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BACKGROUND: Co-exposure to air pollution and neighborhood disadvantage may influence cognition decline. We tested these associations in the context of dementia risk. METHODS: We leveraged a cohort of adults ≥65 years (n = 5397) enrolled from 2011 to 2018 in the National Health and Aging Trends Study (NHATS). Particulate matter (PM) ≤ 10 µm in diameter, PM ≤ 2.5 µm in diameter, carbon monoxide, nitric oxide, and nitrogen dioxide - and neighborhood disadvantage were tested for joint associations with dementia risk. Pollutant concentrations at the 2010 census tract level were assigned using the US Environmental Protection Agency's Community Multiscale Air Quality Modeling System. Neighborhood disadvantage was defined using the tract Social Deprivation Index (SDI). Dementia was determined through self- or proxy-report or scores indicative of "probable dementia" according to NHATS screening tools. Joint effects of air pollutants and SDI were tested using quantile g-computation Cox proportional hazards models. We also stratified joint air pollution effects across SDI tertiles. Analyses adjusted for age at enrollment, sex, education, partner status, urbanicity, income, race and ethnicity, years at residence, census segregation, and census region. RESULTS: SDI score (aHR = 1.08; 95% CI 0.96, 1.22), joint air pollution (aHR = 1.03, 95% CI 0.92, 1.16) and joint SDI with air pollution (aHR = 1.04, 95% CI 0.89, 1.22) were not associated with dementia risk. After accounting for competing risk of death, joint SDI with air pollution was not associated with dementia risk (aHR = 1.06; 95% CI 0.87, 1.29). In stratified models, joint air pollution was associated with greater risk of dementia at high (aHR = 1.19; 95% CI 0.87, 1.63), but not at medium or low SDI. CONCLUSION: Air pollution was associated with greater dementia risk in disadvantaged areas after accounting for competing risks. Air pollution associations with dementia incidence may be attenuated when other risk factors are more prominent in disadvantaged neighborhoods.
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Contaminantes Atmosféricos , Contaminación del Aire , Demencia , Exposición a Riesgos Ambientales , Material Particulado , Humanos , Demencia/epidemiología , Demencia/inducido químicamente , Demencia/etiología , Anciano , Contaminación del Aire/efectos adversos , Contaminación del Aire/análisis , Masculino , Femenino , Contaminantes Atmosféricos/análisis , Anciano de 80 o más Años , Exposición a Riesgos Ambientales/efectos adversos , Material Particulado/análisis , Características de la Residencia/estadística & datos numéricos , Factores de Riesgo , Estudios de Cohortes , Estados Unidos/epidemiología , Características del VecindarioRESUMEN
The US has more firearms than any other country in the world and uses lead ammunition almost exclusively. Lead exposure is a significant public health concern and children are at the greatest risk given their exposure to take-home lead. Firearm-related take-home lead exposure may be one of the greatest influences on elevated pediatric blood lead levels. For this ecological and spatial investigation of the relationship between firearm licensure rates as a proxy for firearm-related lead exposure and prevalence of children with blood lead levels ≥5 µg/dL in 351 cities/towns in Massachusetts, we used 10 years of data (2010-2019). We examined this relationship against other known contributors to pediatric lead exposure including old housing stock (lead paint/dust), occupations, and lead in water. Pediatric blood lead levels were positively correlated with licensure, poverty, and certain occupations and negatively correlated with lead in water and police or firefighter employment. Firearm licensure was a major significant predictor of pediatric blood lead alone (ß = 0.13; 95% CI, 0.10, 0.17) and across all regression models. The final model predicted over half the variation in pediatric blood lead (Adjusted R2 = 0.51). Negative binomial analysis found cities/towns with more firearms had higher pediatric blood lead levels (highest quartile fully adjusted prevalence ratio ((aPR) = 1.18; 95% CI, 1.09, 1.30) with a significant increase in pediatric blood lead per increase in firearms (p < 0.001). There were no significant spatial effects, suggesting that although there could be other factors impacting elevated pediatric blood lead, they are unlikely to influence spatial associations. Our paper provides compelling evidence of a potential and dangerous link between lead ammunition and child blood lead levels and is the first to do so using multiple years' worth of data. More research is required to substantiate this relationship on the individual-level and into prevention/mitigation.
