Polychlorinated biphenyls and incident coronary heart disease-related outcomes in Great Lakes fish consumers.

BACKGROUND: Exposure to polychlorinated biphenyls (PCBs) has been linked to risk factors for cardiovascular disease such as increased inflammation, accelerated atherosclerosis, diabetes, and sex hormone dysregulation. Furthermore, there is increasing evidence suggesting associations between internal dose of PCBs and cardiovascular outcomes. OBJECTIVES: The purpose of this study is to investigate longitudinal associations of PCBs with coronary heart disease (CHD)-related outcomes in a cohort of Great Lakes sport fish consumers. METHODS: The Great Lakes Sport Fish Consumer cohort was established in the early 1990's. Eight hundred nineteen participants were followed from 1993 to 2017. Serum PCBs were measured in 1994/1995 (baseline), in 2001, and in 2004, while health history questionnaires were administered in 1996, 2003, 2010, and 2017. Cox models were used to prospectively investigate associations of total PCBs and PCB groupings, based on aryl hydrocarbon receptor activity, with incident self-reported physician diagnosis of coronary heart disease (CHD), myocardial infarction (MI), and angina pectoris. RESULTS: A 2-fold increase in phenobarbital-type PCBs was associated with a 72% increase in likelihood of self-reported incident diagnosis of CHD (HR=1.72, 95% CI: 1.06-2.81; p=0.0294). Similar results were observed for total PCBs (HR=1.68, 95% CI: 1.05-2.69; p=0.0306) and mixed methacholine/phenobarbital type (mixed-type) PCBs (HR=1.60, 95% CI: 1.02-2.52; p=0.0427), but not methacholine-type PCBs. PCBs were not strongly associated with risk of MI or angina. CONCLUSIONS: This study presents evidence that exposure to PCBs increases the risk of developing coronary heart disease. Given the large number of risk factors and causal pathways for CHD, future research is required to better understand biological mechanisms of action for PCBs on CHD.

Interactome Analysis Identifies MSMEI_3879 as a Substrate of Mycolicibacterium smegmatis ClpC1.

The prevalence of drug-resistant Mycobacterium tuberculosis infections has prompted extensive efforts to exploit new drug targets in this globally important pathogen. ClpC1, the unfoldase component of the essential ClpC1P1P2 protease, has emerged as one particularly promising antibacterial target. However, efforts to identify and characterize compounds that impinge on ClpC1 activity are constrained by our limited knowledge of Clp protease function and regulation. To expand our understanding of ClpC1 physiology, we employed a coimmunoprecipitation and mass spectrometry workflow to identify proteins that interact with ClpC1 in Mycolicibacterium smegmatis, a surrogate for M. tuberculosis. We identify a diverse panel of interaction partners, many of which coimmunoprecipitate with both the regulatory N-terminal domain and the ATPase core of ClpC1. Notably, our interactome analysis establishes MSMEI_3879, a truncated gene product unique to M. smegmatis, as a novel proteolytic substrate. Degradation of MSMEI_3879 by ClpC1P1P2 in vitro requires exposure of its N-terminal sequence, reinforcing the idea that ClpC1 selectively recognizes disordered motifs on substrates. Fluorescent substrates incorporating MSMEI_3879 may be useful in screening for novel ClpC1-targeting antibiotics to help address the challenge of M. tuberculosis drug resistance. IMPORTANCE Drug-resistant tuberculosis infections are a major challenge to global public health. Much effort has been invested in identifying new drug targets in the causative pathogen, Mycobacterium tuberculosis. One such target is the ClpC1 unfoldase. Compounds have been identified that kill M. tuberculosis by disrupting ClpC1 activity, yet the physiological function of ClpC1 in cells has remained poorly defined. Here, we identify interaction partners of ClpC1 in a model mycobacterium. By building a broader understanding of the role of this prospective drug target, we can more effectively develop compounds that inhibit its essential cellular activities.

