asked, some individuals indicate they do not know their health risk. Low education is associated with both lack of knowledge about health risk and with the persistence and exacerbation of gaps in knowledge about health issues. This study uses the context of an emerging infectious disease threat to explore the hypothesis that the education-don't know risk relation results from differences in knowledge about the health issue of interest. Specifically, we examine whether patterns of change over time follow theoretical predictions that disparities in risk knowledge would increase over time in less educated sectors of the population (knowledge gap hypothesis). Secondary analysis of population-representative behavioural surveillance survey. We analysed data from the 1993 to 2000 Behavior Risk Factor Surveillance System surveys, which measured education and perceived HIV/AIDS risk in a population sample collected separately in each survey year; don't know responses were coded. In each year, individuals with higher education were less likely to respond don't know. The absolute prevalence of don't know responding dropped over time; nonetheless, there was an increase over time in the magnitude of the pattern of lower education being associated with greater don't know responding. We found support for the knowledge gap hypothesis. Over time, populations with greater education gained more knowledge about their HIV risk than populations with lower education. Results highlight the need to carefully consider health communication strategies to reach and address those individuals with low education and health knowledge. Statement of contribution What is already known on this subject? A meaningful potion of the population answers 'don't know' when asked to report their risk for health problems, indicating a lack of risk perception in the domain. Previous studies have shown that level of education is

Spatial Analysis of Human Health Risk Due to Arsenic Exposure through Drinking Groundwater in Taiwan's Pingtung Plain.

PubMed

Liang, Ching-Ping; Chien, Yi-Chi; Jang, Cheng-Shin; Chen, Ching-Fang; Chen, Jui-Sheng

2017-01-14

Chronic arsenic (As) exposure continues to be a public health problem of major concern worldwide, affecting hundreds of millions of people. A long-term groundwater quality survey has revealed that 20% of the groundwater in southern Taiwan's Pingtung Plain is clearly contaminated with a measured As concentration in excess of the maximum level of 10 µg/L recommended by the World Health Organization. The situation is further complicated by the fact that more than half of the inhabitants in this area continue to use groundwater for drinking. Efforts to assess the health risk associated with the ingestion of As from the contaminated drinking water are required in order to determine the priorities for health risk management. The conventional approach to conducting a human health risk assessment may be insufficient for this purpose, so this study adopts a geostatistical Kriging method to perform a spatial analysis of the health risk associated with ingesting As through drinking groundwater in the Pingtung Plain. The health risk is assessed based on the hazard quotient (HQ) and target cancer risk (TR) established by the U.S. Environmental Protection Agency. The results show that most areas where the HQ exceeds 1 are in the southwestern part of the study area. In addition, the high-population density townships of Daliao, Linyuan, Donggang, Linbian, Jiadong, and Fangliao presently have exceedingly high TR values that are two orders of magnitude higher than the acceptable standard. Thus, the use of groundwater for drinking in these townships should be strictly avoided. A map that delineates areas with high TR values and high population densities is provided. The findings broaden the scope of the spatial analysis of human health risk and provide a basis for improving the decision-making process.

Sorting Out the Health Risk in California's State-Based Marketplace.

PubMed

Bindman, Andrew B; Hulett, Denis; Gilmer, Todd P; Bertko, John

2016-02-01

To characterize the health risk of enrollees in California's state-based insurance marketplace (Covered California) by metal tier, region, month of enrollment, and plan. 2014 Open-enrollment data from Covered California linked with 2012 hospitalization and emergency department (ED) visit records from statewide all-payer administrative databases. Chronic Illness and Disability Payment System (CDPS) health risk scores derived from an individual's age and sex from the enrollment file and the diagnoses captured in the hospitalization and ED records. CDPS scores were standardized by setting the average to 1.00. Among the 1,286,089 enrollees, 120,573 (9.4 percent) had at least one ED visit and/or a hospitalization in 2012. Higher risk enrollees chose plans with greater actuarial value. The standardized CDPS health risk score was 11 percent higher in the first month of enrollment (1.08; 99 percent CI: 1.07-1.09) than the last month (0.97; 99 percent CI: 0.97-0.97). Four of the 12 plans enrolled 91 percent of individuals; their average health risk scores were each within 3 percent of the marketplace's statewide average. Providing health plans with a means to assess the health risk of their year 1 enrollees allowed them to anticipate whether they would receive or contribute payments to a risk-adjustment pool. After receiving these findings as a part of their negotiations with Covered California, health plans covering the majority of enrollees decreased their initially proposed 2015 rates, saving consumers tens of millions of dollars in potential premiums. © Health Research and Educational Trust.

Inequalities in health and health risk factors in the Southern African Development Community: evidence from World Health Surveys.

PubMed

Umuhoza, Stella M; Ataguba, John E

2018-04-27

Socioeconomic inequalities in health have been documented in many countries including those in the Southern African Development Community (SADC). However, a comprehensive assessment of health inequalities and inequalities in the distribution of health risk factors is scarce. This study specifically investigates inequalities both in poor self-assessed health (SAH) and in the distribution of selected risk factors of ill-health among the adult populations in six SADC countries. Data come from the 2002/04 World Health Survey (WHS) using six SADC countries (Malawi, Mauritius, South Africa, Swaziland, Zambia and Zimbabwe) where the WHS was conducted. Poor SAH is reporting bad or very bad health status. Risk factors such as smoking, heavy drinking, low fruit and vegetable consumption and physical inactivity were considered. Other environmental factors were also considered. Socioeconomic status was assessed using household expenditures. Standardised and normalised concentration indices (CIs) were used to assess socioeconomic inequalities. A positive (negative) concentration index means a pro-rich (pro-poor) distribution where the variable is reported more among the rich (poor). Generally, a pro-poor socioeconomic inequality exists in poor SAH in the six countries. However, this is only significant for South Africa (CI = - 0.0573; p < 0.05), and marginally significant for Zambia (CI = - 0.0341; P < 0.1) and Zimbabwe (CI = - 0.0357; p < 0.1). Smoking and inadequate fruit and vegetable consumption were significantly concentrated among the poor. Similarly, the use of biomass energy, unimproved water and sanitation were significantly concentrated among the poor. However, inequalities in heavy drinking and physical inactivity are mixed. Overall, a positive relationship exists between inequalities in ill-health and inequalities in risk factors of ill-health. There is a need for concerted efforts to tackle the significant socioeconomic inequalities in

Cardiovascular risks in firefighters: implications for occupational health nurse practice.

PubMed

Byczek, Lance; Walton, Surrey M; Conrad, Karen M; Reichelt, Paul A; Samo, Daniel G

2004-02-01

Limited cardiovascular risk data are available for firefighters. This cross sectional study of data collected during annual physical examinations described the prevalence of cardiovascular risk factors among firefighters (N = 200) and examined relationships between body mass index (BMI) and other cardiovascular risk factors. Evidence based guidelines were used to determine prevalence of cardiovascular risk factors and Framingham risk scoring was used to estimate probability of coronary heart disease (CHD). Firefighters ranged in age from 22 to 64 with a mean of 41. The prevalence of obesity, elevated total cholesterol, and elevated blood pressure in firefighters exceeded Healthy People 2010 targets. In addition, their prevalence of obesity, low high density lipoprotein (HDL), high low density lipoprotein (LDL), and high total cholesterol levels was higher relative to the general population. Elevated body mass index (BMI) values had positive significant (p < or = .01) associations with elevated blood pressures, triglycerides, and glucose levels, and a negative significant (p < .05) association with lower HDL cholesterol levels. Fire department worksite health and fitness policies and programs should proactively target firefighters' cardiovascular risks. Future firefighter related intervention research will benefit from considering not only the individual determinants of cardiovascular disease, but also the ecological framework that includes the influences of workplace and external environmental factors.

A study of Minnesota's high-risk health insurance pool.

PubMed

Zellner, B B; Haugen, D K; Dowd, B

1993-01-01

This is a report of a study of Minnesota's high-risk health insurance pool for "medically uninsurable" persons. The study consisted of a survey of current and past enrollees carried out in the Spring of 1990 and an analysis of the claims and membership files for 1988 and 1989. The main policy conclusion we reached is that Minnesota's high-risk pool is an adequate approach to the problem raised by risk segmentation on the basis of health status, providing that enrollment remains a small fraction of the population. The recent high, enrollment growth rates the Minnesota risk pool has experienced raise the possibility that basic structural reforms of the nongroup and small-group health insurance markets are needed.

Reproductive Health Risks Associated with Occupational Exposures to Antineoplastic Drugs in Health Care Settings: A Review of the Evidence

PubMed Central

Connor, Thomas H.; Lawson, Christina C.; Polovich, Martha; McDiarmid, Melissa A.

