Suchergebnisse

AbstractThe health impacts associated with exposure to elevated concentrations of fine particulate matter (PM2.5) are well recognised. There is a substantial number of studies characterising PM2.5 concentrations outdoors, as well as in homes within low- and middle-income countries. In high-income countries (HICs), there is a sizeable literature on indoor PM2.5 relating to smoking, but the evidence on exposure to PM2.5 generated from non-tobacco sources in homes is sparse. This is especially relevant as people living in HICs spend the majority of their time at home, and in the northern hemisphere households often have low air exchange rates for energy efficiency. This review identified 49 studies that described indoor PM2.5 concentrations generated from a variety of common household sources in real-life home settings in HICs. These included wood/solid fuel burning appliances, cooking, candles, incense, cleaning and humidifiers. The reported concentrations varied widely, both between sources and within groups of the same source. The burning of solid fuels was found to generate the highest indoor PM2.5 concentrations. On occasion, other sources were also reported to be responsible for high PM2.5 concentrations; however, this was only in a few select examples. This review also highlights the many inconsistencies in the ways data are collected and reported. The variable methods of measurement and reporting make comparison and interpretation of data difficult. There is a need for standardisation of methods and agreed contextual data to make household PM2.5 data more useful in epidemiological studies and aid comparison of the impact of different interventions and policies.

Abstract

Introduction
Despite world-leading measures in place to protect employees from second-hand smoke exposure in workplaces in the United Kingdom, workers who deliver health and social care in private homes remain unprotected legally in this setting from second-hand smoke exposure (SHS).


Methods
Fourteen individuals took part in either an in-depth telephone interview (n = 11) or an online focus group discussion (n = 3), including home-care workers (n = 5) and managers (n = 5) based in Lanarkshire (Scotland) and local/national policy makers (n = 4). Participants were asked about the extent to which exposure to SHS is an issue during home visits and possible additional measures that could be put in place to eliminate exposure.


Results
Participants highlighted the difficulties in balancing the provision of care in a person's own home with the right of workers to be able to breathe clean air and be protected from SHS. Current strategies to reduce staff exposure to SHS during home visits were often reported as inadequate with SHS not a hazard considered by managers beyond protecting pregnant staff or those with pre-existing respiratory conditions such as asthma. Simple respiratory protective equipment (as used during the COVID-19 pandemic) was rightly identified as being ineffective. Methods such as nicotine replacement therapy and e-cigarettes were identified as potential ways to help people who smoke achieve temporary asbstinence prior to a home visit.


Conclusion
Implementing appropriate and proportionate measures to protect home-care workers from the harms posed by SHS should be a priority to help protect the health of this often overlooked occupational group.

Abstract
Exposure to second-hand tobacco smoke (SHS) in the workplace has been largely controlled in most workplaces in many countries that have adopted smoke-free laws and regulations. Workers in offices, bars, restaurants, and many other settings have experienced substantial reductions in the frequency and intensity of their exposure to SHS. While current exposure to SHS of most non-smoking adults arises from living with a smoker there are likely to be some jobs where non-negligible exposure to SHS continues to occur. This study describes the development of a simple job exposure matrix (JEM) for SHS exposure for the UK working population in 2020 and identifies that at least 1.04 million workers are likely to be exposed to SHS while performing their job. Occupations with the highest frequency and intensity of exposure include those where workers carry out work tasks in private, domestic settings: including care workers and home carers. This SHS-JEM provides a novel method for assessing occupational exposure to SHS in other countries, and can act as a tool to identify priorities for policies to protect those workers who continue to be at risk from SHS.

Abstract

Objectives
Second-hand tobacco smoke (SHS) is a serious cause of ill-health, and concern around SHS exposure at work has driven legislation in public places. In Scotland, most workers are now protected from SHS at work. However, home care workers (HCWs) may still be exposed, as they enter private homes where smoking is unregulated. In this study, we aimed to understand the extent, duration and intensity of that exposure among HCWs in Lanarkshire, Scotland.