Sources of validity evidence in the assessment of perceived motor competence in Brazilian schoolchildren / Fontes de evidência de validade na avaliação da competência motora percebida em escolares brasileiros

INTRODUCTION: The judgment a child makes about his/her competence in the motor domain is known as perceived motor competence, a key element in building the child's healthy behavior; a Pictorial Scale of Perceived Movement Skill Competence (PMSC) seems to be a suitable perceived motor competence's assessment, but its validity needs to be evaluated. OBJECTIVE: To examine the internal structure, the convergent validity, and the reproducibility of the PMSC. METHODS: The sample comprised 187 Brazilian healthy schoolchildren (9.6 years ± 0.8); it was applied to the questionnaires PMSC and the Self-Perception Profile for Children scale. RESULTS: PMSC's confirmatory factor analyses indicated adjustment indexes classified as adequate for a two-factor model; there were satisfactory reliability indices (Cronbach's alpha: 0.654 and 0.652 for locomotion and object control sub domains, respectively); convergent validity (r=0.41 and r=0.56, p<0.001, for locomotion and object control sub domains, respectively). CONCLUSÃO: These results contribute to the accumulation of sources of evidence for the PMSC as a valid tool for perceived motor competence assessment in a local and global context.

INTRODUÇÃO: O julgamento que uma criança faz sobre sua competência no domínio motor é conhecido como competência motora percebida, um elemento-chave na construção do comportamento saudável da criança. A Escala Pictórica de Percepção de Competência nas Habilidades de Movimento (PMSC) parece ser uma ferramenta adequada na avaliação do PMC, mas sua validade precisa ser testada. OBJETIVO: Examinar a estrutura interna, a validade convergente e a reprodutibilidade da escala PMSC. Métodos: A amostra foi composta por 187 escolares brasileiros saudáveis (9,6 anos ± 0,8); foram aplicados os questionários PMSC e a escala Self-Perception Profile for Children. RESULTADOS: As análises fatoriais confirmatórias indicaram índices de ajuste classificados como adequados para um modelo de dois fatores para a PMSC; os índices de confiabilidade foram satisfatórios (alfa de Conbrach: 0,654 e 0,652 para os subdomínios locomoção e controle de objetos, respectivamente); validade convergente (r=0,41 e r=0,56, p<0,001, para os subdomínios locomoção e controle de objeto, respectivamente). CONCLUSÃO: Esses resultados contribuem para o acúmulo de fontes de evidências para que a escala PMSC seja, de fato, uma ferramenta válida para a avaliação da competência motora percebida em um contexto local e global.

Motor competence, physical activity, and perceived motor competence: A relational systems approach.

Being and perceiving oneself as proficient in motor skills seems essential for an active lifestyle; conversely, being active and perceiving oneself as proficient may be associated with greater motor competence. By expanding the causal path view about the relationship between active and healthy developmental system elements, this study tested the mediation hypothesis of perceived motor competence in the relationship between motor competence and physical activity - in both ways - and moderation by developmental phase and sex. This cross-sectional study sampled healthy schoolchildren (n = 379; 8.2 ± 1.7 years; 54.9% boys). Physical activity (questionnaire), motor competence (tests included locomotor and object control skills) and perception of motor competence (a pictorial scale) were assessed. Maximum likelihood structural equation models with fit statistics confirmed the mediation in both ways. Unexpectedly, the relationship between motor competence and physical activity was inverse. Sex was a moderating variable (boys). In a systemic relational paradigm of human development, perceived motor competence, motor competence, and physical activity interact in an active and healthy behavioural system, but the complexities of understanding how these elements relate to one another across childhood point to the need for future longitudinal studies.

Identification of Arginine Phosphorylation in Mycolicibacterium smegmatis.

