Leaded aviation gasoline exposure risk and child blood lead levels

Lead-formulated aviation gasoline (avgas) is the primary source of lead emissions in the United States today, consumed by over 170,000 piston-engine aircraft (PEA). The U.S. Environmental Protection Agency (EPA) estimates that four million people reside within 500m of a PEA-servicing airport. The disposition of avgas around such airports may be an independent source of child lead exposure. We analyze over 14,000 blood lead samples of children (≤5 y of age) residing near one such airport-Reid-Hillview Airport (RHV) in Santa Clara County, California. Across an ensemble of tests, we find that the blood lead levels (BLLs) of sampled children increase in proximity to RHV, are higher among children east and predominantly downwind of the airport, and increase with the volume of PEA traffic and quantities of avgas sold at the airport. The BLLs of airport-proximate children are especially responsive to an increase in PEA traffic, increasing by about 0.72 μg/dL under periods of maximum PEA traffic. We also observe a significant reduction in child BLLs from a series of pandemic-related interventions in Santa Clara County that contracted PEA traffic at the airport. Finally, we find that children's BLLs increase with measured concentrations of atmospheric lead at the airport. In support of the scientific adjudication of the EPAs recently announced endangerment finding, this in-depth case study indicates that the deposition of avgas significantly elevates the BLLs of at-risk children.

Physician behaviour, malpractice risk and defensive medicine: an investigation of cesarean deliveries

Analyzing whether physicians use cesarean sections (c-sections) as defensive medicine (DM) has proven difficult. Using natural experiments arising out of Oregon court decisions overturning a state legislative cap on non-economic damages in tort cases, we analyze the impact of patient conditions on estimates of DM. Consistent with theory, we find heterogeneous impacts of tort laws across patient conditions. When medical exigencies dictate a c-section, tort laws have no impact on physician decisions. When physicians have latitude in their decision making, we find evidence of DM. When we estimate a model combining all women and not accounting for patient conditions (such as models estimated in previous studies) we obtain a result which is the opposite of DM, which we call offensive medicine (OM). The OM result appears to arise out of a bias in the difference-in-differences estimator associated with changes in the marginal distributions of patient conditions in control and treatment groups. The changes in the marginal distributions appear to arise from the impact of tort law on the market for midwives (substitutes for physicians for low-risk women). Our analysis suggests that not accounting for theoretically expected heterogeneity in physician reactions to changes in tort laws may produce biased estimates of DM.

The Longevity-Frailty Hypothesis: Evidence from COVID-19 Death Rates in Europe

By the end of spring (31 May), the COVID-19 death rate was remarkably unevenly distributed across the countries in Europe. While the risk of COVID-19 mortality is known to increase with age, age-specific COVID-19 death rates across Europe were similarly unevenly distributed. To explain these mortality distributions, we present a simple model where more favorable survival environments promote longevity and the accumulation of health frailty among the elderly while less favorable survival environments induce a mortality selection process that results in lower health frailty. Because the age-related conditions of frailty render the elderly less resistant to SARS-CoV-2, pre-existing survival environments may be non-obviously positively related to the COVID-19 death rate. To quantify the survival environment parameter of our model, we leveraged historic cohort- and period-based age-specific probabilities of death and life expectancies at age 65 across Europe. All variables are significantly correlated with indicators of frailty like elderly dependence on others for personal and household care for a subset of European countries. With respect to COVID-19 death rates, we find significant positive relationships between our survival indicators and COVID-19 death rates across Europe, a result that is robust to statistical control for the capacity of a healthcare system to treat and survive infected persons, the timing and stringency of non-pharmaceutical interventions, population density, age structure, case rates and the volume of inbound international travelers, among other factors. To address possible concerns over reporting heterogeneity across countries, we show that results are robust to the substitution of our response variable for a measure of cumulative excess mortality. Also consistent with the intuition of our model, we also show a strong negative association between age-specific COVID-19 death rates and pre-existing all-cause age-specific mortality rates for a subset of European countries. Overall, results support the notion that variation in pre-existing frailty, resulting from heterogeneous survival environments, partially accounts for striking differences in COVID-19 death during the first wave of the pandemic.

Water lead exposure risk in Flint, Michigan after switchback in water source: Implications for lead service line replacement policy

In February of 2016, the City of Flint, Michigan commenced the FAST start initiative with the aim "to get the lead out of Flint" by replacing lead and galvanized steel service lines throughout the city. An estimated 29,100 parcels are scheduled for service line replacement (SLR) at an expected cost of $172 million. The lead exposure benefits of SLR are evaluated by analyzing Sentinel data on hundreds of repeatedly sampled homes in Flint from February 16, 2016 to July 21, 2017, comparing water lead (WL) in homes with and without lead service lines. Samples taken from homes with lead service lines were significantly more likely to exceed specified thresholds of WL than homes without lead service lines. Second, regardless of service line material type, sampled homes experienced significant reductions in WL with elapsed time from Flint's switchback to water provided by the Detroit Water and Sewage Department. Third, the risk of exceedance of WL > 15 μg/L was uncorrelated with service line material type. These results are robust to sample restrictions, period stratification, time operations, reference group definitions, and statistical modeling procedures. On the question of what is gained from SLR over optimal corrosion control techniques, we simulated age-specific lead uptake (μg/day) and blood lead levels (μg/dL) for children in Flint at 16 and 90 weeks of elapsed time from Flint's switchback to Detroit water. At 90 weeks from the switchback in water source, the quantity of water lead consumed by children in homes with lead service lines decreased 93%, as compared to 16 weeks. Lead exposure benefits of SLR have declined in time, with modest differences in lead uptake across homes with different service lines. In light of results, policy considerations for Flint and nationwide are discussed.

