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Ma X, Fisher JA, McGlynn KA, Liao LM, Vasiliou V, Sun N, Kaufman JD, Silverman DT, Jones RR. Long-term exposure to ambient fine particulate matter and risk of liver cancer in the NIH-AARP Diet and Health Study. Environ Int 2024; 187:108637. [PMID: 38636274 DOI: 10.1016/j.envint.2024.108637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/18/2024] [Accepted: 04/04/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Fine particulate matter (PM2.5) exposure has been associated with liver cancer incidence and mortality in a limited number of studies. We sought to evaluate this relationship for the first time in a U.S. cohort with historical exposure assessment. METHODS We used spatiotemporal prediction models to estimate annual average historical PM2.5 concentrations (1980-2015) at residential addresses of 499,729 participants in the NIH-AARP Diet and Health Study, a cohort in 6 states (California, Florida, Louisiana, New Jersey, North Carolina, and Pennsylvania) and 2 metropolitan areas (Atlanta, Georgia, and Detroit, Michigan) enrolled in 1995-1996 and followed up through 2017. We used a time-varying Cox model to estimate the association for liver cancer and the predominant histologic type, hepatocellular carcinoma (HCC), per 5 µg/m3 increase in estimated outdoor PM2.5 levels, incorporating a 5-year average, lagged 10 years prior to cancer diagnosis and adjusting for age, sex, race/ethnicity, education level and catchment state. We also evaluated PM2.5 interactions with hypothesized effect modifiers. RESULTS We observed a non-significantly increased risk of liver cancer associated with estimated PM2.5 exposure (Hazard ratio [HR] = 1.05 [0.96-1.14], N = 1,625); associations were slightly stronger for HCC, (84 % of cases; HR = 1.08 [0.98-1.18]). Participants aged 70 or older at enrollment had an increased risk of liver cancer versus other age groups (HR = 1.50 [1.01-2.23]); p-interaction = 0.01) and risk was elevated among participants who did not exercise (HR = 1.81 [1.22-2.70]; p-interaction = 0.01). We found no evidence of effect modification by sex, smoking status, body mass index, diabetes status, or alcohol consumption (p-interaction > 0.05). CONCLUSIONS Our findings in this large cohort suggest that residential ambient PM2.5 levels may be associated with liver cancer risk. Further exploration of the variation in associations by age and physical activity are important areas for future research.
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Affiliation(s)
- Xiuqi Ma
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Jared A Fisher
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Katherine A McGlynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Vasilis Vasiliou
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Ning Sun
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Debra T Silverman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Rena R Jones
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA.
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Thomas AL, Rhee J, Fisher JA, Horner MJ, Jones RR. Fine particulate matter, noise pollution, and greenspace and prostate cancer risk in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial Cohort. Cancer Epidemiol Biomarkers Prev 2024:741850. [PMID: 38497801 DOI: 10.1158/1055-9965.epi-23-1413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/09/2024] [Accepted: 03/12/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Greenspace is hypothesized as being protective against cancer, whereas noise pollution and fine particulate matter (<2.5 µm in diameter, PM2.5) are both potential risk factors. Findings from recent studies of greenspace and PM2.5 with prostate cancer are not conclusive and the association between noise exposure and cancer has not been evaluated in a U.S. STUDY METHODS We assessed PM2.5, noise, and greenspace exposure using spatiotemporal models and satellite-based estimates at enrollment addresses for N=43,184 male participants of the prospective Prostate, Lung, Colorectal, and Ovarian Cancer (PLCO) Screening Trial cohort (enrolled 1994-2001). We used Cox regression models adjusted for age, race and ethnicity, study center, family history of prostate cancer, and Area Deprivation Index to estimate associations between ambient PM2.5 (µg/m3), greenspace (index range from -1 to 1), and noise pollution (loudest 10% of total existing sound, decibels) and incident prostate cancer risk through December 2017. RESULTS A total of 6,327 cases of prostate cancer were diagnosed among male participants during follow-up. PM2.5 and noise exposures were moderately positively correlated (Spearman's rho=0.46), and PM2.5 and greenspace were not correlated (ρ=0.10); greenspace and noise were inversely correlated (ρ=-0.32). In single-pollutant and multipollutant models mutually adjusted for co-exposures, we found no associations with prostate cancer risk. CONCLUSION We did not find evidence that PM2.5, greenspace, and noise pollution were associated with prostate cancer risk in this large, geographically spread cohort. IMPACT This study contributes to a small body of existing literature investigating these biologically plausible associations.
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Affiliation(s)
| | - Jongeun Rhee
- National Cancer Institute, Rockville, MD, United States
| | | | | | - Rena R Jones
- National Cancer Institute, Rockville, MD, United States
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Jones RR, Fisher JA, Hasheminassab S, Kaufman JD, Freedman ND, Ward MH, Sioutas C, Vermeulen R, Hoek G, Silverman DT. Outdoor Ultrafine Particulate Matter and Risk of Lung Cancer in Southern California. Am J Respir Crit Care Med 2024; 209:307-315. [PMID: 37856832 PMCID: PMC10840777 DOI: 10.1164/rccm.202305-0902oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/19/2023] [Indexed: 10/21/2023] Open
Abstract
Rationale: Particulate matter ⩽2.5 μm in aerodynamic diameter (PM2.5) is an established cause of lung cancer, but the association with ultrafine particulate matter (UFP; aerodynamic diameter < 0.1 μm) is unclear. Objectives: To investigate the association between UFP and lung cancer overall and by histologic subtype. Methods: The Los Angeles Ultrafines Study includes 45,012 participants aged ⩾50 years in southern California at enrollment (1995-1996) followed through 2017 for incident lung cancer (n = 1,770). We estimated historical residential ambient UFP number concentrations via land use regression and back extrapolation using PM2.5. In Cox proportional hazards models adjusted for smoking and other confounders, we estimated associations between 10-year lagged UFP (per 10,000 particles/cm3 and quartiles) and lung cancer overall and by major histologic subtype (adenocarcinoma, squamous cell carcinoma, and small cell carcinoma). We also evaluated relationships by smoking status, birth cohort, and historical duration at the residence. Measurements and Main Results: UFP was modestly associated with lung cancer risk overall (hazard ratio [HR], 1.03 [95% confidence interval (CI), 0.99-1.08]). For adenocarcinoma, we observed a positive trend among men; risk was increased in the highest exposure quartile versus the lowest (HR, 1.39 [95% CI, 1.05-1.85]; P for trend = 0.01) and was also increased in continuous models (HR per 10,000 particles/cm3, 1.09 [95% CI, 1.00-1.18]), but no increased risk was apparent among women (P for interaction = 0.03). Adenocarcinoma risk was elevated among men born between 1925 and 1930 (HR, 1.13 [95% CI, 1.02-1.26] per 10,000) but not for other birth cohorts, and was suggestive for men with ⩾10 years of residential duration (HR, 1.11 [95% CI, 0.98-1.26]). We found no consistent associations for women or other histologic subtypes. Conclusions: UFP exposure was modestly associated with lung cancer overall, with stronger associations observed for adenocarcinoma of the lung.
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Affiliation(s)
- Rena R. Jones
- Occupational and Environmental Epidemiology Branch and
| | | | - Sina Hasheminassab
- Department of Civil and Environmental Engineering, University of Southern California, Los Angeles, California
| | - Joel D. Kaufman
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington
| | - Neal D. Freedman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Mary H. Ward
- Occupational and Environmental Epidemiology Branch and
| | - Constantinos Sioutas
- Department of Civil and Environmental Engineering, University of Southern California, Los Angeles, California
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands; and
- University Medical Center Utrecht, Utrecht, the Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands; and
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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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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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:djae001. [PMID: 38180898 DOI: 10.1093/jnci/djae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [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 U.S. communities, 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 U.S. 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 U.S. Environmental Protection Agency. Odds ratios (ORs) and 95% confidence intervals (CIs) comparing the highest emissions (tertile or quintile) to the referent group (zero emissions/non-exposed) 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 to non-exposed were 10%-20% higher for African Americans, whereas White populations were up to 18% less likely to live in tracts with the highest emissions. Among Hispanics and Latinos, 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 Americans, Hispanics and Latinos, 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, Maryland, 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, Maryland, 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, Maryland, 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, Maryland, 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, Maryland, 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, Maryland, USA
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Ma X, Fisher JA, VoPham T, Vasiliou V, Jones RR. Associations between per- and polyfluoroalkyl substances, liver function, and daily alcohol consumption in a sample of U.S. adults. Environ Res 2023; 235:116651. [PMID: 37451576 PMCID: PMC10948014 DOI: 10.1016/j.envres.2023.116651] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND AND AIM Per- and polyfluoroalkyl substances (PFAS) are ubiquitous in the environment and in the serum of the U.S. POPULATION We sought to evaluate the association of PFAS independently and jointly with alcohol intake on liver function biomarkers in a sample of the U.S. general population. METHODS Using data from the National Health and Nutrition Examination Survey (2003-2016; N = 11,794), we examined the five most historically prevalent PFAS with >75% detection rates. We estimated odds ratios (OR) and 95% confidence intervals (CI) for the association between PFAS (quartiles and log-transformed continuous, ng/mL) and high levels (>95th percentile) of liver injury biomarkers using logistic regression models adjusted for key confounders. We evaluated interactions between PFAS and alcohol consumption and sex via stratified analyses and conducted sub-analyses adjusting for daily alcohol intake among those with available drinking history (N = 10,316). RESULT Serum perfluorooctanoic acid (PFOA) was positively associated with high levels of alanine transferase (ALT) without monotonic trend (ORQ4vsQ1 = 1.45, CI: 0.99-2.12; p-trend = 0.18), and with increased aspartate transaminase when modeled continuously (OR = 1.15, CI: 1.02-1.30; p-trend = 0.03). Perfluorooctane sulfonate (PFOS) and perfluorohexane sulfonate (PFHxS) were both inversely associated with alkaline phosphatase while a trend was evident only for PFHxS (p = 0.02). A non-monotonic inverse association was observed with PFOA (p-trend = 0.10). The highest quartile of PFOS was associated with high total bilirubin (TB; ORQ4vsQ1 = 1.57, CI: 1.01-2.43, p-trend = 0.02). No significant associations were found between any PFAS and γ-glutamyl transpeptidase. We found no associations for perfluorodecanoic acid and perfluorononanoic acid. We observed some suggestive interactions with alcohol intake, particularly among heavy drinkers. CONCLUSION Consistent with other studies, serum levels of PFOA, PFHxS and PFNA were positively associated with high levels of ALT, and we also observed weak positive associations between some PFAS and TB. Associations observed among heavy drinkers warrant additional evaluation.
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Affiliation(s)
- Xiuqi Ma
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
| | - Jared A Fisher
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Trang VoPham
- Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Vasilis Vasiliou
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Rena R Jones
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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Rhee J, Medgyesi DN, Fisher JA, White AJ, Sampson JN, Sandler DP, Ward MH, Jones RR. Residential proximity to dioxin emissions and risk of breast cancer in the sister study cohort. Environ Res 2023; 222:115297. [PMID: 36642125 PMCID: PMC10246344 DOI: 10.1016/j.envres.2023.115297] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 01/11/2023] [Accepted: 01/11/2023] [Indexed: 06/09/2023]
Abstract
Some dioxins are carcinogenic, but few studies have investigated the relationship between ambient polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/F) and risk of breast cancer. We evaluated associations between proximity-based residential exposure to industrial emissions of PCDD/F and breast cancer risk in a large U.S. cohort. Sister Study participants at enrollment (2003-2009) were followed for incident breast cancer through September 2018. After restricting to participants with ≥10 years of residential history prior to enrollment (n = 35,908), we generated 10-year distance- and toxic equivalency quotient (TEQ)-weighted average emissions indices (AEI [g TEQ/km2]) within 3, 5, or 10 km of participants' residences, overall and by facility type. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between AEI quartiles (vs. zero AEI) and risk of breast cancer [invasive or ductal carcinoma in situ]. There were 2670 incident breast cancer cases over 11 years (median) of follow-up. Breast cancer risk was increased for those in the highest quartile [Q] of AEI exposure within 3 km (HRQ4:1.18, 95% CI: 0.99,1.40, Ptrend = 0.03). The HR was higher for the 10-year AEI at 3 km from municipal solid waste facilities (HR ≥ median.vs.0:1.50, 95% CI: 0.98, 2.29; Ptrend = 0.07). Risk was higher among ever smokers (vs. never smokers) in the top quartile of the 3 km AEI (HRQ4:1.41, 95% CI:1.12,1.77, Ptrend = 0.003; Pinteraction = 0.03) and higher risk for ER negative tumors was suggested (HRQ4:1.47, 95% CI: 0.95, 2.28, Ptrend = 0.07, Pheterogeneity = 0.17). Our findings suggest that residential exposure to PCDD/F emissions may confer an increased risk of breast cancer.
