Addressing the Need for Just GeoHealth Engagement: Evolving Models for Actionable Research That Transform Communities.

GeoHealth as a research paradigm offers the opportunity to re-evaluate common research engagement models and science training practices. GeoHealth challenges are often wicked problems that require both transdisciplinary approaches and the establishment of intimate and long-term partnerships with a range of community members. We examine four common modes of community engagement and explore how research projects are launched, who has the power in these relationships, and how projects evolve to become truly transformative for everyone involved.

Maternal and Cord Blood Manganese Concentrations and Early Childhood Neurodevelopment among Residents near a Mining-Impacted Superfund Site.

BACKGROUND: Environmental manganese exposure has been associated with adverse neurodevelopmental outcomes among school-aged children; yet, few studies have evaluated prenatal exposure. OBJECTIVES: Our study examines associations between prenatal manganese concentrations and placental transfer of manganese with neurodevelopment in 224 2-y-old children residing near the Tar Creek Superfund Site. METHODS: We collected maternal and cord blood at delivery, measured manganese using inductively coupled plasma mass spectrometry, and assessed neurodevelopment using the Bayley Scales of Infant Development-II. Associations between manganese and mental (MDI) and psychomotor (PDI) development indices were estimated in multivariable models. Placental transfer, approximated by cord/maternal manganese ratio, cord/total manganese ratio (total=maternal+cord), and by joint classification according to high or low (above or below median) maternal and cord manganese, was evaluated as a predictor of neurodevelopment. RESULTS: Median levels [interquartile ranges (IQR)] of manganese in maternal and cord blood, respectively, were 24.0 (19.5-29.7) and 43.1 (33.5-52.1) µg/L. Adjusting for lead, arsenic, and other potential confounders, an IQR increase in maternal manganese was associated with -3.0 (95% CI: -5.3, -0.7) points on MDI and -2.3 (95% CI: -4.1, -0.4) points on PDI. Cord manganese concentrations were not associated with neurodevelopment scores. Cord/maternal and cord/total manganese ratios were positively associated with MDI [cord/maternal: ß=2.6 (95% Cl: −0.04, 5.3); cord/total: ß=22.0 (95% Cl: 3.2, 40.7)] and PDI (cord/maternal: ß=1.7 (95% Cl: −0.5, 3.9); cord/total: ß=15.6 (95% Cl: 0.3, 20.9)). Compared to mother-child pairs with low maternal and cord manganese, associations with neurodevelopment scores were negative for pairs with either high maternal, high cord, or high maternal and cord manganese. CONCLUSIONS: Maternal blood manganese concentrations were negatively associated with early childhood neurodevelopment scores in our study. Findings highlight the importance of understanding maternal exposures during pregnancy and factors influencing placental transfer. https://doi.org/10.1289/EHP925.

Prenatal Arsenic Exposure and Birth Outcomes among a Population Residing near a Mining-Related Superfund Site.

BACKGROUND: Limited epidemiologic data exist on prenatal arsenic exposure and fetal growth, particularly in the context of co-exposure to other toxic metals. OBJECTIVE: We examined whether prenatal arsenic exposure predicts birth outcomes among a rural U.S. population, while adjusting for exposure to lead and manganese. METHODS: We collected maternal and umbilical cord blood samples at delivery from 622 mother-infant pairs residing near a mining-related Superfund site in Northeast Oklahoma. Whole blood arsenic, lead, and manganese were measured using inductively coupled plasma mass spectrometry. We modeled associations between arsenic concentrations and birth weight, gestational age, head circumference, and birth weight for gestational age. RESULTS: Median (25th-75th percentile) maternal and umbilical cord blood metal concentrations, respectively, were as follows: arsenic, 1.4 (1.0-2.3) and 2.4 (1.8-3.3) µg/L; lead, 0.6 (0.4-0.9) and 0.4 (0.3-0.6) µg/dL; manganese, 22.7 (18.8-29.3) and 41.7 (32.2-50.4) µg/L. We estimated negative associations between maternal blood arsenic concentrations and birth outcomes. In multivariable regression models adjusted for lead and manganese, an interquartile range increase in maternal blood arsenic was associated with -77.5 g (95% CI: -127.8, -27.3) birth weight, -0.13 weeks (95% CI: -0.27, 0.01) gestation, -0.22 cm (95% CI: -0.42, -0.03) head circumference, and -0.14 (95% CI: -0.24, -0.04) birth weight for gestational age z-score units. Interactions between arsenic concentrations and lead or manganese were not statistically significant. CONCLUSIONS: In a population with environmental exposure levels similar to the U.S. general population, maternal blood arsenic was negatively associated with fetal growth. Given the potential for relatively common fetal and early childhood arsenic exposures, our finding that prenatal arsenic can adversely affect birth outcomes is of considerable public health importance. CITATION: Claus Henn B, Ettinger AS, Hopkins MR, Jim R, Amarasiriwardena C, Christiani DC, Coull BA, Bellinger DC, Wright RO. 2016. Prenatal arsenic exposure and birth outcomes among a population residing near a mining-related Superfund site. Environ Health Perspect 124:1308-1315; http://dx.doi.org/10.1289/ehp.1510070.

