[Show abstract][Hide abstract] ABSTRACT: Introduction. Although lead paint and leaded gasoline have not been used in the US for thirty years, thousands of US children continue to have blood lead levels (BLLs) of concern. Methods. We investigated the potential association of modeled air lead levels and BLLs ≥ 10 μ g/dL using a large CDC database with BLLs on children aged 0-3 years. Percent of children with BLLs ≥ 10 μ g/dL (2000-2007) by county and proportion of pre-50 housing and SES variables were merged with the US EPA's National Air Toxics Assessment (NATA) modeled air lead data. Results. The proportion with BLL ≥ 10 μ g/dL was 1.24% in the highest air lead counties, and the proportion with BLL ≥ 10 μ g/dL was 0.36% in the lowest air lead counties, resulting in a crude prevalence ratio of 3.4. Further analysis using multivariate negative binomial regression revealed that NATA lead was a significant predictor of % BLL ≥ 10 μ g/dL after controlling for percent pre-l950 housing, percent rural, and percent black. A geospatial regression revealed that air lead, percent older housing, and poverty were all significant predictors of % BLL ≥ 10 μ g/dL. Conclusions. More emphasis should be given to potential sources of ambient air lead near residential areas.
Journal of Environmental and Public Health 01/2013; 2013:278042.
[Show abstract][Hide abstract] ABSTRACT: The U.S. Environmental Protection Agency (EPA) and the U.S. Centers for Disease Control (CDC) co-organized a symposium on "Air Pollution Exposure and Health" at Research Triangle Park, North Carolina on September 19-20, 2006. The symposium brought together health and environmental scientists to discuss the state of the science and the cross-jurisdictional and methodological challenges in conducting air pollution epidemiology, environmental public health tracking and accountability research. The symposium was held over 2 days and consisted of technical presentations and breakout group discussions on each of the three principal themes of this meeting: (1) monitoring and exposure modeling information, (2) health effects data and (3) linkage of air quality and health data for research, tracking and accountability. This paper summarizes the symposium presentations and the conclusions and recommendations developed during the meeting. The accompanying two papers, which appear in this issue of the Journal, provide more in-depth discussion of issues pertinent to obtaining and analyzing air pollution exposure and health information. The symposium succeeded in identifying areas where there are critical gaps of knowledge in existing air pollution exposure and health information and in discovering institutional or programmatic barriers, which impede accessing and linking disparate data sets. Several suggestions and recommendations emerged from this meeting, directed toward (1) improving the utility of air monitoring data for exposure quantification, (2) improving access to and the quality of health data, (3) studying emerging air quality and health issues, (4) exploring improved or novel methods for linking data and (5) developing partnerships, building capacity and facilitating interdisciplinary communication. The meeting was successful in promoting an interdisciplinary dialogue around these issues and in formulating strategies to support these recommended activities. Finally, this symposium subsequently led to strengthening and initiating new partnerships or interactions between the EPA, CDC, States, academia and the research community at large.
Journal of Exposure Science and Environmental Epidemiology 07/2008; 19(1):19-29. · 3.19 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Consecutive outbreaks of acute aflatoxicosis in Kenya in 2004 and 2005 caused > 150 deaths. In response, the Centers for Disease Control and Prevention and the World Health Organization convened a workgroup of international experts and health officials in Geneva, Switzerland, in July 2005. After discussions concerning what is known about aflatoxins, the workgroup identified gaps in current knowledge about acute and chronic human health effects of aflatoxins, surveillance and food monitoring, analytic methods, and the efficacy of intervention strategies. The workgroup also identified public health strategies that could be integrated with current agricultural approaches to resolve gaps in current knowledge and ultimately reduce morbidity and mortality associated with the consumption of aflatoxin-contaminated food in the developing world. Four issues that warrant immediate attention were identified: a) quantify the human health impacts and the burden of disease due to aflatoxin exposure; b) compile an inventory, evaluate the efficacy, and disseminate results of ongoing intervention strategies; c) develop and augment the disease surveillance, food monitoring, laboratory, and public health response capacity of affected regions; and d) develop a response protocol that can be used in the event of an outbreak of acute aflatoxicosis. This report expands on the workgroup's discussions concerning aflatoxin in developing countries and summarizes the findings.
Environmental Health Perspectives 12/2006; 114(12):1898-903. · 7.26 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To determine if an increased rate of breast cancer in Alaska Native women is related to their consumption of a subsistence diet that may contain p,p'-dichlorodiphenylethylene (DDE) and polychlorinated biphenyls (PCBs).
A retrospective case control design.
We analyzed banked serum collected between 1981 and 1987 from 126 Alaska Native women, including 63 case women who subsequently developed breast cancer and 63 age-matched control women who remained cancer-free. Serum was analyzed for DDT, DDE, 13 other chlorinated pesticides, and 28 PCB congeners.
The geometric mean for p,p'-DDE levels among case women was 8.67 ppb (95% Confidence Interval 7.48, 10.04); among control women, the geometric mean was 7.36 ppb (6.53, 8.30). The geometric mean for total PCB levels among case women was 4.55 ppb (3.61, 5.74) and for control women, the geometric mean was 6.10 ppb (4.73, 7.86). Cancer status and total PCB levels varied across ethnicity (i.e., Eskimo, Aleut, and Indian) but DDE levels were uniform among these ethnic groups. Using conditional logistic regression analysis to adjust for potential confounders (e.g., ethnicity, family history of breast cancer, parity), we found an odds ratio of 1.43 (0.46, 4.47) for the highest tertile of DDE exposure and 0.42 (0.07, 2.38) for the highest tertile of total PCB exposure.
Although the results are limited by small sample size and restricted risk factor information, our findings of higher DDE levels, but lower PCB levels among women with breast cancer are consistent with previous research. Our results confirm exposure to organochlorines among Alaska Native women but do not identify these exposures as a significant risk factor for breast cancer.
International journal of circumpolar health 03/2006; 65(1):18-27. · 1.30 Impact Factor