Jana Jurkovicova

Community response to environmental noise and the impact on cardiovascular risk score.

OBJECTIVE The objective of our study was to investigate and evaluate the relationship between road traffic noise and cardiovascular risk. METHODS The study sample (n=659; 36.9% male, 63.1% female university students, mean age 22.83+/-1.58 years) included a group exposed to road traffic noise (n=280, L(eq,24h)=67+/-2dB(A)) and a control group (n=379, L(eq,24h)=58.7+/-6dB(A)). Subjective response was determined by a validated noise annoyance questionnaire. The ten year risk of developing a coronary heart disease event was quantified as an evaluation of cardiovascular risk (SCORE60, Framingham 10-year risk estimation and projection to the age of 60, relative risk SCORE chart). RESULTS Cardiovascular risk scores were significantly higher in the exposed group based on the Framingham scores projected to the age of 60, SCORE60 (AOR=2.72 (95% CI=1.21-6.15)) and the relative risk SCORE chart (AOR=2.81 (1.46-5.41)). CONCLUSIONS These findings highlight the association between road traffic noise and cardiovascular risk.

Environmental noise and cardiovascular disease in adults: Research in Central, Eastern and South-Eastern Europe and Newly Independent States

The adverse effects of noise on health have been intensely explored in the past 50 years. However, the scope of research conducted in the Central and Eastern Europe, South-East Europe, and Newly Independent States is not well-known. The aim of this review was to present studies on cardiovascular effects of environmental noise in adults published since 1965 and to point out the most important issues that need to be addressed in the future. More than 100 papers on noise and health and about 20 papers on cardiovascular effects of environmental noise in adults were identified by literature search. The authors reviewed scientific international and local journals, conference proceedings, and local reports published in national languages. The major endpoints were high blood pressure, ischemic heart disease, and myocardial infarction. The target populations were adults. Experimental and exposure-assessment studies, field, empirical studies, social surveys, and epidemiological studies are presented. The major sources of environmental noise were road and air traffic. The results were presented in tables and the most relevant articles were briefly discussed. The importance of this review is that it refers to some countries that no longer exist in the same political and governmental systems. The strength of this paper is that it includes publications that were not evaluated in earlier systematic reviews. Strategies for future noise-related research on national and global level are proposed.

Environmental Noise and Annoyance in the Urban Area at Different Time Intervals

Environmental (community) noise, particularly road traffic noise, has attracted widespread attention in recent decades as a major environmental health concern. The aim of the study was to determine the impact of environmental noise on psychosocial well-being of young healthy individuals and to follow the time trends of exposure in the period of 10, 15, 20, 25 years. The validated methodology was used to assess noise annoyance, interference with activities and sleep disturbance; the objectification of noise levels was done by direct measurement using sound level analyzer with a module for frequency analysis. The results revealed the sharp increase during the years 1989 and 1999 (the period of political and socio-economic transformation and the changes in traffic management) and the decrease in the year 2013. The findings of our study indicate the need for preventive measures to reduce environmental noise exposure in residential areas and to emphasize the importance of the elaboration of methods for environmental noise exposure risk assessment.

Determinants of ETS exposure in a sample of Slovak pregnant women.

Abstract Environmental tobacco smoke (ETS) is one of the greatest and the most frequent environmental toxic exposures presenting a high risk to children and to their mothers as well. The aim of the study was to find determinants of the household ETS in the sample of pregnant women living in the household with smokers and to assess their physical and mental health. The survey was distributed to women being seen for follow-up at the obstetric/gynecology departments in hospitals and at gynecological out-patient departments in Bratislava, Slovakia. The medical outcomes short form-12 (SF-12) was included to quantify the mental and physical health of mothers. From the total sample of 617 women, 35.5% (219) were pregnant, 88.6% of them (194) non-smokers, 27.8% (54) lived with a smoking partner, the average mental component summary (MCS) score was 50.8±9.1 and physical component summary (PCS) score was 41.6±10.3. The average age was 31.3±5.1 years. In the sample of 309 non-pregnant non-smoking mothers 23% (71) lived with a smoking partner; the average age was 31.7±4.8 years. The average PCS score was 47.8±8.7 and MCS score 49.1±9. Non-smoking, pregnant women living with a smoker have fewer years of education (p=0.0003) and lower MCS scores (48.50±9.8) (p=0.03). Non-smoking, non-pregnant women living with a smoker are older (p=0.0042), with lower income (p=0.0145), have fewer years of education (p=0.002) and lower PCS score (45±9.1) (p=0.0056). Multivariate analyses revealed the decrease of MCS score in pregnant women and the decrease of PCS score in non-pregnant women living with a smoker. Our results show that living with a smoker is independently associated with worse physical and mental health in a selected sample of Slovak women, which represents an important argument for intervention in families.

