Sex Differences in Electronic Cigarette Device Use Among College Students.

Electronic cigarette use (vaping) has reached epidemic levels in the United States among teenagers and young adults. However, there is a paucity of studies that have examined the relationships between e-cigarette device types and user characteristics. Therefore, the main objective of this study was to characterize e-cigarette device use among a college population with a focus on sex differences in preferred vaping device. We employed a Qualtrics-based smartphone/online survey to gather responses on e-cigarette use; including device type, demographics and other related information during the period October 1, 2020 to January 30, 2022 in the Birmingham, AL metropolitan area. Participants were recruited via flyers with a QR code to the survey. The differences in e-cigarette device type used by the characteristics of the university e-cigarette users were assessed using either a Chi-square analysis or Fisher's Test. The magnitude of any association between the characteristics of the participants and vaping device used was analyzed via logistic regression. Out of 394 students who participated in the survey, 61 reported current exclusive e-cigarette use (15.5%) among our 18-24-year-old college student sample. Among vapers; more females reported use of Disposable e-cigarettes or Juul (pod-type) as their primary vaping device compared to males, who preferred Tanks and Mods + other rechargeable e-cigarettes (p < 0.05). Males also vaped more days per week compared to females. Vaping among young college students remains at concerning levels. The primary vaping device used significantly varies by the users' sex, making it an important factor to consider in future studies.

Exposure to coal ash and depression in children aged 6-14 years old.

BACKGROUND: When coal is burned for energy, coal ash, a hazardous waste product, is generated. Throughout the world, over 1 billion tons of coal ash is produced yearly. In the United States, over 78 million tons of coal ash was produced in 2019. Fly ash, the main component of coal ash contains neurotoxic metal (loid)s that may affect children's neurodevelopment and mental health. The objective of this study was to investigate the association between fly ash and depressive problems in children aged 6-14 years old. METHODS: Children and their parents/guardians were recruited from 2015 to 2020. Tobit regression and logistic regression were used to assess the association between coal fly ash and depressive problems. To determine fly ash presence, Scanning Electron Microscopy was conducted on polycarbonate filters containing PM10 from the homes of the study participants. Depressive problems in children were measured using the Depressive Problems DSM and withdrawn/depressed syndromic problem scales of the Child Behavior Checklist. RESULTS: In covariate-adjusted Tobit regression models, children with fly ash on the filter had higher scores on the DSM Depressive Problems (3.13 points; 95% CI = 0.39, 5.88) compared with children who did not have fly ash on the filter. Logistic regression supported these findings. CONCLUSION: Coal ash is one of the largest waste streams in the U.S, but it is not classified as a hazardous waste by the Environmental Protection Agency. To our knowledge, no studies have assessed the impact of coal ash on children's mental health. This study highlights the need for further research into the effects of coal ash exposure on children's mental health, and improved regulations on release and storage of coal ash.

Nail Samples of Children Living near Coal Ash Storage Facilities Suggest Fly Ash Exposure and Elevated Concentrations of Metal(loid)s.

Children who live near coal-fired power plants are exposed to coal fly ash, which is stored in landfills and surface impoundments near residential communities. Fly ash has the potential to be released as fugitive dust. Using data collected from 263 children living within 10 miles of coal ash storage facilities in Jefferson and Bullitt Counties, Kentucky, USA, we quantified the elements found in nail samples. Furthermore, using principal component analysis (PCA), we investigated whether metal(loid)s that are predominately found in fly ash loaded together to indicate potential exposure to fly ash. Concentrations of several neurotoxic metal(loid)s, such as chromium, manganese, and zinc, were higher than concentrations reported in other studies of both healthy and environmentally exposed children. From PCA, it was determined that iron, aluminum, and silicon in fly ash were found to load together in the nails of children living near coal ash storage facilities. These metal(loid)s were also highly correlated with each other. Last, results of geospatial analyses partially validated our hypothesis that children's proximity to power plants was associated with elevated levels of concentrations of fly ash metal(loid)s in nails. Taken together, nail samples may be a powerful tool in detecting exposure to fly ash.

