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Park HR, Azzara D, Cohen ED, Boomhower SR, Diwadkar AR, Himes BE, O'Reilly MA, Lu Q. Identification of novel NRF2-dependent genes as regulators of lead and arsenic toxicity in neural progenitor cells. JOURNAL OF HAZARDOUS MATERIALS 2024; 463:132906. [PMID: 37939567 PMCID: PMC10842917 DOI: 10.1016/j.jhazmat.2023.132906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023]
Abstract
Lead (Pb) and arsenic (As) are prevalent metal contaminants in the environment. Exposures to these metals are associated with impaired neuronal functions and adverse effects on neurodevelopment in children. However, the molecular mechanisms by which Pb and As impair neuronal functions remain poorly understood. Here, we identified F2RL2, TRIM16L, and PANX2 as novel targets of Nuclear factor erythroid 2-related factor 2 (NRF2)-the master transcriptional factor for the oxidative stress response-that are commonly upregulated with both Pb and As in human neural progenitor cells (NPCs). Using a ChIP (Chromatin immunoprecipitation)-qPCR assay, we showed that NRF2 directly binds to the promoter region of F2RL2, TRIM16L, and PANX2 to regulate expression of these genes. We demonstrated that F2RL2, PANX2, and TRIM16L have differential effects on cell death, proliferation, and differentiation of NPCs in both the presence and absence of metal exposures, highlighting their roles in regulating NPC function. Furthermore, the analyses of the transcriptomic data on NPCs derived from autism spectrum disorder (ASD) patients revealed that dysregulation of F2RL2, TRIM16L, and PANX2 was associated with ASD genetic backgrounds and ASD risk genes. Our findings revealed that Pb and As induce a shared NRF2-dependent transcriptional response in NPCs and identified novel genes regulating NPC function. While further in vivo studies are warranted, this study provides a novel mechanism linking metal exposures to NPC function and identifies potential genes of interest in the context of neurodevelopment.
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Affiliation(s)
- Hae-Ryung Park
- Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
| | - David Azzara
- Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Ethan D Cohen
- Department of Pediatrics, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Steven R Boomhower
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Avantika R Diwadkar
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Blanca E Himes
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael A O'Reilly
- Department of Pediatrics, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Quan Lu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Schachner JN, Wodtke GT. Environmental inequality and disparities in school readiness: The role of neurotoxic lead. Child Dev 2023; 94:e308-e327. [PMID: 37307305 DOI: 10.1111/cdev.13949] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/31/2023] [Accepted: 05/17/2023] [Indexed: 06/14/2023]
Abstract
Developmental science has increasingly scrutinized how environmental hazards influence child outcomes, but few studies examine how contaminants affect disparities in early skill formation. Linking research on environmental inequality and early childhood development, this study assessed whether differences in exposure to neurotoxic lead explain sociodemographic gaps in school readiness. Using panel data tracking a representative sample of 1266 Chicago children (50% female, 16% White, 30% Black, 49% Hispanic, μage = 5.2 months at baseline, collected 1994-2002), analyses quantified the contribution of lead contamination to class and racial disparities in vocabulary skills and attention problems at ages 4 and 5. Results suggested that lead contamination explains 15%-25% and 33%-66% of the disparities in each outcome, respectively, although imprecise estimates preclude drawing firm inferences about attention problems.
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Affiliation(s)
- Jared N Schachner
- Price School of Public Policy, University of Southern California, Los Angeles, California, USA
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Payne-Sturges DC, Taiwo TK, Ellickson K, Mullen H, Tchangalova N, Anderko L, Chen A, Swanson M. Disparities in Toxic Chemical Exposures and Associated Neurodevelopmental Outcomes: A Scoping Review and Systematic Evidence Map of the Epidemiological Literature. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:96001. [PMID: 37754677 PMCID: PMC10525348 DOI: 10.1289/ehp11750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/29/2023] [Accepted: 08/10/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Children are routinely exposed to chemicals known or suspected of harming brain development. Targeting Environmental Neuro-Development Risks (Project TENDR), an alliance of > 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. https://doi.org/10.1289/EHP11750.
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Affiliation(s)
| | | | - Kristie Ellickson
- Minnesota Pollution Control Agency, St. Paul, Minnesota, USA
- Union of Concerned Scientists, Cambridge, Massachusetts, USA
| | - Haley Mullen
- Department of Geographical Sciences, University of Maryland, College Park, Maryland, USA
| | | | - Laura Anderko
- M. Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, USA
| | - Aimin Chen
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Racial residential segregation shapes the relationship between early childhood lead exposure and fourth-grade standardized test scores. Proc Natl Acad Sci U S A 2022; 119:e2117868119. [PMID: 35969764 PMCID: PMC9407651 DOI: 10.1073/pnas.2117868119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Racial residential segregation (RRS) – defined here as the geographic separation of Black individuals and communities from other racial/ethnic groups into separate, unequal neighborhoods – fosters environments inimical to health through disinvestment of resources and concentration of disadvantages. Neighborhood environments influence children’s health and development, but relationships between RRS and cognitive development are poorly understood. We find that: (1) non-Hispanic Black children were more likely to experience multiple adverse exposures in early childhood, and (2) among non-Hispanic Black children, high levels of RRS augmented the detrimental effect of elevated blood levels on reading test scores. Non-linear models were used to model exposure to lead and RRS, and their interaction. Racial/ethnic disparities in academic performance may result from a confluence of adverse exposures that arise from structural racism and accrue to specific subpopulations. This study investigates childhood lead exposure, racial residential segregation, and early educational outcomes. Geocoded North Carolina birth data is linked to blood lead surveillance data and fourth-grade standardized test scores (n = 25,699). We constructed a census tract-level measure of racial isolation (RI) of the non-Hispanic Black (NHB) population. We fit generalized additive models of reading and mathematics test scores regressed on individual-level blood lead level (BLL) and neighborhood RI of NHB (RINHB). Models included an interaction term between BLL and RINHB. BLL and RINHB were associated with lower reading scores; among NHB children, an interaction was observed between BLL and RINHB. Reading scores for NHB children with BLLs of 1 to 3 µg/dL were similar across the range of RINHB values. For NHB children with BLLs of 4 µg/dL, reading scores were similar to those of NHB children with BLLs of 1 to 3 µg/dL at lower RINHB values (less racial isolation/segregation). At higher RINHB levels (greater racial isolation/segregation), children with BLLs of 4 µg/dL had lower reading scores than children with BLLs of 1 to 3 µg/dL. This pattern becomes more marked at higher BLLs. Higher BLL was associated with lower mathematics test scores among NHB and non-Hispanic White (NHW) children, but there was no evidence of an interaction. In conclusion, NHB children with high BLLs residing in high RINHB neighborhoods had worse reading scores.
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Egan KB, Dignam T, Brown MJ, Bayleyegn T, Blanton C. Using Small Area Prevalence Survey Methods to Conduct Blood Lead Assessments among Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106151. [PMID: 35627688 PMCID: PMC9141915 DOI: 10.3390/ijerph19106151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 12/04/2022]
Abstract
Introduction: Prevalence surveys conducted in geographically small areas such as towns, zip codes, neighborhoods or census tracts are a valuable tool for estimating the extent to which environmental risks contribute to children’s blood lead levels (BLLs). Population-based, cross-sectional small area prevalence surveys assessing BLLs can be used to establish a baseline lead exposure prevalence for a specific geographic region. Materials and Methods: The required statistical methods, biological and environmental sampling, supportive data, and fieldwork considerations necessary for public health organizations to rapidly conduct child blood lead prevalence surveys at low cost using small area, cluster sampling methodology are described. Results: Comprehensive small area prevalence surveys include partner identification, background data collection, review of the assessment area, resource availability determinations, sample size calculations, obtaining the consent of survey participants, survey administration, blood lead analysis, environmental sampling, educational outreach, follow-up and referral, data entry/analysis, and report production. Discussion: Survey results can be used to estimate the geographic distribution of elevated BLLs and to investigate inequitable lead exposures and risk factors of interest. Conclusions: Public health officials who wish to assess child and household-level blood lead data can quickly apply the data collection methodologies using this standardized protocol here to target resources and obtain assistance with these complex procedures. The standardized methods allow for comparisons across geographic areas and over time.
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Affiliation(s)
- Kathryn B. Egan
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA;
- Office of Community Health and Hazard Assessment, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
- Correspondence: ; Tel.: +404-718-5778
| | - Timothy Dignam
- Office of the Director, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA;
| | - Mary Jean Brown
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
| | - Tesfaye Bayleyegn
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA;
| | - Curtis Blanton
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA;
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Oshio T, Kupperman J. The Problem Behind the Problem: Applying Human-Centered Design to Child Care in Flint. EARLY CHILDHOOD EDUCATION JOURNAL 2021; 50:1373-1382. [PMID: 34566398 PMCID: PMC8451737 DOI: 10.1007/s10643-021-01263-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/28/2021] [Indexed: 06/13/2023]
Abstract
In response to the water crisis in Flint, Michigan, USA, early childhood education was one of the targets of intervention and prevention for children who were exposed to lead poisoning, because high-quality child care could potentially help improve their developmental trajectories. The Provider Empowerment Program used human-centered design (HCD) to uncover unmet and overlooked needs among child care providers. We discuss the theoretical framework that guided the project and led to a focus on family, friend, and neighbor (FFN) child care providers. We also present three examples of solutions that were uniquely shaped to meet the needs of FFN child care providers in Flint. Each solution was developed by a process that included taking the perspective of the people who faced the problem, spending time to understand the context of the problem, and uncovering the underlying problem which was not apparent at first. Recommendations for use of HCD in community-based problem-solving are discussed.
