Association of Redlining and Natural Environment with Depressive Symptoms in Women in the Sister Study

BACKGROUND

Improving mental health is recognized as an important factor for achieving global development goals. Despite strong evidence that neighborhood greenery promotes better mental health, there are environmental justice concerns over the distribution of neighborhood greenery. Underlying these concerns are present-day consequences of historical discriminatory financial investment practices, such as redlining which was established by the U.S. Federal Home Owners' Loan Corporation (HOLC) in the 1930s. The impacts of redlining on environmental and health disparities have been researched extensively. However, the influences of redlining on the associations between neighborhood environment and health outcomes have not been fully assessed.

OBJECTIVES

The aim of this study was to examine whether associations between residential tree cover and depressive symptoms vary across areas subject to HOLC practices.

METHODS

Depressive symptoms were defined by the 10-item Center for Epidemiologic Studies Depression Scale collected during the period 2008-2012 for 3,555 women in the Sister Study cohort residing in cities subject to HOLC practices across the United States. HOLC rating maps were obtained from the Mapping Inequality Project, University of Richmond, with neighborhoods graded as A (best for financial investment, green), B (still desirable, blue), C (declining, yellow), and D (hazardous, red-known as redlined). Tree cover within 500 m and 2,000 m from residences was estimated using 2011 U.S. Forest Service Percent Tree Canopy Cover. Mixed model using climate zone as the random effect was applied to evaluate the associations with adjustments for potential covariates. Analyses were stratified by HOLC grade.

RESULTS

Tree cover was significantly higher in neighborhoods with better HOLC grades. A 10% increase in tree cover was associated with reduced odds of depressive symptoms for the full study population, with adjusted odds ratios (AORs) of 0.93 [95% confidence interval (CI): 0.88, 0.99], and 0.91 (0.85, 0.97) for 500 -m and 2,000 -m buffer, respectively. Across HOLC grades, the strongest associations were observed in redlined neighborhoods, with respective AORs of 0.72 (95% CI: 0.52, 0.99) and 0.63 (95% CI: 0.45, 0.90) for 500 -m and 2,000 -m buffer.

DISCUSSION

Findings support a remediation strategy focused on neighborhood greenery that would address multiple public health priorities, including mental health and environmental justice. https://doi.org/10.1289/EHP12212.

Cutting-edge computational chemical exposure research at the U.S. Environmental Protection Agency

Exposure science is evolving from its traditional "after the fact" and "one chemical at a time" approach to forecasting chemical exposures rapidly enough to keep pace with the constantly expanding landscape of chemicals and exposures. In this article, we provide an overview of the approaches, accomplishments, and plans for advancing computational exposure science within the U.S. Environmental Protection Agency's Office of Research and Development (EPA/ORD). First, to characterize the universe of chemicals in commerce and the environment, a carefully curated, web-accessible chemical resource has been created. This DSSTox database unambiguously identifies >1.2 million unique substances reflecting potential environmental and human exposures and includes computationally accessible links to each compound's corresponding data resources. Next, EPA is developing, applying, and evaluating predictive exposure models. These models increasingly rely on data, computational tools like quantitative structure activity relationship (QSAR) models, and machine learning/artificial intelligence to provide timely and efficient prediction of chemical exposure (and associated uncertainty) for thousands of chemicals at a time. Integral to this modeling effort, EPA is developing data resources across the exposure continuum that includes application of high-resolution mass spectrometry (HRMS) non-targeted analysis (NTA) methods providing measurement capability at scale with the number of chemicals in commerce. These research efforts are integrated and well-tailored to support population exposure assessment to prioritize chemicals for exposure as a critical input to risk management. In addition, the exposure forecasts will allow a wide variety of stakeholders to explore sustainable initiatives like green chemistry to achieve economic, social, and environmental prosperity and protection of future generations.

Data Mining Approaches for Assessing Chemical Coexposures Using Consumer Product Purchase Data

The use of consumer products presents a potential for chemical exposures to humans. Toxicity testing and exposure models are routinely employed to estimate risks from their use; however, a key challenge is the sparseness of information concerning who uses products and which products are used contemporaneously. Our goal was to demonstrate a method to infer use patterns by way of purchase data. We examined purchase patterns for three types of personal care products (cosmetics, hair care, and skin care) and two household care products (household cleaners and laundry supplies) using data from 60,000 households collected over a one-year period in 2012. The market basket analysis methodology frequent itemset mining (FIM) was used to identify co-occurring sets of product purchases for all households and demographic groups based on income, education, race/ethnicity, and family composition. Our methodology captured robust co-occurrence patterns for personal and household products, globally and for different demographic groups. FIM identified cosmetic co-occurrence patterns captured in prior surveys of cosmetic use, as well as a trend of increased diversity of cosmetic purchases as children mature to teenage years. We propose that consumer product purchase data can be mined to inform person-oriented use patterns for high-throughput chemical screening applications, for aggregate and combined chemical risk evaluations.

Integrating Personal Air Sensor and GPS to Determine Microenvironment-Specific Exposures to Volatile Organic Compounds

Personal exposure to volatile organic compounds (VOCs) from indoor sources including consumer products is an understudied public health concern. To develop and evaluate methods for monitoring personal VOC exposures, we performed a pilot study and examined time-resolved sensor-based measurements of geocoded total VOC (TVOC) exposures across individuals and microenvironments (MEs). We integrated continuous (1 min) data from a personal TVOC sensor and a global positioning system (GPS) logger, with a GPS-based ME classification model, to determine TVOC exposures in four MEs, including indoors at home (Home-In), indoors at other buildings (Other-In), inside vehicles (In-Vehicle), and outdoors (Out), across 45 participant-days for five participants. To help identify places with large emission sources, we identified high-exposure events (HEEs; TVOC > 500 ppb) using geocoded TVOC time-course data overlaid on Google Earth maps. Across the 45 participant-days, the MEs ranked from highest to lowest median TVOC were: Home-In (165 ppb), Other-In (86 ppb), In-Vehicle (52 ppb), and Out (46 ppb). For the two participants living in single-family houses with attached garages, the median exposures for Home-In were substantially higher (209, 416 ppb) than the three participant homes without attached garages: one living in a single-family house (129 ppb), and two living in apartments (38, 60 ppb). The daily average Home-In exposures exceeded the estimated Leadership in Energy and Environmental Design (LEED) building guideline of 108 ppb for 60% of the participant-days. We identified 94 HEEs across all participant-days, and 67% of the corresponding peak levels exceeded 1000 ppb. The MEs ranked from the highest to the lowest number of HEEs were: Home-In (60), Other-In (13), In-Vehicle (12), and Out (9). For Other-In and Out, most HEEs occurred indoors at fast food restaurants and retail stores, and outdoors in parking lots, respectively. For Home-In HEEs, the median TVOC emission and removal rates were 5.4 g h^-1 and 1.1 h^-1, respectively. Our study demonstrates the ability to determine individual sensor-based time-resolved TVOC exposures in different MEs, in support of identifying potential sources and exposure factors that can inform exposure mitigation strategies.

Types and spatial contexts of neighborhood greenery matter in associations with weight status in women across 28 U.S. communities

Excess body weight is a risk factor for many chronic diseases. Studies have identified neighborhood greenery as supportive of healthy weight. However, few have considered plausible effect pathways for ecosystem services (e.g., heat mitigation, landscape aesthetics, and venues for physical activities) or potential variations by climate. This study examined associations between weight status and neighborhood greenery that capture ecosystem services most relevant to weight status across 28 U.S. communities. Weight status was defined by body mass index (BMI) reported for 6591 women from the U.S. Sister Study cohort. Measures of greenery within street and circular areas at 500 m and 2000 m buffer distances from homes were derived for each participant using 1 m land cover data. Street area was defined as a 25 m-wide zone on both sides of street centerlines multiplied by the buffer distances, and circular area was the area of the circle centered on a home within each of the buffer distances. Measures of street greenery characterized the pedestrian environment to capture physically and visually accessible greenery for shade and aesthetics. Circular greenery was generated for comparison. Greenery types of tree and herbaceous cover were quantified separately, and a combined measure of tree and herbaceous cover (i.e., aggregate greenery) was also included. Mixed models accounting for the clustering at the community level were applied to evaluate the associations between neighborhood greenery and the odds of being overweight or obese (BMI > 25) with adjustment for covariates selected using gradient boosted regression trees. Analyses were stratified by climate zone (arid, continental, and temperate). Tree cover was consistently associated with decreased odds of being overweight or obese. For example, the adjusted odds ratio [AOR] was 0.92, 95% Confidence Interval [CI]: 0.88-0.96, given a 10% increase in street tree cover at the 2000 m buffer across the 28 U.S. communities. These associations held across climate zones, with the lowest AOR in the arid climate (AOR: 0.74, 95% CI: 0.54-1.01). In contrast, associations with herbaceous cover varied by climate zone. For the arid climate, a 10% increase in street herbaceous cover at the 2000 m buffer was associated with lower odds of being overweight or obese (AOR: 0.75, 95% CI: 0.55-1.03), whereas the association was reversed for the temperate climate, the odds increased (AOR: 1.19, 95% CI: 1.05-1.35). Associations between greenery and overweight/obesity varied by type and spatial context of greenery, and climate. Our findings add to a growing body of evidence that greenery design in urban planning can support public health. These findings also justify further defining the mechanism that underlies the observed associations.

