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Hood RB, Norris AH, Shoben A, Miller WC, Harris RE, Pomeroy LW. Forecasting Hepatitis C Virus Status for Children in the United States: A Modeling Study. Clin Infect Dis 2024:ciae157. [PMID: 38630853 DOI: 10.1093/cid/ciae157] [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: 07/12/2023] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Virtually all cases of hepatitis C virus (HCV) infection in children in the United States occur through vertical transmission, but it is unknown how many children are infected. Cases of maternal HCV infection have increased in the United States, which may increase the number of children vertically infected with HCV. Infection has long-term consequences for a child's health, but treatment options are now available for children ≥3 years old. Reducing HCV infections in adults could decrease HCV infections in children. METHODS Using a stochastic compartmental model, we forecasted incidence of HCV infections in children in the United States from 2022 through 2027. The model considered vertical transmission to children <13 years old and horizontal transmission among individuals 13-49 years old. We obtained model parameters and initial conditions from the literature and the Centers for Disease Control and Prevention's 2021 Viral Hepatitis Surveillance Report. RESULTS Model simulations assuming direct-acting antiviral treatment for children forecasted that the number of acutely infected children would decrease slightly and the number of chronically infected children would decrease even more. Alone, treatment and early screening in individuals 13-49 years old reduced the number of forecasted cases in children and, together, these policy interventions were even more effective. CONCLUSIONS Based on our simulations, acute and chronic cases of HCV infection are remaining constant or slightly decreasing in the United States. Improving early screening and increasing access to treatment in adults may be an effective strategy for reducing the number of HCV infected children in the United States.
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Affiliation(s)
- Robert B Hood
- Division of Epidemiology, College of Public Health, Ohio State University, Columbus, Ohio, USA
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Alison H Norris
- Division of Epidemiology, College of Public Health, Ohio State University, Columbus, Ohio, USA
| | - Abigail Shoben
- Division of Biostatistics, College of Public Health, Ohio State University, Columbus, Ohio, USA
| | - William C Miller
- Division of Epidemiology, College of Public Health, Ohio State University, Columbus, Ohio, USA
| | - Randall E Harris
- Division of Epidemiology, College of Public Health, Ohio State University, Columbus, Ohio, USA
| | - Laura W Pomeroy
- Division of Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, Ohio, USA
- Translational Data Analytics Institute, Ohio State University, Columbus, Ohio, USA
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Christensen GM, Terrell ML, Pearce BD, Hood RB, Barton H, Pearson M, Marcus M. Exploring autism spectrum disorder (ASD) and attention deficit disorder (ADD/ADHD) in children exposed to polybrominated biphenyl. Environ Epidemiol 2024; 8:e304. [PMID: 38617420 PMCID: PMC11008633 DOI: 10.1097/ee9.0000000000000304] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/16/2024] [Indexed: 04/16/2024] Open
Abstract
Background Although the causes of attention-deficit/hyperactivity disorder (ADHD) and autism have not been identified, exposure to endocrine-disrupting chemicals, such as polybrominated biphenyl (PBB), during fetal development and early life has been suspected to impact neurological development. This study aims to investigate the association between prenatal and early life exposure to PBB and the development of ADHD and autism later in life. Methods Data from the Michigan PBB Registry, a cohort of Michigan residents who had been exposed to PBB in a mass contamination event in 1973, was leveraged for this nested case-control analysis among two distinct samples: (1) Those who self-reported ADHD or autism diagnosis, and (2) mothers who reported their child's ADHD or autism diagnosis. PBB exposure was measured in participants of the PBB Registry, and the mother's PBB level was used in mother-reported analyses. Cases were matched with controls by sex and year of birth. Conditional logistic regression models were used to estimate the association between PBB level and case status. Results PBB levels were higher among those who were exposed in early life compared with those exposed in utero (geometric mean: 0.300 ng/ml vs. 0.016 ng/ml). Among women in this cohort, a higher than expected proportion of self-reported ADHD diagnosis (11.11%), compared with population estimates. PBB was not associated with ADHD or autism in either self-reported or mother-reported analyses. Conclusions This study adds to the sparse literature about prenatal and early life exposure to PBB-153 and ADHD and autism. Future studies should examine potential effect modification by sex.
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Affiliation(s)
- Grace M. Christensen
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Metrecia L. Terrell
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Brad D. Pearce
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Robert B. Hood
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Hillary Barton
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Melanie Pearson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Michele Marcus
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
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Barat S, Hood RB, Terrell ML, Howards PP, Spencer JB, Wainstock T, Barton H, Pearson M, Kesner JS, Meadows JW, Marcus M, Gaskins AJ. In-utero exposure to polybrominated biphenyl (PBB) and menstrual cycle function in adulthood. Int J Hyg Environ Health 2024; 256:114297. [PMID: 38039561 PMCID: PMC10872753 DOI: 10.1016/j.ijheh.2023.114297] [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: 06/20/2023] [Revised: 10/12/2023] [Accepted: 11/23/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND There is evidence that in-utero exposure to PBBs, and similar chemicals, are associated with several adverse reproductive health outcomes including altered pubertal timing. However, less is known about the effects of in-utero exposure to PBBs on menstrual cycle function and reproductive hormone levels in adulthood. METHODS For this menstrual cycle study, we recruited reproductive-aged women in the Michigan PBB Registry who were not pregnant, lactating, or taking hormonal medications (2004-2014). A total of 41 women who were born after the PBB contamination incident (1973-1974) and were prenatally exposed to PBBs, were included in this analysis. We estimated in-utero PBB exposure using maternal serum PBB measurements taken after exposure and extrapolated to time of pregnancy using a PBB elimination model. Women were followed for up to 6 months during which they provided daily urine samples and completed daily diaries. The urine samples were assayed for estrone 3-glucuronide (E13G), pregnanediol 3-glucuronide (Pd3G), and follicle stimulating hormone (FSH). RESULTS Women in our study were, on average, 27.5 (SD:5.3) years old and contributed 4.9 (SD:1.9) menstrual cycles of follow-up. Compared to women with low in-utero PBB exposure (≤1 ppb), women with medium (>1.0-3.0 ppb) and high (>3.0 ppb) exposure had higher maximum 3-day mean Pd3G levels during the luteal phase. Specifically, the age- and creatinine-adjusted maximum 3-day mean luteal phase Pd3G levels (95% CI) in increasing categories of in-utero PBB exposure were 9.2 (4.6,13.9), 14.8 (11.6,18.0), and 16.1 (12.9,19.3) μg/mg creatinine. There were no meaningful differences in average cycle length, follicular or luteal phase cycle length, bleed length, or creatinine-adjusted E13G or FSH levels by category of in-utero PBB exposure. CONCLUSION Higher exposure to PBB in-utero was associated with increased progesterone levels across the luteal phase, however, most other menstrual cycle characteristics were largely unassociated with in-utero PBB exposure. Given our modest sample size, our results require cautious interpretation.
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Affiliation(s)
- Suman Barat
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Robert B Hood
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Metrecia L Terrell
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Penelope P Howards
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jessica B Spencer
- Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Emory University School of Medicine, Atlanta, GA, USA
| | - Tamar Wainstock
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University, Be'er Sheva, Israel
| | - Hillary Barton
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Melanie Pearson
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - James S Kesner
- Division of Applied Research and Technology, National Institute for Occupational Safety & Health, Cincinnati, OH, USA
| | - Juliana W Meadows
- Health Effects Laboratory Division, National Institute for Occupational Safety & Health, Cincinnati, OH, USA
| | - Michele Marcus
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Audrey J Gaskins
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Andre KE, Hood RB, Gaskins AJ, Kawwass JF, Almquist RG, Kramer MR, Hipp HS. Neighborhood deprivation and racial differences in in vitro fertilization outcomes. Am J Obstet Gynecol 2024; 230:352.e1-352.e18. [PMID: 37939983 DOI: 10.1016/j.ajog.2023.11.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND There are significant racial disparities in in vitro fertilization outcomes, which are poorly explained by individual-level characteristics. Environmental factors such as neighborhood-level socioeconomic factors may contribute to these disparities. However, few studies have directly addressed this research question in a large, racially diverse cohort. OBJECTIVE This study aimed to investigate whether neighborhood deprivation is associated with differences in in vitro fertilization outcomes. STUDY DESIGN Our retrospective cohort study included 1110 patients who underwent 2254 autologous in vitro fertilization cycles between 2014 and 2019 at an academic fertility center in the Southeastern United States. Neighborhood deprivation was estimated using the Neighborhood Deprivation Index, a composite variable measuring community levels of material capital based on poverty, occupation, housing, and education domains. Using multivariable log-binomial generalized estimating equations with cluster weighting, risk ratios and 95% confidence intervals were estimated for cycle cancellation, miscarriage (defined as spontaneous pregnancy loss before 20 weeks after a confirmed intrauterine gestation), and live birth according to patient Neighborhood Deprivation Index. RESULTS There were positive associations between increasing Neighborhood Deprivation Index (indicating worsening neighborhood deprivation) and body mass index, as well as increasing prevalence of tubal and uterine factor infertility diagnoses. The crude probability of live birth per cycle was lower among Black (24%) than among White patients (32%), and the crude probability of miscarriage per clinical pregnancy was higher among Black (22%) than among White patients (12%). After adjustment, the Neighborhood Deprivation Index was not significantly associated with risk of cycle cancellation or live birth. Results were consistent when analyses were stratified by race. CONCLUSION Our research demonstrates racial disparities between Black and White women in the incidence of miscarriage and live birth following in vitro fertilization. Although the level of neighborhood deprivation was closely related to race, it did not have strong associations with in vitro fertilization outcomes in our population as a whole or within strata of race.
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Affiliation(s)
- Kerri E Andre
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA.
| | - Robert B Hood
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Audrey J Gaskins
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Jennifer F Kawwass
- Division of Reproductive Endocrinology, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA
| | - R Garland Almquist
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA
| | - Michael R Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Heather S Hipp
- Division of Reproductive Endocrinology, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA
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Tang Z, Gaskins AJ, Hood RB, Ford JB, Hauser R, Smith AK, Everson TM. Former smoking associated with epigenetic modifications in human granulosa cells among women undergoing assisted reproduction. Sci Rep 2024; 14:5009. [PMID: 38424222 PMCID: PMC10904848 DOI: 10.1038/s41598-024-54957-2] [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: 11/14/2023] [Accepted: 02/19/2024] [Indexed: 03/02/2024] Open
Abstract
Smoking exposure during adulthood can disrupt oocyte development in women, contributing to infertility and possibly adverse birth outcomes. Some of these effects may be reflected in epigenome profiles in granulosa cells (GCs) in human follicular fluid. We compared the epigenetic modifications throughout the genome in GCs from women who were former (N = 15) versus never smokers (N = 44) undergoing assisted reproductive technologies (ART). This study included 59 women undergoing ART. Smoking history including time since quitting was determined by questionnaire. GCs were collected during oocyte retrieval and DNA methylation (DNAm) levels were profiled using the Infinium MethylationEPIC BeadChip. We performed an epigenome-wide association study with robust linear models, regressing DNAm level at individual loci on smoking status, adjusting for age, ovarian stimulation protocol, and three surrogate variables. We performed differentially methylated regions (DMRs) analysis and over-representation analysis of the identified CpGs and corresponding gene set. 81 CpGs were differentially methylated among former smokers compared to never smokers (FDR < 0.05). We identified 2 significant DMRs (KCNQ1 and RHBDD2). The former smoking-associated genes were enriched in oxytocin signaling, adrenergic signaling in cardiomyocytes, platelet activation, axon guidance, and chemokine signaling pathway. These epigenetic variations have been associated with inflammatory responses, reproductive outcomes, cancer development, neurodevelopmental disorder, and cardiometabolic health. Secondarily, we examined the relationships between time since quitting and DNAm at significant CpGs. We observed three CpGs in negative associations with the length of quitting smoking (p < 0.05), which were cg04254052 (KCNIP1), cg22875371 (OGDHL), and cg27289628 (LOC148145), while one in positive association, which was cg13487862 (PLXNB1). As a pilot study, we demonstrated epigenetic modifications associated with former smoking in GCs. The study is informative to potential biological pathways underlying the documented association between smoking and female infertility and biomarker discovery for smoking-associated reproductive outcomes.
