{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T11:51:23Z","timestamp":1769169083289,"version":"3.49.0"},"reference-count":71,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T00:00:00Z","timestamp":1621468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["392 NIH 4 P01 ES022848 B COTC)"],"award-info":[{"award-number":["392 NIH 4 P01 ES022848 B COTC)"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000139","name":"U.S. Environmental Protection Agency","doi-asserted-by":"publisher","award":["392 USEPA 83543401"],"award-info":[{"award-number":["392 USEPA 83543401"]}],"id":[{"id":"10.13039\/100000139","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Children are uniquely vulnerable to toxicant exposures in their environment, which can have long-lasting impacts on their health. Childcare providers are an important population to target for environmental health literacy, as most children in the United States under five years of age spend a significant number of waking hours in non-parental care. There is an increasing body of evidence that children are exposed to toxicants in the childcare environment, and yet little is known about what childcare providers know about environmental influences on the health of children in their care. We conducted semi-structured interviews with 36 home- and center-based Illinois childcare providers to better understand their knowledge, attitudes, and behaviors as they relate to environmental influences on children\u2019s health. We found that the majority of providers had a low level of understanding of potential sources of exposure in the childcare environment, and they did not feel that environmental exposures posed a significant risk to children. Future efforts to increase environmental health literacy should focus on raising awareness and knowledge of environmental health issues for childcare providers before addressing ways that providers can reduce or prevent toxicant exposures to children in their care.<\/jats:p>","DOI":"10.3390\/ijerph18105489","type":"journal-article","created":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T11:45:57Z","timestamp":1621511157000},"page":"5489","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["What Do Childcare Providers Know about Environmental Influences on Children\u2019s Health? Implications for Environmental Health Literacy Efforts"],"prefix":"10.3390","volume":"18","author":[{"given":"Brenda D.","family":"Koester","sequence":"first","affiliation":[{"name":"Family Resiliency Center, Department of Human Development and Family Studies, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Sloane","sequence":"additional","affiliation":[{"name":"Family Resiliency Center, Department of Human Development and Family Studies, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9807-8839","authenticated-orcid":false,"given":"Elinor M.","family":"Fujimoto","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2935-8682","authenticated-orcid":false,"given":"Barbara H.","family":"Fiese","sequence":"additional","affiliation":[{"name":"Family Resiliency Center, Department of Human Development and Family Studies, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8661-7196","authenticated-orcid":false,"given":"Leona Yi-Fan","family":"Su","sequence":"additional","affiliation":[{"name":"Charles H. Sandage Department of Advertising, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,20]]},"reference":[{"key":"ref_1","first-page":"101","article-title":"The CDC Fourth National Report on Human Exposure to Environmental Chemicals: What It Tells Us about Our Toxic Burden and How It Assists Environmental Medicine Physicians","volume":"15","author":"Crinnion","year":"2010","journal-title":"Altern. Med. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1289\/ehp.1002727","article-title":"Environmental Chemicals in Pregnant Women in the United States: NHANES 2003\u20132004","volume":"119","author":"Woodruff","year":"2011","journal-title":"Environ. Health Perspect."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.1007\/s13524-019-00831-0","article-title":"The Impact of the Flint Water Crisis on Fertility","volume":"56","author":"Grossman","year":"2019","journal-title":"Demography"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3466","DOI":"10.1210\/en.2015-1434","article-title":"The Role of Epigenetics in the Latent Effects of Early Life Exposure to Obesogenic Endocrine Disrupting Chemicals","volume":"156","author":"Stel","year":"2015","journal-title":"Endocrinology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1515\/reveh-2018-0045","article-title":"Exposure to Environmental Toxicants and Young Children\u2019s Cognitive and Social Development","volume":"34","author":"Davis","year":"2019","journal-title":"Rev. Environ. Health"},{"key":"ref_6","unstructured":"Landrigan, P.J., and Etzel, R.A. (2014). Children\u2019s Exquisite Vulnerability to Environmental Exposures. Textbook of Children\u2019s Environmental Health, Oxford University Press."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.puhe.2011.11.014","article-title":"Developmental Origins of Chronic Disease","volume":"126","author":"Barker","year":"2012","journal-title":"Public Health"},{"key":"ref_8","unstructured":"United Stated Environmental Protection Agency (2009). Highlights of the Child-Specific Exposure Factors Handbook."