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Fisher JA, Medgyesi DN, Deziel NC, Nuckols JR, Ward MH, Jones RR. Residential proximity to dioxin-emitting facilities and risk of non-Hodgkin lymphoma in the NIH-AARP Diet and Health Study. ENVIRONMENT INTERNATIONAL 2024; 188:108767. [PMID: 38795658 PMCID: PMC11218044 DOI: 10.1016/j.envint.2024.108767] [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: 02/20/2024] [Revised: 05/19/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND Polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) are persistent organic pollutants emitted from industrial sources. Residential proximity to these emissions has been associated with risk of non-Hodgkin lymphoma (NHL) in a limited number of studies. METHODS We evaluated associations between residential proximity to PCDD/F-emitting facilities and NHL in the NIH-AARP Diet and Health Study (N = 451,410), a prospective cohort enrolled in 1995-1996 in 6 states and 2 U.S. cities. We linked enrollment addresses with a U.S. Environmental Protection Agency database of 4,478 historical PCDD/F sources with estimated toxic equivalency quotient (TEQ) emissions. We evaluated associations between NHL and exposures during a historical period prior to enrollment (1980-1995) using an average emissions index, weighted by toxicity, distance, and wind direction (AEI-W [g TEQ/km2]) within 3-, 5- and 10 km of residences. We also evaluated proximity-only metrics indicating the presence/absence of one or more facilities within each distance, and metrics calculated separately for each facility type. We used Cox regression to estimate associations (hazard ratio, HR; 95 % confidence interval, 95 %CI) with NHL and major subtypes, adjusting for demographic, lifestyle, and dietary factors. RESULTS A total of 6,467 incident cases of NHL were diagnosed through 2011. Participants with an AEI-W ≥ 95th percentile had elevated risk of NHL compared to those unexposed at 3 km (HR = 1.16; 95 %CI = 0.89-1.52; p-trend = 0.24), 5 km (HR = 1.20;95 %CI = 0.99-1.46;p-trend = 0.05) and 10 km (HR = 1.15; 95 %CI = 0.99-1.34; p-trend = 0.04). We found a positive association at 5 km with follicular lymphoma (HR≥95vs.0 = 1.62; 95 %CI = 0.98-2.67; p-trend = 0.05) and a suggestive association for diffuse large B-cell lymphoma (HR≥95vs.0 = 1.40; 95 %CI = 0.91-2.14; p-trend = 0.11). NHL risk was also associated with high emissions from coal-fired power plants within 10 km (HR≥95vs.0 = 1.42; 95 %CI = 1.09-1.84; p-trend = 0.05). CONCLUSIONS Residential proximity to relatively high dioxin emissions from industrial sources may increase the risk of NHL and specific subtypes.
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Affiliation(s)
- Jared A Fisher
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
| | - Danielle N Medgyesi
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Nicole C Deziel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - John R Nuckols
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; JRN Environmental Health Sciences, Ltd, North Bethesda, MD, USA
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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Madrigal JM, Flory A, Fisher JA, Sharp E, Graubard BI, Ward MH, Jones RR. Sociodemographic inequities in the burden of carcinogenic industrial air emissions in the United States. J Natl Cancer Inst 2024; 116:737-744. [PMID: 38180898 PMCID: PMC11077313 DOI: 10.1093/jnci/djae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Industrial facilities are not located uniformly across communities in the United States, but how the burden of exposure to carcinogenic air emissions may vary across population characteristics is unclear. We evaluated differences in carcinogenic industrial pollution among major sociodemographic groups in the United States and Puerto Rico. METHODS We evaluated cross-sectional associations of population characteristics including race and ethnicity, educational attainment, and poverty at the census tract level with point-source industrial emissions of 21 known human carcinogens using regulatory data from the US Environmental Protection Agency. Odds ratios and 95% confidence intervals comparing the highest emissions (tertile or quintile) to the referent group (zero emissions [ie, nonexposed]) for all sociodemographic characteristics were estimated using multinomial, population density-adjusted logistic regression models. RESULTS In 2018, approximately 7.4 million people lived in census tracts with nearly 12 million pounds of carcinogenic air releases. The odds of tracts having the greatest burden of benzene, 1,3-butadiene, ethylene oxide, formaldehyde, trichloroethylene, and nickel emissions compared with nonexposed were 10%-20% higher for African American populations, whereas White populations were up to 18% less likely to live in tracts with the highest emissions. Among Hispanic and Latino populations, odds were 16%-21% higher for benzene, 1,3-butadiene, and ethylene oxide. Populations experiencing poverty or with less than high school education were associated with up to 51% higher burden, irrespective of race and ethnicity. CONCLUSIONS Carcinogenic industrial emissions disproportionately impact African American and Hispanic and Latino populations and people with limited education or experiencing poverty thus representing a source of pollution that may contribute to observed cancer disparities.
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Affiliation(s)
- Jessica M Madrigal
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD, USA
| | | | - Jared A Fisher
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD, USA
| | - Elizabeth Sharp
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD, USA
| | - Barry I Graubard
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD, USA
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD, USA
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD, USA
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Tsai MH, Moore JX, Cabral DN, Rogers CR, Cortes J. Temporal trends in early-onset colorectal cancer incidence (2000-2020) by age group and five geographic regions in the state of Georgia. Am J Cancer Res 2024; 14:182-191. [PMID: 38323294 PMCID: PMC10839312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/08/2023] [Indexed: 02/08/2024] Open
Abstract
The increase of early-onset colorectal cancer (CRC) among younger adults is a major public health concern. However, little is known about variations in CRC incidence across different age groups within small geographic areas in Georgia. We examined temporal trends of CRC incidence in Clayton, East Central, West Central, Northeast, and Southeast regions, by age groups. Annual incidence rates for CRC in individuals aged 15+ years during 2000-2020 in the five regions of Georgia were included. Temporal trends were examined within the five regions and stratified by age group. Joinpoint regression was employed to calculate the annual percent change and corresponding 95% confidence intervals (CIs). Among 20,215 CRC diagnoses, CRC incidence declined over time for East Central (-2.33%; 95% CI, -3.03, -1.64), Northeast (-1.63%; 95% CI, -2.15, -1.04), Southeast (-1.63%; 95% CI, -2.30, -0.96), and West Central (-1.53%; 95% CI, -2.04, -1.03) Georgia. In the 15-44 age group, a notable increase of CRC incidence was found in Clayton, Northeast, and Southeast regions with a range of 2.2%-3.4%. However, adults aged 60+ years experienced a significant decrease in CRC incidence for most Georgia regions (all p-value <0.05), except for the Clayton region. In conclusion, CRC incidence declined during 2000-2020 in most Georgia regions. However, early-onset CRC is a major concern in Georgia as young adults (<45 years) living in Clayton, Northeast, and Southeast Georgia experienced significant annual increases in CRC incidence. Targeted CRC screening and awareness campaigns should be prioritized for adults <45 years and in the most impacted areas in Georgia.
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Affiliation(s)
- Meng-Han Tsai
- Cancer Prevention, Control and Population Health Program, Georgia Cancer Center, Augusta UniversityAugusta, GA, USA
- Georgia Prevention Institute, Augusta UniversityAugusta, GA, USA
| | - Justin X Moore
- Center for Health Equity Transformation, Department of Behavioral Science and Internal Medicine, Markey Cancer Center, University of Kentucky College of MedicineLexington, KY, USA
| | - Daramola N Cabral
- Department of Health, Human Services and Public Policy, College of Health Sciences and Human Services, California State UniversityMonterey Bay, Seaside, CA, USA
- African Caribbean Cancer ConsortiumPhiladelphia, PA, USA
| | - Charles R Rogers
- Institute for Health and Equity, Medical College of WisconsinMilwaukee, WI, USA
| | - Jorge Cortes
- Georgia Cancer Center, Augusta UniversityAugusta, GA, USA
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White AJ, Fisher JA, Sweeney MR, Freedman ND, Kaufman JD, Silverman DT, Jones RR. Ambient fine particulate matter and breast cancer incidence in a large prospective US cohort. J Natl Cancer Inst 2024; 116:53-60. [PMID: 37691174 PMCID: PMC11045029 DOI: 10.1093/jnci/djad170] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Fine particulate matter (PM2.5) has been inconsistently associated with breast cancer incidence, however, few studies have considered historic exposure when levels were higher. METHODS Outdoor residential PM2.5 concentrations were estimated using a nationwide spatiotemporal model for women in the National Institutes of Health-AARP Diet and Health Study, a prospective cohort located in 6 states (California, Florida, Louisiana, New Jersey, North Carolina, and Pennsylvania) and 2 metropolitan areas (Atlanta, GA, and Detroit, MI) and enrolled in 1995-1996 (n = 196 905). Annual average PM2.5 concentrations were estimated for a 5-year historical period 10 years prior to enrollment (1980-1984). We used Cox regression to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between a 10 µg/m3 increase in PM2.5 and breast cancer incidence overall and by estrogen receptor status and catchment area. RESULTS With follow-up of participants through 2017, a total of 15 870 breast cancer cases were identified. A 10 ug/m3 increase in PM2.5 was statistically significantly associated with overall breast cancer incidence (HR = 1.08, 95% CI = 1.02 to 1.13). The association was evident for estrogen receptor-positive (HR = 1.10, 95% CI = 1.04 to 1.17) but not estrogen receptor-negative tumors (HR = 0.97, 95% CI = 0.84 to 1.13; Pheterogeneity = .3). Overall breast cancer hazard ratios were more than 1 across the catchment areas, ranging from a hazard ratio of 1.26 (95% CI = 0.96 to 1.64) for North Carolina to a hazard ratio of 1.04 (95% CI = 0.68 to 1.57) for Louisiana (Pheterogeneity = .9). CONCLUSIONS In this large US cohort with historical air pollutant exposure estimates, PM2.5 was associated with risk of estrogen receptor-positive breast cancer. State-specific estimates were imprecise but suggest that future work should consider region-specific associations and the potential contribution of PM2.5 chemical constituency in modifying the observed association.
