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Journal of Skin Cancer 2021The aim of this systematic review is to summarise the evidence of the effectiveness of interventions targeted to adolescents (13 to 18 years inclusive) and delivered in... (Review)
Review
AIM
The aim of this systematic review is to summarise the evidence of the effectiveness of interventions targeted to adolescents (13 to 18 years inclusive) and delivered in a secondary school setting with the purpose of improving sun protection behaviour, reducing ultraviolet radiation (UVR) exposure, and/or improving physiological outcomes related to UVR exposure (such as erythema or naevi development).
METHODS
Peer-reviewed journal articles were identified from seven database searches (Cochrane, Embase, CINAHL, Scopus, Medline, PsycInfo, and Web of Science) to January 2020, forward citation searches of relevant articles, and monitoring of WHO INTERSUN UVR list server for recent publications. Relevant articles were collected and critically analysed using the Effective Public Health Practice framework. Two reviewers independently reviewed, and when deemed eligible, extracted data and performed quality appraisals for each study.
RESULTS
Thirteen studies met the criteria for inclusion in the review. There were no studies that met a "strong" quality rating, five received a "moderate" quality rating, and eight studies a "weak" quality rating. Three of those with a moderate rating found evidence for effectiveness. The most promising interventions overall (including the pilot/uncontrolled studies) were those that moved beyond a pure health education approach and used innovative approaches such as the provision of shade, or use of technology (e.g., appearance-based apps or real-time ultraviolet index (UVI) monitors).
CONCLUSIONS
There is a lack of high-quality published studies investigating the interventions delivered in a secondary school setting to protect students from UVR. The evidence could be strengthened if researchers used consistent, standardised outcome measures for sun protection exposure and behaviour. Other factors limiting the strength of evidence were short follow-up times (largely less than 6 months) and/or nonrobust study design.
PubMed: 33747567
DOI: 10.1155/2021/6625761 -
BMJ Open Sep 2020Most of the Chinese occupational population are becoming at risk of noise-induced hearing loss (NIHL). However, there is a limited number of literature reviews on... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Most of the Chinese occupational population are becoming at risk of noise-induced hearing loss (NIHL). However, there is a limited number of literature reviews on occupational NIHL in China. This study aimed to analyse the prevalence and characteristics of occupational NIHL in the Chinese population using data from relevant studies.
DESIGN
Systematic review and meta-analysis.
METHODS
From December 2019 to February 2020, we searched the literature through databases, including Web of Science, PubMed, MEDLINE, Scopus, the China National Knowledge Internet, Chinese Sci-Tech Journal Database (weip.com), WanFang Database and China United Library Database, for studies on NIHL in China published in 1993-2019 and analysed the correlation between NIHL and occupational exposure to noise, including exposure to complex noise and coexposure to noise and chemicals.
RESULTS
A total of 71 865 workers aged 33.5±8.7 years were occupationally exposed to 98.6±7.2 dB(A) (A-weighted decibels) noise for a duration of 9.9±8.4 years in the transportation, mining and typical manufacturing industries. The prevalence of occupational NIHL in China was 21.3%, of which 30.2% was related to high-frequency NIHL (HFNIHL), 9.0% to speech-frequency NIHL and 5.8% to noise-induced deafness. Among manufacturing workers, complex noise contributed to greater HFNIHL than Gaussian noise (overall weighted OR (OR)=1.95). Coexposure to noise and chemicals such as organic solvents, welding fumes, carbon monoxide and hydrogen sulfide led to greater HFNIHL than noise exposure alone (overall weighted OR=2.36). Male workers were more likely to experience HFNIHL than female workers (overall weighted OR=2.26). Age, noise level and exposure duration were also risk factors for HFNIHL (overall weighted OR=1.35, 5.63 and 1.75, respectively).
CONCLUSIONS
The high prevalence of occupational NIHL in China was related to the wide distribution of noise in different industries as well as high-level and long-term noise exposure. The prevalence was further aggravated by exposure to complex noise or coexposure to noise and specific chemicals. Additional efforts are needed to reduce occupational noise exposure in China.
Topics: Adult; China; Female; Hearing Loss, Noise-Induced; Humans; Male; Manufacturing Industry; Noise, Occupational; Occupational Diseases; Occupational Exposure; Young Adult
PubMed: 32988950
DOI: 10.1136/bmjopen-2020-039576 -
Noise & Health 2022Exposure to noise can increase biological stress reactions and that could increase the risk of stress-related prenatal effects, including adverse obstetric outcomes;... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Exposure to noise can increase biological stress reactions and that could increase the risk of stress-related prenatal effects, including adverse obstetric outcomes; however, the association between exposure to noise and adverse obstetric outcomes has not been extensively explored. The objective of this review was to evaluate the evidence between noise exposures and adverse obstetric outcomes, specifically preeclampsia, gestational diabetes, and gestational hypertension.