Clinical Capital and the Risk of Maternal Labor and Delivery Complications: Hospital Scheduling, Timing, and Cohort Turnover Effects

The establishment of interventions to maximize maternal health requires the identification of modifiable risk factors. Toward the identification of modifiable hospital-based factors, we analyze over 2 million births from 2005 to 2010 in Texas, employing a series of quasi-experimental tests involving hourly, daily, and monthly circumstances where medical service quality (or clinical capital) is known to vary exogenously. Motivated by a clinician's choice model, we investigate whether maternal delivery complications (1) vary by work shift, (2) increase by the hours worked within shifts, (3) increase on weekends and holidays when hospitals are typically understaffed, and (4) are higher in July when a new cohort of residents enter teaching hospitals. We find consistent evidence of a sizable statistical relationship between deliveries during nonstandard schedules and negative patient outcomes. Delivery complications are higher during night shifts (OR = 1.21, 95% CI: 1.18-1.25), and on weekends (OR = 1.09, 95% CI: 1.04-1.14) and holidays (OR = 1.29, 95% CI: 1.04-1.60), when hospitals are understaffed and less experienced doctors are more likely to work. Within shifts, we show deterioration of occupational performance per additional hour worked (OR = 1.02, 95% CI: 1.01-1.02). We observe substantial additional risk at teaching hospitals in July (OR = 1.28, 95% CI: 1.14-1.43), reflecting a cohort-turnover effect. All results are robust to the exclusion of noninduced births and intuitively falsified with analyses of chromosomal disorders. Results from our multiple-test strategy indicate that hospitals can meaningfully attenuate harm to maternal health through strategic scheduling of staff.

The effect of contemporary mine emissions on children's blood lead levels

BACKGROUND

Broken Hill is home to Australia's oldest silver-zinc-lead mine. However, the precise source of childhood blood lead (PbB) exposures has been subject to considerable debate. Lead sources include natural soil Pb enrichment, legacy deposition, contemporary mining emissions, and Pb-based paint.

OBJECTIVE

To test whether contemporary mining emissions independently affect childhood PbB in Broken Hill.

METHODS

Children's (<5 years old) PbB measures from 2011 to 2015 (n = 4852), obtained from Broken Hill Child & Family Health Centre, were analyzed using generalised linear regression models, including covariates of household soil Pb, city dust Pb concentrations (PbD), demographic factors and Pb ore production. Two natural experiments involving wind direction and the 2009 dust storm were examined to test whether the PbB-distance gradient from the mining operations was influenced by contemporary emissions. The influence of contemporary emissions was further interrogated by examining the effect of ore production on PbB and PbD.

RESULTS

Children living downwind and proximate to the mine had substantially higher PbB outcomes than children similarly distant but upwind. Dust Pb deposition increased significantly with proximity to mining operations as well to Pb production (1991-2013). Average annual PbB correlated with Pb ore production (p < 0.01) with all subsets of children PbB levels responding with near unit elasticity to Pb ore production (p < 0.01). Pre- and post-analysis of the dust storm showed the PbB-distance gradient remained statistically unaltered further confirming contemporary emissions as a source of exposure.

CONCLUSIONS

Contemporary mining emissions influence children's PbB measures independent of other sources and need to be remediated to facilitate reductions in harmful exposure.

Assessment of the Legionnaires' disease outbreak in Flint, Michigan

The 2014-2015 Legionnaires' disease (LD) outbreak in Genesee County, MI, and the outbreak resolution in 2016 coincided with changes in the source of drinking water to Flint's municipal water system. Following the switch in water supply from Detroit to Flint River water, the odds of a Flint resident presenting with LD increased 6.3-fold (95% CI: 2.5, 14.0). This risk subsided following boil water advisories, likely due to residents avoiding water, and returned to historically normal levels with the switch back in water supply. During the crisis, as the concentration of free chlorine in water delivered to Flint residents decreased, their risk of acquiring LD increased. When the average weekly chlorine level in a census tract was <0.5 mg/L or <0.2 mg/L, the odds of an LD case presenting from a Flint neighborhood increased by a factor of 2.9 (95% CI: 1.4, 6.3) or 3.9 (95% CI: 1.8, 8.7), respectively. During the switch, the risk of a Flint neighborhood having a case of LD increased by 80% per 1 mg/L decrease in free chlorine, as calculated from the extensive variation in chlorine observed. In communities adjacent to Flint, the probability of LD occurring increased with the flow of commuters into Flint. Together, the results support the hypothesis that a system-wide proliferation of legionellae was responsible for the LD outbreak in Genesee County, MI.