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Armas de Fuego , Plomo , Humanos , Niño , Massachusetts/epidemiología , Vivienda , PrevalenciaRESUMEN
BACKGROUND: Literature suggests that maternal exposure to persistent organic pollutants (POPs) may influence child neurodevelopment. Evidence linking prenatal POPs and autism spectrum disorder has been inconclusive and few studies have examined the mixture effect of the POPs on autism-related traits. OBJECTIVE: To evaluate the associations between prenatal exposure to a mixture of POPs and autism-related traits in children from the Early Autism Risk Longitudinal Investigation study. METHODS: Maternal serum concentrations of 17 POPs (11 polychlorinated biphenyls [PCBs], 4 polybrominated diphenyls [PBDEs], and 2 persistent pesticides) in 154 samples collected during pregnancy were included in this analysis. We examined the independent associations of the natural log-transformed POPs with social, cognitive, and behavioral traits at 36 months of age, including Social Responsiveness Scale (SRS), Mullen Scales of Early Learning-Early Learning Composite (MSEL-ELC), and Vineland Adaptive Behavior Scales (VABS) scores, using linear regression models. We applied Bayesian kernel machine regression and quantile g-computation to examine the joint effect and interactions of the POPs. RESULTS: Higher ln-PBDE47 was associated with greater deficits in social reciprocity (higher SRS score) (ß = 6.39, 95% CI: 1.12, 11.65) whereas higher ln-p,p'-DDE was associated with lower social deficits (ß = -8.34, 95% CI: -15.32, -1.37). Positive associations were observed between PCB180 and PCB187 and cognitive (MSEL-ELC) scores (ß = 5.68, 95% CI: 0.18, 11.17; ß = 4.65, 95% CI: 0.14, 9.17, respectively). Adaptive functioning (VABS) scores were positively associated with PCB170, PCB180, PCB187, PCB196/203, and p,p'-DDE. In the mixture analyses, we did not observe an overall mixture effect of POPs on the quantitative traits. Potential interactions between PBDE99 and other PBDEs were identified in association with MSEL-ELC scores. CONCLUSIONS: We observed independent effects of PCB180, PCB187, PBDE47, and p,p' DDE with ASD-related quantitative traits and potential interactions between PBDEs. Our findings highlight the importance of assessing the effect of POPs as a mixture.
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Trastorno del Espectro Autista , Contaminantes Ambientales , Bifenilos Policlorados , Efectos Tardíos de la Exposición Prenatal , Embarazo , Niño , Femenino , Humanos , Preescolar , Contaminantes Orgánicos Persistentes , Efectos Tardíos de la Exposición Prenatal/inducido químicamente , Efectos Tardíos de la Exposición Prenatal/epidemiología , Diclorodifenil Dicloroetileno , Trastorno del Espectro Autista/inducido químicamente , Trastorno del Espectro Autista/epidemiología , Éteres Difenilos Halogenados , Teorema de Bayes , Bifenilos Policlorados/toxicidad , Contaminantes Ambientales/toxicidad , Factores Sociológicos , CogniciónRESUMEN
BACKGROUND: Drinking water is a common source of exposure to inorganic arsenic. In the US, the Safe Drinking Water Act (SDWA) was enacted to protect consumers from exposure to contaminants, including arsenic, in public water systems (PWS). The reproductive effects of preconception and prenatal arsenic exposure in regions with low to moderate arsenic concentrations are not well understood. OBJECTIVES: This study examined associations between preconception and prenatal exposure to arsenic violations in water, measured via residence in a county with an arsenic violation in a regulated PWS during pregnancy, and five birth outcomes: birth weight, gestational age at birth, preterm birth, small for gestational age (SGA), and large for gestational age (LGA). METHODS: Data for arsenic violations in PWS, defined as concentrations exceeding 10 parts per billion, were obtained from the Safe Drinking Water Information System. Participants of the Environmental influences on Child Health Outcomes Cohort Study were matched to arsenic violations by time and location based on residential history data. Multivariable, mixed effects regression models were used to assess the relationship between preconception and prenatal exposure to arsenic violations in drinking water and birth outcomes. RESULTS: Compared to unexposed infants, continuous exposure to arsenic from three months prior to conception through birth was associated with 88.8 g higher mean birth weight (95% CI: 8.2, 169.5), after adjusting for individual-level confounders. No statistically significant associations were observed between any preconception or prenatal violations exposure and gestational age at birth, preterm birth, SGA, or LGA. CONCLUSIONS: Our study did not identify associations between preconception and prenatal arsenic exposure, defined by drinking water exceedances, and adverse birth outcomes. Exposure to arsenic violations in drinking water was associated with higher birth weight. Future studies would benefit from more precise geodata of water system service areas, direct household drinking water measurements, and exposure biomarkers.
