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Chu MT, Fenelon A, Adamkiewicz G, Zota AR. Federal Housing Assistance and Blood Lead Levels in a Nationally Representative US Sample Age 6 and Older: NHANES, 1999-2018. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:37004. [PMID: 38477610 DOI: 10.1289/ehp12645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
BACKGROUND Federal housing assistance is an important policy tool to ensure housing security for low-income households. Less is known about its impact on residential environmental exposures, particularly lead. OBJECTIVES We conducted a quasi-experimental study to investigate the association between federal housing assistance and blood lead levels (BLLs) in a nationally representative US sample age 6 y and older eligible for housing assistance. METHODS We used the 1999-2018 National Health and Nutrition Examination Survey (NHANES) linked with US Department of Housing and Urban Development (HUD) administrative records to assess BLLs of NHANES participants with concurrent HUD housing assistance (i.e., current recipients, n = 3 , 0 71 ) and those receiving assistance within 2 y after the survey (i.e., pseudo-waitlist recipients, n = 1,235 ). We estimated BLL least squares geometric means (LSGMs), odds ratio (OR) for BLL ≥ 3.5 μ g / dL , and percent differences in LSGMs by HUD housing assistance status adjusting for age, sex, family income-to-poverty ratio, education, country of birth, race/ethnicity, region, and survey year. We also examined effect modification using interaction terms and stratified analyses by program type [i.e., public housing, multifamily, housing choice vouchers (HCV)], and race/ethnicity. RESULTS Current HUD recipients had a significantly lower LSGM [1.07 μ g / dL ; 95% confidence interval (CI): 1.02, 1.12] than pseudo-waitlist recipients (1.21 μ g / dL ; 95% CI: 1.14, 1.28), with an adjusted OR of 0.60 (95% CI: 0.42, 0.87) for BLL ≥ 3.5 μ g / dL . Some effect modification were observed: The protective association of HUD assistance on BLL was strongest among public housing (- 19.5 % LSGM; 95% CI: - 27.5 % , - 1 0 . 7 % ), multifamily (- 12.5 % LSGM; 95% CI: - 2 0 . 7 % , - 3.5 % ), and non-Hispanic White (- 2 0 . 6 % LSGM; 95% CI: - 29.8 % , - 1 0 . 3 % ) recipients. It was weaker to null among HCV (- 5.7 % LSGM; 95% CI: - 12.7 , 1.7%), non-Hispanic Black (- 1.6 % LSGM; 95% CI: - 8.1 % , 5.4%), and Mexican American (-12.5% LSGM; 95% CI: - 31.9 % , 12.5 % ) recipients. DISCUSSION Our research underscores the importance of social-structural determinants like federal housing assistance in providing affordable, stable, and healthy housing to very low-income households. More attention is needed to ensure housing quality and racial equity across HUD's three major housing assistance programs. https://doi.org/10.1289/EHP12645.
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Affiliation(s)
- MyDzung T Chu
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia, USA
| | - Andrew Fenelon
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Gary Adamkiewicz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ami R Zota
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia, USA
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
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Shrivastava P, Jain S, Kumar N, Jain VK, Nagpal S. Handheld device for rapid detection of lead (Pb2+) in gunshot residue for forensic application. Microchem J 2021. [DOI: 10.1016/j.microc.2021.106186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Mental health indicators associated with oil spill response and clean-up: cross-sectional analysis of the GuLF STUDY cohort. LANCET PUBLIC HEALTH 2017; 2:e560-e567. [PMID: 29253441 DOI: 10.1016/s2468-2667(17)30194-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 09/19/2017] [Accepted: 09/27/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Adverse mental health effects have been reported following oil spills but few studies have identified specific responsible attributes of the clean-up experience. We aimed to analyse the effects of the 2010 Deepwater Horizon (Gulf of Mexico) disaster on the mental health of individuals involved in oil spill response and clean-up. METHODS We used data from the Gulf Long-term Follow-up Study, a