Capabilities, opportunities, motivations, and practices of different sector professionals working on community environments to improve health.

OBJECTIVE: With rising healthcare costs in Canada from chronic conditions, individual behaviour change interventions in the clinical settings need to be complemented by a determinants of health approach, where multi-sector professionals assist in the creation of healthier community environments. This study sought to gain insights into capabilities, opportunities, motivations, and behaviours (COM-B) of Canadian multi-sector professionals for working together to improve built environments (BE) for health. METHODS: A cross-sectional study was conducted with 61 multi-sector professionals. A 49-item questionnaire measuring constructs of COM-B for healthy BE practices was administered. RESULTS: Public health (PH) professionals were more motivated by personal interest/values in healthy BE and the presence of scientific evidence on BE design health impacts as compared with planning and policy/program development (PPD) professionals. Planning professionals were more likely to be motivated by healthy BE legislation/regulations/codes than PPD professionals. The practice of taking responsibility for the inclusion of healthy features into BE designs was reported more often by planning and other professionals compared to PH professionals. Results trended towards significance for opportunities as a predictor of healthy BE practices among all professionals. CONCLUSION: Though motivators vary among different sector professionals, opportunities may be the most important driver of healthy BE practices and potentially a target to improve multi-sector professional practices in Canada. Future research should confirm findings of this first study of professional practice drivers guided by a theoretical behaviour change framework.

RéSUMé: OBJECTIF: Avec la hausse des coûts des soins de santé liés aux maladies chroniques au Canada, les interventions visant à changer les comportements individuels en conditions cliniques doivent être complétées par une approche axée sur les déterminants de la santé, où des professionnels de plusieurs secteurs aident à créer des cadres communautaires plus sains. Notre étude vise à approfondir la compréhension des capacités, occasions, motivations et comportements (COM-B) des professionnels canadiens de plusieurs secteurs qui les amènent à travailler ensemble à améliorer les cadres bâtis favorisant la santé. MéTHODE: Nous avons mené une étude transversale auprès de 61 professionnels de plusieurs secteurs. Nous leur avons administré un sondage de 49 questions pour mesurer, selon les concepts du modèle COM-B, les pratiques favorisant des cadres bâtis sains. RéSULTATS: Les professionnels de la santé publique (SP) étaient plus motivés par leurs valeurs/leur intérêt personnel envers les cadres bâtis sains et par l'existence de preuves scientifiques des effets de la conception des cadres bâtis sur la santé que les professionnels de la planification et les professionnels de l'élaboration de politiques/programmes (EPP). Les professionnels de la planification étaient plus susceptibles d'être motivés par les lois, les règlements et les codes sur les cadres bâtis sains que les professionnels de l'EPP. La pratique d'assumer la responsabilité de l'inclusion de caractéristiques saines dans la conception des cadres bâtis a été plus souvent déclarée par les professionnels de la planification et de l'EPP que par les professionnels de la SP. Pour l'ensemble des professionnels, les résultats affichent une tendance presque significative : les occasions pourraient être une variable prédictive de l'utilisation de pratiques saines en matière de cadre bâti. CONCLUSION: Les motivations des professionnels varient selon le secteur, mais les occasions pourraient être le principal moteur d'utilisation de pratiques saines en matière de cadres bâtis, et elles pourraient éventuellement être ciblées pour améliorer les pratiques professionnelles dans plusieurs secteurs au Canada. Les études futures devraient vérifier les constats de cette première étude sur les moteurs des pratiques professionnelles, guidée par un cadre théorique du changement des comportements.

Racial and social disparities in Ventura County, California related to agricultural pesticide applications and toxicity.

Application of agricultural pesticides poses health concerns for farmworkers and for local communities due to pesticide drift from spraying or fumigation, pesticide volatilization into the air, contamination of household dust, as well as direct exposure for people who work in agriculture and their families. In this analysis of pesticide use records for Ventura County, California (USA) from 2016 to 2018, we identified the most prevalent toxicological effects of the pesticides applied. We also developed a cumulative toxicity index that incorporates specific toxicity endpoints for individual pesticides, the severity and strength of association for each endpoint, and the reliability of the data sources. Combining the toxicity index for each pesticide with the pounds applied within each square mile section in Ventura County, we calculated the total toxicity-weighted pesticide use and identified pesticides associated with higher potential risk to health. Analysis of U.S. Census data for Ventura County found a greater percentage of Hispanic/Latino, African American and Asian community members in township sections with a greater volume of pesticides applied and higher toxicity-weighted pesticide use. Similarly, areas with limited economic and social resources had elevated pesticide application overall and elevated toxicity-weighted pesticide use. The combination of toxicological and demographic analyses presented in this study provides information that can support the development of policies to protect public health from excessive exposure to pesticides and better environmental health protection for socially vulnerable populations.