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Affiliation(s)
- Ziyin Tang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Audrey J Gaskins
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Robert B Hood
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jennifer B Ford
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Alicia K Smith
- Department of Obstetrics and Gynecology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Todd M Everson
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Hood RB, Terrell ML, Mardovich S, Somers EC, Pearson M, Barton H, Tomlinson MS, Marder ME, Barr DB, Marcus M. Polybrominated biphenyls (PBBs) and prevalence of autoimmune disorders among members of the Michigan PBB registry. Environ Res 2023; 239:117312. [PMID: 37806482 PMCID: PMC10843028 DOI: 10.1016/j.envres.2023.117312] [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] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/15/2023] [Accepted: 10/04/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Polybrominated biphenyls (PBBs), a class of endocrine disrupting chemicals, were the main chemicals present in one of the largest industrial accidents in the United States. We investigated the association between serum PBB-153 levels and autoimmune disorders among members of the Michigan PBB Registry. METHODS Eight hundred and ninety-five members of the registry had both a serum PBB-153 measurement and had completed one or more questionnaires about autoimmune disorders. Autoimmune disorders were examined collectively and within specific organ systems. Sex-stratified unadjusted and adjusted log-binomial models were used to examine the association between tertiles of serum PBB-153 levels and autoimmune disorders. Models were adjusted by lifestage at exposure (in utero, childhood, adulthood), smoking history (never, past, current), and total serum lipid levels (continuous). We utilized cubic spline models to investigate non-linearity between serum PBB-153 levels and the prevalence of autoimmune disorders. RESULTS Approximately 12.9% and 20.7% of male and female participants reported having one or more autoimmune disorders, respectively. After adjustment for potential confounders, we observed no association between PBB-153 tertiles and the composite classification of 'any autoimmune disorder' in either sex. We observed some evidence for an association between serum PBB-153 levels and rheumatoid arthritis in males and females; however, this was not statistically significant in females. We also observed some evidence for an association between serum PBB-153 levels and neurological- and thyroid-related autoimmune disorders in females, but again this was not statistically significant. Additionally, we identified dose-response curves for serum PBB-153 levels and the prevalence of autoimmune disorders that differed by lifestage of exposure and sex. CONCLUSIONS We observed some evidence that increasing serum PBB-153 levels were associated with three specified autoimmune disorders. Studies focusing on these three autoimmune disorders and the potential non-linear trend differences by lifestage of exposure warrant further investigation.
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Affiliation(s)
- Robert B Hood
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA.
| | - Metrecia L Terrell
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Sarah Mardovich
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Emily C Somers
- Departments of Internal Medicine, Environmental Health Sciences and Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Melanie Pearson
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Hillary Barton
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Martha Scott Tomlinson
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - M Elizabeth Marder
- Department of Environmental Toxicology, University of California, Davis, CA, USA
| | - Dana Boyd Barr
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Michele Marcus
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA; Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
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Hood RB, Liang D, Tan Y, Ford JB, Souter I, Chavarro JE, Jones DP, Hauser R, Gaskins AJ. Serum and follicular fluid metabolome and markers of ovarian stimulation. Hum Reprod 2023; 38:2196-2207. [PMID: 37740688 PMCID: PMC10628502 DOI: 10.1093/humrep/dead189] [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: 04/06/2023] [Revised: 08/22/2023] [Indexed: 09/25/2023] Open
Abstract
STUDY QUESTION What metabolic pathways and metabolites in the serum and follicular fluid are associated with peak estradiol levels and the number of mature oocytes? SUMMARY ANSWER In the serum metabolome, mostly fatty acid and amino acid pathways were associated with estradiol levels and mature oocytes while in the follicular fluid metabolome, mostly lipid, vitamin, and hormone pathways were associated with peak estradiol levels and mature oocytes. WHAT IS KNOWN ALREADY Metabolomics has identified several metabolic pathways and metabolites associated with infertility but limited data are available for ovarian stimulation outcomes. STUDY DESIGN, SIZE, DURATION A prospective cohort study of women undergoing IVF from 2009 to 2015. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 125 women undergoing a fresh IVF cycle at a fertility clinic in the Northeast United States who provided a serum and follicular fluid sample. Untargeted metabolomics profiling was conducted using liquid chromatography with high-resolution mass spectrometry in two chromatography columns (C18 and hydrophilic interaction chromatography (HILIC)). The main ovarian stimulation outcomes were peak serum estradiol levels and number of mature oocytes. We utilized adjusted generalized linear regression models to identify significant metabolic features. Models were adjusted for age,BMI, initial infertility diagnosis, and ovarian stimulation protocol. We then conducted pathway analysis using mummichog and metabolite annotation using level-1 evidence. MAIN RESULTS AND ROLE OF CHANCE In the serum metabolome, 480 and 850 features were associated with peak estradiol levels in the C18 and HILIC columns, respectively. Additionally, 437 and 538 features were associated with mature oocytes in the C18 and HILIC columns, respectively. In the follicular fluid metabolome, 752 and 929 features were associated with peak estradiol levels in the C18 and HILIC columns, respectively, Additionally, 993 and 986 features were associated with mature oocytes in the C18 and HILIC columns, respectively. The most common pathways associated with peak estradiol included fatty acids (serum and follicular fluid), hormone (follicular fluid), and lipid pathways (follicular fluid). The most common pathways associated with the number of mature oocytes retrieved included amino acids (serum), fatty acids (serum and follicular fluid), hormone (follicular fluid), and vitamin pathways(follicular fluid). The vitamin D3 pathway had the strongest association with both ovarian stimulation outcomes in the follicularfluid. Four and nine metabolites were identified using level-1 evidence (validated identification) in the serum and follicular fluid metabolomes, respectively. LIMITATIONS, REASONS FOR CAUTION Our sample was majority White and highly educated and may not be generalizable to thewider population. Additionally, residual confounding is possible and the flushing medium used in the follicular fluid could have diluted our results. WIDER IMPLICATIONS OF THE FINDINGS The pathways and metabolites identified by our study provide novel insights into the biologicalmechanisms in the serum and follicular fluid that may underlie follicular and oocyte development, which could potentially be used to improve ovarian stimulation outcomes. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the following grants from the National Institute of Environmental Health Sciences (P30-ES019776, R01-ES009718, R01-ES022955, P30-ES000002, R00-ES026648, and T32-ES012870), and National Institute of Diabetes and Digestive and Kidney Diseases (P30DK046200). The authors have no competing interests to disclose. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Robert B Hood
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Youran Tan
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Jennifer B Ford
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Irene Souter
- Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jorge E Chavarro
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Dean P Jones
- Division of Pulmonary, Allergy, & Critical Care Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Russ Hauser
- 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
| | - Audrey J Gaskins
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
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Hood RB, Miller WC, Shoben A, Harris RE, Norris AH. Maternal hepatitis C virus infection and three adverse maternal outcomes in the United States. PLoS One 2023; 18:e0291994. [PMID: 37851609 PMCID: PMC10584094 DOI: 10.1371/journal.pone.0291994] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 09/09/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Hepatitis Virus C (HCV) infection rates have trended upwards among pregnant people in the USA since 2009. Existing evidence about HCV infections and maternal outcomes is limited; therefore, we used birth certificate data to investigate the association between HCV infection and maternal health outcomes. METHODS We used the 2017 US birth certificate dataset (a cross-section of 1.4 million birth records) to assess the association between prevalent HCV infection and gestational diabetes, gestational hypertension, and eclampsia. Potential confounding variables included prenatal care, age, education, smoking, presence of sexually transmitted infections (STIs), body mass index (BMI), and weight gain during pregnancy. We restricted our analysis to only women with a first singleton pregnancy. Odds ratios were estimated by logistic regression models and separate models were tested for white and Black women. RESULTS Only 0.31% of the women in our sample were infected with HCV (n = 4412). In an unadjusted model, we observed a modest significant protective association between HCV infection and gestational diabetes (Odds ratio [OR]: 0.83; 95% CI: 0.76-0.96); but this was attenuated with adjustment for confounding variables (Adjusted odds ratio [AOR]: 0.88; 95% CI: 0.76, 1.02). There was no association between HCV and gestational hypertension (AOR: 1.03; 95% CI: 0.91, 1.16) or eclampsia (AOR: 1.15; 95% CI: 0.69, 1.93). Results from the race stratified models were similar to the non-stratified summary models. CONCLUSION We observed no statistically significant associations between maternal HCV infection with maternal health outcomes. Although, our analysis did indicate that HCV may lower the risk of gestational diabetes, this may be attributable to confounding. Studies utilizing more accurately measured HCV infection including those collecting type and timing of testing, and timing of infection are warranted to ensure HCV does not adversely impact maternal and/or fetal health. Particularly in the absence of recommended therapy for HCV during pregnancy.
