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- ItemAdoption, reach, and implementation of a cancer education intervention in African American churches(Springer Nature, 2017-03-14) Santos, Sherie Lou Zara; Tagai, Erin K.; Scheirer, Mary Ann; Bowie, Janice; Haider, Muhiuddin; Slade, Jimmie; Wang, Min Qi; Holt, Cheryl L.Use of technology is increasing in health promotion and has continued growth potential in intervention research. Guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, this paper reports on the adoption, reach, and implementation of Project HEAL (Health through Early Awareness and Learning)—a community-based implementation trial of a cancer educational intervention in 14 African American churches. We compare adoption, reach, and implementation at the organizational and participant level for churches in which lay peer community health advisors (CHAs) were trained using traditional classroom didactic methods compared with a new online system. Fifteen churches were randomized to one of two study groups in which two CHAs per church were trained through either classroom (“Traditional”; n = 16 CHAs in 8 churches) or web-based (“Technology”; n = 14 CHAs in 7 churches) training methods. Once trained and certified, all CHAs conducted a series of three group educational workshops in their churches on cancer early detection (breast, prostate, and colorectal). Adoption, reach, and implementation were assessed using multiple data sources including church-level data, participant engagement in the workshops, and study staff observations of CHA performance. The project had a 41% overall adoption rate at the church level. In terms of reach, a total of 375 participants enrolled in Project HEAL—226 participants in the Traditional group (43% reach) and 149 in the Technology group (21% reach; p < .10). Implementation was evaluated in terms of adherence, dosage, and quality. All churches fully completed the three workshops; however, the Traditional churches took somewhat longer (M = 84 days) to complete the workshop series than churches in the Technology group (M = 64 days). Other implementation outcomes were comparable between both the Traditional and Technology groups (p > .05). Overall, the Project HEAL intervention had reasonable adoption, though reach could have been better. Implementation was strong across both study groups, suggesting the promise of using web-based methods to disseminate and implement evidence-based interventions in faith-based settings and other areas where community health educators work to eliminate health disparities.
- ItemAssociation between community socioeconomic factors, animal feeding operations, and campylobacteriosis incidence rates: Foodborne Diseases Active Surveillance Network (FoodNet), 2004–2010(Springer Nature, 2016-07-22) Rosenberg Goldstein, Rachel E.; Cruz-Cano, Raul; Jiang, Chengsheng; Palmer, Amanda; Blythe, David; Ryan, Patricia; Hogan, Brenna; White, Benjamin; Dunn, John R.; Libby, Tanya; Tobin-D’Angelo, Melissa; Huang, Jennifer Y.; McGuire, Suzanne; Scherzinger, Karen; Ting Lee, Mei-Ling; Sapkota, Amy R.Campylobacter is a leading cause of foodborne illness in the United States. Campylobacter infections have been associated with individual risk factors, such as the consumption of poultry and raw milk. Recently, a Maryland-based study identified community socioeconomic and environmental factors that are also associated with campylobacteriosis rates. However, no previous studies have evaluated the association between community risk factors and campylobacteriosis rates across multiple U.S. states. We obtained Campylobacter case data (2004–2010; n = 40,768) from the Foodborne Diseases Active Surveillance Network (FoodNet) and socioeconomic and environmental data from the 2010 Census of Population and Housing, the 2011 American Community Survey, and the 2007 U.S. Census of Agriculture. We linked data by zip code and derived incidence rate ratios using negative binomial regression models. Community socioeconomic and environmental factors were associated with both lower and higher campylobacteriosis rates. Zip codes with higher percentages of African Americans had lower rates of campylobacteriosis (incidence rate ratio [IRR]) = 0.972; 95 % confidence interval (CI) = 0.970,0.974). In Georgia, Maryland, and Tennessee, three leading broiler chicken producing states, zip codes with broiler operations had incidence rates that were 22 % (IRR = 1.22; 95 % CI = 1.03,1.43), 16 % (IRR = 1.16; 95 % CI = 0.99,1.37), and 35 % (IRR = 1.35; 95 % CI = 1.18,1.53) higher, respectively, than those of zip codes without broiler operations. In Minnesota and New York FoodNet counties, two top dairy producing areas, zip codes with dairy operations had significantly higher campylobacteriosis incidence rates (IRR = 1.37; 95 % CI = 1.22, 1.55; IRR = 1.19; 95 % CI = 1.04,1.36). Community socioeconomic and environmental factors are important to consider when evaluating the relationship between possible risk factors and Campylobacter infection.