Age, gender, and racial/ethnic differences in the association of triclocarban with adulthood obesity using NHANES 2013-2016.

This study examined the association between triclocarban and obesity among US adults and compared the pattern of this association across age, gender, and racial/ethnic groups. Study found triclocarban to be associated with obesity (OR: OR:1.123 95% CI: 1.046, 1.205) and this association remained among women (OR:1.14 95% CI: 1.031, 1.261). Study participants aged 60 years and older were more likely to be overweight (OR:1.131 95% CI: 1.022 1.251) and obese (OR:1.192 95% CI: 1.079, 1.317) when compared to other age groups. Likewise, non-Hispanic whites (OR:1.126 95% CI: 1.003, 1.263) and "other race including multi-racial" (OR:1.431 95% CI: 1.219, 1.679) were more likely to be obese when compared to other racial/ethnic groups. In conclusion, triclocarban is associated with obesity among US adults and there is evidence of gender, age, and racial/ethnicity differences in the association.

Community-Level Analysis of Drinking Water Data Highlights the Importance of Drinking Water Metrics for the State, Federal Environmental Health Justice Priorities in the United States.

Research studies analyzing the geospatial distribution of air pollution and other types of environmental contamination documented the persistence of environmental health disparities between communities. Due to the shortage of publicly available data, only limited research has been published on the geospatial distribution of drinking water pollution. Here we present a framework for the joint consideration of community-level drinking water data and demographic data. Our analysis builds on a comprehensive data set of drinking water contaminant occurrence for the United States for 2014-2019 and the American Community Survey 5-year estimates (2015-2019) from the U.S. Census Bureau. Focusing on the U.S. states of California and Texas for which geospatial data on community water system service boundaries are publicly available, we examine cumulative cancer risk for water served by community water systems of different sizes relative to demographic characteristics for the populations served by these water systems. In both California and Texas, greater cumulative cancer risk was observed for water systems serving communities with a higher percentage of Hispanic/Latino and Black/African American community members. This investigation demonstrates that it is both practical and essential to incorporate and expand the drinking water data metrics in the analysis of environmental pollution and environmental health. The framework presented here can support the development of public policies to advance environmental health justice priorities on state and federal levels in the U.S.

Development of health-based exposure limits for radiofrequency radiation from wireless devices using a benchmark dose approach.

BACKGROUND: Epidemiological studies and research on laboratory animals link radiofrequency radiation (RFR) with impacts on the heart, brain, and other organs. Data from the large-scale animal studies conducted by the U.S. National Toxicology Program (NTP) and the Ramazzini Institute support the need for updated health-based guidelines for general population RFR exposure. OBJECTIVES: The development of RFR exposure limits expressed in whole-body Specific Absorption Rate (SAR), a metric of RFR energy absorbed by biological tissues. METHODS: Using frequentist and Bayesian averaging modeling of non-neoplastic lesion incidence data from the NTP study, we calculated the benchmark doses (BMD) that elicited a 10% response above background (BMD10) and the lower confidence limits on the BMD at 10% extra risk (BMDL10). Incidence data for individual neoplasms and combined tumor incidence were modeled for 5% and 10% response above background. RESULTS: Cardiomyopathy and increased risk of neoplasms in male rats were the most sensitive health outcomes following RFR exposures at 900 MHz frequency with Code Division Multiple Access (CDMA) and Global System for Mobile Communications (GSM) modulations. BMDL10 for all sites cardiomyopathy in male rats following 19 weeks of exposure, calculated with Bayesian model averaging, corresponded to 0.27-0.42 W/kg whole-body SAR for CDMA and 0.20-0.29 W/kg for GSM modulation. BMDL10 for right ventricle cardiomyopathy in female rats following 2 years of exposure corresponded to 2.7-5.16 W/kg whole-body SAR for CDMA and 1.91-2.18 W/kg for GSM modulation. For multi-site tumor modeling using the multistage cancer model with a 5% extra risk, BMDL5 in male rats corresponded to 0.31 W/kg for CDMA and 0.21 W/kg for GSM modulation. CONCLUSION: BMDL10 range of 0.2-0.4 W/kg for all sites cardiomyopathy in male rats was selected as a point of departure. Applying two ten-fold safety factors for interspecies and intraspecies variability, we derived a whole-body SAR limit of 2 to 4 mW/kg, an exposure level that is 20-40-fold lower than the legally permissible level of 0.08 W/kg for whole-body SAR under the current U.S. regulations. Use of an additional ten-fold children's health safety factor points to a whole-body SAR limit of 0.2-0.4 mW/kg for young children.

