Environmental Health and Preventive Medicine Journal Impact Factor & Information

Publisher: Nihon Eisei Gakkai, Springer Verlag

Journal description

Journal of the Japan Society for Hygiene

Current impact factor: 0.00

Impact Factor Rankings

Additional details

5-year impact 0.00
Cited half-life 0.00
Immediacy index 0.00
Eigenfactor 0.00
Article influence 0.00
Website Environmental Health and Preventive Medicine website
Other titles Environmental health and preventive medicine (Online), Environmental health and preventive medicine
ISSN 1347-4715
OCLC 47992699
Material type Document, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Springer Verlag

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  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: To examine the participation, implementation, and effect of the prenatal education curriculum provided by hospitals in China, and to provide evidence for the improvement of prenatal education. A cross-sectional survey was conducted in the hospitals in Hunan Province, China. Mothers aged 20-45 years who had given birth between 1 May 2011 and 1 May 2012 and not diagnosed with pregnancy-related complications were invited to participate in the study. A self-administered, structured questionnaire was used to examine the effect of prenatal education curriculum on prenatal examination utilization, delivery mode, and recovery status from delivery. Among the total 604 respondents, only 175 (29.1 %) surveyed mothers participated in prenatal education curriculum provided by hospitals during their latest delivery. These mothers had a higher rate of attending all the required prenatal examinations (57.9 vs. 48.3 %), and a higher rate of recovering very well and well (80 vs. 73.7 %) from the latest delivery, than those who did not participate in prenatal education curriculum (P < 0.05). However, there was no statistical difference in the delivery mode between mothers who participated and those who did not participate in the prenatal education curriculum provided by hospitals. Prenatal education is indispensable for the improvement of maternal and child health, and thus should be advocated. In China, a standard and convenient specification prenatal education curriculum provided by hospitals and their doctors is appropriated for providing prenatal education to pregnant women.
    Environmental Health and Preventive Medicine 07/2015; DOI:10.1007/s12199-015-0480-4
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    ABSTRACT: This study was performed to determine the occupational risks and their effects on the work stress of the health professionals working in state hospitals in the Southeast of Turkey. This cross-sectional and descriptive study was composed of 360 health professionals of the Pazarcık, Ergani, and Şehitkamil State Hospitals between December 2014 and January 2015. The data of the study were obtained by performing the survey which was composed of questions related to the socio-demographic characteristics, factors that were thought to affect the occupational risks and job stress, as well as, the questions of the Work Stress Scale. The analyses of the data have been performed using Student's t test and one-way analysis of variance. The working hours, the number of being on-duty, insomnia, and burnout in health professionals were determined to be with the highest mean scores among other stressful risks and hazards. The mean work stress level, which increases the success by creating the group-stimulus effect, was indicated as 2.4 and 2.5 for the health professionals in Pazarcık and Ergani State Hospital, respectively. However, the stress level which poses a threat for the group-health and efficiency was found to be 4.0 for the health professionals of the Şehitkamil State Hospital. As the exposure of the occupational risks increases in the health professionals, the work stress scores also increase (p < 0.05). The occupational risks and work stress of the health professionals in the Şehitkamil State Hospital should be evaluated in terms of occupational health and safety.
    Environmental Health and Preventive Medicine 07/2015; DOI:10.1007/s12199-015-0481-3
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    ABSTRACT: The aims of this study are to assess cigarette and hookah smoking rates amongst adult population in Jordan and to determine predictors of smoking status. Selected beliefs, perceptions and attitudes toward cigarettes and hookah smoking were also assessed. This cross-sectional study was conducted in five regional governorates of Jordan through face-to-face interviews on a random sample of adult population aged 18-79 years. Data was collected using a piloted questionnaire based on the Global Adult Tobacco Questionnaire. The overall prevalence of cigarette smoking in our sample (869) was 59.1 % amongst males and 23.3 % amongst females, while the overall prevalence of hookah smoking was 18.9 % amongst males and 23.1 % amongst females. Leisure and imitation were the most commonly reported reasons for smoking. Regardless of smoking status, people were aware of health risks associated smoking and also had negative perceptions toward smoking. Smoking rates for both genders have reached alarmingly high rates in Jordan. There is an urgent need for a comprehensive national programme to target the country's growing burden of smoking. Suggestions on leisure time activities should be included in such programmes.