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Affiliation(s)
- Alexandra J White
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Jared A Fisher
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Marina R Sweeney
- Social & Scientific Systems, Inc, a DLH Holdings Company, Durham, NC, USA
| | - Neal D Freedman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Joel D Kaufman
- Department of Environmental & Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
| | - Debra T Silverman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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Njoku A, Sawadogo W, Frimpong P. Racial and Ethnic Disparities in Cancer Occurrence and Outcomes in Rural United States: A Scoping Review. Cancer Control 2024; 31:10732748241261558. [PMID: 38857181 PMCID: PMC11165954 DOI: 10.1177/10732748241261558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 05/09/2024] [Accepted: 05/21/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Cancer is the second-leading cause of death in the United States. Most studies have reported rural versus urban and Black versus White cancer disparities. However, few studies have investigated racial disparities in rural areas. OBJECTIVE We conducted a literature review to explore the current state of knowledge on racial and ethnic disparities in cancer attitudes, knowledge, occurrence, and outcomes in rural United States. METHODS A systematic search of PubMed and Embase was performed. Peer-reviewed articles published in English from 2004-2023 were included. Three authors independently reviewed the articles and reached a consensus. RESULTS After reviewing 993 articles, a total of 30 articles met the inclusion criteria and were included in the present review. Studies revealed that underrepresented racial and ethnic groups in rural areas were more likely to have low cancer-related knowledge, low screening, high incidence, less access to treatment, and high mortality compared to their White counterparts. CONCLUSION Underrepresented racial and ethnic groups in rural areas experienced a high burden of cancer. Improving social determinants of health may help reduce cancer disparities and promote health.
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Affiliation(s)
- Anuli Njoku
- Department of Public Health, College of Health and Human Services, Southern Connecticut State University, New Haven, CT, USA
| | - Wendemi Sawadogo
- Department of Public Health, College of Health and Human Services, Southern Connecticut State University, New Haven, CT, USA
| | - Princess Frimpong
- Department of Public Health, College of Health and Human Services, Southern Connecticut State University, New Haven, CT, USA
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Robinson-Oghogho JN, Alcaraz KI, Thorpe RJ. Structural Racism as a Contributor to Lung Cancer Incidence and Mortality Rates Among Black Populations in the United States. Cancer Control 2024; 31:10732748241248363. [PMID: 38698674 PMCID: PMC11067682 DOI: 10.1177/10732748241248363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/15/2024] [Accepted: 04/03/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Although racial disparities in lung cancer incidence and mortality have diminished in recent years, lung cancer remains the second most diagnosed cancer among US Black populations. Many factors contributing to disparities in lung cancer are rooted in structural racism. To quantify this relationship, we examined associations between a multidimensional measure of county-level structural racism and county lung cancer incidence and mortality rates among Black populations, while accounting for county levels of environmental quality. METHODS We merged 2016-2020 data from the United States Cancer Statistics Data Visualization Tool, a pre-existing county-level structural racism index, the Environmental Protection Agency's 2006-2010 Environmental Quality Index (EQI), 2023 County Health Rankings, and the 2021 United States Census American Community Survey. We conducted multivariable linear regressions to examine associations between county-level structural racism and county-level lung cancer incidence and mortality rates. RESULTS Among Black males and females, each standard deviation increase in county-level structural racism score was associated with an increase in county-level lung cancer incidence of 6.4 (95% CI: 4.4, 8.5) cases per 100,000 and an increase of 3.3 (95% CI: 2.0, 4.6) lung cancer deaths per 100,000. When examining these associations stratified by sex, larger associations between structural racism and lung cancer rates were observed among Black male populations than among Black females. CONCLUSION Structural racism contributes to both the number of new lung cancer cases and the number of deaths caused by lung cancer among Black populations. Those aiming to reduce lung cancer cases and deaths should consider addressing racism as a root-cause.
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Affiliation(s)
- Joelle N. Robinson-Oghogho
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kassandra I. Alcaraz
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA
| | - Roland J. Thorpe
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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7
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O'Kelley L, Swanson B, Bishop-Royse JC. Integrative literature review: Ethylene oxide exposure signs and symptoms. Public Health Nurs 2023; 40:790-809. [PMID: 37254592 DOI: 10.1111/phn.13216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/14/2023] [Accepted: 05/17/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Although ethylene oxide (EtO) gas is designated as a human carcinogen, extant literature reports mixed findings on the health effects of exposure. The disparate findings may reflect industry bias as many studies were funded by a large chemical industry lobby. OBJECTIVE To conduct an integrative review of studies free from industry bias to facilitate compilation of a comprehensive list of reported signs and symptoms of EtO exposure. METHODS We reviewed 1887 papers of which 42 articles met inclusion criteria. The authors conducted this review in accordance with PRISMA guidelines. The presence of bias was assessed using Joanna Briggs Institute checklists. RESULTS Non-industry biased literature confirmed serious adverse health effects associated with EtO exposure at the occupational, hospital, and community level. EtO represents a carcinogen, neurotoxin, and respiratory irritant. CONCLUSION After removal of industry-biased studies, EtO was unequivocally found to pose a threat to human health. There remains a gap in the number of studies examining community-level exposure, which is essential to understanding the impact of EtO. Given that EtO-emitting facilities are concentrated in diverse and disadvantaged communities, further study of EtO exposure health effects is warranted to inform public policy on toxic air emissions.
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Affiliation(s)
- Linda O'Kelley
- The College of Nursing, Rush University, Chicago, Illinois
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Casey M, Odhiambo L, Aggarwal N, Shoukier M, Islam KM, Cortes J. Representation of the population in need for pivotal clinical trials in lymphomas. Blood 2023; 142:846-855. [PMID: 37363870 DOI: 10.1182/blood.2023020052] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 06/28/2023] Open
Abstract
Despite the advances in cancer outcomes, significant health disparities persist. Several new agents have been recently approved for treatment of lymphomas, leading to improved outcomes. Extending the benefits of these new agents starts by adequate enrollment of all affected patient populations. This study aimed to evaluate the extent to which randomized controlled trials (RCTs) match the demographic and geographic diversity of the population affected by lymphoma. Two Food and Drug Administration databases, clinicaltrials.gov, and relevant primary manuscripts were reviewed for drug approval data and demographic representation in RCTs for classical Hodgkin lymphoma (cHL) and non-Hodgkin lymphoma. Maps showing the distribution and frequency of trial participation relative to disease burden, insurance status, and racial representation were created. Black, Hispanic, and female patients were significantly underrepresented in the RCTs for lymphoma compared with that for the disease burden (3.6% [95% confidence interval (CI), 2.8-5.4] vs 14.6% [95% CI, 13.8-15.3]; 6.7% [95% CI, 5.5-7.9] vs 16.3% [95% CI, 15.5-17.1]; and 39.1% [95% CI, 37.3-40.9] vs 42.7% [95% CI, 42.3-43.1], respectively). White and male patients were overrepresented. More counties with higher mortality rates and racial minority representation had low access to the trials, particularly for cHL in the southern region of the United States. There are significant racial misrepresentations in pivotal RCTs in the United States, and geographic distribution of these trials may not provide easy access to all patients in need. Disparities in enrollment should be corrected to make results applicable to all populations.
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Affiliation(s)
- Mycal Casey
- Department of Internal Medicine, Medical College of Georgia at Augusta University, Augusta, GA
| | - Lorriane Odhiambo
- Institute of Public Health and Preventive Health, Augusta University, Augusta, GA
| | - Nidhi Aggarwal
- Medical College of Georgia at Augusta University, Augusta, GA
| | - Mahran Shoukier
- Division of Hematology and Oncology, Georgia Cancer Center at Augusta University, Augusta, GA
| | - K M Islam
- Institute of Public Health and Preventive Health, Augusta University, Augusta, GA
- Medical College of Georgia at Augusta University, Augusta, GA
| | - Jorge Cortes
- Division of Hematology and Oncology, Georgia Cancer Center at Augusta University, Augusta, GA
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Larsen K, Rydz E, Peters CE. Inequalities in Environmental Cancer Risk and Carcinogen Exposures: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095718. [PMID: 37174236 PMCID: PMC10178444 DOI: 10.3390/ijerph20095718] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/11/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023]
Abstract
Background: Cancer is the leading cause of death in Canada and a major cause of death worldwide. Environmental exposure to carcinogens and environments that may relate to health behaviors are important to examine as they can be modified to lower cancer risks. Built environments include aspects such as transit infrastructure, greenspace, food and tobacco environments, or land use, which may impact how people move, exercise, eat, and live. While environments may play a role in overall cancer risk, exposure to carcinogens or healthier environments is not equitably spread across space. Exposures to carcinogens commonly concentrate among socially and/or economically disadvantaged populations. While many studies have examined inequalities in exposure or cancer risk, this has commonly been for one exposure. Methods: This scoping review collected and synthesized research that examines inequities in carcinogenic environments and exposures. Results: This scoping review found that neighborhoods with higher proportions of low-income residents, racialized people, or same-sex couples had higher exposures to carcinogens and environments that may influence cancer risk. There are currently four main themes in research studying inequitable exposures: air pollution and hazardous substances, tobacco access, food access, and other aspects of the built environment, with most research still focusing on air pollution. Conclusions: More work is needed to understand how exposures to these four areas intersect with other factors to reduce inequities in exposures to support longer-term goals toward cancer prevention.
