The effect of shorter exposure versus prolonged exposure on treatment outcome in Tourette syndrome and chronic tic disorders - an open trial.

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van de Griendt, Jolande M T M; van Dijk, Maarten K; Verdellen, Cara W J; Verbraak, Marc J P M

2018-01-11

Exposure and response prevention has shown to be an effective strategy and is considered a first-line intervention in the behavioural treatment of tic disorders. Prior research demonstrated significant tic reduction after 12 two hour sessions. In this open trial, the question is addressed whether, relative to these prolonged sessions, exposure sessions of shorter duration yield differential outcome for patients with tic disorders. A total of 29 patients diagnosed with Tourette syndrome (TS) or chronic tic disorder were treated with shorter exposure sessions (1 h), and these data were compared to the data from a study about prolonged exposure (2 h, n = 21). Outcome was measured by the Yale Global Tic Severity Scale (YGTSS). Results suggest that after taking the difference in illness duration between the two groups into account, the effectiveness of shorter exposure sessions is not inferior to that of prolonged exposure. Results suggest that treatment with shorter exposure might be more efficient and more patients can be reached. Future research is needed to gain more insight into the mechanisms underlying the efficacy of behavioural treatments for tics.

Effect decomposition in the presence of an exposure-induced mediator-outcome confounder

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VanderWeele, Tyler J.; Vansteelandt, Stijn; Robins, James M.

2014-01-01

Methods from causal mediation analysis have generalized the traditional approach to direct and indirect effects in the epidemiologic and social science literature by allowing for interaction and non-linearities. However, the methods from the causal inference literature have themselves been subject to a major limitation in that the so-called natural direct and indirect effects that are employed are not identified from data whenever there is a variable that is affected by the exposure, which also confounds the relationship between the mediator and the outcome. In this paper we describe three alternative approaches to effect decomposition that give quantities that can be interpreted as direct and indirect effects, and that can be identified from data even in the presence of an exposure-induced mediator-outcome confounder. We describe a simple weighting-based estimation method for each of these three approaches, illustrated with data from perinatal epidemiology. The methods described here can shed insight into pathways and questions of mediation even when an exposure-induced mediator-outcome confounder is present. PMID:24487213

Fetal sex modifies effects of prenatal stress exposure and adverse birth outcomes.

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Wainstock, Tamar; Shoham-Vardi, Ilana; Glasser, Saralee; Anteby, Eyal; Lerner-Geva, Liat

2015-01-01

Prenatal maternal stress is associated with pregnancy complications, poor fetal development and poor birth outcomes. Fetal sex has also been shown to affect the course of pregnancy and its outcomes. The aim of this study was to evaluate whether fetal sex modifies the association between continuous exposure to life-threatening rocket attack alarms and adverse pregnancy outcomes. A retrospective cohort study was conducted in which the exposed group was comprised of 1846 women exposed to rocket-attack alarms before and during pregnancy. The unexposed group, with similar sociodemographic characteristics, delivered during the same period of time at the same medical center, but resided out of rocket-attack range. Multivariable models for each gender separately, controlling for possible confounders, evaluated the risk associated with exposure for preterm births (PTB), low birthweight (LBW), small for gestational age and small head circumference (HC). In both univariable and multivariable analyses exposure status was a significant risk factor in female fetuses only: PTB (adj. OR = 1.43; 1.04-1.96), LBW (adj. OR = 1.41; 1.02-1.95) and HC stress.

40 CFR 158.1060 - Post-application exposure-criteria for testing

Science.gov (United States)

2010-07-01

...) Occupational human post-application exposure to pesticide residues on plants or in soil could occur as the...) Residential human post-application exposure to pesticide residues on plants or in soil could occur. Such uses... and industrial or manufacturing facilities. (ii) Residential human post-application exposure to...

Pesticide Exposure and Neurodevelopmental Outcomes: Review of the Epidemiologic and Animal Studies

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Burns, Carol J.; McIntosh, Laura J.; Mink, Pamela J.; Jurek, Anne M.; Li, Abby A.

2013-01-01

Assessment of whether pesticide exposure is associated with neurodevelopmental outcomes in children can best be addressed with a systematic review of both the human and animal peer-reviewed literature. This review analyzed epidemiologic studies testing the hypothesis that exposure to pesticides during pregnancy and/or early childhood is associated with neurodevelopmental outcomes in children. Studies that directly queried pesticide exposure (e.g., via questionnaire or interview) or measured pesticide or metabolite levels in biological specimens from study participants (e.g., blood, urine, etc.) or their immediate environment (e.g., personal air monitoring, home dust samples, etc.) were eligible for inclusion. Consistency, strength of association, and dose response were key elements of the framework utilized for evaluating epidemiologic studies. As a whole, the epidemiologic studies did not strongly implicate any particular pesticide as being causally related to adverse neurodevelopmental outcomes in infants and children. A few associations were unique for a health outcome and specific pesticide, and alternative hypotheses could not be ruled out. Our survey of the in vivo peer-reviewed published mammalian literature focused on effects of the specific active ingredient of pesticides on functional neurodevelopmental endpoints (i.e., behavior, neuropharmacology and neuropathology). In most cases, effects were noted at dose levels within the same order of magnitude or higher compared to the point of departure used for chronic risk assessments in the United States. Thus, although the published animal studies may have characterized potential neurodevelopmental outcomes using endpoints not required by guideline studies, the effects were generally observed at or above effect levels measured in repeated-dose toxicology studies submitted to the U.S. Environmental Protection Agency (EPA). Suggestions for improved exposure assessment in epidemiology studies and more effective

Bias and power in group-based epidemiologic studies of low-back pain exposure and outcome--effects of study size and exposure measurement efforts.

Science.gov (United States)

Coenen, Pieter; Mathiassen, Svend Erik; Kingma, Idsart; Boot, Cécile R L; Bongers, Paulien M; van Dieën, Jaap H

2015-05-01

Exposure-outcome studies, for instance on work-related low-back pain (LBP), often classify workers into groups for which exposures are estimated from measurements on a sample of workers within or outside the specific study. The present study investigated the influence on bias and power in exposure-outcome associations of the sizes of the total study population and the sample used to estimate exposures. At baseline, lifting, trunk flexion, and trunk rotation were observed for 371 of 1131 workers allocated to 19 a-priori defined occupational groups. LBP (dichotomous) was reported by all workers during 3 years of follow-up. All three exposures were associated with LBP in this parent study (P power (P power >0.80 (P level = 0.05). A similar performance required n ≥ 30 workers for rotated trunk. Small numbers of observed workers (k) resulted in biased OR, while power was, in general, more sensitive to the total number of workers (n). In epidemiologic studies using a group-based exposure assessment strategy, statistical performance may be sufficient if outcome is obtained from a reasonably large number of workers, even if exposure is estimated from only few workers per group. © The Author 2014. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

The effects of prenatal cannabis exposure on fetal development and pregnancy outcomes: a protocol.

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Gunn, Jayleen K L; Rosales, Cecilia B; Center, Katherine E; Nuñez, Annabelle V; Gibson, Steven J; Ehiri, John E

2015-03-13

The effects of exposure to marijuana in utero on fetal development are not clear. Given that the recent legislation on cannabis in the US is likely to result in increased use, there is a need to assess the effects of prenatal cannabis exposure on fetal development and pregnancy outcomes. The objective of this review is to assess the effects of prenatal exposure to cannabis on pregnancy outcomes (including maternal and child outcomes). Major databases will be searched from inception to the latest issue, with the aim of identifying studies that reported the effects of prenatal exposure to cannabis on fetal development and pregnancy outcomes. Two investigators will independently review all titles and abstracts to identify potential articles. Discrepancies will be resolved by repeated review, discussion and consensus. Study quality assessment will be undertaken, using standard protocols. To qualify for inclusion, studies must report at least one maternal or neonatal outcome post partum. Cross-sectional, case-control, cohort and randomised controlled trials published in English will be included. In order to rule out the effects of other drugs that may affect fetal development and pregnancy outcomes, studies will only be included if they report outcomes of prenatal exposure to cannabis while excluding other illicit substances. Data from eligible studies will be extracted, and data analysis will include a systematic review and critical appraisal of evidence, and meta-analysis if data permit. Meta-analysis will be conducted if three or more studies report comparable statistics on the same outcome. The review which will result from this protocol has not already been conducted. Preparation of the review will follow the procedures stated in this protocol, and will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Ethical approval of data will not be required since the review will use data that are already available in the

Does fear extinction in the laboratory predict outcomes of exposure therapy? A treatment analog study.

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Forcadell, Eduard; Torrents-Rodas, David; Vervliet, Bram; Leiva, David; Tortella-Feliu, Miquel; Fullana, Miquel A

2017-11-01

Fear extinction models have a key role in our understanding of anxiety disorders and their treatment with exposure therapy. Here, we tested whether individual differences in fear extinction learning and fear extinction recall in the laboratory were associated with the outcomes of an exposure therapy analog (ETA). Fifty adults with fear of spiders participated in a two-day fear-learning paradigm assessing fear extinction learning and fear extinction recall, and then underwent a brief ETA. Correlational analyses indicated that enhanced extinction learning was associated with better ETA outcome. Our results partially support the idea that individual differences in fear extinction learning may be associated with exposure therapy outcome, but suggest that further research in this area is needed. Copyright © 2017 Elsevier B.V. All rights reserved.

Chronic Exposure to Subtherapeutic Antibiotics Aggravates Ischemic Stroke Outcome in Mice

Directory of Open Access Journals (Sweden)

Xiao-Hui Dong

2017-10-01

Full Text Available Subtherapeutic antibiotics have been widely used in agriculture since the 1950s, which can be accumulated in human body through various approaches and may have long-term consequences. However, there is limited information about the link between chronic subtherapeutic antibiotic exposure and the outcome of ischemic brain injury. Here we showed that long-term treatment with subtherapeutic chlortetracycline, penicillin or vancomycin, which were widely used in agriculture approved by US Food and Drug Administration (FDA, could impair EPC functions, reduce ischemic brain angiogenesis and aggravate cerebral ischemic injury and long-term stroke outcomes in mice. In addition, transplantated EPCs from chronic antibiotic-treated mice showed a lower therapeutic effect on cerebral ischemic injury reduction and local angiogenesis promotion compared to those from control mice, and EPCs from the donor animals could integrate into the recipient ischemic brain in mice. Furthermore, transplanted EPCs might exert paracrine effects on cerebral ischemic injury reduction in mice, which could be impaired by chronic antibiotic exposure. In conclusion, chronic subtherapeutic antibiotic exposure aggravated cerebral ischemic injury in mice, which might be partly attributed to the impairment of both EPC-mediated angiogenesis and EPCs' paracrine effects. These findings reveal a previously unrecognized impact of chronic subtherapeutic antibiotic exposure on ischemic injury.

Prospective study of pregnancy outcomes after parental cell phone exposure: the Norwegian Mother and Child Cohort Study.

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Baste, Valborg; Oftedal, Gunnhild; Møllerløkken, Ole Jacob; Mild, Kjell Hansson; Moen, Bente E

2015-07-01

Research about prenatal exposure to electromagnetic fields from cell phones among expectant parents and reproductive outcome is limited. The aim of this article is to investigate the association between pregnancy outcome and parental cell phone exposure in a large prospective study. The study was based on the Norwegian Mother and Child Cohort Study conducted during the decade 1999-2009. In that study, pregnant women were recruited before a routine ultrasound examination during gestational week 15; they answered a questionnaire at that time and again around gestational week 30. The expectant father was invited to answer a questionnaire during gestational week 15 (2001-2009). The forms contained questions regarding cell phone use. The response rate was 38.7% and the cohort comprised 100,730 singleton births. Pregnancy outcomes were obtained by linkage to the Medical Birth Registry of Norway. The risk of preeclampsia was slightly lower among women with medium and high cell phone exposure compared with low exposure after adjusting for potential confounders. Fathers with testis exposure when using cell phones had a borderline increased risk of perinatal mortality among offspring and a slightly decreased risk of partner developing preeclampsia during pregnancy compared with no cell phone exposure of head or testis. None of the other pregnancy outcomes was associated with cell phone exposure. We found no association between maternal prenatal or paternal preconceptional cell phone exposure and any of the studied pregnancy outcomes. The only risk estimate suggesting a potential increased risk was not consistent with other findings.

A Workflow to Investigate Exposure and Pharmacokinetic Influences on High-Throughput in Vitro Chemical Screening Based on Adverse Outcome Pathways

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Phillips, Martin B.; Leonard, Jeremy A.; Grulke, Christopher M.; Chang, Daniel T.; Edwards, Stephen W.; Brooks, Raina; Goldsmith, Michael-Rock; El-Masri, Hisham; Tan, Yu-Mei

2015-01-01

Background Adverse outcome pathways (AOPs) link adverse effects in individuals or populations to a molecular initiating event (MIE) that can be quantified using in vitro methods. Practical application of AOPs in chemical-specific risk assessment requires incorporation of knowledge on exposure, along with absorption, distribution, metabolism, and excretion (ADME) properties of chemicals. Objectives We developed a conceptual workflow to examine exposure and ADME properties in relation to an MIE. The utility of this workflow was evaluated using a previously established AOP, acetylcholinesterase (AChE) inhibition. Methods Thirty chemicals found to inhibit human AChE in the ToxCast™ assay were examined with respect to their exposure, absorption potential, and ability to cross the blood–brain barrier (BBB). Structures of active chemicals were compared against structures of 1,029 inactive chemicals to detect possible parent compounds that might have active metabolites. Results Application of the workflow screened 10 “low-priority” chemicals of 30 active chemicals. Fifty-two of the 1,029 inactive chemicals exhibited a similarity threshold of ≥ 75% with their nearest active neighbors. Of these 52 compounds, 30 were excluded due to poor absorption or distribution. The remaining 22 compounds may inhibit AChE in vivo either directly or as a result of metabolic activation. Conclusions The incorporation of exposure and ADME properties into the conceptual workflow eliminated 10 “low-priority” chemicals that may otherwise have undergone additional, resource-consuming analyses. Our workflow also increased confidence in interpretation of in vitro results by identifying possible “false negatives.” Citation Phillips MB, Leonard JA, Grulke CM, Chang DT, Edwards SW, Brooks R, Goldsmith MR, El-Masri H, Tan YM. 2016. A workflow to investigate exposure and pharmacokinetic influences on high-throughput in vitro chemical screening based on adverse outcome pathways. Environ

Measuring lifetime stress exposure and protective factors in life course research on racial inequality and birth outcomes.

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Malat, Jennifer; Jacquez, Farrah; Slavich, George M

2017-07-01

There has been a long-standing interest in better understanding how social factors contribute to racial disparities in health, including birth outcomes. A recent emphasis in this context has been on identifying the effects of stress exposure and protective factors experienced over the entire lifetime. Yet despite repeated calls for a life course approach to research on this topic, very few studies have actually assessed how stressors and protective factors occurring over women's lives relate to birth outcomes. We discuss this issue here by describing how challenges in the measurement of lifetime stress exposure and protective factors have prevented researchers from developing an empirically-based life course perspective on health. First, we summarize prevailing views on racial inequality and birth outcomes; second, we discuss measurement challenges that exist in this context; and finally, we describe both new tools and needed tools for assessing lifetime stress exposure and suggest opportunities for integrating information on stress exposure and psychosocial protective factors. We conclude that more studies are needed that integrate information about lifetime stress exposures and the protective factors that promote resilience against such exposures to inform policy and practice recommendations to reduce racial disparities in birth outcomes.

The effect of the presence and characteristics of an outlying group on exposure-outcome associations

NARCIS (Netherlands)

Coenen, P.; Mathiassen, S.E.; Kingma, I.; Boot, C.R.L.; Bongers, P.M.; van Dieen, J.H.

2015-01-01

OBJECTIVES: Physical exposures (eg, lifting or bending) are believed to be risk factors for low-back pain (LBP), but the literature is inconsistent. Exposure and LBP prevalence differ considerably between occupations, and exposure-outcome associations could be severely modified by the presence of

Gender differences in cue exposure reactivity and 9-month outcome.

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Sterling, Robert C; Dean, Jessica; Weinstein, Stephen P; Murphy, Jennifer; Gottheil, Edward

2004-07-01

Gender differences have been shown to be related to the course of cocaine dependence and treatment. While previous research has shown cue exposure procedures to be somewhat effective at reducing reactivity of substance dependent individuals to drug related stimuli, the few studies that have examined gender differences in craving and cue-reactivity have yielded equivocal results. We have recently demonstrated that an active cue-exposure procedure that featured cocaine-dependent individuals receiving immediate feedback about their level of physiological arousal following videotaped exposure to cocaine-related stimuli was capable of positively influencing in-treatment (helplessness, abstinence efficacy) as well as 9-month followup outcome (i.e., urinalysis) indices (Sterling, R., Gottheil, E., Murphy, J., & Weinstein, S. (2001). Cue exposure and abstinence efficacy. College on Problems of Drug Dependence, Phoenix, AZ, June 17, 2001). The purpose of the present study was to determine whether differential in-treatment or 9-month followup outcomes were obtained for male and female study participants. Subjects in this study were 81 individuals (47 male/34 female) who met DSM-IV criteria for cocaine dependence and who had consented to be randomly assigned to either the active cue-exposure or control conditions. Participants were compared along a myriad of pre-treatment, in-treatment, and 9-month followup measures. Other than males reporting more recent employment, there was no obvious systematic pattern of differences on pre-treatment indices. No gender differences in treatment retention were observed. With respect to 9-month followup, no gender differences on measures of addiction severity, psychological functioning, or urinalyses were noted. However males were more "cue-reactive" and more successful at establishing control over their reactivity to the cocaine stimuli. Additional research is needed to determine whether these differences in reactivity can be more clearly

Exposure assessment of acrylates/methacrylates in radiation-cured applications

International Nuclear Information System (INIS)

1987-01-01

Occupational exposures to radiation-cured acrylates/methacrylates during their processing and use in coatings, inks, and adhesives were evaluated in 12 walk-through surveys at formulator and applicator sites. Inhalation and dermal-exposure routes were studied. According to the authors, the basic process used to formulate coatings, inks, and adhesives consists of blending raw materials in closed mixing vessels using local exhaust ventilation in the form of elephant trunks at vessel charging and packaging locations. Application methods surveyed included reverse-roll coaters, direct roll coaters, curtain/rain coaters, laminators, pneumatic injection, spray guns, and manual application. At the sites surveyed, the number of workers potentially exposed at each site ranged from two to 142. Process operators at applicator sites had the greatest potential for dermal exposure. Generally, the potential for inhalation exposure was low due to low volatility of the multifunctional acrylates/methacrylates used in the formulations. No reliable air-monitoring data were available at any site. Respirator use was limited and sporadic

Mediating role of stress reactivity in the effects of prenatal tobacco exposure on childhood mental health outcomes.

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Park, Aesoon; O'Malley, Stephanie S; King, Sarah L; Picciotto, Marina R

2014-02-01

Prenatal tobacco exposure, through maternal smoking during pregnancy, has been associated with adverse mental health outcomes in childhood. However, the mechanisms by which prenatal tobacco exposure compromises mental health later in life are unclear. We hypothesized that sensitized reactivity to stressful life events in early childhood mediates the effect of prenatal tobacco exposure on mental health outcomes in middle childhood, after accounting for earlier mental health outcomes. Data were from 12,308 mothers and their children drawn from the Avon Longitudinal Study of Parents and Children, a large prospective population-based study. Mothers' self-reports of smoking during pregnancy, mothers' ratings of their child's reactivity to stressful life events, and teachers' and mothers' ratings of the Strengths and Difficulties Questionnaire assessing 5 domains of mental health outcomes were measured. A positive association was found between prenatal tobacco exposure and stress reactivity between the ages of 2 and 6. In turn, stress reactivity was positively associated with peer (isolation), hyperactivity, conduct, and emotional problems (but not prosocial behaviors) between the ages of 7 and 11, after accounting for the mental health outcome at age 4 and other confounders. Heightened stress reactivity in preschool ages mediated the effect of prenatal tobacco exposure on adverse mental health outcomes between the ages of 7 and 11. Interventions to assist children exposed to tobacco smoke during gestation in coping with stressful life events may help mitigate psychiatric symptoms in this population.

Inhalational and dermal exposures during spray application of biocides.

Science.gov (United States)

Berger-Preiss, Edith; Boehncke, Andrea; Könnecker, Gustav; Mangelsdorf, Inge; Holthenrich, Dagmar; Koch, Wolfgang

2005-01-01

Data on inhalational and potential dermal exposures during spray application of liquid biocidal products were generated. On the one hand, model experiments with different spraying devices using fluorescent tracers were carried out to investigate the influence of parameters relevant to the exposure (e.g. spraying equipment, nozzle size, direction of application). On the other hand, measurements were performed at selected workplaces (during disinfection operations in food and feed areas; pest control operations for private, public and veterinary hygiene; wood protection and antifouling applications) after application of biocidal products such as Empire 20, Responsar SC, Omexan-forte, Actellic, Perma-forte; Fendona SC, Pyrethrum mist; CBM 8, Aldekol Des 03, TAD CID, Basileum, Basilit. The measurements taken in the model rooms demonstrated dependence of the inhalation exposure on the type of spraying device used, in the following order: "spraying with low pressure" < "airless spraying" < "fogging" indicating that the particle diameter of the released spray droplets is the most important parameter. In addition inhalation exposure was lowest when the spraying direction was downward. Also for the potential dermal exposure, the spraying direction was of particular importance: overhead spraying caused the highest contamination of body surfaces. The data of inhalational and potential dermal exposures gained through workplace measurements showed considerable variation. During spraying procedures with low-pressure equipments, dose rates of active substances inhaled by the operators ranged from 7 to 230 microg active substance (a.s.)/h. An increase in inhaled dose rates (6-33 mg a.s./h) was observed after use of high application volumes/time unit during wood protection applications indoors. Spraying in the veterinary sector using medium-pressure sprayers led to inhaled dose rates between 2 and 24mga.s./h. The highest inhaled dose rates were measured during fogging (114 mg a

Infertility, Pregnancy Loss and Adverse Birth Outcomes in Relation to Maternal Secondhand Tobacco Smoke Exposure

Science.gov (United States)

Meeker, John D.; Benedict, Merle D.

2013-01-01

A substantial proportion of the etiology involved in female infertility and adverse pregnancy outcomes remains idiopathic. Recent scientific research has suggested a role for environmental factors in these conditions. Secondhand tobacco smoke (STS) contains a number of known or suspected reproductive toxins, and human exposure to STS is prevalent worldwide. Robust evidence exists for the toxic effects of active smoking on fertility and pregnancy, but studies of passive exposure are much more limited in number. While the association between maternal STS exposure and declined birth weight has been fairly well-documented, only recently have epidemiologic studies begun to provide suggestive evidence for delayed conception, altered menstrual cycling, early pregnancy loss (e.g. spontaneous abortion), preterm delivery, and congenital malformations in relation to STS exposure. There is also new evidence that developmental exposures to tobacco smoke may be associated with reproductive effects in adulthood. To date, most studies have estimated maternal STS exposure through self-report even though exposure biomarkers are less prone to error and recall bias. In addition to utilizing biomarkers of STS exposure, future studies should aim to identify vital windows of STS exposure, important environmental co-exposures, individual susceptibility factors, and specific STS constituents associated with female infertility and adverse pregnancy outcomes. The role of paternal exposures/factors should also be investigated. PMID:23888128

Biomarkers, lactate, and clinical scores as outcome predictors in systemic poisons exposures.

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Lionte, C; Sorodoc, V; Tuchilus, C; Cimpoiesu, D; Jaba, E

2017-07-01

Acute exposure to systemic poisons represents an important challenge in clinical toxicology. We aimed to analyze the potential role of cardiac biomarkers, routine laboratory tests, and clinical scores as morbidity and in-hospital mortality predictors in patients intoxicated with various systemic poisons. We conducted a prospective study on adults acutely exposed to systemic poisons. We determined the PSS, Glasgow Coma Scale (GCS), and we performed electrocardiogram, laboratory tests, lactate and cardiac biomarkers (which were reassessed 4 h, respectively 6 h later). Of 120 patients included, 45% developed complications, 19.2% had a poor outcome, and 5% died. Multivariate logistic regression sustained lactate (odds ratio (OR) 1.58; confidence interval (CI) 95%: 0.97-2.59; p 0.066), MB isoenzyme of creatine kinase (6h-CKMB; OR 1.08; CI 95%: 1.02-1.16; p 0.018) as predictors for a poor outcome. A GCS poisons exposure. Receiver operating characteristic analysis showed that brain natriuretic peptide (area under the curve (AUC), 0.96; CI 95%: 0.92-0.99; p poisons exposure.

Maternal Arsenic Exposure, Arsenic Methylation Efficiency, and Birth Outcomes in the Biomarkers of Exposure to ARsenic (BEAR) Pregnancy Cohort in Mexico

Science.gov (United States)

Laine, Jessica E.; Bailey, Kathryn A.; Rubio-Andrade, Marisela; Olshan, Andrew F.; Smeester, Lisa; Drobná, Zuzana; Herring, Amy H.; Stýblo, Miroslav; García-Vargas, Gonzalo G.

2014-01-01

Background: Exposure to inorganic arsenic (iAs) from drinking water is a global public health problem, yet much remains unknown about the extent of exposure in susceptible populations. Objectives: We aimed to establish the Biomarkers of Exposure to ARsenic (BEAR) prospective pregnancy cohort in Gómez Palacio, Mexico, to better understand the effects of iAs exposure on pregnant women and their children. Methods: Two hundred pregnant women were recruited for this study. Concentrations of iAs in drinking water (DW-iAs) and maternal urinary concentrations of iAs and its monomethylated and dimethylated metabolites (MMAs and DMAs, respectively) were determined. Birth outcomes were analyzed for their relationship to DW-iAs and to the concentrations and proportions of maternal urinary arsenicals. Results: DW-iAs for the study subjects ranged from iAs that exceeded the World Health Organization’s recommended guideline of 10 μg As/L. DW-iAs was significantly associated with the sum of the urinary arsenicals (U-tAs). Maternal urinary concentrations of MMAs were negatively associated with newborn birth weight and gestational age. Maternal urinary concentrations of iAs were associated with lower mean gestational age and newborn length. Conclusions: Biomonitoring results demonstrate that pregnant women in Gómez Palacio are exposed to potentially harmful levels of DW-iAs. The data support a relationship between iAs metabolism in pregnant women and adverse birth outcomes. The results underscore the risks associated with iAs exposure in vulnerable populations. Citation: Laine JE, Bailey KA, Rubio-Andrade M, Olshan AF, Smeester L, Drobná Z, Herring AH, Stýblo M, García-Vargas GG, Fry RC. 2015. Maternal arsenic exposure, arsenic methylation efficiency, and birth outcomes in the Biomarkers of Exposure to ARsenic (BEAR) pregnancy cohort in Mexico. Environ Health Perspect 123:186–192; http://dx.doi.org/10.1289/ehp.1307476 PMID:25325819

Assessing Health Outcomes After Environmental Exposures Associated With Open Pit Burning in Deployed US Service Members.

Science.gov (United States)

Rohrbeck, Patricia; Hu, Zheng; Mallon, Col Timothy M

2016-08-01

This study assessed the long-term health impact of environmental exposures associated with open pit burning in deployed US service members. Two hundred individuals deployed to Balad, Iraq, and Bagram, Afghanistan, with known exposure to open pits, were matched to 200 non-deployed service members. Both cohorts were observed for adverse health outcomes after returning from deployment. Slight increased risks were observed for respiratory diseases in the Bagram cohort (adj RR: 1.259), and for cardiovascular disease in the Balad cohort (adj RR: 1.072), but the findings were not significant. The combined deployed cohort showed lower risks for adverse health outcomes, suggesting a healthy deployer effect. In conclusion, this study did not find significantly increased risks for selected health outcomes after burn pit exposure during deployment among two deployed cohorts compared with a non-deployed cohort.

Assessing exposure to violence using multiple informants: application of hierarchical linear model.

Science.gov (United States)

Kuo, M; Mohler, B; Raudenbush, S L; Earls, F J

2000-11-01

The present study assesses the effects of demographic risk factors on children's exposure to violence (ETV) and how these effects vary by informants. Data on exposure to violence of 9-, 12-, and 15-year-olds were collected from both child participants (N = 1880) and parents (N = 1776), as part of the assessment of the Project on Human Development in Chicago Neighborhoods (PHDCN). A two-level hierarchical linear model (HLM) with multivariate outcomes was employed to analyze information obtained from these two different groups of informants. The findings indicate that parents generally report less ETV than do their children and that associations of age, gender, and parent education with ETV are stronger in the self-reports than in the parent reports. The findings support a multivariate approach when information obtained from different sources is being integrated. The application of HLM allows an assessment of interactions between risk factors and informants and uses all available data, including data from one informant when data from the other informant is missing.

Bias and power in group-based epidemiologic studies of low-back pain exposure and outcome - Effects of study size and exposure measurement efforts

NARCIS (Netherlands)

Coenen, P.; Mathiassen, S.E.; Kingma, I.; Boot, C.R.L.; Bongers, P.M.; Dieën, J.H. van

2015-01-01

Objectives: Exposure-outcome studies, for instance on work-related low-back pain (LBP), often classify workers into groups for which exposures are estimated from measurements on a sample of workers within or outside the specific study. The present study investigated the influence on bias and power

Fetal magnetic resonance imaging: exposure times and functional outcomes at preschool age

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Bouyssi-Kobar, Marine [George Washington University, Institute for Biomedical Sciences, Washington, DC (United States); Children' s National Health System, Advanced Pediatric Brain Imaging Research Laboratory, Departments of Diagnostic Imaging and Radiology, Washington, DC (United States); Du Plessis, Adre J. [Children' s National Health System, Fetal and Transitional Medicine, Washington, DC (United States); Robertson, Richard L. [Children' s Hospital Boston and Harvard Medical School, Department of Radiology, Boston, MA (United States); Limperopoulos, Catherine [Children' s National Health System, Advanced Pediatric Brain Imaging Research Laboratory, Departments of Diagnostic Imaging and Radiology, Washington, DC (United States); Children' s National Health System, Fetal and Transitional Medicine, Washington, DC (United States)

2015-11-15

Fetal magnetic resonance imaging (MRI) has been routinely used as a noninvasive diagnostic tool for more than a decade; however, there is a paucity of follow-up studies examining the effects of prenatal exposure to 1.5-T MRI on developmental outcome. The objective of this study was to assess the safety of 1.5-T fetal MRI by evaluating functional outcomes of preschool children who were exposed in utero. In the context of a prospective observational study, healthy pregnant women underwent a 1.5-T MRI study using single-shot fast spin echo (SSFSE) sequences during the second or third trimester of pregnancy. The study was approved by the institutional review board at our institution, and written informed consent was obtained from all study participants. MRI scanning times were recorded, and prenatal/postnatal clinical data were collected prospectively. Functional outcomes were assessed using the Vineland Adaptive Behavior Scale (VABS), a widely used, norm-referenced and psychometrically sound functional assessment. We studied 72 healthy pregnant women, who underwent fetal MRI at a mean gestational age of 30.5 ± 3.1 weeks. The cohort of fetuses was composed of 43% females, and 18 fetuses were scanned during the second trimester. All fetuses were born at term with appropriate birth weights (3.54 ± 0.5 kg) for gestational age. Mean age at follow-up testing was 24.5 ± 6.7 months. All children had age-appropriate scores in the communication, daily living, socialization and motor skills subdomains of the VABS (z-scores, P > 0.05). Furthermore, all children passed their newborn otoacoustic emission test and had normal hearing at preschool age. MRI study duration and exposure time to radio frequency waves and SSFSE sequences were not associated with adverse functional outcomes or hearing impairment. Prenatal exposure to 1.5-T MRI during the second or third trimester of pregnancy in a cohort of healthy fetuses is not associated with disturbances in functional outcomes or

Fetal magnetic resonance imaging: exposure times and functional outcomes at preschool age

International Nuclear Information System (INIS)

Bouyssi-Kobar, Marine; Du Plessis, Adre J.; Robertson, Richard L.; Limperopoulos, Catherine

2015-01-01

Fetal magnetic resonance imaging (MRI) has been routinely used as a noninvasive diagnostic tool for more than a decade; however, there is a paucity of follow-up studies examining the effects of prenatal exposure to 1.5-T MRI on developmental outcome. The objective of this study was to assess the safety of 1.5-T fetal MRI by evaluating functional outcomes of preschool children who were exposed in utero. In the context of a prospective observational study, healthy pregnant women underwent a 1.5-T MRI study using single-shot fast spin echo (SSFSE) sequences during the second or third trimester of pregnancy. The study was approved by the institutional review board at our institution, and written informed consent was obtained from all study participants. MRI scanning times were recorded, and prenatal/postnatal clinical data were collected prospectively. Functional outcomes were assessed using the Vineland Adaptive Behavior Scale (VABS), a widely used, norm-referenced and psychometrically sound functional assessment. We studied 72 healthy pregnant women, who underwent fetal MRI at a mean gestational age of 30.5 ± 3.1 weeks. The cohort of fetuses was composed of 43% females, and 18 fetuses were scanned during the second trimester. All fetuses were born at term with appropriate birth weights (3.54 ± 0.5 kg) for gestational age. Mean age at follow-up testing was 24.5 ± 6.7 months. All children had age-appropriate scores in the communication, daily living, socialization and motor skills subdomains of the VABS (z-scores, P > 0.05). Furthermore, all children passed their newborn otoacoustic emission test and had normal hearing at preschool age. MRI study duration and exposure time to radio frequency waves and SSFSE sequences were not associated with adverse functional outcomes or hearing impairment. Prenatal exposure to 1.5-T MRI during the second or third trimester of pregnancy in a cohort of healthy fetuses is not associated with disturbances in functional outcomes or

Geospatial exposure to point-of-sale tobacco: real-time craving and smoking-cessation outcomes.

Science.gov (United States)

Kirchner, Thomas R; Cantrell, Jennifer; Anesetti-Rothermel, Andrew; Ganz, Ollie; Vallone, Donna M; Abrams, David B

2013-10-01

Little is known about the factors that drive the association between point-of-sale marketing and behavior, because methods that directly link individual-level use outcomes to real-world point-of-sale exposure are only now beginning to be developed. Daily outcomes during smoking cessation were examined as a function of both real-time geospatial exposure to point-of-sale tobacco (POST) and subjective craving to smoke. Continuous individual geospatial location data collected over the first month of a smoking-cessation attempt in 2010-2012 (N=475) were overlaid on a POST outlet geodatabase (N=1060). Participants' mobility data were used to quantify the number of times they came into contact with a POST outlet. Participants recorded real-time craving levels and smoking status via ecological momentary assessment (EMA) on cellular telephones. The final data set spanned a total of 12,871 days of EMA and geospatial tracking. Lapsing was significantly more likely on days with any POST contact (OR=1.19, 95% CI=1.18, 1.20), and increasingly likely as the number of daily POST contacts increased (OR=1.07, 95% CI=1.06, 1.08). Overall, daily POST exposure was significantly associated with lapsing when craving was low (OR=1.22, 95% CI=1.20, 1.23); high levels of craving were more directly associated with lapse outcomes. These data shed light on the way mobility patterns drive a dynamic interaction between individuals and the POST environment, demonstrating that quantification of individuals' exposure to POST marketing can be used to identify previously unrecognized patterns of association among individual mobility, the built environment, and behavioral outcomes. © 2013 American Journal of Preventive Medicine.

Use of the Finnish Information System on Occupational Exposure (FINJEM) in epidemiologic, surveillance, and other applications.

Science.gov (United States)

Kauppinen, Timo; Uuksulainen, Sanni; Saalo, Anja; Mäkinen, Ilpo; Pukkala, Eero

2014-04-01

This paper reviews the use of the Finnish Information System on Occupational Exposure (Finnish job-exposure matrix, FINJEM) in different applications in Finland and other countries. We describe and discuss studies on FINJEM and studies utilizing FINJEM in regard to the validity of exposure estimates, occupational epidemiology, hazard surveillance and prevention, the assessment of health risks and the burden of disease, the assessment of exposure trends and future hazards, and the construction of job-exposure matrices (JEMs) in countries other than Finland. FINJEM can be used as an exposure assessment tool in occupational epidemiology, particularly in large register-based studies. It also provides information for hazard surveillance at the national level. It is able to identify occupations with high average exposures to chemical agents and can therefore serve the priority setting of prevention. However, it has only limited use at the workplace level due to the variability of exposure between workplaces. The national estimates of exposure and their temporal trends may contribute to the assessment of both the recent and future burden of work-related health outcomes. FINJEM has also proved to be useful in the construction of other national JEMs, for example in the Nordic Occupational Cancer study in the Nordic countries. FINJEM is a quantitative JEM, which can serve many purposes and its comprehensive documentation also makes it potentially useful in countries other than Finland.

Applicability of an exposure model for the determination of emissions from mobile phone base stations

DEFF Research Database (Denmark)

Breckenkamp, J; Neitzke, H P; Bornkessel, C

2008-01-01

Applicability of a model to estimate radiofrequency electromagnetic field (RF-EMF) strength in households from mobile phone base stations was evaluated with technical data of mobile phone base stations available from the German Net Agency, and dosimetric measurements, performed in an epidemiologi......Applicability of a model to estimate radiofrequency electromagnetic field (RF-EMF) strength in households from mobile phone base stations was evaluated with technical data of mobile phone base stations available from the German Net Agency, and dosimetric measurements, performed...... in an epidemiological study. Estimated exposure and exposure measured with dosemeters in 1322 participating households were compared. For that purpose, the upper 10th percentiles of both outcomes were defined as the 'higher exposed' groups. To assess the agreement of the defined 'higher' exposed groups, kappa...... coefficient, sensitivity and specificity were calculated. The present results show only a weak agreement of calculations and measurements (kappa values between -0.03 and 0.28, sensitivity between 7.1 and 34.6). Only in some of the sub-analyses, a higher agreement was found, e.g. when measured instead...

Paternal occupational exposure to radiofrequency electromagnetic fields and risk of adverse pregnancy outcome

International Nuclear Information System (INIS)

Mjoen, Geir; Saetre, Dag Ottar; Lie, Rolv T.; Tynes, Tore; Blaasaas, Karl Gerhard; Hannevik, Merete; Irgens, Lorentz M.

2006-01-01

Background:During the last decades, public concern that radiofrequency radiation (RFR) may be related to adverse reproductive outcomes has been emerging. Our objective was to assess associations between paternal occupational exposure to RFR and adverse pregnancy outcomes including birth defects using population-based data from Norway.Methods:Data on reproductive outcomes derived from the Medical Birth Registry of Norway were linked with data on paternal occupation derived from the general population censuses. An expert panel categorized occupations according to exposure. Using logistic regression, we analyzed 24 categories of birth defects as well as other adverse outcomes.Results:In the offspring of fathers most likely to have been exposed, increased risk was observed for preterm birth (odds ratio (OR): 1.08, 95% confidence interval (CI): 1.03, 1.15). In this group we also observed a decreased risk of cleft lip (OR: 0.63, 95% CI: 0.41, 0.97). In the medium exposed group, we observed increased risk for a category of ,other defects' (OR: 2.40, 95% CI: 1.22, 4.70), and a decreased risk for a category of ,other syndromes' (OR: 0.75, 95% CI: 0.56, 0.99) and upper gastrointestinal defects (OR: 0.61, 95% CI: 0.40, 0.93).Conclusion:The study is partly reassuring for occupationally exposed fathers

Neurological outcome in school-age children after in utero exposure to coumarins

NARCIS (Netherlands)

Wesseling, J; Van Driel, D; Smrkovsky, M; Van der Veer, E; Geven-Boere, LM; Sauer, PJJ; Touwen, BCL

The effect of prenatal exposure to coumarins (acenocoumarol, phenprocoumon) on neurological outcome was assessed in a cohort of 306 children aged 7-15 years. Findings were compared with those in a non-exposed cohort of 267 children, matched for sex, age, and demographic region. We used a

Aerosol exposure: Concepts, criteria, standards and applications

International Nuclear Information System (INIS)

Vincent, James H

2009-01-01

This paper places Inhaled Particles X in the context of the whole sequence of such symposia, going back to the first one in 1961. It draws together some of the essential principles that have been learned since that earlier meeting about the nature of exposure and exposure assessment and thus provides a framework by which to integrate the new knowledge presented at this latest one. In the process, the importance of understanding the formal definition of aerosol exposure is stressed, including the distinction between exposure intensity and exposure history, and how that relates to some measure of cumulative dose which, in turn, may be linked with knowledge about intrinsic toxicity, etc. This then leads to a definition of exposure standards, and the important ingredients of criteria, sampling and limit values. A summary is provided of the current set of particle size-selective criteria that have been widely agreed in the international occupational and environmental health community. Some ideas are presented about how this set might be expanded for certain applications, the important case of ultrafine aerosols being one of them.

Prenatal nonylphenol exposure, oxidative and nitrative stress, and birth outcomes: A cohort study in Taiwan

International Nuclear Information System (INIS)

Wang, Pei-Wei; Chen, Mei-Lien; Huang, Li-Wei; Yang, Winnie; Wu, Kuen-Yuh; Huang, Yu-Fang

2015-01-01

Data concerning the effects of prenatal exposures to nonylphenol (NP) and oxidative stress on neonatal birth outcomes from human studies are limited. A total of 146 pregnant women were studied (1) to investigate the association between prenatal NP exposure and maternal oxidative/nitrative stress biomarkers of DNA damage (8-hydroxy-2’-deoxyguanosine (8-OHdG), 8-nitroguanine (8-NO 2 Gua)) and lipid peroxidation (8-iso-prostaglandin F 2α (8-isoPF 2α ), 4-hydroxy-2-nonenal-mercapturic acid (HNE-MA)) and (2) to explore the associations among oxidative stress biomarkers, NP exposure, and neonatal birth outcomes, including gestational age, birth weight, length, Ponderal index, and head and chest circumferences. NP significantly increased the 8-OHdG and 8-NO 2 Gua levels. All infants born to mothers with urinary 8-OHdG levels above the median exhibited a significantly shorter gestational duration (B adjusted  = −4.72 days; 95% CI: −8.08 to −1.36 days). No clear association was found between NP levels and birth outcomes. Prenatal 8-OHdG levels might be a novel biomarker for monitoring fetal health related to NP exposure. - Highlights: • A cohort of pregnant women was established and followed until delivery. • NP significantly increased 8-OHdG and 8-NO 2 Gua levels. • Maternal 8-OHdG levels were associated with significantly decreased gestational duration. • No clear association was observed between NP and birth outcomes. - NP increased 8-OHdG and 8-NO 2 Gua levels; high 8-OHdG levels significantly decreased gestation length.

Exposure to phthalates: reproductive outcome and children health. A review of epidemiological studies.

Science.gov (United States)

Jurewicz, Joanna; Hanke, Wojciech

2011-06-01

Phthalates are a family of industrial chemicals that have been used for a variety of purposes. As the potential consequences of human exposure to phthalates have raised concerns in the general population, they have been studied in susceptible subjects such as pregnant women, infants and children. This article aims at evaluating the impact of exposure to phthalates on reproductive outcomes and children health by reviewing most recent published literature. Epidemiological studies focusing on exposure to phthalates and pregnancy outcome, genital development, semen quality, precocious puberty, thyroid function, respiratory symptoms and neurodevelopment in children for the last ten years were identified by a search of the PubMed, Medline, Ebsco, Agricola and Toxnet literature bases. The results from the presented studies suggest that there are strong and rather consistent indications that phthalates increase the risk of allergy and asthma and have an adverse impact on children's neurodevelopment reflected by quality of alertness among girls, decreased (less masculine) composite score in boys and attention deficit hyperactivity disorder. Results of few studies demonstrate negative associations between phthalate levels commonly experienced by the public and impaired sperm quality (concentration, morphology, motility). Phthalates negatively impact also on gestational age and head circumference; however, the results of the studies were not consistent. In all the reviewed studies, exposure to phthalates adversely affected the level of reproductive hormones (luteinizing hormone, free testosterone, sex hormone-binding globulin), anogenital distance and thyroid function. The urinary levels of phthalates were significantly higher in the pubertal gynecomastia group, in serum in girls with premature thelarche and in girls with precocious puberty. Epidemiological studies, in spite of their limitations, suggest that phthalates may affect reproductive outcome and children health

Therapist-Aided Exposure for Women with Lifelong Vaginismus: Mediators of Treatment Outcome: A Randomized Waiting List Control Trial.