Tuberculosis is a leading cause of worldwide infectious mortality. The prevalence of multidrug-resistant Mycobacterium tuberculosis infections drives an urgent need to exploit new drug targets. One such target is the ATP-dependent protease ClpC1P1P2, which is strictly essential for viability. However, few proteolytic substrates of mycobacterial ClpC1P1P2 have been identified to date. Recent studies in Bacillus subtilis have shown that the orthologous ClpCP protease recognizes proteolytic substrates bearing posttranslational arginine phosphorylation. While several lines of evidence suggest that ClpC1P1P2 is similarly capable of recognizing phosphoarginine-bearing proteins, the existence of phosphoarginine modifications in mycobacteria has remained in question. Here, we confirm the presence of posttranslational phosphoarginine modifications in Mycolicibacterium smegmatis, a nonpathogenic surrogate of M. tuberculosis. Using a phosphopeptide enrichment workflow coupled with shotgun phosphoproteomics, we identified arginine phosphosites on several functionally diverse targets within the M. smegmatis proteome. Interestingly, phosphoarginine modifications are not upregulated by heat stress, suggesting divergent roles in mycobacteria and Bacillus. Our findings provide new evidence supporting the existence of phosphoarginine-mediated proteolysis by ClpC1P1P2 in mycobacteria and other actinobacterial species. IMPORTANCE Mycobacteria that cause tuberculosis infections employ proteolytic pathways that modulate cellular behavior by destroying specific proteins in a highly regulated manner. Some proteolytic enzymes have emerged as novel antibacterial targets against drug-resistant tuberculosis infections. However, we have only a limited understanding of how these enzymes function in the cell and how they select proteins for destruction. Some proteolytic enzymes are capable of recognizing proteins that carry an unusual chemical modification, arginine phosphorylation. Here, we confirm the existence of arginine phosphorylation in mycobacterial proteins. Our work expands our understanding of a promising drug target in an important global pathogen.

Spanish Facebook Posts as an Indicator of COVID-19 Vaccine Hesitancy in Texas.

Vaccination represents a major public health intervention intended to protect against COVID-19 infections and hospitalizations. However, vaccine hesitancy due to misinformation/disinformation, especially among ethnic minority groups, negatively impacts the effectiveness of such an intervention. The aim of this study is to provide an understanding of how information gleaned from social media can be used to improve attitudes toward vaccination and decrease vaccine hesitancy. This work focused on Spanish-language posts, and will highlight the relationship between vaccination rates across different Texas counties and the sentiment and emotional content of Facebook data, the most popular platform among the Hispanic population. The analysis of this valuable dataset indicates that vaccination rates among this minority group are negatively correlated with negative sentiment and fear, meaning that a higher prevalence of negative and fearful posts indicates lower vaccination rates in these counties. This first study investigating vaccine hesitancy in the Hispanic population suggests that observation of social media can be a valuable tool for measuring attitudes toward public health interventions.

Fish consumption and advisory awareness in the Great Lakes basin.

BACKGROUND: Fish is a dietary staple in the United States. Risk of exposure to persistent contaminants through fish consumption is a significant health concern. Great Lakes basin states, along with the US Environmental Protection Agency and the Great Lakes Consortium for Fish Consumption Advisories, have developed and continuously updated fish consumption advisories specifically for the Great Lakes basin residents. OBJECTIVES: To characterize Great Lakes basin residents' fish consumption and advisory awareness, we conducted a point-in-time survey to describe fish consumption habits and awareness of state and EPA/FDA fish advisories. METHODS: We used a randomized, address-based sampling approach to recruit respondents from the eight Great Lakes basin states. Weighted survey analysis procedures were used to estimate population prevalence of fish consumption habits, state and EPA/FDA advisory awareness, and demographic and background characteristics. Logistic regression models were used to assess the associations between demographic and background factors and fish consumption and awareness of advisories, respectively. RESULTS: About 92% of respondents, representing an estimated 61 million adults, reported eating fish in the last 12 months. About 64% of respondents only consumed commercial fish, and an estimated 5 million fish consumers exceeded the EPA/FDA recommended limit for fish meals. Minorities were more likely to exceed the EPA/FDA recommended limit. About half of the respondents were aware of state or EPA/FDA advisories; however, minorities and women were less aware of the EPA/FDA advisory. After adjusting for demographic characteristics, sportfish consumption was significantly associated with state advisory awareness; commercial fish consumption was significantly associated with EPA/FDA awareness. DISCUSSION: Most respondents only consumed commercial fish, but an estimated 18.6 million adults consumed sportfish. While half of the fish consumers were aware of state or EPA/FDA advisories, minorities and women continue to be less aware of fish advisories. Improved outreach strategies are needed to inform them about safe fish-consumption guidelines.