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Affiliation(s)
- Kristian Larsen
- Health Canada, Office of Environmental Health, Healthy Environments and Consumer Safety Branch, Environmental and Radiation Health Science Directorate, Ottawa, ON K1A 0K9, Canada
- CAREX Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Department of Geography and Planning, University of Toronto, Toronto, ON M5S 3G3, Canada
- Department of Geography and Environmental Studies, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
| | - Ela Rydz
- CAREX Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Cheryl E Peters
- CAREX Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Prevention, Screening and Hereditary Cancer, BC Cancer, Vancouver, BC V5Z 4E6, Canada
- Population and Public Health, British Columbia Centre for Disease Control, Vancouver, BC V5Z 4R4, Canada
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Lord BD, Harris AR, Ambs S. The impact of social and environmental factors on cancer biology in Black Americans. Cancer Causes Control 2023; 34:191-203. [PMID: 36562901 DOI: 10.1007/s10552-022-01664-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
Low socioeconomic status (SES) is associated with early onset of chronic diseases and reduced life expectancy. The involvement of neighborhood-level factors in defining cancer risk and outcomes for marginalized communities has been an active area of research for decades. Yet, the biological processes that underlie the impact of SES on chronic health conditions, such as cancer, remain poorly understood. To date, limited studies have shown that chronic life stress is more prevalent in low SES communities and can affect important molecular processes implicated in tumor biology such as DNA methylation, inflammation, and immune response. Further efforts to elucidate how neighborhood-level factors function physiologically to worsen cancer outcomes for disadvantaged communities are underway. This review provides an overview of the current literature on how socioenvironmental factors within neighborhoods contribute to more aggressive tumor biology, specifically in Black U.S. women and men, including the impact of environmental pollutants, neighborhood deprivation, social isolation, structural racism, and discrimination. We also summarize commonly used methods to measure deprivation, discrimination, and structural racism at the neighborhood-level in cancer health disparities research. Finally, we offer recommendations to adopt a multi-faceted intersectional approach to reduce cancer health disparities and develop effective interventions to promote health equity.
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Affiliation(s)
- Brittany D Lord
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bldg. 37/Room 3050, Bethesda, MD, 20892-4258, USA.
| | - Alexandra R Harris
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bldg. 37/Room 3050, Bethesda, MD, 20892-4258, USA
| | - Stefan Ambs
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bldg. 37/Room 3050, Bethesda, MD, 20892-4258, USA
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11
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Shreves AH, Buller ID, Chase E, Creutzfeldt H, Fisher JA, Graubard BI, Hoover RN, Silverman DT, Devesa SS, Jones RR. Geographic Patterns in U.S. Lung Cancer Mortality and Cigarette Smoking. Cancer Epidemiol Biomarkers Prev 2023; 32:193-201. [PMID: 36413442 PMCID: PMC9905286 DOI: 10.1158/1055-9965.epi-22-0253] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/08/2022] [Accepted: 11/11/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Despite the success of smoking cessation campaigns, lung cancer remains the leading cause of cancer death in the U.S. Variations in smoking behavior and lung cancer mortality are evident by sex and region. METHODS Applying geospatial methods to lung cancer mortality data from the National Vital Statistics System and county-level estimates of smoking prevalences from the NCI's Small Area Estimates of Cancer-Related Measures, we evaluated patterns in lung cancer mortality rates (2005-2018) in relation to patterns in ever cigarette smoking prevalences (1997-2003). RESULTS Overall, ever smoking spatial patterns were generally associated with lung cancer mortality rates, which were elevated in the Appalachian region and lower in the West for both sexes. However, we also observed geographic variation in mortality rates that is not explained by smoking. Using Lee's L statistic for assessing bivariate spatial association, we identified counties where the ever smoking prevalence was low and lung cancer rates were high. We observed a significant cluster of counties (n = 25; P values ranging from 0.001 to 0.04) with low ever smoking prevalence and high mortality rates among females around the Mississippi River region south of St. Louis, Missouri and a similar and smaller cluster among males in Western Mississippi (n = 12; P values ranging from 0.002 to 0.03) that has not been previously described. CONCLUSIONS Our analyses identified U.S. counties where factors other than smoking may be driving lung cancer mortality. IMPACT These novel findings highlight areas where investigation of environmental and other risk factors for lung cancer is needed.
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Affiliation(s)
- Alaina H Shreves
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.,Trans-Divisional Research Program, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
| | - Ian D Buller
- Occupational and Environmental Epidemiology Branch, DCEG, NCI, NIH Bethesda, Maryland.,Cancer Prevention Fellowship Program, Division of Cancer Prevention, NCI, NIH, Bethesda, Maryland
| | - Elizabeth Chase
- Biostatistics Branch, DCEG, NCI, NIH, Bethesda, Maryland.,Department of Biostatistics, University of Michigan School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Hannah Creutzfeldt
- Occupational and Environmental Epidemiology Branch, DCEG, NCI, NIH Bethesda, Maryland.,Fielding School of Public Health, University of California Los Angeles, Los Angeles, California
| | - Jared A Fisher
- Occupational and Environmental Epidemiology Branch, DCEG, NCI, NIH Bethesda, Maryland
| | | | | | - Debra T Silverman
- Occupational and Environmental Epidemiology Branch, DCEG, NCI, NIH Bethesda, Maryland
| | - Susan S Devesa
- Infections and Immunology Branch, DCEG, NCI, NIH, Bethesda, Maryland
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12
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Guo L, Wright ME, Osias MC, Vaezi M, Hughes MC. Creation and Evaluation of the Illinois Cancer Risk Index as a Predictor of Four Common Cancers. Prev Chronic Dis 2022; 19:E75. [DOI: 10.5888/pcd19.220104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Lei Guo
- School of Interdisciplinary Health Professions, Northern Illinois University, DeKalb, Illinois
| | | | - Meredith C. Osias
- School of Health Studies, Northern Illinois University, DeKalb, Illinois
| | - Mahdi Vaezi
- Department of Engineering Technology, Northern Illinois University, DeKalb, Illinois
| | - M. Courtney Hughes
- School of Health Studies, Northern Illinois University, DeKalb, Illinois
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13
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Neighborhood disadvantage and lung cancer risk in a national cohort of never smoking Black women. Lung Cancer 2022; 173:21-27. [PMID: 36108579 PMCID: PMC9588723 DOI: 10.1016/j.lungcan.2022.08.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/25/2022] [Accepted: 08/30/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Compared to women of other races who have never smoked, Black women have a higher risk of lung cancer. Whether neighborhood disadvantage, which Black women experience at higher rates than other women, is linked to never-smoking lung cancer risk remains unclear. This study investigates the association of neighborhood disadvantage and lung cancer risk in Black never-smoking women. METHODS AND MATERIALS This research utilized data from the Black Women's Health Study, a prospective cohort of 59,000 Black women recruited from across the US in 1995 and followed by biennial questionnaires. Associations of lung cancer incidence with neighborhood-level factors (including two composite variables derived from Census Bureau data: neighborhood socioeconomic status and neighborhood concentrated disadvantage), secondhand smoke exposure, and PM2.5 were estimated using Fine-Gray subdistribution hazard models. RESULTS Among 37,650 never-smokers, 77 were diagnosed with lung cancer during follow-up from 1995 to 2018. The adjusted subdistribution hazard ratio (sHR) of lung cancer incidence with ten unit increase in neighborhood concentrated disadvantage index was 1.30 (95 % CI: 1.04, 1.63, p = 0.023). Exposure to secondhand smoke at work was associated with increased risk (sHR = 1.93, 95 % CI: 1.21, 3.10, p = 0.006), but exposure to secondhand smoke at home and PM2.5 was not. CONCLUSION Worse neighborhood concentrated disadvantage was associated with increased lung cancer risk in Black women who never smoked. These findings suggest that non-tobacco-related factors in disadvantaged neighborhoods may be linked to lung cancer risk in Black women and that these factors must be understood and targeted to achieve health equity.
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14
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Resnik DB. Environmental justice and climate change policies. BIOETHICS 2022; 36:735-741. [PMID: 35488802 PMCID: PMC9391311 DOI: 10.1111/bioe.13042] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/04/2022] [Indexed: 06/14/2023]
Abstract
Climate change is an environmental justice issue because it is likely to cause disproportionate harm to low-income countries and low-income populations in higher-income countries. While climate change mitigation and adaptation policies may be able to minimize these harms, they could make them worse unless they are developed and implemented with an eye toward promoting justice and fairness. Those who view climate change as an environmental justice issue should be wary of endorsing policies that sound like they promote the cause of social and economic justice, but in fact do not. While climate change policies may help to mitigate the effects of climate change on poor people, there is no guarantee that they will be just at the local, national, or global level. Those who care about global climate justice must remain actively engaged in policy formation and implementation to ensure that justice does not get shortchanged in the response to global warming.