2015-01-01

Objectives Antineoplastic drugs are known reproductive and developmental toxicants. Our objective was to review the existing literature of reproductive health risks to workers who handle antineoplastic drugs. Methods A structured literature review of 18 peer-reviewed, English language publications of occupational exposure and reproductive outcomes was performed. Results While effect sizes varied with study size and population, occupational exposure to antineoplastic drugs appears to raise the risk of both congenital malformations and miscarriage. Studies of infertility and time-to-pregnancy also suggested an increased risk for sub-fertility. Conclusions Antineoplastic drugs are highly toxic in patients receiving treatment and adverse reproductive effects have been well documented in these patients. Healthcare workers with chronic, low level occupational exposure to these drugs also appear to have an increased risk of adverse reproductive outcomes. Additional precautions to prevent exposure should be considered. PMID:25153300

[Health Risk Assessment of Drinking Water Quality in Tianjin Based on GIS].

PubMed

Fu, Gang; Zeng, Qiang; Zhao, Liang; Zhang, Yue; Feng, Bao-jia; Wang, Rui; Zhang, Lei; Wang, Yang; Hou, Chang-chun

2015-12-01

This study intends to assess the potential health hazards of drinking water quality and explore the application of geographic information system( GIS) in drinking water safety in Tianjin. Eight hundred and fifty water samples from 401 sampling points in Tianjin were measured according to the national drinking water standards. The risk assessment was conducted using the environmental health risk assessment model recommended by US EAP, and GIS was combined to explore the information visualization and risk factors simultaneously. The results showed that the health risks of carcinogens, non-carcinogens were 3.83 x 10⁻⁵, 5.62 x 10⁻⁹ and 3.83 x 10⁻⁵ for total health risk respectively. The rank of health risk was carcinogen > non-carcinogen. The rank of carcinogens health risk was urban > new area > rural area, chromium (VI) > cadmium > arsenic > trichlormethane > carbon tetrachloride. The rank of non-carcinogens health risk was rural area > new area > urban, fluoride > cyanide > lead > nitrate. The total health risk level of drinking water in Tianjin was lower than that of ICRP recommended level (5.0 x 10⁻⁵), while was between US EPA recommended level (1.0 x 10⁻⁴-1.0 x 10⁻⁶). It was at an acceptable level and would not cause obvious health hazards. The main health risks of drinking water came from carcinogens. More attentions should be paid to chromium (VI) for carcinogens and fluoride for non-carcinogens. GIS can accomplish information visualization of drinking water risk assessment and further explore of risk factors.

Neighborhoods and Adolescent Health-Risk Behavior: An Ecological Network Approach1

PubMed Central

Browning, Christopher R.; Soller, Brian; Jackson, Aubrey L.

2014-01-01

This study integrates insights from social network analysis, activity space perspectives, and theories of urban and spatial processes to present an innovative approach to neighborhood effects on health-risk behavior among youth. We suggest spatial patterns of neighborhood residents’ non-home routine activities may be conceptualized as ecological, or “eco”-networks, which are two-mode networks that indirectly link residents through socio-spatial overlap in routine activities. We further argue structural configurations of eco-networks are consequential for youth’s behavioral health. In this study we focus on a key structural feature of eco-networks—the neighborhood-level extent to which households share two or more activity locations, or eco-network reinforcement—and its association with two dimensions of health-risk behavior, substance use and delinquency/sexual activity. Using geographic data on non-home routine activity locations among respondents from the Los Angeles Family and Neighborhood Survey (L.A.FANS), we constructed neighborhood-specific eco-networks by connecting sampled households to “activity clusters,” which are sets of spatially-proximate activity locations. We then measured eco-network reinforcement and examined its association with adolescent dimensions of health risk behavior employing a sample of 830 youth ages 12-17 nested in 65 census tracts. We also examined whether neighborhood-level social processes (collective efficacy and intergenerational closure) mediate the association between eco-network reinforcement and the outcomes considered. Results indicated eco-network reinforcement exhibits robust negative associations with both substance use and delinquency/sexual activity scales. Eco-network reinforcement effects were not explained by potential mediating variables. In addition to introducing a novel theoretical and empirical approach to neighborhood effects on youth, our findings highlight the importance of eco

Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Race/Ethnicity

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2011

2011-01-01

The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

The Association of Employee Engagement at Work With Health Risks and Presenteeism.

PubMed

Burton, Wayne N; Chen, Chin-Yu; Li, Xingquan; Schultz, Alyssa B

2017-10-01

Employee engagement is a key factor in work performance and employee retention. The current study seeks to examine the relationship between employee engagement and health risks and productivity. In 2012, employees of a global financial services corporation participated in a health risk appraisal (HRA) which measured employee engagement, health risks, and on-the-job productivity loss (presenteeism). Three engagement categories were created. The highest engaged employees had significantly fewer health risk factors (69.7% overall low-risk status; 1.91 average health risks) and significantly less presenteeism (7.7%) than the mid engagement (67.9% low-risk, 1.98 risks, 9.2% presenteeism) and worst engagement (55.0% low-risk, 2.53 risks, 14.0% presenteeism) groups. Work engagement appears to be good for both the organization and the individual. Organizations may wish to make use of strategies which increase employee engagement.

Vulnerable Populations Perceive Their Health as at Risk from Climate Change.

PubMed

Akerlof, Karen L; Delamater, Paul L; Boules, Caroline R; Upperman, Crystal R; Mitchell, Clifford S

2015-12-04

Climate change is already taking a toll on human health, a toll that is likely to increase in coming decades. The relationship between risk perceptions and vulnerability to climate change's health threats has received little attention, even though an understanding of the dynamics of adaptation among particularly susceptible populations is becoming increasingly important. We demonstrate that some people whose health will suffer the greatest harms from climate change-due to social vulnerability, health susceptibility, and exposure to hazards-already feel they are at risk. In a 2013 survey we measured Maryland residents' climate beliefs, health risk perceptions, and household social vulnerability characteristics, including medical conditions (n = 2126). We paired survey responses with secondary data sources for residence in a floodplain and/or urban heat island to predict perceptions of personal and household climate health risk. General health risk perceptions, political ideology, and climate beliefs are the strongest predictors. Yet, people in households with the following characteristics also see themselves at higher risk: members with one or more medical conditions or disabilities; low income; racial/ethnic minorities; and residence in a floodplain. In light of these results, climate health communication among vulnerable populations should emphasize protective actions instead of risk messages.

Vulnerable Populations Perceive Their Health as at Risk from Climate Change

PubMed Central

Akerlof, Karen L.; Delamater, Paul L.; Boules, Caroline R.; Upperman, Crystal R.; Mitchell, Clifford S.

2015-01-01

Climate change is already taking a toll on human health, a toll that is likely to increase in coming decades. The relationship between risk perceptions and vulnerability to climate change’s health threats has received little attention, even though an understanding of the dynamics of adaptation among particularly susceptible populations is becoming increasingly important. We demonstrate that some people whose health will suffer the greatest harms from climate change—due to social vulnerability, health susceptibility, and exposure to hazards—already feel they are at risk. In a 2013 survey we measured Maryland residents’ climate beliefs, health risk perceptions, and household social vulnerability characteristics, including medical conditions (n = 2126). We paired survey responses with secondary data sources for residence in a floodplain and/or urban heat island to predict perceptions of personal and household climate health risk. General health risk perceptions, political ideology, and climate beliefs are the strongest predictors. Yet, people in households with the following characteristics also see themselves at higher risk: members with one or more medical conditions or disabilities; low income; racial/ethnic minorities; and residence in a floodplain. In light of these results, climate health communication among vulnerable populations should emphasize protective actions instead of risk messages. PMID:26690184

Financial risk protection from social health insurance.

PubMed

Barnes, Kayleigh; Mukherji, Arnab; Mullen, Patrick; Sood, Neeraj

2017-09-01

This paper estimates the impact of social health insurance on financial risk by utilizing data from a natural experiment created by the phased roll-out of a social health insurance program for the poor in India. We estimate the distributional impact of insurance on of out-of-pocket costs and incorporate these results with a stylized expected utility model to compute associated welfare effects. We adjust the standard model, accounting for conditions of developing countries by incorporating consumption floors, informal borrowing, and asset selling which allow us to separate the value of financial risk reduction from consumption smoothing and asset protection. Results show that insurance reduces out-of-pocket costs, particularly in higher quantiles of the distribution. We find reductions in the frequency and amount of money borrowed for health reasons. Finally, we find that the value of financial risk reduction outweighs total per household costs of the insurance program by two to five times. Copyright © 2017. Published by Elsevier B.V.