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Affiliation(s)
- Robert B. Hood
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States of America
| | - William C. Miller
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States of America
| | - Abigail Shoben
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, United States of America
| | - Randall E. Harris
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States of America
| | - Alison H. Norris
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States of America
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Hoffman SS, Liang D, Hood RB, Tan Y, Terrell ML, Marder ME, Barton H, Pearson MA, Walker DI, Barr DB, Jones DP, Marcus M. Assessing Metabolic Differences Associated with Exposure to Polybrominated Biphenyl and Polychlorinated Biphenyls in the Michigan PBB Registry. Environ Health Perspect 2023; 131:107005. [PMID: 37815925 PMCID: PMC10564108 DOI: 10.1289/ehp12657] [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] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 09/11/2023] [Accepted: 09/18/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Polybrominated biphenyls (PBB) and polychlorinated biphenyls (PCB) are persistent organic pollutants with potential endocrine-disrupting effects linked to adverse health outcomes. OBJECTIVES In this study, we utilize high-resolution metabolomics (HRM) to identify internal exposure and biological responses underlying PCB and multigenerational PBB exposure for participants enrolled in the Michigan PBB Registry. METHODS HRM profiling was conducted on plasma samples collected from 2013 to 2014 from a subset of participants enrolled in the Michigan PBB Registry, including 369 directly exposed individuals (F0) who were alive when PBB mixtures were accidentally introduced into the food chain and 129 participants exposed to PBB in utero or through breastfeeding, if applicable (F1). Metabolome-wide association studies were performed for PBB-153 separately for each generation and Σ PCB (PCB-118, PCB-138, PCB-153, and PCB-180) in the two generations combined, as both had direct PCB exposure. Metabolite and metabolic pathway alterations were evaluated following a well-established untargeted HRM workflow. RESULTS Mean levels were 1.75 ng / mL [standard deviation (SD): 13.9] for PBB-153 and 1.04 ng / mL (SD: 0.788) for Σ PCB . Sixty-two and 26 metabolic features were significantly associated with PBB-153 in F0 and F1 [false discovery rate (FDR) p < 0.2 ], respectively. There were 2,861 features associated with Σ PCB (FDR p < 0.2 ). Metabolic pathway enrichment analysis using a bioinformatics tool revealed perturbations associated with Σ PCB in numerous oxidative stress and inflammation pathways (e.g., carnitine shuttle, glycosphingolipid, and vitamin B9 metabolism). Metabolic perturbations associated with PBB-153 in F0 were related to oxidative stress (e.g., pentose phosphate and vitamin C metabolism) and in F1 were related to energy production (e.g., pyrimidine, amino sugars, and lysine metabolism). Using authentic chemical standards, we confirmed the chemical identity of 29 metabolites associated with Σ PCB levels (level 1 evidence). CONCLUSIONS Our results demonstrate that serum PBB-153 is associated with alterations in inflammation and oxidative stress-related pathways, which differed when stratified by generation. We also found that Σ PCB was associated with the downregulation of important neurotransmitters, serotonin, and 4-aminobutanoate. These findings provide novel insights for future investigations of molecular mechanisms underlying PBB and PCB exposure on health. https://doi.org/10.1289/EHP12657.
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Affiliation(s)
- Susan S. Hoffman
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
| | - Donghai Liang
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, USA
| | - Robert B. Hood
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
| | - Youran Tan
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, USA
| | | | - M. Elizabeth Marder
- Department of Environmental Toxicology, University of California, Davis, Davis, California, USA
| | - Hillary Barton
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
| | - Melanie A. Pearson
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, USA
| | - Douglas I. Walker
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, USA
| | - Dana Boyd Barr
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, USA
| | - Dean P. Jones
- School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Michele Marcus
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, USA
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Hood RB, Hart JE, Laden F, Rosner B, Chavarro JE, Gaskins AJ. Exposure to Particulate Matter Air Pollution and Age of Menarche in a Nationwide Cohort of U.S. Girls. Environ Health Perspect 2023; 131:107003. [PMID: 37792557 PMCID: PMC10549984 DOI: 10.1289/ehp12110] [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] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 08/22/2023] [Accepted: 09/06/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND It remains unclear whether in utero and childhood exposure to air pollution affects pubertal development, particularly age of menarche in girls. OBJECTIVE The aim of this study was to determine whether residential ambient particulate matter (PM) exposure in utero and during childhood is associated with age of menarche. METHODS We studied 5,201 girls in the Growing Up Today Study 2 (2004-present) who were 10-17 y of age at enrollment (47.7% premenarchal; 52.3% postmenarchal). Exposure to three size fractions of PM [fine PM with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ), PM with aerodynamic diameters between 2.5 μ m and 10 μ m (PM 2.5 - 10 ), and PM with aerodynamic diameter 10 μ m (PM 10 )] was assigned based on maternal residential address, updated every 2 y, using nationwide spatiotemporal models. We estimated average PM exposure in utero, and time-varying windows: annual average exposure in the prior 1 and 2 y and cumulative average from birth. Age of menarche was self-reported on three surveys administered in 2004, 2006, and 2008. We calculated hazard ratios (HR) for menarche for an interquartile range (IQR) increase in PM exposure using Cox proportional hazard models adjusting for potential confounders. RESULTS Girls attained menarche at 12.3 y of age on average. In the adjusted model, higher residential exposure to ambient PM 2.5 during all time windows was associated with earlier age of menarche. The HRs of menarche for each IQR (4 μ g / m 3 ) increase in exposure to PM 2.5 during the in utero period, 1 y prior to menarche, and throughout childhood were 1.03 [95% confidence interval (CI): 1.00, 1.06], 1.06 (95% CI: 1.02, 1.10) and 1.06 (95% CI: 1.02, 1.10), respectively. Effect estimates for PM 10 exposure were similar, albeit attenuated, for all time windows. PM 2.5 - 10 exposure was not associated with age of menarche. DISCUSSION Among a large, nationwide, prospective cohort of U.S. girls, higher exposure to PM 2.5 and PM 10 in utero and throughout childhood was associated with an earlier age of menarche. Our results suggest that PM 2.5 and PM 10 may have endocrine-disrupting properties that could lead to altered timing of menarche. https://doi.org/10.1289/EHP12110.
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Affiliation(s)
- Robert B. Hood
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jorge E. Chavarro
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Audrey J. Gaskins
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
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Hood RB, Miller WC, Shoben A, Harris RE, Norris AH. Maternal Hepatitis C Virus Infection and Adverse Newborn Outcomes in the US. Matern Child Health J 2023:10.1007/s10995-023-03666-9. [PMID: 37212945 DOI: 10.1007/s10995-023-03666-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVES We investigated the relationship between maternal hepatitis C virus (HCV) infection and infant health. Furthermore, we evaluated racial disparities with these associations. METHODS Using 2017 US birth certificate data, we investigated the association between maternal HCV infection and infant birthweight, preterm birth, and Apgar score. We used unadjusted and adjusted linear regression and logistic regression models. Models were adjusted for use of prenatal care, maternal age, maternal education, maternal smoking status, and the presence of other sexually transmitted infections. We stratified the models by race to describe the experiences of White and Black women separately. RESULTS Maternal HCV infection was associated with reduced infant birthweight on average by 42.0 g (95% CI: -58.81, -25.30) for women of all races, 64.6 g (95% CI: -81.91, -47.26) for White women and 80.3 g (95% CI: -162.48, 1.93) for Black women. Women with maternal HCV infection had increased odds of having a preterm birth of 1.06 (95% CI: 0.96, 1.17) for women of all races, 1.06 (95% CI: 0.96, 1.18) for White women and 1.35 (95% CI: 0.93, 1.97) for Black women. Overall, women with maternal HCV infection had increased odds 1.26 (95% CI: 1.03, 1.55) of having a low/intermediate Apgar score; White and Black women with HCV infection had similarly increased odds of an infant with low/intermediate Apgar score in a stratified analysis: 1.23 (95% CI: 0.98, 1.53) for White women and 1.24 (95% CI: 0.51, 3.02) for Black women. CONCLUSIONS Maternal HCV infection was associated with lower infant birthweight and higher odds of having a low/intermediate Apgar score. Given the potential for residual confounding, these results should be interpreted with caution.
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Affiliation(s)
- Robert B Hood
- College of Public Health Division of Epidemiology, The Ohio State University, 1841 Neil Ave, Cunz Hall, Columbus, OH, 43235, USA.
| | - William C Miller
- College of Public Health Division of Epidemiology, The Ohio State University, 1841 Neil Ave, Cunz Hall, Columbus, OH, 43235, USA
| | - Abigail Shoben
- College of Public Health Division of Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Randall E Harris
- College of Public Health Division of Epidemiology, The Ohio State University, 1841 Neil Ave, Cunz Hall, Columbus, OH, 43235, USA
| | - Alison H Norris
- College of Public Health Division of Epidemiology, The Ohio State University, 1841 Neil Ave, Cunz Hall, Columbus, OH, 43235, USA
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Gaskins AJ, Hood RB, Ford JB, Hauser R, Knight AK, Smith AK, Everson TM. Traffic-related air pollution and supplemental folic acid intake in relation to DNA methylation in granulosa cells. Clin Epigenetics 2023; 15:84. [PMID: 37179367 PMCID: PMC10183139 DOI: 10.1186/s13148-023-01503-y] [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: 02/27/2023] [Accepted: 05/11/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Higher exposure to traffic-related air pollution (TRAP) is related to lower fertility, with specific adverse effects on the ovary. Folic acid may attenuate these effects. Our goal was to explore the relation of TRAP exposure and supplemental folic acid intake with epigenetic aging and CpG-specific DNA methylation (DNAm) in granulosa cells (GC). Our study included 61 women undergoing ovarian stimulation at a fertility center (2005-2015). DNAm levels were profiled in GC using the Infinium MethylationEPIC BeadChip. TRAP was defined using a spatiotemporal model to estimate residence-based nitrogen dioxide (NO2) exposure. Supplemental folic acid intake was measured with a validated food frequency questionnaire. We used linear regression to evaluate whether NO2 or supplemental folic acid was associated with epigenetic age acceleration according to the Pan-tissue, mural GC, and GrimAge clocks or DNAm across the genome adjusting for potential confounders and accounting for multiple testing with a false discovery rate < 0.1. RESULTS There were no associations between NO2 or supplemental folic acid intake and epigenetic age acceleration of GC. NO2 and supplemental folic acid were associated with 9 and 11 differentially methylated CpG sites. Among these CpGs, only cg07287107 exhibited a significant interaction (p-value = 0.037). In women with low supplemental folic acid, high NO2 exposure was associated with 1.7% higher DNAm. There was no association between NO2 and DNAm in women with high supplemental folic acid. The genes annotated to the top 250 NO2-associated CpGs were enriched for carbohydrate and protein metabolism, postsynaptic potential and dendrite development, and membrane components and exocytosis. The genes annotated to the top 250 supplemental folic acid-associated CpGs were enriched for estrous cycle, learning, cognition, synaptic organization and transmission, and size and composition of neuronal cell bodies. CONCLUSIONS We found no associations between NO2, supplemental folic acid, and DNAm age acceleration of GC. However, there were 20 differentially methylated CpGs and multiple enriched GO terms associated with both exposures suggesting that differences in GC DNAm could be a plausible mechanism underlying the effects of TRAP and supplemental folic acid on ovarian function.