Science.gov (United States)

Ter Kuile, Moniek M; Melles, Reinhilde J; Tuijnman-Raasveld, Charlotte C; de Groot, Helen E; van Lankveld, Jacques J D M

2015-08-01

Therapist-aided exposure seems an effective treatment for lifelong vaginismus, but mechanisms of action have not yet been established. The purpose of the present study was to investigate whether treatment outcome of a therapist-aided exposure treatment was mediated by changes in positive and negative penetration beliefs or feelings of sexual disgust. Participants with lifelong vaginismus were allocated at random to a 3-month exposure (n = 35) or a waiting list control condition (n = 35). Full intercourse was assessed daily during 12 weeks. Secondary outcome measures (complaints about vaginismus and coital pain) were assessed at baseline and after 12 weeks. Possible mediators: penetration beliefs (catastrophic pain beliefs, genital incompatibility beliefs, perceived control beliefs) and feelings of sexual disgust were assessed at baseline and 6 weeks. Treatment outcome (coital frequency, symptoms of vaginismus, and coital pain) at 12 weeks was mediated by changes in negative and positive penetration beliefs at 6 weeks, in particular by more pronounced reduction of catastrophic pain penetration beliefs. No evidence was found that changes in feelings of sexual disgust mediated treatment outcome. The results strongly suggest that therapist-aided exposure affects negative penetration beliefs and that these changes in negative penetration beliefs mediate treatment outcome in women with lifelong vaginismus. Implications for treatment are discussed. © 2015 International Society for Sexual Medicine.

The associations between birth outcomes and satellite-estimated maternal PM2.5 exposure in Shanghai, China

Science.gov (United States)

Xiao, Q.; Liu, Y.; Strickland, M. J.; Chang, H. H.; Kan, H.

2017-12-01

Background: Satellite remote sensing data have been employed for air pollution exposure assessment, with the intent of better characterizing exposure spatio-temproal variations. However, non-random missingness in satellite data may lead to exposure error. Objectives: We explored the differences in health effect estimates due to different exposure metrics, with and without satellite data, when analyzing the associations between maternal PM2.5 exposure and birth outcomes. Methods: We obtained birth registration records of 132,783 singleton live births during 2011-2014 in Shanghai. Trimester-specific and total pregnancy exposures were estimated from satellite PM2.5 predictions with missingness, gap-filled satellite PM2.5 predictions with complete coverage and regional average PM2.5 measurements from monitoring stations. Linear regressions estimated associations between birth weight and maternal PM2.5 exposure. Logistic regressions estimated associations between preterm birth and the first and second trimester exposure. Discrete-time models estimated third trimester and total pregnancy associations with preterm birth. Effect modifications by maternal age and parental education levels were investigated. Results: we observed statistically significant associations between maternal PM2.5 exposure during all exposure windows and adverse birth outcomes. A 10 µg/m3 increase in pregnancy PM2.5 exposure was associated with a 12.85 g (95% CI: 18.44, 7.27) decrease in birth weight for term births, and a 27% (95% CI: 20%, 36%) increase in the risk of preterm birth. Greater effects were observed between first and third trimester exposure and birth weight, as well as between first trimester exposure and preterm birth. Mothers older than 35 years and without college education tended to have higher associations with preterm birth. Conclusions: Gap-filled satellite data derived PM2.5 exposure estimates resulted in reduced exposure error and more precise health effect estimates.

Effects of in utero tributyltin chloride exposure in the rat on pregnancy outcome.

Science.gov (United States)

Adeeko, Adedayo; Li, Daming; Forsyth, Don S; Casey, Valerie; Cooke, Gerard M; Barthelemy, Johanna; Cyr, Daniel G; Trasler, Jacquetta M; Robaire, Bernard; Hales, Barbara F

2003-08-01

Tributyltin, an organotin, is ubiquitous in the environment. The consumption of contaminated marine species leads to human dietary exposure to this compound. Tributyltin is an endocrine disruptor in many wildlife species and inhibits aromatase in mammalian placental and granulosa-like tumor cell lines. We investigated the effects of tributyltin chloride exposure on pregnancy outcome in the Sprague-Dawley rat. Timed pregnant rats were gavaged either with vehicle (olive oil) or tributyltin chloride (0.25, 2.5, 10, or 20 mg/kg) from days 0-19 or 8-19 of gestation. On gestational day 20, dams were sacrificed, and pregnancy outcome was determined. Tributyltin and its metabolites (dibutyltin, monobutyltin) were measured in maternal blood by gas chromatography. Both tributyltin and dibutyltin were present in maternal blood at approximately equal concentrations, whereas monobutyltin contributed minimally to total organotins. Organotin concentrations increased in a dose-dependent pattern in dams, independent of the window of exposure. Tributyltin chloride administration significantly reduced maternal weight gain only at the highest dose (20 mg/kg); a significant increase in post-implantation loss and decreased litter sizes, in addition to decreased fetal weights, was observed in this group. Tributyltin chloride exposure did not result in external malformations, nor was there a change in sex ratios. However, exposure to 0.25, 2.5, or 10 mg/kg tributyltin chloride from gestation days (GD) 0-19 resulted in a significant increase in normalized anogenital distances in male fetuses; exposure from days 8-19 had no effect. There was a dramatic increase in the incidence of low weight (exposure to 20 mg/kg tributyltin chloride. Delayed ossification of the fetal skeleton was observed after in utero exposure to either 10 mg/kg or 20 mg/kg tributyltin chloride. Serum thyroxine and triiodothyronine levels were reduced significantly in dams exposed to 10 and 20 mg/kg tributyltin chloride

Estimating time-varying exposure-outcome associations using case-control data: logistic and case-cohort analyses.

Science.gov (United States)

Keogh, Ruth H; Mangtani, Punam; Rodrigues, Laura; Nguipdop Djomo, Patrick

2016-01-05

Traditional analyses of standard case-control studies using logistic regression do not allow estimation of time-varying associations between exposures and the outcome. We present two approaches which allow this. The motivation is a study of vaccine efficacy as a function of time since vaccination. Our first approach is to estimate time-varying exposure-outcome associations by fitting a series of logistic regressions within successive time periods, reusing controls across periods. Our second approach treats the case-control sample as a case-cohort study, with the controls forming the subcohort. In the case-cohort analysis, controls contribute information at all times they are at risk. Extensions allow left truncation, frequency matching and, using the case-cohort analysis, time-varying exposures. Simulations are used to investigate the methods. The simulation results show that both methods give correct estimates of time-varying effects of exposures using standard case-control data. Using the logistic approach there are efficiency gains by reusing controls over time and care should be taken over the definition of controls within time periods. However, using the case-cohort analysis there is no ambiguity over the definition of controls. The performance of the two analyses is very similar when controls are used most efficiently under the logistic approach. Using our methods, case-control studies can be used to estimate time-varying exposure-outcome associations where they may not previously have been considered. The case-cohort analysis has several advantages, including that it allows estimation of time-varying associations as a continuous function of time, while the logistic regression approach is restricted to assuming a step function form for the time-varying association.

[Relationship between pesticide exposure and adverse pregnancy outcomes among reproductive couples in rural areas of China].

Science.gov (United States)

Qu, Y M; Chen, S; Li, J J; Jin, R R; Pan, H; Jiang, Y

2017-06-10

Objective: To analyze the association between pesticide exposure and adverse pregnancy outcomes in women from the rural areas of China. Methods: Data of "National Free Preconception Health Examination Project (NFPHEP)" from January 2010 to December 2012 was used for analysis. A total of 248 501 families that were planning to deliver a baby in the next 6 months were enrolled. Data on paternal exposure to pesticides before or during pregnancy was collected through questionnaires, with related outcomes on pregnancy recorded by doctors. Results: Among all the 248 501 participants, 1 806 (0.74 % ) women and 2 653 (1.09 % ) men reported to have been exposed to pesticide before pregnancy, with 505 (0.21 % ) reported of having been exposed to pesticide during the period of pregnancy. Maternal exposure to pesticide was found a risk factor related to stillbirth ( OR =3.37, 95 %CI : 2.05-5.55), peculiar smell pregnancy ( OR =3.17, 95 %CI :1.18-8.55) and low birth weight ( OR =7.56, 95 % CI : 5.36-10.66). Paternal exposure to pesticide was also found related to miscarriage ( OR =1.37, 95 % CI : 1.03-1.80), low birth weight ( OR =3.65, 95 % CI :1.51-8.84), or giant infant ( OR =0.64, 95 %CI : 0.44-0.93). Maternal exposure to pesticide during pregnancy appeared a risk factor on miscarriage ( OR =4.65, 95 % CI : 3.47-6.24). Other adverse outcomes on pregnancy would include premature birth and high birth weight. Conclusion: Parental pesticide exposure appeared a risk factor on stillbirth, peculiar smell pregnancy, low birth weight and miscarriage.

Exposure to organophosphate flame retardants in spray polyurethane foam applicators: Role of dermal exposure.

Science.gov (United States)

Bello, Anila; Carignan, Courtney C; Xue, Yalong; Stapleton, Heather M; Bello, Dhimiter

2018-04-01

Spray polyurethane foam (SPF) is a highly effective thermal insulation material that has seen considerable market growth in the past decade. Organophosphate flame retardants (PFRs) are added to SPF formulations to meet fire code requirements. A common flame retardant used in SPF formulations is tris 1-chloro 2-propyl phosphate (TCIPP), a suspected endocrine disruptor. Exposure monitoring efforts during SPF applications have focused primarily on the isocyanate component, a potent respiratory and dermal sensitizer. However, to our knowledge, there is no monitoring data for TCIPP. To characterize occupational exposures to TCIPP and other flame retardants during SPF insulation. Workers at four SPF insulation sites and one foam removal site (total n = 14) were recruited as part of this pilot study. Personal inhalation exposure to TCIPP was monitored with a CIP-10MI inhalable sampler and potential dermal exposure was assessed through the use of a glove dosimeter. Biomarkers of TCIPP and three other PFRs were measured in urine collected from workers pre-and post-shift. Linear mixed effect models were used to analyze associations of urinary biomarkers with inhalation and dermal exposures and paired t-tests were used to examine the difference on the means of urinary biomarkers pre-and post-shift. Chemical analysis of all species was performed with liquid chromatography-electrospray ionization tandem mass spectrometry. Geometric mean (GM) concentrations of TCIPP in personal air monitors and glove dosimeters collected from SPF applicators, 294.7 μg/m 3 and 18.8 mg/pair respectively. Overall, GM concentrations of the two TCIPP urinary biomarkers BCIPP and BCIPHIPP and (6.2 and 88.8 μg/mL) were 26-35 times higher than reported in the general population. Post-shift levels of TCIPP biomarkers were higher than pre-shift even though workers at insulation sites wore supplied air respirators, gloves and coveralls. The urinary biomarkers for the other PFRs were not

Food and beverage television advertising exposure and youth consumption, body mass index and adiposity outcomes.

Science.gov (United States)

Powell, Lisa M; Wada, Roy; Khan, Tamkeen; Emery, Sherry L

2017-05-01

This study examined the relationships between exposure to food and beverage product television advertisements and consumption and obesity outcomes among youth. Individual-level data on fast-food and soft drink consumption and body mass index (BMI) for young adolescents from the Early Childhood Longitudinal Study - Kindergarten Cohort (1998-1999) and adiposity measures for children from the U.S. National Health and Nutrition Examination Survey (2003-2004) were combined with designated market area (DMA) Nielsen media advertising ratings data. To account for unobserved individual-level and DMA-level heterogeneity, various fixed- and random-effects models were estimated. The results showed that exposure to soft drink and sugar-sweetened beverage advertisements are economically and statistically significantly associated with higher frequency of soft drink consumption among youth even after controlling for unobserved heterogeneity, with elasticity estimates ranging from 0.4 to 0.5. The association between fast-food advertising exposure and fast-food consumption disappeared once we controlled for unobservables. Exposure to cereal advertising was significantly associated with young adolescents' BMI percentile ranking but exposures to fast-food and soft drink advertisements were not. The results on adiposity outcomes revealed that children's exposure to cereal advertising was associated with both percent body and trunk fatness; fast-food advertising was significantly associated with percent trunk fatness and marginally significantly associated with percent body fatness; and, exposure to SSB advertising was marginally significantly associated with percent body and trunk fatness. The study results suggest that continued monitoring of advertising is important and policy debates regarding the regulation of youth-directed marketing are warranted.

Antibiotic exposure in neonates and early adverse outcomes: a systematic review and meta-analysis.

Science.gov (United States)

Esaiassen, Eirin; Fjalstad, Jon Widding; Juvet, Lene Kristine; van den Anker, John N; Klingenberg, Claus

2017-07-01

To systematically review and meta-analyse the relationship between antibiotic exposure in neonates and the following early adverse outcomes: necrotizing enterocolitis (NEC), invasive fungal infections (IFIs) and/or death. Data sources were PubMed, Embase, Medline and the Cochrane Database (to December 2016), supplemented by manual searches of reference lists. Randomized controlled trials (RCTs) and observational studies were included if they provided data on different categories of antibiotic exposures (yes versus no, long versus short duration, and/or broad- versus narrow-spectrum regimens) and the risk of developing NEC, IFI and/or death in the neonatal period. Two reviewers extracted data and evaluated the risk of bias using the Cochrane Handbook, adapted to include observational studies. When appropriate, meta-analyses were conducted using the random-effect model. We identified 9 RCTs and 38 observational studies. The quality of the majority of studies was poor to moderate. There was a significant association between prolonged antibiotic exposure and an increased risk of NEC in five observational studies (5003 participants) and/or risk of death in five observational studies (13 534 participants). Eleven of 15 studies with data on broad- versus narrow-spectrum regimens reported an increased risk of IFI after broad-spectrum antibiotic exposure, in particular with third-generation cephalosporins and carbapenems. Meta-analysis was limited by few and old RCTs, insufficient sample sizes and diversity of antibiotic exposure and outcomes reported. Prolonged antibiotic exposure in uninfected preterm infants is associated with an increased risk of NEC and/or death, and broad-spectrum antibiotic exposure is associated with an increased risk of IFI. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Exposure to Childhood Sexual and Physical Abuse and Subsequent Educational Achievement Outcomes

Science.gov (United States)

Boden, Joseph M.; Horwood, L. John; Fergusson, David M.

2007-01-01

Objective: This paper examined the relationship between exposure to sexual and physical abuse (CSA and CPA) in childhood and later educational achievement outcomes in late adolescence and early adulthood in a birth cohort of over 1,000 children studied to age 25. Method: Retrospective data on CSA and CPA were gathered at ages 18 and 21 and used to…

Estimating time-varying exposure-outcome associations using case-control data: logistic and case-cohort analyses

Directory of Open Access Journals (Sweden)

Ruth H. Keogh

2016-01-01

Full Text Available Abstract Background Traditional analyses of standard case-control studies using logistic regression do not allow estimation of time-varying associations between exposures and the outcome. We present two approaches which allow this. The motivation is a study of vaccine efficacy as a function of time since vaccination. Methods Our first approach is to estimate time-varying exposure-outcome associations by fitting a series of logistic regressions within successive time periods, reusing controls across periods. Our second approach treats the case-control sample as a case-cohort study, with the controls forming the subcohort. In the case-cohort analysis, controls contribute information at all times they are at risk. Extensions allow left truncation, frequency matching and, using the case-cohort analysis, time-varying exposures. Simulations are used to investigate the methods. Results The simulation results show that both methods give correct estimates of time-varying effects of exposures using standard case-control data. Using the logistic approach there are efficiency gains by reusing controls over time and care should be taken over the definition of controls within time periods. However, using the case-cohort analysis there is no ambiguity over the definition of controls. The performance of the two analyses is very similar when controls are used most efficiently under the logistic approach. Conclusions Using our methods, case-control studies can be used to estimate time-varying exposure-outcome associations where they may not previously have been considered. The case-cohort analysis has several advantages, including that it allows estimation of time-varying associations as a continuous function of time, while the logistic regression approach is restricted to assuming a step function form for the time-varying association.

Outcome of Accidental Exposure Prone to Blood Borne Viral Infections in an Educational Hospital

Directory of Open Access Journals (Sweden)

Shahnaz Sali

2016-04-01

Full Text Available Background: The risk for transmission of blood-borne viruses (BBVs such as Human immunodeficiency virus (HIV, hepatitis B virus (HBV and hepatitis C virus (HCV due to occupational exposure is a major concern in the health care setting.Materials and Methods: This study among 337 health care workers (HCWs accidentally exposed to BBVs was carried out from January 2009 to March 2015. The data were reviewed in labbafinejhad hospital, Tehran, Iran.Results: 4 HCWs had exposure to HBS Ag positive, which HBS antibody titer of them was higher than 10 mlu/ml, 6 HCWs were exposed to HCV seropositive patients underwent laboratory investigations for  HCV-antibody on 4,12, 24 weeks that results were negative. 3 cases had exposure to HIV seropositive patients which received standard antiretroviral post exposure prophylaxis.Conclusion: Timely performance for PEP (Post Exposure Prophylaxis reducing BBVs transmission among HCWs.prophylaxis. Conclusions: Timely performance for  PEP(Post Exposure Prophylaxis reducing BBVs transmission among HCWs.Key words: Outcome; Accidental Exposure; Blood Borne Viral Infections

Characterization of population exposure to organochlorines: A cluster analysis application

NARCIS (Netherlands)

R.M. Guimarães (Raphael Mendonça); S. Asmus (Sven); A. Burdorf (Alex)

2013-01-01

textabstractThis study aimed to show the results from a cluster analysis application in the characterization of population exposure to organochlorines through variables related to time and exposure dose. Characteristics of 354 subjects in a population exposed to organochlorine pesticides residues

Indoor Exposure and Adverse Birth Outcomes Related to Fetal Growth, Miscarriage and Prematurity—A Systematic Review

Directory of Open Access Journals (Sweden)

Evridiki Patelarou

2014-06-01

Full Text Available The purpose of this review was to summarize existing epidemiological evidence of the association between quantitative estimates of indoor air pollution and all-day personal exposure with adverse birth outcomes including fetal growth, prematurity and miscarriage. We carried out a systematic literature search of MEDLINE and EMBASE databases with the aim of summarizing and evaluating the results of peer-reviewed epidemiological studies undertaken in “westernized” countries that have assessed indoor air pollution and all-day personal exposure with specific quantitative methods. This comprehensive literature search identified 16 independent studies which were deemed relevant for further review and two additional studies were added through searching the reference lists of all included studies. Two reviewers independently and critically appraised all eligible articles using the Critical Appraisal Skills Programme (CASP tool. Of the 18 selected studies, 14 adopted a prospective cohort design, three were case-controls and one was a retrospective cohort study. In terms of pollutants of interest, seven studies assessed exposure to electro-magnetic fields, four studies assessed exposure to polycyclic aromatic hydrocarbons, four studies assessed PM2.5 exposure and three studies assessed benzene, phthalates and noise exposure respectively. Furthermore, 12 studies examined infant growth as the main birth outcome of interest, six examined spontaneous abortion and three studies assessed gestational age at birth and preterm delivery. This survey demonstrates that there is insufficient research on the possible association of indoor exposure and early life effects and that further research is needed.

The Role of Stress Exposure and Family Functioning in Internalizing Outcomes of Urban Families.

Science.gov (United States)

Sheidow, Ashli J; Henry, David B; Tolan, Patrick H; Strachan, Martha K

2014-11-01

Although research suggests that stress exposure and family functioning are associated with internalizing problems in adolescents and caregivers, surprisingly few studies have investigated the mechanisms that underlie this association. To determine whether family functioning buffers the development of internalizing problems in stress-exposed families, we assessed the relation between stress exposure, family functioning, and internalizing symptoms among a large sample of inner-city male youth and their caregivers living in poverty across five waves of data collection. We hypothesized that stress exposure and family functioning would predict development of subsequent youth and caregiver internalizing problems and that family functioning would moderate this relation, with higher functioning families demonstrating greater resiliency to stress exposure. We used a longitudinal, prospective design to evaluate whether family functioning (assessed at waves one through four) activated or buffered the effects of stress exposure (assessed at wave one) on subsequent internalizing symptoms (assessed at waves four and five). Stress from Developmental Transitions and family functioning were significant predictors of depressive symptoms and anxiety in youth; however, family functioning did not moderate the relation. Family functioning mediated the relation between stress from Daily Hassles and internalizing outcomes suggesting that poor parenting practices, low structure, and low emotional cohesion activate depression and anxiety in youth exposed to chronic and frequent everyday stressors. Surprisingly, only family functioning predicted depressive symptoms in caregivers. Results validate the use of a comprehensive, multi-informant assessment of stress when investigating internalizing outcomes in youth and support using family-based interventions in the treatment and prevention of internalizing.

Exposure to power-frequency magnetic fields and the risk of infertility and adverse pregnancy outcomes: update on the human evidence and recommendations for future study designs

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Lewis, Ryan C.; Hauser, Russ; Maynard, Andrew D.; Neitzel, Richard L.; Wang, Lu; Kavet, Robert; Meeker, John D.

2016-01-01

Infertility and adverse pregnancy outcomes are significant public health concerns with global prevalence. Over the past 35 years, research has addressed whether exposure to power-frequency magnetic fields is one of the etiologic factors attributed to these conditions. However, no apparent authoritative reviews on this topic have been published in the peer-reviewed literature for nearly 15 years. This review provides an overview and critical analysis of human studies that were published in the peer-reviewed literature between 2002 and July 2015. Using PubMed, 13 epidemiology studies published during this timeframe that concern exposure to magnetic fields and adverse prenatal (e.g., miscarriage), neonatal (e.g., preterm birth or birth defects), and male fertility (e.g., poor semen quality) outcomes were identified. Some of these studies reported associations whereas others did not, and study design limitations may explain these inconsistencies. Future investigations need to be designed with these limitations in mind to address existing research gaps. In particular, the following issues are discussed: 1) importance of selecting the appropriate study population, 2) need for addressing confounding due to unmeasured physical activity, 3) importance of minimizing information bias from exposure measurement error, 4) consideration of alternative magnetic field exposure metrics, and 5) implications and applications of personal exposure data that is correlated within female-male couples. Further epidemiologic research is needed given the near ubiquitous exposures to power-frequency magnetic fields in the general population. PMID:27030583

Role of oxidative stress in cardiovascular disease outcomes following exposure to ambient air pollution.

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Kelly, Frank J; Fussell, Julia C

2017-09-01

Exposure to ambient air pollution is associated with adverse cardiovascular outcomes. These are manifested through several, likely overlapping, pathways including at the functional level, endothelial dysfunction, atherosclerosis, pro-coagulation and alterations in autonomic nervous system balance and blood pressure. At numerous points within each of these pathways, there is potential for cellular oxidative imbalances to occur. The current review examines epidemiological, occupational and controlled exposure studies and research employing healthy and diseased animal models, isolated organs and cell cultures in assessing the importance of the pro-oxidant potential of air pollution in the development of cardiovascular disease outcomes. The collective body of data provides evidence that oxidative stress (OS) is not only central to eliciting specific cardiac endpoints, but is also implicated in modulating the risk of succumbing to cardiovascular disease, sensitivity to ischemia/reperfusion injury and the onset and progression of metabolic disease following ambient pollution exposure. To add to this large research effort conducted to date, further work is required to provide greater insight into areas such as (a) whether an oxidative imbalance triggers and/or worsens the effect and/or is representative of the consequence of disease progression, (b) OS pathways and cardiac outcomes caused by individual pollutants within air pollution mixtures, or as a consequence of inter-pollutant interactions and (c) potential protection provided by nutritional supplements and/or pharmacological agents with antioxidant properties, in susceptible populations residing in polluted urban cities. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Pregnancy outcome following gestational exposure to azithromycin

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Woodland C Cindy

2006-05-01

Full Text Available Abstract Background Azithromycin is an azalide antibiotic with an extensive range of indications and has become a common treatment option due to its convenient dosing regimen and therapeutic advantages. Human studies addressing gestational use of azithromycin have primarily focused on antibiotic efficacy rather than fetal safety. Our primary objective was to evaluate the possibility of teratogenic risk following gestational exposure to azithromycin. Methods There were 3 groups of pregnant women enrolled in our study: 1 women who took azithromycin. 2 women exposed to non-teratogenic antibiotics for similar indications, and 3 women exposed to non-teratogenic agents. They were matched for gestational age at time of call, maternal age, cigarette and alcohol consumption. Rates of major malformations and other endpoints of interest were compared among the three groups. Results Pregnancy outcome of 123 women in each group was ascertained. There were no statistically significant differences among the three groups in the rates of major malformations; 3.4% (exposed versus 2.3% (disease matched and 3.4% (non teratogen or any other endpoints that were examined. In the azithromycin group, 88 (71.6% women took the drug during the first trimester Conclusion Results suggest that gestational exposure to azithromycin is not associated with an increase in the rate of major malformations above the baseline of 1–3%. Our data adds to previous research showing that macrolide antibiotics, as a group, are generally safe in pregnancy and provides an evidence-based option for health professionals caring for populations with chlamydia.

Assessment of relevant factors and relationships concerning human dermal exposure to pesticides in greenhouse applications.

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Martínez Vidal, Jose L; Egea González, Francisco J; Garrido Frenich, Antonia; Martínez Galera, María; Aguilera, Pedro A; López Carrique, Enrique

2002-08-01

Principal component analysis (PCA) was applied to the gas chromatographic data obtained from 23 different greenhouse trials. This was used to establish which factors, including application technique (very small, small, medium and large drop-size), crop characteristics (short/tall, thin/dense) and pattern application of the operator (walking towards or away from the treated area) are relevant to the dermal exposure levels of greenhouse applicators. The results showed that the highest exposure by pesticides during field applications in greenhouses, in the climatic conditions and in the crop conditions typical of a southern European country, occurs on the lower legs and front thighs of the applicators. Similar results were obtained by hierarchical cluster analysis (HCA). Drop-size seems to be very important in determining total exposure, while height and density of crops have little influence on total exposure under the conditions of the present study. No pesticide type is a major factor in total exposure. The application of multiple regression analysis (MRA) allowed assessment of the relationships between the pesticide exposure of the less affected parts of the body with the most affected parts.

Birth outcomes among military personnel after exposure to documented open-air burn pits before and during pregnancy.

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Conlin, Ava Marie S; DeScisciolo, Connie; Sevick, Carter J; Bukowinski, Anna T; Phillips, Christopher J; Smith, Tyler C

2012-06-01

To examine birth outcomes in military women and men with potential exposure to documented open-air burn pits before and during pregnancy. Electronic data from the Department of Defense Birth and Infant Health Registry and the Defense Manpower Data Center were used to examine the prevalence of birth defects and preterm birth among infants of active-duty women and men who were deployed within a 3-mile radius of a documented open-air burn pit before or during pregnancy. In general, burn pit exposure at various times in relation to pregnancy and for differing durations was not consistently associated with an increase in birth defects or preterm birth in infants of active-duty military personnel. These analyses offer reassurance to service members that burn pit exposure is not consistently associated with these select adverse infant health outcomes.

Preschool outcomes following prenatal serotonin reuptake inhibitor exposure: differences in language and behavior, but not cognitive function.

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Johnson, Katrina C; Smith, Alicia K; Stowe, Zachary N; Newport, D Jeffrey; Brennan, Patricia A

2016-02-01

To test the hypothesis that prenatal exposure to serotonin reuptake inhibitors (SRIs) is associated with language and behavioral outcomes in preschool-aged children, while accounting for confounds such as concomitant exposures and maternal mental illness. An observational, prospective, longitudinal study of mental illness in pregnancy was conducted at a university-based women's mental health clinic (April 2010-November 2012). A sample of 178 mother-child dyads participated in a laboratory visit at preschool age (2.5-5.5 years). The majority of women (87%) received psychotropic medication during pregnancy. Psychiatric status (based on DSM-IV), other medication use, and substance use were serially assessed and tested as confounds. Primary outcome measures included standardized measures of expressive language and cognitive function and mother and alternate caregiver ratings of child behavior problems, including the Pervasive Developmental Disorders (PDD) subscale of the Child Behavior Checklist. Linear regression analyses revealed that, after controlling for relevant covariates, expressive language scores from the Test of Early Language Development, 3rd edition, were negatively associated with prenatal SRI exposure (β = -0.15, t = -2.41), while the PDD behavioral problems subscales completed by alternate caregivers and mothers were positively associated with prenatal SRI exposure (β = 0.17, t = 2.01; β = 0.16, t = 2.00, respectively). Cognitive function, measured using the Differential Ability Scales, 2nd edition, was not associated with any medication exposures. The current data suggest a small but significant association between prenatal SRI exposure and preschool outcomes, including expressive language and behavior problems. These data corroborate data from recent, population-based studies, although overall, published findings are mixed. Replication and identification of moderating risk factors are needed to understand potential clinical implications. �

Self-reported exposure to pesticides and radiation related to pregnancy outcome--results from National Natality and Fetal Mortality Surveys

International Nuclear Information System (INIS)

Savitz, D.A.; Whelan, E.A.; Kleckner, R.C.

1989-01-01

Although fetal development is known to be sensitive to environmental agents, relatively little epidemiologic research has addressed this concern. Effects on pregnancy outcome of self-reported parental exposure to pesticides and to radiation were examined using data from the National Natality and Fetal Mortality Surveys, large national probability samples of live births and stillbirths occurring in 1980. In case-control analyses, maternal exposure to pesticides at home or work was associated with increased risk of stillbirth (odds ratios (ORs) = 1.5-1.6). Paternal pesticide exposure was associated with stillbirth (ORs = 1.2-1.4) and delivery of small-for-gestational-age infants (ORs = 1.4-2.0). A small increased risk of stillbirth (OR = 1.3) was found in relation to either parent's reported exposure to radiation. In spite of limitations in the quality of exposure data and the possibility of biased recall related to pregnancy outcome, associations of reported pesticide exposure to either parent with risk of stillbirth and small-for-gestational-age infants warrant further evaluation

Applicability of western chemical dietary exposure models to the Chinese population.

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Zhao, Shizhen; Price, Oliver; Liu, Zhengtao; Jones, Kevin C; Sweetman, Andrew J

2015-07-01

A range of exposure models, which have been developed in Europe and North America, are playing an increasingly important role in priority setting and the risk assessment of chemicals. However, the applicability of these tools, which are based on Western dietary exposure pathways, to estimate chemical exposure to the Chinese population to support the development of a risk-based environment and exposure assessment, is unclear. Three frequently used modelling tools, EUSES, RAIDAR and ACC-HUMANsteady, have been evaluated in terms of human dietary exposure estimation by application to a range of chemicals with different physicochemical properties under both model default and Chinese dietary scenarios. Hence, the modelling approaches were assessed by considering dietary pattern differences only. The predicted dietary exposure pathways were compared under both scenarios using a range of hypothetical and current emerging contaminants. Although the differences across models are greater than those between dietary scenarios, model predictions indicated that dietary preference can have a significant impact on human exposure, with the relatively high consumption of vegetables and cereals resulting in higher exposure via plants-based foodstuffs under Chinese consumption patterns compared to Western diets. The selected models demonstrated a good ability to identify key dietary exposure pathways which can be used for screening purposes and an evaluative risk assessment. However, some model adaptations will be required to cover a number of important Chinese exposure pathways, such as freshwater farmed-fish, grains and pork. Copyright © 2015 Elsevier Inc. All rights reserved.

Prenatal Heavy Metal Exposure and Adverse Birth Outcomes in Myanmar: A Birth-Cohort Study

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Kyi Mar Wai

2017-11-01

Full Text Available Arsenic, cadmium and lead are well-known environmental contaminants, and their toxicity at low concentration is the target of scientific concern. In this study, we aimed to identify the potential effects of prenatal heavy metal exposure on the birth outcomes among the Myanmar population. This study is part of a birth-cohort study conducted with 419 pregnant women in the Ayeyarwady Division, Myanmar. Face-to-face interviews were performed using a questionnaire, and maternal spot urine samples were collected at the third trimester. Birth outcomes were evaluated at delivery during the follow up. The median values of adjusted urinary arsenic, cadmium, selenium and lead concentration were 74.2, 0.9, 22.6 and 1.8 μg/g creatinine, respectively. Multivariable logistic regression revealed that prenatal cadmium exposure (adjusted odds ratio (OR = 1.10; 95% confidence interval (CI: 1.01–1.21; p = 0.043, gestational age (adjusted OR = 0.83; 95% CI: 0.72–0.95; p = 0.009 and primigravida mothers (adjusted OR = 4.23; 95% CI: 1.31–13.65; p = 0.016 were the predictors of low birth weight. The present study identified that Myanmar mothers were highly exposed to cadmium. Prenatal maternal cadmium exposure was associated with an occurrence of low birth weight.

Prenatal Heavy Metal Exposure and Adverse Birth Outcomes in Myanmar: A Birth-Cohort Study.

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Wai, Kyi Mar; Mar, Ohn; Kosaka, Satoko; Umemura, Mitsutoshi; Watanabe, Chiho

2017-11-03

Arsenic, cadmium and lead are well-known environmental contaminants, and their toxicity at low concentration is the target of scientific concern. In this study, we aimed to identify the potential effects of prenatal heavy metal exposure on the birth outcomes among the Myanmar population. This study is part of a birth-cohort study conducted with 419 pregnant women in the Ayeyarwady Division, Myanmar. Face-to-face interviews were performed using a questionnaire, and maternal spot urine samples were collected at the third trimester. Birth outcomes were evaluated at delivery during the follow up. The median values of adjusted urinary arsenic, cadmium, selenium and lead concentration were 74.2, 0.9, 22.6 and 1.8 μg/g creatinine, respectively. Multivariable logistic regression revealed that prenatal cadmium exposure (adjusted odds ratio (OR) = 1.10; 95% confidence interval (CI): 1.01-1.21; p = 0.043), gestational age (adjusted OR = 0.83; 95% CI: 0.72-0.95; p = 0.009) and primigravida mothers (adjusted OR = 4.23; 95% CI: 1.31-13.65; p = 0.016) were the predictors of low birth weight. The present study identified that Myanmar mothers were highly exposed to cadmium. Prenatal maternal cadmium exposure was associated with an occurrence of low birth weight.

A meta-analysis of exposure to particulate matter and adverse birth outcomes

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Dirga Kumar Lamichhane

2015-11-01

Full Text Available Objectives The objective of this study was to conduct a systematic review to provide summarized evidence on the association between maternal exposure to particulate air pollution and birth weight (BW and preterm birth (PTB after taking into consideration the potential confounding effect of maternal smoking. Methods We systematically searched all published cohort and case-control studies examining BW and PTB association with particulate matter (PM, less than or equal to 2.5μm and 10.0 μm in diameter, PM2.5 and PM10, respectively from PubMed and Web of Science, from January 1980 to April 2015. We extracted coefficients for continuous BW and odds ratio (OR for PTB from each individual study, and meta-analysis was used to combine the coefficient and OR of individual studies. The methodological quality of individual study was assessed using a standard protocol proposed by Downs and Black. Forty-four studies met the inclusion criteria. Results In random effects meta-analyses, BW as a continuous outcome was negativelyassociated with 10 μg/m3 increase in PM10 (-10.31 g; 95% confidence interval [CI], -13.57 to -3.13 g; I-squared=0%, p=0.947 and PM2.5 (-22.17 g; 95% CI, -37.93 to -6.41 g; I-squared=92.3%, p <0.001 exposure during entire pregnancy, adjusted for maternal smoking. A significantly increased risk of PTB per 10 μg/m3 increase in PM10 (OR, 1.23; 95% CI, 1.04 to 1.41; I-squared=0%, p =0.977 and PM2.5 (OR, 1.14; 95% CI, 1.06 to 1.22; I-squared=92.5%, p <0.001 exposure during entire pregnancy was observed. Effect size of change in BW per 10 μg/m3 increase in PM tended to report stronger associations after adjustment for maternal smoking. Conclusions While this systematic review supports an adverse impact of maternal exposure to particulate air pollution on birth outcomes, variation in effects by exposure period and sources of heterogeneity between studies should be further explored.

Effects of Elevated Ambient Temperature on Reproductive Outcomes and Offspring Growth Depend on Exposure Time

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Huda Yahia Hamid

2012-01-01

Full Text Available Reproductive performance has been shown to be greatly affected by changes in environmental factors, such as temperature. However, it is also crucial to identify the particular stage of pregnancy that is most adversely affected by elevated ambient temperature. The aims of this study were to determine the effect on reproductive outcomes of exposure to elevated ambient temperature during different stages of pregnancy and to determine the effect of prenatal heat stress on offspring growth. Sixty pregnant rats were used in this study. The rats were divided equally into four groups as group 1 (control, group 2 (exposed to elevated temperature following implantation, group 3 (exposed to elevated temperature during pre- and periimplantation, and group 4 (exposed to elevated temperature during pre- and periimplantation and following implantation. Groups 3 and 4 had prolonged gestation periods, reduced litter sizes, and male-biased sex ratios. Moreover, the growth patterns of group 3 and 4 pups were adversely affected by prenatal exposure to elevated temperature. The differences between group 1 and group 3 and between group 1 and group 4 were highly significant. However, no significant differences were observed between groups 1 and 2 in the gestation length, sex ratios, and growth patterns. Thus, it can be concluded that exposure to elevated ambient temperature during pre- and periimplantation has stronger adverse effects on reproductive outcomes and offspring growth than postimplantation exposure.

Association Between a Single General Anesthesia Exposure Before Age 36 Months and Neurocognitive Outcomes in Later Childhood.

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Sun, Lena S; Li, Guohua; Miller, Tonya L K; Salorio, Cynthia; Byrne, Mary W; Bellinger, David C; Ing, Caleb; Park, Raymond; Radcliffe, Jerilynn; Hays, Stephen R; DiMaggio, Charles J; Cooper, Timothy J; Rauh, Virginia; Maxwell, Lynne G; Youn, Ahrim; McGowan, Francis X

2016-06-07

Exposure of young animals to commonly used anesthetics causes neurotoxicity including impaired neurocognitive function and abnormal behavior. The potential neurocognitive and behavioral effects of anesthesia exposure in young children are thus important to understand. To examine if a single anesthesia exposure in otherwise healthy young children was associated with impaired neurocognitive development and abnormal behavior in later childhood. Sibling-matched cohort study conducted between May 2009 and April 2015 at 4 university-based US pediatric tertiary care hospitals. The study cohort included sibling pairs within 36 months in age and currently 8 to 15 years old. The exposed siblings were healthy at surgery/anesthesia. Neurocognitive and behavior outcomes were prospectively assessed with retrospectively documented anesthesia exposure data. A single exposure to general anesthesia during inguinal hernia surgery in the exposed sibling and no anesthesia exposure in the unexposed sibling, before age 36 months. The primary outcome was global cognitive function (IQ). Secondary outcomes included domain-specific neurocognitive functions and behavior. A detailed neuropsychological battery assessed IQ and domain-specific neurocognitive functions. Parents completed validated, standardized reports of behavior. Among the 105 sibling pairs, the exposed siblings (mean age, 17.3 months at surgery/anesthesia; 9.5% female) and the unexposed siblings (44% female) had IQ testing at mean ages of 10.6 and 10.9 years, respectively. All exposed children received inhaled anesthetic agents, and anesthesia duration ranged from 20 to 240 minutes, with a median duration of 80 minutes. Mean IQ scores between exposed siblings (scores: full scale = 111; performance = 108; verbal = 111) and unexposed siblings (scores: full scale = 111; performance = 107; verbal = 111) were not statistically significantly different. Differences in mean IQ scores between sibling pairs were

Air Pollution Exposure Modeling for Health Studies | Science ...

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Dr. Michael Breen is leading the development of air pollution exposure models, integrated with novel personal sensor technologies, to improve exposure and risk assessments for individuals in health studies. He is co-investigator for multiple health studies assessing the exposure and effects of air pollutants. These health studies include participants with asthma, diabetes, and coronary artery disease living in various U.S. cities. He has developed, evaluated, and applied novel exposure modeling and time-activity tools, which includes the Exposure Model for Individuals (EMI), GPS-based Microenvironment Tracker (MicroTrac) and Exposure Tracker models. At this seminar, Dr. Breen will present the development and application of these models to predict individual-level personal exposures to particulate matter (PM) for two health studies in central North Carolina. These health studies examine the association between PM and adverse health outcomes for susceptible individuals. During Dr. Breen’s visit, he will also have the opportunity to establish additional collaborations with researchers at Harvard University that may benefit from the use of exposure models for cohort health studies. These research projects that link air pollution exposure with adverse health outcomes benefit EPA by developing model-predicted exposure-dose metrics for individuals in health studies to improve the understanding of exposure-response behavior of air pollutants, and to reduce participant

The perception of pre- and post-natal marijuana exposure on health outcomes: A content analysis of twitter messages.

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Dakkak, H; Brown, R; Twynstra, J; Charbonneau, K; Seabrook, J A

2018-05-23

The prevalence of marijuana use during pregnancy ranges from 3- 30% , and most of this is for recreational purposes. Marijuana exposure during pregnancy has been linked with low birth weight babies and other adverse child health outcomes. Twitter is a popular news and social networking outlet, and is frequently used to access information about population health and behavior. The primary objective of this study was to investigate the types of messages disseminated on Twitter about marijuana use and infant and maternal health. The secondary objective was to describe the reported health outcomes associated with prenatal and postnatal marijuana use. Tweets were collected from the inception of Twitter (2006) until April 2017. If tweets included links, these links were examined to investigate the source of the message and to clarify the user's intent. In total, 550 tweets were captured, with most tweets (77.6%) having a neutral tweet tone, suggesting uncertainty about the health effects associated with pre- and post-natal marijuana exposure. The sources attached to the original tweets, however, were more likely to report on negative health outcomes. The most common health outcomes associated with prenatal marijuana exposure were: poor brain development (27.3%), inadequate development of the nervous system (23.6%), low birth weight (23.3%), poor behavioral outcomes (21.0%), and infant memory issues (19.3%). The inverse association between marijuana use and the quality and quantity of milk produced by the mother was the most commonly reported tweet for the lactation period.

Children and Caregivers' Exposure to Adverse Childhood Experiences (ACES): Association with Children's and Caregivers' Psychological Outcomes in a Therapeutic Preschool Program.

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Ziv, Yair; Sofri, Inbar; Capps Umphlet, Kristen L; Olarte, Stephanie; Venza, Jimmy

2018-03-31

Exposure to adverse childhood experiences (ACE) has been found to have a profound negative impact on multiple child outcomes, including academic achievement, social cognition patterns, and behavioral adjustment. However, these links have yet to be examined in preschool children that are already experiencing behavior or social-emotional problems. Thus, the present study examined the links between the caregiver's and the child's exposure to ACE and multiple child and caregiver's outcomes in a sample of 30 preschool children enrolled in a Therapeutic Nursery Program (TNP). Children are typically referred to this TNP due to significant delays in their social emotional development that often result in difficulty functioning in typical childcare, home, and community settings. Analyses revealed some contradictory patterns that may be specific to this clinical sample. Children with higher exposure to ACE showed more biased social information processing patterns and their caregivers reported lower child social skills than caregivers of children with less exposure, however their inhibitory control levels were higher (better control) and staff reported that these children exhibited better social skills as well as better approaches to learning than children with less exposure. No such contradictions were found in relation to the caregiver's exposure to ACE, as it was positively associated with a number of negative child and caregiver outcomes.

Estimating overall exposure effects for the clustered and censored outcome using random effect Tobit regression models.

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Wang, Wei; Griswold, Michael E

2016-11-30

The random effect Tobit model is a regression model that accommodates both left- and/or right-censoring and within-cluster dependence of the outcome variable. Regression coefficients of random effect Tobit models have conditional interpretations on a constructed latent dependent variable and do not provide inference of overall exposure effects on the original outcome scale. Marginalized random effects model (MREM) permits likelihood-based estimation of marginal mean parameters for the clustered data. For random effect Tobit models, we extend the MREM to marginalize over both the random effects and the normal space and boundary components of the censored response to estimate overall exposure effects at population level. We also extend the 'Average Predicted Value' method to estimate the model-predicted marginal means for each person under different exposure status in a designated reference group by integrating over the random effects and then use the calculated difference to assess the overall exposure effect. The maximum likelihood estimation is proposed utilizing a quasi-Newton optimization algorithm with Gauss-Hermite quadrature to approximate the integration of the random effects. We use these methods to carefully analyze two real datasets. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

In Utero Exposure to Compounds with Dioxin-like Activity and Birth Outcomes

DEFF Research Database (Denmark)

Vafeiadi, Marina; Agramunt, Silvia; Pedersen, Marie

2014-01-01

BACKGROUND: Maternal exposure to dioxins and dioxin-like compounds may affect fetal growth and development. We evaluated the association between in utero dioxin-like activity and birth outcomes in a prospective European mother-child study. METHODS: We measured dioxin-like activity in maternal...... and cord blood plasma samples collected at delivery using the Dioxin-Responsive Chemically Activated LUciferase eXpression (DR CALUX) bioassay in 967 mother-child pairs, in Denmark, Greece, Norway, Spain, and England. Multiple linear regression models were used to investigate the associations with birth...... weight, gestational age, and head circumference. RESULTS: Plasma dioxin-like activity was higher in maternal sample than in cord samples. Birth weight was lower with medium (-58 g [95% confidence interval (CI) = -176 to 62]) and high (-82 g [-216 to 53]) tertiles of exposure (cord blood) compared...

