Do US Ambient Air Lead Levels Have a Significant Impact on Childhood Blood Lead Levels: Results of a National Study

Introduction. Although lead paint and leaded gasoline have not been used in the US for thirty years, thousands of US children continue to have blood lead levels (BLLs) of concern. Methods. We investigated the potential association of modeled air lead levels and BLLs ≥ 10 μg/dL using a large CDC database with BLLs on children aged 0–3 years. Percent of children with BLLs ≥ 10 μg/dL (2000–2007) by county and proportion of pre-50 housing and SES variables were merged with the US EPA's National Air Toxics Assessment (NATA) modeled air lead data. Results. The proportion with BLL ≥ 10 μg/dL was 1.24% in the highest air lead counties, and the proportion with BLL ≥ 10 μg/dL was 0.36% in the lowest air lead counties, resulting in a crude prevalence ratio of 3.4. Further analysis using multivariate negative binomial regression revealed that NATA lead was a significant predictor of % BLL ≥ 10 μg/dL after controlling for percent pre-l950 housing, percent rural, and percent black. A geospatial regression revealed that air lead, percent older housing, and poverty were all significant predictors of % BLL ≥ 10 μg/dL. Conclusions. More emphasis should be given to potential sources of ambient air lead near residential areas

Estimation of Short-Term Effects of Air Pollution on Stroke Hospital Admissions in Wuhan, China

Background and Objective:High concentrations of air pollutants have been linked to increased incidence of stroke in North America and Europe but not yet assessed in mainland China. The aim of this study is to evaluate the association between stroke hospitalization and short-term elevation of air pollutants in Wuhan, China.Methods:Daily mean NO2, SO2 and PM10 levels, temperature and humidity were obtained from 2006 through 2008. Data on stroke hospitalizations (ICD 10: I60-I69) at four hospitals in Wuhan were obtained for the same period. A time-stratified case-crossover design was performed by season (April-September and October-March) to assess effects of pollutants on stroke hospital admissions.Results:Pollution levels were higher in October-March with averages of 136.1 μg/m3 for PM10, 63.6 μg/m3 for NO2 and 71.0 μg/m3 for SO2 than in April-September when averages were 102.0 μg/m3, 41.7 μg/m3 and 41.7 μg/m3, respectively (p<.001). During the cold season, every 10 μg/m3 increase in NO2 was associated with a 2.9% (95%C.I. 1.2%-4.6%) increase in stroke admissions on the same day. Every 10 ug/m3 increase in PM10 daily concentration was significantly associated with an approximate 1% (95% C.I. 0.1%-1.4%) increase in stroke hospitalization. A two-pollutant model indicated that NO2 was associated with stroke admissions when controlling for PM10. During the warm season, no significant associations were noted for any of the pollutants.Conclusions:Exposure to NO2 is significantly associated with stroke hospitalizations during the cold season in Wuhan, China when pollution levels are 50% greater than in the warm season. Larger and multi-center studies in Chinese cities are warranted to validate our findings. © 2013 Xiang et al

Perinatal outcomes and unconventional natural gas operations in Southwest Pennsylvania.

Unconventional gas drilling (UGD) has enabled extraordinarily rapid growth in the extraction of natural gas. Despite frequently expressed public concern, human health studies have not kept pace. We investigated the association of proximity to UGD in the Marcellus Shale formation and perinatal outcomes in a retrospective cohort study of 15,451 live births in Southwest Pennsylvania from 2007-2010. Mothers were categorized into exposure quartiles based on inverse distance weighted (IDW) well count; least exposed mothers (first quartile) had an IDW well count less than 0.87 wells per mile, while the most exposed (fourth quartile) had 6.00 wells or greater per mile. Multivariate linear (birth weight) or logistical (small for gestational age (SGA) and prematurity) regression analyses, accounting for differences in maternal and child risk factors, were performed. There was no significant association of proximity and density of UGD with prematurity. Comparison of the most to least exposed, however, revealed lower birth weight (3323 ± 558 vs 3344 ± 544 g) and a higher incidence of SGA (6.5 vs 4.8%, respectively; odds ratio: 1.34; 95% confidence interval: 1.10-1.63). While the clinical significance of the differences in birth weight among the exposure groups is unclear, the present findings further emphasize the need for larger studies, in regio-specific fashion, with more precise characterization of exposure over an extended period of time to evaluate the potential public health significance of UGD

Trends in acute myocardial infarction hospitalization rates for US States in the CDC tracking network.

