Browsing by Author "Nandasena, Y.L.S."

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Air pollution and health in Sri Lanka: a review of epidemiologic studies
(BioMed Central, 2010) Nandasena, Y.L.S.; Wickremasinghe, A.R.; Sathiakumar, N.
BACKGROUND: Air pollution is increasingly documented as a threat to public health in most developing countries. Evaluation of current air quality levels, regulatory standards and scientific literature on outdoor and indoor air pollution, and health effects are important to identify the burden, develop and implement interventions and to fill knowledge gaps in Sri Lanka.METHODS: PUBMED and Medline databases, local journals and conference proceedings were searched for epidemiologic studies pertaining to air pollution and health effects in Sri Lanka. All the studies pertaining to air pollution and health effects were considered. RESULTS: Sixteen studies investigated the association between exposure to ambient or indoor air pollution (IAP) and various health outcomes ranging from respiratory symptoms, low birth weight and lung cancers. Of the sixteen, three used a case control design. Half of the studies collected exposure data only through questionnaires. There were positive associations between air pollution and adverse health effects in all studies. Methodological limitations in most of the studies resulted in poor quantification of risk estimates. CONCLUSION: A limited number of epidemiological studies in Sri Lanka have investigated the health effects of air pollution. Based on findings of studies and reported air quality levels, air pollution may be considered a neglected public health problem in Sri Lanka.
Do newspapers fulfil the demand for adolescent reproductive health?
(Faculty of Medicine, University of Kelaniya & Plan International, 2008) Kumarendran, B.; Nandasena, Y.L.S.; Abeysena, C.
OBJECTIVE: To describe the expectations of adolescent school children, perceptions of editorial staff and coverage of topics of articles published by selected Sinhala newspapers regarding reproductive health. METHOD: Data were extracted from three national and three tabloid newspapers published during the period May to October 2007. Thematic analysis was done to analyse in-depth interviews of eleven editorial staff. One hundred and thirty four 17-18 year old school children were sampled using stratified (based on stream, sex and urban/rural) purposive sampling from the Gampaha district. Content analysis of 14 Focus Group Discussions (FGD) was done. RESULTS: Ninety two and 58 articles on reproductive health were published in national and tabloid papers respectively during the study period. Pregnancy related issues were the commonest topic addressed followed by reproductive system, commercial sex and sexually transmitted infections (STIs). Most of the published articles included photographs. The majority was written with the guidance of professionally qualified doctors. Although journalists knew the spectrum of reproductive health issues, they were more prone to write on STIs and less on homosexuality, virginity and family planning. The opportunities given for selecting a topic by the press authorities were not satisfactory. Adolescent girls were interested to read about puberty, menstruation, contraception, commercial sex, virginity and STIs and boys were interested to read about homosexuality, heterosexuality, masturbation, STIs, contraception and abortion. Most of the students claimed that they were not provided with adequate RH related knowledge by the newspapers. The way of presenting the articles was not, satisfactory. Most of the adolescents preferred information in simple language (than scientific jargon) in question and answer form without seductive photographs. CONCLUSIONS: Reproductive health coverage by newspapers are not satisfactory. Publishing articles to fulfil the expectations of adolescents would make newspapers a successful mode of RH education.
Effect of indoor air pollution due to solid fuel combustion on childhood respiratory diseases
(Sri Lanka Medical Association, 2014) Ranathunga, R.A.N.; Perera, K.P.J.; Nandasena, Y.L.S.; Kasturiratne, A.; Sathiakumar, N.; Wickremasinghe, A.R.
Introduction and objectives: To determine the association between indoor air pollution and respiratory symptoms in children under 5 years of age. Methods: A prospective study was conducted over a 22 month period in the Ragarna MOH area. All children under 5 years in the selected households were followed up for 12 months and data on respiratory symptoms were extracted from a symptom diary. Sodoeconomic data of the households and main fuel type used for cooking was recorded. Air quality measurements were made in a sub sample of househords. Results: 262 children were followed up. The incidence of lower respiratory tract infections (RR-1.513, 95% C.t= 1.071-2.158) and infection induced asthma (RR-1.758, 95% C.l= 1.159-2.718) were significantly higher among in children resident in households using biomass fuel compared to children resident in households using LPG and electricity. The incidence of asthma attacks, rhinitis exacerbations and rhino conjunctivitis exacerbations were not associated with exposure to indoor air pollution. Houses which used biomass fuel had significantly higher concentrations of CO (3.27 vs. 1.49) and PM2.5 (1.14 vs. 0.31} compared to houses using LPG and electricity for cooking but CO2 concentration was not higher. Conclusions: CO and PM2.5 concentrations are significantly higher in households which use biomass fuel for cooking. There is a 1.5 times higher risk of lower respiratory tract infections and 1.8 times higher risk of infection induced asthma among children resident in households using biomass fuel for cooking compared to children in households using LPG or electricity.
Fine particle air pollution due to secondhand smoke in selected public places in Colombo
(College of Community Physicians of Sri Lanka, 2009) Nandasena, Y.L.S.; Wickremasinghe, A.R.; Lee, K.; Sathiakumar, N.
