Dataset Information

Identification and Prioritization of Environmental Reproductive Hazards: A First Step in Establishing Environmental Perinatal Care.

ABSTRACT: In 2015, the International Federation of Gynecology and Obstetrics established the prevention of exposures to environmental reprotoxic substances as a priority for health professionals. However, available information about reproductive hazards is voluminous, dispersed, and complex, and this is a severe limitation for physicians to incorporate the prevention of environmental exposure into standard preventive care. One difficulty frequently cited by physicians is the lack of evidence-based information. The objective of our study was to identify a list of environmental chemical hazards to reproduction. We used lists present in relevant regulations or included in scientific reports or databases to identify reproductive hazards. The reproductive hazards were prioritized according to the strength of evidence concerning their impact on fertility or development of the offspring. We identified 1251 reproductive hazards. Our prioritization approach resulted in a high-priority classification for 462 risk factors belonging to the following eight classes: drugs (n = 206), metals (n = 116), pesticides (n = 38), organic solvents (n = 27), synthesizing and/or processing agents in industrial processes (n = 23), phthalates (n = 13), perfluorinated compounds (n = 13), and other compounds (n = 26). Despite the limitations of this work, the generated lists constitute a useful working basis to put in place innovative environmental preventive measures according to the principle of evidence-based medicine.

SUBMITTER: Teysseire R

PROVIDER: S-EPMC6388153 | biostudies-other | 2019 Jan

REPOSITORIES: biostudies-other

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Identification and Prioritization of Environmental Reproductive Hazards: A First Step in Establishing Environmental Perinatal Care.

Teysseire Raphaëlle R Brochard Patrick P Sentilhes Loïc L Delva Fleur F

International journal of environmental research and public health 20190128 3

In 2015, the International Federation of Gynecology and Obstetrics established the prevention of exposures to environmental reprotoxic substances as a priority for health professionals. However, available information about reproductive hazards is voluminous, dispersed, and complex, and this is a severe limitation for physicians to incorporate the prevention of environmental exposure into standard preventive care. One difficulty frequently cited by physicians is the lack of evidence-based informa ...[more]

PMID: 30696096

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Project description:Male reproductive disorders that are of interest from an environmental point of view include sexual dysfunction, infertility, cryptorchidism, hypospadias and testicular cancer. Several reports suggest declining sperm counts and increase of these reproductive disorders in some areas during some time periods past 50 years. Except for testicular cancer this evidence is circumstantial and needs cautious interpretation. However, the male germ line is one of the most sensitive tissues to the damaging effects of ionizing radiation, radiant heat and a number of known toxicants. So far occupational hazards are the best documented risk factors for impaired male reproductive function and include physical exposures (radiant heat, ionizing radiation, high frequency electromagnetic radiation), chemical exposures (some solvents as carbon disulfide and ethylene glycol ethers, some pesticides as dibromochloropropane, ethylendibromide and DDT/DDE, some heavy metals as inorganic lead and mercury) and work processes such as metal welding. Improved working conditions in affluent countries have dramatically decreased known hazardous workplace exposures, but millions of workers in less affluent countries are at risk from reproductive toxicants. New data show that environmental low-level exposure to biopersistent pollutants in the diet may pose a risk to people in all parts of the world. For other toxicants the evidence is only suggestive and further evaluation is needed before conclusions can be drawn. Whether compounds as phthalates, bisphenol A and boron that are present in a large number of industrial and consumer products entails a risk remains to be established. The same applies to psychosocial stressors and use of mobile phones. Finally, there are data indicating a particular vulnerability of the fetal testis to toxicants-for instance maternal tobacco smoking. Time has come where male reproductive toxicity should be addressed form entirely new angles including exposures very early in life.

Project description:An emphasis on biosecurity in the cattle industry was made over the years to improve animal and public health. Nevertheless, the level of implementation of biosecurity measures (BSM) remains largely insufficient due to certain constraints. It is therefore necessary to prioritize the different BSM to be applied in accordance with the individual context and the main infectious diseases affecting cattle. Previous prioritization exercises of infectious diseases were neither specific to Belgium nor based on an exhaustive list of diseases. This study aimed at classifying the most important infectious diseases affecting cattle in Belgium. A list of 74 cattle infectious diseases reported in Europe was compiled based on a literature review. Through an online survey, Belgian rural veterinary practitioners (RVP) were asked to assign a score to each disease according to their frequency (question 1), their trends estimated between 2013-15 (question 2), and finally to list the five most important diseases for adult cattle (question 3). Respectively, 107 and 93 RVP answered the first two questions and the last one. Results of the survey were used to classify the diseases based on their frequency, trends, and importance through an additional weighting system and a subsequent regression tree analysis. Belgian laboratory databases and previous disease prioritization exercises were also analysed and taken into account as additional data sources. For the most important diseases identified (those ranked as important by the three data sources), a literature review was performed in PubMed to identify their related risk factors and BSM. A total of 48 infectious diseases were classified as important in Belgium with six of them considered as important from the three data sources: bovine respiratory diseases (BRD), bovine respiratory syncytial virus (BRSV), bovine viral diarrhoea (BVD), infectious bovine rhinotracheitis (IBR), Q fever, and salmonellosis. Their related BSM should be prioritized in terms of BSM implementation.

Project description:BackgroundMental health Step-up, Step-down services (SUSD), also known as subacute services or Prevention and Recovery Services, have emerged to fill an identified gap between hospital-based inpatient care and clinical community-based mental health support. Evidence for the effectiveness of the SUSD service model is limited but growing. Accordingly, this study looked to add to the extant body of knowledge, by (i) assessing change outcomes in mental health and wellbeing, and predictors of these changes, for patients who accessed Western Australia's first SUSD service; and (ii) evaluating patients' satisfaction with service, and what patients value from their stay.MethodsThis was a mixed-method retrospective cohort study. Participants comprised 382 patients who accessed a 22-bed Mental Health SUSD facility and incurred 551 episodes of care during the 01/07/2014-30/06/2016 period. Patients' change outcomes in psychological distress, general self-efficacy, and work and social adjustment from service entry to service exit were analyzed using generalized linear modeling. Simple Pearson's correlation coefficients were calculated for preliminary assessment of the associations between patients' service satisfaction and their change outcomes. Qualitative outcomes that patients valued from their stay were analyzed thematically according to a semi-grounded theoretical approach.ResultsSignificant improvements were observed in patients' self-reported psychological distress, self-efficacy, and work and social adjustment (all p?<?0.0001). A strong and persistent baseline effect existed across the three measures. Older age, female gender, and having a dependent child in the same household were protective/enhancing factors for the patients' recovery. Satisfaction with service was high. Patients valued having the time and space to recuperate, gain insight, focus, and create changes in their lives.ConclusionThe encouraging findings, regarding both patients' change outcomes and satisfaction with service, support the value of the SUSD service model for patients with mental illnesses. Strengths and limitations were discussed; ensued recommendations were offered to both service providers and researchers to enhance the robustness of future research findings, to help inform more effective policy and funding decisions related to mental health care.

Dataset Information

Identification and Prioritization of Environmental Reproductive Hazards: A First Step in Establishing Environmental Perinatal Care.

Publications

Identification and Prioritization of Environmental Reproductive Hazards: A First Step in Establishing Environmental Perinatal Care.

Similar Datasets

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