Adverse pregnancy outcomes after exposure to methylphenidate or atomoxetine during pregnancy

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Bro SP

2015-01-01

Full Text Available Søren Pauli Bro,1 Maiken Ina Siegismund Kjaersgaard,2 Erik Thorlund Parner,2 Merete Juul Sørensen,3 Jørn Olsen,4 Bodil Hammer Bech,4 Lars Henning Pedersen,4,5 Jakob Christensen,6,7 Mogens Vestergaard11Research Unit and Section for General Practice, Department of Public Health, 2Section for Biostatistics, Department of Public Health, Aarhus University, 3Regional Center for Child and Adolescent Psychiatry, Aarhus University Hospital, 4Section for Epidemiology, Department of Public Health, 5Department of Clinical Medicine – Obstetrics and Gynecology, Aarhus University, 6Department of Clinical Pharmacology, 7Department of Neurology, Aarhus University Hospital, Aarhus, DenmarkObjective: To determine if prenatal exposure to methylphenidate (MPH or atomoxetine (ATX increases the risk of adverse pregnancy outcomes in women with attention deficit/hyperactivity disorder (ADHD.Materials and methods: This was a population-based cohort study of all pregnancies in Denmark from 1997 to 2008. Information on use of ADHD medication, ADHD diagnosis, and pregnancy outcomes was obtained from nationwide registers.Results: We identified 989,932 pregnancies, in which 186 (0.02% women used MPH/ATX and 275 (0.03% women had been diagnosed with ADHD but who did not take MPH/ATX. Our reference pregnancies had no exposure to MPH/ATX and no ADHD diagnosis. Exposure to MPH/ATX was associated with an increased risk of spontaneous abortion (SA; ie, death of an embryo or fetus in the first 22 weeks of gestation (adjusted relative risk [aRR] 1.55, 95% confidence interval [CI] 1.03–2.36. The risk of SA was also increased in pregnancies where the mother had ADHD but did not use MPH/ATX (aRR 1.56, 95% CI 1.11–2.20. The aRR of Apgar scores <10 was increased among exposed women (aRR 2.06, 95% CI 1.11–3.82 but not among unexposed women with ADHD (aRR 0.99, 95% CI 0.48–2.05.Conclusion: MPH/ATX was associated with a higher risk of SA, but our study indicated that it may at

Mendelian randomization analysis of a time-varying exposure for binary disease outcomes using functional data analysis methods.

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Cao, Ying; Rajan, Suja S; Wei, Peng

2016-12-01

A Mendelian randomization (MR) analysis is performed to analyze the causal effect of an exposure variable on a disease outcome in observational studies, by using genetic variants that affect the disease outcome only through the exposure variable. This method has recently gained popularity among epidemiologists given the success of genetic association studies. Many exposure variables of interest in epidemiological studies are time varying, for example, body mass index (BMI). Although longitudinal data have been collected in many cohort studies, current MR studies only use one measurement of a time-varying exposure variable, which cannot adequately capture the long-term time-varying information. We propose using the functional principal component analysis method to recover the underlying individual trajectory of the time-varying exposure from the sparsely and irregularly observed longitudinal data, and then conduct MR analysis using the recovered curves. We further propose two MR analysis methods. The first assumes a cumulative effect of the time-varying exposure variable on the disease risk, while the second assumes a time-varying genetic effect and employs functional regression models. We focus on statistical testing for a causal effect. Our simulation studies mimicking the real data show that the proposed functional data analysis based methods incorporating longitudinal data have substantial power gains compared to standard MR analysis using only one measurement. We used the Framingham Heart Study data to demonstrate the promising performance of the new methods as well as inconsistent results produced by the standard MR analysis that relies on a single measurement of the exposure at some arbitrary time point. © 2016 WILEY PERIODICALS, INC.

Reproductive Outcomes Following Maternal Exposure to the Events of September 11, 2001, at the World Trade Center, in New York City.

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Maslow, Carey B; Caramanica, Kimberly; Li, Jiehui; Stellman, Steven D; Brackbill, Robert M

2016-10-01

To estimate associations between exposure to the events of September 11, 2001, (9/11) and low birth weight (LBW), preterm delivery (PD), and small size for gestational age (SGA). We matched birth certificates filed in New York City for singleton births between 9/11 and the end of 2010 to 9/11-related exposure data provided by mothers who were World Trade Center Health Registry enrollees. Generalized estimating equations estimated associations between exposures and LBW, PD, and SGA. Among 3360 births, 5.8% were LBW, 6.5% were PD, and 9% were SGA. Having incurred at least 2 of 4 exposures, having performed rescue or recovery work, and probable 9/11-related posttraumatic stress disorder 2 to 3 years after 9/11 were associated with PD and LBW during the early study period. Disasters on the magnitude of 9/11 may exert effects on reproductive outcomes for several years. Women who are pregnant during and after a disaster should be closely monitored for physical and psychological sequelae. In utero and maternal disaster exposure may affect birth outcomes. Researchers studying effects of individual disasters should identify commonalities that may inform postdisaster responses to minimize disaster-related adverse birth outcomes.

The Influence of Methotrexate Treatment on Male Fertility and Pregnancy Outcome After Paternal Exposure.

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Grosen, Anne; Kelsen, Jens; Hvas, Christian Lodberg; Bellaguarda, Emanuelle; Hanauer, Stephen B

2017-04-01

Inflammatory bowel disease incidence peaks during the reproductive years. Methotrexate (MTX) is frequently used for inflammatory bowel disease, but its use during pregnancy is contraindicated in women because of teratogenic effects. The aim of this review is to investigate the influence of MTX on male fertility and pregnancy outcomes after paternal MTX exposure. A systematic literature search was performed by applying 2 focus areas, "methotrexate" and "male fertility or pregnancy outcome." Terms and keywords were used both as MeSH terms and free-text searches. Pertinent articles were searched for additional relevant references. In animal studies, MTX induces aberrations in sperm DNA that have not been identified in humans. The effects of MTX on human sperm quality have only been described in case reports. A transient adverse effect on sperm quality with low-dose MTX has been reported, but several other cases have not found harmful effects of MTX. MTX has not been measured in human sperm ejaculates; yet, the risk of a direct toxic effect on the fetus through MTX-contaminated seminal plasma seems negligible. Until now, 284 pregnancies with paternal MTX exposure have been reported. The outcomes were 248 live births and a total of 13 malformations, with no overt indication of MTX embryopathy. This review reveals the lack of studies on the safety of MTX with regard to male reproduction. It is not clear whether MTX transiently influences male fertility and sperm DNA integrity, and more studies are needed. Comparative cohort studies found no increased risk of adverse pregnancy outcomes.

Application of ALAP concept to exposure of workers at light-water reactors

International Nuclear Information System (INIS)

Dickson, H.W.; Cottrell, W.D.; Jacobs, D.G.

1975-11-01

The application of the as-low-as-practicable (ALAP) philosophy to radiation exposure of workers at light-water reactors (LWR's) has recently received increased attention. The purpose of this project is to investigate the means by which occupational exposure at operating LWR's can be reduced to the lowest practicable levels. Nine such LWR stations, including 16 operating reactors, have been studied in phase I of the project to identify significant sources of exposure and to determine the magnitude of the exposures. A complete site review consists of compiling information from safety analysis reports (SAR's), plant technical specifications, and radiation exposure records and then making an on-site visit for discussions with plant personnel, observation of procedures, and measurement of radiation levels. In phase II, specific problem areas are being studied in-depth with regard to corrective measures to reduce exposure. Information has been collected on solving the problem of exposure from valve maintenance and repair. These corrective measures will be evaluated with respect to ease of application and cost effectiveness. The results of this study will serve as technical backup for the preparation of regulatory guides

Socio-environmental exposures and health outcomes among persons with sickle cell disease

OpenAIRE

Asnani, Monika R.; Knight Madden, Jennifer; Reid, Marvin; Greene, Lisa-Gaye; Lyew-Ayee, Parris

2017-01-01

There is much variability in the expression of sickle cell disease (SCD) and recent works suggest that environmental and social factors may also influence this variability. This paper aims to use geographic information systems technology to examine the association between socio-environmental exposures and health outcomes in all persons who have attended or currently attend the Sickle Cell Unit in Jamaica. Rural patients presented for clinical care at older ages and had less annual visits to c...

Seeing Green: Mere Exposure to Money Triggers a Business Decision Frame and Unethical Outcomes

Science.gov (United States)

Kouchaki, Maryam; Smith-Crowe, Kristin; Brief, Arthur P.; Sousa, Carlos

2013-01-01

Can mere exposure to money corrupt? In four studies, we examined the likelihood of unethical outcomes when the construct of money was activated through the use of priming techniques. The results of Study 1 demonstrated that individuals primed with money were more likely to demonstrate unethical intentions than those in the control group. In Study…

Violent crime exposure classification and adverse birth outcomes: a geographically-defined cohort study

Directory of Open Access Journals (Sweden)

Herring Amy

2006-05-01

Full Text Available Abstract Background Area-level socioeconomic disparities have long been associated with adverse pregnancy outcomes. Crime is an important element of the neighborhood environment inadequately investigated in the reproductive and public health literature. When crime has been used in research, it has been variably defined, resulting in non-comparable associations across studies. Methods Using geocoded linked birth record, crime and census data in multilevel models, this paper explored the relevance of four spatial violent crime exposures: two proximal violent crime categorizations (count of violent crime within a one-half mile radius of maternal residence and distance from maternal residence to nearest violent crime and two area-level crime categorizations (count of violent crimes within a block group and block group rate of violent crimes for adverse birth events among women in living in the city of Raleigh NC crime report area in 1999–2001. Models were adjusted for maternal age and education and area-level deprivation. Results In black and white non-Hispanic race-stratified models, crime characterized as a proximal exposure was not able to distinguish between women experiencing adverse and women experiencing normal birth outcomes. Violent crime characterized as a neighborhood attribute was positively associated with preterm birth and low birth weight among non-Hispanic white and black women. No statistically significant interaction between area-deprivation and violent crime category was observed. Conclusion Crime is variably categorized in the literature, with little rationale provided for crime type or categorization employed. This research represents the first time multiple crime categorizations have been directly compared in association with health outcomes. Finding an effect of area-level violent crime suggests crime may best be characterized as a neighborhood attribute with important implication for adverse birth outcomes.

Protection from potential exposures: application to selected radiation sources

International Nuclear Information System (INIS)

1997-09-01

This ICRP Report begins with the general principles of radiation protection in the case of potential exposures, followed by special issues in application and compliance with regulatory aims. The rest of the report uses event trees or fault trees to derive the logical structure of six scenarios of potential exposure, i.e. two irradiators, a large research accelerator, an accelerator for industrial isotope production, an industrial radiography device using a mobile source of radiation, and finally a medical gamma radiotherapy device. (UK)

Phthalate Exposure and Health-Related Outcomes in Specific Types of Work Environment

Directory of Open Access Journals (Sweden)

Branislav Kolena

2014-05-01

Full Text Available Many toxic substances in the workplace can modify human health and quality of life and there is still insufficient data on respiratory outcomes in adults exposed to phthalates. The aim of this work was to assess in waste management workers from the Nitra region of Slovakia (n = 30 the extent of exposure to phthalates and health-related outcomes. Four urinary phthalate metabolites mono(2-ethylhexyl phthalate (MEHP, monobutyl phthalate (MnBP, monoethyl phthalate (MEP and monoisononyl phthalate (MiNP were determined by high-performance liquid chromatography with mass spectrometry (HPLC-MS/MS. Urinary concentration of MEHP was positively associated with ratio of forced expiratory volume in 1 s to forced vital capacity % (FEV1/FVC (r = 0.431; p = 0.018 and MiNP with fat free mass index (FFMI (r = 0.439; p = 0.015. The strongest predictor of pulmonary function was the pack/year index as smoking history that predicted a decrease of pulmonary parameters, the FEV1/FVC, % of predicted values of peak expiratory flow (PEF % of PV and FEV1 % of PV. Unexpectedly, urinary MEHP and MINP were positively associated with pulmonary function expressed as PEF % of PV and FEV1/FVC. We hypothesize that occupational exposure to phthalates estimated from urinary metabolites (MEHP, MiNP can modify pulmonary function on top of lifestyle factors.

What Doesn't Kill You Makes You Weaker: Prenatal Pollution Exposure and Educational Outcomes

Science.gov (United States)

Sanders, Nicholas J.

2012-01-01

I examine the impact of prenatal total suspended particulate (TSP) exposure on educational outcomes using county-level variation in the timing and severity of the industrial recession of the early 1980s as a shock to ambient TSPs (similar to Chay and Greenstone 2003b). I then instrument for pollution levels using county-level changes in relative…

Maternal exposure to UV filters: associations with maternal thyroid hormones, IGF-I/IGFBP3 and birth outcomes.

Science.gov (United States)

Krause, M; Frederiksen, H; Sundberg, K; Jørgensen, F S; Jensen, L N; Nørgaard, P; Jørgensen, C; Ertberg, P; Petersen, J H; Feldt-Rasmussen, U; Juul, A; Drzewiecki, K T; Skakkebaek, N E; Andersson, A M

2018-02-01

Several chemical UV filters/absorbers ('UV filters' hereafter) have endocrine-disrupting properties in vitro and in vivo . Exposure to these chemicals, especially during prenatal development, is of concern. To examine maternal exposure to UV filters, associations with maternal thyroid hormone, with growth factor concentrations as well as to birth outcomes. Prospective study of 183 pregnant women with 2nd trimester serum and urine samples available. Maternal concentrations of the chemical UV filters benzophenone-1 (BP-1) and benzophenone-3 (BP-3) in urine and 4-hydroxy-benzophenone (4-HBP) in serum were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The relationships between 2nd trimester maternal concentrations of the three chemical UV filters and maternal serum concentrations of thyroid hormones and growth factors, as well as birth outcomes (weight, height, and head and abdominal circumferences) were examined. Positive associations between maternal serum concentrations of 4-HBP and triiodothyronine (T 3 ), thyroxine (T 4 ), insulin-like growth factor I (IGF-I) and its binding protein IGFBP3 were observed in mothers carrying male fetuses. Male infants of mothers in the middle 4-HBP exposure group had statistically significantly lower weight and shorter head and abdominal circumferences at birth compared to the low exposure group. Widespread exposure of pregnant women to chemical UV filters and the possible impact on maternal thyroid hormones and growth factors, and on fetal growth, calls for further studies on possible long-term consequences of the exposure to UV filters on fetal development and children's health. © 2018 The authors.

Occupational radiation exposure during the production of eye applicators and in radiosynovectomy

International Nuclear Information System (INIS)

Mielcarek, J.; Barth, I.

2002-01-01

Beta-emitters have increasingly been used in medical therapy. Measurements, in particular of the personal dose H p (0.07), were carried out at workplaces of the following areas of application to determine radiation exposure during source production and medical therapy: 1. Production of eye applicators (Ru-106/Rh-106) for the therapy of intra-ocular tumours. This involves handling of unsealed and sealed radioactive substances. 2. Radiosynovectomy (Radiosynoviothesis, RSO). A method used for the therapy of inflammatory joint disease. The used radionuclides Er-169, Re-186 and Y-90 are injected as radioactive solutions. Both areas of application are marked by: handling of high activities (MBq- to GBq-range), very small distances between source and skin, high risk of contamination, unsatisfactory area and personal dose measuring technique. Highly sensitive thermoluminescence detectors (LiF:Mg,Cu,P) were used to determine the beta- exposure especially of the the skin of the hands. Supplementing contamination measurements indicated that additional exposure of the skin was to be expected. A skin dose of 1.4 mSv was caused by the production of eye applicators (daily output). In contrast to this, in the RSO in some cases exposures of the hands due to direct radiation of more than 100 mSv per working day were found. Skin doses caused by contamination were in the same order of magnitude. The exposures could, however, be reduced drastically by using manipulators, the consequent wearing of protective gloves, contamination monitoring and fulfilment of specific safety requirements at work. Consequences for the performance of beta personnel dosimetry are discussed. (orig.)

Application of the ALAP concept to occupational exposure at operating light water reactors

International Nuclear Information System (INIS)

Dickson, H.W.; Cottrell, W.D.; Jacobs, D.G.

1975-01-01

The application of the as-low-as-practicable (ALAP) concept to radiation exposure of workers at light-water reactors (LWR's) has recently received increased attention. The purpose of the project described is to investigate the means by which occupational exposure at operating LWR's can be reduced to the lowest practicable levels. Nine LWR stations, including 16 operating reactors, were studied in Phase I of the project to identify significant sources of exposure and to determine the magnitude of the exposures. A complete site review consists of compiling information from safety analysis reports, plant technical specifications, and radiation exposure records coupled with an on-site visit for discussions with plant personnel, observation of procedures, and measurement of radiation levels. In Phase II, specific problem areas are being studied in-depth with regard to corrective measures to reduce exposure. Information has been collected on exposure from valve maintenance and repair. Corrective measures will be evaluated with respect to ease of application and cost effectiveness. The results presented will serve as technical backup for the preparation of regulatory guides

Occupational exposures in industrial application of radiation during 1999-2008

International Nuclear Information System (INIS)

Sanaye, S.S.; Baburajan, Sujatha; Pawar, S.G.; Nalawade, S.K.; Sapra, B.K.

2012-01-01

Application of radiation in industry, medicine and research sector has increase significantly over the years. In industry main applications are industrial radiography, industrial fluoroscopy, radiation processing, luminizing, nucleonic gauges. Since the strength of the source used is generally high compared to other applications as well as the operating conditions prevailing during the exposure, radiological protection plays important role in this sector. Analysis of dose data, available with National Occupational Dose Registry of RPAD, Bhabha Atomic Research Centre, provides some insight into trends in occupational exposures received by industrial radiation workers. This helps in providing information on adequateness of radiation protection practices followed in the industry. This paper presents the trends in occupational exposure received by radiation workers in the industry during past 10 years (1999 to 2008). It is observed that there is a gradual increase in the occupational radiation workers during the period. The number of persons monitored as well as exposed is highest in industrial radiography compared to other sub-categories. Major contribution to collective dose is also from industrial radiography. The highest annual average as well as exposed average doses are contributed by industrial radiography. The monitored persons receiving dose d 5 mSv is 96.9% industry

Spatial cluster detection for repeatedly measured outcomes while accounting for residential history.

Science.gov (United States)

Cook, Andrea J; Gold, Diane R; Li, Yi

2009-10-01

Spatial cluster detection has become an important methodology in quantifying the effect of hazardous exposures. Previous methods have focused on cross-sectional outcomes that are binary or continuous. There are virtually no spatial cluster detection methods proposed for longitudinal outcomes. This paper proposes a new spatial cluster detection method for repeated outcomes using cumulative geographic residuals. A major advantage of this method is its ability to readily incorporate information on study participants relocation, which most cluster detection statistics cannot. Application of these methods will be illustrated by the Home Allergens and Asthma prospective cohort study analyzing the relationship between environmental exposures and repeated measured outcome, occurrence of wheeze in the last 6 months, while taking into account mobile locations.

Effect of prenatal polycyclic aromatic hydrocarbons exposure on birth outcomes: the Polish mother and child cohort study.

Science.gov (United States)

Polanska, Kinga; Dettbarn, Gerhard; Jurewicz, Joanna; Sobala, Wojciech; Magnus, Per; Seidel, Albrecht; Hanke, Wojciech

2014-01-01

The aim of this study was to assess the impact of PAH exposure on various anthropometric measures of birth outcomes. The study population consisted of 210 nonsmoking pregnant women. Urine samples collected between 20th and 24th week of pregnancy were used for analysis of the following PAH metabolites: 1-, 2-, 3-, 4-, and 9-hydroxyphenanthrene (1-, 2-, 3-, 4-, and 9-OH-PHE), 1-hydroxypyrene (1-OH-PYR), 1,6 + 1,8-dihydroxypyrene (DI-OH-PYR), phenanthrene trans-1,2-dihydrodiol (PHE-1,2-diol), and phenanthrene trans-9,10-dihydrodiol (PHE-9,10-diol) by gas chromatography-mass spectrometry. Environmental tobacco smoke exposure (ETS) was assessed by cotinine level in saliva using a stable isotope dilution LC-ESI-MS/MS method. The mean PAH metabolite concentrations were in the range of 0.15 µg/g creatinine for 9-OH-PHE to 5.9 µg/g creatinine for PHE-9,10-diol. It was shown that none of the individual PAH exposure markers demonstrate a statistically significant influence on birth outcomes. Interestingly a statistically significant association was found between the sum of OH-PHE along with cotinine level and the cephalization index after adjusting for potential confounders (P = 0.04). This study provides evidence that combined exposure of pregnant women to common environmental pollutants such as PAH and ETS might adversely affect fetal development. Thus, reduction of human exposure to these mixtures of hazardous compounds would in particular result in substantial health benefits for newborns.

Impact of environmental tobacco smoke exposure in women on oxidative stress in the antral follicle and assisted reproduction outcomes.

Science.gov (United States)

Kazemi, Ashraf; Ramezanzadeh, Fatemeh; Esfahani, Mohammad Hosein Nasr; Saboor-Yaraghi, Ali Akbar; Nejat, Saharnaz; Rahimi-Foroshani, Abbas

2013-08-01

Cigarette smoke contains many oxidants and may alter the human reproduction by inducing oxidative stress (OS) in both active and passive smokers. This study was designed to evaluate the effect of environmental tobacco smoke (ETS) exposure on oxidative stress in the follicular fluid and the assisted reproduction outcomes. An observational prospective study was carried out on 236 infertile women, who underwent assisted reproduction cycles. The ETS exposure was assessed using self-reported ETS exposure and the cotinine level in follicular fluid. To evaluate the OS in follicular fluid (FF) malon-di-aldehyde (MDA) and total antioxidant capacity (TAC) were measured. The number of retrieved oocytes, rate of metaphase II stage oocytes, fertilization rate, good cleavage rate, and no-fragmented embryo rate were considered as the assisted reproduction outcomes. The results were adjusted for age, body mass index, duration, and etiology of infertility; P-values less than 0.05 were considered significant. The MDA and TAC levels in FF were not related to the self-report number of the weekly ETS exposure and cotinine levels in FF. Also, the number of retrieved oocytes, MII stage oocytes, fertilization rate, good cleavage rate, and no-fragmented embryo rate were not related to the cotinine level and weekly ETS exposure. However, in women whose cotinine levels in FF were lower and equal/above 3.5 ng/ml, the number of retrieved oocytes was higher (12.63 ± .71 vs. 9.28 ± 1.11, P = 0.01). The relationship between the MDA level and cleavage rate (Beta = -18.5, confidence interval-34.9 and-2.1, P assisted reproduction success by influencing the number of available oocytes. Although, the OS in a follicular environment affect the ability of oocytes to reach the specific cleavage stages at appropriate time intervals, it does not mediate poor-assisted reproduction outcomes due to ETS exposure.

Occupational exposure to pesticides and pregnancy outcomes in gardeners and farmers: a study within the Danish National Birth Cohort

DEFF Research Database (Denmark)

Zhu, Jin Liang; Hjøllund, Niels Henrik Ingvar; Andersen, AM

2006-01-01

OBJECTIVE: We conducted a follow-up study to examine whether exposure to pesticides during pregnancy had an adverse effect on pregnancy outcomes among Danish gardeners and farmers. METHODS: Using data from the National Birth Cohort in Denmark, we identified 226 pregnancies of gardeners and 214...... regression was applied to analyze late fetal loss and congenital malformations, and logistic regression was used to analyze preterm birth and small for gestational age. RESULTS: There were no significant differences in the studied pregnancy outcomes between gardeners or farmers and all other workers, except...... for an increased risk of very preterm birth for gardeners and a favorable birth weight for farmers. With the exception of biologic approach used in gardening, neither work activities nor exposure to pesticides showed a significant increased risk of adverse birth outcomes among gardeners or farmers. CONCLUSIONS...

Potential Dermal Exposure to Flonicamid and Risk Assessment of Applicators During Treatment in Apple Orchards.

Science.gov (United States)

Zhao, Mei-Ai; Yu, Aili; Zhu, Yong-Zhe; Kim, Jeong-Han

2015-01-01

Exposure and risk assessments of flonicamid for applicators were performed in apple orchards in Korea. Fifteen experiments were done with two experienced applicators under typical field conditions using a speed sprayer. In this study, cotton gloves, socks, masks, and dermal patches were used to monitor potential dermal exposure to flonicamid, and personal air samplers with XAD-2 resin and glass fiber filter were used to monitor potential inhalation exposure. The analytical methods were validated for the limit of detection, limit of quantitation, reproducibility, linearity of the calibration curve, and recovery of flonicamid from various exposure matrices. The results were encouraging and acceptable for an exposure study. The applicability of XAD-2 resin was evaluated via a trapping efficiency and breakthrough test. During the mixing/loading, the average total dermal exposure was 22.6 μg of flonicamid, corresponding to 4.5×10(-5)% of the prepared amount. For the spraying, the potential dermal exposure was 9.32 mg, and the ratio to applied amount was 1.9 × 10(-2%). The primary exposed body parts were the thigh (2.90 mg), upper arm (1.75 mg), and lower leg (1.66 mg). By comparison, absorbable quantity of exposure was small, only 1.62 μg (3.2×10(-6)%). The margin of safety (MOS) were calculated for risk assessment, in all sets of trials, MOS > 1, indicating the exposure level of flonicamid was considered to be safe in apple orchards. Although this was a limited study, it provided a good estimate of flonicamid exposure for orchard applicators.

Children and Caregivers’ Exposure to Adverse Childhood Experiences (ACES: Association with Children’s and Caregivers’ Psychological Outcomes in a Therapeutic Preschool Program

Directory of Open Access Journals (Sweden)

Yair Ziv

2018-03-01

Full Text Available Exposure to adverse childhood experiences (ACE has been found to have a profound negative impact on multiple child outcomes, including academic achievement, social cognition patterns, and behavioral adjustment. However, these links have yet to be examined in preschool children that are already experiencing behavior or social-emotional problems. Thus, the present study examined the links between the caregiver’s and the child’s exposure to ACE and multiple child and caregiver’s outcomes in a sample of 30 preschool children enrolled in a Therapeutic Nursery Program (TNP. Children are typically referred to this TNP due to significant delays in their social emotional development that often result in difficulty functioning in typical childcare, home, and community settings. Analyses revealed some contradictory patterns that may be specific to this clinical sample. Children with higher exposure to ACE showed more biased social information processing patterns and their caregivers reported lower child social skills than caregivers of children with less exposure, however their inhibitory control levels were higher (better control and staff reported that these children exhibited better social skills as well as better approaches to learning than children with less exposure. No such contradictions were found in relation to the caregiver’s exposure to ACE, as it was positively associated with a number of negative child and caregiver outcomes.

Prenatal coke: what's behind the smoke? Prenatal cocaine/alcohol exposure and school-age outcomes: the SCHOO-BE experience.

Science.gov (United States)

Delaney-Black, V; Covington, C; Templin, T; Ager, J; Martier, S; Compton, S; Sokol, R

1998-06-21

Despite media reports and educators' concerns, little substantive data have been published to document or refute the emerging reports that children prenatally exposed to cocaine have serious behavioral problems in school. Recent pilot data from this institution have indeed demonstrated teacher-reported problem behaviors following prenatal cocaine exposure after controlling for the effects of prenatal alcohol use and cigarette exposure. Imperative in the study of prenatal exposure and child outcome is an acknowledgement of the influence of other control factors such as postnatal environment, secondary exposures, and parenting issues. We report preliminary evaluation from a large ongoing historical prospective study of prenatal cocaine exposure on school-age outcomes. The primary aim of this NIDA-funded study is to determine if a relationship exists between prenatal cocaine/alcohol exposures and school behavior and, if so, to determine if the relationship is characterized by a dose-response relationship. A secondary aim evaluates the relationship between prenatal cocaine/alcohol exposures and school achievement. Both relationships will be assessed in a black, urban sample of first grade students using multivariate statistical techniques for confounding as well as mediating and moderating prenatal and postnatal variables. A third aim is to evaluate the relationship between a general standardized classroom behavioral measure and a tool designed to tap the effects thought to be specific to prenatal cocaine exposure. This interdisciplinary research team can address these aims because of the existence of a unique, prospectively collected perinatal Database, funded in part by NIAAA and NICHD. The database includes repeated measures of cocaine, alcohol, and other substances for over 3,500 births since 1986. Information from this database is combined with information from the database of one of the largest public school systems in the nation. The final sample will be

Prenatal Coke: What's Behind the Smoke?: Prenatal Cocaine/Alcohol Exposure and School-Age Outcomes: The SCHOO-BE Experiencea.

Science.gov (United States)

Delaney-Black, Virginia; Covington, Chandice; Templin, Tom; Ager, Joel; Martier, Sue; Compton, Scott; Sokol, Robert

1998-06-01

Despite media reports and educators' concerns, little substantive data have been published to document or refute the emerging reports that children prenatally exposed to cocaine have serious behavioral problems in school. Recent pilot data from this institution have indeed demonstrated teacher-reported problem behaviors following prenatal cocaine exposure after controlling for the effects of prenatal alcohol use and cigarette exposure. Imperative in the study of prenatal exposure and child outcome is an acknowledgment of the influence of other control factors such as postnatal environment, secondary exposures, and parenting issues. We report preliminary evaluation from a large ongoing historical prospective study of prenatal cocaine exposure on school-age outcomes. The primary aim of this NIDA-funded study is to determine if a relationship exists between prenatal cocaine/alcohol exposures and school behavior and, if so, to determine if the relationship is characterized by a dose-response relationship. A secondary aim evaluates the relationship between prenatal cocaine/alcohol exposures and school achievement. Both relationships will be assessed in a black, urban sample of first grade students using multivariate statistical techniques for confounding as well as mediating and moderating prenatal and postnatal variables. A third aim is to evaluate the relationship between a general standardized classroom behavioral measure and a tool designed to tap the effects thought to be specific to prenatal cocaine exposure. This interdisciplinary research team can address these aims because of the existence of a unique, prospectively collected Perinatal Database, funded in part by NIAAA and NICHD. The database includes repeated measures of cocaine, alcohol, and other substances for over 3,500 births since 1986. Information from this database is combined with information from the database of one of the largest public school systems in the nation. The final sample will be composed

The 2008-2009 recession and alcohol outcomes: differential exposure and vulnerability for Black and Latino populations.

Science.gov (United States)

Zemore, Sarah E; Mulia, Nina; Jones-Webb, Rhonda J; Liu, Huiguo; Schmidt, Laura

2013-01-01

We examined whether race/ethnicity was related to exposure to acute economic losses in the 2008-2009 recession, even accounting for individual-level and geographic variables, and whether it influenced associations between economic losses and drinking patterns and problems. Data were from the 2010 National Alcohol Survey (N = 5,382). Surveys assessed both severe losses (i.e., job and housing loss) and moderate losses (i.e., reduced hours/pay and trouble paying the rent/mortgage) attributed to the 2008-2009 recession. Alcohol outcomes included total annual volume, monthly drunkenness, drinking consequences, and alcohol dependence (based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition). Compared with Whites, Blacks reported significantly greater exposure to job loss and trouble paying the rent/mortgage, and Latinos reported greater exposure to all economic losses. However, only Black-White differences were robust in multivariate analyses. Interaction tests suggested that associations between exposure to economic loss and alcohol problems were stronger among Blacks than Whites. Given severe (vs. no) loss, Blacks had about 13 times the odds of both two or more drinking consequences and alcohol dependence, whereas the corresponding odds ratios for Whites were less than 3. Conversely, associations between economic loss and alcohol outcomes were weak and ambiguous among Latinos. Results suggest greater exposure to economic loss for both Blacks and Latinos (vs. Whites) and that the Black population may be particularly vulnerable to the negative effects of economic hardship on the development and/or maintenance of alcohol problems. Findings extend the economic literature and signal policy makers and service providers that Blacks and Latinos may be at special risk during economic downturns.

Socio-environmental exposures and health outcomes among persons with sickle cell disease.

Directory of Open Access Journals (Sweden)

Monika R Asnani

Full Text Available There is much variability in the expression of sickle cell disease (SCD and recent works suggest that environmental and social factors may also influence this variability. This paper aims to use geographic information systems technology to examine the association between socio-environmental exposures and health outcomes in all persons who have attended or currently attend the Sickle Cell Unit in Jamaica. Rural patients presented for clinical care at older ages and had less annual visits to clinic. Persons travelled relatively long distances to seek SCD care and those travelling longer had less health maintenance visits. Urban patients had a higher prevalence of significant pain crises (69.4% vs. 55.8%, p value<0.001 and respiratory events (21.2% vs. 14%, p value<0.001. Prevalence of leg ulcers did not vary between rural and urban patients but was higher in males than in females. Females also had lower odds of having respiratory events but there was no sex difference in history of painful crises. Persons with more severe genotypes lived in higher poverty and travelled longer for healthcare services. Persons in areas with higher annual rainfall, higher mean temperatures and living farther from factories had less painful crises and respiratory events. The paper highlights a need for better access to healthcare services for Jamaicans with SCD especially in rural areas of the island. It also reports interesting associations between environmental climatic exposures and health outcomes.

Birth outcomes and background exposures to select elements, the Longitudinal Investigation of Fertility and the Environment (LIFE).

Science.gov (United States)

Bloom, Michael S; Buck Louis, Germaine M; Sundaram, Rajeshwari; Maisog, Jose M; Steuerwald, Amy J; Parsons, Patrick J

2015-04-01

Evidence suggests that trace exposures to select elements may increase the risk for adverse birth outcomes. To investigate further, we used multiple regression to assess associations between preconception parental exposures to Pb, Cd, and total Hg in blood, and 21 elements in urine, with n=235 singleton birth outcomes, adjusted for confounders and partner's exposure. Earlier gestational age at delivery (GA) was associated with higher tertiles of urine maternal W (-1.22 days) and paternal U (-1.07 days), but GA was later for higher tertiles of maternal (+1.11 days) and paternal (+1.30 days) blood Hg. Additional analysis indicated shorter GA associated with higher paternal urine Ba, W, and U, and with higher maternal blood Pb for boys, but GA was longer in association with higher maternal urine Cr. Birth weight (BW) was lower for higher tertiles of paternal urine Cs (-237.85g), U (-187.34g), and Zn (-209.08g), and for higher continuous Cr (P=0.021). In contrast, BW was higher for higher tertiles of paternal urine As (+194.71g) and counterintuitively for maternal blood Cd (+178.52g). Birth length (BL) was shorter for higher tertiles of urine maternal W (-1.22cm) and paternal U (-1.10cm). Yet, higher tertiles of maternal (+1.11cm) and paternal (+1.30) blood Hg were associated with longer BL. Head circumference at delivery was lower for higher tertiles of paternal urine U (-0.83cm), and for higher continuous Mo in boys (-0.57cm). Overall, associations were most consistently indicated for GA and measures of birth size with urine W and U, and paternal exposures were more frequently associated than maternal. Though limited by several factors, ours is the largest multi-element investigation of prospective couple-level trace exposures and birth outcomes to date; the novel observations for W and U merit further investigation. Copyright © 2015 Elsevier Inc. All rights reserved.

Modeling lifetime costs and health outcomes attributable to secondhand smoke exposure at home among Korean adult women.

Science.gov (United States)

Lee, Jiyae; Han, Ah Ram; Choi, Dalwoong; Lim, Kyung-Min; Bae, SeungJin

2017-05-17

The aim of this research is to estimate lifetime costs and health consequences for Korean adult women who were exposed to secondhand smoke (SHS) at home. A Markov model was developed to project the lifetime healthcare costs and health outcomes of a hypothetical cohort of Korean women who are 40 years old and were married to current smokers. The Korean epidemiological data were used to reflect the natural history of SHS-exposed and non-exposed women. The direct healthcare costs (in 2014 US dollars) and quality-adjusted life years (QALYs) were annually discounted at 5% to reflect time preference. The time horizon of the analysis was lifetime and the cycle length was 1 year. Deterministic and probabilistic sensitivity analyses were conducted. In the absence of SHS exposure, Korean women will live 41.32 years or 34.56 QALYs before discount, which corresponded to 17.29 years or 15.35 QALYs after discount. The SHS-exposed women were predicted to live 37.91 years and 31.08 QALYs before discount and 16.76 years and 14.62 QALYs after discount. The estimated lifetime healthcare cost per woman in the SHS non-exposed group was US$11 214 before the discount and US$2465 after discount. The negative impact of SHS exposure on health outcomes and healthcare costs escalated as the time horizon increased, suggesting that the adverse impact of SHS exposure may have higher impact on the later part of the lifetime. The result was consistent across a wide range of assumptions. Life expectancy might underestimate the impact of SHS exposure on health outcomes, especially if the time horizon of the analysis is not long enough. Early intervention on smoking behaviour could substantially reduce direct healthcare costs and improve quality of life attributable to SHS exposure. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Campylobacter, Salmonella, and Yersinia antibodies and pregnancy outcome in Danish women with occupational exposure to animals

DEFF Research Database (Denmark)

Kantsø, Bjørn; Andersen, Anne-Marie Nybo; Mølbak, Kåre

2014-01-01

to occupational exposure to animals in women exposed to food producing animals. METHODS: We used data and blood samples from the Danish National Birth Cohort. Serum samples collected during the first trimester from 192 pregnant women who were occupationally exposed to domestic animals and 188 randomly selected...... unexposed pregnant women were analysed for IgG, IgM, and IgA antibodies against Campylobacter, Salmonella, and Yersinia. Pregnancy outcomes of interest were identified through the Danish National Patient Register. RESULTS: Women with occupational exposure to animals had significantly higher IgG antibody...

Associations of maternal organophosphate pesticide exposure and PON1 activity with birth outcomes in SAWASDEE birth cohort, Thailand

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Naksen, Warangkana; Prapamontol, Tippawan; Mangklabruks, Ampica; Chantara, Somporn; Thavornyutikarn, Prasak; Srinual, Niphan; Panuwet, Parinya; Ryan, P. Barry; Riederer, Anne M.; Barr, Dana Boyd

2015-01-01

Prenatal organophosphate (OP) pesticide exposure has been reported to be associated with adverse birth outcomes and neurodevelopment. However, the mechanisms of toxicity of OP pesticides on human fetal development have not yet been elucidated. Our pilot study birth cohort, the Study of Asian Women and Offspring’s Development and Environmental Exposures (SAWASDEE cohort) aimed to evaluate environmental chemical exposures and their relation to birth outcomes and infant neurodevelopment in 52 pregnant farmworkers in Fang district, Chiang Mai province, Thailand. A large array of data was collected multiple times during pregnancy including approximately monthly urine samples for evaluation of pesticide exposure, three blood samples for pesticide-related enzyme measurements and questionnaire data. This study investigated the changes in maternal acetylcholinesterase (AChE) and paraoxonase 1 (PON1) activities and their relation to urinary diakylphosphates (DAPs), class-related metabolites of OP pesticides, during pregnancy. Maternal AChE, butyrylcholinesterase (BChE) and PON1 activities were measured three times during pregnancy and urinary DAP concentrations were measured, on average, 8 times from enrollment during pregnancy until delivery. Among the individuals in the group with low maternal PON1 activity (n = 23), newborn head circumference was negatively correlated with log10 maternal ΣDEAP and ΣDAP at enrollment (gestational age=12±3 weeks; β = −1.0 cm, p = 0.03 and β = −1.8 cm, p <0.01, respectively) and at 32 weeks pregnancy (β = −1.1 cm, p = 0.04 and β = −2.6 cm, p = 0.01, respectively). Furthermore, among these mothers, newborn birthweight was also negatively associated with log10 maternal ΣDEAP and ΣDAP at enrollment (β = −219.7 g, p = 0.05 and β = −371.3 g, p = 0.02, respectively). Associations between maternal DAP levels and newborn outcomes were not observed in the group of participants with high maternal PON1 activity. Our results

Neonatal Morphine Exposure in Very Preterm Infants – Cerebral Development and Outcomes

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Steinhorn, Rachel; McPherson, Chris; Anderson, Peter J; Neil, Jeffrey; Doyle, Lex W; Inder, Terrie

2015-01-01

Objective To investigate the association of morphine exposure in very preterm infants with cerebral volumes and neurodevelopmental outcome from birth through middle childhood. Study design Observational study of very preterm infants in the Victorian Infant Brain Study cohort. 230 infants born neonatal intensive care unit (NICU) of the Royal Women’s Hospital. 57 (25%) infants received morphine analgesia during their NICU stay at the attending physician’s discretion. Primary outcomes were regional brain volumes at term and 7 years; neurobehavioral performance at term; and cognitive, motor, emotional, behavioral, communication, and executive function scores at age 2 and 7 years. Linear regressions were used to compare outcomes between participants who did and did not receive morphine. Results At term, preterm infants who received morphine had similar rates of grey matter injury to no-morphine infants, but a trend towards smaller cortical volumes in the orbitofrontal (pleft=0.002, pright=0.01) and subgenual (pleft=0.01) regions. At seven years, cortical volumes did not differ between groups. At 2 years, morphine-exposed children were more likely to show behavioral dysregulation (p=0.007) than no-morphine children, but at seven years no detrimental impacts of morphine on neurobehavioral outcome were observed. Conclusions Low-dose morphine analgesia received during neonatal intensive care was associated with early alterations in cerebral structure and short-term neurobehavioral problems that did not persist into childhood. PMID:25919729

Effect of Prenatal Polycyclic Aromatic Hydrocarbons Exposure on Birth Outcomes: The Polish Mother and Child Cohort Study

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Kinga Polanska

2014-01-01

Full Text Available The aim of this study was to assess the impact of PAH exposure on various anthropometric measures of birth outcomes. The study population consisted of 210 nonsmoking pregnant women. Urine samples collected between 20th and 24th week of pregnancy were used for analysis of the following PAH metabolites: 1-, 2-, 3-, 4-, and 9-hydroxyphenanthrene (1-, 2-, 3-, 4-, and 9-OH-PHE, 1-hydroxypyrene (1-OH-PYR, 1,6 + 1,8-dihydroxypyrene (DI-OH-PYR, phenanthrene trans-1,2-dihydrodiol (PHE-1,2-diol, and phenanthrene trans-9,10-dihydrodiol (PHE-9,10-diol by gas chromatography-mass spectrometry. Environmental tobacco smoke exposure (ETS was assessed by cotinine level in saliva using a stable isotope dilution LC-ESI-MS/MS method. The mean PAH metabolite concentrations were in the range of 0.15 µg/g creatinine for 9-OH-PHE to 5.9 µg/g creatinine for PHE-9,10-diol. It was shown that none of the individual PAH exposure markers demonstrate a statistically significant influence on birth outcomes. Interestingly a statistically significant association was found between the sum of OH-PHE along with cotinine level and the cephalization index after adjusting for potential confounders (P=0.04. This study provides evidence that combined exposure of pregnant women to common environmental pollutants such as PAH and ETS might adversely affect fetal development. Thus, reduction of human exposure to these mixtures of hazardous compounds would in particular result in substantial health benefits for newborns.

Prenatal drug exposure: infant and toddler outcomes.

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Bandstra, Emmalee S; Morrow, Connie E; Mansoor, Elana; Accornero, Veronica H

2010-04-01

This manuscript provides an overview of the current scientific literature on the impact of maternal drug use, specifically opioids and cocaine, during pregnancy on the acute and long-term outcomes of infants and toddlers from birth through age 3 years. Emphasis with regard to opioids is placed on heroin and opioid substitutes used to treat opioid addiction, including methadone, which has long been regarded as the standard of care in pregnancy, and buprenorphine, which is increasingly being investigated and prescribed as an alternative to methadone. Controlled studies comparing methadone at high and low doses, as well as those comparing methadone with buprenorphine, are highlighted and the diagnosis and management of neonatal abstinence syndrome is discussed. Over the past two decades, attention of the scientific and lay communities has also been focused on the potential adverse effects of cocaine and crack cocaine, especially during the height of the cocaine epidemic in the United States. Herein, the findings are summarized from prospective studies comparing cocaine-exposed with non-cocaine-exposed infants and toddlers with respect to anthropometric growth, infant neurobehavior, visual and auditory function, and cognitive, motor, and language development. The potentially stigmatizing label of the so-called "crack baby" preceded the evidence now accumulating from well-designed prospective investigations that have revealed less severe sequelae in the majority of prenatally exposed infants than originally anticipated. In contrast to opioids, which may produce neonatal abstinence syndrome and infant neurobehavioral deficits, prenatal cocaine exposure appears to be associated with what has been described as statistically significant but subtle decrements in neurobehavioral, cognitive, and language function, especially when viewed in the context of other exposures and the caregiving environment which may mediate or moderate the effects. Whether these early findings may

Association between Household Air Pollution Exposure and Chronic Obstructive Pulmonary Disease Outcomes in 13 Low- and Middle-Income Country Settings.

