Publications by authors named "Gabriele Bolte"

69 Publications

Built and socioeconomic neighbourhood environments and overweight in preschool aged children. A multilevel study to disentangle individual and contextual relationships.

Environ Res 2016 10 21;150:328-336. Epub 2016 Jun 21.

Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany.

Background: Structural factors of neighbourhood environments in which children live have attracted increasing attention in epidemiological research. This study investigated whether neighbourhood socioeconomic position (SEP), public playground and park space, and perceived environmental exposures were independently associated with overweight in preschool aged children while simultaneously considering individual child and family factors.

Methods: Body-Mass-Index (BMI) data from 3499 children (53% boys and 47% girls) from three surveys between 2004 and 2007 from 18 school enrolment zones in the city of Munich, Germany, were analysed with hierarchical logistic regression models. An index of neighbourhood SEP was calculated with principal component analysis. Individual socioeconomic data, parental BMI, birth weight, housing characteristics, and perceived annoyance due to exposures to noise, air pollution, lack of greenspace, and traffic were collected with parental questionnaires. Measures of age-specific playground space and availability of park space derived from Geographic Information System were additionally weighted with age-specific population data.

Results: In bivariate analysis perceived annoyance due to exposures to noise or lack of greenspace, high frequency of lorries, traffic jam, living in a multiple dwelling or next to a main road, low neighbourhood SEP, and low playground space were significantly associated with overweight. However, in multivariate analysis only living in a multiple dwelling was independently associated with overweight. From the considered individual child and family factors low parental education, parental overweight or obesity, and a high birthweight showed an independent relation to overweight.

Conclusions: Our study identified individual child and parental factors, and living in a multiple dwelling as the strongest predictors for overweight in preschool aged children. However, perceived annoyance to built environmental exposures additionally explained overweight variance between neighbourhoods. Based on our findings interventions and policies addressing overweight prevention in young children should focus on parental behaviours and the immediate home environment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.envres.2016.06.024DOI Listing
October 2016

Gender inequalities in mental wellbeing in 26 European countries: do welfare regimes matter?

Eur J Public Health 2016 10 3;26(5):872-876. Epub 2016 Jun 3.

Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany.

Background: Nature and extent of welfare regimes and social policies are important determinants of health and health inequalities. This study examines the association of gender and mental wellbeing in European countries and investigates whether type of welfare regime plays a role in this association.

Method: Data of 19 366 women and 14 338 men of the third round of the European Quality of Life Survey (2011-12) was used to analyse mental wellbeing, assessed by the World Health Organization 5-Mental Wellbeing Index. Multilevel logistic regression analyses were performed to analyse the association between gender and good mental wellbeing first at country-level, and secondly the between country variation was analysed and welfare regimes were included as explanatory variables.

Results: We observed cross-national variation in good mental wellbeing. At country levels gender inequalities in good mental wellbeing were observed in 7 out of 26 countries. In analyses considering all countries together gender inequalities in good mental wellbeing were identified independent of further individual socio-demographic variables and independent of the welfare regimes that people lived in [women vs. men: OR = 0.76; (95% CI = 0.71-0.81)]. Gender inequalities in good mental wellbeing were not modified by welfare regimes.

Conclusion: There are cross-national differences in good mental wellbeing between European countries. Gender inequalities with a lower prevalence of good mental wellbeing among women are common in European countries. This study suggests that welfare regimes do not modify these gender inequalities in mental wellbeing.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/eurpub/ckw074DOI Listing
October 2016

Neighbourhood socioeconomic context, individual socioeconomic position, and overweight in young children: a multilevel study in a large German city.

BMC Obes 2016 6;3:25. Epub 2016 May 6.

Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany.

Background: The context of the close neighbourhood environment in which children live has gained increasing attention in epidemiological research. This study aimed to investigate if contextual neighbourhood socioeconomic position (SEP) was independently associated with overweight in young children aged 5-7 years while simultaneously considering a wide range of individual socioeconomic determinants and known risk factors for overweight.

Methods: Objectively measured body mass index (BMI) data from 3499 children (53 % boys and 47 % girls) from three surveys between 2004 and 2007 clustered in 18 school enrolment zones in the city of Munich, Germany, were analysed with hierarchical logistic regression models. An index of neighbourhood SEP was calculated with principal component analysis using aggregated data. Individual socioeconomic data, maternal BMI, and birth weight were collected with parental questionnaires. We analysed how much of the between neighbourhood variance of overweight was attributable to individual factors and how much was explained by neighbourhood SEP.

Results: The prevalence of overweight, including obesity, was 14.1 %. In the final adjusted model low neighbourhood SEP was independently associated with overweight (odds ratio (OR) = 1.42, 95 % confidence interval (CI) = 1.00-2.00) compared to high neighbourhood SEP. On the individual level low parental education (OR = 1.99, 95 % CI = 1.49-2.65) or middle parental education (OR = 1.50, 95 % CI = 1.16-1.95) compared to high parental education and nationality of the child other than German (OR = 1.53, 95 % CI = 1.17-1.99) compared to German nationality were independently associated with overweight.

Conclusions: Whereas individual determinants were the main drivers in explaining between neighbourhood variance, neighbourhood SEP additionally explained differences in overweight between neighbourhoods. Thus, considering neighbourhood context in intervention planning could result in more effective strategies compared to measures only focusing on individual determinants of overweight.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s40608-016-0106-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859982PMC
May 2016

Association of sociodemographic and environmental factors with the mental health status among preschool children-Results from a cross-sectional study in Bavaria, Germany.

Int J Hyg Environ Health 2016 07 29;219(4-5):458-67. Epub 2016 Apr 29.

Department of Occupational and Environmental Health/Epidemiology, Bavarian Health and Food Safety Authority, Pfarrstr. 3, 80538 Munich, Germany.

Aim: It has been reported that a great proportion of mental health disorders have an origin in early childhood. In order to evaluate factors possibly associated with children's health, the health monitoring units have been established since 2004 in six study regions in Bavaria, Germany. The second health monitoring survey, implemented in 2005-06, focuses on the mental health status of preschool children. The goal of this study is (1) to examine the association of sociodemographic and environmental factors with mental health and (2) to analyze the applicability of the results of the health monitoring units to all preschool children in Bavaria by calculating weighting factors.

Methods: Data on 6206 preschool children are available. Logistic regression analysis is applied to analyze possible associations with mental health. A weighting method is applied to correct for deviances compared to the whole population of preschool children in Bavaria (N=132,783).

Results: 11% of preschool children show mental health problems. Regarding different indicators of sociodemographic status, low household income [unadjusted OR 3.34, 95% CI: 2.23-4.98] shows the strongest association of mental health problems. Non-accessibility of green space [unadjusted OR 2.74, 95% CI: 1.87-4.00] is also strongly associated with mental health. The results of the unweighted and weighted analysis are similar.