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Affiliation(s)
- David B Resnik
- National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA
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15
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Spatio-Temporal Variation-Induced Group Disparity of Intra-Urban NO 2 Exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105872. [PMID: 35627409 PMCID: PMC9141847 DOI: 10.3390/ijerph19105872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/17/2022]
Abstract
Previous studies on exposure disparity have focused more on spatial variation but ignored the temporal variation of air pollution; thus, it is necessary to explore group disparity in terms of spatio-temporal variation to assist policy-making regarding public health. This study employed the dynamic land use regression (LUR) model and mobile phone signal data to illustrate the variation features of group disparity in Shanghai. The results showed that NO2 exposure followed a bimodal, diurnal variation pattern and remained at a high level on weekdays but decreased on weekends. The most critical at-risk areas were within the central city in areas with a high population density. Moreover, women and the elderly proved to be more exposed to NO2 pollution in Shanghai. Furthermore, the results of this study showed that it is vital to focus on land-use planning, transportation improvement programs, and population agglomeration to attenuate exposure inequality.
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16
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Colorectal Cancer in Younger Adults. Hematol Oncol Clin North Am 2022; 36:449-470. [DOI: 10.1016/j.hoc.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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17
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Roberts JD, Dickinson KL, Hendricks MD, Jennings V. "I Can't Breathe": Examining the Legacy of American Racism on Determinants of Health and the Ongoing Pursuit of Environmental Justice. Curr Environ Health Rep 2022; 9:211-227. [PMID: 35244891 PMCID: PMC8894549 DOI: 10.1007/s40572-022-00343-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 12/03/2022]
Abstract
Purpose of Review “I can’t breathe” were the last words spoken by Eric Garner (July 17, 2014), Javier Ambler (March 28, 2019), Elijah McClain (August 30, 2019), Manuel Ellis (March 3, 2020), and George Floyd (May 25, 2020). These were all African American men who died at the hands of police in the United States. Recently, police brutality has gained critical and overdue attention as one clear manifestation of systemic racism. However, historical and current policies related to a wide range of environmental hazards have exposed Black, Indigenous, and People of Color (BIPOC) to disproportionately high levels of physical, mental, social, emotional, and cultural toxicities, thus creating unbreathable and unlivable communities. Recent Findings This paper traces the roots of systemic anti-Black racism in America from its origins in the 1400s, through systems of scientific racism that pathologized Blackness in order to justify slavery, and through evolving policies and structures that have shifted over time but consistently exposed many African American communities to unsafe and unhealthy environments. Summary We conclude with calls for bold solutions to move through and past this oppressive history and toward true environmental justice the enables all communities to thrive together.
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Affiliation(s)
- Jennifer D Roberts
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, 20742, USA.
| | - Katherine L Dickinson
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz, Aurora, CO, 80045, USA
| | - Marccus D Hendricks
- Department of Urban Studies and Planning, School of Architecture, Planning and Preservation, University of Maryland, College Park, MD, 20742, USA
| | - Viniece Jennings
- Department of Public Health, Agnes Scott College, Decatur, GA, 30030, USA
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18
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A multiscale analysis of social and spatial determinants of cancer and noncancer hazards from on-road air pollution in Texas. Spat Spatiotemporal Epidemiol 2022; 41:100484. [DOI: 10.1016/j.sste.2022.100484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 01/17/2022] [Accepted: 01/20/2022] [Indexed: 11/22/2022]
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19
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Ashing KT, Jones V, Bedell F, Phillips T, Erhunmwunsee L. Calling Attention to the Role of Race-Driven Societal Determinants of Health on Aggressive Tumor Biology: A Focus on Black Americans. JCO Oncol Pract 2022; 18:15-22. [PMID: 34255546 PMCID: PMC8758120 DOI: 10.1200/op.21.00297] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Blacks have the highest incidence and mortality from most cancers. The reasons for these disparities remain unclear. Blacks are exposed to adverse social determinants because of historic and contemporary racist polices; however, how these determinants affect the disparities that Blacks experience is understudied. As a result of discriminatory community policies, like redlining, Blacks have higher exposure to air pollution and neighborhood deprivation. Studies investigating how these factors affect tumor biology are emerging. We highlight the literature that connects racism-related community exposure to the tumor biology in breast, lung, prostate, and colorectal cancer. Further investigations that clarify the link between adverse social determinants that result from systemic racism and aggressive tumor biology are required if health equity is to be achieved. Without recognition that racism is a public health risk with carcinogenic impact, health care delivery and cancer care will never achieve excellence. In response, health systems ought to establish corrective actions to improve Black population health and bring medical justice to marginalized racialized groups.
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Affiliation(s)
- Kimlin T. Ashing
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA,African-Caribbean Cancer Consortium, Fox Chase Cancer Center, Philadelphia, PA,Kimlin T. Ashing, PhD, CCARE—Department of Population Sciences, City of Hope Comprehensive Cancer Center, 1500 E Duarte Rd, Duarte, CA 91010-3000; e-mail:
| | - Veronica Jones
- African-Caribbean Cancer Consortium, Fox Chase Cancer Center, Philadelphia, PA
| | - Fornati Bedell
- Division of Urology and Urologic Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Tanyanika Phillips
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Loretta Erhunmwunsee
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA,Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA
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20
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Dickinson KL, Roberts JD, Banacos N, Neuberger L, Koebele E, Blanch-Hartigan D, Shanahan EA. Structural Racism and the COVID-19 Experience in the United States. Health Secur 2021; 19:S14-S26. [PMID: 34076499 DOI: 10.1089/hs.2021.0031] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The long, fallacious history of attributing racial disparities in public health outcomes to biological inferiority or poor decision making persists in contemporary conversations about the COVID-19 pandemic. Given the disproportionate impacts of this pandemic on communities of color, it is essential for scholars, practitioners, and policymakers to focus on how structural racism drives these disparate outcomes. In May and June 2020, we conducted a 6-state online survey to examine racial/ethnic differences in exposure to COVID-19, risk mitigation behaviors, risk perceptions, and COVID-19 impacts. Results show that Black and Hispanic individuals were more likely than White respondents to experience factors associated with structural racism (eg, living in larger households, going to work in person, using public transportation) that, by their very nature, increase the likelihood of exposure to COVID-19. Controlling for other demographic and socioeconomic characteristics, non-White respondents were equally or more likely than White respondents to take protective actions against COVID-19, including keeping distance from others and wearing masks. Black and Hispanic respondents also perceived higher risks of dying of the disease and of running out of money due to the pandemic, and 40% of Black respondents reported knowing someone who had died of COVID-19 at a time when the US death toll had just surpassed 100,000 people. To manage the current pandemic and prepare to combat future health crises in an effective, equitable, and antiracist manner, it is imperative to understand the structural factors perpetuating racial inequalities in the COVID-19 experience.