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Siddharthan, Trishul; Grigsby, Matthew R; Goodman, Dina; Chowdhury, Muhammad; Rubinstein, Adolfo; Irazola, Vilma; Gutierrez, Laura; Miranda, J Jaime; Bernabe-Ortiz, Antonio; Alam, Dewan; Kirenga, Bruce; Jones, Rupert; van Gemert, Frederick; Wise, Robert A; Checkley, William

2018-03-01

Forty percent of households worldwide burn biomass fuels for energy, which may be the most important contributor to household air pollution. To examine the association between household air pollution exposure and chronic obstructive pulmonary disease (COPD) outcomes in 13 resource-poor settings. We analyzed data from 12,396 adult participants living in 13 resource-poor, population-based settings. Household air pollution exposure was defined as using biomass materials as the primary fuel source in the home. We used multivariable regressions to assess the relationship between household air pollution exposure and COPD outcomes, evaluated for interactions, and conducted sensitivity analyses to test the robustness of our findings. Average age was 54.9 years (44.2-59.6 yr across settings), 48.5% were women (38.3-54.5%), prevalence of household air pollution exposure was 38% (0.5-99.6%), and 8.8% (1.7-15.5%) had COPD. Participants with household air pollution exposure were 41% more likely to have COPD (adjusted odds ratio, 1.41; 95% confidence interval, 1.18-1.68) than those without the exposure, and 13.5% (6.4-20.6%) of COPD prevalence may be caused by household air pollution exposure, compared with 12.4% caused by cigarette smoking. The association between household air pollution exposure and COPD was stronger in women (1.70; 1.24-2.32) than in men (1.21; 0.92-1.58). Household air pollution exposure was associated with a higher prevalence of COPD, particularly among women, and it is likely a leading population-attributable risk factor for COPD in resource-poor settings.

The application of volume-outcome contouring in data warehousing.

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Studnicki, James; Berndt, Donald J; Luther, Stephen L; Fisher, John W

2004-01-01

Despite a compelling body of published research on the nature of provider volume and clinical outcomes, healthcare executives and policymakers have not managed to develop and implement systems that are useful in directing patients to higher volume providers via selective referral or avoidance. A specialized data warehouse application, utilizing hospital discharge data linked to physician biographical information, allows detailed analysis of physician and hospital volume and the resulting pattern (contour) of related outcomes such as mortality, complications, and medical errors. The approach utilizes a historical repository of hospital discharge data in which the outcomes of interest, important patient characteristics and risk factors used in severity-adjusting of the outcomes are derived from the coding structure of the data.

Oxygen Exposure Resulting in Arterial Oxygen Tensions Above the Protocol Goal Was Associated With Worse Clinical Outcomes in Acute Respiratory Distress Syndrome.

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Aggarwal, Neil R; Brower, Roy G; Hager, David N; Thompson, B Taylor; Netzer, Giora; Shanholtz, Carl; Lagakos, Adrian; Checkley, William

2018-04-01

High fractions of inspired oxygen may augment lung damage to exacerbate lung injury in patients with acute respiratory distress syndrome. Participants enrolled in Acute Respiratory Distress Syndrome Network trials had a goal partial pressure of oxygen in arterial blood range of 55-80 mm Hg, yet the effect of oxygen exposure above this arterial oxygen tension range on clinical outcomes is unknown. We sought to determine if oxygen exposure that resulted in a partial pressure of oxygen in arterial blood above goal (> 80 mm Hg) was associated with worse outcomes in patients with acute respiratory distress syndrome. Longitudinal analysis of data collected in these trials. Ten clinical trials conducted at Acute Respiratory Distress Syndrome Network hospitals between 1996 and 2013. Critically ill patients with acute respiratory distress syndrome. None. We defined above goal oxygen exposure as the difference between the fraction of inspired oxygen and 0.5 whenever the fraction of inspired oxygen was above 0.5 and when the partial pressure of oxygen in arterial blood was above 80 mm Hg. We then summed above goal oxygen exposures in the first five days to calculate a cumulative above goal oxygen exposure. We determined the effect of a cumulative 5-day above goal oxygen exposure on mortality prior to discharge home at 90 days. Among 2,994 participants (mean age, 51.3 yr; 54% male) with a study-entry partial pressure of oxygen in arterial blood/fraction of inspired oxygen that met acute respiratory distress syndrome criteria, average cumulative above goal oxygen exposure was 0.24 fraction of inspired oxygen-days (interquartile range, 0-0.38). Participants with above goal oxygen exposure were more likely to die (adjusted interquartile range odds ratio, 1.20; 95% CI, 1.11-1.31) and have lower ventilator-free days (adjusted interquartile range mean difference of -0.83; 95% CI, -1.18 to -0.48) and lower hospital-free days (adjusted interquartile range mean difference of -1.38; 95

Exposure-lag-response in Longitudinal Studies: Application of Distributed Lag Non-linear Models in an Occupational Cohort.

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Neophytou, Andreas M; Picciotto, Sally; Brown, Daniel M; Gallagher, Lisa E; Checkoway, Harvey; Eisen, Ellen A; Costello, Sadie

2018-02-13

Prolonged exposures can have complex relationships with health outcomes, as timing, duration, and intensity of exposure are all potentially relevant. Summary measures such as cumulative exposure or average intensity of exposure may not fully capture these relationships. We applied penalized and unpenalized distributed lag non-linear models (DLNMs) with flexible exposure-response and lag-response functions in order to examine the association between crystalline silica exposure and mortality from lung cancer and non-malignant respiratory disease in a cohort study of 2,342 California diatomaceous earth workers, followed 1942-2011. We also assessed associations using simple measures of cumulative exposure assuming linear exposure-response and constant lag-response. Measures of association from DLNMs were generally higher than from simpler models. Rate ratios from penalized DLNMs corresponding to average daily exposures of 0.4 mg/m3 during lag years 31-50 prior to the age of observed cases were 1.47 (95% confidence interval (CI) 0.92, 2.35) for lung cancer and 1.80 (95% CI: 1.14, 2.85) for non-malignant respiratory disease. Rate ratios from the simpler models for the same exposure scenario were 1.15 (95% CI: 0.89-1.48) and 1.23 (95% CI: 1.03-1.46) respectively. Longitudinal cohort studies of prolonged exposures and chronic health outcomes should explore methods allowing for flexibility and non-linearities in the exposure-lag-response. © The Author(s) 2018. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Impact of environmental tobacco smoke exposure in women on oxidative stress in the antral follicle and assisted reproduction outcomes

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Kazemi, Ashraf; Ramezanzadeh, Fatemeh; Esfahani, Mohammad Hosein Nasr; Saboor-Yaraghi, Ali Akbar; Nejat, Saharnaz; Rahimi-Foroshani, Abbas

2013-01-01

Background: Cigarette smoke contains many oxidants and may alter the human reproduction by inducing oxidative stress (OS) in both active and passive smokers. This study was designed to evaluate the effect of environmental tobacco smoke (ETS) exposure on oxidative stress in the follicular fluid and the assisted reproduction outcomes. Materials and Methods: An observational prospective study was carried out on 236 infertile women, who underwent assisted reproduction cycles. The ETS exposure was assessed using self-reported ETS exposure and the cotinine level in follicular fluid. To evaluate the OS in follicular fluid (FF) malon-di-aldehyde (MDA) and total antioxidant capacity (TAC) were measured. The number of retrieved oocytes, rate of metaphase II stage oocytes, fertilization rate, good cleavage rate, and no-fragmented embryo rate were considered as the assisted reproduction outcomes. The results were adjusted for age, body mass index, duration, and etiology of infertility; P-values less than 0.05 were considered significant. Results: The MDA and TAC levels in FF were not related to the self-report number of the weekly ETS exposure and cotinine levels in FF. Also, the number of retrieved oocytes, MII stage oocytes, fertilization rate, good cleavage rate, and no-fragmented embryo rate were not related to the cotinine level and weekly ETS exposure. However, in women whose cotinine levels in FF were lower and equal/above 3.5 ng/ml, the number of retrieved oocytes was higher (12.63 ± .71 vs. 9.28 ± 1.11, P = 0.01). The relationship between the MDA level and cleavage rate (Beta = −18.5, confidence interval-34.9 and-2.1, P reproduction success by influencing the number of available oocytes. Although, the OS in a follicular environment affect the ability of oocytes to reach the specific cleavage stages at appropriate time intervals, it does not mediate poor-assisted reproduction outcomes due to ETS exposure. PMID:24379845

Association between Exposure of Young Children to Procedures Requiring General Anesthesia and Learning and Behavioral Outcomes in a Population-based Birth Cohort.

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Hu, Danqing; Flick, Randall P; Zaccariello, Michael J; Colligan, Robert C; Katusic, Slavica K; Schroeder, Darrell R; Hanson, Andrew C; Buenvenida, Shonie L; Gleich, Stephen J; Wilder, Robert T; Sprung, Juraj; Warner, David O

2017-08-01

Exposure of young animals to general anesthesia causes neurodegeneration and lasting behavioral abnormalities; whether these findings translate to children remains unclear. This study used a population-based birth cohort to test the hypothesis that multiple, but not single, exposures to procedures requiring general anesthesia before age 3 yr are associated with adverse neurodevelopmental outcomes. A retrospective study cohort was assembled from children born in Olmsted County, Minnesota, from 1996 to 2000 (inclusive). Propensity matching selected children exposed and not exposed to general anesthesia before age 3 yr. Outcomes ascertained via medical and school records included learning disabilities, attention-deficit/hyperactivity disorder, and group-administered ability and achievement tests. Analysis methods included proportional hazard regression models and mixed linear models. For the 116 multiply exposed, 457 singly exposed, and 463 unexposed children analyzed, multiple, but not single, exposures were associated with an increased frequency of both learning disabilities and attention-deficit/hyperactivity disorder (hazard ratio for learning disabilities = 2.17 [95% CI, 1.32 to 3.59], unexposed as reference). Multiple exposures were associated with decreases in both cognitive ability and academic achievement. Single exposures were associated with modest decreases in reading and language achievement but not cognitive ability. These findings in children anesthetized with modern techniques largely confirm those found in an older birth cohort and provide additional evidence that children with multiple exposures are more likely to develop adverse outcomes related to learning and attention. Although a robust association was observed, these data do not determine whether anesthesia per se is causal.

Single-session gamified virtual reality exposure therapy for spider phobia vs. traditional exposure therapy: study protocol for a randomized controlled non-inferiority trial.

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Miloff, Alexander; Lindner, Philip; Hamilton, William; Reuterskiöld, Lena; Andersson, Gerhard; Carlbring, Per

2016-02-02

Traditional one-session exposure therapy (OST) in which a patient is gradually exposed to feared stimuli for up to 3 h in a one-session format has been found effective for the treatment of specific phobias. However, many individuals with specific phobia are reluctant to seek help, and access to care is lacking due to logistic challenges of accessing, collecting, storing, and/or maintaining stimuli. Virtual reality (VR) exposure therapy may improve upon existing techniques by facilitating access, decreasing cost, and increasing acceptability and effectiveness. The aim of this study is to compare traditional OST with in vivo spiders and a human therapist with a newly developed single-session gamified VR exposure therapy application with modern VR hardware, virtual spiders, and a virtual therapist. Participants with specific phobia to spiders (N = 100) will be recruited from the general public, screened, and randomized to either VR exposure therapy (n = 50) or traditional OST (n = 50). A behavioral approach test using in vivo spiders will serve as the primary outcome measure. Secondary outcome measures will include spider phobia questionnaires and self-reported anxiety, depression, and quality of life. Outcomes will be assessed using a non-inferiority design at baseline and at 1, 12, and 52 weeks after treatment. VR exposure therapy has previously been evaluated as a treatment for specific phobias, but there has been a lack of high-quality randomized controlled trials. A new generation of modern, consumer-ready VR devices is being released that are advancing existing technology and have the potential to improve clinical availability and treatment effectiveness. The VR medium is also particularly suitable for taking advantage of recent phobia treatment research emphasizing engagement and new learning, as opposed to physiological habituation. This study compares a market-ready, gamified VR spider phobia exposure application, delivered using consumer VR hardware, with

Comparison of neurological health outcomes between two adolescent cohorts exposed to pesticides in Egypt.

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Ahmed A Ismail

Full Text Available Pesticide-exposed adolescents may have a higher risk of neurotoxic effects because of their developing brains and bodies. However, only a limited number of studies have addressed this risk among adolescents. The aim of this study was to compare neurological outcomes from two cohorts of Egyptian adolescents working as pesticide applicators. In 2005 and 2009, two cohorts of male adolescents working as pesticide applicators for the cotton crop were recruited from Menoufia Governorate, Egypt. The same application schedule and pesticides were used at both times, including both organophosphorus, and pyrethroid compounds. Participants in both cohorts completed three neurobehavioral tests, health and exposure questionnaires, and medical and neurological screening examinations. In addition, blood samples were collected to measure butyryl cholinesterase (BChE activity. Pesticide applicators in both cohorts reported more neurological symptoms and signs than non-applicators, particularly among participants in the 2005 cohort (OR ranged from 1.18 to 15.3. Except for one test (Trail Making B, there were no significant differences between either applicators or non-applicators of both cohorts on the neurobehavioral outcome measures (p > 0.05. The 2005 cohort showed greater inhibition of serum BChE activity than the 2009 cohort (p < 0.05. In addition, participants with depressed BChE activity showed more symptoms and signs than others without BChE depression (p < 0.05. Our study is the first to examine the consistency of health outcomes associated with pesticide exposure across two cohorts tested at different times from the same geographical region in rural Egypt. This similar pattern of findings across the two cohorts provides strong evidence of the health impact of exposure of adolescents to pesticides.

A Review of Nitrates in Drinking Water: Maternal Exposure and Adverse Reproductive and Developmental Outcomes

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Manassaram, Deana M.; Backer, Lorraine C.; Moll, Deborah M.

2006-01-01

In this review we present an update on maternal exposure to nitrates in drinking water in relation to possible adverse reproductive and developmental effects, and also discuss nitrates in drinking water in the United States. The current standard for nitrates in drinking water is based on retrospective studies and approximates a level that protects infants from methemoglobinemia, but no safety factor is built into the standard. The current standard applies only to public water systems. Drinking water source was related to nitrate exposure (i.e., private systems water was more likely than community system water to have nitrate levels above the maximum contaminant limit). Animal studies have found adverse reproductive effects resulting from higher doses of nitrate or nitrite. The epidemiologic evidence of a direct exposure–response relationship between drinking water nitrate level and adverse reproductive effect is still not clear. However, some reports have suggested an association between exposure to nitrates in drinking water and spontaneous abortions, intrauterine growth restriction, and various birth defects. Uncertainties in epidemiologic studies include the lack of individual exposure assessment that would rule out confounding of the exposure with some other cause. Nitrates may be just one of the contaminants in drinking water contributing to adverse outcomes. We conclude that the current literature does not provide sufficient evidence of a causal relationship between exposure to nitrates in drinking water and adverse reproductive effects. Future studies incorporating individual exposure assessment about users of private wells—the population most at risk—should be considered. PMID:16507452

Optimization (Alara) and probabilistic exposures: the application of optimization criteria to the control of risks due to exposures of a probabilistic nature

International Nuclear Information System (INIS)

Gonzalez, A.J.

1989-01-01

The paper described the application of the principles of optimization recommended by the International Commission on Radiological Protection (ICRP) to the restrain of radiation risks due to exposures that may or may not be incurred and to which a probability of occurrence can be assigned. After describing the concept of probabilistic exposures, it proposes a basis for a converging policy of control for both certain and probabilistic exposures, namely the dose-risk relationship adopted for radiation protection purposes. On that basis some coherent approaches for dealing with probabilistic exposures, such as the limitation of individual risks, are discussed. The optimization of safety for reducing all risks from probabilistic exposures to as-low-as-reasonably-achievable (ALARA) levels is reviewed in full. The principles of optimization of protection are used as a basic framework and the relevant factors to be taken into account when moving to probabilistic exposures are presented. The paper also reviews the decision-aiding techniques suitable for performing optimization with particular emphasis to the multi-attribute utility-analysis technique. Finally, there is a discussion on some practical application of decision-aiding multi-attribute utility analysis to probabilistic exposures including the use of probabilistic utilities. In its final outlook, the paper emphasizes the need for standardization and solutions to generic problems, if optimization of safety is to be successful

CHILDREN'S RESIDENTIAL EXPOSURE TO CHLORPYRIFOS: APPLICATION OF CPPAES FIELD MEASUREMENTS OF CHLORPYRIFOS AND TCPY WITHIN MENTOR/SHEDS PESTICIDES MODEL

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The comprehensive individual field-measurements on non-dietary exposure collected in the Children's-Post-Pesticide-Application-Exposure-Study (CPPAES) were used within MENTOR/SHEDS-Pesticides, a physically based stochastic human exposure and dose model. In this application, howev...

Evaluation of radiological exposure from Plowshare applications, 1967--1975

International Nuclear Information System (INIS)

Barton, C.J.; Kaye, S.V.

1975-08-01

A review of the highlights and accomplishments of the nine-year program, FY 1967-75, at ORNL on the evaluation of the radiological exposure from Plowshare applications is presented. Conclusions based on the studies summarized are given. Chronological lists of presentations, reports and open literature publications on the various investigations of the program are appended to the report. (auth)

Influence of Disease and Patient Characteristics on Daratumumab Exposure and Clinical Outcomes in Relapsed or Refractory Multiple Myeloma

DEFF Research Database (Denmark)

Yan, Xiaoyu; Clemens, Pamela L; Puchalski, Thomas

2018-01-01

OBJECTIVE: The aim of this study was to understand the influence of disease and patient characteristics on exposure to daratumumab, an immunoglobulin Gκ (IgGκ) monoclonal antibody, and clinical outcomes in relapsed or refractory multiple myeloma (MM). PATIENTS AND METHODS: Baseline myeloma type, ...

Semiparametric methods for estimation of a nonlinear exposure‐outcome relationship using instrumental variables with application to Mendelian randomization

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Staley, James R.

2017-01-01

ABSTRACT Mendelian randomization, the use of genetic variants as instrumental variables (IV), can test for and estimate the causal effect of an exposure on an outcome. Most IV methods assume that the function relating the exposure to the expected value of the outcome (the exposure‐outcome relationship) is linear. However, in practice, this assumption may not hold. Indeed, often the primary question of interest is to assess the shape of this relationship. We present two novel IV methods for investigating the shape of the exposure‐outcome relationship: a fractional polynomial method and a piecewise linear method. We divide the population into strata using the exposure distribution, and estimate a causal effect, referred to as a localized average causal effect (LACE), in each stratum of population. The fractional polynomial method performs metaregression on these LACE estimates. The piecewise linear method estimates a continuous piecewise linear function, the gradient of which is the LACE estimate in each stratum. Both methods were demonstrated in a simulation study to estimate the true exposure‐outcome relationship well, particularly when the relationship was a fractional polynomial (for the fractional polynomial method) or was piecewise linear (for the piecewise linear method). The methods were used to investigate the shape of relationship of body mass index with systolic blood pressure and diastolic blood pressure. PMID:28317167

Potential applications of SIMS technique for environmental monitoring based on exposure of aquatic organisms

International Nuclear Information System (INIS)

Noller, B.N.

2000-01-01

Full text: The kinds of environmental monitoring applications for which SIMS may be applicable, particularly with aquatic organisms, fall into 2 main categories: a) Undertaking controlled dose experiments with aquatic organisms where the nature of exposure is known together with water concentration, soft tissue and shell concentrations; and b) Using aquatic organisms from historically or currently impacted sites where other data or information may or may not be available to give some insight into the exposure pattern, generally from existing water monitoring data, sediment concentrations and other data such as water release or flow data. The advantage of experiments undertaken under controlled conditions is that they enable modelling to be developed and be applied. Usually the controlled studies with aquatic organisms are undertaken following cases of historical exposure. The usefulness of historical studies is therefore questionable unless a clear link with the organism exposure can be established. Some examples will be given to show how historical data could be used to bridge the information gap

Self-reported parental exposure to pesticide during pregnancy and birth outcomes: the MecoExpo cohort study.

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Flora Mayhoub

Full Text Available The MecoExpo study was performed in the Picardy region of northern France, in order to investigate the putative relationship between parental exposures to pesticides (as reported by the mother on one hand and neonatal parameters on the other. The cohort comprised 993 mother-newborn pairs. Each mother completed a questionnaire that probed occupational, domestic, environmental and dietary sources of parental exposure to pesticides during her pregnancy. Multivariate regression analyses were then used to test for associations between the characteristics of parental pesticide exposure during pregnancy and the corresponding birth outcomes. Maternal occupational exposure was associated with an elevated risk of low birth weight (odds ratio (OR [95% confidence interval]: 4.2 [1.2, 15.4]. Paternal occupational exposure to pesticides was associated with a lower than average gestational age at birth (-0.7 weeks; p = 0.0002 and an elevated risk of prematurity (OR: 3.7 [1.4, 9.7]. Levels of domestic exposure to veterinary antiparasitics and to pesticides for indoor plants were both associated with a low birth weight (-70 g; p = 0.02 and -160 g; p = 0.005, respectively. Babies born to women living in urban areas had a lower birth length and a higher risk of low birth length (-0.4 cm, p = 0.006 and OR: 2.9 [1.5, 5.5], respectively. The present study results mainly demonstrate a negative correlation between fetal development on one hand and parental occupational and domestic exposure to pesticides on the other. Our study highlights the need to perform a global and detailed screening of all potential physiological effects when assessing in utero exposure to pesticides.

Self-reported parental exposure to pesticide during pregnancy and birth outcomes: the MecoExpo cohort study.

Science.gov (United States)

Mayhoub, Flora; Berton, Thierry; Bach, Véronique; Tack, Karine; Deguines, Caroline; Floch-Barneaud, Adeline; Desmots, Sophie; Stéphan-Blanchard, Erwan; Chardon, Karen

2014-01-01

The MecoExpo study was performed in the Picardy region of northern France, in order to investigate the putative relationship between parental exposures to pesticides (as reported by the mother) on one hand and neonatal parameters on the other. The cohort comprised 993 mother-newborn pairs. Each mother completed a questionnaire that probed occupational, domestic, environmental and dietary sources of parental exposure to pesticides during her pregnancy. Multivariate regression analyses were then used to test for associations between the characteristics of parental pesticide exposure during pregnancy and the corresponding birth outcomes. Maternal occupational exposure was associated with an elevated risk of low birth weight (odds ratio (OR) [95% confidence interval]: 4.2 [1.2, 15.4]). Paternal occupational exposure to pesticides was associated with a lower than average gestational age at birth (-0.7 weeks; p = 0.0002) and an elevated risk of prematurity (OR: 3.7 [1.4, 9.7]). Levels of domestic exposure to veterinary antiparasitics and to pesticides for indoor plants were both associated with a low birth weight (-70 g; p = 0.02 and -160 g; p = 0.005, respectively). Babies born to women living in urban areas had a lower birth length and a higher risk of low birth length (-0.4 cm, p = 0.006 and OR: 2.9 [1.5, 5.5], respectively). The present study results mainly demonstrate a negative correlation between fetal development on one hand and parental occupational and domestic exposure to pesticides on the other. Our study highlights the need to perform a global and detailed screening of all potential physiological effects when assessing in utero exposure to pesticides.

Infant and childhood neurodevelopmental outcomes following prenatal exposure to selective serotonin reuptake inhibitors: overview and design of a Finnish Register-Based Study (FinESSI

Directory of Open Access Journals (Sweden)

Malm Heli

2012-12-01

Full Text Available Abstract Background Experimental animal studies and one population-based study have suggested an increased risk for adverse neurodevelopmental outcome after prenatal exposure to SSRIs. We describe the methods and design of a population-based study examining the association between prenatal SSRI exposure and neurodevelopment until age 14. Methods and design This is a cohort study of national registers in Finland: the Medical Birth Register, the Register of Congenital Malformations, the Hospital Discharge Register including inpatient and outpatient data, the Drug Reimbursement Register, and the Population Register. The total study population includes 845,345 women and their live-born, singleton offspring aged 14 or younger and born during Jan 1st 1996-Dec 31st 2010. We will compare the prevalence of psychiatric and neurodevelopmental outcomes in offspring exposed prenatally to SSRIs to offspring exposed to prenatal depression and unexposed to SSRIs. Associations between exposure and outcome are assessed by statistical methods including specific modeling to account for correlated outcomes within families and differences in duration of follow-up between the exposure groups. Descriptive results. Of all pregnant women with pregnancy ending in delivery (n = 859,359, 1.9% used SSRIs. The prevalence of diagnosed depression and depression-related psychiatric disorders within one year before or during pregnancy was 1.7%. The cumulative incidence of registered psychiatric or neurodevelopmental disorders was 6.9% in 2010 among all offspring born during the study period (age range 0–14 years. Discussion The study has the potential for significant public health importance in providing information on prenatal exposure to SSRIs and long-term neurodevelopment.

Self-Reported and FEMA Flood Exposure Assessment after Hurricane Sandy: Association with Mental Health Outcomes.

Directory of Open Access Journals (Sweden)

Wil Lieberman-Cribbin

Full Text Available Hurricane Sandy caused extensive physical and economic damage; the long-term mental health consequences are unknown. Flooding is a central component of hurricane exposure, influencing mental health through multiple pathways that unfold over months after flooding recedes. Here we assess the concordance in self-reported and Federal Emergency Management (FEMA flood exposure after Hurricane Sandy and determine the associations between flooding and anxiety, depression, and post-traumatic stress disorder (PTSD. Self-reported flood data and mental health symptoms were obtained through validated questionnaires from New York City and Long Island residents (N = 1231 following Sandy. Self-reported flood data was compared to FEMA data obtained from the FEMA Modeling Task Force Hurricane Sandy Impact Analysis. Multivariable logistic regressions were performed to determine the relationship between flooding exposure and mental health outcomes. There were significant discrepancies between self-reported and FEMA flood exposure data. Self-reported dichotomous flooding was positively associated with anxiety (ORadj: 1.5 [95% CI: 1.1-1.9], depression (ORadj: 1.7 [1.3-2.2], and PTSD (ORadj: 2.5 [1.8-3.4], while self-reported continuous flooding was associated with depression (ORadj: 1.1 [1.01-1.12] and PTSD (ORadj: 1.2 [1.1-1.2]. Models with FEMA dichotomous flooding (ORadj: 2.1 [1.5-2.8] or FEMA continuous flooding (ORadj: 1.1 [1.1-1.2] were only significantly associated with PTSD. Associations between mental health and flooding vary according to type of flood exposure measure utilized. Future hurricane preparedness and recovery efforts must integrate micro and macro-level flood exposures in order to accurately determine flood exposure risk during storms and realize the long-term importance of flooding on these three mental health symptoms.

Systematic Review of Chromium and Nickel Exposure During Pregnancy and Impact on Child Outcomes.

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McDermott, Suzanne; Salzberg, Deborah C; Anderson, Anna Paige; Shaw, Timothy; Lead, Jamie

2015-01-01

Some forms of chromium (Cr) and nickel (Ni) are toxic, especially with chronic elevated exposure, and certain forms such as hexavalent chromium or nickel carbonyl were labeled as carcinogens. Since both metals are naturally occurring, and used in industrial processes, individuals may be exposed through ingestion of contaminated food or water, inhalation, or dermal contact. This study focused on the impact of toxic forms of Cr and Ni during pregnancy and outcomes in newborn and young children. A systematic literature review following "The Navigation Guide" was applied, and 16 reports that satisfied the inclusion criteria were scored. Six papers studied birth weight, prematurity, or gestational age: one found an association between Ni and small for gestational age, while another linked Ni with low birth weight; however, four reported no marked associations. Of six studies that examined birth defects, three found no significant associations; one noted an association between Ni and neural tube defects; one showed an association between Ni and structural birth defects; and one reported a weak effect for Cr exposure and musculoskeletal defects. In the remaining four studies, weak associations were found for hexavalent Cr and neuroblastoma, Ni and autism spectrum disorder, Cr and Ni and DNA damage, and Cr and lymphocyte damage. Among the studies that were rated as good for execution and reliability, there was weak evidence of an association between Ni and autism spectrum disorder and small for gestational age, but no significant association between Cr and a child outcome.

Health Outcomes of Exposure to Biological and Chemical Components of Inhalable and Respirable Particulate Matter.

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Morakinyo, Oyewale Mayowa; Mokgobu, Matlou Ingrid; Mukhola, Murembiwa Stanley; Hunter, Raymond Paul

2016-06-14

Particulate matter (PM) is a key indicator of air pollution and a significant risk factor for adverse health outcomes in humans. PM is not a self-contained pollutant but a mixture of different compounds including chemical and biological fractions. While several reviews have focused on the chemical components of PM and associated health effects, there is a dearth of review studies that holistically examine the role of biological and chemical components of inhalable and respirable PM in disease causation. A literature search using various search engines and (or) keywords was done. Articles selected for review were chosen following predefined criteria, to extract and analyze data. The results show that the biological and chemical components of inhalable and respirable PM play a significant role in the burden of health effects attributed to PM. These health outcomes include low birth weight, emergency room visit, hospital admission, respiratory and pulmonary diseases, cardiovascular disease, cancer, non-communicable diseases, and premature death, among others. This review justifies the importance of each or synergistic effects of the biological and chemical constituents of PM on health. It also provides information that informs policy on the establishment of exposure limits for PM composition metrics rather than the existing exposure limits of the total mass of PM. This will allow for more effective management strategies for improving outdoor air quality.

Health Outcomes of Exposure to Biological and Chemical Components of Inhalable and Respirable Particulate Matter

Directory of Open Access Journals (Sweden)

Oyewale Mayowa Morakinyo

2016-06-01

Full Text Available Particulate matter (PM is a key indicator of air pollution and a significant risk factor for adverse health outcomes in humans. PM is not a self-contained pollutant but a mixture of different compounds including chemical and biological fractions. While several reviews have focused on the chemical components of PM and associated health effects, there is a dearth of review studies that holistically examine the role of biological and chemical components of inhalable and respirable PM in disease causation. A literature search using various search engines and (or keywords was done. Articles selected for review were chosen following predefined criteria, to extract and analyze data. The results show that the biological and chemical components of inhalable and respirable PM play a significant role in the burden of health effects attributed to PM. These health outcomes include low birth weight, emergency room visit, hospital admission, respiratory and pulmonary diseases, cardiovascular disease, cancer, non-communicable diseases, and premature death, among others. This review justifies the importance of each or synergistic effects of the biological and chemical constituents of PM on health. It also provides information that informs policy on the establishment of exposure limits for PM composition metrics rather than the existing exposure limits of the total mass of PM. This will allow for more effective management strategies for improving outdoor air quality.

Pesticide Application and Khat Chewing as Predictors of the Neurological Health Outcomes among Pesticide Applicators in a Vector Control Unit, Saudi Arabia

Directory of Open Access Journals (Sweden)

Ahmed A Ismail

2018-01-01

Full Text Available Background: Pesticide applicators are at risk of developing neurological symptoms and neurobehavioral deficits. This risk may increase if the applicator chews stimulant plants like khat. Objective: To examine the sociodemographic and exposure determinants of neurological symptoms presentation, neurobehavioral performance, and cholinesterase activity among pesticide applicators in a vector control unit, Saudi Arabia. Methods: In a cross-sectional study, 30 pesticide applicators and 32 non-applicators from a vector control unit in Jazan region, Saudi Arabia, were studied. The study participants completed an exposure and medical questionnaire, and a neurobehavioral test battery. Their blood samples were also tested for the measurement of butyryl cholinesterase (BChE. Results: The mean blood BChE level was no significantly different between the applicators and non-applicators. Working in pesticide application and chewing khat were significant predictors of the neurological symptoms presentation and neurobehavioral deficits among the study participants. Each factor was associated with about 40% of the symptoms included in the questionnaire. Exposure to pyrethroids was significantly associated with a decrement in symbol digit test latency, tapping (TAP non-preferred hand, and TAP alternating hands measures, representing the executive and motor speed/coordination functions. Khat chewing was associated with TAP preferred and non-preferred hands and serial digit learning measures, representing the memory and motor speed/coordination functions. Conclusions: It seems that being exposed to pyrethroids and chewing khat are associated with neurological and neurobehavioral drawbacks among pesticide applicators.

Application of Six Sigma towards improving surgical outcomes.

Science.gov (United States)

Shukla, P J; Barreto, S G; Nadkarni, M S

2008-01-01

Six Sigma is a 'process excellence' tool targeting continuous improvement achieved by providing a methodology for improving key steps of a process. It is ripe for application into health care since almost all health care processes require a near-zero tolerance for mistakes. The aim of this study is to apply the Six Sigma methodology into a clinical surgical process and to assess the improvement (if any) in the outcomes and patient care. The guiding principles of Six Sigma, namely DMAIC (Define, Measure, Analyze, Improve, Control), were used to analyze the impact of double stapling technique (DST) towards improving sphincter preservation rates for rectal cancer. The analysis using the Six Sigma methodology revealed a Sigma score of 2.10 in relation to successful sphincter preservation. This score demonstrates an improvement over the previous technique (73% over previous 54%). This study represents one of the first clinical applications of Six Sigma in the surgical field. By understanding, accepting, and applying the principles of Six Sigma, we have an opportunity to transfer a very successful management philosophy to facilitate the identification of key steps that can improve outcomes and ultimately patient safety and the quality of surgical care provided.

Exposures and Health Outcomes in Relation to Bioaerosol Emissions From Composting Facilities: A Systematic Review of Occupational and Community Studies

Science.gov (United States)

Pearson, Clare; Littlewood, Emma; Douglas, Philippa; Robertson, Sarah; Gant, Timothy W.; Hansell, Anna L.

2015-01-01

The number of composting sites in Europe is rapidly increasing, due to efforts to reduce the fraction of waste destined for landfill, but evidence on possible health impacts is limited. This article systematically reviews studies related to bioaerosol exposures within and near composting facilities and associated health effects in both community and occupational health settings. Six electronic databases and bibliographies from January 1960 to July 2014 were searched for studies reporting on health outcomes and/or bioaerosol emissions related to composting sites. Risk of bias was assessed using a customized score. Five hundred and thirty-six papers were identified and reviewed, and 66 articles met the inclusion criteria (48 exposure studies, 9 health studies, 9 health and exposure studies). Exposure information was limited, with most measurements taken in occupational settings and for limited time periods. Bioaerosol concentrations were highest on-site during agitation activities (turning, shredding, and screening). Six studies detected concentrations of either Aspergillus fumigatus or total bacteria above the English Environment Agency’s recommended threshold levels beyond 250 m from the site. Occupational studies of compost workers suggested elevated risks of respiratory illnesses with higher bioaerosol exposures. Elevated airway irritation was reported in residents near composting sites, but this may have been affected by reporting bias. The evidence base on health effects of bioaerosol emissions from composting facilities is still limited, although there is sufficient evidence to support a precautionary approach for regulatory purposes. While data to date are suggestive of possible respiratory effects, further study is needed to confirm this and to explore other health outcomes. PMID:25825807

Effects of in utero and lactational exposure to triphenyltin chloride on pregnancy outcome and postnatal development in rat offspring.

Science.gov (United States)

Grote, Konstanze; Hobler, Carolin; Andrade, Anderson J M; Grande, Simone Wichert; Gericke, Christine; Talsness, Chris E; Appel, Klaus E; Chahoud, Ibrahim

2007-09-05

The organotin compound (OTC) triphenyltin (TPT) is used extensively as a herbicide, pesticide and fungicide in agriculture as well as, together with tributyltin (TBT), in marine antifouling paints. We studied the effects of in utero exposure to 2 or 6 mg triphenyltinchloride (TPTCl)/kgb.w. on pregnancy outcome and postnatal development in rat offspring. Gravid Wistar rats were treated per gavage from gestational day 6 until the end of lactation. In the 6 mg TPTCl dose group gestational mortality in dams as well as an increased incidence of anticipated and delayed parturition was observed. Furthermore, treatment resulted in a significant increase in perinatal mortality, a decrease in lactational body weight gain as well as in delayed physical maturation of offspring. Similarily, exposure to 2mg TPTCl/kgb.w. resulted in a significant increase in perinatal mortality and in delayed eye opening. Lactational body weight gain and other landmarks of physical maturation were unaffected in the low dose group. We conclude, that in utero exposure to TPTCl at the described dose levels severely affected pregnancy outcome and perinatal survival of offspring. These results were unexpected, as in two earlier studies with pubertal rats TPTCl at the same dose levels no signs of general toxicity were observed.

Analytic strategies to evaluate the association of time-varying exposures to HIV-related outcomes: Alcohol consumption as an example.

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Cook, Robert L; Kelso, Natalie E; Brumback, Babette A; Chen, Xinguang

2016-01-01

As persons with HIV are living longer, there is a growing need to investigate factors associated with chronic disease, rate of disease progression and survivorship. Many risk factors for this high-risk population change over time, such as participation in treatment, alcohol consumption and drug abuse. Longitudinal datasets are increasingly available, particularly clinical data that contain multiple observations of health exposures and outcomes over time. Several analytic options are available for assessment of longitudinal data; however, it can be challenging to choose the appropriate analytic method for specific combinations of research questions and types of data. The purpose of this review is to help researchers choose the appropriate methods to analyze longitudinal data, using alcohol consumption as an example of a time-varying exposure variable. When selecting the optimal analytic method, one must consider aspects of exposure (e.g. timing, pattern, and amount) and outcome (fixed or time-varying), while also addressing minimizing bias. In this article, we will describe several analytic approaches for longitudinal data, including developmental trajectory analysis, generalized estimating equations, and mixed effect models. For each analytic strategy, we describe appropriate situations to use the method and provide an example that demonstrates the use of the method. Clinical data related to alcohol consumption and HIV are used to illustrate these methods.

Web-Based Survey Application to Collect Contextually Relevant Geographic Data With Exposure Times: Application Development and Feasibility Testing

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Tobin, Karin; Rudolph, Jonathan; Latkin, Carl

2018-01-01

Background Although studies that characterize the risk environment by linking contextual factors with individual-level data have advanced infectious disease and substance use research, there are opportunities to refine how we define relevant neighborhood exposures; this can in turn reduce the potential for exposure misclassification. For example, for those who do not inject at home, injection risk behaviors may be more influenced by the environment where they inject than where they live. Similarly, among those who spend more time away from home, a measure that accounts for different neighborhood exposures by weighting each unique location proportional to the percentage of time spent there may be more correlated with health behaviors than one’s residential environment. Objective This study aimed to develop a Web-based application that interacts with Google Maps application program interfaces (APIs) to collect contextually relevant locations and the amount of time spent in each. Our analysis examined the extent of overlap across different location types and compared different approaches for classifying neighborhood exposure. Methods Between May 2014 and March 2017, 547 participants enrolled in a Baltimore HIV care and prevention study completed an interviewer-administered Web-based survey that collected information about where participants were recruited, worked, lived, socialized, injected drugs, and spent most of their time. For each location, participants gave an address or intersection which they confirmed using Google Map and Street views. Geographic coordinates (and hours spent in each location) were joined to neighborhood indicators by Community Statistical Area (CSA). We computed a weighted exposure based on the proportion of time spent in each unique location. We compared neighborhood exposures based on each of the different location types with one another and the weighted exposure using analysis of variance with Bonferroni corrections to account for

Passive Smoke Exposure and Its Effects on Cognition, Sleep, and Health Outcomes in Overweight and Obese Children.

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Davis, Catherine L; Tingen, Martha S; Jia, Jenny; Sherman, Forrest; Williams, Celestine F; Bhavsar, Kruti; Wood, Nancy; Kobleur, Jessica; Waller, Jennifer L

2016-04-01

Passive smoke exposure (PSE) may be a risk factor for childhood overweight and obesity and is associated with worse neurocognitive development, cognition, and sleep in children. The purpose of the study is to examine the effects of PSE on adiposity, cognition, and sleep in overweight and obese children using an objective measure of PSE. Overweight or obese children (n = 222) aged 7-11 (9.4 ± 1.1 years; 58% black; 58% female; 85% obese) were recruited from schools near Augusta, Georgia, over the course of the school year from 2003-2006 for a clinical trial, with data analyzed in 2009-2010. Passive smoke exposure was measured with plasma cotinine. Health, cognitive, and sleep measures and parent report of smoke exposure were obtained. Overweight and obese children with PSE had greater overall and central adiposity than nonexposed overweight and obese children (p prevent adverse health outcomes related to tobacco use and obesity.

Concept of malignant significant factor and its applicability for and occupational exposures

International Nuclear Information System (INIS)

Hashizume, Tadashi; Maruyama, Takashi; Tateno, Yukio

1980-01-01

In the medical and occupational exposures, there is a tradition to use the genetically significant dose as an index of harm to the population although it only includes the genetical effects from ionizing radiations. A similar significant dose for somatic effects such as radiation leukemogenesis and carcinogenesis should be added to the genetically significant dose in order to approach an index of total harm to the population from medical and occupational exposures. For this purpose, leukemia and malignant significant factors were determined based on the induction of malignant diseases including leukemia for the atomic bombs in Hiroshima and Nagasaki and the life expectancy of individuals subject to medical examinations or treatments as well as radiation workers, taking account of the possibility of their deaths due to other diseases or accidents during a latent period of malignant diseases. The resultant significant factors were tabulated as a function of life expectancy for their application to medical and occupational exposures. For an example, the malignant significant factor for a person having the life expectancy of 60, 40 and 20 years was about 0.87, 0.45 and 0.10, respectively. This paper will discuss the applicability of the leukemia and malignant significant factors to the risk estimation of medical and occupational exposures; namely (1) the risk estimation for an individual in the population; (2) the risk estimation for individuals in a given age group who were continuously irradiated with natural radiations or received occupational exposures; (3) the risk estimation for the pupulation in a given age distribution and (4) the risk estimation for individuals after retirement of radiation works. (author)

Prenatal exposure to Chernobyl fallout in Norway: neurological and developmental outcomes in a 25-year follow-up.

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Lie, Rolv Terje; Moster, Dag; Strand, Per; Wilcox, Allen James

2017-12-01

Ionizing radiation at high doses early in life may cause neurodevelopmental problems. Possible effects of lower doses are, however, controversial. We use carefully collected exposure data for Norway following the Chernobyl accident in April 1986 combined with population-based registries to assess long-term effects of fetal exposure on neurodevelopmental outcomes. Radiation doses were estimated for each Norwegian municipality for each calendar month from May 1986 to April 1989. We established a cohort of all Norwegian pregnancies during the three-year period of radiation measurement and compared them with appropriate unexposed groups. All cohorts were followed into adulthood. Risks of cerebral palsy, mental retardation, schizophrenia, epilepsy, vision or hearing problems, school dropout, and low income were estimated. We also conducted an analysis of mathematics and language grades using siblings born after the exposure period as comparison. There was little evidence of associations between radiation exposure and cerebral palsy, mental retardation, schizophrenia, epilepsy, or hearing or vision problems associated with radiation exposure. (p-values for trend with exposure dose were 0.27, 0.14, 0.83, 0.35 and 0.42.) Slightly more of the exposed failed to complete high school (p = 0.05), but there was no increase in the proportion with low income (p = 0.38). The natural advantage of older siblings over younger siblings in mathematics grades was diminished with exposure of older siblings (p = 0.003), but there was no association of exposure with Norwegian language grades (p = 0.37). There is scant evidence that the low-dose fallout from Chernobyl in Norway increased the risk for serious neurodevelopmental problems. We cannot exclude the possibility of lower mathematics grades with exposure, similar to a report from Sweden.

Completing the Link between Exposure Science and Toxicology for Improved Environmental Health Decision Making: The Aggregate Exposure Pathway Framework.

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Teeguarden, Justin G; Tan, Yu-Mei; Edwards, Stephen W; Leonard, Jeremy A; Anderson, Kim A; Corley, Richard A; Kile, Molly L; Simonich, Staci M; Stone, David; Tanguay, Robert L; Waters, Katrina M; Harper, Stacey L; Williams, David E

2016-05-03

Driven by major scientific advances in analytical methods, biomonitoring, computation, and a newly articulated vision for a greater impact in public health, the field of exposure science is undergoing a rapid transition from a field of observation to a field of prediction. Deployment of an organizational and predictive framework for exposure science analogous to the "systems approaches" used in the biological sciences is a necessary step in this evolution. Here we propose the aggregate exposure pathway (AEP) concept as the natural and complementary companion in the exposure sciences to the adverse outcome pathway (AOP) concept in the toxicological sciences. Aggregate exposure pathways offer an intuitive framework to organize exposure data within individual units of prediction common to the field, setting the stage for exposure forecasting. Looking farther ahead, we envision direct linkages between aggregate exposure pathways and adverse outcome pathways, completing the source to outcome continuum for more meaningful integration of exposure assessment and hazard identification. Together, the two frameworks form and inform a decision-making framework with the flexibility for risk-based, hazard-based, or exposure-based decision making.

