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Amadou A, Giampiccolo C, Bibi Ngaleu F, Praud D, Coudon T, Grassot L, Faure E, Couvidat F, Frenoy P, Severi G, Romana Mancini F, Roy P, Fervers B. Multiple xenoestrogen air pollutants and breast cancer risk: Statistical approaches to investigate combined exposures effect. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 351:124043. [PMID: 38679129 DOI: 10.1016/j.envpol.2024.124043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 02/10/2024] [Accepted: 04/23/2024] [Indexed: 05/01/2024]
Abstract
Studies suggested that exposure to air pollutants, with endocrine disrupting (ED) properties, have a key role in breast cancer (BC) development. Although the population is exposed simultaneously to a mixture of multiple pollutants and ED pollutants may act via common biological mechanisms leading to synergic effects, epidemiological studies generally evaluate the effect of each pollutant separately. We aimed to assess the complex effect of exposure to a mixture of four xenoestrogen air pollutants (benzo-[a]-pyrene (BaP), cadmium, dioxin (2,3,7,8-Tétrachlorodibenzo-p-dioxin TCDD)), and polychlorinated biphenyl 153 (PCB153)) on the risk of BC, using three recent statistical methods, namely weighted quantile sum (WQS), quantile g-computation (QGC) and Bayesian kernel machine regression (BKMR). The study was conducted on 5222 cases and 5222 matched controls nested within the French prospective E3N cohort initiated in 1990. Annual average exposure estimates to the pollutants were assessed using a chemistry transport model, at the participants' residence address between 1990 and 2011. We found a positive association between the WQS index of the joint effect and the risk of overall BC (adjusted odds ratio (OR) = 1.10, 95% confidence intervals (CI): 1.03-1.19). Similar results were found for QGC (OR = 1.11, 95%CI: 1.03-1.19). Despite the association did not reach statistical significance in the BKMR model, we observed an increasing trend between the joint effect of the four pollutants and the risk of BC, when fixing other chemicals at their median concentrations. BaP, cadmium and PCB153 also showed positive trends in the multi-pollutant mixture, while dioxin showed a modest inverse trend. Despite we found a clear evidence of a positive association between the joint exposure to pollutants and BC risk only from WQS and QGC regression, we observed a similar suggestive trend using BKMR. This study makes a major contribution to the understanding of the joint effects of air pollution.
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Affiliation(s)
- Amina Amadou
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France.
| | - Camille Giampiccolo
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France; Service de Biostatistique-Bioinformatique, Pole Sante Publique, Hospices Civils de Lyon, Lyon, France; Laboratoire de Biometrie Et Biologie Evolutive, CNRS UMR 5558, Villeurbanne, France
| | - Fabiola Bibi Ngaleu
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France
| | - Delphine Praud
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France
| | - Thomas Coudon
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France
| | - Lény Grassot
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France
| | - Elodie Faure
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France
| | - Florian Couvidat
- National Institute for industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France
| | - Pauline Frenoy
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France
| | - Gianluca Severi
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France; Department of Statistics, Computer Science and Applications (DISIA), University of Florence, Italy
| | - Francesca Romana Mancini
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France.
| | - Pascal Roy
- Université Claude Bernard Lyon 1, Lyon, France; Service de Biostatistique-Bioinformatique, Pole Sante Publique, Hospices Civils de Lyon, Lyon, France; Laboratoire de Biometrie Et Biologie Evolutive, CNRS UMR 5558, Villeurbanne, France
| | - Béatrice Fervers
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France.
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Tong R, Zhang B. Cumulative risk assessment for combinations of environmental and psychosocial stressors: A systematic review. INTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT 2024; 20:602-615. [PMID: 37526127 DOI: 10.1002/ieam.4821] [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: 05/26/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/02/2023]
Abstract
With the growing awareness of stressors, cumulative risk assessment (CRA) has been proposed as a potential method to evaluate possible additive and synergistic effects of multiple stressors on human health, thus informing environmental regulation and protecting public health. However, CRA is still in its exploratory stage due to the lack of generally accepted quantitative approaches. It is an ideal time to summarize the existing progress to guide future research. To this end, a systematic review of the literature on CRA issues dealing with combinations of environmental and psychosocial stressors was conducted in this study. Using typology and bibliometric analysis, the body of knowledge, hot topics, and research gaps in this field were characterized. It was found that research topics and objectives mainly focus on qualitative analysis and community settings; more attention should be paid to the development of quantitative approaches and the inclusion of occupational settings. Further, the roles of air pollution and vulnerability factors in CRA have attracted the most attention. This study concludes with views on future prospects to promote theoretical and practical development in this field; specifically, CRA is a multifaceted topic that requires substantial collaborations with various stakeholders and substantial knowledge from multidisciplinary fields. This study presents an overall review as well as research directions worth investigating in this field, which provides a historical reference for future study. Integr Environ Assess Manag 2024;20:602-615. © 2023 SETAC.
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Affiliation(s)
- Ruipeng Tong
- School of Emergency Management and Safety Engineering, China University of Mining and Technology-Beijing, Beijing, China
| | - Boling Zhang
- School of Emergency Management and Safety Engineering, China University of Mining and Technology-Beijing, Beijing, China
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Chen F, Chen JT, Hart JE, Coull BA, Scammell MK, Chu MT, Adamkiewicz G. Disparities in joint exposure to environmental and social stressors in urban households in Greater Boston. ENVIRONMENTAL RESEARCH 2023; 238:117104. [PMID: 37689339 PMCID: PMC10763609 DOI: 10.1016/j.envres.2023.117104] [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: 03/21/2023] [Revised: 08/31/2023] [Accepted: 09/06/2023] [Indexed: 09/11/2023]
Abstract
OBJECTIVES Understanding how environmental and social stressors cluster is critical to explaining and addressing health disparities. It remains unclear how these stressors cluster at fine spatial resolution in low to medium-income, urban households. We explored patterns of environmental and social exposures at the household-level and potential predictors of these joint exposures in two environmental justice communities in the Greater Boston area. METHODS We recruited 150 households in Chelsea, MA and the Dorchester neighborhood of Boston, MA, between 2016 and 2019 and collected data on two domains: environmental and social stressor. For each domain, we fit Latent Class Analysis (LCA) models to exposure data to assess intra-domain variability, and cross-classified the resultant classes to identify joint exposure profiles. We compared differences in the distribution of these profiles by participants' demographic and household characteristics using χ2, Fisher's exact, Analysis of Variance, and Kruskal-Wallis tests. RESULTS We identified two latent classes in each domain: High environmental (n = 90; 60.4%), Low environmental (n = 59; 39.6%), High Social (n = 31; 20.8%), and Low Social (n = 118; 79.2%). Cross-classification yielded four joint exposure profiles: Both Low (n = 46, 30.9%); Both High (n = 18, 12.1%); High environmental-Low Social (n = 72, 48.3%); and Low environmental-High Social (n = 13, 8.7%). Significant group differences were found by housing type (e.g., single-family vs. multi-family) (Fisher's exact p = 0.0016), housing tenure (p = 0.0007), and study site (p < 0.0001). We also observed differences by race/ethnicity, income, and education: households that were Hispanic/Latinx, below the poverty level, and with lower education were more likely to be in the Both High group. CONCLUSIONS Our analyses confirmed that environmental and social stressors cluster in socially disadvantaged households. Housing type, housing tenure, and location of the residence were also strong predictors of cluster membership, with renter and multi-family residents at risk of high exposures to environmental and social stressors.
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Affiliation(s)
- Futu Chen
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Jarvis T Chen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Jaime E Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Hospital and Harvard Medical School, Boston, MA, USA
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Madeleine K Scammell
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - MyDzung T Chu
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Gary Adamkiewicz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Aubourg MA, Sawtell G, Deanes L, Fabricant N, Thomas M, Spicer K, Wagar C, Campbell S, Ulman A, Heaney CD. Community-driven research and capacity building to address environmental justice concerns with industrial air pollution in Curtis Bay, South Baltimore. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1198321. [PMID: 38099060 PMCID: PMC10720608 DOI: 10.3389/fepid.2023.1198321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 07/20/2023] [Indexed: 12/17/2023]
Abstract
Introduction Curtis Bay (CB) is an environmental justice (EJ) community in South Baltimore. With a high concentration of industrial polluters and compounding non-chemical stressors, CB has experienced socioeconomic, quality of life, and health burdens for over 100 years. Today, these polluters include the open-air CSX Coal Terminal, waste-to-energy incinerators, and heavy diesel traffic through residential areas. The Community of Curtis Bay Association, Free Your Voice, and South Baltimore Community Land Trust are local organizations enacting a vision for equitable, healthy, and community-led development without industrial encroachment. In response to community-identified EJ concerns and an explosion at the CSX Coal Terminal, CB community groups partnered with academic researchers to develop a community-driven hyperlocal air monitoring and capacity building approach. This paper describes this approach to characterizing hyperlocal air quality in CB, building bridges between community residents and regulatory agencies, and nurturing a cohesive and effective community-academic partnership toward EJ. Methods Using hyperlocal air monitoring, we are collecting real-time air pollution (particulate matter, black carbon, and ground-level gas species) and meteorological data from 15 low-cost sensors in residential and industrial areas of CB. We also use trail cameras to record activities at the CSX Coal Terminal. We merge air pollution and industrial activity data to evaluate the following: overall air quality in CB, multi-air pollutant profiles of elevated events, spatiotemporal changes in air quality in the community, patterns of industrial activity, and potential correlations between air quality and observed industrial activity. Members of our partnership also lead a high school course educating students about the history and ongoing efforts of the EJ movement in their community. Students in this course learn how to employ qualitative and quantitative data collection and analysis methods to bring scientific support to community EJ concerns. Results and Discussion Our hyperlocal air monitoring network and community-academic partnership are continuing to evolve and have already demonstrated the ability to respond to community-identified EJ issues with real-time data while developing future EJ leaders. Our reflections can assist other community and academic groups in developing strong and fruitful partnerships to address similar EJ issues.