National secular trends in ambient air volatile organic compound levels and biomarkers of exposure in the United States.

BACKGROUND: Exposure to air pollution is a leading cause of global mortality. Volatile organic compounds (VOCs) are constituents of ambient air that could exert adverse health effects. OBJECTIVE: To examine the relationship between VOC levels in ambient air and individual-level exposure to VOCs, as assessed by urinary VOC metabolites. METHODS: Secular trends in 11 ambient air VOCs (2005-2013) and individual-level metabolites of 14 VOCs (2005-2014) were assessed using National Monitoring Programs (NMP) and National Health and Nutrition Examination Survey (NHANES) data, respectively. To isolate environmental exposure, individuals reporting exposure to tobacco smoke were excluded. Quantile regression models were used to assess secular trends in VOC exposure, and survey-weighted regression models were built to identify factors associated with VOC exposure. RESULTS: All annual levels of ambient VOCs decreased from 2005 to 2013 (Range: 12.5%-77.2%). However, 11 of the corresponding VOC metabolites increased during the same time (Range: 0.3%-53.6%). There was a proportional change in patterns of VOC exposure across NHANES waves, with the middle quantiles of exposure showing the largest increase. VOC exposures were significantly associated with age, sex, race, education, and physical inactivity, but not with secular VOC trends. DISCUSSION: In the United States, individual-level exposure to several VOCs increased between 2005 and 2014 despite a decline in ambient air VOC levels. This inverse relationship suggests that ambient VOCs are not the primary source of VOC exposure, therefore, decreasing ambient VOCs alone may not be sufficient to protect against the adverse health effects associated with VOC exposure.

Recruitment strategies and challenges: Lessons learned from a coal ash and children's health study.

The purpose of this paper is to describe the approaches and recruitment strategies of a study focused on the impact of coal fly ash on neurobehavioral performance among children living in proximity to coal-burning power plants. Challenges encountered with each recruitment approach are highlighted as well as solutions used to overcome those challenges and ultimately enroll children and one of their parents or guardians. To ensure participants were distributed throughout the study area, geographical information systems were used to guide recruitment and achieve the target sample size (N = 300). Several approaches were employed to recruit the number of needed participants, including "shoe leather" or door-to-door recruitment, placement of flyers and brochures in public spaces, mailings to targeted addresses, media announcements, and local government outreach. Since September 2015, 265 participants have been enrolled in the study using a combination of the described recruitment approaches. Even with a well-designed plan, it is important to re-examine strategies at every step to maximize recruitment efforts. Researcher flexibility in adapting to new strategies is vital in facilitating recruitment efforts, and the recruitment of participants in the study remains a dynamic and evolving process.

Elevated Blood Lead Levels by Length of Time From Resettlement to Health Screening in Kentucky Refugee Children.

OBJECTIVES: To examine elevated blood lead levels (EBLLs) in refugee children by postrelocation duration with control for several covariates. METHODS: We assessed EBLLs (≥ 5µg/dL) between 2012 and 2016 of children younger than 15 years (n = 1950) by the duration of resettlement to health screening by using logistic regression, with control for potential confounders (gender, region of birth, age of housing, and intestinal infestation) in a cross-sectional study. RESULTS: Prevalence of EBLLs was 11.2%. Length of time from resettlement to health screening was inversely associated with EBLLs (tertile 2 unadjusted odds ratio [OR] = 0.79; 95% confidence interval [CI] = 0.56, 1.12; tertile 3 OR = 0.62; 95% CI = 0.42, 0.90; tertile 2 adjusted odds ratio [AOR] = 0.62; 95% CI = 0.39, 0.97; tertile 3 AOR = 0.57; 95% CI = 0.34, 0.93). There was a significant interaction between intestinal infestation and age of housing (P < .003), indicating significant risk in the joint exposure of intestinal infestation (a pica proxy) and age of house. CONCLUSIONS: Elevated blood lead levels were reduced with increasing length of time of resettlement in unadjusted and adjusted models. Improved housing, early education, and effective safe-house inspections may be necessary to address EBLLs in refugees.