Motivators and Barriers to Incorporating Climate Change-Related Health Risks in Environmental Health Impact Assessment

PubMed Central

Turner, Lyle R.; Alderman, Katarzyna; Connell, Des; Tong, Shilu

2013-01-01

Climate change presents risks to health that must be addressed by both decision-makers and public health researchers. Within the application of Environmental Health Impact Assessment (EHIA), there have been few attempts to incorporate climate change-related health risks as an input to the framework. This study used a focus group design to examine the perceptions of government, industry and academic specialists about the suitability of assessing the health consequences of climate change within an EHIA framework. Practitioners expressed concern over a number of factors relating to the current EHIA methodology and the inclusion of climate change-related health risks. These concerns related to the broad scope of issues that would need to be considered, problems with identifying appropriate health indicators, the lack of relevant qualitative information that is currently incorporated in assessment and persistent issues surrounding stakeholder participation. It was suggested that improvements are needed in data collection processes, particularly in terms of adequate communication between environmental and health practitioners. Concerns were raised surrounding data privacy and usage, and how these could impact on the assessment process. These findings may provide guidance for government and industry bodies to improve the assessment of climate change-related health risks. PMID:23525029

Community Gardens as Environmental Health Interventions: Benefits Versus Potential Risks.

PubMed

Al-Delaimy, W K; Webb, M

2017-06-01

The purpose of this paper was to summarize current findings on community gardens relevant to three specific areas of interest as follows: (1) health benefits, (2) garden interventions in developing versus developed countries, and (3) the concerns and risks of community gardening. Community gardens are a reemerging phenomenon in many low- and high-income urban neighborhoods to address the common risk factors of modern lifestyle. Community gardens are not limited to developed countries. They also exist in developing low-income countries but usually serve a different purpose of food security. Despite their benefits, community gardens can become a source of environmental toxicants from the soil of mostly empty lands that might have been contaminated by toxicants in the past. Therefore, caution should be taken about gardening practices and the types of foods to be grown on such soil if there was evidence of contamination. We present community gardens as additional solutions to the epidemic of chronic diseases in low-income urban communities and how it can have a positive physical, mental and social impact among participants. On balance, the benefits of engaging in community gardens are likely to outweigh the potential risk that can be remedied. Quantitative population studies are needed to provide evidence of the benefits and health impacts versus potential harms from community gardens.

Physical Activity, Health Benefits, and Mortality Risk

PubMed Central

Kokkinos, Peter

2012-01-01

A plethora of epidemiologic evidence from large studies supports unequivocally an inverse, independent, and graded association between volume of physical activity, health, and cardiovascular and overall mortality. This association is evident in apparently healthy individuals, patients with hypertension, type 2 diabetes mellitus, and cardiovascular disease, regardless of body weight. Moreover, the degree of risk associated with physical inactivity is similar to, and in some cases even stronger than, the more traditional cardiovascular risk factors. The exercise-induced health benefits are in part related to favorable modulations of cardiovascular risk factors observed by increased physical activity or structured exercise programs. Although the independent contribution of the exercise components, intensity, duration, and frequency to the reduction of mortality risk is not clear, it is well accepted that an exercise volume threshold defined at caloric expenditure of approximately 1,000 Kcal per week appears to be necessary for significant reduction in mortality risk. Further reductions in risk are observed with higher volumes of energy expenditure. Physical exertion is also associated with a relatively low and transient increase in risk for cardiac events. This risk is significantly higher for older and sedentary individuals. Therefore, such individuals should consult their physician prior to engaging in exercise. “Walking is man’s best medicine”Hippocrates PMID:23198160

Automatic Identification of Web-Based Risk Markers for Health Events

PubMed Central

Borsa, Diana; Hayward, Andrew C; McKendry, Rachel A; Cox, Ingemar J

2015-01-01

Background The escalating cost of global health care is driving the development of new technologies to identify early indicators of an individual’s risk of disease. Traditionally, epidemiologists have identified such risk factors using medical databases and lengthy clinical studies but these are often limited in size and cost and can fail to take full account of diseases where there are social stigmas or to identify transient acute risk factors. Objective Here we report that Web search engine queries coupled with information on Wikipedia access patterns can be used to infer health events associated with an individual user and automatically generate Web-based risk markers for some of the common medical conditions worldwide, from cardiovascular disease to sexually transmitted infections and mental health conditions, as well as pregnancy. Methods Using anonymized datasets, we present methods to first distinguish individuals likely to have experienced specific health events, and classify them into distinct categories. We then use the self-controlled case series method to find the incidence of health events in risk periods directly following a user’s search for a query category, and compare to the incidence during other periods for the same individuals. Results Searches for pet stores were risk markers for allergy. We also identified some possible new risk markers; for example: searching for fast food and theme restaurants was associated with a transient increase in risk of myocardial infarction, suggesting this exposure goes beyond a long-term risk factor but may also act as an acute trigger of myocardial infarction. Dating and adult content websites were risk markers for sexually transmitted infections, such as human immunodeficiency virus (HIV). Conclusions Web-based methods provide a powerful, low-cost approach to automatically identify risk factors, and support more timely and personalized public health efforts to bring human and economic benefits. PMID

Latino Solo Grandparents Raising Grandchildren: Health Risks and Behaviors.

PubMed

Whitley, Deborah M; Fuller-Thomson, Esme

2018-03-01

The purpose of this descriptive report is to provide the first representative information on the sociodemographic profile and the prevalence of mental and physical health conditions of two "at-risk" groups of Latino caregivers: solo grandparent caregivers and single parents. The 2012 Behavior Risk Factor Surveillance System was used to compare five dimensions of health on a sample of Latino solo grandparents and Latino single parents, raising their grandchildren/children alone. Bivariate and logistic regression comparative analyses were conducted on study measures. Latino solo grandparents have a high prevalence of chronic health conditions, including arthritis (51%), depression (40%), diabetes (34%), and asthma (34%). Latino single parents have lower but troubling health risks, including depression (22%), diabetes (14%), and asthma (14%). Differences between the two groups were largely due to the grandparents older age. Latino solo grandparents have a high prevalence of several chronic medical conditions. The prevalence of disorders is much lower for Latino single parents, although they too have disturbing health risks. Latino solo grandparents perform their parenting role under intense physical and emotional strain. Health professionals can be instrumental in facilitating interventions that affect the well-being of this expanding family group.

Bioethics and the Framing of Climate Change's Health Risks.

PubMed

Valles, Sean A

2015-06-01

Cheryl Cox Macpherson recently argued, in an article for this journal, that 'Climate Change is a Bioethics Problem'. This article elaborates on that position, particularly highlighting bioethicists' potential ability to help reframe the current climate change discourse to give more attention to its health risks. This reframing process is especially important because of the looming problem of climate change skepticism. Recent empirical evidence from science framing experiments indicates that the public reacts especially positively to climate change messages framed in public health terms, and bioethicists are particularly well positioned to contribute their expertise to the process of carefully developing and communicating such messages. Additionally, as climate framing research and practice continue, it will be important for bioethicists to contribute to the creation of that project's nascent ethical standards. The discourse surrounding antibiotic resistance is posited as an example that can lend insight into how communicating a public health-framed message, including the participation of bioethicists, can help to override public skepticism about the findings of politically contentious scientific fields. © 2014 John Wiley & Sons Ltd.

Occupational Risks of Health Professionals in Turkey as an Emerging Economy.

PubMed

Ulutasdemir, Nilgun; Cirpan, Metin; Copur, Ebru Ozturk; Tanir, Ferdi

2015-01-01

Health services are one of the work areas that contain important risks in terms of the occupational health and safety of the laborer. Professionals in various areas of health services encounter biological, chemical, physical, ergonomic, and psychosocial risks, particularly in hospitals. This study has been performed to evaluate the impacts of the occupational risks on health of health professionals in Turkey. In Turkey, as an emerging economy, the history of studies on health professionals is not longstanding. There have been various regulations intended for the occupational health and safety of health professionals in line with the Regulation of the Provision on Patient and Staff Safety prepared in 2012. However, applications can differ from region to region, institution to institution, and person to person. We believe that this review will lead health professionals to be aware of occupational risks and contribute to planning health services for health professionals. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Conservative Exposure Predictions for Rapid Risk Assessment of Phase-Separated Additives in Medical Device Polymers.

PubMed

Chandrasekar, Vaishnavi; Janes, Dustin W; Saylor, David M; Hood, Alan; Bajaj, Akhil; Duncan, Timothy V; Zheng, Jiwen; Isayeva, Irada S; Forrey, Christopher; Casey, Brendan J

2018-01-01

A novel approach for rapid risk assessment of targeted leachables in medical device polymers is proposed and validated. Risk evaluation involves understanding the potential of these additives to migrate out of the polymer, and comparing their exposure to a toxicological threshold value. In this study, we propose that a simple diffusive transport model can be used to provide conservative exposure estimates for phase separated color additives in device polymers. This model has been illustrated using a representative phthalocyanine color additive (manganese phthalocyanine, MnPC) and polymer (PEBAX 2533) system. Sorption experiments of MnPC into PEBAX were conducted in order to experimentally determine the diffusion coefficient, D = (1.6 ± 0.5) × 10 -11  cm 2 /s, and matrix solubility limit, C s  = 0.089 wt.%, and model predicted exposure values were validated by extraction experiments. Exposure values for the color additive were compared to a toxicological threshold for a sample risk assessment. Results from this study indicate that a diffusion model-based approach to predict exposure has considerable potential for use as a rapid, screening-level tool to assess the risk of color additives and other small molecule additives in medical device polymers.