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Affiliation(s)
- Matthew A. Aubourg
- Community Science and Innovation for Environmental Justice (CSI EJ) Initiative, Center for a Livable Future, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Greg Sawtell
- Community of Curtis Bay Association, Curtis Bay, Baltimore, MD, United States
- South Baltimore Community Land Trust, Curtis Bay, Baltimore, MD, United States
| | - Lauren Deanes
- Community Science and Innovation for Environmental Justice (CSI EJ) Initiative, Center for a Livable Future, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Nicole Fabricant
- Department of Anthropology, Sociology, and Criminal Justice, Towson University, Towson, MD, United States
| | - Meleny Thomas
- Community of Curtis Bay Association, Curtis Bay, Baltimore, MD, United States
- South Baltimore Community Land Trust, Curtis Bay, Baltimore, MD, United States
| | - Kristoffer Spicer
- Community Science and Innovation for Environmental Justice (CSI EJ) Initiative, Center for a Livable Future, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Caila Wagar
- Community Science and Innovation for Environmental Justice (CSI EJ) Initiative, Center for a Livable Future, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Shashawnda Campbell
- Community of Curtis Bay Association, Curtis Bay, Baltimore, MD, United States
- South Baltimore Community Land Trust, Curtis Bay, Baltimore, MD, United States
| | - Abigail Ulman
- Community Science and Innovation for Environmental Justice (CSI EJ) Initiative, Center for a Livable Future, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Christopher D. Heaney
- Community Science and Innovation for Environmental Justice (CSI EJ) Initiative, Center for a Livable Future, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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Racz L, Rish W. Exposure monitoring toward environmental justice. INTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT 2022; 18:858-862. [PMID: 34633140 DOI: 10.1002/ieam.4534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/27/2021] [Accepted: 10/10/2021] [Indexed: 06/13/2023]
Abstract
Executive Order 14008, signed on 27 January 2021, established environmental justice (EJ) as a core priority of the Biden Administration. There is a need for state and federal regulators, as well as industry, to enhance risk assessment methods and exposure monitoring approaches to be more inclusive of EJ community involvement and more representative of EJ community exposures. Cumulative risk assessment models are critical for understanding the unique interaction between chemical exposures and nonchemical stressors that EJ communities encounter daily. Enhanced environmental monitoring with personal and portable sensors, especially when deployed using community partnerships, can capture chemical exposures with sufficient resolution to characterize exposures down to the neighborhood level. Use of internet-linked sensors will also require thoughtful advances in management of big data to inform meaningful and time-sensitive decisions. Integr Environ Assess Manag 2022;18:858-862. © 2021 SETAC.
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Affiliation(s)
- LeeAnn Racz
- ToxStrategies Inc., Fort Walton Beach, Florida, USA
| | - William Rish
- ToxStrategies Inc., Asheville, North Carolina, USA
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Hyland C, Bradshaw P, Deardorff J, Gunier RB, Mora AM, Kogut K, Sagiv SK, Bradman A, Eskenazi B. Interactions of agricultural pesticide use near home during pregnancy and adverse childhood experiences on adolescent neurobehavioral development in the CHAMACOS study. ENVIRONMENTAL RESEARCH 2022; 204:111908. [PMID: 34425114 DOI: 10.1016/j.envres.2021.111908] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 05/12/2023]
Abstract
BACKGROUND Studies have documented independent adverse associations between prenatal and early-life exposure to environmental chemicals and social adversity with child neurodevelopment; however, few have considered these exposures jointly. The objective of this analysis is to examine whether associations of pesticide mixtures and adolescent neurobehavioral development are modified by early-life adversity in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) cohort. METHODS We used linear mixed effects Bayesian Hierarchical Models (BHM) to examine the joint effect of applications of 11 agricultural pesticides within 1 km of maternal homes during pregnancy and youth-reported Adverse Childhood Experiences (ACEs) with maternal and youth-reported internalizing behaviors, hyperactivity, and attention problems assessed via the Behavior Assessment for Children (BASC) (mean = 50, standard deviation = 10) at ages 16 and 18 years (n = 458). RESULTS The median (25th-75th percentiles) of ACEs was 1 (0-3); 72.3% of participants had low ACEs (0-2 events) and 27.7% had ACEs (3+ events). Overall, there was little evidence of modification of exposure-outcome associations by ACEs. A two-fold increase in malathion use was associated with increased internalizing behaviors among those with high ACEs from both maternal- (β = 1.9; 95% Credible Interval (CrI): 0.2, 3.7 for high ACEs vs. β = -0.1; 95% CrI: 1.2, 0.9 for low ACEs) and youth-report (β = 2.1; 95% CrI: 0.4, 3.8 for high ACEs vs. β = 0.2; 95% CrI: 0.8, 1.2 for low ACEs). Applications of malathion and dimethoate were also associated with higher youth-reported hyperactivity and/or inattention among those with high ACEs. CONCLUSION We observed little evidence of effect modification of agricultural pesticide use near the home during pregnancy and adolescent behavioral problems by child ACEs. Future studies should examine critical windows of susceptibility of exposure to chemical and non-chemical stressors and should consider biomarker-based exposure assessment methods.
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Affiliation(s)
- Carly Hyland
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States; Department of Public Health and Population Science, College of Health Sciences, Boise State University, Boise, ID, United States
| | - Patrick Bradshaw
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Julianna Deardorff
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States
| | - Robert B Gunier
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States
| | - Ana M Mora
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States
| | - Katherine Kogut
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States
| | - Sharon K Sagiv
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States; Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Asa Bradman
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States; Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, United States
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States.
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Kermani M, Asadgol Z, Gholami M, Jafari AJ, Shahsavani A, Goodarzi B, Arfaeinia H. Occurrence, spatial distribution, seasonal variations, potential sources, and inhalation-based health risk assessment of organic/inorganic pollutants in ambient air of Tehran. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2021; 43:1983-2006. [PMID: 33216310 DOI: 10.1007/s10653-020-00779-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 11/08/2020] [Indexed: 06/11/2023]
Abstract
The present study evaluated the concentrations, spatial distribution, seasonal variations, potential sources, and risk assessment of organic/inorganic pollutants in ambient air of Tehran city. Totally, 180 air samples were taken from 9 sampling stations from March 2018 to March 2019 and were analyzed to determine the concentrations of organic pollutants (BTEX compounds and PM2.5-bound PAHs) plus inorganic pollutants (PM2.5-bound metals and asbestos fibers). The results revealed that the mean concentrations of ∑ PAHs, BTEX, ∑ heavy metals, and asbestos fibers were 5.34 ng/m3, 60.55 µg/m3, 8585.12 ng/m3, and 4.13 fiber/ml in the cold season, respectively, and 3.88 ng/m3, 33.86 µg/m3, 5682.61 ng/m3, and 3.21 fiber/ml in the warm season, respectively. Source apportionment of emission of the air pollutants showed that PAHs are emitted from diesel vehicles and industrial activities. BTEX and asbestos are also released mainly by vehicles. The results of the inhalation-based risk assessment indicated that the carcinogenic risk of PAHs, BTEX, and asbestos exceeded the recommended limit by The US environmental protection agency (US EPA) and WHO (1 × 10-4). The risk of carcinogenesis of heavy metal of lead and chromium also exceeded the recommended limit. Thus, proper management strategies are required to control the concentration of these pollutants in Tehran's ambient air in order to maintain the health of Tehran's citizens.
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Affiliation(s)
- Majid Kermani
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Asadgol
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mitra Gholami
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Jonidi Jafari
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Shahsavani
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Babak Goodarzi
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran.
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
- Department of Environmental Health Engineering, School of Public Health, Hormozgan University of Medical Sciences, Hormozgan, Iran.
| | - Hossein Arfaeinia
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.
- Department of Environmental Health Engineering, School of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran.
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Framing Environmental Health Decision-Making: The Struggle over Cumulative Impacts Policy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083947. [PMID: 33918632 PMCID: PMC8070174 DOI: 10.3390/ijerph18083947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 12/03/2022]
Abstract
Little progress has been made to advance U.S. federal policy responses to growing scientific findings about cumulative environmental health impacts and risks, which also show that many low income and racial and ethnic minority populations bear a disproportionate share of multiple environmental burdens. Recent scholarship points to a “standard narrative” by which policy makers rationalize their slow efforts on environmental justice because of perceived lack of data and analytical tools. Using a social constructivist approach, ethnographic research methods, and content analysis, we examined the social context of policy challenges related to cumulative risks and impacts in the state of Maryland between 2014 and 2016. We identified three frames about cumulative impacts as a health issue through which conflicts over such policy reforms materialize and are sustained: (a) perceptions of evidence, (b) interpretations of social justice, and (c) expectations of authoritative bodies. Our findings illustrate that policy impasse over cumulative impacts is highly dependent on how policy-relevant actors come to frame issues around legislating cumulative impacts, rather than the “standard narrative” of external constraints. Frame analysis may provide us with more robust understandings of policy processes to address cumulative risks and impacts and the social forces that create health policy change.
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von Stackelberg K, Williams PR. Evolving Science and Practice of Risk Assessment. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2021; 41:571-583. [PMID: 33295028 PMCID: PMC8257268 DOI: 10.1111/risa.13647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 07/15/2020] [Accepted: 10/26/2020] [Indexed: 05/03/2023]
Abstract
Managing public health risks from environmental contaminants has historically relied on a risk assessment process defined by the regulatory context in which these risks are assessed. Risk assessment guidance follows a straightforward, chemical-by-chemical approach to inform regulatory decisions around the question "what is the risk-based concentration protective of human and ecological health outcomes?" Here we briefly summarize regulatory risk assessment in the context of innovative risk assessment approaches based on an evolving understanding of the underlying scientific disciplines that support risk analysis more broadly. We discuss scientific versus regulatory tensions in the application of these approaches for future risk assessments, and challenges in translating our improved understanding of the underlying scientific complexity to the regulatory landscape to better inform decision making that extends beyond conventional regulatory mandates.
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Affiliation(s)
- Katherine von Stackelberg
- NEK Associates LTD, Allston, MA, 02134, USA
- Harvard Center for Risk Analysis, 401 Park Drive, Boston, MA, 02215, USA
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Payne-Sturges DC, Cory-Slechta DA, Puett RC, Thomas SB, Hammond R, Hovmand PS. Defining and Intervening on Cumulative Environmental Neurodevelopmental Risks: Introducing a Complex Systems Approach. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:35001. [PMID: 33688743 PMCID: PMC7945198 DOI: 10.1289/ehp7333] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 02/05/2021] [Accepted: 02/10/2021] [Indexed: 05/21/2023]
Abstract
BACKGROUND The combined effects of multiple environmental toxicants and social stressor exposures are widely recognized as important public health problems contributing to health inequities. However cumulative environmental health risks and impacts have received little attention from U.S. policy makers at state and federal levels to develop comprehensive strategies to reduce these exposures, mitigate cumulative risks, and prevent harm. An area for which the inherent limitations of current approaches to cumulative environmental health risks are well illustrated is children's neurodevelopment, which exhibits dynamic complexity of multiple interdependent and causally linked factors and intergenerational effects. OBJECTIVES We delineate how a complex systems approach, specifically system dynamics, can address shortcomings in environmental health risk assessment regarding exposures to multiple chemical and nonchemical stressors and reshape associated public policies. DISCUSSION Systems modeling assists in the goal of solving problems by improving the "mental models" we use to make decisions, including regulatory and policy decisions. In the context of disparities in children's cumulative exposure to neurodevelopmental stressors, we describe potential policy insights about the structure and behavior of the system and the types of system dynamics modeling that would be appropriate, from visual depiction (i.e., informal maps) to formal quantitative simulation models. A systems dynamics framework provides not only a language but also a set of methodological tools that can more easily operationalize existing multidisciplinary scientific evidence and conceptual frameworks on cumulative risks. Thus, we can arrive at more accurate diagnostic tools for children's' environmental health inequities that take into consideration the broader social and economic environment in which children live, grow, play, and learn. https://doi.org/10.1289/EHP7333.