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Affiliation(s)
- Audrey J Gaskins
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA.
| | - Robert B Hood
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Jennifer B Ford
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Anna K Knight
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, GA, 30322, USA
| | - Alicia K Smith
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, GA, 30322, USA
| | - Todd M Everson
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
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Olivo-Marston SE, Singh S, Hood RB, Adetona O. Abstract 4218: Cancer prevalence among Ohio firefighters: data from the Ohio Cancer Incidence Surveillance System (OCISS) 1996-2019. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-4218] [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] [Indexed: 04/07/2023]
Abstract
Abstract
Firefighting is classified as a Group 1 carcinogen or “carcinogenic to humans” by the International Agency for Research on Cancer. Compared to the general population, firefighters have a 9% increased risk of cancer incidence and a 14% increased risk of cancer mortality. Although there have been previous studies of cancer incidence among firefighters in Florida and Massachusetts, there have been no studies examining cancer incidence among firefighters in the state of Ohio. Therefore, this is the first study to examine cancer prevalence among Ohio firefighters. The study utilized data from the Ohio Cancer Incidence Surveillance System (OCISS), the Ohio state cancer registry. This study examined data from 1996-2019, including a total of 1,314,318 people. Occupation was classified as firefighter, police, or general population. The odds of being a firefighter versus a police officer or the general population was calculated for specific cancer types. In addition, this analysis was stratified by gender. Police were used as a comparison group because it is an occupation similar to firefighters with the exception of exposure. There was a total of 3,397 firefighters, 3,341 police, and 1,307,580 people in the general population. Among firefighters, they were mostly male (86.8%), White (92.7%), Non-Hispanic (3.4%), married (67.7%), and never used tobacco (19.8%). The mean age at cancer diagnosis among firefighters was 66 years and most of them were diagnosed between 2010 and 2014. A similar distribution was seen among police except the mean age at cancer diagnosis was 63 years and most of them were current tobacco users (18.5%). The distribution was similar among the general population except the majority of them were female (51.6%). Firefighters had increased odds of esophageal cancer, cancers of the soft tissue including the heart, skin, prostate, testis, bladder, and brain compared to the general population. Cancer of the oral cavity, pharynx, and kidney were also increased among firefighters; however, they did not reach statistical significance. Compared to police, firefighters had increased odds of breast, uterine, prostate, brain, and thyroid cancer. In addition, they had decreased odds of pancreatic and bladder cancer. When stratified by gender, among the 2,948 male firefighters, there were increased odds of cancer of the soft tissue including heart, prostate, brain, cranial nerves, and thyroid cancer compared to the general population. They also had decreased odds of cancer of the larynx, lung & bronchus, and bladder. Number of female firefighters was small generating unstable odds ratios. We observed increased prevalence of several types of cancer among Ohio firefighters, similar to previous studies. Although there were limitations present due to many people lacking data on occupation, the current study supports that Ohio firefighters have an increased risk of many different types of cancer.
Citation Format: Susan E. Olivo-Marston, Shashank Singh, Robert B. Hood, Olorunfemi Adetona. Cancer prevalence among Ohio firefighters: data from the Ohio Cancer Incidence Surveillance System (OCISS) 1996-2019. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4218.
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Affiliation(s)
- Susan E. Olivo-Marston
- 1Simmons Cancer Institute at Southern Illinois University School of Medicine, Springfield, IL
| | - Shashank Singh
- 2West Virginia School of Osteopathic Medicine, Lewisburg, WV
| | - Robert B. Hood
- 3Rollins School of Public Health at Emory University, Atlanta, GA
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Chakraborty P, Chettri S, Gallo MF, Smith MH, Hood RB, Bessett D, Casterline J, Norris AH, Turner AN. Factors associated with never-use of long-acting reversible contraception among adult reproductive-aged women in Ohio. Perspect Sex Reprod Health 2023; 55:38-48. [PMID: 36336335 PMCID: PMC10104276 DOI: 10.1363/psrh.12212] [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] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND The number of women using long-acting reversible contraception (LARC)-intrauterine devices (IUDs) and implants-is increasing and 14% of contraceptive users in the United States adopt LARC. We examined correlates of LARC never-use in a population-based survey of reproductive-aged women in Ohio. METHODS We analyzed data from the 2018-19 Ohio Survey of Women. We examined the prevalence of LARC never-use and reasons for never-use among ever users of contraception (N = 2388). Using Poisson regression to generate prevalence ratios (PRs), we examined associations between selected correlates (demographic factors, healthcare access/quality measures, and religious/political views) and LARC never-use. RESULTS Most Ohio women (74%) had never used LARC. Commonly reported reasons for not using an IUD or an implant were preferring a different method (46% and 45%, respectively), not wanting an object inside their body (45% and 43%), side effect concerns (39% and 33%), insertion/removal concerns (31% and 25%), and unfamiliarity (13% and 20%). Conservative political views (PR: 1.12, 95% confidence interval [CI]: 1.04-1.22), pro-life affiliation (PR: 1.11, 95% CI: 1.02-1.20), placing high importance on religion in daily life (PR: 1.15, 95% CI: 1.06-1.26), and being non-Hispanic white as compared to non-Hispanic Black (PR: 1.20, 95% CI: 1.02-1.41) were significantly associated with LARC never-use. Findings were generally similar for models analyzing IUD and implant never-use separately. CONCLUSIONS Among ever-users of contraception, LARC never-use was associated with having conservative political views, being religious, and having a pro-life affiliation. Except for race/ethnicity, demographic and healthcare measures were not associated with LARC never-use among women in Ohio.
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Affiliation(s)
- Payal Chakraborty
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Shibani Chettri
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Maria F. Gallo
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Mikaela H. Smith
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Robert B. Hood
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Danielle Bessett
- Department of Sociology, University of Cincinnati, Cincinnati, Ohio, USA
| | - John Casterline
- Department of Sociology, College of Arts and Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Alison H. Norris
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Abigail Norris Turner
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA
- Division of Infectious Diseases, College of Medicine, The Ohio State University, Columbus, Ohio, USA
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Hood RB, Terrell ML, Smith AK, Curtis S, Conneely K, Pearson M, Barton H, Barr DB, Marder EM, Marcus M. Elimination of PBB-153; findings from a cohort of Michigan adults. Environ Res 2023; 220:115146. [PMID: 36566966 PMCID: PMC9898188 DOI: 10.1016/j.envres.2022.115146] [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] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND An industrial accident led to the widespread contamination of polybrominated biphenyl (PBB), a flame retardant, into the food system in Michigan in the 1970's. PBB continues to be detected in Michiganders' blood some forty years later. It is necessary to understand the elimination rate and half-life of PBB because it may provide clues on how to hasten the elimination of it from the human body. METHODS Serum samples were taken from young adult and adult participants of the Michigan PBB registry from 1974 to 2019. A single compartment model was assumed for the elimination rate for PBB-153 in young adults and adults (≥16 years). Generalized linear mixed models were used to estimate the average elimination rate of PBB-153 and allowed for a random intercept and slope for the time between measurements. Models were adjusted for age at exposure, body mass index (BMI) at initial measurement, and smoking. Models were also stratified by demographic characteristics. RESULTS In total, 1974 participants contributed 4768 samples over a forty-year span. The median initial PBB-153 level was 1.542 parts per billion (ppb) (Range: 0.001-1442.48 ppb). The adjusted median participant-specific half-life for PBB-153 was 12.23 years. The half-life of PBB-153 was lengthened by higher initial PBB level (∼1.5 years), younger age at exposure (∼5.4 years), higher BMI (∼1.0 years), and increased gravidity (∼7.3 years). Additionally, the half-life of PBB-153 was shortened by smoking status (∼-2.8 years) and breastfeeding (∼-3.5 years). CONCLUSIONS Consistent with previous studies, PBB-153 has been demonstrated to have a long half-life in the human body and may be modified by some demographic characteristics. These updated estimates of half-life will further support evaluation of health effects associated with PBB exposure. Investigations into mechanisms to accelerate elimination and reduce body burdens of PBB-153, especially those related to body weight, are needed.
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Affiliation(s)
- Robert B Hood
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA.
| | - Metrecia L Terrell
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Alicia K Smith
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA; Department of Psychiatry and Behavioral Science, Emory University School of Medicine, Atlanta, GA, USA
| | - Sarah Curtis
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Karen Conneely
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Melanie Pearson
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Hillary Barton
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Dana Boyd Barr
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Elizabeth M Marder
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Michele Marcus
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA; Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
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Smith MH, McGowan M, Chakraborty P, Hood RB, Field MP, Bessett D, Norwood C, Norris AH. Kentucky's abortion landscape, 2010 to 2019: an analysis of pre- Dobbs abortion disparities in a rural, restrictive state. Lancet Reg Health Am 2023; 19:100441. [PMID: 36852333 PMCID: PMC9958464 DOI: 10.1016/j.lana.2023.100441] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 02/17/2023]
Abstract
Background Since 2010, many US states have passed laws restricting abortion providers' ability to provide care. Such legislation has no demonstrated health benefits and creates inequitable barriers for patients. Methods To examine how Kentucky's abortion policies coincided with facility closures and abortion utilisation, we conducted a review of state abortion policies from 2010 to 2019 using newspapers and websites. We calculated abortion rates (abortions per 1000 women ages 15-44) by state of residence and provision for Kentucky, the South, and the US using data from the CDC and Kentucky Department of Health. We calculated percentages leaving and from out-of-state, and analysed abortions by race, pregnancy duration, and method. Findings Of 17 policies passed between 2010 and 2019, ten were enacted, including 20-week and telemedicine bans. One of Kentucky's two abortion facilities closed in 2017. The pooled average abortion rate in Kentucky (4.1) and for Kentuckians (5.8) was lower than national averages (11.8 and 11.1). An average of 38% of Kentuckians left their state for care, compared to 7% nationally. In 2019, the abortion rate in Kentucky was 5.8 times higher for Black patients than White patients (compared to 4.8 times nationally). The majority (62%) of abortions in Kentucky took place at 7-13 weeks' gestation. Interpretation Abortions in Kentucky were less frequent than in the South and US. The larger Black-White abortion rate gap reflects race- and class-based structural inequities in healthcare. Without federal protections, abortion access in Kentucky will continue waning. Funding This study was supported by a philanthropic foundation that makes grants anonymously.
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Affiliation(s)
- Mikaela H. Smith
- Division of Epidemiology, The Ohio State University, College of Public Health, Columbus, OH, USA,Corresponding author.
| | - Michelle McGowan
- Biomedical Ethics Research Program, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA,Department of Women's, Gender & Sexuality Studies, University of Cincinnati, Cincinnati, OH, USA
| | - Payal Chakraborty
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Robert B. Hood
- Department of Epidemiology, Emory University, Rollins School of Public Health, Atlanta, GA, USA
| | | | - Danielle Bessett
- Department of Sociology, University of Cincinnati, Cincinnati, OH, USA
| | - Carolette Norwood
- Department of Sociology and Criminology, Howard University, Washington, DC, USA
| | - Alison H. Norris
- Division of Epidemiology, The Ohio State University, College of Public Health, Columbus, OH, USA
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Hwang S, Hood RB, Hauser R, Schwartz J, Laden F, Jones D, Liang D, Gaskins AJ. Using follicular fluid metabolomics to investigate the association between air pollution and oocyte quality. Environ Int 2022; 169:107552. [PMID: 36191487 PMCID: PMC9620437 DOI: 10.1016/j.envint.2022.107552] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/22/2022] [Accepted: 09/27/2022] [Indexed: 05/07/2023]
Abstract
BACKGROUND AND AIM Our objective was to use metabolomics in a toxicological-relevant target tissue to gain insight into the biological processes that may underlie the negative association between air pollution exposure and oocyte quality. METHODS Our study included 125 women undergoing in vitro fertilization at an academic fertility center in Massachusetts, US (2005-2015). A follicular fluid sample was collected during oocyte retrieval and untargeted metabolic profiling was conducted using liquid chromatography with ultra-high-resolution mass spectrometry and two chromatography columns (C18 and HILIC). Daily exposure to nitrogen dioxide (NO2), ozone, fine particulate matter, and black carbon was estimated at the women's residence using spatiotemporal models and averaged over the period of ovarian stimulation (2-weeks). Multivariable linear regression models were used to evaluate the associations between the air pollutants, number of mature oocytes, and metabolic feature intensities. A meet-in-the-middle approach was used to identify overlapping features and metabolic pathways. RESULTS Of the air pollutants, NO2 exposure had the largest number of overlapping metabolites (C18: 105; HILIC: 91) and biological pathways (C18: 3; HILIC: 6) with number of mature oocytes. Key pathways of overlap included vitamin D3 metabolism (both columns), bile acid biosynthesis (both columns), C21-steroid hormone metabolism (HILIC), androgen and estrogen metabolism (HILIC), vitamin A metabolism (HILIC), carnitine shuttle (HILIC), and prostaglandin formation (C18). Three overlapping metabolites were confirmed with level-1 or level-2 evidence. For example, hypoxanthine, a metabolite that protects against oxidant-induced cell injury, was positively associated with NO2 exposure and negatively associated with number of mature oocytes. Minimal overlap was observed between the other pollutants and the number of mature oocytes. CONCLUSIONS Higher exposure to NO2 during ovarian stimulation was associated with many metabolites and biologic pathways involved in endogenous vitamin metabolism, hormone synthesis, and oxidative stress that may mediate the observed associations with lower oocyte quality.