Youth doing dangerous tasks: Supervision matters.

BACKGROUND: Supervisors are partially responsible for ensuring that teens are safe at work. The purpose of this study was to explore whether supervision is related to teens' willingness to do a dangerous task at work. METHODS: A mixed-methods study consisting of focus groups and a cross-sectional survey was conducted with teens from two public high schools. RESULTS: If asked by a supervisor, 21% of working teens would do a dangerous task. After controlling for gender and age, teens whose supervisor did not establish weekly goals (AOR = 3.54, 95%CI = 1.55-8.08), teens who perceived their supervisors as not approachable (AOR = 2.35, 95%CI = 1.34-4.13), and teens who were not comfortable talking about safety issues (AOR = 1.97, 95%CI = 1.08-3.61) were more likely to do a dangerous task if asked by their supervisors. CONCLUSION: This study indicates that how teens perceive their supervisor may be associated with whether teens do a dangerous task when asked by their supervisor.

Community views about the health and exposure of children living near a coal ash storage site.

Coal ash, a waste product generated from burning coal, is composed of small particles comprised of highly toxic elements. Coal ash particles contain heavy metals such as arsenic, lead, and mercury, as well as polyaromatic hydrocarbons and radioactive elements. Most coal ash is stored in landfills and ponds, often located in close proximity to low income communities. Currently, there are no federal regulations governing the storage and transport of coal ash; however the Environmental Protection Agency proposed a coal ash rule in 2010, which could designate coal ash as a hazardous waste. This is the first article to assess community impact from coal ash storage, by exploring parents' perceptions of their children's health and its relationship to chronic exposure to coal ash. This was a community-based study involving four neighborhoods adjacent to a large coal ash storage facility. Focus groups were conducted with community members and the transcripts were analyzed to identify themes regarding children's health, children's exposure to coal ash, and behaviors done to protect children from exposure. The majority of parents (85 %) reported that their children suffered from health conditions; specifically respiratory and emotional and behavioral disorders. Parents highlighted ways in which their children were exposed to coal ash, although many felt they were constantly exposed just by living in the area. Parents felt strongly that exposure to coal ash from the landfill is affecting the health and well-being of their children. Some parents attempted protective behaviors, but most parents felt helpless in reducing children's exposure.

The association of manganese overexposure and neurobehavioral function is moderated by arsenic: A metal mixture analysis of children living near coal ash storage sites.

Manganese is an essential element but can be neurotoxic if overexposed. Our previous study found that a higher level of manganese in nail biomarkers from children living near coal ash storage sites was associated with poorer neurobehavioral function. Children living near this type of pollution may be exposed to other metal neurotoxicants and a better understanding of manganese in the context of multiple exposures is needed. Mixture analyses were completed using nail samples from 251 children aged 6-14 years old. These biomarkers containing metals known to impact brain functioning were investigated to test our hypothesis that a mixture of metals including manganese impacts the development of children living near coal ash sites. Nails collected from children were analyzed using ICP-MS for manganese, arsenic, cadmium, lead, and zinc based on previous research on neurotoxicity. Bayesian kernel machine regression (BKMR) was used while adjusting for age, sex, and maternal education as potential covariates. Children also completed the Behavioral Assessment Research System (BARS) to provide neurobehavioral measures of attention and processing speed as outcomes for mixture analyses. Metal mixture analyses indicated that the relationship of manganese concentration and attention and processing speed was moderated by arsenic.,. When nail biomarkers for arsenic were highest (90th percentile), manganese was associated with poorer neurobehavioral performance on the BARS, measured by CPT hit latency. At low levels of arsenic (10th percentile), there was no evidence of harmful effects from overexposure to manganese on CPT hit latency based on BKMR analysis. Previously reported effects of manganese on neurobehavioral function may be moderated by arsenic exposure. Metal exposures and behavior outcomes can be studied with mixture analyses such as BKMR to evaluate effects of simultaneous exposures on children exposed to pollution.