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Affiliation(s)
- Devon C. Payne-Sturges
- Maryland Institute for Applied Environmental Health, University of Maryland School of UMD Public Health, College Park, Maryland, USA
| | | | - Robin C. Puett
- Maryland Institute for Applied Environmental Health, University of Maryland School of UMD Public Health, College Park, Maryland, USA
| | - Stephen B. Thomas
- Department of Health Policy and Management and Maryland Center for Health Equity, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Ross Hammond
- Brown School of Social Work, Washington University, St. Louis, Missouri, USA
- Center on Social Dynamics and Policy, The Brookings Institution, Washington, DC, USA
| | - Peter S. Hovmand
- Center for Community Health Integration, Case Western Reserve University, Cleveland, Ohio, USA
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Thomson EM, Christidis T, Pinault L, Tjepkema M, Colman I, Crouse DL, van Donkelaar A, Martin RV, Hystad P, Robichaud A, Ménard R, Brook JR, Burnett RT. Self-rated stress, distress, mental health, and health as modifiers of the association between long-term exposure to ambient pollutants and mortality. ENVIRONMENTAL RESEARCH 2020; 191:109973. [PMID: 32810502 DOI: 10.1016/j.envres.2020.109973] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/16/2020] [Accepted: 07/17/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Individual and neighbourhood-scale socioeconomic characteristics modify associations between exposure to air pollution and mortality. The role of stress, which may integrate effects of social and environmental exposures on health, is unknown. We examined whether an individual's perspective on their own well-being, as assessed using self-rated measures of stress and health, modifies the pollutant-mortality relationship. METHODS The Canadian Community Health Survey (CCHS)-mortality cohort includes respondents from surveys administered between 2001 and 2012 linked to vital statistics and postal codes from 1981 until 2016. Annual fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3) exposure estimates were attached to a sample of cohort members aged 30-89 years (n = 398,300 respondents/3,848,400 person-years). We examined whether self-rated stress, distress, mental health, and general health modified associations between long-term exposure to each pollutant (three-year moving average with one-year lag) and non-accidental mortality using Cox survival models, adjusted for individual- (i.e. socioeconomic and behavioural) and neighbourhood-scale covariates. RESULTS In fully-adjusted models, the relationship between exposure to pollutants and mortality was stronger among those with poor self-rated mental health, including a significant difference for NO2 (hazard ratio (HR) = 1.15, 95% CI 1.06-1.25 per IQR) compared to those with very good/excellent mental health (HR = 1.05, 95% CI 1.01-1.08; Cochran's Q = 4.01; p < 0.05). Poor self-rated health was similarly associated with higher pollutant-associated HRs, but only in unadjusted models. Stress and distress did not modify pollutant-mortality associations. CONCLUSIONS Poor self-rated mental and general health were associated with increased mortality attributed to exposure to ambient pollutants.
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Affiliation(s)
- Errol M Thomson
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada; Department of Biochemistry, Microbiology and Immunology, University of Ottawa, ON, Canada.
| | | | - Lauren Pinault
- Health Analysis Division, Statistics Canada, Ottawa, ON, Canada
| | | | - Ian Colman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | | | - Aaron van Donkelaar
- Department of Physics & Atmospheric Science, Dalhousie University, Halifax, NS, Canada; Department of Energy, Environmental & Chemical Engineering, Washington University in St. Louis, MO, USA
| | - Randall V Martin
- Department of Physics & Atmospheric Science, Dalhousie University, Halifax, NS, Canada; Department of Energy, Environmental & Chemical Engineering, Washington University in St. Louis, MO, USA; Harvard-Smithsonian Center for Astrophysics, Cambridge, MA, USA
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Alain Robichaud
- Air Quality Research Division, Environment and Climate Change Canada, Dorval, QC, Canada
| | - Richard Ménard
- Air Quality Research Division, Environment and Climate Change Canada, Dorval, QC, Canada
| | - Jeffrey R Brook
- Dalla Lana School of Public Health, University of Toronto, ON, Canada
| | - Richard T Burnett
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
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Thomson EM. Air Pollution, Stress, and Allostatic Load: Linking Systemic and Central Nervous System Impacts. J Alzheimers Dis 2020; 69:597-614. [PMID: 31127781 PMCID: PMC6598002 DOI: 10.3233/jad-190015] [Citation(s) in RCA: 126] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Air pollution is a risk factor for cardiovascular and respiratory morbidity and mortality. A growing literature also links exposure to diverse air pollutants (e.g., nanoparticles, particulate matter, ozone, traffic-related air pollution) with brain health, including increased incidence of neurological and psychiatric disorders such as cognitive decline, dementia (including Alzheimer’s disease), anxiety, depression, and suicide. A critical gap in our understanding of adverse impacts of pollutants on the central nervous system (CNS) is the early initiating events triggered by pollutant inhalation that contribute to disease progression. Recent experimental evidence has shown that particulate matter and ozone, two common pollutants with differing characteristics and reactivity, can activate the hypothalamic-pituitary-adrenal (HPA) axis and release glucocorticoid stress hormones (cortisol in humans, corticosterone in rodents) as part of a neuroendocrine stress response. The brain is highly sensitive to stress: stress hormones affect cognition and mental health, and chronic stress can produce profound biochemical and structural changes in the brain. Chronic activation and/or dysfunction of the HPA axis also increases the burden on physiological stress response systems, conceptualized as allostatic load, and is a common pathway implicated in many diseases. The present paper provides an overview of how systemic stress-dependent biological responses common to particulate matter and ozone may provide insight into early CNS effects of pollutants, including links with oxidative, inflammatory, and metabolic processes. Evidence of pollutant effect modification by non-chemical stressors (e.g., socioeconomic position, psychosocial, noise), age (prenatal to elderly), and sex will also be reviewed in the context of susceptibility across the lifespan.
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Affiliation(s)
- Errol M Thomson
- Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada
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Identification of component-based approach for prediction of joint chemical mixture toxicity risk assessment with respect to human health: A critical review. Food Chem Toxicol 2020; 143:111458. [DOI: 10.1016/j.fct.2020.111458] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/24/2020] [Accepted: 05/25/2020] [Indexed: 11/22/2022]
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A Cumulative Risk Perspective for Occupational Health and Safety (OHS) Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176342. [PMID: 32878292 PMCID: PMC7503320 DOI: 10.3390/ijerph17176342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/28/2020] [Accepted: 08/19/2020] [Indexed: 12/21/2022]
Abstract
Cumulative risk assessment (CRA) addresses the combined risk associated with chemical and non-chemical exposures. Although CRA approaches are utilized in environmental and ecological contexts, they are rarely applied in workplaces. In this perspectives article, we strive to raise awareness among occupational health and safety (OHS) professionals and foster the greater adoption of a CRA perspective in practice. Specifically, we provide an overview of CRA literature as well as preliminary guidance on when to consider a CRA approach in occupational settings and how to establish reasonable boundaries. Examples of possible workplace co-exposures and voluntary risk management actions are discussed. We also highlight important implications for workplace CRA research and practice. In particular, future needs include simple tools for identifying combinations of chemical and non-chemical exposures, uniform risk management guidelines, and risk communication materials. Further development of practical CRA methods and tools are essential to meet the needs of complex and changing work environments.
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Population based Air Pollution Exposure and its influence factors by Integrating Air Dispersion Modeling with GIS Spatial Analysis. Sci Rep 2020; 10:479. [PMID: 31949216 PMCID: PMC6965307 DOI: 10.1038/s41598-019-57385-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 12/31/2019] [Indexed: 11/30/2022] Open
Abstract
Air pollution is a major environmental health problem. The study of interaction between air pollution and human will benefit to the human health and well-being of community. Both a model for assessing population relative risk of air pollution exposure (MAPRRAPE) and air pollution concentration methods were applied in a case study to determine the optimal method in evaluating risk of population exposure to Sulfur Dioxide (SO2). The framework for building the MAPRRAPE was described in detail. Then, the spatial patterns of population by demographic characteristics exposed to SO2 from industrial, vehicle, and the mixture of industrial and vehicle pollution sources, as well as an in-depth quantitative investigation using correlation analysis were studied for further source appointment. The results showed that the MAPRRAPE was more reliable than air pollution concentration model in determining population exposure risks by demographic characteristics. The high risk areas of whites exposed to SO2 were larger than blacks and the other races due to a large number of whites, and other age groups exposed to SO2 were larger than children and the old people. In addition, the correlation analyses showed that the relative risks of population by demographic characteristics exposed to SO2 had a more significant correlation with vehicle pollution source than industrial pollution source. The results of source appointment thus demonstrated that vehicle pollution source was the main pollution source. This study suggests that there is a clear need for the implementation of programs and services that will reduce population exposed to air pollution with focusing on densely populated areas for an ultimate improvement of community health status and the environmental conditions.