Mining of Consumer Product Ingredient and Purchasing Data to Identify Potential Chemical Coexposures

BACKGROUND

Chemicals in consumer products are a major contributor to human chemical coexposures. Consumers purchase and use a wide variety of products containing potentially thousands of chemicals. There is a need to identify potential real-world chemical coexposures to prioritize in vitro toxicity screening. However, due to the vast number of potential chemical combinations, this identification has been a major challenge.

OBJECTIVES

We aimed to develop and implement a data-driven procedure for identifying prevalent chemical combinations to which humans are exposed through purchase and use of consumer products.

METHODS

We applied frequent itemset mining to an integrated data set linking consumer product chemical ingredient data with product purchasing data from 60,000 households to identify chemical combinations resulting from co-use of consumer products.

RESULTS

We identified co-occurrence patterns of chemicals over all households as well as those specific to demographic groups based on race/ethnicity, income, education, and family composition. We also identified chemicals with the highest potential for aggregate exposure by identifying chemicals occurring in multiple products used by the same household. Last, a case study of chemicals active in estrogen and androgen receptor in silico models revealed priority chemical combinations co-targeting receptors involved in important biological signaling pathways.

DISCUSSION

Integration and comprehensive analysis of household purchasing data and product-chemical information provided a means to assess human near-field exposure and inform selection of chemical combinations for high-throughput screening in in vitro assays. https://doi.org/10.1289/EHP8610.

How do natural features in the residential environment influence women's self-reported general health? Results from cross-sectional analyses of a U.S. national cohort

BACKGROUND

The relationship between health and human interaction with nature is complex. Here we conduct analyses to provide insights into potential health benefits related to residential proximity to nature.

OBJECTIVES

We aimed to examine associations between measures of residential nature and self-reported general health (SRGH), and to explore mediation roles of behavioral, social, and air quality factors, and variations in these relationships by urbanicity and regional climate.

METHODS

Using residential addresses for 41,127 women from the Sister Study, a U.S.-based national cohort, we derived two nature exposure metrics, canopy and non-gray cover, using Percent Tree Canopy and Percent Developed Imperviousness from the National Land Cover Database. Residential circular buffers of 250 m and 1250 m were considered. Gradient boosted regression trees were used to model the effects of nature exposure on the odds of reporting better SRGH (Excellent/Very Good versus the referent, Good/Fair/Poor). Analyses stratified by urbanicity and regional climate (arid, continental, temperate) and mediation by physical activity, social support, and air quality were conducted.

RESULTS

A 10% increase in canopy and non-gray cover within 1250 m buffer was associated with 1.02 (95% CI: 1.00-1.03) and 1.03 (95% CI: 1.01-1.04) times the odds of reporting better SRGH, respectively. Stronger associations were observed for the urban group and for continental climate relative to other strata. Social support and physical activity played a more significant mediation role than air quality for the full study population.

DISCUSSION

Findings from this study identified a small but important beneficial association between residential nature and general health. These findings could inform community planning and investments in neighborhood nature for targeted health improvements and potential societal and environmental co-benefits.

The Next Generation Blueprint of Computational Toxicology at the U.S. Environmental Protection Agency

The U.S. Environmental Protection Agency (EPA) is faced with the challenge of efficiently and credibly evaluating chemical safety often with limited or no available toxicity data. The expanding number of chemicals found in commerce and the environment, coupled with time and resource requirements for traditional toxicity testing and exposure characterization, continue to underscore the need for new approaches. In 2005, EPA charted a new course to address this challenge by embracing computational toxicology (CompTox) and investing in the technologies and capabilities to push the field forward. The return on this investment has been demonstrated through results and applications across a range of human and environmental health problems, as well as initial application to regulatory decision-making within programs such as the EPA's Endocrine Disruptor Screening Program. The CompTox initiative at EPA is more than a decade old. This manuscript presents a blueprint to guide the strategic and operational direction over the next 5 years. The primary goal is to obtain broader acceptance of the CompTox approaches for application to higher tier regulatory decisions, such as chemical assessments. To achieve this goal, the blueprint expands and refines the use of high-throughput and computational modeling approaches to transform the components in chemical risk assessment, while systematically addressing key challenges that have hindered progress. In addition, the blueprint outlines additional investments in cross-cutting efforts to characterize uncertainty and variability, develop software and information technology tools, provide outreach and training, and establish scientific confidence for application to different public health and environmental regulatory decisions.

Advancing Environmental Epidemiology to Assess the Beneficial Influence of the Natural Environment on Human Health and Well-Being

Environmental health research can be oriented across a continuum of effects ranging from adverse to cobenefits to salutogenic. We argue that the salutogenic end of the continuum is insufficiently represented in research and as a basis for environmental protection, even though there is growing evidence that the natural environment plays a critical role in blunting adverse effects and promoting human health and well-being. Thus, we advocate for advancing environmental health research through environmental epidemiology that more fully and directly accounts for the salutogenic effects of the natural environment on individual well-being by (1) defining "natural environments" broadly, from pristine natural areas to urban green infrastructure; (2) considering exposure comprehensively to encompass residential, occupational, and recreational settings, local and distant, day-to-day and occasional; (3) doing individual-level assessments that include both health and well-being outcomes and one's experience of nature, including potential mediation by connectedness to nature and individual perceptions and preferences, as well as sociocultural and demographic effect modifiers; and (4) collecting longitudinal and nationally representative data.

Assessment of temperature and ultraviolet radiation effects on sunburn incidence at an inland U.S. Beach: A cohort study

BACKGROUND

Increases in outdoor temperature may lead to increases in sunburn, outdoor exposure, and skin cancer in human populations.

OBJECTIVE

This study aimed to quantify sunburn incidence and risk for Ohio beachgoers exposed to varying outdoor conditions.

METHODS

Sunburn incidence data were obtained through a prospective cohort study at East Fork Lake (Cincinnati, Ohio, USA). Recruitment occurred over 26 weekend days. Beach interviews and follow-up telephone interviews obtained exposure and health information. New sunburns were self-reported 8-9 days post-enrollment. Survey data were paired with ultraviolet radiation (UVR) index and temperature data for statistical analysis.

RESULTS

Among 947 beachgoers, new sunburns were reported in 18% of swimmers. Sunburn incidence was associated with temperature (odds ratio = 1.2; 95% CI: 1.1 - 1.4) and UVR index (odds ratio = 1.6; 95% CI: 1.0 - 2.5) in models adjusted for water exposure, arrival time, and beach visit frequency. Some evidence of a temperature+UVR interaction was observed.

LIMITATIONS

Exposure and sunburn data were self-reported without clinical diagnosis and date of onset. The follow-up period enabled sunburns to be reported from a variety of days rather than only the beach visit day thereby limiting interpretation. Sun protection behaviors were not evaluated.

CONCLUSIONS

Temperature and UVR influence sunburn frequency. Temperature, however was more strongly associated with sunburn in beachgoers than the nearest measured UVR index, suggesting future investigations are needed to better understand how temperature effects sunburn development. Interventions for decreasing sunburn are needed.

Computational Exposure Science: An Emerging Discipline to Support 21st-Century Risk Assessment

BACKGROUND

Computational exposure science represents a frontier of environmental science that is emerging and quickly evolving.

OBJECTIVES

In this commentary, we define this burgeoning discipline, describe a framework for implementation, and review some key ongoing research elements that are advancing the science with respect to exposure to chemicals in consumer products.

DISCUSSION

The fundamental elements of computational exposure science include the development of reliable, computationally efficient predictive exposure models; the identification, acquisition, and application of data to support and evaluate these models; and generation of improved methods for extrapolating across chemicals. We describe our efforts in each of these areas and provide examples that demonstrate both progress and potential.

CONCLUSIONS

Computational exposure science, linked with comparable efforts in toxicology, is ushering in a new era of risk assessment that greatly expands our ability to evaluate chemical safety and sustainability and to protect public health.

CITATION

Egeghy PP, Sheldon LS, Isaacs KK, Özkaynak H, Goldsmith M-R, Wambaugh JF, Judson RS, Buckley TJ. 2016. Computational exposure science: an emerging discipline to support 21st-century risk assessment. Environ Health Perspect 124:697-702; http://dx.doi.org/10.1289/ehp.1509748.

GPS-based microenvironment tracker (MicroTrac) model to estimate time-location of individuals for air pollution exposure assessments: model evaluation in central North Carolina

A critical aspect of air pollution exposure assessment is the estimation of the time spent by individuals in various microenvironments (ME). Accounting for the time spent in different ME with different pollutant concentrations can reduce exposure misclassifications, while failure to do so can add uncertainty and bias to risk estimates. In this study, a classification model, called MicroTrac, was developed to estimate time of day and duration spent in eight ME (indoors and outdoors at home, work, school; inside vehicles; other locations) from global positioning system (GPS) data and geocoded building boundaries. Based on a panel study, MicroTrac estimates were compared with 24-h diary data from nine participants, with corresponding GPS data and building boundaries of home, school, and work. MicroTrac correctly classified the ME for 99.5% of the daily time spent by the participants. The capability of MicroTrac could help to reduce the time-location uncertainty in air pollution exposure models and exposure metrics for individuals in health studies.