Patient Characteristics and Patient Behavior as Predictors of Outcome in Cognitive Therapy and Exposure Therapy for Hypochondriasis.

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Richtberg, Samantha; Jakob, Marion; Höfling, Volkmar; Weck, Florian

2017-06-01

Psychotherapy for hypochondriasis has greatly improved over the last decades and cognitive-behavioral treatments are most promising. However, research on predictors of treatment outcome for hypochondriasis is rare. Possible predictors of treatment outcome in cognitive therapy (CT) and exposure therapy (ET) for hypochondriasis were investigated. Characteristics and behaviors of 75 patients were considered as possible predictors: sociodemographic variables (sex, age, and cohabitation); psychopathology (pretreatment hypochondriacal symptoms, comorbid mental disorders, and levels of depression, anxiety, and somatic symptoms); and patient in-session interpersonal behavior. Severity of pretreatment hypochondriacal symptoms, comorbid mental disorders, and patient in-session interpersonal behavior were significant predictors in multiple hierarchical regression analyses. Interactions between the predictors and the treatment (CT or ET) were not found. In-session interpersonal behavior is an important predictor of outcome. Furthermore, there are no specific contraindications to treating hypochondriasis with CT or ET. © 2016 Wiley Periodicals, Inc.

A novel method for standardized application of fungal spore coatings for mosquito exposure bioassays.

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Farenhorst, Marit; Knols, Bart G J

2010-01-20

Interest in the use of fungal entomopathogens against malaria vectors is growing. Fungal spores infect insects via the cuticle and can be applied directly on the insect to evaluate infectivity. For flying insects such as mosquitoes, however, application of fungal suspensions on resting surfaces is more realistic and representative of field settings. For this type of exposure, it is essential to apply specific amounts of fungal spores homogeneously over a surface for testing the effects of fungal dose and exposure time. Contemporary methods such as spraying or brushing spore suspensions onto substrates do not produce the uniformity and consistency that standardized laboratory assays require. Two novel fungus application methods using equipment developed in the paint industry are presented and compared. Wired, stainless steel K-bars were tested and optimized for coating fungal spore suspensions onto paper substrates. Different solvents and substrates were evaluated. Two types of coating techniques were compared, i.e. manual and automated coating. A standardized bioassay set-up was designed for testing coated spores against malaria mosquitoes. K-bar coating provided consistent applications of spore layers onto paper substrates. Viscous Ondina oil formulations were not suitable and significantly reduced spore infectivity. Evaporative Shellsol T solvent dried quickly and resulted in high spore infectivity to mosquitoes. Smooth proofing papers were the most effective substrate and showed higher infectivity than cardboard substrates. Manually and mechanically applied spore coatings showed similar and reproducible effects on mosquito survival. The standardized mosquito exposure bioassay was effective and consistent in measuring effects of fungal dose and exposure time. K-bar coating is a simple and consistent method for applying fungal spore suspensions onto paper substrates and can produce coating layers with accurate effective spore concentrations. The mosquito bioassay

A novel method for standardized application of fungal spore coatings for mosquito exposure bioassays

Directory of Open Access Journals (Sweden)

Knols Bart GJ

2010-01-01

Full Text Available Abstract Background Interest in the use of fungal entomopathogens against malaria vectors is growing. Fungal spores infect insects via the cuticle and can be applied directly on the insect to evaluate infectivity. For flying insects such as mosquitoes, however, application of fungal suspensions on resting surfaces is more realistic and representative of field settings. For this type of exposure, it is essential to apply specific amounts of fungal spores homogeneously over a surface for testing the effects of fungal dose and exposure time. Contemporary methods such as spraying or brushing spore suspensions onto substrates do not produce the uniformity and consistency that standardized laboratory assays require. Two novel fungus application methods using equipment developed in the paint industry are presented and compared. Methods Wired, stainless steel K-bars were tested and optimized for coating fungal spore suspensions onto paper substrates. Different solvents and substrates were evaluated. Two types of coating techniques were compared, i.e. manual and automated coating. A standardized bioassay set-up was designed for testing coated spores against malaria mosquitoes. Results K-bar coating provided consistent applications of spore layers onto paper substrates. Viscous Ondina oil formulations were not suitable and significantly reduced spore infectivity. Evaporative Shellsol T solvent dried quickly and resulted in high spore infectivity to mosquitoes. Smooth proofing papers were the most effective substrate and showed higher infectivity than cardboard substrates. Manually and mechanically applied spore coatings showed similar and reproducible effects on mosquito survival. The standardized mosquito exposure bioassay was effective and consistent in measuring effects of fungal dose and exposure time. Conclusions K-bar coating is a simple and consistent method for applying fungal spore suspensions onto paper substrates and can produce coating layers

Glyphosate in the general population and in applicators: a critical review of studies on exposures.

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Solomon, Keith R

2016-09-01

The recent classification of glyphosate as a probable human carcinogen by the International Agency for Research on Cancer (IARC) was arrived at without a detailed assessment of exposure. Glyphosate is widely used as an herbicide, which might result in exposures of the general public and applicators. Exposures were estimated from information in the open literature and unpublished reports provided by Monsanto Company. Based on the maximum measured concentration in air, an exposure dose of 1.04 × 10  -   6  mg/kg body mass (b.m.)/d was estimated. Assuming consumption of surface water without treatment, the 90th centile measured concentration would result in a consumed dose of 2.25 × 10  -   5  mg/kg b.m./d. Estimates by the Food and Agriculture Organization of the United Nations (FAO) of consumed doses in food provided a median exposure of 0.005 mg/kg b.m./d (range 0.002-0.013). Based on tolerance levels, the conservative estimate by the US Environmental Protection Agency (US EPA) for exposure of the general population via food and water was 0.088 mg/kg b.m./d (range 0.058-0.23). For applicators, 90th centiles for systemic exposures based on biomonitoring and dosimetry (normalized for penetration through the skin) were 0.0014 and 0.021 mg/kg b.m./d, respectively. All of these exposures are less than the reference dose and the acceptable daily intakes proposed by several regulatory agencies, thus supporting a conclusion that even for these highly exposed populations the exposures were within regulatory limits.

Occupational Exposure to Endocrine-Disrupting Chemicals and Birth Weight and Length of Gestation

DEFF Research Database (Denmark)

Birks, Laura; Casas, Maribel; Garcia, Ana M.

2016-01-01

Background: Women of reproductive age can be exposed to endocrine-disrupting chemicals (EDCs) at work, and exposure to EDCs in pregnancy may affect fetal growth.Objectives: We assessed whether maternal occupational exposure to EDCs during pregnancy as classified by application of a job exposure...... women were classified as exposed to EDCs at work during pregnancy, based on job title. Classification of exposure to one or more EDC group was associated with an increased risk of term LBW [odds ratio (OR) = 1.25; 95% CI: 1.04, 1.49], as were most specific EDC groups; this association was consistent...... groups as assessed through a job exposure matrix. For each group, we combined the two levels of exposure categories (possible and probable) and compared birth outcomes with the unexposed group (exposure unlikely). We performed meta-analyses of cohort-specific estimates.Results: Eleven percent of pregnant...

Pregnancy outcome after risk assessment of occupational exposure to organic solvents: a prospective cohort study.

Science.gov (United States)

Testud, François; D'Amico, Andrea; Lambert-Chhum, Rachel; Garayt, Christelle; Descotes, Jacques

2010-11-01

A rational medical, occupational and toxicological approach is instrumental to select objectively among pregnant women exposed to chemicals at the workplace those who should be withdrawn or benefit from improvements of working conditions. Risk assessment is based on a comprehensive review of compounds' hazards and a thorough evaluation of the actual exposure including biomonitoring whenever as possible. Since 1996, the Lyon Poison Center has been conducting a prospective follow-up of pregnant women exposed to chemicals at the workplace. Of these, 206 exposed to organic solvents since conception were selected and matched with 206 exposed to a non-embryotoxic agent. Total withdrawal from the workplace was recommended in 22% of cases, but exposure was not considered to be hazardous to pregnancy in 51%. Overall, no increase in adverse outcomes was found. Maintaining pregnant women at their workplace, particularly most of the laboratory technicians, is reasonably possible after careful toxicological risk assessment. Copyright © 2010 Elsevier Inc. All rights reserved.

Clinical applicability of nursing outcomes in the evolution of orthopedic patients with Impaired Physical Mobility.

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da Silva, Marcos Barragan; Almeida, Miriam de Abreu; Panato, Bruna Paulsen; Siqueira, Ana Paula de Oliveira; da Silva, Mariana Palma; Reisderfer, Letícia

2015-01-01

to evaluate the clinical applicability of outcomes, according to the Nursing Outcomes Classification (NOC) in the evolution of orthopedic patients with Impaired Physical Mobility longitudinal study conducted in 2012 in a university hospital, with 21 patients undergoing Total Hip Arthroplasty, evaluated daily by pairs of trained data collectors. Data were collected using an instrument containing five Nursing Outcomes, 16 clinical indicators and a five point Likert scale, and statistically analyzed. The outcomes Body Positioning: self-initiated, Mobility, Knowledge: prescribed activity, and Fall Prevention Behavior presented significant increases in mean scores when comparing the first and final evaluations (p<0.001) and (p=0.035). the use of the NOC outcomes makes it possible to demonstrate the clinical progression of orthopedic patients with Impaired Physical Mobility, as well as its applicability in this context.

HIV Pre-exposure Prophylaxis Program Implementation Using Intervention Mapping.

Science.gov (United States)

Flash, Charlene A; Frost, Elizabeth L T; Giordano, Thomas P; Amico, K Rivet; Cully, Jeffrey A; Markham, Christine M

2018-04-01

HIV pre-exposure prophylaxis has been proven to be an effective tool in HIV prevention. However, numerous barriers still exist in pre-exposure prophylaxis implementation. The framework of Intervention Mapping was used from August 2016 to October 2017 to describe the process of adoption, implementation, and maintenance of an HIV prevention program from 2012 through 2017 in Houston, Texas, that is nested within a county health system HIV clinic. Using the tasks outlined in the Intervention Mapping framework, potential program implementers were identified, outcomes and performance objectives established, matrices of change objectives created, and methods and practical applications formed. Results include the formation of three matrices that document program outcomes, change agents involved in the process, and the determinants needed to facilitate program adoption, implementation, and maintenance. Key features that facilitated successful program adoption and implementation were obtaining leadership buy-in, leveraging existing resources, systematic evaluation of operations, ongoing education for both clinical and nonclinical staff, and attention to emergent issues during launch. The utilization of Intervention Mapping to delineate the program planning steps can provide a model for pre-exposure prophylaxis implementation in other settings. Copyright © 2018. Published by Elsevier Inc.

Effects of chronic exposure to low doses of ionizing radiation on the reproductive performance and outcome of an exposed population

International Nuclear Information System (INIS)

Mannino, J.A.

1978-01-01

This study was designed to test the hypothesis that low doses of ionizing radiation (cumulative dose less than 5.0 rads/yr) effects the reproductive history and/or outcome of a human population. Medically-related personnel who were exposed to low doses of radiation in the course of their employment were compared with medically-related personnel who were not routinely exposed to ionizing radiation. Each population consisted of 3000 persons from the states of Michigan and Ohio. Reproductive performance, history, and outcome of each sample population was compared statistically. Nineteen congenital defects and 47 postnatal defects were recorded for conceptions of the non-exposed population and 50 congenital defects and 83 postnatal defects were recorded for the exposed group. These groups were further broken down as to whether conception took place before, during, or after exposure and the results statistically analyzed. It was found that the exposure population had greater than expected numbers of postnatal defects and less than expected numbers of normal conceptions

Exposure to Perfluorinated Alkyl Substances and Health Outcomes in Children: A Systematic Review of the Epidemiologic Literature

Science.gov (United States)

Rappazzo, Kristen M.; Coffman, Evan; Hines, Erin P.

2017-01-01

Perfluoroalkyl substances (PFAS), chemicals used to make products stain and stick resistant, have been linked to health effects in adults and adverse birth outcomes. A growing body of literature also addresses health effects in children exposed to PFAS. This review summarizes the epidemiologic evidence for relationships between prenatal and/or childhood exposure to PFAS and health outcomes in children as well as to provide a risk of bias analysis of the literature. A systematic review was performed by searching PubMed for studies on PFAS and child health outcomes. We identified 64 studies for inclusion and performed risk of bias analysis on those studies. We determined that risk of bias across studies was low to moderate. Six categories of health outcomes emerged. These were: immunity/infection/asthma, cardio-metabolic, neurodevelopmental/attention, thyroid, renal, and puberty onset. While there are a limited number of studies for any one particular health outcome, there is evidence for positive associations between PFAS and dyslipidemia, immunity (including vaccine response and asthma), renal function, and age at menarche. One finding of note is that while PFASs are mixtures of multiple compounds few studies examine them as such, therefore the role of these compounds as complex mixtures remains largely unknown. PMID:28654008

How can GPS technology help us better understand exposure to the food environment? A systematic review

Directory of Open Access Journals (Sweden)

Andreea Cetateanu

2016-12-01

Full Text Available Purpose: Global Positioning Systems (GPS are increasingly being used to objectively assess movement patterns of people related to health behaviours. However research detailing their application to the food environment is scarce. This systematic review examines the application of GPS in studies of exposure to food environments and their potential influences on health. Methods: Based on an initial scoping exercise, published articles to be included in the systematic review were identified from four electronic databases and reference lists and were appraised and analysed, the final cut-off date for inclusion being January 2015. Included studies used GPS to identify location of individuals in relation to food outlets and link that to health or diet outcomes. They were appraised against a set of quality criteria. Results: Six studies met the inclusion criteria, which were appraised to be of moderate quality. Newer studies had a higher quality score. Associations between observed mobility patterns in the food environment and diet related outcomes were equivocal. Findings agreed that traditional food exposure measures overestimate the importance of the home food environment. Conclusions: The use of GPS to measure exposure to the food environment is still in its infancy yet holds much potential. There are considerable variations and challenges in developing and standardising the methods used to assess exposure. Keywords: Global positioning systems, Geographic information system, Food environments, Food exposure, Systematic review

Timing and Duration of Drug Exposure Affects Outcomes of a Drug-Nutrient Interaction During Ontogeny

Directory of Open Access Journals (Sweden)

Jane Alcorn

2010-10-01

Full Text Available Significant drug-nutrient interactions are possible when drugs and nutrients share the same absorption and disposition mechanisms. During postnatal development, the outcomes of drug-nutrient interactions may change with postnatal age since these processes undergo ontogenesis through the postnatal period. Our study investigated the dependence of a significant drug-nutrient interaction (cefepime-carnitine on the timing and duration of drug exposure relative to postnatal age. Rat pups were administered cefepime (5 mg/kg twice daily subcutaneously according to different dosing schedules (postnatal day 1-4, 1-8, 8-11, 8-20, or 1-20. Cefepime significantly reduced serum and heart L-carnitine levels in postnatal day 1-4, 1-8 and 8-11 groups and caused severe degenerative changes in ventricular myocardium in these groups. Cefepime also altered the ontogeny of several key L-carnitine homeostasis pathways. The qualitative and quantitative changes in levels of hepatic γ-butyrobetaine hydroxylase mRNA and activity, hepatic trimethyllysine hydroxlase mRNA, intestinal organic cation/carnitine transporter (Octn mRNA, and renal Octn2 mRNA depended on when during postnatal development the cefepime exposure occurred and duration of exposure. Despite lower levels of heart L-carnitine in earlier postnatal groups, levels of carnitine palmitoyltransferase mRNA and activity, heart Octn2 mRNA and ATP levels in all treatment groups remained unchanged with cefepime exposure. However, changes in other high energy phosphate substrates were noted and reductions in the phosphocreatine/ATP ratio were found in rat pups with normal serum L-carnitine levels. In summary, our data suggest a significant drug-nutrient transport interaction in developing neonates, the nature of which depends on the timing and duration of exposure relative to postnatal age.

Obsessive Compulsive Personality Disorder as a Predictor of Exposure and Ritual Prevention Outcome for Obsessive Compulsive Disorder

OpenAIRE

Pinto, Anthony; Liebowitz, Michael R.; Foa, Edna B.; Simpson, H. Blair

2011-01-01

Despite elevated rates of obsessive compulsive personality disorder (OCPD) in patients with obsessive compulsive disorder (OCD), no study has specifically examined comorbid OCPD as a predictor of exposure and ritual prevention (EX/RP) outcome. Participants were adult outpatients (n = 49) with primary OCD and a Yale-Brown Obsessive Compulsive Scale (YBOCS) total score ≥ 16 despite a therapeutic serotonin reuptake inhibitor dose for at least 12 weeks prior to entry. Participants received 17 ses...

How can GPS technology help us better understand exposure to the food environment? A systematic review.

Science.gov (United States)

Cetateanu, Andreea; Jones, Andy

2016-12-01

Global Positioning Systems (GPS) are increasingly being used to objectively assess movement patterns of people related to health behaviours. However research detailing their application to the food environment is scarce. This systematic review examines the application of GPS in studies of exposure to food environments and their potential influences on health. Based on an initial scoping exercise, published articles to be included in the systematic review were identified from four electronic databases and reference lists and were appraised and analysed, the final cut-off date for inclusion being January 2015. Included studies used GPS to identify location of individuals in relation to food outlets and link that to health or diet outcomes. They were appraised against a set of quality criteria. Six studies met the inclusion criteria, which were appraised to be of moderate quality. Newer studies had a higher quality score. Associations between observed mobility patterns in the food environment and diet related outcomes were equivocal. Findings agreed that traditional food exposure measures overestimate the importance of the home food environment. The use of GPS to measure exposure to the food environment is still in its infancy yet holds much potential. There are considerable variations and challenges in developing and standardising the methods used to assess exposure.

Long-term cognitive and cardiac outcomes after prenatal exposure to chemotherapy in children aged 18 months or older: an observational study.

NARCIS (Netherlands)

Amant, F.; Calsteren, K. van; Halaska, M.J.; Gziri, M.M.; Hui, W.; Lagae, L.; Willemsen, M.A.A.P.; Kapusta, L.; Calster, B. van; Wouters, H; Heyns, L.; Han, S.N.; Tomek, V.; Mertens, L.; Ottevanger, P.B.

2012-01-01

BACKGROUND: Chemotherapy for the treatment of maternal cancers during pregnancy has become more acceptable in the past decade; however, the effect of prenatal exposure to chemotherapy on cardiac and neurodevelopmental outcomes of the offspring is still uncertain. We aimed to record the general

Occupational exposures in industrial application of radiation during 1999-2008

International Nuclear Information System (INIS)

Sanaye, Suresh Shantaram; Baburajan, Sujatha; Pawar, Suresh Ganpat; Nalawade, Shailesh Krishna; Sapra, Balvinder Kaur

2012-01-01

Radiation sources are used in various industrial applications like industrial radiograph, industrial irradiation, industrial fluoroscopy, nucleonic gauges, well logging etc., Gamma, beta X-ray as well as neutron sources are used for various applications. Number of radiation workers in this field has increased over the years. Due to operating conditions prevailing during the exposure as well as the strength of the sources used in some of the applications, radiation protection plays an important role in this field. Analysis of doses received by radiation workers in industry provides information on trends of doses as well as adequateness of radiation protection practices followed in this sector. In India, National Occupational Dose Registry System (NODRS) of Radiological Physics and Advisory Division (RPAD), Bhabha Atomic Research Centre (BARC) maintains personnel dose information of monitored radiation workers in the country. Analysis of occupational dose data of industrial radiation workers for last 10 years, i.e., 1999-2008 has been presented in this paper. It is observed that even though there is an increase in monitored radiation workers, percentage of persons receiving radiation exposure has come down during this period. There is also a decrease in the average annual dose as well as the collective dose. Further analysis of sub-categories shows that industrial radiography operations are the main contributor for collective dose (about 77%) followed by well logging and industrial X-ray operations (about 8% each). Thus, in addition to industrial radiography attention is also to be given to operations in these areas. (author)

Impact of short-term preconceptional exposure to particulate air pollution on treatment outcome in couples undergoing in vitro fertilization and embryo transfer (IVF/ET)

Science.gov (United States)

Maluf, Mariangela; Czeresnia, Carlos Eduardo; Januário, Daniela Aparecida Nicolosi Foltran; Saldiva, Paulo Hilário Nascimento

2010-01-01

Purpose To assess the potential effects of short-term exposure to particulate air pollution during follicular phase on clinical, laboratory, and pregnancy outcomes of women undergoing IVF/ET. Methods Retrospective cohort study of 400 first IVF/ET cycles of women exposed to ambient particulate matter during follicular phase. Particulate matter (PM) was categorized into quartiles (Q1: ≤30.48 µg/m3, Q2: 30.49–42.00 µg/m3, Q3: 42.01–56.72 µg/m3, and Q4: >56.72 µg/m3). Results Clinical, laboratory, or treatment variables were not affected by follicular phase PM exposure periods. Women exposed to Q4 period during the follicular phase of conception cycles had a higher risk of miscarriage (odds ratio, 5.05; 95% confidence interval: 1.04–25.51) when compared to women exposed to Q1–3 periods. Conclusion Our results show an association between brief exposure to high levels of ambient PM during the preconceptional period and early pregnancy loss, although no effect of this exposure on clinical, laboratory, and treatment outcomes was observed. PMID:20405197

Virtual reality exposure therapy: Process and outcome in anxiety disorders

NARCIS (Netherlands)

Meyerbröker, K.

2012-01-01

Angststoornissen kunnen behandeld worden met exposure-therapie, een van de hoofdcomponenten van cognitieve gedragstherapie. Bij exposure-therapie wordt de patiënt blootgesteld aan datgene waar hij bang voor is zonder dat de gevreesde consequentie optreedt. Dit gebeurt meestal in het echt (exposure

Impact of Fluoroquinolone Exposure Prior to Tuberculosis Diagnosis on Clinical Outcomes in Immunocompromised Patients.

Science.gov (United States)

Lee, Ju Young; Lee, Hyun Jung; Kim, Yong Kyun; Yu, Shinae; Jung, Jiwon; Chong, Yong Pil; Lee, Sang-Oh; Choi, Sang-Ho; Shim, Tae Sun; Kim, Yang Soo; Woo, Jun Hee; Kim, Sung-Han

2016-07-01

There have been concerns about an association of fluoroquinolone (FQ) use prior to tuberculosis (TB) diagnosis with adverse outcomes. However, FQ use might prevent clinical deterioration in missed TB patients, especially in those who are immunocompromised, until they receive definitive anti-TB treatment. All adult immunocompromised patients with smear-negative and culture-positive TB at a tertiary care hospital in Korea over a 2-year period were included in this study. Long-term FQ (≥7 days) use was defined as exposure to FQ for at least 7 days prior to TB diagnosis. A total of 194 patients were identified: 33 (17%) in the long-term FQ group and 161 (83%) in the comparator, including a short-term FQ group (n = 23), non-FQ group (n = 78), and a group receiving no antibiotics (n = 60). Patients in the long-term FQ group presented with atypical chest radiologic pattern more frequently than those in the comparator (77% [24/31] versus 46% [63/138]; P = 0.001). The median time from mycobacterial test to positive mycobacterial culture appeared to be longer in the long-term FQ group (8.1 weeks versus 7.7 weeks; P = 0.09), although the difference was not statistically significant. Patients in the long-term FQ group were less likely to receive empirical anti-TB treatment (55% versus 74%; P = 0.03). The median time from mycobacterial test to anti-TB therapy was longer in the long-term FQ group (4.6 weeks versus 2.2 weeks; P 0.99) or in the 30-day (6% versus 6%; P > 0.99) or 90-day (12% versus 12%; P > 0.99) mortality rate between the two groups. FQ exposure (≥7 days) prior to TB diagnosis in immunocompromised patients appears not to be associated with adverse outcomes. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Developmental toxicity of prenatal exposure to toluene.

Science.gov (United States)

Bowen, Scott E; Hannigan, John H

2006-01-01

Organic solvents have become ubiquitous in our environment and are essential for industry. Many women of reproductive age are increasingly exposed to solvents such as toluene in occupational settings (ie, long-term, low-concentration exposures) or through inhalant abuse (eg, episodic, binge exposures to high concentrations). The risk for teratogenic outcome is much less with low to moderate occupational solvent exposure compared with the greater potential for adverse pregnancy outcomes, developmental delays, and neurobehavioral problems in children born to women exposed to high concentrations of abused organic solvents such as toluene, 1,1,1-trichloroethane, xylenes, and nitrous oxide. Yet the teratogenic effects of abuse patterns of exposure to toluene and other inhalants remain understudied. We briefly review how animal models can aid substantially in clarifying the developmental risk of exposure to solvents for adverse biobehavioral outcomes following abuse patterns of use and in the absence of associated health problems and co-drug abuse (eg, alcohol). Our studies also begin to establish the importance of dose (concentration) and critical perinatal periods of exposure to specific outcomes. The present results with our clinically relevant animal model of repeated, brief, high-concentration binge prenatal toluene exposure demonstrate the dose-dependent effect of toluene on prenatal development, early postnatal maturation, spontaneous exploration, and amphetamine-induced locomotor activity. The results imply that abuse patterns of toluene exposure may be more deleterious than typical occupational exposure on fetal development and suggest that animal models are effective in studying the mechanisms and risk factors of organic solvent teratogenicity.

Using Geographic Information Systems for Exposure Assessment in Environmental Epidemiology Studies

OpenAIRE

Nuckols, John R.; Ward, Mary H.; Jarup, Lars

2004-01-01

Geographic information systems (GIS) are being used with increasing frequency in environmental epidemiology studies. Reported applications include locating the study population by geocoding addresses (assigning mapping coordinates), using proximity analysis of contaminant source as a surrogate for exposure, and integrating environmental monitoring data into the analysis of the health outcomes. Although most of these studies have been ecologic in design, some have used GIS in estimating enviro...

Endocrine-disrupting activity of hydraulic fracturing chemicals and adverse health outcomes after prenatal exposure in male mice

Science.gov (United States)

Kassotis, Christopher D.; Klemp, Kara C.; Vu, Danh C.; Lin, Chung-Ho; Meng, Chun-Xia; Besch-Williford, Cynthia L.; Pinatti, Lisa; Zoeller, R. Thomas; Drobnis, Erma Z.; Balise, Victoria D.; Isiguzo, Chiamaka J.; Williams, Michelle A.; Tillitt, Donald E.; Nagel, Susan C.

2015-01-01

Oil and natural gas operations have been shown to contaminate surface and ground water with endocrine-disrupting chemicals. In the current study, we fill several gaps in our understanding of the potential environmental impacts related to this process. We measured the endocrine-disrupting activities of 24 chemicals used and/or produced by oil and gas operations for five nuclear receptors using a reporter gene assay in human endometrial cancer cells. We also quantified the concentration of 16 of these chemicals in oil and gas wastewater samples. Finally, we assessed reproductive and developmental outcomes in male C57BL/6J mice after the prenatal exposure to a mixture of these chemicals. We found that 23 commonly used oil and natural gas operation chemicals can activate or inhibit the estrogen, androgen, glucocorticoid, progesterone, and/or thyroid receptors, and mixtures of these chemicals can behave synergistically, additively, or antagonistically in vitro. Prenatal exposure to a mixture of 23 oil and gas operation chemicals at 3, 30, and 300 μg/kg · d caused decreased sperm counts and increased testes, body, heart, and thymus weights and increased serum testosterone in male mice, suggesting multiple organ system impacts. Our results suggest possible adverse developmental and reproductive health outcomes in humans and animals exposed to potential environmentally relevant levels of oil and gas operation chemicals.

A conceptual framework to support exposure science research ...

Science.gov (United States)

While knowledge of exposure is fundamental to assessing and mitigating risks, exposure information has been costly and difficult to generate. Driven by major scientific advances in analytical methods, biomonitoring, computational tools, and a newly articulated vision for a greater impact in public health, the field of exposure science is undergoing a rapid transition that allows it to be more agile, predictive, and data- and knowledge-driven. A necessary element of this evolved paradigm is an organizational and predictive framework for exposure science that furthers the application of systems-based approaches. To enable such systems-based approaches, we proposed the Aggregate Exposure Pathway (AEP) concept to organize data and information emerging from an invigorated and expanding field of exposure science. The AEP framework is a layered structure that describes the elements of an exposure pathway, as well as the relationship between those elements. The basic building blocks of an AEP adopt the naming conventions used for Adverse Outcome Pathways (AOPs): Key Events (KEs) to describe the measurable, obligate steps through the AEP; and Key Event Relationships (KERs) describe the linkages between KEs. Importantly, the AEP offers an intuitive approach to organize exposure information from sources to internal site of action, setting the stage for predicting stressor concentrations at an internal target site. These predicted concentrations can help inform the r

Exposure-response relationships for select cancer and non-cancer health outcomes in a cohort of U.S. firefighters from San Francisco, Chicago and Philadelphia (1950-2009).

Science.gov (United States)

Daniels, Robert D; Bertke, Stephen; Dahm, Matthew M; Yiin, James H; Kubale, Travis L; Hales, Thomas R; Baris, Dalsu; Zahm, Shelia H; Beaumont, James J; Waters, Kathleen M; Pinkerton, Lynne E

2015-10-01

To examine exposure-response relationships between surrogates of firefighting exposure and select outcomes among previously studied US career firefighters. Eight cancer and four non-cancer outcomes were examined using conditional logistic regression. Incidence density sampling was used to match each case to 200 controls on attained age. Days accrued in firefighting assignments (exposed-days), run totals (fire-runs) and run times (fire-hours) were used as exposure surrogates. HRs comparing 75th and 25th centiles of lagged cumulative exposures were calculated using loglinear, linear, log-quadratic, power and restricted cubic spline general relative risk models. Piecewise constant models were used to examine risk differences by time since exposure, age at exposure and calendar period. Among 19,309 male firefighters eligible for the study, there were 1333 cancer deaths and 2609 cancer incidence cases. Significant positive associations between fire-hours and lung cancer mortality and incidence were evident. A similar relation between leukaemia mortality and fire-runs was also found. The lung cancer associations were nearly linear in cumulative exposure, while the association with leukaemia mortality was attenuated at higher exposure levels and greater for recent exposures. Significant negative associations were evident for the exposure surrogates and colorectal and prostate cancers, suggesting a healthy worker survivor effect possibly enhanced by medical screening. Lung cancer and leukaemia mortality risks were modestly increasing with firefighter exposures. These findings add to evidence of a causal association between firefighting and cancer. Nevertheless, small effects merit cautious interpretation. We plan to continue to follow the occurrence of disease and injury in this cohort. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Comparative exposure to DEHP from food contact materials: application of the product intake fraction

DEFF Research Database (Denmark)

Ernstoff, Alexi; Jolliet, Olivier; Fantke, Peter

Quantitative Sustainability Assessment Food contact materials (FCM), e.g. bottles and food handling gloves, can contain potentially endocrine disrupting chemicals, such as di-2-ethylhexyl phthalate(DEHP, CAS: 117-81-7). To investigate the contribution of FCM to dietary DEHP exposure we apply...... thresholds. A hypothetical average PiF for the FCM sector was calculated via production volume and oral exposure doses estimated from NHANES data. In both cases the indication was gloves may contribute more to DEHP exposure when used with certain food items than bottled water. DEHP content in gloves greater...... than 5% would cause exceedance of US EPA threshold when used with certain food items,e.g. radishes based on PiF calculated here. The PiF used in thís context has applications for regulations related to FCM and exposure assessments on a per unit kilo basis....

Maternal arsenic exposure and birth outcomes: a comprehensive review of the epidemiologic literature focused on drinking water.

Science.gov (United States)

Bloom, Michael S; Surdu, Simona; Neamtiu, Iulia A; Gurzau, Eugen S

2014-09-01

Inorganic arsenic (iAs) is a human toxicant to which populations may be exposed through consumption of geogenically contaminated groundwater. A growing body of experimental literature corroborates the reproductive toxicity of iAs; however, the results of human studies are inconsistent. Therefore, we conducted a comprehensive review of epidemiologic studies focused on drinking water iAs exposure and birth outcomes to assess the evidence for causality and to make recommendations for future study. We reviewed 18 English language papers assessing birth weight, gestational age, and birth size. Thirteen of the studies were conducted among populations with frequent exposure to high-level groundwater iAs contamination (>10 μg/L) and five studies were conducted in areas without recognized contamination. Most studies comprised small samples and used cross-sectional designs, often with ecologic exposure assessment strategies, although several large prospective investigations and studies with individual-level measurements were also reported. We conclude that: (1) the epidemiologic evidence for an increased risk of low birth weight (water iAs contamination quality epidemiologic studies are necessary to more definitively assess the risk. Copyright © 2014 Elsevier GmbH. All rights reserved.

Prenatal exposure to dental amalgam in the Seychelles Child Development Nutrition Study: associations with neurodevelopmental outcomes at 9 and 30 months.

Science.gov (United States)

Watson, Gene E; Evans, Katie; Thurston, Sally W; van Wijngaarden, Edwin; Wallace, Julie M W; McSorley, Emeir M; Bonham, Maxine P; Mulhern, Maria S; McAfee, Alison J; Davidson, Philip W; Shamlaye, Conrad F; Strain, J J; Love, Tanzy; Zareba, Grazyna; Myers, Gary J

2012-12-01

Dental amalgam is approximately 50% metallic mercury and releases mercury vapor into the oral cavity, where it is inhaled and absorbed. Maternal amalgams expose the developing fetus to mercury vapor. Mercury vapor can be toxic, but uncertainty remains whether prenatal amalgam exposure is associated with neurodevelopmental consequences in offspring. To determine if prenatal mercury vapor exposure from maternal dental amalgam is associated with adverse effects to cognition and development in children. We prospectively determined dental amalgam status in a cohort of 300 pregnant women recruited in 2001 in the Republic of Seychelles to study the risks and benefits of fish consumption. The primary exposure measure was maternal amalgam surfaces present during gestation. Maternal occlusal points were a secondary measure. Outcomes were the child's mental (MDI) and psychomotor (PDI) developmental indices of the Bayley Scales of Infant Development-II (BSID-II) administered at 9 and 30 months. Complete exposure, outcome, and covariate data were available on a subset of 242 mother-child pairs. The number of amalgam surfaces was not significantly (p>0.05) associated with either PDI or MDI scores. Similarly, secondary analysis with occlusal points showed no effect on the PDI or MDI scores for boys and girls combined. However, secondary analysis of the 9-month MDI was suggestive of an adverse association present only in girls. We found no evidence of an association between our primary exposure metric, amalgam surfaces, and neurodevelopmental endpoints. Secondary analyses using occlusal points supported these findings, but suggested the possibility of an adverse association with the MDI for girls at 9 months. Given the continued widespread use of dental amalgam, we believe additional prospective studies to clarify this issue are a priority. Copyright © 2012 Elsevier Inc. All rights reserved.

Children's residential exposure to chlorpyrifos: Application of CPPAES field measurements of chlorpyrifos and TCPy within MENTOR/SHEDS-Pesticides model

International Nuclear Information System (INIS)

Hore, Paromita; Zartarian, Valerie; Xue Jianping; Ozkaynak, Haluk; Wang, S.-W.; Yang, Y.-C.; Chu, P.-Ling; Sheldon, Linda; Robson, Mark; Needham, Larry; Barr, Dana; Freeman, Natalie; Georgopoulos, Panos; Lioy, Paul J.

2006-01-01

The comprehensive individual field-measurements on non-dietary exposure collected in the Children's-Post-Pesticide-Application-Exposure-Study (CPPAES) were used within MENTOR/SHEDS-Pesticides, a physically based stochastic human exposure and dose model. In this application, however, the model was run deterministically. The MENTOR/SHEDS-Pesticides employed the CPPAES as input variables to simulate the exposure and the dose profiles for seven children over a 2-week post-application period following a routine residential and professional indoor crack-and-crevice chlorpyrifos application. The input variables were obtained from a personal activity diary, microenvironmental measurements and personal biomonitoring data obtained from CPPAES samples collected from the individual children and in their homes. Simulation results were compared with CPPAES field measured values obtained from the children's homes to assess the utility of the different microenvironmental data collected in CPPAES, i.e. indicator toys and wipe samplers to estimate aggregate exposures that can be result from one or more exposure pathways and routes. The final analyses of the database involved comparisons of the actual data obtained from the individual biomarker samples of a urinary metabolite of chlorpyrifos (TCPy) and the values predicted by MENTOR/SHEDS-Pesticides using the CPPAES-derived variables. Because duplicate diet samples were not part of the CPPAES study design, SHEDs-Pesticides simulated dose profiles did not account for the dietary route. The research provided more confidence in the types of data that can be used in the inhalation and dermal contact modules of MENTOR/SHEDS-Pesticides to predict the pesticide dose received by a child. It was determined that we still need additional understanding about: (1) the types of activities and durations of activities that result in non-dietary ingestion of pesticides and (2) the influence of dietary exposures on the levels of TCPy found in the

Bystander Exposure to Ultra-Low-Volume Insecticide Applications Used for Adult Mosquito Management

Directory of Open Access Journals (Sweden)

Robert K.D. Peterson

2011-06-01

Full Text Available A popular and effective management option for adult mosquitoes is the use of insecticides applied by ultra-low-volume (ULV equipment. However, there is a paucity of data on human dermal exposure to insecticides applied by this method. The objective of the current study was to estimate dermal exposures to the insecticide active ingredient permethrin using water- (Aqua-Reslin® and oil-based (Permanone® 30-30 formulations with passive dosimetry. No significant differences in deposition of permethrin were observed between years, distance from the spray source, front or back of the body, or the placement of the patches on the body. However, exposure to Aqua-Reslin was significantly greater than Permanone 30-30 and average concentrations deposited on the body were 4.2 and 2.1 ng/cm2, respectively. The greater deposition of Aqua-Reslin is most likely due to the higher density of the water-based formulation which causes it to settle out faster than the lighter oil-based formulation of Permanone 30-30. The estimated average absorbed dermal exposure for permethrin from Aqua-Reslin and Permanone 30-30 was 0.00009 and 0.00005 mg/kg body weight, respectively. We also found that ground deposition of ULV insecticides can be used as a surrogate for estimating dermal exposure. The estimated exposures support the findings of previous risk assessments that exposure to ULV applications used for mosquito management are below regulatory levels of concern.

Obsessive compulsive personality disorder as a predictor of exposure and ritual prevention outcome for obsessive compulsive disorder.

Science.gov (United States)

Pinto, Anthony; Liebowitz, Michael R; Foa, Edna B; Simpson, H Blair

2011-08-01

Despite elevated rates of obsessive compulsive personality disorder (OCPD) in patients with obsessive compulsive disorder (OCD), no study has specifically examined comorbid OCPD as a predictor of exposure and ritual prevention (EX/RP) outcome. Participants were adult outpatients (n = 49) with primary OCD and a Yale-Brown Obsessive Compulsive Scale (YBOCS) total score ≥ 16 despite a therapeutic serotonin reuptake inhibitor dose for at least 12 weeks prior to entry. Participants received 17 sessions of EX/RP over 8 weeks. OCD severity was assessed with the YBOCS pre- and post-treatment by independent evaluators. At baseline, 34.7% of the OCD sample met criteria for comorbid DSM-IV OCPD, assessed by structured interview. OCPD was tested as a predictor of outcome both as a diagnostic category and as a dimensional score (severity) based on the total number of OCPD symptoms coded as present and clinically significant at baseline. Both OCPD diagnosis and greater OCPD severity predicted worse EX/RP outcome, controlling for baseline OCD severity, Axis I and II comorbidity, prior treatment, quality of life, and gender. When the individual OCPD criteria were tested separately, only perfectionism predicted worse treatment outcome, over and above the previously mentioned covariates. These findings highlight the importance of assessing OCPD and suggest a need to directly address OCPD-related traits, especially perfectionism, in the context of EX/RP to minimize their interference in outcome. Copyright © 2011 Elsevier Ltd. All rights reserved.

Neonatal outcomes following exposure in utero to fallout from Chernobyl.

Science.gov (United States)

Hatch, Maureen; Little, Mark P; Brenner, Alina V; Cahoon, Elizabeth K; Tereshchenko, Valery; Chaikovska, Ludmyla; Pasteur, Igor; Likhtarov, Ilya; Bouville, Andre; Shpak, Victor; Bolshova, Olena; Zamotayeva, Galyna; Grantz, Katherine; Sun, Liping; Mabuchi, Kiyohiko; Albert, Paul; Tronko, Mykola

2017-12-01

Iodine 131 (I-131), the principal component of nuclear fallout from the Chernobyl accident, concentrates in the thyroid gland and may pose risks to fetal development. To evaluate this, neonatal outcomes following the accident in April of 1986 were investigated in a cohort of 2582 in utero-exposed individuals from northern Ukraine for whom estimates of fetal thyroid I-131 dose were available. We carried out a retrospective review of cohort members' prenatal, delivery and newborn records. The relationships of dose with neonatal anthropometrics and gestational length were modeled via linear regression with adjustment for potentially confounding variables. We found similar, statistically significant dose-dependent reductions in both head circumference (-1.0 cm/Gy, P = 0.005) and chest circumference (-0.9 cm/Gy, P = 0.023), as well as a similar but non-significant reduction in neonatal length (-0.6 cm/Gy, P = 0.169). Gestational length was significantly increased with increasing fetal dose (0.5 wks/Gy, P = 0.007). There was no significant (P > 0.1) effect of fetal dose on birth weight. The observed associations of radioiodine exposure with decreased head and chest circumference are consistent with those observed in the Japanese in utero-exposed atomic bomb survivors.

Gulf War illness: an overview of events, most prevalent health outcomes, exposures, and clues as to pathogenesis.

Science.gov (United States)

Kerr, Kathleen J

2015-01-01

During or very soon after the 1990-1991 Persian Gulf War, veterans of the conflict began to report symptoms of illness. Common complaints included combinations of cognitive difficulties, fatigue, myalgia, rashes, dyspnea, insomnia, gastrointestinal symptoms and sensitivity to odors. Gradually in the USA, and later in the UK, France, Canada, Denmark and Australia, governments implemented medical assessment programs and epidemiologic studies to determine the scope of what was popularly referred to as "the Gulf War syndrome". Attention was drawn to numerous potentially toxic deployment-related exposures that appeared to vary by country of deployment, by location within the theater, by unit, and by personal job types. Identifying a single toxicant cause was considered unlikely and it was recognized that outcomes were influenced by genetic variability in xenobiotic metabolism. Derived from primary papers and key reports by the Research Advisory Committee on Gulf War Veterans' Illnesses and the Institute of Medicine, a brief overview is presented of war related events, symptoms and diagnostic criteria for Gulf War illness (GWV), some international differences, the various war-related exposures and key epidemiologic studies. Possible exposure interactions and pathophysiologic mechanisms are discussed. Exposures to pyridostigmine bromide, pesticides, sarin and mustard gas or combinations thereof were most associated with GWI, especially in some genotype subgroups. The resultant oxidant stress and background exposome must be assumed to have played a role. Gulf War (GW) exposures and their potential toxic effects should be considered in the context of the human genome, the human exposome and resultant oxidant stress to better characterize this unique environmentally-linked illness and, ultimately, provide a rationale for more effective interventions and future prevention efforts.

Prenatal air pollution exposure induces sexually dimorphic fetal programming of metabolic and neuroinflammatory outcomes in adult offspring.

Science.gov (United States)

Bolton, Jessica L; Auten, Richard L; Bilbo, Staci D

2014-03-01

Environmental chemical exposures during critical windows of development may contribute to the escalating prevalence of obesity. We tested the hypothesis that prenatal exposure to diesel exhaust particles (DEP), a primary component of air pollution, would prime microglia long-term, resulting in exacerbated metabolic and affective outcomes following exposure to a high-fat diet in adulthood. Time-mated mouse dams were intermittently exposed to respiratory instillations of either vehicle (VEH) or DEP throughout gestation. Adult male and female offspring were then fed either a low-fat diet (LFD) or high-fat diet (HFD) for 9 weeks. The male offspring of DEP-exposed dams exhibited exaggerated weight gain, insulin resistance, and anxiety-like behavior on HFD compared to the male offspring of VEH-exposed dams, whereas female offspring did not differ according to prenatal treatment. Furthermore, HFD induced evidence of macrophage infiltration of both adipose tissue and the brain in both sexes, but these cells were more activated specifically in DEP/HFD males. DEP/HFD males also expressed markedly higher levels of microglial/macrophage, but not astrocyte, activation markers in the hippocampus, whereas females exhibited only a suppression of astrocyte activation markers due to HFD. In a second experiment, DEP male offspring mounted an exaggerated peripheral IL-1β response to an LPS challenge at postnatal day (P)30, whereas their central IL-1β response did not differ from VEH male offspring, which is suggestive of macrophage priming due to prenatal DEP exposure. In sum, prenatal air pollution exposure "programs" offspring for increased susceptibility to diet-induced metabolic, behavioral, and neuroinflammatory changes in adulthood in a sexually dimorphic manner. Copyright © 2013 Elsevier Inc. All rights reserved.

