Criteria for successful sanitation programmes in low income countries.
In the International Drinking Water Supply and Sanitation Decade (1981-90), the development of a consensus on the concept of sanitation and the planning and implementation of effective and efficient sanitation programmes was not emphasized. Yet lack of good sanitation is a growing burden and environmental threat. Significant improvement of human health cannot be achieved without good environmental sanitation conditions and practices. A consensus on what makes a sanitation programme successful can help to conserve limited funds and spend those available more wisely. It will also help to reduce the increasing flows of waste poisoning precious sources of drinking water. This article was written to stimulate discussion on what attributes can be taken as characteristic of good environmental sanitation programmes, and on which indicators can be used to assess those attributes in actual sanitation programmes. (+info)
Symposium overview: the role of genetic polymorphism and repair deficiencies in environmental disease.
A symposium of this title was presented at the 37th Annual Meeting of the Society of Toxicology held in Seattle, Washington during March of 1998. The symposium focused on heritable variations in metabolism, DNA replication, and DNA repair that may predispose humans to environmental diseases. Human metabolic, replication, and repair enzymes function in protective roles. Metabolic enzymes are protective because they detoxify a stream of chemicals to which the body is exposed. Replication and repair enzymes are also protective; they function to maintain the integrity of the human genome. Polymorphisms in the genes that code for some of these enzymes are known to give rise to variations in their protective functions. For example, functional polymorphisms of the N-acetyltransferases, paraoxonases, and microsomal epoxide hydrolases vary in their capacity to metabolize environmental chemicals. Specific isoforms of the N-acetyltransferases and microsomal epoxide hydrolases are increasingly associated with incidences of cancer attributable to exposure to these chemicals. Thus, maintenance of cellular-growth homeostasis, normally and in the face of environmental challenge, is dependent on an inherited assortment of metabolic isoforms. Since replication and repair are also protective cellular functions, and since mutations in genes that code for these functions are associated with tumorigenesis, one can reasonably speculate that common functional polymorphisms of replication and repair enzymes may also impart susceptibility to environmental disease. (+info)
Lines that connect: assessing the causality inference in the case of particulate pollution.
The question of when it would be appropriate to conclude that the associations between particulate pollution and various outcomes (including mortality) should be judged as causal in nature has been difficult and controversial. Although such a judgment must be subject to revision, the volume of new information and new experimental findings has been so great that such a reevaluation is required at frequent intervals. The useful summary by Gamble [PM(2. 5) and Mortality in Long-Term Prospective Cohort Studies: Cause-Effect or Statistical Associations? Environ Health Perspect 106:535-554 (1998)] of the reasons why a causal inference was, in his opinion, not justified provides a basis for reevaluation in the light of new data. Such a reexamination indicates that the associative evidence is now stronger and that the biologic basis for a number of adverse effects has now been demonstrated. All of the useful guideline criteria customarily applied to such questions seem to have been met, although there is still much to be learned about interactive effects and the possibility of statistical thresholds. (+info)
Reproducibility of the University of Toronto self-administered questionnaire used to assess environmental sensitivity.
Environmental sensitivity patients report symptoms provoked by low-level exposure to a wide range of substances. Features of published case definitions include nature of onset, chronicity, symptom provocation by multiple substances, symptom provocation by an escalating number of exposures, involvement of multiple body systems including the nervous system, provocation by unrelated substances, and addictive behaviors. This study assessed the reproducibility of a Canadian self-administered questionnaire, the University of Toronto Health Survey, designed to determine the prevalence of the features described in these case definitions. A total of 191 eligible respondents aged 16-70 years who attended several types of medical practices in 1994 were invited to complete a second questionnaire 5-7 months after the first; 134 (70.2%) complied. Total agreement on whether patients satisfied each of seven case definitions ranged from 80% to 90%. After adjustment for chance, major agreement was observed for three of the seven case definitions (kappa = 0.69, 0.68, and 0.78). The survey achieved good reproducibility regarding self-report of symptoms described in published case definitions of environmental sensitivity. (+info)
Attention deficit/hyperactivity disorder (ADHD) in children: rationale for its integrative management.