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"11","DOI":"10.2307\/1602354","article-title":"Environmental Health Hazards: How Children Are Different from Adults","volume":"5","author":"Bearer","year":"1995","journal-title":"Future Child."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1038\/jes.2016.11","article-title":"Toddler\u2019s Behavior and Its Impacts on Exposure to Polybrominated Diphenyl Ethers","volume":"27","author":"Hoffman","year":"2017","journal-title":"J. Expo. Sci. Environ. Epidemiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1006\/enrs.1997.3726","article-title":"Pathways of Lead Exposure in Urban Children","volume":"74","author":"Lanphear","year":"1997","journal-title":"Environ. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"0732","DOI":"10.1371\/journal.pmed.0050101","article-title":"Association of Prenatal and Childhood Blood Lead Concentrations with Criminal Arrests in Early Adulthood","volume":"5","author":"Wright","year":"2008","journal-title":"PLoS Med."},{"key":"ref_13","unstructured":"Centers for Disease Control and Prevention (2020, December 10). Prevent Children\u2019s Exposure to Lead, Available online: https:\/\/www.cdc.gov\/features\/leadpoisoning\/index.html."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1177\/1090198114560790","article-title":"Peeling Lead Paint Turns Into Poisonous Dust. Guess Where It Ends Up? A Media Campaign to Prevent Childhood Lead Poisoning in New York City","volume":"42","author":"Greene","year":"2015","journal-title":"Heal. Educ. Behav."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"283","DOI":"10.2105\/AJPH.2015.303003","article-title":"Elevated Blood Lead Levels in Children Associated with the Flint Drinking Water Crisis: A Spatial Analysis of Risk and Public Health Response","volume":"106","author":"LaChance","year":"2016","journal-title":"Am. J. Public Health"},{"key":"ref_16","unstructured":"(2011). American Healthy Homes Survey: Lead and Arsenic Findings."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Aurisano, N., Huang, L., Mil\u00e0 i Canals, L., Jolliet, O., and Fantke, P. (2021). Chemicals of Concern in Plastic Toys. Environ. Int., 146.","DOI":"10.1016\/j.envint.2020.106194"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"7593","DOI":"10.1021\/es501189t","article-title":"Phthalate Exposure and Risk Assessment in California Child Care Facilities","volume":"48","author":"Gaspar","year":"2014","journal-title":"Environ. Sci. Technol."},{"key":"ref_19","unstructured":"United States Environmental Protection Agency (USEPA) (2017). NIEHS\/EPA Children\u2019s Environmental Health and Disease Prevention Research Centers: Protecting Children s Health for a Lifetime."},{"key":"ref_20","first-page":"4","article-title":"Home Environmental Health Risks","volume":"12","year":"2007","journal-title":"Online J. Issues Nurs."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.envres.2015.12.005","article-title":"Volatile Organic Compounds and Particulate Matter in Child Care Facilities in the District of Columbia: Results from a Pilot Study","volume":"146","author":"Wilson","year":"2016","journal-title":"Environ. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.1016\/S2468-2667(16)30023-8","article-title":"Air Pollution and Health","volume":"2","author":"Landrigan","year":"2017","journal-title":"Lancet Public Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1486","DOI":"10.1164\/ajrccm\/136.6.1486","article-title":"Health Effects and Sources of Indoor Air Pollution Part I","volume":"136","author":"Samet","year":"1987","journal-title":"Am. Rev. Respitory Dis."},{"key":"ref_24","unstructured":"Department of Health and Human Services, Office of Disease Prevention and Health Promotion (2021, April 20). Healthy People 2030, U.S., Available online: https:\/\/health.gov\/healthypeople."},{"key":"ref_25","unstructured":"Executive Office of the President of the United States (1997). Executive Order 13045: Protection of Children from Environmental Health Risks and Safety Risks. Fed. Regist., 62, 19855\u201319888."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1289\/ehp.1409337","article-title":"The Emergence of Environmental Health Literacy\u2014From Its Roots to Its Future Potential","volume":"125","author":"Finn","year":"2017","journal-title":"Environ. Health Perspect."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1093\/heapro\/dax015","article-title":"Improving Health Literacy in Community Populations: A Review of Progress","volume":"33","author":"Nutbeam","year":"2018","journal-title":"Health Promot. Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1080\/10810730.2010.499994","article-title":"Promoting Health Literacy Research to Reduce Health Disparities","volume":"15","author":"Wolf","year":"2010","journal-title":"J. Health Commun."},{"key":"ref_29","first-page":"170","article-title":"The Importance of Early Childhood in Addressing Equity and Health Literacy Development in the Life-Course","volume":"5","author":"Okan","year":"2019","journal-title":"Public Heal. Panor."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/10810730.2011.604708","article-title":"Health Literacy and the Elimination of Health Disparities","volume":"16","author":"Ruffin","year":"2011","journal-title":"J. Health Commun."