Conclusion: Our findings suggest that sociodemographic status and factors in the living environment show associations with mental health of children. Based on the results of the unweighted and weighted analyses, the second health monitoring analysis shows little deviances compared to data of all Bavarian preschool children. Therefore, the results can be compared to all Bavarian preschool children.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijheh.2016.04.012DOI Listing
July 2016

[Predictors of Health-related Quality of Life in Bavarian Preschool Children].

Gesundheitswesen 2018 02 20;80(S 01):S1-S4. Epub 2016 Apr 20.

Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Sachgebiet Arbeits- und Umweltmedizin/Epidemiologie, München.

Background: Little data are available on health-related quality of life (HRQOL) of children in Germany at the age of school enrollment.

Objective: Aim of this study was to investigate the HRQOL of children during school enrollment and to determine its predictors with special focus on environmental factors.

Methods: Data from the fifth survey of the Health-Monitoring-Units (GME) conducted in Bavaria (2010/2011) were analyzed. Parent-reported data on HRQOL using the KINDL-R(evised), the Strength and Difficulties Questionnaire (SDQ), socio-demographic characteristics and characteristics of the living environment were assessed.

Results: The sample included a total of 3,744 children (45.9% female; mean age: 6.0; SD=0.4). Girls had significantly higher values than boys in total HRQOL (83.7 vs. 82.4, p ≤0.0001) and in all KINDL-R subscales except "psychological well-being" and "physical well-being". For the latter, boys had significantly higher values than girls (84.1 vs. 82.9, p=0.0103). Multiple linear regression analysis showed that parental annoyance with air or noise pollution, possibility for children to safely play outside and the time a child is outside on weekdays in the summertime were significant predictors of total HRQOL measured by the KINDL-R. Obesity was not linked to HRQOL. Children with migration background had significantly higher values in the subscales "family" and "friends".

Conclusions: Environmental factors are associated with HRQOL in children at the age of school enrollment but only partially of relevant use. Although they show significant associations, their explanatory power of the variability observed is rather limited.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1055/s-0042-104117DOI Listing
February 2018

No further increase in the parent reported prevalence of allergies in Bavarian preschool children: Results from three cross-sectional studies.

Int J Hyg Environ Health 2016 07 15;219(4-5):343-8. Epub 2016 Feb 15.

Department of Occupational and Environmental Epidemiology, Bavarian Health and Food Safety Authority, Pfarrstr. 3, 80538, Munich, Germany.

Background: After three decades of an increase in the prevalence of asthma and allergies, new findings show a plateau in the prevalence of industrialized nations. The objective of this study was to determine whether there was a change in the parent reported prevalence of asthma and allergies among Bavarian preschool children since 2004.

Methods: A parent questionnaire was administered as part of the Bavarian school entrance examination in three cross-sectional studies from 2004/2005, 2006/2007 and 2012/2013. The questionnaire included items on allergy testing history, identified allergens, symptoms (e.g. wheezing, itchy eyes, rash), medically diagnosed asthma, hay fever and atopic dermatitis. Logistic regression was performed to observe time patterns and adjust for risk factors.

Results: Data were available for 6350 (2004/2005), 6483 (2006/2007) and 5052 (2012/2013) individuals. Symptoms and diseases were more frequent in boys, except for allergies which affect the skin. From 2004 to 2012 the parent reported prevalence of asthma (2.6% to 2.8%), hay fever (4.7% to 4.0%) and atopic dermatitis (12.4% to 11.1%) either remained quite stable or decreased not significantly.

Conclusions: Results from these three cross-sectional surveys of parent reports suggest that the parent reported prevalences of asthma and allergies are quite stable with small fluctuations since 2004 for Bavarian preschool children. Future research is needed to determine if this trend will continue.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijheh.2016.02.001DOI Listing
July 2016

Equity impact of interventions to promote physical activity in older adults: protocol for a systematic review.

Syst Rev 2016 Feb 1;5:17. Epub 2016 Feb 1.

Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany.

Background: Public health strategies to promote physical activity among older adults are increasingly being implemented. However, it is not known whether these interventions are equally effective among all social groups of the older adult population. The objectives of the proposed systematic review are to (1) describe the extent to which effects on social inequalities are considered in studies evaluating the effectiveness of interventions to promote physical activity among older adults, (2) describe the methods used for measuring these effects, and (3) assess the implications of the equity related findings for health promotion research and practice.

Methods/design: MEDLINE, PsycINFO, CINAHL, CENTRAL, Physical Education Index, Social Science Citation Index, ASSIA, Sociological Abstracts, and IBSS databases as well as the German language journal Prävention und Gesundheitsförderung will be searched to identify experimental or observational quantitative studies evaluating the effects of interventions on self-reported or objectively measured physical activity among the general population of older adults (≥ 50 years). English or German language peer-reviewed journal articles published since 2005 will be included. Data on whether and how several social factors are considered for both the description of baseline characteristics of participants and for measuring intervention effectiveness will be extracted. The quality of studies will be assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Results will be presented in a narrative synthesis. If feasible, harvest plots will be used to synthesize evidence about how intervention effects vary between different social groups.

Discussion: This systematic review will provide evidence on what is known about the effects of interventions on social inequalities in physical activity among older adults, which is a prerequisite for the prioritization of those interventions most likely to be effective across all social groups of this target population. Therefore, the results of this review will be of major interest to researchers, policy makers, and practitioners in the area of physical activity promotion for older adults.

Systematic Review Registration: This protocol has been registered with the PROSPERO international prospective register of systematic reviews (PROSPERO 2015 CRD42015025066).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13643-016-0194-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4736241PMC
February 2016

Environmental noise and incident mental health problems: A prospective cohort study among school children in Germany.

Environ Res 2015 Nov 1;143(Pt A):49-54. Epub 2015 Oct 1.

Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Grazer Straße 4, 28359 Bremen, Germany; Health Sciences Bremen, University of Bremen, Germany; Bavarian Health and Food Safety Authority, Munich, Germany.

Background: Environmental noise is considered a threat to public health as 20% of the EU population is exposed to health influencing noise levels. An association of noise and mental health problems in children has been suggested by some studies, but results are not consistent and there are no longitudinal studies of this association. Our aim was to investigate the influence of different environmental noise sources at children's homes on incident mental health problems in school-aged children.

Method: A cohort study of children from first (t0) to fourth grade (t1) of primary school was conducted. Different environmental noise sources (day/night separately) at children's home were assessed via parental annoyance reports. Increased noise exposure between t0 and t1 was the exposure variable. Incident mental health problems were assessed with the parental version of the Strengths and Difficulties Questionnaire (SDQ). RRs and 95% CIs were analysed to investigate the association between different noise sources and incident mental health problems.