Indoor coal ash and school and social competency among children aged 6-14 years.

BACKGROUND: A child's ability to succeed in social interactions and in a school setting are important for their development and growth. Exposure to environmental pollutants has been associated with poorer school performance and fewer social interaction in children. Fly ash, a waste product generated when burning coal for energy, is comprised of small glass spheres with neurotoxic heavy metal(loid)s found to be risk factors for learning and social problems in school. OBJECTIVE: The purpose of this novel study was to assess the association of fly ash in children's homes with school and social competency. METHODS: We recruited children aged 6-14 years old from communities located within 10 miles of two coal-burning power plants. In homes of the participants, fly ash was collected on polycarbonate filters using personal modular impactors. We measured school competency and social competency using the validated Child Behavioral Checklist. Using Tobit and linear regression we investigated the relationship of indoor fly ash with school and social competency. RESULTS: Forty-three percent of children in the study had fly ash in their homes. In covariate-adjusted Tobit models, children with fly ash in their homes scored on average 2.63 (95% CI: -4.98, -0.28) points lower on the school competency scale than peers without ash in their homes. We did not observe that fly ash in homes was related with lower social competency. SIGNIFICANCE: Results from this study suggest that children with fly ash in their homes had poorer performance in the school setting, compared to peers without fly ash in their homes. In the US, coal-fired power plants are being closed, however health concerns about pollution from coal ash storage facilities remains. Findings from this study can provide impetus for creating of public health policy and to highlight the need future research on children's exposure to fly ash. IMPACT: Children's growth and development are impacted by their social interactions and ability to perform in school settings. Environmental pollutants may impact these essential elements of development. Millions of children are exposed to fly ash which is a waste product generated from burning coal. Fly ash, an environmental health threat throughout the world, is comprised of small glass spheres with trace concentrations of neurotoxic metal(loid)s. Findings from this research show that children with fly ash in their homes are significantly more likely to have poorer school performance than children without fly ash in their homes.

Working for mom and dad: are teens more likely to get injured working in family-owned businesses?

Recent controversy regarding the issue of children working in family-owned businesses has come to the forefront, pitting safety and health versus parent's right to teach their children the family trade. While studies have characterized injury among working teens, no studies have assessed work and injury among teens employed in family-owned businesses. This study is the first to examine teenagers working in family-owned businesses and to compare the experiences of teens working in family-businesses to the experiences of other working teens. A questionnaire was distributed to 8,085 teens in high schools throughout the five public health regions of Wisconsin. A total of 6, 810 teens responded (84%). Overall 2,858 high school teens aged 14-17 reported working (42%); of which 963 (34%) worked in a family-business. Teens working in family-businesses were more likely to report that their injury was severe, affecting their activities for more than three days, compared with other working teens (33% vs. 21%, P = 0.05). The percentage of teens working in family-businesses that reported broken bones or crushed body parts was 17% compared to only 5% of other-working teens. Additionally, teens employed in family-businesses were more likely to file for workers' compensation (28% vs. 12%, P = 0.005). Teens working in family-owned businesses may be at a greater risk for more severe injury based on the jobs and tasks they are doing. Teens working in family-owned businesses were more likely to report engaging in dangerous tasks, including some that are illegal under the Hazardous Occupation Orders. More research is needed to assess the dynamics that exist for teens working in family-owned businesses.

Attitudes of teenagers towards workplace safety training.

More than 70 % of teenagers are employed before graduating high school. Every 10 min, in the United States, a young worker is injured on the job. Safety training has been suggested as a way to prevent injuries, yet little is known about the methods of safety training and the effectiveness of training that teens receive at work. This study is the first to assess the attitudes teens hold towards safety training and what they believe would help them stay safe on the job. In 2010, focus groups and interviews were conducted with 42 teens from public high schools in Jefferson County, Kentucky. Participating teens were aged 15-19 years old, 43 % male, 69 % African-American, and 56 % worked either in the restaurant/food industry or in retail jobs. Most teens reported receiving safety training. Although the majority believed that safety training was important, many felt that they personally did not need safety training; that it was "common sense." However, 52 % of teens reported workplace injuries. Many viewed injury lightly and as part of the job, even those that sustained severe injuries. Most teens were trained by methods that seem at best "boring" and at worst, ineffective. Little interaction, action, or repetition is used. Training is not geared towards teens' developmental levels or interest, as in most cases all workers received the same type of training. Safety training may be a powerful way to reduce injury rates among working teenagers, but it is essential that training methods which are geared towards teens are utilized.

