Judy Lakind

Johns Hopkins University | JHU · Department of Applied Mathematics and Statistics

Epidemiology research plays an important role in regulatory risk assessments. However, regulatory approaches to evaluating study utility and quality for risk assessment purposes can vary, even within a single agency. The goal of the current review is to compare different guidelines within the US Environmental Protection Agency (US EPA) for evaluati...

Human biomonitoring (HBM) data measured in specific contexts or populations provide information for comparing population exposures. There are numerous health-based biomonitoring guidance values, but to locate these values, interested parties need to seek them out individually from publications, governmental reports, websites and other sources. Unti...

Background: Per- and polyfluoroalkyl substances (PFAS) are transferred from mother to infants through breastfeeding, a time when children may be particularly vulnerable to PFAS-mediated adverse health effects. Infants can also be exposed to PFAS from infant formula consumption. Our recent literature-based scoping of breast milk levels reported tha...

The herbicide 2,4-D (2,4-dichlorophenoxyacetic acid) has been widely used for many decades. Occupational determinants of 2,4-D exposure are linked to processes related to its application. However, in the general population, the sources, pathways, and routes of exposure are less well-studied. Should exposure reductions be desired, this type of infor...

The COVID-19 pandemic has resulted in an extraordinary incidence of morbidity and mortality, with almost 6 million deaths worldwide at the time of this writing (https://covid19.who.int/). There has been a pressing need for research that would shed light on factors – especially modifiable factors – that could reduce risks to human health. At least s...

Background: Despite 20 y of biomonitoring studies of per- and polyfluoroalkyl substances (PFAS) in both serum and urine, we have an extremely limited understanding of PFAS concentrations in breast milk of women from the United States and Canada. The lack of robust information on PFAS concentrations in breast milk and implications for breastfed inf...

Pyrethroid insecticides have been the subject of numerous epidemiology studies in the past two decades. We examined the pyrethroids epidemiology literature published between 2016 and 2021. Our objective with this exercise was to inform interested readers regarding information on methodological elements that strengthen a study's use for translation...

Background The Matrix is designed to facilitate discussions between practitioners of risk assessment and epidemiology and, in so doing, to enhance the utility of epidemiology research for public health decision-making. The Matrix is comprised of nine fundamental “asks” of epidemiology studies, focusing on the types of information valuable to the ri...

We utilized a practical, transparent approach for systematically reviewing a chemical-specific evidence base. This approach was used for a case study of ozone inhalation exposure and adverse metabolic effects (overweight/obesity, Type 1 diabetes [T1D], Type 2 diabetes [T2D], and metabolic syndrome). We followed the basic principles of systematic re...

In epidemiologic and exposure research, biomonitoring is often used as the basis for assessing human exposure to environmental chemicals. Studies frequently rely on a single urinary measurement per participant to assess exposure to non-persistent chemicals. However, there is a growing consensus that single urine samples may be insufficient for adeq...

Background Assessments of scientific evidence often involve a systematic comparison of findings within and across studies. An important consideration in systematic reviews is multiplicity, which can arise from simultaneous consideration of multiple independent and dependent variables, use of multiple statistical models, or multiple subgroup analyse...

Risk assessment is a well-established process used for various types of public health decision-making, such as setting chemical site clean-up levels, developing limits on exposures to chemicals in soil, water, air and food, and determining occupational exposure limits[...]

A Matrix has recently been presented as a tool to assist in the translation of epidemiology literature for the needs of risk assessment. The Matrix is an approach to bridge the epidemiology-risk assessment gap and includes nine risk assessor “asks” of epidemiology studies. The Matrix is designed to facilitate awareness about how choices regarding a...

Abstract In this paper, we review methodological approaches used in studies that evaluated the association between occupational exposure to quaternary ammonium compounds (quats) and occupational asthma. This association is of interest because quats are a common active ingredient of disinfectants and have been linked to work-related asthma in some c...