Results: The study population consisted of 583 boys and 602 girls. The most common increase in noise exposure between t0 and t1 was road traffic noise day (26.38%). After adjusting for covariates exposure to road traffic night was significantly associated with the total difficulties score (RR=2.06; 95% CI=1.25-3.40), emotional symptoms (RR=1.69, 95% CI=1.04-2.72), and conduct problems (RR=1.57, 95% CI=1.04-2.38). Noise by neighbours during the day was associated with conduct problems (RR=1.62, 95% CI=1.11-2.40) and hyperactivity (RR=1.69, 95% CI=1.08-2.65). Aircraft noise day and construction work day were not associated with any of the SDQ categories at a significant level.

Conclusion: Environmental noise is an important public health problem. This is the first study to investigate the association of a broad range of noise sources and incident mental health problems in children in a cohort study. Our results suggest that exposure to noise at children's home is associated with mental health problems such as emotional symptoms, conduct problems and hyperactivity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.envres.2015.08.003DOI Listing
November 2015

Total leisure noise exposure and its association with hearing loss among adolescents.

Int J Audiol 2015 23;54(10):665-73. Epub 2015 Apr 23.

a * Department of Occupational and Environmental Medicine and Epidemiology , Bavarian Health and Food Safety Authority , Munich , Germany.

Objective: To investigate total leisure noise exposure among adolescents and to assess its association with hearing.

Design: Based on self-reported time spent on 19 leisure activities and associated mean sound pressure levels reported in the literature, total leisure noise exposure was evaluated and compared to noise at work limits (> 85 dB(A) = hazardous) in a cross-sectional survey. Tympanometry and pure-tone audiometry was performed in sound isolated rooms.

Study Sample: The study sample consists of 2143 pupils attending grade nine in any school in a German city 2009-2011 (mean age: 15.4 years; range: 13-19 years). Audiometric data were available for 1837 (85.8%) pupils (53.9% girls).

Results: 41.9% of the 2143 adolescents who had provided self-reported data on leisure activities associated with noise exposure were estimated to be hazardously exposed to leisure time noise. The interaction of gender with total leisure time noise exposure was not significant. No association between leisure time noise exposure and audiometric notches could be detected.

Conclusion: While hearing loss seems seldom in this age group, a high proportion of adolescents aged 15-16 years are exposed to noise levels during leisure time bearing long-term risks of hearing loss.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/14992027.2015.1030510DOI Listing
June 2016

Interactive and independent associations between the socioeconomic and objective built environment on the neighbourhood level and individual health: a systematic review of multilevel studies.

PLoS One 2015 7;10(4):e0123456. Epub 2015 Apr 7.

Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany.

Background: The research question how contextual factors of neighbourhood environments influence individual health has gained increasing attention in public health research. Both socioeconomic neighbourhood characteristics and factors of the built environment play an important role for health and health-related behaviours. However, their reciprocal relationships have not been systematically reviewed so far. This systematic review aims to identify studies applying a multilevel modelling approach which consider both neighbourhood socioeconomic position (SEP) and factors of the objective built environment simultaneously in order to disentangle their independent and interactive effects on individual health.

Methods: The three databases PubMed, PsycINFO, and Web of Science were systematically searched with terms for title and abstract screening. Grey literature was not included. Observational studies from USA, Canada, Australia, New Zealand, and Western European countries were considered which analysed simultaneously factors of neighbourhood SEP and the objective built environment with a multilevel modelling approach. Adjustment for individual SEP was a further inclusion criterion.

Results: Thirty-three studies were included in qualitative synthesis. Twenty-two studies showed an independent association between characteristics of neighbourhood SEP or the built environment and individual health outcomes or health-related behaviours. Twenty-one studies found cross-level or within-level interactions either between neighbourhood SEP and the built environment, or between neighbourhood SEP or the built environment and individual characteristics, such as sex, individual SEP or ethnicity. Due to the large variation of study design and heterogeneous reporting of results the identification of consistent findings was problematic and made quantitative analysis not possible.

Conclusions: There is a need for studies considering multiple neighbourhood dimensions and applying multilevel modelling in order to clarify their causal relationship towards individual health. Especially, more studies using comparable characteristics of neighbourhood SEP and the objective built environment and analysing interactive effects are necessary to disentangle health impacts and identify vulnerable neighbourhoods and population groups.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0123456PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4388459PMC
April 2016

Material, psychosocial and sociodemographic determinants are associated with positive mental health in Europe: a cross-sectional study.

BMJ Open 2014 May 28;4(5):e005095. Epub 2014 May 28.

Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany.

Objectives: To investigate the association between psychosocial, sociodemographic and material determinants of positive mental health in Europe.

Design: Cross-sectional analysis of survey data.

Setting: 34 European countries.

Participants: Representative Europe-wide sample consisting of 21 066 men and 22 569 women aged 18 years and over, from 34 European countries participating in the third wave of the European Quality of Life Survey (2011-2012).

Outcome: Positive mental health as measured by the WHO-5-Mental Well-being Index, while the lowest 25% centile indicated poor positive mental health.

Results: The prevalence of poor positive mental health was 30% in women and 24% in men. Material, as well as psychosocial, and sociodemographic factors were independently associated with poor positive mental health in a Europe-wide sample from 34 European countries. When studying all factors together, the highest OR for poor positive mental health was reported for social exclusion (men: OR=1.73, 95% CI 1.59 to 1.90; women: OR=1.69, 95% CI 1.57 to 1.81) among the psychosocial factors. Among the material factors, material deprivation had the highest impact (men: OR=1.96, 95% CI 1.78 to 2.15; women: OR=1.93, 95% CI 1.79 to 2.08).

Conclusions: This study gives the first overview on determinants of positive mental health at a European level and could be used as the basis for preventive policies in the field of positive mental health in Europe.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2014-005095DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4039806PMC
May 2014

The prevalence of audiometric notches in adolescents in Germany: The Ohrkan-study.

Noise Health 2013 Nov-Dec;15(67):412-9

Department of Occupational and Environmental Medicine and Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany.

Although there is concern about increasing hearing loss in adolescents caused by leisure noise exposure, prevalence data are scarce. In an US study, about 16-17% of adolescents were affected by audiometric notches. To estimate the prevalence of audiometric notches in adolescents in Germany, baseline data of the cohort study Ohrkan, recruitment during the school years 2009/2010 and 2010/2011 were analyzed. All students in grade 9 visiting any school in the city of Regensburg were eligible for participation. Data was collected via standardized questionnaires from students and their parents. In addition, students were asked to visit the University Clinics of Regensburg for ear examination including a tympanogram and the determination of hearing thresholds in air conduction audiometry. The prevalence of audiometric notches was determined in students with normal tympanogram in both ears and complete audiometry data. Audiometric notches were defined according to criteria used to analyse US data. Overall, 2149 students (1158 girls, 991 boys mainly aged 15-16 years) of the 3846 eligible adolescents (56%) participated. Among the 1843 adolescents with complete audiometry and tympanometry data, the prevalence of audiometric notches was 2.4% (95% confidence interval 1.7-3.1%). We could not confirm the high prevalence of audiometric notches as reported in National Health and Nutrition Examination Surveys for adolescents in the US. Differences in prevalence might be at least partly due to methodical differences in audiometry. Even if empirical evidence is presently ambiguous, it is reasonable to educate young people about the potential risks of high leisure noise exposure.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/1463-1741.121241DOI Listing
February 2014

Determinants of inadequate parental sun protection behaviour in their children--results of a cross-sectional study in Germany.