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Ferguson KK, Rosen EM, Barrett ES, Nguyen RHN, Bush N, McElrath TF, Swan SH, Sathyanarayana S. Joint impact of phthalate exposure and stressful life events in pregnancy on preterm birth. ENVIRONMENT INTERNATIONAL 2019; 133:105254. [PMID: 31675562 PMCID: PMC6924167 DOI: 10.1016/j.envint.2019.105254] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/19/2019] [Accepted: 10/08/2019] [Indexed: 05/18/2023]
Abstract
BACKGROUND Urinary phthalate metabolites and psychosocial stress in pregnancy have each been associated with preterm birth (PTB), but no study has examined the joint impact of these two environmental exposures. We hypothesized that there would be stronger associations between phthalate exposure and PTB in mothers with higher stress in pregnancy compared to mothers with lower stress. METHODS We addressed this question using data from The Infant Development and the Environment Study (TIDES), a prospective birth cohort conducted at four US sites (N = 783). We examined urinary phthalate metabolite concentrations measured in samples collected from up to three trimesters of pregnancy. Mothers reported their exposure to stressful life events (SLE) in each trimester in a questionnaire administered in the third trimester. PTB was defined as delivery before 37 weeks completed gestation (n = 71, 9.1%). We examined associations between urinary phthalate metabolite concentrations (individual time points and on average) and PTB using logistic regression models adjusted for maternal race, age, pre-pregnancy body mass index, education, specific gravity, and gestational age at sample collection. In addition, we created models stratified by whether or not mothers were exposed to any or no SLE in pregnancy. RESULTS Summed di-2-ethylhexyl phthalate (ΣDEHP) metabolites measured in urine samples from the third trimester, but not the first trimester, were associated with an increased odds ratio (OR) of PTB (OR = 1.44, 95% confidence interval [CI] = 1.06, 1.95). In models stratified by SLE, associations between third trimester ΣDEHP concentrations and PTB were significant only for women experiencing one or more SLE during pregnancy (OR for ΣDEHP: 2.09, 95% CI: 1.29, 3.37) but not for women with no SLE during pregnancy (OR for ΣDEHP: 1.04, 95% CI: 0.66, 1.63) (p for interaction = 0.07). CONCLUSIONS We observed an association between urinary ΣDEHP levels and PTB that was modified by whether a mother was exposed to one or more psychosocial stressors during pregnancy. Additional research to understand the joint impacts of chemical and non-chemical exposures, with an emphasis on timing of exposure, is needed in order to advance the state of the science on how the environment influences pregnancy.
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Affiliation(s)
- Kelly K Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
| | - Emma M Rosen
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Ruby H N Nguyen
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Nicole Bush
- Department of Psychiatry and Pediatrics, University of California at San Francisco, San Francisco, CA, USA
| | - Thomas F McElrath
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Shanna H Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sheela Sathyanarayana
- Department of Pediatrics, Seattle Children's Research Institute, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
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State-of-the-Science Review of Non-Chemical Stressors Found in a Child's Social Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224417. [PMID: 31718056 PMCID: PMC6888402 DOI: 10.3390/ijerph16224417] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/07/2019] [Accepted: 11/08/2019] [Indexed: 12/14/2022]
Abstract
Background: Children are exposed to chemical and non-chemical stressors from their built, natural, and social environments. Research is needed to advance our scientific understanding of non-chemical stressors, evaluate how they alter the biological response to a chemical stressor, and determine how they impact children’s health and well-being. To do this, we conducted a state-of-the-science review of non-chemical stressors found in a child’s social environment. Methods: Studies eligible for inclusion in this review were identified through a search of the peer-reviewed literature using PubMed and PsycINFO. Combinations of words associated with non-chemical stressors and children were used to form search strings. Filters were used to limit the search to studies published in peer-reviewed journals from 2000–2016 and written in English. Publications found using the search strings and filters went through two rounds of screening. Results: A total of 146 studies met the inclusion criteria. From these studies, 245 non-chemical stressors were evaluated. The non-chemical stressors were then organized into 13 general topic areas: acculturation, adverse childhood experiences, economic, education, family dynamics, food, greenspace, neighborhood, social, stress, urbanicity, violence, and other. Additional information on health outcomes, studies evaluating both chemical and non-chemical stressors, and animal studies are provided. This review provides evidence that non-chemical stressors found in a child’s social environment do influence their health and well-being in both beneficial (e.g., salutatory effects of greenspace and social support) and adverse (e.g., poor relationships between health and selected non-chemical stressors such as economics, educational attainment, exposure to violence, stress) ways. Conclusions: This literature review identified a paucity of studies addressing the combined effects of chemical and non-chemical stressors and children’s health and well-being. This literature review was further complicated by inconsistencies in terminology, methodologies, and the value of non-chemical stressor research in different scientific disciplines. Despite these limitations, this review showed the importance of considering non-chemical stressors from a child’s social environment when addressing children’s environmental health considerations.
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Thomson EM, Filiatreault A, Guénette J. Stress hormones as potential mediators of air pollutant effects on the brain: Rapid induction of glucocorticoid-responsive genes. ENVIRONMENTAL RESEARCH 2019; 178:108717. [PMID: 31520820 DOI: 10.1016/j.envres.2019.108717] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 08/20/2019] [Accepted: 09/01/2019] [Indexed: 05/27/2023]
Abstract
Air pollution is associated with adverse effects on brain health including cognitive decline, dementia, anxiety, depression, and suicide. While toxicological studies have demonstrated the potential for repeated or chronic pollutant exposure to lead to disease states, characterisation of initial biological responses to exposure is needed to better understand underlying mechanisms. The brain is highly sensitive to glucocorticoids (primarily cortisol in humans, corticosterone in rodents), stress hormones that play important roles in cognition and mental health. We tested whether glucocorticoids could be implicated in central nervous system (CNS) effects of pollutant exposure by examining glucocorticoid-dependent signaling across brain regions after exposure to the common pollutant ozone. Male Fischer-344 rats were exposed for 4 h to air or 0.8 ppm ozone ± metyrapone (50 mg/kg), a drug that blocks corticosterone synthesis (n = 5/group). Key glucocorticoid-responsive genes (serum- and glucocorticoid-inducible kinase, SGK; glucocorticoid-inducible leucine zipper, GILZ), and a gene responsive to both glucocorticoids and oxidative stress (metallothionein (MT)-1), were increased by ozone in all brain regions (olfactory bulb, frontal lobe, cortex, midbrain, hippocampus, cerebellum, brainstem), correlating with plasma corticosterone levels. Metyrapone prevented the increase in SGK and GILZ, and reduced but did not eliminate the effect on MT-1, suggesting glucocorticoid-dependent and -independent regulation. Administering exogenous corticosterone (10 mg/kg) to air-exposed rats reproduced the ozone effects, confirming specificity. The results demonstrate that early pollutant effects include stress hormone-dependent signaling. As both ozone and particulate matter activate the hypothalamic-pituitary-adrenal axis, and elevated glucocorticoids are implicated in brain pathologies, stress hormones could contribute to CNS impacts of air pollutants.
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Affiliation(s)
- Errol M Thomson
- Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, K1A 0K9, Canada.
| | - Alain Filiatreault
- Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, K1A 0K9, Canada.
| | - Josée Guénette
- Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, K1A 0K9, Canada.
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Prochaska JD, Kim H, Buschmann RN, Jupiter D, Croisant S, Linder SH, Sexton K. The utility of a system dynamics approach for understanding cumulative health risk from exposure to environmental hazards. ENVIRONMENTAL RESEARCH 2019; 172:462-469. [PMID: 30844571 PMCID: PMC6755670 DOI: 10.1016/j.envres.2019.02.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 02/22/2019] [Accepted: 02/26/2019] [Indexed: 05/30/2023]
Abstract
The potential of system dynamics modeling to advance our understanding of cumulative risk in the service of optimal health is discussed. The focus is on exploring system dynamics modeling as a systems science methodology that can provide a framework for examining the complexity of real-world social and environmental exposures among populations-particularly those exposed to multiple disparate sources of risk. The discussion also examines how system dynamics modeling can engage a diverse body of key stakeholders throughout the modeling process, promoting the collective assessment of assumptions and systematic gathering of critical data. Though not a panacea, system dynamics modeling provides a promising methodology to complement traditional research methods in understanding cumulative health effects from exposure to multiple environmental and social stressors.
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Affiliation(s)
- John D Prochaska
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, 301 University Blvd. Route 1153, Galveston, TX 77555-1153, USA; Center in Environmental Toxicology, University of Texas Medical Branch, Galveston, TX, USA.
| | - Hyunjung Kim
- Department of Management, California State University, Chico, CA, USA
| | - Robert N Buschmann
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, 301 University Blvd. Route 1153, Galveston, TX 77555-1153, USA
| | - Daniel Jupiter
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, 301 University Blvd. Route 1153, Galveston, TX 77555-1153, USA; Office of Biostatistics, University of Texas Medical Branch, Galveston, TX, USA
| | - Sharon Croisant
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, 301 University Blvd. Route 1153, Galveston, TX 77555-1153, USA; Center in Environmental Toxicology, University of Texas Medical Branch, Galveston, TX, USA
| | - Stephen H Linder
- Department of Management, Policy and Community Health, University of Texas Health Science Center Houston School of Public Health, Houston, TX, USA
| | - Ken Sexton
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas, Health Science Center, School of Public Health, Houston, TX, USA
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Burwell-Naney K, Wilson SM, Whitlock ST, Puett R. Hybrid Resiliency-Stressor Conceptual Framework for Informing Decision Support Tools and Addressing Environmental Injustice and Health Inequities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1466. [PMID: 31027209 PMCID: PMC6518295 DOI: 10.3390/ijerph16081466] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/19/2019] [Accepted: 04/19/2019] [Indexed: 02/06/2023]
Abstract
While structural factors may drive health inequities, certain health-promoting attributes of one's "place" known as salutogens may further moderate the cumulative impacts of exposures to socio-environmental stressors that behave as pathogens. Understanding the synergistic relationship between socio-environmental stressors and resilience factors is a critical component in reducing health inequities; however, the catalyst for this concept relies on community-engaged research approaches to ultimately strengthen resiliency and promote health. Furthermore, this concept has not been fully integrated into environmental justice and cumulative risk assessment screening tools designed to identify geospatial variability in environmental factors that may be associated with health inequities. As a result, we propose a hybrid resiliency-stressor conceptual framework to inform the development of environmental justice and cumulative risk assessment screening tools that can detect environmental inequities and opportunities for resilience in vulnerable populations. We explore the relationship between actual exposures to socio-environmental stressors, perceptions of stressors, and one's physiological and psychological stress response to environmental stimuli, which collectively may perpetuate health inequities by increasing allostatic load and initiating disease onset. This comprehensive framework expands the scope of existing screening tools to inform action-based solutions that rely on community-engaged research efforts to increase resiliency and promote positive health outcomes.
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Affiliation(s)
- Kristen Burwell-Naney
- Center for Outreach in Alzheimer's, Aging and Community Health, North Carolina A&T State University, 2105 Yanceyville Street, Greensboro, NC 27405, USA.
| | - Sacoby M Wilson
- Maryland Institute for Applied Environmental Health, School of Public Heath, University of Maryland, 255 Valley Drive, College Park, MD 20742, USA.
| | - Siobhan T Whitlock
- Office of Environmental Justice and Sustainability, U.S. Environmental Protection Agency, 61 Forsyth Street SW, Atlanta, GA 30303, USA.
| | - Robin Puett
- Maryland Institute for Applied Environmental Health, School of Public Heath, University of Maryland, 255 Valley Drive, College Park, MD 20742, USA.