Confiabilidade da análise de processo para o desempenho da tarefa de levantar-se do solo em idosos / Intra e inter reliability of supine-to-stand task performance in older adults

A tarefa de levantar-se do solo a partir do decúbito dorsal (STS) tem apresentado recursos avaliativos complementares, em termos de julgamento do desempenho motor, físico e funcional em idosos por meio de medidas quantitativas e qualitativas. Especificamente, em medidas de processo (qualitativas) há sete protocolos que categorizam o desempenho do STS em idosos. Objetivo: Determinar o nível de confiabilidade intra e entre avaliadores da análise de processo do STS em idosos, segundo protocolo adaptado de Manini et al. Métodos: 25 idosos (12 mulheres) realizaram a tarefa de levantar-se do solo a partir do decúbito dorsal sem auxílio. Dois codificadores de vídeo, estudantes de graduação no nível superior de educação - tempo de experiência > 2 anos em Educação Física e ± 6 meses de uso do protocolo classificaram o desempenho dos idosos de acordo com o protocolo. A confiabilidade intra-avaliador e entre avaliadores foi considerada moderada (K = 0,533; p = 0,001; K = 0,466; p = 0,001) e substancial para a medida intra-avaliador 2 (K = 0,736; p = 0,001). O nível de confiabilidade intra e entreavaliadores do STS segundo o protocolo adaptado de Manini foi considerado moderado para sujeitos idosos. (AU)

The Supine-To-Stand task (STS) has presented complementary assessment resources, in terms of motor, physical and functional assessment in the elderly through quantitative and qualitative measures. Specifically, in process measures (qualitative) seven protocols categorize the performance of STS in the elderly. Objective: To determine the level of reliability within and between evaluators of the STS process analysis in the elderly, according to a protocol adapted from Manini et al. Methods: 25 elderly (12 female) performed the task of rising from the ground from the supine position without assistance. Two video encoders, graduate students at the higher education level - time of experience >2 years in Physical Education and ± 6 months in use of the protocol classified the performance of the elderly according to this protocol. Intra-rater and between rater reliability was considered moderate (K = 0.533; p = 0.001; K = 0.466; p = 0.001) and substantial for intra-rater 2 (K = 0.736; p = 0.001). The level of intra- and inter-rater reliability of the STS according to the adapted protocol of Manini was considered moderate for elderly subjects. (AU)

Associations of PCBS, dioxins and furans with follicle-stimulating hormone and luteinizing hormone in postmenopausal women: National Health and Nutrition Examination Survey 1999-2002.

BACKGROUND: The general population is exposed to the group of endocrine disrupting chemicals persistent organic pollutants (POPs), that includes polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs). OBJECTIVES: The aim of this research was to evaluate the associations of serum levels of PCB, PCDD, and PCDF congeners with follicle stimulating hormone (FSH) and luteinizing hormone (LH) in postmenopausal women not taking exogenous hormones. We hypothesized that associations of POPs with these gonadotropins could be modified by factors affecting endogenous hormones. METHODS: Cross-sectional analyses were conducted on data from 89 postmenopausal women using data from the National Health and Nutrition Examination Survey (NHANES). POPs were summarized based on classification schemes thought to reflect toxicological properties. Associations of POPs and gonadotropin hormones were modeled with multivariable regression models. When evidence of interaction was found, conditional effects were estimated. RESULTS: We found inverse associations of LH, but not FSH, with exposure to anti-estrogenic and/or dioxin-like POPs, but not with non dioxin-like PCBs. A doubling of dioxin-like toxic equivalents (TEQs) was associated with a decrease in LH of 11.9% (95% CI = -21.3%, -1.4%, p = 0.03). Inverse associations were enhanced by potential effect modifiers related to both direct and indirect estrogenicity, including obesity and the obesity-related condition inflammation. CONCLUSIONS: These investigations support a pattern of endocrine-disrupting effects by dioxin-like POPs among postmenopausal women, especially those with conditions related to peripheral estrogenicity.

Assessment in the Supine-To-Stand Task and Functional Health from Youth to Old Age: A Systematic Review.

Performance in the supine-to-stand (STS) task is an important functional and health marker throughout life, but the evaluation methods and some correlates can impact it. This article aims to examine the studies that assessed the performance of the STS task of young people, adults and the elderly. Evidence of the association between the STS task and body weight status, musculoskeletal fitness and physical activity was investigated, and a general protocol was proposed. MEDLINE/Pubmed and Web of Science databases were accessed for searching studies measuring the STS task directly; identification, objective, design, sample, protocols and results data were extracted; the risk of bias was assessed (PROSPERO CRD42017055693). From 13,155 studies, 37 were included, and all demonstrated a low to moderate risk of bias. The STS task was applied in all world, but the protocols varied across studies, and they lacked detail; robust evidence demonstrating the association between STS task and musculoskeletal fitness was found; there was limited research examining body weight status, physical activity and the STS task performance. In conclusion, the STS task seems to be a universal tool to track motor functional competence and musculoskeletal fitness throughout life for clinical or research purposes.