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Affiliation(s)
- Jongeun Rhee
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), 9609 Medical Center Drive, Rockville, MD, United States.
| | - Danielle N Medgyesi
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), 9609 Medical Center Drive, Rockville, MD, United States
| | - Jared A Fisher
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), 9609 Medical Center Drive, Rockville, MD, United States
| | - Alexandra J White
- Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), NIH, A323, David P Rall Building, 111 Tw Alexander Drive, Research Triangle Park, NC, United States
| | - Joshua N Sampson
- Biostatistics Branch, DCEG, NCI, NIH, 9609 Medical Center Drive, Rockville, MD, United States
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), NIH, A323, David P Rall Building, 111 Tw Alexander Drive, Research Triangle Park, NC, United States
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), 9609 Medical Center Drive, Rockville, MD, United States
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), 9609 Medical Center Drive, Rockville, MD, United States
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Medgyesi DN, Trabert B, Fisher JA, Xiao Q, James P, White AJ, Madrigal JM, Jones RR. Outdoor light at night and risk of endometrial cancer in the NIH-AARP diet and health study. Cancer Causes Control 2023; 34:181-187. [PMID: 36222982 DOI: 10.1007/s10552-022-01632-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 09/15/2022] [Indexed: 01/28/2023]
Abstract
PURPOSE Outdoor light at night (LAN) can result in circadian disruption and hormone dysregulation and is a suspected risk factor for some cancers. Our study is the first to evaluate the association between LAN and risk of endometrial cancer, a malignancy with known relationship to circulating estrogen levels. METHODS We linked enrollment addresses (1996) for 97,677 postmenopausal women in the prospective NIH-AARP cohort to satellite imagery of nighttime radiance to estimate LAN exposure. Multivariable Cox models estimated hazard ratios (HR) and 95% confidence intervals (95% CI) for LAN quintiles and incident endometrial cancer overall (1,669 cases) and endometrioid adenocarcinomas (991 cases) through follow-up (2011). We tested for interaction with established endometrial cancer risk factors. RESULTS We observed no association for endometrial cancer overall (HRQ1vsQ5 0.92; 95% CI 0.78-1.08; p trend = 0.67) or endometrioid adenocarcinoma (HRQ1vsQ5 1.01; 95% CI 0.82-1.24; p trend = 0.36). Although body mass index and menopause hormone therapy were both associated with risk, there was no evidence of interaction with LAN (p interactions = 0.52 and 0.50, respectively). CONCLUSION Our study did not find an association between outdoor LAN and endometrial cancer risk, but was limited by the inability to account for individual-level exposure determinants. Future studies should consider approaches to improve characterization of personal exposures to light.
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Affiliation(s)
- Danielle N Medgyesi
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Britton Trabert
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Jared A Fisher
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Qian Xiao
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.,Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Alexandra J White
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Jessica M Madrigal
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA. .,Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Room 6E606, Rockville, MD, 20850, USA.
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Jones RR, Fisher JA, Medgyesi DN, Buller ID, Liao LM, Gierach G, Ward MH, Silverman DT. Ethylene oxide emissions and incident breast cancer and non-Hodgkin lymphoma in a U.S. cohort. J Natl Cancer Inst 2023; 115:405-412. [PMID: 36633307 PMCID: PMC10086621 DOI: 10.1093/jnci/djad004] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 11/16/2022] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Ethylene oxide (EtO) is a carcinogenic gas used in chemical production and to sterilize medical equipment that has been linked to risk of breast and lymphohematopoietic cancers in a small number of occupational studies. We investigated the relationship between environmental EtO exposure and risk of these cancers. METHODS Using the U.S. Environmental Protection Agency's Toxics Release Inventory, we estimated historical exposures for NIH-AARP Diet and Health Study participants enrolled in 1995-1996. We constructed two metrics at 3, 5, and 10 km: 1) distance between residences and EtO-emitting facilities, weighted by the proportion of time the home was downwind of each facility, and 2) distance-weighted, wind-direction-adjusted average airborne emissions index (AEI=∑[lbs EtO/km2]). We estimated risk (hazard ratio [HR], 95% confidence interval [95%CI]) of incident breast cancer (in situ and invasive) among postmenopausal women (N = 173,670) overall and by tumor estrogen receptor (ER) status and non-Hodgkin lymphoma (NHL) in the full cohort (N = 451,945). RESULTS We observed an increased risk of breast cancer associated with EtO-emitting facilities within 10 km (HR[≤10vs>10]=1.05, 95%CI = 1.00-1.10) that appeared stronger for in situ (HR[≤10vs>10]=1.13,95%CI = 1.00-1.27) than invasive (HR[≤10vs>10]=1.03,95%CI = 0.97-1.09) disease. Risk of breast cancer in situ was also increased in the top AEI quartiles, and associations weakened with larger distances (HRs[Q4vs0]=1.60,95%CI = 0.98-2.61; 1.28,95%CI = 0.92-1.79; 1.25,95%CI = 1.02-1.53 at 3, 5, and 10 km, respectively). No differences in breast cancer risk were observed by ER status. We found no clear pattern of increased NHL risk. CONCLUSIONS A novel potential association between EtO emissions and risk of in situ, but not invasive, breast cancer warrants additional evaluation.
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Affiliation(s)
- Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Jared A Fisher
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Danielle N Medgyesi
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Ian D Buller
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA.,Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Linda M Liao
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Gretchen Gierach
- Integrative Tumor Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Debra T Silverman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
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11
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Manley CK, Spaur M, Madrigal JM, Fisher JA, Jones RR, Parks CG, Hofmann JN, Sandler DP, Beane Freeman L, Ward MH. Drinking water sources and water quality in a prospective agricultural cohort. Environ Epidemiol 2022; 6:e210. [PMID: 35702502 PMCID: PMC9187174 DOI: 10.1097/ee9.0000000000000210] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 04/04/2022] [Indexed: 11/26/2022] Open
Abstract
We describe drinking water sources and water quality for a large agricultural cohort. We used questionnaire data from the Agricultural Health Study (N = 89,655), a cohort of licensed pesticide applicators and their spouses in Iowa (IA) and North Carolina (NC), to ascertain drinking water source at enrollment (1993-1997). For users of public water supplies (PWS), we linked participants' geocoded addresses to contaminant monitoring data [five haloacetic acids (HAA5), total trihalomethanes (TTHM), and nitrate-nitrogen (NO3-N)]. We estimated private well nitrate levels using random forest models accounting for well depth, soil characteristics, nitrogen inputs, and other predictors. We assigned drinking water source for 84% (N = 74,919) of participants. Among these, 69% of IA and 75% of NC participants used private wells; 27% in IA and 21% in NC used PWS. Median PWS nitrate concentrations (NO3-N) were higher in IA [0.9 mg/L, interquartile range (IQR): 0.4-3.1 mg/L] than NC (0.1 mg/L, IQR: 0.1-0.2 mg/L), while median HAA5 and TTHM concentrations were higher in NC (HAA5: 11.9 µg/L, IQR: 5.5-33.4 µg/L; TTHM: 37.7 µg/L, IQR: 10.7-54.7 µg/L) than IA (HAA5: 5.0 µg/L, IQR: 3.7-10.7 µg/L; TTHM: 13.0 µg/L, IQR: 4.2-32.4 µg/L). Private well nitrate concentrations in IA (1.5 mg/L, IQR: 0.8-4.9 mg/L) and NC (1.9 mg/L, IQR: 1.4-2.5 mg/L) were higher than PWS. More private wells in IA (12%) exceeded 10 mg/L NO3-N (regulatory limit for PWS) than NC (<1%). Due to the proximity of their drinking water sources to farms, agricultural communities may be exposed to elevated nitrate levels.
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Affiliation(s)
- Cherrel K. Manley
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Maya Spaur
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York City, New York
| | - Jessica M. Madrigal
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Jared A. Fisher
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Rena R. Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Christine G. Parks
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Jonathan N. Hofmann
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Laura Beane Freeman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Mary H. Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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12
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Medgyesi DN, Trabert B, Sampson J, Weyer PJ, Prizment A, Fisher JA, Beane Freeman LE, Ward MH, Jones RR. Drinking Water Disinfection Byproducts, Ingested Nitrate, and Risk of Endometrial Cancer in Postmenopausal Women. Environ Health Perspect 2022; 130:57012. [PMID: 35622390 PMCID: PMC9138501 DOI: 10.1289/ehp10207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Disinfection byproducts (DBPs) and N-nitroso compounds (NOC), formed endogenously after nitrate ingestion, are suspected endometrial carcinogens, but epidemiological studies are limited. OBJECTIVES We investigated the relationship of these exposures with endometrial cancer risk in a large prospective cohort. METHODS Among postmenopausal women in the Iowa Women's Health Study cohort, we evaluated two major classes of DBPs, total trihalomethanes (TTHM) and five haloacetic acids (HAA5), and nitrate-nitrogen (NO3-N) in public water supplies (PWS) in relation to incident primary endometrial cancer (1986-2014). For women using their PWS >10y at enrollment (n=10,501; cases=261), we computed historical averages of annual concentrations; exposures were categorized into quantiles and when possible ≥95th percentile. We also computed years of PWS use above one-half the U.S. maximum contaminant level (>½ MCL; 40μg/L TTHM; 30μg/L HAA5; 5mg/L NO3-N). Dietary nitrate/nitrite intakes were estimated from a food frequency questionnaire. We estimated hazard ratios (HR) and 95% confidence intervals (CI) via Cox models adjusted for age, endometrial cancer risk factors [e.g., body mass index, hormone replacement therapy (HRT)], and mutually adjusted for DBPs or NO3-N. We evaluated associations for low-grade (cases=99) vs. high-grade (cases=114) type I tumors. We assessed interactions between exposures and endometrial cancer risk factors and dietary factors influencing NOC formation. RESULTS Higher average concentrations of DBPs (95th percentile: TTHM ≥93μg/L, HAA5 ≥49μg/L) were associated with endometrial cancer risk (TTHM: HR95vsQ1=2.19, 95% CI: 1.41, 3.40; HAA5: HR95vsQ1=1.84, 95% CI: 1.19, 2.83; ptrend<0.01). Associations were similarly observed for women greater than median years of PWS use with levels >½ MCL, in comparison with zero years (TTHM: HR36+vs0y=1.61, 95% CI: 1.18, 2.21; HAA5: HR38+vs0y=1.85, 95% CI: 1.31, 2.62). Associations with DBPs appeared stronger for low-grade tumors (TTHM: HRQ4vsQ1=2.12, 95% CI: 1.17, 3.83; p-trend=0.008) than for high-grade tumors (TTHM: HRQ4vsQ1=1.40, 95% CI: 0.80, 2.44; p-trend=0.339), but differences were not statistically significant (p-heterogeneity=0.43). Associations with TTHM were stronger among ever HRT users than non-HRT users (p-interaction<0.01). We observed no associations with NO3-N in drinking water or diet. DISCUSSION We report novel associations between the highest DBP levels and endometrial cancer for our Iowa cohort that warrant future evaluation. https://doi.org/10.1289/EHP10207.
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Affiliation(s)
- Danielle N. Medgyesi
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Britton Trabert
- Metabolic Epidemiology Branch, DCEG, NCI, NIH, DHHS, Bethesda, Maryland, USA
| | - Joshua Sampson
- Biostatistics Branch, DCEG, NCI, NIH, DHHS, Bethesda, Maryland, USA
| | - Peter J. Weyer
- Center for Health Effects of Environmental Contamination, University of Iowa, Iowa City, Iowa, USA
| | - Anna Prizment
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jared A. Fisher
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Laura E. Beane Freeman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Mary H. Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Rena R. Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
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13
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White AJ, Gregoire AM, Fisher JA, Medgyesi DN, Li L, Koutrakis P, Sandler DP, Jones RR. Exposure to Particle Radioactivity and Breast Cancer Risk in the Sister Study: A U.S.-Wide Prospective Cohort. Environ Health Perspect 2022; 130:47701. [PMID: 35377195 PMCID: PMC8978644 DOI: 10.1289/ehp10288] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 03/01/2022] [Accepted: 03/17/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Alexandra J. White
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Allyson M. Gregoire
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Jared A. Fisher
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Danielle N. Medgyesi
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Longxiang Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Rena R. Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
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VoPham T, Bertrand KA, Fisher JA, Ward MH, Laden F, Jones RR. Emissions of dioxins and dioxin-like compounds and incidence of hepatocellular carcinoma in the United States. Environ Res 2022; 204:112386. [PMID: 34800530 PMCID: PMC8671236 DOI: 10.1016/j.envres.2021.112386] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/19/2021] [Accepted: 11/12/2021] [Indexed: 05/07/2023]
Abstract
Ambient dioxin exposure from industrial sources, excluding exposures from occupations and accidental releases/contamination, may be associated with risk of developing hepatocellular carcinoma (HCC). The objective of this study was to examine the association between county-level ambient dioxin air emissions from industrial sources and HCC risk in the US. We obtained information on 90,359 incident HCC cases diagnosed between 2000 and 2016 from population-based cancer registries across the US in the Surveillance, Epidemiology, and End Results (SEER) database. Dioxin emissions from 1987 to 2007 from a nationwide spatial database of historical dioxin-emitting facilities were linked to the SEER county of residence at diagnosis using a geographic information system (GIS). Poisson regression with robust variance estimation was used to calculate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for the association between county-level dioxin emissions and HCC rates adjusting for individual-level age at diagnosis, sex, race/ethnicity, year of diagnosis, SEER registry, and county-level information on health conditions, lifestyle factors, and socioeconomic status. There was no association between dioxin emissions based on the number of dioxin-emitting facilities within a county or average annual emissions within a county and HCC risk. In analyses by facility type, there were positive associations between county-level dioxin emissions from coal-fired power plants (adjusted IRR 1.09, 95% CI 1.01-1.17), but not with the number of these facilities. Similarly, positive associations for industrial boilers and sewage sludge incinerators were evident, but not consistent across both exposure metrics. Future research should incorporate individual-level data to further explore the findings suggested by these ecologic analyses.