Development of a consumer product ingredient database for chemical exposure screening and prioritization

Consumer products are a primary source of chemical exposures, yet little structured information is available on the chemical ingredients of these products and the concentrations at which ingredients are present. To address this data gap, we created a database of chemicals in consumer products using product Material Safety Data Sheets (MSDSs) publicly provided by a large retailer. The resulting database represents 1797 unique chemicals mapped to 8921 consumer products and a hierarchy of 353 consumer product "use categories" within a total of 15 top-level categories. We examine the utility of this database and discuss ways in which it will support (i) exposure screening and prioritization, (ii) generic or framework formulations for several indoor/consumer product exposure modeling initiatives, (iii) candidate chemical selection for monitoring near field exposure from proximal sources, and (iv) as activity tracers or ubiquitous exposure sources using "chemical space" map analyses. Chemicals present at high concentrations and across multiple consumer products and use categories that hold high exposure potential are identified. Our database is publicly available to serve regulators, retailers, manufacturers, and the public for predictive screening of chemicals in new and existing consumer products on the basis of exposure and risk.

Evidence of high rates of undiagnosed asthma in central Ohio elementary schoolchildren

BACKGROUND

In Ohio, 14.5% of 5- to 9-year-olds and 17.3% of 10- to 17-year-olds have asthma. Moreover, there is concern that these numbers may underestimate the true disease burden. We sought to evaluate variability in asthma rates and respiratory symptoms among central Ohio fourth graders as a means to assess potential undiagnosed and undertreated asthma and its determinants.

METHODS

We recruited 13 central Ohio elementary schools representing a broad range of nonurban settings and surveyed fourth graders to estimate school-level physician-diagnosed asthma (PDA), respiratory morbidity, and home exposures to smoking and pets. We used generalized linear mixed models with random intercept for school to examine relationships among exposures, respiratory symptoms, and PDA.

RESULTS

Across the 13 schools, 94% of students participated in the survey, and the estimated asthma prevalence rate was 10.2% (N = 101 of 987). An additional 41% reported not having PDA but then went on to report symptoms consistent with asthma potentially suggestive of undiagnosed asthma. Of students with PDA, 21% reported symptoms suggestive of poorly controlled asthma. High levels of secondhand smoke (SHS) exposure were associated both with PDA (p = .05) and with respiratory symptoms (p < .0001). Students who owned a cat or a bird were more likely to report respiratory symptoms (p = .02 and p = .04, respectively).

CONCLUSIONS

We provide evidence that the already high childhood asthma public health burden in central Ohio may be underreported. Schools may be an ideal location to conduct screenings and implement environmental interventions oriented toward SHS and household pets that will yield respiratory morbidity benefits.

Ambient air toxics and asthma prevalence among a representative sample of US kindergarten-age children

BACKGROUND

Criteria pollutants have been associated with exacerbation of children's asthma, but the role of air toxics in relation to asthma is less clear. Our objective was to evaluate whether exposure to outdoor air toxics in early childhood increased asthma risk or severity.

METHODS

Air toxics exposure was estimated using the 2002 National Air toxics Assessment (NATA) and linked to longitudinal data (n=6950) from a representative sample of US children born in 2001 and followed through kindergarten-age in the Early Child Longitudinal Study-Birth Cohort (ECLS-B).

RESULTS

Overall, 17.7% of 5.5 year-olds had ever been told by a healthcare professional they had asthma, and 6.8% had been hospitalized or visited an emergency room for an asthma attack. Higher rates of asthma were observed among boys (20.1%), low-income (24.8%), and non-Hispanic black children (30.0%) (p≤0.05). Air toxics exposure was greater for minority race/ethnicity (p<0.0001), low income (p<0.0001), non-rural area (p<0.001). Across all analyses, greater air toxics exposure, as represented by total NATA respiratory hazard index, or when limited to respiratory hazard index from onroad mobile sources or diesel PM, was not associated with a greater prevalence of asthma or hospitalizations (p trend >0.05). In adjusted logistic regression models, children exposed to the highest respiratory hazard index were not more likely to have asthma compared to those exposed to the lowest respiratory hazard index of total, onroad sources, or diesel PM.

CONCLUSIONS

Early childhood exposure to outdoor air toxics in a national sample has not previously been studied relative to children's asthma. Within the constraints of the study, we found no evidence that early childhood exposure to outdoor air toxics increased risk for asthma. As has been previously reported, it is evident that there are environmental justice and disparity concerns for exposure to air toxics and asthma prevalence in US children.

Nonoutbreak-related airborne Staphylococcus spp in a veterinary hospital

BACKGROUND

Methicillin-resistant Staphylococcus spp (MRS), such as methicillin-resistant Staphylococcus aureus (MRSA), is a nosocomial pathogen of significant concern. This study evaluates the prevalence and determinants of airborne MRS and methicillin-susceptible Staphylococcus spp (MSS) in a veterinary teaching hospital during periods of no known active clinical cases of Staphylococci infections.

METHODS

Airborne MRS and MRSA were sampled from 10 areas on 3 days each over 3 consecutive months in a veterinary teaching hospital. Each location was sampled twice each day (daytime and evening). Hospital clinical personnel were surveyed for activity levels across the areas sampled.

RESULTS

Airborne MSS was detected in 52% (25/48) of samples and mecA-confirmed airborne MRS in 12.5% (6/48) of samples. Among daytime air samples, Staphylococcus spp varied by functional area (P < .001), and airborne MRS varied by human activity level (P = .011) with the hallway posing the greatest risk for both.

CONCLUSION

Our results indicate that (1) Staphylococcus spp is present in air in clinical environments during periods of no known clinical Staphylococci cases and (2) levels of airborne Staphylococcus spp are associated with functional space and human activity level. Applying these findings to MRSA surveillance creates opportunities for improving the accuracy and precision of exposure classification and risk mitigation.

Comparability and repeatability of methods for estimating the dietary intake of the heterocyclic amine contaminant 2-amino-1-methyl-6-phenylimidazo[4,5b]pyridine (PhIP)

Inconsistent risk estimates for dietary heterocyclic amine (HCA) exposure and cancers may be due to differences in exposure assessment methods and the associated measurement error. We evaluated repeatability and comparability of intake estimates of the HCA 2-amino-1-methyl-6-phenylimidazo[4,5b]pyridine (PhIP) among two food frequency questionnaire (FFQ) collections, three diary collections, and three measurements of urinary PhIP and its metabolites in 36 non-smokers in Baltimore, Maryland, during 2004-2005. Collections spanned ∼9 months. Method repeatability was characterised with intraclass correlation coefficients (ICCs). Comparability among methods was assessed with Spearman correlation coefficients. Within-subject variability in PhIP intake was comparably high across all methods (ICCs of 0.20, 0.30, and 0.15 for FFQ, diary, and creatinine-adjusted urinary PhIP, respectively). Mean diary-based PhIP intake and mean urinary PhIP concentration were strongly correlated when restricting the analysis to participants with at least one non-zero diary-based estimate of PhIP intake (n = 15, r = 0.75, p = 0.001), but not in the full study population (n = 36, r = 0.18, p = 0.28). Mean PhIP intake from the FFQ was not associated with that either based on the diary or urinary PhIP separately, but was modestly correlated with a metric that combined the diary- and biomarker-based approaches (r = 0.30, p = 0.08). The high within-subject variability will result in significantly attenuated associations if a single measure is used to estimate exposure within an epidemiologic study. Improved HCA assessment tools, such as a combination of methods or validated biomarkers that capture long term exposure, are needed.

In vivo phycocyanin flourometry as a potential rapid screening tool for predicting elevated microcystin concentrations at eutrophic lakes

Current approaches for assessing human health risks associated with cyanotoxins often rely on the quantification of microcystin. Significant limitations of current approaches are cost and time to obtain a result. To address these challenges, a numerical index for screening microcystin risks above the World Health Organization's (WHO) low-risk threshold for microcystin was developed for eutrophic Midwestern U.S. lakes based on water quality results from 182 beach water samples collected from seven Ohio lakes. In 48 (26.4%) samples we observed microcystin concentrations as measured by ELISA that exceeded the 4 μg/L microcystin threshold. A multivariable logistic regression model using practical real-time measures of in vivo phycocyanin (by fluorometry) and secchi depth was constructed to estimate the probability of a beach sample exceeding 4 μg/L microcystin. The final model achieved statistical significance (p = 0.030) as well as good calibration (as measured by the goodness-of-fit test comparing observed to expected counts within deciles of risk based on the model, p = 0.329) and discrimination (as indicated by the area under the receiver-operator-curve (0.795)). These results demonstrate two rapid and practical measures of recreational water quality are effective in identifying "at risk" lake conditions warranting additional management (e.g., advisory and/or advanced testing).

