Prevalence of Asthma among Young Men Residing in Urban Areas with Different Sources of Air Pollution.

Background: Asthma is a common respiratory disease, which is linked to air pollution. However, little is known about the effect of specific air pollution sources on asthma occurrence.

Objectives: To assess individual asthma risk in three urban areas in Israel characterized by different primary sources of air pollution: predominantly traffic-related air pollution (Tel Aviv) or predominantly industrial air pollution (Haifa bay area and Hadera).

Epidemiologic Surveillance in Israel of Cryptosporidium, a Unique Waterborne Notifiable Pathogen, and Public Health Policy.

Background: Cryptosporidium is a major threat to water supplies worldwide. Various biases and obstacles in case identification are recognized. In Israel, Cryptosporidiosis was included among notifiable diseases in 2001 in order to determine the burden of parasite-inflicted morbidity and to justify budgeting a central drinking water filtration plant.

Environmental risk factors associated with low birth weight: The case study of the Haifa Bay Area in Israel.

Background: Low birth weight (LBW) is known to be associated with infant mortality and postnatal health complications. Previous studies revealed strong relationships between LBW rate and several socio-demographic factors, including ethnicity, maternal age, and family income. However, studies of association between LBW rate and environmental risk factors remain infrequent.

Application of the double kernel density approach to the analysis of cancer incidence in a major metropolitan area.

Rationale: Although cancer is a main cause of human morbidity worldwide, relatively small numbers of new cancer cases are recorded annually in single urban areas. This makes the association between cancer morbidity and environmental risk factors, such as ambient air pollution, difficult to detect using traditional methods of analysis based on age standardized rates and zonal estimates.

Study Goal: The present study investigates the association between air pollution and cancer morbidity in the Greater Haifa Metropolitan Area in Israel by comparing two analytical techniques: the traditional zonal approach and more recently developed Double Kernel Density (DKD) tools.

Environmental rather than genetic factors determine the variation in the age of the infancy to childhood transition: a twins study.

Objective: Using a twins study, we sought to assess the contribution of genetic against environmental factor as they affect the age at transition from infancy to childhood (ICT).

Study Design: The subjects were 56 pairs of monozygotic twins, 106 pairs of dizygotic twins, and 106 pairs of regular siblings (SBs), for a total of 536 children. Their ICT was determined, and a variance component analysis was implemented to estimate components of the familial variance, with simultaneous adjustment for potential covariates.

Variables correlated with elderly referral from nursing homes to general hospitals.

Background: Referring patients from nursing homes to general hospitals exposes them to nosocomial diseases, and may result in the development of a broad spectrum of physical, mental and social damages. Therefore, minimizing the referring of nursing home patients to hospitals is an important factor for keeping the elderly healthy and minimizing health expenditures. In this study we examined the variables related to the referral rates from nursing homes to general hospitals and the relationship between the referral and the mortality rates among the elderly who live in nursing homes in the Haifa Sub-district.

Contribution of nitrogen oxide and sulfur dioxide exposure from power plant emissions on respiratory symptom and disease prevalence.

This study investigates the association between exposure to ambient NOx and SO2 originating from power plant emissions and prevalence of obstructive pulmonary disease and related symptoms. The Orot Rabin coal-fired power plant is the largest power generating facility in the Eastern Mediterranean. Two novel methods assessing exposure to power plant-specific emissions were estimated for 2244 participants who completed the European Community Respiratory Health Survey.

Residential proximity to petroleum storage tanks and associated cancer risks: Double Kernel Density approach vs. zonal estimates.

Background And Aims: The relationship between exposure to petroleum products and cancer is well-established in occupational studies carried out among employees of transportation and oil-producing industries. However, question remains whether living near petroleum storage facilities may represent a cancer risk. In the present study, we examined cancer incidence rates associated with residential proximity to the Kiryat Haim industrial zone in Northern Israel, using different analytical techniques and adjusting for several potential confounders, such as road proximity, population density, smoking rates and socio-demographic attributes.

High prevalence of childhood asthma in Northern Israel is linked to air pollution by particulate matter: evidence from GIS analysis and Bayesian Model Averaging.

The medical records of 3922 school children residing in the Greater Haifa Metropolitan Area in Northern Israel were analyzed. Individual exposure to ambient air pollution (SO(2) and PM(10)) for each child was estimated using Geographic Information Systems tools. Factors affecting childhood asthma risk were then investigated using logistic regression and the more recently developed Bayesian Model Averaging (BMA) tools.

Influenza vaccination coverage determinants among employees of the Nazareth Hospital in Israel.

Background: Health care workers bear the risk of both contracting influenza from patients and transmitting it to them. Although influenza vaccine is the most effective and safest public health measure against influenza and its complications, and despite recommendations that HCWs be vaccinated, influenza vaccination coverage among them remains low.

Objectives: To characterize influenza vaccination coverage and its determinants among employees in an Arab hospital in Israel.