Investigating Molecular Mechanisms of Immunotoxicity and the Utility of ToxCast for Immunotoxicity Screening of Chemicals Added to Food.

The development of high-throughput screening methodologies may decrease the need for laboratory animals for toxicity testing. Here, we investigate the potential of assessing immunotoxicity with high-throughput screening data from the U.S. Environmental Protection Agency ToxCast program. As case studies, we analyzed the most common chemicals added to food as well as per- and polyfluoroalkyl substances (PFAS) shown to migrate to food from packaging materials or processing equipment. The antioxidant preservative tert-butylhydroquinone (TBHQ) showed activity both in ToxCast assays and in classical immunological assays, suggesting that it may affect the immune response in people. From the PFAS group, we identified eight substances that can migrate from food contact materials and have ToxCast data. In epidemiological and toxicological studies, PFAS suppress the immune system and decrease the response to vaccination. However, most PFAS show weak or no activity in immune-related ToxCast assays. This lack of concordance between toxicological and high-throughput data for common PFAS indicates the current limitations of in vitro screening for analyzing immunotoxicity. High-throughput in vitro assays show promise for providing mechanistic data relevant for immune risk assessment. In contrast, the lack of immune-specific activity in the existing high-throughput assays cannot validate the safety of a chemical for the immune system.

Environment-wide association study on childhood obesity in the U.S.

BACKGROUND: Childhood obesity is a national public health issue with increasing prevalence. It has been linked to diet, lack of physical activity, and genetic susceptibility, with more recent evidence that it could also result from environmental factors. Studies linking it to environmental factors are limited, unsystematic, incomprehensive, and inconclusive. OBJECTIVE: To conduct an environment-wide association study (EWAS) to comprehensively investigate all the environmental factors available in a nationally representative sample of children to determine factors associated with childhood obesity. METHODS: We utilized the 1999-2016 National Health and Nutrition Examination Survey (NHANES) datasets and included all children/adolescents (6-17 years). Obesity was measured using body mass index and waist to height ratio. A multinomial and binary logistic regression were used adjusting for age, sex, race/ethnicity, creatinine, calorie intake, physical activity, screen time, limitation to physical activities, and socioeconomic status. We then controlled for multiple hypothesis testing and validated our findings on a different cohort of children. RESULTS: We found that metals such as beryllium (OR: 3.305 CI: 1.460-7.479) and platinum (OR: 1.346 CI: 1.107-1.636); vitamins such as gamma-tocopherol (OR: 8.297 CI: 5.683-12.114) and delta-tocopherol (OR: 1.841 CI:1.476-2.297); heterocyclic aromatic amines such as 2-Amino-9H-pyrido (2,3-b) indole (OR: 1.323 CI: 1.083-1.617) and 2-Amino-3-methyl-9H-pyriodo(2,3-b)indole (OR: 2.799 CI: 1.442-5.433); polycyclic aromatic amines such as 9- fluorene (OR: 1.509 CI: 1.230-1.851) and 4-phenanthrene (OR: 2.828 CI: 1.632-4.899); and caffeine metabolites such as 1,3,7-trimethyluric acid (OR: 1.22 CI: 1.029-1.414) and 1,3,7-trimethylxanthine (OR: 1.258 CI: 1.075-1.473) were positively and significantly associated with childhood obesity. CONCLUSION: Following the unique concept of EWAS, certain environmental factors were associated with childhood obesity. Further studies are required to confirm these associations while investigating their mechanisms of action.