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Arsénico , Agua Potable , Nacimiento Prematuro , Efectos Tardíos de la Exposición Prenatal , Embarazo , Lactante , Niño , Femenino , Humanos , Recién Nacido , Peso al Nacer , Arsénico/toxicidad , Arsénico/análisis , Estudios de Cohortes , Nacimiento Prematuro/inducido químicamente , Nacimiento Prematuro/epidemiología , Agua Potable/análisis , Retardo del Crecimiento Fetal , Exposición Materna/efectos adversosRESUMEN
Studies of statins and amyotrophic lateral sclerosis (ALS) incidence and survival have had conflicting findings possibly related to difficulties with confounding by indication. We considered potency of statins used and duration of use to explore confounding by indication. Within the Clalit Health Services in Israel, we identified 948 ALS case patients from 2004 through 2017 and matched them with 1,000 control subjects each. Any statin use up to 3 years before ALS onset was not associated with ALS incidence but was associated with a reduced hazard ratio (HR) for death. Odds of ALS did not vary by statin potency, but use of only lower-potency statins was associated with longer survival (HR = 0.82, 95% CI: 0.68, 0.98), whereas the association with higher-potency statins was null compared with those case patients who did not use statins. However, duration of statin use appeared to account for these findings. Those who used statins only up to 3 years had longer survival (HR = 0.77, 95% CI: 0.61, 0.96) than did case patients who did not use statins, but those who used statins for >3 years did not. Although other explanations are possible, these findings could suggest a protective effect of statins on ALS survival that is partially masked by a worse prognosis from underlying reasons for taking statins that deserves further exploration.
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Esclerosis Amiotrófica Lateral , Inhibidores de Hidroximetilglutaril-CoA Reductasas , Esclerosis Amiotrófica Lateral/tratamiento farmacológico , Esclerosis Amiotrófica Lateral/epidemiología , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Incidencia , Israel/epidemiología , Modelos de Riesgos ProporcionalesRESUMEN
It is important to identify the factors that influence the prevalence of disinhibitory behaviors, as tobacco and alcohol use in adolescence is a strong predictor of continued use and substance abuse into adulthood. Organochlorine pesticides (OCPs) are persistent organic pollutants that pose a potential risk to the developing fetus and offspring long-term health. We examined associations between prenatal exposure OCPs and their metabolites (i.e., p,p'-DDT, p,p'-DDE, o,p'-DDT, oxychlordane, and hexachlorobenzene (HCB)), both as a mixture and single compounds, and alcohol consumption and smoking at adolescence in a sample (n = 554) from the Child Health and Development Studies prospective birth cohort. Bayesian Kernel Machine Regression demonstrated a trend of higher risk of alcohol use and smoking with higher quartile mixture levels. Single-component analysis showed increased odds of smoking and drinking with increases in lipid-adjusted p,p'-DDE serum levels (aOR = 2.06, 95% CI 0.99-4.31, p = 0.05, per natural log unit increase). We found significant effect modification in these associations by sex with higher p,p'-DDT serum levels (aOR = 0.26, 95% CI 0.09-0.076, p = 0.01, per natural log unit increase) was associated with lower odds of smoking and drinking in female adolescents, while higher p,p'-DDE serum levels (aOR = 2.98, 95% CI 1.04-8.51, p = 0.04, per natural log unit increase) was associated with higher odds of the outcomes. Results of the mutually adjusted model were not significant for male adolescents. Further research to understand reasons for these sex-differences are warranted.
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Hidrocarburos Clorados , Plaguicidas , Efectos Tardíos de la Exposición Prenatal , Adolescente , Adulto , Teorema de Bayes , Niño , DDT/análisis , Diclorodifenil Dicloroetileno , Conducta de Ingestión de Líquido , Femenino , Humanos , Masculino , Plaguicidas/análisis , Embarazo , Efectos Tardíos de la Exposición Prenatal/inducido químicamente , Efectos Tardíos de la Exposición Prenatal/epidemiología , Estudios Prospectivos , Fumar/epidemiologíaRESUMEN
BACKGROUND: Socioeconomic factors may be involved in risk of multiple sclerosis (MS), either indirectly or as confounding factors. In this study two comprehensive indicators reflecting socioeconomic differences, including the Human Development Index (HDI) and Prosperity Index (PI), were used to assess the impact of these factors on the worldwide distribution of MS. METHODS: The data for this global ecological study were obtained from three comprehensive databases including the Global Burden of Disease (as the source of MS indices), United Nations Development Programme (source for HDI) and the Legatum Institute Database for PI. MS indices (including prevalence, incidence, mortality, and disability-adjusted life years) were all analyzed in the form of age- and sex-standardized. Correlation and regression analyses were used to investigate the relationship between HDI and PI and their subsets with MS indices. RESULTS: All MS indices were correlated with HDI and PI. It was also found that developed countries had significantly higher prevalence and incidence rates of MS than developing countries. Education and governance from the PI, and gross national income and expected years of schooling from the HDI were more associated with MS. Education was significantly related to MS indices (p < 0.01) in both developed and developing countries. CONCLUSION: In general, the difference in income and the socioeconomic development globally have created a landscape for MS that should be studied in more detail in future studies.