Int J Hyg Environ Health 2014 Mar 1;217(2-3):363-9. Epub 2013 Aug 1.

Department of Occupational and Environmental Epidemiology, Bavarian Health and Food Safety Authority, Germany; Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Germany. Electronic address:

Objective: Unprotected sun exposure especially during childhood is a risk factor for skin cancer. A combined use of sun protection measures is recommended to protect children. However, the prevalence and determinants for combined use have been scarcely studied in children. The objective of this study was to identify determinants of parental sun protection behaviour.

Methods: A cross-sectional survey was performed in five regions in Bavaria (Germany) during school entrance health examination (2010/2011). Parents of 4579 children (47% female, aged 5-6 years) completed a self-administered questionnaire (response 61%).

Results: Most children were regularly protected with single measures (shade (69%), clothes (80%), hat (83%), sunscreen (89%), sunglasses (20%)). However, regarding regular and combined use, >50% of children were inadequately protected. Larger family size, lower household equivalent income, darker skin and sunburn history were associated with inadequate use of different sun protection measures. The less frequent use of one sun protection measure was associated with less frequent use of the others. Child's sex, migration background, parental education and sun exposure showed inconsistent results regarding the different sun protection outcomes.

Conclusion: Based on our results a regular, combined and correct use of multiple sun protection for children should be promoted independent of sociodemographic characteristics. Priority of shade, clothes and hat before sunscreen should be clarified.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijheh.2013.07.013DOI Listing
March 2014

Phthalate and di-(2-ethylhexyl) adipate (DEHA) intake by German infants based on the results of a duplicate diet study and biomonitoring data (INES 2).

Food Chem Toxicol 2013 Mar 13;53:272-80. Epub 2012 Dec 13.

Department of Chemical Safety and Toxicology, Bavarian Health and Food Safety Authority, Pfarrstrasse 3, D-80538 Munich, Germany.

Phthalates as well as di-(2-ethylhexyl) adipate (DEHA) are used as plasticizers in diverse applications and are of toxicological concern. The study was conducted with a study population of 25 German subjects aged between 15 and 21 months. Overall, 16 phthalates and DEHA were measured by gas chromatography-mass spectrometry in a total of 171 duplicate diet samples collected over 7 consecutive days, and 20 phthalate metabolites were analyzed in the urine samples collected over 7 consecutive days using a liquid chromatography-tandem mass spectrometry method. The median "high" daily dietary intake based on 95th percentiles was 4.66 μg/kg b.w. for di-2-ethylhexyl phthalate (DEHP), 1.03 μg/kg b.w. for di-isobutyl phthalate (DiBP), and 0.70 μg/kg b.w. for di-n-butyl phthalate (DnBP), and 1.0 μg/kg b.w. for DEHA. The "high" daily total intake from biomonitoring data was 4.9 μg/kg b.w. for DEHP, 2.2 μg/kg b.w. for DnBP, 3.9 μg/kg b.w. for DiBP, and 2.6 μg/kg b.w. for di-isononyl phthalate. The comparison of the two intake estimates indicates that the dominant intake source of DEHP was food ingestion, whereas other sources considerably contributed to the total intake of other phthalates. Using our "high" intake scenario, none of the analyzed phthalates reached the recommended tolerable daily intake levels.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.fct.2012.12.004DOI Listing
March 2013

Increased health risks of children with single mothers: the impact of socio-economic and environmental factors.

Eur J Public Health 2013 Jun 8;23(3):469-75. Epub 2012 Jun 8.

Department of Occupational and Environmental Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany.

Background: Adverse effects of single parenthood on children's health have been reported before. Socio-economic difficulties are discussed as mediating factors. As child health also depends on environmental conditions, we investigated the impact of environmental exposures and socio-economic factors on differences in health outcomes of children with single mothers vs. couple families.

Methods: Data on 17,218 pre-school children (47% female) from three cross-sectional surveys conducted during 2004-07 in Germany were analysed. Health and exposure assessment were primarily based on parental report. Effects of socio-economic indicators (maternal education, household income) and environmental factors (traffic load at the place of residence, perceived environmental quality) on associations of four health outcomes (parent-reported health status, asthma, overweight, psychological problems) with single parenthood were determined by logistic regression analyses.

Results: Children with single mothers showed an increased risk regarding parent-reported poor health status [boys: odds ratio (OR) 1.39 (95% confidence interval (CI): 1.06-1.82), girls: 1.73 (1.28-2.33)], psychological problems [boys: 1.90 (1.38-2.61), girls: 1.58 (1.03-2.42)], overweight [only boys: OR 1.23 (1.01-1.50) and asthma [only girls: OR 1.90 (1.15-3.15)]. Adjusting for socio-economic factors attenuated the strength of the association of family type with child health. Although environmental factors were associated with most health outcomes investigated and children of single mothers were more often exposed, these environmental factors did not alter the differences between children with single mothers and couple families.

Conclusions: The increased health risks of children from single-mother families vs. couple families are partly explained by socio-economic factors, but not by the environmental exposures studied.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/eurpub/cks062DOI Listing
June 2013

High concentrations of cadmium, cerium and lanthanum in indoor air due to environmental tobacco smoke.

Sci Total Environ 2012 Jan 2;414:738-41. Epub 2011 Dec 2.

Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany.

Background: Environmental tobacco smoke (ETS) is one of the most important sources for indoor air pollution and a substantial threat to human health, but data on the concentrations of the trace metals cerium (Ce) and lanthanum (La) in context with ETS exposure are scarce. Therefore the aim of our study was to quantify Ce and La concentrations in indoor air with high ETS load.

Methods: In two subsequent investigations Ce, La and cadmium (Cd) in 3 smokers' (11 samples) and 7 non-smokers' (28 samples) households as well as in 28 hospitality venues in Southern Germany were analysed. Active sampling of indoor air was conducted continuously for seven days in every season in the smokers' and non-smokers' residences, and for 4h during the main visiting hours in the hospitality venues (restaurants, pubs, and discotheques).