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Affiliation(s)
- Toko Oshio
- Department of Education, University of Michigan-Flint, 430 French Hall, 303 E. Kearsley, Flint, MI 48502-1950 USA
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Bravo MA, Miranda ML. Effects of accumulated environmental, social and host exposures on early childhood educational outcomes. ENVIRONMENTAL RESEARCH 2021; 198:111241. [PMID: 33933487 PMCID: PMC8176571 DOI: 10.1016/j.envres.2021.111241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Persistent disparities in academic performance may result from a confluence of adverse exposures accruing disproportionately to specific subpopulations. OBJECTIVE Our overarching objective was to investigate how multiple exposures experienced over time affect early childhood educational outcomes. We were specifically interested in whether there were: racial/ethnic disparities in prevalence of adverse exposures; racial/ethnic disparities in associations observed between adverse exposures and early childhood educational outcomes; and interactions between exposures, suggesting that one exposure augments susceptibility to adverse effects of another exposure. METHODS We link geocoded North Carolina birth data for non-Hispanic white (NHW) and non-Hispanic black (NHB) children to blood lead surveillance data and 4th grade end-of-grade (EOG) standardized test scores (n = 65,151). We construct a local, spatial index of racial isolation (RI) of NHB at the block group level. We fit race-stratified multi-level models of reading and mathematics EOG scores regressed on birthweight percentile for gestational age, blood lead level, maternal smoking, economic disadvantage, and RI, adjusting for maternal- and child-level covariates and median household income. RESULTS There were marked racial/ethnic disparities in prevalence of adverse exposures. Specifically, NHB children were more likely than NHW children to be economically disadvantaged (80% vs. 40%), live in block groups with the highest quintile of RI (46% vs. 5%), have higher blood lead levels (4.6 vs. 3.7 μg/dL), and lower birthweight percentile for gestational age (mean: 39th percentile vs. 51st percentile). NHB children were less likely to have mothers who reported smoking during pregnancy (11% and 22%). We observed associations between key adverse exposures and reading and math EOG scores in 4th grade. Higher birthweight percentile for gestational age was associated with higher EOG scores, while economic disadvantage, maternal smoking, and elevated blood lead levels were associated with lower EOG scores. Associations observed for NHB and NHW children were generally not statistically different from one another, with the exception of neighborhood RI. NHB children residing in block groups in the highest RI quintile had reading and math scores 1.54 (0.74, 2.34) and 1.12 (0.38, 1.87) points lower, respectively, compared to those in the lowest RI quintile; statistically significant decrements in EOG scores associated with RI were not observed for NHW children. We did not find evidence of multiplicative interactions between exposures for NHB or NHW children. DISCUSSION Key adverse host, environmental, and social exposures accrue disproportionately to NHB children. Decrements in test scores associated with key adverse exposures were often but not always larger for NHB children, but were not significantly different from those estimated for NHW children. While we did not observe interactive effects, NHB children on average experience more deleterious combined exposures, resulting in larger decrements to test scores compared to NHW children.
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Affiliation(s)
- Mercedes A Bravo
- Biostatistics and Epidemiology Division, Research Triangle Institute (RTI) International, Durham, NC, USA; Children's Environmental Health Initiative, University of Notre Dame, South Bend, IN, USA.
| | - Marie Lynn Miranda
- Children's Environmental Health Initiative, University of Notre Dame, South Bend, IN, USA; Department of Applied and Computational Mathematics and Statistics, University of Notre Dame, South Bend, IN, USA
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Rasnick E, Ryan PH, Bailer AJ, Fisher T, Parsons PJ, Yolton K, Newman NC, Lanphear BP, Brokamp C. Identifying sensitive windows of airborne lead exposure associated with behavioral outcomes at age 12. Environ Epidemiol 2021; 5:e144. [PMID: 33870016 PMCID: PMC8043737 DOI: 10.1097/ee9.0000000000000144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 02/12/2021] [Indexed: 11/25/2022] Open
Abstract
Despite the precipitous decline of airborne lead concentrations following the removal of lead in gasoline, lead is still detectable in ambient air in most urban areas. Few studies, however, have examined the health effects of contemporary airborne lead concentrations in children. METHODS We estimated monthly air lead exposure among 263 children (Cincinnati Childhood Allergy and Air Pollution Study; Cincinnati, OH; 2001-2005) using temporally scaled predictions from a validated land use model and assessed neurobehavioral outcomes at age 12 years using the parent-completed Behavioral Assessment System for Children, 2nd edition. We used distributed lag models to estimate the effect of airborne lead exposure on behavioral outcomes while adjusting for potential confounding by maternal education, community-level deprivation, blood lead concentrations, greenspace, and traffic related air pollution. RESULTS We identified sensitive windows during mid- and late childhood for increased anxiety and atypicality scores, whereas sensitive windows for increased aggression and attention problems were identified immediately following birth. The strongest effect was at age 12, where a 1 ng/m3 increase in airborne lead exposure was associated with a 3.1-point (95% confidence interval: 0.4, 5.7) increase in anxiety scores. No sensitive windows were identified for depression, somatization, conduct problems, hyperactivity, or withdrawal behaviors. CONCLUSIONS We observed associations between exposure to airborne lead concentrations and poor behavioral outcomes at concentrations 10 times lower than the National Ambient Air Quality Standards set by the US Environmental Protection Agency.
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Affiliation(s)
- Erika Rasnick
- Department of Statistics, Miami University, Oxford
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center
| | - Patrick H. Ryan
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
| | | | | | - Patrick J. Parsons
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany
- Department of Environmental Health Sciences, School of Public Health, University at Albany, Rensselaer, New York
| | - Kimberly Yolton
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center
| | - Nicholas C. Newman
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany
- Department of Environmental and Public Health Sciences, University of Cincinnati, Cincinnati, Ohio
| | - Bruce P. Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Cole Brokamp
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
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Egan KB, Cornwell CR, Courtney JG, Ettinger AS. Blood Lead Levels in U.S. Children Ages 1-11 Years, 1976-2016. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:37003. [PMID: 33730866 PMCID: PMC7969125 DOI: 10.1289/ehp7932] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 12/29/2020] [Accepted: 02/15/2021] [Indexed: 05/23/2023]
Abstract
BACKGROUND Lead can adversely affect child health across a wide range of exposure levels. We describe the distribution of blood lead levels (BLLs) in U.S. children ages 1-11 y by selected sociodemographic and housing characteristics over a 40-y period. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) II (1976-1980), NHANES III (Phase 1: 1988-1991 and Phase II: 1991-1994), and Continuous NHANES (1999-2016) were used to describe the distribution of BLLs (in micrograms per deciliter; 1 μ g / dL = 0.0483 μ mol / L ) in U.S. children ages 1-11 y from 1976 to 2016. For all children with valid BLLs (n = 27,122 ), geometric mean (GM) BLLs [95% confidence intervals (CI)] and estimated prevalence ≥ 5 μ g / dL (95% CI) were calculated overall and by selected characteristics, stratified by age group (1-5 y and 6-11 y). RESULTS The GM BLL in U.S. children ages 1-5 y declined from 15.2 μ g / dL (95% CI: 14.3, 16.1) in 1976-1980 to 0.83 μ g / dL (95% CI: 0.78, 0.88) in 2011-2016, representing a 94.5% decrease over time. For children ages 6-11 y, GM BLL declined from 12.7 μ g / dL (95% CI: 11.9, 13.4) in 1976-1980 to 0.60 μ g / dL (95% CI: 0.58, 0.63) in 2011-2016, representing a 95.3% decrease over time. Even so, for the most recent period (2011-2016), estimates indicate that approximately 385,775 children ages 1-11 y had BLLs greater than or equal to the CDC blood lead reference value of 5 μ g / dL . Higher GM BLLs were associated with non-Hispanic Black race/ethnicity, lower family income-to-poverty-ratio, and older housing age. DISCUSSION Overall, BLLs in U.S. children ages 1-11 y have decreased substantially over the past 40 y. Despite these notable declines in population exposures to lead over time, higher GM BLLs are consistently associated with risk factors such as race/ethnicity, poverty, and housing age that can be used to target blood lead screening efforts. https://doi.org/10.1289/EHP7932.
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Affiliation(s)
- Kathryn B. Egan
- National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Cheryl R. Cornwell
- National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Joseph G. Courtney
- National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Adrienne S. Ettinger
- National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
- Rutgers Biomedical and Health Sciences, Rutgers University, New Brunswick, New Jersey USA
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Trentacosta CJ, Mulligan DJ. New directions in understanding the role of environmental contaminants in child development: Four themes. New Dir Child Adolesc Dev 2020; 2020:39-51. [PMID: 32920950 PMCID: PMC8189654 DOI: 10.1002/cad.20363] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Environmental contaminants, which include several heavy metals, persistent organic pollutants, and other harmful chemicals, impair several domains of child development. This article describes four themes from recent research on the impact of environmental contaminants on child development. The first theme, disparities in exposure, focuses on how marginalized communities are disproportionately exposed to harmful environmental contaminants. The second theme, complexity of exposures, encapsulates recent emphases on timing of exposures and mixtures of multiple exposures. The third theme, mechanisms that link exposures to outcomes, focuses on processes that elucidate how contaminants impact outcomes. The fourth theme, mitigating risks associated with exposures, sheds light on potential protective factors that could ameliorate many of the harmful effects of contaminant exposures. Developmental scientists are well positioned to contribute to interdisciplinary research that addresses these themes, which could foster additional conceptual and empirical innovations and inform policies and practices to mitigate risks and improve children's well-being.