Epidemic gasoline exposures following Hurricane Sandy.

Science.gov (United States)

Kim, Hong K; Takematsu, Mai; Biary, Rana; Williams, Nicholas; Hoffman, Robert S; Smith, Silas W

2013-12-01

Major adverse climatic events (MACEs) in heavily-populated areas can inflict severe damage to infrastructure, disrupting essential municipal and commercial services. Compromised health care delivery systems and limited utilities such as electricity, heating, potable water, sanitation, and housing, place populations in disaster areas at risk of toxic exposures. Hurricane Sandy made landfall on October 29, 2012 and caused severe infrastructure damage in heavily-populated areas. The prolonged electrical outage and damage to oil refineries caused a gasoline shortage and rationing unseen in the USA since the 1970s. This study explored gasoline exposures and clinical outcomes in the aftermath of Hurricane Sandy. Prospectively collected, regional poison control center (PCC) data regarding gasoline exposure cases from October 29, 2012 (hurricane landfall) through November 28, 2012 were reviewed and compared to the previous four years. The trends of gasoline exposures, exposure type, severity of clinical outcome, and hospital referral rates were assessed. Two-hundred and eighty-three gasoline exposures were identified, representing an 18 to 283-fold increase over the previous four years. The leading exposure route was siphoning (53.4%). Men comprised 83.0% of exposures; 91.9% were older than 20 years of age. Of 273 home-based calls, 88.7% were managed on site. Asymptomatic exposures occurred in 61.5% of the cases. However, minor and moderate toxic effects occurred in 12.4% and 3.5% of cases, respectively. Gastrointestinal (24.4%) and pulmonary (8.4%) symptoms predominated. No major outcomes or deaths were reported. Hurricane Sandy significantly increased gasoline exposures. While the majority of exposures were managed at home with minimum clinical toxicity, some patients experienced more severe symptoms. Disaster plans should incorporate public health messaging and regional PCCs for public health promotion and toxicological surveillance.

The mediation proportion: a structural equation approach for estimating the proportion of exposure effect on outcome explained by an intermediate variable

DEFF Research Database (Denmark)

Ditlevsen, Susanne; Christensen, Ulla; Lynch, John

2005-01-01

It is often of interest to assess how much of the effect of an exposure on a response is mediated through an intermediate variable. However, systematic approaches are lacking, other than assessment of a surrogate marker for the endpoint of a clinical trial. We review a measure of "proportion...... of several intermediate variables. Binary or categorical variables can be included directly through threshold models. We call this measure the mediation proportion, that is, the part of an exposure effect on outcome explained by a third, intermediate variable. Two examples illustrate the approach. The first...... example is a randomized clinical trial of the effects of interferon-alpha on visual acuity in patients with age-related macular degeneration. In this example, the exposure, mediator and response are all binary. The second example is a common problem in social epidemiology-to find the proportion...

42 CFR 83.16 - How will the Secretary decide the outcome(s) of a petition?

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false How will the Secretary decide the outcome(s) of a... AS MEMBERS OF THE SPECIAL EXPOSURE COHORT UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS... Secretary decide the outcome(s) of a petition? (a) The Director of NIOSH will propose a decision to add or...

TESS-based dose-response using pediatric clonidine exposures.

Science.gov (United States)

Benson, Blaine E; Spyker, Daniel A; Troutman, William G; Watson, William A

2006-06-01

The toxic and lethal doses of clonidine in children are unclear. This study was designed to determine whether data from the American Association of Poison Control Centers Toxic Exposure Surveillance System (TESS) could be utilized to determine a dose-response relationship for pediatric clonidine exposure. 3,458 single-substance clonidine exposures in children TESS from January 2000 through December 2003 were examined. Dose ingested, age, and medical outcome were available for 1550 cases. Respiratory arrest cases (n = 8) were classified as the most severe of the medical outcome categories (Arrest, Major, Moderate, Mild, and No effect). Exposures reported as a "taste or lick" (n = 51) were included as a dose of 1/10 of the dosage form involved. Dose ranged from 0.4 to 1980 (median 13) microg/kg. Weight was imputed based on a quadratic estimate of weight for age. Dose certainty was coded as exact (26% of cases) or not exact (74%). Medical outcome (response) was examined via logistic regression using SAS JMP (release 5.1). The logistic model describing medical outcome (P TESS data can provide the basis for a statistically sound description of dose-response for pediatric clonidine poisoning exposures.

House dust-mite allergen exposure is associated with serum specific IgE but not with respiratory outcomes.

Science.gov (United States)

Bakolis, I; Heinrich, J; Zock, J P; Norbäck, D; Svanes, C; Chen, C M; Accordini, S; Verlato, G; Olivieri, M; Jarvis, D

2015-06-01

Exposure to house dust has been associated with asthma in adults, and this is commonly interpreted as a direct immunologic response to dust-mite allergens in those who are IgE sensitized to house dust-mite. Mattress house dust-mite concentrations were measured in a population-based sample of 2890 adults aged between 27 and 56 years living in 22 centers in 10 countries. Generalized linear mixed models were employed to explore the association of respiratory symptoms with house dust-mite concentrations, adjusting for individual and household confounders. There was no overall association of respiratory outcomes with measured house dust-mite concentrations, even in those who reported they had symptoms on exposure to dust and those who had physician-diagnosed asthma. However, there was a positive association of high serum specific IgE levels to HDM (>3.5 kUA /l) with mattress house dust-mite concentrations and a negative association of sensitization to cat with increasing house dust-mite concentrations. In conclusion, there was no evidence that respiratory symptoms in adults were associated with exposure to house dust-mite allergen in the mattress, but an association of house mite with strong sensitization was observed. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Potential Dermal Exposure in greenhouses for manual sprayers: Analysis of the mix/load, application and re-entry stages

Energy Technology Data Exchange (ETDEWEB)

Ramos, Laura M.; Querejeta, Giselle A.; Flores, Andrea P.; Hughes, Enrique A.; Zalts, Anita [Instituto de Ciencias, Universidad Nacional de General Sarmiento (UNGS), J. M. Gutierrez 1150, (B1613GSX) Los Polvorines, Prov. de Buenos Aires (Argentina); Montserrat, Javier M., E-mail: jmontser@ungs.edu.ar [Instituto de Ciencias, Universidad Nacional de General Sarmiento (UNGS), J. M. Gutierrez 1150, (B1613GSX) Los Polvorines, Prov. de Buenos Aires (Argentina); Instituto de Investigaciones en Ingenieria Genetica y Biologia Molecular (CONICET), Vuelta de Obligado 2490, 2o piso, Buenos Aires (Argentina)

2010-09-01

An evaluation of the Potential Dermal Exposure for the mix/load, application and re-entry stages, associated with procymidone and deltamethrin usage, was carried out for tomatoes grown in greenhouses of small production units in Argentina. Eight experiments were done with four different operators, under typical field conditions with a lever operated backpack sprayer. The methodology applied was based on the Whole Body Dosimetry technique, evaluating a set of different data for the mix and load, application and re-entry operations. These results indicated that the Potential Dermal Exposure of the application step was (38 {+-} 17) mL h{sup -1} with the highest proportion on torso, head and arms. When the three stages were compared, re-entry was found to contribute least towards the total Potential Dermal Exposure; meanwhile in all cases, except one, the mix/load operation was the stage with highest exposure. The Margin of Safety for each different operation was also calculated and the proportion of pesticide drift from the greenhouse to the environment is presented. These results emphasize the importance of improving the personal protection measures in the mix and load stage, an operation that is not usually associated with high-risk in small production units.

Potential Dermal Exposure in greenhouses for manual sprayers: Analysis of the mix/load, application and re-entry stages

International Nuclear Information System (INIS)

Ramos, Laura M.; Querejeta, Giselle A.; Flores, Andrea P.; Hughes, Enrique A.; Zalts, Anita; Montserrat, Javier M.

2010-01-01

An evaluation of the Potential Dermal Exposure for the mix/load, application and re-entry stages, associated with procymidone and deltamethrin usage, was carried out for tomatoes grown in greenhouses of small production units in Argentina. Eight experiments were done with four different operators, under typical field conditions with a lever operated backpack sprayer. The methodology applied was based on the Whole Body Dosimetry technique, evaluating a set of different data for the mix and load, application and re-entry operations. These results indicated that the Potential Dermal Exposure of the application step was (38 ± 17) mL h -1 with the highest proportion on torso, head and arms. When the three stages were compared, re-entry was found to contribute least towards the total Potential Dermal Exposure; meanwhile in all cases, except one, the mix/load operation was the stage with highest exposure. The Margin of Safety for each different operation was also calculated and the proportion of pesticide drift from the greenhouse to the environment is presented. These results emphasize the importance of improving the personal protection measures in the mix and load stage, an operation that is not usually associated with high-risk in small production units.

Pregnancy outcomes after fetal exposure to antithyroid medications or levothyroxine

DEFF Research Database (Denmark)

Schurmann, Lene; Hansen, Anne Vinkel; Garne, Ester

2016-01-01

AIM: To investigate whether fetal exposure to antithyroid drugs (ATD) and levothyroxine affects gestational age (GA), birth weight, birth length, head circumference and prevalence of congenital anomalies. METHODS: Cohort of all pregnancies from GA 12 weeks recorded in Danish registries from 1995......-2010. Exposure was having a prescription for ATD or levothyroxine from 91 days before to 91 days after pregnancy start (n=8318). The reference group was pregnant women without exposure of ATD or levothyroxine (n=969303). A subpopulation was linked to the Danish EUROCAT congenital anomaly register. RESULTS......: Overall 0.66% of the pregnant women had a prescription for levothyroxine and 0.19% had a prescription for ATD during the exposure period. There was no difference in proportion of live births compared to non-exposed pregnancies, but infants exposed to ATD were more often born very preterm (1.99% versus 0...

Mechanism-based drug exposure classification in pharmacoepidemiological studies

NARCIS (Netherlands)

Verdel, B.M.

2010-01-01

Mechanism-based classification of drug exposure in pharmacoepidemiological studies In pharmacoepidemiology and pharmacovigilance, the relation between drug exposure and clinical outcomes is crucial. Exposure classification in pharmacoepidemiological studies is traditionally based on

Behavioural outcome of school-age children after prenatal exposure to coumarins

NARCIS (Netherlands)

Wesseling, J; Van Driel, D; Heymans, HSA; Van der Veer, E; Sauer, PJJ; Touwen, BCL; Smrkovsky, M

In utero exposure to coumarin derivatives may affect the development of the central nervous system of the child, irrespective of the period of exposure in pregnancy. Little is known about effects on development in the long term. The aim of the present study was to determine whether prenatal exposure

Behavioural outcome of school-age children after prenatal exposure to coumarins

NARCIS (Netherlands)

Wesseling, J.; van Driel, D.; Heymans, H. S.; Van der Veer, E.; Sauer, P. J.; Touwen, B. C.; Smrkovsky, M.

2000-01-01

In utero exposure to coumarin derivatives may affect the development of the central nervous system of the child, irrespective of the period of exposure in pregnancy. Little is known about effects on development in the long term. The aim of the present study was to determine whether prenatal exposure

Baseline psychophysiological and cortisol reactivity as a predictor of PTSD treatment outcome in virtual reality exposure therapy.

Science.gov (United States)

Norrholm, Seth Davin; Jovanovic, Tanja; Gerardi, Maryrose; Breazeale, Kathryn G; Price, Matthew; Davis, Michael; Duncan, Erica; Ressler, Kerry J; Bradley, Bekh; Rizzo, Albert; Tuerk, Peter W; Rothbaum, Barbara O

2016-07-01

Baseline cue-dependent physiological reactivity may serve as an objective measure of posttraumatic stress disorder (PTSD) symptoms. Additionally, prior animal model and psychological studies would suggest that subjects with greatest symptoms at baseline may have the greatest violation of expectancy to danger when undergoing exposure based psychotherapy; thus treatment approaches which enhanced the learning under these conditions would be optimal for those with maximal baseline cue-dependent reactivity. However methods to study this hypothesis objectively are lacking. Virtual reality (VR) methodologies have been successfully employed as an enhanced form of imaginal prolonged exposure therapy for the treatment of PTSD. Our goal was to examine the predictive nature of initial psychophysiological (e.g., startle, skin conductance, heart rate) and stress hormone responses (e.g., cortisol) during presentation of VR-based combat-related stimuli on PTSD treatment outcome. Combat veterans with PTSD underwent 6 weeks of VR exposure therapy combined with either d-cycloserine (DCS), alprazolam (ALP), or placebo (PBO). In the DCS group, startle response to VR scenes prior to initiation of treatment accounted for 76% of the variance in CAPS change scores, p < 0.001, in that higher responses predicted greater changes in symptom severity over time. Additionally, baseline cortisol reactivity was inversely associated with treatment response in the ALP group, p = 0.04. We propose that baseline cue-activated physiological measures will be sensitive to predicting patients' level of response to exposure therapy, in particular in the presence of enhancement (e.g., DCS). Published by Elsevier Ltd.

The effects of indoor environmental exposures on pediatric asthma: a discrete event simulation model

Directory of Open Access Journals (Sweden)

Fabian M Patricia

2012-09-01

Full Text Available Abstract Background In the United States, asthma is the most common chronic disease of childhood across all socioeconomic classes and is the most frequent cause of hospitalization among children. Asthma exacerbations have been associated with exposure to residential indoor environmental stressors such as allergens and air pollutants as well as numerous additional factors. Simulation modeling is a valuable tool that can be used to evaluate interventions for complex multifactorial diseases such as asthma but in spite of its flexibility and applicability, modeling applications in either environmental exposures or asthma have been limited to date. Methods We designed a discrete event simulation model to study the effect of environmental factors on asthma exacerbations in school-age children living in low-income multi-family housing. Model outcomes include asthma symptoms, medication use, hospitalizations, and emergency room visits. Environmental factors were linked to percent predicted forced expiratory volume in 1 second (FEV1%, which in turn was linked to risk equations for each outcome. Exposures affecting FEV1% included indoor and outdoor sources of NO2 and PM2.5, cockroach allergen, and dampness as a proxy for mold. Results Model design parameters and equations are described in detail. We evaluated the model by simulating 50,000 children over 10 years and showed that pollutant concentrations and health outcome rates are comparable to values reported in the literature. In an application example, we simulated what would happen if the kitchen and bathroom exhaust fans were improved for the entire cohort, and showed reductions in pollutant concentrations and healthcare utilization rates. Conclusions We describe the design and evaluation of a discrete event simulation model of pediatric asthma for children living in low-income multi-family housing. Our model simulates the effect of environmental factors (combustion pollutants and allergens

Noise and neurotoxic chemical exposure relationship to workplace traumatic injuries: A review.

Science.gov (United States)

Estill, Cheryl Fairfield; Rice, Carol H; Morata, Thais; Bhattacharya, Amit

2017-02-01

More than 5,000 fatalities and eight million injuries occurred in the workplace in 2007 at a cost of $6 billion and $186 billion, respectively. Neurotoxic chemicals are known to affect central nervous system functions among workers, which include balance and hearing disorders. However, it is not known if there is an association between exposure to noise and solvents and acute injuries. A thorough review was conducted of the literature on the relationship between noise or solvent exposures and hearing loss with various health outcomes. The search resulted in 41 studies. Health outcomes included: hearing loss, workplace injuries, absence from work due to sickness, fatalities, hospital admissions due to workplace accidents, traffic accidents, hypertension, balance, slip, trips, or falls, cognitive measures, or disability retirement. Important covariates in these studies were age of employee, type of industry or occupation, or length of employment. Most authors that evaluated noise exposure concluded that higher exposure to noise resulted in more of the chosen health effect but the relationship is not well understood. Studies that evaluated hearing loss found that hearing loss was related to occupational injury, disability retirement, or traffic accidents. Studies that assessed both noise exposure and hearing loss as risk factors for occupational injuries reported that hearing loss was related to occupational injuries as much or more than noise exposure. Evidence suggests that solvent exposure is likely to be related to accidents or other health consequences such balance disorders. Many authors reported that noise exposures and hearing loss, respectively, are likely to be related to occupational accidents. Practical applications: The potential significance of the study is that findings could be used by managers to reduce injuries and the costs associated with those injures. Published by Elsevier Ltd.

Psychometric evaluation of self-report outcome measures for prosthetic applications.

Science.gov (United States)

Hafner, Brian J; Morgan, Sara J; Askew, Robert L; Salem, Rana

2016-01-01

Documentation of clinical outcomes is increasingly expected in delivery of prosthetic services and devices. However, many outcome measures suitable for use in clinical care and research have not been psychometrically tested with prosthesis users. The aim of this study was to determine test-retest reliability, mode-of-administration (MoA) equivalence, standard error of measurement (SEM), and minimal detectable change (MDC) of standardized, self-report instruments that assess constructs of importance to people with lower limb loss. Prosthesis users (n = 201) were randomly assigned to groups based on MoA (i.e., paper, electronic, or mixed-mode). Participants completed two surveys 2 to 3 d apart. Instruments included the Prosthetic Limb Users Survey of Mobility, Prosthesis Evaluation Questionnaire-Mobility Subscale, Activities-Specific Balance Confidence Scale, Quality of Life in Neurological Conditions-Applied Cognition/General Concerns, Patient-Reported Outcomes Measurement Information System Profile, and Socket Comfort Score. Intraclass correlation coefficients indicated all instruments are appropriate for group-level comparisons and select instruments are suitable for individual-level applications. Several instruments showed evidence of possible floor and ceiling effects. All were equivalent across MoAs. SEM and MDC were quantified to facilitate interpretation of outcomes and change scores. These results can enhance clinicians' and researchers' ability to select, apply, and interpret scores from instruments administered to prosthesis users.

Negative control exposure studies in the presence of measurement error: implications for attempted effect estimate calibration.

Science.gov (United States)

Sanderson, Eleanor; Macdonald-Wallis, Corrie; Davey Smith, George

2018-04-01

Negative control exposure studies are increasingly being used in epidemiological studies to strengthen causal inference regarding an exposure-outcome association when unobserved confounding is thought to be present. Negative control exposure studies contrast the magnitude of association of the negative control, which has no causal effect on the outcome but is associated with the unmeasured confounders in the same way as the exposure, with the magnitude of the association of the exposure with the outcome. A markedly larger effect of the exposure on the outcome than the negative control on the outcome strengthens inference that the exposure has a causal effect on the outcome. We investigate the effect of measurement error in the exposure and negative control variables on the results obtained from a negative control exposure study. We do this in models with continuous and binary exposure and negative control variables using analysis of the bias of the estimated coefficients and Monte Carlo simulations. Our results show that measurement error in either the exposure or negative control variables can bias the estimated results from the negative control exposure study. Measurement error is common in the variables used in epidemiological studies; these results show that negative control exposure studies cannot be used to precisely determine the size of the effect of the exposure variable, or adequately adjust for unobserved confounding; however, they can be used as part of a body of evidence to aid inference as to whether a causal effect of the exposure on the outcome is present.

Sex-Dependent Effects of Developmental Lead Exposure on the Brain

Science.gov (United States)

Singh, Garima; Singh, Vikrant; Sobolewski, Marissa; Cory-Slechta, Deborah A.; Schneider, Jay S.

2018-01-01

The role of sex as an effect modifier of developmental lead (Pb) exposure has until recently received little attention. Lead exposure in early life can affect brain development with persisting influences on cognitive and behavioral functioning, as well as, elevated risks for developing a variety of diseases and disorders in later life. Although both sexes are affected by Pb exposure, the incidence, manifestation, and severity of outcomes appears to differ in males and females. Results from epidemiologic and animal studies indicate significant effect modification by sex, however, the results are not consistent across studies. Unfortunately, only a limited number of human epidemiological studies have included both sexes in independent outcome analyses limiting our ability to draw definitive conclusions regarding sex-differentiated outcomes. Additionally, due to various methodological differences across studies, there is still not a good mechanistic understanding of the molecular effects of lead on the brain and the factors that influence differential responses to Pb based on sex. In this review, focused on prenatal and postnatal Pb exposures in humans and animal models, we discuss current literature supporting sex differences in outcomes in response to Pb exposure and explore some of the ideas regarding potential molecular mechanisms that may contribute to sex-related differences in outcomes from developmental Pb exposure. The sex-dependent variability in outcomes from developmental Pb exposure may arise from a combination of complex factors, including, but not limited to, intrinsic sex-specific molecular/genetic mechanisms and external risk factors including sex-specific responses to environmental stressors which may act through shared epigenetic pathways to influence the genome and behavioral output. PMID:29662502

Sex-Dependent Effects of Developmental Lead Exposure on the Brain

Directory of Open Access Journals (Sweden)

Garima Singh

2018-03-01

Full Text Available The role of sex as an effect modifier of developmental lead (Pb exposure has until recently received little attention. Lead exposure in early life can affect brain development with persisting influences on cognitive and behavioral functioning, as well as, elevated risks for developing a variety of diseases and disorders in later life. Although both sexes are affected by Pb exposure, the incidence, manifestation, and severity of outcomes appears to differ in males and females. Results from epidemiologic and animal studies indicate significant effect modification by sex, however, the results are not consistent across studies. Unfortunately, only a limited number of human epidemiological studies have included both sexes in independent outcome analyses limiting our ability to draw definitive conclusions regarding sex-differentiated outcomes. Additionally, due to various methodological differences across studies, there is still not a good mechanistic understanding of the molecular effects of lead on the brain and the factors that influence differential responses to Pb based on sex. In this review, focused on prenatal and postnatal Pb exposures in humans and animal models, we discuss current literature supporting sex differences in outcomes in response to Pb exposure and explore some of the ideas regarding potential molecular mechanisms that may contribute to sex-related differences in outcomes from developmental Pb exposure. The sex-dependent variability in outcomes from developmental Pb exposure may arise from a combination of complex factors, including, but not limited to, intrinsic sex-specific molecular/genetic mechanisms and external risk factors including sex-specific responses to environmental stressors which may act through shared epigenetic pathways to influence the genome and behavioral output.

Risk of adverse pregnancy outcome in women exposed to livestock

DEFF Research Database (Denmark)

Nielsen, Stine Yde; Henriksen, T B; Hjøllund, Niels Henrik Ingvar

2013-01-01

outcome in women with self-reported occupational or domestic contact with livestock compared to pregnant women without such contact. The Danish National Birth Cohort collected information on pregnancy outcome from 100 418 pregnant women (1996-2002) from which three study populations with occupational and....../or domestic exposure to livestock and a reference group of women with no animal contact was sampled. Outcome measures were miscarriage, very preterm birth (before gestational week 32), preterm birth (before 37 gestational weeks), small for gestational age (SGA), and perinatal death. Adverse reproductive...... outcomes were assessed in four different exposure groups of women with occupational or domestic exposure to livestock with no association found between exposure to livestock and miscarriage, preterm birth, SGA or perinatal death. These findings should diminish general occupational health concerns...

Children's residential exposure to chlorpyrifos: Application of CPPAES field measurements of chlorpyrifos and TCPy within MENTOR/SHEDS-Pesticides model

Energy Technology Data Exchange (ETDEWEB)

Hore, Paromita [Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers University and the University of Medicine and Dentistry of New Jersey (UMDNJ), Robert Wood Johnson Medical School, 170 Frelinghuysen Road, Piscataway, NJ 08855 (United States)]|[New York City Department of Health, 253 Broadway New York, New York 10007 (United States); Zartarian, Valerie; Xue Jianping; Ozkaynak, Haluk [National Exposure Research Laboratory, U.S. EPA, 109 TW Alexander Drive, Research Triangle Park, NC 27709 (United States); Wang, S.-W.; Yang, Y.-C.; Chu, P.-Ling; Robson, Mark; Georgopoulos, Panos [Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers University and the University of Medicine and Dentistry of New Jersey (UMDNJ), Robert Wood Johnson Medical School, 170 Frelinghuysen Road, Piscataway, NJ 08855 (United States); Sheldon, Linda [National Exposure Research Laboratory, U.S. EPA, 109 TW Alexander Drive, Research Triangle Park, NC 27709 (United States); Needham, Larry Barr, Dana [Contemporary Pesticide Laboratory, Centers for Disease Control, 4770 Buford Highway, Atlanta, GA 30341 (United States); Freeman, Natalie [Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers University and the University of Medicine and Dentistry of New Jersey (UMDNJ), Robert Wood Johnson Medical School, 170 Frelinghuysen Road, Piscataway, NJ 08855 (United States)]|[University of Florida, Gainesville, FL 32611 (United States); Lioy, Paul J. [Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers University and the University of Medicine and Dentistry of New Jersey (UMDNJ), Robert Wood Johnson Medical School, 170 Frelinghuysen Road, Piscataway, NJ 08855 (United States)]. E-mail: plioy@eohsi.rutgers.edu

2006-08-01

The comprehensive individual field-measurements on non-dietary exposure collected in the Children's-Post-Pesticide-Application-Exposure-Study (CPPAES) were used within MENTOR/SHEDS-Pesticides, a physically based stochastic human exposure and dose model. In this application, however, the model was run deterministically. The MENTOR/SHEDS-Pesticides employed the CPPAES as input variables to simulate the exposure and the dose profiles for seven children over a 2-week post-application period following a routine residential and professional indoor crack-and-crevice chlorpyrifos application. The input variables were obtained from a personal activity diary, microenvironmental measurements and personal biomonitoring data obtained from CPPAES samples collected from the individual children and in their homes. Simulation results were compared with CPPAES field measured values obtained from the children's homes to assess the utility of the different microenvironmental data collected in CPPAES, i.e. indicator toys and wipe samplers to estimate aggregate exposures that can be result from one or more exposure pathways and routes. The final analyses of the database involved comparisons of the actual data obtained from the individual biomarker samples of a urinary metabolite of chlorpyrifos (TCPy) and the values predicted by MENTOR/SHEDS-Pesticides using the CPPAES-derived variables. Because duplicate diet samples were not part of the CPPAES study design, SHEDs-Pesticides simulated dose profiles did not account for the dietary route. The research provided more confidence in the types of data that can be used in the inhalation and dermal contact modules of MENTOR/SHEDS-Pesticides to predict the pesticide dose received by a child. It was determined that we still need additional understanding about: (1) the types of activities and durations of activities that result in non-dietary ingestion of pesticides and (2) the influence of dietary exposures on the levels of TCPy found

Context-sensitive ecological momentary assessments; integrating real-time exposure measurements, data-analytics and health assessment using a smartphone application.

Science.gov (United States)

van Wel, Luuk; Huss, Anke; Bachmann, Philipp; Zahner, Marco; Kromhout, Hans; Fröhlich, Jürg; Vermeulen, Roel

2017-06-01

Modern sensor technology makes it possible to collect vast amounts of environmental, behavioural and health data. These data are often linked to contextual information on for example exposure sources which is separately collected with considerable lag time, leading to complications in assessing transient and/or highly spatially variable environmental exposures. Context-Sensitive Ecological Momentary Assessments 1 (CS-EMAs) could be used to address this. We present a case study using radiofrequency-electromagnetic fields (RF-EMF) exposure as an example for implementing CS-EMA in environmental research. Participants were asked to install a custom application on their own smartphone and to wear an RF-EMF exposimeter for 48h. Questionnaires were triggered by the application based on a continuous data stream from the exposimeter. Triggers were divided into four categories: relative and absolute exposure levels, phone calls, and control condition. After the two days of use participants filled in an evaluation questionnaire. 74% of all CS-EMAs were completed, with an average time of 31s to complete a questionnaire once it was opened. Participants reported minimal influence on daily activities. There were no significant differences found between well-being and type of RF-EMF exposure. We show that a CS-EMA based method could be used in environmental research. Using several examples involving environmental stressors, we discuss both current and future applications of this methodology in studying potential health effects of environmental factors. Copyright © 2017 Elsevier Ltd. All rights reserved.

The development of a clinical outcomes survey research application: Assessment Center.

Science.gov (United States)

Gershon, Richard; Rothrock, Nan E; Hanrahan, Rachel T; Jansky, Liz J; Harniss, Mark; Riley, William

2010-06-01

The National Institutes of Health sponsored Patient-Reported Outcome Measurement Information System (PROMIS) aimed to create item banks and computerized adaptive tests (CATs) across multiple domains for individuals with a range of chronic diseases. Web-based software was created to enable a researcher to create study-specific Websites that could administer PROMIS CATs and other instruments to research participants or clinical samples. This paper outlines the process used to develop a user-friendly, free, Web-based resource (Assessment Center) for storage, retrieval, organization, sharing, and administration of patient-reported outcomes (PRO) instruments. Joint Application Design (JAD) sessions were conducted with representatives from numerous institutions in order to supply a general wish list of features. Use Cases were then written to ensure that end user expectations matched programmer specifications. Program development included daily programmer "scrum" sessions, weekly Usability Acceptability Testing (UAT) and continuous Quality Assurance (QA) activities pre- and post-release. Assessment Center includes features that promote instrument development including item histories, data management, and storage of statistical analysis results. This case study of software development highlights the collection and incorporation of user input throughout the development process. Potential future applications of Assessment Center in clinical research are discussed.

Adverse Reproductive Health Outcomes and Exposure to Gaseous and Particulate-Matter Air Pollution in Pregnant Women.

Science.gov (United States)

Wu, Jun; Laurent, Olivier; Li, Lianfa; Hu, Jianlin; Kleeman, Michael

2016-07-01

There is growing epidemiologic evidence of associations between maternal exposure to ambient air pollution and adverse birth outcomes, such as preterm birth (PTB). Recently, a few studies have also reported that exposure to ambient air pollution may also increase the risk of some common pregnancy complications, such as preeclampsia and gestational diabetes mellitus (GDM). Research findings, however, have been mixed. These inconsistent results could reflect genuine differences in the study populations, the study locations, the specific pollutants considered, the designs of the study, its methods of analysis, or random variation. Dr. Jun Wu of the University of California– Irvine, a recipient of HEI’s Walter A. Rosenblith New Investigator Award, and colleagues have examined the association between air pollution and adverse birth and pregnancy outcomes in California women. In addition, they examined the effect modification by socioeconomic status (SES) and other factors. A retrospective nested case–control study was conducted using birth certificate data from about 4.4 million birth records in California from 2001 to 2008. Wu and colleagues analyzed data on low birth weight (LBW) at term (infants born between 37 and 43 weeks of gestation and weighing less than 2500 g), PTB (infants born before 37 weeks of gestation), and preeclampsia (including eclampsia) of the mother during the pregnancy. In addition, they obtained data on GDM for the years 2006– 2008. In the analyses, all outcomes were included as binary variables. Maternal residential addresses at the time of delivery were geocoded, and a large suite of air pollution exposure metrics was considered, such as (1) regulatory monitoring data on concentrations of criteria pollutants NO2, PM2.5 (particulate matter ≤ 2.5 μm in aerodynamic diameter), and ozone (O3) estimated by empirical Bayesian kriging; (2) concentrations of primary and secondary PM2.5 and PM0.1 components and sources estimated by the

Association between Vancomycin Day 1 Exposure Profile and Outcomes among Patients with Methicillin-Resistant Staphylococcus aureus Infective Endocarditis

Science.gov (United States)

Casapao, Anthony M.; Lodise, Thomas P.; Davis, Susan L.; Claeys, Kimberly C.; Kullar, Ravina; Levine, Donald P.

2015-01-01

Given the critical importance of early appropriate therapy, a retrospective cohort (2002 to 2013) was performed at the Detroit Medical Center to evaluate the association between the day 1 vancomycin exposure profile and outcomes among patients with MRSA infective endocarditis (IE). The day 1 vancomycin area under the concentration-time curve (AUC0–24) and the minimum concentration at 24 h (Cmin 24) was estimated for each patient using the Bayesian procedure in ADAPT 5, an approach shown to accurately predict the vancomycin exposure with low bias and high precision with limited pharmacokinetic sampling. Initial MRSA isolates were collected and vancomycin MIC was determined by broth microdilution (BMD) and Etest. The primary outcome was failure, defined as persistent bacteremia (≥7 days) or 30-day attributable mortality. Classification and regression tree analysis (CART) was used to determine the vancomycin exposure variables associated with an increased probability of failure. In total, 139 patients met study criteria; 76.3% had right-sided IE, 16.5% had left-sided IE, and 7.2% had both left and right-sided IE. A total of 89/139 (64%) experienced failure by composite definition. In the CART analysis, failure was more pronounced in patients with an AUC0–24/MIC as determined by BMD of ≤600 relative to those with AUC0–24/MIC as determined by BMD of >600 (69.8% versus 54.7%, respectively, P = 0.073). In the logistic regression analysis, an AUC/MIC as determined by BMD of ≤600 (adjusted odds ratio, 2.3; 95% confidence interval, 1.01 to 5.37; P = 0.047) was independently associated with failure. Given the retrospective nature of the present study, further prospective studies are required but these data suggest that patients with an AUC0–24/MIC as determined by BMD of ≤600 present an increased risk of failure. PMID:25753631

Risks for the development of outcomes related to occupational allergies: an application of the asthma-specific job exposure matrix compared with self-reports and investigator scores on job-training-related exposure.

NARCIS (Netherlands)

Suarthana, E.; Heederik, D.J.J.; Ghezzo, H.; Malo, J.L.; Kennedy, S.M.; Gautrin, D.

2009-01-01

BACKGROUND AND AIM: Risks for development of occupational sensitisation, bronchial hyper-responsiveness, rhinoconjunctival and chest symptoms at work associated with continued exposure to high molecular weight (HMW) allergens were estimated with three exposure assessment methods. METHODS: A Cox

TESS-based dose-response using pediatric clonidine exposures

International Nuclear Information System (INIS)

Benson, Blaine E.; Spyker, Daniel A.; Troutman, William G.; Watson, William A.

2006-01-01

Objective: The toxic and lethal doses of clonidine in children are unclear. This study was designed to determine whether data from the American Association of Poison Control Centers Toxic Exposure Surveillance System (TESS) could be utilized to determine a dose-response relationship for pediatric clonidine exposure. Methods: 3458 single-substance clonidine exposures in children <6 years of age reported to TESS from January 2000 through December 2003 were examined. Dose ingested, age, and medical outcome were available for 1550 cases. Respiratory arrest cases (n = 8) were classified as the most severe of the medical outcome categories (Arrest, Major, Moderate, Mild, and No effect). Exposures reported as a 'taste or lick' (n = 51) were included as a dose of 1/10 of the dosage form involved. Dose ranged from 0.4 to 1980 (median 13) μg/kg. Weight was imputed based on a quadratic estimate of weight for age. Dose certainty was coded as exact (26% of cases) or not exact (74%). Medical outcome (response) was examined via logistic regression using SAS JMP (release 5.1). Results: The logistic model describing medical outcome (P < 0.0001) included Log dose/kg (P 0.0000) and Certainty (P = 0.045). Conclusion: TESS data can provide the basis for a statistically sound description of dose-response for pediatric clonidine poisoning exposures

Chronic particulate exposure, mortality and cardiovascular outcomes in the nurses health study

Science.gov (United States)

Adverse health effects of exposures to acute air pollution have been well studied. Fewer studies have examined effects of chronic exposure. Previous studies used exposure estimates for narrow time periods and were limited by the geographic distribution of pollution monitors. This...

Application and comparison of scoring indices to predict outcomes in patients with healthcare-associated pneumonia

OpenAIRE

Fang, Wen-Feng; Yang, Kuang-Yao; Wu, Chieh-Liang; Yu, Chong-Jen; Chen, Chang-Wen; Tu, Chih-Yen; Lin, Meng-Chih

2011-01-01

Introduction Healthcare-associated pneumonia (HCAP) is a relatively new category of pneumonia. It refers to infections that occur prior to hospital admission in patients with specific risk factors following contact or exposure to a healthcare environment. There is currently no scoring index to predict the outcomes of HCAP patients. We applied and compared different community acquired pneumonia (CAP) scoring indices to predict 30-day mortality and 3-day and 14-day intensive care unit (ICU) adm...

Medium wave exposure characterisation using exposure quotients.

Science.gov (United States)

Paniagua, Jesús M; Rufo, Montaña; Jiménez, Antonio; Antolín, Alicia; Pinar, Iván

2010-06-01

One of the aspects considered in the International Commission on Non-Ionizing Radiation Protection guidelines is that, in situations of simultaneous exposure to fields of different frequencies, exposure quotients for thermal and electrical stimulation effects should be examined. The aim of the present work was to analyse the electromagnetic radiation levels and exposure quotients for exposure to multiple-frequency sources in the vicinity of medium wave radio broadcasting antennas. The measurements were made with a spectrum analyser and a monopole antenna. Kriging interpolation was used to prepare contour maps and to estimate the levels in the towns and villages of the zone. The results showed that the exposure quotient criterion based on electrical stimulation effects to be more stringent than those based on thermal effects or power density levels. Improvement of dosimetry evaluations requires the spectral components of the radiation to be quantified, followed by application of the criteria for exposure to multiple-frequency sources.

Transportation noise exposure and children's health and cognition

NARCIS (Netherlands)

Kempen, E.E.M.M. van

2008-01-01

This thesis focuses on the effects of transportation noise on children. Children are suspected of being more susceptible to noise exposure. There is a lack of source-specific exposure-response relations describing the association between noise exposure and specific health and cognitive outcomes in

Prenatal exposure to cannabis and maternal and child health outcomes: a systematic review and meta-analysis.

Science.gov (United States)

Gunn, J K L; Rosales, C B; Center, K E; Nuñez, A; Gibson, S J; Christ, C; Ehiri, J E

2016-04-05

To assess the effects of use of cannabis during pregnancy on maternal and fetal outcomes. 7 electronic databases were searched from inception to 1 April 2014. Studies that investigated the effects of use of cannabis during pregnancy on maternal and fetal outcomes were included. Case-control studies, cross-sectional and cohort studies were included. Data synthesis was undertaken via systematic review and meta-analysis of available evidence. All review stages were conducted independently by 2 reviewers. Maternal, fetal and neonatal outcomes up to 6 weeks postpartum after exposure to cannabis. Meta-analyses were conducted on variables that had 3 or more studies that measured an outcome in a consistent manner. Outcomes for which meta-analyses were conducted included: anaemia, birth weight, low birth weight, neonatal length, placement in the neonatal intensive care unit, gestational age, head circumference and preterm birth. 24 studies were included in the review. Results of the meta-analysis demonstrated that women who used cannabis during pregnancy had an increase in the odds of anaemia (pooled OR (pOR)=1.36: 95% CI 1.10 to 1.69) compared with women who did not use cannabis during pregnancy. Infants exposed to cannabis in utero had a decrease in birth weight (low birth weight pOR=1.77: 95% CI 1.04 to 3.01; pooled mean difference (pMD) for birth weight=109.42 g: 38.72 to 180.12) compared with infants whose mothers did not use cannabis during pregnancy. Infants exposed to cannabis in utero were also more likely to need placement in the neonatal intensive care unit compared with infants whose mothers did not use cannabis during pregnancy (pOR=2.02: 1.27 to 3.21). Use of cannabis during pregnancy may increase adverse outcomes for women and their neonates. As use of cannabis gains social acceptance, pregnant women and their medical providers could benefit from health education on potential adverse effects of use of cannabis during pregnancy. Published by the BMJ

Effects of a liquefied petroleum gas stove intervention on pollutant exposure and adult cardiopulmonary outcomes (CHAP): study protocol for a randomized controlled trial.

Science.gov (United States)

Fandiño-Del-Rio, Magdalena; Goodman, Dina; Kephart, Josiah L; Miele, Catherine H; Williams, Kendra N; Moazzami, Mitra; Fung, Elizabeth C; Koehler, Kirsten; Davila-Roman, Victor G; Lee, Kathryn A; Nangia, Saachi; Harvey, Steven A; Steenland, Kyle; Gonzales, Gustavo F; Checkley, William

2017-11-03

Biomass fuel smoke is a leading risk factor for the burden of disease worldwide. International campaigns are promoting the widespread adoption of liquefied petroleum gas (LPG) in resource-limited settings. However, it is unclear if the introduction and use of LPG stoves, in settings where biomass fuels are used daily, reduces pollution concentration exposure, improves health outcomes, or how cultural and social barriers influence the exclusive adoption of LPG stoves. We will conduct a randomized controlled, field intervention trial of LPG stoves and fuel distribution in rural Puno, Peru, in which we will enroll 180 female participants aged 25-64 years and follow them for 2 years. After enrollment, we will collect information on sociodemographic characteristics, household characteristics, and cooking practices. During the first year of the study, LPG stoves and fuel tanks will be delivered to the homes of 90 intervention participants. During the second year, participants in the intervention arm will keep their LPG stoves, but the gas supply will stop. Control participants will receive LPG stoves and vouchers to obtain free fuel from distributors at the beginning of the second year, but gas will not be delivered. Starting at baseline, we will collect longitudinal measurements of respiratory symptoms, pulmonary function, blood pressure, endothelial function, carotid artery intima-media thickness, 24-h dietary recalls, exhaled carbon monoxide, quality-of-life indicators, and stove-use behaviors. Environmental exposure assessments will occur six times over the 2-year follow-up period, consisting of 48-h personal exposure and kitchen concentration measurements of fine particulate matter and carbon monoxide, and 48-h kitchen concentrations of nitrogen dioxide for a subset of 100 participants. Findings from this study will allow us to better understand behavioral patterns, environmental exposures, and cardiovascular and pulmonary outcomes resulting from the adoption of

Pregnancy outcome after 1st-trimester inadvertent exposure to barium sulphate as a contrast media for upper gastrointestinal tract radiography.

Science.gov (United States)

Han, B H; Lee, K S; Han, J Y; Choi, J S; Ahn, H K; Ryu, H M; Yang, J H; Han, H W; Nava-Ocampo, A A

2011-10-01

Despite barium being used as a contrast media for decades, the specific assessment of its safety in pregnant women is scarce. We are reporting the favourable pregnancy outcome in women who were inadvertently exposed to barium swallow and associated ionising radiation, early in pregnancy. A control group of age- and gravidity-matched unexposed pregnant women was also included. There were 32 live-born babies in the exposed group and 94 in the control group. Women had undergone diagnostic upper gastrointestinal tract (UGT) fluoroscopic examination at 3.3 ± 1.5 weeks' gestation. Estimated maternal radiation dose secondary to barium swallow varied widely, the maximum dose was estimated to be 2.45 mSv. Similar pregnancy outcomes were observed between the groups. The number of babies born with major malformations was not significantly different (p = 1.0) between cases and controls: one (3.1%) vs three (3.2%), respectively. In conclusion, our small prospective cohort study of women suggests no association between inadvertent exposure to ionising radiation and barium sulphate during fluoroscopic barium swallow and adverse fetal outcomes.

Modeling U-Shaped Exposure-Response Relationships for Agents that Demonstrate Toxicity Due to Both Excess and Deficiency.

Science.gov (United States)

Milton, Brittany; Farrell, Patrick J; Birkett, Nicholas; Krewski, Daniel

2017-02-01

Essential elements such as copper and manganese may demonstrate U-shaped exposure-response relationships due to toxic responses occurring as a result of both excess and deficiency. Previous work on a copper toxicity database employed CatReg, a software program for categorical regression developed by the U.S. Environmental Protection Agency, to model copper excess and deficiency exposure-response relationships separately. This analysis involved the use of a severity scoring system to place diverse toxic responses on a common severity scale, thereby allowing their inclusion in the same CatReg model. In this article, we present methods for simultaneously fitting excess and deficiency data in the form of a single U-shaped exposure-response curve, the minimum of which occurs at the exposure level that minimizes the probability of an adverse outcome due to either excess or deficiency (or both). We also present a closed-form expression for the point at which the exposure-response curves for excess and deficiency cross, corresponding to the exposure level at which the risk of an adverse outcome due to excess is equal to that for deficiency. The application of these methods is illustrated using the same copper toxicity database noted above. The use of these methods permits the analysis of all available exposure-response data from multiple studies expressing multiple endpoints due to both excess and deficiency. The exposure level corresponding to the minimum of this U-shaped curve, and the confidence limits around this exposure level, may be useful in establishing an acceptable range of exposures that minimize the overall risk associated with the agent of interest. © 2016 Society for Risk Analysis.

Estimating pediatric general anesthesia exposure: Quantifying duration and risk.

Science.gov (United States)

Bartels, Devan Darby; McCann, Mary Ellen; Davidson, Andrew J; Polaner, David M; Whitlock, Elizabeth L; Bateman, Brian T

2018-05-02

Understanding the duration of pediatric general anesthesia exposure in contemporary practice is important for identifying groups at risk for long general anesthesia exposures and designing trials examining associations between general anesthesia exposure and neurodevelopmental outcomes. We performed a retrospective cohort analysis to estimate pediatric general anesthesia exposure duration during 2010-2015 using the National Anesthesia Clinical Outcomes Registry. A total of 1 548 021 pediatric general anesthetics were included. Median general anesthesia duration was 57 minutes (IQR: 28-86) with 90th percentile 145 minutes. Children aged 3 hours. High ASA physical status and care at a university hospital were associated with longer exposure times. While the vast majority (94%) of children undergoing general anesthesia are exposed for risk for longer exposures. These findings may help guide the design of future trials aimed at understanding neurodevelopmental impact of prolonged exposure in these high-risk groups. © 2018 John Wiley & Sons Ltd.

