Awareness bias in environmental health research is the tendency to report more illness because of concerns arising from proximity to a hazard in the absence of a measurable biological effect. Such ...bias complicates the interpretation of self-reported symptoms in communities exposed to emissions from heavy industry. We used data from two epidemiologic studies in Northeast England where community concerns existed about health risks from industry. An association between proximity to industry and self-reported respiratory and nonrespiratory illnesses and symptoms had been found in one study but not in the other. An indicator of concern about industrial pollution was constructed from responses to a 17-item questionnaire about issues that had caused stress or anxiety. Univariate and multivariate analyses of health outcome variables in both studies showed that individuals with "industry-related worries" reported more illness, irrespective of proximity to industry. We conclude that self-reported illness was influenced by both worry and proximity to industry, but that worry about the hazard had the greatest effect on self-reported illness. We suggest that because absolute certainty about the role and extent of awareness bias in environmental epidemiology studies is unlikely to be achieved, self-reported data should be supplemented with other observations.
Review of web sites, CD-ROMs and books Ott, Cordula; Schmidt, Matthias; Hickey, Anthony ...
Mountain Research and Development,
02/2005, Letnik:
25, Številka:
1
Book Review, Journal Article
An epidemiological study of the impact of industrial pollution from a coking works in north-east England on the health of a population resident nearby uncovered strong but localised public concern ...about the possible dangers of air pollution. This paper discusses these popular concerns in the context of empirical findings from the study which examined evidence of ill-health alongside evidence on air quality levels. The substantive issues this paper examines relate to local variations in popular beliefs about health risks, and the relation between such beliefs and measurable differences in health states and status. The methodological issues addressed centre on the difficulties of interpreting this relationship between popular beliefs and concerns, on the one hand, and health experience, or apparent health experience, on the other.
OBJECTIVE--To determine whether there was excess ill health in people living near a coking works, and if so whether it was related to exposure to coking works' emissions. DESIGN--Populations varying ...in proximity to the coking works were compared with control populations. Health data were correlated with available environmental data. METHODS--Analysis of routinely collected mortality, cancer registration, and birth statistics; community survey using self completed postal questionnaires; retrospective analysis of general practice (GP) records; tests of respiratory function; and analysis of available environmental data. MAIN RESULTS--Study and control populations were comparable in terms of response rates, gender, and most socioeconomic indicators. For adults, age standardised mortality and cancer rates of the population closest to the coking works were comparable with those for the district as a whole. Gender ratios, birthweight, and stillbirth rates were comparable in the study and control populations. For several indicators of respiratory health including cough, sinus trouble, glue ear, and wheeze (but not for asthma and chronic bronchitis) there was a gradient of self reported ill health, with the highest prevalence in areas closest to the works. For example, sinus trouble was reported by 20% of adults and 13% of children in the area closest to the works compared with 13% and 6% respectively in the control area. GP consultations for respiratory disorders increased when pollution (measured by SO2 levels) was high: annual consultation rates per 1000 varied from 752 in the top group of daily pollution levels to 424 in the bottom group. Analysis of locally collected smoke and SO2 data indicated that SO2 concentrations were highest closest to the works and, after closure of the coking works, the number of days on which SO2 and smoke levels exceeded 100 micrograms/m3 and 90 micrograms/m3, respectively, fell steeply. CONCLUSION--Routinely available indicators failed to provide convincing evidence that the coking works had harmed health. Self report and GP consultations indicated that respiratory ill health in the people living close to the works was worse than expected. Some of the excess probably resulted from exposure to coking works emissions. The health effects of relatively low level but intermittently high air pollution from a point source may be subtle, contributing to respiratory morbidity, but not apparent in analysis of routine health indicators.
This article examines the centrality of 'safety' in Grangemouth's recent politics. Scotland's main petrochemical center is a town dominated for well over fifty years by a major BP complex. In a ...context of extensive redundancies at BP, new insecurities surrounding the future of the company's Grangemouth site, and a series of recent accidents, as well as controversy over planning applications from other chemical companies, the town has been pushed into unusually searching questioning about both safety and economic security. This article explores the different lines of reasoning and rationalization on risk, safety, and the future advanced by regulators, BP, and residents and their political representatives. We emphasize how important the familiarity of petrochemical technology has been in public responses to the question of safety, in contrast to many environmental risk controversies. And we argue that safety has provided a focus for social, moral, economic, and political perspectives on the town's present circumstances and future prospects to be played out.
OBJECTIVE An epidemiological investigation to assess the validity of residential proximity to industry as a measure of community exposure. METHODS 19 Housing estates in Teesside (population 1991: 77 ...330) in north east England were grouped into zones: A=near; B=intermediate; C=further from industry. With residential proximity of socioeconomically matched populations as a starting point a historical land use survey, historical air quality reports, air quality monitoring, dispersion modelling data, and questionnaire data, were examined. RESULTS The populations in zones A, B, and C were similar for socioeconomic indicators and smoking history. Areas currently closest to industry had also been closest for most of the 20th century. Historical reports highlighted the influence of industrial emissions to local air quality, but it was difficult to follow spatial pollution patterns over time. Whereas contemporary NOx and benzene concentrations showed no geographical variation, dispersion modelling of emissions (116 industrial stacks, traffic, and domestic sources) showed a gradient associated with industry. The presumed exposure gradient of areas by proximity to industry (A>B>C) was evident for all of zone A and most of zones B and C. CONCLUSIONS It was feasible to assemble a picture of community exposure by integration of measurements from different sources. Proximity of residence was a reasonable surrogate for complex community exposure.
For women, marriage is axiomatic in rural India. On the fringes of the Himalaya in Kangra, however, the status of sādhin offers a small number of women an unconventional, but respectable, alternative ...to the accepted female roles of wife and mother. The name carries ascetic connotations, and the status derives its legitimacy from association with the Hindu ascetic tradition. Yet it is marriage and sexuality which a sādhin renounces, not worldly life generally: she remains in her natal village, may acquire property, and most visibly dresses and acts in many contexts like a man. This account links the highly localized and comparatively recent historical emergence of this unusual practice with the settlement in Kangra of Gaddis and neighboring Hindu groups, migrating from the mountainous interior over the last century, and with the consequent collision of differing codes and conventions about women's conduct. At issue is the regulation of female sexuality and the impossibility of simple spinsterhood in Kangra's culturally fastidious environment.
Rural health inequalities have been relatively neglected in recent years. The data assembled for a large study of health and deprivation in the Northern Region of England have been reanalysed to ...examine three questions. How wide are rural health inequalities compared with those in urban areas? Is health intrinsically better in rural areas, given comparable deprivation or affluence? Is the association between health and wealth weaker in rural than in urban areas? It is shown that, although health inequalities are wider in urban areas, this corresponds to wider socioeconomic divisions: at equivalent levels of wealth, health measures are similar. This relationship breaks down, however, when the most remote rural areas are compared with matching localities in conurbations, for in this case rural areas have a clear advantage. We go on to show that the apparent weakness of the association between health and wealth in rural areas is largely an artefact; the association becomes stronger when the units of population (electoral wards) are enlarged to resemble more closely those in urban contexts. The comparability of rural and urban forms of deprivation is discussed in the light of these results.
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