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Carga Global de Enfermedades , Esclerosis Múltiple/epidemiología , Factores Socioeconómicos , Bases de Datos Factuales , Escolaridad , Femenino , Salud Global , Humanos , Incidencia , Renta , Masculino , Prevalencia , Años de Vida Ajustados por Calidad de Vida , Naciones UnidasRESUMEN
Increasing diverse engagement in the Society for Epidemiologic Research (SER) will positively impact the field of epidemiology. As the largest and longest-running epidemiologic society in North America, SER has long been a pioneer in promoting diversity and inclusion. A recent survey of SER members, however, showed there is still room for improving diversity, inclusion, representation, and participation in the Society. In this commentary, as members of both the SER and the Johns Hopkins Bloomberg School of Public Health Department of Epidemiology's Inclusion, Diversity, Equity, Anti-Racism, and Science (Epi IDEAS) Working Group, we recommend 4 goals for the SER Annual Meeting and beyond: 1) convene epidemiologic researchers with diverse backgrounds and ideas; 2) promote an inclusive environment at the SER Annual Meeting; 3) develop, compile, and disseminate best practices to honor diversity in epidemiologic research; and 4) increase prioritization of health disparities research and methods. We also suggest strategies for achieving these goals so that SER can better include, support, and elevate members from historically disadvantaged groups. While our recommendations are tailored specifically to SER, the greater epidemiologic and academic communities could benefit from adopting these goals and strategies within their professional societies and conferences.
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Congresos como Asunto , Diversidad Cultural , Epidemiología/organización & administración , Diseño de Investigaciones Epidemiológicas , HumanosRESUMEN
Studies of occupational solvent exposures and amyotrophic lateral sclerosis (ALS) have been conflicting. We conducted a population-based case-control study of mixed occupational solvent exposures and ALS. Using the Danish National Patient Registry, we identified ALS cases in Denmark from 1982 to 2013, and matched them to 100 controls based on sex and birth year. We estimated cumulative exposures to solvents (benzene, methylene chloride, toluene, trichloroethylene, perchloroethylene, and 1,1,1-trichloroethane) via job exposure matrices and applied them to occupational history from the Danish Pension Fund. Sex-stratified conditional logistic regression analyses revealed higher adjusted odds of ALS for men with exposure to benzene (aOR = 1.20; 95% CI 1.02, 1.41) and methylene chloride (aOR = 1.23; 95% CI 1.07, 1.42). We used weighted quantile sum regression to explore combined solvent exposures and risk of ALS in exposed subjects and found increased odds of 26 to 28% in all exposure lag periods for every one-unit increase in the mixture index in men. Weights of methylene chloride predominated the mixture index in all lag periods. Our study suggests an increased risk of ALS in men exposed to multiple solvents, with the greatest influence being from methylene chloride. These findings highlight the need to utilize mixtures analysis when considering co-occurring exposures.
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Esclerosis Amiotrófica Lateral/inducido químicamente , Enfermedades Profesionales/inducido químicamente , Exposición Profesional/efectos adversos , Solventes/efectos adversos , Adulto , Anciano , Esclerosis Amiotrófica Lateral/epidemiología , Estudios de Casos y Controles , Dinamarca/epidemiología , Femenino , Humanos , Masculino , Cloruro de Metileno/efectos adversos , Persona de Mediana Edad , Enfermedades Profesionales/epidemiología , Vigilancia de la Población , Factores de RiesgoRESUMEN
We conducted exposure assessment using toenails from 20 fishermen living in Bodo City, a community of the Niger delta region in Nigeria. This community has been affected by over 4000 oil spills and environmental disasters. Fishing is the primary source of food and income for individuals in this community. Previous research in Bodo City found elevated metal levels in fish. Toenails were used as a biomarker to investigate the feasibility for use in risk assessment studies in developing countries. The toenails collected had significantly higher manganese levels (median 5.8 µg/g) and lead levels (median 0.98 µg/g) than those reported in more developed countries, comparable levels to those from other low-middle incomes countries. These exposure levels are likely a direct result of exposures from the environmental disasters the community has experienced and would be related to increased risks for many diseases previously associated with heavy metal exposures.