A pilot study of workplace dermal exposures to cypermethrin at a chemical manufacturing plant

Exposure during the manufacture of pesticides is of particular concern due to their toxicity and because little is known about worker exposure, since most studies have focused on end-use application within agriculture or buildings. Even though dermal exposure can be expected to dominate for pesticides, little is known about workplace dermal exposures or even appropriate methods for their assessment. The current study begins to address this gap by evaluating alternative methods for assessing dermal exposure at a chemical manufacturing plant. For this pilot study, eight workers were recruited from a U.S. plant that produced the pesticide cypermethrin. Exposure was evaluated using three approaches: (1) survey assessment (questionnaire), (2) biological monitoring, and (3) workplace environmental sampling including ancillary measurements of glove contamination (interior and exterior). In each case, cypermethrin was quantified by enzyme-linked immunosorbent assay (ELISA). Environmental measurements identified two potential pathways of cypermethrin exposure: glove and surface contamination. Workplace exposure was also indicated by urine levels (specific gravity adjusted) of the parent compound, which ranged from 35 to 253 μg/L (median of 121 μg/L) with no clear trend in levels from pre- to post-shift. An exploratory analysis intended to guide future studies revealed a positive predictive association (Spearman correlation, p ≤ 0.10) between post-shift urine concentrations and a subset of survey questions evaluating worker knowledge, attitudes, and perceptions (KAP) of workplace dermal hazards, i.e., personal protective equipment self-efficacy, and inverse associations with behavior belief and information belief scales. These findings are valuable in demonstrating a variety of dermal exposure methods (i.e., behavioral attributes, external contamination, and biomarker) showing feasibility and providing measurement ranges and preliminary associations to support future and more complete assessments. Although these pilot data are useful for supporting design and sample size considerations for larger exposure and health studies, there is a need for validation studies of the ELISA assay for quantification of cypermethrin and its metabolites in urine.

Comparison of standard methods for assessing dietary intake of benzo[a]pyrene

BACKGROUND

Inconsistent presence and strength of associations between dietary benzo[a]pyrene (BaP) exposure and cancers may be due to differences in exposure assessment methods. Thus, we determined correlations of usual meat and BaP intake among three methods: food frequency questionnaires (FFQ), diet diaries, and a biomarker.

METHODS

Thirty-six nonsmokers were recruited in Baltimore, MD during 2004-2005. Meat and BaP intake estimated from baseline and follow-up FFQs combined with a BaP residue database (FFQ-RD), mean meat and BaP intake estimated from three diet diaries coupled with the residue database (Diary-RD), and mean of three urinary 1-hydroxypyrene glucuronide (1-OHPG) measurements were compared using Spearman correlations. Collections spanned approximately nine months.

RESULTS

BaP intakes from meat from the baseline [median = 6.4, interquartile range (IQR) = 13.9 ng/d] and follow-up FFQ-RD (median = 7.3, IQR = 35.7 ng/d) were higher than the Diary-RD (median = 1.1, IQR = 7.4 ng/d). Mean 1-OHPG concentration was weakly correlated with mean meat intake (r = 0.33, P = 0.05) and BaP intake from meat (r = 0.27, P = 0.11) from the Diary-RD. Mean BaP intake estimated from the Diary-RD was positively correlated with the follow-up (r = 0.35, P = 0.04) but not baseline (r = 0.20, P = 0.24) FFQ; the converse was true for meat intake.

CONCLUSIONS

Diary-RD estimates were supported by biomarker measurements, but considerable unexplained variability remained. Limited correlation among the dietary BaP exposure assessment methods could be due to differences in timeframes covered by the assessments, interpersonal variability in metabolism, deficiencies in the residue database, or nondietary exposures to BaP.

IMPACT

Limited correlation in estimated BaP intake among standard methods may contribute to inconsistent epidemiology of BaP and cancer.

Effectiveness of UV-C equipped vacuum at reducing culturable surface-bound microorganisms on carpets

Carpets are both sinks and sources for exposure to chemicals, allergens, and microbes and consequently influence health, including asthma, allergies, and infectious diseases. Asthmatics, children, and the immune-compromised are particularly vulnerable to health risks resulting from exposure to carpet contaminants. To address this risk, a commercial upright vacuum cleaner with an ultraviolet germicidal lamp (λ=253.7 nm, UVC) has been developed for residential and commercial uses. However, its effectiveness in reducing microbial load on real-world carpets has not been previously demonstrated. Accordingly, the purpose of the current study was to evaluate the effectiveness of a UVC-equipped vacuum in reducing the carpet surface-bound microbial load. This was accomplished by comparing the carpet microbial surface load from pre- to post-treatment of 9 ft(2) in-use carpet sections under three treatment scenarios: 1) UVC alone (UV), 2) the beater-bar plus vacuum (BB+Vac), or 3) a combination of all three (COMB). Each treatment was two minutes in duration. Microbial surface loads were measured by pressing contact plates containing Sabourauds Dextrose agar onto the carpet surface. In-use carpets from three locations were tested in place. The treatment effect was evaluated at two levels. First, we considered the mean reduction in CFU from pre- to post-treatment for each 9 ft(2) carpet grid (n = 4 for each treatment). The second level considered each 1 ft(2) section using a paired analysis (n = 40 to 49 for each treatment). A total of 125 pre/post-sample pairs were collected across the three treatments. Results showed that all three treatments were associated with a reduction in carpet microbial load (p < 0.0001). The COMB yielded the largest reduction of 13 CFU/plate (87% reduction) and was approximately the sum of the individual effects of either UVC (6.6 CFU/plate, 60% reduction, p = 0.009) or BB+Vac (7.3 CFU/plate, 78% reduction, p < 0.0001). We therefore conclude that a UVC-equipped vacuum approximately doubles the unit's effectiveness in reducing surface-bound microbial load, thereby holding promise as a means for decreasing indoor infectious disease risk.

Association of gastrointestinal illness and recreational water exposure at an inland U.S. beach

Recent epidemiology studies examining U.S. recreational water exposure and illness relationships have focused primarily on coastal and Great Lakes beaches. Human-made lakes in the U.S. have received little attention in epidemiology studies despite contributing to more waterborne disease epidemics annually than coastal U.S. waters. In a comprehensive beach cohort study, we examined relationships between water quality indicators and reported adverse health outcomes among users of a beach at an inland U.S. lake. Human health data was collected over 26 swimming days during the 2009 swimming season in conjunction with water quality measurements. Adverse health outcomes were reported 8-9 days post-exposure via a phone survey. Wading, playing or swimming in the water was observed to be a significant risk factor for GI illness (adjusted odds ratio (AOR) of 3.2; CI 1.1, 9.0). Among water users, Escherichia coli density was significantly associated with elevated GI illness risk where the highest E. coli quartile was associated with an AOR of 7.0 (CI 1.5, 32). GI illness associations are consistent with previous freshwater epidemiology studies. Our findings are unique in that our observations of positive associations with GI illness risk are based upon a single daily E. coli measurement. Lastly, this study focused on an understudied issue, illness risk at inland reservoirs. Our results support the usefulness of E. coli as a health-relevant indicator of water quality for this inland U.S. beach.

The longitudinal dependence of black carbon concentration on traffic volume in an urban environment

The purpose of this study was to evaluate the effect of traffic volume on ambient black carbon (BC) concentration in an inner-city neighborhood "hot spot" while accounting for modifying effects of weather and time. Continuous monitoring was conducted for 12 months at the Baltimore Traffic Study site surrounded by major urban streets that together carry over 150,000 vehicles per day. Outdoor BC concentration was measured with an Aethalometer; vehicles were counted pneumatically on two nearby streets. Meteorological data were also obtained. Missing data were imputed and all data were normalized to a 5-min observational interval (n = 105,120). Time-series modeling accounted for autoregressively (AR) correlated errors. This study found that outdoor BC was positively correlated at a statistically significant level with neighborhood-level vehicle counts, which contributed at a rate of 66 +/- 10 (SE) ng/m3 per 100 vehicles every 5 min. Winds from the SW-S-SE quarter were associated with the greatest increases in BC (376-612 ng/m3). These winds would have entrained BC from Baltimore's densely trafficked central business district, as well as a nearby interstate highway. The strong influence of wind direction implicates atmospheric transport processes in determining BC exposure. Dew point, mixing height, wind speed, season, and workday were also statistically significant predictors. Background exposure to BC was estimated to be 905 ng/m3. The optimal, statistically significant representation of BC's autocorrelation was AR([1:6]) x 288 x 2016, where the short-term AR factor (lags 1-6) indicated that BC concentrations are correlated for up to 30 min, and the AR factors for lags 288 and 2016 indicate longer-term autocorrelations at diurnal and weekly cycles, respectively. It was concluded that local exposure to BC from mobile sources is substantially modified by meteorological and temporal conditions, including atmospheric transport processes. BC concentration also demonstrates statistically significant autocorrelation at several time scales.

Polycyclic aromatic hydrocarbons in human milk of nonsmoking U.S. women

The determination of polycyclic aromatic hydrocarbons (PAHs) in human milk is relevant in assessing the dose to mothers and infants. Since measurements for the United States are lacking, we analyzed 13 PAHs in human milk from 12 nonsmoking American mothers. Analytes were extracted from milk by using a combination of centrifugation, liquid-liquid, and solid-phase extraction techniques. Following method validation with spiked bovine milk, PAH concentrations in human milk were determined by isotope dilution gas chromatography/mass spectrometry. Phenanthrene, fluorene, fluoranthene, and pyrene were found at median concentrations of 11.8, 3.0, 1.6, and 1.1 ng/g milk fat, respectively, whereas 9 additional analytes including benzo[a]pyrene were not detected (<0.04 ng/g). Calculated average daily doses from ingestion (high: 75.8, phenanthrene; low: 6.1 ng/kg/day pyrene) were compared to doses from air pollution inhalation. Milk ingestion accounted for 47.9-81.4% of the total dose of individual PAHs to the infant. However, calculated total average daily doses of phenanthrene and pyrene from ingestion and inhalation combined (12.2 to 110.3 ng/kg-day, respectively) were 3 orders of magnitude lower than documented doses known to cause health effects. These first measurements of PAH levels in U.S. human milk are comparable to concentrations reported previously for European and Asian women.