Rural Community Leaders’ Perceptions of Environmental Health Risks

PubMed Central

Larsson, Laura S.; Butterfield, Patricia; Christopher, Suzanne; Hill, Wade

2015-01-01

Qualitative description was used to explore how rural community leaders frame, interpret, and give meaning to environmental health issues affecting their constituents and communities. Six rural community leaders discussed growth, vulnerable families, and the action avoidance strategies they use or see used in lieu of adopting health-promoting behaviors. Findings suggest intervention strategies should be economical, use common sense, be sensitive to regional identity, and use local case studies and “inside leadership.” Occupational health nurses addressing the disparate environmental health risks in rural communities are encouraged to use agenda-neutral, scientifically based risk communication efforts and foster collaborative relationships among nurses, planners, industry, and other community leaders. PMID:16562621

County-level job automation risk and health: Evidence from the United States.

PubMed

Patel, Pankaj C; Devaraj, Srikant; Hicks, Michael J; Wornell, Emily J

2018-04-01

Previous studies have observed a positive association between automation risk and employment loss. Based on the job insecurity-health risk hypothesis, greater exposure to automation risk could also be negatively associated with health outcomes. The main objective of this paper is to investigate the county-level association between prevalence of workers in jobs exposed to automation risk and general, physical, and mental health outcomes. As a preliminary assessment of the job insecurity-health risk hypothesis (automation risk → job insecurity → poorer health), a structural equation model was used based on individual-level data in the two cross-sectional waves (2012 and 2014) of General Social Survey (GSS). Next, using county-level data from County Health Rankings 2017, American Community Survey (ACS) 2015, and Statistics of US Businesses 2014, Two Stage Least Squares (2SLS) regression models were fitted to predict county-level health outcomes. Using the 2012 and 2014 waves of the GSS, employees in occupational classes at higher risk of automation reported more job insecurity, that, in turn, was associated with poorer health. The 2SLS estimates show that a 10% increase in automation risk at county-level is associated with 2.38, 0.8, and 0.6 percentage point lower general, physical, and mental health, respectively. Evidence suggests that exposure to automation risk may be negatively associated with health outcomes, plausibly through perceptions of poorer job security. More research is needed on interventions aimed at mitigating negative influence of automation risk on health. Copyright © 2018 Elsevier Ltd. All rights reserved.

Estimating risk reduction required to break even in a health promotion program.

PubMed

Ozminkowski, Ronald J; Goetzel, Ron Z; Santoro, Jan; Saenz, Betty-Jo; Eley, Christine; Gorsky, Bob

2004-01-01

To illustrate a formula to estimate the amount of risk reduction required to break even on a corporate health promotion program. A case study design was implemented. Base year (2001) health risk and medical expenditure data from the company, along with published information on the relationships between employee demographics, health risks, and medical expenditures, were used to forecast demographics, risks, and expenditures for 2002 through 2011 and estimate the required amount of risk reduction. Motorola. 52,124 domestic employees. Demographics included age, gender, race, and job type. Health risks for 2001 were measured via health risk appraisal. Risks were noted as either high or low and related to exercise/eating habits, body weight, blood pressure, blood sugar levels, cholesterol levels, depression, stress, smoking/drinking habits, and seat belt use. Medical claims for 2001 were used to calculate medical expenditures per employee. Assuming a dollar 282 per employee program cost, Motorola employees would need to reduce their lifestyle-related health risks by 1.08% to 1.42% per year to break even on health promotion programming, depending upon the discount rate. Higher or lower program investments would change the risk reduction percentages. Employers can use information from published studies, along with their own data, to estimate the amount of risk reduction required to break even on their health promotion programs.

Must I Respond if My Health is at Risk?

PubMed

Iserson, Kenneth V

2018-05-14

Widespread epidemics, pandemics, and other risk-prone disasters occur with disturbing regularity. When such events occur, how should, and will, clinicians respond? The moral backbone of medical professionals-a duty to put the needs of patients first-may be sorely tested. It is incumbent on health care professionals to ask what we must do and what we should do if a dangerous health care situation threatens both ourselves and our community. Despite numerous medical ethical codes, nothing-either morally or legally-requires a response to risk-prone situations from civilian clinicians; it remains a personal decision. The most important questions are: What will encourage us to respond to these situations? And will we respond? These questions are necessary, not only for physicians and other direct health care providers, but also for vital health care system support personnel. Those who provide care in the face of perceived risk demonstrate heroic bravery, but the choice to do so has varied throughout history. To improve individual response rates, disaster planners and managers must communicate the risks clearly to all members of the health care system and help mitigate their risks by providing them with as much support and security as possible. The decision to remain in or to leave a risky health care situation will ultimately depend on the provider's own risk assessment and value system. If history is any guide, we can rest assured that most clinicians will choose to stay, following the heroic example established through the centuries and continuing today. Copyright © 2018 Elsevier Inc. All rights reserved.

Associations of muscular fitness with psychological positive health, health complaints, and health risk behaviors in Spanish children and adolescents.

PubMed

Padilla-Moledo, Carmen; Ruiz, Jonatan R; Ortega, Francisco B; Mora, Jesús; Castro-Piñero, José

2012-01-01

We examined the association of muscular fitness with psychological positive health, health complaints, and health risk behaviors in 690 (n = 322 girls) Spanish children and adolescents (6-17.9 years old). Lower body muscular strength was assessed with the standing long jump test, and upper-body muscular strength was assessed with the throw basketball test. A muscular fitness index was computed by means of standardized measures of both tests. Psychosocial positive health, health complaints, and health risk behaviors were self-reported using the items of the Health Behavior in School-aged Children questionnaire. Psychological positive health indicators included the following: perceived health status, life satisfaction, quality of family relationships, quality of peer relationships, and academic performance. We computed a health complaints index from 8 registered symptoms: headache, stomach ache, backache, feeling low, irritability or bad temper, feeling nervous, difficulties getting to sleep, and feeling dizzy. The health risk behavior indicators studied included tobacco use, alcohol use, and getting drunk. Children and adolescents with low muscular fitness (below the mean) had a higher odds ratio (OR) of reporting fair (vs. excellent) perceived health status, low life satisfaction (vs. very happy), low quality of family relationships (vs. very good), and low academic performance (vs. very good). Likewise, children and adolescents having low muscular fitness had a significantly higher OR of reporting smoking tobacco sometimes (vs. never), drinking alcohol sometimes (vs. never), and getting drunk sometimes (vs. never). The results of this study suggest a link between muscular fitness and psychological positive health and health risk behavior indicators in children and adolescents.

Mental Health and Health Risk Behaviours of Homeless Adolescents and Youth: A Mixed Methods Study

ERIC Educational Resources Information Center

Oppong Asante, Kwaku; Meyer-Weitz, Anna; Petersen, Inge

2016-01-01

Background: Homeless youth, as a vulnerable population are susceptible to various mental and health risk behaviours. However, less is known of the mental health status of these homeless youth and its role in risky sexual behaviours; neither do we understand the reasons homeless youth give for their engagement in various health risk behaviour.…

Effectiveness of personalized and interactive health risk calculators: a randomized trial.

PubMed

Harle, Christopher A; Downs, Julie S; Padman, Rema

2012-01-01

Risk calculators are popular websites that provide individualized disease risk assessments to the public. Little is known about their effect on risk perceptions and health behavior. This study sought to test whether risk calculator features-namely, personalized estimates of one's disease risk and feedback about the effects of risk-mitigating behaviors-improve risk perceptions and motivate healthy behavior. A web-based experimental study using simple randomization was conducted to compare the effects of 3 prediabetes risk communication websites. Setting The study was conducted in the context of ongoing health promotion activities sponsored by a university's human resources office. Patients Participants were adult university employees. Intervention The control website presented nonindividualized risk information. The personalized noninteractive website presented individualized risk calculations. The personalized interactive website presented individualized risk calculations and feedback about the effects of hypothetical risk-mitigating behaviors. Measurements Pre- and postintervention risk perceptions were measured in absolute and relative terms. Health behavior was measured by assessing participant interest in follow-up preventive health services. On average, risk perceptions decreased by 2%. There was no general effect of personalization or interactivity in aligning subjective risk perceptions with objective risk calculations or in increasing healthy behaviors. However, participants who previously overestimated their risk reduced their perceptions by 16%. This was a significantly larger change than the 2% increase by participants who underestimated their risk. Limitations Results may not generalize to different populations, different diseases, or longer-term outcomes. Compared to nonpersonalized information, individualized risk calculators had little positive effect on prediabetes risk perception accuracy or health behavior. Risk perception accuracy was improved in

Improved classification of evidence for EMF health risks.