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Exposición a Riesgos Ambientales/estadística & datos numéricos , Metales Pesados/metabolismo , Uñas/química , Contaminantes Químicos del Agua/metabolismo , Biomarcadores , Monitoreo del Ambiente , Contaminación de Alimentos , Humanos , Plomo , Manganeso/análisis , Metales Pesados/análisis , Nigeria , Contaminación por Petróleo , Alimentos Marinos , Contaminantes Químicos del Agua/análisisRESUMEN
OBJECTIVES: Previous research has indicated links between lead (Pb) exposure and increased risk of neurodegenerative disorders, including amyotrophic lateral sclerosis (ALS). In this study, we evaluated the association between occupational Pb exposures and ALS. METHODS: ALS cases were ascertained through the Danish National Patient Registry from 1982 to 2013 and age and sex-matched to 100 controls. Using complete employment history since 1964 from the Danish Pension Fund, cumulative Pb exposure was estimated for each subject via a Danish job exposure matrix. Associations were evaluated using conditional logistic regression analyses and stratified by sex. RESULTS: For men with >50% probability of exposure, there was an increase in odds of ALS for exposures in the 60th percentile or higher during any time 5 years prior to diagnosis (aOR: 1.35; 95% CI 1.04 to 1.76) and 10 years prior to diagnosis (aOR: 1.33; 95% CI 1.03 to 1.72). No significant associations were observed in women, and there were no linear trends seen for Pb exposures for either sex. CONCLUSIONS: Our study indicates an association between consistently higher occupational Pb exposures and ALS. These findings support those of previously reported associations between ALS and specific occupations that commonly experience Pb exposure.
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Esclerosis Amiotrófica Lateral/diagnóstico , Plomo/efectos adversos , Exposición Profesional/efectos adversos , Adulto , Anciano , Esclerosis Amiotrófica Lateral/epidemiología , Dinamarca/epidemiología , Femenino , Humanos , Plomo/análisis , Plomo/sangre , Modelos Logísticos , Masculino , Persona de Mediana Edad , Exposición Profesional/análisis , Vigilancia de la Población/métodos , Factores de RiesgoRESUMEN
BACKGROUND: Bone lead measured via x-ray fluorescence (XRF) has been used for decades in health studies. A portable XRF device for bone lead measurement is gaining in popularity for its ease of use and shorter measurement times. Previous XRF devices have measured different bone types in order to sample both cortical and trabecular bone, in which lead has different half residence times. OBJECTIVE: The portable XRF uses lower energy to measure bone lead than previous devices, and, thus, only measures the surface of the bone. Because all bones have a cortical shell, we hypothesized that portable XRF bone lead measurements would be similar regardless of the bone measured. METHODS: This study tested differences in portable XRF bone lead measurements across different cortical and trabecular bones in measurements made on 31 cadavers. We also compared tissue thicknesses overlying different bones, which can impact portable XRF measurements. RESULTS: The correlation coefficients found between bones were higher (rho ~0.4) than previous K-shell XRF bone measurements in cortical and trabecular over the same range of values (rho~0.2). The concentrations were shown to vary non-significantly across different bones within individuals.
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Huesos , Plomo , Huesos/química , Cadáver , Fluorescencia , Humanos , Plomo/análisis , Rayos XRESUMEN
Previous studies have suggested an increased risk of amyotrophic lateral sclerosis (ALS) and other motor neuron diseases for persons in occupations commonly involving exposure to diesel exhaust (DE). In this study, we investigated the association between occupational exposure to DE and odds of ALS. ALS cases were identified from the Danish National Patient Registry (1982-2013) and individually matched to 100 controls per case on the basis of birth year and sex. Using information on occupational history from 1964 onward obtained from the Danish Pension Fund, we estimated cumulative DE exposures using a job exposure matrix. We evaluated associations using conditional logistic regression analyses and stratified the analyses by sex. Using a 10-year lag period, DE exposure was positively associated with ALS among men who had ever been exposed (adjusted odds ratio (aOR) = 1.20, 95% confidence interval (CI): 1.05, 1.38). For men with greater than 50% probability of DE exposure, we observed a positive association between ALS and highest-quartile exposure during the 5-year (aOR = 1.35, 95% CI: 1.07, 1.70) and 10-year (aOR = 1.41, 95% CI: 1.11, 1.79) lag periods. Our study suggests an association between consistently higher exposures to DE and ALS in men, but not in women. These findings support previous reports of associations between ALS and occupations commonly involving DE exposure.