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Klemick H, Mason H, Sullivan K. Superfund Cleanups and Children's Lead Exposure. JOURNAL OF ENVIRONMENTAL ECONOMICS AND MANAGEMENT 2020; 100:10.1016/j.jeem.2019.102289. [PMID: 32132762 PMCID: PMC7055517 DOI: 10.1016/j.jeem.2019.102289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study evaluates the effect of EPA's Superfund cleanup program on children's lead exposure. We linked two decades of blood lead level (BLL) measurements from children in six states with data on Superfund sites and other lead risk factors. We used quasi-experimental methods to identify the causal effect of proximity to Superfund cleanups on rates of elevated BLL. We estimated a difference-in-difference model comparing the change in elevated BLL of children closer to versus farther from lead-contaminated sites before, during, and after cleanup. We also estimated a triple difference model including children near hazardous sites with minimal to no lead contamination as a comparison group. We used spatial fixed effects and matching to minimize potential bias from unobserved differences between the treatment and comparison groups. Results indicate that Superfund cleanups lowered the risk of elevated BLL for children living within 2 kilometers of lead-contaminated sites 13 to 26 percent.
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Affiliation(s)
- Heather Klemick
- U.S. Environmental Protection Agency, Office of Policy, National Center for Environmental Economics, Washington, DC 20460
| | - Henry Mason
- U.S. Environmental Protection Agency, Office of Policy, National Center for Environmental Economics, Washington, DC 20460
| | - Karen Sullivan
- U.S. Environmental Protection Agency, Office of Land and Emergency Management, Office for Communications, Partnerships, and Analysis, Washington, DC 20460
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12
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Doyi INY, Isley CF, Soltani NS, Taylor MP. Human exposure and risk associated with trace element concentrations in indoor dust from Australian homes. ENVIRONMENT INTERNATIONAL 2019; 133:105125. [PMID: 31634663 DOI: 10.1016/j.envint.2019.105125] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/23/2019] [Accepted: 08/23/2019] [Indexed: 05/22/2023]
Abstract
This study examines residential indoor dust from 224 homes in Sydney, Australia for trace element concentrations measured using portable X-ray Fluorescence (pXRF) and their potential risk of harm. Samples were collected as part of a citizen science program involving public participation via collection and submission of vacuum dust samples for analysis of their As, Cr, Cu, Mn, Ni, Pb and Zn concentrations. The upper 95% confidence level of the mean values for 224 samples (sieved to <250 μm) were 20.2 mg/kg As, 99.8 mg/kg Cr, 298 mg/kg Cu, 247 mg/kg Mn, 56.7 mg/kg Ni, 364 mg/kg Pb and 2437 mg/kg Zn. The spatial patterns and variations of the metals indicate high homogeneity across Sydney, but with noticeably higher Pb values in the older areas of the city. Potential hazard levels were assessed using United States Environmental Protection Agency's (US EPA) carcinogenic, non-carcinogenic and Integrated Exposure Uptake Biokinetic (IEUBK) model human health risk assessment tools for children and adults. US EPA hazard indexes (HI) for Cr and Pb were higher than the safe level of 1.0 for children. HI > 1 suggests potential non-carcinogenic health effects. Carcinogenic risks were estimated for As, Cr and Pb whose carcinogenic slope factors (CSF) were available. Only the risk factor for Cr exceeded the US EPA's carcinogenic threshold (1 × 10-4) for children. Children aged 1-2 years had the highest predicted mean child blood lead (PbB) of 4.6 μg/dL, with 19.2% potentially having PbB exceeding 5 μg/dL and 5.80% exceeding 10 μg/dL. The Cr and Pb levels measured in indoor dust therefore pose potentially significant adverse health risks to children.
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Affiliation(s)
- Israel N Y Doyi
- Department of Environmental Sciences, Faculty of Science & Engineering, Macquarie University, Sydney, NSW 2109, Australia.
| | - Cynthia Faye Isley
- Department of Environmental Sciences, Faculty of Science & Engineering, Macquarie University, Sydney, NSW 2109, Australia
| | - Neda Sharifi Soltani
- Department of Environmental Sciences, Faculty of Science & Engineering, Macquarie University, Sydney, NSW 2109, Australia
| | - Mark Patrick Taylor
- Department of Environmental Sciences, Faculty of Science & Engineering, Macquarie University, Sydney, NSW 2109, Australia.
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Shadbegian R, Guignet D, Klemick H, Bui L. Early childhood lead exposure and the persistence of educational consequences into adolescence. ENVIRONMENTAL RESEARCH 2019; 178:108643. [PMID: 31473504 PMCID: PMC7038535 DOI: 10.1016/j.envres.2019.108643] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/11/2019] [Accepted: 08/08/2019] [Indexed: 05/12/2023]
Abstract
BACKGROUND There is consensus that early childhood lead exposure causes adverse cognitive and behavioral effects, even at blood lead levels (BLL) below 5 μg/dL. What has not been established is to what extent the effects of childhood lead exposure persist across grades. OBJECTIVE To measure the effects of early childhood lead exposure (BLL 1-10 μg/dL) on educational performance from grades 3-8; to determine if effects in lower grades persist as a child progresses through school; and if so, to characterize the pattern of persistence. METHODS We examine data from 560,624 children living in North Carolina between 2000 and 2012 with a BLL ≤10 μg/dL measured between age 0-5 years. Children are matched to their standardized math and reading scores for grades 3-8, creating an unbalanced panel of 2,344,358 student-year observations. We use socio-economic, demographic, and school information along with matching techniques to control for confounding effects. RESULTS We find that early childhood exposure to low lead levels caused persistent deficits in educational performance across grades. In each grade (3-8), children with higher blood lead levels had, on average, lower percentile scores in both math and reading than children with lower blood lead levels. In our primary model, we find that children with BLL = 5 μg/dL in early childhood ranked 0.90-1.20 (1.35-1.55) percentiles lower than children with BLL ≤ 1 μg/dL on math (reading) tests during grades 3-8. As children progressed through school, the average percentile deficit in their test scores remained stable. CONCLUSIONS Our study shows that the adverse effects of early childhood exposure to low lead levels persist through early adolescence, and that the magnitude of the test-score percentile deficit remains steady between grades 3-8.
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Affiliation(s)
- Ron Shadbegian
- US EPA, National Center for Environmental Economics, 1200 Pennsylvania Avenue, NW (mail Code 1809T), Washington, DC, 20460, USA.
| | | | - Heather Klemick
- US EPA, National Center for Environmental Economics, Washington, DC, USA.
| | - Linda Bui
- Brandeis University, Waltham, MA, USA.
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Caron-Beaudoin É, Ayotte P, Laouan Sidi EA, Gros-Louis McHugh N, Lemire M. Exposure to perfluoroalkyl substances (PFAS) and associations with thyroid parameters in First Nation children and youth from Quebec. ENVIRONMENT INTERNATIONAL 2019; 128:13-23. [PMID: 31029975 DOI: 10.1016/j.envint.2019.04.029] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 04/11/2019] [Accepted: 04/11/2019] [Indexed: 05/24/2023]
Abstract
BACKGROUND Perfluoroalkyl substances (PFASs) are found in several consumer goods. Exposure to PFASs in children has been associated with alteration in thyroid hormones, which have critical roles in brain function. OBJECTIVE In 2015, 198 children and youth (3-19 y) were recruited as part of the pilot project Jeunes, Environnement et Santé/Youth, Environment and Health (JES!-YEH!), realized in collaboration with four First Nation communities in Quebec. We aimed to evaluate serum concentrations of PFASs in relation to concentrations of thyroid-stimulating hormone (TSH), free thyroxine (T4) and thyroglobulin while adjusting for relevant confounders. METHODS PFASs (PFOS, PFOA, PFHxS, PFNA), 2,2',4,4'-Tetrabromodiphenyl ether (PBDE-47) thyroid parameters (TSH, free T4, and thyroglobulin) were measured in serum samples of 186 participants. Iodine, creatinine, and cotinine were measured in urine samples. Serum levels of PFASs were compared to those measured in the general Canadian population and elsewhere. Multivariate regression analyses were performed to determine associations between PFASs and TSH, free T4 and thyroglobulin. RESULTS PFOS, PFOA and PFHxS serum concentrations were low. However, PFNA concentrations among participants aged 12 to 19 years old from Anishinabe communities were three times higher than those measured in the Canadian Health Measures Survey (2009-2011) for the same age group (Geometric Means: 3.01 μg/L and 0.71 μg/L, respectively) and were particularly higher in the Anishinabe participants aged 6 to 11 years old (GM: 9.44 μg/L). Few participants had levels of TSH, free T4, and thyroglobulin outside age-specific paediatric ranges. When adjusted for relevant covariates and other contaminants, PFNA serum concentrations were positively associated with free T4 levels (Adjusted β = 0.36; p = 0.0014), but not with TSH and thyroglobulin levels. No association was observed between the other PFAS and thyroid hormones parameters. CONCLUSION This pilot project reveals among the highest exposure to PFNA in children reported until today, and suggests effects of PFNA as an endocrine disruptor, highlighting the importance of investigating the sources and effects of disproportionate exposure to emerging contaminants in some indigenous communities and ban all PFAS at the international scale.
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Affiliation(s)
- Élyse Caron-Beaudoin
- Université de Montreal School of Public Health, Department of Environmental and Occupational Health, QC, Montreal, Canada.
| | - Pierre Ayotte
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec - Université Laval, Canada; Département de médecine sociale et préventive, Université Laval, Québec, Canada; Institut national de santé publique du Québec, QC, Québec, Canada
| | - Elhadji Anassour Laouan Sidi
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec - Université Laval, Canada
| | - Nancy Gros-Louis McHugh
- First Nations of Quebec and Labrador Health and Social Services Commission, Wendake, QC, Canada
| | - Mélanie Lemire
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec - Université Laval, Canada; Département de médecine sociale et préventive, Université Laval, Québec, Canada
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Rushton and Jensen’s Work has Parallels with Some Concepts of Race Awareness in Ancient Greece. PSYCH 2019. [DOI: 10.3390/psych1010028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rushton and Jensen’s “Thirty Years of Research on Race Differences in Cognitive Ability” documents IQ differences in populations on the basis of race. The authors explain these data by arguing that cold winter conditions in Europe had greater pressure for the selection of higher intelligence. Critics of Rushton and Jensen, and of the very category of race, claim that race is a social construct that only came up in the 16th century, as a result of overseas voyages and the Atlantic slave trade. The goal of this article is to refute that particular claim, by documenting how, long before the 16th century, in classical antiquity race was already a meaningful concept, and how some Greek authors even developed ideas that bear some resemblance to Rushton and Jensen’s theory. The article documents how ancient Egyptians already had keen awareness of race differences amongst various populations. Likewise, the article documents passages from the Hippocratic and Aristotelian corpus, which attests that already in antiquity, there was a conception that climatic differences had an influence on intelligence, and that these differences eventually become enshrined in fixed biological traits.
