17 research outputs found

    Mapping modeled exposure of wildland fire smoke for human health studies in California

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    Wildland fire smoke exposure affects a broad proportion of the U.S. population and is increasing due to climate change, settlement patterns and fire seclusion. Significant public health questions surrounding its effects remain, including the impact on cardiovascular disease and maternal health. Using atmospheric chemical transport modeling, we examined general air quality with and without wildland fire smoke PM2.5. The 24-h average concentration of PM2.5 from all sources in 12-km gridded output from all sources in California (2007–2013) was 4.91 ÎŒg/m3. The average concentration of fire-PM2.5 in California by year was 1.22 ÎŒg/m3 (~25% of total PM2.5). The fire-PM2.5 daily mean was estimated at 4.40 ÎŒg/m3 in a high fire year (2008). Based on the model-derived fire-PM2.5 data, 97.4% of California’s population lived in a county that experienced at least one episode of high smoke exposure (“smokewave”) from 2007–2013. Photochemical model predictions of wildfire impacts on daily average PM2.5 carbon (organic and elemental) compared to rural monitors in California compared well for most years but tended to over-estimate wildfire impacts for 2008 (2.0 ”g/m3 bias) and 2013 (1.6 ”g/m3 bias) while underestimating for 2009 (−2.1 ”g/m3 bias). The modeling system isolated wildfire and PM2.5 from other sources at monitored and unmonitored locations, which is important for understanding population exposure in health studies. Further work is needed to refine model predictions of wildland fire impacts on air quality in order to increase confidence in the model for future assessments. Atmospheric modeling can be a useful tool to assess broad geographic scale exposure for epidemiologic studies and to examine scenario-based health impacts

    Reliability of goniometric measurements in children with cerebral palsy: A comparative analysis of universal goniometer and electronic inclinometer. A pilot study

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    <p>Abstract</p> <p>Background</p> <p>Even though technological progress has provided us with more and more sophisticated equipment for making goniometric measurements, the most commonly used clinical tools are still the universal goniometer and, to a lesser extent, the inclinometer. There is, however, no published study so far that uses an inclinometer for measurements in children with cerebral palsy (CP). The objective of this study was two-fold: to independently assess the intra and inter-examiner reliability for measuring the hip abduction range of motion in children with CP using two different instruments, the universal two-axis goniometer and electronic inclinometer. A pool of 5 examiners with different levels of experience as paediatric physiotherapists participated. The study did not compare both instruments because the measurement procedure and the hip position were different for each.</p> <p>Methods</p> <p>A prospective, observational study of goniometery was carried out with 14 lower extremities of 7 children with spastic CP. The inclinometer study was carried out with 8 lower extremities of 4 children with spastic CP. This study was divided into two independent parts: a study of the reliability of the hip abduction range of motion measured with a universal goniometer (hip at 0° flexion) and with an electronic inclinometer (hip at 90° flexion). The Intraclass Correlation Coefficient (ICC) was calculated to analyse intra and inter-examiner agreement for each instrument.</p> <p>Results</p> <p>For the goniometer, the intra-examiner reliability was excellent (>0.80), while the inter-examiner reliability was low (0.375 and 0.475). For the inclinometer, both the intra-examiner (0.850-0.975) and inter-examiner reliability were excellent (0.965 and 0.979).</p> <p>Conclusions</p> <p>The inter-examiner reliability for goniometric measurement of hip abduction in children with CP was low, in keeping with other results found in previous publications. The inclinometer has proved to be a highly reliable tool for measuring the hip abduction range of motion in children with CP, which opens up new possibilities in this field, despite having some measurement limitations.</p

    Associations of Long-term Particulate Matter and Ozone Air Pollution Exposures with Pulmonary Function: Does Excess Weight Increase Risk of Enhanced Decrements?