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Esclerosis Amiotrófica Lateral/epidemiología , Exposición Profesional/efectos adversos , Emisiones de Vehículos/toxicidad , Adulto , Anciano , Estudios de Cohortes , Dinamarca/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sistema de Registros , Factores de RiesgoRESUMEN
OBJECTIVES: Several manuscripts have proposed associations between amyotrophic lateral sclerosis (ALS) and occupational toxicant exposures-not to mention physical activity and trauma/injury. Some have also reported associations in investigations of specific occupations. Using data from a prospective Danish cohort study, we investigated the association between employment in certain industries and ALS diagnosis. METHODS: We identified 1826 ALS cases who were 25 years old or less in 1964 and diagnosed from 1982 to 2013 from the Danish National Patient Registry then matched 100 population controls to each case based on birth year and sex. Demographic data were linked to the Danish Pension Fund to determine occupation history. Conditional logistic regression models were adjusted for socioeconomic status, marital status and residential location at the index date. RESULTS: There was an increase in odds of ALS among men who worked in agriculture, hunting, forestry or fishing (adjusted OR (aOR)=1.21; 95% CI 1.02 to 1.45). There was also a positive association for men employed in construction (aOR=1.21; 95% CI 1.05 to 1.39). In women, a protective association was seen with employment in the cleaning industry (aOR=0.69; 95% CI 0.52 to 0.93). CONCLUSIONS: Our study shows various occupations with exposure to toxicants, such as diesel exhaust and lead, and strenuous physical activity associated with increased odds of ALS in men. Future studies should have a particular focus on gathering detailed information on physical exertion and toxicant exposures specific to certain job tasks.
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Esclerosis Amiotrófica Lateral/etiología , Enfermedades Profesionales/etiología , Exposición Profesional/efectos adversos , Adulto , Anciano , Esclerosis Amiotrófica Lateral/epidemiología , Dinamarca/epidemiología , Femenino , Humanos , Incidencia , Modelos Logísticos , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/epidemiología , Oportunidad Relativa , Estudios Prospectivos , Sistema de Registros , Factores de RiesgoRESUMEN
Lead, mercury, and arsenic are neurotoxicants with known effects on neurodevelopment. Autism spectrum disorder (ASD) is a neurodevelopmental disorder apparent by early childhood. Using data on 4486 children with ASD residing in 2489 census tracts in five sites of the Centers for Disease Control and Prevention's Autism and Developmental Disabilities Monitoring (ADDM) Network, we used multi-level negative binomial models to investigate if ambient lead, mercury, and arsenic concentrations, as measured by the US Environmental Protection Agency National-Scale Air Toxics Assessment (EPA-NATA), were associated with ASD prevalence. In unadjusted analyses, ambient metal concentrations were negatively associated with ASD prevalence. After adjusting for confounding factors, tracts with air concentrations of lead in the highest quartile had significantly higher ASD prevalence than tracts with lead concentrations in the lowest quartile (prevalence ratio (PR) = 1.36; 95 '% CI: 1.18, 1.57). In addition, tracts with mercury concentrations above the 75th percentile (>1.7 ng/m(3)) and arsenic concentrations below the 75th percentile (≤0.13 ng/m(3)) had a significantly higher ASD prevalence (adjusted RR = 1.20; 95 % CI: 1.03, 1.40) compared to tracts with arsenic, lead, and mercury concentrations below the 75th percentile. Our results suggest a possible association between ambient lead concentrations and ASD prevalence and demonstrate that exposure to multiple metals may have synergistic effects on ASD prevalence.