Results: In terms of residences median levels of Cd were 0.1 ng/m(3) for non-smokers' and 0.8 ng/m(3) for smokers' households. Median concentrations of Ce were 0.4 ng/m(3) and 9.6 ng/m(3), and median concentrations of La were 0.2 ng/m(3) and 5.9 ng/m(3) for non-smokers' and for smokers' households, respectively. In the different types of hospitality venues median levels ranged from 2.6 to 9.7 ng/m(3) for Cd, from 18.5 to 50.0 ng/m(3) for Ce and from 10.6 to 23.0 ng/m(3) for La with highest median levels in discotheques.

Conclusions: The high concentrations of Ce and La found in ETS enriched indoor air of smokers' households and hospitality venues are an important finding as Ce and La are associated with adverse health effects and data on this issue are scarce. Further research on their toxicological, human and public health consequences is urgently required.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.scitotenv.2011.11.017DOI Listing
January 2012

The impact of the social environment on children's mental health in a prosperous city: an analysis with data from the city of Munich.

BMC Public Health 2010 Apr 21;10:199. Epub 2010 Apr 21.

Helmholtz Zentrum München, German Research Centre for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany.

Background: Children with a low socioeconomic position are more affected by mental difficulties as compared to children with a higher socioeconomic position. This paper explores whether this socioeconomic pattern persists in the prosperous German city of Munich which features high quality of life and coverage of children mental health specialists that lies well above the national average and is among the highest in Europe.

Methods: 1,265 parents of preschool children participated in a cross-sectional health survey. They were given a self-administered questionnaire (including socioeconomic variables) and the 'Strengths and Difficulties Questionnaire (SDQ)', a well-established method to identify mental difficulties among children and adolescents. Prevalence estimates for the 'SDQ-Total Difficulties Score' were calculated, with a special focus on differences by parental (resp. household) socioeconomic position. The association between parental education, household income, single parenthood, nationality, and parental working status on one hand, and their children's mental health on the other, was explored using multivariable logistic regression models. The coverage of mental health specialists per 100,000 children aged 14 or younger in the city of Munich was also calculated.

Results: In Munich, the distribution of mental health difficulties among children follows the same socioeconomic pattern as described previously at the national level, but the overall prevalence is about 30% lower. Comparing different indicators of socioeconomic position, low parental education and household income are the strongest independent variables associated with mental difficulties among children (OR = 2.7; CI = 1.6 - 4.4 and OR = 2.8; CI = 1.4 - 5.6, respectively).

Conclusions: Socioeconomic differences in the prevalence of childhood mental difficulties are very stable. Even in a city such as Munich, which is characterized by high quality of life, high availability of mental health specialists, and low overall prevalence of these mental difficulties, they are about as pronounced as in Germany as a whole. It can be concluded that the effect of several characteristics of socioeconomic position 'overrules' the effect of a health promoting regional environment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/1471-2458-10-199DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874531PMC
April 2010

Environmental inequalities among children in Europe--evaluation of scientific evidence and policy implications.

Eur J Public Health 2010 Feb 29;20(1):14-20. Epub 2009 Dec 29.

Department of Environmental Health, Bavarian Health and Food Safety Authority, Oberschleissheim, Germany.

Background: Socio-economic inequalities in the living environment are major contributing factors to health inequalities. Consequently, protecting children from undesirable environmental exposures by taking socio-economic conditions into account has been identified as a policy priority area in Europe. This review aims to evaluate the evidence on environmental inequalities among children in Europe and to discuss its policy implications.

Methods: A systematic literature search was conducted in various literature databases. Further sources for information were reviews, international reports and working documents for a WHO expert meeting on environmental inequalities in 2009. One major inclusion criterion for publications was consideration of socio-economic factors as influencing factors, not merely as confounder.

Results: The overall pattern based on the available fragmentary data is that children living in adverse social circumstances suffer from multiple and cumulative exposures. A low socio-economic position is associated with an increased exposure of children to traffic-related air pollution, noise, lead, environmental tobacco smoke, inadequate housing and residential conditions and less opportunities for physical activity. For most topics and exposures reviewed here there were no studies investigating the modification of the exposure-response function by socio-economic factors. Due to a variety of methodological approaches and studies on one hand and lack of data for many topics and countries on the other hand it was not possible to quantify the magnitude of environmental inequalities.

Conclusion: Action is needed along the whole causal pathway of the social divide in environmental hazards with priority to policy measures aiming at removing socially determined differences in environmental conditions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/eurpub/ckp213DOI Listing
February 2010

Association between peer relationship problems and childhood overweight/obesity.

Acta Paediatr 2009 Dec 13;98(12):1950-5. Epub 2009 Aug 13.

Division of Epidemiology, Institute of Social Pediatrics and Adolescent Medicine, Ludwig-Maximilian-University of Munich, Munich, Germany.

Aims: To assess the association between peer relationship problems and childhood overweight and obesity.

Methods: Data on 4718 preschool children were obtained at the obligatory school entry health examination in Bavaria. Parentally reported peer relationship problems ('normal', 'borderline' or 'abnormal') were assessed from the Strengths and Difficulties Questionnaire. Overweight and obesity were defined according to age- and gender-specific BMI cut-off points. Multivariate logistic regression analysis was performed to control potential confounders.

Results: The prevalence of overweight and obesity was higher among children with 'borderline' or 'abnormal' peer relationship problems compared to 'normal' children. The association of 'abnormal' peer relationship problems was still significant in the final logistic regression model for girls [odds ratio (OR) for overweight 2.0; 95% confidence interval (CI): 1.4-3.0; OR for obesity 2.6; 95% CI: 1.3-5.0]. Among boys the adjusted odds ratio were lower and no longer significant.

Conclusion: The significantly increased prevalence of overweight and obesity among preschool children with peer relationship problems could not be explained by confounding. It seems evident that there is a relevant co-morbidity of peer relationship problems and obesity in pre-school children pointing to the need of interventions focusing on both physical as well as psychosocial health.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/j.1651-2227.2009.01484.xDOI Listing
December 2009

Intake and body burden of dioxin-like compounds in Germany: the INES study.

Chemosphere 2009 Sep 8;76(11):1457-63. Epub 2009 Aug 8.

Department of Environmental Health, Bavarian Health and Food Safety Authority, Veterinärstrasse 2, D-85764 Oberschleissheim, Germany.