- ItemThe association of long-term exposure to PM2.5 on all-cause mortality in the Nurses’ Health Study and the impact of measurement-error correction(Springer Nature, 2015-05-01) Hart, Jaime E; Liao, Xiaomei; Hong, Biling; Puett, Robin C; Yanosky, Jeff D; Suh, Helen; Kioumourtzoglou, Marianthi-Anna; Spiegelman, Donna; Laden, FrancineLong-term exposure to particulate matter less than 2.5 μm in diameter (PM2.5) has been consistently associated with risk of all-cause mortality. The methods used to assess exposure, such as area averages, nearest monitor values, land use regressions, and spatio-temporal models in these studies are subject to measurement error. However, to date, no study has attempted to incorporate adjustment for measurement error into a long-term study of the effects of air pollution on mortality. We followed 108,767 members of the Nurses’ Health Study (NHS) 2000–2006 and identified all deaths. Biennial mailed questionnaires provided a detailed residential address history and updated information on potential confounders. Time-varying average PM2.5 in the previous 12-months was assigned based on residential address and was predicted from either spatio-temporal prediction models or as concentrations measured at the nearest USEPA monitor. Information on the relationships of personal exposure to PM2.5 of ambient origin with spatio-temporal predicted and nearest monitor PM2.5 was available from five previous validation studies. Time-varying Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95 percent confidence intervals (95%CI) for each 10 μg/m3 increase in PM2.5. Risk-set regression calibration was used to adjust estimates for measurement error. Increasing exposure to PM2.5 was associated with an increased risk of mortality, and results were similar regardless of the method chosen for exposure assessment. Specifically, the multivariable adjusted HRs for each 10 μg/m3 increase in 12-month average PM2.5 from spatio-temporal prediction models were 1.13 (95%CI:1.05, 1.22) and 1.12 (95%CI:1.05, 1.21) for concentrations at the nearest EPA monitoring location. Adjustment for measurement error increased the magnitude of the HRs 4-10% and led to wider CIs (HR = 1.18; 95%CI: 1.02, 1.36 for each 10 μg/m3 increase in PM2.5 from the spatio-temporal models and HR = 1.22; 95%CI: 1.02, 1.45 from the nearest monitor estimates). These findings support the large body of literature on the adverse effects of PM2.5, and suggest that adjustment for measurement error be considered in future studies where possible.
- ItemBeing overburdened and medically underserved: assessment of this double disparity for populations in the state of Maryland(Springer Nature, 2014-04-04) Wilson, Sacoby; Zhang, Hongmei; Jiang, Chengsheng; Burwell, Kristen; Rehr, Rebecca; Murray, Rianna; Dalemarre, Laura; Naney, CharlesEnvironmental justice research has shown that many communities of color and low-income persons are differentially burdened by noxious land uses including Toxic Release Inventory (TRI) facilities. However, limited work has been performed to assess how these populations tend to be both overburdened and medically underserved. We explored this “double disparity” for the first time in Maryland. We assessed spatial disparities in the distribution of TRI facilities in Maryland across varying levels of sociodemographic composition using 2010 US Census Health Professional Shortage Area (HPSA) data. Univariate and multivariate regression in addition to geographic information systems (GIS) were used to examine relationships between sociodemographic measures and location of TRI facilities. Buffer analysis was also used to assess spatial disparities. Four buffer categories included: 1) census tracts hosting one or more TRI facilities; 2) tracts located more than 0 and up to 0.5 km from the closest TRI facility; 3) tracts located more than 0.5 km and up to 1 km from a TRI facility; and 4) tracts located more than 1 km and up to 5 km from a TRI facility. We found that tracts with higher proportions of non-white residents and people living in poverty were more likely to be closer to TRI facilities. A significant increase in income was observed with an increase in distance between a census tract and the closest TRI facility. In general, percent non-white was higher in HPSA tracts that host at least one TRI facility than in non-HPSA tracts that host at least one TRI facility. Additionally, percent poverty, unemployment, less than high school education, and homes built pre-1950 were higher in HPSA tracts hosting TRI facilities than in non-HPSA tracts hosting TRI facilities. We found that people of color and low-income groups are differentially burdened by TRI facilities in Maryland. We also found that both low-income groups and persons without a high school education are both overburdened and medically underserved. The results of this study provide insight into how state agencies can better address the double disparity of disproportionate environmental hazards and limited access to health care resources facing vulnerable communities in Maryland.