Maternal Smoking and Child Behavior in Slovakia

Background: Numerous human epidemiologic and animal studies indicate that childrens secondhand smoke exposure (SHS) is associated with increased rates of child behavior problems. Objective: To investigate the relation between childrens exposure to SHS in their homes and rates of child behavior problems in Slovakia, an area where such investigation has not been previously investigated and where rates of adult smoking are substantially higher than they are in the United States. Setting and Method: Surveys were administered to parents of 1,478 children ages 6 to 15 years throughout Slovakia. Information was collected about child and family sociodemographic characteristics (child age and gender, household income and residence, and maternal and paternal educational and smoking status), and child behavior problems were assessed using the well-utilized parent-reported Child Behavior Problem Index. Bivariate and multivariate analyses were conducted. Results: The response rate was 73 percent, and girls and children from more affluent families were less likely to have behavior problems (in multivariate analyses the adjusted odds ratio for behavior problems and the 95 percent confidence interval (CI) for girls was 0.438 (95 percent CI = 0.286-0.669) and for those living in households earning more than the average income was 0.395 (95 percent CI = 0.260-0.599). In contrast, there was no evidence in bivariate or multivariate analyses of increased rates of behavior problems in children living in households with smokers. Conclusion: Children exposed to household SHS in Slovakia were not found to have increased rates of behavior problems, possibly due to the substantially higher rate of smoking in this country than in the United States and the lack of regulations limiting smoking in public settings.

The Average Annual Percent Change Analyzes of Preventive Dental Care in the Slovak Republic, 2014-2016

Objective: To analyse of the average annual percent change (AAPC) of registered dental patients, patients with preventive dental care and patients requiring dental treatment in the period of 2014-2016 in the Slovak Republic. Material and Methods: Data from registered dental patients (n=14,736,888), patients with preventive dental care (n=8,212,441) and patients requiring dental treatment (n=5,262,323) in the period of 2014-2016 were obtained from the Statistical Office of the Slovak Republic; 28,211,652 dental patients were analysed. The Theil-Sen estimator of trend line based on median and its significance was tested by nonparametric Wilcoxon test using statistical software R package. Results: The significant decrease (-4.11%) of the AAPC rates of registered dental patient (p<0.05) during the entire period (2014-2016) can be observed in age subcategory 15-18 years, while in age subcategory 19+ years the non-significant increase (1.08%) of the AAPC rate of registered dental patients in the same period was achieved. In the period of 2014-2016, the highest AAPC rate of patients with preventive dental care with the significant decrease was found in age subcategory 6-14 years (-17.19%; p<0.001). The AAPC rate of patients requiring dental treatment proved the significant negative values in age subcategory 0-5 years (-7.26%; p<0.01), in age subcategory 6-14 years (-9.33%; p<0.001), in age subcategory 15-18 years (-8.81%; p<0.01). Conclusion: The highest decrease AAPC rate of registered dental patients was observed in age subcategory 15-18 years. The statistical significant decrease AAPC rate of patients with preventive dental care was found in children ≤ 18 years. In patients requiring dental treatment (≤ 18 y.) was observed decrease AAPC rate.

Exposure to Environmental Tobacco Smoke in Relation to Behavioral, Emotional, Social and Health Indicators of Slovak School Children

Environmental tobacco smoke (ETS) exposure has been shown in general as a major environmental risk factor and deserves attention in vulnerable population groups. The aim of the project is to analyze the relationships among the ETS and behavior and health in 6−15-year-old children in Slovakia. The status of physical and mental health of children in relation to exposure to tobacco smoke was examined in a representative group of 1478 school children. The methods used, included anonymous questionnaires filled in by parents, Columbia Impairment Scale (CIS), Behavior Problem Index (BPI) and anthropometry. The prevalence of ETS exposure is the highest in the capital (27%) and southern cities. A significant association was found between ETS and age, socio-economic status, incompleteness of the family, level of mother’s education and a higher prevalence of respiratory diseases (26.7%). The relationships of ETS with emotional (CIS scores ≥ 16) and behavioral functions (BPI score ≥ 14) were significant in children exposed to mother’s or father’s smoking at home. In the multivariate analysis these associations were not significant; the factors such as income and completeness of the family were dominant. The results showed mostly the predominant impact of social factors on the physical and mental health status of Slovak school children.

