85 research outputs found

    Science and Health Risks Research Since Love Canal

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    Racial and Socioeconomic Disparities in Melanoma Incidence Rates in Georgia: 2000-2011

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    Background: The objective of this research was to investigate melanoma incidence rates and health outcomes in Georgia over time and by race, socio-economic status (SES), and gender. Methods: Age-adjusted melanoma incidence rates were obtained from the Georgia Comprehensive Cancer Registry SEER*Stat Database (2000-2011). To compare incidence rates across counties, and public health districts and by race, SES and gender, maps were generated using Geographic Information Systems (GIS). A cluster analysis was performed by use of SaTScan, and maps were created to visualize clusters of melanoma cases. Results: In Georgia, from 2000-2011, age-adjusted incidence rates for melanoma were higher among Whites than Blacks (28.0 vs. 1.1 per 100,000 population). For both races, high rates were found to be associated with high SES. For Whites, high rates were concentrated in urban areas relative to Blacks in rural areas. Clusters of melanoma incident cases were found mainly in the north central region of Georgia. Conclusions: For Georgia, results for map comparisons are consistent with previous research findings that higher melanoma incidence rates are associated with high SES for Whites and, to a lesser extent, for Blacks. Melanoma interventions in Georgia should focus on urban White and rural Black at-risk populations, especially those with high SES

    Communicating serum chemical concentrations to study participants: follow up survey

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    <p>Abstract</p> <p>Background</p> <p>A considerable literature now supports the importance of effective communication with study participants, including how best to develop communication plans focusing on the uncertainty of health risks associated with particular environmental exposures. Strategies for communicating individual concentrations of environmental chemicals in human biological samples in the absence of clearly established safe or hazardous levels have been discussed from a conceptual basis and to a lesser extent from an empirical basis. We designed and evaluated an empirically based communication strategy for women of reproductive age who previously participated in a prospective study focusing on persistent environmental chemicals and reproductive outcomes.</p> <p>Methods</p> <p>A cohort of women followed from preconception through pregnancy or up to 12 menstrual cycles without pregnancy was given their individual serum concentrations for lead, dichloro-2,2-bis<it>p</it>-chlorophenyl ethylene, and select polychlorinated biphenyl congeners. Two versions of standardized letters were prepared depending upon women's exposure status, which was characterized as low or high. Letters included an introduction, individual concentrations, population reference values and guidance for minimizing future exposures. Participants were actively monitored for any questions or concerns following receipt of letters.</p> <p>Results</p> <p>Ninety-eight women were sent letters informing them of their individual concentrations to select study chemicals. None of the 89 (91%) participating women irrespective of exposure status contacted the research team with questions or concerns about communicated exposures despite an invitation to do so.</p> <p>Conclusions</p> <p>Our findings suggest that study participants can be informed about their individual serum concentrations without generating unnecessary concern.</p

    Spatial Environmental Modeling of Autoantibody Outcomes among an African American Population

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    In this study of autoimmunity among a population of Gullah African Americans in South Carolina, the links between environmental exposures and autoimmunity (presence of antinuclear antibodies (ANA)) have been assessed. The study population included patients with systemic lupus erythematosus (n = 10), their first degree relatives (n = 61), and unrelated controls (n = 9) where 47.5% (n = 38) were ANA positive. This paper presents the methodology used to model ANA status as a function of individual environmental influences, both self-reported and measured, while controlling for known autoimmunity risk factors. We have examined variable dimension reduction and selection methods in our approach. Following the dimension reduction and selection methods, we fit logistic spatial Bayesian models to explore the relationship between our outcome of interest and environmental exposures adjusting for personal variables. Our analysis also includes a validation “strip” where we have interpolated information from a specific geographic area for a subset of the study population that lives in that vicinity. Our results demonstrate that residential proximity to exposure site is important in this form of analysis. The use of a validation strip network demonstrated that even with small sample numbers some significant exposure-outcome relationships can be detected

    Temporal Trends in Cardiovascular Hospital Discharges Following a Mass Chlorine Exposure Event in Graniteville, South Carolina