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Affiliation(s)
- Trang VoPham
- Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N, Seattle, WA, 98109, United States; Department of Epidemiology, University of Washington School of Public Health, 3980 15th Avenue NE, Seattle, WA, 98195, United States.
| | - Kimberly A Bertrand
- Slone Epidemiology Center at Boston University, 72 East Concord Street L-7, Boston, MA, 02118, United States
| | - 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, 9609 Medical Center Drive MSC 9776, Bethesda, MD, 20850, United States
| | - 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, 9609 Medical Center Drive MSC 9776, Bethesda, MD, 20850, United States
| | - Francine Laden
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, United States
| | - 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, 9609 Medical Center Drive MSC 9776, Bethesda, MD, 20850, United States
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15
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Medgyesi DN, Fisher JA, Flory AR, Hayes RB, Thurston GD, Liao LM, Ward MH, Silverman DT, Jones RR. Evaluation of a commercial database to estimate residence histories in the los angeles ultrafines study. Environ Res 2021; 197:110986. [PMID: 33689822 PMCID: PMC8187285 DOI: 10.1016/j.envres.2021.110986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/04/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Commercial databases can be used to identify participant addresses over time, but their quality and impact on environmental exposure assessment is uncertain. OBJECTIVE To evaluate the performance of a commercial database to find residences and estimate environmental exposures for study participants. METHODS We searched LexisNexis® for participant addresses in the Los Angeles Ultrafines Study, a prospective cohort of men and women aged 50-71 years. At enrollment (1995-1996) and follow-up (2004-2005), we evaluated attainment (address found for the corresponding time period) and match rates to survey addresses by participant characteristics. We compared geographically-referenced predictors and estimates of ultrafine particulate matter (UFP) exposure from a land use regression model using LexisNexis and survey addresses at enrollment. RESULTS LexisNexis identified an address for 69% of participants at enrollment (N = 50,320) and 95% of participants at follow-up (N = 24,432). Attainment rate at enrollment modestly differed (≥5%) by age, smoking status, education, and residential mobility between surveys. The match rate at both survey periods was high (82-86%) and similar across characteristics. When using LexisNexis versus survey addresses, correlations were high for continuous values of UFP exposure and its predictors (rho = 0.86-0.92). SIGNIFICANCE Time period and population characteristics influenced the attainment of addresses from a commercial database, but accuracy and subsequent estimation of specific air pollution exposures were high in our older study population.
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Affiliation(s)
- Danielle N Medgyesi
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States.
| | - Jared A Fisher
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | | | - Richard B Hayes
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, United States; Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - George D Thurston
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, United States; Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Linda M Liao
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Debra T Silverman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
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16
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Jones RR, Ward MH, Deziel NC, Medgyesi DN, Pronk A, Nuckols JR, Fisher JA. Residential Proximity to Dioxin-emitting Facilities and Risk of Non-Hodgkin Lymphoma in the NIH-AARP Diet and Health Study. Cancer Epidemiol Biomarkers Prev 2021. [DOI: 10.1158/1055-9965.epi-21-0219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Purpose: Few studies have investigated the relationship between risk of non-Hodgkin lymphoma (NHL) and residential proximity to polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/F) emitted from industrial combustion and manufacturing sources. Methods: We evaluated this relationship among participants of the NIH-AARP Diet and Health Study, a prospective cohort (N = 548,845) in 6 states and 2 cities in the U.S. We linked geocoded enrollment addresses (1995–1996) with a U.S. Environmental Protection Agency database of 4,478 historical PCDD/F sources, which contained toxic equivalency quotient (TEQ) emissions estimates from 1995. Exposure metrics indicated presence/absence of any facility within 3 and 5km of participant homes, overall and by type of facility (e.g., coal-fired power plants, waste incinerators), which vary in emissions levels and constituency. We also calculated exposure as a distance- and toxicity-weighted average emissions index (AEI [g TEQ]). We used Cox regression to estimate associations (hazard ratios; HR and 95% confidence intervals; CI) with NHL and major subtypes, adjusting for and by strata of sociodemographic and lifestyle characteristics. Results: With 6,747 incident cases through 2011, we found no association between living near any or specific types of PCDD/F-emitting facilities and NHL risk. However, participants with an AEI >95th percentile within 5km had increased risk of NHL compared to unexposed (HR = 1.28; CI = 1.05–1.55; p-trend = 0.01). Specifically, we observed increased risk for lymphoplasmacytic lymphoma (HR = 2.98, CI = 1.16–7.63; p-trend = 0.03) and diffuse large B-cell lymphoma (HR = 1.65, CI = 1.11–2.46; p-trend = 0.01). Non-Hispanic blacks were nearly three times as likely as whites to live <5 km of a facility, although we had limited power to evaluate heterogeneity in associations by race/ethnicity. Associations did not vary by age, smoking status, body mass index, or urbanicity of residence. Conclusions: Using an exposure metric accounting for distance and the toxicity of emissions, we found significant positive associations between residential exposure to high PCDD/F emissions and risk of NHL and two subtypes. Our results underscore the hazard for populations living near sources of these persistent organic pollutants.
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Xiao Q, James P, Breheny P, Jia P, Park Y, Zhang D, Fisher JA, Ward MH, Jones RR. Outdoor light at night and postmenopausal breast cancer risk in the NIH-AARP diet and health study. Int J Cancer 2020; 147:2363-2372. [PMID: 32488897 DOI: 10.1002/ijc.33016] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/21/2020] [Accepted: 04/03/2020] [Indexed: 12/24/2022]
Abstract
Circadian disruption may play a role in breast carcinogenesis. Previous studies reported relationships between outdoor light at night (LAN) and the breast cancer risk, but their findings are mixed. There is also a need to examine LAN and breast cancer incidence according to different individual and environmental characteristics to identify subpopulations at greater risk associated with LAN exposure. We studied residential outdoor LAN estimated from satellite imagery at baseline (1996) in relation to postmenopausal breast cancer incidence over ~16 years of follow-up in 186 981 postmenopausal women including 12 318 incident postmenopausal breast cancer cases in the NIH-AARP Diet and Health Study. We used Cox proportional hazards models to estimate hazard ratios (HR) and two-sided 95% confidence intervals (CI) of the relationship between quintiles of LAN and postmenopausal breast cancer risk, overall and by hormone receptor status and cancer stage. We found that when compared to women in the lowest quintile of baseline LAN, those in the highest quintile had a 10% increase in postmenopausal breast cancer risk (HR (95% CI), 1.10 (1.02, 1.18), P-trend, .002). The association appeared to be stronger for estrogen receptor (ER) positive breast cancer (1.12 [1.02, 1.24], .007) than for ER-negative cancer (1.07 [0.85, 1.34], .66). Our findings also suggested that the relationship between LAN and breast cancer risk may differ by individual characteristics, such as smoking, alcohol drinking, sleep duration and BMI, and neighborhood environment. In conclusion, our study suggests that higher outdoor LAN exposure may be a risk factor for postmenopausal breast cancer.
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Affiliation(s)
- Qian Xiao
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Patrick Breheny
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Peng Jia
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China.,International Initiative on Spatial Lifecourse Epidemiology, Hong Kong, China
| | - Yikyung Park
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St Louis, St. Louis, Missouri, USA
| | - Dong Zhang
- Department of Health and Human physiology, College of Liberal Arts and Sciences, University of Iowa, Iowa City, Iowa, USA
| | - Jared A Fisher
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
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Jones RR, Hoek G, Fisher JA, Hasheminassab S, Wang D, Ward MH, Sioutas C, Vermeulen R, Silverman DT. Land use regression models for ultrafine particles, fine particles, and black carbon in Southern California. Sci Total Environ 2020; 699:134234. [PMID: 31793436 DOI: 10.1016/j.scitotenv.2019.134234] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/31/2019] [Accepted: 08/31/2019] [Indexed: 05/26/2023]
Abstract
Exposure models are needed to evaluate health effects of long-term exposure to ambient ultrafine particles (UFP; <0.1 μm) and to disentangle their association from other pollutants, particularly PM2.5 (<2.5 μm). We developed land use regression (LUR) models to support UFP exposure assessment in the Los Angeles Ultrafines Study, a cohort in Southern California. We conducted a short-term measurement campaign in Los Angeles and parts of Riverside and Orange counties to measure UFP, PM2.5, and black carbon (BC), collecting three 30-minute average measurements at 215 sites across three seasons. We averaged concentrations for each site and evaluated geographic predictors including traffic intensity, distance to airports, land use, and population and building density by supervised stepwise selection to develop models. UFP and PM2.5 measurements (r = 0.001) and predictions (r = 0.05) were uncorrelated at the sites. UFP model explained variance was robust (R2 = 0.66) and 10-fold cross-validation indicated good performance (R2 = 0.59). Explained variation was moderate for PM2.5 (R2 = 0.47) and BC (R2 = 0.38). In the cohort, we predicted a 2.3-fold exposure contrast from the 5th to 95th percentiles for all three pollutants. The correlation between modeled UFP and PM2.5 at cohort residences was weak (r = 0.28), although higher than between measured levels. LUR models, particularly for UFP, were successfully developed and predicted reasonable exposure contrasts.
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Affiliation(s)
- Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States.
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, Netherlands
| | - Jared A Fisher
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Sina Hasheminassab
- Department of Civil and Environmental Engineering, University of Southern California, Los Angeles, CA, United States
| | - Dongbin Wang
- Department of Civil and Environmental Engineering, University of Southern California, Los Angeles, CA, United States
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Constantinos Sioutas
- Department of Civil and Environmental Engineering, University of Southern California, Los Angeles, CA, United States
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, Netherlands; University Medical Center, Utrecht University, Utrecht, Netherlands
| | - Debra T Silverman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
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19
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Fisher JA, Friesen MC, Kim S, Locke SJ, Kefelegn Y, Wong JY, Albert PS, Jones RR. Sources of Variability in Real-time Monitoring Data for Fine Particulate Matter: Comparability of Three Wearable Monitors in an Urban Setting. Environ Sci Technol Lett 2019; 6:222-227. [PMID: 36618715 PMCID: PMC9815482 DOI: 10.1021/acs.estlett.9b00115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The increasing availability of portable air pollution monitoring devices has greatly enhanced the ability to measure personal exposures in real time. However, these devices vary considerably in their cost and specifications, and questions remain as to their reliability and practicality for use in epidemiological investigations. In this field study, three personal PM2.5 exposure monitors (two nephelometers, one optical particle counter) were compared in an urban setting to assess their feasibility for use in future studies. In total, 3963 1-min measurements were collected over 12 days from locations of several types (e.g., above and below-ground subway stations, sidewalks next to urban traffic, outdoor construction sites) in the Washington, D.C. metropolitan area. Overall, we observed moderate-to-high agreement in pairwise comparisons of PM2.5 concentrations between devices (R2 range: 0.37 to 0.75). Bland-Altman plots showed that differences in device agreement varied over the range of mean concentrations. In linear mixed models adjusting for temperature and relative humidity, we saw significant interaction between device and location (p<0.05), suggesting that the relationship between devices was not constant in all locations. Our finding of heterogeneity in instrument comparability by location may have important implications in epidemiologic studies incorporating personal PM2.5 measurements.
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Affiliation(s)
- Jared A. Fisher
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Bethesda, MD 20850
| | - Melissa C. Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Bethesda, MD 20850
| | - Sungduk Kim
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Bethesda, MD 20850
| | - Sarah J. Locke
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Bethesda, MD 20850
| | - Yonathan Kefelegn
- Department of Public Health Sciences, Division of Environmental and Occupational Health, University of California, Davis, CA 95616
| | - Jason Y.Y. Wong
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Bethesda, MD 20850
| | - Paul S. Albert
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Bethesda, MD 20850
| | - Rena R. Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Bethesda, MD 20850
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20
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Fisher JA, Puett RC, Laden F, Wellenius GA, Sapkota A, Liao D, Yanosky JD, Carter-Pokras O, He X, Hart JE. Case-crossover analysis of short-term particulate matter exposures and stroke in the health professionals follow-up study. Environ Int 2019; 124:153-160. [PMID: 30641259 PMCID: PMC6692897 DOI: 10.1016/j.envint.2018.12.044] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 12/16/2018] [Accepted: 12/19/2018] [Indexed: 05/20/2023]
Abstract
BACKGROUND Stroke is a leading cause of morbidity and mortality in the United States. Associations between short-term exposures to particulate matter (PM) air pollution and stroke are inconsistent. Many prior studies have used administrative and hospitalization databases where misclassification of the type and timing of the stroke event may be problematic. METHODS In this case-crossover study, we used a nationwide kriging model to examine short-term ambient exposure to PM10 and PM2.5 and risk of ischemic and hemorrhagic stroke among men enrolled in the Health Professionals Follow-up Study. Conditional logistic regression models were used to obtain estimates of odds ratios (OR) and 95% confidence intervals (CI) associated with an interquartile range (IQR) increase in PM2.5 or PM10. Lag periods up to 3 days prior to the stroke event were considered in addition to a 4-day average. Stratified models were used to examine effect modification by patient characteristics. RESULTS Of the 727 strokes that occurred between 1999 and 2010, 539 were ischemic and 122 were hemorrhagic. We observed positive statistically significant associations between PM10 and ischemic stroke (ORlag0-3 = 1.26; 95% CI: 1.03-1.55 per IQR increase [14.46 μg/m3]), and associations were elevated for nonsmokers, aspirin nonusers, and those without a history of high cholesterol. However, we observed no evidence of a positive association between short-term exposure to PM and hemorrhagic stroke or between PM2.5 and ischemic stroke in this cohort. CONCLUSIONS Our study provides evidence that ambient PM10 may be associated with higher risk of ischemic stroke and highlights that ischemic and hemorrhagic strokes are heterogeneous outcomes that should be treated as such in analyses related to air pollution.