cohort of workers and volunteers involved in oil spill clean-up after the Deepwater Horizon disaster. We included 8968 workers (hired after completing training for oil spill response and clean-up) and 2225 non-workers (completed training but were not hired) who completed a Patient Health Questionnaire-8 and four-item Primary Care PTSD Screen to assess for probable depression and post-traumatic stress disorder (PTSD) indicators. Participants were recruited between March 28, 2011, and March 29, 2013. The mental health indicators were assessed at home visits done between May 12, 2011, and May 15, 2013. We used regression models to analyse the effect of potentially stressful job experiences, job type, and total hydrocarbon exposure on mental health indicators. FINDINGS Oil spill response and clean-up work was associated with increased prevalence of depression (prevalence ratio [PR] 1·22, 95% CI 1·08-1·37) and PTSD (PR 1·35, 95% CI 1·07-1·71). Among workers, individuals who reported smelling oil, dispersants, or cleaning chemicals had an elevated prevalence of depression (1·56, 1·37-1·78) and PTSD (2·25, 1·71-2·96). Stopping work because of the heat was also associated with depression (1·37, 1·23-1·53) and PTSD (1·41, 1·15-1·74), as was working as a commercial fisherman before the spill (1·38, 1·21-1·57; and 2·01, 1·58-2·55, respectively). An increase in exposure to total hydrocarbons appeared to be associated with depression and PTSD, but after taking into account oil spill job experiences, only the association between the highest amount of total hydrocarbons and PTSD remained (1·75, 1·11-2·76). INTERPRETATION Oil spill clean-up workers with high amounts of total hydrocarbon exposure or potentially stressful job experiences had an increased prevalence of depression and PTSD. These findings provide evidence that response and clean-up work is associated with adverse psychological effects and suggest the need for mental health services both before and after the event. FUNDING National Institutes of Health (NIH) Common Fund and the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences.
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Heo YS, Chang SJ, Park SG, Leem JH, Jeon SH, Lee BJ, Rhee KY, Kim HC. Association between Workplace Risk Factor Exposure and Sleep Disturbance: Analysis of the 2nd Korean Working Conditions Survey. Ann Occup Environ Med 2013; 25:41. [PMID: 24472113 PMCID: PMC3923362 DOI: 10.1186/2052-4374-25-41] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 10/31/2013] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Sleep is essential for human beings to live and work properly. This study was conducted to investigate the relationship between occupational exposures to workplace risk factors and sleep disturbance in Korean workers. METHODS The data were drawn from the second Korean Working Conditions Survey (KWCS); a total of 7,112 paid workers were analyzed. The independent variables were occupational exposures such as physical, chemical, biological, and psychosocial risk factor in the workplace, and psychosocial risk factor was divided into five categories (job demand, job control, social support, job insecurity, lack of reward). We estimated the relationship between various occupational exposures and sleep disturbance using multivariate logistic regression analysis. RESULTS The results showed that people who exposed to physical, chemical, biological, and psychosocial (high job demand, inadequate social support, lack of reward) risk factors were more likely to increase the risk of sleep disturbance. Furthermore, after adjusting for general and occupational characteristics, we found significant positive associations between exposures to physical (odds ratios [OR] 1.47, 95% confidence interval [CI] 1.05-2.07) and psychosocial (high job demand (OR 2.93, 95% CI 2.16-3.98), inadequate social support (OR 1.57, 95% CI 1.14-2.15), lack of reward (OR 1.45, 95% CI 1.08-1.96)) risk factors and sleep disturbance. CONCLUSION These results suggest that occupational exposures to physical and psychosocial workplace risk factors are significantly related to sleep disturbance.
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Affiliation(s)
| | | | | | | | | | | | | | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, South Korea.