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Kaufman BG, Klemish D, Kassner CT, Reiter JP, Li F, Harker M, O'Brien EC, Taylor DH, Bhavsar NA. Predicting Length of Hospice Stay: An Application of Quantile Regression. J Palliat Med 2018; 21:1131-1136. [PMID: 29762075 DOI: 10.1089/jpm.2018.0039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Use of the Medicare hospice benefit has been associated with high-quality care at the end of life, and hospice length of use in particular has been used as a proxy for appropriate timing of hospice enrollment. Quantile regression has been underutilized as an alternative tool to model distributional changes in hospice length of use and hospice payments outside of the mean. OBJECTIVE To test for heterogeneity in the relationship between patient characteristics and hospice outcomes across the distribution of hospice days. SETTING Medicare Beneficiary Summary File and survey data (2014) for hospice beneficiaries in North and South Carolina with common terminal diagnoses. MEASUREMENTS Distributional shifts associated with patient characteristics were evaluated at the 25th and 75th percentiles of hospice days and hospice payments using quantile regressions and compared to the mean shift estimated by ordinary least squares (OLS) regression. PRINCIPAL FINDINGS Significant (p < 0.001) heterogeneity in the marginal effects on hospice days and costs was observed, with patient characteristics associated with generally larger shifts in the 75th percentile than the 25th percentile. Mean effects estimated by OLS regression overestimate the magnitude of the median marginal effects for all patient characteristics except for race. Results for hospice payments in 2014 were similar. CONCLUSIONS Methodological decisions can have a meaningful impact in the evaluation of factors influencing hospice length of use or cost.
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Affiliation(s)
- Brystana G Kaufman
- 1 Department of Health Policy and Management, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.,2 Department of Statistical Sciences, Duke University School of Medicine , Durham, North Carolina
| | - David Klemish
- 3 Department of Statistical Sciences, Duke University , Durham, North Carolina
| | | | - Jerome P Reiter
- 3 Department of Statistical Sciences, Duke University , Durham, North Carolina
| | - Fan Li
- 3 Department of Statistical Sciences, Duke University , Durham, North Carolina
| | - Matthew Harker
- 5 Margolis Center for Health Policy , Duke University, Durham, North Carolina
| | - Emily C O'Brien
- 2 Department of Statistical Sciences, Duke University School of Medicine , Durham, North Carolina
| | - Donald H Taylor
- 6 Sanford School of Public Policy , Duke University, Durham, North Carolina
| | - Nrupen A Bhavsar
- 2 Department of Statistical Sciences, Duke University School of Medicine , Durham, North Carolina
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Gracy D, Fabian A, Basch CH, Scigliano M, MacLean SA, MacKenzie RK, Redlener IE. Missed opportunities: Do states require screening of children for health conditions that interfere with learning? PLoS One 2018; 13:e0190254. [PMID: 29342147 PMCID: PMC5771574 DOI: 10.1371/journal.pone.0190254] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 12/10/2017] [Indexed: 11/30/2022] Open
Abstract
METHODS Investigators reviewed websites of state departments of health and education, and legislation for all 50 states and DC. For states with mandated screenings and a required form, investigators applied structured analysis to assess HBL inclusion. RESULTS No state mandated that schools require screening for all 7 HBLs. Less than half (49%) required comprehensive school health examinations and only 12 states plus DC required a specific form. Of these, 12 of the forms required documentation of vision screening, 11 of hearing screening, and 12 of dental screening. Ten forms asked about asthma and 9 required documentation of lead testing. Seven asked about general well-being, emotional problems, or mental health. None addressed hunger. When including states without comprehensive school health examination requirements, the most commonly required HBL screenings were for vision (80% of states; includes DC), hearing (75% of states; includes DC) and dental (24% of state; includes DC). CONCLUSION The lack of state mandated requirements for regular student health screening represents a missed opportunity to identify children with HBLs. Without state mandates, accompanying comprehensive forms, and protocols, children continue to be at risk of untreated health conditions that can undermine their success in school.
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Affiliation(s)
- Delaney Gracy
- Children’s Health Fund, New York, NY, United States of America
| | - Anupa Fabian
- Children’s Health Fund, New York, NY, United States of America
| | - Corey Hannah Basch
- Department of Public Health, William Paterson University, New York, NY, United States of America
| | - Maria Scigliano
- Children’s Health Fund, New York, NY, United States of America
| | - Sarah A. MacLean
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | | | - Irwin E. Redlener
- Children’s Health Fund, New York, NY, United States of America
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, United States of America
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Caron-Beaudoin É, Valter N, Chevrier J, Ayotte P, Frohlich K, Verner MA. Gestational exposure to volatile organic compounds (VOCs) in Northeastern British Columbia, Canada: A pilot study. ENVIRONMENT INTERNATIONAL 2018; 110:131-138. [PMID: 29122312 DOI: 10.1016/j.envint.2017.10.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 10/23/2017] [Accepted: 10/23/2017] [Indexed: 05/02/2023]
Abstract
BACKGROUND Northeastern British Columbia (Canada) is an area of intense hydraulic fracturing for unconventional natural gas exploitation. There have been multiple reports of air and water contamination by volatile organic compounds in the vicinity of gas wells. Although these chemicals are known developmental toxicants, no biomonitoring effort has been carried out in the region. OBJECTIVE To evaluate gestational exposure to benzene and toluene in the Peace River Valley, Northeastern British Columbia (Canada). METHODS Urine samples were collected over five consecutive days from 29 pregnant women. Metabolites of benzene (s-phenylmercapturic acid (S-PMA) and trans, trans-muconic acid (t,t-MA)) and toluene (s-benzylmercapturic acid (S-BMA)) were measured in pooled urine samples from each participant. Levels of benzene metabolites were compared to those from the general Canadian population and from a biomonitoring study of residents from an area of active gas exploitation in Pavillion, Wyoming (USA). Levels measured in participants from the two recruitment sites, and self-identifying as Indigenous or non-Indigenous, were also compared. RESULTS Whereas the median S-PMA level (0.18μg/g creatinine) in our study was similar to that in the general Canadian population, the median t,t-MA level (180μg/g creatinine) was approximately 3.5 times higher. Five women had t,t-MA levels above the biological exposure index® proposed by the American Conference of Governmental Industrial Hygienists. The median urinary S-BMA level in our pilot study was 7.00μg/g creatinine. Urinary metabolite levels were slightly higher in self-identifying Indigenous women, but this difference was only statistically significant for S-PMA. DISCUSSION Urinary t,t-MA levels, but not S-PMA levels, measured in our study are suggestive of a higher benzene exposure in participating pregnant women from the Peace River Valley than in the general Canadian population. Given the small sample size and limitations of t,t-MA measurements (e.g., non-specificity), more extensive monitoring is warranted.
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Affiliation(s)
- Élyse Caron-Beaudoin
- Department of Occupational and Environmental Health, School of Public Health, Université de Montréal, 2375 chemin de la Cote-Sainte-Catherine, Montreal, QC H3T 1A8, Canada; Université de Montréal Public Health Research Institute (IRSPUM), Université de Montréal, 7101, Parc Ave., Montreal, QC H3N 1X7, Canada; INRS-Institut Armand-Frappier, Université du Québec, 531 boulevard des Prairies, Laval, QC H7V 1B7, Canada; Center for Interdisciplinary Research on Well-Being, Health, Society and Environment (CINBIOSE), Université du Québec à Montréal, C.P. 8888, Succursale Centre-ville, Montreal, QC H3C 3P8, Canada.
| | - Naomi Valter
- Department of Occupational and Environmental Health, School of Public Health, Université de Montréal, 2375 chemin de la Cote-Sainte-Catherine, Montreal, QC H3T 1A8, Canada; Université de Montréal Public Health Research Institute (IRSPUM), Université de Montréal, 7101, Parc Ave., Montreal, QC H3N 1X7, Canada
| | - Jonathan Chevrier
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medecine, 1020 Pine Avenue West, room 42, Montreal, QC H3A 1A2, Canada
| | - Pierre Ayotte
- Centre de toxicologie du Québec, Institut National de la Santé Publique du Québec, 945 avenue Wolfe, Québec, QC G1V 5B3, Canada; Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec-Université Laval, Hôpital du Saint-Sacrement, 1050 Chemin Ste-Foy, Québec, QC G1S 4L8, Canada
| | - Katherine Frohlich
- Université de Montréal Public Health Research Institute (IRSPUM), Université de Montréal, 7101, Parc Ave., Montreal, QC H3N 1X7, Canada; Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, 7101 Av du Parc, Montréal, QC H3N 1X9, Canada
| | - Marc-André Verner
- Department of Occupational and Environmental Health, School of Public Health, Université de Montréal, 2375 chemin de la Cote-Sainte-Catherine, Montreal, QC H3T 1A8, Canada; Université de Montréal Public Health Research Institute (IRSPUM), Université de Montréal, 7101, Parc Ave., Montreal, QC H3N 1X7, Canada
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The Neurodevelopmental Toxicity of Lead: History, Epidemiology, and Public Health Implications. LINKING ENVIRONMENTAL EXPOSURE TO NEURODEVELOPMENTAL DISORDERS 2018. [DOI: 10.1016/bs.ant.2018.03.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Kramer MR, Schneider EB, Kane JB, Margerison-Zilko C, Jones-Smith J, King K, Davis-Kean P, Grzywacz JG. Getting Under the Skin: Children's Health Disparities as Embodiment of Social Class. POPULATION RESEARCH AND POLICY REVIEW 2017; 36:671-697. [PMID: 29398742 PMCID: PMC5791911 DOI: 10.1007/s11113-017-9431-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 03/02/2017] [Indexed: 10/19/2022]
Abstract
Social class gradients in children's health and development are ubiquitous across time and geography. The authors develop a conceptual framework relating three actions of class-material allocation, salient group identity, and inter-group conflict-to the reproduction of class-based disparities in child health. A core proposition is that the actions of class stratification create variation in children's mesosystems and microsystems in distinct locations in the ecology of everyday life. Variation in mesosystems (e.g., health care, neighborhoods) and microsystems (e.g., family structure, housing) become manifest in a wide variety of specific experiences and environments that produce the behavioral and biological antecedents to health and disease among children. The framework is explored via a review of theoretical and empirical contributions from multiple disciplines and high-priority areas for future research are highlighted.