Critical review of the epidemiological literature on occupational exposure to perchloroethylene and cancer.

Science.gov (United States)

Mundt, Kenneth A; Birk, Thomas; Burch, Margaret T

2003-09-01

Of an estimated 500,000 workers in the USA potentially exposed to perchloroethylene (PCE), the largest share is employed in the dry-cleaning industry. PCE, a non-flammable solvent, has commercial applications as a chemical intermediate, metal degreaser and, since the 1950s, primary solvent in the dry-cleaning industry. The International Agency for Research on Cancer (IARC) currently finds sufficient evidence to designate PCE as carcinogenic in animals, with limited evidence in humans. With regard to occupational exposure through dry-cleaning, PCE is considered to be possibly carcinogenic to humans. This review was conducted to assess the current epidemiological literature on PCE and specific cancers. A comprehensive search was conducted to identify all available epidemiological literature pertaining to the carcinogenic effects of PCE. Forty-four papers that provided reasonable data on up to 17 cancer sites were critically reviewed in the context of the available background literature for each cancer site and were assessed on the basis of specified methodological and scientific quality criteria. While all the epidemiological studies selected for review investigated similar exposure-health outcome relationships, there was a broad diversity of proxy measurements of exposure to PCE, as well as numerous specific cancer outcomes of interest. The widespread lack of valid exposure measurements or other adequate indicators of potential for exposure were consistent limitations. We found no evidence of an association between breast, prostate, skin or brain cancer and exposure to PCE. A relationship between PCE and cancer of the following sites was considered unlikely: oral cavity, liver, pancreas, cervix lung. Scientific evidence was inadequate for laryngeal, kidney, esophageal and bladder cancers. The current epidemiological evidence does not support a conclusion that occupational exposure to PCE is a risk factor for cancer of any specific site. Priority areas in which

Impacts of 17α-ethynylestradiol exposure on metabolite profiles of zebrafish (Danio rerio) liver cells

Energy Technology Data Exchange (ETDEWEB)

Teng, Quincy, E-mail: teng.quincy@epa.gov [National Exposure Research Laboratory, U.S. Environmental Protection Agency, 960 College Station Road, Athens, GA 30605 (United States); Ekman, Drew R., E-mail: ekman.drew@epa.gov [National Exposure Research Laboratory, U.S. Environmental Protection Agency, 960 College Station Road, Athens, GA 30605 (United States); Huang, Wenlin, E-mail: whuang2@ccny.cuny.edu [National Exposure Research Laboratory, U.S. Environmental Protection Agency, 960 College Station Road, Athens, GA 30605 (United States); Collette, Timothy W., E-mail: collette.tim@epa.gov [National Exposure Research Laboratory, U.S. Environmental Protection Agency, 960 College Station Road, Athens, GA 30605 (United States)

2013-04-15

Highlights: ► We apply NMR-based metabolomics to study responses of ZFL cells exposed to EE2. ► The metabolomics approach has capability to capture cellular response to exposure. ► The analysis provides detailed molecular information on chemical's mode of action. ► Cellular metabolomics may have application for screening chemical exposure/toxicity. -- Abstract: Endocrine disrupting chemicals (EDCs) that are frequently detected in bodies of water downstream from sewage treatment facilities can have adverse impacts on fish and other aquatic organisms. To properly assess risk(s) from EDCs, tools are needed that can establish linkages from chemical exposures to adverse outcomes. Traditional methods of testing chemical exposure and toxicity using experimental animals are excessively resource- and time-consuming. In line with EPA's goal of reducing animal use in testing, these traditional screening methods may not be sustainable in the long term, given the ever increasing number of chemicals that must be tested for safety. One of the most promising ways to reduce costs and increase throughput is to use cell cultures instead of experimental animals. In accordance with National Research Council's vision on 21st century toxicity testing, we have developed a cell culture-based metabolomics approach for this application. Using a zebrafish (Danio rerio) liver cell line (ZFL), we have applied NMR-based metabolomics to investigate responses of ZFL cells exposed to 17α-ethynylestradiol (EE2). This analysis showed that metabolite changes induced by EE2 exposure agree well with known impacts of estrogens on live fish. The results of this study demonstrate the potential of cell-based metabolomics to assess chemical exposure and toxicity for regulatory application.

Impacts of 17α-ethynylestradiol exposure on metabolite profiles of zebrafish (Danio rerio) liver cells

International Nuclear Information System (INIS)

Teng, Quincy; Ekman, Drew R.; Huang, Wenlin; Collette, Timothy W.

2013-01-01

Highlights: ► We apply NMR-based metabolomics to study responses of ZFL cells exposed to EE2. ► The metabolomics approach has capability to capture cellular response to exposure. ► The analysis provides detailed molecular information on chemical's mode of action. ► Cellular metabolomics may have application for screening chemical exposure/toxicity. -- Abstract: Endocrine disrupting chemicals (EDCs) that are frequently detected in bodies of water downstream from sewage treatment facilities can have adverse impacts on fish and other aquatic organisms. To properly assess risk(s) from EDCs, tools are needed that can establish linkages from chemical exposures to adverse outcomes. Traditional methods of testing chemical exposure and toxicity using experimental animals are excessively resource- and time-consuming. In line with EPA's goal of reducing animal use in testing, these traditional screening methods may not be sustainable in the long term, given the ever increasing number of chemicals that must be tested for safety. One of the most promising ways to reduce costs and increase throughput is to use cell cultures instead of experimental animals. In accordance with National Research Council's vision on 21st century toxicity testing, we have developed a cell culture-based metabolomics approach for this application. Using a zebrafish (Danio rerio) liver cell line (ZFL), we have applied NMR-based metabolomics to investigate responses of ZFL cells exposed to 17α-ethynylestradiol (EE2). This analysis showed that metabolite changes induced by EE2 exposure agree well with known impacts of estrogens on live fish. The results of this study demonstrate the potential of cell-based metabolomics to assess chemical exposure and toxicity for regulatory application

Exposure of the general public due to wireless LAN applications in public places

International Nuclear Information System (INIS)

Schmid, G.; Preiner, P.; Lager, D.; Ueberbacher, R.; Georg, R.

2007-01-01

The typical exposure caused by wireless LAN applications in public areas has been investigated in a variety of scenarios. Small-sized (internet cafe) and large-scale (airport) indoor scenarios as well as outdoor scenarios in the environment of access points (AP) supplying for residential areas and public places were considered. The exposure assessment was carried out by numerical GTD/UTD computations based on optical wave propagation, as well as by verifying frequency selective measurements in the considered scenarios under real life conditions. In the small-sized indoor scenario the maximum temporal peak values of power density, spatially averaged over body dimensions, were found to be lower than 20 mW/m 2 , corresponding to 0.2% of the reference level according to the European Council Recommendation 1999/519/EC. Local peak values of power density might be 1-2 orders of magnitude higher, spatial and time-averaged values for usual data traffic conditions might be 2-3 orders of magnitude lower, depending on the actual data traffic. In the considered outdoor scenarios, exposure was several orders of magnitude lower than in indoor scenarios due to the usually larger distances to the AP antennas. (authors)

Impact of barbecued meat consumed in pregnancy on birth outcomes accounting for personal prenatal exposure to airborne polycyclic aromatic hydrocarbons: Birth cohort study in Poland.

Science.gov (United States)

Jedrychowski, Wieslaw; Perera, Frederica P; Tang, Deliang; Stigter, Laura; Mroz, Elzbieta; Flak, Elzbieta; Spengler, John; Budzyn-Mrozek, Dorota; Kaim, Irena; Jacek, Ryszard

2012-04-01

We previously reported an association between prenatal exposure to airborne polycyclic aromatic hydrocarbons (PAH) and lower birth weight, birth length, and head circumference. The main goal of the present analysis was to assess the possible impact of coexposure to PAH-containing barbecued meat consumed during pregnancy on birth outcomes. The birth cohort consisted of 432 pregnant women who gave birth at term (>36 wk of gestation). Only non-smoking women with singleton pregnancies, 18-35 y of age, and who were free from chronic diseases such as diabetes and hypertension, were included in the study. Detailed information on diet over pregnancy was collected through interviews and the measurement of exposure to airborne PAHs was carried out by personal air monitoring during the second trimester of pregnancy. The effect of barbecued meat consumption on birth outcomes (birth weight, length, and head circumference at birth) was adjusted in multiple linear regression models for potential confounding factors such as prenatal exposure to airborne PAHs, child's sex, gestational age, parity, size of mother (maternal prepregnancy weight, weight gain in pregnancy), and prenatal environmental tobacco smoke. The multivariable regression model showed a significant deficit in birth weight associated with barbecued meat consumption in pregnancy (coeff = -106.0 g; 95%CI: -293.3, -35.8). The effect of exposure to airborne PAHs was about the same magnitude order (coeff. = -164.6 g; 95%CI: -172.3, -34.7). Combined effect of both sources of exposure amounted to birth weight deficit of 214.3 g (95%CI: -419.0, -9.6). Regression models performed for birth length and head circumference showed similar trends but the estimated effects were of borderline significance level. As the intake of barbecued meat did not affect the duration of pregnancy, the reduced birth weight could not have been mediated by a shortened gestation period. In conclusion, the study results provided epidemiologic

HERCA WG Medical Applications / Sub WG 'Exposure of Asymptomatic Individuals in Health Care' - 'Position Paper on Screening'

International Nuclear Information System (INIS)

Griebel, Juergen; Ebdon-Jackson, Steve

2012-05-01

Over the course of several meetings the HERCA-Working Group (WG) 'Medical Applications' has discussed the exposure of asymptomatic individuals in health care. In particular, the discussions focused on the issue of the early detection of severe diseases, by use of X-rays, for those who do not present with symptoms. An important and established example is the use of X-ray mammography to detect early breast cancer and this has traditionally been referred to as screening. An emerging application is the use of computed tomography in a range of circumstances, some of which may be better described as a separate category of medical exposure as they are neither diagnostic nor screening in the accepted sense. The discussions have indicated that it is pivotal to clearly define the relevant terms generally applied and to clearly differentiate these terms from diagnostic examinations used in health care. In this context, it is important to note, that the revision of the Euratom Basic Safety Standards (Euratom BSS) Directive is under way and addresses in particular medical radiological procedures on asymptomatic individuals, intended to be performed for early detection of disease (Draft Proposal 29 September 2011 Article 54). Hereby, two types of examinations of asymptomatic individuals, (that in some cases have both been referred to as screening) are addressed: (1) exposures as part of screening programmes and (2) exposures associated with individual health assessment. On adoption, this directive will have significant implications for and a substantial impact on the work of the radiation protection authorities in Europe. In this position paper the WG 'Medical Applications' proposes a clear distinction between screening and radiological procedures as part of an individual health assessment and highlights special requirements for the latter. Finally, the impact on the work of radiation protection authorities in Europe is addressed

Exposure to violence predicts poor educational outcomes in young children in South Africa and Malawi.

Science.gov (United States)

Sherr, L; Hensels, I S; Skeen, S; Tomlinson, M; Roberts, K J; Macedo, A

2016-01-01

Violence during childhood may affect short and long-term educational factors. There is scant literature on younger children from resource poor settings. This study assessed child violence experiences (harsh punishment and exposure to domestic or community violence) and school enrolment, progress and attendance in children attending community-based organisations in South Africa and Malawi (n=989) at baseline and at 15 months' follow-up, examining differential experience of HIV positive, HIV affected and HIV unaffected children. Violence exposure was high: 45.4% experienced some form of psychological violence, 47.8% physical violence, 46.7% domestic violence and 41.8% community violence. Primary school enrolment was 96%. Violence was not associated with school enrolment at baseline but, controlling for baseline, children exposed to psychological violence for discipline were more than ten times less likely to be enrolled at follow-up (OR 0.09; 95% CI 0.01 to 0.57). Harsh discipline was associated with poor school progress. For children HIV positive a detrimental effect of harsh physical discipline was found on school performance (OR 0.10; 95% CI 0.02 to 0.61). Violence experiences were associated with a number of educational outcomes, which may have long-term consequences. Community-based organisations may be well placed to address such violence, with a particular emphasis on the challenges faced by children who are HIV positive. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Exposure and non-fear emotions: A randomized controlled study of exposure-based and rescripting-based imagery in PTSD treatment.

Science.gov (United States)

Langkaas, Tomas Formo; Hoffart, Asle; Øktedalen, Tuva; Ulvenes, Pål G; Hembree, Elizabeth A; Smucker, Mervin

2017-10-01

Interventions involving rescripting-based imagery have been proposed as a better approach than exposure-based imagery when posttraumatic stress disorder (PTSD) is associated with emotions other than fear. Prior research led to the study's hypotheses that (a) higher pretreatment non-fear emotions would predict relatively better response to rescripting as compared to exposure, (b) rescripting would be associated with greater reduction in non-fear emotions, and (c) pretreatment non-fear emotions would predict poor response to exposure. A clinically representative sample of 65 patients presenting a wide range of traumas was recruited from patients seeking and being offered PTSD treatment in an inpatient setting. Subjects were randomly assigned to 10 weeks of treatment involving either rescripting-based imagery (Imagery Rescripting; IR) or exposure-based imagery (Prolonged Exposure; PE). Patients were assessed on outcome and emotion measures at pretreatment, posttreatment and 12 months follow-up. Comparison to control benchmarks indicated that both treatments were effective, but no outcome differences between them appeared. None of the initial hypotheses were supported. The results from this study challenge previous observations and hypotheses about exposure mainly being effective for fear-based PTSD and strengthen the notion that exposure-based treatment is a generally effective treatment for all types of PTSD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Occupational exposures and health outcomes among Latina hotel cleaners.

Science.gov (United States)

Hsieh, Yu-Chin Jerrie; Apostolopoulos, Yorghos; Hatzudis, Kiki; Sönmez, Sevil

2014-01-01

The poor working conditions of Latina hotel cleaners render them particularly vulnerable to elevated occupational hazards that lead to adverse health outcomes. This article presents a comprehensive review of occupational risks (including physical, chemical, biological, and psychosocial risk factors) and health outcomes (including musculoskeletal disorders, respiratory diseases, dermatological diseases and allergies, and psychological disorders) for Latina hotel cleaners, within their unique sociocultural contexts. Preventive interventions for improving Latina hotel cleaners' work and health conditions are recommended.

Risks for the development of outcomes related to occupational allergies: an application of the asthma-specific job exposure matrix compared with self-reports and investigator scores on job-training-related exposure.

OpenAIRE

Suarthana, E.; Heederik, D.J.J.; Ghezzo, H.; Malo, J.L.; Kennedy, S.M.; Gautrin, D.

2009-01-01

BACKGROUND AND AIM: Risks for development of occupational sensitisation, bronchial hyper-responsiveness, rhinoconjunctival and chest symptoms at work associated with continued exposure to high molecular weight (HMW) allergens were estimated with three exposure assessment methods. METHODS: A Cox regression analysis with adjustment for atopy and smoking habit was carried out in 408 apprentices in animal health technology, pastry making, and dental hygiene technology with an 8-year follow-up aft...

Personal Chemical Exposure informatics

Science.gov (United States)

Chemical Exposure science is the study of human contact with chemicals (from manufacturing facilities, everyday products, waste) occurring in their environments and advances knowledge of the mechanisms and dynamics of events that cause or prevent adverse health outcomes. (adapted...

Effects of occupational exposure to ionizing radiation on reproductive and child health

International Nuclear Information System (INIS)

Bienefeld, M.K.; McLaughlin, J.R.

1998-01-01

The evidence regarding the effects of occupational exposure to low levels of ionizing radiation on reproductive health is limited. However, exposure to high doses of ionizing radiation is associated with increased risk of adverse reproductive outcomes. The resulting uncertainty about the effects of occupational exposures has caused concern among some workers, therefore, we have designed a study to examine this question among Canadian medical radiation technologists. A short mailed questionnaire will be sent to all CAMRT members to obtain information about reproductive history, and a sample of respondents will receive a second questionnaire requesting information about other important exposures. Occupational dose records will be retrieved from the National Dose Registry. Using this information, relative risks for each outcome will be calculated for different radiation dose levels. This article provides a brief review of the literature on ionizing radiation exposure and reproductive outcomes, and an outline of the proposed study

Failure to replicate the deleterious effects of safety behaviors in exposure therapy.

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Sy, Jennifer T; Dixon, Laura J; Lickel, James J; Nelson, Elizabeth A; Deacon, Brett J

2011-05-01

The current study attempted to replicate the finding obtained by Powers, Smits, and Telch (2004; Journal of Consulting and Clinical Psychology, 72, 448-545) that both the availability and utilization of safety behaviors interfere with the efficacy of exposure therapy. An additional goal of the study was to evaluate which explanatory theories about the detrimental effects of safety behaviors best account for this phenomenon. Undergraduate students (N=58) with high claustrophobic fear were assigned to one of three treatment conditions: (a) exposure only, (b) exposure with safety behavior availability, and (c) exposure with safety behavior utilization. Participants in each condition improved substantially, and there were no significant between-group differences in fear reduction. Unexpectedly, exposure with safety behavior utilization led to significantly greater improvement in self-efficacy and claustrophobic cognitions than exposure only. The extent to which participants inferred danger from the presence of safety aids during treatment was associated with significantly less improvement on all outcome measures. The findings call into question the hypothesized deleterious effects of safety behaviors on the outcome of exposure therapy and highlight a possible mechanism through which the mere presence of safety cues during exposure trials might affect treatment outcomes depending on participants' perceptions of the dangerousness of exposure stimuli. Published by Elsevier Ltd.

Exposure to Perfluoroalkyl Substances and Metabolic Outcomes in Pregnant Women: Evidence from the Spanish INMA Birth Cohorts.

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Matilla-Santander, Nuria; Valvi, Damaskini; Lopez-Espinosa, Maria-Jose; Manzano-Salgado, Cyntia B; Ballester, Ferran; Ibarluzea, Jesús; Santa-Marina, Loreto; Schettgen, Thomas; Guxens, Mònica; Sunyer, Jordi; Vrijheid, Martine

2017-11-13

Exposure to perfluoroalkyl substances (PFASs) may increase risk for metabolic diseases; however, epidemiologic evidence is lacking at the present time. Pregnancy is a period of enhanced tissue plasticity for the fetus and the mother and may be a critical window of PFAS exposure susceptibility. We evaluated the associations between PFAS exposures and metabolic outcomes in pregnant women. We analyzed 1,240 pregnant women from the Spanish INMA [Environment and Childhood Project (INfancia y Medio Ambiente)] birth cohort study (recruitment period: 2003-2008) with measured first pregnancy trimester plasma concentrations of four PFASs (in nanograms/milliliter). We used logistic regression models to estimate associations of PFASs (log 10 -transformed and categorized into quartiles) with impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM), and we used linear regression models to estimate associations with first-trimester serum levels of triglycerides, total cholesterol, and C-reactive protein (CRP). Perfluorooctane sulfonate (PFOS) and perfluorohexane sulfonate (PFHxS) were positively associated with IGT (137 cases) [OR per log 10 -unit increase=1.99 (95% CI: 1.06, 3.78) and OR=1.65 ( 95% CI: 0.99, 2.76), respectively]. PFOS and PFHxS associations with GDM (53 cases) were in a similar direction, but less precise. PFOS and perfluorononanoate (PFNA) were negatively associated with triglyceride levels [percent median change per log 10 -unit increase=-5.86% (95% CI: -9.91%, -1.63%) and percent median change per log 10 -unit increase=-4.75% (95% CI: -8.16%, -0.61%, respectively], whereas perfluorooctanoate (PFOA) was positively associated with total cholesterol [percent median change per log 10 -unit increase=1.26% (95% CI: 0.01%, 2.54%)]. PFASs were not associated with CRP in the subset of the population with available data ( n =640). Although further confirmation is required, the findings from this study suggest that PFAS exposures during pregnancy may

Timing of prenatal maternal exposure to severe life events and adverse pregnancy outcomes: A population study of 2.6 million pregnancies

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Class, Quetzal A.; Lichtenstein, Paul; Långström, Niklas; D'Onofrio, Brian M.

2011-01-01

Objective To identify the impact of timing of prenatal stress exposure on offspring risk for shortened gestational age (GA), preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA) using a population-based sample. Methods Swedish longitudinal population registries were linked to study all individuals born in Sweden 1973–2004. Prenatal maternal stress exposure was defined as death of the father of the child or first degree relative of the mother. Using linear and logistic regression, timing of stress exposure was examined across pregnancy, by month, and by novel periods created based on month of stress exposure findings. Results A total of 2,618,777 live-born, singleton infants without congenital anomalies were included; 32,286 exposed to prenatal maternal stress. Examining associations between stress exposure and outcome by the month revealed that risk increases mid-gestation, particularly following months 5 and 6. Combining months 1–4, 5 and 6, and 7–9 as potential periods of differing vulnerability, it was found that stress during period 2 (months 5 and 6) was associated with the greatest risk for shortened GA (−0.52 days, SE=0.15, p=0.0006), PTB (OR=1.24, 99% CI=1.08–1.42), LBW (OR=1.38, 99% CI=1.19–1.61), and SGA (OR=1.25, 99% CI=1.05–1.49). Conclusions Risk for shortened GA, PTB, LBW, and SGA are greater following stress exposure during the 5th and/or 6th month of pregnancy. It may be beneficial to refine future analyses to these months. Possible mechanisms include alterations in the hypothalamic-pituitary-adrenal axis and associated stress-responsive molecular regulators. PMID:21321257

Radiation in complex exposure situations. Assessing health risks at low levels from concomitant exposures to radiation and chemicals

International Nuclear Information System (INIS)

Hornhardt, S.; Jung, T.; Burkart, W.

2000-01-01

Health effects from exposures to ionizing radiation are in general the result of complex multi-step reaction chains involving changes and responses on the level of molecules, cells, tissues and organisms. In environmental low dose exposure situations ionizing radiation only contributes a small fraction to the life-long attack on DNA by other exogenous and endogenous genotoxins. Nevertheless, efforts to assess and quantify deleterious effects at low exposure levels are directed mainly towards radiation as a single isolated agent, and rarely towards the concomitant presence of other natural and anthropogenic toxicants. Only these combined exposures may lead to observable health risk effects. In addition they might differ from those expected from simple addition of the individual risks due to interaction. The existing data base on combined effects is rudimentary, mainly descriptive and rarely covers exposure ranges large enough to make direct inferences to present day low dose exposure situations. Therefore, any risk assessment will have to consider the question whether combined effects, i.e. interaction between two or more agents will influence the health outcome from specific exposure situations in such a way that predictions derived from simple standard exposure situations would have to be revised. In view of the multitude of possible interactions between the large number of potentially harmful agents in the human environment, descriptive approaches will have to be supplemented by the use of mechanistic models for critical health endpoints such as cancer. Agents will have to be grouped depending on their physical or chemical mode of action at the molecular and cellular level, to generalize and predict the outcome of combined exposures at low exposure levels and the possibility of interactions. (author)

Hydroquinone PBPK model refinement and application to dermal exposure.

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Poet, Torka S; Carlton, Betsy D; Deyo, James A; Hinderliter, Paul M

2010-11-01

A physiologically based pharmacokinetic (PBPK) model for hydroquinone (HQ) was refined to include an expanded description of HQ-glucuronide metabolites and a description of dermal exposures to support route-to-route and cross-species extrapolation. Total urinary excretion of metabolites from in vivo rat dermal exposures was used to estimate a percutaneous permeability coefficient (K(p); 3.6×10(-5) cm/h). The human in vivo K(p) was estimated to be 1.62×10(-4) cm/h, based on in vitro skin permeability data in rats and humans and rat in vivo values. The projected total multi-substituted glutathione (which was used as an internal dose surrogate for the toxic glutathione metabolites) was modeled following an exposure scenario based on submersion of both hands in a 5% aqueous solution of HQ (similar to black and white photographic developing solution) for 2 h, a worst-case exposure scenario. Total multi-substituted glutathione following this human dermal exposure scenario was several orders of magnitude lower than the internal total glutathione conjugates in rats following an oral exposure to the rat NOEL of 20 mg/kg. Thus, under more realistic human dermal exposure conditions, it is unlikely that toxic glutathione conjugates (primarily the di- and, to a lesser degree, the tri-glutathione conjugate) will reach significant levels in target tissues. Copyright © 2010. Published by Elsevier Ltd.

Effectiveness of the ‘Home-but not Alone’ mobile health application educational programme on parental outcomes

DEFF Research Database (Denmark)

Shorey, Shefaly; Peng Mei, Yvonne; Danbjørg, Dorthe Boe

2017-01-01

-time parents and parents already with kids on the day of their discharge from a public hospital. Eligible parents will be randomly allocated to either a control group (receiving routine care) or an intervention group (routine care plus access to the 'Home-but not Alone' mobile health application. Outcome...... measures comprise of parenting self-efficacy, social support, parenting satisfaction and postnatal depression. Data will be collected at the baseline (on the day of discharge) and at four weeks postpartum. DISCUSSION: This will be an empirical study that evaluates a theory-based educational programme...... delivered via an innovative mobile health application on parental outcomes. Results from this study will enhance parenting self-efficacy, social support and parenting satisfaction, which may then reduce parental risks of postnatal depression....

A Workflow to Investigate Exposure and Pharmacokinetic Influences on High-Throughput in Vitro Chemical Screening Based on Adverse Outcome Pathways

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Background: Adverse outcome pathways (AOPs) link adverse effects in individuals or populations to a molecular initiating event (MIE) that can be quantified using in vitro methods. Practical application of AOPs in chemical-specific risk assessment requires incorporation of knowled...

Xplicit, a novel approach in probabilistic spatiotemporally explicit exposure and risk assessment for plant protection products.

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Schad, Thorsten; Schulz, Ralf

2011-10-01

The quantification of risk (the likelihood and extent of adverse effects) is a prerequisite in regulatory decision making for plant protection products and is the goal of the Xplicit project. In its present development stage, realism is increased in the exposure assessment (EA), first by using real-world data on, e.g., landscape factors affecting exposure, and second, by taking the variability of key factors into account. Spatial and temporal variability is explicitly addressed. Scale dependencies are taken into account, which allows for risk quantification at different scales, for example, at landscape scale, an overall picture of the potential exposure of nontarget organisms can be derived (e.g., for all off-crop habitats in a given landscape); at local scale, exposure might be relevant to assess recovery and recolonization potential; intermediate scales might best refer to population level and hence might be relevant for risk management decisions (e.g., individual off-crop habitats). The Xplicit approach is designed to comply with a central paradigm of probabilistic approaches, namely, that each individual case that is derived from the variability functions employed should represent a potential real-world case. This is mainly achieved by operating in a spatiotemporally explicit fashion. Landscape factors affecting the local exposure of habitats of nontarget species (i.e., receptors) are derived from geodatabases. Variability in time is resolved by operating at discrete time steps, with the probability of events (e.g., application) or conditions (e.g., wind conditions) defined in probability density functions (PDFs). The propagation of variability of parameters into variability of exposure and risk is done using a Monte Carlo approach. Among the outcomes are expectancy values on the realistic worst-case exposure (predicted environmental concentration [PEC]), the probability p that the PEC exceeds the ecologically acceptable concentration (EAC) for a given

Beta Radiation Exposure of Personnel in Radiosynovectomy and at the Production of Eye Application

International Nuclear Information System (INIS)

Mielcarek, J.; Barth, I.

2001-01-01

Full text: Beta radionuclides are increasingly used in nuclear medicine therapy. In a study of exposure at working places with supposed enhanced radiation risk the followings are monitored: 1. Production of eye applicators ( 106 Ru/ 106 Rh) for therapy of intraocular tumours. During the processes radionuclides are used in sealed and unsealed form. 2. Radiosynovectomy (RSO). This therapy is often used in treatment of inflammatory joint disease. The radionuclides 169 Er, 186 Re and 90 Y are applied in form of radioactive solutions. A complex of problems has to be solved here: Handling of high activities (several GBq per day), very small distances between source and skin, high risk of skin contamination, unsatisfactory dose measurement techniques. In our investigations high sensitive thin thermoluminescence dosimeters (LiF:Mg,Cu,P) were used to determine the skin dose of the hands especially fingertips during preparation and application of the radioactive substances at several institutions. During production of eye applicators we found hand doses essentially below the annual limit. But direct radiation at RSO caused more than 100 mSv at the fingertips per working day in some cases. Even higher doses (more than 50% of the annual limit for skin during a working day) were caused by contamination of the hands. By use of manipulators, wearing of appropriate protection gloves and by improvement of directions for work, the radiation exposure could be reduced dramatically. Consequences for individual beta dosimetry and with respect to license of use of beta radionuclides are discussed. (author)

A Systematic Review of Carcinogenic Outcomes and Potential Mechanisms from Exposure to 2,4-D and MCPA in the Environment

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Katherine von Stackelberg

2013-01-01

Full Text Available Chlorophenoxy compounds, particularly 2,4-dichlorophenoxyacetic acid (2,4-D and 4-chloro-2-methylphenoxyacetic acid (MCPA, are amongst the most widely used herbicides in the United States for both agricultural and residential applications. Epidemiologic studies suggest that exposure to 2,4-D and MCPA may be associated with increased risk non-Hodgkins lymphoma (NHL, Hodgkin’s disease (HD, leukemia, and soft-tissue sarcoma (STS. Toxicological studies in rodents show no evidence of carcinogenicity, and regulatory agencies worldwide consider chlorophenoxies as not likely to be carcinogenic or unclassifiable as to carcinogenicity. This systematic review assembles the available data to evaluate epidemiologic, toxicological, pharmacokinetic, exposure, and biomonitoring studies with respect to key cellular events noted in disease etiology and how those relate to hypothesized modes of action for these constituents to determine the plausibility of an association between exposure to environmentally relevant concentrations of 2,4-D and MCPA and lymphohematopoietic cancers. The combined evidence does not support a genotoxic mode of action. Although plausible hypotheses for other carcinogenic modes of action exist, a comparison of biomonitoring data to oral equivalent doses calculated from bioassay data shows that environmental exposures are not sufficient to support a causal relationship. Genetic polymorphisms exist that are known to increase the risk of developing NHL. The potential interaction between these polymorphisms and exposures to chlorophenoxy compounds, particularly in occupational settings, is largely unknown.

Prospective outcomes of injury study.

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Derrett, S; Langley, J; Hokowhitu, B; Ameratunga, S; Hansen, P; Davie, G; Wyeth, E; Lilley, R

2009-10-01

In New Zealand (NZ), 20% of adults report a disability, of which one-third is caused by injury. No prospective epidemiological studies of predictors of disability following all-cause injury among New Zealanders have been undertaken. Internationally, studies have focused on a limited range of predictors or specific injuries. Although these studies provide useful insights, applicability to NZ is limited given the importance of NZ's unique macro-social factors, such as NZ's no-fault accident compensation and rehabilitation scheme, the Accident Compensation Corporation (ACC). (1) To quantitatively determine the injury, rehabilitation, personal, social and economic factors leading to disability outcomes following injury in NZ. (2) To qualitatively explore experiences and perceptions of injury-related outcomes in face-to-face interviews with 15 Māori and 15 other New Zealanders, 6 and 12 months after injury. Four geographical regions within NZ. Prospective cohort study with telephone interviews 1, 4 and 12 months after injury. 2500 people (including 460 Māori), aged 18-64 years, randomly selected from ACC's entitlement claims register (people likely to be off work for at least 1 week or equivalent). Telephone interviews, electronic hospital and ACC injury data. Exposures include demographic, social, economic, work-related, health status, participation and/or environmental factors. Primary: disability (including WHODAS II) and health-related quality of life (including EQ-5D). Secondary: participation (paid and unpaid activities), life satisfaction and costs. Separate regression models will be developed for each of the outcomes. Repeated measures outcomes will be modelled using general estimating equation models and generalised linear mixed models.

CONTROLLED EXPOSURES OF HUMAN VOLUNTEERS TO DIESEL ENGINE EXHAUST: BIOMARKERS OF EXPOSURE AND HEALTH OUTCOMES

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Combustion of diesel fuel contributes to ambient air pollutant fine particulate matter (PM) and gases. Fine PM exposure has been associated with increased mortality due to adverse cardiac events, and morbidity, such as increased hospitalization for asthma symptoms and lung infect...

Physiologically based pharmacokinetic toolkit to evaluate environmental exposures: Applications of the dioxin model to study real life exposures

Energy Technology Data Exchange (ETDEWEB)

Emond, Claude, E-mail: claude.emond@biosmc.com [BioSimulation Consulting Inc, Newark, DE (United States); Ruiz, Patricia; Mumtaz, Moiz [Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Atlanta, GA (United States)

2017-01-15

Chlorinated dibenzo-p-dioxins (CDDs) are a series of mono- to octa-chlorinated homologous chemicals commonly referred to as polychlorinated dioxins. One of the most potent, well-known, and persistent member of this family is 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). As part of translational research to make computerized models accessible to health risk assessors, we present a Berkeley Madonna recoded version of the human physiologically based pharmacokinetic (PBPK) model used by the U.S. Environmental Protection Agency (EPA) in the recent dioxin assessment. This model incorporates CYP1A2 induction, which is an important metabolic vector that drives dioxin distribution in the human body, and it uses a variable elimination half-life that is body burden dependent. To evaluate the model accuracy, the recoded model predictions were compared with those of the original published model. The simulations performed with the recoded model matched well with those of the original model. The recoded model was then applied to available data sets of real life exposure studies. The recoded model can describe acute and chronic exposures and can be useful for interpreting human biomonitoring data as part of an overall dioxin and/or dioxin-like compounds risk assessment. - Highlights: • The best available dioxin PBPK model for interpreting human biomonitoring data is presented. • The original PBPK model was recoded from acslX to the Berkeley Madonna (BM) platform. • Comparisons were made of the accuracy of the recoded model with the original model. • The model is a useful addition to the ATSDR's BM based PBPK toolkit that supports risk assessors. • The application of the model to real-life exposure data sets is illustrated.

Increased traffic exposure and negative birth outcomes: a prospective cohort in Australia

Directory of Open Access Journals (Sweden)

Wilson Lee-Ann

2011-04-01

Full Text Available Abstract Background Pregnant women exposed to traffic pollution have an increased risk of negative birth outcomes. We aimed to investigate the size of this risk using a prospective cohort of 970 mothers and newborns in Logan, Queensland. Methods We examined two measures of traffic: distance to nearest road and number of roads around the home. To examine the effect of distance we used the number of roads around the home in radii from 50 to 500 metres. We examined three road types: freeways, highways and main roads. Results There were no associations with distance to road. A greater number of freeways and main roads around the home were associated with a shorter gestation time. There were no negative impacts on birth weight, birth length or head circumference after adjusting for gestation. The negative effects on gestation were largely due to main roads within 400 metres of the home. For every 10 extra main roads within 400 metres of the home, gestation time was reduced by 1.1% (95% CI: -1.7, -0.5; p-value = 0.001. Conclusions Our results add weight to the association between exposure to traffic and reduced gestation time. This effect may be due to the chemical toxins in traffic pollutants, or because of disturbed sleep due to traffic noise.

Aggregate exposure pathways in support of risk assessment

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Over time, risk assessment has shifted from establishing relationships between exposure to a single chemical and a resulting adverse health outcome, to evaluating multiple chemicals and disease outcomes simultaneously. As a result, there is an increasing need to better understand...

Accounting for misclassification in electronic health records-derived exposures using generalized linear finite mixture models.

Science.gov (United States)

Hubbard, Rebecca A; Johnson, Eric; Chubak, Jessica; Wernli, Karen J; Kamineni, Aruna; Bogart, Andy; Rutter, Carolyn M

2017-06-01

Exposures derived from electronic health records (EHR) may be misclassified, leading to biased estimates of their association with outcomes of interest. An example of this problem arises in the context of cancer screening where test indication, the purpose for which a test was performed, is often unavailable. This poses a challenge to understanding the effectiveness of screening tests because estimates of screening test effectiveness are biased if some diagnostic tests are misclassified as screening. Prediction models have been developed for a variety of exposure variables that can be derived from EHR, but no previous research has investigated appropriate methods for obtaining unbiased association estimates using these predicted probabilities. The full likelihood incorporating information on both the predicted probability of exposure-class membership and the association between the exposure and outcome of interest can be expressed using a finite mixture model. When the regression model of interest is a generalized linear model (GLM), the expectation-maximization algorithm can be used to estimate the parameters using standard software for GLMs. Using simulation studies, we compared the bias and efficiency of this mixture model approach to alternative approaches including multiple imputation and dichotomization of the predicted probabilities to create a proxy for the missing predictor. The mixture model was the only approach that was unbiased across all scenarios investigated. Finally, we explored the performance of these alternatives in a study of colorectal cancer screening with colonoscopy. These findings have broad applicability in studies using EHR data where gold-standard exposures are unavailable and prediction models have been developed for estimating proxies.

Inhalation exposure during spray application and subsequent sanding of a wood sealant containing zinc oxide nanoparticles.

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Cooper, Michael R; West, Gavin H; Burrelli, Leonard G; Dresser, Daniel; Griffin, Kelsey N; Segrave, Alan M; Perrenoud, Jon; Lippy, Bruce E

2017-07-01

Nano-enabled construction products have entered into commerce. There are concerns about the safety of manufactured nanomaterials, and exposure assessments are needed for a more complete understanding of risk. This study assessed potential inhalation exposure to ZnO nanoparticles during spray application and power sanding of a commercially available wood sealant and evaluated the effectiveness of local exhaust ventilation in reducing exposure. A tradesperson performed the spraying and sanding inside an environmentally-controlled chamber. Dust control methods during sanding were compared. Filter-based sampling, electron microscopy, and real-time particle counters provided measures of exposure. Airborne nanoparticles above background levels were detected by particle counters for all exposure scenarios. Nanoparticle number concentrations and particle size distributions were similar for sanding of treated versus untreated wood. Very few unbound nanoparticles were detected in aerosol samples via electron microscopy, rather nano-sized ZnO was contained within, or on the surface of larger airborne particles. Whether the presence of nanoscale ZnO in these aerosols affects toxicity merits further investigation. Mass-based exposure measurements were below the NIOSH Recommended Exposure Limit for Zn, although there are no established exposure limits for nanoscale ZnO. Local exhaust ventilation was effective, reducing airborne nanoparticle number concentrations by up to 92% and reducing personal exposure to total dust by at least 80% in terms of mass. Given the discrepancies between the particle count data and electron microscopy observations, the chemical identity of the airborne nanoparticles detected by the particle counters remains uncertain. Prior studies attributed the main source of nanoparticle emissions during sanding to copper nanoparticles generated from electric sander motors. Potentially contrary results are presented suggesting the sander motor may not have been

Age-stratified analysis of long-term outcomes of transvaginal mesh repair for treatment of pelvic organ prolapse.

Science.gov (United States)

Dong, Shengnan; Zhong, Yanbo; Chu, Lei; Li, Huaifang; Tong, Xiaowen; Wang, Jianjun

2016-10-01

To investigate long-term outcomes after transvaginal mesh repair among patients with pelvic organ prolapse in different age groups. A retrospective cohort study was conducted among women who underwent transvaginal mesh repair with polypropylene mesh for pelvic organ prolapse of stage II or higher between January 2007 and November 2011 at a center in Shanghai, China. Patients were invited to attend a follow-up appointment between July 2014 and May 2015. Surgical outcomes were compared among three age groups (≤59, 60-74, and ≥75 years), and quality-of-life questionnaires were evaluated. Multivariate logistic regression was used to identify risk factors associated with recurrent prolapse and mesh exposure. Among 158 patients, 143 (90.5%) were objectively cured and 149 (94.3%) were subjectively cured at follow-up. Surgical outcomes were similar across all age groups. Significant improvements were observed on the Pelvic Floor Distress Inventory across all applicable subscales in all age groups (Pmesh exposure (odds ratio 11.89, 95% confidence interval 1.08-131.48; P=0.043). Transvaginal mesh repair was found to be a safe and effective technique for treating pelvic organ prolapse among women of all ages. An active postoperative sex life increased the odds of mesh exposure. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Causal mediation analysis for longitudinal data with exogenous exposure.

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Bind, M-A C; Vanderweele, T J; Coull, B A; Schwartz, J D

2016-01-01

Mediation analysis is a valuable approach to examine pathways in epidemiological research. Prospective cohort studies are often conducted to study biological mechanisms and often collect longitudinal measurements on each participant. Mediation formulae for longitudinal data have been developed. Here, we formalize the natural direct and indirect effects using a causal framework with potential outcomes that allows for an interaction between the exposure and the mediator. To allow different types of longitudinal measures of the mediator and outcome, we assume two generalized mixed-effects models for both the mediator and the outcome. The model for the mediator has subject-specific random intercepts and random exposure slopes for each cluster, and the outcome model has random intercepts and random slopes for the exposure, the mediator, and their interaction. We also expand our approach to settings with multiple mediators and derive the mediated effects, jointly through all mediators. Our method requires the absence of time-varying confounding with respect to the exposure and the mediator. This assumption is achieved in settings with exogenous exposure and mediator, especially when exposure and mediator are not affected by variables measured at earlier time points. We apply the methodology to data from the Normative Aging Study and estimate the direct and indirect effects, via DNA methylation, of air pollution, and temperature on intercellular adhesion molecule 1 (ICAM-1) protein levels. Our results suggest that air pollution and temperature have a direct effect on ICAM-1 protein levels (i.e. not through a change in ICAM-1 DNA methylation) and that temperature has an indirect effect via a change in ICAM-1 DNA methylation. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Arsenic exposure and outcomes of antimonial treatment in visceral leishmaniasis patients in Bihar, India: a retrospective cohort study.

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Meghan R Perry

2015-03-01

Full Text Available In the late twentieth century, emergence of high rates of treatment failure with antimonial compounds (SSG for visceral leishmaniasis (VL caused a public health crisis in Bihar, India. We hypothesize that exposure to arsenic through drinking contaminated groundwater may be associated with SSG treatment failure due to the development of antimony-resistant parasites.A retrospective cohort design was employed, as antimony treatment is no longer in routine use. The study was performed on patients treated with SSG between 2006 and 2010. Outcomes of treatment were assessed through a field questionnaire and treatment failure used as a proxy for parasite resistance. Arsenic exposure was quantified through analysis of 5 water samples from within and surrounding the patient's home. A logistic regression model was used to evaluate the association between arsenic exposure and treatment failure. In a secondary analysis survival curves and Cox regression models were applied to assess the risk of mortality in VL patients exposed to arsenic.One hundred and ten VL patients treated with SSG were analysed. The failure rate with SSG was 59%. Patients with high mean local arsenic level had a non-statistically significant higher risk of treatment failure (OR = 1.78, 95% CI: 0.7-4.6, p = 0.23 than patients using wells with arsenic concentration <10 μg/L. Twenty one patients died in our cohort, 16 directly as a result of VL. Arsenic levels ≥ 10 μg/L increased the risk of all-cause (HR 3.27; 95% CI: 1.4-8.1 and VL related (HR 2.65; 95% CI: 0.96-7.65 deaths. This was time dependent: 3 months post VL symptom development, elevated risks of all-cause mortality (HR 8.56; 95% CI: 2.5-29.1 and of VL related mortality (HR 9.27; 95% CI: 1.8-49.0 were detected.This study indicates a trend towards increased treatment failure in arsenic exposed patients. The limitations of the retrospective study design may have masked a strong association between arsenic exposure and selection

Potential exposure to endocrine disrupting chemicals and selected adverse pregnancy outcomes

DEFF Research Database (Denmark)

Bengtsson, Jessica; Thygesen, Pernille Søgaard; Kaerlev, Linda

2017-01-01

potential occupational exposure to endocrine disrupting chemicals (EDC) of the mother during pregnancy is associated with preterm birth and low birth weight. Methods: Pregnant women referred to an Occupational Health Clinic (OHC) in two Danish regions (Copenhagen or Aarhus) between 1984 and 2010, suspected...... on the suspicion of other exposures than EDC (n = 620), and to a sample of births by all occupationally active women in the same geographical regions (n = 346,544), including 1,077 births of the referred women’s non-referred pregnancies. Results: No indications of reduced birth weight or increased risk of preterm...... birth were found among women potentially exposed to EDC. Women potentially exposed to EDC had children with a higher birth weight compared to the sample of occupationally active women but not compared to other women referred to an OHC. Conclusions: Potential maternal exposure to EDC at Danish workplaces...