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Hallit S, Raherison C, Malaeb D, Hallit R, Waked M, Kheir N, Salameh P. Development of an asthma risk factors scale (ARFS) for risk assessment asthma screening in children. Pediatr Neonatol 2019; 60:156-165. [PMID: 29983338 DOI: 10.1016/j.pedneo.2018.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/16/2018] [Accepted: 05/30/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The study objective was to create asthma risk factors scale (ARFS) score that would be correlated with the increased risk of asthma in Lebanese children. This scale would eventually be used both to identify children at risk and assess early diagnosis of asthma. METHODS A case-control study (study 1) of 1276 children (976 controls and 300 cases) and a cross-sectional study (study 2) of 1000 children were conducted using a parental questionnaire. Children aged between 3 and 16 years were screened for possible enrollment. The ARFS was created by combining the following risk factors: child's exposure to pesticides, detergent mixing, alcohol, smoking and drug intake during pregnancy and breastfeeding, the actual paternal and maternal smoking status and history of asthma, and the types of food the child consumes. RESULTS There was a significant increase in the risk assessment screening for asthma per 15 points increments of ARFS (p < 0.001 for trend). The score category 0-14.99 best-represented control individuals (88.8% controls), while a score higher than 45 represented asthmatic children best (98.4% asthmatics). The positive predictive value (disease positive/all positive by scale) came out as 94.02%, whereas the negative predictive value (disease negative/all negative by scale) was found to be 90.47%. These results were confirmed in the second study sample. CONCLUSION The ARFS is a simple and easy-to-use tool, composed of 15 questions, for the clinician risk assessment of asthma in children, taking into account the environmental exposure, parental history of asthma and dietary habits of the child. Its value for asthma diagnosis remains to be confirmed in future prospective studies, especially in children with chronic respiratory symptoms.
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Affiliation(s)
- Souheil Hallit
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon; Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon; Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon; Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center, Inserm - Université de Bordeaux, Bordeaux, France; INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon.
| | - Chantal Raherison
- Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center, Inserm - Université de Bordeaux, Bordeaux, France; Department of Pneumology, University Hospital, Bordeaux, France
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon
| | - Mirna Waked
- Faculty of Medicine, Balamand University, Koura, Lebanon
| | - Nelly Kheir
- Faculty of Science II, Lebanese University, Fanar, Lebanon
| | - Pascale Salameh
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon; Faculty of Medicine, Lebanese University, Beirut, Lebanon
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Tseng CH, Chen LL, Yeh PC. Modeling contamination conditions in small-scale industrial areas to estimate health savings benefits associated with remediation. Heliyon 2018; 4:e00995. [PMID: 30623125 PMCID: PMC6313816 DOI: 10.1016/j.heliyon.2018.e00995] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 09/27/2018] [Accepted: 11/28/2018] [Indexed: 11/19/2022] Open
Abstract
Mercury and dioxin pollution associated with the China Petrochemical Development Corporation's An-shun plant is one of the most severe soil contamination incidents in Taiwan's history. Residents living nearby were exposed to heavy metals and dioxins that led to significant impacts on human health and safety. While many studies related to contamination in large-scale industrial areas have been conducted to evaluate the effects of occupational contaminant exposure, studies related to people who live near small-scale industry areas are less common. In this study, we use the system dynamics modeling to build a media flow pattern for mercury and dioxin in the vicinity of the An-shun plant, simulate the concentrations of the pollutants before and after remediation, and compare the simulated values with the measurements of actual conditions after remediation to evaluate the feasibility and accuracy of the model. This study also estimated the concentration of mercury and dioxin in each food medium to simulate the daily exposure of the human body to these contaminants. Finally, the reduction in mercury and dioxin levels in the study area was used to estimate the total health benefits to the local population. The objective of this study was to evaluate the application of this methodology to small-scale industrial areas as well as improve the decision-making process before, during, and after remediation of contaminated sites. The results of this study revealed the health benefits to residents living in the Annan District after remediation was completed at the An-shun plant were significant.
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Affiliation(s)
| | - Ling-Ling Chen
- Institute of Environment Engineering and Management, National Taipei University of Technology, 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan
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Burgos S, Madrid MA, Maldonado A, Medina F, Iglesias V. Integrating multivariate and geostatistical analyses for assessing the socio-environmental vulnerability of children in the vicinity of a contaminated site. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2018; 28:642-652. [PMID: 30052069 DOI: 10.1080/09603123.2018.1500529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 07/11/2018] [Indexed: 06/08/2023]
Abstract
Vulnerability assessments are commonly based on complex indices that may be inappropriate for characterizing risks in small groups of people exposed to environmental hazards. The aim was to present a multivariate and geostatistical approach to explore human health risks at the individual, household and community level. First, biological and socioeconomic characteristics from 179 children were used in a cluster analysis to find groups and identify vulnerability profiles. Then, both the exposure of children to arsenic and lead in soils and their accessibility to community resources were assessed using a geospatial analysis. The results identified three vulnerability profiles among children that were not in agreement with the environmental exposure and deficit of community resources. The proposed approach helps optimize strategies to manage both environmental and social risks based on the vulnerability of the exposed population.
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Affiliation(s)
- Soledad Burgos
- a University of Chile, Faculty of Medicine , School of Public Health , Santiago , Chile
| | - Miguel A Madrid
- a University of Chile, Faculty of Medicine , School of Public Health , Santiago , Chile
| | - Ana Maldonado
- a University of Chile, Faculty of Medicine , School of Public Health , Santiago , Chile
| | - Felipe Medina
- a University of Chile, Faculty of Medicine , School of Public Health , Santiago , Chile
| | - Verónica Iglesias
- a University of Chile, Faculty of Medicine , School of Public Health , Santiago , Chile
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Barzyk TM, Huang H, Williams R, Kaufman A, Essoka J. Advice and Frequently Asked Questions (FAQs) for Citizen-Science Environmental Health Assessments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E960. [PMID: 29751612 PMCID: PMC5981999 DOI: 10.3390/ijerph15050960] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/02/2018] [Accepted: 05/09/2018] [Indexed: 11/21/2022]
Abstract
Citizen science provides quantitative results to support environmental health assessments (EHAs), but standardized approaches do not currently exist to translate findings into actionable solutions. The emergence of low-cost portable sensor technologies and proliferation of publicly available datasets provides unparalleled access to supporting evidence; yet data collection, analysis, interpretation, visualization, and communication are subjective approaches that must be tailored to a decision-making audience capable of improving environmental health. A decade of collaborative efforts and two citizen science projects contributed to three lessons learned and a set of frequently asked questions (FAQs) that address the complexities of environmental health and interpersonal relations often encountered in citizen science EHAs. Each project followed a structured step-by-step process in order to compare and contrast methods and approaches. These lessons and FAQs provide advice to translate citizen science research into actionable solutions in the context of a diverse range of environmental health issues and local stakeholders.
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Affiliation(s)
- Timothy M Barzyk
- National Exposure Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
| | - Hongtai Huang
- Program on Reproductive Health and the Environment, University of California, San Francisco, CA 94143, USA.
| | - Ronald Williams
- National Exposure Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
| | - Amanda Kaufman
- Office of Air Quality Planning and Standards, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
| | - Jonathan Essoka
- U.S. Environmental Protection Agency, Region III, Philadelphia, PA 19103, USA.
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A Systematic Review of the Interplay Between Social Determinants and Environmental Exposures for Early-Life Outcomes. Curr Environ Health Rep 2018; 3:287-301. [PMID: 27344145 DOI: 10.1007/s40572-016-0099-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Early-life social and environmental exposures have independent effects on many child health outcomes. Increasingly, investigators have suggested that these exposures, which commonly co-occur, may have synergistic effects and have thus begun to evaluate if environmental and social factors jointly contribute to child health. This systematic review summarizes findings and methodological approaches across studies examining the interplay between environmental and social exposures in relation to commonly assessed childhood health outcomes: asthma, cognition and behavior, perinatal outcomes, and obesity. RECENT FINDINGS Forty-one studies met the search criteria and were reviewed. Of these, 37, 34, and 29 % of studies focused on asthma, cognition/behavior, and perinatal outcomes, respectively. No study focused on obesity. Across all studies reviewed, 72 % observed significant synergistic associations between social and environmental exposures. Air pollution was the most frequently studied environmental exposure, and socioeconomic status was the most commonly studied social factor. The emerging evidence suggests that social and environmental risks may jointly affect child health. Recommendations for future research are discussed, including enhancing characterization of the social environment and broadening the types of environmental risks assessed.
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Lichtveld K, Thomas K, Tulve NS. Chemical and non-chemical stressors affecting childhood obesity: a systematic scoping review. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2018; 28:1-12. [PMID: 28952603 PMCID: PMC6097845 DOI: 10.1038/jes.2017.18] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 07/03/2017] [Indexed: 05/02/2023]
Abstract
Childhood obesity in the United States has doubled over the last three decades and currently affects 17% of children and adolescents. While much research has focused on individual behaviors impacting obesity, little research has emphasized the complex interactions of numerous chemical and non-chemical stressors found in a child's environment and how these interactions affect a child's health and well-being. The objectives of this systematic scoping review were to (1) identify potential chemical stressors in the context of non-chemical stressors that impact childhood obesity; and, (2) summarize our observations for chemical and non-chemical stressors in regards to child-specific environments within a community setting. A review was conducted to identify chemical and non-chemical stressors related to childhood obesity for the childhood life stages ranging from prenatal to adolescence. Stressors were identified and grouped into domains: individual behaviors, family/household behaviors, community stressors, and chemical exposures. Stressors were related to the child and the child's everyday environments and used to characterize child health and well-being. This review suggests that the interactions of chemical and non-chemical stressors are important for understanding a child's overall health and well-being. By considering these relationships, the exposure science research community can better design and implement strategies to reduce childhood obesity.