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Affiliation(s)
- Michael R Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA 30322
| | - Eric B Schneider
- Department of Economic History, London School of Economics and Political Science
| | | | - Claire Margerison-Zilko
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University
| | - Jessica Jones-Smith
- Department of International Health, Johns Hopkins Bloomberg School of Public Health
| | - Katherine King
- Department of Community and Family Medicine, Duke University
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Wilson IH, Wilson SB. Confounding and causation in the epidemiology of lead. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2016; 26:467-482. [PMID: 27009351 DOI: 10.1080/09603123.2016.1161179] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 02/27/2016] [Indexed: 06/05/2023]
Abstract
The National Health and Medical Research Council recently reported that there were not enough high-quality studies to conclude that associations between health effects and blood lead levels <10 μg/dL were caused by lead. It identified uncontrolled confounding, measurement error and other potential causal factors as common weaknesses. This paper supports those findings with evidence of uncontrolled confounding by parental education, intelligence or household management from several papers. It suggests that inappropriate statistical tests and aggregation of data representing different exposure routes partly explain why confounding has been overlooked. Inadequate correction of confounding has contributed to incorrect conclusions regarding causality at low levels of lead. Linear or log-linear regression models have tended to mask any threshold. While the effects of higher levels of lead exposure are not disputed, overestimation of health effects at low lead exposures has significant implications for policy-makers endeavouring to protect public health through cost-effective regulations.
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Affiliation(s)
- Ian Harold Wilson
- a Sustainable Resource Sciences , Chapel Hill , Australia
- b School of Geography, Planning and Environmental Management , University of Queensland , St Lucia , Australia
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Bellinger DC, Matthews-Bellinger JA, Kordas K. A developmental perspective on early-life exposure to neurotoxicants. ENVIRONMENT INTERNATIONAL 2016; 94:103-112. [PMID: 27235688 DOI: 10.1016/j.envint.2016.05.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 05/14/2016] [Accepted: 05/14/2016] [Indexed: 05/24/2023]
Abstract
BACKGROUND Studies of early-life neurotoxicant exposure have not been designed, analyzed, or interpreted in the context of a fully developmental perspective. OBJECTIVES The goal of this paper is to describe the key principles of a developmental perspective and to use examples from the literature to illustrate the relevance of these principles to early-life neurotoxicant exposures. METHODS Four principles are discussed: 1) the effects of early-life neurotoxicant exposure depend on a child's developmental context; 2) deficits caused by early-life exposure initiate developmental cascades that can lead to pathologies that differ from those observed initially; 3) early-life neurotoxicant exposure has intra-familial and intergenerational impacts; 4) the impacts of early-life neurotoxicant exposure influence a child's ability to respond to future insults. The first principle is supported by considerable evidence, but the other three have received much less attention. DISCUSSION Incorporating a developmental perspective in studies of early-life neurotoxicant exposures requires prospective collection of data on a larger array of covariates than usually considered, using analytical approaches that acknowledge the transactional processes between a child and the environment and the phenomenon of developmental cascades. CONCLUSION Consideration of early-life neurotoxicant exposure within a developmental perspective reveals that many issues remain to be explicated if we are to achieve a deep understanding of the societal health burden associated with early-life neurotoxicant exposures.
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Affiliation(s)
- David C Bellinger
- Department of Neurology, Harvard Medical School, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02112, USA; Department of Psychiatry, Harvard Medical School, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Julia A Matthews-Bellinger
- Department of Psychiatry, University of Massachusetts Medical School, Boston Psychoanalytic Society and Institute, 19 Fair Oaks Park, Needham, MA 02492, USA.
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, University at Buffalo, 270 Farber Hall, Buffalo, NY 14214, USA.
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Blackowicz MJ, Hryhorczuk DO, Rankin KM, Lewis DA, Haider D, Lanphear BP, Evens A. The Impact of Low-Level Lead Toxicity on School Performance among Hispanic Subgroups in the Chicago Public Schools. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080774. [PMID: 27490560 PMCID: PMC4997460 DOI: 10.3390/ijerph13080774] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 06/20/2016] [Accepted: 07/26/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Environmental lead exposure detrimentally affects children's educational performance, even at very low blood lead levels (BLLs). Among children in Chicago Public Schools (CPS), the severity of the effects of BLL on reading and math vary by racial subgroup (White vs. Hispanic vs. non-Hispanic Black). We investigated the impact of BLL on standardized test performance by Hispanic subgroup (Mexican, Puerto Rican, and Other Hispanic). METHODS We examined 12,319 Hispanic children born in Chicago between 1994 and 1998 who were tested for BLL between birth and 2006 and enrolled in the 3rd grade at a CPS school between 2003 and 2006. We linked the Chicago birth registry, the Chicago Blood Lead Registry, and 3rd grade Illinois Standard Achievement Test (ISAT) scores to examine associations between BLL and school performance. Primary analyses were restricted to children with BLL below 10 µg/dL (0.483 µmol/L). RESULTS BLLs below 10 µg/dL (0.483 µmol/L) were inversely associated with reading and math scores in all Hispanic subgroups. Adjusted Relative Risks (RRadj) and 95% confidence intervals (CI) for reading and math failure were 1.34 (95% CI = 1.25, 1.63) and 1.53 (95% CI = 1.32, 1.78), respectively, per each additional 5 µg/dL of lead exposure for Hispanic children; RRadj did not differ across subgroups. We estimate that 7.0% (95% CI = 1.8, 11.9) of reading and 13.6% (95% CI = 7.7, 19.2) of math failure among Hispanic children can be attributed to exposure to BLLs of 5-9 µg/dL (0.242 to 0.435 µmol/L) vs. 0-4 µg/dL (0-0.193 µmol/L). The RRadj of math failure for each 5 µg/dL (0.242 µmol/L) increase in BLL was notably (p = 0.074) stronger among black Puerto Rican children (RRadj = 5.14; 95% CI = 1.65-15.94) compared to white Puerto Rican children (RRadj = 1.50; 95% CI = 1.12-2.02). CONCLUSIONS Early childhood lead exposure is associated with poorer achievement on standardized reading and math tests in the 3rd grade for Mexican, Puerto Rican, and Other Hispanic children enrolled in Chicago Public Schools. While we did not see interactions between BLL and ISAT performance by Hispanic subgroup, the stronger association between BLL and math failure for Black Puerto Rican children is intriguing and warrants further study.
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Affiliation(s)
- Michael J Blackowicz
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA.
| | - Daniel O Hryhorczuk
- Center for Global Health, University of Illinois College of Medicine, Chicago, IL 60612, USA.
- Division of Environmental and Occupational Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA.
| | - Kristin M Rankin
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA.
| | - Dan A Lewis
- School of Education and Social Policy, Northwestern University, Evanston, IL 60208, USA.
| | - Danish Haider
- Center for Global Health, University of Illinois College of Medicine, Chicago, IL 60612, USA.
| | - Bruce P Lanphear
- Child & Family Research Institute, BC Children's Hospital and Faculty of Health Sciences, Simon Fraser University, Vancouver, BC V5Z 4H4, Canada.
| | - Anne Evens
- Division of Environmental and Occupational Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA.
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Trentacosta CJ, Davis-Kean P, Mitchell C, Hyde L, Dolinoy D. Environmental Contaminants and Child Development. CHILD DEVELOPMENT PERSPECTIVES 2016. [DOI: 10.1111/cdep.12191] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Padilla-Moledo C, Ruiz JR, Castro-Piñero J. Parental educational level and psychological positive health and health complaints in Spanish children and adolescents. Child Care Health Dev 2016; 42:534-43. [PMID: 27097753 DOI: 10.1111/cch.12342] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 01/14/2016] [Accepted: 03/20/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND Interest on the impact of socioeconomic differences on youth's health is growing. The aim of the present study was to examine the association of parental educational level with psychological positive health and health complaints in Spanish children and adolescents. METHODS Parental educational level, psychological positive health indicators (perceived health status, life satisfaction, quality of family relationships, quality of peer relationships and academic performance) and health complaint index (headache, stomach ache, backache, feeling low, irritability or bad temper, feeling nervous, difficulties getting to sleep, feeling dizzy) were self-reported using the Health Behavior in School-aged Children questionnaire in 685 (366 boys and 319 girls) children and adolescents. RESULTS Children reporting parents with non-university studies (father, mother or both) had significantly higher odd ratio of having lower academic performance, lower life satisfaction, perceiving their health status as otherwise (vs. excellent) and having health complaints sometime than their counterparts reporting parents with university studies (father, mother or both). CONCLUSION Current results provide evidence that children having parents with a university degree (father, mother or both) are more likely to have higher psychological positive health and lower health complaints than children reporting parents with non-university studies. This is particularly important for the welfare policy that must pay attention for implementing programs for helping population to access to university studies by their impact on youth health.