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Sears ME. Chelation: harnessing and enhancing heavy metal detoxification--a review. ScientificWorldJournal 2013; 2013:219840. [PMID: 23690738 PMCID: PMC3654245 DOI: 10.1155/2013/219840] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 03/14/2013] [Indexed: 01/21/2023] Open
Abstract
Toxic metals such as arsenic, cadmium, lead, and mercury are ubiquitous, have no beneficial role in human homeostasis, and contribute to noncommunicable chronic diseases. While novel drug targets for chronic disease are eagerly sought, potentially helpful agents that aid in detoxification of toxic elements, chelators, have largely been restricted to overt acute poisoning. Chelation, that is multiple coordination bonds between organic molecules and metals, is very common in the body and at the heart of enzymes with a metal cofactor such as copper or zinc. Peptides glutathione and metallothionein chelate both essential and toxic elements as they are sequestered, transported, and excreted. Enhancing natural chelation detoxification pathways, as well as use of pharmaceutical chelators against heavy metals are reviewed. Historical adverse outcomes with chelators, lessons learned in the art of using them, and successes using chelation to ameliorate renal, cardiovascular, and neurological conditions highlight the need for renewed attention to simple, safe, inexpensive interventions that offer potential to stem the tide of debilitating, expensive chronic disease.
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Affiliation(s)
- Margaret E Sears
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, Canada.
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What's out there making us sick? JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2011; 2012:605137. [PMID: 22262979 PMCID: PMC3202108 DOI: 10.1155/2012/605137] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Accepted: 07/26/2011] [Indexed: 02/08/2023]
Abstract
Throughout the continuum of medical and scientific history, repeated evidence has confirmed that the main etiological determinants of disease are nutritional deficiency, toxicant exposures, genetic predisposition, infectious agents, and psychological dysfunction. Contemporary conventional medicine generally operates within a genetic predestination paradigm, attributing most chronic and degenerative illness to genomic factors, while incorporating pathogens and psychological disorder in specific situations. Toxicity and deficiency states often receive insufficient attention as common source causes of chronic disease in the developed world. Recent scientific evidence in health disciplines including molecular medicine, epigenetics, and environmental health sciences, however, reveal ineluctable evidence that deficiency and toxicity states feature prominently as common etiological determinants of contemporary ill-health. Incorporating evidence from historical and emerging science, it is evident that a reevaluation of conventional wisdom on the current construct of disease origins should be considered and that new knowledge should receive expeditious translation into clinical strategies for disease management and health promotion. An analysis of almost any scientific problem leads automatically to a study of its history. —Ernst Mayr
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Abstract
BACKGROUND There is disturbing evidence of escalating chronic disease among children--a phenomenon that is extracting a heavy toll from individuals, families, and health-care systems. METHODS This review was prepared by assessing medical and scientific literature available from Medline, as well as by reviewing numerous books, conference proceedings, and government publications. RESULTS Knowledge translation in medical science, the process whereby new research is incorporated into clinical practice, remains lethargic. Nutritional and environmental factors have recently been recognized as common determinants of modern illness, and various diagnostic techniques in molecular medicine are now available to facilitate diagnosis of disease etiology. CONCLUSIONS A re-evaluation of the current pediatric clinical paradigm is required in light of emerging research from fields such as epigenetics, molecular medicine and environmental health. Education about these branches of medical science should be integrated into pediatric medical education, and important research information from these disciplines should be incorporated into public health care and clinical practice relating to children.
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Affiliation(s)
- Stephen J Genuis
- University of Alberta Faculty of Medicine, Edmonton, Alberta, Canada.
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Grandjean P, Satoh H, Murata K, Eto K. Adverse effects of methylmercury: environmental health research implications. ENVIRONMENTAL HEALTH PERSPECTIVES 2010; 118:1137-45. [PMID: 20529764 PMCID: PMC2920086 DOI: 10.1289/ehp.0901757] [Citation(s) in RCA: 173] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 06/08/2010] [Indexed: 05/19/2023]
Abstract
BACKGROUND The scientific discoveries of health risks resulting from methylmercury exposure began in 1865 describing ataxia, dysarthria, constriction of visual fields, impaired hearing, and sensory disturbance as symptoms of fatal methylmercury poisoning. OBJECTIVE Our aim was to examine how knowledge and consensus on methylmercury toxicity have developed in order to identify problems of wider concern in research. DATA SOURCES AND EXTRACTION We tracked key publications that reflected new insights into human methylmercury toxicity. From this evidence, we identified possible caveats of potential significance for environmental health research in general. SYNTHESIS At first, methylmercury research was impaired by inappropriate attention to narrow case definitions and uncertain chemical speciation. It also ignored the link between ecotoxicity and human toxicity. As a result, serious delays affected the recognition of methylmercury as a cause of serious human poisonings in Minamata, Japan. Developmental neurotoxicity was first reported in 1952, but despite accumulating evidence, the vulnerability of the developing nervous system was not taken into account in risk assessment internationally until approximately 50 years later. Imprecision in exposure assessment and other forms of uncertainty tended to cause an underestimation of methylmercury toxicity and repeatedly led to calls for more research rather than prevention. CONCLUSIONS Coupled with legal and political rigidity that demanded convincing documentation before considering prevention and compensation, types of uncertainty that are common in environmental research delayed the scientific consensus and were used as an excuse for deferring corrective action. Symptoms of methylmercury toxicity, such as tunnel vision, forgetfulness, and lack of coordination, also seemed to affect environmental health research and its interpretation.