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Affiliation(s)
- Katherine L Dickinson
- Katherine L. Dickinson, PhD, is an Assistant Professor and Natalie Banacos, MS, is a Professional Research Assistant; both in the Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz, Aurora, CO. Jennifer D. Roberts, DrPH, is an Assistant Professor, Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD. Lindsay Neuberger, PhD, is an Associate Professor, Nicholson School of Communication and Media, University of Central Florida, Orlando, FL. Elizabeth Koebele, PhD, is an Assistant Professor, Department of Political Science, University of Nevada, Reno, Reno, NV. Danielle Blanch-Hartigan, PhD, MPH, is Associate Professor of Health Studies, Department of Natural and Applied Sciences, Bentley University, Waltham, MA. Elizabeth A. Shanahan, DA, MPA, MS, is a Professor and Associate Vice President of Research Development, Department of Political Science, Montana State University, Bozeman, MT
| | - Jennifer D Roberts
- Katherine L. Dickinson, PhD, is an Assistant Professor and Natalie Banacos, MS, is a Professional Research Assistant; both in the Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz, Aurora, CO. Jennifer D. Roberts, DrPH, is an Assistant Professor, Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD. Lindsay Neuberger, PhD, is an Associate Professor, Nicholson School of Communication and Media, University of Central Florida, Orlando, FL. Elizabeth Koebele, PhD, is an Assistant Professor, Department of Political Science, University of Nevada, Reno, Reno, NV. Danielle Blanch-Hartigan, PhD, MPH, is Associate Professor of Health Studies, Department of Natural and Applied Sciences, Bentley University, Waltham, MA. Elizabeth A. Shanahan, DA, MPA, MS, is a Professor and Associate Vice President of Research Development, Department of Political Science, Montana State University, Bozeman, MT
| | - Natalie Banacos
- Katherine L. Dickinson, PhD, is an Assistant Professor and Natalie Banacos, MS, is a Professional Research Assistant; both in the Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz, Aurora, CO. Jennifer D. Roberts, DrPH, is an Assistant Professor, Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD. Lindsay Neuberger, PhD, is an Associate Professor, Nicholson School of Communication and Media, University of Central Florida, Orlando, FL. Elizabeth Koebele, PhD, is an Assistant Professor, Department of Political Science, University of Nevada, Reno, Reno, NV. Danielle Blanch-Hartigan, PhD, MPH, is Associate Professor of Health Studies, Department of Natural and Applied Sciences, Bentley University, Waltham, MA. Elizabeth A. Shanahan, DA, MPA, MS, is a Professor and Associate Vice President of Research Development, Department of Political Science, Montana State University, Bozeman, MT
| | - Lindsay Neuberger
- Katherine L. Dickinson, PhD, is an Assistant Professor and Natalie Banacos, MS, is a Professional Research Assistant; both in the Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz, Aurora, CO. Jennifer D. Roberts, DrPH, is an Assistant Professor, Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD. Lindsay Neuberger, PhD, is an Associate Professor, Nicholson School of Communication and Media, University of Central Florida, Orlando, FL. Elizabeth Koebele, PhD, is an Assistant Professor, Department of Political Science, University of Nevada, Reno, Reno, NV. Danielle Blanch-Hartigan, PhD, MPH, is Associate Professor of Health Studies, Department of Natural and Applied Sciences, Bentley University, Waltham, MA. Elizabeth A. Shanahan, DA, MPA, MS, is a Professor and Associate Vice President of Research Development, Department of Political Science, Montana State University, Bozeman, MT
| | - Elizabeth Koebele
- Katherine L. Dickinson, PhD, is an Assistant Professor and Natalie Banacos, MS, is a Professional Research Assistant; both in the Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz, Aurora, CO. Jennifer D. Roberts, DrPH, is an Assistant Professor, Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD. Lindsay Neuberger, PhD, is an Associate Professor, Nicholson School of Communication and Media, University of Central Florida, Orlando, FL. Elizabeth Koebele, PhD, is an Assistant Professor, Department of Political Science, University of Nevada, Reno, Reno, NV. Danielle Blanch-Hartigan, PhD, MPH, is Associate Professor of Health Studies, Department of Natural and Applied Sciences, Bentley University, Waltham, MA. Elizabeth A. Shanahan, DA, MPA, MS, is a Professor and Associate Vice President of Research Development, Department of Political Science, Montana State University, Bozeman, MT
| | - Danielle Blanch-Hartigan
- Katherine L. Dickinson, PhD, is an Assistant Professor and Natalie Banacos, MS, is a Professional Research Assistant; both in the Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz, Aurora, CO. Jennifer D. Roberts, DrPH, is an Assistant Professor, Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD. Lindsay Neuberger, PhD, is an Associate Professor, Nicholson School of Communication and Media, University of Central Florida, Orlando, FL. Elizabeth Koebele, PhD, is an Assistant Professor, Department of Political Science, University of Nevada, Reno, Reno, NV. Danielle Blanch-Hartigan, PhD, MPH, is Associate Professor of Health Studies, Department of Natural and Applied Sciences, Bentley University, Waltham, MA. Elizabeth A. Shanahan, DA, MPA, MS, is a Professor and Associate Vice President of Research Development, Department of Political Science, Montana State University, Bozeman, MT
| | - Elizabeth A Shanahan
- Katherine L. Dickinson, PhD, is an Assistant Professor and Natalie Banacos, MS, is a Professional Research Assistant; both in the Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz, Aurora, CO. Jennifer D. Roberts, DrPH, is an Assistant Professor, Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD. Lindsay Neuberger, PhD, is an Associate Professor, Nicholson School of Communication and Media, University of Central Florida, Orlando, FL. Elizabeth Koebele, PhD, is an Assistant Professor, Department of Political Science, University of Nevada, Reno, Reno, NV. Danielle Blanch-Hartigan, PhD, MPH, is Associate Professor of Health Studies, Department of Natural and Applied Sciences, Bentley University, Waltham, MA. Elizabeth A. Shanahan, DA, MPA, MS, is a Professor and Associate Vice President of Research Development, Department of Political Science, Montana State University, Bozeman, MT
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21
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The Intersection of Rural Residence and Minority Race/Ethnicity in Cancer Disparities in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041384. [PMID: 33546168 PMCID: PMC7913122 DOI: 10.3390/ijerph18041384] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/29/2021] [Accepted: 01/30/2021] [Indexed: 12/15/2022]
Abstract
One in every twenty-five persons in America is a racial/ethnic minority who lives in a rural area. Our objective was to summarize how racism and, subsequently, the social determinants of health disproportionately affect rural racial/ethnic minority populations, provide a review of the cancer disparities experienced by rural racial/ethnic minority groups, and recommend policy, research, and intervention approaches to reduce these disparities. We found that rural Black and American Indian/Alaska Native populations experience greater poverty and lack of access to care, which expose them to greater risk of developing cancer and experiencing poorer cancer outcomes in treatment and ultimately survival. There is a critical need for additional research to understand the disparities experienced by all rural racial/ethnic minority populations. We propose that policies aim to increase access to care and healthcare resources for these communities. Further, that observational and interventional research should more effectively address the intersections of rurality and race/ethnicity through reduced structural and interpersonal biases in cancer care, increased data access, more research on newer cancer screening and treatment modalities, and continued intervention and implementation research to understand how evidence-based practices can most effectively reduce disparities among these populations.
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22
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Stoffel EM, Murphy CC. Epidemiology and Mechanisms of the Increasing Incidence of Colon and Rectal Cancers in Young Adults. Gastroenterology 2020; 158:341-353. [PMID: 31394082 PMCID: PMC6957715 DOI: 10.1053/j.gastro.2019.07.055] [Citation(s) in RCA: 284] [Impact Index Per Article: 71.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/02/2019] [Accepted: 07/03/2019] [Indexed: 02/07/2023]
Abstract
In contrast to the decreasing incidence of colorectal cancer (CRC) in older populations, the incidence has nearly doubled in younger adults since the early 1990s. Approximately 1 in 10 new diagnoses of CRC are now made in individuals 50 years or younger. Patients' risk of CRC has been calculated largely by age and family history, yet 3 of 4 patients with early-onset CRC have no family history of the disease. Rapidly increasing incidence rates in younger people could result from generational differences in diet, environmental exposures, and lifestyle factors. We review epidemiologic trends in CRC, data on genetic and nongenetic risk factors, and new approaches for determining CRC risk. These may identify individuals likely to benefit from early screening and specialized surveillance.
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Affiliation(s)
- Elena M Stoffel
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Caitlin C Murphy
- Division of Epidemiology, Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas; Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
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23
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Ekenga CC, Yeung CY, Oka M. Cancer risk from air toxics in relation to neighborhood isolation and sociodemographic characteristics: A spatial analysis of the St. Louis metropolitan area, USA. ENVIRONMENTAL RESEARCH 2019; 179:108844. [PMID: 31708169 PMCID: PMC6901107 DOI: 10.1016/j.envres.2019.108844] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 09/15/2019] [Accepted: 10/18/2019] [Indexed: 05/27/2023]
Abstract
BACKGROUND A growing body of research has examined relationships between neighborhood characteristics and exposure to air toxics in the United States. However, a limited number of studies have addressed neighborhood isolation, a measure of spatial segregation. We investigated the spatial distribution of carcinogenic air toxics in the St. Louis metropolitan area and tested the hypothesis that neighborhood isolation and sociodemographic characteristics are associated with exposure to carcinogenic air toxics. METHODS We obtained lifetime air toxics cancer risk data from the United States Environmental Protection Agency's National Air Toxic Assessment and sociodemographic data from the American Community Survey. We used geographic information systems to identify statistically significant clusters of census tracts with elevated all-site cancer risk due to air toxics in the St. Louis metropolitan area. Relative Risks (RR) were estimated for the association between neighborhood characteristics and air toxic hot spots. Using a local spatial isolation index to evaluate residential segregation, we also evaluated the association between neighborhood racial and economic isolation and air toxic hot spots. RESULTS Approximately 14% (85 of the 615) of census tracts had elevated cancer risk due to air toxics (p < 0.01). These air toxic hot spots were independently associated with neighborhoods with high levels of poverty and unemployment and low levels of education. Census tracts with the highest levels of both racial isolation of Blacks and economic isolation of poverty were more likely to be located in air toxic hotspots than those with low combined racial and economic isolation (RR = 5.34; 95% CI = 3.10-9.22). CONCLUSIONS These findings provide strong evidence of unequal distribution of carcinogenic air toxics in the St. Louis metropolitan area. Study results may be used to inform public health efforts to eliminate sociodemographic inequalities in exposure to air pollutants.
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Affiliation(s)
| | - Cheuk Yui Yeung
- Division of Occupational and Environmental Medicine, University of California, Irvine School of Medicine, Irvine, CA, USA.
| | - Masayoshi Oka
- Faculty of Management, Josai University, Sakado, Saitama, Japan.
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24
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Terry MB, Michels KB, Brody JG, Byrne C, Chen S, Jerry DJ, Malecki KMC, Martin MB, Miller RL, Neuhausen SL, Silk K, Trentham-Dietz A. Environmental exposures during windows of susceptibility for breast cancer: a framework for prevention research. Breast Cancer Res 2019; 21:96. [PMID: 31429809 PMCID: PMC6701090 DOI: 10.1186/s13058-019-1168-2] [Citation(s) in RCA: 128] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background The long time from exposure to potentially harmful chemicals until breast cancer occurrence poses challenges for designing etiologic studies and for implementing successful prevention programs. Growing evidence from animal and human studies indicates that distinct time periods of heightened susceptibility to endocrine disruptors exist throughout the life course. The influence of environmental chemicals on breast cancer risk may be greater during several windows of susceptibility (WOS) in a woman’s life, including prenatal development, puberty, pregnancy, and the menopausal transition. These time windows are considered as specific periods of susceptibility for breast cancer because significant structural and functional changes occur in the mammary gland, as well as alterations in the mammary micro-environment and hormone signaling that may influence risk. Breast cancer research focused on these breast cancer WOS will accelerate understanding of disease etiology and prevention. Main text Despite the plausible heightened mechanistic influences of environmental chemicals on breast cancer risk during time periods of change in the mammary gland’s structure and function, most human studies of environmental chemicals are not focused on specific WOS. This article reviews studies conducted over the past few decades that have specifically addressed the effect of environmental chemicals and metals on breast cancer risk during at least one of these WOS. In addition to summarizing the broader evidence-base specific to WOS, we include discussion of the NIH-funded Breast Cancer and the Environment Research Program (BCERP) which included population-based and basic science research focused on specific WOS to evaluate associations between breast cancer risk and particular classes of endocrine-disrupting chemicals—including polycyclic aromatic hydrocarbons, perfluorinated compounds, polybrominated diphenyl ethers, and phenols—and metals. We outline ways in which ongoing transdisciplinary BCERP projects incorporate animal research and human epidemiologic studies in close partnership with community organizations and communication scientists to identify research priorities and effectively translate evidence-based findings to the public and policy makers. Conclusions An integrative model of breast cancer research is needed to determine the impact and mechanisms of action of endocrine disruptors at different WOS. By focusing on environmental chemical exposure during specific WOS, scientists and their community partners may identify when prevention efforts are likely to be most effective.