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Affiliation(s)
- Sueyoun Hwang
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Robert B Hood
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, United States
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, United States
| | - Dean Jones
- Division of Pulmonary, Allergy, & Critical Care Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Audrey J Gaskins
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, United States.
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Hood RB, Liang D, Tan Y, Ford J, Souter I, Jones DP, Hauser R, Gaskins AJ. Characterizing the follicular fluid metabolome: quantifying the correlation across follicles and differences with the serum metabolome. Fertil Steril 2022; 118:970-979. [PMID: 36175211 PMCID: PMC9938636 DOI: 10.1016/j.fertnstert.2022.07.023] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To compare the variability in metabolomes between the serum and follicular fluid, as well as across 3 dominant follicles. DESIGN Prospective cohort study. SETTING An academic fertility clinic in the northeastern United States, 2005-2015. PATIENTS One hundred thirty-five women undergoing in vitro fertilization treatment who provided a serum sample during ovarian stimulation and up to 3 follicular fluid samples during oocyte retrieval. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Samples were analyzed using liquid chromatography with high-resolution mass spectrometry and 2 chromatography columns (C18 hydrophobic negative and hydrophilic interaction chromatography [HILIC] positive). We calculated overall, feature-specific, and subject-specific correlation coefficients to describe how strongly the intensity of overlapping metabolic features were associated between the serum and follicular fluid and between the 1st-2nd, 1st-3rd, and 2nd-3rd follicles. Feature-specific correlations were adjusted for age, body mass index, infertility diagnosis, ovarian stimulation protocol, and year. RESULT(S) From the C18-negative column and the high-resolution mass spectrometry, 7,830 serum features and 10,790 follicular fluid features were detected in ≥20% of samples. After screening retention times and checking for 1:1 matching, 1,928 features overlapped between the 2 metabolomes. From the HILIC-positive column and the high-resolution mass spectrometry, after applying the same exclusion criteria, there were 9,074 serum features, 5,542 follicular fluid features, and 1,149 features that overlapped. When comparing the feature intensity of overlapping metabolites in the serum and the follicular fluid, the overall (C18, 0.45; HILIC, 0.63), median feature-specific (C18, 0.35; HILIC, 0.37), and median subject-specific (C18, 0.42; HILIC, 0.59) correlations were low to moderate. In contrast, among the overlapping features across all 3 follicles, the overall (C18, all 0.99; HILIC, all 0.99), median feature-specific (C18, 0.74-0.81; HILIC, 0.79-0.85), and median subject-specific (C18, 0.88-0.89; HILIC, 0.90-0.91) correlations between follicular fluid metabolomics features within a woman were high. CONCLUSION(S) We observed minimal overlap and weak-to-moderate correlation between metabolomic features in the serum and follicular fluid but a large overlap and strong correlation between metabolomic features across follicles within a woman. The follicular fluid appears to represent a novel matrix, distinct from serum, which may be a rich source of biologic predictors of female fertility and reproductive outcomes.
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Affiliation(s)
- Robert B Hood
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia.
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Youran Tan
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Jennifer Ford
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Irene Souter
- Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Dean P Jones
- Division of Pulmonary, Allergy, & Critical Care Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Russ Hauser
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Audrey J Gaskins
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia
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Hyder A, Smith M, Sealy-Jefferson S, Hood RB, Chettri S, Dundon A, Underwood A, Bessett D, Norris AH. Community-based Systems Dynamics for Reproductive Health: An Example from Urban Ohio. Prog Community Health Partnersh 2022; 16:361-383. [PMID: 36120879 DOI: 10.1353/cpr.2022.0053] [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: 11/11/2022]
Abstract
BACKGROUND Health outcomes, risk factors, and policies are complexly related to the reproductive health system. Systems-level frameworks for understanding and acting within communities through community-engaged research are needed to mitigate adverse reproductive health outcomes more effectively within the community. OBJECTIVES To describe and share lessons learned from an ongoing application of a participatory modeling approach (community-based system dynamics) that aims to eliminate racial inequities in Black-White reproductive health outcomes. METHODS The community-based system dynamics approach involves conducting complementary activities, workshops, modeling, and dissemination. We organized workshops, co-developed a causal loop diagram of the reproductive health system with participants from the community, and created materials to disseminate workshop findings and preliminary models. LESSONS LEARNED Many opportunities exist for cross-fertilization of best practices between community-based system dynamics and community-based participatory research. Shared learning environments offer benefits for modelers and domain experts alike. Additionally, identifying local champions from the community helps manage group dynamics. CONCLUSIONS Community-based system dynamics is well-suited for understanding complexity in the reproductive health system. It allows participants from diverse perspectives to identify strategies to eliminate racial inequities in reproductive health outcomes.
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20
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Hood RB, Moseson H, Smith M, Chakraborty P, Norris AH, Gallo MF. Comparison of abortion incidence estimates derived from direct survey questions versus the list experiment among women in Ohio. PLoS One 2022; 17:e0269476. [PMID: 35657985 PMCID: PMC9165909 DOI: 10.1371/journal.pone.0269476] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/20/2022] [Indexed: 12/02/2022] Open
Abstract
Abortion is highly stigmatized in the United States which prevents its accurate measurement in surveys. The list experiment aims to improve the reporting of abortion history. We evaluated whether a list experiment resulted in higher reporting of abortion experiences than did two direct questions. Utilizing data from a representative survey of adult women of reproductive age in Ohio, we examined abortion history using two direct questions and a double list experiment. Through the double list experiment, we asked respondents to report how many of two lists of health items they had experienced; one list included abortion. We compared weighted history of abortion between these measures and by respondent demographic characteristics (age and socioeconomic status). Estimates of abortion history were similar between direct and list experiment questions. When measured with the two different direct question of abortion history, 8.4% and 8.0% of all respondents indicated ever having an abortion and with the list experiment, 8.5% indicated ever having an abortion. In a Midwestern state-level survey, the list experiment did not lead to increases in abortion reporting as compared to the direct questions. Subgroup analyses require larger samples, and future iterations should incorporate related but non-stigmatized control items to reduce misclassification and under-powering of such subgroup analyses.
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Affiliation(s)
- Robert B. Hood
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Heidi Moseson
- Ibis Reproductive Health, Oakland, CA, United States of America
| | - Mikaela Smith
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States of America
| | - Payal Chakraborty
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States of America
| | - Alison H. Norris
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States of America
| | - Maria F. Gallo
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States of America
- * E-mail:
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21
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Li Z, Sarnat JA, Liu KH, Hood RB, Chang CJ, Hu X, Tran V, Greenwald R, Chang HH, Russell A, Yu T, Jones DP, Liang D. Evaluation of the Use of Saliva Metabolome as a Surrogate of Blood Metabolome in Assessing Internal Exposures to Traffic-Related Air Pollution. Environ Sci Technol 2022; 56:6525-6536. [PMID: 35476389 PMCID: PMC9153955 DOI: 10.1021/acs.est.2c00064] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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] [Indexed: 05/23/2023]
Abstract
In the omics era, saliva, a filtrate of blood, may serve as an alternative, noninvasive biospecimen to blood, although its use for specific metabolomic applications has not been fully evaluated. We demonstrated that the saliva metabolome may provide sensitive measures of traffic-related air pollution (TRAP) and associated biological responses via high-resolution, longitudinal metabolomics profiling. We collected 167 pairs of saliva and plasma samples from a cohort of 53 college student participants and measured corresponding indoor and outdoor concentrations of six air pollutants for the dormitories where the students lived. Grand correlation between common metabolic features in saliva and plasma was moderate to high, indicating a relatively consistent association between saliva and blood metabolites across subjects. Although saliva was less associated with TRAP compared to plasma, 25 biological pathways associated with TRAP were detected via saliva and accounted for 69% of those detected via plasma. Given the slightly higher feature reproducibility found in saliva, these findings provide some indication that the saliva metabolome offers a sensitive and practical alternative to blood for characterizing individual biological responses to environmental exposures.
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Affiliation(s)
- Zhenjiang Li
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, United States
| | - Jeremy A Sarnat
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, United States
| | - Ken H Liu
- Clinical Biomarkers Laboratory, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia 30322, United States
| | - Robert B Hood
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, United States
| | - Che-Jung Chang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, United States
| | - Xin Hu
- Clinical Biomarkers Laboratory, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia 30322, United States
| | - ViLinh Tran
- Clinical Biomarkers Laboratory, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia 30322, United States
| | - Roby Greenwald
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia 30302, United States
| | - Howard H Chang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, United States
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, United States
| | - Armistead Russell
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332, United States
| | - Tianwei Yu
- School of Data Science, The Chinese University of Hong Kong, Shenzhen, Guangdong 518172, China
| | - Dean P Jones
- Clinical Biomarkers Laboratory, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia 30322, United States
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, United States
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22
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Hood RB, Liang D, Chiu YH, Sandoval-Insausti H, Chavarro JE, Jones D, Hauser R, Gaskins AJ. Pesticide residue intake from fruits and vegetables and alterations in the serum metabolome of women undergoing infertility treatment. Environ Int 2022; 160:107061. [PMID: 34959198 PMCID: PMC8821142 DOI: 10.1016/j.envint.2021.107061] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Pesticide exposure is linked to a myriad of negative health effects; however, the mechanisms underlying these associations are less clear. We utilized metabolomics to describe the alterations in the serum metabolome associated with high and low pesticide residue intake from fruits and vegetables (FVs), the most common route of exposure in humans. METHODS This analysis included 171 women undergoing in vitro fertilization who completed a validated food frequency questionnaire and provided a serum sample during controlled ovarian stimulation (2007-2015). FVs were categorized as high or low-to-moderate pesticide residue using a validated method based on pesticide surveillance data from the USDA. We conducted untargeted metabolic profiling using liquid chromatography with high-resolution mass spectrometry and two chromatography columns. We used multivariable generalized linear models to identified metabolic features (p < 0.005) associated with high and low-to-moderate pesticide residue FV intake, followed by enriched pathway analysis. RESULTS We identified 50 and 109 significant features associated with high pesticide residue FV intake in the C18 negative and HILIC positive columns, respectively. Additionally, we identified 90 and 62 significant features associated with low-to-moderate pesticide residue FV intake in the two columns, respectively. Four metabolomic pathways were associated with intake of high pesticide residue FVs including those involved in energy, vitamin, and enzyme metabolism. 12 pathways were associated with intake of low-to-moderate pesticide residue FVs including cellular receptor, energy, intercellular signaling, lipid, vitamin, and xenobiotic metabolism. One energy pathway was associated with both high and low-to-moderate pesticide residue FVs. CONCLUSIONS We identified limited overlap in the pathways associated with intake of high and low-to-moderate pesticide residue FVs, which supports findings of disparate health effects associated with these two exposures. The identified pathways suggest there is a balance between the dietary antioxidant intake associated with FVs intake and heightened oxidative stress as a result of dietary pesticide exposure.