The human body burden of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and dioxin-like polychlorinated biphenyls (dl-PCBs) and the dietary intake of dl-PCB were investigated in Germany. In total, 50 adults (between 14 and 60 years old) were recruited, and duplicate diet samples were collected over seven consecutive days from each participant. Blood samples were acquired from 48 participants. Seventeen PCDD/Fs and 12 dl-PCBs (non- and mono-ortho congeners) were measured in the blood, and all dl-PCBs were measured in duplicate diet portions. Daily intake via food was calculated by multiplying the measured concentrations by the consumption data. Median (95th percentile) concentrations in the blood (expressed as WHO-TEQ) for PCDD/Fs, non-ortho PCBs and mono-ortho PCBs were 10.1 (25.0) pg g(-1) lipid, 4.2 (14.9) pg g(-1) lipid and 4.5 (14.2) pg g(-1) lipid, respectively. The contribution of mono-ortho PCBs and non-ortho PCBs to total TEQ was 25% and 24%, respectively. For each study subject, median intake levels for seven consecutive days were calculated. From these data, the median (95th percentile) daily intake via food was 0.12 (0.32) pg TEQ kg(-1)b.w. for non-ortho congeners and 0.06 (0.12) pg TEQ kg(-1)b.w. for the mono-ortho congeners. PCB 126, PCB 118 and PCB 156 accounted for about 93% of the total PCB intake. Our study indicates that dl-PCB exposure in adults consuming a normal mixed diet is quite low at present in Germany. The median and maximum daily intake contributed to 10% and 25% to the tolerable daily intake recommended for total PCDD/Fs and dl-PCBs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chemosphere.2009.07.010DOI Listing
September 2009

Human exposure to polybrominated diphenyl ethers (PBDE), as evidenced by data from a duplicate diet study, indoor air, house dust, and biomonitoring in Germany.

Environ Int 2009 Nov 6;35(8):1125-35. Epub 2009 Aug 6.

Department of Environmental Health, Bavarian Health and Food Safety Authority, Veterinärstrasse 2, D-85764 Oberschleissheim, Germany.

Polybrominated diphenyl ethers (PBDE) are used as flame retardants in a wide variety of products. As part of the Integrated Exposure Assessment Survey (INES), this study aimed to characterize the exposure of an adult German population using duplicate diet samples, which were collected daily over seven consecutive days, and indoor air and house dust measurements. Our study population consisted of 27 female and 23 male healthy subjects, aged 14-60 years, all of whom resided in 34 homes in southern Bavaria. In these 34 residences the air was sampled using glass fiber filters and polyurethane foams and the dust was collected from used vacuum cleaner bags. The median (95th percentile) daily dietary intake of six Tetra- to HeptaBDE congeners was 1.2 ng/kg b.w. (3.3 ng/kg b.w.) or 67.8 ng/day (208 ng/day) (calculated from the 7-day median values of each study subject). Concentrations in indoor air and dust (cumulative Tri- to DecaBDE congener readings) ranged from 8.2 to 477 pg/m(3) (median: 37.8 pg/m(3)) and 36.6 to 1580 ng/g (median: 386 ng/g), respectively. For some congeners, we identified a significant correlation between air and dust levels. The median (95th percentile) blood concentration of total Tetra- to HexaBDE congener readings was 5.6 (13.2)ng/g lipid. No significant sex differences were observed, but higher blood concentrations were found in younger participants. Using a simplified toxicokinetic model to predict the body burden from exposure doses led to results that were of the same order of magnitude as the measured blood concentrations. Based on these measurements and given our exposure assumptions, we estimated for the total tetra- to heptabrominated congener count an average (high) comprehensive total daily intake of 1.2 ng/kg b.w. (2.5 ng/kg b.w.). Overall, our results suggest that dietary exposure is the dominant intake pathway at least in our study population, responsible for 97% (average intake) and 95% (high intake) of the total intake of an adult population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.envint.2009.07.003DOI Listing
November 2009

Socioeconomic determinants of children's environmental tobacco smoke exposure and family's home smoking policy.

Eur J Public Health 2009 Jan 25;19(1):52-8. Epub 2008 Nov 25.

Department of Environmental Health, Bavarian Health and Food Safety Authority, Oberschleissheim, Germany.

Background: Few studies have analysed the impact of different socioeconomic indicators on the prevalence of children's environmental tobacco smoke (ETS) exposure at several indoor environments and on family's home smoking policy.

Methods: Data on 12 422 pre-school children (48% female) from two cross-sectional surveys conducted during 2004-06 in Germany were analysed. Exposure assessment was based on parental report. Independent effects of socioeconomic indicators were determined by mutually adjustment in logistic regression analyses.

Results: Low parental education, unemployment, low household equivalent income, non-German nationality, single-parent family and family size were independently associated with children's ETS exposure at home and in cars. The strongest associations were observed for low parental education [at home: adjusted odds ratio (OR) 3.94; 95% confidence interval (CI) 3.46-4.49; in cars: 5.00; 3.84-6.50]. Indicators of material living conditions (relative poverty: 0.48; 0.39-0.57, parental unemployment: 0.55; 0.46-0.65), as well as single-parent family, non-German nationality and family size, but not parental education, were independently associated with ETS exposure at hospitality venues. Smoking households with low parental education, unemployment, poverty, single-parent family and non-German nationality were less likely to have the rule of exclusively smoking on the balcony or terrace. Low parental education and unemployment were negatively associated with no smoking in presence of the child in households with smoking inside the flat.

Conclusion: Several dimensions of socioeconomic position have to be considered in explanations of social inequalities in children's ETS exposure and family's home smoking policy as well as in development of targeted interventions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/eurpub/ckn114DOI Listing
January 2009

A simple assessment of physical activity is associated with obesity and motor fitness in pre-school children.

Public Health Nutr 2009 Aug 30;12(8):1242-7. Epub 2008 Sep 30.

Institute for Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians University, Heiglhofstrasse 63, D-81377 Munich, Germany.

Objective: Physical activity is an important determinant of energy balance. However, its impact on overweight/obesity has proved difficult to measure in pre-school children and few studies have found significant associations. A set of simple questions was used to distinguish pre-school children with high and low physical activity, and the association of this classification with childhood overweight/obesity and performance in an established motor test was investigated.

Design: Survey, cross-sectional.

Setting And Subjects: Weight and height were measured in 12,556 children taking part in the obligatory school entrance health examination 2004-5 and 2005-6 in three urban and three rural Bavarian regions. Their parents were asked to answer a questionnaire with a set of questions on physical activity.

Results: The mean age of the children evaluated was 5.78 (sd 0.43) years, 6535 (52.1 %) were boys. Physically active children were less likely to be overweight (OR = 0.786, 95 % CI 0.687, 0.898) or obese (OR = 0.655, 95 % CI 0.506, 0.849) and achieved 6.7 (95 % CI 5.8, 7.7) % more jumps per 30 s than less active children in a motor test, adjusted for a number of potentially confounding variables.

Conclusions: Classification of pre-school children as physically active or not, based on a small set of questions, revealed significant associations with overweight/obesity and a motor test. Once further validated, this classification might provide a valuable tool to assess the impact of physical activity on the risk of childhood overweight and obesity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S1368980008003753DOI Listing
August 2009

Association of fatty acids in serum phospholipids with lung function and bronchial hyperresponsiveness in adults.