Common household activities are associated with elevated particulate matter concentrations in bedrooms of inner-city Baltimore pre-school children

Asthma disproportionately affects inner-city, minority children in the U.S. Outdoor pollutant concentrations, including particulate matter (PM), are higher in inner-cities and contribute to childhood asthma morbidity. Although children spend the majority of time indoors, indoor PM exposures have been less extensively characterized. There is a public health imperative to characterize indoor sources of PM within this vulnerable population to enable effective intervention strategies. In the present study, we sought to identify determinants of indoor PM in homes of Baltimore inner-city pre-school children. Children ages 2-6 (n=300) who were predominantly African-American (90%) and from lower socioeconomic backgrounds were enrolled. Integrated PM(2.5) and PM(10) air sampling was conducted over a 3-day period in the children's bedrooms and at a central monitoring site while caregivers completed daily activity diaries. Homes of pre-school children in inner-city Baltimore had indoor PM concentrations that were twice as high as simultaneous outdoor concentrations. The mean indoor PM(2.5) and PM(10) concentrations were 39.5+/-34.5 and 56.2+/-44.8 microg/m(3), compared to the simultaneously measured ambient PM(2.5) and PM(10) (15.6+/-6.9 and 21.8+/-9.53 microg/m(3), respectively). Common modifiable household activities, especially smoking and sweeping, contributed significantly to higher indoor PM, as did ambient PM concentrations. Open windows were associated with significantly lower indoor PM. Further investigation of the health effects of indoor PM exposure is warranted, as are studies to evaluate the efficacy of PM reduction strategies on asthma health of inner-city children.

Survey assessment of worker dermal exposure and underlying behavioral determinants

Within the workplace, there is less reliance on engineering controls for dermal exposure protection and more reliance on the worker's motivation and training in use of personal protective equipment. Behavior thus becomes a significant determinant of dermal exposure, and its assessment paramount in examining and understanding factors influencing exposure. The main objectives of this study were to: (i) assess worker knowledge, attitudes, and perceptions (KAP) of workplace dermal hazards using a self-complete questionnaire and to examine KAP associations with behavior and exposure; (ii) compare worker and manager scores to identify potential gaps in KAP between the two groups; (iii) utilize a semiquantitative observational DeRmal Exposure Assessment Methodology (DREAM) to evaluate worker dermal exposure; and (iv) identify potential behavioral factors underlying exposure using DREAM and KAP. Nineteen industries across the Baltimore, Md. and Lancaster, Pa., regions participated in the study including a total of 89 workers and 17 managers. The scales within the KAP questionnaire that served as the outcome measure included knowledge, training, behavior, behavior beliefs, information beliefs, self-efficacy, and overall beliefs. DREAM scores ranged from 0.15 to 545 with a median of 8 and a mean (SD) of 22 (62.5). Whereas worker self-efficacy with respect to PPE use, and the group "workers with 10-20 years of experience" were marginally positively associated with protective behavior (p < 0.08 and p < 0.06, respectively), a question related to barriers to PPE use was negatively associated with precautionary behavior (p < 0.01). Dermal exposure was positively associated with workers in the age group 40-49 years as compared with those less than 40 years of age (OR = 4.86, 95% CI = 0.93, 25.62). There were no statistically significant associations between KAP and DREAM. This is one of the first studies to begin to elucidate worker knowledge, attitudes, and perceptions that underlie behaviors that lead to occupational dermal exposures. Results of the KAP questionnaire can inform strategies to improve awareness and protective practices in the workplace through factors such as increased worker dermal hazard knowledge, well-informed company PPE selection and availability, and improved worker training.

Home indoor pollutant exposures among inner-city children with and without asthma

BACKGROUND

Evidence for environmental causes of asthma is limited, especially among African Americans. To look for systematic differences in early life domestic exposures between inner-city preschool children with and without asthma, we performed a study of home indoor air pollutants and allergens.

METHODS

Children 2-6 years of age were enrolled in a cohort study in East Baltimore, Maryland. From the child's bedroom, air was monitored for 3 days for particulate matter <or= 2.5 and <or= 10 microm in aerodynamic diameter (PM(2.5), PM(10)), nitrogen dioxide, and ozone. Median baseline values were compared for children with (n = 150) and without (n = 150) asthma. Housing characteristics related to indoor air pollution were assessed by caregiver report and home inspection. In addition, indoor allergen levels were measured in settled dust.

RESULTS

Children were 58% male, 91% African American, and 88% with public health insurance. Housing characteristics related to pollutant exposure and bedroom air pollutant concentrations did not differ significantly between asthmatic and control subjects [median: PM(2.5), 28.7 vs. 28.5 microg/m(3); PM(10), 43.6 vs. 41.4 microg/m(3); NO(2), 21.6 vs. 20.9 ppb; O(3), 1.4 vs. 1.8 ppb; all p > 0.05]. Settled dust allergen levels (cat, dust mite, cockroach, dog, and mouse) were also similar in bedrooms of asthmatic and control children.

CONCLUSIONS

Exposures to common home indoor pollutants and allergens are similar for inner-city preschool children with and without asthma. Although these exposures may exacerbate existing asthma, this study does not support a causative role of these factors for risk of developing childhood asthma.

Concentrations of vehicle-related air pollutants in an urban parking garage

There is growing evidence that traffic-related air pollution poses a public health threat, yet the dynamics of human exposure are not well understood. The urban parking garage is a microenvironment that is of concern but has not been characterized. Using time-resolved measurement methods, we evaluated air toxics levels within an urban parking garage and assessed the influence of vehicle activity and type on their levels. Carbon monoxide (CO) and particle-bound polycyclic aromatic hydrocarbons (pPAH) were measured with direct-reading instruments. Volatile organic compounds (VOCs) were measured in 30 min intervals using a sorbent tube loaded sequential sampler. Vehicle volume and type were evaluated by video recording. Sampling was conducted from June 24 to July 17, 2002. We observed garage traffic median volumes of 71 counts/h on weekdays and 6 counts/h on weekends. The 12-fold reduction in traffic volume from weekday to weekend corresponded with a decrease in median air pollution that varied from a minimum 2- (CO) to a maximum 7 (pPAH)-fold. The actual 30-min median weekday and weekend values were: CO--2.6/1.2 ppm; pPAH--19/2.6 ng/m(3); 1,3-butadiene-0.5/0.2 microg/m(3), MTBE-7.4/0.4 microg/m(3); and benzene-2.7/0.3 microg/m(3). The influence of traffic was quantified using longitudinal models. The pollutant coefficients provide an indication of the average air pollution vehicle source contribution and ranged from 0.31 (CO) to 1.08 (pPAH) percent increase/vehicle count. For some pollutants, a slightly higher (0.5-0.6%) coefficient was observed for light-trucks relative to cars. This study has public health relevance in providing a unique assessment of air pollution levels and source contribution for the urban parking garage.

Application of flow cytometry for the assessment of preservation and recovery efficiency of bioaerosol samplers spiked with Pantoea agglomerans

Exposure assessment of biological aerosols requires trade-offs between efficient sampling of airborne microorganisms as either particles or viable units. The main objective of this work was to characterize aspects of bioaerosol measurement efficiency. A known concentration of the vegetative bacteria Pantoea agglomerans was spiked onto different samplers (AGI-30, BioSampler, and membrane filters) and then run for increasing time periods using HEPA filtered air. Measurement efficiency was evaluated based on total, viable, and culturable counts. Total and viable counts were determined by flow-cytometry (FCM); culturable counts were evaluated by standard plating. FCM as a method for assaying viability showed excellent agreement with known proportions of live/dead organisms (slope = 0.82, R(2) = 0.99). P. agglomerans recoveries (total, viable, and culturable) in order of best sampler performance included the BioSampler (75%, 52%, and 50%), filtration (50%, 13%, and 2%), and the AGI-30 (<30%, 15%, and 5%). The difference between viability and culturability provided an indication of viable but nonculturable (VBNC) cells. VBNC efficiency for sampling by filter, AGI-30, and BioSampler was 80%, 50%, and 100%, respectively. This research helps characterize recovery, survival, and culturability efficiencies while sampling environmentally sensitive airborne bacteria for purposes of exposure assessment, epidemiologic studies, and homeland security.

Volatile organic compounds in human milk: methods and measurements

The present study was conducted to optimize methods for measurement of volatile organic compounds (VOCs) by use of headspace solid-phase microextraction (HS-SPME) and to provide a preliminary assessment of levels in human milk. MTBE (methyl tert-butyl ether), chloroform, benzene, and toluene were measured from two sources of milk: a North Carolina milk bank (n = 5) and multiple samples from three women within nonsmoking households in inner-city Baltimore, MD (n = 8). In Baltimore, indoor air VOC concentrations in the respective households were also measured by active sampling and thermal desorption gas chromatography/mass spectrometry in selective ion monitoring (GC/MS/SIM) over each of the 3 days of milk collection. By application of these optimized methods, we observed median VOC concentrations in Baltimore human milk of 0.09, 0.55, 0.12, and 0.46 ng/mL for MTBE, chloroform, benzene, and toluene, respectively. For benzene, toluene, and MTBE, milk levels trended with observed indoor air concentrations. On the basis of measured concentrations in air and milk, infant average daily dose by inhalation exceeded ingestion rates by 25-135-fold. Thus, VOC exposure from breast milk is vastly exceeded by that from indoor air in nonsmoking households. Accordingly, strategies to mitigate infant VOC exposure should focus on the indoor air inhalation pathway of exposure.