- ItemBoth parents matter: a national-scale analysis of parental race/ethnicity, disparities in prenatal PM2.5 exposures and related impacts on birth outcomes(Springer Nature, 2022-05-06) Payne-Sturges, Devon C.; Puett, Robin; Cory-Slechta, Deborah A.Most U.S. studies that report racial/ethnic disparities in increased risk of low birth weight associated with air pollution exposures have been conducted in California or northeastern states and/or urban areas, limiting generalizability of study results. Few of these studies have examined maternal racial/ethnic groups other than Non-Hispanic Black, non-Hispanic White and Hispanic, nor have they included paternal race. We aimed to examine the independent effects of PM2.5 on birth weight among a nationally representative sample of U.S. singleton infants and how both maternal and paternal race/ethnicity modify relationships between prenatal PM2.5 exposures and birth outcomes. We used data from the Early Childhood Longitudinal Study, Birth Cohort (ECLS–B), a longitudinal nationally representative cohort of 10,700 U.S. children born in 2001, which we linked to U.S.EPA’s Community Multi-scale Air Quality (CMAQ)-derived predicted daily PM2.5 concentrations at the centroid of each Census Bureau Zip Code Tabulation Area (ZCTA) for maternal residences. We examined relationships between term birthweight (TBW), term low birthweight rate (TLBW) and gestational PM2.5 pollutant using multivariate regression models. Effect modification of air pollution exposures on birth outcomes by maternal and paternal race was evaluated using stratified models. All analyses were conducted with sample weights to provide national-scale estimates. The majority of mothers were White (61%). Fourteen percent of mothers identified as Black, 21% as Hispanic, 3% Asian American and Pacific Islander (AAPI) and 1% American Indian and Alaskan Native (AIAN). Fathers were also racially/ethnically diverse with 55% identified as White Non-Hispanic, 10% as Black Non-Hispanic, 19% as Hispanic, 3% as AAPI and 1% as AIAN. Results from the chi-square and ANOVA tests of significance for racial/ethnic differences indicate disparities in prenatal exposures and birth outcomes by both maternal and paternal race/ethnicity. Prenatal PM2.5 was associated with reduced birthweights during second and third trimester and over the entire gestational period in adjusted regression models, although results did not reach statistical significance. In models stratified by maternal race and paternal race, one unit increase in PM2.5 was statistically significantly associated with lower birthweights among AAPI mothers, -5.6 g (95% CI:-10.3, -1.0 g) and AAPI fathers, -7.6 g (95% CI: -13.1, -2.1 g) during 3rd trimester and among births where father’s race was not reported, -14.2 g (95% CI: -24.0, -4.4 g). These data suggest that paternal characteristics should be used, in addition to maternal characteristics, to describe the risks of adverse birth outcomes. Additionally, our study suggests that serious consideration should be given to investigating environmental and social mechanisms, such as air pollution exposures, as potential contributors to disparities in birth outcomes among AAPI populations.
- ItemClimate change, extreme events, and increased risk of salmonellosis: foodborne diseases active surveillance network (FoodNet), 2004-2014(Springer Nature, 2021-09-18) Morgado, Michele E.; Jiang, Chengsheng; Zambrana, Jordan; Upperman, Crystal Romeo; Mitchell, Clifford; Boyle, Michelle; Sapkota, Amy R.; Sapkota, AmirInfections with nontyphoidal Salmonella cause an estimated 19,336 hospitalizations each year in the United States. Sources of infection can vary by state and include animal and plant-based foods, as well as environmental reservoirs. Several studies have recognized the importance of increased ambient temperature and precipitation in the spread and persistence of Salmonella in soil and food. However, the impact of extreme weather events on Salmonella infection rates among the most prevalent serovars, has not been fully evaluated across distinct U.S. regions. To address this knowledge gap, we obtained Salmonella case data for S. Enteriditis, S. Typhimurium, S. Newport, and S. Javiana (2004-2014; n = 32,951) from the Foodborne Diseases Active Surveillance Network (FoodNet), and weather data from the National Climatic Data Center (1960-2014). Extreme heat and precipitation events for the study period (2004-2014) were identified using location and calendar day specific 95th percentile thresholds derived using a 30-year baseline (1960-1989). Negative binomial generalized estimating equations were used to evaluate the association between exposure to extreme events and salmonellosis rates. We observed that extreme heat exposure was associated with increased rates of infection with S. Newport in Maryland (Incidence Rate Ratio (IRR): 1.07, 95% Confidence Interval (CI): 1.01, 1.14), and Tennessee (IRR: 1.06, 95% CI: 1.04, 1.09), both FoodNet sites with high densities of animal feeding operations (e.g., broiler chickens and cattle). Extreme precipitation events were also associated with increased rates of S. Javiana infections, by 22% in Connecticut (IRR: 1.22, 95% CI: 1.10, 1.35) and by 5% in Georgia (IRR: 1.05, 95% CI: 1.01, 1.08), respectively. In addition, there was an 11% (IRR: 1.11, 95% CI: 1.04-1.18) increased rate of S. Newport infections in Maryland associated with extreme precipitation events. Overall, our study suggests a stronger association between extreme precipitation events, compared to extreme heat, and salmonellosis across multiple U.S. regions. In addition, the rates of infection with Salmonella serovars that persist in environmental or plant-based reservoirs, such as S. Javiana and S. Newport, appear to be of particular significance regarding increased heat and rainfall events.
