Probabilistic risk assessment of residential exposure to metal(loid)s in a mining impacted community.

The "Gold Country" region of California is impacted by legacy and active gold mines. Concomitantly, Gold Country has an increased rate of female breast cancer relative to the state average. Using community-based participatory research methods, 40 participants completed surveys and collected a total of 354 water, soil, home-grown foods, and dust samples from their homes, which we compared to state, federal, and international contamination standards for arsenic, cadmium, and lead. All soil samples exceeded U.S. EPA and California EPA soil standards for arsenic. When comparing other media to state, federal and international standards for arsenic, cadmium, and lead, 15 additional exceedances for indoor/outdoor dust, drinking water, and/or vegetable were documented. A probabilistic risk assessment was conducted to determine an adult female's exposure to arsenic, cadmium, and lead and estimated risk. Arsenic exposure, due largely to water (63.5 %) and homegrown food (33.3 %), presents carcinogenic risks in excess of the EPA recommended upper limit for contaminated sites (1 × 10-4) in 12.5 % of scenarios, and exceeds a risk level of 1 × 10-6 in 98.0 % of cases. Cadmium exposure results mainly from homegrown food consumption (83.7 %), and lead exposure results from a broader range of sources. This research indicates that rural areas in Gold Country face environmental exposures different than in urban areas. Exposure to arsenic in the female population of Gold Country may be driven by consumption of home-grown foods and water, and exposure to cadmium is driven by home-grown food intake. Since mining sites are of concern internationally, this risk assessment process and associated findings are significant and can be used to inform and tailor public health interventions. The weight of the evidence suggests that the arsenic exposure identified in this study could contribute to increases in the cancer rate among those living in Gold Country, California.

Impact of Social and Built Environment Factors on Body Size among Breast Cancer Survivors: The Pathways Study.

Background: As social and built environment factors have been shown to be associated with physical activity, dietary patterns, and obesity in the general population, they likely also influence these health behaviors among cancer survivors and thereby impact survivorship outcomes.Methods: Enhancing the rich, individual-level survey and medical record data from 4,505 breast cancer survivors in the Pathways Study, a prospective cohort drawn from Kaiser Permanente Northern California, we geocoded baseline residential addresses and appended social and built environment data. With multinomial logistic models, we examined associations between neighborhood characteristics and body mass index and whether neighborhood factors explained racial/ethnic/nativity disparities in overweight/obesity.Results: Low neighborhood socioeconomic status, high minority composition, high traffic density, high prevalence of commuting by car, and a higher number of fast food restaurants were independently associated with higher odds of overweight or obesity. The higher odds of overweight among African Americans, U.S.-born Asian Americans/Pacific Islanders, and foreign-born Hispanics and the higher odds of obesity among African Americans and U.S.-born Hispanics, compared with non-Hispanic whites, remained significant, although somewhat attenuated, when accounting for social and built environment features.Conclusions: Addressing aspects of neighborhood environments may help breast cancer survivors maintain a healthy body weight.Impact: Further research in this area, such as incorporating data on individuals' perceptions and use of their neighborhood environments, is needed to ultimately inform multilevel interventions that would ameliorate such disparities and improve outcomes for breast cancer survivors, regardless of their social status (e.g., race/ethnicity, socioeconomic status, nativity). Cancer Epidemiol Biomarkers Prev; 26(4); 505-15. ©2017 AACRSee all the articles in this CEBP Focus section, "Geospatial Approaches to Cancer Control and Population Sciences."

Tracing a Path to the Past: Exploring the Use of Commercial Credit Reporting Data to Construct Residential Histories for Epidemiologic Studies of Environmental Exposures.

Large-scale environmental epidemiologic studies often rely on exposure estimates based on linkage to residential addresses. This approach, however, is limited by the lack of residential histories typically available for study participants. Our objective was to evaluate the feasibility of using address data from LexisNexis (a division of RELX, Inc., Dayton, Ohio), a commercially available credit reporting company, to construct residential histories for participants in the California Teachers Study (CTS), a prospective cohort study initiated in 1995-1996 to study breast cancer (n = 133,479). We evaluated the degree to which LexisNexis could provide retrospective addresses prior to study enrollment, as well as the concordance with existing prospective CTS addresses ascertained at the time of the completion of 4 self-administered questionnaires. For approximately 80% of CTS participants, LexisNexis provided at least 1 retrospective address, including nearly 25,000 addresses completely encompassed by time periods prior to enrollment. This approach more than doubled the proportion of the study population for whom we had an address of residence during the childbearing years-an important window of susceptibility for breast cancer risk. While overall concordance between the prospective addresses contained in these 2 data sources was good (85%), it was diminished among black women and women under the age of 40 years.

A cross-sectional analysis of light at night, neighborhood sociodemographics and urinary 6-sulfatoxymelatonin concentrations: implications for the conduct of health studies.