Spatial analysis of air pollution and cancer incidence rates in Haifa Bay, Israel.

The Israel National Cancer Registry reported in 2001 that cancer incidence rates in the Haifa area are roughly 20% above the national average. Since Haifa has been the major industrial center in Israel since 1930, concern has been raised that the elevated cancer rates may be associated with historically high air pollution levels. This work tests whether persistent spatial patterns of metrics of chronic exposure to air pollutants are associated with the observed patterns of cancer incidence rates.

Who is affected more by air pollution-sick or healthy? Some evidence from a health survey of schoolchildren living in the vicinity of a coal-fired power plant in Northern Israel.

Objective: To evaluate the effects of exposure to air pollution by NO(x) and SO(2) on the development of pulmonary function of children, characterized by different health status.

Methods: A cohort of 1181 schoolchildren from the 2nd to 5th grades, residing near a major coal-fired power plant in the Hadera district of Israel, were subdivided into three health status groups, according to the diagnosis given by a physician at the beginning of the study period in 1996: (a) healthy children; (b) children experiencing chest symptoms, and (c) children with asthma or spastic bronchitis. Pulmonary Function Tests (PFTs) were performed twice (in 1996 and 1999) and analyzed in conjunction with air pollution estimates at the children's places of residence and several potential confounders-height, age, gender, parental education, passive smoking, housing density, length of residence in the study area and proximity to the main road.

Exploratory analysis of potential risk factors of a rare disease: spatial distribution of adrenocortical carcinoma in Israel as a case study.

The underlying assumption of the proposed exploratory approach is that, if the geographic patterns of different diseases are compared, the cases of a 'subject' disease should occur closer to cases of a disease with similar environmental risk factors (etiology) and farther away from cases of a disease with different etiology. In the present study, the performance of proposed approach is investigated by cross-examination of the spatial patterns of three widespread cancers--lung, larynx and colorectal (CRC)--with that of a rare malignant disease--Adrenocortical Carcinoma (ACC). As the analysis indicates, the spatial distribution of ACC is more likely to be related to hereditary factors than to environmental causes, in accordance with current knowledge about this rare disease.

On ecological fallacy, assessment errors stemming from misguided variable selection, and the effect of aggregation on the outcome of epidemiological study.

In social and environmental sciences, ecological fallacy is an incorrect assumption about an individual based on aggregate data for a group. In the present study, the validity of this assumption was tested using both individual estimates of exposure to air pollution and aggregate data for 1,492 schoolchildren living in the in vicinity of a major coal-fired power station in the Hadera region of Israel. In 1996 and 1999, the children underwent subsequent pulmonary function tests (PFT), and their parents completed a detailed questionnaire on their health status and housing conditions.

A change in rabies post-exposure treatment guidelines after decision analysis in Israel.

Background: Rabies remains a significant public health problem in Israel. Some 16 000-20 000 persons come yearly to the district health offices after being bitten by animals and 16-18% receive rabies post-exposure treatment. A quality assessment of the rabies post-exposure prophylaxis decisions was never held in Israel before.

Estimating the effect of air pollution from a coal-fired power station on the development of children's pulmonary function.

Using geographical information systems (GIS) tools, the present study analyzed the association between children's lung function development and their long-term exposure to air pollution. The study covered the cohort of 1492 schoolchildren living in the vicinity of a major coal-fired power station in the Hadera sub-district of Israel. In 1996 and 1999, the children underwent subsequent pulmonary function tests (PFT) (forced vital capacity (FVC) and forced expiratory volume during the first second (FEV(1))), and the children's parents completed a detailed questionnaire on their health status and household characteristics.

Classic Kaposi sarcoma. Which KSHV-seropositive individuals are at risk?

Background: Classic Kaposi sarcoma (CKS) is a relatively rare vascular disease primarily affecting human immunodeficiency virus (HIV)-uninfected elderly men. The infection with Kaposi sarcoma-associated herpesvirus (KSHV) is necessary for the establishment of Kaposi sarcoma (KS), although it is not sufficient. Thus, only a small fraction of KSHV-infected individuals develops KS.

Infection with Kaposi's sarcoma-associated herpesvirus among families of patients with classic Kaposi's sarcoma.

Background: Classic Kaposi's sarcoma (CKS) primarily affects elderly Mediterranean or Eastern European men. Incidence rates of CKS in Israel are among the world's highest. In practically all cases, antibodies against Kaposi's sarcoma-associated herpesvirus (KSHV) can be detected.

Is there an association between shigellosis incidence and socioeconomic status in metropolitan Haifa?

Background: Shigellosis incidence rates in Israel have declined continuously over the past 50 years, but they remain 20 times greater than those in the United States. Socioeconomic factors may influence shigellosis morbidity, but this may be difficult to demonstrate in the absence of data for individual patients and when using composite rates for large geographic areas. Use of census tract data for small, relatively homogeneous geographic areas may lessen the effects of the "ecological fallacy.