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Affiliation(s)
- Jared A Fisher
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
| | - Robin C Puett
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Gregory A Wellenius
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Duanping Liao
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Jeff D Yanosky
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Olivia Carter-Pokras
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | - Xin He
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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21
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Somogyi RB, Vesely AE, Preiss D, Prisman E, Volgyesi G, Azami T, Iscoe S, Fisher JA, Sasano H. Precise Control of End-tidal Carbon Dioxide Levels Using Sequential Rebreathing Circuits. Anaesth Intensive Care 2019; 33:726-32. [PMID: 16398376 DOI: 10.1177/0310057x0503300604] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Anaesthesiologists have traditionally been consulted to help design breathing circuits to attain and maintain target end-tidal carbon dioxide (PETCO2). The methodology has recently been simplified by breathing circuits that sequentially deliver fresh gas (not containing carbon dioxide (CO2)) and reserve gas (containing CO2). Our aim was to determine the roles of fresh gas flow, reserve gas PCO2 and minute ventilation in the determination of PETCO2. We first used a computer model of a non-rebreathing sequential breathing circuit to determine these relationships. We then tested our model by monitoring PETCO2 in human volunteers who increased their minute ventilation from resting to five times resting levels. The optimal settings to maintain PETCO2 independently of minute ventilation are 1) fresh gas flow equal to minute ventilation minus anatomical deadspace ventilation, and 2) reserve gas PCO2 equal to alveolar PCO2. We provide an equation to assist in identifying gas settings to attain a target PCO2. The ability to precisely attain and maintain a target PCO2 (isocapnia) using a sequential gas delivery circuit has multiple therapeutic and scientific applications.
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Affiliation(s)
- R B Somogyi
- University Health Network, Toronto General Hospital, University of Toronto, Department of Physiology, Queen's University, Kingston, Canada
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22
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McKetton L, Venkatraghavan L, Rosen C, Mandell DM, Sam K, Sobczyk O, Poublanc J, Gray E, Crawley A, Duffin J, Fisher JA, Mikulis DJ. Improved White Matter Cerebrovascular Reactivity after Revascularization in Patients with Steno-Occlusive Disease. AJNR Am J Neuroradiol 2018; 40:45-50. [PMID: 30573457 DOI: 10.3174/ajnr.a5912] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/08/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE One feature that patients with steno-occlusive cerebrovascular disease have in common is the presence of white matter (WM) lesions on MRI. The purpose of this study was to evaluate the effect of direct surgical revascularization on impaired WM cerebrovascular reactivity in patients with steno-occlusive disease. MATERIALS AND METHODS We recruited 35 patients with steno-occlusive disease, Moyamoya disease (n = 24), Moyamoya syndrome (n = 3), atherosclerosis (n = 6), vasculitis (n = 1), and idiopathic stenosis (n = 1), who underwent unilateral brain revascularization using a direct superficial temporal artery-to-MCA bypass (19 women; mean age, 45.8 ± 16.5 years). WM cerebrovascular reactivity was measured preoperatively and postoperatively using blood oxygen level-dependent (BOLD) MR imaging during iso-oxic hypercapnic changes in end-tidal carbon dioxide and was expressed as %Δ BOLD MR signal intensity per millimeter end-tidal partial pressure of CO2. RESULTS WM cerebrovascular reactivity significantly improved after direct unilateral superficial temporal artery-to-middle cerebral artery (STA-MCA) bypass in the revascularized hemisphere in the MCA territory (mean ± SD, -0.0005 ± 0.053 to 0.053 ± 0.046 %BOLD/mm Hg; P < .0001) and in the anterior cerebral artery territory (mean, 0.0015 ± 0.059 to 0.021 ± 0.052 %BOLD/mm Hg; P = .005). There was no difference in WM cerebrovascular reactivity in the ipsilateral posterior cerebral artery territory nor in the vascular territories of the nonrevascularized hemisphere (P < .05). CONCLUSIONS Cerebral revascularization surgery is an effective treatment for reversing preoperative cerebrovascular reactivity deficits in WM. In addition, direct-STA-MCA bypass may prevent recurrence of preoperative symptoms.
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Affiliation(s)
- L McKetton
- From the Division of Neuroradiology, Joint Department of Medical Imaging (L.M., C.R., D.M.M., K.S., O.S., J.P., E.G., A.C., D.J.M.)
| | - L Venkatraghavan
- Department of Anesthesia and Pain Management (L.V., J.A.F.), University Health Network, Toronto, Ontario, Canada
| | - C Rosen
- From the Division of Neuroradiology, Joint Department of Medical Imaging (L.M., C.R., D.M.M., K.S., O.S., J.P., E.G., A.C., D.J.M.)
| | - D M Mandell
- From the Division of Neuroradiology, Joint Department of Medical Imaging (L.M., C.R., D.M.M., K.S., O.S., J.P., E.G., A.C., D.J.M.)
| | - K Sam
- From the Division of Neuroradiology, Joint Department of Medical Imaging (L.M., C.R., D.M.M., K.S., O.S., J.P., E.G., A.C., D.J.M.).,Russell H. Morgan Department of Radiology and Radiological Science (K.S.), John Hopkins School of Medicine, Baltimore, Maryland
| | - O Sobczyk
- From the Division of Neuroradiology, Joint Department of Medical Imaging (L.M., C.R., D.M.M., K.S., O.S., J.P., E.G., A.C., D.J.M.)
| | - J Poublanc
- From the Division of Neuroradiology, Joint Department of Medical Imaging (L.M., C.R., D.M.M., K.S., O.S., J.P., E.G., A.C., D.J.M.)
| | - E Gray
- From the Division of Neuroradiology, Joint Department of Medical Imaging (L.M., C.R., D.M.M., K.S., O.S., J.P., E.G., A.C., D.J.M.)
| | - A Crawley
- From the Division of Neuroradiology, Joint Department of Medical Imaging (L.M., C.R., D.M.M., K.S., O.S., J.P., E.G., A.C., D.J.M.)
| | - J Duffin
- Department of Physiology (J.D., J.A.F.).,Institute of Medical Sciences (J.D., J.A.F., D.J.M.), University of Toronto, Toronto, Ontario, Canada
| | - J A Fisher
- Department of Anesthesia and Pain Management (L.V., J.A.F.), University Health Network, Toronto, Ontario, Canada.,Department of Physiology (J.D., J.A.F.).,Institute of Medical Sciences (J.D., J.A.F., D.J.M.), University of Toronto, Toronto, Ontario, Canada
| | - D J Mikulis
- From the Division of Neuroradiology, Joint Department of Medical Imaging (L.M., C.R., D.M.M., K.S., O.S., J.P., E.G., A.C., D.J.M.) .,Institute of Medical Sciences (J.D., J.A.F., D.J.M.), University of Toronto, Toronto, Ontario, Canada
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23
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Mashari A, Fisher JA, Fedorko L, Wąsowicz M, Meineri M. Technology III: in-line vaporizer with reflector. J Clin Monit Comput 2017; 32:647-650. [PMID: 29124561 DOI: 10.1007/s10877-017-0078-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 10/28/2017] [Indexed: 01/21/2023]
Abstract
As the clinical advantages of vapor anesthesia (VA) for sedation of patients in ICU become more apparent, the ergonomics, economy and safety issues need to be better addressed. Here we describe the use of a new commercial digital in-line anesthetic vaporizer that can be attached to the inspiratory limb of a ventilator. If used with a simple, and easily assembled secondary circuit and anesthetic reflector, the circuit remains remote from the patient, the VA consumption approaches a physical minimum, VA level is controlled and monitored, and the tidal volume size is not limited.
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Affiliation(s)
- A Mashari
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada
| | - J A Fisher
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada. .,Thornhill Research Inc., Toronto, Canada.
| | - L Fedorko
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada.,Thornhill Research Inc., Toronto, Canada
| | - M Wąsowicz
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada
| | - M Meineri
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada
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24
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Fisher JA, Jiang C, Soneja SI, Mitchell C, Puett RC, Sapkota A. Summertime extreme heat events and increased risk of acute myocardial infarction hospitalizations. J Expo Sci Environ Epidemiol 2017; 27:276-280. [PMID: 28176761 DOI: 10.1038/jes.2016.83] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 11/14/2016] [Indexed: 06/06/2023]
Abstract
Few studies have examined the association between exposure to extreme heat events and risk of acute myocardial infarction (AMI) or demonstrated which populations are most vulnerable to the effects of extreme heat. We defined extreme heat events as days when the daily maximum temperature (TMAX) exceeded the location- and calendar day-specific 95th percentile of the distribution of daily TMAX during the 30-year baseline period (1960-1989). We used a time-stratified case-crossover design to analyze the association between exposure to extreme heat events and risk of hospitalization for AMI in the summer months (June-August) with 0, 1, or 2 lag days. There were a total of 32,670 AMI hospitalizations during the summer months in Maryland between 2000 and 2012. Overall, extreme heat events on the day of hospitalization were associated with an increased risk of AMI (lag 0 OR=1.11; 95% CI: 1.05-1.17). Results considering lag periods immediately before hospitalization were comparable, but effect estimates varied among several population subgroups. As extreme weather events are expected to become more frequent and intense in response to our changing climate, community-specific adaptation strategies are needed to account for the differential susceptibility across ethnic subgroups and geographic areas.
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Affiliation(s)
- Jared A Fisher
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Chengsheng Jiang
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Sutyajeet I Soneja
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Clifford Mitchell
- Prevention and Health Promotion Administration, Maryland Department of Health and Mental Hygiene, Baltimore, Maryland, USA
| | - Robin C Puett
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA
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25
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Dinsmore M, Han JS, Fisher JA, Chan VWS, Venkatraghavan L. Effects of acute controlled changes in end-tidal carbon dioxide on the diameter of the optic nerve sheath: a transorbital ultrasonographic study in healthy volunteers. Anaesthesia 2017; 72:618-623. [PMID: 28177116 DOI: 10.1111/anae.13784] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2016] [Indexed: 02/03/2023]
Abstract
Transorbital ultrasonographic measurement of the diameter of the optic nerve sheath is a non-invasive, bed-side examination for detecting raised intracranial pressure. However, the ability of the optic nerve sheath diameter to predict acute changes in intracranial pressures remains unknown. The aim of this study was to examine the dynamic changes of the optic nerve sheath diameter in response to mild fluctuations in cerebral blood volume induced by changes in end-tidal carbon dioxide. We studied 11 healthy volunteers. End-tidal carbon dioxide was controlled by a model-based prospective end-tidal targeting system (RespirAct™). The volunteers' end-tidal carbon dioxide was targeted and maintained for 10 min each at normocapnia (baseline); hypercapnia (6.5 kPa); normocapnia (baseline 1); hypocapnia (3.9 kPa) and on return to normocapnia (baseline 2). A single investigator repeatedly measured the optic nerve sheath diameter for 10 min at each level of carbon dioxide. With hypercapnia, there was a significant increase in optic nerve sheath diameter, with a mean (SD) increase from baseline 4.2 (0.7) mm to 4.8 (0.8) mm; p < 0.001. On return to normocapnia, the optic nerve sheath diameter rapidly reverted back to baseline values. This study confirms dynamic changes in the optic nerve sheath diameter with corresponding changes in carbon dioxide, and their reversibly with normocapnia.
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Affiliation(s)
- M Dinsmore
- Department of Anaesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - J S Han
- Department of Anaesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - J A Fisher
- Department of Anaesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - V W S Chan
- Department of Anaesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - L Venkatraghavan
- Department of Anaesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
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26
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Sam K, Crawley AP, Poublanc J, Conklin J, Sobczyk O, Mandell DM, Duffin J, Venkatraghavan L, Fisher JA, Black SE, Mikulis DJ. Vascular Dysfunction in Leukoaraiosis. AJNR Am J Neuroradiol 2016; 37:2258-2264. [PMID: 27492072 DOI: 10.3174/ajnr.a4888] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 06/07/2016] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND PURPOSE The pathogenesis of leukoaraiosis has long been debated. This work addresses a less well-studied mechanism, cerebrovascular reactivity, which could play a leading role in the pathogenesis of this disease. Our aim was to evaluate blood flow dysregulation and its relation to leukoaraiosis. MATERIALS AND METHODS Cerebrovascular reactivity, the change in the blood oxygen level-dependent 3T MR imaging signal in response to a consistently applied step change in the arterial partial pressure of carbon dioxide, was measured in white matter hyperintensities and their contralateral spatially homologous normal-appearing white matter in 75 older subjects (age range, 50-91 years; 40 men) with leukoaraiosis. Additional quantitative evaluation of regions of leukoaraiosis was performed by using diffusion (n = 75), quantitative T2 (n = 54), and DSC perfusion MRI metrics (n = 25). RESULTS When we compared white matter hyperintensities with contralateral normal-appearing white matter, cerebrovascular reactivity was lower by a mean of 61.2% ± 22.6%, fractional anisotropy was lower by 44.9 % ± 6.9%, and CBF was lower by 10.9% ± 11.9%. T2 was higher by 61.7% ± 13.5%, mean diffusivity was higher by 59.0% ± 11.7%, time-to-maximum was higher by 44.4% ± 30.4%, and TTP was higher by 6.8% ± 5.8% (all P < .01). Cerebral blood volume was lower in white matter hyperintensities compared with contralateral normal-appearing white matter by 10.2% ± 15.0% (P = .03). CONCLUSIONS Not only were resting blood flow metrics abnormal in leukoaraiosis but there is also evidence of reduced cerebrovascular reactivity in these areas. Studies have shown that reduced cerebrovascular reactivity is more sensitive than resting blood flow parameters for assessing vascular insufficiency. Future work is needed to examine the sensitivity of resting-versus-dynamic blood flow measures for investigating the pathogenesis of leukoaraiosis.