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Affiliation(s)
- Kim Lichtveld
- ORISE Post-Doctoral Participant, U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, Research Triangle Park, NC, USA
- Current Affiliation: Assistant Professor, The University of Findlay, Department of Environmental, Safety and Occupational Health, Findlay, OH
| | - Kent Thomas
- U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, Research Triangle Park, NC, USA
| | - Nicolle S. Tulve
- U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, Research Triangle Park, NC, USA
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27
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Mundorf CA, Lichtveld MY. Using community-based, ethnographic methods to examine risk perceptions and actions of low-income, first-time mothers in a post-spill environment. JOURNAL OF RISK RESEARCH 2018; 21:308-322. [PMID: 29805295 PMCID: PMC5966034 DOI: 10.1080/13669877.2016.1200656] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Following the 2010 Gulf Oil Spill, area pregnant women were thought to be at-risk for poor health outcomes from the stress of managing health actions in this post-disaster environment. Research directed by an ongoing community- academic partnership sought to explore the specific role of culture in environmental risk protection actions among low-income pregnant women. As a part of the first-phase of a mixed-methods cultural study, community health workers (CHWs) used freelisting methods to survey low-income, first-time mother (n = 20) for the threats in the environment and relevant protective actions. Then, a separate pile sort activity (n = 31) was used to further investigate these cultural topics. Results elicited a diverse range of threats, protective actions, and sources of support across socio-demographic groups. Results also showed a culturally tailored conceptualization of threats in the environment. Exploring beliefs among a diverse population helps to uncover cultural differences in a population. Results will aid in developing culturally tailored policies and interventions, and increase the relevance of such interventions to address community concerns. Moreover, incorporating CHWs into the research process enhanced researcher literacy, and fostered mutual trust between the community and researchers.
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Fuller CH, Feeser KR, Sarnat JA, O’Neill MS. Air pollution, cardiovascular endpoints and susceptibility by stress and material resources: a systematic review of the evidence. Environ Health 2017; 16:58. [PMID: 28615066 PMCID: PMC5471931 DOI: 10.1186/s12940-017-0270-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 06/06/2017] [Indexed: 05/29/2023]
Abstract
BACKGROUND AND METHODS Evidence shows that both the physical and social environments play a role in the development of cardiovascular disease. The purpose of this systematic review is two-fold: First, we summarize research from the past 12 years from the growing number of studies focused on effect modification of the relationships between air pollution and cardiovascular disease (CVD) outcomes by socioeconomic position (SEP) and; second, we identify research gaps throughout the published literature on this topic and opportunities for addressing these gaps in future study designs. RESULTS We identified 30 articles that examined the modifying effects of either material resources or psychosocial stress (both related to SEP) on associations between short and long-term air pollution exposure and CVD endpoints. Although 18 articles identified at least one interaction between an air pollutant and material resource indicator, 11 others did not. Support for susceptibility to air pollution by psychosocial stress was weaker; however, only three articles tested this hypothesis. Further studies are warranted to investigate how air pollution and SEP together may influence CVD. CONCLUSIONS We recommend that such research include thorough assessment of air pollution and SEP correlations, including spatial correlation; investigate air pollution indices or multi-pollutant models; use standardized metrics of SEP to enhance comparability across studies; and evaluate potentially susceptible populations.
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Affiliation(s)
- Christina H. Fuller
- Division of Environmental Health, School of Public Health, Georgia State University, Atlanta, GA USA
| | - Karla R. Feeser
- Division of Environmental Health, School of Public Health, Georgia State University, Atlanta, GA USA
| | - Jeremy A. Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Marie S. O’Neill
- Departments of Environmental Health Sciences and Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI USA
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Fox MA, Brewer LE, Martin L. An Overview of Literature Topics Related to Current Concepts, Methods, Tools, and Applications for Cumulative Risk Assessment (2007-2016). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040389. [PMID: 28387705 PMCID: PMC5409590 DOI: 10.3390/ijerph14040389] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 03/10/2017] [Accepted: 03/21/2017] [Indexed: 11/26/2022]
Abstract
Cumulative risk assessments (CRAs) address combined risks from exposures to multiple chemical and nonchemical stressors and may focus on vulnerable communities or populations. Significant contributions have been made to the development of concepts, methods, and applications for CRA over the past decade. Work in both human health and ecological cumulative risk has advanced in two different contexts. The first context is the effects of chemical mixtures that share common modes of action, or that cause common adverse outcomes. In this context two primary models are used for predicting mixture effects, dose addition or response addition. The second context is evaluating the combined effects of chemical and nonchemical (e.g., radiation, biological, nutritional, economic, psychological, habitat alteration, land-use change, global climate change, and natural disasters) stressors. CRA can be adapted to address risk in many contexts, and this adaptability is reflected in the range in disciplinary perspectives in the published literature. This article presents the results of a literature search and discusses a range of selected work with the intention to give a broad overview of relevant topics and provide a starting point for researchers interested in CRA applications.
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Affiliation(s)
- Mary A Fox
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - L Elizabeth Brewer
- Office of the Science Advisor, U.S. Environmental Protection Agency, Oak Ridge Institute for Science and Education (ORISE), Washington, DC 20004, USA.
| | - Lawrence Martin
- Office of the Science Advisor, U.S. Environmental Protection Agency, Washington, DC 20004, USA.
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Coker E, Liverani S, Ghosh JK, Jerrett M, Beckerman B, Li A, Ritz B, Molitor J. Multi-pollutant exposure profiles associated with term low birth weight in Los Angeles County. ENVIRONMENT INTERNATIONAL 2016; 91:1-13. [PMID: 26891269 DOI: 10.1016/j.envint.2016.02.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 02/04/2016] [Accepted: 02/05/2016] [Indexed: 05/12/2023]
Abstract
Research indicates that multiple outdoor air pollutants and adverse neighborhood conditions are spatially correlated. Yet health risks associated with concurrent exposure to air pollution mixtures and clustered neighborhood factors remain underexplored. Statistical models to assess the health effects from pollutant mixtures remain limited, due to problems of collinearity between pollutants and area-level covariates, and increases in covariate dimensionality. Here we identify pollutant exposure profiles and neighborhood contextual profiles within Los Angeles (LA) County. We then relate these profiles with term low birth weight (TLBW). We used land use regression to estimate NO2, NO, and PM2.5 concentrations averaged over census block groups to generate pollutant exposure profile clusters and census block group-level contextual profile clusters, using a Bayesian profile regression method. Pollutant profile cluster risk estimation was implemented using a multilevel hierarchical model, adjusting for individual-level covariates, contextual profile cluster random effects, and modeling of spatially structured and unstructured residual error. Our analysis found 13 clusters of pollutant exposure profiles. Correlations between study pollutants varied widely across the 13 pollutant clusters. Pollutant clusters with elevated NO2, NO, and PM2.5 concentrations exhibited increased log odds of TLBW, and those with low PM2.5, NO2, and NO concentrations showed lower log odds of TLBW. The spatial patterning of pollutant cluster effects on TLBW, combined with between-pollutant correlations within pollutant clusters, imply that traffic-related primary pollutants influence pollutant cluster TLBW risks. Furthermore, contextual clusters with the greatest log odds of TLBW had more adverse neighborhood socioeconomic, demographic, and housing conditions. Our data indicate that, while the spatial patterning of high-risk multiple pollutant clusters largely overlaps with adverse contextual neighborhood cluster, both contribute to TLBW while controlling for the other.
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Affiliation(s)
- Eric Coker
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | | | - Jo Kay Ghosh
- School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Michael Jerrett
- School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Bernardo Beckerman
- School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Arthur Li
- Department of Information Science, City of Hope National Cancer Center, Duarte, CA, United States
| | - Beate Ritz
- School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - John Molitor
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
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31
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Ruiz JDC, Quackenboss JJ, Tulve NS. Contributions of a Child's Built, Natural, and Social Environments to Their General Cognitive Ability: A Systematic Scoping Review. PLoS One 2016; 11:e0147741. [PMID: 26840411 PMCID: PMC4739499 DOI: 10.1371/journal.pone.0147741] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 12/09/2015] [Indexed: 12/24/2022] Open
Abstract
The etiology of a child’s cognitive ability is complex, with research suggesting that it is not attributed to a single determinant or even a defined period of exposure. Rather, cognitive development is the product of cumulative interactions with the environment, both negative and positive, over the life course. The aim of this systematic scoping review was to collate evidence associated with children’s cognitive health, including inherent factors as well as chemical and non-chemical stressors from the built, natural, and social environments. Three databases were used to identify recent epidemiological studies (2003–2013) that examined exposure factors associated with general cognitive ability in children. Over 100 factors were evaluated from 258 eligible studies. We found that recent literature mainly assessed the hypothesized negative effects of either inherent factors or chemical exposures present in the physical environment. Prenatal growth, sleep health, lead and water pollutants showed consistent negative effects. Of the few studies that examined social stressors, results consistently showed cognitive development to be influenced by both positive and negative social interactions at home, in school or the community. Among behavioral factors related to diet and lifestyle choices of the mother, breastfeeding was the most studied, showing consistent positive associations with cognitive ability. There were mostly inconsistent results for both chemical and non-chemical stressors. The majority of studies utilized traditional exposure assessments, evaluating chemical and non-chemical stressors separately. Collective evidence from a limited number of studies revealed that cumulative exposure assessment that incorporates multiple chemical and non-chemical stressors over the life course may unravel the variability in effect on cognitive development and help explain the inconsistencies across studies. Future research examining the interactions of multiple stressors within a child’s total environment, depicting a more real-world exposure, will aid in understanding the cumulative effects associated with a child’s ability to learn.
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Affiliation(s)
- Jazmin Del Carmen Ruiz
- Oak Ridge Institute for Science and Education, Research Participation Program, Oak Ridge, TN, United States of America
- Human Exposure and Atmospheric Sciences Division, National Exposure Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, Durham, NC, United States of America
- * E-mail: ;
| | - James J. Quackenboss
- Human Exposure and Atmospheric Sciences Division, National Exposure Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency, Las Vegas, NV, United States of America
| | - Nicolle S. Tulve
- Human Exposure and Atmospheric Sciences Division, National Exposure Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, Durham, NC, United States of America
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Payne-Sturges DC, Korfmacher KS, Cory-Slechta DA, Jimenez M, Symanski E, Carr Shmool JL, Dotson-Newman O, Clougherty JE, French R, Levy JI, Laumbach R, Rodgers K, Bongiovanni R, Scammell MK. Engaging Communities in Research on Cumulative Risk and Social Stress-Environment Interactions: Lessons Learned from EPA's STAR Program. ENVIRONMENTAL JUSTICE (PRINT) 2015; 8:203-212. [PMID: 27688822 PMCID: PMC4981147 DOI: 10.1089/env.2015.0025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Studies have documented cumulative health effects of chemical and nonchemical exposures, particularly chronic environmental and social stressors. Environmental justice groups have advocated for community participation in research that assesses how these interactions contribute to health disparities experienced by low-income and communities of color. In 2009, the U.S. Environmental Protection Agency issued a request for research applications (RFA), "Understanding the Role of Nonchemical Stressors and Developing Analytic Methods for Cumulative Risk Assessments." Seven research projects were funded to help address this knowledge gap. Each engaged with communities in different ways. We describe the community engagement approaches of the seven research projects, which ranged from outreach through shared leadership/participatory. We then assess the experiences of these programs with respect to the community engagement goals of the RFA. We present insights from these community engagement efforts, including how the grants helped to build or enhance the capacity of community organizations in addition to contributing to the research projects. Our analysis of project proposals, annual grantee reports, and participant observation of these seven projects suggests guidelines for the development of future funding mechanisms and for conducting community-engaged research on cumulative risk involving environmental and social stressors including: 1) providing for flexibility in the mode of community engagement; 2) addressing conflict between research timing and engagement needs, 3) developing approaches for communicating about the uniquely sensitive issues of nonchemical stressors and social risks; and 4) encouraging the evaluation of community engagement efforts.
