51 research outputs found

    Relative performance of different exposure modeling approaches for sulfur dioxide concentrations in the air in rural western Canada

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    <p>Abstract</p> <p>Background</p> <p>The main objective of this paper is to compare different methods for predicting the levels of SO<sub>2 </sub>air pollution in oil and gas producing area of rural western Canada. Month-long average air quality measurements were collected over a two-year period (2001–2002) at multiple locations, with some side-by-side measurements, and repeated time-series at selected locations.</p> <p>Methods</p> <p>We explored how accurately location-specific mean concentrations of SO<sub>2 </sub>can be predicted for 2002 at 666 locations with multiple measurements. Means of repeated measurements on the 666 locations in 2002 were used as the alloyed gold standard (AGS). First, we considered two approaches: one that uses one measurement from each location of interest; and the other that uses context data on proximity of monitoring sites to putative sources of emission in 2002. Second, we imagined that all of the previous year's (2001's) data were also available to exposure assessors: 9,464 measurements and their context (month, proximity to sources). Exposure prediction approaches we explored with the 2001 data included regression modeling using either mixed or fixed effects models. Third, we used Bayesian methods to combine single measurements from locations in 2002 (not used to calculate AGS) with different <it>priors</it>.</p> <p>Results</p> <p>The regression method that included both fixed and random effects for prediction (Best Linear Unbiased Predictor) had the best agreement with the AGS (Pearson correlation 0.77) and the smallest mean squared error (MSE: 0.03). The second best method in terms of correlation with AGS (0.74) and MSE (0.09) was the Bayesian method that uses normal mixture <it>prior </it>derived from predictions of the 2001 mixed effects applied in the 2002 context.</p> <p>Conclusion</p> <p>It is likely that either collecting some measurements from the desired locations and time periods or predictions of a reasonable empirical mixed effects model perhaps is sufficient in most epidemiological applications. The method to be used in any specific investigation will depend on how much uncertainty can be tolerated in exposure assessment and how closely available data matches circumstances for which estimates/predictions are required.</p

    The Role of Genotypes That Modify the Toxicity of Chemical Mutagens in the Risk for Myeloproliferative Neoplasms

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    Background: The etiology of myeloproliferative neoplasms (MPN) (polycythemia vera; essential thrombocythemia; primary myelofibrosis) is unknown, however they are associated with a somatic mutation—JAK2 V617F—suggesting a potential role for environmental mutagens. Methods: We conducted a population-based case-control study in three rural Pennsylvania counties of persons born 1921–1968 and residing in the area between 2000–2008. Twenty seven MPN cases and 292 controls were recruited through random digit dialing. Subjects were genotyped and odds ratios estimated for a select set of polymorphisms in environmentally sensitive genes that might implicate specific environmental mutagens if found to be associated with a disease. Results: The presence of NAT2 slow acetylator genotype, and CYP1A2, GSTA1, and GSTM3 variants were associated with an average 3–5 fold increased risk. Conclusions: Exposures, such as to aromatic compounds, whose toxicity is modified by genotypes associated with outcome in our analysis may play a role in the environmental etiology of MPNs

    What to Do When Accumulated Exposure Affects Health but Only Its Duration Was Measured? A Case of Linear Regression

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    Background: We considered a problem of inference in epidemiology when cumulative exposure is the true dose metric for disease, but investigators are only able to measure its duration on each subject. Methods: We undertook theoretical analysis of the problem in the context of a continuous response caused by cumulative exposure, when duration and intensity of exposure follow log-normal distributions, such that analysis by linear regression is natural. We present a Bayesian method to adjust duration-only analysis to incorporate partial knowledge about the relationship between duration and intensity of exposure and illustrate this method in the context of association of smoking and lung function. Results: We derive equations that (a) describe under what circumstances bias arises when duration of exposure is used as a proxy of cumulative exposure, (b) quantify the degree of such bias and loss of precision, and (c) describe how knowledge about relationship of duration and intensity of exposure can be used to recover an estimate of the effect of cumulative exposure when only duration was observed on every subject. Conclusions: Under our assumptions, when duration and intensity of exposure are either independent or positively correlated, we can be more confident in qualitatively interpreting the direction of effects that arise from use of duration of exposure per se. We can use external information on the relationship between duration and intensity of exposure (namely: correlation and variance of intensity), even if intensity of exposure is not available at the individual level, to make reliable inferences about the magnitude of effect of cumulative exposure on the outcome