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Affiliation(s)
- Philippe Grandjean
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark.
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Abstract
There is compelling evidence that various chemical agents are important determinants of myriad health afflictions--several xenobiotics have the potential to disrupt reproductive, developmental, and neurological processes and some agents in common use have carcinogenic, epigenetic, endocrine-disrupting, and immune-altering action. Some toxicants appear to have biological effect at miniscule levels and certain chemical compounds are persistent and bioaccumulative within the human body. Despite escalating public health measures to preclude further exposures, many people throughout the world have already accrued a significant body burden of toxicants, placing them at potential health risk. As a result, increasing discussion is underway about possible interventions to facilitate elimination of persistent toxicants from the human organism in order to obviate health affliction and to potentially ameliorate chronic degenerative illness. An overview of the clinical aspects of detoxification is presented with discussion of established and emerging interventions for the elimination of persistent xenobiotics. Potential therapies to circumvent enterohepatic recirculation and a case report highlighting a clinical outcome associated with detoxification are also presented for consideration.
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Affiliation(s)
- Stephen J Genuis
- University of Alberta, 2935-66 Street, Edmonton, Alberta, Canada.
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Brinkel J, Khan MH, Kraemer A. A systematic review of arsenic exposure and its social and mental health effects with special reference to Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2009; 6:1609-19. [PMID: 19543409 PMCID: PMC2697931 DOI: 10.3390/ijerph6051609] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2009] [Accepted: 04/09/2009] [Indexed: 11/17/2022]
Abstract
Underground water in many regions of the world is contaminated with high concentrations of arsenic and the resulting toxicity has created a major environmental and public health problem in the affected regions. Chronic arsenic exposure can cause many diseases, including various physical and psychological harms. Although the physical problems caused by arsenic toxicity are well reported in literature, unfortunately the consequences of arsenic exposure on mental health are not adequately studied. Therefore we conducted a review of the available literature focusing on the social consequences and detrimental effects of arsenic toxicity on mental health. Chronic arsenic exposures have serious implications for its victims (i.e. arsenicosis patients) and their families including social instability, social discrimination, refusal of victims by community and families, and marriage-related problems. Some studies conducted in arsenic affected areas revealed that arsenic exposures are associated with various neurologic problems. Chronic arsenic exposure can lead to mental retardation and developmental disabilities such as physical, cognitive, psychological, sensory and speech impairments. As health is defined by the World Health Organization as "a state of complete physical, mental and social wellbeing", the social dimensions have a large impact on individual's mental health. Furthermore studies in China und Bangladesh have shown that mental health problems (e.g. depression) are more common among the people affected by arsenic contamination. Our study indicates various neurological, mental and social consequences among arsenic affected victims. Further studies are recommended in arsenic-affected areas to understand the underlying mechanisms of poor mental health caused by arsenic exposure.
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Affiliation(s)
- Johanna Brinkel
- Department of Public Health Medicine, University of Bielefeld, Bielefeld, Germany; E-Mails:
(J.B.);
(A.K.)
| | - Mobarak H. Khan
- Department of Public Health Medicine, University of Bielefeld, Bielefeld, Germany; E-Mails:
(J.B.);
(A.K.)
| | - Alexander Kraemer
- Department of Public Health Medicine, University of Bielefeld, Bielefeld, Germany; E-Mails:
(J.B.);
(A.K.)
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