Methods
We surveyed HCWs in four organisations involved in providing care at home: a public healthcare agency (NHS Lanarkshire), two local government entities and a private healthcare company. We also conducted personal exposure monitoring (PEM) of exposure to airborne nicotine and SHS-related fine particulate matter (PM2.5) with 32 HCWs.


Results
The vast majority of HCWs surveyed reported being exposed to SHS at work (395/537, 74%), and 50% of those who reported exposure in the home indicated daily exposure. We conducted PEM over 82 home visits, with 21% (17) demonstrating PM2.5 concentrations in excess of the WHO's 2010 air quality guideline limit for 24 h exposure. Duration of exposure to SHS tended to be short and as a result all nicotine samples were below the limit of quantification.


Conclusions
Most HCWs are exposed to minimal levels of SHS at work. However, a minority may be exposed to concentrations which affect health. Policies to mitigate this exposure should be considered, such as the use of respiratory protective equipment, improved ventilation during visits, and interventions to reduce smoking in homes.

The authors acknowledge the support provided by the European Union through the African Component of the ACP Research Programme for Sustainable Development as well as the African Union Commission (No. AURG/2/058/2012). Furthermore we are grateful to Afri-Flame network, Esther Pedie, Thierry Tame, Niccolo Merigi and Jelte Harnmeijer for their collaboration, contributing their knowledge, experiences and opinions. ; Peer reviewed ; Postprint

Abstract

Background
Use of pesticides has been linked to neurobehavioral deficits among exposed workers. In Malaysia, organophosphate and pyrethroid pesticides are commonly used to control mosquito-borne diseases.


Objectives
This study aims to assess workers' lifetime occupational pesticide exposure and examine the relationship with neurobehavioral health.


Methods
A cross-sectional study was conducted on 158 pesticide-exposed and 176 non-exposed workers. To collect historical exposure and job tasks, a questionnaire and an occupational history interview were used. Pesticide exposure was measured in a subgroup of workers via inhalation and skin contact. The total pesticide intake of each worker was assessed using inhalation and dermal exposure models. CANTAB® computerised neurobehavioral performance assessments were used.


Results
The participants' mean age was 31 (8) years. Pirimiphos-methyl (median = 0.569 mg/m3, Interquartile range [IQR] = 0.151, 0.574) and permethrin (median = 0.136 mg/m3, IQR = 0.116, 0.157) had the highest measured personal inhalation concentrations during thermal spraying. The estimated total lifetime pesticide intake for exposed workers ranged from 0.006 g to 12800 g (median = 379 g and IQR = 131, 794 g). Dermal exposure was the predominant route of pesticide intake for all workers. Compared to controls, workers with high lifetime pesticide intake had lower Match to Sample Visual (adjusted B = −1.4, 95% Confidence Interval (CI) = −2.6, 0.1), Spatial Recognition Memory (adjusted B = −3.3, 95% CI = −5.8, 0.8), Spatial Span (SSP) (adjusted B = −0.6, 95% CI = −0.9, 0.3) scores. Workers with low pesticide intake performed worse than controls (adjusted B = −0.5, 95% CI = −0.8, −0.2) in the SSP test, but scored higher in the Motor Screening test (adjusted B = 0.9, 95% CI = 0.1, 1.6). Higher Paired Associates Learning test scores were observed among higher (adjusted B = 7.4, 95% CI = 2.3, 12.4) and lower (adjusted B = 8.1, 95% CI = 3, 13.2) pesticide intake groups. There was no significant difference between the Reaction Time and Pattern Recognition Memory tests with lifetime pesticide intake after adjusting for confounders.


Conclusion
Pesticide exposure has been linked to poorer neurobehavioral performance. As dermal exposure accounts for a major fraction of total intake, pesticide prevention should focus on limiting dermal exposure.