Attention Deficit/Hyperactivity Disorder (ADHD) is the most common behavioral disorder in children. ADHD is characterized by attention deficit, impulsivity, and sometimes overactivity ("hyperactivity"). The diagnosis is empirical, with no objective confirmation available to date from laboratory measures. ADHD begins in childhood and often persists into adulthood. The exact etiology is unknown; genetics plays a role, but major etiologic contributors also include adverse responses to food additives, intolerances to foods, sensitivities to environmental chemicals, molds, and fungi, and exposures to neurodevelopmental toxins such as heavy metals and organohalide pollutants. Thyroid hypofunction may be a common denominator linking toxic insults with ADHD symptomatologies. Abnormalities in the frontostriatal brain circuitry and possible hypofunctioning of dopaminergic pathways are apparent in ADHD, and are consistent with the benefits obtained in some instances by the use of methylphenidate (Ritalin) and other potent psychostimulants. Mounting controversy over the widespread use of methylphenidate and possible life-threatening effects from its long-term use make it imperative that alternative modalities be implemented for ADHD management. Nutrient deficiencies are common in ADHD; supplementation with minerals, the B vitamins (added in singly), omega-3 and omega-6 essential fatty acids, flavonoids, and the essential phospholipid phosphatidylserine (PS) can ameliorate ADHD symptoms. When individually managed with supplementation, dietary modification, detoxification, correction of intestinal dysbiosis, and other features of a wholistic/integrative program of management, the ADHD subject can lead a normal and productive life. (+info)
The effect of supplementary antioxidant therapy in patients who report hypersensitivity to electricity: a randomized controlled trial.
CONTEXT: Hypersensitivity to electricity is a proposed environmental illness of unknown etiology. Patients report a variety of symptoms that they relate to electric equipment. The afflicted individuals suffer from ill health. Many interventions have been tried but, to date, there is no one specific treatment that has been proven superior to other remedial actions. In general, there is a lack of controlled prospective studies. OBJECTIVE: To test the hypothesis that antioxidant therapy reduces symptoms and improves health in patients reporting hypersensitivity to electricity. DESIGN: Randomized, double-blind, crossover, placebo-controlled study. SETTING: Patients referred to the Environmental Illness Research Centre, Stockholm County Council. PATIENTS: Sixteen patients reporting hypersensitivity to electricity. INTERVENTION: Antioxidant supplementation (vitamins C and E, selenium). MAIN OUTCOME MEASURES: Self-reported symptoms and reported degree of hypersensitivity to electricity, serum levels of uric acid and diphenylpycrylhydrazyl (DPPH). RESULTS: The results indicated no significant differences in reported symptoms, reported hypersensitivity to electricity, or oxidative status in serum between periods of antioxidant and placebo treatments. Serum levels of DPPH and uric acid showed no correlation with the reported degree of symptoms or hypersensitivity to electricity. CONCLUSIONS: The study did not show any beneficial effect of antioxidant supplementation for patients reporting hypersensitivity to electricity. The results do not support the hypothesis that oxidative stress is a major contributor to ill health in patients who report hypersensitivity to electricity. (+info)
Etiology of uveitis in rural and urban areas of mid-eastern Poland.
The aim of this study was to assess and compare the frequencies of uveitis etiology in inhabitants of rural and urban areas of mid-eastern Poland. We reviewed the cases of 563 patients (263 males, 300 females; aged 2-87) with uveitis, treated at the 1st Department of Ophthalmology at the Medical Academy in Lublin and at the District Ophthalmic Hospital in Kielce, Poland, from January 1996-December 2000. Anatomical classification of uveitis was used according to the International Uveitis Study Group and etiological classification including uveitis associated with trauma, infection, systemic disease, non-associated with a systemic disease and masquerade syndromes. Data regarding age, gender, place of residence, anatomical location and etiology of uveitis were obtained. Statistical analyses were performed using Pearson's chi-square test, Spearman's rank correlation test and logistic regression. Etiology of uveitis was established in 70.0% of cases. The most common cause of uveitis was infection. Patients from rural areas were significantly more likely to have uveitis of infectious origin whereas patients from urban areas significantly more likely to have uveitis associated with a systemic disease. In conclusion, the pattern of uveitis in mid-eastern Poland confirms the influence of environmental factors on the etiology of this heterogenous disease. (+info)
Rashes among schoolchildren--14 states, October 4, 2001-February 27, 2002.
Fourteen states (Arizona, Connecticut, Florida, Georgia, Indiana, Mississippi, New York, Ohio, Oregon, Pennsylvania, Texas, Virginia, Washington, and West Virginia) have reported investigations of multiple schoolchildren who have developed rashes. This report summarizes the investigation by state and local health departments of these rashes, which have occurred during October 2001 through February 2002, and provides examples for four states. Preliminary findings indicate that further investigation is needed to determine whether a common etiology for these rashes exists. (+info)