INTRODUCTION: Globally, about five million deaths per year are attributed to tobacco smoke. Secondhand smoke accounts for a substantial proportion of these deaths. Most countries including Sri Lanka have legislation banning smoking in indoor workplaces and public places. Certain public places such as entertainment venues continue to permit smoking. Particulate matter (PM2.5) is a widely accepted indicator to evaluate secondhand smoke levels. OBJECTIVE: To determine PM2.5 concentrations in selected public places (defined as a space which can be visited without permission) in Colombo, Sri Lanka. METHODS: Using convenient sampling technique, we measured PM2.5 concentration levels in four types of public places (restaurants: n=6; bars: n=6; cafes: n=4; pubs and entertainment venues: n=4) during January to March, 2009. A particulate matter monitor (Model AM510 - SIDEPAK Personal Aerosol Monitor) was used to measure indoor air quality for 40 minutes and the immediate outdoors for 10 minutes before and after the indoor measurement. RESULTS: The mean indoor PM2.5 concentration was 124.9 ug/m3 (SD± 81.0) [range 33 ug/m3 - 299 ug/m3; median, 97.0 ug/m3]. The mean outdoor PM2.5 concentration was 39.7 ug/m3 (±14.3) [range 18 ug/m - 83 ug/m3; median, 37.5 ug/m3]. Indoor to outdoor (I/O) PM2.5 ratio ranged from 1.1 to 14.9. The highest PM2.s concentration was recorded in a bar and the highest I/O ratio in an entertainment venue. Smoking density (number of burning cigarettes divided by volume of the public place) was not correlated with average indoor PM2.5 concentration (Pearson correlation = 0.36, p=0.12) or with I/O PM2.5 ratio (Pearson correlation = 0.07, p=0.76). The reported values are equal or above, compared to such venues in other countries. CONCLUSION: The authorities should take steps in enforcing the smoking ban in public places. Areas where smoking is permitted, proper ventilation should be ensured.
Perceptions of editorial staff and coverage of reproductive health related newspaper articles and adolescents3 expectations
(Sri Lanka Medical Association, 2009) Kumarendran, B.; Nandasena, Y.L.S.; Abeysena, H.T.C.S.
OBJECTIVE: 1. To describe coverage of selected Sinhalese newspaper articles on reproductive health (RH) and to explore the attitudes of editorial staff related to RH publications. 2. To explore the mpressions and expectations of adolescent school children about reproductive health (RH) information published in Sinhalese newspapers METHODS: Most popular three national and three tabloid newspapers were identified through focus group discussions with adolescent school children in the Gampaha district. The newspapers published during the preceding six months (May to October 2007) to the survey were selected and data extraction was done by two medical officers. In-depth interviews were conducted with ditorial staff (n=ll) of the selected newspapers to explore their attitudes regarding the RH related publications and their constraints. Focus group discussions (FGD) were conducted among advanced level students (n=134) in five schools in the Gampaha district selected by stratified purposive sampling based on subject stream, sex and location (urban/rural). RESULTS: 268 articles were published on RH in national and tabloid papers during the reference period. Pregnancy related issues (n= 67, 25%) were the most commonly discussed topic in both types of newspapers. Other articles were mainly on sexually transmitted diseases (n=38, 14.2%), commercial sex (n=35, 13.1%), and abortion (n= 26, 9.7%). Most of the published articles included photographs. Half (n= 138) of the articles were written with the guidance of qualified medical doctors. Although the spectrum of RH issues was known, the journalists tend to write on topics such as sexually transmitted diseases but not on homosexuality, virginity and family planning. This narrow coverage was due to limited space, cultural restrictions in the selection of topics and inadequate guidance from medical personnel. The majority of the students were not satisfied about the adequacy of various aspects covered and presentation of RH related information by newspapers. CONCLUSION: RH related newspaper information was limited to selected topics. Although journalists knew the spectrum of RH related topics, publications were limited to selected topics. The topics covered on RH by newspapers were not presented in an adolescent friendly manner and were not on areas that they have a quest for.
Socio-demographic characteristics and principal cooking fuel type in Sri Lanka: comparison of data from two Demographic and Health Surveys
(College of Community Physicians of Sri Lanka, 2009) Nandasena, Y.L.S.; Wickremasinghe, A.R.; Sathiakumar, N.
INTRODUCTION: Indoor air pollution is a growing public health concern due to its well documented ill effects. Biomass- cooking fuel is the main source of indoor air pollution in the majority of households in the developing world. OBJECTIVES: To determine the trends of cooking fuel pattern and associated factors in Sri Lanka. METHODS: Determinants and the use of cooking fuel in households in Sri Lanka were abstracted from data collected by the Demographic Health Surveys (DHS) of 2000 and 2007. The DHS was based on a representative sample (multi-stage stratified probability sample) of the whole country except the provinces afflicted by the war. The results are based on a sample of 8,169 households in 2000 and 19,862 households in 2007. RESULTS: Firewood was the principal type of cooking fuel in 78.3%(n=6397) and 78.5%(n=15592) of households in years 2000 and 2007, respectively. In 2007, 96.3%(n=897) of estate sector households used firewood as compared to 84.2%(n=13850) in the rural and 34.6%(n=859) in the urban sector. Similar trends were seen in year 2000 as well. Electricity was the main source of lighting in 68%(n=5571) of households in year 2000 and the corresponding figure for year 2007,was 80%(n=15890). In year 2000, 25.9%(n=1442) of the houses having electricity used clean fuel (electricity/ LP gas) for cooking and the rest relied on biomass or kerosene. The higher the educational level of the respondent, the more likely the household will use a clean fuel (Chi square for trend: p<0.001). CONCLUSION: The shift from firewood to cleaner fuels in Sri Lanka is negligible from 2000 to 2007. Improving the quality of life of the population does not necessarily predict a shift towards the use of cleaner cooking fuels in Sri Lanka.