Effect of school type and family income on motor competence changes in pre-school children: a repeated cross sectional study / Efeito do tipo de escola e renda familiar nas mudanças da competência motora em crianças pré-escolares: um estudo transversal repetido

ABSTRACT Motor competence (MC) is an attribute associated with positive health behaviors; contextual factors, seems to play a important role for MC of children. The purpose of this study was to compare the MC of preschool children in two different years and to identify the effect of contextual factors (school type and family income). Two representative samples of children (3 to 5 years old) from Recife were assessed in two time periods: 2010 (n= 282 children, 151 boys) and 2012 (n=270 children, 148 boys). MC was assessed using the Test of Gross Motor Development - 2. Data analysis used the Anova Two-Way and the Ancova tests adjusted by type of school (public and private) and family income, a p <0.05 was used. Locomotor skills, object control and overall motor quotient were superior for the children analyzed in 2010. Furthermore, the school type and income increased the effect size in the differences in object control skills and the general motor quotient. We can conclude that there was a decrease in MC of the preschool population after two years and that the contextual variables type of school and family income are important for the development of MC.

RESUMO A competência motora (CM) é um atributo associado a comportamentos positivos de saúde; fatores contextuais, parecem desempenhar um papel importante para CM de crianças. O objetivo deste estudo foi comparar a CM de pré-escolares em dois diferentes anos e identificar o efeito de fatores contextuais (tipo de escola e renda). Duas amostras representativas de crianças (3 a 5 anos) da cidade do Recife foram avaliadas em dois momentos: no ano de 2010 (282 crianças; 151 meninos) e 2012 (270 crianças; 148 meninos). A avaliação da CM foi realizada com o Test of Gross Motor Development - 2. A análise dos dados utilizou a Anova Two-Way e a Ancova ajustada por tipo de escola (pública e particular) e renda familiar, foi adotado um p<0.05. Foi identificada uma superioridade nas habilidades locomotoras, de controle de objetos e no quociente motor geral para as crianças analisadas em 2010 e o tipo de escola e renda aumentaram o tamanho do efeito das diferenças nas habilidades de controle de objetos e no quociente motor geral. Podemos concluir que houve uma diminuição na CM da população pré-escolar após dois anos e que as variáveis contextuais tipo de escola e renda são importantes para o desenvolvimento da CM.

Silicosis: Diagnosis and Medicolegal Implications.

Despite well-publicized sources of occupational hazard, silicosis continues to threaten industrial workers in the United States. We performed a retrospective search of the University of Wisconsin electronic pathology database to retrieve autopsy cases of silicosis and collaborated with the Wisconsin Department of Health Services to obtain statewide epidemiologic data regarding silicosis morbidity/mortality since 2003. Three silicosis autopsy cases were retrieved: all were men with ≥ 30 years of occupational crystalline silica exposure and similar histologic features of collagenous pulmonary nodules with admixed refractile particles. Overall, our state exceeds the national rate of silicosis-related hospitalizations and mortality, that is, 10.1 hospitalizations per million WI residents versus 1.2 nationally and 1.2 deaths per million WI residents versus 0.4 nationally. Surveillance is crucial to identify emerging occupational hazards and protect workers. A diagnosis of silicosis must be carefully considered at autopsy since it carries substantial implications for worker's compensation, compensatory losses, and employer liability.

An Occupational Legacy: Malignant Mesothelioma Incidence and Mortality in Wisconsin.

OBJECTIVES: The aim of the study was to describe mesothelioma occurrence in Wisconsin from 1997 to 2013 by usual industry and occupation (I&O), including occupations generally considered low risk. METHODS: Population-based rates and standardized incidence and mortality ratios were calculated. Two case-control analyses were designed to compare mesothelioma incidence and mortality in specific I&O groups with occurrence of (1) brain and central nervous system cancers and (2) other causes of death, using logistic regression. RESULTS: Mesothelioma incidence and mortality were elevated in Wisconsin (SIRadj = 1.20 [1.13 to 1.28]; SMRadj = 1.30 [1.22 to 1.38]). Certain industry (construction, manufacturing) and occupation (construction and extraction) groups were associated with increased odds of mesothelioma, with some evidence of increased risk among teachers. CONCLUSIONS: Forty years after the Occupational and Safety Health Act, mesothelioma incidence and mortality remain elevated in Wisconsin, with increased risk continuing for certain I&O groups.