Proximity to coal-fired power plants and neurobehavioral symptoms in children.

BACKGROUND: Coal-fired power plants are a major source of air pollution that can impact children's health. Limited research has explored if proximity to coal-fired power plants contributes to children's neurobehavioral disorders. OBJECTIVE: This community-based study collected primary data to investigate the relationships of residential proximity to power plants and neurobehavioral problems in children. METHODS: 235 participants aged 6-14 years who lived within 10 miles of two power plants were recruited. Exposure to particulate matter ≤10 µm (PM10) was measured in children's homes using personal modular impactors. Neurobehavioral symptoms were assessed using the Child Behavior Checklist (CBCL). Multiple regression models were performed to test the hypothesized associations between proximity/exposure and neurobehavioral symptoms. Geospatial statistical methods were used to map the spatial patterns of exposure and neurobehavioral symptoms. RESULTS: A small proportion of the variations of neurobehavioral problems (social problems, affective problems, and anxiety problems) were explained by the regression models in which distance to power plants, traffic proximity, and neighborhood poverty was statistically associated with the neurobehavioral health outcomes. Statistically significant hot spots of participants who had elevated levels of attention deficit hyperactivity disorder, anxiety, and social problems were observed in the vicinity of the two power plants. SIGNIFICANCE: Results of this study suggest an adverse impact of proximity to power plants on children's neurobehavioral health. Although coal-fired power plants are being phased out in the US, health concern about exposure from coal ash storage facilities remains. Furthermore, other countries in the world are increasing coal use and generating millions of tons of pollutants and coal ash. Findings from this study can inform public health policies to reduce children's risk of neurobehavioral symptoms in relation to proximity to power plants.

Heavy Metal(loid) Body Burden in Environmentally Exposed Children With and Without Internalizing Behavior Problems.

The prevalence of internalizing behavior disorders in children is increasing. Reasons for increasing anxiety and depression include several factors with a less studied consideration being the potential neurotoxic effects of environmental exposures. One group at risk for environmental exposures is children living near coal-burning power plants with coal ash storage facilities. Multivariate logistic regression was used to assess the relationship between metal(loid) exposures and internalizing behaviors in children aged 6-14 years. Metal(loid)s in nail samples were determined by Proton-Induced X-ray Emission and internalizing behavior problems were obtained from the parent ratings on the Child Behavior Checklist. Results indicated that concentrations of metal(loid)s in nails differ between children with internalizing behaviors and without internalizing behaviors. Logistic regression models suggested that exposure to zinc and imputed zirconium were associated with internalizing behaviors in children. However, when a sex-metal(loid) interaction term was included, none of the metal(loid)s were associated with internalizing behaviors indicating a role of sex differences in neurotoxicity with zinc and copper showing effects only for males. In all models, greater exposure to traffic was associated with internalizing behaviors. Zinc has previously been shown to increase risk for mental health problems, while zirconium has received less attention. Out findings indicate that environmental exposures of zinc and zirconium deserve further attention in studies of childhood internalizing disorders.

School-sponsored work programs: a first look at differences in work and injury outcomes of teens enrolled in school-to-work programs compared to other-working teens.