PubMed

Leitgeb, Norbert

2012-08-01

Classifying evidence of causality between a risk factor and its potential health effect is challenging, in particular in an already emotional situation. Even the assessment of health risks by designated bodies may still depend on their composition of individuals with their background, bias, and, in worst case, their interests. This may explain opposing conclusions from the same pool of data which, consequently, may undermine credibility if not communicated properly. To overcome existing weakness in classifying and communicating evidence of health risks such as from electromagnetic fields, a new rule-based approach is presented. Developed by the German Commission on Radiological Protection (SSK), it discloses step-by-step the criteria for weighing scientific data and pools partial evidences of different scientific approaches to conclude on the overall evidence of causality between risk factor and effects. The validity of the approach is demonstrated by analyzing evidence of carcinogenicity of ionizing radiation, mobile phone use, and nocturnal exposure to visible light.

TOXICOPROTEOMICS AND ITS APPLICATION TO HUMAN HEALTH RISK ASSESSMENT

EPA Science Inventory

Humans are exposed to a variety of environmental toxicants, and this together with a large number of interacting factors can contribute to an individual's risk for health. To understand the toxic mechanisms and/or modes of action for human health risk assessment, molecular charac...

Documentary analysis of risk-assessment and safety-planning policies and tools in a mental health context.

PubMed

Higgins, Agnes; Doyle, Louise; Morrissey, Jean; Downes, Carmel; Gill, Ailish; Bailey, Sive

2016-08-01

Despite the articulated need for policies and processes to guide risk assessment and safety planning, limited guidance exists on the processes or procedures to be used to develop such policies, and there is no body of research that examines the quality or content of the risk-management policies developed. The aim of the present study was to analyse the policies of risk and safety management used to guide mental health nursing practice in Ireland. A documentary analysis was performed on 123 documents received from 22 of the 23 directors of nursing contacted. Findings from the analysis revealed a wide variation in how risk, risk assessment, and risk management were defined. Emphasis within the risk documentation submitted was on risk related to self and others, with minimal attention paid to other types of risks. In addition, there was limited evidence of recovery-focused approaches to positive risk taking that involved service users and their families within the risk-related documentation. Many of the risk-assessment tools had not been validated, and lacked consistency or guidance in relation to how they were to be used or applied. The tick-box approach and absence of space for commentary within documentation have the potential to impact severely on the quality of information collected and documented, and subsequent clinical decision-making. Managers, and those tasked with ensuring safety and quality, need to ensure that policies and processes are, where possible, informed by best evidence and are in line with national mental health policy on recovery. © 2016 Australian College of Mental Health Nurses Inc.

Family Sources of Sexual Health Information, Primary Messages, and Sexual Behavior of At-Risk, Urban Adolescents

PubMed Central

Rosengard, Cynthia; Tannis, Candace; Dove, David C.; van den Berg, Jacob J.; Lopez, Rosalie; Stein, L. A. R.; Morrow, Kathleen M.

2016-01-01

Background Sources of sexual health information exert strong influence on adolescents’ sexual behavior. Purpose The current study was undertaken to understand how family serve as sexual information sources, the messages adolescents recall from family, and how family learning experiences affect sexual behavior among at-risk adolescents. Methods Individual interviews were conducted with 69 teens, ages 15–18 years, from an alternative high school and a juvenile correctional facility to capture adolescents’ early sexual health learning experiences involving family and evaluate their association with teens’ recent sexual behavior. Sexual learning narratives were compared among gender and sexual experience groups. Results Many participants identified family as sexual health information sources. Primary messages recalled: risks of sex, protection, and relationship advice. Many adolescents portrayed learning experiences as negative, cautionary, lacking detail and not always balanced with positive messages. Participants who reported four or more sexual risks were the only group to identify pornography as a sexual health information source. Participants who reported fewer than four sexual risks were most likely to identify family sexual health information sources. Discussion Participants identified family members as sources of sexual health information, with variations by gender. Negative/cautionary messages require teens to seek additional sexual information elsewhere (primarily friends/media). Males, in particular, appear to often lack familial guidance/education. Translation to Health Education Practice Sexual health messages should be tailored to adolescents’ needs for practical and sex-positive guidance regarding mechanics of sex and formation of healthy relationships, and balanced with cautions regarding negative consequences. PMID:27882190

Pre-Feedback Risk Expectancies and Reception of Low-Risk Health Feedback: Absolute and Comparative Lack of Reassurance.

PubMed

Gamp, Martina; Renner, Britta

2016-11-01

Personalised health-risk assessment is one of the most common components of health promotion programs. Previous research on responses to health risk feedback has commonly focused on the reception of bad news (high-risk feedback). The reception of low-risk feedback has been comparably neglected since it is assumed that good news is reassuring and readily received. However, field studies suggest mixed responses to low-risk health feedback. Accordingly, we examine whether pre-feedback risk expectancies can mitigate the reassuring effects of good news. In two studies (N = 187, N = 565), after assessing pre-feedback risk expectancies, participants received low-risk personalised feedback about their own risk of developing (the fictitious) Tucson Chronic Fatigue Syndrome (TCFS). Study 2 also included peer TCFS risk status feedback. Afterwards, self- and peer-related risk perception for TCFS was assessed. In both studies, participants who expected to be at high risk but received good news (unexpected low-risk feedback) showed absolute lack of reassurance. Specifically, they felt at significantly greater TCFS risk than participants who received expected good news. Moreover, the unexpected low-risk group even believed that their risk was as high as (Study 1) or higher (Study 2) than that of their peers (comparative lack of reassurance). Results support the notion that high pre-feedback risk expectancies can mitigate absolute and comparative reassuring effects of good news. © 2016 The International Association of Applied Psychology.

Estimating community health needs against a Triple Aim background: What can we learn from current predictive risk models?

PubMed

Elissen, Arianne M J; Struijs, Jeroen N; Baan, Caroline A; Ruwaard, Dirk

2015-05-01

To support providers and commissioners in accurately assessing their local populations' health needs, this study produces an overview of Dutch predictive risk models for health care, focusing specifically on the type, combination and relevance of included determinants for achieving the Triple Aim (improved health, better care experience, and lower costs). We conducted a mixed-methods study combining document analyses, interviews and a Delphi study. Predictive risk models were identified based on a web search and expert input. Participating in the study were Dutch experts in predictive risk modelling (interviews; n=11) and experts in healthcare delivery, insurance and/or funding methodology (Delphi panel; n=15). Ten predictive risk models were analysed, comprising 17 unique determinants. Twelve were considered relevant by experts for estimating community health needs. Although some compositional similarities were identified between models, the combination and operationalisation of determinants varied considerably. Existing predictive risk models provide a good starting point, but optimally balancing resources and targeting interventions on the community level will likely require a more holistic approach to health needs assessment. Development of additional determinants, such as measures of people's lifestyle and social network, may require policies pushing the integration of routine data from different (healthcare) sources. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Health risk assessment on pesticide residues in drinking water in Shenzhen].

PubMed

Liu, Guohong; Peng, Zhaoqiong; Lan, Tao; Xu, Xinyun; Huang, Guangwen; Yu, Shuyuan; Liu, Guihua; Li, Jin

2015-03-01

To conduct a health risk assessment of pesticide residues and its annual trend analysis in drinking water in Shenzhen City. The water quality monitoring data of product water, pipe water and secondary supply water during from 2011 to 2013 were collected and analyzed. The risk evaluation models recommended by the U. S. Environmental Protection Agency (USEPA) were employed to perform health risk assessments for children and adults on the 12 non-carcinogenic materials (namely, heptachlor, pentachlorophenol, hexachlorocyclohexane, hexachlorobenzene, DDT, malathion, glyphosate, dimethoate, bentazone, atrazine, chlorothalonil, furadan). Results The results of the analysis for water quality from 84 factory samples, 11 peripheral samples and one secondary supply water sample showed that all of the measured indicators in the above mentioned water samples met the National Health Standards (GB 5749-2006) published by Ministry of Health of the People's Republic of China. The adults and children' s health indices (HIs) of the 12 non-carcinogenic materials were greater than 1 (2. 323 - 6. 312). Dimethoate in factory and peripheral water samples posed the largest risks of harm among the non-carcinogenic pollutants measured. And its HIi were also greater than 1 (1. 995 - 5. 094) and followed by hexachlorobenzene and heptachlor. Annual rising trend on health risk of the 12 pesticide residues indicated that their HIT on adults was 2323. 18 x 10(-3) in 2011, 2340. 18 x 10(-3) in 2012 and 2431. 97 x 10(-3) in 2013, and on children 2965. 07 x 10 (-3) in 2011, 2986. 77 x 10(-3) in 2012 and 3103. 93 x 10(-3) in 2013, respectively. This study also suggested that the average risk of peripheral water samples (HIT was equal to 2619. 64 x 10(-3) was greater than that of factory samples (HIT was same as 2366. 92 x 10(-3), and more children' s health risk than adults' risk. Health risks of pesticide residues in drinking water in Shenzhen have exceeded the threshold value and dimethoate was the

Identifying community risk factors for HIV among South African adolescents with mental health problems: a qualitative study of parental perceptions.