We examined temporal trends, spatial variation, and gender differences in rates of hospitalization due to acute myocardial infarction.We used data from the Centers for Disease Control National Environmental Public Health Tracking Network to evaluate temporal trends, geographic variation, and gender differences in 20 Environmental Public Health Tracking Network states from 2000 to 2008. A longitudinal linear mixed effects model was fitted to the acute myocardial infarction hospitalization rates for the states and counties within each state to examine the overall temporal trend.There was a significant overall decrease in age-adjusted acute myocardial infarction hospitalization rates between 2000 and 2008, with most states showing over a 20% decline during the period. The ratio of male/female rates for acute myocardial infarction hospitalization rates remained relatively consistent over time, approximately two-fold higher in men compared to women. A large geographic variability was found for age-adjusted acute myocardial infarction hospitalization rates, with the highest rates found in the Northeastern states. Results of two ecological analyses revealed that the NE region remained significantly associated with increased AMI hospitalization rates after adjustment for socio-demographic factors.This investigation is one of the first to explore geographic differences in AMI age adjusted hospital rates in individuals 35+ years of age for 2000-2008. We showed a decreasing trend in AMI hospitalization rates in men and women. A large geographic variability in rates was found with particularly higher rates in the New England/Mid-Atlantic region of the US and lower rates in the mountain and Pacific states of the tracking network. It appeared that over time this disparity in rates became less notable

Unadjusted and adjusted odds ratios (OR) and 95% confidence intervals (CI) for prematurity (adjusted for mom’s age, mom’s education, pre-pregnancy weight, gender of infant, prenatal visits, smoking during pregnancy, gestational diabetes, WIC, race, and birth order).

<p>Key: Referent (First quartile), <0.87 wells per mile; Second quartile (2Q), 0.87 to 2.59 wells per mile; Third quartile (3Q), 2.60 to 5.99 wells per mile; Fourth quartile (4Q), ≥6.00 wells per mile.</p

Maternal and Child Risk Factors for Geocoded versus Not Geocoded Residences and Those With versus Without at Least One Well Within 10-miles.

<p>Maternal and Child Risk Factors for Geocoded versus Not Geocoded Residences and Those With versus Without at Least One Well Within 10-miles.</p

Association of all strokes, ischemic and hemorrhagic strokes and pollutant concentrations by lag days for 10 µg/m³ increases in pollutant levels adjusted for temperature and humidity, Wuhan, 2006–2008.

<p>Association of all strokes, ischemic and hemorrhagic strokes and pollutant concentrations by lag days for 10 µg/m³ increases in pollutant levels adjusted for temperature and humidity, Wuhan, 2006–2008.</p

The association of stroke admissions and air pollutants in cold (winter and spring) and warm (summer and fall) seasons for 10 µg/m³ increases in pollutant level, adjusted for temperature and humidity, Wuhan, 2006–2008.

<p>The association of stroke admissions and air pollutants in cold (winter and spring) and warm (summer and fall) seasons for 10 µg/m³ increases in pollutant level, adjusted for temperature and humidity, Wuhan, 2006–2008.</p

Relationship between stroke and PM₁₀ and NO₂ concentrations in a two-pollutant model in the cold season for 10 µg/m³ increases in pollutant level, adjusted for temperature and humidity.

<p>Relationship between stroke and PM₁₀ and NO₂ concentrations in a two-pollutant model in the cold season for 10 µg/m³ increases in pollutant level, adjusted for temperature and humidity.</p

Ambient air pollution concentrations and meteorological parameters in Wuhan, 2006–2008.

*<p>Q1, first quartile value; Q3, third quartile value.</p>†<p>There are significant differences in PM₁₀, NO₂, SO₂ concentration in summer/fall and winter/spring, Wilcoxon test <i>P</i><0.001.</p