Reproductive outcomes among former Love Canal residents, Niagara Falls, New York.

Love Canal, located in Niagara Falls, NY, and among the earliest and most significant hazardous waste sites in the United States, first came to public attention in 1978. In this study, researchers evaluated 1,799 live births from 1960 through 1996 to 980 women who formerly lived in the Love Canal Emergency Declaration Area and were of reproductive age sometime during that time period. Using Upstate New York and Niagara County as external comparison populations, standardized incidence ratios with 95% confidence intervals were calculated for low birth weight, preterm birth, small for gestational age, and congenital malformations, and unadjusted proportions of male to female births were calculated. Internal comparisons among the infants were also performed according to several measures of potential exposure using generalized estimating equations. The results indicated a statistically significant elevated risk of preterm birth among children born on the Love Canal prior to the time of evacuation and relocation of residents from the Emergency Declaration Area, using Upstate New York as the standard population (standardized incidence ratio=1.40; 95% confidence interval: 1.01, 1.90). Additionally, the ratio of male to female births was lower for children conceived in the Emergency Declaration Area (sex ratio=0.94 versus sex ratio=1.05 in the standard population) and the frequency of congenital malformations was greater than expected among Love Canal boys born from 1983 to 1996 (standardized incidence ratio=1.50 when compared to Upstate New York), although in both cases the 95% confidence interval included the null value. Finally, increased risk for low birth weight infants among mothers who lived closest to the Canal as children was found (odds ratio=4.68; 95% confidence interval: 1.24, 17.66), but this estimate was limited due to small numbers (n=4). The study adds to the knowledge of the possible reproductive effects from exposure to chemicals arising from hazardous waste; however, given the small number of some events, the qualitative nature of the exposure assessment, and possibility of spurious associations due to multiple comparisons, the findings should be interpreted cautiously.

Concentrations of selected organochlorines and chlorobenzenes in the serum of former Love Canal residents, Niagara Falls, New York.

BACKGROUND: Love Canal, in Niagara Falls, NY is among the earliest and most significant hazardous waste sites in the USA, but no study has ever measured chemical body burdens in nearby residents to document that human exposure occurred. This study measured concentrations of selected organochlorines and chlorinated benzenes in archived serum samples collected from former Love Canal residents. METHODS: We analyzed serum samples collected from 373 former residents in 1978-1979 for compounds disposed of at Love Canal, and we compared their concentrations according to surrogate indicators of exposure such as residential proximity, adjusting for potential confounders. RESULTS: Three compounds were detectable in the serum of most participants: 1,2,4-trichlorobenzene (1,2,4-TCB), beta-hexachlorocyclohexane (beta-HCH) and 1,2-dichlorobenzene (1,2-DCB). Concentrations of 1,2,4-TCB and 1,2-DCB were 2-14 times greater among persons who at the time their blood was collected lived closest to the Canal compared to those living further away. We found no consistent trends for beta-HCH with respect to any exposure definition. CONCLUSIONS: These results provide evidence that residential proximity to Love Canal contributed to the body burden of certain contaminants, and helps validate the use of surrogate exposure measures in health effect studies. Further surveillance of the Love Canal cohort is warranted.

Growth of infants' length, weight, head and arm circumferences in relation to low levels of blood lead measured serially.

To determine whether levels of blood lead during gestation and infancy that are below the CDC action level of 10 microg/dl affect infant growth, we studied 211 disadvantaged mother-infant pairs from Albany, NY. Mothers' lead levels were low (second trimester chi = 2.8 microg/dl) as were infants' (chi = 3.3 microg/dl at 6 months; 6.4 microg/dl at 12 months). Multiple linear regression analyses showed that second trimester lead levels were related to reduced head circumference at 6 and 12 months. Infants of mothers with second trimester lead at or above the median (>or=3 microg/dl) exhibited negative associations between blood lead and head circumference at 6 and 12 months, and with weight-for-age, weight-for-length, and upper arm circumference at 6 months, but those below the median did not. Infants' 6-month lead level was related to head circumference at 12 months in the total sample, and in the subsample of infants whose blood lead was above the infants' 6-month blood lead median. Infants were also grouped by changes in their relative blood lead status, that is, above vs. below the median, from second trimester to 12 months of age. Infants whose lead levels changed from above to below the median were larger than infants whose lead levels went from below to above the median. The results suggest that lead may affect some dimensions of infant growth at levels below 10 microg/dl, but effects of lead levels less than 3 microg/dl are not evident in this sample.