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Contaminantes Atmosféricos/análisis , Arsénico/análisis , Trastorno del Espectro Autista/epidemiología , Monitoreo del Ambiente/métodos , Plomo/análisis , Mercurio/análisis , Niño , Preescolar , Factores de Confusión Epidemiológicos , Humanos , Masculino , Prevalencia , Estados Unidos/epidemiología , United States Environmental Protection AgencyRESUMEN
Lead is a heavy metal known to be detrimental to neurologic, physiologic, and behavioral health of children. Previous studies from Jamaica reported that mean lead levels in soil are four times that of lead levels in some other parts of the world. Other studies detected lead levels in fruits and root vegetables, which were grown in areas with lead contaminated soil. In this study, we investigate environmental factors associated with blood lead concentrations in Jamaican children. The participants in this study comprised 125 typically developing (TD) children (ages 2-8 years) who served as controls in an age- and sex-matched case-control study that enrolled children from 2009-2012 in Jamaica. We administered a questionnaire to assess demographic and socioeconomic information as well as potential exposures to lead through food. Using General Linear Models (GLMs), we identified factors associated with blood lead concentrations in Jamaican children. The geometric mean blood lead concentration (GMBLC) in the sample of children in this study was 2.80 µg dL(-1). In univariable GLM analyses, GMBLC was higher for children whose parents did not have education beyond high school compared to those whose parents had attained this level (3.00 µg dL(-1) vs. 2.31 µg dL(-1); P = 0.05), children living near a high traffic road compared to those who did not (3.43 µg dL(-1) vs. 2.52 µg dL(-1); P < 0.01), and children who reported eating ackee compared to those who did not eat this fruit (2.89 µg dL(-1) vs. 1.65 µg dL(-1); P < 0.05). In multivariable analysis, living near a high traffic road was identified as an independent risk factor for higher adjusted GMBLC (3.05 µg dL(-1) vs. 2.19 µg dL(-1); P = 0.01). While our findings indicate that GMBLC in Jamaican children has dropped by at least 62% during the past two decades, children living in Jamaica still have GMBLC that is twice that of children in more developed countries. In addition, we have identified significant risk factors for higher blood lead concentrations in Jamaican children. We believe increasing awareness among parents regarding these risk factors could potentially lead to a lower level of lead exposure in Jamaican children.
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Exposición a Riesgos Ambientales , Contaminantes Ambientales/sangre , Intoxicación por Plomo/epidemiología , Plomo/sangre , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Humanos , Jamaica/epidemiología , Masculino , Factores de Riesgo , Factores SocioeconómicosAsunto(s)
Esclerosis Amiotrófica Lateral , Estudios de Cohortes , Dinamarca , Humanos , Emisiones de VehículosRESUMEN
BACKGROUND: Manganese is an essential element for human health and development. Previous studies have shown neurotoxic effects in children exposed to higher levels of manganese. Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that impairs social interaction and communication. Several studies have hypothesized that ASD is caused through environmental exposures during crucial stages in brain development. We investigated the possible association between blood manganese concentrations (BMC) and ASD. We also identified factors associated with BMC in typically developing (TD) Jamaican children. METHODS: We used data from 109 ASD cases with their 1:1 age- and sex-matched TD controls to compare mean BMC in Jamaican children (2-8 years of age) with and without ASD. We administered a pre-tested questionnaire to assess demographic and socioeconomic information, medical history, and potential exposure to manganese. Finally, we collected 2 mL of whole blood from each child for analysis of manganese levels. Using General Linear Models (GLM), we assessed the association between BMC and ASD status. Furthermore, we used two independent sample t-tests to identify factors associated with BMC in TD children. RESULTS: In univariable GLM analysis, we found no significant association between BMC and ASD, (10.9 µg/L for cases vs. 10.5 µg/L for controls; P = 0.29). In a multivariable GLM adjusting for paternal age, parental education, place of child's birth (Kingston parish), consumption of root vegetables, cabbage, saltwater fish, and cakes/buns, there was still no significant association between BMC and ASD status, (11.5 µg/L for cases vs. 11.9 µg/L for controls; P = 0.48). Our findings also indicated TD children who ate fresh water fish had a higher BMC than children who did not (11.0 µg/L vs. 9.9 µg/L; P = 0.03) as younger TD children (i.e., 2 ≤ age ≤4), (12.0 µg/L vs. 10.2 µg/L; P = 0.01). CONCLUSIONS: While these results cannot be used to assess early exposure at potentially more susceptible time period, our findings suggest that there is no significant association between manganese exposures and ASD case status in Jamaica. Our findings also indicate that BMC in Jamaican children resemble those of children in the developed world and are much lower than those in the developing countries.