- ItemCode to reproduce analysis of manuscript: Minimal transmission in an influenza A (H3N2) human challenge-transmission model with exposure events in a controlled environment(2019-12-10) Bueno de Mesquita, Paul Jacob; Milton, Donald K.
- ItemThe Community Environmental Health Assessment Workbook: A Guide to Evaluating your Community's Health(Environmental Law Institute, 2000-12) Payne-Sturges, Devon; Locke, Paul; Keiner, SuellenThis Workbook will help community leaders, local organizers, and citizens groups assess environmental health problems in their neighborhoods and assist them in tackling these problems. It outlines an approach to identifying problems, gathering information, and establishing the community’s priorities for improving the environmental health of its residents. The Workbook is divided into four parts. It is written mainly for the citizen organizer, community leader, or other person who will serve as the project manager and take the lead in organizing the assessment. Part One is a brief introduction and discussion of this Workbook. Part Two discusses the reasons why your community should undertake an environmental health assessment, and outlines the assessment process. Part Three explains the community environmental health assessment process step-by-step, and shows citizens in detail how to conduct an assessment. Part Four suggests possible next steps after a community assessment is completed.
- ItemCoupled DNA-labeling and sequencing approach enables the detection of viable-but-non-culturable Vibrio spp. in irrigation water sources in the Chesapeake Bay watershed(Springer Nature, 2021-06-22) Malayil, Leena; Chattopadhyay, Suhana; Mongodin, Emmanuel F.; Sapkota, Amy R.Nontraditional irrigation water sources (e.g., recycled water, brackish water) may harbor human pathogens, including Vibrio spp., that could be present in a viable-but-nonculturable (VBNC) state, stymieing current culture-based detection methods. To overcome this challenge, we coupled 5-bromo-2′-deoxyuridine (BrdU) labeling, enrichment techniques, and 16S rRNA sequencing to identify metabolically-active Vibrio spp. in nontraditional irrigation water (recycled water, pond water, non-tidal freshwater, and tidal brackish water). Our coupled BrdU-labeling and sequencing approach revealed the presence of metabolically-active Vibrio spp. at all sampling sites. Whereas, the culture-based method only detected vibrios at three of the four sites. We observed the presence of V. cholerae, V. vulnificus, and V. parahaemolyticus using both methods, while V. aesturianus and V. shilonii were detected only through our labeling/sequencing approach. Multiple other pathogens of concern to human health were also identified through our labeling/sequencing approach including P. shigelloides, B. cereus and E. cloacae. Most importantly, 16S rRNA sequencing of BrdU-labeled samples resulted in Vibrio spp. detection even when our culture-based methods resulted in negative detection. This suggests that our novel approach can effectively detect metabolically-active Vibrio spp. that may have been present in a VBNC state, refining our understanding of the prevalence of vibrios in nontraditional irrigation waters.
- ItemA Critical Review of an Authentic and Transformative Environmental Justice and Health Community — University Partnership(Multidisciplinary Digital Publishing Institute, 2014-12-11) Wilson, Sacoby; Campbell, Dayna; Dalemarre, Laura; Fraser-Rahim, Herb; Williams, EdithDistressed neighborhoods in North Charleston (SC, USA) are impacted by the cumulative effects of multiple environmental hazards and expansion of the Port of Charleston. The Low Country Alliance for Model Communities (LAMC) built an environmental justice partnership to address local concerns. This case study examines the process of building and sustaining a successful transformative and authentic community-university partnership. We apply the framework established by Community-Campus Partnerships for Health (CCPH), focusing on four of the nine principles of Good Practice of Community Campus Partnerships.