Development of a questionnaire to assess worker knowledge, attitudes and perceptions underlying dermal exposure

OBJECTIVES

Workers' behavior is identified as an important determinant of dermal exposure and is influenced by knowledge, attitudes, and risk perceptions. Because behavior may be a significant predictor of exposure, its assessment provides a means for examining exposure and designing strategies and incentives that encourage worker protective behavior. Currently, there are no psychosocial instruments examining worker knowledge, attitudes, and perceptions with respect to dermal hazards. Accordingly, a questionnaire was developed and tested to provide an instrument for measuring worker knowledge, attitudes, and perceptions.

METHODS

The questionnaire was developed on the basis of a literature review and expert consultation. Scales were constructed based on standard methods. Two worker focus groups were used to evaluate worker understanding and content validity of the KAP (knowledge, attitudes, perceptions) questionnaire. The resulting 115-item questionnaire that included scales for knowledge (N=13), attitudes (N=27), perceptions (N=15), behavior (N=8), behavioral intentions (N=15), barriers (N=13), and facilitators (N=5) was tested on 89 workers from 19 facilities.

RESULTS

The concepts identified in the focus groups included worker perception of higher risk due to a poor fit and replacement frequency for personal protective equipment and cross-contamination by workers moving into work zones. Field testing of the questionnaire (N=89) yielded Cronbach's alpha reliability scores ranging from 0.87 for the self-efficacy personal protective equipment scale to 0.92 for the overall belief scale, indicating high internal reliability.

CONCLUSIONS

Although further testing and refinement is needed, this survey instrument provides an initial and conceptually unique means for evaluating behavioral determinants of worker dermal exposure.

Household mouse allergen exposure and asthma morbidity in inner-city preschool children

BACKGROUND

Inner-city children experience disproportionate asthma morbidity, and suspected reasons include indoor environmental exposures.

OBJECTIVE

To determine if mouse allergen exposure is a risk factor for asthma morbidity.

METHODS

Preschool children with asthma were recruited from inner-city Baltimore, MD. Skin testing was performed and blood was collected at the baseline visit for quantification of mouse allergen specific IgE. A questionnaire evaluated symptoms, medication, and health care use at baseline, 3 months, and 6 months. A trained technician collected dust samples from the child's home for analysis of Mus m 1 at baseline, 3 months, and 6 months. Outcomes were compared between mouse-sensitized, highly exposed children and all other children.

RESULTS

A total of 127 children had complete data for mouse sensitization status and bedroom settled dust mouse allergen levels at baseline. The mean age of the children was 4.4 years, 92% were African American, and 26% were sensitized to mouse. Mouse-sensitized children exposed to higher levels of Mus m 1 (>0.5 microg/g) had 50% more days of symptoms (incidence rate ratio [IRR], 1.5; 95% confidence interval [CI], 1.1-2.1) and 80% more days of beta-agonist use than other children (IRR, 1.8; 95% CI, 1.3-2.5). Children in the sensitized and highly exposed group were also more likely to have an unscheduled physician visit (odds ratio [OR], 3.1; 95% CI, 1.6-6.3), emergency department visit (OR, 2.1; 95% CI, 1.1-4.1), and hospitalization (OR, 36.6; 95% CI, 4.1-327.3) than other children. These associations between mouse allergen exposure and asthma symptoms and morbidity remained statistically significant after adjusting for potential confounders, including atopy and cockroach sensitization and exposure.

CONCLUSIONS

In mouse-sensitized inner-city children, exposure to mouse allergen may be an important cause of asthma morbidity.

Urinary biomarkers of 1,3-butadiene in environmental settings using liquid chromatography isotope dilution tandem mass spectrometry

Although, 1,3-butadiene is a known human carcinogen emitted from mobile sources, little is known about traffic-related human exposure to this toxicant. This pilot study was designed to characterize traffic-related environmental exposure to 1,3-butadiene and evaluate its urinary mercapturic acids as biomarkers of exposure in these settings. Personal air samples and multiple urine samples were collected on two separate occasions from three groups of individuals that differed by spatial proximity as well as intensity of traffic: (i) toll collectors, (ii) urban-weekday and (iii) suburban-weekend group. Air samples were analyzed using thermal desorption followed by GC/MS and urine samples were analyzed using isotope dilution liquid chromatography tandem mass spectrometry (ID-LC-MS/MS) for two mercapturic acids of 1,3-butadiene: monohydroxy-3-butenyl mercapturic acid (MHBMA) and 1,2-dihydroxybutyl mercapturic acid (DHBMA). Exposure differed between groups (p<0.05) with median values of 2.38, 1.62 and 0.88 microg/m(3) for toll collectors, the urban-weekday group and the suburban-weekend group, respectively. A refined ID-LC-MS/MS method enabled detection of MHBMA, previously detected only in occupational settings, with high frequency. MHBMA and DHBMA were detected in 95 and 100% of urine samples at levels (mean+/-S.D.) of 9.7+/-9.5, 6.0+/-4.3 and 6.8+/-2.6 ng/mL for MHBMA and 378+/-196, 258+/-133 and 306+/-242 ng/mL for DHBMA for the three different groups, respectively. Mean biomarker levels were higher among the toll collectors compared to the other two groups, however, the differences were not statistically significant (p>0.05). This study is the first to evaluate 1,3-butadiene biomarkers for subtle differences in environmental exposures. However, additional research will be required to ascertain whether the lack of statistical association observed here is real or attributable to unexpectedly small differences in exposure between groups (<1 microg/m(3)), non-specificity of the biomarker at low exposure, and/or small sample size.

Assessment of an aerosol treatment to improve air quality in a swine concentrated animal feeding operation (CAFO)

Poor air quality within swine concentrated animal feeding operations (CAFOs) poses a threat to workers, the surrounding community, and farm production. Accordingly, the current study was conducted to evaluate a technology for reducing air pollution including particulate matter (PM), viable bacteria, and ammonia within such a facility. The technology consists of an acid-oil-alcohol aerosol applied daily. Its effectiveness was evaluated by comparing air quality from before to after treatment and between treated and untreated sides of a barn separated by an impervious partition. On the untreated side, air quality was typical for a swine CAFO, with mean PM2.5 of 0.28 mg/m3 and PM(TOT) of 1.5 mg/m3. The treatment yielded a reduction in PM concentration of 75-90% from before to after treatment. Effectiveness increased with time, application, and particle size (40% reduction for 1 microm and 90% for >10 microm). Airborne bacteria levels (total bacteria, Enterobacteriaceae, and gram-positive cocci) decreased one logarithmic unit after treatment. In contrast, treatment had no effect on ammonia concentrations. These findings demonstrate the effectiveness of an intervention in yielding exposure and emission reductions.

Socioeconomic and racial disparities in cancer risk from air toxics in Maryland

We linked risk estimates from the U.S. Environmental Protection Agency's National Air Toxics Assessment (NATA) to racial and socioeconomic characteristics of census tracts in Maryland (2000 Census) to evaluate disparities in estimated cancer risk from exposure to air toxics by emission source category. In Maryland, the average estimated cancer risk across census tracts was highest from on-road sources (50% of total risk from nonbackground sources), followed by nonroad (25%), area (23%), and major sources (< 1%). Census tracts in the highest quartile defined by the fraction of African-American residents were three times more likely to be high risk (> 90th percentile of risk) than those in the lowest quartile (95% confidence interval, 2.0-5.0). Conversely, risk decreased as the proportion of whites increased (p < 0.001). Census tracts in the lowest quartile of socioeconomic position, as measured by various indicators, were 10-100 times more likely to be high risk than those in the highest quartile. We observed substantial risk disparities for on-road, area, and nonroad sources by socioeconomic measure and on-road and area sources by race. There was considerably less evidence of risk disparities from major source emissions. We found a statistically significant interaction between race and income, suggesting a stronger relationship between race and risk at lower incomes. This research demonstrates the utility of NATA for assessing regional environmental justice, identifies an environmental justice concern in Maryland, and suggests that on-road sources may be appropriate targets for policies intended to reduce the disproportionate environmental health burden among economically disadvantaged and minority populations.