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Affiliation(s)
- Robert B Hood
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA.
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Yu-Han Chiu
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
| | | | - Jorge E Chavarro
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Dean Jones
- Division of Pulmonary, Allergy, & Critical Care Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Russ Hauser
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Audrey J Gaskins
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
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Hood RB, Norris AH, Huber-Krum S, Garver S, Chapotera G, Turner AN. Food insecurity and adverse pregnancy outcomes among rural Malawian women. Int J Gynaecol Obstet 2022; 156:309-315. [PMID: 33507564 PMCID: PMC9808894 DOI: 10.1002/ijgo.13630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 07/27/2020] [Revised: 11/09/2020] [Accepted: 01/25/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate whether food insecurity is associated with adverse pregnancy outcomes such as miscarriage, stillbirth, and neonatal mortality among women in rural Malawi. METHODS We analyzed data from the baseline (July 2014 to February 2015) and follow-up (January 2018 to May 2018) waves of a longitudinal study of reproductive-age women in rural Malawi. We sampled women from villages from the catchment area of a community hospital in rural Lilongwe district of Malawi using stratified cluster sampling. We classified women as food secure or insecure at baseline. Using unadjusted and adjusted log-binomial models, we used baseline data to examine the cross-sectional association between food insecurity and ever experiencing an adverse pregnancy outcome. We used baseline and follow-up data to assess the longitudinal association between food insecurity and experiencing a new adverse pregnancy outcome during follow-up. In a subgroup analysis, we repeated the longitudinal analysis after restricting the sample to women who had no adverse pregnancy outcomes at baseline. RESULTS We observed no significant cross-sectional association between baseline food insecurity and ever experiencing an adverse pregnancy outcome (adjusted prevalence ratio: 1.09; 95% confidence interval [CI]: 0.78-1.53). Baseline food insecurity was not associated with experiencing a new adverse pregnancy outcome during follow-up (adjusted risk ratio [aRR]: 1.14, 95% CI: 0.60-2.20) or in the subgroup analysis (aRR: 1.52, 95% CI: 0.78-2.96). CONCLUSIONS While food insecurity is a critical issue, in this cohort of rural Malawian women, food insecurity was not associated with adverse pregnancy outcomes.
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Affiliation(s)
- Robert B Hood
- The Ohio State University College of Public Health, Columbus, OH, USA
| | - Alison H Norris
- The Ohio State University College of Public Health, Columbus, OH, USA,The Ohio State University College of Medicine, Columbus, OH, USA
| | | | | | | | - Abigail N Turner
- The Ohio State University College of Public Health, Columbus, OH, USA,The Ohio State University College of Medicine, Columbus, OH, USA
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Kadir M, Hood RB, Minguez-Alarcon L, Maldonado-Cárceles AB, Ford JB, Souter I, Chavarro JE, Gaskins AJ. Folate intake and ovarian reserve among women attending a fertility center. Fertil Steril 2022; 117:171-180. [PMID: 34809974 PMCID: PMC8714696 DOI: 10.1016/j.fertnstert.2021.09.037] [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: 06/15/2021] [Revised: 09/09/2021] [Accepted: 09/09/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To examine the association between dietary folate intake and antral follicle count (AFC) among women seeing treatment for infertility. DESIGN Cohort study. SETTING Academic fertility center. PATIENTS A total of 552 women attending the Massachusetts General Hospital Fertility Center (2007-2019) who participated in the Environment and Reproductive Health Study. INTERVENTIONS None. Folate intake was measured with a validated food frequency questionnaire at study entry. Multivariable Poisson regression models with robust standard errors were used to estimate the association of folate intake with AFC adjusting for calorie intake, age, body mass index, physical activity, education, smoking status, year of AFC, and intakes of vitamin B12, iron, and vitamin D. Nonlinearity was assessed with restricted cubic splines. MAIN OUTCOME MEASURE AFC as measured by transvaginal ultrasonography as part of routine care. RESULTS Among the 552 women (median age, 35.0 years; median folate intake, 1,005 μg/d), total and supplemental folate intake had a significant nonlinear relationship with AFC. There was a positive linear association with AFC up to approximately 1,200 μg/d for total folate intake and up to 800 μg/d for supplemental folate intake; however, there was no additional benefit of higher folate intakes. The magnitude of the association was modest; for example, the predicted adjusted difference in AFC between a woman consuming 400 vs. 800 μg/d of supplemental folate was approximately 1.5 follicles. CONCLUSION Higher intake of folate, particularly from supplements, was associated with modestly higher ovarian reserve as measured by AFC among women attending a fertility center. CLINICAL TRIAL REGISTRATION NUMBER This trial was registered at clinicaltrials.gov as NCT00011713.
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Affiliation(s)
- Mumta Kadir
- Department of Epidemiology, Rollins School of Public
Health, Emory University, Atlanta, GA, 30322, USA
| | - Robert B. Hood
- Department of Epidemiology, Rollins School of Public
Health, Emory University, Atlanta, GA, 30322, USA
| | - Lidia Minguez-Alarcon
- Department of Environmental Health, Harvard T.H. Chan
School of Public Health, Boston, MA, 02115, USA
| | | | - Jennifer B. Ford
- Department of Environmental Health, Harvard T.H. Chan
School of Public Health, Boston, MA, 02115, USA
| | - Irene Souter
- Massachusetts General Hospital Fertility Center and Harvard
Medical School, Boston, MA, 02114, USA
| | - Jorge E. Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public
Health, Boston, MA, 02115, USA,Department of Epidemiology, Harvard T.H. Chan School of
Public Health, Boston, MA, 02115, USA,Channing Division of Network Medicine, Department of
Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston,
MA, 02115, USA
| | - Audrey J. Gaskins
- Department of Epidemiology, Rollins School of Public
Health, Emory University, Atlanta, GA, 30322, USA
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Gaskins AJ, Tang Z, Hood RB, Ford J, Schwartz JD, Jones DP, Laden F, Liang D. Periconception air pollution, metabolomic biomarkers, and fertility among women undergoing assisted reproduction. Environ Int 2021; 155:106666. [PMID: 34116378 PMCID: PMC8292230 DOI: 10.1016/j.envint.2021.106666] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [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: 03/01/2021] [Revised: 05/06/2021] [Accepted: 05/24/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Air pollution exposure has been linked with diminished fertility. Identifying the metabolic changes induced by periconception air pollution exposure among women could enhance our understanding of the potential biological pathways underlying air pollution's reproductive toxicity. OBJECTIVE To identify serum metabolites associated with periconception air pollution exposure and evaluate the extent to which these metabolites mediate the association between air pollution and live birth. METHODS We included 200 women undergoing a fresh assisted reproductive technology (ART) cycle at Massachusetts General Hospital Fertility Center (2005-2015). A serum sample was collected during stimulation, and untargeted metabolic profiling was conducted using liquid chromatography with ultra-high-resolution mass spectrometry. Exposure to nitrogen dioxide (NO2), ozone (O3), fine particulate matter <2.5 µm (PM2.5), and black carbon (BC) was estimated using validated spatiotemporal models. Multivariable linear regression models were used to evaluate the associations between the air pollutants, live birth, and metabolic feature intensities. A meet in the middle approach was used to identify overlapping features and metabolic pathways. RESULTS From the C18 and HILIC chromatography columns, 10,803 and 12,968 metabolic features were extracted. There were 190 metabolic features and 18 pathways that were significantly associated with both air pollution and live birth (P < 0.05) across chromatography columns. Eight features were confirmed metabolites implicated in amino acid and nutrient metabolism with downstream effects on oxidative stress and inflammation. Six confirmed metabolites fell into two intuitive clusters - "antioxidants" and "oxidants"- which could potentially mediate some of the association between air pollution and lower odds of live birth. Tryptophan and vitamin B3 metabolism were common pathways linking air pollution exposure to decreased probability of live birth. CONCLUSION Higher periconception air pollution exposure was associated with metabolites and biologic pathways involved in inflammation and oxidative stress that may mediate the observed associations with lower probability of live birth following ART.
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Affiliation(s)
- Audrey J Gaskins
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, United States.
| | - Ziyin Tang
- Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Robert B Hood
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Jennifer Ford
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Brigham & Women's Hospital & Harvard Medical School, Boston, MA, United States
| | - Dean P Jones
- Division of Pulmonary, Allergy, & Critical Care Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Brigham & Women's Hospital & Harvard Medical School, Boston, MA, United States
| | - Donghai Liang
- Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, United States
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Hood RB, James P, Fong KC, Mínguez-Alarcón L, Coull BA, Schwartz J, Kloog I, Laden F, Gaskins AJ. The influence of fine particulate matter on the association between residential greenness and ovarian reserve. Environ Res 2021; 197:111162. [PMID: 33905704 PMCID: PMC8487590 DOI: 10.1016/j.envres.2021.111162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 11/30/2020] [Revised: 03/01/2021] [Accepted: 04/07/2021] [Indexed: 05/10/2023]
Abstract
BACKGROUND Natural vegetation, or greenness, is thought to improve health through its ability to buffer and reduce harmful environmental exposures as well as relieve stress, promote physical activity, restore attention, and increase social cohesion. In concert, these effects could help mitigate the detrimental effects of air pollution on reproductive aging in women. METHODS Our analysis included 565 women attending the Massachusetts General Hospital Fertility Center (2004-2014) who had a measured antral follicle count (AFC), a marker of ovarian reserve. We calculated peak residential greenness in the year prior to AFC using 250 m2 normalized difference vegetation index (NDVI) from the Terra and Aqua satellites operated by the United States National Aeronautics and Space Administration. Validated spatiotemporal models estimated daily residential exposure to particulate matter <2.5 μm (PM2.5) for the 3 months prior to AFC. Poisson regression models with robust standard errors were used to estimate the association between peak greenness, average PM2.5 exposure, and AFC adjusted for age, BMI, smoking status, education, year, and season. RESULTS Women in our study had a mean age of 35.2 years with a standard deviation (SD) of 4.3 years (min: 20 years, max: 45 years). The peak residential NDVI ranged from 0.07 to 0.92 with a SD of 0.18. There was no statistically significant association between peak residential greenness and AFC; however, higher exposure to PM2.5 was associated with lower AFC (-6.2% per 2 μg/m3 [1 SD increase] 95% CI -11.8, -0.3). There was a significant interaction between exposure to PM2.5 and peak greenness on AFC (P-interaction: 0.03). Among women with an average PM2.5 exposure of 7 μg/m3, a SD increase in residential peak greenness was associated with a 5.6% (95% CI -0.4, 12.0) higher AFC. Conversely, among women with a PM2.5 exposure of 12 μg/m3, a SD increase in residential peak greenness was associated with a 5.8% (95% CI -13.1, 2.1) lower AFC. CONCLUSIONS Residing in an area with high levels of greenness may slow reproductive aging in women only when exposure to PM2.5 is low.