Four phases of the Flint Water Crisis: Evidence from blood lead levels in children

The Flint Water Crisis (FWC) is divisible into four phases of child water-lead exposure risk: Phase A) before the switch in water source to the Flint River (our baseline); Phase B) after the switch in water source, but before boil water advisories; Phase C) after boil water advisories, but before the switch back to the baseline water source of the Detroit Water and Sewerage Department (DWSD); and Phase D) after the switch back to DWSD. The objective of this work is to estimate water-lead attributable movements in child blood lead levels (BLLs) that correspond with the four phases in the FWC. With over 21,000 geo-referenced and time-stamped blood lead samples from children in Genesee County drawn from January 01, 2013 to July 19, 2016, we develop a series of quasi-experimental models to identify the causal effect of water-lead exposure on child BLLs in Flint. We find that the switch in water source (transitioning from phase A to B) caused mean BLLs to increase by about 0.5μg/dL, and increased the likelihood of a child presenting with a BLL ≥ 5μg/dL by a factor of 1.91-3.50, implying an additional 561 children exceeding 5μg/dL. We conservatively estimate cohort social costs (through lost earnings alone) of this increase in water-lead exposed children at $65 million, contrasted with expected annual savings of $2 million from switching water source. On the switch from Phase B to C, we find BLLs decreased about 50% from their initial rise following boil water advisories and subsequent water avoidance behaviors by households. Finally, the return to the baseline source water (Phase D) returned child BLLs to pre-FWC levels further implicating water-lead exposure as a causal source of child BLLs throughout the FWC.

Motor neuron disease mortality and lifetime petrol lead exposure: Evidence from national age-specific and state-level age-standardized death rates in Australia

BACKGROUND

The age standardized death rate from motor neuron disease (MND) for persons 40-84 years of age in the Australian States of New South Wales, Victoria, and Queensland increased dramatically from 1958 to 2013. Nationally, age-specific MND death rates also increased over this time period, but the rate of the rise varied considerably by age-group. The historic use of lead (Pb) additives in Australian petrol is a candidate explanation for these trends in MND mortality (International Classification of Disease (ICD)-10 G12.2).

METHODS

Leveraging temporal and spatial variation in petrol lead exposure risk resulting from the slow rise and rapid phase-out of lead as a constituent in gasoline in Australia, we analyze relationships between (1) national age-specific MND death rates in Australia and age-specific lifetime petrol lead exposure, (2) annual between-age dispersions in age-specific MND death rates and age-specific lifetime petrol lead exposure; and (3) state-level age-standardized MND death rates as a function of age-weighted lifetime petrol lead exposure.

RESULTS

Other things held equal, we find that a one percent increase in lifetime petrol lead exposure increases the MND death rate by about one-third of one percent in both national age-specific and state-level age-standardized models of MND mortality. Lending support to the supposition that lead exposure is a driver of MND mortality risk, we find that the annual between-age group standard deviation in age-specific MND death rates is strongly correlated with the between-age standard deviation in age-specific lifetime petrol lead exposure.

CONCLUSION

Legacy petrol lead emissions are associated with age-specific MND death rates as well as state-level age-standardized MND death rates in Australia. Results indicate that we are approaching peak lead exposure-attributable MND mortality.

Environmental Justice and the Role of Criminology

An increasing number of scholars and activists have begun to tackle a variety of issues relevant to environmental justice studies. This study attempts to address the role of criminologists in this domain. The authors examine 425 environmental justice articles in 204 academic journals, representing 18 programs/departments between 1970 and 2003. First, they measure the environmental justice contributions in the literature by academic department or activist affiliation. Second, they identify the major themes in the literature as they have developed and reveal the current and future directions of environmental justice studies. Such themes include the spatial distribution of hazards, social movements, law and public policy, and environmental discrimination. Finally, the authors seek to call attention to the evident linkages between accepted areas of criminological scholarship and environmental justice. From this latter objective, the authors seek to demonstrate how criminology and criminal justice can advance this critical dialogue and social movement.

Environmental contamination in an Australian mining community and potential influences on early childhood health and behavioural outcomes

Arsenic, cadmium and lead in aerosols, dusts and surface soils from Australia's oldest continuous lead mining town of Broken Hill were compared to standardised national childhood developmental (year 1) and education performance measures (years 3,5,7,9). Contaminants close to mining operations were elevated with maximum lead levels in soil: 8900 mg/kg; dust wipe: 86,061 μg/m(2); dust deposition: 2950 μg/m(2)/day; aerosols: 0.707 μg/m(3). The proportion of children from Broken Hill central, the area with the highest environmental contamination, presented with vulnerabilities in two or more developmental areas at 2.6 times the national average. Compared with other school catchments of Broken Hill, children in years 3 and 5 from the most contaminated school catchment returned consistently the lowest educational scores. By contrast, children living and attending schools associated with lower environmental contamination levels recorded higher school scores and lower developmental vulnerabilities. Similar results were identified in Australia's two other major lead mining and smelting cities of Port Pirie and Mount Isa.

Entrepreneurship, Information, and Growth

We examine the contribution to economic growth of entrepreneurial "marketplace information" within a regional endogenous growth framework. Entrepreneurs are posited to provide an input to economic growth through the information revealed by their successes and failures. We empirically identify this information source with the regional variation in establishment births and deaths, which create geographic information asymmetries that influence subsequent entrepreneurial activity and economic growth. We find that local establishment birth and death rates are significantly and positively correlated with subsequent entrepreneurship for US counties. To account for the potential endogeneity caused by forward-looking entrepreneurs, we utilize instruments based on historic mining activity. We find that the information spillover component of local establishment birth and death rates have significant positive effects on subsequent entrepreneurship and employment growth for US counties and metropolitan areas. With the help of these intruments, we show that establishment births have a positive and significant effect on future employment growth within all counties, and that in line with the information hypothesis, local establishment death rates have a similar positive effect within metropolitan counties.