MATERIALS AND METHODS
A systematic review of English language, comparative studies available in PubMed, Cochrane Central, EMBASE, and CINAHL databases between January 1, 1980 and December 29, 2021 was performed. Risk of bias for individual studies was assessed using the Risk of Bias Instrument for Nonrandomized Studies of Exposures, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the certainty of the body of evidence for each outcome.
RESULTS
Six studies reporting on preeclampsia, gestational diabetes, and gestational hypertension were identified. Although some studies suggested there may be signals of increased responses to increased noise exposure for preeclampsia and gestational hypertension, the certainty in the evidence of an effect of increased noise on all the outcomes was very low due to concerns with risk of bias, inconsistency across studies, and imprecision in the effect estimates.
CONCLUSIONS
While the certainty of the evidence for noise exposure and adverse obstetric outcomes was very low, the findings from this review may be useful for directing further research in this area, as there is currently limited evidence available. These findings may also be useful for informing guidelines and policies involving noise exposure situations or environments.
Topics: Bias; Diabetes, Gestational; Female; Humans; Hypertension, Pregnancy-Induced; Noise; Pre-Eclampsia; Pregnancy
PubMed: 36124522
DOI: 10.4103/nah.nah_22_22 -
Medical Journal of the Islamic Republic... 2020Positron Emission Mammography (PEM) is an imaging technique which is increasing focuses on imaging the chest instead of imaging the whole body. The aim of this study... (Review)
Review
Positron Emission Mammography (PEM) is an imaging technique which is increasing focuses on imaging the chest instead of imaging the whole body. The aim of this study was to conduct a systematic review of the clinical efficacy and coste-ffectiveness of PEM technology, as compared with PET, as a diagnostic method used for breast cancer patients. The present study was a Health Technology Assessment (HTA), which was conducted via a systematic review of clinical efficacy and cost-effectiveness of the methods based on domestic evidence. To evaluate the efficacy of the PEM diagnostic method, as compared with PET, we used efficacy indices, including Sensitivity, Specificity, Accuracy, PPV, and NPV. The required data were collected through a meta-analysis of studies published in electronic databases from 1990 to 2016. In addition, direct costs in both methods were estimated and finally, a cost-effectiveness analysis was performed using the results of the study. Also, a one-way sensitivity analysis was performed to examine the effects of parameters' uncertainty in the model. In this study, we used STATA software to integrate the results of studies with similar parameters. A total of 722 cases (N) were obtained from the five final studies. The results of the meta-analysis performed on the collected data showed that the two methods were identical in terms of the Specificity and PPV parameters. However, as to Sensitivity, NPV, and Accuracy parameters, the PEM method was superior to the PET for diagnosis of primary breast cancer. The total cost of using PEM and PET was $1737385.7 and $1940903.5, respectively, and the cost of a one-time scan (cost per unit) using PEM and PET devices was $86.82 and $157.63, respectively. As compared with the PET method, the use of the PEM diagnostic method for diagnosis of breast cancer was cost-effective in terms of all the five studied parameters (it was definitely cost-effective for four parameters and was also considered as cost-effective for another index, since ICER was below the threshold). The results showed that the use of PEM technology for the diagnosis of primary breast cancer is more cost-effective than PET technology; thus, due to the wide range of PET technology in different fields, it is recommended that this method should be used in other areas of priority.
PubMed: 33315994
DOI: 10.34171/mjiri.34.100 -
The Lancet. Public Health Jul 2023Low emission zones (LEZs) and congestion charging zones (CCZs) have been implemented in several cities globally. We systematically reviewed the evidence on the effects... (Review)
Review
Low emission zones (LEZs) and congestion charging zones (CCZs) have been implemented in several cities globally. We systematically reviewed the evidence on the effects of these air pollution and congestion reduction schemes on a range of physical health outcomes. We searched MEDLINE, Embase, Web of Science, IDEAS, Greenfile, and Transport Research International Documentation databases from database inception to Jan 4, 2023. We included studies that evaluated the effect of implementation of a LEZ or CCZ on air pollution-related health outcomes (cardiovascular and respiratory diseases, birth outcomes, dementia, lung cancer, diabetes, and all-cause) or road traffic injuries (RTIs) using longitudinal study designs and empirical health data. Two authors independently assessed papers for inclusion. Results were narratively synthesised and visualised using harvest plots. Risk of bias was assessed using the Graphic Appraisal Tool for Epidemiological studies. The protocol was registered with PROSPERO (CRD42022311453). Of 2279 studies screened, 16 were included, of which eight assessed LEZs and eight assessed CCZs. Several LEZ studies identified positive effects on air pollution-related outcomes, with reductions in some cardiovascular disease subcategories found in five of six studies investigating this outcome, although results for other health outcomes were less consistent. Six of seven studies on the London CCZ reported reductions in total or car RTIs, although one study reported an increase in cyclist and motorcyclist injuries and one reported an increase in serious or fatal injuries. Current evidence suggests LEZs can reduce air pollution-related health outcomes, with the most consistent effect on cardiovascular disease. Evidence on CCZs is mainly limited to London but suggests that they reduce overall RTIs. Ongoing evaluation of these interventions is necessary to understand longer term health effects.