    Environmental Health and Preventive Medicine 07/2015; DOI:10.1007/s12199-015-0483-1
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    ABSTRACT: Since the Cabinet's decision concerning the Basic Policies 2005, the Japanese government has implemented specific measures to suppress increases in national medical care expenditure. However, we believe that the economic significance of medical care should be quantified in terms of its economic impact on national medical care expenditure. No one has examined the economic impact of all medical institutions in Japan using data from a statement of profits and losses. We used an input-output analysis to quantitatively estimate economic impact of medical care and examined its estimation range with a probabilistic sensitivity analysis. To estimate the economic impact and economic impact multipliers of all medical institutions in Japan, an input-output analysis model was developed using an input-output table, statement of profits and losses, margin rates, employee income rates, consumption propensity and an equilibrium output model. Probabilistic sensitivity analysis was conducted using a Monte Carlo simulation. Economic impact of medical care in all medical institutions was ¥72,107.4 billion ($661.5 billion). This impact yielded a 2.78-fold return of medical care expenditure with a 95 % confidence interval ranging from 2.74 to 2.90. Economic impact of medical care in Japan was two to three times the medical care expenditure (per unit). Production inducement of medical care is comparable to other industrial sectors that are highly influential toward the economy. The contribution to medical care should be evaluated more explicitly in national medical care expenditure policies.
    Environmental Health and Preventive Medicine 07/2015; DOI:10.1007/s12199-015-0478-y
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    ABSTRACT: This study investigated the mesothelin (MSLN) methylation and its relationship with soluble mesothelin-related protein (SMRP) levels in participants stratified by asbestos exposure scenarios and benign asbestos-related diseases (ARDs). The presence of benign ARDs was confirmed through chest X-ray and the asbestos exposure history was obtained using a standardized questionnaire in this study, including 262 participants. Sera SMRP were measured using MESOMARK, and MSLN methylation in genomic DNA extracted from whole blood was detected by real-time methylation-specific PCR. Covariates were compared with SMRP concentrations using correlation analysis and the potential covariates affecting SMRP were determined by multiple linear regression analysis, and the distribution of methylation status was analyzed by Chi-square test. There was a trend toward elevation of SMRP values in healthy individuals exposed to asbestos as compared with those without asbestos exposure. The highest median level of SMRP was 1.3 nM in subjects with asbestosis, followed by cases with pleura plaque and asbestosis (1.2 nM), pleura plaque (0.9 nM), healthy subjects with occupational exposure (0.9 nM), non-occupational exposure (0.8 nM), and mixed exposure (0.8 nM). Within asbestosis cases, those with higher profusion scores had higher SMRP values than those with lower profusion scores (1.6 vs. 0.8 nM). Based on multi-regression analysis, the trend toward elevation of SMRP remained significant in subjects with occupational exposure or in those with asbestosis, as compared with healthy subjects without exposure (p < 0.01), although body mass index had an effect on SMRP (p < 0.0001). Regardless of the differences in SMRP levels among these subgroups, MSLN methylation ranged from 80.5 to 92.5 %, with no significant difference. The elevated level of SMRP in asbestosis with higher profusion scores could not be attributed to low MSLN methylation status. Our findings suggest that the elevation of SMRP is related to asbestos exposure and benign ARDs especially for cases with high profusion scores, which is independent of MSLN methylation.
    Environmental Health and Preventive Medicine 07/2015; DOI:10.1007/s12199-015-0477-z
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    ABSTRACT: The aim of this study was to correlate different combinations of manganese (Mn) and iron (Fe) concentration in drinking water with prevalence of dental caries in both primary and permanent dentition, among school children with similar socio-demographic characteristics. Evros region, in North-Eastern Greece, was divided into four areas, according to combinations of levels of Mn and Fe in drinking water (High Mn-high Fe; High Mn-low Fe; Low Mn-high Fe; Low Mn-low Fe). Children of similar socio-economic background, attending either first or sixth grade (primary or permanent dentition, respectively) of elementary schools, were clinically assessed for caries by three dentists. Caries was defined by the use of dmft/DMFT index. A questionnaire answered by the parents was also analysed. 573 children were included. Caries prevalence was high in both age groups (64.2 % with mean dmft 3.3 ± 3.6 in primary and 60.7 % with mean DMFT 2.3 ± 2.5 in permanent dentition, respectively). Residence in a high Mn-low Fe area was associated with a significant OR for caries in both age groups [OR (95 % CIs) for primary and permanent dentition was, respectively, 3.75 (1.68-8.37), p = 0.001 and 3.09 (1.48-6.44), p = 0.003], independently of factors like sugar consumption or brushing frequency. Prevalence of caries was high in general, and was associated with the combination of high Mn/low Fe levels in drinking water, independently of various socio-demographic factors.
