The association between oil spill cleanup-related total hydrocarbon exposure and diabetes.

BACKGROUND: Although evidence suggests relationships between some crude oil components and glycemic dysregulation, no studies have examined oil spill-related chemical exposures in relation to type 2 diabetes mellitus (DM) risk. This study examined the relationship between total hydrocarbon (THC) exposure among workers involved in the 2010 Deepwater Horizon (DWH) oil spill and risk of DM up to 6 years afterward. METHODS: Participants comprised 2660 oil-spill cleanup or response workers in the prospective GuLF Study who completed a clinical exam and had no self-reported DM diagnosis prior to the spill. Maximum THC exposure was estimated with a job-exposure matrix based on interview data and personal measurements taken during cleanup operations. We defined incident DM by self-reported physician diagnosis of DM, antidiabetic medication use, or a measured hemoglobin A1c value ≥ 6.5%. We used log binomial regression to estimate risk ratios (RRs) for DM across ordinal categories of THC exposure. The fully adjusted model controlled for age, sex, race/ethnicity, education, employment status, and health insurance status. We also stratified on clinical body mass index categories. RESULTS: We observed an exposure-response relationship between maximum daily ordinal THC exposure level and incident DM, especially among overweight participants. RRs among overweight participants were 0.99 (95% CI: 0.37, 2.69), 1.46 (95% CI: 0.54, 3.92), and 2.11 (95% CI: 0.78, 5.74) for exposure categories 0.30-0.99 ppm, 1.00-2.99 ppm, and ≥3.00 ppm, respectively (ptrend = 0.03). CONCLUSION: We observed suggestively increasing DM risk with increasing THC exposure level among overweight participants, but not among normal weight or obese participants.

Data Linkages for Wildfire Exposures and Human Health Studies: A Scoping Review.

Wildfires are increasing in frequency and intensity, with significant consequences that impact human health. A scoping review was conducted to: (a) understand wildfire-related health effects, (b) identify and describe environmental exposure and health outcome data sources used to research the impacts of wildfire exposures on health, and (c) identify gaps and opportunities to leverage exposure and health data to advance research. A literature search was conducted in PubMed and a sample of 83 articles met inclusion criteria. A majority of studies focused on respiratory and cardiovascular outcomes. Hospital administrative data was the most common health data source, followed by government data sources and health surveys. Wildfire smoke, specifically fine particulate matter (PM2.5), was the most common exposure measure and was predominantly estimated from monitoring networks and satellite data. Health data were not available in real-time, and they lacked spatial and temporal coverage to study health outcomes with longer latency periods. Exposure data were often available in real-time and provided better temporal and spatial coverage but did not capture the complex mixture of hazardous wildfire smoke pollutants nor exposures associated with non-air pathways such as soil, household dust, food, and water. This scoping review of the specific health and exposure data sources used to underpin these studies provides a framework for the research community to understand: (a) the use and value of various environmental and health data sources, and (b) the opportunities for improving data collection, integration, and accessibility to help inform our understanding of wildfires and other environmental exposures.

Pregnancy and perinatal health in Inner Mongolia, China, 1996-1999.

OBJECTIVE: To obtain descriptive measures of maternal and perinatal health in the Ba Men Region of Inner Mongolia, China. METHODS: Data collected from the Examination Chart for Pregnant Women for approximately 22,000 pregnancies in a three-county area of Inner Mongolia, China from December 1, 1996 through December 31, 1999 were analyzed for maternal, perinatal, and neonatal outcomes. RESULTS: Compared to selected developing countries, a higher percentage of women (99%) in this region received at least one prenatal care visit. This region was also characterized by a low percentage of low birthweight (<2.5 kg) infants (1%) and neonatal mortality rate (5 deaths per 1000 live births). CONCLUSIONS: Maternal and neonatal health outcomes in this region of Inner Mongolia were better than those in selected developing countries.

The use of census data for determining race and education as SES indicators: a validation study.

PURPOSE: Little research has examined the validity of using census data to determine an individual's socio-economic status (SES), as measured by race and educational level. This study assessed the accuracy of using aggregate level data from United States Census Block Groups in determining race and education SES indicators in a cohort of women from North Carolina. METHODS: The study analyzed patient data from the Carolina Mammography Registry and 1990 United States Census in 21 North Carolina counties. Women (n = 39,546) were geocoded to their census block group and their block group characteristics (surrogate measures) were validated with their self-reported values on race and education. An analysis was performed to explore whether using these surrogate measures would affect measured associations with the self-reported values. RESULTS: Whites were accurately identified (84.8%) more consistently than Blacks (14.1%) regardless of their urban/rural status. Women without a high school diploma or equivalent were accurately identified (56.2%) more often than those with higher education levels (45.9%). Analyses using the surrogate measures were significantly different than the true values according to chi-square statistics. CONCLUSIONS: Use of census data to derive SES indicators tends to be more accurate for the majority than the minority population. Researchers must be sensitive to the ecologic fallacy when using aggregate level data such as the census to determine individual level characteristics.