Following restrictions on smoking in vehicles carrying children in several countries, legislation to safeguard minors from second-hand smoke exposure in vehicles is under-consideration or has been implemented across the United Kingdom. This article presents the first investigation into social constructions of children, smokers and smoking parents in newsprint media and coverage of debates about protecting children from exposure to second-hand smoke in vehicles. Using Scotland as an example, articles on children's exposure to second-hand smoke published between 1 January 2004 and 16 February 2014 in three Scottish newspapers were identified using Nexis UK. In all, 131 articles were thematically coded and analysed. Children were portrayed as vulnerable and requiring protection, with few articles highlighting children's ability to voice concerns about the dangers of smoking. Smokers and smoking parents were mainly portrayed in a factual manner, but also frequently as irresponsible and, in some cases, intentionally imposing harm. Individual smokers were blamed for their recklessness, with only a small number of articles mentioning the need to assist smokers in quitting. Supporters of legislation focused on corresponding discourse, whereas critics directed debates towards established arguments against policy, including individual freedom, privacy and problems of enforcement. Focusing on children's vulnerability to second-hand smoke might have increased support for legislation but risked a side effect of smokers being stigmatised. The media and supporters of public health policy are encouraged to consider appropriate approaches to raise awareness of the health harms of second-hand smoke to children while avoiding unintended stigmatisation of those in which they want to encourage behaviour change.

Following restrictions on smoking in vehicles carrying children in several countries, legislation to safeguard minors from second-hand smoke exposure in vehicles is under-consideration or has been implemented across the United Kingdom. This article presents the first investigation into social constructions of children, smokers and smoking parents in newsprint media and coverage of debates about protecting children from exposure to second-hand smoke in vehicles. Using Scotland as an example, articles on children's exposure to second-hand smoke published between 1 January 2004 and 16 February 2014 in three Scottish newspapers were identified using Nexis UK. In all, 131 articles were thematically coded and analysed. Children were portrayed as vulnerable and requiring protection, with few articles highlighting children's ability to voice concerns about the dangers of smoking. Smokers and smoking parents were mainly portrayed in a factual manner, but also frequently as irresponsible and, in some cases, intentionally imposing harm. Individual smokers were blamed for their recklessness, with only a small number of articles mentioning the need to assist smokers in quitting. Supporters of legislation focused on corresponding discourse, whereas critics directed debates towards established arguments against policy, including individual freedom, privacy and problems of enforcement. Focusing on children's vulnerability to second-hand smoke might have increased support for legislation but risked a side effect of smokers being stigmatised. The media and supporters of public health policy are encouraged to consider appropriate approaches to raise awareness of the health harms of second-hand smoke to children while avoiding unintended stigmatisation of those in which they want to encourage behaviour change. © 2016, © The Author(s) 2016.

Following restrictions on smoking in vehicles carrying children in several countries, legislation to safeguard minors from second-hand smoke exposure in vehicles is under-consideration or has been implemented across the United Kingdom. This article presents the first investigation into social constructions of children, smokers and smoking parents in newsprint media and coverage of debates about protecting children from exposure to second-hand smoke in vehicles. Using Scotland as an example, articles on children's exposure to second-hand smoke published between 1 January 2004 and 16 February 2014 in three Scottish newspapers were identified using Nexis UK. In all, 131 articles were thematically coded and analysed. Children were portrayed as vulnerable and requiring protection, with few articles highlighting children's ability to voice concerns about the dangers of smoking. Smokers and smoking parents were mainly portrayed in a factual manner, but also frequently as irresponsible and, in some cases, intentionally imposing harm. Individual smokers were blamed for their recklessness, with only a small number of articles mentioning the need to assist smokers in quitting. Supporters of legislation focused on corresponding discourse, whereas critics directed debates towards established arguments against policy, including individual freedom, privacy and problems of enforcement. Focusing on children's vulnerability to second-hand smoke might have increased support for legislation but risked a side effect of smokers being stigmatised. The media and supporters of public health policy are encouraged to consider appropriate approaches to raise awareness of the health harms of second-hand smoke to children while avoiding unintended stigmatisation of those in which they want to encourage behaviour change.