Maternal blood lead concentration, diet during pregnancy, and anthropometry predict neonatal blood lead in a socioeconomically disadvantaged population.

To determine the influences of maternal diet and nutrition during pregnancy on the blood lead level of neonates, we conducted a study of mother-infant pairs from lower socioeconomic circumstances living in Albany County, New York. Maternal blood lead (MBPb), anthropometry, and diet were assessed in each trimester. Neonates' blood lead (NBPb) levels were low (geometric mean = 1.58 micro g/dL), and none had elevated blood lead. More than 50% of the mothers had intakes below the recommended dietary allowances for zinc, calcium, iron, vitamin D, and kilocalories. As expected, MBPb was strongly and positively related to NBPb. Among the anthropometric measures of maternal nutritional status, variables measuring gain in weight and arm circumference were negatively related to NBPb. In multivariable models reflecting different analytic strageties and including MBPb, anthropometry, and sociodemographic characteristics, dietary intakes of iron and vitamin D were negatively related to NBPb. The effect of zinc varied substantially depending on model covariates. Effects of dietary constituents are difficult to distinguish, given the intercorrelated nature of nutrients in the diet. Nevertheless, the influences of maternal anthropometric variables, iron, and vitamin D on neonatal lead levels are clear in our analyses.

Watercraft-related drownings among New York State residents, 1988-1994.

OBJECTIVE: To describe environmental and personal risk factors associated with watercraft-related drownings. This information may be useful in developing boating safety programs, regulations, and enforcement priorities. METHODS: A companion article in this issue (Unintentional Drownings Among New York State Residents, page 448) summarizes an investigation of 883 non-bathtub drownings among New York State residents for the years 1988 to 1994 using medical examiner, coroner, police, and hospital records in addition to death certificate data. This report details the environmental and personal risk factors associated with 216 watercraft-related drownings. RESULTS: Ninety-three percent of watercraft-related drowning victims were male, with the highest rate of drowning observed among males ages 15-44 years. Most commonly, the victim entered the water when the watercraft capsized (36%), the victim fell overboard (24%), or the victim intended to swim (11%). Personal flotation devices (PFDs) were known to be worn by only 9% of drowning victims, and in these cases other risks overwhelmed the effectiveness of the PFD. Of 73 individuals 15 years of age or older for whom adequate blood alcohol concentration analyses were provided, 44% were positive for blood alcohol. CONCLUSIONS: Based on this study, increased use of PFDs, avoidance of dangerous currents, and less alcohol use by operators and passengers of all types of watercraft would result in a reduction in watercraft-related drownings. In addition to continued education efforts, boating safety measures that deserve consideration include enforcement of current PFD and boating while intoxicated (BWI) regulations and expansion of BWI laws to apply to all boaters.

Unintentional drownings among New York State residents, 1988-1994.

OBJECTIVE: This study examines situations in which drownings occur (environmental risk factors) and the victims' personal risk factors (age, gender, use of personal flotation device, medical condition, alcohol or drug use) to provide guidance for future drowning prevention efforts. METHODS: The authors investigated 883 non-bathtub drownings among New York State residents for the years 1988 to 1994 using medical examiner, coroner, police, and/or hospital records in addition to death certificate data. RESULTS: Males, children ages 0-4 years, and African American males ages 5-14 years residing in New York State outside New York City experienced the highest rates of drowning. The majority of drownings occurred in a natural body of water for all age groups, with the exception of children ages 0-4 years. Most drownings among children ages 0-4 years occurred in residential swimming pools. The child usually gained access to the pool via inadequate fencing, an open or ineffective gate, or a ladder (to an above-ground pool) left in the "down" position. Less than 10% of victims of watercraft-related drownings were wearing personal flotation devices. Blood alcohol concentration (BAC) tests were positive for 44% of 250 persons 15 years of age and older for whom valid toxicology results were provided; 30% had BACs of 100 mg/dl or more. CONCLUSIONS: Suggested prevention efforts include stricter enforcement of fencing requirements for residential swimming pools and drowning prevention education stressing personal flotation device use while boating and the danger of mixing alcohol and water-related activities.

Mortality among a cohort of female farm residents in New York State.

A retrospective cohort study of mortality among 6,405 female farm residents who were New York Farm Bureau members, or spouses or relatives of members, was conducted from 1980 through 1993. Similar to previous findings for male farmers, the cohort experienced significantly lower mortality rates for all causes combined (including malignant neoplasms and cardiovascular disease), compared with rural nonfarm female residents. These findings suggest that farmers and farm residents of both genders have favorable habits with respect to several lifestyle factors. The results of this study were consistent with those from other studies of farm populations worldwide.