Indoor exposures to air pollutants and allergens in the homes of asthmatic children in inner-city Baltimore

This paper presents indoor air pollutant concentrations and allergen levels collected from the homes of 100 Baltimore city asthmatic children participating in an asthma intervention trial. Particulate matter (PM), NO2, and O3 samples were collected over 72 h in the child's sleeping room. Time-resolved PM was also assessed using a portable direct-reading nephelometer. Dust allergen samples were collected from the child's bedroom, the family room, and the kitchen. The mean PM10 concentration, 56.5+/-40.7 microg/m3, is 25% higher than the PM2.5 concentration (N=90), 45.1+/-37.5 microg/m3. PM concentrations measured using a nephelometer are consistent and highly correlated with gravimetric estimates. Smoking households' average PM2.5 and PM10 concentrations are 33-54 microg/m3 greater than those of nonsmoking houses, with each cigarette smoked adding 1.0 microm/m3 to indoor PM2.5 and PM10 concentrations. Large percentages of NO2 and O3 samples, 25% and 75%, respectively, were below the limit of detection. The mean NO2 indoor concentration is 31.6+/-40.2 ppb, while the mean indoor O3 concentration in the ozone season was 3.3+/-7.7 ppb. The levels of allergens are similar to those found in other inner cities. Results presented in this paper indicate that asthmatic children in Baltimore are exposed to elevated allergens and indoor air pollutants. Understanding this combined insult may help to explain the differential asthma burden between inner-city and non-inner-city children.

Tollbooth workers and mobile source-related hazardous air pollutants: how protective is the indoor environment?

Tollbooth workers are potentially exposed to high levels of mobile source-related air pollutants due to the proximity and intensity of the source. To evaluate this worker hazard, we measured the concentration of air toxins including volatile organic compounds (VOCs) and particle-bound polycyclic aromatic hydrocarbons (PAHs) inside and outside a Baltimore Harbor Tunnel tollbooth during the summer of 2001. Mean outdoor benzene and 1,3-butadiene concentrations varied by shift with the morning (10.7 and 19.8 microg/m3) exceeding afternoon (7.2 and 14.9 microg/m3) and the lowest levels observed during the night (3.7 and 4.9 microg/m3, respectively) when traffic volume was the lowest. In comparison, considerable protection was provided to workers bythe indoor environment where lower concentrations of 1,3-butadiene and benzene were observed for all three shifts (2.9 and 6.7, 0.9 and 3.2, and 0.9 and 2.4 microg/m3, respectively). The greatest protection offered by the tollbooth was observed during the afternoon shift (5-8-fold reduction in indoor concentration), whereas the morning and night shifts experienced similar protection (2-4-fold reduction). Chlorinated hydrocarbons were observed at higher concentrations within the tollbooth, indicating the presence of indoor sources and the opportunity for exposure mitigation. Levels of PAHs were similarly reduced from outdoors (50 ng/m3) to indoors (15.4 ng/m3). The protective nature of the tollbooth highlighted in this study is likely due to the positive pressure control ventilation system that was present at this specific facility, which represents 55% of tollbooths in Maryland. This study provides an estimate of tollbooth workers potential exposures to various mobile source-related pollutants and highlights the protective nature of tollbooths equipped with positive pressure control ventilation systems.

Airborne mouse allergen in the homes of inner-city children with asthma

BACKGROUND

Airborne mouse allergen has not previously been measured in inner-city homes, and its relationship to settled dust mouse allergen levels is unknown.

OBJECTIVE

To quantify airborne and settled dust Mus m 1 levels in homes of inner-city patients with asthma and to identify risk factors for mouse allergen exposure.

METHODS

One hundred inner-city school-age children with asthma in Baltimore underwent skin testing to a panel of aeroallergens, and their homes were inspected by a trained technician. Air and settled dust were sampled in the child's bedroom. Mus m 1, particulate matter smaller than 10 microns (PM 10 ), and particulate matter smaller than 2.5 microns were quantified in air samples, and Mus m 1 was quantified in settled dust samples.

RESULTS

Mus m 1 was detected in settled dust samples from 100% of bedrooms. Airborne mouse allergen was detected in 48 of 57 (84%) bedrooms, and the median airborne mouse allergen concentration was 0.03 ng/m 3 . The median PM 10 concentration was 48 microg/m 3 . Airborne and settled dust mouse allergen levels were moderately correlated ( r = .52; P < .0001), and airborne Mus m 1 and PM 10 levels were weakly correlated ( r = .29; P = .03). Having cracks or holes in doors or walls, evidence of food remains in the kitchen, and mouse infestation were all independently associated with having detectable airborne mouse allergen.

CONCLUSION

Airborne mouse allergen concentrations in many inner-city homes may be similar to those found in animal facilities, where levels are sufficiently high to elicit symptoms in sensitized individuals. Exposed food remains, cracks and holes in doors or walls, and evidence of mouse infestation appear to be risk factors for having detectable airborne Mus m 1.

Impact of the 2002 Canadian forest fires on particulate matter air quality in Baltimore city

With increasing evidence of adverse health effects associated with particulate matter (PM), the exposure impact of natural sources, such as forest fires, has substantial public health relevance. In addition to the threat to nearby communities, pollutants released from forest fires can travel thousands of kilometers to heavily populated urban areas. There was a dramatic increase in forest fire activity in the province of Quebec, Canada, during July 2002. The transport of PM released from these forest fires was examined using a combination of a moderate-resolution imaging spectroradiometer satellite image, back-trajectories using a hybrid single-particle Lagrangian integrated trajectory, and local light detection and ranging measurements. Time- and size-resolved PM was evaluated at three ambient and four indoor measurement sites using a combination of direct reading instruments (laser, time-of-flight aerosol spectrometer, nephelometer, and an oscillating microbalance). The transport and monitoring results consistently identified a forest fire related PM episode in Baltimore that occurred the first weekend of July 2002 and resulted in as much as a 30-fold increase in ambientfine PM. On the basis of tapered element oscillating microbalance measurements, the 24 h PM25 concentration reached 86 microg/m3 on July 7, 2002, exceeding the 24 h national ambient air quality standard. The episode was primarily comprised of particles less than 2.5 microm in aerodynamic diameter, highlighting the preferential transport of the fraction of PM that is of greatest health concern. Penetration of the ambient episode indoors was efficient (median indoor-to-outdoor ratio 0.91) such that the high ambient levels were similarly experienced indoors. These results are significant in demonstrating the impact of a natural source thousands of kilometers away on ambient levels of and potential exposures to air pollution within an urban center. This research highlights the significance of transboundary air pollution and the need for studies that assess the public health impacts associated with such sources and transport processes.

Relationship between concentration of pyrene and aerosol size distribution in traffic exhausts in Taipei, Taiwan

Variations in pyrene concentrations in motor-vehicle emissions were assessed on the basis of aerodynamic particle size and by the type of vehicle (i.e., car, truck, or bus) that passed through a Taipei, Taiwan, highway toll station. Airborne particles were collected with 8-stage cascade samplers equipped with 34-mm polyvinyl chloride filters and located in the breathing zones of toll-station workers. The authors used gas chromatography/mass spectrometry to analyze 22 polycyclic aromatic hydrocarbons that were collected. The absolute concentration of pyrene was highest in the fine-particle emission fraction for trucks, buses, and passenger cars; however, fine particles in truck and bus exhausts contained higher pyrene concentrations than the corresponding size fraction of particles emitted from passenger cars. Truck and bus emissions contained a higher concentration of pyrene than car emissions because trucks and buses produced greater amounts of fine and coarse particles, and their fine particles contained higher concentrations of pyrene.

Comparative Analysis of Passive Dosimetry and Biomonitoring for Assessing Chlorpyrifos Exposure in Pesticide Workers

Under the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA), the US Environmental Protection Agency (EPA) has the authority to regulate the use of pesticides to prevent unreasonable adverse human health effects associated with pesticide exposure. Accordingly, the EPA requires pesticide registrants to perform studies evaluating the potential for pesticide handler exposure. Data from five such studies that included exposure measurements based on both external measurements and biological monitoring were used to examine methods of assessment, routes and determinants of exposure and dose to the pesticide chlorpyrifos. Eighty workers across four job classes were included: mixer/loaders (M/L, n = 24), mixer/loader/applicators (M/L/A, n = 37), applicators (A, n = 9) and re-entry scouts (RS, n = 10). Results showed that doses were highly variable and differed by job class (P < 0.05) with median total (inhalation and dermal combined) exposure-derived absorbed doses (EDADtot) of 129, 88, 85 and 45 microg/application for A, M/L/A, M/L and RS, respectively. Doses derived from the measurement of 3,5,6-trichloro- 2-pyridinol (3,5,6-TCP) in urine were similar in magnitude but differed in rank with median values of 275, 189, 122 and 97 microg/application for A, M/L, RS, and M/L/A, respectively. The relative contribution of dermal to inhalation exposure was examined by their ratio. The median ratios of exposure-derived absorbed dermal dose (EDADderm) (assuming 3% absorption) to exposure-derived absorbed inhalation dose (EDADinh) (assuming 100% absorption) across job classes were 1.7, 1.5, 0.44 and 0.18 for RS, M/L, A and M/L/A, respectively, with an overall median of 0.6. For 34 of 77 workers (44%), this ratio exceeded 1.0, indicating the significance of the dermal exposure pathway. Different dermal absorption factor (DAF) assumptions were examined by comparing EDADtot to the biomarker-derived absorbed dose (BDAD) as a ratio where EDADtot was calculated assuming a DAF of 1, 3 and 10%. Median ratios of 0.45, 0.71 and 1.28, respectively, were determined suggesting the DAF is within the range of 3-10%. A simple linear regression of urinary 3,5,6-TCP against EDADtot indicates a positive association explaining 29% of the variability in the 3,5,6-TCP derived estimate of dose. A multiple linear regression model including the variables EDADderm, EDADinh and application type explained 46% of the variability (R2 = 0.46) in the urinary dose estimate. EDADderm was marginally significant (P = 0.066) while EDADinh was not (P = 0.57). The EDADderm regression coefficient (0.0007) exceeded the coefficient for EDADinh (0.00002) by a factor of 35. This study demonstrates the value of the pesticide registrant database for the purpose of evaluating pesticide worker exposure. It highlights the significance of the dermal exposure pathway, and identifies the need for methods and research to close the gap between external and internal exposure measures.