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"S\u00f8rensen, K., Van Den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., and Brand, H. (2012). Health Literacy and Public Health: A Systematic Review and Integration of Definitions and Models. BMC Public Health, 12.","DOI":"10.1186\/1471-2458-12-80"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Gray, K.M. (2018). From Content Knowledge to Community Change: A Review of Representations of Environmental Health Literacy. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15030466"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Finn, S., and Fallon, L.R.O. (2019). Environmental Health Literacy, Springer International Publishing. [1st ed.].","DOI":"10.1007\/978-3-319-94108-0"},{"key":"ref_34","first-page":"70","article-title":"Who\u2019s Minding the Kids ? Child Care Arrangements: Spring 2011","volume":"2009","author":"Laughlin","year":"2013","journal-title":"Househ. Econ. Stud."},{"key":"ref_35","unstructured":"McFarland, J., Hussar, B., Zhang, J., Wang, X., Hein, S., Diliberti, M., Cataldi, E.F., Mann, F.B., Barner, A., and Nachazel, T. (2019). The Condition of Education 2019."},{"key":"ref_36","first-page":"993","article-title":"The Ecology of Developmental Processes","volume":"Volume 1","author":"Bronfenbrenner","year":"1998","journal-title":"Handbook of Child Psychology: Theoretical Models of Human Development"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1089\/chi.2012.0150","article-title":"Risk Factors for Overweight\/Obesity in Preschool Children: An Ecological Approach","volume":"9","author":"Dev","year":"2013","journal-title":"Child. Obes."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.amepre.2008.06.030","article-title":"Nutrition and Physical Activity in Child Care. Results from an Environmental Intervention","volume":"35","author":"Ward","year":"2008","journal-title":"Am. J. Prev. Med."},{"key":"ref_39","unstructured":"Environmental Law Institute (2015). Reducing Environmental Exposures in Child Care Facilities A Review of State Policy, Environmental Law Institute."},{"key":"ref_40","first-page":"24","article-title":"Regulations, Policies, and Guidelines Addressing Environmental Exposures in Early Learning Environments: A Review","volume":"76","author":"Hudson","year":"2014","journal-title":"J. Environ. Health"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Landrigan, P.J., and Etzel, R.A. (2014). The Chemical Environment and Children\u2019s Health. Textbook of Children\u2019s Environmental Health, Oxford University Press.","DOI":"10.1093\/med\/9780199929573.003.0003"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s10661-017-6438-9","article-title":"Plastic Toys as a Source of Exposure to Bisphenol-A and Phthalates at Childcare Facilities","volume":"190","author":"Andaluri","year":"2018","journal-title":"Environ. Monit. Assess."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1111\/ina.12340","article-title":"VOC Exposures in California Early Childhood Education Environments","volume":"27","author":"Hoang","year":"2017","journal-title":"Indoor Air"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.ajic.2018.06.013","article-title":"Do We Know How Best to Disinfect Child Care Sites in the United States? A Review of Available Disinfectant Efficacy Data and Health Risks of the Major Disinfectant Classes","volume":"47","author":"Holm","year":"2018","journal-title":"Am. J. Infect. Control"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Seltenrich, N. (2013). News | Environmental Exposures in the Context of Child Care. Environ. Health Perspect., A160\u2013A165.","DOI":"10.1289\/ehp.121-a160"},{"key":"ref_46","unstructured":"United States Environmental Protection Agency (USEPA) (2013). America\u2019s Children and the Environment."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"126771","DOI":"10.1016\/j.chemosphere.2020.126771","article-title":"Per- and Polyfluoroalkyl Substances in Paired Dust and Carpets from Childcare Centers","volume":"251","author":"Wu","year":"2020","journal-title":"Chemosphere"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"113714","DOI":"10.1016\/j.envpol.2019.113714","article-title":"Indoor Exposure to Per- and Polyfluoroalkyl Substances (PFAS) in the Childcare Environment","volume":"258","author":"Zheng","year":"2020","journal-title":"Environ. Pollut."},{"key":"ref_49","unstructured":"Janssen, S., Sass, J., Schettler, T., and Solomon, G. (2012). Strengthening Toxic Chemical Risk Assessments to Protect Human Health, National Resources Defense Council."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1111\/j.1525-1446.2009.00804.x","article-title":"The Environmental Health Engagement Profile: What People Think and Do about Environmental Health","volume":"26","author":"Dixon","year":"2009","journal-title":"Public Health Nurs."},{"key":"ref_51","first-page":"22","article-title":"What Does the Public Know About Environmental Health ? A Qualitative Approach to Refining an Environmental Health Awareness Instrument","volume":"77","author":"Ratnapradipa","year":"2015","journal-title":"J. Environ. Health"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"147","DOI":"10.7721\/chilyoutenvi.30.2.0147","article-title":"Attitudes and Actions towards Toxic Chemicals: An Environmental Health and Risk Perception Survey of Massachusetts Childcare Providers","volume":"30","author":"Bouldin","year":"2020","journal-title":"Child. Youth Environ."