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Affiliation(s)
- K Sam
- From the Departments of Physiology (K.S., J.D., J.A.F.).,Division of Neuroradiology (K.S., A.P.C., J.P., J.C., O.S., D.M.M., D.J.M.), Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
| | - A P Crawley
- Medical Imaging (A.P.C., D.J.M.), University of Toronto, Toronto, Ontario, Canada.,Division of Neuroradiology (K.S., A.P.C., J.P., J.C., O.S., D.M.M., D.J.M.), Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
| | - J Poublanc
- Division of Neuroradiology (K.S., A.P.C., J.P., J.C., O.S., D.M.M., D.J.M.), Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
| | - J Conklin
- Division of Neuroradiology (K.S., A.P.C., J.P., J.C., O.S., D.M.M., D.J.M.), Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
| | - O Sobczyk
- Division of Neuroradiology (K.S., A.P.C., J.P., J.C., O.S., D.M.M., D.J.M.), Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
| | - D M Mandell
- Division of Neuroradiology (K.S., A.P.C., J.P., J.C., O.S., D.M.M., D.J.M.), Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
| | - J Duffin
- From the Departments of Physiology (K.S., J.D., J.A.F.).,Department of Anesthesiology (J.D., L.V., J.A.F.), University Health Network and The University of Toronto, Toronto, Ontario, Canada
| | - L Venkatraghavan
- Department of Anesthesiology (J.D., L.V., J.A.F.), University Health Network and The University of Toronto, Toronto, Ontario, Canada
| | - J A Fisher
- From the Departments of Physiology (K.S., J.D., J.A.F.).,Department of Anesthesiology (J.D., L.V., J.A.F.), University Health Network and The University of Toronto, Toronto, Ontario, Canada
| | - S E Black
- L.C. Campbell Cognitive Neurology Research Unit (S.E.B.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - D J Mikulis
- Medical Imaging (A.P.C., D.J.M.), University of Toronto, Toronto, Ontario, Canada .,Division of Neuroradiology (K.S., A.P.C., J.P., J.C., O.S., D.M.M., D.J.M.), Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
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Fisher JA, Puett RC, Hart JE, Camargo CA, Varraso R, Yanosky JD, Laden F. Particulate matter exposures and adult-onset asthma and COPD in the Nurses' Health Study. Eur Respir J 2016; 48:921-4. [PMID: 27288040 DOI: 10.1183/13993003.00845-2015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 05/09/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Jared A Fisher
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA Dept of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | - Robin C Puett
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA Dept of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | - Jaime E Hart
- Channing Division of Network Medicine, Dept of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA Dept of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Carlos A Camargo
- Channing Division of Network Medicine, Dept of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA Dept of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Dept of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Raphaёlle Varraso
- INSERM U1168, VIMA (Aging and Chronic Diseases: Epidemiological and Public Health Approaches), Villejuif, France UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Versailles, France
| | - Jeff D Yanosky
- Dept of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Francine Laden
- Channing Division of Network Medicine, Dept of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA Dept of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA Dept of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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28
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Sobczyk O, Crawley AP, Poublanc J, Sam K, Mandell DM, Mikulis DJ, Duffin J, Fisher JA. Identifying Significant Changes in Cerebrovascular Reactivity to Carbon Dioxide. AJNR Am J Neuroradiol 2016; 37:818-24. [PMID: 26846924 DOI: 10.3174/ajnr.a4679] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 10/23/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND PURPOSE Changes in cerebrovascular reactivity can be used to assess disease progression and response to therapy but require discrimination of pathology from normal test-to-test variability. Such variability is due to variations in methodology, technology, and physiology with time. With uniform test conditions, our aim was to determine the test-to-test variability of cerebrovascular reactivity in healthy subjects and in patients with known cerebrovascular disease. MATERIALS AND METHODS Cerebrovascular reactivity was the ratio of the blood oxygen level-dependent MR imaging response divided by the change in carbon dioxide stimulus. Two standardized cerebrovascular reactivity tests were conducted at 3T in 15 healthy men (36.7 ± 16.1 years of age) within a 4-month period and were coregistered into standard space to yield voxelwise mean cerebrovascular reactivity interval difference measures, composing a reference interval difference atlas. Cerebrovascular reactivity interval difference maps were prepared for 11 male patients. For each patient, the test-retest difference of each voxel was scored statistically as z-values of the corresponding voxel mean difference in the reference atlas and then color-coded and superimposed on the anatomic images to create cerebrovascular reactivity interval difference z-maps. RESULTS There were no significant test-to-test differences in cerebrovascular reactivity in either gray or white matter (mean gray matter, P = .431; mean white matter, P = .857; paired t test) in the healthy cohort. The patient cerebrovascular reactivity interval difference z-maps indicated regions where cerebrovascular reactivity increased or decreased and the probability that the changes were significant. CONCLUSIONS Accounting for normal test-to-test differences in cerebrovascular reactivity enables the assessment of significant changes in disease status (stability, progression, or regression) in patients with time.
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Affiliation(s)
- O Sobczyk
- From the Institute of Medical Science (O.S., D.J.M., J.A.F.)
| | - A P Crawley
- Joint Department of Medical Imaging and the Functional Neuroimaging Laboratory (A.P.C., J.P., K.S., D.M.M., D.J.M.)
| | - J Poublanc
- Joint Department of Medical Imaging and the Functional Neuroimaging Laboratory (A.P.C., J.P., K.S., D.M.M., D.J.M.)
| | - K Sam
- Department of Physiology (K.S., J.D., J.A.F.), University of Toronto, Toronto, Canada Joint Department of Medical Imaging and the Functional Neuroimaging Laboratory (A.P.C., J.P., K.S., D.M.M., D.J.M.)
| | - D M Mandell
- Joint Department of Medical Imaging and the Functional Neuroimaging Laboratory (A.P.C., J.P., K.S., D.M.M., D.J.M.)
| | - D J Mikulis
- From the Institute of Medical Science (O.S., D.J.M., J.A.F.) Joint Department of Medical Imaging and the Functional Neuroimaging Laboratory (A.P.C., J.P., K.S., D.M.M., D.J.M.)
| | - J Duffin
- Department of Physiology (K.S., J.D., J.A.F.), University of Toronto, Toronto, Canada Department of Anaesthesia and Pain Management (J.D., J.A.F.), University Health Network, Toronto, Canada
| | - J A Fisher
- From the Institute of Medical Science (O.S., D.J.M., J.A.F.) Department of Physiology (K.S., J.D., J.A.F.), University of Toronto, Toronto, Canada Department of Anaesthesia and Pain Management (J.D., J.A.F.), University Health Network, Toronto, Canada
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Marais EA, Jacob DJ, Jimenez JL, Campuzano-Jost P, Day DA, Hu W, Krechmer J, Zhu L, Kim PS, Miller CC, Fisher JA, Travis K, Yu K, Hanisco TF, Wolfe GM, Arkinson HL, Pye HOT, Froyd KD, Liao J, McNeill VF. Aqueous-phase mechanism for secondary organic aerosol formation from isoprene: application to the Southeast United States and co-benefit of SO 2 emission controls. Atmos Chem Phys 2016; 16:1603-1618. [PMID: 32742280 PMCID: PMC7394309 DOI: 10.5194/acp-16-1603-2016] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Isoprene emitted by vegetation is an important precursor of secondary organic aerosol (SOA), but the mechanism and yields are uncertain. Aerosol is prevailingly aqueous under the humid conditions typical of isoprene-emitting regions. Here we develop an aqueous-phase mechanism for isoprene SOA formation coupled to a detailed gas-phase isoprene oxidation scheme. The mechanism is based on aerosol reactive uptake coefficients (γ) for water-soluble isoprene oxidation products, including sensitivity to aerosol acidity and nucleophile concentrations. We apply this mechanism to simulation of aircraft (SEAC4RS) and ground-based (SOAS) observations over the Southeast US in summer 2013 using the GEOS-Chem chemical transport model. Emissions of nitrogen oxides (NOx ≡ NO + NO2) over the Southeast US are such that the peroxy radicals produced from isoprene oxidation (ISOPO2) react significantly with both NO (high-NOx pathway) and HO2 (low-NOx pathway), leading to different suites of isoprene SOA precursors. We find a mean SOA mass yield of 3.3 % from isoprene oxidation, consistent with the observed relationship of total fine organic aerosol (OA) and formaldehyde (a product of isoprene oxidation). Isoprene SOA production is mainly contributed by two immediate gas-phase precursors, isoprene epoxydiols (IEPOX, 58% of isoprene SOA) from the low-NOx pathway and glyoxal (28%) from both low- and high-NOx pathways. This speciation is consistent with observations of IEPOX SOA from SOAS and SEAC4RS. Observations show a strong relationship between IEPOX SOA and sulfate aerosol that we explain as due to the effect of sulfate on aerosol acidity and volume. Isoprene SOA concentrations increase as NOx emissions decrease (favoring the low-NOx pathway for isoprene oxidation), but decrease more strongly as SO2 emissions decrease (due to the effect of sulfate on aerosol acidity and volume). The US EPA projects 2013-2025 decreases in anthropogenic emissions of 34% for NOx (leading to 7% increase in isoprene SOA) and 48% for SO2 (35% decrease in isoprene SOA). Reducing SO2 emissions decreases sulfate and isoprene SOA by a similar magnitude, representing a factor of 2 co-benefit for PM2.5 from SO2 emission controls.
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Affiliation(s)
- E A Marais
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - D J Jacob
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
- Earth and Planetary Sciences, Harvard University, Cambridge, MA, USA
| | - J L Jimenez
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
- Department of Chemistry and Biochemistry, University of Colorado, Boulder, CO, USA
| | - P Campuzano-Jost
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
- Department of Chemistry and Biochemistry, University of Colorado, Boulder, CO, USA
| | - D A Day
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
- Department of Chemistry and Biochemistry, University of Colorado, Boulder, CO, USA
| | - W Hu
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
- Department of Chemistry and Biochemistry, University of Colorado, Boulder, CO, USA
| | - J Krechmer
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
- Department of Chemistry and Biochemistry, University of Colorado, Boulder, CO, USA
| | - L Zhu
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - P S Kim
- Earth and Planetary Sciences, Harvard University, Cambridge, MA, USA
| | - C C Miller
- Earth and Planetary Sciences, Harvard University, Cambridge, MA, USA
| | - J A Fisher
- School of Chemistry and School of Earth and Environmental Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - K Travis
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - K Yu
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - T F Hanisco
- Atmospheric Chemistry and Dynamics Lab, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - G M Wolfe
- Atmospheric Chemistry and Dynamics Lab, NASA Goddard Space Flight Center, Greenbelt, MD, USA
- Joint Center for Earth Systems Technology, University of Maryland Baltimore County, Baltimore, MD, USA
| | - H L Arkinson
- Department of Atmospheric and Oceanic Science, University of Maryland, College Park, MD, USA
| | - H O T Pye
- National Exposure Research Laboratory, US EPA, Research Triangle Park, NC, USA
| | - K D Froyd
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
- Chemical Sciences Division, Earth System Research Laboratory, NOAA, Boulder, Colorado, USA
| | - J Liao
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
- Chemical Sciences Division, Earth System Research Laboratory, NOAA, Boulder, Colorado, USA
| | - V F McNeill
- Department of Chemical Engineering, Columbia University, New York, New York 10027, USA
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30
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Marais EA, Jacob DJ, Jimenez JL, Campuzano-Jost P, Day DA, Hu W, Krechmer J, Zhu L, Kim PS, Miller CC, Fisher JA, Travis K, Yu K, Hanisco TF, Wolfe GM, Arkinson HL, Pye HOT, Froyd KD, Liao J, McNeill VF. Aqueous-phase mechanism for secondary organic aerosol formation from isoprene: application to the Southeast United States and co-benefit of SO 2 emission controls. Atmos Chem Phys 2016. [PMID: 32742280 DOI: 10.5194/acp16-1603-2016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Isoprene emitted by vegetation is an important precursor of secondary organic aerosol (SOA), but the mechanism and yields are uncertain. Aerosol is prevailingly aqueous under the humid conditions typical of isoprene-emitting regions. Here we develop an aqueous-phase mechanism for isoprene SOA formation coupled to a detailed gas-phase isoprene oxidation scheme. The mechanism is based on aerosol reactive uptake coefficients (γ) for water-soluble isoprene oxidation products, including sensitivity to aerosol acidity and nucleophile concentrations. We apply this mechanism to simulation of aircraft (SEAC4RS) and ground-based (SOAS) observations over the Southeast US in summer 2013 using the GEOS-Chem chemical transport model. Emissions of nitrogen oxides (NOx ≡ NO + NO2) over the Southeast US are such that the peroxy radicals produced from isoprene oxidation (ISOPO2) react significantly with both NO (high-NOx pathway) and HO2 (low-NOx pathway), leading to different suites of isoprene SOA precursors. We find a mean SOA mass yield of 3.3 % from isoprene oxidation, consistent with the observed relationship of total fine organic aerosol (OA) and formaldehyde (a product of isoprene oxidation). Isoprene SOA production is mainly contributed by two immediate gas-phase precursors, isoprene epoxydiols (IEPOX, 58% of isoprene SOA) from the low-NOx pathway and glyoxal (28%) from both low- and high-NOx pathways. This speciation is consistent with observations of IEPOX SOA from SOAS and SEAC4RS. Observations show a strong relationship between IEPOX SOA and sulfate aerosol that we explain as due to the effect of sulfate on aerosol acidity and volume. Isoprene SOA concentrations increase as NOx emissions decrease (favoring the low-NOx pathway for isoprene oxidation), but decrease more strongly as SO2 emissions decrease (due to the effect of sulfate on aerosol acidity and volume). The US EPA projects 2013-2025 decreases in anthropogenic emissions of 34% for NOx (leading to 7% increase in isoprene SOA) and 48% for SO2 (35% decrease in isoprene SOA). Reducing SO2 emissions decreases sulfate and isoprene SOA by a similar magnitude, representing a factor of 2 co-benefit for PM2.5 from SO2 emission controls.