Evaluating the efficacy of playground washing to reduce environmental metal exposures

Washing and wet mopping is often advocated as a remedial treatment to limit exposure to lead dust. Here, surface and pre- and post-play wipes were measured to ascertain dust metal exposures (arsenic, cadmium, copper, lead and zinc) following play routines at four playgrounds in the smelter city of Port Pirie, South Australia, which are washed regularly. Although post-play hand wipe metals were 55.9% (95% CI: -0.78, -0.34) lower on wash days, loadings increased ∼5.1% (95% CI: 1.2, 11.7) per hour after washing. Despite washing, post-play hand lead exceeded a conservative value of 800 μg/m(2) within 24 h or sooner, with loadings increasing in proximity to the smelter. Post-play lead loadings were always >1000 μg/m(2) at the playground closest to smelter. Playground washing results in short-lived exposure reduction and effective treatment requires elimination of smelter emissions.

Stress and telomere shortening among central Indian conservation refugees

Research links psychosocial stress to premature telomere shortening and accelerated human aging; however, this association has only been demonstrated in so-called "WEIRD" societies (Western, educated, industrialized, rich, and democratic), where stress is typically lower and life expectancies longer. By contrast, we examine stress and telomere shortening in a non-Western setting among a highly stressed population with overall lower life expectancies: poor indigenous people--the Sahariya--who were displaced (between 1998 and 2002) from their ancestral homes in a central Indian wildlife sanctuary. In this setting, we examined adult populations in two representative villages, one relocated to accommodate the introduction of Asiatic lions into the sanctuary (n = 24 individuals), and the other newly isolated in the sanctuary buffer zone after their previous neighbors were moved (n = 22). Our research strategy combined physical stress measures via the salivary analytes cortisol and α-amylase with self-assessments of psychosomatic stress, ethnographic observations, and telomere length assessment [telomere-fluorescence in situ hybridization (TEL-FISH) coupled with 3D imaging of buccal cell nuclei], providing high-resolution data amenable to multilevel statistical analysis. Consistent with expectations, we found significant associations between each of our stress measures--the two salivary analytes and the psychosomatic symptom survey--and telomere length, after adjusting for relevant behavioral, health, and demographic traits. As the first study (to our knowledge) to link stress to telomere length in a non-WEIRD population, our research strengthens the case for stress-induced telomere shortening as a pancultural biomarker of compromised health and aging.

Maternal exposure to neighborhood soil Pb and eclampsia risk in New Orleans, Louisiana (USA): evidence from a natural experiment in flooding

BACKGROUND

Previous studies link maternal blood lead (Pb) levels and pregnancy-related hypertensive disorders.

OBJECTIVE

Assess the relationship between neighborhood soil Pb and maternal eclampsia risk.

METHODS

Zip code summarized high density soil survey data of New Orleans collected before and after Hurricanes Katrina and Rita (HKR) were merged with pregnancy outcome data on 75,501 mothers from the Louisiana office of public health. Cross-sectional logistic regression analyses are performed testing the association between pre-HKR accumulation of Pb in soils in thirty-two neighborhoods and eclampsia risk. Then we examine whether measured declines in soil Pb following the flooding of the city resulted in corresponding reductions of eclampsia risk.

RESULTS

Cross-sectional analyses show that a one standard deviation increase in soil Pb increases the odds of eclampsia by a factor of 1.48 (95% CI: 1.31, 1.66). Mothers in zip code areas with soil Pb>333 mg/kg were 4.00 (95% CI: 3.00, 5.35) times more likely to experience eclampsia than mothers residing in neighborhoods with soil Pb<50mg/kg. Difference-in-differences analyses capturing the exogenous reduction in soil Pb following the 2005 flooding of New Orleans indicate that mothers residing in zip codes experiencing decrease in soil Pb (-387.9 to -33.6 mg/kg) experienced a significant decline in eclampsia risk (OR=0.619; 95% CI: 0.397, 0.963).

CONCLUSIONS

Mothers residing in neighborhoods with high accumulation of Pb in soils are at heightened risk of experiencing eclampsia.

Maternal exposure to hurricane destruction and fetal mortality

BACKGROUND

The majority of research documenting the public health impacts of natural disasters focuses on the well-being of adults and their living children. Negative effects may also occur in the unborn, exposed to disaster stressors when critical organ systems are developing and when the consequences of exposure are large.

METHODS

We exploit spatial and temporal variation in hurricane behaviour as a quasi-experimental design to assess whether fetal death is dose-responsive in the extent of hurricane damage. Data on births and fetal deaths are merged with Parish-level housing wreckage data. Fetal outcomes are regressed on housing wreckage adjusting for the maternal, fetal, placental and other risk factors. The average causal effect of maternal exposure to hurricane destruction is captured by difference-in-differences analyses.

RESULTS

The adjusted odds of fetal death are 1.40 (1.07-1.83) and 2.37 (1.684-3.327) times higher in parishes suffering 10-50% and >50% wreckage to housing stock, respectively. For every 1% increase in the destruction of housing stock, we observe a 1.7% (1.1-2.4%) increase in fetal death. Of the 410 officially recorded fetal deaths in these parishes, between 117 and 205 may be attributable to hurricane destruction and postdisaster disorder. The estimated fetal death toll is 17.4-30.6% of the human death toll.

CONCLUSIONS

The destruction caused by Hurricanes Katrina and Rita imposed significant measurable losses in terms of fetal death. Postdisaster migratory dynamics suggest that the reported effects of maternal exposure to hurricane destruction on fetal death may be conservative.