Cancer incidence among a cohort of female farm residents in New York State.

A retrospective cohort study of cancer incidence among 6,310 female farm residents who were New York Farm Bureau members, or members' spouses or relatives, was conducted from 1980 through 1993. Similar to the previous findings for New York State male farmers, the female farm resident cohort experienced significantly lower cancer rates for all cancers combined, and for lung cancer, compared with rural nonfarm female residents. In addition, significantly low rates for colorectal cancer and ovarian cancer were found among the female cohort members. Nonsignificant excesses were found for thyroid and liver cancers. The findings suggest that female farm residents in this cohort might have experienced some of the same cancer-protective factors as male farmers.

A study of the distribution of aluminium in human placental tissues based on alkaline solubilization with determination by electrothermal atomic absorption spectrometry.

Aluminium (Al) is a nonessential element known to induce neurotoxic effects, such as dialysis dementia, in patients on hemodialysis, with compromised kidney function. The role of Al in the progression of some neurodegenerative diseases, such as Alzheimer's disease (AD), is controversial, and remains unclear. The effects of Al on other vulnerable populations, such as fetuses and infants, have been infrequently studied. In the present study, Al has been measured in human placenta samples, comprising ∼160 each of placenta bodies, placenta membranes, and umbilical cords, using electrothermal atomic absorption spectrometry (ETAAS) after atmospheric pressure digestion with tetramethylammonium hydroxide (TMAH) and ethylenediaminetetraacidic acid (EDTA). The sensitivity, or characteristic mass (m(0)), for Al at the 309.3-nm line was found to be 30 ± 4 pg. The instrumental detection limit (IDL) (3s) for Al in solution was calculated as 0.72 µg L(-1) while the method detection limit (MDL) (3s) was 0.25 µg g(-1). Accuracy was assessed through analysis of quality control (QC) materials, including certified reference materials (CRMs), in-house reference materials (RMs), and spike recovery experiments, of varying matrices. Placental tissue analyses revealed geometric mean concentrations of approximately 0.5 µg g(-1) Al in placenta bodies (n = 165) and membranes (n = 155), while Al concentrations in umbilical cords (n = 154) were about 0.3 µg g(-1). Al was detected in 95% of placenta bodies, and 81% of placenta membranes, but only in 46% of umbilical cords.

Relationship between blood lead concentration and dietary intakes of infants from 3 to 12 months of age.

Data from a study of mother-infant pairs of low socioeconomic status living in Albany County, NY, were analyzed to determine the influence of diet and nutrition on the blood lead level of infants during the first year of life. Children's diets were assessed at 3-month intervals using a 24-h diet recall as reported by the primary caregiver. The potential impact of dietary consumption of protein, iron, zinc, calcium, vitamin D, and fat, as well as serum vitamin D and ferritin on blood lead levels at 6 and 12 months of age was examined with multivariable statistical analyses, controlling for other influences on lead levels. Neonates' blood lead levels were low at birth (geometric mean=1.6 microg/dL), and none were elevated (> or = 10 microg/dL). By 12 months, the mean blood lead for this sample was 5.1 microg/dL, and 18% of the sample had an elevated blood lead level. We observed significant inverse relationships between infants' 6-month lead level and their intake of zinc, iron, and calcium. At 12 months, low iron intake continued to be associated with higher lead levels, although zinc and calcium did not. Protein had a paradoxical effect, being associated with lower lead at 6 months, but higher lead at 12 months. Serum vitamin D and ferritin were not associated with lead levels, nor was vitamin supplement use. The results reported here emphasize the value of key minerals in the diet to reduce lead absorption during early infancy.

Longitudinal study of energy and nutrient intakes for infants from low-income, urban families.