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Affiliation(s)
- C Padilla-Moledo
- Department of Physical Education, School of Education, University of Cádiz, Puerto Real, Spain
| | - J R Ruiz
- PROmoting FITness and Health through physical activity research group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - J Castro-Piñero
- Department of Physical Education, School of Education, University of Cádiz, Puerto Real, Spain
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Environmental Health: Children׳s Health, a Clinician׳s Dilemma. Curr Probl Pediatr Adolesc Health Care 2016; 46:184-9. [PMID: 26846483 DOI: 10.1016/j.cppeds.2015.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 12/04/2015] [Indexed: 11/20/2022]
Abstract
Few pediatricians receive training in environmental health, yet accumulating research shows that a disproportionate burden of exposure from environmental toxicants (man-made contaminants) is borne by children, adolescents, and the developing fetus. This is explained in part because of children׳s vulnerability to environmental-toxicants based on socioeconomic status, body surface area, metabolism, and potential transfers via placenta and breast milk. Public concern about toxicants affecting children in air, land, water, food, and beverages places pediatricians in the challenging position of being expected to knowledgably answer questions about environmental exposures while lacking sufficient training in the field. Surveys show pediatricians have high interest in environmental topics, yet feel a low sense of self-efficacy regarding patient education and lack evidence-based treatment guidelines and other effective educational tools. The goal of this article is to provide an overview of selected toxicants relevant to pediatric health, review practical suggestions to reduce or eliminate children's exposures, and introduce resources for taking an environmental health history to better prepare pediatricians and other clinicians caring for children to decrease harmful exposures in infants, children, and adolescents.
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Verner MA, Hart JE, Sagiv SK, Bellinger DC, Altshul LM, Korrick SA. Measured Prenatal and Estimated Postnatal Levels of Polychlorinated Biphenyls (PCBs) and ADHD-Related Behaviors in 8-Year-Old Children. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:888-94. [PMID: 25769180 PMCID: PMC4559949 DOI: 10.1289/ehp.1408084] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 03/11/2015] [Indexed: 05/21/2023]
Abstract
BACKGROUND Epidemiologic studies of postnatal PCB exposure and behavior have not reported consistent evidence of adverse associations, possibly because of challenges in exposure estimation. We previously developed a pharmacokinetic model to improve estimation of children's PCB exposure. OBJECTIVES We aimed to assess whether estimated serum PCB levels in infancy are associated with attention deficit/hyperactivity disorder (ADHD)-related behaviors at 8 years of age among children whose cord serum PCB levels were previously shown to be associated with ADHD-related behaviors. METHODS We used a pharmacokinetic model to estimate monthly serum polychlorinated biphenyl (PCB)-153 levels in 441 infants (ages 1-12 months) based on parameters such as breastfeeding and cord serum PCB-153 levels. Behavior was evaluated at age 8 using the Conners' Rating Scale for Teachers (CRS-T). Associations between PCB-153 levels and ADHD-related CRS-T indices were assessed using multivariable quantile regression at the 50th and 75th percentiles of CRS-T scores, where higher percentiles reflect more adverse behaviors. RESULTS Cord serum PCB-153 levels (median, 38 ng/g lipids) were associated with ADHD-related behaviors, although statistical significance was observed with quantile regression models only at the 75th percentile. Associations with postnatal exposure estimates were attenuated. For example, hyperactive-impulsive behavior scores at age 8 years were 0.9 points (95% CI: 0.2, 2.5), 0.5 points (95% CI: 0.3, 2.3), and 0.3 points (95% CI: -0.2, 1.5) higher in association with interquartile range increases in serum PCB-153 at birth, 2 months, and 12 months of age, respectively. CONCLUSIONS Associations between estimated postnatal PCB-153 exposures and ADHD-related behaviors at 8 years of age were weaker than associations with PCB-153 concentrations measured in cord serum at birth. CITATION Verner MA, Hart JE, Sagiv SK, Bellinger DC, Altshul LM, Korrick SA. 2015. Measured prenatal and estimated postnatal levels of polychlorinated biphenyls (PCBs) and ADHD-related behaviors in 8-year-old children. Environ Health Perspect 123:888-894; http://dx.doi.org/10.1289/ehp.1408084.
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Affiliation(s)
- Marc-André Verner
- Channing Division of Network Medicine, Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Jarrett RL, Hamilton MB, Coba-Rodriguez S. "So we would all help pitch in:" The family literacy practices of low-income African American mothers of preschoolers. JOURNAL OF COMMUNICATION DISORDERS 2015; 57:81-93. [PMID: 26338290 DOI: 10.1016/j.jcomdis.2015.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 07/17/2015] [Accepted: 07/19/2015] [Indexed: 06/05/2023]
Abstract
UNLABELLED The development of emergent literacy skills are important for the development of later literacy competencies and affect school readiness. Quantitative researchers document race- and social class-based disparities in emergent literacy competence between low-income African American and middle-income White children. Some researchers suggest that deficits in parenting practices account for limited literacy skills among low-income African American children. A small body of qualitative research on low-income African American families finds that despite economic challenges, some African American families were actively engaged in promoting child literacy development. Using qualitative interviews that emphasize family strengths, we add to this small body of research to highlight positive family practices obscured in many quantitative analyses that concentrate on family shortcomings. Specifically, we examine in-home literacy practices and child literacy development with a sample of low-income African American mothers (families) of preschoolers. Key findings include identification of various literacy activities promoting child literacy development and inclusion of multiple family members assisting in literacy activities. These findings add to substantive discussions of emergent literacy and resilience. Insights from the qualitative interviews also provide culturally-sensitive recommendations to childhood educators and speech-language pathologists (SLP) who work with low-income African American families and children. LEARNING OUTCOMES Reader should recognize that (1) there is not a 'right' phenotype and therefore not a right form of environmental input and (2) that context matters (at both the level of the cell and the individual organism).
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Affiliation(s)
- Robin L Jarrett
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, United States; Department of African American Studies, University of Illinois at Urbana-Champaign, United States.
| | - Megan-Brette Hamilton
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, United States
| | - Sarai Coba-Rodriguez
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, United States
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Skerfving S, Löfmark L, Lundh T, Mikoczy Z, Strömberg U. Late effects of low blood lead concentrations in children on school performance and cognitive functions. Neurotoxicology 2015; 49:114-20. [DOI: 10.1016/j.neuro.2015.05.009] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 05/22/2015] [Accepted: 05/23/2015] [Indexed: 12/01/2022]
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Neurocognitive outcomes and school performance in solid tumor cancer survivors lacking therapy to the central nervous system. J Pers Med 2015; 5:83-90. [PMID: 25867598 PMCID: PMC4493487 DOI: 10.3390/jpm5020083] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 03/27/2015] [Accepted: 04/08/2015] [Indexed: 11/17/2022] Open
Abstract
School performance in patients who have received therapy for childhood cancers has been studied in depth. Risk factors have historically included cranial radiation, intrathecal chemotherapy, and high doses of chemotherapy, including methotrexate and cytarabine. Leukemia and brain tumor survivors who receive such therapy have been the primary focus of this area of investigation. Extracranial solid tumor cancer patients lacking such risk factors have historically been expected to have normal school performance. We examined the medical records of 58 young pediatric extracranial solid tumor patients who lacked CNS-directed therapy or other known risk factors for cognitive impairment to evaluate the incidence of reported difficulties or abnormalities in neuropsychological testing. Thirty-one percent of patients were found to have at least one reported difficulty or abnormality. Of note, 34% of patients with Wilms tumor possessed difficulties compared to 23% of patients with other extracranial solid tumors. Extracranial solid tumor cancer survivors without known risk factors for school performance difficulties appear to have a higher incidence of problems than expected.
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Magzamen S, Amato MS, Imm P, Havlena JA, Coons MJ, Anderson HA, Kanarek MS, Moore CF. Quantile regression in environmental health: Early life lead exposure and end-of-grade exams. ENVIRONMENTAL RESEARCH 2015; 137:108-19. [PMID: 25531815 DOI: 10.1016/j.envres.2014.12.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 11/14/2014] [Accepted: 12/02/2014] [Indexed: 05/22/2023]
Abstract
Conditional means regression, including ordinary least squares (OLS), provides an incomplete picture of exposure-response relationships particularly if the primary interest resides in the tail ends of the distribution of the outcome. Quantile regression (QR) offers an alternative methodological approach in which the influence of independent covariates on the outcome can be specified at any location along the distribution of the outcome. We implemented QR to examine heterogeneity in the influence of early childhood lead exposure on reading and math standardized fourth grade tests. In children from two urban school districts (n=1,076), lead exposure was associated with an 18.00 point decrease (95% CI: -48.72, -3.32) at the 10th quantile of reading scores, and a 7.50 point decrease (95% CI: -15.58, 2.07) at the 90th quantile. Wald tests indicated significant heterogeneity of the coefficients across the distribution of quantiles. Math scores did not show heterogeneity of coefficients, but there was a significant difference in the lead effect at the 10th (β=-17.00, 95% CI: -32.13, -3.27) versus 90th (β=-4.50, 95% CI: -10.55, 4.50) quantiles. Our results indicate that lead exposure has a greater effect for children in the lower tail of exam scores, a result that is masked by conditional means approaches.