Identification of lead sources in residential environments: Sydney Australia

Interior and exterior dust, soil and paint were analysed at five brick urban Sydney homes over 15 months to evaluate temporal variations and discriminate sources of lead (Pb) exposure. Exterior dust gauge Pb loading rates (μg/m(2)/28 days), interior vacuum dust Pb concentrations (mg/kg) and interior petri-dish Pb loading rates (μg/m(2)/28 days), were correlated positively with soil Pb concentrations. Exterior dust gauge Pb loading rates and interior vacuum dust Pb concentrations peaked in the summer. Lead isotope and Pb speciation (XAS) were analysed in soil and vacuum dust samples from three of the five houses that had elevated Pb concentrations. Results show that the source of interior dust lead was primarily from soil in two of the three houses and from soil and Pb paint in the third home. IEUBK child blood Pb modelling predicts that children's blood Pb levels could exceed 5 μg/dL in two of the five houses.

A quasi-experimental analysis of maternal altitude exposure and infant birth weight

OBJECTIVES

We analyzed singleton births to determine the relationship between birth weight and altitude exposure.

METHODS

We analyzed 715,213 singleton births across 74 counties from the western states of Arizona, California, Colorado, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, and Washington from January 1, 2000, to December 31, 2000. Birth data were obtained from the Division of Vital Statistics, National Center for Health Statistics, for registered births.

RESULTS

Regression analyses supported previous research by showing that a 1000-meter increase in maternal altitude exposure in pregnancy was associated with a 75.9-gram reduction in birth weight (95% confidence interval = -84.1, -67.6). Quantile regression models indicated significant and near-uniform depressant effects from altitude exposure across the conditional distribution of birth weight. Bivariate sample-selection models showed that a 1000-meter increase in altitude exposure, over and above baseline residential altitude, decreased birth weight by an additional 58.8 grams (95% confidence interval = -98.4, -19.2).

CONCLUSIONS

Because of calculable health care-related costs associated with lower birth weight, our reported results might be of interest to clinicians practicing at higher altitudes.

Determining the relative importance of soil sample locations to predict risk of child lead exposure

Soil lead in urban neighborhoods is a known predictor of child blood lead levels. In this paper, we address the question where one ought to concentrate soil sample collection efforts to efficiently predict children at-risk for soil Pb exposure. Two extensive data sets are combined, including 5467 surface soil samples collected from 286 census tracts, and geo-referenced blood Pb data for 55,551 children in metropolitan New Orleans, USA. Random intercept least squares, random intercept logistic, and quantile regression results indicate that soils collected within 1m adjacent to residential streets most reliably predict child blood Pb outcomes in child blood Pb levels. Regression decomposition results show that residential street soils account for 39.7% of between-neighborhood explained variation, followed by busy street soils (21.97%), open space soils (20.25%), and home foundation soils (18.71%). Just as the age of housing stock is used as a statistical shortcut for child risk of exposure to lead-based paint, our results indicate that one can shortcut the characterization of child risk of exposure to neighborhood soil Pb by concentrating sampling efforts within 1m and adjacent to residential and busy streets, while significantly reducing the total costs of collection and analysis. This efficiency gain can help advance proactive upstream, preventive methods of environmental Pb discovery.

Daily variation in natural disaster casualties: information flows, safety, and opportunity costs in tornado versus hurricane strikes

Casualties from natural disasters may depend on the day of the week they strike. With data from the Spatial Hazard Events and Losses Database for the United States (SHELDUS), daily variation in hurricane and tornado casualties from 5,043 tornado and 2,455 hurricane time/place events is analyzed. Hurricane forecasts provide at-risk populations with considerable lead time. Such lead time allows strategic behavior in choosing protective measures under hurricane threat; opportunity costs in terms of lost income are higher during weekdays than during weekends. On the other hand, the lead time provided by tornadoes is near zero; hence tornados generate no opportunity costs. Tornado casualties are related to risk information flows, which are higher during workdays than during leisure periods, and are related to sheltering-in-place opportunities, which are better in permanent buildings like businesses and schools. Consistent with theoretical expectations, random effects negative binomial regression results indicate that tornado events occurring on the workdays of Monday through Thursday are significantly less lethal than tornados that occur on weekends. In direct contrast, and also consistent with theory, the expected count of hurricane casualties increases significantly with weekday occurrences. The policy implications of observed daily variation in tornado and hurricane events are considered.

Environmental lead exposure risks associated with children's outdoor playgrounds

This study examines exposure risks associated with lead smelter emissions at children's public playgrounds in Port Pirie, South Australia. Lead and other metal values were measured in air, soil, surface dust and on pre- and post-play hand wipes. Playgrounds closest to the smelter were significantly more lead contaminated compared to those further away (t(27.545) = 3.76; p = .001). Port Pirie post-play hand wipes contained significantly higher lead loadings (maximum hand lead value of 49,432 μg/m(2)) than pre-play hand wipes (t(27) = 3.57, p = .001). A 1% increase in air lead (μg/m(3)) was related to a 0.713% increase in lead dust on play surfaces (95% CI, 0.253-1.174), and a 0.612% increase in post-play wipe lead (95% CI, 0.257-0.970). Contaminated dust from smelter emissions is determined as the source and cause of childhood lead poisoning at a rate of approximately one child every third day.