DNA damage in buccal epithelial cells from individuals chronically exposed to arsenic via drinking water in Inner Mongolia, China.

The purpose of this pilot study was to assess DNA damage in buccal cells from individuals chronically exposed to arsenic via drinking water in Ba Men, Inner Mongolia. Buccal cells were collected from 19 Ba Men residents exposed to arsenic at 527.5 +/- 23.7 micrograms/L (mean +/- SEM) and 13 controls exposed to arsenic at 4.4 +/- 1.0 micrograms/L. DNA fragmentation by the DNA ladder and TUNEL assay were used to detect DNA damage in buccal cells. In the DNA ladder assay, 89% (17/19) of the arsenic-exposed group showed < 100 bp DNA fragments, in contrast to 15% (2/13) of the controls (p < 0.0001). For the TUNEL assay, the mean frequencies of positive cells were higher in the exposed group (15.1%) than in the controls (2.0%) (p < 0.0001). This study showed that high arsenic exposure via drinking water resulted in DNA damage and DNA fragmentation in buccal cells thus may be an appropriate biomarker for assessing chronic effects of arsenic in humans. A study investigating DNA fragmentation from the individuals with low levels of arsenic exposure in this population is in progress.

Comparison of woman-specific versus breast-specific data for reporting screening mammography performance.

RATIONALE AND OBJECTIVES: Screening mammography data can be reported on a breast-specific or woman-specific level, and much mammography data available for research is woman-specific. The purpose of this study was to determine if woman-specific screening mammography data are sufficient for research and reporting by measuring and comparing the accuracy of screening mammography on a breast-specific and on a woman-specific level. MATERIALS AND METHODS: Definitions for true-positive and false-positive mammography results were developed to distinguish between breast-specific and woman-specific calculations. The sensitivity, specificity, and positive predictive values of screening mammography were calculated on a breast-specific and on a woman-specific basis for the entire population of the Carolina Mammography Registry and for a randomly selected subset of the population. RESULTS: Only small differences were found in breast-specific versus woman-specific calculations of sensitivity, specificity, and positive predictive values for both the entire population and the smaller subset population. For both populations, woman-specific sensitivity and positive predictive values were slightly higher than the same breast-specific values, and woman-specific specificity was slightly lower. CONCLUSION: For research and reporting, woman-specific data are sufficient.

Moyamoya disease in Singapore.

A retrospective survey of 38 cases of Moyamoya disease was done. The majority of patients were adults, and Chinese. There was a relative paucity of juveniles in our series which appear to differentiate it from Japanese results. The majority of adults presented with either subarachnoid haemorrhage or motor paresis. Associated aneurysms were noted in 3 cases. This study represents one of the largest series of this condition published outside Japan and appears to confirm the belief that this is not a condition peculiar to the Japanese and may occur more commonly outside Japan than is commonly believed.

Thoracic skeletal abnormalities in young men with mitral valve prolapse.

Young National Servicemen were screened for cardiac murmurs and 74 cases of mitral valve prolapse were diagnosed. PA and lateral Chest X-rays were taken. 18% of the subjects had straight back, 24% had scoliosis, 38% had sternal abnormalities while 58% had one or more thoracic skeletal deformities. Comparisons were made with other series. Four radiographic measurements (AP diameter, AP/transthoracic ratio, vertebral index and angle of kyphosis) done differed significantly from the normal population. These measurements were also compared with foreign series. There were 2 cases with 'pancake' appearance of the heart. The significance and aetiology of this association is discussed. Mitral valve prolapse should be excluded in patients with thoracic skeletal abnormalities, especially those presenting with cardiac murmurs.

Maternal drinking water arsenic exposure and perinatal outcomes in inner Mongolia, China.

BACKGROUND: Bayingnormen is a region located in western Inner Mongolia China, with a population that is exposed to a wide range of drinking water arsenic concentrations. The relationship between maternal drinking water arsenic exposure and perinatal endpoints (term birth weight, preterm birth, stillbirth and neonatal death) in this region was evaluated in this study. METHODS: An analysis was conducted of all singleton deliveries in a defined geographical area of Inner Mongolia from December 1996 to December 1999 (n=9890). Outcome and covariate data were abstracted from prenatal care records. Exposure was based on well-water measures for the maternal subvillage. Mean birth weight at term was compared across four arsenic categories using analysis of covariance. ORs for stillbirth, preterm birth and neonatal death were estimated by logistic regression with arsenic exposure dichotomised at 50 microg/l. RESULTS: Term birth weight was 0.05 kg higher (95% CI 0.02 to 0.08) in the highest exposure category (>100 microg/l) compared to the reference (below limit of detection to 20 microg/l). Arsenic >50 microg/l was associated with an increased risk of neonatal death (OR 2.01, 95% CI 1.12 to 3.59). No relationship was found between maternal arsenic exposure and preterm or stillbirth delivery. CONCLUSIONS: At the levels observed in our study, arsenic does not appear to contribute to adverse birth outcomes. Exposure may play a role in neonatal death; however, the neonatal death rate in this population was low and this potential association merits further research.