BACKGROUND: There is accumulating evidence that circadian disruption, mediated by alterations in melatonin levels, may play an etiologic role in a wide variety of diseases. The degree to which light-at-night (LAN) and other factors can alter melatonin levels is not well-documented. Our primary objective was to evaluate the degree to which estimates of outdoor environmental LAN predict 6-sulftoxymelatonin (aMT6s), the primary urinary metabolite of melatonin. We also evaluated other potential behavioral, sociodemographic, and anthropomorphic predictors of aMT6s. METHODS: Study participants consisted of 303 members of the California Teachers Study who provided a 24-hour urine specimen and completed a self-administered questionnaire in 2000. Urinary aMT6s was measured using the Bühlmann ELISA. Outdoor LAN levels were estimated from satellite imagery data obtained from the U.S. Defense Meteorological Satellite Program's (DMSP) Operational Linescan System and assigned to study participants' geocoded residential address. Information on other potential predictors of aMT6s was derived from self-administered surveys. Neighborhood socioeconomic status (SES) was based on U.S. Census block group data. RESULTS: Lower aMT6s levels were significantly associated with older age, shorter nights, and residential locations in lower SES neighborhoods. Outdoor sources of LAN estimated using low-dynamic range DMSP data had insufficient variability across urban neighborhoods to evaluate. While high-dynamic range DMSP offered much better variability, it was not significantly associated with urinary aMT6s. CONCLUSIONS: Future health studies should utilize the high-dynamic range DMSP data and should consider other potential sources of circadian disruption associated with living in lower SES neighborhoods.

An excess of breast cancer among young California-born Asian women.

OBJECTIVE: To compare breast cancer risk among young Asian and Pacific Islander (API) women to White women, all of whom were born in California during the 1960s. DESIGN: We used previously-collected data from a population-based case-control study in which breast cancer cases were linked to their California birth records. SETTING: California, US. PARTICIPANTS: Invasive breast cancer cases diagnosed 1988-2004 among women aged < 45 were identified from the population-based California Cancer Registry. Breast cancer cases (n = 3,799) were linked to their California birth records. Controls (n = 17,461) were randomly selected from California birth records for females, frequency matched to cases by birth year. MAIN OUTCOME MEASURES: Odds ratios (ORs) and 95% confidence intervals (95% CI) were estimated using logistic regression. RESULTS: Among young women born in California, API women had higher risks of breast cancer than Whites (OR = 1.62, 95% CI: 1.35-1.94). Among APIs, the risks were highest for women of Filipina (OR = 1.72, 95% Cl: 1.15-2.56) and Japanese ancestry (OR = 1.59, 95% Cl 1.20-2.10). CONCLUSIONS: Our finding of breast cancer risk among young API women who were born in California that exceeds that of young White women highlights the need for further evaluations of breast cancer risk among young API women and underscores the need to consider both ancestry and migration status in such evaluations.

Is house-dust nicotine a good surrogate for household smoking?

The literature is inconsistent regarding associations between parental smoking and childhood leukemia, possibly because previous studies used self-reported smoking habits as surrogates for children's true exposures to cigarette smoke. Here, the authors investigated the use of nicotine concentrations in house dust as measures of children's exposure to cigarette smoke in 469 households from the Northern California Childhood Leukemia Study (1999-2007). House dust was collected by using high-volume surface samplers and household vacuum cleaners and was analyzed for nicotine via gas chromatography-mass spectrometry. Using multivariable linear regression, the authors evaluated the effects of self-reported parental smoking, parental demographics, house characteristics, and other covariates on house-dust nicotine concentrations. They observed that nicotine concentrations in house dust were associated with self-reported smoking for periods of months and years before dust collection. Furthermore, the authors found that the relation between nicotine dust levels and self-reported smoking varied by parental age and socioeconomic status. These findings suggest that house-dust nicotine concentrations reflect long-term exposures to cigarette smoke in the home and that they may be less biased surrogates for children's exposures to cigarette smoke than self-reported smoking habits.

Dietary assessment in the California Teachers Study: reproducibility and validity.

OBJECTIVE: To evaluate the reproducibility and validity of the food-frequency questionnaire (FFQ) used in the California Teachers Study (CTS) cohort and to use this data to quantify the effects of correcting nutrient-breast cancer relative risks for measurement error. METHODS: One hundred and ninety five CTS cohort members participated in a 10-month dietary validation study that included four 24-h dietary recalls and pre- and post-study FFQs. Shrout-Fleiss intraclass correlations for reproducibility were computed. Under several standard assumptions concerning the correlations of errors in the FFQs and 24-h recalls, we calculated energy-adjusted deattenuated Pearson correlations for validity and tested for differences in validity according to a number of demographic and other risk factors. For each nutrient, we compared the performance of the FFQ versus the 24-h recalls, estimating the number of days of recalls that give equivalent information about true intake as does a single FFQ. Finally, the effects of adjustment for measurement error on risk estimates were evaluated in 44,423 postmenopausal cohort members, 1,544 of whom developed breast cancer during seven years of follow-up. Relative risks (RR) and confidence intervals (CI) were calculated using Cox proportional hazards with and without correction for measurement error. RESULTS: Reproducibility correlations for the nutrients ranged from 0.60 to 0.87. With a few exceptions, validity correlations were reasonably high (range: 0.55-0.85), including r = 0.74 for alcohol. Performance of the FFQ differed by age for percent of calories from fat and by body mass index and hormone therapy use for alcohol consumption. For most nutrients examined, our FFQ is comparable to two to six recalls for each subject in capturing true intake. In the measurement error-adjusted risk analyses, corrected RRs were within 13% of uncorrected values for all nutrients examined except for linoleic acid. For alcohol consumption the corrected RR (per 20 g/1,000 kcal/d) was 1.36 (95% CI: 1.03-1.51) compared to the uncorrected estimate of 1.25 (95% CI: 1.10-1.42). CONCLUSION: The FFQ dietary assessment used in the CTS is reproducible and valid for all nutrients except the unsaturated fatty acids. Correcting relative risk estimates for measurement error resulted in relatively small changes in the associations between the majority of nutrients and the risk of postmenopausal breast cancer.

