Abstract:With the increasing emphasis on sustainable construction, it has become important to better understand the impacts of common materials. This is especially paramount with the introduction of the United Nations (UN) Sustainable Development Goals (SDGs) which call for more comprehensive evaluations, adding many aspects of social consideration to the issues of environmental sustainability, including human health. Polyvinyl chloride (PVC)/vinyl can be seen as a material with potential for significant adverse effects on a multiplicity of levels, and the construction industry is its single most significant consumer. This article presents a transdisciplinary review of adverse health impacts associated with PVC showing a number of issues: some that could be eliminated through design, but also some which appear inherent to the material itself and therefore unavoidable. The totality of issues revealed in relation to PVC presents a compelling case for a call for complete elimination of use of this material in sustainable construction.

Objective To determine the effectiveness of community-based rehabilitation interventions which incorporate outdoor mobility on physical activity, endurance, outdoor mobility and falls-related self-efficacy in older adults. Design MEDLINE, Embase, CINAHL, PEDro and OpenGrey were searched systematically from inception to June 2021 for randomised controlled trials (RCTs) of community-based rehabilitation incorporating outdoor mobility on physical activity, endurance, outdoor mobility and/or falls-related self-efficacy in older adults. Duplicate screening, selection, extraction and appraisal were completed. Results were reported descriptively and with random-effects meta-analyses stratified by population (proactive [community-dwelling], reactive [illness/injury]). Results A total of 29 RCTs with 7,076 participants were identified (66% high bias for at least one domain). The outdoor mobility component was predominantly a walking programme with behaviour change. Rehabilitation for reactive populations increased physical activity (seven RCTs, 587 participants. Hedge’s g 1.32, 95% CI: 0.31, 2.32), endurance (four RCTs, 392 participants. Hedges g 0.24; 95% CI: 0.04, 0.44) and outdoor mobility (two RCTs with 663 participants. Go out as much as wanted, likelihood of a journey) at intervention end versus usual care. Where reported, effects were preserved at follow-up. One RCT indicated a benefit of rehabilitation for proactive populations on moderate-to-vigorous activity and outdoor mobility. No effect was noted for falls-related self-efficacy, or other outcomes following rehabilitation for proactive populations. Conclusion Reactive rehabilitation for older adults may include walking programmes with behaviour change techniques. Future research should address the potential benefit of a walking programme for proactive populations and address mobility-related anxiety as a barrier to outdoor mobility for both proactive and reactive populations.

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