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Affiliation(s)
- E A Marais
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - D J Jacob
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
- Earth and Planetary Sciences, Harvard University, Cambridge, MA, USA
| | - J L Jimenez
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
- Department of Chemistry and Biochemistry, University of Colorado, Boulder, CO, USA
| | - P Campuzano-Jost
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
- Department of Chemistry and Biochemistry, University of Colorado, Boulder, CO, USA
| | - D A Day
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
- Department of Chemistry and Biochemistry, University of Colorado, Boulder, CO, USA
| | - W Hu
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
- Department of Chemistry and Biochemistry, University of Colorado, Boulder, CO, USA
| | - J Krechmer
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
- Department of Chemistry and Biochemistry, University of Colorado, Boulder, CO, USA
| | - L Zhu
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - P S Kim
- Earth and Planetary Sciences, Harvard University, Cambridge, MA, USA
| | - C C Miller
- Earth and Planetary Sciences, Harvard University, Cambridge, MA, USA
| | - J A Fisher
- School of Chemistry and School of Earth and Environmental Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - K Travis
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - K Yu
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - T F Hanisco
- Atmospheric Chemistry and Dynamics Lab, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - G M Wolfe
- Atmospheric Chemistry and Dynamics Lab, NASA Goddard Space Flight Center, Greenbelt, MD, USA
- Joint Center for Earth Systems Technology, University of Maryland Baltimore County, Baltimore, MD, USA
| | - H L Arkinson
- Department of Atmospheric and Oceanic Science, University of Maryland, College Park, MD, USA
| | - H O T Pye
- National Exposure Research Laboratory, US EPA, Research Triangle Park, NC, USA
| | - K D Froyd
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
- Chemical Sciences Division, Earth System Research Laboratory, NOAA, Boulder, Colorado, USA
| | - J Liao
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
- Chemical Sciences Division, Earth System Research Laboratory, NOAA, Boulder, Colorado, USA
| | - V F McNeill
- Department of Chemical Engineering, Columbia University, New York, New York 10027, USA
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Fisher JA, Jacob DJ, Travis KR, Kim PS, Marais EA, Miller CC, Yu K, Zhu L, Yantosca RM, Sulprizio MP, Mao J, Wennberg PO, Crounse JD, Teng AP, Nguyen TB, St Clair JM, Cohen RC, Romer P, Nault BA, Wooldridge PJ, Jimenez JL, Campuzano-Jost P, Day DA, Hu W, Shepson PB, Xiong F, Blake DR, Goldstein AH, Misztal PK, Hanisco TF, Wolfe GM, Ryerson TB, Wisthaler A, Mikoviny T. Organic nitrate chemistry and its implications for nitrogen budgets in an isoprene- and monoterpene-rich atmosphere: constraints from aircraft (SEAC 4RS) and ground-based (SOAS) observations in the Southeast US. Atmos Chem Phys 2016; 16:5969-5991. [PMID: 29681921 PMCID: PMC5906813 DOI: 10.5194/acp-16-5969-2016] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Formation of organic nitrates (RONO2) during oxidation of biogenic volatile organic compounds (BVOCs: isoprene, monoterpenes) is a significant loss pathway for atmospheric nitrogen oxide radicals (NOx), but the chemistry of RONO2 formation and degradation remains uncertain. Here we implement a new BVOC oxidation mechanism (including updated isoprene chemistry, new monoterpene chemistry, and particle uptake of RONO2) in the GEOS-Chem global chemical transport model with ∼25 × 25 km2 resolution over North America. We evaluate the model using aircraft (SEAC4RS) and ground-based (SOAS) observations of NOx, BVOCs, and RONO2 from the Southeast US in summer 2013. The updated simulation successfully reproduces the concentrations of individual gas- and particle-phase RONO2 species measured during the campaigns. Gas-phase isoprene nitrates account for 25-50% of observed RONO2 in surface air, and we find that another 10% is contributed by gas-phase monoterpene nitrates. Observations in the free troposphere show an important contribution from long-lived nitrates derived from anthropogenic VOCs. During both campaigns, at least 10% of observed boundary layer RONO2 were in the particle phase. We find that aerosol uptake followed by hydrolysis to HNO3 accounts for 60% of simulated gas-phase RONO2 loss in the boundary layer. Other losses are 20% by photolysis to recycle NOx and 15% by dry deposition. RONO2 production accounts for 20% of the net regional NOx sink in the Southeast US in summer, limited by the spatial segregation between BVOC and NOx emissions. This segregation implies that RONO2 production will remain a minor sink for NOx in the Southeast US in the future even as NOx emissions continue to decline.
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Affiliation(s)
- J A Fisher
- Centre for Atmospheric Chemistry, School of Chemistry, University of Wollongong, Wollongong, NSW, Australia
- School of Earth and Environmental Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - D J Jacob
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
- Department of Earth and Planetary Sciences, Harvard University, Cambridge, MA, USA
| | - K R Travis
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - P S Kim
- Department of Earth and Planetary Sciences, Harvard University, Cambridge, MA, USA
| | - E A Marais
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - C Chan Miller
- Department of Earth and Planetary Sciences, Harvard University, Cambridge, MA, USA
| | - K Yu
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - L Zhu
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - R M Yantosca
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - M P Sulprizio
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - J Mao
- Program in Atmospheric and Oceanic Sciences, Princeton University, Princeton, NJ, USA
- Geophysical Fluid Dynamics Laboratory/National Oceanic and Atmospheric Administration, Princeton, NJ, USA
| | - P O Wennberg
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA, USA
- Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, USA
| | - J D Crounse
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA, USA
| | - A P Teng
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA, USA
| | - T B Nguyen
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA, USA
- Now at Department of Environmental Toxicology, University of California at Davis, Davis, CA, USA
| | - J M St Clair
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA, USA
- Now at Atmospheric Chemistry and Dynamics Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA and Joint Center for Earth Systems Technology, University of Maryland Baltimore County, Baltimore, MD, USA
| | - R C Cohen
- Department of Chemistry, University of California at Berkeley, Berkeley, CA, USA
- Department of Earth and Planetary Science, University of California at Berkeley, Berkeley, CA, USA
| | - P Romer
- Department of Chemistry, University of California at Berkeley, Berkeley, CA, USA
| | - B A Nault
- Department of Earth and Planetary Science, University of California at Berkeley, Berkeley, CA, USA
- Now at Department of Chemistry and Biochemistry and Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - P J Wooldridge
- Department of Chemistry, University of California at Berkeley, Berkeley, CA, USA
| | - J L Jimenez
- Department of Chemistry and Biochemistry, University of Colorado, Boulder, CO, USA
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - P Campuzano-Jost
- Department of Chemistry and Biochemistry, University of Colorado, Boulder, CO, USA
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - D A Day
- Department of Chemistry and Biochemistry, University of Colorado, Boulder, CO, USA
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - W Hu
- Department of Chemistry and Biochemistry, University of Colorado, Boulder, CO, USA
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - P B Shepson
- Department of Chemistry, Purdue University, West Lafayette, IN, USA
- Department of Earth, Atmospheric and Planetary Sciences, Purdue University, West Lafayette, IN, USA
| | - F Xiong
- Department of Chemistry, Purdue University, West Lafayette, IN, USA
| | - D R Blake
- Department of Chemistry, University of California Irvine, Irvine, CA, USA
| | - A H Goldstein
- Department of Environmental Science, Policy, and Management, University of California at Berkeley, Berkeley, CA, USA
- Department of Civil and Environmental Engineering, University of California at Berkeley, Berkeley, CA, USA
| | - P K Misztal
- Department of Environmental Science, Policy, and Management, University of California at Berkeley, Berkeley, CA, USA
| | - T F Hanisco
- Atmospheric Chemistry and Dynamics Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - G M Wolfe
- Atmospheric Chemistry and Dynamics Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA
- Joint Center for Earth Systems Technology, University of Maryland Baltimore County, Baltimore, MD, USA
| | - T B Ryerson
- Chemical Sciences Division, Earth System Research Lab, National Oceanic and Atmospheric Administration, Boulder, CO, USA
| | - A Wisthaler
- Department of Chemistry, University of Oslo, Oslo, Norway
- Institute for Ion Physics and Applied Physics, University of Innsbruck, Innsbruck, Austria
| | - T Mikoviny
- Department of Chemistry, University of Oslo, Oslo, Norway
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Puett RC, Hart JE, Yanosky JD, Spiegelman D, Wang M, Fisher JA, Hong B, Laden F. Particulate matter air pollution exposure, distance to road, and incident lung cancer in the nurses' health study cohort. Environ Health Perspect 2014; 122:926-32. [PMID: 24911062 PMCID: PMC4154215 DOI: 10.1289/ehp.1307490] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 06/02/2014] [Indexed: 05/03/2023]
Abstract
BACKGROUND A body of literature has suggested an elevated risk of lung cancer associated with particulate matter and traffic-related pollutants. OBJECTIVE We examined the relation of lung cancer incidence with long-term residential exposures to ambient particulate matter and residential distance to roadway, as a proxy for traffic-related exposures. METHODS For participants in the Nurses' Health Study, a nationwide prospective cohort of women, we estimated 72-month average exposures to PM2.5, PM2.5-10, and PM10 and residential distance to road. Follow-up for incident cases of lung cancer occurred from 1994 through 2010. Cox proportional hazards models were adjusted for potential confounders. Effect modification by smoking status was examined. RESULTS During 1,510,027 person-years, 2,155 incident cases of lung cancer were observed among 103,650 participants. In fully adjusted models, a 10-μg/m3 increase in 72-month average PM10 [hazard ratio (HR) = 1.04; 95% CI: 0.95, 1.14], PM2.5 (HR = 1.06; 95% CI: 0.91, 1.25), or PM2.5-10 (HR = 1.05; 95% CI: 0.92, 1.20) was positively associated with lung cancer. When the cohort was restricted to never-smokers and to former smokers who had quit at least 10 years before, the associations appeared to increase and were strongest for PM2.5 (PM10: HR = 1.15; 95% CI: 1.00, 1.32; PM2.5: HR = 1.37; 95% CI: 1.06, 1.77; PM2.5-10: HR = 1.11; 95% CI: 0.90, 1.37). RESULTS were most elevated when restricted to the most prevalent subtype, adenocarcinomas. Risks with roadway proximity were less consistent. CONCLUSIONS Our findings support those from other studies indicating increased risk of incident lung cancer associated with ambient PM exposures, especially among never- and long-term former smokers.
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Affiliation(s)
- Robin C Puett
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA
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Fisher JA, Puett RC, Yanosky JD, Pavlovich M, Reed RM, Hibbert J, Mitchell BD. Seasonality of Metabolic Syndrome Characteristics in the Old Order Amish. Ann Epidemiol 2014. [DOI: 10.1016/j.annepidem.2014.06.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Li Y, Weber NS, Fisher JA, Yolken RH, Cowan DN, Larsen RA, Niebuhr DW. Association between antibodies to multiple infectious and food antigens and new onset schizophrenia among US military personnel. Schizophr Res 2013; 151:36-42. [PMID: 24139899 DOI: 10.1016/j.schres.2013.10.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 09/30/2013] [Accepted: 10/03/2013] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Multiple studies have documented immune activation in many individuals with schizophrenia suggesting that antigens capable of generating a prolonged immune response may be important environmental factors in many cases of this disorder. While existing studies have found single-agent associations of antibodies to food and neurotropic infectious agents with schizophrenia, a simultaneous examination of multiple agents may shed light on agent interactions or possible etiopathogenic pathways. METHODS We used traditional regression and novel statistical techniques to examine associations of single and combined infectious and food antigens with schizophrenia. We tested 6106 serum samples from 855 cases and 1165 matched controls. RESULTS Higher antibody levels to casein were borderline significant in the prediction of schizophrenia (HR=1.08, p=0.06). Study participants with higher cytomegalovirus (CMV) IgG antibody levels had a reduced risk of developing schizophrenia (HR=0.90; p=0.02). While IgG antibodies to gliadin, Toxoplasma gondii, vaccinia, measles, and human herpesvirus-6 (HHV-6) showed no significant independent associations with schizophrenia, the increase in antibody levels to several combinations of agents, to include casein, measles, CMV, T. gondii and vaccinia, was predictive of an 18-34% increase in the risk of developing schizophrenia. CONCLUSION Certain patterns of antibodies, involving some agents, were predictive of developing schizophrenia, with the magnitude of association rising when the level of antibodies increased to two or more agents. A heightened antibody response to a combination of several infectious/food antigens might be an indicator of an altered immune response to antigenic stimuli.