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Affiliation(s)
- Robert B Hood
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA.
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kelvin C Fong
- School of the Environment, Yale University, New Haven, CT, USA
| | - Lidia Mínguez-Alarcón
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- 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; Channing Division of Network Medicine, Department of Medicine. Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Itai Kloog
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Francine Laden
- 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; Channing Division of Network Medicine, Department of Medicine. Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Audrey J Gaskins
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
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Chakraborty P, Gallo MF, Nawaz S, Smith MH, Hood RB, Chettri S, Bessett D, Norris AH, Casterline J, Turner AN. Use of nonpreferred contraceptive methods among women in Ohio. Contraception 2021; 103:328-335. [PMID: 33607120 PMCID: PMC10104247 DOI: 10.1016/j.contraception.2021.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 06/14/2020] [Revised: 02/06/2021] [Accepted: 02/10/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES We describe the prevalence and correlates of nonuse of preferred contraceptive method among women 18-44 years of age in Ohio using contraception. STUDY DESIGN The population-representative Ohio Survey of Women had 2529 participants in 2018-2019, with a response rate of 33.5%. We examined prevalence of preferred method nonuse, reasons for nonuse, and satisfaction with current method among current contraception users (n = 1390). We evaluated associations between demographic and healthcare factors and preferred method nonuse. RESULTS About 25% of women reported not using their preferred contraceptive method. The most common barrier to obtaining preferred method was affordability (13%). Those not using their preferred method identified long-acting methods (49%), oral contraception (33%), or condoms (21%) as their preferred methods. The proportion using their preferred method was highest among intrauterine device (IUD) users (86%) and lowest among emergency contraception users (64%). About 16% of women using permanent contraception reported it was not their preferred method. Having the lowest socioeconomic status (versus highest) (prevalence ratio [PR]: 1.47, 95% CI: 1.11-1.96), Hispanic ethnicity (versus non-Hispanic white) (PR: 1.83, 95% CI: 1.15-2.90), reporting poor provider satisfaction related to contraceptive care (PR: 2.33, 95% CI: 1.02-5.29), and not having a yearly women's checkup (PR: 1.31, 95% CI: 1.01-1.68) were significantly associated with nonuse of preferred method. Compared to preferred-method nonusers, higher proportions of preferred-method users reported consistent contraceptive use (89% vs. 73%, p < 0.001) and intent to continue use (79% vs. 58%, p < 0.001). CONCLUSIONS Affordability and poor provider satisfaction related to contraceptive care were associated with nonuse of preferred contraceptive method. Those using their preferred method reported more consistent use. IMPLICATIONS Cost is an important barrier for women in obtaining their preferred contraceptive methods. Low quality birth control care may also be a barrier to preferred-method use. Removal of cost barriers and improvement in contraceptive counseling strategies may increase access to preferred contraceptive methods.
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Affiliation(s)
- Payal Chakraborty
- The Ohio State University, College of Public Health, Division of Epidemiology, Columbus, OH, United States.
| | - Maria F Gallo
- The Ohio State University, College of Public Health, Division of Epidemiology, Columbus, OH, United States
| | - Saira Nawaz
- The Ohio State University, College of Public Health, Center for Health Outcomes, Policy, and Evaluation Studies, Columbus, OH, United States
| | - Mikaela H Smith
- The Ohio State University, College of Public Health, Division of Epidemiology, Columbus, OH, United States
| | - Robert B Hood
- The Ohio State University, College of Public Health, Division of Epidemiology, Columbus, OH, United States
| | - Shibani Chettri
- The Ohio State University, College of Public Health, Division of Epidemiology, Columbus, OH, United States
| | - Danielle Bessett
- University of Cincinnati, Department of Sociology, Cincinnati, OH, United States
| | - Alison H Norris
- The Ohio State University, College of Public Health, Division of Epidemiology, Columbus, OH, United States
| | - John Casterline
- The Ohio State University, College of Arts and Sciences, Department of Sociology, Columbus, OH, United States
| | - Abigail Norris Turner
- The Ohio State University, College of Medicine, Division of Infectious Diseases, Columbus, OH, United States
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Hood RB, Felix A. Abstract C057: Neighborhood disadvantage is associated with liver cancer treatment and survival. Cancer Epidemiol Biomarkers Prev 2020. [DOI: 10.1158/1538-7755.disp19-c057] [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] [Indexed: 11/16/2022] Open
Abstract
Abstract
Liver cancer is the 5th leading cause of cancer mortality in the United States and is predicted to increase in the US as a consequence of the opioid epidemic. Associations between individual-level risk factors, such as socioeconomic status, and liver cancer survival have been explored; however, the role of neighborhood-level factors, such as neighborhood deprivation, are noticeably absent from the literature. We explored the association between greater neighborhood deprivation and disparities in tumor characteristics, treatment and 5-year survival among primary liver cancer patients in Ohio diagnosed between 2003 and 2016 using data from the Ohio Cancer Incidence Surveillance System. We restricted our sample to only patients who were 18 years older and who could be geographically linked to a census tract based on their address at diagnosis. We created a neighborhood deprivation index (NDI) using nine variables at the Census tract level including: % less than high school diploma, % college graduates, % at or below the federal poverty line, % unemployed, median household income, % vacancy, % owner occupied unites, median house/unit value and % African American. We used principal component analysis to create the index and derived quintiles of deprivation with the higher quintiles reflective of areas with higher deprivation. We examined associations between tumor characteristics and NDI quintile using chi-square tests and ANOVA. We examined concordance with treatment guidelines as binary variable using log-binomial regression. For 5-year survival we utilized Cox proportional hazard models. Confounding variables for each regression model were selected using Directed Acyclic Graphs. After exclusion criteria were applied, 8,208 primary liver cancer patients were included in the study. We observed no statistically significant differences in tumor characteristics by quintile of NDI. However, we found a clear gradient between levels of deprivation and decrease likelihood of receiving guideline-concordant care. Specifically, between the most and least deprived areas, a 25% lower risk (Risk ratio [RR]=0.75; 95% Confidence Interval [CI]=0.67, 0.85) of receiving guideline-concordant care was observed in our adjusted log-binomial regression model. In adjusted survival models we observed an increased risk of death comparing the most and least deprived areas (Hazard ratio [HR]=1.14, 95% CI=1.02, 1.27). Our study suggests a potential negative effect of neighborhood deprivation on treatment concordance and liver cancer survival. Interventions targeting disparities in liver cancer should focus on not only individual level factors but address larger neighborhood level factors as well. Future analyses are needed to confirm these disparities observed and determine if similar neighborhood level effects occur in other cancer disparities. This study includes data provide by the Ohio Department of Health which should not be considered an endorsement of this study or its conclusions.
Citation Format: Robert B Hood, Ashley Felix. Neighborhood disadvantage is associated with liver cancer treatment and survival [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C057.
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Affiliation(s)
- Robert B Hood
- The Ohio State University; College of Public Health, Columbus, OH, USA
| | - Ashley Felix
- The Ohio State University; College of Public Health, Columbus, OH, USA
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Norris AH, Chakraborty P, Lang K, Hood RB, Hayford SR, Keder L, Bessett D, Smith MH, Hill BJ, Broscoe M, Norwood C, McGowan ML. Abortion Access in Ohio's Changing Legislative Context, 2010-2018. Am J Public Health 2020; 110:1228-1234. [PMID: 32437269 DOI: 10.2105/ajph.2020.305706] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To examine abortion utilization in Ohio from 2010 to 2018, a period when more than 15 abortion-related laws became effective.Methods. We evaluated changes in abortion rates and ratios examining gestation, geographic distribution, and abortion method in Ohio from 2010 to 2018. We used data from Ohio's Office of Vital Statistics, the Centers for Disease Control and Prevention's Abortion Surveillance Reports, the American Community Survey, and Ohio's Public Health Data Warehouse.Results. During 2010 through 2018, abortion rates declined similarly in Ohio, the Midwest, and the United States. In Ohio, the proportion of early first trimester abortions decreased; the proportion of abortions increased in nearly every later gestation category. Abortion ratios decreased sharply in most rural counties. When clinics closed, abortion ratios dropped in nearby counties.Conclusions. More Ohioans had abortions later in the first trimester, compared with national patterns, suggesting delays to care. Steeper decreases in abortion ratios in rural versus urban counties suggest geographic inequity in abortion access.Public Health Implications. Policies restricting abortion access in Ohio co-occur with delays to care and increasing geographic inequities. Restrictive policies do not improve reproductive health.