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Affiliation(s)
- Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, 1681 Campus Delivery, Fort Collins, CO 80523-1681, United States.
| | - Michael S Amato
- Department of Psychology, University of Wisconsin, 1202 West Johnson Street, Madison, WI 53706, United States
| | - Pamela Imm
- Bureau of Environmental and Occupational Health, Wisconsin Department of Health Services, 1 West Wilson Street, Madison, WI 53703, United States
| | - Jeffrey A Havlena
- Department of Surgery, University of Wisconsin, 600 Highland Ave, Madison, WI 53792, United States
| | - Marjorie J Coons
- Bureau of Environmental and Occupational Health, Wisconsin Department of Health Services, 1 West Wilson Street, Madison, WI 53703, United States
| | - Henry A Anderson
- Bureau of Environmental and Occupational Health, Wisconsin Department of Health Services, 1 West Wilson Street, Madison, WI 53703, United States
| | - Marty S Kanarek
- Department of Population Health Sciences, University of Wisconsin, 707 WARF, 610 Walnut Street, Madison, WI 53726, United States; Nelson Institute for Environmental Studies, University of Wisconsin, 550 North Park Street, 122 Science Hall, Madison, WI 53706, United States
| | - Colleen F Moore
- Department of Psychology, University of Wisconsin, 1202 West Johnson Street, Madison, WI 53706, United States; Department of Psychology, Montana State University, PO Box 173440, Bozeman, MT 59717, United States
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Lassiter MG, Owens EO, Patel MM, Kirrane E, Madden M, Richmond-Bryant J, Hines EP, Davis JA, Vinikoor-Imler L, Dubois JJ. Cross-species coherence in effects and modes of action in support of causality determinations in the U.S. Environmental Protection Agency's Integrated Science Assessment for Lead. Toxicology 2015; 330:19-40. [PMID: 25637851 DOI: 10.1016/j.tox.2015.01.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 12/24/2014] [Accepted: 01/26/2015] [Indexed: 01/26/2023]
Abstract
The peer-reviewed literature on the health and ecological effects of lead (Pb) indicates common effects and underlying modes of action across multiple organisms for several endpoints. Based on such observations, the United States (U.S.) Environmental Protection Agency (EPA) applied a cross-species approach in the 2013 Integrated Science Assessment (ISA) for Lead for evaluating the causality of relationships between Pb exposure and specific endpoints that are shared by humans, laboratory animals, and ecological receptors (i.e., hematological effects, reproductive and developmental effects, and nervous system effects). Other effects of Pb (i.e., cardiovascular, renal, and inflammatory responses) are less commonly assessed in aquatic and terrestrial wildlife limiting the application of cross-species comparisons. Determinations of causality in ISAs are guided by a framework for classifying the weight of evidence across scientific disciplines and across related effects by considering aspects such as biological plausibility and coherence. As illustrated for effects of Pb where evidence across species exists, the integration of coherent effects and common underlying modes of action can serve as a means to substantiate conclusions regarding the causal nature of the health and ecological effects of environmental toxicants.
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Affiliation(s)
- Meredith Gooding Lassiter
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
| | - Elizabeth Oesterling Owens
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
| | - Molini M Patel
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
| | - Ellen Kirrane
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
| | - Meagan Madden
- Oak Ridge Institute for Science and Education Research Participation Program, National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
| | - Jennifer Richmond-Bryant
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
| | - Erin Pias Hines
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
| | - J Allen Davis
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
| | - Lisa Vinikoor-Imler
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
| | - Jean-Jacques Dubois
- Southern Region Integrated Pest Management Center, North Carolina State University, 1730 Varsity Drive, Suite 110, Raleigh, NC 27606, USA.
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Grandjean P, Herz KT. Trace elements as paradigms of developmental neurotoxicants: Lead, methylmercury and arsenic. J Trace Elem Med Biol 2015; 31:130-4. [PMID: 25175507 PMCID: PMC4321972 DOI: 10.1016/j.jtemb.2014.07.023] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 06/12/2014] [Accepted: 07/07/2014] [Indexed: 11/26/2022]
Abstract
Trace elements have contributed unique insights into developmental neurotoxicity and serve as paradigms for such adverse effects. Many trace elements are retained in the body for long periods and can be easily measured to assess exposure by inexpensive analytical methods that became available several decades ago so that past and cumulated exposures could be easily characterized through analysis of biological samples, e.g. blood and urine. The first compelling evidence resulted from unfortunate poisoning events that allowed scrutiny of long-term outcomes of acute exposures that occurred during early development. Pursuant to this documentation, prospective studies of children's cohorts that applied sensitive neurobehavioral methods supported the notion that the brain is uniquely vulnerable to toxic damage during early development. Lead, methylmercury, and arsenic thereby serve as paradigm neurotoxicants that provide a reference for other substances that may have similar adverse effects. Less evidence is available on manganese, fluoride, and cadmium, but experience from the former trace elements suggest that, with time, adverse effects are likely to be documented at exposures previously thought to be low and safe.
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Affiliation(s)
- Philippe Grandjean
- Department of Environmental Medicine, University of Southern Denmark, 5000 Odense, Denmark; Department of Environmental Health, Harvard School of Public Health, Boston, MA 02215, USA.
| | - Katherine T Herz
- Department of Environmental Health, Harvard School of Public Health, Boston, MA 02215, USA
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Gebrie HA, Tessema DA, Ambelu A. Elevated blood lead levels among unskilled construction workers in Jimma, Ethiopia. J Occup Med Toxicol 2014; 9:12. [PMID: 24645964 PMCID: PMC3995301 DOI: 10.1186/1745-6673-9-12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 03/10/2014] [Indexed: 11/29/2022] Open
Abstract
Background No study has been carried out to assess the blood lead levels of workers or the contribution of common workplace practices to lead exposure in Ethiopia. This study was carried out to assess the blood lead levels of female and male laborers in the construction sector in Jimma town, Ethiopia. Method A cross-sectional study on the blood lead levels of 45 construction workers was carried out in the town of Jimma. The t-test, analysis of variance, the Kruskal-Wallis, Mann–Whitney and odds ratio tests were used to compare mean blood lead levels and to investigate the associations between specific job type, use of self-protection device, sex, service years and occurrence of non-specific symptoms with BLLs. Results The mean blood lead level of the exposed group (40.03 ± 10.41 μg/dL) was found to be significantly greater than that of the unexposed group (29.81 ± 10.21 μg/dL), p = 0.05. Among the exposed group female workers were found to have higher mean blood lead level (42.04 ± 4.11 μg/dL) than their male colleagues (33.99 ± 3.28 μg/dL). Laborers who were regularly using self-protection devices were found to have significantly lower blood lead levels than those who were not using. Conclusion The blood lead levels of construction workers in Jimma town are considerably high with a range of 20.46 – 70.46 μg/dL and the workers are in danger of imminent lead toxicity. More endangered are female construction workers who are bearers of the future children of the country and the issue requires urgent attention.
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Affiliation(s)
| | - Dejene A Tessema
- Department of Chemistry, College of Natural Sciences, Jimma University, Jimma, Ethiopia.
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Moderate lead exposure and elementary school end-of-grade examination performance. Ann Epidemiol 2013; 23:700-7. [DOI: 10.1016/j.annepidem.2013.08.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 06/28/2013] [Accepted: 08/31/2013] [Indexed: 11/21/2022]
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McLaine P, Navas-Acien A, Lee R, Simon P, Diener-West M, Agnew J. Elevated blood lead levels and reading readiness at the start of kindergarten. Pediatrics 2013; 131:1081-9. [PMID: 23669514 DOI: 10.1542/peds.2012-2277] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To evaluate the relationship between blood lead levels (BLLs) and reading readiness at kindergarten entry, an early marker of school performance, in a diverse urban school population. METHODS Kindergarten reading readiness test scores for children attending public kindergarten in Providence, Rhode Island, were linked to state health department records of blood lead testing by using individual identifiers. The study population (N = 3406) was 59% Hispanic. For each child, the geometric mean BLL was estimated by using all previously reported BLLs. Analyses were adjusted for gender, age, year enrolled, race, child language, and free/reduced lunch status as a measure of socioeconomic status. RESULTS The median geometric mean BLL was 4.2 µg/dL; 20% of children had at least 1 venous BLL ≥10 µg/dL. Compared with children with BLLs <5 µg/dL, the adjusted prevalence ratios (95% confidence interval [CI]) for failing to achieve the national benchmark for reading readiness were 1.21 (1.19 to 1.23) and 1.56 (1.51 to 1.60) for children with BLLs of 5 to 9 and ≥10 µg/dL, respectively. On average, reading readiness scores decreased by 4.5 (95% CI: -2.9 to -6.2) and 10.0 (95% CI: -7.0 to -13.3) points for children with BLLs of 5 to 9 and ≥10 µg/dL, respectively, compared with BLLs <5 µg/dL. CONCLUSIONS BLLs well below 10 µg/dL were associated with lower reading readiness at kindergarten entry. The high prevalence of elevated BLLs warrants additional investigation in other high-risk US populations. Results suggest benefits from additional collaboration between public health, public education, and community data providers.
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Affiliation(s)
- Pat McLaine
- University of Maryland School of Nursing, Baltimore, MD 21201, USA.
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Amato MS, Moore CF, Magzamen S, Imm P, Havlena JA, Anderson HA, Kanarek MS. Lead exposure and educational proficiency: moderate lead exposure and educational proficiency on end-of-grade examinations. Ann Epidemiol 2012; 22:738-43. [PMID: 22902043 DOI: 10.1016/j.annepidem.2012.07.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 07/03/2012] [Accepted: 07/08/2012] [Indexed: 11/19/2022]
Abstract
PURPOSE To investigate and quantify the impact of moderate lead exposure on students' ability to score at the "proficient" level on end-of-grade standardized tests. METHODS We compared the scores of 3757 fourth grade students from Milwaukee, Wisconsin, on the Wisconsin Knowledge and Concepts Exam (WKCE). The sample consisted of children with a blood lead test before age 3 years that was either unquantifiable at the time of testing (<5 μg/dL) or in the range of moderate exposure (10-19 μg/dL). RESULTS After controlling for gender, poverty, English language learner status, race/ethnicity, school disciplinary actions, and attendance percentage, results showed a significant negative effect of moderate lead exposure on academic achievement for all 5 subtests of the WKCE. Test score deficits owing to lead exposure were equal to 22% of the interval between student categorization at the "proficient" or "basic" levels in Reading, and 42% of the interval in Mathematics. CONCLUSIONS Children exposed to amounts of lead before age 3 years that are insufficient to trigger intervention under current policies in many states are nonetheless at a considerable educational disadvantage compared with their unexposed peers 7 to 8 years later. Exposed students are at greater risk of scoring below the proficient level, an outcome with serious negative consequences for both the student and the school.