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Shmool JLC, Yonas MA, Newman OD, Kubzansky LD, Joseph E, Parks A, Callaway C, Chubb LG, Shepard P, Clougherty JE. Identifying Perceived Neighborhood Stressors Across Diverse Communities in New York City. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2015; 56:145-55. [PMID: 26148979 DOI: 10.1007/s10464-015-9736-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
There is growing interest in the role of psychosocial stress in health disparities. Identifying which social stressors are most important to community residents is critical for accurately incorporating stressor exposures into health research. Using a community-academic partnered approach, we designed a multi-community study across the five boroughs of New York City to characterize resident perceptions of key neighborhood stressors. We conducted 14 community focus groups; two to three in each borough, with one adolescent group and one Spanish-speaking group per borough. We then used systematic content analysis and participant ranking data to describe prominent neighborhood stressors and identify dominant themes. Three inter-related themes regarding the social and structural sources of stressful experiences were most commonly identified across neighborhoods: (1) physical disorder and perceived neglect, (2) harassment by police and perceived safety and (3) gentrification and racial discrimination. Our findings suggest that multiple sources of distress, including social, political, physical and economic factors, should be considered when investigating health effects of community stressor exposures and psychological distress. Community expertise is essential for comprehensively characterizing the range of neighborhood stressors that may be implicated in psychosocial exposure pathways.
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Affiliation(s)
- Jessie L C Shmool
- Department of Environmental and Occupational Health, University of Pittsburgh Graduate School of Public Health, 100 Technology Drive, Suite 350, Pittsburgh, PA, 15219, USA,
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Schulz AJ, Mentz GB, Sampson NR, Dvonch JT, Reyes AG, Izumi B. Effects of particulate matter and antioxidant dietary intake on blood pressure. Am J Public Health 2015; 105:1254-61. [PMID: 25320896 PMCID: PMC4400223 DOI: 10.2105/ajph.2014.302176] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2014] [Indexed: 01/20/2023]
Abstract
OBJECTIVES We assessed 2 pathways through which dietary antioxidants may counter adverse effects of exposure to particulate matter less than 2.5 micrometers in diameter (PM2.5) on blood pressure (BP): main (compensatory) and modifying (protective) models. METHODS We used 2002 to 2003 data from the Detroit Healthy Environments Partnership community survey conducted with a multiethnic sample of adults (n = 347) in low- to moderate-income, predominantly Hispanic and non-Hispanic Black neighborhoods in Detroit, Michigan. We used generalized estimating equations to test the effects of ambient exposure to PM2.5 and dietary antioxidant intake on BP, with adjustment for multiple confounders. RESULTS Dietary antioxidant intake was inversely associated with systolic BP (b = -0.5; P < .05) and pulse pressure (b = -0.6; P < .05) in neighborhoods closest to major sources of air pollutants. Adverse effects of PM2.5 remained significant after accounting for antioxidant intakes. Exploratory analyses suggested potential modifying effects of antioxidant intake on associations between ambient PM2.5 exposure and BP. CONCLUSIONS Interventions to improve access to antioxidant-rich foods in polluted urban areas may be protective of cardiovascular health. However, efforts to reduce PM2.5 exposure remain critical for cardiovascular health promotion.
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Affiliation(s)
- Amy J Schulz
- Amy J. Schulz and Graciela B. Mentz are with the Department of Health Behavior and Health Education, and J. Timothy Dvonch is with the Department of Environmental Health Science, School of Public Health, University of Michigan, Ann Arbor. Natalie R. Sampson is with the University of Michigan, Dearborn. Angela G. Reyes is with the Detroit Hispanic Development Corporation, Detroit, MI. Betty Izumi is with the School of Community Health, Portland State University, Portland, OR
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35
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Barzyk TM, Wilson S, Wilson A. Community, state, and federal approaches to cumulative risk assessment: challenges and opportunities for integration. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:4546-71. [PMID: 25918910 PMCID: PMC4454925 DOI: 10.3390/ijerph120504546] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 04/10/2015] [Accepted: 04/14/2015] [Indexed: 11/22/2022]
Abstract
Community, state, and federal approaches to conventional and cumulative risk assessment (CRA) were described and compared to assess similarities and differences, and develop recommendations for a consistent CRA approach, acceptable across each level as a rigorous scientific methodology, including partnership formation and solution development as necessary practices. Community, state, and federal examples were described and then summarized based on their adherence to CRA principles of: (1) planning, scoping, and problem formulation; (2) risk analysis and ranking, and (3) risk characterization, interpretation, and management. While each application shared the common goal of protecting human health and the environment, they adopted different approaches to achieve this. For a specific project-level analysis of a particular place or instance, this may be acceptable, but to ensure long-term applicability and transferability to other projects, recommendations for developing a consistent approach to CRA are provided. This approach would draw from best practices, risk assessment and decision analysis sciences, and historical lessons learned to provide results in an understandable and accepted manner by all entities. This approach is intended to provide a common ground around which to develop CRA methods and approaches that can be followed at all levels.
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Affiliation(s)
- Timothy M Barzyk
- National Exposure Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC 27709, USA.
| | - Sacoby Wilson
- School of Public Health, University of Maryland, College Park, MD 20740, USA.
| | - Anthony Wilson
- Oak Ridge Institute for Science and Education (ORISE), U.S. Environmental Protection Agency, Research Triangle Park, NC 27709, USA.
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36
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Evolution of the chemical-environmental risk of territorial compatibility under the framework of the Seveso Directive: A case study of the autonomous community of Andalusia (southern Spain). J Loss Prev Process Ind 2015. [DOI: 10.1016/j.jlp.2015.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Clougherty JE, Shmool JLC, Kubzansky LD. The Role of Non-Chemical Stressors in Mediating Socioeconomic Susceptibility to Environmental Chemicals. Curr Environ Health Rep 2014. [DOI: 10.1007/s40572-014-0031-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Cumulative risk assessment toolbox: methods and approaches for the practitioner. J Toxicol 2013; 2013:310904. [PMID: 23762048 PMCID: PMC3665252 DOI: 10.1155/2013/310904] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 11/13/2012] [Indexed: 01/28/2023] Open
Abstract
The historical approach to assessing health risks of environmental chemicals has been to evaluate them one at a time. In fact, we are exposed every day to a wide variety of chemicals and are increasingly aware of potential health implications. Although considerable progress has been made in the science underlying risk assessments for real-world exposures, implementation has lagged because many practitioners are unaware of methods and tools available to support these analyses. To address this issue, the US Environmental Protection Agency developed a toolbox of cumulative risk resources for contaminated sites, as part of a resource document that was published in 2007. This paper highlights information for nearly 80 resources from the toolbox and provides selected updates, with practical notes for cumulative risk applications. Resources are organized according to the main elements of the assessment process: (1) planning, scoping, and problem formulation; (2) environmental fate and transport; (3) exposure analysis extending to human factors; (4) toxicity analysis; and (5) risk and uncertainty characterization, including presentation of results. In addition to providing online access, plans for the toolbox include addressing nonchemical stressors and applications beyond contaminated sites and further strengthening resource accessibility to support evolving analyses for cumulative risk and sustainable communities.
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White HL, O’Campo P, Moineddin R, Matheson FI. Modeling the cumulative effects of social exposures on health: moving beyond disease-specific models. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:1186-201. [PMID: 23528813 PMCID: PMC3709312 DOI: 10.3390/ijerph10041186] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 03/13/2013] [Accepted: 03/19/2013] [Indexed: 11/25/2022]
Abstract
The traditional explanatory models used in epidemiology are “disease specific”, identifying risk factors for specific health conditions. Yet social exposures lead to a generalized, cumulative health impact which may not be specific to one illness. Disease-specific models may therefore misestimate social factors’ effects on health. Using data from the Canadian Community Health Survey and Canada 2001 Census we construct and compare “disease-specific” and “generalized health impact” (GHI) models to gauge the negative health effects of one social exposure: socioeconomic position (SEP). We use logistic and multinomial multilevel modeling with neighbourhood-level material deprivation, individual-level education and household income to compare and contrast the two approaches. In disease-specific models, the social determinants under study were each associated with the health conditions of interest. However, larger effect sizes were apparent when outcomes were modeled as compound health problems (0, 1, 2, or 3+ conditions) using the GHI approach. To more accurately estimate social exposures’ impacts on population health, researchers should consider a GHI framework.
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Affiliation(s)
- Heather L. White
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada; E-Mail:
- Institute for Clinical Evaluative Sciences, Toronto, ON M4N 3M5, Canada; E-Mails: (R.M.); (F.I.M.)
| | - Patricia O’Campo
- Institute for Clinical Evaluative Sciences, Toronto, ON M4N 3M5, Canada; E-Mails: (R.M.); (F.I.M.)
- Centre for Research on Inner City Health, The Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5C 1N8, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Department of Population, Reproductive and Family Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Author to whom correspondence should be addressed; E-Mail: co’; Tel.: +1-416-864-5403; Fax: +1-416-864-5485
| | - Rahim Moineddin
- Institute for Clinical Evaluative Sciences, Toronto, ON M4N 3M5, Canada; E-Mails: (R.M.); (F.I.M.)
- Centre for Research on Inner City Health, The Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5C 1N8, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Flora I. Matheson
- Institute for Clinical Evaluative Sciences, Toronto, ON M4N 3M5, Canada; E-Mails: (R.M.); (F.I.M.)