- ItemCumulative Risk Webinar Series: What We Learned(U.S. Environmental Protection Agency, 2014-07) Payne-Sturges, Devon; Lawrence, MartinThis document summarized key science and science-policy issues for advancing the practice and utility of cumulative risk assessment identified during a webinar series present from August 2012 through December 2013 by the U.S. Environmental Protection Agency for the public.
- ItemCurrent progress and future opportunities in applications of bioinformatics for biodefense and pathogen detection: report from the Winter Mid-Atlantic Microbiome Meet-up, College Park, MD, January 10, 2018(Springer Nature, 2018-11-05) Meisel, Jacquelyn S.; Nasko, Daniel J.; Brubach, Brian; Cepeda-Espinoza, Victoria; Chopyk, Jessica; Corrada-Bravo, Héctor; Fedarko, Marcus; Ghurye, Jay; Javkar, Kiran; Olson, Nathan D.; Shah, Nidhi; Allard, Sarah M.; Bazinet, Adam L.; Bergman, Nicholas H.; Brown, Alexis; Caporaso, J. Gregory; Conlan, Sean; DiRuggiero, Jocelyne; Forry, Samuel P.; Hasan, Nur A.; Kralj, Jason; Luethy, Paul M.; Milton, Donald K.; Ondov, Brian D.; Preheim, Sarah; Ratnayake, Shashikala; Rogers, Stephanie M.; Rosovitz, M. J.; Sakowski, Eric G.; Schliebs, Nils Oliver; Sommer, Daniel D.; Ternus, Krista L.; Uritskiy, Gherman; Zhang, Sean X.; Pop, Mihai; Treangen, Todd J.The Mid-Atlantic Microbiome Meet-up (M3) organization brings together academic, government, and industry groups to share ideas and develop best practices for microbiome research. In January of 2018, M3 held its fourth meeting, which focused on recent advances in biodefense, specifically those relating to infectious disease, and the use of metagenomic methods for pathogen detection. Presentations highlighted the utility of next-generation sequencing technologies for identifying and tracking microbial community members across space and time. However, they also stressed the current limitations of genomic approaches for biodefense, including insufficient sensitivity to detect low-abundance pathogens and the inability to quantify viable organisms. Participants discussed ways in which the community can improve software usability and shared new computational tools for metagenomic processing, assembly, annotation, and visualization. Looking to the future, they identified the need for better bioinformatics toolkits for longitudinal analyses, improved sample processing approaches for characterizing viruses and fungi, and more consistent maintenance of database resources. Finally, they addressed the necessity of improving data standards to incentivize data sharing. Here, we summarize the presentations and discussions from the meeting, identifying the areas where microbiome analyses have improved our ability to detect and manage biological threats and infectious disease, as well as gaps of knowledge in the field that require future funding and focus.
- ItemDeterminants of urinary bisphenol A concentrations in Mexican/Mexican-American pregnant women.(Elsevier, 2013-09) Quiros-Alcala, Lesliam; Eskenazi, Brenda; Bradman, Asa; Ye, Xiaoyun; Calafat, Antonia M; Harley, KimPrenatal exposure to bisphenol A (BPA) may be associated with adverse health effects in the developing fetus; however, little is known about predictors of BPA exposure during pregnancy. We examined BPA exposure in 491 pregnant women from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) cohort and explored the role of living in the United States on significant dietary predictors of BPA exposure. Women provided urine samples up to two times during pregnancy (n = 866 total samples). We computed the intraclass correlation coefficient (ICC) to evaluate variability in concentrations between collections and used generalized estimating equation (GEE) models to assess predictors of exposure. Geometric mean (GSD) BPA concentrations were 0.9 (2.8) μg/L and 1.0 (2.6) μg/L at the first and second prenatal visits, respectively. We observed greater within- than between-woman variability in urinary BPA concentrations (ICC = 0.22). GEE models suggest that women who lived in the United States their entire life had 38% (CI: − 0.1, 89.3) higher urinary BPA concentrations compared with other immigrant women. Additionally, women who consumed ≥ 3 sodas per day or hamburgers three times a week or more had 58% (CI: 18.0, 112.1) and 20% (CI: − 0.2, 45.2) higher urinary BPA concentrations, respectively, compared with women who consumed no sodas or hamburgers. A higher percentage of women who lived their entire life in the United States reported increased consumption of sodas and hamburgers compared with other immigrant women. Independent of other factors, BPA urinary concentrations were slightly higher when the sample was collected later in the day. As in previous studies, high within-woman variability in urinary BPA concentrations confirms that several samples are needed to properly characterize exposure during pregnancy. Results also suggest that some factors could be modified to minimize exposures during pregnancy in our study participants (e.g., reducing soda and hamburger intake) and that factors associated with acculturation might increase BPA concentrations.