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Affiliation(s)
- Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 1611, New York, NY, 10032, USA
| | - Karin B Michels
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Drive South, CHS 71-254, Los Angeles, CA, 90095, USA
| | | | - Celia Byrne
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road A-1039F, Bethesda, MD, 20814, USA
| | - Shiuan Chen
- Department of Cancer Biology, Beckman Research Institute of City of Hope, 1450 E. Duarte Road, Duarte, CA, 91010, USA
| | - D Joseph Jerry
- Pioneer Valley Life Sciences Institute and Department of Veterinary & Animal Sciences, University of Massachusetts Amherst, 661 North Pleasant St., Amherst, MA, 01003, USA
| | - Kristen M C Malecki
- Department of Population Health Sciences and the Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut St., WARF Room 605, Madison, WI, 53726, USA
| | - Mary Beth Martin
- Departments of Oncology and Biochemistry & Molecular Biology, Georgetown University Medical Center, E411 New Research Building, Washington, DC, 20057, USA
| | - Rachel L Miller
- Departments of Medicine, Pediatrics, Environmental Health Sciences; Vagelos College of Physicians and Surgeons, Mailman School of Public Health, Columbia University, PH8E-101B, 630 W. 168th St, New York, NY, 10032, USA
| | - Susan L Neuhausen
- Department of Population Sciences, Beckman Research Institute of City of Hope, 1450 E. Duarte Road, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Kami Silk
- Department of Communication, University of Delaware, 250 Pearson Hall, 125 Academy St, Newark, DE, 19716, USA
| | - Amy Trentham-Dietz
- Department of Population Health Sciences and Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut St., WARF Room 307, Madison, WI, 53726, USA.
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Examining the Association between Socioeconomic Status and Exposure to Carcinogenic Emissions in Gyeonggi of South Korea: A Multi-Level Analysis. SUSTAINABILITY 2019. [DOI: 10.3390/su11061777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although South Korea introduced the Pollutant Release and Transfer Register system in 1996, there is relatively limited evidence on how socioeconomic status at both individual and municipal levels is associated with exposure to toxic chemicals in Korea because of limited data sources. Using a multi-level negative binomial model, this study examined the socioeconomic status of both individuals and municipalities with a higher level of exposure to carcinogenic emissions from industrial facilities in Gyeonggi province, South Korea. The results reveal that economic minority individuals (national basic livelihood security recipients, unemployed people, and tenants), municipalities with higher percentages of industrial land use, and foreign-born populations had more facilities that produce carcinogenic emissions. While similar findings have been reported by many environmental justice studies conducted in other countries, this is the first Korean case study that reports the relationship between socioeconomic status at both individual and municipal levels and exposure to toxic chemicals.
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Xue Z, Jia C. A Model-to-Monitor Evaluation of 2011 National-Scale Air Toxics Assessment (NATA). TOXICS 2019; 7:E13. [PMID: 30857354 PMCID: PMC6468659 DOI: 10.3390/toxics7010013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/05/2019] [Accepted: 03/05/2019] [Indexed: 12/31/2022]
Abstract
Environmental research has widely utilized the ambient concentrations of hazardous air pollutants (HAPs) modeled by the National-Scale Air Toxics Assessment (NATA) program; however, limited studies have evaluated the model's performance. This study aims to evaluate the model-to-monitor agreement of the 2011 NATA data with the monitoring data reported to the U.S. Environmental Protection Agency's (EPA) Air Quality System (AQS). Concentrations of 27 representative HAPs measured at 274 sites in the U.S. in 2011 were merged with NATA data by census tract. The comparison consisted of two steps for each HAP: first, the model-monitor difference at each site was compared with the limit of quantitation (LOQ); second, the modeled annual average was compared to the 95% confidence interval of the monitored annual average. Nationally, NATA could predict national medians of most HAPs well; however, it was unable to capture high concentrations. At individual sites, a large portion of model-monitor differences was below the LOQs, indicating they were unquantifiable. Model-to-monitor agreement displayed inconsistent patterns in terms of chemical groups or EPA regions and was strongly impacted by the comparison methods. The substantial non-agreements of NATA predictions with monitoring data require caution in environmental epidemiology and justice studies that are based on NATA data.
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Affiliation(s)
- Zhuqing Xue
- School of Public Health, University of Memphis, Memphis, TN 38152, USA.
| | - Chunrong Jia
- School of Public Health, University of Memphis, Memphis, TN 38152, USA.
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Relation between Observed and Perceived Traffic Noise and Socio-Economic Status in Urban Blocks of Different Characteristics. URBAN SCIENCE 2018. [DOI: 10.3390/urbansci2010020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Bhambra GK. Brexit, Trump, and 'methodological whiteness': on the misrecognition of race and class. THE BRITISH JOURNAL OF SOCIOLOGY 2017; 68 Suppl 1:S214-S232. [PMID: 29114873 DOI: 10.1111/1468-4446.12317] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 09/07/2017] [Indexed: 06/07/2023]
Abstract
The rhetoric of both the Brexit and Trump campaigns was grounded in conceptions of the past as the basis for political claims in the present. Both established the past as constituted by nations that were represented as 'white' into which racialized others had insinuated themselves and gained disproportionate advantage. Hence, the resonant claim that was broadcast primarily to white audiences in each place 'to take our country back'. The politics of both campaigns was also echoed in those social scientific analyses that sought to focus on the 'legitimate' claims of the 'left behind' or those who had come to see themselves as 'strangers in their own land'. The skewing of white majority political action as the action of a more narrowly defined white working class served to legitimize analyses that might otherwise have been regarded as racist. In effect, I argue that a pervasive 'methodological whiteness' has distorted social scientific accounts of both Brexit and Trump's election victory and that this needs to be taken account of in our discussion of both phenomena.
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Bulka C, Nastoupil LJ, Koff JL, Bernal-Mizrachi L, Ward KC, Williams JN, Bayakly AR, Switchenko JM, Waller LA, Flowers CR. Relations Between Residential Proximity to EPA-Designated Toxic Release Sites and Diffuse Large B-Cell Lymphoma Incidence. South Med J 2017; 109:606-614. [PMID: 27706495 DOI: 10.14423/smj.0000000000000545] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Examining the spatial patterns of diffuse large B-cell lymphoma (DLBCL) incidence and residential proximity to toxic release locations may provide insight regarding environmental and sociodemographic risk factors. METHODS We linked and geocoded cancer incidence data for the period 1999-2008 from the Georgia Comprehensive Cancer Registry with population data from the US Census and the Environmental Protection Agency's Toxics Release Inventory. We conducted cluster analyses and constructed Poisson regression models to assess DLBCL incidence as a function of mean distance to the toxic release sites. RESULTS In total, 3851 incident DLBCL cases occurred among adults residing in Georgia between 1999 and 2008. Significant focal clustering was observed around 57% of ethylene oxide sites, 5% of benzene sites, 9% of tetrachloroethylene sites, 7% of styrene sites, 10% of formaldehyde sites, 5% of trichloroethylene sites, and 10% of all release sites. Mean distance to sites was significantly associated with DLBCL risk for all chemicals. CONCLUSIONS Proximity to Toxics Release Inventory sites can be linked to increased DLBCL risk as assessed through focal clustering and Poisson regression, and confirmatory studies using geospatial mapping can aid in further specifying risk factors for DLBCL.