    Environmental Health and Preventive Medicine 07/2015; DOI:10.1007/s12199-015-0482-2
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    ABSTRACT: It would be quite convenient if daily dietary cadmium intake (Cd-D) can be estimated either from Cd in blood (Cd-B) or from Cd in urine (Cd-U). The aim of the study was to examine if Cd-D can be estimated from Cd-B or Cd-U. The data available in a previous publication were employed for regression analyses between Cd-D and Cd-B, and between Cd-D and Cd-U. 30 sites in various prefectures throughout Japan were surveyed and 20 adult women/site on average provided food duplicate, peripheral blood, and second morning urine samples. Geometric means were taken as representative values and employed in regression analyses. Cd-D, Cd-B, and Cd-Ucr [i.e., Cd-U after correction for creatinine (cr) concentration] distributed in ranges of 12.5-70.5 μg/day, 0.46-3.98 μg/l, and 1.16-11.02 μg/g cr, respectively. A close correlation was observed between Cd-D and Cd-B, and also between Cd-D and Cd-Ucr with r = 0.76 and r = 0.79 (p < 0.001 for both), respectively. Both regression lines passed close to the origins. Application of 1.23 μg Cd/l blood and 1.26 μg Cd/g cr in urine (average levels for adult Japanese women) to the regression equations gave 16.5 and 11.5 μg Cd/day. The analyses suggested that it may be possible to estimate Cd-D from Cd-B or Cd-U. Cd-B-based estimation should be more respected. As variations in the estimation parameters and estimated values are inherent to field surveys, care should be taken in the application of the study results. Application on a group basis (and not on an individual basis) should be considered.
    Environmental Health and Preventive Medicine 07/2015; DOI:10.1007/s12199-015-0479-x
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    ABSTRACT: The purpose of the study was to determine the prevalence of low back pain (LBP) among brick field workers and to explore attributed causes of LBP, investigate the relationship between LBP and psychophysical and psychosocial factors and measure the impact of LBP. A modified Nordic Musculoskeletal Disorder Questionnaire along with Body Part Discomfort scale were administered to brick field workers (N = 148). Working posture of the participants was assessed using Rapid Entire Body Assessment (REBA) method. The study showed that 70 % of the female workers reported LBP due to awkward working posture for prolonged period of time. This was mainly reported by brick moulders. 45 % reported LBP due to manual material handling (MMH) and 40 % due to awkward lifting of heavy objects (brick). The study shows that the LBP is more prevalent (OR 1.59 and 95 % CI 0.411-6.207). 78 % of the female workers want the job rotation to relieve from their job monotony. LBP occurred among female workers due to awkward posture, repetitive work and MMH. This study also stated that psychosocial cause of LBP is inadequacy income, monotony work, job dissatisfaction. Working posture analysis REBA suggests that all the working postures are high-risk level.
    Environmental Health and Preventive Medicine 07/2015; DOI:10.1007/s12199-015-0476-0
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    ABSTRACT: Mennonites reside in clusters, do not use modern sewage systems and consume water from non-municipal sources. The purpose of this study is to assess risk of Escherichia coli exposure via consumption of non-municipal waters in Mennonite versus non-Mennonite rural households. Results were reviewed for non-municipal water samples collected by the local health department from Mennonite and non-Mennonite lifestyle households from 1998 through 2012. Water contamination was examined with the help of two study variables: water quality (potable, polluted) and gastrointestinal (GI) health risk (none, low, high). These variables were analyzed for association with lifestyle (Mennonite, non-Mennonite) and season (fall, winter, spring, summer) of sample collection. Data were split into two periods to adjust for the ceiling effect of laboratory instrument. From the entire cohort, 82 % samples were polluted and 46 % samples contained E. coli, which is consistent with high GI health risk. In recent years (2009 through 2012), the presence of total coliforms was higher in non-Mennonites (39 %, P = 0.018) and presence of E. coli was higher in Mennonites (P = 0.012). Most polluted samples were collected during summer (45 %, P = 0.019) and had high GI health risk (51 %, P = 0.008) as compared to other seasons. Majority of non-municipal waters in this region are polluted, consuming those poses a high GI health risk and contamination is prevalent in all households consuming these waters. An association of E. coli exposure with the Mennonite lifestyle was limited to recent years. Seasons with high heat index and increased surface runoffs were the riskiest to consume non-municipal waters.