- ItemDisparities in Toxic Chemical Exposures and Associated Neurodevelopmental Outcomes: A Scoping Review and Systematic Evidence Map of the Epidemiological Literature(2023-09-27) Devon C. Payne-Sturges; Tanya Khemet Taiwo; Kristie Ellickson; Haley Mullen; Nedelina Tchangalova; Laura Anderko; Aimin Chen; Maureen SwansonBACKGROUND: Children are routinely exposed to chemicals known or suspected of harming brain development. Targeting Environmental Neuro-Development Risks (Project TENDR), an alliance of more than 50 leading scientists, health professionals, and advocates, is working to protect children from these toxic chemicals and pollutants, especially the disproportionate exposures experienced by children from families with low incomes and families of color. OBJECTIVE: This scoping review was initiated to map existing literature on disparities in neurodevelopmental outcomes for U.S. children from population groups who have been historically economically/socially marginalized and exposed to seven exemplar neurotoxicants: combustion-related air pollution (AP), lead (Pb), mercury (Hg), organophosphate pesticides (OPs), phthalates (Phth), polybrominated diphenyl ethers (PBDEs), and polychlorinated biphenyls (PCBs). METHODS: Systematic literature searches for the seven exemplar chemicals, informed by the Population, Exposure, Comparator, Outcome (PECO) framework, were conducted through 18 November 2022, using PubMed, CINAHL Plus (EBSCO), GreenFILE (EBSCO), and Web of Science sources. We examined these studies regarding authors’ conceptualization and operationalization of race, ethnicity, and other indicators of sociodemographic and socioeconomic disadvantage; whether studies presented data on exposure and outcome disparities and the patterns of those disparities; and the evidence of effect modification by or interaction with race and ethnicity. RESULTS: Two hundred twelve individual studies met the search criteria and were reviewed, resulting in 218 studies or investigations being included in this review. AP and Pb were the most commonly studied exposures. The most frequently identified neurodevelopmental outcomes were cognitive and behavioral/psychological. Approximately a third (74 studies) reported investigations of interactions or effect modification with 69% (51 of 74 studies) reporting the presence of interactions or effect modification. However, less than half of the studies presented data on disparities in the outcome or the exposure, and fewer conducted formal tests of heterogeneity. Ninety-two percent of the 165 articles that examined race and ethnicity did not provide an explanation of their constructs for these variables, creating an incomplete picture. DISCUSSION: As a whole, the studies we reviewed indicated a complex story about how racial and ethnic minority and low-income children may be disproportionately harmed by exposures to neurotoxicants, and this has implications for targeting interventions, policy change, and other necessary investments to eliminate these health disparities. We provide recommendations on improving environmental epidemiological studies on environmental health disparities. To achieve environmental justice and health equity, we recommend concomitant strategies to eradicate both neurotoxic chemical exposures and systems that perpetuate social inequities.
- ItemThe effect of COVID-19 stay-at-home order and campus closure on the prevalence of acute respiratory infection symptoms in college campus cohorts.(2020-12-12) Adenaiye, Oluwasanmi; Bueno de Mesquita, Paul; Wu, Qiong; Hong, Filbert; Chen, Shuo; Milton, DonaldEvaluation of population-based COVID-19 control measures informs strategies to quell the current pandemic and reduce the impact of those yet to come. Effective COVID-19 control measures may simultaneously reduce the incidence of other acute respiratory infections (ARIs) due to shared transmission modalities. To assess the impact of stay-at-home orders and other physical distancing measures on the prevalence of ARI-related symptoms, we compared symptoms reported by prospective college cohorts enrolled during two consecutive academic years. ARI-related symptoms declined following campus closure and implementation of stay-at-home orders, demonstrating the impact of population-based physical distancing measures on control of a broad range of respiratory infections.
