Association between exposure to household smoking and dental caries in preschool children: a cross-sectional study

BACKGROUND@#We aimed to examine the association of exposure to environmental tobacco smoke with dental caries among preschool children. Exposure to environmental tobacco smoke was assessed in terms of urinary cotinine concentrations and pack-years of exposure to smoking by parents and other family members at home.@*METHODS@#This cross-sectional study included 405 preschool children aged 3-6 years from two preschools in Japan in 2006. Information on the smoking habits of family members living with the child was obtained from parent-administered questionnaires. Dental examination was conducted to assess dental caries, that is, decayed and/or filled teeth. Urinary cotinine levels were measured using first-void morning urine samples.@*RESULTS@#Overall, 31.1% of the children had dental caries, and 29.5% had decayed teeth. Exposure to current maternal and paternal smoking was positively associated with the presence of dental caries after controlling for covariates. More than three pack-years of exposure to maternal smoking and more than five pack-years of exposure to smoking by all family members were significantly associated with the presence of dental caries as compared with no exposure (odds ratio [OR] = 5.55, 95% confidence interval [CI] = 2.17-14.22, P for trend < 0.001 and OR = 2.00, 95% CI = 1.12-3.58, P for trend = 0.004, respectively). These exposure variables were similarly associated with the presence of decayed teeth (OR = 2.92, 95% CI = 1.23-6.96, P for trend = 0.01 and OR = 1.75, 95% CI = 0.96-3.20, P for trend = 0.03, respectively). As compared with lowest tertile of the urinary cotinine level, the highest tertile of the urinary cotinine level was significantly associated with the presence of dental caries as well as decayed teeth; the ORs for the highest vs. lowest tertile of urinary cotinine levels were 3.10 (95% CI = 1.71-5.63, P for trend = 0.012) and 2.02 (95% CI = 1.10-3.70, P for trend = 0.10), respectively.@*CONCLUSIONS@#These data suggest that exposure to tobacco smoke may have a dose-dependent influence on the development of caries.

An impact of great flood on health among victims in Thailand- a descriptive study based on emergency relief activities / 国際保健医療

<B>Introduction</B><BR>Floods are the most common natural disaster. Although infectious diseases are paid attention in flood settings, public health impact from other diseases has been rarely discussed. In Thailand, a large-scale flood disaster severely affected local people and the societies mainly in the North and Central regions due to unusual heavy rain in 2011. To provide information on health issues from a prolonged flood, we reported the health issues among the patients in several areas of Thailand where a flood lasted more than 1 month.<BR><B>Methods</B><BR>Data on the patients were extracted from records of the collaborated activities between two NGOs in Thailand and Japan in three areas of two provinces in the Central region at the end of November, 2011. The data on the venues were also abstracted: main stations for medical care in three areas and mobile clinics at evacuation centers (tent, temple, and school) in two areas. We evaluated distributions of health issues, and examined the characteristics of the distributions stratifying by place and patients' age.<BR><B>Results</B><BR>High prevalence was observed for muscle and joint pain, chronic diseases, and acute respiratory infections. Among patients with the infections, 96 % or more was those with upper respiratory infections. In the evacuation centers, the prevalence of acute respiratory infections was high (39 %) at school compared to that at other places. The prevalence of muscle and joint pain sharply increased among patients in their 30's, which was highest among those in their 40's and 50's.<BR><B>Conclusions</B><BR>Muscle and joint pain, chronic diseases, and acute respiratory infections were main issues in this flood setting. This study would provide information on potential health issues in the coming floods. Future research is needed to examine whether an occurrence of flood disaster could be associated with increased risk of muscle and joint pain.

The Role and Significance of a Mobile Unit Providing Prostheses in Thailand / 国際保健医療

<b>Introduction</b><br> Developing countries have many urgent issues to cope with, such as infectious diseases, and therefore people with disabilities have not had enough opportunities to receive rehabilitation services. A mobile unit as an outreach approach seems to be valuable in countries or areas lacking in adequate health care facilities. In Thailand, there are about 56 thousand people with lower extremity amputations. There are very few workshops and technicians in health care facilities producing prostheses. We studied a working mobile unit to clarify its effectiveness.<br><b>Method</b><br> We conducted participatory observations of the mobile unit in Chiang Rai, Thailand in October, 2006 run by the Prostheses Foundation, and hearings from the staff and the amputees to collect the information such as outlines of the foundation and the unit, and the number of participants. We collected data on those amputees from the reception note, such as their occupations, causes of amputations, kinds of prostheses, and their experiences of using prostheses.<br><b>Results</b><br> The mobile unit was a huge scale activity including 75 staff members, who visited the field with all necessary equipments. Fifty-four technicians produced 204 prostheses for 177 amputees in 4 days. Eighty percent of those amputees were unstable in income, such as farmers and those unemployed. Landmines were the cause of amputation for 20 percent of those seen. Thirty percent experienced their prostheses initially, 20 percent of whom had waited for 6 years or more to receive them. Therefore, it was found to be an effective activity to provide prostheses for poor people with amputations in rural areas. Also, technicians in rural areas learnt skills regarding prostheses from specialists in cities.<br><b>Conclusions</b><br> A mobile unit seems to be effective in Thailand to provide amputees with prostheses, and Prosthetics and Orthotics technicians in rural areas with opportunities for education.