    Environmental Health and Preventive Medicine 06/2015; DOI:10.1007/s12199-015-0472-4
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    ABSTRACT: The present study aimed to investigate the association between body mass index (BMI) and uric acid (UA) using the twin study methodology to adjust for genetic factors. The association between BMI and UA was investigated in a cross-sectional study using data from both monozygotic and dizygotic twins registered at the Osaka University Center for Twin Research and the Osaka University Graduate School of Medicine. From January 2011 to March 2014, 422 individuals participated in the health examination. We measured height, weight, age, BMI, lifestyle habits (Breslow's Health Practice Index), serum UA, and serum creatinine. To investigate the association between UA and BMI with adjustment for the clustering of a twin within a pair, individual-level analyses were performed using generalized linear mixed models (GLMMs). To investigate an association with adjustment for genetic and family environmental factors, twin-pair difference values analyses were performed. In all analysis, BMI was associated with UA in men and women. Using the GLMMs, standardized regression coefficients were 0.194 (95 % confidence interval: 0.016-0.373) in men and 0.186 (95 % confidence interval: 0.071-0.302) in women. Considering twin-pair difference value analyses, standardized regression coefficients were 0.333 (95 % confidence interval: 0.072-0.594) in men and 0.314 (95 % confidence interval: 0.151-0.477) in women. The present study shows that BMI was significantly associated with UA, after adjusting for both genetic and familial environment factors in both men and women.
    Environmental Health and Preventive Medicine 06/2015; DOI:10.1007/s12199-015-0473-3
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    ABSTRACT: This study is aimed to find out the handwashing habits and their relations to the socio-economic variables. The sampling is determined regarding the address-based population registration system of the country. The multi-staged stratified cluster sampling method was used. It is conducted by a face to face questionnaire with 6854 persons. 22 questions are asked whether they are washing their hands or not related to different situations, the results are graded and the "Handwashing Habits Score" (HHS) is obtained. The reasons for not handwashing were evaluated by categorizing as individual, environmental and combined reasons. The HHS is increasing in the older age groups (β = 0.148, p < 0.001), females (β = 0.306, p < 0.001), citizens of urban settlement (β = 0.061, p < 0.001), higher education levels (β = 0.191, p < 0.001). The reasons for not handwashing were found as 53.3 % individual, 39.2 % environmental, 7.5 % combined. The frequency of mentioning not washing hands because of the environmental reasons is getting higher in the older age groups, in the urban side, and in the higher education level (p < 0.001). The handwashing habits are shaped by the determinant networks which form a complex structure by intertwining individual, socio-economic and environmental factors in different sub-groups with various weights. This result might contribute to the efforts of conceptualizing the health behaviors with ecological model.
    Environmental Health and Preventive Medicine 05/2015; DOI:10.1007/s12199-015-0470-6
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    ABSTRACT: This study was initiated to elucidate the extent of dietary exposure of children in Korea to two pollutant metals of cadmium (Cd) and lead (Pb). Possible urban-rural difference was also examined. Food duplicate and morning spot urine samples were collected from 108 children in 4 kindergartens (KG) (1 KG in Seoul and 3 KGs in Jeju Island), as reported in a previous publication. The samples were analyzed for Cd and Pb by ICP-MS. Cd and Pb in food duplicate and urine samples were distributed approximately log-normally. Geometric means for Cd and Pb in food duplicate samples were 12.4 and 5.8 μg/day, or 0.58 and 0.27 μg/kg body weight/day, respectively, and the values for Cd and Pb in urine (as observed, i.e., with no correction for urine density) were 0.91 and 1.64 μg/L, respectively. 2.41 and 0.30 μg/day of Cd and Pb (accounting for 19.5 and 5.1 %) came from boiled rice, the staple food. The levels of Cd and Pb burden among the children in the present survey were essentially the same with the levels reported for children in Pusan. The reasons for difference in the rank in Cd-D and Cd-U among the 4 KGs need further study. The observed levels of Cd and Pb exposure were more or less similar to what were reported for children in Pusan. No apparent urban-rural difference could be detected.