- ItemEffect of Organic Diet Intervention on Pesticide Exposures in Young Children Living in Low-Income Urban and Agricultural Communities(2015) Bradman, Asa; Quiros-Alcala, Lesliam; Castorina, Rosemary; Aguilar Schall, Raul; Camacho, Jose; Barr, Dana B.Background: Recent organic diet intervention studies suggest that diet is a significant source of pesticide exposure in young children. These studies have focused on children living in suburban communities. Objectives: We aimed to determine whether consuming an organic diet reduced urinary pesticide metabolite concentrations in 40 Mexican-American children, 3–6 years of age, living in California urban and agricultural communities. Methods: In 2006, we collected urine samples over 16 consecutive days from children who consumed conventionally grown food for 4 days, organic food for 7 days, and then conventionally grown food for 5 days. We measured 23 metabolites, reflecting potential exposure to organophosphorous (OP), pyrethroid, and other pesticides used in homes and agriculture. We used linear mixed-effects models to evaluate the effects of diet on urinary metabolite concentrations. Results: For six metabolites with detection frequencies > 50%, adjusted geometric mean concentrations during the organic phase were generally lower for all children, and were significant for total dialkylphosphates (DAPs) and dimethyl DAPs (DMs; metabolites of OP insecticides) and 2,4-D (2,4-dichlorophenoxyacetic acid, a herbicide), with reductions of 40%, 49%, and 25%, respectively (p < 0.01). Chemical-specific metabolite concentrations for several OP pesticides, pyrethroids, and herbicides were either infrequently detected and/or not significantly affected by diet. Concentrations for most of the frequently detected metabolites were generally higher in Salinas compared with Oakland children, with DMs and metolachlor at or near significance (p = 0.06 and 0.03, respectively). Conclusion: An organic diet was significantly associated with reduced urinary concentrations of nonspecific dimethyl OP insecticide metabolites and the herbicide 2,4-D in children. Additional research is needed to clarify the relative importance of dietary and non-dietary sources of pesticide exposures to young children.
- ItemEffects of endotoxin exposure on childhood asthma risk are modified by a genetic polymorphism in ACAA1(Springer Nature, 2011-12-08) Sordillo, Joanne E; Sharma, Sunita; Poon, Audrey; Lasky-Su, Jessica; Belanger, Kathleen; Milton, Donald K; Bracken, Michael B; Triche, Elizabeth W; Leaderer, Brian P; Gold, Diane R; Litonjua, Augusto APolymorphisms in the endotoxin-mediated TLR4 pathway genes have been associated with asthma and atopy. We aimed to examine how genetic polymorphisms in innate immunity pathways interact with endotoxin to influence asthma risk in children. In a previous analysis of 372 children from the Boston Home Allergens and the Connecticut Childhood Asthma studies, 7 SNPs in 6 genes (CARD15, TGFB1, LY96, ACAA1, DEFB1 and IFNG) involved in innate immune pathways were associated with asthma, and 5 SNPs in 3 genes (CD80, STAT4, IRAK2) were associated with eczema. We tested these SNPs for interaction with early life endotoxin exposure (n = 291), in models for asthma and eczema by age 6. We found a significant interaction between endotoxin and a SNP (rs156265) in ACAA1 (p = 0.0013 for interaction). Increased endotoxin exposure (by quartile) showed protective effects for asthma in individuals with at least one copy of the minor allele (OR = 0.39 per quartile increase in endotoxin, 95% CI 0.15 to 1.01). Endotoxin exposure did not reduce the risk of asthma in children homozygous for the major allele. Our findings suggest that protective effects of endotoxin exposure on asthma may vary depending upon the presence or absence of a polymorphism in ACAA1.