Topics: Humans; Cardiovascular Diseases; Longitudinal Studies; Lung Neoplasms; Air Pollution; Cities
PubMed: 37393094
DOI: 10.1016/S2468-2667(23)00120-2 -
Journal of Environmental Radioactivity Oct 2021In order to reduce lung cancer due to radon exposure situations, not only authorities and organisations but also citizens may meaningfully contribute to radon mitigation...
In order to reduce lung cancer due to radon exposure situations, not only authorities and organisations but also citizens may meaningfully contribute to radon mitigation actions. Citizen science (CS) initiatives are recognised for their scientific, societal and policy value related to environmental issues. The purpose of this paper is to identify which CS initiatives in the field of radon exist and evaluate to what extent these CS initiatives contribute to radon research and/or radiation protection from radon. We conducted a systematic review of internet pages and scientific literature (September-December 2020) as well as expert consultation to help us identify and assess CS initiatives on radon (September 2020-February 2021). The ten principles of the European Citizen Science Association have been used as a starting point to develop indicators for the analysis of CS contributions to radon research. The results show that there are at least eight CS initiatives in the world contributing to radon related research which comply, to some degree, with each of the ten principles. In all these initiatives citizens contributed or are contributing meaningfully to radon testing and measurements. However, most of them apply the simplest form of participation (crowdsourcing) and only one focuses on radon mitigation. Moreover, unlike CS initiatives in other environmental areas, those focusing on radon are always led by the authorities and/or universities, in a top-down manner. Yet, results confirm that both the experts in radon-related fields and the citizen scientists from radon prone areas benefit from taking part in radon CS initiatives. Experiences and lessons learned in radon related to CS initiatives are identified and discussed in order to inspire future CS initiatives potentially contributing to reducing exposure to radon as well as to the implementation of national radon action plans.
Topics: Citizen Science; Radiation Monitoring; Radon
PubMed: 34265518
DOI: 10.1016/j.jenvrad.2021.106685 -
International Journal of Environmental... Aug 2022People who practice outdoor sports have an increased risk of skin cancer as they are exposed to high doses of ultraviolet (UV) radiation. Recent studies have shown that...
People who practice outdoor sports have an increased risk of skin cancer as they are exposed to high doses of ultraviolet (UV) radiation. Recent studies have shown that in many athletes, sun protection behaviours are inadequate, with the risk that this entails. The aim of this review is to collect the information published to date about the knowledge, attitudes and habits of athletes in relation to sun exposure and its risks. A systematic review was conducted using PubMed and Embase with the search algorithm "(skin cancer OR melanoma) AND (exercise OR sport OR athletes)". All studies analysing the knowledge, attitudes and habits of photoprotection in athletes were included. A total of 2,365 publications were found, of which 23 were selected, including a total of 10,445 sportspeople. The majority of participants declared their voluntary intention to tan and stated that the sun made them feel better, although they also showed concern about possible damage associated with UV radiation. In most studies, less than half of the participants made adequate use of photoprotective measures. In general, most athletes had a high level of knowledge regarding the risk of skin cancer associated with sun exposure. In conclusion, most athletes are aware of the risks associated with UV radiation but do not make adequate use of photoprotective cream. New training programs on photoprotection could help improve athletes' photoprotective behaviour, reducing the incidence of skin cancer and precancerous lesions in this population.