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Affiliation(s)
- Catherine Bulka
- From the Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, the University of Texas MD Anderson Cancer Center, Houston, the Departments of Hematology and Oncology and Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, and the Departments of Epidemiology and Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, and the Georgia Department of Public Health, Atlanta
| | - Loretta J Nastoupil
- From the Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, the University of Texas MD Anderson Cancer Center, Houston, the Departments of Hematology and Oncology and Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, and the Departments of Epidemiology and Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, and the Georgia Department of Public Health, Atlanta
| | - Jean L Koff
- From the Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, the University of Texas MD Anderson Cancer Center, Houston, the Departments of Hematology and Oncology and Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, and the Departments of Epidemiology and Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, and the Georgia Department of Public Health, Atlanta
| | - Leon Bernal-Mizrachi
- From the Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, the University of Texas MD Anderson Cancer Center, Houston, the Departments of Hematology and Oncology and Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, and the Departments of Epidemiology and Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, and the Georgia Department of Public Health, Atlanta
| | - Kevin C Ward
- From the Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, the University of Texas MD Anderson Cancer Center, Houston, the Departments of Hematology and Oncology and Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, and the Departments of Epidemiology and Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, and the Georgia Department of Public Health, Atlanta
| | - Jessica N Williams
- From the Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, the University of Texas MD Anderson Cancer Center, Houston, the Departments of Hematology and Oncology and Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, and the Departments of Epidemiology and Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, and the Georgia Department of Public Health, Atlanta
| | - A Rana Bayakly
- From the Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, the University of Texas MD Anderson Cancer Center, Houston, the Departments of Hematology and Oncology and Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, and the Departments of Epidemiology and Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, and the Georgia Department of Public Health, Atlanta
| | - Jeffrey M Switchenko
- From the Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, the University of Texas MD Anderson Cancer Center, Houston, the Departments of Hematology and Oncology and Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, and the Departments of Epidemiology and Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, and the Georgia Department of Public Health, Atlanta
| | - Lance A Waller
- From the Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, the University of Texas MD Anderson Cancer Center, Houston, the Departments of Hematology and Oncology and Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, and the Departments of Epidemiology and Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, and the Georgia Department of Public Health, Atlanta
| | - Christopher R Flowers
- From the Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, the University of Texas MD Anderson Cancer Center, Houston, the Departments of Hematology and Oncology and Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, and the Departments of Epidemiology and Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, and the Georgia Department of Public Health, Atlanta
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Chitewere T, Shim JK, Barker JC, Yen IH. How Neighborhoods Influence Health: Lessons to be learned from the application of political ecology. Health Place 2017; 45:117-123. [PMID: 28342425 DOI: 10.1016/j.healthplace.2017.03.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 02/23/2017] [Accepted: 03/07/2017] [Indexed: 01/09/2023]
Abstract
AIM This paper articulates how political ecology can be a useful tool for asking fundamental questions and applying relevant methods to investigate structures that impact relationship between neighborhood and health. Through a narrative analysis, we identify how political ecology can develop our future agendas for neighborhood-health research as it relates to social, political, environmental, and economic structures. Political ecology makes clear the connection between political economy and neighborhood by highlighting the historical and structural processes that produce and maintain social inequality, which affect health and well-being. These concepts encourage researchers to examine how people construct neighborhood and health in different ways that, in turn, can influence different health outcomes and, thus, efforts to address solutions.
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Affiliation(s)
- Tendai Chitewere
- San Francisco State University, Department of Geography & Environment, 1600 Holloway Avenue, San Francisco, CA 94132, USA.
| | - Janet K Shim
- University of California, San Francisco, Department of Social and Behavioral Sciences, USA
| | - Judith C Barker
- University of California, San Francisco, Department of Anthropology, History and Social Medicine, USA
| | - Irene H Yen
- University of California, San Francisco, Department of Medicine, Division of General Internal Medicine, USA
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Ruiz-Rudolph P, Arias N, Pardo S, Meyer M, Mesías S, Galleguillos C, Schiattino I, Gutiérrez L. Impact of large industrial emission sources on mortality and morbidity in Chile: A small-areas study. ENVIRONMENT INTERNATIONAL 2016; 92-93:130-138. [PMID: 27104670 DOI: 10.1016/j.envint.2016.03.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 03/19/2016] [Accepted: 03/29/2016] [Indexed: 06/05/2023]
Abstract
Chile suffers significant pollution from large industrial emitters associated with the mining, metal processing, paper production, and energy industries. The aim of this research was to determine whether the presence of large industrial facilities (i.e. coal- and oil-fired power plants, pulp and paper mills, mining facilities, and smelters) affects mortality and morbidity rates in Chile. For this, we conducted an ecological study that used Chilean communes as small-area observation units to assess mortality and morbidity. Public databases provided information on large pollution sources relevant to Chile. The large sources studied were oil- and coal-fired power plants, copper smelters, pulp and paper mills, and large mining facilities. Large sources were filtered by first year of production, type of process, and size. Mortality and morbidity data were acquired from public national databases, with morbidity being estimated from hospitalization records. Cause-specific rates were calculated for the main outcomes: cardiovascular, respiratory, cancer; and other more specific health outcomes. The impact of the large pollution sources was estimated using Bayesian models that included spatial correlation, overdispersion, and other covariates. Large and significant increases in health risks (around 20%-100%) were found for communes with power plants and smelters for total, cardiovascular, respiratory, all-cancer, and lung cancer mortality. Higher hospitalization rates for cardiovascular disease, respiratory disease, cancer, and pneumonia (20-100%) were also found for communes with power plants and smelters. The impacts were larger for men than women in terms of both mortality and hospitalizations. The impacts were also larger when the sources were analyzed as continuous (production volume) rather than dichotomous (presence/absence) variables. In conclusion, significantly higher rates of total cardiovascular, respiratory, all-cancer and lung cancer mortality and cardiovascular, respiratory, cancer and pneumonia hospitalizations were observed in communes with power plants and smelters.
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Affiliation(s)
- Pablo Ruiz-Rudolph
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile.
| | - Nelson Arias
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile; Departamento de Salud Pública, Universidad de Caldas, Carrera 25 N° 48-56, Manizales, Colombia
| | - Sandra Pardo
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Pedro de Valdivia 641, Providencia, Santiago, Chile
| | - Marianne Meyer
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile
| | - Stephanie Mesías
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile
| | - Claudio Galleguillos
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile
| | - Irene Schiattino
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile
| | - Luis Gutiérrez
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile
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Wang KL, Huang WC, Chou JC, Weng TC, Hu S, Lieu FK, Lai WH, Idova G, Wang PS, Wang SW. Effects of acrolein on aldosterone release from zona glomerulosa cells in male rats. Steroids 2016; 111:89-94. [PMID: 26980145 DOI: 10.1016/j.steroids.2016.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 03/09/2016] [Accepted: 03/11/2016] [Indexed: 10/22/2022]
Abstract
A positive correlation between smoking and hypertension has been well established. Acrolein is a major toxic volatile compound found in cigarette smoke. Human exposure to low levels of acrolein is unavoidable due to its production in daily activities, such as smoke from industrial, hot oil cooking vapors, and exhaust fumes from vehicles. The toxicity and the action mechanism of acrolein to induce apoptosis have been extensively studied, but the effects of acrolein on hypertension are still unknown. The present study aimed to examine the effects of acrolein on aldosterone release both in vivo and in vitro. Male rats were divided into three groups, and intraperitoneally injected with normal saline, or acrolein (2mg/kg) for 1 (group A-1) or 3 (group A-3) days, respectively. After sacrificing, rat blood samples were obtained to measure plasma aldosterone and angiotensin II (Ang II) levels. Zona glomerulosa (ZG) cells were prepared from rat adrenal cortex, and were incubated with or without stimulants. We found that the serum aldosterone was increased by 1.2-fold (p<0.05) in A-3 group as compared to control group. Basal aldosterone release from ZG cells in A-3 group was also increased significantly. Moreover, acrolein enhanced the stimulatory effects of Ang II and 8-bromo-cyclic AMP on aldosterone secretion from ZG cells prepared in both A-1 and A-3 groups. Furthermore, the enzyme activity of P450scc, the rate-limiting step of aldosterone synthesis, was elevated after acrolein injection. Plasma level of Ang II was increased in both A-1 and A-3 groups. These results suggested that acrolein exposure increased aldosterone production, at least in part, through elevating the level of plasma Ang II and stimulating steroidogenesis pathways.
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Affiliation(s)
- Kai-Lee Wang
- Department of Physiology, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan; School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan
| | - Wen-Ching Huang
- Department of Physiology, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan
| | - Jou-Chun Chou
- Medical Center of Aging Research, China Medical University Hospital, Taichung 40402, Taiwan
| | - Ting-Chun Weng
- Medical Center of Aging Research, China Medical University Hospital, Taichung 40402, Taiwan
| | - Sindy Hu
- Aesthetic Medical Center, Department of Dermatology, Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33333, Taiwan
| | - Fu-Kong Lieu
- Department of Rehabilitation, Cheng Hsin General Hospital, Taipei 11283, Taiwan
| | - Wei-Ho Lai
- Department of Rehabilitation, Cheng Hsin General Hospital, Taipei 11283, Taiwan
| | - Galina Idova
- State Scientific Research Institute of Physiology and Basic Medicine, Timacova Street, 4, Novosibirsk 630117, Russia
| | - Paulus S Wang
- Department of Physiology, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan; Medical Center of Aging Research, China Medical University Hospital, Taichung 40402, Taiwan; Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei 11217, Taiwan; Department of Biotechnology, Asia University, Taichung 41354, Taiwan.
| | - Shyi-Wu Wang
- Department of Physiology and Pharmacology, College of Medicine, Chang-Gung University, Taoyuan 33333, Taiwan; Aesthetic Medical Center, Department of Dermatology, Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan.