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    Background: On January 6, 2005, a train derailed in Graniteville, South Carolina, releasing nearly 60,000 kg of toxic chlorine gas. The disaster left nine people dead and was responsible for hundreds of hospitalizations and outpatient visits in the subsequent weeks. While chlorine gas primarily affects the respiratory tract, a growing body of evidence suggests that acute exposure may also cause vascular injury and cardiac toxicity. Here, we describe the incidence of cardiovascular hospitalizations among residents of the zip codes most affected by the chlorine gas plume, and compare the incidence of cardiovascular discharges in the years leading up to the event (2000–2004) to the incidence in the years following the event (2005–2014). Methods: De-identified hospital discharge information was collected from the South Carolina Revenue and Fiscal Affairs Office for individuals residing in the selected zip codes for the years 2000 to 2014. A quasi-experimental study design was utilized with a population-level interrupted time series model to examine hospital discharge rates for Graniteville-area residents for three cardiovascular diagnoses: hypertension (HTN), acute myocardial infarction (AMI), and coronary heart disease (CHD). We used linear regression with autoregressive error correction to compare slopes for pre- and post-spill time periods. Data from the 2000 and 2010 censuses were used to calculate rates and to provide information on potential demographic shifts over the course of the study. Results: A significant increase in hypertension-related hospital discharge rates was observed for the years following the Graniteville chlorine spill (slope 8.2, p \u3c 0.001). Concurrent changes to CHD and AMI hospital discharge rates were in the opposite direction (slopes −3.2 and −0.3, p \u3c 0.01 and 0.14, respectively). Importantly, the observed trend cannot be attributed to an aging population. Conclusions: An unusual increase in hypertension-related hospital discharge rates in the area affected by the Graniteville chlorine spill contrasts with national and state-level trends. A number of factors related to the spill may be contributing the observation: disaster-induced hypertension, healthcare services access issues, and, possibly, chlorine-induced susceptibility to vascular pathologies. Due to the limitations of our data, we cannot determine whether the individuals who visited the hospital were the ones exposed to chlorine gas, however, the finding warrants additional research. Future studies are needed to determine the etiology of the increase and whether individuals exposed to chlorine are at a heightened risk for hypertensive heart disease

    Cardiorespiratory Fitness as a Predictor of Fatal and Nonfatal Stroke in Asymptomatic Women and Men

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    Background and Purpose - Prospective data on the association between cardiorespiratory fitness (CRF) and stroke are largely limited to studies in men or do not separately examine risks for fatal and nonfatal stroke. This study examined the association between CRF and fatal and nonfatal stroke in a large cohort of asymptomatic women and men. Methods - A total of 46,405 men and 15,282 women without known myocardial infarction or stroke at baseline completed a maximal treadmill exercise test between 1970 and 2001. CRF was grouped as quartiles of the sex-specific distribution of maximal metabolic equivalents achieved. Mortality follow-up was through December 31, 2003, using the National Death Index. Nonfatal stroke, defined as physician-diagnosed stroke, was ascertained from surveys during 1982 to 2004. Cox regression models quantified the pattern and magnitude of association between CRF and stroke. Results - There were 692 strokes during 813,944 man-years of exposure and 171 strokes during 248,902 woman-years of exposure. Significant inverse associations between CRF and age-adjusted fatal, nonfatal, and total stroke rates were observed for women and men (Ptrend≤0.05 each). After adjusting for several cardiovascular disease risk factors, the inverse association between CRF and each stroke outcome remained significant (Ptrend\u3c0.05 each) in men. In women, the multivariable-adjusted relationship between CRF and nonfatal and total stroke remained significant (Ptrend≤0.01 each), but not between CRF and fatal stroke (Ptrend=0.18). A CRF threshold of 7 to 8 maximal metabolic equivalents was associated with a substantially reduced rate of total stroke in both men and women. Conclusions - These findings suggest that CRF is an independent determinant of stroke incidence in initially asymptomatic and cardiovascular disease-free adults, and the strength and pattern of the association is similar for men and women

    Validation of the Actical Activity Monitor in Middle-Aged and Older Adults

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    Purpose: This study was designed to validate the Actical activity monitor in middle-aged and older adults of varying body composition to develop accelerometer thresholds to distinguish between light and moderate intensity physical activity (PA). Methods: Nonobese 45 to 64 yr (N = 29), obese 45 to 64 yr (N = 21), and ≥65 yr (N = 23; varying body composition) participants completed laboratory-based sitting, household, and locomotive activities while wearing an Actical monitor and a portable metabolic measurement system. Non-linear regression analysis was used to identify activity count (AC) cut-points to differentiate between light intensity (\u3c3 METs) and moderate intensity (≥3 METs) PA. Results: Using group-specific algorithms, AC cut points for 3 METs were 1634, 1107, and 431 for the obese 45 to 64 yr group, nonobese 45 to 64 yr group, and ≥65 yr group, respectively. However, sensitivity and specificity analysis revealed that an AC cut-point of 1065 yielded similar accuracy for detecting an activity as less than or greater than 3 METs, regardless of age and body composition. Conclusion: For the Actical activity monitor, an AC cut-point of 1065 can be used to determine light and moderate intensity PA in people ≥45 years of age
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