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Trastornos Generalizados del Desarrollo Infantil/epidemiología , Exposición a Riesgos Ambientales , Contaminantes Ambientales/sangre , Manganeso/sangre , Estudios de Casos y Controles , Niño , Trastornos Generalizados del Desarrollo Infantil/sangre , Trastornos Generalizados del Desarrollo Infantil/inducido químicamente , Preescolar , Dieta/efectos adversos , Femenino , Humanos , Lactante , Jamaica/epidemiología , Masculino , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
Social cohesion can reduce stress, increase social interaction, and improve cognitive reserve. These social mechanisms may modify the effects of air pollution on dementia risk. This cohort study examines the potential moderating effect of social cohesion on associations between joint air pollution exposure and incident dementia leveraging data from 5112 community-dwelling adults ≥65 years of age enrolled in the National Health and Aging Trends Study (NHATS). Study participants were enrolled in 2011 and followed through 2018. We assigned 2010 residential census tract-level exposures to five air pollutants, particulate matter (PM) ≤ 10 µm in diameter, PM ≤ 2.5 µm in diameter, carbon monoxide, nitric oxide, and nitrogen dioxide, using the US Environmental Protection Agency's Community Multiscale Air Quality Modeling System. Dementia status was determined based on self- or proxy-reported dementia diagnosis or "probable dementia" according to NHATS cognitive screening tools. Participants' self-rated neighborhood social cohesion was evaluated based on three questions: neighbors knowing each other, being helpful, and being trustworthy. Social cohesion was dichotomized at the median into high vs low social cohesion. Associations between air pollutants and incident dementia were assessed using quantile g-computation Cox proportional hazard models and stratified by high vs low social cohesion, adjusting for age, sex, education, partner status, urbanicity, annual income, race and ethnicity, years lived at current residence, neighborhood disadvantage index, and tract segregation. High social cohesion (HR = 1.20, 95 % CI = 0.98, 1.47) and air pollution (HR = 1.08, 95 % CI = 0.92, 1.28) were not associated with incident dementia alone. However, when stratified, greater joint air pollution exposure increased dementia risk among participants at low (HR = 1.34, 95 % CI = 1.04, 1.72), but not high (HR = 1.00, 95 % CI = 0.93, 1.06) social cohesion. Air pollution was a risk factor for dementia only when reported social cohesion was low, suggesting that social interaction may play a protective role, mitigating dementia risk via air pollution exposure.
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Contaminantes Atmosféricos , Contaminación del Aire , Demencia , Exposición a Riesgos Ambientales , Material Particulado , Humanos , Demencia/epidemiología , Demencia/inducido químicamente , Anciano , Contaminación del Aire/estadística & datos numéricos , Masculino , Femenino , Exposición a Riesgos Ambientales/estadística & datos numéricos , Contaminantes Atmosféricos/análisis , Material Particulado/análisis , Anciano de 80 o más Años , Estudios de Cohortes , IncidenciaRESUMEN
Recent findings from the Centers for Disease Control and Prevention's (CDC) Autism and Developmental Disabilities Monitoring (ADDM) Network's 2020 prevalence report indicate that disparities in autism diagnoses between Black and White youth have narrowed, reflecting improved screening, awareness, and access to services (Maenner et al., 2023. Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C.: 2002), 72, 1-14.). Claims of reducing disparities beyond prevalence rates, however, are not fully supported, as indicated by the reality that Black youth whose screenings indicate autistic traits are still not being referred for full evaluation or early intervention services at the same rate as their White peers (Major et al., 2020. Autism, 24, 1629-1638; Smith et al., 2020. Pediatrics, 145, S35-S46.). Black 8-year-olds identified as autistic still experience disparate educational placements (Waitoller et al., 2010. The Journal of Special Education. 44, 29-49.) where services may not be autism-specific or have Individual Education Plan goals only focused on "behavior problems" (Severini et al., 2018. Journal of Autism and Developmental Disorders, 48, 3261-3272.), are served in the most restrictive environments (Skiba et al., 2006. Exceptional Children, 72, 411-424.) and lack consistent augmentative and alternative communication support (Pope et al., 2022. American Journal of Speech-Language Pathology, 31, 2159-2174.). Additionally, ADMM researchers report consistent disparities in the identification of co-occurring intellectual disability where Black autistic children have significantly more co-occurrences than White autistic children. The purpose of this commentary is to first examine the assertion that the narrowed gap indicates, " improved access to services among historically underserved groups," (p. 9) (Maenner et al., 2023. Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C.: 2002), 72, 1-14.). We will then recommend strategies to address the ongoing disparities.