OBJECTIVES: To evaluate work experiences among teens enrolled in school-sponsored work (SSW) programs and compare the findings to other-working teens. This study, the first to assess work-related safety and health for teens in SSW programs, includes teens working one job and teens working multiple jobs. METHODS: A survey was conducted among 6810 teens in school districts in five public health regions in Wisconsin. Information on demographics, work characteristics, injury and school performance was collected. RESULTS: Of 3411 high school teens (14-18 years old) working during the school year, 461 were enrolled in SSW programs. SSW teens were more likely to hold multiple jobs, work over 40 h per week, and work 2 or more days per week before 8:00 h compared with other-working teens. SSW teens working only one job were no more likely to be injured than other-working teens. However, SSW teens working multiple jobs were significantly more likely to be severely injured compared to other-working teens (AOR 3.49; 95% CI 1.52 to 8.02). CONCLUSIONS: SSW programs were created to prepare youth for transition into the workforce after high school. This first study suggests that students in SSW programs working only one job are no more likely to be injured at work compared with other-working teens. However, being enrolled in SSW programs is not protective against work injury, which would have been expected based on the philosophy of these programs. Furthermore, when students work multiple jobs, those enrolled in SSW programs are more likely to be severely injured. Possible explanations are provided.

Students enrolled in school-sponsored work programs: the effect of multiple jobs on workplace safety and school-based behaviors.

BACKGROUND: Throughout the United States, over 70% of public schools with 12th grade offer school-sponsored work (SSW) programs for credit; 60% offer job-shadowing programs for students. Wisconsin offers a variety of work-based learning programs for students, including, but not limited to, job shadowing, internships, co-op education, and youth apprenticeship programs. No research has compared workplace injury and school-based behaviors in students enrolled in SSW programs who work only 1 job compared with those who work multiple jobs. METHODS: A total of 6810 students in the 5 public health regions in Wisconsin responded to an anonymous questionnaire that was administered in 2003. The questionnaire asked about employment, injury, characteristics of injury, and school-based behaviors and performance. RESULTS: A total of 3411 high school students aged 14 to 18 reported they were employed during the school year. Among the working students, 13.5% were enrolled in a SSW program. Of the SSW students, 44% worked multiple jobs. SSW students who worked multiple jobs were more likely to do hazardous job tasks, to work after 11 PM, to work over 40 hours per week, to have a near-miss incident, to have a coworker injured, and to be injured at work. CONCLUSIONS: SSW students who are working multiple jobs are violating labor laws that put their safety and their school performance at risk. The responsibilities of employers and schools have to be addressed to ensure that SSW students are abiding by labor laws when working multiple jobs.

Travelling to polluted cities: a systematic review on the harm of air pollution on international travellers' health.

RATIONALE FOR REVIEW: In 2019, approximately, 1.4 billion people travelled internationally. Many individuals travel to megacities where air pollution concentrations can vary significantly. Short-term exposure to air pollutants can cause morbidity and mortality related to cardiovascular and respiratory disease, with the literature clearly reporting a strong association between short-term exposure to particulate matter ≤2.5 µm and ozone with adverse health outcomes in resident populations. However, limited research has been conducted on the health impacts of short-term exposure to air pollution in individuals who travel internationally. The objective of this systematic review was to review the evidence for the respiratory and cardiovascular health impacts from exposure to air pollution during international travel to polluted cities in adults aged ≥18 years old. KEY FINDINGS: We searched PubMed, Scopus and EMBASE for studies related to air pollution and the health impacts on international travellers. Of the initially identified 115 articles that fit the search criteria, 6 articles were selected for the final review. All six studies found indications of adverse health impacts of air pollution exposure on international travellers, with most of the changes being reversible upon return to their home country/city. However, none of these studies contained large populations nor investigated vulnerable populations, such as children, elderly or those with pre-existing conditions. CONCLUSIONS: More research is warranted to clearly understand the impacts of air pollution related changes on travellers' health, especially on vulnerable groups who may be at higher risk of adverse impacts during travel to polluted cities.

Manganese body burden in children is associated with reduced visual motor and attention skills.