Linking source and effect: resuspended soil lead, air lead, and children's blood lead levels in Detroit, Michigan

This study evaluates atmospheric concentrations of soil and Pb aerosols, and blood lead levels (BLLs) in 367839 children (ages 0-10) in Detroit, Michigan from 2001 to 2009 to test a hypothesized soil → air dust → child pathway of contemporary Pb risk. Atmospheric soil and Pb show near-identical seasonal properties that match seasonal variation in children's BLLs. Resuspended soil appears to be a significant underlying source of atmospheric Pb. A 1% increase in the amount of resuspended soil results in a 0.39% increase in the concentration of Pb in the atmosphere (95% CI, 0.28 to 0.50%). In turn, atmospheric Pb significantly explains age-dependent variation in child BLLs. Other things held equal, a change of 0.0069 μg/m(3) in atmospheric Pb increases BLL of a child 1 year of age by 10%, while approximately 3 times the concentration of Pb in air (0.023 μg/m(3)) is required to induce the same increase in BLL of a child 7 years of age. Similarly, a 0.0069 μg/m(3) change in air Pb increases the odds of a child <1 year of age having a BLL ≥ 5 μg/dL by a multiplicative factor of 1.32 (95% CI, 1.26 to 1.37). Overall, the resuspension of Pb contaminated soil explains observed seasonal variation in child BLLs.

Linking source and effect: resuspended soil lead, air lead, and children's blood lead levels in Detroit, Michigan

This study evaluates atmospheric concentrations of soil and Pb aerosols, and blood lead levels (BLLs) in 367839 children (ages 0-10) in Detroit, Michigan from 2001 to 2009 to test a hypothesized soil → air dust → child pathway of contemporary Pb risk. Atmospheric soil and Pb show near-identical seasonal properties that match seasonal variation in children's BLLs. Resuspended soil appears to be a significant underlying source of atmospheric Pb. A 1% increase in the amount of resuspended soil results in a 0.39% increase in the concentration of Pb in the atmosphere (95% CI, 0.28 to 0.50%). In turn, atmospheric Pb significantly explains age-dependent variation in child BLLs. Other things held equal, a change of 0.0069 μg/m(3) in atmospheric Pb increases BLL of a child 1 year of age by 10%, while approximately 3 times the concentration of Pb in air (0.023 μg/m(3)) is required to induce the same increase in BLL of a child 7 years of age. Similarly, a 0.0069 μg/m(3) change in air Pb increases the odds of a child <1 year of age having a BLL ≥ 5 μg/dL by a multiplicative factor of 1.32 (95% CI, 1.26 to 1.37). Overall, the resuspension of Pb contaminated soil explains observed seasonal variation in child BLLs.

Associations between standardized school performance tests and mixtures of Pb, Zn, Cd, Ni, Mn, Cu, Cr, Co, and V in community soils of New Orleans

In New Orleans a strong inverse association was previously identified between community soil lead and 4th grade school performance. This study extends the association to zinc, cadmium, nickel, manganese, copper, chromium, cobalt, and vanadium in community soil and their comparative effects on 4th grade school performance. Adjusting for poverty, food security, racial composition, and teacher-student ratios, regression results show that soil metals variously reduce and compress student scores. Soil metals account for 22%-24% while food insecurity accounts for 29%-37% of variation in school performance. The impact on grade point averages were Ni > Co > Mn > Cu ~ Cr ~ Cd > Zn > Pb, but metals are mixtures in soils. The quantities of soil metal mixtures vary widely across the city with the largest totals in the inner city and smallest totals in the outer city. School grade point averages are lowest where the soil metal mixtures and food insecurity are highest.

The urban rise and fall of air lead (Pb) and the latent surge and retreat of societal violence

We evaluate air Pb emissions and latent aggravated assault behavior at the scale of the city. We accomplish this by regressing annual Federal Bureau of Investigation aggravated assault rate records against the rise and fall of annual vehicle Pb emissions in Chicago (Illinois), Indianapolis (Indiana), Minneapolis (Minnesota), San Diego (California), Atlanta (Georgia), and New Orleans (Louisiana). Other things held equal, a 1% increase in tonnages of air Pb released 22 years prior raises the present period aggravated assault rate by 0.46% (95% CI, 0.28 to 0.64). Overall our model explains 90% of the variation in aggravated assault across the cities examined. In the case of New Orleans, 85% of temporal variation in the aggravated assault rate is explained by the annual rise and fall of air Pb (total=10,179 metric tons) released on the population of New Orleans 22 years earlier. For every metric ton of Pb released 22 years prior, a latent increase of 1.59 (95% CI, 1.36 to 1.83, p<0.001) aggravated assaults per 100,000 were reported. Vehicles consuming fuel containing Pb additives contributed much larger quantities of Pb dust than generally recognized. Our findings along with others predict that prevention of children's lead exposure from lead dust now will realize numerous societal benefits two decades into the future, including lower rates of aggravated assault.

Maternal benzene exposure and low birth weight risk in the United States: a natural experiment in gasoline reformulation

We investigate the relationship between maternal exposure to benzene and birth weight outcomes for resident births in the United States in 1996 and 1999, taking advantage of a natural experiment afforded by the regulation of benzene content of gasoline in various American cities. Regression results show that a unit increase (μg/m(3)) in maternal exposure to benzene reduces birth weight by 16.5 g (95% CI, 17.6 to 15.4). A unit increase in benzene exposure increases the odds of a low birth weight event by 7%. Similarly, a 1 μg/m(3) increase in benzene concentration increases the odds of very low birth weight event by a multiplicative factor of 1.23 (95% CI, 1.19 to 1.28). Difference-in-differences analyses show that birth weight increased by 13.7 g (95% CI, 10.7 to 16.8) and the risk of low birth weight decreased by a factor of .95 (95% CI, .93 to .98) in counties experiencing a 25% decline in benzene concentrations from 1996 to 1999. Public health policy and economic implications of results are discussed.