Eur J Epidemiol 2008 16;23(3):175-90. Epub 2008 Jan 16.

Institute of Epidemiology, GSF - National Research Center for Environment and Health, P.O. Box 1129, 85758, Neuherberg, Germany.

Background: The dietary intake of certain fatty acids might have an impact on inflammatory processes in the lung and therefore contribute to the development of lung diseases like asthma or COPD.

Methods: In this study data from a population based cross-sectional study on respiratory health including measurement of fatty acids in serum phospholipids of 593 adults between 20 and 64 years of age were analyzed.

Results: Statistically significant positive associations were found between percentage predicted FEV1 (P = 0.0085) and FVC (P = 0.0267) and docosahexaenoic acid concentration in serum phospholipids in men. Dihomo-gamma-linolenic acid content in serum phospholipids was significantly negatively associated with percentage predicted FEV1 (P = 0.0003) and FVC (P = 0.0045) and transformed dose-response slopes (P = 0.0488) in men. Palmitoleic acid was negatively associated with percentage predicted FEV1 (P = 0.0037) and FVC (P = 0.0029) in men. Other fatty acids in serum phospholipids did not consistently affect lung function parameters or bronchial hyperreactivity.

Conclusion: A high concentration of docosahexaenoic acid in serum phospholipids may have a protective effect on lung function. Because this long-chain n-3 polyunsaturated fatty acid is almost exclusively derived from marine oils, fish might have a beneficial effect on lung diseases.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10654-007-9218-yDOI Listing
November 2008

Parental smoking and childhood obesity--is maternal smoking in pregnancy the critical exposure?

Int J Epidemiol 2008 Feb 3;37(1):210-6. Epub 2007 Dec 3.

Institute of Social Pediatrics and Adolescent Medicine, Ludwig-Maximilian-University, Heiglhofstr. 63, 81337 Munich, Germany.

Background: The concept of priming of childhood obesity by prenatal exposure to maternal smoking is based on a number of consistent studies. A recent paper found similar associations between paternal smoking and childhood obesity, questioning the presumed causal effect attributed to the prenatal exposure. Is the relation to paternal smoking consistent? Does it explain the effect of maternal smoking before or in pregnancy?

Methods: Data from a cross sectional study on 5899 children in the setting of the 2005 school entrance health examinations in Bavaria were analysed. Associations between paternal smoking or maternal smoking before or in pregnancy and childhood obesity were assessed with adjustment for potential confounders.

Results: The children's mean age was 5.8 years. The unadjusted odds ratio for obesity and paternal smoking was 2.0 (95% CI: 1.5, 2.6) and similar to that for maternal smoking before or in pregnancy with 2.3 (95% CI: 1.8, 3.1). After adjustment for a number of potential confounders and paternal smoking at interview the odds ratio for maternal smoking before or in pregnancy and childhood obesity was 1.9 (95% CI: 1.3, 2.7). There was no evidence for interaction between paternal smoking and maternal smoking before or in pregnancy (P = 0.38).

Conclusions: Although of similar magnitude, the association of paternal smoking could only partially explain the effect of maternal smoking before or in pregnancy on childhood obesity. Whether this persistent association reflects residual confounding or causality is unclear.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/ije/dym239DOI Listing
February 2008

Intake of phthalates and di(2-ethylhexyl)adipate: results of the Integrated Exposure Assessment Survey based on duplicate diet samples and biomonitoring data.

Environ Int 2007 Nov 3;33(8):1012-20. Epub 2007 Jul 3.

Department of Environmental Health, Bavarian Health and Food Safety Authority, Veterinärstrasse 2, D-85764 Oberschleissheim, Germany.

Phthalates are ubiquitous environmental chemicals with potential detrimental health effects. The purpose of our study was to quantify dietary intake of phthalates and of DEHA (Di-ethylhexyl adipate) using duplicate diet samples and to compare these data with the calculated data based on urinary levels of primary and secondary phthalate metabolites. 27 female and 23 male healthy subjects aged 14-60 years collected daily duplicate diet samples over 7 consecutive days. Overall, 11 phthalates were measured in the duplicates by GC/MS and LC/MS methods. Urinary levels of primary and secondary phthalate metabolites are also available. The median (95th percentile) daily intake via food was 2.4 (4.0) microg/kg b.w. (Di-2-ethylhexyl phthalate, DEHP), 0.3 (1.4) microg/kg b.w. (Di-n-butyl phthalate, DnBP), 0.6 (2.1) microg/kg b.w. (Di-isobutyl phthalate, DiBP) and 0.7 (2.2) microg/kg b.w. for DEHA. MEPH (Mono-2-ethylhexyl phthalate) was detectable only in minor concentrations in the samples, thus conversion of DEHP to MEHP and dietary intake of MEHP were negligible. When comparing back-calculated intake data of the DEHP metabolites with dietary DEHP intake from the day before significant correlations were observed for most of the metabolites. No correlation was found for DnBP and only a weak but significant correlation for DiBP. The median and 95th percentile daily dietary intake of all target analytes did not exceed the recommended tolerable daily intake. Our data indicated that food was the predominant intake source of DEHP, whilst other sources considerably contributed to the daily intake of DnBP and DiBP in an adult population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.envint.2007.05.006DOI Listing
November 2007

Exposure to environmental tobacco smoke in German restaurants, pubs and discotheques.

J Expo Sci Environ Epidemiol 2008 May 13;18(3):262-71. Epub 2007 Jun 13.

Department of Environmental Health, Bavarian Health and Food Safety Authority, Oberschleissheim, Germany.

In contrast to other countries, there is an on-going debate but still no smoke-free legislation in Germany. Exposure to environmental tobacco smoke (ETS) in hospitality venues is assumed to be high, but air quality data are lacking. Therefore, the aim of our study was to perform a comprehensive exposure assessment by analysing the indoor air concentration of toxic or carcinogenic ETS compounds in restaurants, pubs, and discotheques. Active sampling of indoor air was conducted for 4 h during the main visiting hours in 28 hospitality venues. Polycyclic aromatic hydrocarbons (PAH), volatile organic compounds (VOC), aldehydes/ketones, and cadmium were analysed. In addition, particle mass concentration was assessed with two different methods and particle number concentration (PNC) was determined. Median nicotine levels were 15 microg/m(3) in restaurants, 31 microg/m(3) in pubs, and 193 microg/m(3) in discotheques. Across these three sampling site categories median levels of 3-ethenylpyridine ranged from 3 to 24 microg/m(3), median levels of benzene from 8 to 20 microg/m(3), median levels of cadmium from 3 to 10 ng/m(3), and median levels of the sum of 16 PAH according to US-EPA from 215 to 375 ng/m(3), respectively. Median PM(2.5) mass concentration assessed gravimetrically varied between 178 and 808 microg/m(3) and PNC between 120,000 and 210,000 particles per cm(3) in restaurants, pubs, and discotheques. The majority of the particles had a size of 0.01-0.5 microm. Concentrations of ETS compounds were always highest in discotheques. The strong correlation between ETS-specific markers (nicotine, 3-ethenylpyridine) and PM(2.5), PAH, VOC, aldehydes/ketones, and cadmium indicated ETS as main source of these toxic or carcinogenic substances. In conclusion, indoor air concentrations of ETS constituents were high in German hospitality venues and represented a substantial health threat. Effective measures to protect patrons and staff from ETS exposure are necessary from a public health point of view.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/sj.jes.7500590DOI Listing
May 2008

Occurrence and daily variation of phthalate metabolites in the urine of an adult population.