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Affiliation(s)
- Alison H Norris
- At the time of the study, Alison H. Norris, Payal Chakraborty, Kaiting Lang, Robert B. Hood, and Mikaela H. Smith were with the College of Public Health, Ohio State University, Columbus. Sarah R. Hayford was with the Department of Sociology, Ohio State University, Columbus. Lisa Keder was with the College of Medicine, Ohio State University, Columbus. Danielle Bessett and Molly Broscoe were with the Department of Sociology, University of Cincinnati, Cincinnati, OH. B. Jessie Hill was with the Case Western Reserve University School of Law, Cleveland, OH. Carolette Norwood was with the Department of Women's, Gender & Sexuality Studies, University of Cincinnati. Michelle L. McGowan was with Cincinnati Children's Hospital Medical Center Ethics Center, Cincinnati, OH
| | - Payal Chakraborty
- At the time of the study, Alison H. Norris, Payal Chakraborty, Kaiting Lang, Robert B. Hood, and Mikaela H. Smith were with the College of Public Health, Ohio State University, Columbus. Sarah R. Hayford was with the Department of Sociology, Ohio State University, Columbus. Lisa Keder was with the College of Medicine, Ohio State University, Columbus. Danielle Bessett and Molly Broscoe were with the Department of Sociology, University of Cincinnati, Cincinnati, OH. B. Jessie Hill was with the Case Western Reserve University School of Law, Cleveland, OH. Carolette Norwood was with the Department of Women's, Gender & Sexuality Studies, University of Cincinnati. Michelle L. McGowan was with Cincinnati Children's Hospital Medical Center Ethics Center, Cincinnati, OH
| | - Kaiting Lang
- At the time of the study, Alison H. Norris, Payal Chakraborty, Kaiting Lang, Robert B. Hood, and Mikaela H. Smith were with the College of Public Health, Ohio State University, Columbus. Sarah R. Hayford was with the Department of Sociology, Ohio State University, Columbus. Lisa Keder was with the College of Medicine, Ohio State University, Columbus. Danielle Bessett and Molly Broscoe were with the Department of Sociology, University of Cincinnati, Cincinnati, OH. B. Jessie Hill was with the Case Western Reserve University School of Law, Cleveland, OH. Carolette Norwood was with the Department of Women's, Gender & Sexuality Studies, University of Cincinnati. Michelle L. McGowan was with Cincinnati Children's Hospital Medical Center Ethics Center, Cincinnati, OH
| | - Robert B Hood
- At the time of the study, Alison H. Norris, Payal Chakraborty, Kaiting Lang, Robert B. Hood, and Mikaela H. Smith were with the College of Public Health, Ohio State University, Columbus. Sarah R. Hayford was with the Department of Sociology, Ohio State University, Columbus. Lisa Keder was with the College of Medicine, Ohio State University, Columbus. Danielle Bessett and Molly Broscoe were with the Department of Sociology, University of Cincinnati, Cincinnati, OH. B. Jessie Hill was with the Case Western Reserve University School of Law, Cleveland, OH. Carolette Norwood was with the Department of Women's, Gender & Sexuality Studies, University of Cincinnati. Michelle L. McGowan was with Cincinnati Children's Hospital Medical Center Ethics Center, Cincinnati, OH
| | - Sarah R Hayford
- At the time of the study, Alison H. Norris, Payal Chakraborty, Kaiting Lang, Robert B. Hood, and Mikaela H. Smith were with the College of Public Health, Ohio State University, Columbus. Sarah R. Hayford was with the Department of Sociology, Ohio State University, Columbus. Lisa Keder was with the College of Medicine, Ohio State University, Columbus. Danielle Bessett and Molly Broscoe were with the Department of Sociology, University of Cincinnati, Cincinnati, OH. B. Jessie Hill was with the Case Western Reserve University School of Law, Cleveland, OH. Carolette Norwood was with the Department of Women's, Gender & Sexuality Studies, University of Cincinnati. Michelle L. McGowan was with Cincinnati Children's Hospital Medical Center Ethics Center, Cincinnati, OH
| | - Lisa Keder
- At the time of the study, Alison H. Norris, Payal Chakraborty, Kaiting Lang, Robert B. Hood, and Mikaela H. Smith were with the College of Public Health, Ohio State University, Columbus. Sarah R. Hayford was with the Department of Sociology, Ohio State University, Columbus. Lisa Keder was with the College of Medicine, Ohio State University, Columbus. Danielle Bessett and Molly Broscoe were with the Department of Sociology, University of Cincinnati, Cincinnati, OH. B. Jessie Hill was with the Case Western Reserve University School of Law, Cleveland, OH. Carolette Norwood was with the Department of Women's, Gender & Sexuality Studies, University of Cincinnati. Michelle L. McGowan was with Cincinnati Children's Hospital Medical Center Ethics Center, Cincinnati, OH
| | - Danielle Bessett
- At the time of the study, Alison H. Norris, Payal Chakraborty, Kaiting Lang, Robert B. Hood, and Mikaela H. Smith were with the College of Public Health, Ohio State University, Columbus. Sarah R. Hayford was with the Department of Sociology, Ohio State University, Columbus. Lisa Keder was with the College of Medicine, Ohio State University, Columbus. Danielle Bessett and Molly Broscoe were with the Department of Sociology, University of Cincinnati, Cincinnati, OH. B. Jessie Hill was with the Case Western Reserve University School of Law, Cleveland, OH. Carolette Norwood was with the Department of Women's, Gender & Sexuality Studies, University of Cincinnati. Michelle L. McGowan was with Cincinnati Children's Hospital Medical Center Ethics Center, Cincinnati, OH
| | - Mikaela H Smith
- At the time of the study, Alison H. Norris, Payal Chakraborty, Kaiting Lang, Robert B. Hood, and Mikaela H. Smith were with the College of Public Health, Ohio State University, Columbus. Sarah R. Hayford was with the Department of Sociology, Ohio State University, Columbus. Lisa Keder was with the College of Medicine, Ohio State University, Columbus. Danielle Bessett and Molly Broscoe were with the Department of Sociology, University of Cincinnati, Cincinnati, OH. B. Jessie Hill was with the Case Western Reserve University School of Law, Cleveland, OH. Carolette Norwood was with the Department of Women's, Gender & Sexuality Studies, University of Cincinnati. Michelle L. McGowan was with Cincinnati Children's Hospital Medical Center Ethics Center, Cincinnati, OH
| | - B Jessie Hill
- At the time of the study, Alison H. Norris, Payal Chakraborty, Kaiting Lang, Robert B. Hood, and Mikaela H. Smith were with the College of Public Health, Ohio State University, Columbus. Sarah R. Hayford was with the Department of Sociology, Ohio State University, Columbus. Lisa Keder was with the College of Medicine, Ohio State University, Columbus. Danielle Bessett and Molly Broscoe were with the Department of Sociology, University of Cincinnati, Cincinnati, OH. B. Jessie Hill was with the Case Western Reserve University School of Law, Cleveland, OH. Carolette Norwood was with the Department of Women's, Gender & Sexuality Studies, University of Cincinnati. Michelle L. McGowan was with Cincinnati Children's Hospital Medical Center Ethics Center, Cincinnati, OH
| | - Molly Broscoe
- At the time of the study, Alison H. Norris, Payal Chakraborty, Kaiting Lang, Robert B. Hood, and Mikaela H. Smith were with the College of Public Health, Ohio State University, Columbus. Sarah R. Hayford was with the Department of Sociology, Ohio State University, Columbus. Lisa Keder was with the College of Medicine, Ohio State University, Columbus. Danielle Bessett and Molly Broscoe were with the Department of Sociology, University of Cincinnati, Cincinnati, OH. B. Jessie Hill was with the Case Western Reserve University School of Law, Cleveland, OH. Carolette Norwood was with the Department of Women's, Gender & Sexuality Studies, University of Cincinnati. Michelle L. McGowan was with Cincinnati Children's Hospital Medical Center Ethics Center, Cincinnati, OH
| | - Carolette Norwood
- At the time of the study, Alison H. Norris, Payal Chakraborty, Kaiting Lang, Robert B. Hood, and Mikaela H. Smith were with the College of Public Health, Ohio State University, Columbus. Sarah R. Hayford was with the Department of Sociology, Ohio State University, Columbus. Lisa Keder was with the College of Medicine, Ohio State University, Columbus. Danielle Bessett and Molly Broscoe were with the Department of Sociology, University of Cincinnati, Cincinnati, OH. B. Jessie Hill was with the Case Western Reserve University School of Law, Cleveland, OH. Carolette Norwood was with the Department of Women's, Gender & Sexuality Studies, University of Cincinnati. Michelle L. McGowan was with Cincinnati Children's Hospital Medical Center Ethics Center, Cincinnati, OH
| | - Michelle L McGowan
- At the time of the study, Alison H. Norris, Payal Chakraborty, Kaiting Lang, Robert B. Hood, and Mikaela H. Smith were with the College of Public Health, Ohio State University, Columbus. Sarah R. Hayford was with the Department of Sociology, Ohio State University, Columbus. Lisa Keder was with the College of Medicine, Ohio State University, Columbus. Danielle Bessett and Molly Broscoe were with the Department of Sociology, University of Cincinnati, Cincinnati, OH. B. Jessie Hill was with the Case Western Reserve University School of Law, Cleveland, OH. Carolette Norwood was with the Department of Women's, Gender & Sexuality Studies, University of Cincinnati. Michelle L. McGowan was with Cincinnati Children's Hospital Medical Center Ethics Center, Cincinnati, OH
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Chakraborty P, Norris AH, Huber-Krum S, Garver S, Hood RB, Banda V, Esber A, Patricia CR, Krysiak R, Turner AN. An Assessment of Risk Factors for Herpes Simplex Virus Type 2 Infection in Malawian Women Using 2 Classifications for the HerpeSelect 2 Test. Sex Transm Dis 2020; 47:192-196. [PMID: 31876866 PMCID: PMC7816111 DOI: 10.1097/olq.0000000000001121] [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] [Indexed: 11/25/2022]
Abstract
BACKGROUND The HerpeSelect 2 ELISA IgG test for herpes simplex virus type 2 (HSV-2) infection is widely used, convenient, and inexpensive. However, it has been shown to have lower specificity among populations in Sub-Saharan Africa compared with HSV-2 tests regarded as criterion standards. METHODS In 2016, we collected blood and survey data from 248 women participating in a community-based cohort study in rural Malawi (the Umoyo wa Thanzi project). Using multinomial logistic regression accounting for village-level clustering, we examined unadjusted associations between select demographic and sexual risk factors and HSV-2 serostatus. Because increasing the index value cutpoint for a positive result improves specificity, we coded HSV-2 serostatus in 2 ways: the manufacturer's recommended cutpoints (<0.9, negative; 0.9-1.1, indeterminate; >1.1, positive) and modified cutpoints with improved specificity (<0.9, negative; 0.9-3.5, indeterminate; >3.5, positive). We aimed to investigate whether associations between select risk factors and HSV-2 serostatus varied under the 2 approaches. RESULTS The prevalence of HSV-2 in this sample was 67% under the manufacturer's cutpoint and 22% under the modified cutpoint. Under both cutpoints, age, household size, number of marriages, and number of pregnancies were associated with HSV-2-positive serostatus. Using modified cutpoints, current bacterial vaginosis (odds ratio [OR], 3.17; 95% confidence interval [CI], 1.35-7.47), partner concurrency (OR, 4.88; 95% CI, 2.54-9.37) and unsure about partner concurrency (OR, 1.91; 95% CI, 1.08-3.38) were associated with HSV-2 seropositivity. Household size, education, and marital status were the only variables significantly associated with indeterminate HSV-2 serostatus using the modified cutpoints. CONCLUSION HSV-2-focused interventions informed by identifying individuals likely to have or acquire HSV-2 must be aware that different target populations may emerge depending on which cutpoints are adopted.
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Affiliation(s)
| | | | - Sarah Huber-Krum
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Sarah Garver
- Department of Sociology, University of Chicago, Chicago, IL
| | - Robert B Hood
- From the Division of Epidemiology, College of Public Health
| | - Venson Banda
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
| | | | | | | | - Abigail Norris Turner
- Division of Infectious Diseases, College of Medicine, The Ohio State University, Columbus, OH
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Thomas PD, Hunt WC, Garry PJ, Hood RB, Goodwin JM, Goodwin JS. Hearing acuity in a healthy elderly population: effects on emotional, cognitive, and social status. J Gerontol 1983; 38:321-5. [PMID: 6841927 DOI: 10.1093/geronj/38.3.321] [Citation(s) in RCA: 65] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Hearing acuity and the relationships between untreated hearing deficits and emotional state, cognitive functioning, and social integration were examined in 239 physically healthy, independent-living elderly men and women with a mean age of 72 years. Air-conduction, pure-tone thresholds in both ears were determined at high- and mid-frequencies, and participants were also given the Speech Perception in Noise test. Multivariate techniques were used to test for associations between hearing acuity and scores from the Kellner-Sheffield Symptom Questionnaire, the Jacobs Cognitive Screening Exam, the Halstead Category Test, the Wechsler Memory Scale, and the Interview Schedule for Social Interaction. No deleterious effects of untreated hearing deficits on emotional status or social integration were found. The findings suggest that those with a hearing loss perform less well on verbal but not on nonverbal tests of cognition.
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Browder JA, Hood RB, Lamb LE. The physician and the child with hearing impairment. Guide to early recognition and management. Rocky Mt Med J 1973; 70:42-6. [PMID: 4727695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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