Abstract Background Mass media representations of health issues influence public perceptions of those issues. Despite legislation prohibiting smoking in public spaces, second-hand smoke (SHS) remains a health risk in the United Kingdom (UK). Further legislation might further limit children's exposure to SHS by prohibiting smoking in private vehicles carrying children. This research was designed to determine how UK national newspapers represented the debate around proposed legislation to prohibit smoking in private vehicles carrying children. Methods Quantitative analysis of the manifest content of 422 articles about children and SHS published in UK and Scottish newspapers between 1st January 2003 and 16th February 2014. Researchers developed a coding frame incorporating emergent themes from the data. Each article was double-coded. Results The frequency of relevant articles rose and fell in line with policy debate events. Children were frequently characterised as victims of SHS, and SHS was associated with various health risks. Articles discussing legislation targeting SHS in private vehicles carrying children presented supportive arguments significantly more frequently than unsupportive arguments. Conclusions The relatively positive representation of legislation prohibiting smoking in vehicles carrying children is favourable to policy advocates, and potentially indicative of likely public acceptance of legislation. Our findings support two lessons that public health advocates may consider: the utility of presenting children as a vulnerable target population, and the possibility of late surges in critical arguments preceding policy events.

Support statement: This work was funded in its entirety by a project grant awarded by the Chief Scientist's Office of the Scottish Government Health Dept (CZG/2/573). The funding source had no role in the study design, data collection, analysis, and interpretation, in preparation of the manuscript, or the decision to submit it for publication. ; Peer reviewed ; Publisher PDF

Background Mass media representations of health issues influence public perceptions of those issues. Despite legislation prohibiting smoking in public spaces, second-hand smoke (SHS) remains a health risk in the United Kingdom (UK). Further legislation might further limit children's exposure to SHS by prohibiting smoking in private vehicles carrying children. This research was designed to determine how UK national newspapers represented the debate around proposed legislation to prohibit smoking in private vehicles carrying children. Methods Quantitative analysis of the manifest content of 422 articles about children and SHS published in UK and Scottish newspapers between 1st January 2003 and 16th February 2014. Researchers developed a coding frame incorporating emergent themes from the data. Each article was double-coded. Results The frequency of relevant articles rose and fell in line with policy debate events. Children were frequently characterised as victims of SHS, and SHS was associated with various health risks. Articles discussing legislation targeting SHS in private vehicles carrying children presented supportive arguments significantly more frequently than unsupportive arguments. Conclusions The relatively positive representation of legislation prohibiting smoking in vehicles carrying children is favourable to policy advocates, and potentially indicative of likely public acceptance of legislation. Our findings support two lessons that public health advocates may consider: the utility of presenting children as a vulnerable target population, and the possibility of late surges in critical arguments preceding policy events.

Second-hand tobacco smoke (SHS) exposure generates a large public health burden. Recent legislation has moved to prohibit smoking in public places and there are concerns that this may lead to an increase in exposures in private homes. Measurement of SHS aerosol has tended to use active pumped samples or longer-term diffusive badges. Pumped methods are noisy and poorly tolerated in home settings while diffusive badges do not provide real-time data. The UCB particle monitor (UCB-PM) is a modified smoke-alarm device capable of logging changes in airborne particulate matter over extended periods and has been used successfully to measure biomass fuel smoke concentrations in developing world settings This study has examined the use of the UCB-PM to measure SHS aerosol in both controlled laboratory conditions and a pilot field trial over a 7 day period in a smoker's home. Comparisons with a pumped sampler (TSI Sidepak Personal Aerosol Monitor) indicate good agreement over a range of exposure concentrations but there is evidence of a threshold effect at approximately 0.5 mg/m3 of fine particulate measured as PM2.5. While this threshold effect undermines the ability of the device to provide useful data on the time-weighted average SHS concentration, the field trial indicates that that the UCB-PM has a sensitivity of about 71% and a specificity of 98%. The device has many advantages including zero noise operation, low cost and long battery life and may be a useful tool in quitting and smoke-free home intervention studies.