    Using an epiphytic moss to identify previously unknown sources of atmospheric cadmium pollution

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    Urban networks of air-quality monitors are often too widely spaced to identify sources of air pollutants, especially if they do not disperse far from emission sources. The objectives of this study were to test the use of moss bioindicators to develop a fine-scale map of atmospherically-derived cadmium and to identify the sources of cadmium in a complex urban setting.We collected 346 samples of the moss Orthotrichum lyellii from deciduous trees in December, 2013 using a modified randomized grid-based sampling strategy across Portland, Oregon.We estimated a spatial linear model of moss cadmium levels and predicted cadmium on a 50 m grid across the city. Cadmium levels in moss were positively correlated with proximity to two stained-glass manufacturers, proximity to the Oregon– Washington border, and percent industrial land in a 500 m buffer, and negatively correlated with percent residential land in a 500 m buffer. The maps showed very high concentrations of cadmium around the two stained-glass manufacturers, neither of which were known to environmental regulators as cadmium emitters. In addition, in response to our findings, the Oregon Department of Environmental Quality placed an instrumental monitor 120 m from the larger stained-glass manufacturer in October, 2015. The monthly average atmospheric cadmium concentration was 29.4 ng/m3,which is 49 times higher than Oregon\u27s benchmark of 0.6 ng/m3, and high enough to pose a health risk from even short-term exposure. Both stained-glass manufacturers voluntarily stopped using cadmium after the monitoring results were made public, and the monthly average cadmium levels precipitously dropped to 1.1 ng/m3 for stained-glass manufacturer #1 and 0.67 ng/m3 for stained-glass manufacturer #2

    A Case–Control Study of Lung Cancer Nested in a Cohort of European Asphalt Workers

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    BACKGROUND: We conducted a nested case-control study in a cohort of European asphalt workers in which an increase in lung cancer risk has been reported among workers exposed to airborne bitumen fume, although potential bias and confounding were not fully addressed. OBJECTIVE: We investigated the contribution of exposure to bitumen, other occupational agents, and tobacco smoking to the risk of lung cancer among asphalt workers. METHODS: Cases were cohort members in Denmark, Finland, France, Germany, the Netherlands, Norway, and Israel who had died of lung cancer between 1980 and the end of follow-up (2002-2005). Controls were individually matched in a 3:1 ratio to cases on year of birth and country. We derived exposure estimates for bitumen fume and condensate, organic vapor, and polycyclic aromatic hydrocarbons, as well as for asbestos, crystalline silica, diesel motor exhaust, and coal tar. Odds ratios (ORs) were calculated for ever-exposure, duration, average exposure, and cumulative exposure after adjusting for tobacco smoking and exposure to coal tar. RESULTS: A total of 433 cases and 1,253 controls were included in the analysis. The OR was 1.12 [95% confidence interval (CI), 0.84-1.49] for inhalation exposure to bitumen fume and 1.17 (95% CI, 0.88-1.56) for dermal exposure to bitumen condensate. No significant trend was observed between lung cancer risk and duration, average exposure, or cumulative exposure to bitumen fume or condensate. CONCLUSIONS: We found no consistent evidence of an association between indicators of either inhalation or dermal exposure to bitumen and lung cancer risk. A sizable proportion of the excess mortality from lung cancer relative to the general population observed in the earlier cohort phase is likely attributable to high tobacco consumption and possibly to coal tar exposure, whereas other occupational agents do not appear to play an important role

    "Che tempo fa?" Indagine sul grado di Soddisfazione dei servizi offerti dal Centro Basaglia: l'opinione dei pazienti.

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    Studio costituito da una prima parte nella quale viene presentata l’evoluzione storica del Sistema Sanitario Nazionale italiano presentando successivamente i piani sanitari odierni in materia di salute mentale; l’importanza della valutazione della soddisfazione del servizio in salute mentale per migliorare la qualità di vita degli utenti apprendendo l’evoluzione dello stesso concetto e della sua importanza. Nella seconda parte della tesi verrà descritto nello specifico la rete dei servizi nel settore della salute mentale svolte sul territorio pisano con un attenzione particolare al Centro Basaglia, luogo in cui è stato possibile raccogliere i dati a testimonianza di tale ricerca
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