PubMed

Kagee, Ashraf; Donenberg, Geri; Davids, Alicia; Vermaak, Redwaan; Simbayi, Leickness; Ward, Catherine; Naidoo, Pamela; Mthembu, Jacky

2014-01-01

High risk sexual behaviour, alcohol and drug use, and mental health problems combine to yield high levels of HIV-risk behaviour among adolescents with mental health problems. In South Africa, little research has been conducted on parental perspectives of HIV-risk among this population. We conducted a series of focus group discussions with 28 mothers of adolescents receiving services at two mental health clinics in South Africa to identify, from their perspectives, the key community problems facing their children. Participants indicated that HIV remained a serious threat to their adolescent children's well-being, in addition to substance abuse, early sexual debut, and teenage pregnancy. These social problems were mentioned as external to their household dynamics, and thus seemingly beyond the purview of the parent-adolescent relationship. These data have implications for the design of family-based interventions to ameliorate the factors associated with HIV-risk among youth receiving mental health services.

Adolescent peer crowd affiliation: linkages with health-risk behaviors and close friendships.

PubMed

La Greca, A M; Prinstein, M J; Fetter, M D

2001-01-01

To examine adolescents' peer crowd affiliation and its linkages with health-risk behaviors, their friends' health-risk behaviors, the presence of close friends in the same peer crowd, and adolescents' social acceptance. We interviewed 250 high school students and identified six categories: popular, jocks, brains, burnouts, nonconformists, or average/other. Adolescents also reported on their health-risk behaviors (including use of cigarettes, alcohol, marijuana and other drugs; risky sexual behaviors; and other risk-taking behaviors), the health-risk behaviors of their friends, the peer crowd affiliation of their closest friends, and their perceived social acceptance. Burnouts and nonconformists had the highest levels of health-risk behaviors across the areas assessed, the greatest proportions of close friends who engaged in similar behaviors, and relatively low social acceptance from peers. Brains and their friends engaged in extremely low levels of health-risk behaviors. Jocks and populars also showed evidence of selected areas of health risk; these teens also were more socially accepted than others. In general, adolescents' closest friends were highly nested within the same peer crowds. The findings further our understanding of adolescent behaviors that put them at risk for serious adult onset conditions associated with high rates of morbidity and mortality. We discuss the implications of the findings for developing health promotion efforts for adolescents.

Long-duration space exploration and emotional health: Recommendations for conceptualizing and evaluating risk

NASA Astrophysics Data System (ADS)

Alfano, Candice A.; Bower, Joanne L.; Cowie, Jennifer; Lau, Simon; Simpson, Richard J.

2018-01-01

Spaceflight to Mars will by far exceed the duration of any previous mission. Although behavioral health risks are routinely highlighted among the most serious threats to crew safety, understanding of specific emotional responses most likely to occur and interfere with mission success has lagged in comparison to other risk domains. Even within the domain of behavioral health, emotional constructs remain to be 'unpacked' to the same extent as other factors such as attention and fatigue. The current paper provides a review of previous studies that have examined emotional responses in isolated, confined, extreme environments (ICE) toward informing a needed research agenda. We include research conducted during space flight, long-duration space simulation analogs, and polar environments and utilize a well-established model of emotion and emotion regulation to conceptualize specific findings. Lastly, we propose four specific directions for future research: (1) use of a guiding theoretical framework for evaluating emotion responses in ICE environments; (2) leveraging multi-method approaches to improve the reliability of subjective reports of emotional health; (3) a priori selection of precise emotional constructs to guide measure selection; and (4) focusing on positive in addition to negative emotion in order to provide a more complete understanding of individual risk and resilience.

The impact of health claims and food deprivation levels on health risk perceptions of fast-food restaurants.

PubMed

Cadario, Romain

2016-01-01

We examined the effect of health claims and food deprivation levels on the health risk perceptions of fast-food restaurants. Consistent with previous research, we used a within-subjects experimental design to manipulate the health claims of fast-food restaurants using real brands: Subway, expressing strong health claims vs. McDonald's, expressing weak health claims. Participants who did not have access to nutrition information were asked to estimate the health risk associated with food items that were slightly more caloric for Subway than McDonald's (640 kcal vs. 600 kcal). We collected data through a web survey with a sample consisting of 414 American adults. Based on the USDA Food Insufficiency Indicator, participants were classified into two categorical food deprivation levels: food sufficiency and food insufficiency. We find that risk perceptions for obesity, diabetes and cardiac illnesses are lower (higher) for the restaurant with stronger (lower) health claims, i.e., Subway (McDonald's). Moreover, we also find that food deprivation levels moderate this effect, such that health risk underestimation is aggravated for individuals who suffer from food insufficiency. More precisely, we find that food insufficient individuals are more responsive to health claims, such that they perceive less health risk than food sufficient individuals for the restaurant with stronger health claims (Subway). Exploring the underlying mechanism of the latter effect, we found that dietary involvement mediates the relationship between food deprivation levels and health risk perceptions for the restaurant with stronger health claims (Subway). These results provide an interdisciplinary contribution in consumer psychology and public health. Copyright © 2015 Elsevier Ltd. All rights reserved.

Supplementary health insurance as a tool for risk-selection in mandatory basic health insurance markets.

PubMed

Paolucci, Francesco; Schut, Erik; Beck, Konstantin; Gress, Stefan; Van de Voorde, Carine; Zmora, Irit

2007-04-01

As the share of supplementary health insurance (SI) in health care finance is likely to grow, SI may become an increasingly attractive tool for risk-selection in basic health insurance (BI). In this paper, we develop a conceptual framework to assess the probability that insurers will use SI for favourable risk-selection in BI. We apply our framework to five countries in which risk-selection via SI is feasible: Belgium, Germany, Israel, the Netherlands, and Switzerland. For each country, we review the available evidence of SI being used as selection device. We find that the probability that SI is and will be used for risk-selection substantially varies across countries. Finally, we discuss several strategies for policy makers to reduce the chance that SI will be used for risk-selection in BI markets.

Fundamentals of health risk assessment. Use, derivation, validity and limitations of safety indices.

PubMed

Putzrath, R M; Wilson, J D

1999-04-01

We investigated the way results of human health risk assessments are used, and the theory used to describe those methods, sometimes called the "NAS paradigm." Contrary to a key tenet of that theory, current methods have strictly limited utility. The characterizations now considered standard, Safety Indices such as "Acceptable Daily Intake," "Reference Dose," and so on, usefully inform only decisions that require a choice between two policy alternatives (e.g., approve a food additive or not), decided solely on the basis of a finding of safety. Risk is characterized as the quotient of one of these Safety Indices divided by an estimate of exposure: a quotient greater than one implies that the situation may be considered safe. Such decisions are very widespread, both in the U.S. federal government and elsewhere. No current method is universal; different policies lead to different practices, for example, in California's "Proposition 65," where statutory provisions specify some practices. Further, an important kind of human health risk assessment is not recognized by this theory: this kind characterizes risk as likelihood of harm, given estimates of exposure consequent to various decision choices. Likelihood estimates are necessary whenever decision makers have many possible decision choices and must weigh more than two societal values, such as in EPA's implementation of "conventional air pollutants." These estimates can not be derived using current methods; different methods are needed. Our analysis suggests changes needed in both the theory and practice of human health risk assessment, and how what is done is depicted.