Fish consumption as a driver of risk-management decisions and human health-based water quality criteria.

The use and interpretation of fish consumption surveys and interviews, the application of fish consumption rates for sediment evaluation and cleanup, and the development of human health water quality criteria (HH WQC) are complex and interrelated issues. The present article focuses on these issues using examples from the United States, although the issues may be relevant for other countries. Some key considerations include the fact that there are many types of fish consumption surveys (e.g., 24-h recall surveys, food frequency questionnaires, creel surveys), and these surveys have different advantages and limitations. Identification of target populations for protection, identification of the species and quantities of fish consumed, and determination of bioaccumulation assumptions are important factors when developing water quality and sediment screening levels and standards. Accounting for the cultural importance of fish consumption for some populations is an even more complex element. Discussions about HH WQC often focus only on the fish consumption rate and may not have broad public input. Some states are trying to change this through extensive public participation efforts and use of probabilistic approaches to derive HH WQC. Finally, there are limits to what WQC can achieve. Solutions beyond the establishment of WQC that target toxics reduction from other sources may provide the greatest improvements to water quality and reductions in human health risks in the future.

A longitudinal study of mercury exposure associated with consumption of freshwater fish from a reservoir in rural south central USA.

Methylmercury (MeHg) exposure through fish consumption is a worldwide health concern. Saltwater fish account for most dietary MeHg exposure in the general U.S. population, but less is known about seasonal variations in MeHg exposure and fish consumption among millions of freshwater anglers. This longitudinal study examined associations between MeHg exposure and fish consumption in a rural, low-income population relying on a freshwater reservoir (Oklahoma, USA) for recreational and subsistence fishing. We interviewed 151 participants, primarily anglers and their families, seasonally for one year using 90-day recall food frequency questionnaires to assess general and species-specific fish consumption, and tested hair biomarker samples for total mercury (THg hair). Mean THg hair was 0.27 µg/g (n=595, range: 0.0044-3.1 µg/g), with 4% of participants above U.S. EPA's guideline for women of childbearing age and children. Mean fish consumption was 58 g/d (95% CI: 49-67 g/d), within the range previously reported for recreational freshwater anglers and above the national average. Unlike the general U.S. population, freshwater species contributed the majority of fish consumption (69%) and dietary Hg exposure (60%) among participants, despite relatively low THg in local fish. THg hair increased with fish consumption, age, and education, and was higher among male participants and the lowest in winter. Our results suggest that future studies of anglers should consider seasonality in fish consumption and MeHg exposure and include household members who share their catch. Efforts to evaluate benefits of reducing Hg emissions should consider dietary patterns among consumers of fish from local freshwater bodies.

Maternal iron metabolism gene variants modify umbilical cord blood lead levels by gene-environment interaction: a birth cohort study.

BACKGROUND: Given the relationship between iron metabolism and lead toxicokinetics, we hypothesized that polymorphisms in iron metabolism genes might modify maternal-fetal lead transfer. The objective of this study was to determine whether maternal and/or infant transferrin (TF) and hemochromatosis (HFE) gene missense variants modify the association between maternal blood lead (MBL) and umbilical cord blood lead (UCBL). METHODS: We studied 476 mother-infant pairs whose archived blood specimens were genotyped for TF P570S, HFE H63D and HFE C282Y. MBL and UCBL were collected within 12 hours of delivery. Linear regression models were used to examine the association between log-transformed MBL and UCBL, examine for confounding and collinearity, and explore gene-environment interactions. RESULTS: The geometric mean MBL was 0.61 µg/dL (range 0.03, 3.2) and UCBL 0.42 (<0.02, 3.9). Gene variants were common with carrier frequencies ranging from 12-31%; all were in Hardy-Weinberg equilibrium. In an adjusted linear regression model, log MBL was associated with log UCBL (ß = 0.92, 95% CI: 0.82, 1.03; p < 0.01) such that a 1% increase in MBL was associated with a 0.92% increase in UCBL among infants born to wild-type mothers. In infants born to C282Y variants, however, a 1% increase in MBL is predicted to increase UCBL 0.65% (ß(Main Effect) = -0.002, 95% CI: -0.09, -0.09; p = 0.97; ß(Interaction) = -0.27, 95% CI: -0.52, -0.01; p = 0.04), representing a 35% lower placental lead transfer among women with MBL 5 µg/dL. CONCLUSIONS: Maternal HFE C282Y gene variant status is associated with greater reductions in placental transfer of lead as MBL increases. The inclusion of gene-environment interaction in risk assessment models may improve efforts to safeguard vulnerable populations.