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Affiliation(s)
- Yuanzhang Li
- Preventive Medicine Program, Walter Reed Army Institute of Research, 503 Robert Grant Ave., Silver Spring, MD 20910, United States
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Fierstra J, Sobczyk O, Battisti-Charbonney A, Mandell DM, Poublanc J, Crawley AP, Mikulis DJ, Duffin J, Fisher JA. Measuring cerebrovascular reactivity: what stimulus to use? J Physiol 2013; 591:5809-21. [PMID: 24081155 DOI: 10.1113/jphysiol.2013.259150] [Citation(s) in RCA: 201] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Cerebrovascular reactivity is the change in cerebral blood flow in response to a vasodilatory or vasoconstrictive stimulus. Measuring variations of cerebrovascular reactivity between different regions of the brain has the potential to not only advance understanding of how the cerebral vasculature controls the distribution of blood flow but also to detect cerebrovascular pathophysiology. While there are standardized and repeatable methods for estimating the changes in cerebral blood flow in response to a vasoactive stimulus, the same cannot be said for the stimulus itself. Indeed, the wide variety of vasoactive challenges currently employed in these studies impedes comparisons between them. This review therefore critically examines the vasoactive stimuli in current use for their ability to provide a standard repeatable challenge and for the practicality of their implementation. Such challenges include induced reductions in systemic blood pressure, and the administration of vasoactive substances such as acetazolamide and carbon dioxide. We conclude that many of the stimuli in current use do not provide a standard stimulus comparable between individuals and in the same individual over time. We suggest that carbon dioxide is the most suitable vasoactive stimulus. We describe recently developed computer-controlled MRI compatible gas delivery systems which are capable of administering reliable and repeatable vasoactive CO2 stimuli.
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Affiliation(s)
- J Fierstra
- J. Duffin: Department of Physiology, Medical Sciences Building, 1 King's College Circle, University of Toronto, Toronto, Ontario, Canada, M5S 1A8.
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Weber NS, Fisher JA, Cowan DN, Postolache TT, Larsen RA, Niebuhr DW. Descriptive epidemiology and underlying psychiatric disorders among hospitalizations with self-directed violence. PLoS One 2013; 8:e59818. [PMID: 23555791 PMCID: PMC3608546 DOI: 10.1371/journal.pone.0059818] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 02/19/2013] [Indexed: 12/02/2022] Open
Abstract
Background Suicide claims over one million lives worldwide each year. In the United States, 1 per 10,000 persons dies from suicide every year, and these rates have remained relatively constant over the last 20 years. There are nearly 25 suicide attempts for each suicide, and previous self-directed violence is a strong predictor of death from suicide. While many studies have focused on suicides, the epidemiology of non-fatal self-directed violence is not well-defined. Objective We used a nationally representative survey to examine demographics and underlying psychiatric disorders in United States (US) hospitalizations with non-fatal self-directed violence (SDV). Method International Classification of Disease, 9th Revision (ICD-9) discharge diagnosis data from the National Hospital Discharge Survey (NHDS) were examined from 1997 to 2006 using frequency measures and adjusted logistic regression. Results The rate of discharges with SDV remained relatively stable over the study time period with 4.5 to 5.7 hospitalizations per 10,000 persons per year. Excess SDV was documented for females, adolescents, whites, and those from the Midwest or West. While females had a higher likelihood of self-poisoning, both genders had comparable proportions of hospitalizations with SDV resulting in injury. Over 86% of the records listing SDV also included psychiatric disorders, with the most frequent being affective (57.8%) and substance abuse (37.1%) disorders. The association between psychiatric disorders and self-injury was strongest for personality disorders for both males (OR = 2.1; 95% CI = 1.3–3.4) and females (OR = 3.8; 95% CI = 2.7–5.3). Conclusion The NHDS provides new insights into the demographics and psychiatric morbidity of those hospitalized with SDV. Classification of SDV as self-injury or self-poisoning provides an additional parameter useful to epidemiologic studies.
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Affiliation(s)
- Natalya S Weber
- Preventive Medicine Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America.
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Weber NS, Fisher JA, Cowan DN, Niebuhr DW. Psychiatric and general medical conditions comorbid with bipolar disorder in the National Hospital Discharge Survey. Psychiatr Serv 2011; 62:1152-8. [PMID: 21969641 DOI: 10.1176/ps.62.10.pss6210_1152] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE From 40% to 65% of patients with bipolar disorder are estimated to have diagnoses of one or more comorbid conditions. The purpose of this study was to identify comorbid disorders and compare their prevalence in hospitalizations of persons with or without bipolar disorder. METHODS Data from the 1979-2006 National Hospital Discharge Survey (NHDS) were analyzed to examine temporal trends in the proportional morbidity of bipolar disorder, demographic characteristics, and the most frequent comorbid conditions in hospitalizations of patients with or without bipolar disorder. Among discharges of patients ages 13-64, the conditions of those with a primary diagnosis of bipolar disorder (N=27,054) were compared with those with other primary diagnoses (N=2,325,247). Proportional morbidity ratios (PMRs) were calculated. RESULTS There was an average 10% (p<.001) increase per year in the proportion of discharges with bipolar disorder. Proportions of discharge records that noted bipolar disorder were higher among females and whites and were highest among persons ages 13-19 and those from the Northeast. Discharge records noting a primary diagnosis of bipolar disorder showed higher proportions of most psychiatric and some general medical conditions, including acquired hypothyroidism (proportional morbidity ratio=2.6), viral hepatitis (1.6), obesity (1.4), and various diseases of the skin and subcutaneous tissue (range 2.6-4.2) and of the nervous (1.4-3.8), respiratory (1.4-2.3), and musculoskeletal (1.2-1.9) systems. CONCLUSIONS Patients with bipolar disorder have an increased illness burden from many psychiatric and general medical conditions. Knowledge of the most prevalent comorbid conditions and methods for their prevention, early diagnosis, and treatment are critical in improving the prognosis of patients with bipolar disorder.
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Affiliation(s)
- Natalya S Weber
- Division of Preventive Medicine, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA.
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Battisti-Charbonney A, Fisher JA, Duffin J. Respiratory, cerebrovascular and cardiovascular responses to isocapnic hypoxia. Respir Physiol Neurobiol 2011; 179:259-68. [PMID: 21939786 DOI: 10.1016/j.resp.2011.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Revised: 09/05/2011] [Accepted: 09/06/2011] [Indexed: 10/17/2022]
Abstract
We simultaneously measured respiratory, cerebrovascular and cardiovascular responses to 10-min of isoxic hypoxia at three constant CO(2) tensions in 15 subjects. We observed four response patterns, some novel, for ventilation, middle cerebral artery blood flow velocity, heart rate and mean arterial blood pressure. The occurrence of the response patterns was correlated between some measures. Isoxic hyperoxic and hypoxic ventilatory sensitivities to CO(2) derived from these responses were equivalent to those measured with modified (Duffin) rebreathing tests, but cerebrovascular sensitivities were not. We suggest the different ventilatory response patterns reflect the time course of carotid body afferent activity; in some individuals, carotid body function changes during hypoxia in more complex ways than previously thought. We concluded that isoxic hyperoxic and hypoxic ventilatory sensitivities to CO(2) can be measured using multiple hypoxic ventilatory response tests only if care is taken choosing the isocapnic CO(2) levels used, but a similar approach to measuring the cerebrovascular response to isocapnic hyperoxia and hypoxia is unfeasible.
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Katznelson R, Naughton F, Friedman Z, Lei D, Duffin J, Fedorko L, Wasowicz M, Van Rensburg A, Murphy J, Fisher JA. Increased lung clearance of isoflurane shortens emergence in obesity: a prospective randomized-controlled trial. Acta Anaesthesiol Scand 2011; 55:995-1001. [PMID: 21770896 DOI: 10.1111/j.1399-6576.2011.02486.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is a concern that obesity may play a role in prolonging emergence from fat-soluble inhalational anaesthetics. We hypothesized that increased pulmonary clearance of isoflurane will shorten immediate recovery from anaesthesia and post-anaesthesia care unit (PACU) stay in obese patients. METHODS After Ethics Review Board approval, 44 ASA I-III patients with BMI>30 kg/m(2) undergoing elective gynaecological or urological surgery were randomized after completion of surgery to either an isocapnic hyperpnoea (IH) or a conventional recovery (C) group. The anaesthesia protocol included propofol, fentanyl, morphine, rocuronium and isoflurane in air/O(2) . Groups were compared using unpaired t-test and ANOVA. RESULTS Minute ventilation in the IH group before extubation was 22.6 ± 2.7 vs. 6.3 ± 1.8 l/min in the C group. Compared with C, the IH group had a shorter time to extubation (5.4 ± 2.7 vs. 15.8 ± 2.7 min, P<0.01), initiation of spontaneous ventilation (2.7 ± 2.3 vs. 6.5 ± 4.5 min, P<0.01), BIS recovery >75 (3.2 ± 2.3 vs. 8.9 ± 5.8 min, P<0.01), eye opening (4.6 ± 2.9 vs. 13.6 ± 7.1 min, P<0.01) and eligibility for leaving the operating room (7.1 ± 2.9 vs. 19.9 ± 11.9 min, P<0.01). There was no difference in time for eligibility for PACU discharge. CONCLUSION Increasing alveolar ventilation enhances anaesthetic elimination and accelerates short-term recovery in obese patients.
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Affiliation(s)
- R Katznelson
- Department of Anesthesia and Pain Management, University Health Network, Toronto General Hospital, ON, Canada.
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Conklin J, Fierstra J, Crawley AP, Han JS, Poublanc J, Silver FL, Tymianski M, Fisher JA, Mandell DM, Mikulis DJ. Mapping white matter diffusion and cerebrovascular reactivity in carotid occlusive disease. Neurology 2011; 77:431-8. [PMID: 21775744 DOI: 10.1212/wnl.0b013e318227b1e7] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To characterize the relationship between cerebrovascular reactivity (CVR) and white matter (WM) diffusion in patients with internal carotid artery (ICA) occlusive disease. METHODS In this exploratory observational study, 41 patients with severe stenosis or occlusion of the extracranial ICA and 12 healthy control subjects underwent CVR mapping using the fMRI response to hypercapnia. Conventional anatomic and diffusion-weighted MRI sequences were used to calculate maps of the apparent diffusion coefficient (ADC) and to exclude areas of previous ischemic injury. In all subjects, ADC was compared between WM with positive and negative CVR. In 27 patients with unilateral ICA involvement, ADC and CVR were compared between ipsilateral and contralateral WM while covarying for relevant clinical risk factors. RESULTS In patients with bilateral disease and in the ipsilateral hemisphere of patients with unilateral disease, negative CVR was associated with increased WM ADC (p < 0.01 and p < 0.005, respectively). In patients with unilateral disease, the ipsilateral CVR deficit was correlated with the degree of hemispheric WM ADC elevation (p < 0.005). ADC elevation remained significant after correction for potential confounding risk factors. CONCLUSIONS CVR impairment is associated with ADC elevation in normal-appearing WM of patients with severe stenosis or occlusion of the extracranial ICA. This finding is consistent with the presence of early, low-grade ischemic injury.
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Affiliation(s)
- J Conklin
- Department of Medical Imaging, Toronto Western Hospital, Toronto, ON, Canada
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Niebuhr DW, Li Y, Cowan DN, Weber NS, Fisher JA, Ford GM, Yolken R. Association between bovine casein antibody and new onset schizophrenia among US military personnel. Schizophr Res 2011; 128:51-5. [PMID: 21376538 DOI: 10.1016/j.schres.2011.02.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Revised: 02/01/2011] [Accepted: 02/04/2011] [Indexed: 11/24/2022]
Abstract
Schizophrenia is a pervasive neuropsychiatric disorder of uncertain etiology. Multiple studies have documented immune activation in individuals with schizophrenia. One antigen capable of inducing a prolonged immune response is bovine casein derived from ingested milk products. Increased levels of casein antibodies have been found in individuals with schizophrenia after diagnosis. This study was directed at determining the potential association between schizophrenia and pre-illness onset levels of immunoglobulin G (IgG) antibodies to bovine casein. Parallel analyses for casein antibody levels with bipolar disorder were included as comparison. Cases were service members who received medical discharges from the military with a schizophrenia diagnosis from 1992 to 2005. Serum specimens were selected for 855 cases and 1165 matched healthy controls. IgG antibodies to bovine whole-casein were measured by solid phase enzyme-linked immunosorbent assays (ELISAs). Hazard ratios (HR) were calculated to examine the associations of casein IgG level with risk of schizophrenia by time to diagnosis and by subjects' initial level. Increasing casein IgG antibody levels among those with a high initial level, drawn before diagnosis, was associated with an 18% increase in the hazard risk of schizophrenia per unit increase (value of low-positive standard) in IgG antibody levels (HR=1.18; 95% CI 1.04, 1.34). This is the first report to identify an association between the risk of schizophrenia and elevated antibodies to bovine casein prior to disease onset. Additional research is required to elucidate the complex genetic environmental interactions involved in the pathogenesis of schizophrenia and to identify potentially modifiable risk factors.
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Affiliation(s)
- David W Niebuhr
- Division of Preventive Medicine, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD 20910, USA.
