Pesticide Exposures and Body Mass Index (BMI) of Pesticide Applicators From the Agricultural Health Study.

Endocrine-disrupting chemicals, including pesticides, may be associated with weight gain. This is the first longitudinal study to examine a potential association between weight gain and pesticides using data on 8,365 male pesticide applicators from the Agricultural Health Study (AHS) cohort established in 1993. The relationship between total cumulative days of exposure to pesticide functional/chemical classes and to the four most frequently used individual pesticides was studied in relation to body mass index (BMI) at the time of 5-yr follow-up (beginning in 1998) with the length of the exposure period dating back to age 20 yr. Multiple regression, Spearman correlation, ordinal logistic regression, and logistic regression models all utilized a Bonferroni-adjusted p value, were adjusted for relevant covariates, and were stratified by state of residence (Iowa/North Carolina) and presence/absence of weight-related health conditions. Adjusted multiple regression yielded statistically significant positive parameter estimates for the study sample and Iowa subgroups with consistent findings for triazine herbicides and atrazine: Change in BMI per 100 cumulative pesticide exposure days ranged from 0.07 to 0.11 for triazine herbicides and from 0.10 to 0.19 for atrazine. Ordinal logistic regression compared normal weight with overweight and with obese using the zero exposure category as referent. Statistically significant adjusted odds ratios identified for the study sample and both state subgroups for the highest level of atrazine exposure ranged from 1.4 to 1.7. Further investigation is warranted to evaluate the associations identified here.

DC Water and Sewer Authority and lead in drinking water: a case study in environmental health risk management.

In 2001, following a change in disinfection agent in anticipation of the Environment Protection Agency Disinfection Byproduct Rule, lead levels began rising in drinking water in Washington, District of Columbia, and in 2002, the DC Water and Sewer Authority was found to have exceeded the Environment Protection Agency lead action level, requiring compliance with a series of measures under the Lead and Copper Rule. In 2004, the issue became a public concern, drawing considerable media attention. The problem was eventually resolved through the application of orthophosphate but while it played out, the utility was forced to respond to a novel public health issue with few risk management options. This case study examines the lessons learned.

Elevated lead in drinking water in Washington, DC, 2003-2004: the public health response.

BACKGROUND: In 2003, residents of the District of Columbia (DC) experienced an abrupt rise in lead levels in drinking water, which followed a change in water-disinfection treatment in 2001 and which was attributed to consequent changes in water chemistry and corrosivity. OBJECTIVES: To evaluate the public health implications of the exceedance, the DC Department of Health expanded the scope of its monitoring programs for blood lead levels in children. METHODS: From 3 February 2004 to 31 July 2004, 6,834 DC residents were screened to determine their blood lead levels. RESULTS: Children from 6 months to 6 years of age constituted 2,342 of those tested; 65 had blood lead levels > 10 microg/dL (the "level of concern" defined by the Centers for Disease Control and Prevention), the highest with a level of 68 microg/dL. Investigation of their homes identified environmental sources of lead exposure other than tap water as the source, when the source was identified. Most of the children with elevated blood lead levels (n = 46; 70.8%) lived in homes without lead drinking-water service lines, which is the principal source of lead in drinking water in older cities. Although residents of houses with lead service lines had higher blood lead levels on average than those in houses that did not, this relationship is confounded. Older houses that retain lead service lines usually have not been rehabilitated and are more likely to be associated with other sources of exposure, particularly lead paint. None of 96 pregnant women tested showed blood lead levels > 10 microg/dL, but two nursing mothers had blood lead levels > 10 microg/dL. Among two data sets of 107 and 71 children for whom paired blood and water lead levels could be obtained, there was no correlation (r(2) = -0.03142 for the 107). CONCLUSIONS: The expanded screening program developed in response to increased lead levels in water uncovered the true dimensions of a continuing problem with sources of lead in homes, specifically lead paint. This study cannot be used to correlate lead in drinking water with blood lead levels directly because it is based on an ecologic rather than individualized exposure assessment; the protocol for measuring lead was based on regulatory requirements rather than estimating individual intake; numerous interventions were introduced to mitigate the effect; exposure from drinking water is confounded with other sources of lead in older houses; and the period of potential exposure was limited and variable.

Hormone replacement therapy and invasive and borderline epithelial ovarian cancer risk.

Risk of epithelial ovarian cancer (EOC) attendant to use of hormone replacement therapy (HRT) was evaluated in a population-based case-control study of newly diagnosed EOC cases (n=256) and randomly selected population controls (n=1122). Telephone interviews were conducted to obtain information on history of HRT and several other covariates. Multivariate adjusted odds ratio (OR) and 95% confidence intervals (CI) were derived from unconditional logistic regression. The OR for ever use of HRT was 1.39 (95% CI: 1.01-1.93) compared to never use. Long-term use (>10 years) increased risk (OR: 1.62, CI: 1.05-2.50) although the trend p-value for duration of use was of only borderline significance (p=0.08). The relationship was stronger in women without hysterectomy (OR: 1.66, 95% CI: 1.14-2.41) or tubal ligation (OR: 1.56, 95% CI: 1.08-2.26). In this study, use of HRT is associated with an increased risk of EOC.

Silicosis and lung function decrements among female ceramic workers in Italy.

It is well known that male ceramic workers have elevated risks of chronic silicosis. The objective of this study was to assess whether female ceramic workers also have an increased risk of silicosis and whether these women have decreased lung function related to silica exposure. Ceramic workers from Civitacastellana, Italy, were enrolled in health surveillance during the 1970s. A total of 642 women were under surveillance; a respiratory monitoring program was conducted from 1974 to 1987, with follow-up through 1991 that included annual chest radiography and measurement of lung function. Radiography findings were defined as silicosis if the chest films were > or =1/0 with small, rounded opacities. Multiple linear regression models for repeated measures (generalized estimating equations) were run to evaluate associations of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV(1)) with years of exposure and radiograph opacities. Nine cases of silicosis were identified on the basis of radiographic evidence. Silicosis risk was not associated with smoking but was related to employment before 1970 and demonstrated a dose-response gradient for years of exposure. FVC and FEV(1) both showed significant (p < 0.05) associations with duration of exposure and with positive radiography findings. The results for female ceramic workers are consistent with those for male employees regarding exposure to fibrogenic dusts.