Different latex aeroallergen size distributions between powdered surgical and examination gloves: significance for environmental avoidance

BACKGROUND

Proactive medical institutions implement latex allergen avoidance to protect workers and patients with latex allergy and to prevent latex sensitization in these groups by creating latex-safe environments that include replacement of natural rubber latex examination and surgical gloves, especially those that are powdered, with synthetic alternatives. We have hypothesized that an apparent decreasing trend in new latex allergy cases in hospitals using only synthetic examination gloves but the occasional powdered latex surgical glove might result from constitutive differences in allergen content (particle size distribution and quantity) between powdered surgical gloves and examination gloves.

OBJECTIVE

Because aerodynamic particle size determines where inhaled airborne allergen deposits in the airway, the aim of this study was to investigate the differential particle size distribution of latex allergen released from powdered latex examination and surgical gloves.

METHODS

Powdered and nonpowdered latex examination and surgical gloves were processed to create an aerosol in a glove box equipped with air sampling equipment capable of total particle number and mass measurements. Air particulate generated in the glove box was collected on impactors with less than 2.5-microm, 2.5- to 10-microm, and greater than 10-microm particle size limits (4 L/min for 4 hours). All filters were extracted, and latex allergen was quantified by using a latex-CAP inhibition assay with a human IgE anti-latex serum pool.

RESULTS

Latex aeroallergen on powdered sterile surgical gloves resided primarily on particles greater than 10 microm in size (P <.006). In contrast, powdered examination gloves released the highest total latex aeroallergen content, with 68% of the particles sized in the respirable 2.5- to 10-microm range and carrying 56% of the airborne latex allergen.

CONCLUSIONS

Significantly lower quantities and larger sizes of latex allergen-containing particles released from surgical gloves provides one potential explanation as to why an apparent decrease in new cases of latex allergy can occur in hospitals that successfully replace latex examination gloves with synthetic gloves but continue occasional use of powdered surgical gloves.

Methods and issues in conducting a community-based environmental randomized trial

The environment is suspected to play an important role in the prevalence and severity of asthma in inner-city children. This paper describes the implementation and baseline data of an inner-city community-based participatory research clinical trial designed to test the effectiveness of a pollutant and allergen control strategy on children's asthma morbidity. Participants were 100 elementary-school-aged children with asthma, graduates of a school-based asthma education program in East Baltimore. The intervention for half of the randomly assigned families consisted of environmental control education, allergen-proof encasements, pest extermination, and a HEPA air cleaner at the beginning of the study. Controls received the same at the end of the study. Participants visited a clinic for questionnaires, allergy skin testing, spirometry, and blood sample at baseline and 12 months. Home environments, NO(2), O(3), airborne particulates, and allergens were evaluated at baseline and at 6 and 12 months. Asthma morbidity and adherence was assessed quarterly. Collaboration with the community proved very beneficial in creating a study design and procedures acceptable to an inner-city community.

Personal exposure meets risk assessment: a comparison of measured and modeled exposures and risks in an urban community

Human exposure research has consistently shown that, for most volatile organic compounds (VOCs), personal exposures are vastly different from outdoor air concentrations. Therefore, risk estimates based on ambient measurements may over- or underestimate risk, leading to ineffective or inefficient management strategies. In the present study we examine the extent of exposure misclassification and its impact on risk for exposure estimated by the U.S. Environmental Protection Agency (U.S. EPA) Assessment System for Population Exposure Nationwide (ASPEN) model relative to monitoring results from a community-based exposure assessment conducted in Baltimore, Maryland (USA). This study is the first direct comparison of the ASPEN model (as used by the U.S. EPA for the Cumulative Exposure Project and subsequently the National-Scale Air Toxics Assessment) and human exposure data to estimate health risks. A random sampling strategy was used to recruit 33 nonsmoking adult community residents. Passive air sampling badges were used to assess 3-day time-weighted-average personal exposure as well as outdoor and indoor residential concentrations of VOCs for each study participant. In general, personal exposures were greater than indoor VOC concentrations, which were greater than outdoor VOC concentrations. Public health risks due to actual personal exposures were estimated. In comparing measured personal exposures and indoor and outdoor VOC concentrations with ASPEN model estimates for ambient concentrations, our data suggest that ASPEN was reasonably accurate as a surrogate for personal exposures (measured exposures of community residents) for VOCs emitted primarily from mobile sources or VOCs that occur as global "background" source pollutant with no indoor source contributions. Otherwise, the ASPEN model estimates were generally lower than measured personal exposures and the estimated health risks. ASPEN's lower exposures resulted in proportional underestimation of cumulative cancer risk when pollutant exposures were combined to estimate cumulative risk. Median cumulative lifetime cancer risk based on personal exposures was 3-fold greater than estimates based on ASPEN-modeled concentrations. These findings demonstrate the significance of indoor exposure sources and the importance of indoor and/or personal monitoring for accurate assessment of risk. Environmental health policies may not be sufficient in reducing exposures and risks if they are based solely on modeled ambient VOC concentrations. Results from our study underscore the need for a coordinated multimedia approach to exposure assessment for setting public health policy.

Exposure to Fine Particulate Matter (PM2.5) Among Highway Toll Station Workers in Taipei: Direct and Indirect Exposure Assessment

In this study, the authors assessed occupational exposure to PM2.5 among 47 highway toll station workers in Taipei, Taiwan. The subjects were monitored for 10 days to assess integrated 8-hr fine particulate matter (PM2.5) breathing zone concentration. Researchers constructed a microenvironment-time-concentration matrix and applied direct and indirect approaches to assess cumulative exposure. Mean PM2.5 concentration for workers in the truck and bus lanes was 308 microg/m3 (SD = 115.5 microg/m3), substantially higher compared with cash-payment car lanes (mean 115, SD = 41.8, p < 0.001) and ticket-payment car lanes (mean 109, SD = 48.7, p < 0.001). Concentration per vehicle in the truck and bus lanes was 6.4 and 3.7 times higher, respectively, than that of ticket- or cash-payment car lanes. Mean cumulative exposure for the 10-day period was 4,900-13,407 microg/m3.hr, with a mean of 8,019 microg/m3.hr (SD = 2,375.3). Indirect and direct concentrations were strongly correlated (r2 = .61, F(1,125); p = 0.000). The results of this study show that personal exposure to PM2.5 can be reliably estimated using indirect approaches.

Urinary 1-Hydroxypyrene-Glucuronide as a Biomarker of Exposure to Various Vehicle Exhausts among Highway Toll-Station Workers in Taipei, Taiwan

In this cross-sectional study, the authors evaluated urinary 1-hydroxypyrene-glucuronide (1-OHP-gluc) as a potential biomarker of exposure to various traffic exhausts. Subjects were 47 female highway toll-station workers and 27 female office workers in training for toll-station employment in Taipei, Taiwan. The mean concentration of urinary 1 -OHP-gluc was 0.117 micromol/mol creatinine in the exposed group and 0.073 micromol/mol creatinine in the reference group (difference in mean concentrations: 0.044 micromol/mol creatinine [95% confidence interval [CI]: 0.015, 0.072). In the lanes where tolls were collected from passenger cars, there was a significant relationship between cumulative traffic and 1-OHP-gluc concentration (i.e., average increase of 0.015 micromol/mol creatinine [95% CI: 0.003, 0.027] per 1,000 vehicles). The average increase for truck/bus lanes was similar to that identified for the car lanes (i.e., average increase of 0.011 micromol/mol creatinine [95% Cl: -0.024, 0.045] per 1,000 vehicles). The authors determined that exposure to various traffic exhausts increased the urinary concentration of 1-OHP-gluc in a dose-response pattern, which suggests that this chemical may be a useful biomarker for exposure to vehicle exhausts.

Closing the research loop: a risk-based approach for communicating results of air pollution exposure studies

Communities have long been concerned about the environmental health and environmental quality of their neighborhoods. Community-based exposure assessments have the potential to be an effective way to address these concerns. The success of such studies depends critically on the effective translation and communication of study results back to the study participants and the community. In this article we describe the communication approach applied as part of the South Baltimore Community Exposure Study. Specifically, in conjunction with collecting measurements, we asked the community to define questions they wanted answered and the way in which they wanted to receive study results. To meet their needs, we applied the risk assessment framework. The approach we developed helped residents interpret exposure assessment measurements and gave them the raw materials to effect change in their community. The risk-based approach to presenting participant and community results provides the means to move beyond traditional reporting of concentration values in three important ways. First, risk takes into consideration toxicity, thereby enabling a dialogue about community health concerns. Second, risk provides a common denominator so that exposure and risk can be compared and priorities identified. Third, exposure and risk can be summed, thereby meeting the community's need for information regarding cumulative exposure. This approach may be a useful model for other researchers conducting exposure assessments in response to community concerns.