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Nance E, King D, Wright B, Bullard RD. Ambient air concentrations exceeded health-based standards for fine particulate matter and benzene during the Deepwater Horizon oil spill. JOURNAL OF THE AIR & WASTE MANAGEMENT ASSOCIATION (1995) 2016; 66:224-36. [PMID: 26565439 DOI: 10.1080/10962247.2015.1114044] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
UNLABELLED The Deepwater Horizon oil spill is considered one of the largest marine oil spills in the history of the United States. Air emissions associated with the oil spill caused concern among residents of Southeast Louisiana. The purpose of this study was to assess ambient concentrations of benzene (n=3,887) and fine particulate matter (n=102,682) during the oil spill and to evaluate potential exposure disparities in the region. Benzene and fine particulate matter (PM2.5) concentrations in the targeted parishes were generally higher following the oil spill, as expected. Benzene concentrations reached 2 to 19 times higher than background, and daily exceedances of PM2.5 were 10 to 45 times higher than background. Both benzene and PM2.5 concentrations were considered high enough to exceed public health criteria, with measurable exposure disparities in the coastal areas closer to the spill and clean-up activities. These findings raise questions about public disclosure of environmental health risks associated with the oil spill. The findings also provide a science-based rationale for establishing health-based action levels in future disasters. IMPLICATIONS Benzene and particulate matter monitoring during the Deepwater Horizon oil spill revealed that ambient air quality was a likely threat to public health and that residents in coastal Louisiana experienced significantly greater exposures than urban residents. Threshold air pollution levels established for the oil spill apparently were not used as a basis for informing the public about these potential health impacts. Also, despite carrying out the most comprehensive air monitoring ever conducted in the region, none of the agencies involved provided integrated analysis of the data or conclusive statements about public health risk. Better information about real-time risk is needed in future environmental disasters.
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Affiliation(s)
- Earthea Nance
- a Texas Southern University , Barbara Jordan-Mickey Leland School of Public Affairs , Houston , TX , USA
| | - Denae King
- a Texas Southern University , Barbara Jordan-Mickey Leland School of Public Affairs , Houston , TX , USA
| | - Beverly Wright
- b Dillard University , Deep South Center for Environmental Justice , New Orleans , LA , USA
| | - Robert D Bullard
- a Texas Southern University , Barbara Jordan-Mickey Leland School of Public Affairs , Houston , TX , USA
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Quach T, Liu R, Nelson DO, Hurley S, Von Behren J, Hertz A, Reynolds P. Disaggregating data on Asian American and Pacific Islander women to provide new insights on potential exposures to hazardous air pollutants in California. Cancer Epidemiol Biomarkers Prev 2015; 23:2218-28. [PMID: 25368397 DOI: 10.1158/1055-9965.epi-14-0468] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The Asian American and Pacific Islander (AAPI) population is heterogeneous and rapidly growing in the United States, with a high proportion concentrated in California. Although traditionally assumed to have lower rates of breast cancer than non-Hispanic white women, recent studies have suggested considerable variation in incidence by AAPI ethnic group, with rates in some exceeding those in non-Hispanic whites. The potential role of environmental toxicants has not been well explored and may provide insights into these patterns. METHODS We created an exposure potential index (EPI) score for 24 hazardous air pollutants modeled by the U.S. Environmental Protection Agency National-Scale Air Toxics Assessment considered to be mammary gland carcinogens, and compared values at the census tract level for "geographically concentrated" AAPI groups throughout the State. "Geographically concentrated" populations were defined as census tracts with at least 100 individuals from a specified racial/ethnic population as enumerated by the 2000 Census. RESULTS Although EPI scores differed little between census tracts with aggregated AAPI (mean EPI = 0.53) and non-Hispanic white women (mean EPI = 0.63), there was substantial variation between tracts for disaggregated AAPI groups, with notably higher EPI scores for tracts enumerated for Korean or Japanese women (mean EPI of 0.78 and 0.77, respectively) compared with other AAPI groups. CONCLUSIONS Our findings underscore the importance of disaggregating data for the heterogeneous AAPI population to identify differences in potential environmental exposures across groups. IMPACT Future cancer etiology studies should examine environmental exposure differences within and across groups for the diverse AAPI population.
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Affiliation(s)
- Thu Quach
- Cancer Prevention Institute of California, Berkeley, California. Department of Health Research and Policy, School of Medicine, Stanford University, Stanford, California.
| | - Ruiling Liu
- Cancer Prevention Institute of California, Berkeley, California
| | - David O Nelson
- Cancer Prevention Institute of California, Berkeley, California. Department of Health Research and Policy, School of Medicine, Stanford University, Stanford, California
| | - Susan Hurley
- Cancer Prevention Institute of California, Berkeley, California
| | | | - Andrew Hertz
- Cancer Prevention Institute of California, Berkeley, California
| | - Peggy Reynolds
- Cancer Prevention Institute of California, Berkeley, California. Department of Health Research and Policy, School of Medicine, Stanford University, Stanford, California
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Black carbon exposure, socioeconomic and racial/ethnic spatial polarization, and the Index of Concentration at the Extremes (ICE). Health Place 2015; 34:215-28. [PMID: 26093080 DOI: 10.1016/j.healthplace.2015.05.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Revised: 05/09/2015] [Accepted: 05/12/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Scant data quantify associations between economic and racial/ethnic spatial polarization and individual's exposure to pollution. METHODS We linked data on the socioeconomic position (SEP) of 1757 urban working class white, black, and Latino adults (age 25-64; Boston, MA: 2003-2004; 2008-2010) to: (1) spatiotemporal model-based estimates of cumulative black carbon exposure at their exact residential address, and (2) their census tract values for the Index of Concentration at the Extremes (ICE) for SEP and race/ethnicity. RESULTS ICE measures, but not individual- and household-SEP, remained independently associated with black carbon exposure. CONCLUSIONS The ICE may be useful for environmental health research.
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Patil RR, Chetlapally SK, Bagvandas M. Application environmental epidemiology to vehicular air pollution and health effects research. Indian J Occup Environ Med 2015; 19:8-13. [PMID: 26023265 PMCID: PMC4446943 DOI: 10.4103/0019-5278.156999] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Vehicular pollution is one of the major contributors to the air pollution in urban areas and perhaps and accounts for the major share of anthropogenic green-house gases such as carbon dioxide, carbon monoxide, nitrogen oxides. Knowledge of human health risks related to environmental exposure to vehicular pollution is a current concern. Analyze the range health effects are attributed varied constituents of vehicular air pollution examine evidence for a causal association to specific health effect. In many instances scenario involves exposure to very low doses of putative agents for extended periods, sometimes the period could mean over a lifetime of an individual and yet may result in small increase in health risk that may be imperceptible. Secondary data analysis and literature review. In environmental exposures, traditional epidemiological approaches evaluating mortality and morbidity indicators display many limiting factors such as nonspecificity of biological effects latency time between exposure and magnitude of the effect. Long latency period between exposure and resultant disease, principally for carcinogenic effects and limitation of epidemiological studies for detecting small risk increments. The present paper discusses the methodological challenges in studying vehicular epidemiology and highlights issues that affect the validity of epidemiological studies in vehicular pollution.
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Affiliation(s)
- Rajan R Patil
- Division of Epidemiology, School of Public Health, SRM University, Chennai, Tamil Nadu, India
| | | | - M Bagvandas
- School of Public Health, SRM University, Chennai, Tamil Nadu, India
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Jia C, James W, Kedia S. Relationship of racial composition and cancer risks from air toxics exposure in Memphis, Tennessee, U.S.A. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:7713-24. [PMID: 25089776 PMCID: PMC4143828 DOI: 10.3390/ijerph110807713] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 07/11/2014] [Accepted: 07/24/2014] [Indexed: 11/25/2022]
Abstract
African Americans in the U.S. often live in poverty and segregated urban neighborhoods, many of which have dense industrial facilities resulting in high exposure to harmful air toxics. This study aims to explore the relationship between racial composition and cancer risks from air toxics exposure in Memphis/Shelby County, Tennessee, U.S.A. Air toxics data were obtained from 2005 National Air Toxics Assessment (NATA), and the demographic data, including racial composition, were extracted from the 2000 United States Census. The association was examined using multivariable geographically weighted regression (GWR) analysis. The risk difference between African American and White concentrated areas was defined as the absolute disparity, and the percent difference as the relative disparity. GWR analyses show that cancer risks increase with respect to increasing percent of African Americans at the census tract level. Individuals in African American concentrated tracts bear 6% more cancer risk burden than in White concentrated tracts. The distribution of major roads causes the largest absolute disparity and the distribution of industrial facilities causes the largest relative disparity. Effective strategies for reduction in environmental disparity should especially target sources of large absolute disparities.
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Affiliation(s)
- Chunrong Jia
- School of Public Health, University of Memphis, Memphis, TN 38152, USA.
| | - Wesley James
- Department of Sociology, University of Memphis, Memphis, TN 38152, USA.
| | - Satish Kedia
- School of Public Health, University of Memphis, Memphis, TN 38152, USA.
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Fajersztajn L, Veras M, Barrozo LV, Saldiva P. Air pollution: a potentially modifiable risk factor for lung cancer. Nat Rev Cancer 2013; 13:674-8. [PMID: 23924644 DOI: 10.1038/nrc3572] [Citation(s) in RCA: 157] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Economic growth and increased urbanization pose a new risk for cancer development: the exposure of high numbers of people to ambient air pollution. Epidemiological evidence that links air pollution to mortality from lung cancer is robust. An ability to produce high-quality scientific research that addresses these risks and the ability of local health authorities to understand and respond to these risks are basic requirements to solve the conflict between economic development and the preservation of human health. However, this is currently far from being achieved. Thus, this Science and Society article addresses the possibilities of expanding scientific networking to increase awareness of the risk of lung cancer that is promoted by air pollution.
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Affiliation(s)
- Laís Fajersztajn
- Laboratory of Experimental Air Pollution (LIM05), Department of Pathology, School of Medicine, University of São Paulo, São Paulo 01246-903, São Paulo State, Brazil
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