The full publications from HEI Energy and the Research Committee can be downloaded at https://hei-energy.org/. There are two reports. One is a systematic review of the epidemiology literature and the other is a companion exposure report.

Environmental epidemiologic research provides invaluable information for understanding the relationship between environmental exposures and health outcomes. Chemical risk assessment, a foundation of public health decision-making, benefits from having information from various disciplines including epidemiology. While epidemiology and risk assessment...

Recent rapid technological advances are producing exposure data sets for which there are no available data quality assessment tools. At the same time, regulatory agencies are moving in the direction of data quality assessment for environmental risk assessment and decision-making. A transparent and systematic approach to evaluating exposure data wil...

Purpose of Review We offer here a review of intraindividual variability in urinary biomarkers for assessing exposure to nonpersistent chemicals. We provide thoughts on how to better evaluate exposure to nonpersistent chemicals. Recent Findings We summarized reported values of intraclass correlation coefficients and found that most values fall into...

Introduction: The use of biomonitoring data as an indicator of national levels of human exposure to environmental chemicals has grown in importance and prevalence. Nationally representative urinary bisphenol A (BPA) data are now available for Canada, the United States and Korea. Here we address the following questions: Are urinary BPA data from th...

Background: Human health risk assessment methods have advanced in recent years to more accurately estimate risks associated with exposure during childhood. However, predicting risks related to infant exposures to environmental chemicals in breast milk and formula remains challenging. Objectives: Our goal was to compile available information on i...

Background: The benefits of breastfeeding to the infant and mother have been well documented. It is also well known that breast milk contains environmental chemicals, and numerous epidemiological studies have explored relationships between background levels of chemicals in breast milk and health outcomes in infants and children. Objectives: In t...

Background Preterm infants (PTI) in the NICU are often placed in incubators that may increase their exposure to volatile organic chemicals (VOCs). To determine whether PTI in incubators have higher urinary concentrations of VOC metabolites compared with infants in cribs. Methods Urine from 40 PTI in incubators and 40 infants in cribs was collected...

The herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) has been commercially available since the 1940’s. Despite decades of data on 2,4-D in food, air, soil, and water, as well as in humans, the quality the quality of these data has not been comprehensively evaluated. Using selected elements of the Biomonitoring, Environmental Epidemiology, and Short...

Environmental epidemiology data are becoming increasingly important in public health decision making, which commonly incorporates a systematic review of multiple studies. This review addresses two fundamental questions: What is the quality of available reviews on associations between exposure to synthetic organic chemicals and neurodevelopmental ou...

Uncertainties in understanding all potential modes-of-action for asthma induction and elicitation hinders design of hazard characterization and risk assessment methods that adequately screen and protect against hazardous chemical exposures. To address this challenge and identify current research needs, the University of Cincinnati and the American...

The ability of epidemiologic evidence to inform regulatory decisions is largely dependent on the coherence and quality of the published literature. This systematic review examines the quality and consistency of studies assessing health outcomes associated with exposure to triclosan (TCS), an antimicrobial chemical with a short physiologic half-life...

Climate change is anticipated to alter the production, use, release, and fate of environmental chemicals, likely leading to increased uncertainty in exposure and human health risk predictions. Exposure science provides a key connection between changes in climate and associated health outcomes. The theme of the 2015 Annual Meeting of the Internation...

Single point estimates of human health hazard/toxicity values such as a reference dose (RfD) are generally used in chemical hazard and risk assessment programs for assessing potential risks associated with site- or use-specific exposures. The resulting point estimates are often used by risk managers for regulatory decision-making, including standar...

Nationally representative data on urinary levels of BPA and its metabolites in the United States from the 2003-2004 to 2011-2012 National Health and Nutrition Examination Surveys (NHANES) were used to estimate daily BPA intakes and examine temporal trends. Additionally, NHANES data on lifestyle/demographic/dietary factors previously reported to be...

Dioxins and furans are ubiquitous, lipophilic, persistent organic chemicals that can be measured in many human tissues and fluids. The most frequently biomonitored human samples are blood and human milk because of the relative ease of sample collection and because these chemicals readily partition into the lipid fraction. In this chapter we will re...