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    Few studies evaluate how long-term air pollution exposures affects lung function among young adults. Data from existing epidemiologic and toxicologic studies support the hypothesis that obese adults’ lung function responds more negatively to long-term air pollution exposure compared to non-obese adults. 5,026 Black and White participants in the Coronary Artery Risk Development In Young Adults Study (CARDIA), aged 18 to 30 years in 1985-86, provided lung function measurements, demographic and clinical data, and were followed 2, 5, 10 and 20 years later. Using air quality monitoring data and residential history, for each participant we estimated one long-term average exposure over the period of study attendance for particulate matter (PM10) and ozone. We fit linear mixed effects models to estimate associations between long-term air pollution and level and rate of change per year in forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC, adjusting for confounders. We examined effect modification by obesity status using body mass index (BMI) ≄ 30.0 kg/m2. An increase of 10 ”g/m3 in long-term (1984-2006) PM10 exposure was associated with a decreased rate of change in FEV1 of 1.7 ml per year of followup (p-value 0.04) and a decrease in level of FVC of 56.0 ml (p-value 0.04). Associations with rate of change were stronger among women than men. No associations were observed between long-term PM10 exposure and FEV1/FVC, nor between long-term ozone exposures and any lung function measure, for all participants. For the most part, obesity status did not modify the association between long-term PM10 and ozone exposures and FEV1, FVC, or FEV1/FVC. Only ozone associations with FEV1 and FVC differed by obesity status as participants aged. In CARDIA, long-term PM10 exposures were associated with decreases in lung function but ozone exposures were not. We did not observe effect modification in level by obesity status; however, BMI and obesity status are imprecise measures. Research with more precise obesity and exposure estimation and different designs in CARDIA and other cohorts is needed to understand how air pollution exposure may affect pulmonary health in young adults as they age and gain weight.  PhDEnvironmental Health SciencesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttps://deepblue.lib.umich.edu/bitstream/2027.42/133492/1/tkoman_1.pd

    Population susceptibility: A vital consideration in chemical risk evaluation under the Lautenberg Toxic Substances Control Act.

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    The 2016 Frank Lautenberg Chemical Safety for the 21st Century Act (Lautenberg TSCA) amended the 1976 Toxic Substances Control Act (TSCA) to mandate protection of susceptible and highly exposed populations. Program implementation entails a myriad of choices that can lead to different degrees of public health protections. Well-documented exposures to multiple industrial chemicals occur from air, soil, water, food, and products in our workplaces, schools, and homes. Many hazardous chemicals are associated with or known to cause health risks; for other industrial chemicals, no data exist to confirm their safety because of flaws in 1976 TSCA. Under the 2016 Lautenberg amendments, the United States Environmental Protection Agency (EPA) must evaluate chemicals against risk-based safety standards under enforceable deadlines, with an explicit mandate to identify and assess risks to susceptible and highly exposed populations. Effective public health protection requires EPA to implement the Lautenberg TSCA requirements by incorporating intrinsic and extrinsic factors that affect susceptibility, adequately assessing exposure among vulnerable groups, and accurately identifying highly exposed groups. We recommend key scientific and risk assessment principles to inform health-protective chemical policy such as consideration of aggregate exposures from all pathways and, when data are lacking, the use of health-protective defaults

    Toxic Substances Control Act (TSCA) Implementation: How the Amended Law Has Failed to Protect Vulnerable Populations from Toxic Chemicals in the United States

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    Exposures to industrial chemicals are widespread and can increase the risk of adverse health effects such as cancer, developmental disorders, respiratory effects, diabetes, and reproductive problems. The amended Toxic Substances Control Act (amended TSCA) requires the U.S. Environmental Protection Agency (EPA) to evaluate risks of chemicals in commerce, account for risk to potentially exposed and susceptible populations, and mitigate risks for chemicals determined to pose an unreasonable risk to human health and the environment. This analysis compares EPA's first 10 chemical risk evaluations under amended TSCA to best scientific practices for conducting risk assessments. We find EPA's risk evaluations underestimated human health risks of chemical exposures by excluding conditions of use and exposure pathways; not considering aggregate exposure and cumulative risk; not identifying all potentially exposed or susceptible subpopulations, and not quantifying differences in risk for susceptible groups; not addressing data gaps; and using flawed systematic review approaches to identify and evaluate the relevant evidence. We present specific recommendations for improving the implementation of amended TSCA using the best available science to ensure equitable, socially just safeguards to public health. Failing to remedy these shortcomings will result in continued systematic underestimation of risk for all chemicals evaluated under amended TSCA
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