- ItemEl Niño Southern Oscillation, monsoon anomaly, and childhood diarrheal disease morbidity in Nepal(Oxford University Press, 2022-03-29) Adams, Nicholas; Dhimal, Meghnath; Mathews, Shifali; Iyer, Veena; Murtugudde, Raghu; Liang, Xin-Zhong; Haider, Muhiuddin; Cruz-Cano, Raul; Thu, Dang Thi Anh; Hashim, Jamal Hisham; Gao, Chuansi; Wang, Yu-Chun; Sapkota, AmirClimate change is adversely impacting the burden of diarrheal diseases. Despite significant reduction in global prevalence, diarrheal disease remains a leading cause of morbidity and mortality among young children in low- and middle-income countries. Previous studies have shown that diarrheal disease is associated with meteorological conditions but the role of large-scale climate phenomena such as El Niño-Southern Oscillation (ENSO) and monsoon anomaly is less understood. We obtained 13 years (2002–2014) of diarrheal disease data from Nepal and investigated how the disease rate is associated with phases of ENSO (El Niño, La Niña, vs. ENSO neutral) monsoon rainfall anomaly (below normal, above normal, vs. normal), and changes in timing of monsoon onset, and withdrawal (early, late, vs. normal). Monsoon season was associated with a 21% increase in diarrheal disease rates (Incident Rate Ratios [IRR]: 1.21; 95% CI: 1.16–1.27). El Niño was associated with an 8% reduction in risk while the La Niña was associated with a 32% increase in under-5 diarrheal disease rates. Likewise, higher-than-normal monsoon rainfall was associated with increased rates of diarrheal disease, with considerably higher rates observed in the mountain region (IRR 1.51, 95% CI: 1.19–1.92). Our findings suggest that under-5 diarrheal disease burden in Nepal is significantly influenced by ENSO and changes in seasonal monsoon dynamics. Since both ENSO phases and monsoon can be predicted with considerably longer lead time compared to weather, our findings will pave the way for the development of more effective early warning systems for climate sensitive infectious diseases.
- ItemExposure to extreme heat and precipitation events associated with increased risk of hospitalization for asthma in Maryland, U.S.A.(Springer Nature, 2016-04-27) Soneja, Sutyajeet; Jiang, Chengsheng; Fisher, Jared; Upperman, Crystal Romeo; Mitchell, Clifford; Sapkota, AmirSeveral studies have investigated the association between asthma exacerbations and exposures to ambient temperature and precipitation. However, limited data exists regarding how extreme events, projected to grow in frequency, intensity, and duration in the future in response to our changing climate, will impact the risk of hospitalization for asthma. The objective of our study was to quantify the association between frequency of extreme heat and precipitation events and increased risk of hospitalization for asthma in Maryland between 2000 and 2012. We used a time-stratified case-crossover design to examine the association between exposure to extreme heat and precipitation events and risk of hospitalization for asthma (ICD-9 code 493, n = 115,923). Occurrence of extreme heat events in Maryland increased the risk of same day hospitalization for asthma (lag 0) by 3 % (Odds Ratio (OR): 1.03, 95 % Confidence Interval (CI): 1.00, 1.07), with a considerably higher risk observed for extreme heat events that occur during summer months (OR: 1.23, 95 % CI: 1.15, 1.33). Likewise, summertime extreme precipitation events increased the risk of hospitalization for asthma by 11 % in Maryland (OR: 1.11, 95 % CI: 1.06, 1.17). Across age groups, increase in risk for asthma hospitalization from exposure to extreme heat event during the summer months was most pronounced among youth and adults, while those related to extreme precipitation event was highest among ≤4 year olds. Exposure to extreme heat and extreme precipitation events, particularly during summertime, is associated with increased risk of hospitalization for asthma in Maryland. Our results suggest that projected increases in frequency of extreme heat and precipitation event will have significant impact on public health.
- ItemFrequency of Extreme Heat Event as a Surrogate Exposure Metric for Examining the Human Health Effects of Climate Change(PLOS (Public Library of Science), 2015-12-07) Upperman, Crystal Romeo; Parker, Jennifer; Jiang, Chengsheng; He, Xin; Murtugudde, Raghuram; Sapkota, AmirEpidemiological investigation of the impact of climate change on human health, particularly chronic diseases, is hindered by the lack of exposure metrics that can be used as a marker of climate change that are compatible with health data. Here, we present a surrogate exposure metric created using a 30-year baseline (1960–1989) that allows users to quantify long-term changes in exposure to frequency of extreme heat events with near unabridged spatial coverage in a scale that is compatible with national/state health outcome data. We evaluate the exposure metric by decade, seasonality, area of the country, and its ability to capture long-term changes in weather (climate), including natural climate modes. Our findings show that this generic exposure metric is potentially useful to monitor trends in the frequency of extreme heat events across varying regions because it captures long-term changes; is sensitive to the natural climate modes (ENSO events); responds well to spatial variability, and; is amenable to spatial/temporal aggregation, making it useful for epidemiological studies.