OBJECTIVE: To assess the energy and nutrient intakes of healthy infants from low-income families and to compare intakes with current recommendations. DESIGN: We interviewed mother-infant pairs longitudinally when the infants were 3, 6, 9, 12, 18 and 24 months old. Food intake data were obtained by 24-hour dietary recalls. Selected nutrient intakes were calculated and compared with the Recommended Dietary Allowances (RDAs). SUBJECTS/SETTING: Infants were the offspring of low-income, pregnant women recruited at the Albany County Department of Health, New York for the Albany Pregnancy and Infancy Lead Study, a prospective investigation of factors related to blood lead levels, including nutrition. Interviews were conducted during paediatric clinic visits. STATISTICAL ANALYSES PERFORMED: Means and standard deviations were used to describe energy and micronutrient intakes for age groups. The probability approach was utilised to examine the prevalence of inadequate intakes. RESULTS: Mean energy and nutrient intakes generally met or exceeded the RDA. The exceptions were vitamin D and zinc for which observed means were below the RDA at several data points. Protein consumption was exceptionally high in this sample. The highest estimated prevalences of inadequate intakes were observed for iron, zinc and vitamin D at the older ages. CONCLUSIONS: This study identified several potential concerns about the diets of infants during the transition from infant food and formula to table foods. Low intakes of vitamin D, zinc and iron, especially at 12 and 18 months, were observed. High protein intakes were noted at all ages.

Investigation and reporting practices for drownings: implications for injury prevention research in new york state.

The New York State Department of Health conducted a study of drownings among New York State residents. A total of 883 drownings between 1988 and 1994 met study criteria. Medical examiner, coroner, police, and hospital records were obtained to supplement death certificate data. Although police reports were an important source of information, acquiring police records was labor intensive and time consuming and would be unnecessary if ME/Cs used standard death investigation guidelines and a uniform reporting form. The authors compared International Classification of Diseases-9 E codes listed on death certificates with information from supplementary data sources. Appropriate International Classification of Diseases-9 E codes were often not used in cases for which a specific code was available. In some cases, a code was assigned that failed to correctly reflect information provided on the death certificate. More frequently, the description provided by the medical examiner or coroner did not permit the use of a more specific code. The role of alcohol could not be assessed for 38% of drowning victims because toxicology testing was not performed, results were not made available by the medical examiner or coroner, or samples were collected 24 hours or more after the time of the drowning. Investigation and reporting practices that would benefit injury prevention research are suggested.

Prevalence and predictors of respiratory symptoms among New York farmers and farm residents.

BACKGROUND: Data from telephone interviews with New York farmers and farm residents were used to study the prevalence and risk factors of symptoms that could be related to asthma and allergies. METHODS: Participants were asked if they had wheezing or whistling in the chest in the past year and about the occurrence of stuffy, itchy, runny nose or watery, itchy eyes in the past year. RESULTS: The prevalence of wheeze was 18.2% and of stuffy nose/watery eyes was 57.4% (N = 1,620). Significant risk factors for wheeze were cigarette smoking, a systemic reaction to allergy skin testing, immunotherapy, or insect sting, reactivity to a pet, having goats, and more acreage in corn for silage. Significant risk factors of stuffy nose/watery eyes were younger age, having more than a high school education, being a worker on the farm, and having done spraying. CONCLUSIONS: Wheeze may be indicative of existing or latent asthma, a potentially limiting respiratory illness. Stuffy, itchy, runny nose or watery, itchy eyes, which may cause irritation and discomfort, may also indicate an increased sensitivity to respirable dusts and chemicals. This cohort of New York farmers had significant farm-related risk factors for wheeze and stuffy nose/watery eyes.

Increases leukemia, lymphoma, and spontaneous abortion in Western New York following a flood disaster

The New York State Department of Health was asked in September 1978 to investigate a cluster of leukemias and lymphomas in a rural town in western New York State of less than 1.000 people. Four cases of these diseases had been diagnosed in the town's population in the previous 10 months. Residents were concerned about environmental hazards such as background radiation and contamination of their water supply. A total environmental study of the area was not feasible or warranted, but certain environmental studies of the area were conducted. No environmental health hazards were identifird. Incidence rates for towns in the four-county area (population 281,000) surrounding the study town were analyzed, based on data from the New York State Cancer Registry. These four counties had been severely affected by the flood following the 1972 Hurricane Agnes. Examination of annual leukemia and lymphoma incidence rates for these counties for 1966-77 revealed that the rates for towns in the river valley (population 102,000), but not for nonriver-valley towns, were 20 to 50 percent above the statewide rates for 1972-77. All other cancer rates remained level throughout both periods. An analysis of spontaneous abortion rates for the four counties for 1968-77 showed a significant peak in 1973, but not for the rest of upstate New York. The peak was concentrated in the towns in the river valley. The apparent time-space cluster of leukemias and lymphomas in conjunction with a marked increase in the spontaneous abortion rate suggest an unidentified flood-related environmental exposure(AU)