    Environmental Health and Preventive Medicine 05/2015; DOI:10.1007/s12199-015-0467-1
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    ABSTRACT: Nutrient intakes of children were surveyed at the time when a nation-wide shift took place in the Republic of Korea from agriculture-based to industrialized society. Taking advantage of the survey locations (see below), possible delay in nutritional improvement in rural areas (as compared with that in an urban area) was also examined. In total, 108 4- to 6-year-old children (boys and girls in combination) in 4 kindergartens (KGs; 1 in Seoul and 3 in Jeju Island) participated in the survey in 2003-2004. 24-h food duplicate samples were prepared by the mother of each child. Food items in each duplicate sample were separated and coded with reference to the Dietary Reference Intake for Koreans (the 2005 version). Nutrient intake of the day was estimated from the code and weight followed by summation for daily intake. The children in the KG in Seoul studied were younger, and therefore were smaller in body size than those in other KGs. Thus, it was considered necessary to evaluate nutrient intake not only on a daily basis, but after adjustment for body weight. The AM daily intake of energy (protein in parenthesis) for the 108 children was 1479 kcal (55 g)/day or 69.8 kcal (2.6 g)/kg body weight/day. Evaluation by individual nutrient suggested that the intake was sufficient for almost all nutrients except for sodium and potassium. Sodium and potassium intake (2285 and 1840 mg/day, respectively) was in excess and insufficient, respectively, with potential risk of inducing hypertension later in life. Inter-KG difference was not remarkable and therefore urban-rural difference was not apparent. Nutrient intakes as a whole appeared to be sufficient urban and rural areas. Nevertheless, excess Na intake coupled with insufficient K intake was a common problem.
    Environmental Health and Preventive Medicine 05/2015; DOI:10.1007/s12199-015-0465-3
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    ABSTRACT: Dietary intake of tin (Sn) may be increased in some children in kindergartens in Korea. The present study was intended to examine this possibility and clarify the extent of the elevation. 24-hour food duplicate and spot urine samples were collected in 2003-2004 from 108 4-6-year-old children (boys and girls combined) in 4 kindergartens (1 in Seoul and 3 in Jeju Island), as reported in a previous publication. These samples were employed in the present analyses to examine tin levels in the diet (including beverages) (Sn-D). A portion of the samples were wet-ashed, and the liquid samples were analyzed for Sn by the ICP-MS method. For statistical evaluation, χ (2) method and Smirnov's test for extreme value were used. Sn-D in the 108 cases distributed as extremely biased, and could be divided into two groups, i.e., those with <10 μg Sn/day (accounting for 90 % of the cases), and those with >10 μg/day (for 10 %). Sn-D in the former group was distributed quasi-normally with an AM (median) of 2.9 (2.5) μg/day. The maximum in the latter group was 3012 μg/day. No correlation was detected between Sn-D and Sn in urine (Sn-U). Comparison of the findings with published articles strongly suggested that the high Sn-D was due to consumption of foods (including beverages) preserved in tin-plated cans. No positive confirmation was however possible due to insufficient information on food records. About 10 % of children surveyed had elevated Sn-D (up to 3 mg/day). It was quite possible that high Sn-D was associated with tin-canned food intake.
    Environmental Health and Preventive Medicine 05/2015; DOI:10.1007/s12199-015-0466-2
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    ABSTRACT: Reactive oxygen species (ROS) induced by exogenous toxicants are suggested to be involved in carcinogenesis by oxidative modification of DNA. 8-Hydroxyl-2-deoxyguanosine (8-OHdG) has been considered as a reliable biomarker for oxidative DNA damage both in vivo and in vitro studies. But the effect of smoking on oxidative damage has not yet been fully elucidated. Wistar rats were exposed to cigarette smoke at concentrations of 20 and 60 % for 30 min, twice/day for 45 weeks. Then the histopathology of lung tissues, levels of ROS, 8-OHdG, and total antioxidant (T-AOC), expression of DNA repair enzymes, e.g. 8-oxyguaine DNA glycosylase (OGG1), and MutThomolog 1 (Oxidized Purine Nucleoside Triphosphatase, MTH1) were determined in urine, peripheral blood lymphocytes, and lung tissue. The results showed that long-term cigarette smoke exposure can cause obvious damages of lung tissue in rats. In addition, a significant and cigarette smoke concentration-dependent increase in ROS and 8-OHdG were observed compared with the non-exposed control rats. In contrast, the expression of OGG1 and MTH1, and T-AOC levels were obviously decreased after long-term exposure to cigarette smoke. These findings indicate that long-term exposure to cigarette smoker increases ROS levels, decreases total antioxidant capacity, and interferes DNA repair capacity that eventually induces oxidative DNA damage, which appears to play an important role in cigarette smoke-induced lung injury in rats, and determination of 8-OHdG levels might be a useful method for monitoring oxidative damage in cigarette smokers.