Lead Exposure Among Workers at a Shipyard-Wisconsin, 2015 to 2016.

OBJECTIVE: In March 2016, the state health departments of Wisconsin and Minnesota learned of three shipyard workers with blood lead levels (BLLs) more than 40 µg/dL. An investigation was conducted to determine the extent of and risk factors for the exposure. METHODS: We defined a case as an elevated BLL more than or equal to 5 µg/dL in a shipyard worker. Workers were interviewed regarding their symptoms and personal protective equipment (PPE) use. RESULTS: Of 357 workers, 65.0% had received more than or equal to 1 BLL test. Among tested workers, 171 (73.7%) had BLLmax more than or equal to 5 µg/dL. Workers who received respirator training or fit testing had a median BLLmax of 18.0 µg/dL, similar to the median BLLmax of workers who did not receive such training (22.6 µg/dL, P = 0.20). CONCLUSIONS: Our findings emphasize the importance of adequate provision and use of PPE to prevent occupational lead exposure.

Effect of a pilot multi-component intervention on motor performance and metabolic risks in overweight/obese youth.

This study evaluated the effect of a multi-component intervention on motor performance (MP) and metabolic risk markers (MRM) in overweight/obese youth. A secondary aim was to examine whether changes in MP are associated to changes in MRM. A 3-month multi-component intervention was performed, consisting of physical exercise sessions (twice/week;1h), nutritional education sessions (once/month), and parental support (twice/week). The sample included 35 volunteers (7-13 y.o), allocated to intervention (INT, n = 17) and control (CONT, n = 18) group. Variables were measured pre (T0) and post intervention (T1). Fasting blood samples were analyzed for MRM. MP tests included the measurement of health related physical fitness components and motor coordination performance (KTK battery). To assess food intake, a 24-hour recall diary was used. GLM-ANCOVA was performed. Standardized scores were calculated for the outcome variables, and multilinear regressions were applied to analyze associations between the key variables. INT group showed improvements in MP, glycolytic and hepatic profiles. After adjustments for MVPA, SB, total intake and maturational stage, negative associations between %ΔMP and %Δglycolytic (ß = -.424; 95%CI:-0.343:-0.022), and %Δhepatic scores (ß = -.382 95%CI:-0.001:-0.009) were observed. The intervention produced a moderate-to-high effect on the MP and some MRM. Changes in MP were inversely associated with changes in glycolytic and hepatic markers.

Association of methylmercury intake from seafood consumption and blood mercury level among the Asian and Non-Asian populations in the United States.

BACKGROUND: MeHg is a well-established neurotoxicant for fetal brain growth and development and has been shown to increase the risk of cardiovascular disease in aging populations. In the U.S., Asian populations are of particular concern because of their seafood consumption behaviors. OBJECTIVES: Our objective was to calculate the average daily MeHg intake (ADMI) from seafood and to assess the relationship between ADMI with blood methylmercury (BMeHg) concentrations, specifically among women of reproductive age (WORA) and adults ≥ 50 years of age. METHODS: We estimated ADMI from seafood using the 30-day fish consumption data from the NHANES 2011-2014 datasets. Using multivariable linear regression, we estimated the proportional change in mean BMeHg associated with a doubling of the ADMI. Further, correlations between ADMI and BMeHg were compared between Asians and other racial/ethnic groups. RESULTS: Our analysis found both Asian WORA and Asian adults age ≥ 50 years old had significantly higher BMeHg levels and ADMI than their Non-Asian counterparts. Correlations between ADMI from seafood and blood Hg levels were stronger among Asian WORA than among Non-Asian WORA. Key fish species that influenced the dietary MeHg intake for Asians were mackerel, tuna, and "other known/unknown fish species". CONCLUSION: We confirmed that Asian populations have higher MeHg intake than the Non-Asian population in the U.S. and seafood intake is a key predictor of blood Hg concentration, especially among Asian women of reproductive age. Future studies should incorporate information on other known and unknown fish species that are frequently consumed by Asian populations and different parts and fish organs eaten to better understand determinants of MeHg exposure.