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Affiliation(s)
- Michael S Amato
- Department of Population Health Sciences, University of Wisconsin, Madison, WI 53706, USA.
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Strayhorn JC, Strayhorn JM. Lead exposure and the 2010 achievement test scores of children in New York counties. Child Adolesc Psychiatry Ment Health 2012; 6:4. [PMID: 22269775 PMCID: PMC3292821 DOI: 10.1186/1753-2000-6-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 01/23/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lead is toxic to cognitive and behavioral functioning in children even at levels well below those producing physical symptoms. Continuing efforts in the U.S. since about the 1970s to reduce lead exposure in children have dramatically reduced the incidence of elevated blood lead levels (with elevated levels defined by the current U.S. Centers for Disease Control threshold of 10 μg/dl). The current study examines how much lead toxicity continues to impair the academic achievement of children of New York State, using 2010 test data. METHODS This study relies on three sets of data published for the 57 New York counties outside New York City: school achievement data from the New York State Department of Education, data on incidence of elevated blood lead levels from the New York State Department of Health, and data on income from the U.S. Census Bureau. We studied third grade and eighth grade test scores in English Language Arts and mathematics. Using the county as the unit of analysis, we computed bivariate correlations and regression coefficients, with percent of children achieving at the lowest reported level as the dependent variable and the percent of preschoolers in the county with elevated blood lead levels as the independent variable. Then we repeated those analyses using partial correlations to control for possible confounding effects of family income, and using multiple regressions with income included. RESULTS The bivariate correlations between incidence of elevated lead and number of children in the lowest achievement group ranged between 0.38 and 0.47. The partial correlations ranged from 0.29 to 0.40. The regression coefficients, both bivariate and partial (both estimating the increase in percent of children in the lowest achievement group for every percent increase in the children with elevated blood lead levels), ranged from 0.52 to 1.31. All regression coefficients, when rounded to the nearest integer, were approximately 1. Thus, when the percent of children showing elevated lead increases by one percent, the percent of children in the lowest achievement group, according to the regression equations generated, also increases by about one percent. All associations were significant at the 0.05 level. CONCLUSION Despite public health advances, and despite the imprecision of measures, an association between the incidence of elevated blood lead and achievement in New York counties is still apparent, not attributable to confounding by income. Efforts to reduce lead exposure should persist with vigor.
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Affiliation(s)
- Jillian C Strayhorn
- Undergraduate student, Cornell University College of Arts and Sciences, 147 Goldwin Smith Hall, Ithaca, NY 14853, USA.
| | - Joseph M Strayhorn
- Department of Psychiatry, Drexel University College of Medicine, Allegheny Campus, 320 East North Avenue, Pittsburgh, PA 15212, USA
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Lobdell DT, Jagai JS, Rappazzo K, Messer LC. Data sources for an environmental quality index: availability, quality, and utility. Am J Public Health 2011; 101 Suppl 1:S277-85. [PMID: 21836111 PMCID: PMC3222503 DOI: 10.2105/ajph.2011.300184] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2011] [Indexed: 11/04/2022]
Abstract
OBJECTIVES An environmental quality index (EQI) for all counties in the United States is under development to explore the relationship between environmental insults and human health. The EQI is potentially useful for investigators researching health disparities to account for other concurrent environmental conditions. This article focused on the identification and assessment of data sources used in developing the EQI. Data source strengths, limitations, and utility were addressed. METHODS Five domains were identified that contribute to environmental quality: air, water, land, built, and sociodemographic environments. An inventory of possible data sources was created. Data sources were evaluated for appropriate spatial and temporal coverage and data quality. RESULTS The overall data inventory identified multiple data sources for each domain. From the inventory (187 sources, 617 records), the air, water, land, built environment, and sociodemographic domains retained 2, 9, 7, 4, and 2 data sources for inclusion in the EQI, respectively. However, differences in data quality, geographic coverage, and data availability existed between the domains. CONCLUSIONS The data sources identified for use in the EQI may be useful to researchers, advocates, and communities to explore specific environmental quality questions.
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Affiliation(s)
- Danelle T Lobdell
- Office of Research and Development, US Environmental Protection Agency Research Triangle Park, NC 27711, USA.
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Schwartz J, Bellinger D, Glass T. Exploring potential sources of differential vulnerability and susceptibility in risk from environmental hazards to expand the scope of risk assessment. Am J Public Health 2011; 101 Suppl 1:S94-101. [PMID: 22021315 DOI: 10.2105/ajph.2011.300272] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Genetic factors, other exposures, individual disease states and allostatic load, psychosocial stress, and socioeconomic position all have the potential to modify the response to environmental exposures. Moreover, many of these modifiers covary with the exposure, leading to much higher risks in some subgroups. These are not theoretical concerns; rather, all these patterns have already been demonstrated in studies of the effects of lead and air pollution. However, recent regulatory impact assessments for these exposures have generally not incorporated these findings. Therefore, differential risk and vulnerability is a critically important but neglected area within risk assessment, and should be incorporated in the future.
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Affiliation(s)
- Joel Schwartz
- Department of Environmental Health and Epidemiology, Harvard School of Public Health, and Harvard Center for Risk Analysis, Harvard University, Boston, MA 02215, USA.
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Miranda ML, Anthopolos R, Hastings D. A geospatial analysis of the effects of aviation gasoline on childhood blood lead levels. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:1513-6. [PMID: 21749964 PMCID: PMC3230438 DOI: 10.1289/ehp.1003231] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Accepted: 07/13/2011] [Indexed: 05/23/2023]
Abstract
BACKGROUND Aviation gasoline, commonly referred to as avgas, is a leaded fuel used in small aircraft. Recent concern about the effects of lead emissions from planes has motivated the U.S. Environmental Protection to consider regulating leaded avgas. OBJECTIVE In this study we investigated the relationship between lead from avgas and blood lead levels in children living in six counties in North Carolina. METHODS We used geographic information systems to approximate areas surrounding airports in which lead from avgas may be present in elevated concentrations in air and may also be deposited to soil. We then used regression analysis to examine the relationship between residential proximity to airports and North Carolina blood lead surveillance data in children 9 months to 7 years of age while controlling for factors including age of housing, socioeconomic characteristics, and seasonality. RESULTS Our results suggest that children living within 500 m of an airport at which planes use leaded avgas have higher blood lead levels than other children. This apparent effect of avgas on blood lead levels was evident also among children living within 1,000 m of airports. The estimated effect on blood lead levels exhibited a monotonically decreasing dose-response pattern, with the largest impact on children living within 500 m. CONCLUSIONS We estimated a significant association between potential exposure to lead emissions from avgas and blood lead levels in children. Although the estimated increase was not especially large, the results of this study are nonetheless directly relevant to the policy debate surrounding the regulation of leaded avgas.
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Affiliation(s)
- Marie Lynn Miranda
- Children's Environmental Health Initiative, Nicholas School of the Environment, Duke University, Durham, North Carolina, USA.
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Bellinger DC. The protean toxicities of lead: new chapters in a familiar story. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2011; 8:2593-628. [PMID: 21845148 PMCID: PMC3155319 DOI: 10.3390/ijerph8072593] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 06/17/2011] [Accepted: 06/20/2011] [Indexed: 12/11/2022]
Abstract
Many times in the history of lead toxicology the view that "the problem" has been solved and is no longer a major health concern has prevailed, only to have further research demonstrate the prematurity of this judgment. In the last decade, an extraordinary amount of new research on lead has illustrated, all too clearly, that "the problem" has not disappeared, and that, in fact, it has dimensions never before considered. Recent risk assessments have concluded that research has yet to identify a threshold level below which lead can be considered "safe." Although children's intelligence has traditionally been considered to be the most sensitive endpoint, and used as the basis for risk assessment and standard setting, increased lead exposure has been associated with a wide variety of other morbidities both in children and adults, in some cases at biomarker levels comparable to those associated with IQ deficits in children. In adults, these endpoints include all-cause mortality and dysfunctions in the renal, cardiovascular, reproductive, central nervous systems. In children, IQ deficits are observed at blood lead levels well below 10 μg/dL, and the dose-effect relationship appears to be supra-linear. Other health endpoints associated with greater early-life lead exposure in children include ADHD, conduct disorder, aggression and delinquency, impaired dental health, and delayed sexual maturation. Studies employing neuroimaging modalities such as volumetric, diffusion tensor, and functional MRI are providing insights into the neural bases of the cognitive impairments associated with greater lead exposure.
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Affiliation(s)
- David C Bellinger
- Children's Hospital Boston, Farley Basement Box 127, 300 Longwood Avenue, Boston, MA 02115, USA.
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Blood lead levels among pregnant women: historical versus contemporaneous exposures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2010; 7:1508-19. [PMID: 20617043 PMCID: PMC2872339 DOI: 10.3390/ijerph7041508] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 03/23/2010] [Accepted: 03/29/2010] [Indexed: 11/16/2022]
Abstract
Blood lead among pregnant women, even at modest levels, may impair offspring cognitive development. We examine whether blood lead levels (BLLs) result from current versus historic exposures, among a cohort of pregnant women. Cumulative logit models were used to characterize the relationship between maternal risk factors and higher BLLs. Maternal blood lead levels more likely result from lead remobilization from historic versus contemporaneous exposures. Even if all lead sources were abated immediately, women and their fetuses would experience lead exposure for decades. This work emphasizes the importance of addressing sources of environmental lead exposure in the United States and internationally.
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