Arsenic: geochemical distribution and health risk in Italy

NASA Astrophysics Data System (ADS)

Zuzolo, Daniela; Cicchella, Domenico; Albanese, Stefano; Catani, Vittorio; Dinelli, Enrico; Lima, Annamaria; Valera, Paolo; De Vivo, Benedetto

2017-04-01

Characterization of risks to human health is determinant for risk management and population surveillance. This study represent the first work at national scale for Italy about arsenic occurrence, distribution and health impact. We analyzed the As geochemical distribution in different environmental matrices on the whole Italian territory, and assessed both carcinogenic and non-carcinogenic risks for different exposure routes and age groups. The results demonstrate that, in Italy, arsenic is present in significant concentrations both in water (up to 27.2 µg/L) and soils (up to 70 mg/kg). Its presence is mainly controlled by geological processes and locally reflects the industrial history of the Country. The population of the Central Italy, where high content of arsenic in the analyzed samples is due to the presence of alkaline volcanics, are the most exposed to the health risk. Based on the results of our work, it is clear that the consumption of tap water for potable use is the most impactful route for As daily exposure and play an important role in governing potential cancer and non-cancer risks for the considered population. It is interesting to observe that the Incremental Life Cancer Risk through water ingestion show that almost 80% of data falls above the internationally accepted benchmark value of 1 x 10-5. Moreover it was demonstrated that childhood is the most susceptible age stage to As exposure. Geochemical mapping provided a useful tool to spatially analyze and represent data and to highlight the most critic areas and the most exposed population to arsenic at national scale. In conclusion, this study improve knowledge about As occurrence for an entire Country, recognizing an health emerging problem. It might be a good starting point to support the urgently needed policy actions, in order to prevent and reduce the health risk. Moreover, the performed method in this case study research is potentially generalizable and applicable in other countries.

Uncertainties in estimating health risks associated with exposure to ionising radiation.

PubMed

Preston, R Julian; Boice, John D; Brill, A Bertrand; Chakraborty, Ranajit; Conolly, Rory; Hoffman, F Owen; Hornung, Richard W; Kocher, David C; Land, Charles E; Shore, Roy E; Woloschak, Gayle E

2013-09-01

The information for the present discussion on the uncertainties associated with estimation of radiation risks and probability of disease causation was assembled for the recently published NCRP Report No. 171 on this topic. This memorandum provides a timely overview of the topic, given that quantitative uncertainty analysis is the state of the art in health risk assessment and given its potential importance to developments in radiation protection. Over the past decade the increasing volume of epidemiology data and the supporting radiobiology findings have aided in the reduction of uncertainty in the risk estimates derived. However, it is equally apparent that there remain significant uncertainties related to dose assessment, low dose and low dose-rate extrapolation approaches (e.g. the selection of an appropriate dose and dose-rate effectiveness factor), the biological effectiveness where considerations of the health effects of high-LET and lower-energy low-LET radiations are required and the transfer of risks from a population for which health effects data are available to one for which such data are not available. The impact of radiation on human health has focused in recent years on cancer, although there has been a decided increase in the data for noncancer effects together with more reliable estimates of the risk following radiation exposure, even at relatively low doses (notably for cataracts and cardiovascular disease). New approaches for the estimation of hereditary risk have been developed with the use of human data whenever feasible, although the current estimates of heritable radiation effects still are based on mouse data because of an absence of effects in human studies. Uncertainties associated with estimation of these different types of health effects are discussed in a qualitative and semi-quantitative manner as appropriate. The way forward would seem to require additional epidemiological studies, especially studies of low dose and low dose

Therapeutic relationships, risk, and mental health practice.

PubMed

Felton, Anne; Repper, Julie; Avis, Mark

2018-06-01

Despite significant changes to mental health services, nurses remain the professional group most likely to be in close contact with people who experience mental health problems. A core part of the contemporary identity of the mental health nurse is one who is able to provide acceptance and support for an individual's recovery through the therapeutic relationship. Yet there have always been some tensions with the mental health nursing role that can appear to challenge this relational focus. An increasing prominence of risk management in mental health care can position mental health nurses as responsible for enacting restrictions and has reignited interest in the role of mental health professionals in social control. This paper reports on one part of a multiple case study, which aimed to explore mental health professionals' experiences of such tensions in the context of decision-making. Interviews and observations were undertaken in acute ward and assertive outreach settings. Findings suggested that risk dominated decision-making to such an extent it defined the way service users were understood and treated. A distant relationship between professionals and service users helped to create and maintain this situation. There needs to be a greater focus on service users' subjective experiences in the decision-making process to challenge the definition of people with mental health problems as risky. © 2017 Australian College of Mental Health Nurses Inc.

Risk assessment of vector-borne diseases for public health governance.

PubMed

Sedda, L; Morley, D W; Braks, M A H; De Simone, L; Benz, D; Rogers, D J

2014-12-01

In the context of public health, risk governance (or risk analysis) is a framework for the assessment and subsequent management and/or control of the danger posed by an identified disease threat. Generic frameworks in which to carry out risk assessment have been developed by various agencies. These include monitoring, data collection, statistical analysis and dissemination. Due to the inherent complexity of disease systems, however, the generic approach must be modified for individual, disease-specific risk assessment frameworks. The analysis was based on the review of the current risk assessments of vector-borne diseases adopted by the main Public Health organisations (OIE, WHO, ECDC, FAO, CDC etc…). Literature, legislation and statistical assessment of the risk analysis frameworks. This review outlines the need for the development of a general public health risk assessment method for vector-borne diseases, in order to guarantee that sufficient information is gathered to apply robust models of risk assessment. Stochastic (especially spatial) methods, often in Bayesian frameworks are now gaining prominence in standard risk assessment procedures because of their ability to assess accurately model uncertainties. Risk assessment needs to be addressed quantitatively wherever possible, and submitted with its quality assessment in order to enable successful public health measures to be adopted. In terms of current practice, often a series of different models and analyses are applied to the same problem, with results and outcomes that are difficult to compare because of the unknown model and data uncertainties. Therefore, the risk assessment areas in need of further research are identified in this article. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Development of a flood-induced health risk prediction model for Africa

NASA Astrophysics Data System (ADS)

Lee, D.; Block, P. J.

2017-12-01

Globally, many floods occur in developing or tropical regions where the impact on public health is substantial, including death and injury, drinking water, endemic disease, and so on. Although these flood impacts on public health have been investigated, integrated management of floods and flood-induced health risks is technically and institutionally limited. Specifically, while the use of climatic and hydrologic forecasts for disaster management has been highlighted, analogous predictions for forecasting the magnitude and impact of health risks are lacking, as is the infrastructure for health early warning systems, particularly in developing countries. In this study, we develop flood-induced health risk prediction model for African regions using season-ahead flood predictions with climate drivers and a variety of physical and socio-economic information, such as local hazard, exposure, resilience, and health vulnerability indicators. Skillful prediction of flood and flood-induced health risks can contribute to practical pre- and post-disaster responses in both local- and global-scales, and may eventually be integrated into multi-hazard early warning systems for informed advanced planning and management. This is especially attractive for areas with limited observations and/or little capacity to develop flood-induced health risk warning systems.

Occupational Risks and Exposures Among Wildlife Health Professionals.

PubMed

Garland-Lewis, Gemina; Whittier, Christopher; Murray, Suzan; Trufan, Sally; Rabinowitz, Peter M

2017-03-01

Most emerging infectious diseases are zoonotic in origin, with wildlife a frequent source of zoonotic disease events. Although individuals with extensive wildlife contact may be at the greatest risk of contracting novel infectious agents, the occupational risk of those working closely with wildlife has not been well studied. This study assessed the occupational exposures among wildlife health professionals working in multiple countries worldwide. An occupational risk survey of past and present exposures was developed and administered online in a confidential manner to wildlife workers recruited through an ongoing international wildlife pathogen surveillance project. Surveys were completed by 71 participants in 14 countries. Significant lifetime exposures reported included bites from bats and rodents and touching dead animals. Completion of training in occupational safety was reported by 75% of respondents. While gloves were used for most tasks, use of N95 respirators and other personal protective equipment varied by task. Eighty percent of workers reported rabies vaccination. Some respondents indicated interest in enhanced occupational health services targeting their unique needs. Wildlife workers represent an occupational population at risk of zoonotic infection and injury. Enhanced occupational health services targeting wildlife workers could reduce the risk and sequelae of zoonotic exposure and infection.

Application of epigenetic data in human health risk assessment.

PubMed

Cote, Ila L; McCullough, Shaun D; Hines, Ronald N; Vandenberg, John J

2017-11-06

Despite the many recent advances in the field of epigenetics, application of this knowledge in environmental health risk assessment has been limited. In this paper, we identify opportunities for application of epigenetic data to support health risk assessment. We consider current applications and present a vision for the future.

Multi-risk infants: predicting attachment security from sociodemographic, psychosocial, and health risk among African-American preterm infants.

PubMed

Candelaria, Margo; Teti, Douglas M; Black, Maureen M

2011-08-01

Ecological and transactional theories link child outcomes to accumulated risk. This study hypothesized that cumulative risk was negatively related to attachment, and that maternal sensitivity mediated linkages between risk and attachment. One hundred and twelve high-risk African-American premature infant-mother dyads participated. Psychosocial (maternal depression, stress and self-efficacy) and sociodemographic risk (poverty, maternal education, marital status) were maternal self-report (0-4 months). Infant health risk was obtained from hospital charts. Infant-mother attachment (12 months) and maternal sensitivity (4 months) were assessed with Q-sort measures. Psychosocial and sociodemographic risk, but not infant health risk, negatively related to attachment. Both were mediated by maternal sensitivity. The impact of risk domains on attachment security was mediated by maternal sensitivity. Results emphasize the need for early intervention programs targeting premature infants to identify and address environmental and personal factors that place parenting at risk. © 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health.