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.jada.2008.10.018","article-title":"An Introduction to Qualitative Research for Food and Nutrition Professionals","volume":"109","author":"Harris","year":"2009","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1289\/ehp.0901762","article-title":"Qualitative Environmental Health Research: An Analysis of the Literature, 1991\u20132008","volume":"118","author":"Scammell","year":"2010","journal-title":"Environ. Health Perspect."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1016\/j.jneb.2016.06.001","article-title":"Practical Qualitative Research Strategies: Training Interviewers and Coders","volume":"48","author":"Goodell","year":"2016","journal-title":"J. Nutr. Educ. Behav."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1159\/000064989","article-title":"Ecocultural Understanding of Children\u2019s Developmental Pathways","volume":"45","author":"Weisner","year":"2002","journal-title":"Hum. Dev."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"26152","DOI":"10.3402\/qhw.v9.26152","article-title":"What Can \u201cThematic Analysis\u201d Offer Health and Wellbeing Researchers?","volume":"9","author":"Braun","year":"2014","journal-title":"Int. J. Qual. Stud. Health Well-being"},{"key":"ref_58","unstructured":"SocioCultural Research Consultants, LLC (2018). Dedoose Version 8.0.35: Web Application for Managing, Analyzing, and Presenting Qualitative and Mixed Methods Research Data, SocioCultural Research Consultants, LLC."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Lincoln, Y.S., and Guba, E.G. (1985). Establishing Trustworthiness. Naturalistic Inquiry, SAGE Publications, Inc.","DOI":"10.1016\/0147-1767(85)90062-8"},{"key":"ref_60","unstructured":"(2019, July 23). NAEYC Early Learning Program Accreditation. Available online: https:\/\/www.naeyc.org\/accreditation\/early-learning\/standards."},{"key":"ref_61","unstructured":"(2019, July 23). ExceleRate Illinois. Available online: http:\/\/www.excelerateillinois.com\/."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e209","DOI":"10.1093\/pubmed\/fdv135","article-title":"Findings from a Pilot Environmental Health Intervention at Early Childhood Centers in the District of Columbia","volume":"38","author":"Amoah","year":"2016","journal-title":"J. Public Health (Bangk.)"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Finn, S., and O\u2019Fallon, L.R. (2019). Measuring Environmental Health Literacy. Environmental Health Literacy, Springer International Publishing.","DOI":"10.1007\/978-3-319-94108-0"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/jjns.12347","article-title":"Development and Assessment of an Instrument Measuring Environmental Health Perception and Behavior toward Reproductive Health of Female Adolescents","volume":"17","author":"Kim","year":"2020","journal-title":"Jpn. J. Nurs. Sci."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Lichtveld, M.Y., Covert, H.H., Sherman, M., Shankar, A., Wickliffe, J.K., and Alcala, C.S. (2019). Advancing Environmental Health Literacy: Validated Scales of General Environmental Health and Environmental Media-Specific Knowledge, Attitudes and Behaviors. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16214157"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2051","DOI":"10.2105\/AJPH.94.12.2051","article-title":"Communication at the Core of Effective Public Health","volume":"94","author":"Bernhardt","year":"2004","journal-title":"Am. J. Public Health"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1146\/annurev.pu.16.050195.001251","article-title":"Advances in Public Health Communication","volume":"16","author":"Maibach","year":"1995","journal-title":"Annu. Rev. Public Health"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Finn, S., and O\u2019Fallon, L.R. (2019). Communication Research in the Environmental Health Sciences. Environmental Health Literacy, Springer International Publishing.","DOI":"10.1007\/978-3-319-94108-0"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1080\/10810730.2012.712612","article-title":"Health Literacy INDEX: Development, Reliability, and Validity of a New Tool for Evaluating the Health Literacy Demands of Health Information Materials","volume":"17","author":"Kaphingst","year":"2012","journal-title":"J. Health Commun."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1109\/TPC.2017.2761578","article-title":"Use of Plain-Language Guidelines to Promote Health Literacy","volume":"60","author":"Grene","year":"2017","journal-title":"IEEE Trans. Prof. Commun."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1057\/palgrave.jphp.3200102","article-title":"Plain Language: A Strategic Response to the Health Literacy Challenge","volume":"28","author":"Stableford","year":"2007","journal-title":"J. Public Health Policy"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/10\/5489\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:04:55Z","timestamp":1760162695000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/10\/5489"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,20]]},"references-count":71,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["ijerph18105489"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18105489","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,20]]}}}