Impact of mine waste on airborne respirable particulates in northeastern Oklahoma, United States.

Atmospheric dispersion of particles from mine waste is potentially an important route of human exposure to metals in communities close to active and abandoned mining areas. This study assessed sources of mass and metal concentrations in two size fractions of respirable particles using positive matrix factorization (U.S. Environmental Protection Agency [EPA] PMF 3.0). Weekly integrated samples of particulate matter (PM) 10 microm in aerodynamic diameter or less (PM10) and fine PM (PM2.5, or PM <2.5 microm in aerodynamic diameter) were collected at three monitoring sites, varying distances (0.5-20 km) from mine waste piles, for 58 consecutive weeks in a former lead (Pb) and zinc (Zn) mining region. Mean mass concentrations varied significantly across sites for coarse PM (PM10-PM2.5) but not PM2.5 particles. Concentrations of Pb and Zn significantly decreased with increasing distance from the mine waste piles in PM10-PM2.5 (P < 0.0001) and PM2.5 (P < 0.0005) fractions. Source apportionment analyses deduced five sources contributing to PM2.5 (mobile source combustion, secondary sulfates, mine waste, crustal/soil, and a source rich in calcium [Ca]) and three sources for the coarse fraction (mine waste, crustal/soil, and a Ca-rich source). In the PM2.5 fraction, mine waste contributed 1-6% of the overall mass, 40% of Pb, and 63% of Zn. Mine waste impacts were more apparent in the PM10-PM2.5 fraction and contributed 4-39% of total mass, 88% of Pb, and 97% of Zn. Percent contribution of mine waste varied significantly across sites (P < 0.0001) for both size fractions, with highest contributions in the site closest to the mine waste piles. Seasonality, wind direction, and concentrations of the Ca-rich source were also associated with levels of ambient aerosols from the mine waste source. Scanning electron microscopy results indicated that the PMF-identified mine waste source is mainly composed of Zn-Pb agglomerates on crustal particles in the PM10-PM2.5 fraction. In conclusion, the differential impacts of mine waste on respirable particles by size fraction and location should be considered in future exposure evaluations.

Potential health impacts of heavy-metal exposure at the Tar Creek Superfund site, Ottawa County, Oklahoma.

The potential impact of exposure to heavy metals and health problems was evaluated at the Tar Creek Superfund site, Ottawa County, Oklahoma, USA. Observed versus expected mortality was calculated for selected conditions in the County and exposed cities. Excess mortality was found for stroke and heart disease when comparing the exposed County to the state but not when comparing the exposed cities to the nonexposed rest of the County. However, sample sizes in the exposed area were small, population emigration has been ongoing, and geographic coding of mortality data was incomplete. In an exposed community, 62.5% of children under the age of 6 years had blood lead levels exceeding 10 microg/dl. The relationships between heavy-metal exposure and children's health and chronic disease in adults are suggestive that a more thorough investigation might be warranted. A number of possible environmental and health studies are suggested, including those focusing on possible central nervous system impacts. Unfortunately, the exposed population is dispersing. One lesson learned at this site is that health studies need to be conducted as soon as possible after an environmental problem is identified to both study the impact of the most acute exposures and to maximize study sample size-including those exposed to higher doses-and minimize the loss of individuals to follow-up.

Neuropsychological correlates of hair arsenic, manganese, and cadmium levels in school-age children residing near a hazardous waste site.

A pilot study was conducted to explore the potential associations between hair metal levels and the neuropsychological function and behavior of school-aged children. Thirty-two children, 11-13 years old, were administered a battery of tests that assessed general intelligence, visual-motor skills, receptive language, verbal memory, nonverbal problem-solving, and behavior problems. Parents and teachers rated the children's attention, executive functions, and behavior problems. The concentrations of manganese (Mn), arsenic (As), and cadmium (Cd) were measured in hair samples provided by 31 of the children. The mean hair metal levels were: Mn, 471.5 parts per billion (ppb); As, 17.8 ppb; Cd, 57.7 ppb. Children's general intelligence scores, particularly verbal IQ scores, were significantly related, inversely, to hair Mn and As levels, as were scores on tests of memory for stories and a word list. In some cases, a significant Mn-by-As interaction was found. It appeared that it was the low scores of children for whom both Mn and As levels were above the median values in the sample that were responsible for the main effects observed for each metal. No other significant relationships were found. These results suggest the need to study further the neuropsychological correlates of developmental exposure to Mn and As, particularly as a mixture.