Topics: Health Knowledge, Attitudes, Practice; Humans; Melanoma; Skin Neoplasms; Sunburn; Sunlight; Sunscreening Agents; Ultraviolet Rays
PubMed: 36011808
DOI: 10.3390/ijerph191610175 -
Preventive Medicine Nov 2022Air pollution exposure is associated with negative health consequences among children and adolescents. Physical activity is recommended for all children/adolescents due... (Review)
Review
Air pollution exposure is associated with negative health consequences among children and adolescents. Physical activity is recommended for all children/adolescents due to benefits to health and development. However, it is unclear if physically active children have additional protective benefits when exposed to higher levels of air pollution, compared to less active children. This systematic review evaluates all available literature since 2000 and examines if effect measure modification (EMM) exists between air pollution exposure and health outcomes among children/adolescents partaking in regular physical activity. PubMed, Science Direct, Scopus, Web of Science, and ProQuest Agricultural & Environmental Science databases were queried, identifying 2686 articles. Title/abstract screening and full-text review eliminated 2620 articles, and 56 articles were removed for evaluating individuals >21, leaving 10 articles for review. Of the included articles, half were conducted in China, three in the United States, and one each in Indonesia and Germany. Seven articles identified EMM between active children and air-pollution related health outcomes. Five of these indicated that children/adolescents do not experience any additional benefits from being physically active in higher levels of air pollution, with some studies implying active children may experience additional detriments, compared to less active children. However, the remaining two EMM studies highlighted modest benefits of having a higher activity level, even in polluted air. Overall, active children/adolescents may be at greater risk from air pollution exposure, but results were not consistent across all studies. Future studies assessing the intersection between air pollution and regular physical activity among children would be useful.
Topics: Child; Adolescent; Humans; Environmental Exposure; Air Pollution; Exercise; China; Germany; Particulate Matter
PubMed: 36244521
DOI: 10.1016/j.ypmed.2022.107306 -
Diagnostics (Basel, Switzerland) Jun 2021Lung cancer continues to be one of the main causes of cancer death in Europe. Low-dose computed tomography (LDCT) has shown high potential for screening of lung cancer... (Review)
Review
Lung cancer continues to be one of the main causes of cancer death in Europe. Low-dose computed tomography (LDCT) has shown high potential for screening of lung cancer in smokers, most recently in two European trials. The aim of this review was to assess lung cancer screening of smokers by LDCT with respect to clinical effectiveness, radiological procedures, quality of life, and changes in smoking behavior. We searched electronic databases in April 2020 for publications of randomized controlled trials (RCT) reporting on lung cancer and overall mortality, lung cancer morbidity, and harms of LDCT screening. A meta-analysis was performed to estimate effects on mortality. Forty-three publications on 10 RCTs were included. The meta-analysis of eight studies showed a statistically significant relative reduction of lung cancer mortality of 12% in the screening group (risk ratio = 0.88; 95% CI: 0.79-0.97). Between 4% and 24% of screening-LDCT scans were classified as positive, and 84-96% of them turned out to be false positive. The risk of overdiagnosis was estimated between 19% and 69% of diagnosed lung cancers. Lung cancer screening can reduce disease-specific mortality in (former) smokers when stringent requirements and quality standards for performance are met.
PubMed: 34198856
DOI: 10.3390/diagnostics11061040 -
International Journal of Molecular... Jul 2021Medical staff represent the largest group of workers occupationally exposed to ionizing radiation (IR). Chronic exposure to low-dose IR may result in DNA damage and... (Meta-Analysis)
Meta-Analysis
Medical staff represent the largest group of workers occupationally exposed to ionizing radiation (IR). Chronic exposure to low-dose IR may result in DNA damage and genotoxicity associated with increased risk of cancer. This review aims to identify the genotoxicity biomarkers that are the most elevated in IR-exposed vs. unexposed health workers. A systematic review of the literature was performed to retrieve relevant studies with various biomarkers of genotoxicity. Subsequent meta-analyses produced a pooled effect size for several endpoints. The search procedure yielded 65 studies. Chromosome aberrations (CA) and micronuclei (MN) frequencies were significantly different between IR-exposed and unexposed workers (θ = 3.19, 95% CI 1.46-4.93; and θ = 1.41, 95% CI 0.97-1.86, for total aberrant cells and MN frequencies, respectively), which was not the case for ring chromosomes and nucleoplasmic bridges. Although less frequently used, stable translocations, sister chromatid exchanges (SCE) and comet assay endpoints were also statistically different between IR-exposed and unexposed workers. This review confirms the relevance of CA and MN as genotoxicity biomarkers that are consistently elevated in IR-exposed vs. unexposed workers. Other endpoints are strong candidates but require further studies to validate their usefulness. The integration of the identified biomarkers in future prospective epidemiological studies is encouraged.
Topics: Biomarkers; Chromosome Aberrations; DNA Damage; Dose-Response Relationship, Radiation; Health Personnel; Humans; Occupational Exposure; Radiation, Ionizing
PubMed: 34299125
DOI: 10.3390/ijms22147504