Epidemiologic studies evaluating associations between biomarkers of exposure to short-lived chemicals and health endpoints in humans face special challenges. Perhaps the most critical challenges are the need to determine the type and optimal number of samples, and the proper timing of specimen collection. Further, as many short-lived chemicals are...

In observational research, evidence is usually derived from multiple studies, and any single result is rarely considered sufficient for public health decision making. Despite more than five decades of research and thousands of studies published, the ability to draw robust conclusions regarding the presence or absence of causal links between specifi...

The quality of exposure assessment is a major determinant of the overall quality of any environmental epidemiology study. The use of biomonitoring as a tool for assessing exposure to ubiquitous chemicals with short physiologic half-lives began relatively recently. These chemicals present several challenges, including their presence in analytical la...

Chemicals with estrogenic activity are derived from many different natural and synthetic processes and products, including endogenous production (e.g., estradiol, conjugated estrogens), drugs (e.g., ethinyl estradiol, conjugated estrogens), plants used as foods (phytoestrogens such as genistein, daidzein, S-equol), and man-made chemicals (xenoestro...

Lipophilic persistent environmental chemicals (LPECs) have the potential to accumulate within a woman's body lipids over the course of many years prior to pregnancy, to partition into human milk, and to transfer to infants upon breastfeeding. As a result of this accumulation and partitioning, a breastfeeding infant's intake of these LPECs may be mu...

Residential clusters of non-communicable diseases are a source of enduring public concern, and at times, controversy. Many clusters reported to public health agencies by concerned citizens are accompanied by expectations that investigations will uncover a cause of disease. While goals, methods and conclusions of cluster studies are debated in the s...

Introduction: Phthalates, a class of commonly used compounds with widespread human exposure, have been described as obesogens, or chemicals that disrupt lipid metabolism and produce metabolic changes leading to increased risk of type 2 diabetes mellitus (DM) and cardiovascular disease (CVD). This communication provides a systematic review of the a...

Introduction: Bisphenol A (BPA), a high-volume chemical with weak estrogenic properties, has been linked to obesity, cardiovascular diseases (CVD) and diabetes mellitus (DM). This review evaluates both the consistency and the quality of epidemiological evidence from studies testing the hypothesis that BPA exposure is a risk factor for these health...

Most of the information available on environmental chemicals in breast milk is focused on persistent, lipophilic chemicals; the database on levels of these chemicals has expanded substantially since the 1950s. Currently, various types of chemicals are measured in breast milk and the number of countries for which data are available is increasing. Se...

Women in the United States have breast milk concentrations of polybrominated diphenyl ethers (PBDEs) that are among the highest in the world, leading to concerns over the potential health implications to breastfeeding infants during critical stages of growth and development. Developing cost effective and sustainable methods for assessing chemical e...

Canned foods and beverages constitute a major part of the global food supply. Consumers expect canned foods and beverages to maintain their flavour, texture and colour and be free of illness-causing pathogens. This is generally accomplished by coating can interiors with protective resins. With recent calls for the removal of commonly used epoxy res...

Background: The National Health and Nutrition Examination Survey (NHANES) is one example of cross-sectional datasets that have been used to draw causal inferences regarding environmental chemical exposures and adverse health outcomes. Our objectives were to analyze four NHANES datasets using consistent a priori selected methods to address the foll...

Continued monitoring of environmental chemicals is important for understanding human exposure and potentially related health risk(s). Cinar et al. [1] contribute to our knowledge on infant exposures to environmental chemicals in breast milk. However, the messages implicit both in the title and in the paper itself are unnecessarily alarming and are...

Cancer clusters garner considerable public and legislative attention, and there is often an expectation that cluster investigations in a community will reveal a causal link to an environmental exposure. At a 1989 national conference on disease clusters, it was reported that cluster studies conducted in the 1970s and 1980s rarely, if ever, produced...