Manganese (Mn) is an essential element, however, children with moderate to high Mn exposure can exhibit neurobehavioral impairments. One way Mn appears to affect brain function is through altering dopaminergic systems involved with motor and cognitive control including frontal - striatal brain systems. Based on the risk for motor and attention problems, we evaluated neurobehavioral function in 255 children at risk for Mn exposure due to living in proximity to coal ash storage sites. Proton Induced X-ray Emissions (PIXE) analysis was conducted on finger and toenails samples. Multiple neuropsychological tests were completed with the children. Fifty-five children had Mn concentrations above the limit of detection (LOD) (median concentration = 3.95 ppm). Children with detectable Mn concentrations had reduced visual motor skills (ß = -5.62, CI: -9.11, -2.12, p = 0.008) and more problems with sustained attention, based on incorrect responses on a computerized attention test, (ß = 0.40, CI: 0.21, 0.59, p < 0.001) compared with children who had Mn concentrations below the LOD. Findings suggest that Mn exposure impacts attention and motor control possibly due to neurotoxicity involving basal ganglia and forebrain regions. Visual-motor and attention tests may provide a sensitive measure of Mn neurotoxicity, useful for evaluating the effects of exposure in children and leading to better treatment options.

A review on fly ash from coal-fired power plants: chemical composition, regulations, and health evidence.

Throughout the world, coal is responsible for generating approximately 38% of power. Coal ash, a waste product, generated from the combustion of coal, consists of fly ash, bottom ash, boiler slag, and flue gas desulfurization material. Fly ash, which is the main component of coal ash, is composed of spherical particulate matter with diameters that range from 0.1 µm to >100 µm. Fly ash is predominately composed of silica, aluminum, iron, calcium, and oxygen, but the particles may also contain heavy metals such as arsenic and lead at trace levels. Most nations throughout the world do not consider fly ash a hazardous waste and therefore regulations on its disposal and storage are lacking. Fly ash that is not beneficially reused in products such as concrete is stored in landfills and surface impoundments. Fugitive dust emissions and leaching of metals into groundwater from landfills and surface impoundments may put people at risk for exposure. There are limited epidemiological studies regarding the health effects of fly ash exposure. In this article, the authors provide an overview of fly ash, its chemical composition, the regulations from nations generating the greatest amount of fly ash, and epidemiological evidence regarding the health impacts associated with exposure to fly ash.

Sex differences in the association between exposure to indoor particulate matter and cognitive control among children (age 6-14 years) living near coal-fired power plants.

Coal fly ash consists of inhalable particulate matter with varying concentrations of neurotoxic metals. Children living near coal-fired power plants with coal fly ash storage facilities may be exposed to coal fly ash when it escapes as fugitive dust emissions into surrounding communities. Previous research on outdoor particulate matter air pollution of similar aerodynamic diameter (PM10) suggests exposure may be associated with impaired cognitive control. The purpose of this research was to investigate sex-differences in the association between exposure to indoor PM10 and cognitive control among children (n = 221), ages 6-14 years, living near coal-fired power plants with fly ash storage facilities. In an ongoing community-based study, we measured indoor PM10 concentrations in participants' housing units and used performance measures from the BARS (Behavior Assessment and Research System) Continuous Performance Test (CPT) and Selective Attention Test (SAT) to assess neurotoxic effects on cognitive control. In adjusted negative binomial regression models, we found children living in housing units with higher indoor PM10 concentrations had a higher risk of commission errors on the CPT (incidence rate ratio (IRR) = 1.22 per interquartile range difference (IQR = 0.72 µg/m3) in natural log-transformed PM10 concentrations; 95% CI = 1.01, 1.46) and SAT (IRR = 1.14; 95% CI = 1.01, 1.28). Furthermore, child sex modified the association between PM10 concentration and CPT commission errors. Among females, higher PM10 concentration was associated with higher risk of CPT commission errors (IRR = 1.39; 95% CI = 1.06, 1.82), but we found no association among males (IRR = 1.01; 95% CI = 0.79, 1.30). We found no association between PM10 concentrations and CPT or SAT response latency. Our results suggest females living near coal-fired plants with coal fly ash storage facilities may be more susceptible to impaired cognitive control associated with particulate matter exposure. Children living near coal-fired power plants with coal fly ash storage facilities who are exposed to particulate matter may have an increased risk of impulse control problems.