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      Pediatrician’s Perception of Air Pollution and its Impact on Children’s Health in Indonesia

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          Abstract

          Introduction

          Air pollution is an unseen threat to children's health as it increases the risk of respiratory infection by impairing immune responses to the respiratory tract. Nevertheless, health promotion emphasizing the impact of air pollution is not popular, even among health professionals. Therefore, this study aimed to explore the perceptions of paediatricians regarding its impact on children’s health in Indonesia.

          Materials and Methods

          A cross-sectional design using an online questionnaire was employed in this study. It was composed of 30 items and divided into 4 sections, i.e. section 1 explored the demographic variables, section 2 measured the respondent’s information-seeking behavior on the issue of air pollution, section 3 measured the perception of issues related to air pollution and its impact on children’s health, and section 4 explored the respondent’s experience in practicing environmental health education with respect to their patients. Only completed surveys were analysed.

          Results

          Of the 171 pediatricians who were accessed for the survey, 120 (70.2%) completed it. The majority of respondents (69%) resided in Java island and worked in urban areas (84%). About 41.7% of the respondents had little to no information on the impact of air pollution on children’s health. More than 80% of the respondents received information from scientific articles, followed by seminars (61.5%), the internet (53.8%), colleagues (30.7%), and workshops/training (17.3%). Nearly one-third of the respondents considered air quality as poor in their working environment. Almost all agreed that air pollution can affect children’s health and increase the risk of respiratory allergies and even the risk of skin allergies for children under two years of age. In daily practice, most respondents (53.3%) admitted that they never or rarely treated patients with diseases related to air pollution. About one-third of the respondents (36.7%) had never or rarely asked their patients about their living environment.

          Conclusion

          Pediatricians are aware of the impact of air pollution on the risk of respiratory allergies and infection, and therefore often provide environmental health education to patients. This study has reported that the majority of pediatricians in Indonesia have an understanding of the impact of air pollution on children’s health; however, there is still a lack of health promotion to be communicated to the patients and their families in their daily practice.

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          Most cited references26

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          Environmental and Health Impacts of Air Pollution: A Review

          One of our era's greatest scourges is air pollution, on account not only of its impact on climate change but also its impact on public and individual health due to increasing morbidity and mortality. There are many pollutants that are major factors in disease in humans. Among them, Particulate Matter (PM), particles of variable but very small diameter, penetrate the respiratory system via inhalation, causing respiratory and cardiovascular diseases, reproductive and central nervous system dysfunctions, and cancer. Despite the fact that ozone in the stratosphere plays a protective role against ultraviolet irradiation, it is harmful when in high concentration at ground level, also affecting the respiratory and cardiovascular system. Furthermore, nitrogen oxide, sulfur dioxide, Volatile Organic Compounds (VOCs), dioxins, and polycyclic aromatic hydrocarbons (PAHs) are all considered air pollutants that are harmful to humans. Carbon monoxide can even provoke direct poisoning when breathed in at high levels. Heavy metals such as lead, when absorbed into the human body, can lead to direct poisoning or chronic intoxication, depending on exposure. Diseases occurring from the aforementioned substances include principally respiratory problems such as Chronic Obstructive Pulmonary Disease (COPD), asthma, bronchiolitis, and also lung cancer, cardiovascular events, central nervous system dysfunctions, and cutaneous diseases. Last but not least, climate change resulting from environmental pollution affects the geographical distribution of many infectious diseases, as do natural disasters. The only way to tackle this problem is through public awareness coupled with a multidisciplinary approach by scientific experts; national and international organizations must address the emergence of this threat and propose sustainable solutions.
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            Trust and sources of health information: the impact of the Internet and its implications for health care providers: findings from the first Health Information National Trends Survey.

            The context in which patients consume health information has changed dramatically with diffusion of the Internet, advances in telemedicine, and changes in media health coverage. The objective of this study was to provide nationally representative estimates for health-related uses of the Internet, level of trust in health information sources, and preferences for cancer information sources. Data from the Health Information National Trends Survey were used. A total of 6369 persons 18 years or older were studied. The main outcome measures were online health activities, levels of trust, and source preference. Analyses indicated that 63.0% (95% confidence interval [CI], 61.7%-64.3%) of the US adult population in 2003 reported ever going online, with 63.7% (95% CI, 61.7%-65.8%) of the online population having looked for health information for themselves or others at least once in the previous 12 months. Despite newly available communication channels, physicians remained the most highly trusted information source to patients, with 62.4% (95% CI, 60.8%-64.0%) of adults expressing a lot of trust in their physicians. When asked where they preferred going for specific health information, 49.5% (95% CI, 48.1%-50.8%) reported wanting to go to their physicians first. When asked where they actually went, 48.6% (95% CI, 46.1%-51.0%) reported going online first, with only 10.9% (95% CI, 9.5%-12.3%) going to their physicians first. The Health Information National Trends Survey data portray a tectonic shift in the ways in which patients consume health and medical information, with more patients looking for information online before talking with their physicians.
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              Trust in the health care professional and health outcome: A meta-analysis

              Objective To examine whether patients’ trust in the health care professional is associated with health outcomes. Study selection We searched 4 major electronic databases for studies that reported quantitative data on the association between trust in the health care professional and health outcome. We screened the full-texts of 400 publications and included 47 studies in our meta-analysis. Data extraction and data synthesis We conducted random effects meta-analyses and meta-regressions and calculated correlation coefficients with corresponding 95% confidence intervals. Two interdependent researchers assessed the quality of the included studies using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Results Overall, we found a small to moderate correlation between trust and health outcomes (r = 0.24, 95% CI: 0.19–0.29). Subgroup analyses revealed a moderate correlation between trust and self-rated subjective health outcomes (r = 0.30, 0.24–0.35). Correlations between trust and objective (r = -0.02, -0.08–0.03) as well as observer-rated outcomes (r = 0.10, -0.16–0.36) were non-significant. Exploratory analyses showed a large correlation between trust and patient satisfaction and somewhat smaller correlations with health behaviours, quality of life and symptom severity. Heterogeneity was small to moderate across the analyses. Conclusions From a clinical perspective, patients reported more beneficial health behaviours, less symptoms and higher quality of life and to be more satisfied with treatment when they had higher trust in their health care professional. There was evidence for upward bias in the summarized results. Prospective studies are required to deepen our understanding of the complex interplay between trust and health outcomes.
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                Author and article information

                Journal
                TOPHJ
                Open Public Health J
                The Open Public Health Journal
                Open Public Health J.
                Bentham Science Publishers
                1874-9445
                04 October 2023
                2023
                : 16
                : e187494452308250
                Affiliations
                [1 ] deptDepartment of Community Medicine, Faculty of Medicine , Universitas Indonesia , Jakarta, Indonesia
                [2 ] Medical and Science Affairs Division, Danone Specialized Nutrition, Jakarta , Indonesia
                Author notes
                [* ]Address correspondence to this author at the Department of Community Medicine, Faculty of Medicine, Universitas, Jakarta, Indonesia; E-mail: ray.basrowi@ 123456gmail.com
                Article
                e187494452308250
                10.2174/18749445-v16-e230925-2023-108
                8351de20-5180-45cf-ae6d-150f19ff4334
                © 2023 The Author(s). Published by Bentham Open.

                This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 23 April 2023
                : 11 July 2023
                : 30 July 2023
                Categories
                Medicine

                Medicine,Chemistry,Life sciences
                Children’s health,Air pollution,Respiratory,Skin allergies,Pediatrician,Pediatricians

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