A novel community-based model to enhance health promotion, risk factor management and chronic disease prevention.

PubMed

Carson, Shannon Ryan; Carr, Caroline; Kohler, Graeme; Edwards, Lynn; Gibson, Rick; Sampalli, Tara

2014-01-01

Chronic disease is a highly expensive but preventable problem to the healthcare system. Evidence suggests that impacting modifiable behaviours and risk management factors in the areas of physical inactivity, unhealthy diet, stress and obesity can alleviate the burden of chronic disease problem to a large extent. Despite this recognition, the challenge is embedding these recognized priorities into the community and in primary care in a sustainable and meaningful manner. Primary Health Care in Capital Health responded to this challenge by developing and implementing a free, interprofessional and community-based service, namely, the Community Health Teams (CHTs), that offers health and wellness, risk factor management, wellness navigation and behaviour-based programming. In this paper, the development and implementation of the CHTs are discussed. Preliminary outcomes for the model are significant and promising. Formal and large-scale studies are planned to validate these outcomes with additional research rigour. Copyright © 2014 Longwoods Publishing.

Relationship between number of sexual intercourse partners and selected health risk behaviors among public high school adolescents.

PubMed

Valois, R F; Oeltmann, J E; Waller, J; Hussey, J R

1999-11-01

To examine the relationship between number of sexual partners and selected health risk behaviors in a statewide sample of public high school students. The Centers for Disease Control and Prevention Youth Risk Behavior Survey was used to secure usable sexual risk-taking, substance use, and violence/aggression data from 3805 respondents. Because simple polychotomous logistic regression analysis revealed a significant Race x Gender interaction, subsequent multivariate models were constructed separately for each race-gender group. Odds ratios and 95% confidence intervals was calculated from polychotomous logistic regression models for number of sexual intercourse partners and their potential risk behavior correlates. An increased number of sexual intercourse partners were correlated with a cluster of risk behaviors that place adolescents at risk for unintended pregnancy, human immunodeficiency virus/acquired immunodeficiency syndrome, and other sexually transmitted infections. For Black females, alcohol, tobacco, marijuana use, and dating violence behaviors were the strongest predictors of an increased number of sexual partners; white females had similar predictors with the addition of physical fighting. For white males, alcohol, tobacco, marijuana use, physical fighting, carrying weapons, and dating violence were the strongest predictors of an increased number of sexual intercourse partners. Black males had similar predictors with the addition of binge alcohol use. Prevention of adolescent sexual and other health risk behaviors calls for creative approaches in school and community settings and will require long-term intervention strategies focused on adolescent behavior changes and environmental modifications.

Risk management: FIFA's approach for protecting the health of football players.

PubMed

Fuller, Colin W; Junge, Astrid; Dvorak, Jiri

2012-01-01

Sport and exercise have long-term health benefits, but there is also a risk that participants will sustain injuries and/or ill health from these activities. For this reason, international sports governing bodies have a responsibility to identify the risks that exist within their sport and to provide guidance to participants and other stakeholders on how these risks can be controlled within acceptable levels. To demonstrate how Fédération Internationale de Football Association (FIFA), as football's governing body, uses a risk management framework to identify, quantify, mitigate and communicate the risks of injury and ill health in football for men, women and children in all environments. All the research papers published by FIFA's Medical Assessment and Research Centre (F-MARC) during the period 1994 to 2011 were reviewed and categorised according to an established sport-related risk management framework. F-MARC investigated and mitigated 17 areas of risk to footballers' health in a coherent and consistent approach through the process of risk management.

Spatial Distribution, Sources Apportionment and Health Risk of Metals in Topsoil in Beijing, China.

PubMed

Sun, Chunyuan; Zhao, Wenji; Zhang, Qianzhong; Yu, Xue; Zheng, Xiaoxia; Zhao, Jiayin; Lv, Ming

2016-07-20

In order to acquire the pollution feature and regularities of distribution of metals in the topsoil within the sixth ring road in Beijing, a total of 46 soil samples were collected, and the concentrations of twelve elements (Nickel, Ni, Lithium, Li, Vanadium, V, Cobalt, Co, Barium, Ba, Strontium, Sr, Chrome, Cr, Molybdenum, Mo, Copper, Cu, Cadmium, Cd, Zinc, Zn, Lead, Pb) were analyzed. Geostatistics and multivariate statistics were conducted to identify spatial distribution characteristics and sources. In addition, the health risk of the analyzed heavy metals to humans (adult) was evaluated by an U.S. Environmental Protection Agency health risk assessment model. The results indicate that these metals have notable variation in spatial scale. The concentration of Cr was high in the west and low in the east, while that of Mo was high in the north and low in the south. High concentrations of Cu, Cd, Zn, and Pb were found in the central part of the city. The average enrichment degree of Cd is 5.94, reaching the standard of significant enrichment. The accumulation of Cr, Mo, Cu, Cd, Zn, and Pb is influenced by anthropogenic activity, including vehicle exhaustion, coal burning, and industrial processes. Health risk assessment shows that both non-carcinogenic and carcinogenic risks of selected heavy metals are within the safety standard and the rank of the carcinogenic risk of the four heavy metals is Cr > Co > Ni > Cd.

Spatial Distribution, Sources Apportionment and Health Risk of Metals in Topsoil in Beijing, China

PubMed Central

Sun, Chunyuan; Zhao, Wenji; Zhang, Qianzhong; Yu, Xue; Zheng, Xiaoxia; Zhao, Jiayin; Lv, Ming

2016-01-01

In order to acquire the pollution feature and regularities of distribution of metals in the topsoil within the sixth ring road in Beijing, a total of 46 soil samples were collected, and the concentrations of twelve elements (Nickel, Ni, Lithium, Li, Vanadium, V, Cobalt, Co, Barium, Ba, Strontium, Sr, Chrome, Cr, Molybdenum, Mo, Copper, Cu, Cadmium, Cd, Zinc, Zn, Lead, Pb) were analyzed. Geostatistics and multivariate statistics were conducted to identify spatial distribution characteristics and sources. In addition, the health risk of the analyzed heavy metals to humans (adult) was evaluated by an U.S. Environmental Protection Agency health risk assessment model. The results indicate that these metals have notable variation in spatial scale. The concentration of Cr was high in the west and low in the east, while that of Mo was high in the north and low in the south. High concentrations of Cu, Cd, Zn, and Pb were found in the central part of the city. The average enrichment degree of Cd is 5.94, reaching the standard of significant enrichment. The accumulation of Cr, Mo, Cu, Cd, Zn, and Pb is influenced by anthropogenic activity, including vehicle exhaustion, coal burning, and industrial processes. Health risk assessment shows that both non-carcinogenic and carcinogenic risks of selected heavy metals are within the safety standard and the rank of the carcinogenic risk of the four heavy metals is Cr > Co > Ni > Cd. PMID:27447657

Spatial Analysis of Human Health Risk Due to Arsenic Exposure through Drinking Groundwater in Taiwan’s Pingtung Plain

PubMed Central

Liang, Ching-Ping; Chien, Yi-Chi; Jang, Cheng-Shin; Chen, Ching-Fang; Chen, Jui-Sheng

2017-01-01

Chronic arsenic (As) exposure continues to be a public health problem of major concern worldwide, affecting hundreds of millions of people. A long-term groundwater quality survey has revealed that 20% of the groundwater in southern Taiwan’s Pingtung Plain is clearly contaminated with a measured As concentration in excess of the maximum level of 10 µg/L recommended by the World Health Organization. The situation is further complicated by the fact that more than half of the inhabitants in this area continue to use groundwater for drinking. Efforts to assess the health risk associated with the ingestion of As from the contaminated drinking water are required in order to determine the priorities for health risk management. The conventional approach to conducting a human health risk assessment may be insufficient for this purpose, so this study adopts a geostatistical Kriging method to perform a spatial analysis of the health risk associated with ingesting As through drinking groundwater in the Pingtung Plain. The health risk is assessed based on the hazard quotient (HQ) and target cancer risk (TR) established by the U.S. Environmental Protection Agency. The results show that most areas where the HQ exceeds 1 are in the southwestern part of the study area. In addition, the high-population density townships of Daliao, Linyuan, Donggang, Linbian, Jiadong, and Fangliao presently have exceedingly high TR values that are two orders of magnitude higher than the acceptable standard. Thus, the use of groundwater for drinking in these townships should be strictly avoided. A map that delineates areas with high TR values and high population densities is provided. The findings broaden the scope of the spatial analysis of human health risk and provide a basis for improving the decision-making process. PMID:28098817