The Analysis of Selected Malocclusion Risk Factors: A Pilot Study

Objective: To analyse selected malocclusion risk factors, their exposure time and overall malocclusion risk scores. Material and Methods: The self-prepared questionnaires were collected at dental practitioners’ waiting rooms from 6/2014 to 12/2015. The study group consisted of patients treated by dental braces (n=82; 15.5±4.4 years) and the control group consisted of other patients not treated by dental braces (n=45; 17.6±4.7 years). Data were processed by the statistical program SPSS using descriptive statistics. To verify the hypothesis wad used two sample t-test to compare the average exposure scores and the exposure time between the two groups. To determine associations between categorical variables was used Chi-square test. Statistical significance was set at p-value <0.05. Results: Our results confirmed longer exposure times in all studied malocclusion risk factors, in the case of pacifier sucking the difference was significant (p=0.001). The longest exposure time was found in mouth breathing in the study group (12.2±6.5 years). The lip sucking/chewing cannot be confirmed as a malocclusion risk factor. The study group had higher level of an overall mean risk score (19.8±11.5) compared the control group (16.1±12.1), although not significant. It can be concluded that non-nutritive sucking habits and/or mouth breathing could have damaging effect to normal teeth development. Conclusion: Malocclusions could be preventable, thus we recommend setting up educational programs for dentists and paediatricians as well as for parents focusing on the improvement of oral health knowledge.

Prevalencia nadváhy a obezity u adolescentov a jej asociácia s kardiometabolickými rizikovými faktormi a životným štýlom

V sucasnosti celosvetovo sledujeme narast prevalencie obezity ako jedneho z rizikových faktorov kardiovaskularnych chorob nielen v dospelej populacii, ale už aj u deti a mladistvých. V praci prezentujeme prevalenciu nadvahy a obezity v subore 2 629 adolescentov (45,8 % chlapcov) vo veku 14-18 rokov a porovnanie vybraných kardiometabolických markerov v skupine s normalnou hmotnosťou a v skupine s nadvahou/obezitou so zreteľom na telesnu zdatnosť a vybrane faktory životneho stýlu. Uskutocnili sme zakladne antropometricke vysetrenie zamerane na nadvahu/obezitu, celkovu telesnu zdatnosť sme hodnotili pomocou Ruffierovho testu. Z venoznej krvi sa vysetril kompletný lipidový profil, hladina glykemie, C-reaktivny protein a homocystein, z vysetrených parametrov sme vypocitali hladinu LDL-cholesterolu a aterogenny index plazmy (log TAG/HDL-cholesterol). Merali sme krvný tlak a pokojovu pulzovu frekvenciu, objektivne vysetrenie doplnilo vyplnenie obsiahleho dotaznika, kde sme sa zamerali najma na vybrane charakteristiky životneho stýlu. V pasme nadvahy/obezity bolo 30,7 % chlapcov (13,1 % obeznych) a 22,9 % dievcat (7,9 % obeznych). Adolescenti s nadvahou/obezitou mali s výnimkou glykemie a hladiny homocysteinu vsetky biochemicke ukazovatele významne horsie, mali významne vyssie priemerne hodnoty krvneho tlaku, rýchlejsiu pokojovu pulzovu frekvenciu (chlapci významne) a horsie ukazovatele telesnej zdatnosti; metabolický syndrom sme zistili u 5,5 % adolescentov s nadvahou/obezitou. V skupine s normalnou hmotnosťou pozorujeme v stravovacom režime castejsiu a pravidelnejsiu konzumaciu jednotlivých denných jedal, významne vyssi priemerný pocet jedal denne, nevýznamne dlhsie trvanie týždennej telesnej aktivity, kratsi cas venovaný sledovaniu TV a u chlapcov dlhsie trvanie spanku. Výsledky potvrdili horsi kardiovaskularny rizikový profil a výskyt metabolickeho syndromu v skupine s nadvahou/obezitou už v adolescentnom veku a potrebu intenzivnej primarnej prevencie a intervencie zameranu najma na prevenciu obezity už od najmladsich vekových skupin.