Economics of disaster risk, social vulnerability, and mental health resilience

We investigate the relationship between exposure to Hurricanes Katrina and/or Rita and mental health resilience by vulnerability status, with particular focus on the mental health outcomes of single mothers versus the general public. We advance a measurable notion of mental health resilience to disaster events. We also calculate the economic costs of poor mental health days added by natural disaster exposure. Negative binomial analyses show that hurricane exposure increases the expected count of poor mental health days for all persons by 18.7% (95% confidence interval [CI], 7.44-31.14%), and by 71.88% (95% CI, 39.48-211.82%) for single females with children. Monthly time-series show that single mothers have lower event resilience, experiencing higher added mental stress. Results also show that the count of poor mental health days is sensitive to hurricane intensity, increasing by a factor of 1.06 (95% CI, 1.02-1.10) for every billion (U.S.$) dollars of damage added for all exposed persons, and by a factor of 1.08 (95% CI, 1.03-1.14) for single mothers. We estimate that single mothers, as a group, suffered over $130 million in productivity loss from added postdisaster stress and disability. Results illustrate the measurability of mental health resilience as a two-dimensional concept of resistance capacity and recovery time. Overall, we show that natural disasters regressively tax disadvantaged population strata.

Nonlinear associations between blood lead in children, age of child, and quantity of soil lead in metropolitan New Orleans

Previous studies identified a curvilinear association between aggregated blood lead (BL) and soil lead (SL) data in New Orleans census tracts. In this study we investigate the relationships between SL (mg/kg), age of child, and BL (μg/dL) of 55,551 children in 280 census tracts in metropolitan New Orleans, 2000 to 2005. Analyses include random effects regression models predicting BL levels of children (μg/dL) and random effects logistic regression models predicting the odds of BL in children exceeding 15, 10, 7, 5, and 3 μg/dL as a function of age and SL exposure. Economic benefits of SL reduction scenarios are estimated. A unit raise in median SL⁰·⁵ significantly increases the BL level in children (b=0.214 p= or <0.01), and a unit change in Age⁰·⁵ significantly increases child BL (b=0.401, p= or <0.01). A unit change in Age⁰·⁵ increases the odds of a child BL exceeding 10 μg/dL by a multiplicative factor of 1.23 (95% CI 1.21 to 1.25), and a unit (mg/kg) addition of SL increases the odds of child BL> 10 μg/dL by a factor of 1.13 (95% CI 1.12 to 1.14). Extrapolating from regression results, we find that a shift in SL regulatory standard from 400 to 100 mg/kg provides each child with an economic benefit ranging from $4710 to $12,624 ($US 2000). Children's BL is a curvilinear function of both age and level of exposure to neighborhood SL. Therefore, a change in SL regulatory standard from 400 to 100mg/kg provides children with substantial economic benefit.

Maternal hurricane exposure and fetal distress risk

Logistic regression and spatial analytic techniques are used to model fetal distress risk as a function of maternal exposure to Hurricane Andrew. First, monthly time series compare the proportion of infants born distressed in hurricane affected and unaffected areas. Second, resident births are analyzed in Miami-Dade and Broward counties, before, during, and after Hurricane Andrew. Third, resident births are analyzed in all Florida locales with 100,000 or more persons, comparing exposed and unexposed gravid females. Fourth, resident births are analyzed along Hurricane Andrew's path from southern Florida to northeast Mississippi. Results show that fetal distress risk increases significantly with maternal exposure to Hurricane Andrew in second and third trimesters, adjusting for known risk factors. Distress risk also correlates with the destructive path of Hurricane Andrew, with higher incidences of fetal distress found in areas of highest exposure intensity. Hurricane exposed African-American mothers were more likely to birth distressed infants. The policy implications of in utero costs of natural disaster exposure are discussed.

New Orleans before and after Hurricanes Katrina/Rita: a quasi-experiment of the association between soil lead and children's blood lead

Prior to Hurricanes Katrina and Rita (HKR), significant associations were noted between soil lead (SL) and blood lead (BL) in New Orleans. Engineering failure of New Orleans levees and canal walls after HKR set the stage for a quasi-experiment to evaluate BL responses by 13 306 children to reductions in SL. High density soil surveying conducted in 46 census tracts before HKR was repeated after the flood. Paired t test results show that SL decreased from 328.54 to 203.33 mg/kg post-HKR (t = 3.296, p < or = 0.01). Decreases in SL are associated with declines in children's BL response (r = 0.308, p < or = 0.05). When SL decreased at least 1%, median children's BL declined 1.55 microg/dL. Declines in median BL are largest in census tracts with > or =50% decrease in SL. Also individual BL in children was predicted as a function of SL, adjusting for age, year of observation, and depth of flood waters. At the individual scale, BL decreased significantly in post-HKR as a function of SL, with BL decreases ranging from b = -1.20 to -1.65 microg/dL, depending on the decline of SL and whether children were born in the post-HKR period. Our results support policy to improve soil conditions for children.

