Exposome-based public health interventions for infectious diseases in urban settings

Andrianou, Xanthi; Pronk, Anjoeka; Galea, Karen S.; Stierum, Rob; Loh, Miranda; Riccardo, Flavia; Pezzotti, Patrizio; Makris, Konstantinos C.

doi:10.1016/j.envint.2020.106246

Cited by 29 publications

(22 citation statements)

References 34 publications

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“…Their activities and movements are influenced by businesses and organizations located in the environment of daily life ( Saarloos et al, 2009 ). The urban setting features, such as the location of commercial zones and public transportation and socioeconomic gradient, contribute and shape human exposure ( Andrianou et al, 2020 ; Wild, 2005 ). The area of community commercial activities, where a high possibility of close contact between people exists, potentially has a high risk of an uncontained outbreak of COVID-19 infection ( Lee et al, 2020 ).…”

Section: Hypothetical Conceptual Frameworkmentioning

confidence: 99%

Built environment and early infection of COVID-19 in urban districts: A case study of Huangzhou

You

et al. 2021

Sustainable Cities and Society

114

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Section: Hypothetical Conceptual Frameworkmentioning

confidence: 99%

Built environment and early infection of COVID-19 in urban districts: A case study of Huangzhou

You

et al. 2021

Sustainable Cities and Society

114

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“…The fact that the majority of children conformed to a sedentary lifestyle in combination with the higher consumption of sugar following the re-opening of schools needs to be reassessed in future prospective studies and should inform future policy making of promoting healthy lifestyle for children when measures such as stay-at-home orders are in place. The use of exposome tools will be important to identify susceptible sub-population groups and to facilitate the deployment of site-tailored public health measures [37] , promoting a healthier lifestyle during periods in which physical distancing is necessary.…”

Section: Discussionmentioning

confidence: 99%

Exposome changes in primary school children following the wide population non-pharmacological interventions implemented due to COVID-19 in Cyprus: A national survey

Konstantinou¹,

Andrianou²,

Constantinou³

et al. 2021

EClinicalMedicine

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Background: Non-pharmacological interventions (NPI), including lockdowns, have been used to address the COVID-19 pandemic. We describe changes in the environment and lifestyle of school children in Cyprus before the lockdown and during school reopening , and assess compliance to NPI, using the exposome concept. Methods: During June 2020, parents completed an online questionnaire about their children's lifestyle/behaviours for two periods; school reopening (May 21-June 26) following the population-wide lockdown, and the school period before lockdown (before March). Findings: Responses were received for 1509 children from over 180 primary schools. More than 72% of children complied with most NPI measures; however, only 48% decreased the number of vulnerable contacts at home. Sugary food consumption was higher in the post-lockdown period with 37% and 26% of the children eating sugary items daily and 4À6 times/week, compared to 33% and 19%, respectively, for the pre-lockdown period (p<0.001). Children's physical activity decreased compared to pre-lockdown (p<0.001), while screen time increased in the post-lockdown period, with 25% of children spending 4-7 hours/day in front of screens vs. 10% in the pre-lockdown period (p<0.001). About half of the children washed their hands with soap 4À7 times/day post-lockdown vs. 30% in the pre-lockdown period (p<0.001). Interpretation: This national survey showed a high degree of compliance to NPI measures among school children. Furthermore, the exposome profile of children may be affected in the months following NPI measures due to alterations in diet, physical activity, sedentary behaviour, and hand hygiene habits.

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“…The fact that the majority of children conformed to a sedentary lifestyle in combination with the higher consumption of sugar following the re-opening of schools needs to be reassessed in future prospective studies and should inform future policy making of promoting healthy lifestyle for children as part of a comprehensive response to epidemic waves. The use of exposome tools will be important to identify susceptible sub-population groups and to facilitate the deployment of site-tailored public health measures (26) promoting a healthier lifestyle during periods in which physical distancing is necessary.…”

Section: Discussionmentioning

confidence: 99%

Exposome changes in primary school children following the wide population non-pharmacological interventions implemented due to COVID-19 in Cyprus: a national survey

Konstantinou

Andrianou

Constantinou

et al. 2020

Preprint

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Background: School closures were part of a series of non-pharmacological intervention (NPI) measures addressing the COVID-19 pandemic in Cyprus. We aimed to study changes in the environment, diet, behavior, personal hygiene, contacts, lifestyle choices and the degree of compliance to NPI measures by primary school children in Cyprus at school and at home for two periods, i.e., before lockdown and during the school re-opening using the methodological context of the human exposome. Methods: During June 2020, an online survey questionnaire was forwarded to parents of primary school children through schools administrations, with questions about the children lifestyle/behaviours for two periods; school re-opening, following the population-wide lockdown (May 21-June 26, 2020), and the school period before lockdown (before March 2020). Descriptive statistics and exposome wide association analysis were implemented to agnostically assess associations of demographic, lifestyle and behavioral parameters with the degree of compliance to NPI measures. Findings: A total of 1509 children from more than 180 primary schools (out of 330 schools) in Cyprus were included. Median number of contacts per day at home, school and other places during weekdays was lower (p<0.001) in the post-lockdown period compared to the pre-lockdown period (5 vs 12, 10 vs 29 and 6 vs 14, respectively). Vulnerable contacts with children also decreased from 2[1, 3] in the pre-lockdown to 1[0, 2] in the post-lockdown period (p<0.001). Differences in sugary and ready-made food consumption, physical activity, screen time, digital communication and hand hygiene were noted between the two periods. More than 72% of children complied with the NPI measures, with the exception of the decrease in number of vulnerable contact(s) indicator (48%). Eating meat more frequently post-lockdown and doing less physical activity during school break post-lockdown were positively associated with increased time spent at home post-lockdown. Furthermore, the odds of compliance, as indicated by the time spent at home post-lockdown were lower with days elapsing from school re-opening, living in smaller town and using antiseptic more frequently pre-lockdown. Interpretation: In this national survey, children showed a high degree of compliance to most NPI measures for the community and primary school settings in Cyprus. The initial NPI measures may have affected children exposome profile in the following months, by altering their diet, physical activity, sedentary lifestyle and hand hygiene habits.

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Exposome-based public health interventions for infectious diseases in urban settings

Cited by 29 publications

References 34 publications

Built environment and early infection of COVID-19 in urban districts: A case study of Huangzhou

Built environment and early infection of COVID-19 in urban districts: A case study of Huangzhou

Exposome changes in primary school children following the wide population non-pharmacological interventions implemented due to COVID-19 in Cyprus: A national survey

Exposome changes in primary school children following the wide population non-pharmacological interventions implemented due to COVID-19 in Cyprus: a national survey

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