Linkage of the California Pesticide Use Reporting Database with spatial land use data for exposure assessment.

BACKGROUND: The State of California maintains a comprehensive Pesticide Use Reporting Database (CPUR). The California Department of Water Resources (CDWR) maps all crops in agricultural counties in California about once every 5 years. OBJECTIVE: We integrated crop maps with CPUR to more accurately locate where pesticides are applied and evaluated the effects for exposure assessment. METHODS: We mapped 577 residences and used the CPUR and CDWR data to compute two exposure metrics based on putative pesticide use within a 500-m buffer. For the CPUR metric, we assigned pesticide exposure to the residence proportionally for all square-mile Sections that intersected the buffer. For the CDWR metric, we linked CPUR crop-specific pesticide use to crops mapped within the buffer and assigned pesticide exposure. We compared the metrics for six pesticides: simazine, trifluralin (herbicides), dicofol, propargite (insecticides), methyl bromide, and metam sodium (fumigants). RESULTS: For all six pesticides we found good agreement (88-98%) as to whether the pesticide use was predicted. When we restricted the analysis to residences with reported pesticide use in Sections within 500 m, agreement was greatly reduced (35-58%). The CPUR metric estimates of pesticide use within 500 m were significantly higher than the CDWR metric for all six pesticides. CONCLUSIONS: Our findings may have important implications for exposure classification in epidemiologic studies of agricultural pesticide use using CPUR. There is a need to conduct environmental and biological measurements to ascertain which, if any, of these metrics best represent exposure.

Reliability and validity of an assessment of usual phytoestrogen consumption (United States).

OBJECTIVE: To evaluate the reliability and validity of a food-frequency questionnaire (FFQ) and database designed to quantify phytoestrogen consumption. METHODS: This study included 195 members of the California Teachers Study (CTS) cohort who, over a 10-month period, completed four 24-h dietary recalls, a pre- and post-study FFQ, and provided two 24-h urine specimens. Participants (n = 106) in a parallel study (and 18 women who dropped out of the long-term study) completed a single recall and FFQ, and provided one 24-h urine specimen. Urinary phytoestrogens were determined using liquid chromatography-mass spectrometry. Reliability and validity were evaluated using Shrout-Fleiss intraclass correlations and energy-adjusted deattenuated Pearson correlations, respectively. RESULTS: Correlations reflecting the reproducibility of the FFQ phytoestrogen assessment ranged from 0.67 to 0.81. Validity correlations (FFQ compared to dietary recalls) ranged from 0.67 to 0.79 for the major phytoestrogenic compounds (i.e., daidzein, genistein, and secoisolariciresinol) and 0.43 to 0.54 for the less common compounds. Compared to urinary levels, validity correlations ranged from 0.41 to 0.55 for the isoflavones and 0.16 to 0.21 for total lignans. CONCLUSION: Our isoflavone assessment is reproducible, valid, and an excellent tool for evaluating the relationship with disease risk in non-Asian populations. Further research is needed before these tools can accurately be used to assess lignan consumption.

Traffic density in California: socioeconomic and ethnic differences among potentially exposed children.

Motor vehicles are the main source of many hazardous air pollutants in California. Previous studies have shown that low-income and minority populations are more likely to live near industrial sources of pollution and in areas that do not meet national air quality standards. We estimated neighborhood exposures to motor vehicle emissions from a road network with daily traffic counts using a geographic information system. To calculate traffic density, we summed the average daily vehicle miles of travel per square mile of land area for each census block group in the state. We used 1990 census data to characterize the population by age, race and socioeconomic status in block groups with high traffic density. Block groups with more than 500,000 vehicle miles of travel per square mile were defined to be high traffic density. Statewide, about 5% of all block groups met this criterion and more than 215,000 children under 15 years of age lived in these high traffic density areas. Block groups in the lowest quartile of median family income were three times more likely to have high traffic density than block groups in the highest income quartile. The percentage of children living in high traffic density block groups increased with decreasing median family income for all race and ethnicities except White. Overall, children of color were about three times more likely to live in high-traffic areas than were white children. Based on this analysis, low-income and children of color have higher potential exposure to vehicle emissions. Future exposure assessment studies should target the highest traffic density areas, and health studies should consider the differences by income and race or ethnicity during design.