    Environmental Health and Preventive Medicine 05/2015; DOI:10.1007/s12199-015-0469-z
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    ABSTRACT: Establish new biocontrol practices with low persistence in the environment against dermatophyte causing mycosis. Antimycotic activity of twenty-six plant-derived commercial essential oils (EOs) was evaluated against four dermatophyte keratinophilic fungi (Microsporum canis, Epidermophyton floccosum, Trichophyton rubrum and Trichophyton mentagrophytes). Commercial EOs which showed the strongest mycelial growth inhibitions were selected and re-extracted in vitro from fresh plant samples. Minimal inhibition concentration (MIC) and antifungal index (AI) of pure and combined extracted oils and were evaluated. All samples were collected and examined during the year of 2014. The results revealed that commercial EOs of Prunus armeniaca, Prunus dulcis var. amara, Olea europaea and Mentha piperita were the most potent antidermatophyte. The mixture of the extracted four oils was the strongest fungicides followed by the alternative two-oil combined extractions then pure extracted oils. MIC was at 50, 25 and 12.5 μg/disc for pure oils, two-oil combinations and four-oil mixture, respectively. Achieved values of AI were found variable. Using of natural products like plant-derived EOs instead of chemotherapy on pathogens can be regarded as an environmental safety mode of diseases control.
    Environmental Health and Preventive Medicine 05/2015; DOI:10.1007/s12199-015-0462-6
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    ABSTRACT: Long-term exposure study was conducted to investigate the effects of extremely low-frequency electromagnetic field on the tumor promotion process and fertility. Ten pregnant C57BL/6NCrj mice were exposed to 50 Hz field 500 mG for 1 week (12 h per day), and 24 male and 42 female B6C3F1mice born from them were further exposed up to 15.5 months. As a control group, 10 pregnant mice were bred without exposure, and 30 produced male and 32 female mice were observed without exposure for the same period. Mean body weights of exposed groups of male and female mice were decreased significantly than those of the control groups. In exposed mice, there was no increased incidence of liver and lung tumor. In female mice, the incidence of chronic myeloid leukemia [3/42 (7 %)] in the exposed group was significantly greater than in the control group. The size of seminiferous tubules in the EMF exposed groups were significantly less than the control group. These data support the hypothesis that long-term exposure of 50 Hz magnetic fields is a significant risk factor for neoplastic development and fertility in mice.
    Environmental Health and Preventive Medicine 05/2015; DOI:10.1007/s12199-015-0463-5
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    ABSTRACT: A significant number of people in the North Central Province of Sri Lanka suffer from chronic kidney diseases (CKD), and the author revisits existing literature related to CKD to find its causative factor. There is a direct connection between high fluoride levels in drinking water and kidney disease, and there are unhealthy levels of fluoride in the groundwater in Sri Lanka's CKD-affected areas. Based on the following observations, the author believes with confidence that excess fluoride in drinking water and in the locally grown food in the affected areas are the culprits of CKD in Sri Lanka. Fluoride excretion rate is considerably lower in children than adults, leading to renal damage of children living in areas with high fluoride. Adults who had renal damage due to fluoride in childhood are vulnerable to CKD with continued consumption of water from the same source. Patients with chronic renal insufficiency are at an increased risk of chronic fluoride toxicity. High content of fluoride in groundwater paves the way to excess fluoride in local food crops, consequently adding more fluoride to the systems of the consumers. People who work outdoors for prolonged periods consume excess water and tea, and are subjected to additional doses of fluoride in their system. In the mid-1980s, the increase in water table levels of the affected areas due to new irrigation projects paved the way to adding more fluorides to their system through drinking water and locally grown foods.
    Environmental Health and Preventive Medicine 04/2015; DOI:10.1007/s12199-015-0464-4