The Centers for Disease Control and Prevention provides biomonitoring data in the United States as part of the National Health and Nutrition Examination Survey (NHANES). Recently, Statistics Canada initiated a similar survey - the Canadian Health Measures Survey (CHMS). Comparison of US and Canadian biomonitoring data can generate hypotheses regard...

Water disinfection is not only crucial for protecting public health but also leads to the formation of disinfection by-products (DBPs) including the trihalomethanes (THMs). Exposure to THMs has been associated with adverse health outcomes. Accurate THM exposure characterization is crucial for relating exposure with health effects, yet exposure asse...

Although most of the information available on environmental chemicals in breast milk is focused on persistent, lipophilic chemicals, the database on levels of environmental chemicals in breast milk has expanded substantially since the 1950s in terms of types of chemicals measured and the number of countries for which data are available. Several eme...

Foram examinados estudos degrupoque avaliaram arelaçãoentre a exposiçãopré-natal e neonatalaos bifenilospoliclorados (PCB)e o desenvolvimento neuropsicomotoremcrianças a fim de avaliar aviabilidadedarealização deuma meta-análise parasuporte à tomadade decisão. Nós descrevemos os estudosem termos de exposição, categorizações, análiseestatísticae ela...

The ability to conduct weight-of-evidence assessments to inform the evaluation of potential environmental neurotoxicants is limited by lack of comparability of study methods, data analysis, and reporting. There is a need to establish consensus guidelines for conducting, analyzing, and reporting neurodevelopmental environmental epidemiologic studies...

Exposure science can move us toward a more protective chemicals management policy by preventing human and ecological risks that may occur when existing "bad actors" are replaced with alternative chemicals that may not be as well studied.

Swimming is a healthful activity that comes with increased risk of exposure to pathogenic microorganisms and disinfection agents/byproducts.

Nationally representative data on urinary levels of bisphenol A (BPA) and its metabolites in the United States from the 2005-2006 National Health and Nutrition Examination Survey (NHANES) were used to estimate daily BPA intakes. In addition, NHANES data on potential sources of BPA exposure and personal characteristics were explored for their associ...

Biomonitoring, or the measurement of environmental chemicals in human tissues and fluids, is used to supplement-and in some cases replace-more traditional exposure assessments which measure chemicals in environmental media. Volatile organic compounds (VOCs) in physiological fluids are biomarkers of exposure that present numerous challenges for samp...

Epidemiologic weight-of-evidence reviews to support regulatory decision making regarding the association between environmental chemical exposures and neurodevelopmental outcomes in children are often complicated by lack of consistency across studies. We examined prospective cohort studies evaluating the relation between prenatal and neonatal exposu...

With research suggesting increasing incidence of pediatric neurodevelopmental disorders, questions regarding etiology continue to be raised. Neurodevelopmental function tests have been used in epidemiology studies to evaluate relationships between environmental chemical exposures and neurodevelopmental deficits. Limitations of currently used tests...

Conventional wisdom regarding exposures to persistent organic chemicals via breast-feeding assumes that concentrations decline over the course of lactation and that the mother's body burden reflects her cumulative lifetime exposure. Two important implications stemming from these lines of thought are, first, that assessments of early childhood expos...

Trihalomethanes (THMs) can form as byproducts during drinking water disinfection, which is crucial for limiting human exposure to disease-causing pathogens. The US Environmental Protection Agency (USEPA), recognizing both the importance of water disinfection for public health protection and potential risks associated with THM exposure, developed di...

Abstract The increasing number of environmental chemicals measured in breastmilk is a consequence of improved analytical capabilities and the increased interest in biomonitoring. It has been generally concluded that the benefits to the infant from breastfeeding outweigh potential risks associated with environmental chemical exposures associated wit...

Recent studies have explored the potential for swimming pool disinfection by-products (DBPs), which are respiratory irritants, to cause asthma in young children. Here we describe the state of the science on methods for understanding children's exposure to DBPs and biologics at swimming pools and associations with new-onset childhood asthma and reco...