Private-well stewardship among a general population based sample of private well-owners.

Private well stewardship, including on-going testing and treatment, can ensure private well users are able to maintain source-water quality and prevent exposures to potentially harmful constituents in primary drinking water supplies. Unlike municipal water supplies, private well users are largely responsible for their own testing and treatment and well stewardship is often minimal. The importance of factors influencing regular testing, and treatment behaviors, including knowledge, risk perception, convenience and social norms, can vary by geography and population characteristics. The primary goals of this study were to survey a general statewide population of private well users in Wisconsin in order to quantify testing and treatment patterns and gather data on motivations and barriers to well stewardship. The majority of respondents reported using and drinking well water daily but only about one half of respondents reported testing their wells in the last ten years and of these, only 10% reported testing in the last 12months. Bacteria and nitrates were contaminants most often tested; and, a private laboratory most often conducted testing. The most commonly reported water treatment was a water softener. Living in a particular geographic region and income were the most significant predictors of water testing and treatment. Iron and hardness, which influence water aesthetics but not always safety, were the most commonly reported water quality problems. Health concerns or perceived lack thereof were, respectively, motivators and barriers to testing and treatment. Limited knowledge of testing and treatment options were also identified as barriers. Results confirm previous findings that well stewardship practices are minimal and often context specific. Understanding the target population's perceptions of risk and knowledge are important elements to consider in identifying vulnerable populations and developing education and policy efforts to improve well stewardship.

Changes in Hair Mercury Levels Among Women of Child-Bearing Age Following an Educational Intervention.

OBJECTIVE: Describe mercury exposures among women of childbearing age before and after an educational intervention. METHODS: Women age 18 to 45 were recruited to participate in an educational intervention concerning fish consumption. Fish consumption habits and total mercury concentration in hair were assessed pre- and post-intervention. Regression models examined associations between mercury, fish consumption, and demographics. RESULTS: Overall, 234 women completed the study. On average, mercury concentrations increased by 0.01 ppm (parts per million) following the intervention, despite declines in fish consumption; however, women in the 90th percentile for mercury at baseline decreased concentrations significantly while maintaining high rates of fish consumption. Mercury concentrations were positively correlated with fish consumption and certain demographic characteristics. CONCLUSIONS: The intervention reached individuals most at-risk. Healthcare providers should discuss fish consumption habits with women to encourage consumption of low-risk fish, and identify women needing education and counseling.

Elevated Blood Lead Levels Associated with Retained Bullet Fragments - United States, 2003-2012.

An estimated 115,000 firearm injuries occur annually in the United States, and approximately 70% are nonfatal (1). Retained bullet fragments (RBFs) are an infrequently reported, but important, cause of lead toxicity; symptoms are often nonspecific and can appear years after suffering a gunshot wound (2,3). Adult blood lead level (BLL) screening is most commonly indicated for monitoring of occupational lead exposure; routine testing of adults with RBFs is infrequent (3). States collaborate with CDC's National Institute for Occupational Safety and Health (NIOSH) to monitor elevated BLLs through the Adult Blood Lead Epidemiology and Surveillance (ABLES) program (4,5). To help assess the public health burden of RBFs, data for persons with BLLs ≥10 µg/dL reported to ABLES during 2003-2012 were analyzed. An RBF-associated case was defined as a BLL ≥10 µg/dL in a person with an RBF. A non-RBF-associated case was defined as a BLL ≥10 µg/dL without an RBF. During 2003-2012, a total of 145,811 persons aged ≥16 years with BLLs ≥10 µg/dL were reported to ABLES in 41 states. Among these, 457 RBF-associated cases were identified with a maximum RBF-associated BLL of 306 µg/dL. RBF-associated cases accounted for 0.3% of all BLLs ≥10 µg/dL and 4.9% of BLLs ≥80 µg/dL. Elevated BLLs associated with RBFs occurred primarily among young adult males in nonoccupational settings. Low levels of suspicion of lead toxicity from RBFs by medical providers might cause a delay in diagnosis (3). Health care providers should inquire about an RBF as the potential cause for lead toxicity in an adult with an elevated BLL whose lead exposure is undetermined.