Children's blood lead and standardized test performance response as indicators of neurotoxicity in metropolitan New Orleans elementary schools

This study analyzes pre-Katrina variation in aggregate student performance and children's blood lead (BPb) in 117 elementary school districts in metropolitan New Orleans. Fourth grade student achievement on Louisiana Educational Assessment Program (LEAP) tests were analyzed as a function of BPb for children 1-6 years old within school districts, controlling for student-teacher ratios, percent of students eligible for a free or discounted lunch, and school racial demography. Measures of performance across subject areas (English Language Arts, Science, Mathematics, and Social Studies) include school Achievement Test Scores (ATS) and indices of agreement and variation in student achievement. ATS are measured on a 5-point scale, corresponding to achievement categories of advanced=5 to unsatisfactory=1. Regression results show that median BPb (microg/dL) and percent of children with BPb > or =10 microg/dL are significantly associated with reductions in test scores across all subjects and depress variation in student performance across achievement categories. These data suggest that assisting children with improved school performance requires alleviation of pre-school Pb exposure and its associated neurotoxic damage. Cost-benefit calculations suggest that it is more cost effective to pay for onetime primary prevention instead of paying continuous expenses focused on reversing neurotoxic damage.

Policy learning for flood mitigation: a longitudinal assessment of the community rating system in Florida

Floods continue to inflict the most damage upon human communities among all natural hazards in the United States. Because localized flooding tends to be spatially repetitive over time, local decisionmakers often have an opportunity to learn from previous events and make proactive policy adjustments to reduce the adverse effects of a subsequent storm. Despite the importance of understanding the degree to which local jurisdictions learn from flood risks and under what circumstances, little if any empirical, longitudinal research has been conducted along these lines. This article addresses the research gap by examining the change in local flood mitigation policies in Florida from 1999 to 2005. We track 18 different mitigation activities organized into four series of activities under the Federal Emergency Management Agency's (FEMA) Community Rating System (CRS) for every local jurisdiction in Florida participating in the FEMA program on a yearly time step. We then identify the major factors contributing to policy changes based on CRS scores over the seven-year study period. Using multivariate statistical models to analyze both natural and social science data, we isolate the effects of several variables categorized into the following groups: hydrologic conditions, flood disaster history, socioeconomic and human capital controls. Results indicate that local jurisdictions do in fact learn from histories of flood risk and this process is expedited under specific conditions.

Social vulnerability and the natural and built environment: a model of flood casualties in Texas

Studies on the impacts of hurricanes, tropical storms, and tornados indicate that poor communities of colour suffer disproportionately in human death and injury.(2) Few quantitative studies have been conducted on the degree to which flood events affect socially vulnerable populations. We address this research void by analysing 832 countywide flood events in Texas from 1997-2001. Specifically, we examine whether geographic localities characterised by high percentages of socially vulnerable populations experience significantly more casualties due to flood events, adjusting for characteristics of the natural and built environment. Zero-inflated negative binomial regression models indicate that the odds of a flood casualty increase with the level of precipitation on the day of a flood event, flood duration, property damage caused by the flood, population density, and the presence of socially vulnerable populations. Odds decrease with the number of dams, the level of precipitation on the day before a recorded flood event, and the extent to which localities have enacted flood mitigation strategies. The study concludes with comments on hazard-resilient communities and protection of casualty-prone populations.

Vulnerability and Capacity: Explaining Local Commitment to Climate-Change Policy

We examine the reasons why a US locality would voluntarily commit to the Cities for Climate Protection (CCP) campaign. Using geographic information systems analytic techniques, we map and measure a locality's vulnerability to climate-change impacts at the county level of spatial precision. We analyze multiple measures of climate-change vulnerability, including expected temperature change, extreme weather events, and coastal proximity, as well as economic variables, demographic variables, and civic-participation variables that constitute a locality's socioeconomic capacity to commit to costly climate-change policy initiatives. Bivariate and logistic regression results indicate that CCP-committed localities are quantitatively different to noncommitted localities on both climate-change risk and socioeconomic-capacity dimensions. On vulnerability measures, the odds of CCP-campaign participation increase significantly with the number of people killed and injured by extreme weather events, projected temperature change, and coastal proximity. On socioeconomic-capacity measures, the odds of CCP-campaign involvement increase with the percentage of citizens that vote Democrat and recycle, as well as the number of nonprofit organizations with an environment focus. The odds decrease in a county area as the percentage of the labor force employed in carbon-intensive industries increases.

Identifying the impact of the built environment on flood damage in Texas

Floods continue to pose the greatest threat to the property and safety of human communities among all natural hazards in the United States. This study examines the relationship between the built environment and flood impacts in Texas, which consistently sustains the most damage from flooding of any other state in the country. Specifically, we calculate property damage resulting from 423 flood events between 1997 and 2001 at the county level. We identify the effect of several built environment measures, including wetland alteration, impervious surface, and dams on reported property damage while controlling for biophysical and socio-economic characteristics. Statistical results suggest that naturally occurring wetlands play a particularly important role in mitigating flood damage. These findings provide guidance to planners and flood managers on how to alleviate most effectively the costly impacts of foods at the community level.

Personal efficacy, the information environment, and attitudes toward global warming and climate change in the United States

Despite the growing scientific consensus about the risks of global warming and climate change, the mass media frequently portray the subject as one of great scientific controversy and debate. And yet previous studies of the mass public's subjective assessments of the risks of global warming and climate change have not sufficiently examined public informedness, public confidence in climate scientists, and the role of personal efficacy in affecting global warming outcomes. By examining the results of a survey on an original and representative sample of Americans, we find that these three forces-informedness, confidence in scientists, and personal efficacy-are related in interesting and unexpected ways, and exert significant influence on risk assessments of global warming and climate change. In particular, more informed respondents both feel less personally responsible for global warming, and also show less concern for global warming. We also find that confidence in scientists has unexpected effects: respondents with high confidence in scientists feel less responsible for global warming, and also show less concern for global warming. These results have substantial implications for the interaction between scientists and the public in general, and for the public discussion of global warming and climate change in particular.