Int J Hyg Environ Health 2007 Jan 19;210(1):21-33. Epub 2006 Dec 19.

Bavarian Health and Food Safety Authority, Department of Environmental Health, Veterinaerstrasse 2, D-85764 Oberschleissheim, Germany.

Phthalates like di-(2-ethylhexyl) phthalate (DEHP) are commonly used as plasticizers and their metabolites are suspect of especially reproductive toxicity. The aim of our study was to assess phthalate exposure in adults by measuring urinary phthalate metabolite levels and to explore individual temporal variability. Urine samples were collected by 27 women and 23 men aged 14-60 years during 8 consecutive days. We quantified four monoesters, four oxidative DEHP metabolites, and two secondary metabolites of di-isononyl phthalate (DiNP) by a LC/LC-MS/MS method. If we analyzed all 399 available samples independent of classification, the highest median values of primary metabolites in this study were found for mono-n-butyl phthalate (MnBP: 49.6 microg/l), followed by mono-isobutyl phthalate (MiBP: 44.9 microg/l), mono-benzyl phthalate (MBzP: 7.2 microg/l), and mono-2-ethylhexyl phthalate (MEHP: 4.9 microg/l). The median concentrations of the oxidized metabolites of DEHP were 8.3 microg/l for mono-(2-carboxymethylhexyl) phthalate (2cx-MMHP), 19.2 microg/l for mono-(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP), 14.7 microg/l for mono-(2-ethyl-5-oxohexyl) phthalate (5oxo-MEHP), and 26.2 microg/l for mono-(2-ethyl-5-carboxypentyl) phthalate (5cx-MEPP). The concentrations of the two DiNP secondary metabolites mono (oxoisononyl) phthalate (oxo-MiNP) and mono(hydroxyisononyl) phthalate (OH-MiNP) ranged from
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijheh.2006.09.005DOI Listing
January 2007

Exposure to multiple environmental agents and their effect.

Acta Paediatr Suppl 2006 Oct;95(453):106-13

Ecobaby Foundation and Emma Children's Hospital Academic Medical Centre University of Amsterdam, The Netherlands.

Introduction: All children are exposed to multiple physical, chemical and biological challenges that can result in adverse health effects before and after birth. In this context, the danger of multiple exposures cannot be assessed from a single-chemical approach as used in classical toxicology.

Aim: To open up a 'negotiation space' for the problem of multiple exposure to environmental stressors, defined as any physical, chemical or biological entity that can induce an adverse response. In this context, two further questions obtain: to what extent can synergistic risks be assessed, and how far could potential adverse effects be prevented by enhanced regulation?

Methods: A discussion of two general approaches is taken: 1) the investigation of mixtures such as smoking or air pollution without specifying the individual agents, and 2) the investigation of individual substances with a focus on possible interactions in the context of dose to receptor.

Results: Although mixtures of compounds can have effects, it may not be possible to ascribe causation to a single compound. Furthermore, cumulative low-dose insult can, in some circumstances, be more toxic than a single high-dose exposure, e.g. endocrine disruptive effects of a combination of PCBs and dioxins which disrupt the thyroid hormone status; this tends to contradict elements of classical toxicology, . These cumulative insults may further combine with heavy metals and can disrupt the heme synthesis. It is possible that groups of pollutants could be used to test their cumulative capacity to multiple stress-susceptible receptor targets as is done in smoking and air pollution. This methodology could be used for further groups of potential pollutants, for example those associated with cleaning products, or cosmetics. Testing individual substances with a focus on interactions means that not only chemicals but also concurrent diseases should be taken into account. We suggest that the enhanced regulation of potential multiple stressors falls into two discrete categories. The first comprises a more precautionary approach (as demonstrated by the banning of chemicals such as some brominated flame retardants in Europe). The second comprises a more 'permissive' liberal approach involving the initial study of an individual compound, and subsequent interrogation of that compound in combination with another (as demonstrated by lowering the carcinogenicity of aflatoxin by vaccination against hepatitis B).

Conclusions: It is necessary to define and study groups of multiple stressors as in US EPA's Framework for Cumulative Risk Assessment (U.S. EPA 2003). Recent increased knowledge of the greater sensitivity of the unborn baby, the infant and the child, has led to general recognition that a higher degree of precaution is now needed in regulating for multiple stressors on the young. The more liberal permissive approach proceeding from established effects of the individual exposures is becoming less acceptable now that we know that there is much we do not understand about chronic effects of stressors during the early development phases. Conflicts over which approach to take may have to be resolved through engagement and negotiation with a wide community of stakeholders. This "community of interest" may include fundamental research scientists, practicing clinical paediatricians, patient groups, and others concerned with the health and wellbeing of infants and children.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08035320600886646DOI Listing
October 2006

Children's environmental health: why should social disparities be considered?

Acta Paediatr Suppl 2006 Oct;95(453):26-30

Institute of Epidemiology, GSF National Research Centre for Environment and Health, Neuherberg, Germany.

Background/methods: The aim of workpackage 5 'Environmental exposures and children's health: impact of socioeconomic factors' in the EU-funded network PINCHE (Policy Interpretation Network on Children's Health and Environment) was to review and interpret the current knowledge of social inequalities in environmental exposures and children's health. Socioeconomic factors may impact on children's environmental health in two ways: 1) environmental exposures may differ according to socioeconomic status; 2) given a certain level of harmful environmental exposure, socioeconomic factors may modify the health effects by influencing the susceptibility characteristics of children.

Results: There is a lack of information to evaluate and quantify the effect of socioeconomic factors on environmental exposures and children's health in Europe. In most circumstances there seems to be an inverse social gradient with increased burden concerning exposures and health outcomes in children of lower social status.

Conclusions: There is a need to improve research on social inequalities in children's health and environment. Because of the complexity, integrated approaches and a combination of different intervention measures and policies are necessary to reduce environmental exposure and adverse health effects in children. Paediatricians may contribute to improvement of children's environmental health by risk communication and health advocacy at community and governmental level.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08035250600885910DOI Listing
October 2006