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Cowan DN, Weber NS, Fisher JA, Bedno SA, Niebuhr DW. Incidence of adult onset schizophrenic disorders in the US military: patterns by sex, race and age. Schizophr Res 2011; 127:235-40. [PMID: 21227655 DOI: 10.1016/j.schres.2010.12.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Revised: 12/03/2010] [Accepted: 12/06/2010] [Indexed: 11/17/2022]
Abstract
BACKGROUND There are limited data describing the epidemiology of adult-onset schizophrenic disorders in the United States. Although the military is not proportionately comparable in all demographic characteristics to the civilian population, it is drawn from all racial/ethnic subgroups, and members range in age from 17 to >60 years. We describe the incidence of hospitalization for new onset schizophrenic disorders among military members by sex, race, and age. METHODS Using military inpatient data, we evaluated patterns of initial hospitalizations for schizophrenic disorders among military personnel for 2000-2009, focusing on sex, race, and age. No individual-level data were available. RESULTS From 2000-2009, 1976 military personnel had a first schizophrenic disorder hospitalization, with an overall incidence rate of 0.14/1000 person-years. There were no consistent changes in rates over time. While overall incidence rates were similar for men and women (incidence rate ratio (IRR)=1.10), rates were higher among men than women below age 25; after 25-30 rates were higher among women. Incidence was higher among blacks and other racial groups, with IRR=2.0 and 1.3, respectively. CONCLUSION Medical screening of military applicants prevents persons with overt or a reported history of psychosis, and most with serious behavior problems, from enlisting; therefore, first hospitalization is likely to reflect new illness. No pre-military socioeconomic data were available, however, essentially all study subjects were high school graduates; unmeasured differences in socioeconomic status were unlikely to explain the observed results. This report may provide lower bound estimates of the schizophrenic disorder incidence in the United States.
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Affiliation(s)
- David N Cowan
- Walter Reed Army Institute of Research, Department of Epidemiology, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA.
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Mandell DM, Han JS, Poublanc J, Crawley AP, Fierstra J, Tymianski M, Fisher JA, Mikulis DJ. Quantitative measurement of cerebrovascular reactivity by blood oxygen level-dependent MR imaging in patients with intracranial stenosis: preoperative cerebrovascular reactivity predicts the effect of extracranial-intracranial bypass surgery. AJNR Am J Neuroradiol 2011; 32:721-7. [PMID: 21436343 DOI: 10.3174/ajnr.a2365] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND PURPOSE CVR is a measure of cerebral hemodynamic impairment. A recently validated technique quantifies CVR by using a precise CO(2) vasodilatory stimulus and BOLD MR imaging. Our aim was to determine whether preoperative CO(2) BOLD CVR predicts the hemodynamic effect of ECIC bypass surgery in patients with intracranial steno-occlusive disease. MATERIALS AND METHODS Twenty-five patients undergoing ECIC bypass surgery for treatment of intracranial stenosis or occlusion were recruited. CVR was measured preoperatively and postoperatively and expressed as %ΔBOLD MR signal intensity per mm Hg ΔPetCO(2). Using normative data from healthy subjects, we stratified patients on the basis of preoperative CVR into 3 groups: normal CVR, reduced CVR, and negative (paradoxical) CVR. Wilcoxon 2-sample tests (2-sided, α = 0.05) were used to determine whether the 3 groups differed with respect to change in CVR following bypass surgery. RESULTS The group with normal preoperative CVR demonstrated no significant change in CVR following bypass surgery (mean, 0.22% ± 0.05% to 0.22% ± 0.01%; P = .881). The group with reduced preoperative CVR demonstrated a significant improvement following bypass surgery (mean, 0.08% ± 0.05% to 0.21 ± 0.08%; P < .001), and the group with paradoxical preoperative CVR demonstrated the greatest improvement (mean change, -0.04% ± 0.03% to 0.27% ± 0.03%; P = .028). CONCLUSIONS Preoperative measurement of CVR by using CO(2) BOLD MR imaging predicts the hemodynamic effect of ECIC bypass in patients with intracranial steno-occlusive disease. The technique is potentially useful for selecting patients for surgical revascularization.
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Affiliation(s)
- D M Mandell
- Division of Neuroradiology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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Slessarev M, Prisman E, Ito S, Watson RR, Jensen D, Preiss D, Greene R, Norboo T, Stobdan T, Diskit D, Norboo A, Kunzang M, Appenzeller O, Duffin J, Fisher JA. Differences in the control of breathing between Himalayan and sea-level residents. J Physiol 2010; 588:1591-606. [PMID: 20194122 DOI: 10.1113/jphysiol.2009.185504] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
We compared the control of breathing of 12 male Himalayan highlanders with that of 21 male sea-level Caucasian lowlanders using isoxic hyperoxic ( = 150 mmHg) and hypoxic ( = 50 mmHg) Duffin's rebreathing tests. Highlanders had lower mean +/- s.e.m. ventilatory sensitivities to CO(2) than lowlanders at both isoxic tensions (hyperoxic: 2.3 +/- 0.3 vs. 4.2 +/- 0.3 l min(1) mmHg(1), P = 0.021; hypoxic: 2.8 +/- 0.3 vs. 7.1 +/- 0.6 l min(1) mmHg(1), P < 0.001), and the usual increase in ventilatory sensitivity to CO(2) induced by hypoxia in lowlanders was absent in highlanders (P = 0.361). Furthermore, the ventilatory recruitment threshold (VRT) CO(2) tensions in highlanders were lower than in lowlanders (hyperoxic: 33.8 +/- 0.9 vs. 48.9 +/- 0.7 mmHg, P < 0.001; hypoxic: 31.2 +/- 1.1 vs. 44.7 +/- 0.7 mmHg, P < 0.001). Both groups had reduced ventilatory recruitment thresholds with hypoxia (P < 0.001) and there were no differences in the sub-threshold ventilations (non-chemoreflex drives to breathe) between lowlanders and highlanders at both isoxic tensions (P = 0.982), with a trend for higher basal ventilation during hypoxia (P = 0.052). We conclude that control of breathing in Himalayan highlanders is distinctly different from that of sea-level lowlanders. Specifically, Himalayan highlanders have decreased central and absent peripheral sensitivities to CO(2). Their response to hypoxia was heterogeneous, with the majority decreasing their VRT indicating either a CO(2)-independent increase in activity of peripheral chemoreceptor or hypoxia-induced increase in [H(+)] at the central chemoreceptor. In some highlanders, the decrease in VRT was accompanied by an increase in sensitivity to CO(2), while in others VRT remained unchanged and their sub-threshold ventilations increased, although these were not statistically significant.
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Affiliation(s)
- M Slessarev
- Department of Anesthesia, University Health Network, University of Toronto, Toronto, Canada
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Heyn C, Poublanc J, Crawley A, Mandell D, Han JS, Tymianski M, terBrugge K, Fisher JA, Mikulis DJ. Quantification of cerebrovascular reactivity by blood oxygen level-dependent MR imaging and correlation with conventional angiography in patients with Moyamoya disease. AJNR Am J Neuroradiol 2010; 31:862-7. [PMID: 20075092 DOI: 10.3174/ajnr.a1922] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND PURPOSE BOLD MR imaging combined with a technique for precision control of end-tidal pCO(2) was used to produce quantitative maps of CVR in patients with Moyamoya disease. The technique was validated against measures of disease severity by using conventional angiography; it then was used to study the relationship between CVR, vascular steal, and disease severity. MATERIALS AND METHODS A retrospective analysis comparing conventional angiography with BOLD MR imaging was performed on 11 patients with Moyamoya disease. Iso-oxic cycling of end-tidal pCO(2) between 2 target values was performed during BOLD MR imaging. CVR was calculated as the BOLD signal difference per Delta pCO(2). CVR was correlated with the presence of Moyamoya or pial collaterals and the degree of Moyamoya disease as graded by using a modified Suzuki score. RESULTS A good correlation between mean CVR and Suzuki score was found for the MCA and ACA territories (Pearson correlation coefficient, -0.7560 and -0.6140, respectively; P < .0001). A similar correlation was found between mean CVR and the presence of pial and Moyamoya collateral vessels for combined MCA and ACA territories (Pearson correlation coefficient, -0.7466; P < .0001). On a voxel-for-voxel basis, there was a greater extent of steal within vascular territories with increasing disease severity (higher modified Suzuki score). Mean CVR was found to scale nonlinearly with the extent of vascular steal. CONCLUSIONS Quantitative measures of CVR show direct correlation with impaired vascular supply as measured by the modified Suzuki score and enable direct investigation of the physiology of autoregulatory reserve, including steal phenomenon, within a given vascular territory.
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Affiliation(s)
- C Heyn
- Departments of Medical Imaging, Toronto Western Hospital of the University Health Network, Toronto, Ontario, Canada
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Hartel PG, Rodgers K, Moody GL, Hemmings SNJ, Fisher JA, McDonald JL. Combining targeted sampling and fluorometry to identify human fecal contamination in a freshwater creek. J Water Health 2008; 6:105-116. [PMID: 17998611 DOI: 10.2166/wh.2007.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Many bacterial source tracking (BST) methods are too expensive for most communities to afford. In an effort to develop an inexpensive method of detecting human sources of fecal contamination in a freshwater creek during baseflow and stormflow conditions, we combined targeted sampling with fluorometry. Targeted sampling is a prelude to BST and finds sources of fecal contamination by continued sampling and resampling over ever-decreasing distances. Fluorometry identifies human fecal contamination in water by detecting fluorescing compounds, optical brighteners, from laundry detergents. Potato Creek, a freshwater creek in Georgia (U.S.A.), had three reaches identified as containing high numbers of fecal bacteria, and these reaches were sampled by targeted sampling and fluorometry. Targeted sampling quickly and inexpensively identified humans, cattle, and dogs as the major sources of fecal contamination in the first, second, and third reaches, respectively. Fluorometric values were consistent with these identifications, but high fluorometric values were sometimes observed in areas with no fecal contamination. One likely cause of these false-positive signals was fluorescence from organic matter. For targeted sampling, the cost of each sample was $6, with a one-time equipment cost of $3,650; for fluorometry, the cost of each sample was negligible, with a one-time equipment cost of $14,250. This was the first study of this relatively inexpensive combination in freshwater during both baseflow and stormflow conditions.
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Affiliation(s)
- Peter G Hartel
- Department of Crop & Soil Sciences, University of Georgia, 3111 Plant Sciences, Athens, GA 30602-7272, USA.
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Hartel PG, Hagedorn C, McDonald JL, Fisher JA, Saluta MA, Dickerson JW, Gentit LC, Smith SL, Mantripragada NS, Ritter KJ, Belcher CN. Exposing water samples to ultraviolet light improves fluorometry for detecting human fecal contamination. Water Res 2007; 41:3629-42. [PMID: 17475305 DOI: 10.1016/j.watres.2007.03.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2007] [Revised: 03/07/2007] [Accepted: 03/20/2007] [Indexed: 05/15/2023]
Abstract
Fluorometry identifies human fecal contamination by detecting optical brighteners in environmental waters. Because optical brighteners are sensitive to sunlight, we determined if we could improve fluorometry by exposing water samples to ultraviolet (UV) light to differentiate between optical brighteners and other fluorescing organic compounds. Optical brighteners were likely present when the relative percentage difference in fluorometric value of the water before and after UV light exposure was >30% (glass cuvettes, 30 min exposure) or >15% (polymethacrylate cuvettes, 5 min exposure). In a blind study, we correctly identified the presence or absence of optical brighteners in 178 of 180 (99%) of the samples tested with a more expensive field fluorometer and in 175 of 180 (97%) of the samples tested with a less expensive handheld fluorometer. In the field, the method correctly identified two negative and three positive locations for human fecal contamination. When combined with counts of fecal bacteria, the new fluorometric method may be a simple, quick, and easy way to identify human fecal contamination in environmental waters.
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Affiliation(s)
- Peter G Hartel
- Department of Crop and Soil Sciences, 3111 Plant Sciences, University of Georgia, Athens, GA 30602-7272, USA.
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Watson RR, Greene ER, Prisman E, Slessarev M, Ito S, Norboo T, Stobdan T, Diskit D, Norboo A, Kunzang M, Fisher JA, Appenzeller O. Intima‐media thickness in Ladakh highlanders. FASEB J 2007. [DOI: 10.1096/fasebj.21.6.a947-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - E Prisman
- U of TToronto Gen HospTorontoM5G 2C4Canada
| | | | - S Ito
- U of TToronto Gen HospTorontoM5G 2C4Canada
| | | | | | | | | | | | - J A Fisher
- U of TToronto Gen HospTorontoM5G 2C4Canada
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McDonald JL, Hartel PG, Gentit LC, Belcher CN, Gates KW, Rodgers K, Fisher JA, Smith KA, Payne KA. Identifying sources of fecal contamination inexpensively with targeted sampling and bacterial source tracking. J Environ Qual 2006; 35:889-97. [PMID: 16641326 DOI: 10.2134/jeq2005.0328] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Most bacterial source tracking (BST) methods are too expensive for most communities to afford. We developed targeted sampling as a prelude to BST to reduce these costs. We combined targeted sampling with three inexpensive BST methods, Enterococcus speciation, detection of the esp gene, and fluorometry, to confirm the sources of fecal contamination to beaches on Georgia's Jekyll and Sea Islands during calm and stormy weather conditions. For Jekyll Island, the most likely source of contamination was bird feces because the percentage of Ent. faecalis was high (30%) and the esp gene was not detected. For the Sea Island beach during calm conditions, the most likely sources of fecal contamination were leaking sewer lines and wildlife feces. The leaking sewer lines were confirmed with fluorometry and detection of the esp gene. For the Sea Island beach during stormflow conditions, the most likely sources of fecal contamination were wildlife feces and runoff discharging from two county-maintained pipes. For the pipes, the most likely source of contamination was bird feces because the percentage of Ent. faecalis was high (30%) and the esp gene was not detected. Sediments were also a reservoir of fecal enterococci for both Jekyll and Sea Islands. Combining targeted sampling with two or more BST methods identified sources of fecal contamination quickly, easily, and inexpensively. This combination was the first time targeted sampling was conducted during stormy conditions, and the first time targeted sampling was combined with enterococcal speciation, detection of the esp gene, and fluorometry.
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Affiliation(s)
- Jennifer L McDonald
- Marine Extension Service, 715 Bay St., University of Georgia, Brunswick, GA 31520-4601, USA
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