- Centre for Research on Inner City Health, The Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5C 1N8, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
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The effect of social trust on citizens’ health risk perception in the context of a petrochemical industrial complex. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:399-416. [PMID: 23337129 PMCID: PMC3564150 DOI: 10.3390/ijerph10010399] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 12/21/2012] [Accepted: 01/08/2013] [Indexed: 11/17/2022]
Abstract
Perceived risk of environmental threats often translates into psychological stress with a wide range of effects on health and well-being. Petrochemical industrial complexes constitute one of the sites that can cause considerable pollution and health problems. The uncertainty around emissions results in a perception of risk for citizens residing in neighboring areas, which translates into anxiety and physiological stress. In this context, social trust is a key factor in managing the perceived risk. In the case of industrial risks, it is essential to distinguish between trust in the companies that make up the industry, and trust in public institutions. In the context of a petrochemical industrial complex located in the port of Castellón (Spain), this paper primarily discusses how trust—both in the companies located in the petrochemical complex and in the public institutions—affects citizens’ health risk perception. The research findings confirm that while the trust in companies negatively affects citizens’ health risk perception, trust in public institutions does not exert a direct and significant effect. Analysis also revealed that trust in public institutions and health risk perception are essentially linked indirectly (through trust in companies).
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Williams PRD, Dotson GS, Maier A. Cumulative Risk Assessment (CRA): transforming the way we assess health risks. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2012; 46:10868-74. [PMID: 22938698 PMCID: PMC4728715 DOI: 10.1021/es3025353] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Human health risk assessments continue to evolve and now focus on the need for cumulative risk assessment (CRA). CRA involves assessing the combined risk from coexposure to multiple chemical and nonchemical stressors for varying health effects. CRAs are broader in scope than traditional chemical risk assessments because they allow for a more comprehensive evaluation of the interaction between different stressors and their combined impact on human health. Future directions of CRA include greater emphasis on local-level community-based assessments; integrating environmental, occupational, community, and individual risk factors; and identifying and implementing common frameworks and risk metrics for incorporating multiple stressors.
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Hennig B, Ormsbee L, McClain CJ, Watkins BA, Blumberg B, Bachas LG, Sanderson W, Thompson C, Suk WA. Nutrition can modulate the toxicity of environmental pollutants: implications in risk assessment and human health. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:771-4. [PMID: 22357258 PMCID: PMC3385446 DOI: 10.1289/ehp.1104712] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Accepted: 02/22/2012] [Indexed: 05/18/2023]
Abstract
BACKGROUND The paradigm of human risk assessment includes many variables that must be viewed collectively in order to improve human health and prevent chronic disease. The pathology of chronic diseases is complex, however, and may be influenced by exposure to environmental pollutants, a sedentary lifestyle, and poor dietary habits. Much of the emerging evidence suggests that nutrition can modulate the toxicity of environmental pollutants, which may alter human risks associated with toxicant exposures. OBJECTIVES In this commentary, we discuss the basis for recommending that nutrition be considered a critical variable in disease outcomes associated with exposure to environmental pollutants, thus establishing the importance of incorporating nutrition within the context of cumulative risk assessment. DISCUSSION A convincing body of research indicates that nutrition is a modulator of vulnerability to environmental insults; thus, it is timely to consider nutrition as a vital component of human risk assessment. Nutrition may serve as either an agonist or an antagonist (e.g., high-fat foods or foods rich in antioxidants, respectively) of the health impacts associated with exposure to environmental pollutants. Dietary practices and food choices may help explain the large variability observed in human risk assessment. CONCLUSION We recommend that nutrition and dietary practices be incorporated into future environmental research and the development of risk assessment paradigms. Healthful nutrition interventions might be a powerful approach to reduce disease risks associated with many environmental toxic insults and should be considered a variable within the context of cumulative risk assessment and, where appropriate, a potential tool for subsequent risk reduction.
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Affiliation(s)
- Bernhard Hennig
- University of Kentucky Superfund Research Program, Lexington, Kentucky 40536, USA.
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U.S. EPA authority to use cumulative risk assessments in environmental decision-making. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:1997-2019. [PMID: 22829786 PMCID: PMC3397360 DOI: 10.3390/ijerph9061997] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Revised: 04/25/2012] [Accepted: 04/26/2012] [Indexed: 12/20/2022]
Abstract
Conventionally, in its decision-making, the U.S. EPA has evaluated the effects and risks associated with a single pollutant in a single exposure medium. In reality, people are exposed to mixtures of pollutants or to the same pollutant through a variety of media, including the air, water, and food. It is now more recognized than before that environmental exposure to pollutants occurs via multiple exposure routes and pathways, including inhalation, ingestion, and dermal absorption. Moreover, chemical, biologic, radiologic, physical, and psychologic stressors are all acknowledged as affecting human health. Although many EPA offices attempt to consider cumulative risk assessment and cumulative effects in various ways, there is no Agency-wide policy for considering these risks and the effects of exposure to these risks when making environmental decisions. This article examines how U.S. courts might assess EPA's general authority and discretion to use cumulative risk assessment as the basis for developing data in support of environmental decision-making, and how courts might assess the validity of a cumulative risk assessment methodology itself.
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Daughton CG. Using biomarkers in sewage to monitor community-wide human health: isoprostanes as conceptual prototype. THE SCIENCE OF THE TOTAL ENVIRONMENT 2012; 424:16-38. [PMID: 22425170 DOI: 10.1016/j.scitotenv.2012.02.038] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 02/10/2012] [Accepted: 02/18/2012] [Indexed: 04/14/2023]
Abstract
Timely assessment of the aggregate health of small-area human populations is essential for guiding the optimal investment of resources needed for preventing, avoiding, controlling, or mitigating exposure risks. Seeking those interventions yielding the greatest benefit with respect to allocation of resources is essential for making progress toward community sustainability, promoting social justice, and maintaining or improving health and well-being. More efficient approaches are needed for revealing cause-effect linkages between environmental stressors and human health and for measuring overall aggregate health of small-area populations. A new concept is presented--community health assessment via Sewage Chemical Information Mining (SCIM)--for quickly gauging overall, aggregate health status or trends for entire small-area populations. The approach--BioSCIM--would monitor raw sewage for specific biomarkers broadly associated with human disease, stress, or health. A wealth of untapped chemical information resides in raw sewage, a portion comprising human biomarkers of exposure and effects. BioSCIM holds potential for capitalizing on the presence of biomarkers in sewage for accomplishing any number of objectives. One of the many potential applications of BioSCIM could use various biomarkers of stress resulting from the collective excretion from all individuals in a local population. A prototype example is presented using a class of biomarkers that measures collective, systemic oxidative stress--the isoprostanes (prostaglandin-like free-radical catalyzed oxidation products from certain polyunsaturated fatty acids). Sampling and analysis of raw sewage hold great potential for quickly determining aggregate biomarker levels for entire communities. Presented are the basic principles of BioSCIM, together with its anticipated limitations, challenges, and potential applications in assessing community-wide health. Community health assessment via BioSCIM could allow rapid assessments and intercomparisons of health status among distinct populations, revealing hidden or emerging trends or disparities and aiding in evaluating correlations (or hypotheses) between stressor exposures and disease.
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Affiliation(s)
- Christian G Daughton
- Environmental Sciences Division, National Exposure Research Laboratory, US Environmental Protection Agency, 944 East Harmon Avenue, Las Vegas, NV 89119, USA.
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Sexton K. Cumulative risk assessment: an overview of methodological approaches for evaluating combined health effects from exposure to multiple environmental stressors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:370-90. [PMID: 22470298 PMCID: PMC3315252 DOI: 10.3390/ijerph9020370] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 01/23/2012] [Accepted: 01/23/2012] [Indexed: 12/22/2022]
Abstract
Systematic evaluation of cumulative health risks from the combined effects of multiple environmental stressors is becoming a vital component of risk-based decisions aimed at protecting human populations and communities. This article briefly examines the historical development of cumulative risk assessment as an analytical tool, and discusses current approaches for evaluating cumulative health effects from exposure to both chemical mixtures and combinations of chemical and nonchemical stressors. A comparison of stressor-based and effects-based assessment methods is presented, and the potential value of focusing on viable risk management options to limit the scope of cumulative evaluations is discussed. The ultimate goal of cumulative risk assessment is to provide answers to decision-relevant questions based on organized scientific analysis; even if the answers, at least for the time being, are inexact and uncertain.
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Affiliation(s)
- Ken Sexton
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas, School of Public Health, Brownsville Regional Campus, 80 Fort Brown, Brownsville, TX 78520, USA.
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Chahine T, Schultz BD, Zartarian VG, Xue J, Subramanian SV, Levy JI. Modeling joint exposures and health outcomes for cumulative risk assessment: the case of radon and smoking. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2011; 8:3688-711. [PMID: 22016710 PMCID: PMC3194111 DOI: 10.3390/ijerph8093688] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 09/05/2011] [Accepted: 09/06/2011] [Indexed: 11/16/2022]
Abstract
Community-based cumulative risk assessment requires characterization of exposures to multiple chemical and non-chemical stressors, with consideration of how the non-chemical stressors may influence risks from chemical stressors. Residential radon provides an interesting case example, given its large attributable risk, effect modification due to smoking, and significant variability in radon concentrations and smoking patterns. In spite of this fact, no study to date has estimated geographic and sociodemographic patterns of both radon and smoking in a manner that would allow for inclusion of radon in community-based cumulative risk assessment. In this study, we apply multi-level regression models to explain variability in radon based on housing characteristics and geological variables, and construct a regression model predicting housing characteristics using U.S. Census data. Multi-level regression models of smoking based on predictors common to the housing model allow us to link the exposures. We estimate county-average lifetime lung cancer risks from radon ranging from 0.15 to 1.8 in 100, with high-risk clusters in areas and for subpopulations with high predicted radon and smoking rates. Our findings demonstrate the viability of screening-level assessment to characterize patterns of lung cancer risk from radon, with an approach that can be generalized to multiple chemical and non-chemical stressors.
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Affiliation(s)
- Teresa Chahine
- Harvard School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA 02215, USA; E-Mails: (SV.S.); (J.I.L.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-617-669-2235; Fax: +1-617-384-8859
| | - Bradley D. Schultz
- US Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, Research Triangle Park, NC 27711, USA; E-Mails: (B.D.S.); (V.G.Z.); (J.P.X.)
| | - Valerie G. Zartarian
- US Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, Research Triangle Park, NC 27711, USA; E-Mails: (B.D.S.); (V.G.Z.); (J.P.X.)
| | - Jianping Xue
- US Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, Research Triangle Park, NC 27711, USA; E-Mails: (B.D.S.); (V.G.Z.); (J.P.X.)
| | - SV Subramanian
- Harvard School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA 02215, USA; E-Mails: (SV.S.); (J.I.L.)
| | - Jonathan I. Levy
- Harvard School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA 02215, USA; E-Mails: (SV.S.); (J.I.L.)
- Boston University School of Public Health, 715 Albany Street, Talbot Building, Boston, MA 02118, USA
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