Assessing Children's Exposure to Intimate Partner Violence

Science.gov (United States)

Knutson, John F.; Lawrence, Erika; Taber, Sarah M.; Bank, Lew; DeGarmo, David S.

2009-01-01

Child exposure to intimate partner violence (IPV) is widely acknowledged as a threat to the psycho-social and academic well-being of children. Unfortunately, as reflected in the literature, the specific link between such exposure and childhood outcomes is ambiguous. Based on a review of the literature, this article suggests that this state of…

A new approach to hierarchical data analysis: Targeted maximum likelihood estimation for the causal effect of a cluster-level exposure.

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Balzer, Laura B; Zheng, Wenjing; van der Laan, Mark J; Petersen, Maya L

2018-01-01

We often seek to estimate the impact of an exposure naturally occurring or randomly assigned at the cluster-level. For example, the literature on neighborhood determinants of health continues to grow. Likewise, community randomized trials are applied to learn about real-world implementation, sustainability, and population effects of interventions with proven individual-level efficacy. In these settings, individual-level outcomes are correlated due to shared cluster-level factors, including the exposure, as well as social or biological interactions between individuals. To flexibly and efficiently estimate the effect of a cluster-level exposure, we present two targeted maximum likelihood estimators (TMLEs). The first TMLE is developed under a non-parametric causal model, which allows for arbitrary interactions between individuals within a cluster. These interactions include direct transmission of the outcome (i.e. contagion) and influence of one individual's covariates on another's outcome (i.e. covariate interference). The second TMLE is developed under a causal sub-model assuming the cluster-level and individual-specific covariates are sufficient to control for confounding. Simulations compare the alternative estimators and illustrate the potential gains from pairing individual-level risk factors and outcomes during estimation, while avoiding unwarranted assumptions. Our results suggest that estimation under the sub-model can result in bias and misleading inference in an observational setting. Incorporating working assumptions during estimation is more robust than assuming they hold in the underlying causal model. We illustrate our approach with an application to HIV prevention and treatment.

Opportunities for using spatial property assessment data in air pollution exposure assessments

Directory of Open Access Journals (Sweden)

Keller C Peter

2005-10-01

Full Text Available Abstract Background Many epidemiological studies examining the relationships between adverse health outcomes and exposure to air pollutants use ambient air pollution measurements as a proxy for personal exposure levels. When pollution levels vary at neighbourhood levels, using ambient pollution data from sparsely located fixed monitors may inadequately capture the spatial variation in ambient pollution. A major constraint to moving toward exposure assessments and epidemiological studies of air pollution at a neighbourhood level is the lack of readily available data at appropriate spatial resolutions. Spatial property assessment data are widely available in North America and may provide an opportunity for developing neighbourhood level air pollution exposure assessments. Results This paper provides a detailed description of spatial property assessment data available in the Pacific Northwest of Canada and the United States, and provides examples of potential applications of spatial property assessment data for improving air pollution exposure assessment at the neighbourhood scale, including: (1 creating variables for use in land use regression modelling of neighbourhood levels of ambient air pollution; (2 enhancing wood smoke exposure estimates by mapping fireplace locations; and (3 using data available on individual building characteristics to produce a regional air pollution infiltration model. Conclusion Spatial property assessment data are an extremely detailed data source at a fine spatial resolution, and therefore a source of information that could improve the quality and spatial resolution of current air pollution exposure assessments.

Early childhood exposure to media violence: What parents and policymakers ought to know

OpenAIRE

Caroline Fitzpatrick; Michael J Oghia; Jad Melki; Linda S Pagani

2016-01-01

We review the state of evidence supporting a link between violent media exposure in preschool- aged children and subsequent well-being outcomes. We searched through four decades (1971–2011) of literature for enlightening details on the relationship between early exposure to media violence and health outcomes in later childhood and adolescence. Evidence suggests that preschool exposure may be linked to increased aggression and self-regulation problems. Results are discussed in the context of d...

Human reproductive system disturbances and pesticide exposure in Brazil

Directory of Open Access Journals (Sweden)

Koifman Sergio

2002-01-01

Full Text Available The observation of reproductive disturbances in humans and in the wildlife has been reported in the last decade in different countries. Exposure to different chemicals possibly acting in the endocrine system or endocrine disruptors, including pesticides, has been a hypothesis raised to explain the observed changes. This paper aimed to present results of an epidemiological ecologic study carried out to explore population data on pesticides exposure in selected Brazilian states in the eighties and human reproductive outcomes in the nineties. Pearson correlation coefficients were ascertained between available data pesticides sales in eleven states in Brazil in 1985 and selected further reproductive outcomes or their surrogates. Moderate to high correlations were observed to infertility, testis, breast, prostate and ovarian cancer mortality. Despite the restrains of ecologic studies to establish cause-effect relationships, the observed results are in agreement with evidence supporting a possible association between pesticides exposure and the analyzed reproductive outcomes.

Exposing exposure: automated anatomy-specific CT radiation exposure extraction for quality assurance and radiation monitoring.

Science.gov (United States)

Sodickson, Aaron; Warden, Graham I; Farkas, Cameron E; Ikuta, Ichiro; Prevedello, Luciano M; Andriole, Katherine P; Khorasani, Ramin

2012-08-01

To develop and validate an informatics toolkit that extracts anatomy-specific computed tomography (CT) radiation exposure metrics (volume CT dose index and dose-length product) from existing digital image archives through optical character recognition of CT dose report screen captures (dose screens) combined with Digital Imaging and Communications in Medicine attributes. This institutional review board-approved HIPAA-compliant study was performed in a large urban health care delivery network. Data were drawn from a random sample of CT encounters that occurred between 2000 and 2010; images from these encounters were contained within the enterprise image archive, which encompassed images obtained at an adult academic tertiary referral hospital and its affiliated sites, including a cancer center, a community hospital, and outpatient imaging centers, as well as images imported from other facilities. Software was validated by using 150 randomly selected encounters for each major CT scanner manufacturer, with outcome measures of dose screen retrieval rate (proportion of correctly located dose screens) and anatomic assignment precision (proportion of extracted exposure data with correctly assigned anatomic region, such as head, chest, or abdomen and pelvis). The 95% binomial confidence intervals (CIs) were calculated for discrete proportions, and CIs were derived from the standard error of the mean for continuous variables. After validation, the informatics toolkit was used to populate an exposure repository from a cohort of 54 549 CT encounters; of which 29 948 had available dose screens. Validation yielded a dose screen retrieval rate of 99% (597 of 605 CT encounters; 95% CI: 98%, 100%) and an anatomic assignment precision of 94% (summed DLP fraction correct 563 in 600 CT encounters; 95% CI: 92%, 96%). Patient safety applications of the resulting data repository include benchmarking between institutions, CT protocol quality control and optimization, and cumulative

Risk assessment strategies for nanoscale and fine-sized titanium dioxide particles: Recognizing hazard and exposure issues.

Science.gov (United States)

Warheit, David B; Donner, E Maria

2015-11-01

The basic tenets for assessing health risks posed by nanoparticles (NP) requires documentation of hazards and the corresponding exposures that may occur. Accordingly, this review describes the range and types of potential human exposures that may result from interactions with titanium dioxide (TiO2) particles or NP - either in the occupational/workplace environment, or in consumer products, including food materials and cosmetics. Each of those applications has a predominant route of exposure. Very little is known about the human impact potential from environmental exposures to NP - thus this particular issue will not be discussed further. In the workplace or occupational setting inhalation exposure predominates. Experimental toxicity studies demonstrate low hazards in particle-exposed rats. Only at chronic overload exposures do rats develop forms of lung pathology. These findings are not supported by multiple epidemiology studies in heavily-exposed TiO2 workers which demonstrate a lack of correlation between chronic particle exposures and adverse health outcomes including lung cancer and noncancerous chronic respiratory effects. Cosmetics and sunscreens represent the major application of dermal exposures to TiO2 particles. Experimental dermal studies indicate a lack of penetration of particles beyond the epidermis with no consequent health risks. Oral exposures to ingested TiO2 particles in food occur via passage through the gastrointestinal tract (GIT), with studies indicating negligible uptake of particles into the bloodstream of humans or rats with subsequent excretion through the feces. In addition, standardized guideline-mandated subchronic oral toxicity studies in rats demonstrate very low toxicity effects with NOAELs of >1000 mg/kg bw/day. Additional issues which are summarized in detail in this review are: 1) Methodologies for implementing the Nano Risk Framework - a process for ensuring the responsible development of products containing nanoscale

Video-enabled cue-exposure-based intervention improves postdischarge drinking outcomes among alcohol-dependent men: A prospective study at a government addiction treatment setting in India.

Science.gov (United States)

Nattala, Prasanthi; Murthy, Pratima; Leung, Kit Sang; Rentala, Sreevani; Ramakrishna, Jayashree

2017-04-25

Returning to alcohol use following inpatient treatment occurs due to various real life cues/triggers. It is a challenge to demonstrate to patients how to deal with these triggers during inpatient treatment. Aims of the current study were (a) to evaluate the effectiveness of video-enabled cue-exposure-based intervention (VE-CEI) in influencing treatment outcomes in alcohol dependence, (b) to identify postdischarge predictors of intervention failure (returning to ≥50% of baseline alcohol consumption quantity/day). The VE-CEI comprises live action videos in which human characters model various alcohol use cues and strategies to deal with them effectively. The VE-CEI was administered to an inpatient alcohol-dependent sample (n = 43) and compared with treatment as usual (TAU) (n = 42) at a government addiction treatment setting in India. Patients were followed up over 6 months postdischarge to evaluate effectiveness of the VE-CEI on specific drinking outcomes. Over 6-month follow-up, VE-CEI group (vs. TAU) reported significantly lesser alcohol consumption quantity, fewer drinking days, and lower intervention failure rates. Results of multivariate Cox regression showed that participants who did not receive VE-CEI had an elevated risk of intervention failure (hazards ratio: 11.14; 95% confidence interval [4.93, 25.15]), other intervention failure predictors being early-onset dependence and increased baseline drinking. Findings provide evidence from India for effectiveness of cue-exposure-based intervention delivered using video technology in improving postdischarge treatment outcomes.

Occupational risk and lifetime exposure

International Nuclear Information System (INIS)

Lapp, R.E.

1991-01-01

Any lowering of annual radiation limits for occupational exposure should be based on industry experience with lifetime doses and not on a worst case career exposure of 47 years. Two decades of experience show a lifetime accumulation of less than 1.5 rem for workers with measurable exposure. This is 5% of the normal lifetime exposure of Americans to natural and medical radiation. Any epidemiology of the US nuclear power workforce's two decade long exposure would have to focus on excess leukemia. Application of the Hiroshima and Nagasaki cancer mortality shows that too few leukemias would be expressed to permit a feasible epidemiology. Ionizing radiation appears to be a mild carcinogen as compared to physical and chemical agents presented in the occupational environment. A realistic factor in determining any change in occupational exposure limits for ionizing radiation should take into account the past performance of the licensee and potential health effects applicable to the workplace. Specifically, the lifetime exposure data for workers at nuclear power plants and naval shipyards should be considered. The nuclear industry and the US Navy have detailed data on the annual exposure of workers with a combined collective exposure approaching 1 million worker-rem. The lifetime dose for naval personnel and shipyard workers averages 1.1 rem J 1990. Shipyard workers have an annual dose of 0.28 rem per work-year and a mean exposure time of 4.4 years. The data apply to workers with measurable dose

Proteomic profiling of halloysite clay nanotube exposure in intestinal cell co-culture.

Science.gov (United States)

Lai, Xianyin; Agarwal, Mangilal; Lvov, Yuri M; Pachpande, Chetan; Varahramyan, Kody; Witzmann, Frank A

2013-11-01

Halloysite is aluminosilicate clay with a hollow tubular structure with nanoscale internal and external diameters. Assessment of halloysite biocompatibility has gained importance in view of its potential application in oral drug delivery. To investigate the effect of halloysite nanotubes on an in vitro model of the large intestine, Caco-2/HT29-MTX cells in monolayer co-culture were exposed to nanotubes for toxicity tests and proteomic analysis. Results indicate that halloysite exhibits a high degree of biocompatibility characterized by an absence of cytotoxicity, in spite of elevated pro-inflammatory cytokine release. Exposure-specific changes in expression were observed among 4081 proteins analyzed. Bioinformatic analysis of differentially expressed protein profiles suggest that halloysite stimulates processes related to cell growth and proliferation, subtle responses to cell infection, irritation and injury, enhanced antioxidant capability, and an overall adaptive response to exposure. These potentially relevant functional effects warrant further investigation in in vivo models and suggest that chronic or bolus occupational exposure to halloysite nanotubes may have unintended outcomes. Copyright © 2013 John Wiley & Sons, Ltd.

Assessment of radiation exposure of personnel during clinical application of radioactive iridium

Energy Technology Data Exchange (ETDEWEB)

Dworakowski, M; Krystman-Mazgajska, E; Wysopolski, J [Instytut Onkologii, Warsaw (Poland); Centralne Lab. Ochrony Radiologicznej, Warsaw (Poland))

1975-01-01

The authors describe the results of measurements of doses and the evaluation of radiation exposure of the personnel of the Department of General Oncology working with application of radioactive iridium for interstitial and superficial treatment of neoplasma. The doses were measured by the photographic method simultaneously at six sites of the body: on the forehead, left side of the chest, 4th fingers of both hands, and on the left and right sides of the trunk at the level of gonads. The authors believe that introduction of iridium in place of radium will improve the conditions of work from the standpoint of protection against radioactivity.

Toxic Exposure Surveillance System (TESS)-based characterization of U.S. non-native venomous snake exposures, 1995-2004.

Science.gov (United States)

Seifert, Steven A; Oakes, Jennifer A; Boyer, Leslie V

2007-01-01

Non-native (exotic) snake exposures in the United States have not been systematically characterized. The Toxic Exposure Surveillance System (TESS) database of the American Association of Poison Control Centers was analyzed to quantify the number and types, demographic associations, clinical presentations, managements and outcomes, and the health resource utilization of non-native snake exposures. From 1995 through 2004, there were 399 non-native exposures in the TESS database. Of these, 350 snakes (87%) were identified by genus and species, comprising at least 77 different varieties. Roughly equal percentages of snakes originated in Asia, Africa and Latin America, with a smaller number from the Middle-East, Australia, and Europe. Nearly half were viperids and a little more than a third were elapids. The vast majority of exposed individuals were adults. However, almost 15% were aged 17 years or less, and almost 7% were children aged 5 years or younger. Eighty-four percent were males. The vast majority of exposures occurred at the victim's own residence. Over 50% were evaluated at a healthcare facility, with 28.7% admitted to an ICU. Overall, 26% of patients were coded as receiving antivenom treatment. Coded outcomes were similar between viperid and elapid envenomations. There were three deaths, two involving viperid snakes and one elapid. Enhancements to the TESS database are required for better precision in and more complete characterization of non-native snake envenomations.

Nano-risk Science: application of toxicogenomics in an adverse outcome pathway framework for risk assessment of multi-walled carbon nanotubes.

Science.gov (United States)

Labib, Sarah; Williams, Andrew; Yauk, Carole L; Nikota, Jake K; Wallin, Håkan; Vogel, Ulla; Halappanavar, Sabina

2016-03-15

A diverse class of engineered nanomaterials (ENMs) exhibiting a wide array of physical-chemical properties that are associated with toxicological effects in experimental animals is in commercial use. However, an integrated framework for human health risk assessment (HHRA) of ENMs has yet to be established. Rodent 2-year cancer bioassays, clinical chemistry, and histopathological endpoints are still considered the 'gold standard' for detecting substance-induced toxicity in animal models. However, the use of data derived from alternative toxicological tools, such as genome-wide expression profiling and in vitro high-throughput assays, are gaining acceptance by the regulatory community for hazard identification and for understanding the underlying mode-of-action. Here, we conducted a case study to evaluate the application of global gene expression data in deriving pathway-based points of departure (PODs) for multi-walled carbon nanotube (MWCNT)-induced lung fibrosis, a non-cancer endpoint of regulatory importance. Gene expression profiles from the lungs of mice exposed to three individual MWCNTs with different physical-chemical properties were used within the framework of an adverse outcome pathway (AOP) for lung fibrosis to identify key biological events linking MWCNT exposure to lung fibrosis. Significantly perturbed pathways were categorized along the key events described in the AOP. Benchmark doses (BMDs) were calculated for each perturbed pathway and were used to derive transcriptional BMDs for each MWCNT. Similar biological pathways were perturbed by the different MWCNT types across the doses and post-exposure time points studied. The pathway BMD values showed a time-dependent trend, with lower BMDs for pathways perturbed at the earlier post-exposure time points (24 h, 3d). The transcriptional BMDs were compared to the apical BMDs derived by the National Institute for Occupational Safety and Health (NIOSH) using alveolar septal thickness and fibrotic lesions

Using Social Media Applications for Educational Outcomes in College Teaching: A Structural Equation Analysis

Science.gov (United States)

Cao, Yingxia; Ajjan, Haya; Hong, Paul

2013-01-01

As more and more faculty members jump on the wagon of social media, an increasing number of publications began to investigate the adoption of social media applications and its motivators in and out of the classrooms. However, little research has paid close attention to the educational outcomes of social media utilization in college teaching. Thus,…

Development of gamma exposure chart (Selenium-75) for Industrial Radiography Application

International Nuclear Information System (INIS)

Sapizah Rahim; Shaharudin Sayuti; Noorhazleena Azaman

2011-01-01

Radiographic exposure can be determined by either trial exposure, reference to previous data or using exposure chart. Without previous data, exposure chart is the easiest and economic way to achieve correct exposure. It will minimize re-shoot and time. This paper presents the development of gamma exposure chart for Selenium-75 source. Film radiography method has been chosen for this development using steel step wedge blocks. Agfa Structurix D7 films have been used during the exposure and the optical density of the films was measured by using X-Rite densitometer. Method of development of the chart is explained. The chart is tested on pipe and welded plate test sample and the results are discussed. (author)

Exposure to Perfluoroalkyl Substances and Metabolic Outcomes in Pregnant Women: Evidence from the Spanish INMA Birth Cohorts

Science.gov (United States)

Matilla-Santander, Nuria; Valvi, Damaskini; Lopez-Espinosa, Maria-Jose; Manzano-Salgado, Cyntia B.; Ballester, Ferran; Ibarluzea, Jesús; Santa-Marina, Loreto; Schettgen, Thomas; Guxens, Mònica; Sunyer, Jordi

2017-01-01

Background: Exposure to perfluoroalkyl substances (PFASs) may increase risk for metabolic diseases; however, epidemiologic evidence is lacking at the present time. Pregnancy is a period of enhanced tissue plasticity for the fetus and the mother and may be a critical window of PFAS exposure susceptibility. Objective: We evaluated the associations between PFAS exposures and metabolic outcomes in pregnant women. Methods: We analyzed 1,240 pregnant women from the Spanish INMA [Environment and Childhood Project (INfancia y Medio Ambiente)] birth cohort study (recruitment period: 2003–2008) with measured first pregnancy trimester plasma concentrations of four PFASs (in nanograms/milliliter). We used logistic regression models to estimate associations of PFASs (log10-transformed and categorized into quartiles) with impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM), and we used linear regression models to estimate associations with first-trimester serum levels of triglycerides, total cholesterol, and C-reactive protein (CRP). Results: Perfluorooctane sulfonate (PFOS) and perfluorohexane sulfonate (PFHxS) were positively associated with IGT (137 cases) [OR per log10-unit increase=1.99 (95% CI: 1.06, 3.78) and OR=1.65 ( 95% CI: 0.99, 2.76), respectively]. PFOS and PFHxS associations with GDM (53 cases) were in a similar direction, but less precise. PFOS and perfluorononanoate (PFNA) were negatively associated with triglyceride levels [percent median change per log10-unit increase=−5.86% (95% CI: −9.91%, −1.63%) and percent median change per log10-unit increase=−4.75% (95% CI: −8.16%, −0.61%, respectively], whereas perfluorooctanoate (PFOA) was positively associated with total cholesterol [percent median change per log10-unit increase=1.26% (95% CI: 0.01%, 2.54%)]. PFASs were not associated with CRP in the subset of the population with available data (n=640). Conclusions: Although further confirmation is required, the findings from this

Infant and mother related outcomes from exposure to metals with endocrine disrupting properties during pregnancy

Energy Technology Data Exchange (ETDEWEB)

Rahman, A. [Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa (Canada); Kumarathasan, P. [Environmental Health Science and Research Bureau, Health Canada, Ottawa (Canada); Gomes, J., E-mail: jgomes@uottawa.ca [Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa (Canada); McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa (Canada)

2016-11-01

Background: Endocrine-related adverse health effects from exposure to heavy metals such as lead, arsenic, cadmium, and mercury are yet to be adequately described. The purpose of this review was to gain insight into maternal exposure to heavy metals, and to identify potential endocrine-related adverse health effects in the mother and the infant. Methods: Relevant databases were searched for original research reports and a total of 46 articles were retained for scrutiny. Required data was extracted from these studies and their methodology was assessed. Results: Impaired fetal growth was observed from exposure to all endocrine disrupting metals, while exposure to lead and arsenic were associated with spontaneous abortion, stillbirth and neonatal deaths. Maternal exposure to arsenic was associated with impaired glucose tolerance in these mothers. Conclusion: Impaired fetal growth, fetal loss, and neonatal deaths were significantly associated with heavy metals exposure during pregnancy; however, hypertension and gestational diabetes require further investigation. - Highlights: • Low and high dose exposure to lead was associated with low birth weight, preterm birth, stillbirths, spontaneous abortions and hypertension. • Exposure to arsenic was associated with fetal loss, stillbirths and spontaneous abortions. • Exposure to cadmium was associated with low birth weight. • Exposure to mercury was associated with spontaneous abortions and neurotoxic effects. • Exposure to copper was associated with low birth weight and spontaneous abortions and exposure to zinc was associated with low birth weight.

Infant and mother related outcomes from exposure to metals with endocrine disrupting properties during pregnancy

International Nuclear Information System (INIS)

Rahman, A.; Kumarathasan, P.; Gomes, J.

2016-01-01

Background: Endocrine-related adverse health effects from exposure to heavy metals such as lead, arsenic, cadmium, and mercury are yet to be adequately described. The purpose of this review was to gain insight into maternal exposure to heavy metals, and to identify potential endocrine-related adverse health effects in the mother and the infant. Methods: Relevant databases were searched for original research reports and a total of 46 articles were retained for scrutiny. Required data was extracted from these studies and their methodology was assessed. Results: Impaired fetal growth was observed from exposure to all endocrine disrupting metals, while exposure to lead and arsenic were associated with spontaneous abortion, stillbirth and neonatal deaths. Maternal exposure to arsenic was associated with impaired glucose tolerance in these mothers. Conclusion: Impaired fetal growth, fetal loss, and neonatal deaths were significantly associated with heavy metals exposure during pregnancy; however, hypertension and gestational diabetes require further investigation. - Highlights: • Low and high dose exposure to lead was associated with low birth weight, preterm birth, stillbirths, spontaneous abortions and hypertension. • Exposure to arsenic was associated with fetal loss, stillbirths and spontaneous abortions. • Exposure to cadmium was associated with low birth weight. • Exposure to mercury was associated with spontaneous abortions and neurotoxic effects. • Exposure to copper was associated with low birth weight and spontaneous abortions and exposure to zinc was associated with low birth weight.

Root causes, clinical effects, and outcomes of unintentional exposures to buprenorphine by young children.

Science.gov (United States)

Lavonas, Eric J; Banner, William; Bradt, Pamela; Bucher-Bartelson, Becki; Brown, Kimberly R; Rajan, Pradeep; Murrelle, Lenn; Dart, Richard C; Green, Jody L

2013-11-01

To characterize the rates, root causes, and clinical effects of unintentional exposures to buprenorphine sublingual formulations among young children and to determine whether exposure characteristics differ between formulations. Unintentional exposures to buprenorphine-containing products among children 28 days to less than 6 years old were collected from the Researched Abuse, Diversion, and Addiction-Related Surveillance System Poison Center Program and Reckitt Benckiser Pharmaceuticals' pharmacovigilance system from October 2009-March 2012. After adjustment for drug availability, negative binomial regression was used to estimate average exposure rates. Root cause assessment was conducted, and an expert clinician panel adjudicated causality and severity of moderate to severe adverse events (AEs). A total of 2380 cases were reviewed, including 4 deaths. Exposures to buprenorphine-naloxone combination film were significantly less frequent than exposures to buprenorphine tablets (rate ratio 3.5 [95% CI, 2.7-4.5]) and buprenorphine-naloxone combination tablets (rate ratio 8.8 [7.2-10.6]). The most commonly identified root causes were medication stored in sight, accessed from a bag or purse, and not stored in the original packaging. Among 536 panel review cases, the most common AEs reported for all formulations were lethargy, respiratory depression, miosis, and vomiting. The highest level AE severity did not differ significantly by formulation. Unintentional exposure to buprenorphine can cause central nervous system depression, respiratory depression, and death in young children. Exposure rates to film formulations are significantly less than to tablet formulations. Package and storage deficiencies contribute to unintentional exposures in young children. Copyright © 2013 Mosby, Inc. All rights reserved.

Fish consumption and prenatal methylmercury exposure: cognitive and behavioral outcomes in the main cohort at 17 years from the Seychelles child development study.

Science.gov (United States)

Davidson, Philip W; Cory-Slechta, Deborah A; Thurston, Sally W; Huang, Li-Shan; Shamlaye, Conrad F; Gunzler, Douglas; Watson, Gene; van Wijngaarden, Edwin; Zareba, Grazyna; Klein, Jonathan D; Clarkson, Thomas W; Strain, J J; Myers, Gary J

2011-12-01

People worldwide depend upon daily fish consumption as a major source of protein and other nutrients. Fish are high in nutrients essential for normal brain development, but they also contain methylmercury (MeHg), a neurotoxicant. Our studies in a population consuming fish daily have indicated no consistent pattern of adverse associations between prenatal MeHg and children's development. For some endpoints we found performance improved with increasing prenatal exposure to MeHg. Follow up studies indicate this association is related to the beneficial nutrients present in fish. To determine if the absence of adverse outcomes and the presence of beneficial associations between prenatal MeHg and developmental outcomes previously reported persists into adolescence. This study was conducted on the Main Cohort of the Seychelles Child Development Study (SCDS). We examined the association between prenatal MeHg exposure and subjects' performance at 17 years of age on 27 endpoints. The test battery included the Wisconsin Card Sorting Test (WCST), the California Verbal Learning Test (CVLT), the Woodcock-Johnson (W-J-II) Achievement Test, subtests of the Cambridge Neuropsychological Test Automated Battery (CANTAB), and measures of problematic behaviors. Analyses for all endpoints were adjusted for postnatal MeHg, sex, socioeconomic status, maternal IQ, and child's age at testing and the child's IQ was added for problematic behavioral endpoints. Mean prenatal MeHg exposure was 6.9 ppm. There was no association between prenatal MeHg and 21 endpoints. Increasing prenatal MeHg was associated with better scores on four endpoints (higher W-J-II math calculation scores, reduced numbers of trials on the Intra-Extradimensional Shift Set of the CANTAB), fewer reports of substance use and incidents of and referrals for problematic behaviors in school. Increasing prenatal MeHg was adversely associated with one level of referrals to a school counselor. At age 17 years there was no consistent

HERA: A dynamic web application for visualizing community exposure to flood hazards based on storm and sea level rise scenarios

Science.gov (United States)

Jones, Jeanne M.; Henry, Kevin; Wood, Nathan J.; Ng, Peter; Jamieson, Matthew

2017-01-01

The Hazard Exposure Reporting and Analytics (HERA) dynamic web application was created to provide a platform that makes research on community exposure to coastal-flooding hazards influenced by sea level rise accessible to planners, decision makers, and the public in a manner that is both easy to use and easily accessible. HERA allows users to (a) choose flood-hazard scenarios based on sea level rise and storm assumptions, (b) appreciate the modeling uncertainty behind a chosen hazard zone, (c) select one or several communities to examine exposure, (d) select the category of population or societal asset, and (e) choose how to look at results. The application is designed to highlight comparisons between (a) varying levels of sea level rise and coastal storms, (b) communities, (c) societal asset categories, and (d) spatial scales. Through a combination of spatial and graphical visualizations, HERA aims to help individuals and organizations to craft more informed mitigation and adaptation strategies for climate-driven coastal hazards. This paper summarizes the technologies used to maximize the user experience, in terms of interface design, visualization approaches, and data processing.

HERA: A dynamic web application for visualizing community exposure to flood hazards based on storm and sea level rise scenarios

Science.gov (United States)

Jones, Jeanne M.; Henry, Kevin; Wood, Nathan; Ng, Peter; Jamieson, Matthew

2017-12-01

The Hazard Exposure Reporting and Analytics (HERA) dynamic web application was created to provide a platform that makes research on community exposure to coastal-flooding hazards influenced by sea level rise accessible to planners, decision makers, and the public in a manner that is both easy to use and easily accessible. HERA allows users to (a) choose flood-hazard scenarios based on sea level rise and storm assumptions, (b) appreciate the modeling uncertainty behind a chosen hazard zone, (c) select one or several communities to examine exposure, (d) select the category of population or societal asset, and (e) choose how to look at results. The application is designed to highlight comparisons between (a) varying levels of sea level rise and coastal storms, (b) communities, (c) societal asset categories, and (d) spatial scales. Through a combination of spatial and graphical visualizations, HERA aims to help individuals and organizations to craft more informed mitigation and adaptation strategies for climate-driven coastal hazards. This paper summarizes the technologies used to maximize the user experience, in terms of interface design, visualization approaches, and data processing.

Exposure to antidepressants during pregnancy--prevalences and outcomes

DEFF Research Database (Denmark)

Jimenez-Solem, Espen

2014-01-01

conflicting. The main challenge is how to discern between the effects of the drug and the effect of the depression itself. We approached this dire problem conducting a nation-wide register based study analyzing the relation between use of antidepressants during pregnancy and the risk of congenital...... that the apparent risk associated with use of SSRIs during pregnancy is not related to the drug exposure, but to unknown characteristics associated with mothers redeeming a prescription for an antidepressant. We found no increased risk of stillbirths or neonatal mortality among off-spring exposed in utero...

Barrier function and natural moisturizing factor levels after cumulative exposure to a fruit-derived organic acid and a detergent: different outcomes in atopic and healthy skin and relevance for occupational contact dermatitis in the food industry.

Science.gov (United States)

Angelova-Fischer, Irena; Hoek, Anne-Karin; Dapic, Irena; Jakasa, Ivone; Kezic, Sanja; Fischer, Tobias W; Zillikens, Detlef

2015-12-01

Fruit-derived organic compounds and detergents are relevant exposure factors for occupational contact dermatitis in the food industry. Although individuals with atopic dermatitis (AD) are at risk for development of occupational contact dermatitis, there have been no controlled studies on the effects of repeated exposure to multiple irritants, relevant for the food industry, in atopic skin. The aim of the study was to investigate the outcomes of repeated exposure to a fruit-derived organic acid and a detergent in AD compared to healthy volunteers. The volunteers were exposed to 2.0% acetic acid (AcA) and/or 0.5% sodium lauryl sulfate (SLS) in controlled tandem repeated irritation test. The outcomes were assessed by measurements of erythema, transepidermal water loss (TEWL) and natural moisturizing factor (NMF) levels. In the AD volunteers, repeated AcA exposure led to barrier disruption and significant TEWL increase; no significant differences after the same exposure in the healthy controls were found. Repeated exposure to SLS and the irritant tandems enhanced the reactions and resulted in a significantly higher increase in TEWL in the AD compared to the control group. Cumulative irritant exposure reduced the NMF levels in both groups. Differences in the severity of irritant-induced barrier impairment in atopic individuals contribute to the risk for occupational contact dermatitis in result of multiple exposures to food-derived irritants and detergents. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Screen Media Exposure and Obesity in Children and Adolescents.

Science.gov (United States)

Robinson, Thomas N; Banda, Jorge A; Hale, Lauren; Lu, Amy Shirong; Fleming-Milici, Frances; Calvert, Sandra L; Wartella, Ellen

2017-11-01

Obesity is one of the best-documented outcomes of screen media exposure. Many observational studies find relationships between screen media exposure and increased risks of obesity. Randomized controlled trials of reducing screen time in community settings have reduced weight gain in children, demonstrating a cause and effect relationship. Current evidence suggests that screen media exposure leads to obesity in children and adolescents through increased eating while viewing; exposure to high-calorie, low-nutrient food and beverage marketing that influences children's preferences, purchase requests, consumption habits; and reduced sleep duration. Some evidence also suggests promise for using interactive media to improve eating and physical activity behaviors to prevent or reduce obesity. Future interdisciplinary research is needed to examine the effects of newer mobile and other digital media exposures on obesity; to examine the effectiveness of additional interventions to mitigate the adverse effects of media exposures on obesity and possible moderators and mediators of intervention effects; to effectively use digital media interventions to prevent and reduce obesity; and to uncover the mechanisms underlying the causal relationships and interactions between obesity-related outcomes and media content, characteristics, and context. Copyright © 2017 by the American Academy of Pediatrics.

Screen Media Exposure and Obesity in Children and Adolescents

Science.gov (United States)

Robinson, Thomas N.; Banda, Jorge A.; Hale, Lauren; Lu, Amy Shirong; Fleming-Milici, Frances; Calvert, Sandra L.; Wartella, Ellen

2018-01-01

Obesity is one of the best-documented outcomes of screen media exposure. Many observational studies find relationships between screen media exposure and increased risks of obesity. Randomized controlled trials of reducing screen time in community settings have reduced weight gain in children, demonstrating a cause and effect relationship. Current evidence suggests that screen media exposure leads to obesity in children and adolescents through increased eating while viewing; exposure to high-calorie, low-nutrient food and beverage marketing that influences children’s preferences, purchase requests, consumption habits; and reduced sleep duration. Some evidence also suggests promise for using interactive media to improve eating and physical activity behaviors to prevent or reduce obesity. Future interdisciplinary research is needed to examine the effects of newer mobile and other digital media exposures on obesity; to examine the effectiveness of additional interventions to mitigate the adverse effects of media exposures on obesity and possible moderators and mediators of intervention effects; to effectively use digital media interventions to prevent and reduce obesity; and to uncover the mechanisms underlying the causal relationships and interactions between obesity-related outcomes and media content, characteristics, and context. PMID:29093041

Role of caregiver-reported outcomes in identification of children with prenatal alcohol exposure during the first year of life.

Science.gov (United States)

Bakhireva, Ludmila N; Lowe, Jean; Garrison, Laura M; Cano, Sandra; Leyva, Yuridia; Qeadan, Fares; Stephen, Julia M

2018-05-16

BackgroundEarlier identification of children with prenatal alcohol exposure (PAE) remains a challenge. The objective of this study was to identify neurobehavioral (NB) outcomes associated with PAE in infants.MethodsThis manuscript evaluates NB outcomes at 6.33±1.12 months of age in 93 infants (39 PAE and 54 No-PAE) recruited prospectively into the ENRICH cohort. PAE was assessed by prospective repeated TLFB interviews and a panel of ethanol biomarkers. NB outcomes were evaluated by the Bayley Scales of Infant Development (BSID-III), Parenting Stress Index (PSI), Infant Behavior Questionnaire (IBQ-R), and Infant Sensory Profile (ISP).ResultsMean maternal age at enrollment was 28.18±5.75, and 64.52% were Hispanic/Latina. Across three TLFB calendars, absolute alcohol per day in the PAE group was 0.44±0.72, corresponding to low-moderate alcohol consumption. While no association was observed between PAE and BSID-III (P's>0.05), PAE was associated with higher scores on the PSI difficult child scale (=13.9; P=0.015), total stress (=13.9; P=0.010), and IBQ negative affect (=8.60; P=0.008) measures after adjustment for covariates.ConclusionsCaregiver-reported assessments may provide a currently unrecognized opportunity to identify behavioral deficits, point to early interventions, and should be included in clinical assessments of infants at-risk for fetal alcohol spectrum disorder.Pediatric Research advance online publication, 16 May 2018; doi:10.1038/pr.2018.26.

Exposure to cannabis in popular music and cannabis use among adolescents.

Science.gov (United States)

Primack, Brian A; Douglas, Erika L; Kraemer, Kevin L

2010-03-01

Cannabis use is referenced frequently in American popular music, yet it remains uncertain whether exposure to these references is associated with actual cannabis use. We aimed to determine if exposure to cannabis in popular music is associated independently with current cannabis use in a cohort of urban adolescents. We surveyed all 9th grade students at three large US urban high schools. We estimated participants' exposure to lyrics referent to cannabis with overall music exposure and content analyses of their favorite artists' songs. Outcomes included current (past 30 days) and ever use of cannabis. We used multivariable regression to assess independent associations between exposures and outcomes while controlling for important covariates. Each of the 959 participants was exposed to an estimated 27 cannabis references per day [correction added on 19 January 2010, after first online publication: 40 has been changed to 27] (standard deviation = 73 [correction added on 19 January 2010, after first online publication: 104 has been changed to 73]). Twelve per cent (n = 108) were current cannabis users and 32% (n = 286) had ever used cannabis. Compared with those in the lowest tertile of total cannabis exposure in music, those in the highest tertile of exposure were almost twice as likely to have used cannabis in the past 30 days (odds ratio = 1.83; 95% confidence interval = 1.04, 3.22), even after adjusting for socio-demographic variables, personality characteristics and parenting style. As expected, however, there was no significant relationship between our cannabis exposure variable and a sham outcome variable of alcohol use. This study supports an independent association between exposure to cannabis in popular music and early cannabis use among urban American adolescents.

Behavioral effects of developmental methylmercury drinking water exposure in rodents.

Science.gov (United States)

Bisen-Hersh, Emily B; Farina, Marcelo; Barbosa, Fernando; Rocha, Joao B T; Aschner, Michael

2014-04-01

Early methylmercury (MeHg) exposure can have long-lasting consequences likely arising from impaired developmental processes, the outcome of which has been exposed in several longitudinal studies of affected populations. Given the large number of newborns at an increased risk of learning disabilities associated with in utero MeHg exposure, it is important to study neurobehavioral alterations using ecologically valid and physiologically relevant models. This review highlights the benefits of using the MeHg drinking water exposure paradigm and outlines behavioral outcomes arising from this procedure in rodents. Combination treatments that exacerbate or ameliorate MeHg-induced effects, and possible molecular mechanisms underlying behavioral impairment are also discussed. Copyright © 2013 Elsevier GmbH. All rights reserved.

Identification of fipronil metabolites in rodents by time-of-flight mass spectrometry for application in a human exposure study

Science.gov (United States)

Fipronil is a phenylpyrazole insecticide commonly used in residential and agricultural applications. To understand more about the potential risks associated with fipronil, dosed Long Evans rats were evaluated for metabolites to develop a set of biomarkers for use in human exposur...

Respiratory health effects of occupational exposure to charcoal dust in Namibia

Science.gov (United States)

Kgabi, Nnenesi

2016-01-01

Background Charcoal processing activities can increase the risk of adverse respiratory outcomes. Objective To determine dose–response relationships between occupational exposure to charcoal dust, respiratory symptoms and lung function among charcoal-processing workers in Namibia. Methods A cross-sectional study was conducted with 307 workers from charcoal factories in Namibia. All respondents completed interviewer-administered questionnaires. Spirometry was performed, ambient and respirable dust levels were assessed in different work sections. Multiple logistic regression analysis estimated the overall effect of charcoal dust exposure on respiratory outcomes, while linear regression estimated the exposure-related effect on lung function. Workers were stratified according to cumulative dust exposure category. Results Exposure to respirable charcoal dust levels was above occupational exposure limits in most sectors, with packing and weighing having the highest dust exposure levels (median 27.7 mg/m3, range: 0.2–33.0 for the 8-h time-weighted average). The high cumulative dust exposure category was significantly associated with usual cough (OR: 2.1; 95% CI: 1.1–4.0), usual phlegm (OR: 2.1; 95% CI: 1.1–4.1), episodes of phlegm and cough (OR: 2.8; 95% CI: 1.1–6.1), and shortness of breath. A non-statistically significant lower adjusted mean-predicted % FEV1 was observed (98.1% for male and 95.5% for female) among workers with greater exposure. Conclusions Charcoal dust levels exceeded the US OSHA recommended limit of 3.5 mg/m3 for carbon-black-containing material and study participants presented with exposure-related adverse respiratory outcomes in a dose–response manner. Our findings suggest that the Namibian Ministry of Labour introduce stronger enforcement strategies of existing national health and safety regulations within the industry. PMID:27687528

Application of a pilot control banding tool for risk level assessment and control of nanoparticle exposures.

Science.gov (United States)

Paik, Samuel Y; Zalk, David M; Swuste, Paul

2008-08-01

Control banding (CB) strategies offer simplified solutions for controlling worker exposures to constituents that are found in the workplace in the absence of firm toxicological and exposure data. These strategies may be particularly useful in nanotechnology applications, considering the overwhelming level of uncertainty over what nanomaterials and nanotechnologies present as potential work-related health risks, what about these materials might lead to adverse toxicological activity, how risk related to these might be assessed and how to manage these issues in the absence of this information. This study introduces a pilot CB tool or 'CB Nanotool' that was developed specifically for characterizing the health aspects of working with engineered nanoparticles and determining the level of risk and associated controls for five ongoing nanotechnology-related operations being conducted at two Department of Energy research laboratories. Based on the application of the CB Nanotool, four of the five operations evaluated in this study were found to have implemented controls consistent with what was recommended by the CB Nanotool, with one operation even exceeding the required controls for that activity. The one remaining operation was determined to require an upgrade in controls. By developing this dynamic CB Nanotool within the realm of the scientific information available, this application of CB appears to be a useful approach for assessing the risk of nanomaterial operations, providing recommendations for appropriate engineering controls and facilitating the allocation of resources to the activities that most need them.

Estimating exposure of terrestrial wildlife to contaminants

Energy Technology Data Exchange (ETDEWEB)

Sample, B.E.; Suter, G.W. II

1994-09-01

This report describes generalized models for the estimation of contaminant exposure experienced by wildlife on the Oak Ridge Reservation. The primary exposure pathway considered is oral ingestion, e.g. the consumption of contaminated food, water, or soil. Exposure through dermal absorption and inhalation are special cases and are not considered hereIN. Because wildlife mobile and generally consume diverse diets and because environmental contamination is not spatial homogeneous, factors to account for variation in diet, movement, and contaminant distribution have been incorporated into the models. To facilitate the use and application of the models, life history parameters necessary to estimate exposure are summarized for 15 common wildlife species. Finally, to display the application of the models, exposure estimates were calculated for four species using data from a source operable unit on the Oak Ridge Reservation.

Estimating exposure of terrestrial wildlife to contaminants

International Nuclear Information System (INIS)

Sample, B.E.; Suter, G.W. II.

1994-09-01

This report describes generalized models for the estimation of contaminant exposure experienced by wildlife on the Oak Ridge Reservation. The primary exposure pathway considered is oral ingestion, e.g. the consumption of contaminated food, water, or soil. Exposure through dermal absorption and inhalation are special cases and are not considered hereIN. Because wildlife mobile and generally consume diverse diets and because environmental contamination is not spatial homogeneous, factors to account for variation in diet, movement, and contaminant distribution have been incorporated into the models. To facilitate the use and application of the models, life history parameters necessary to estimate exposure are summarized for 15 common wildlife species. Finally, to display the application of the models, exposure estimates were calculated for four species using data from a source operable unit on the Oak Ridge Reservation

Air ions and respiratory function outcomes: a comprehensive review

Science.gov (United States)

2013-01-01

Background From a mechanistic or physical perspective there is no basis to suspect that electric charges on clusters of air molecules (air ions) would have beneficial or deleterious effects on respiratory function. Yet, there is a large lay and scientific literature spanning 80 years that asserts exposure to air ions affects the respiratory system and has other biological effects. Aims This review evaluates the scientific evidence in published human experimental studies regarding the effects of exposure to air ions on respiratory performance and symptoms. Methods We identified 23 studies (published 1933–1993) that met our inclusion criteria. Relevant data pertaining to study population characteristics, study design, experimental methods, statistical techniques, and study results were assessed. Where relevant, random effects meta-analysis models were utilized to quantify similar exposure and outcome groupings. Results The included studies examined the therapeutic benefits of exposure to negative air ions on respiratory outcomes, such as ventilatory function and asthmatic symptoms. Study specific sample sizes ranged between 7 and 23, and studies varied considerably by subject characteristics (e.g., infants with asthma, adults with emphysema), experimental method, outcomes measured (e.g., subjective symptoms, sensitivity, clinical pulmonary function), analytical design, and statistical reporting. Conclusions Despite numerous experimental and analytical differences across studies, the literature does not clearly support a beneficial role in exposure to negative air ions and respiratory function or asthmatic symptom alleviation. Further, collectively, the human experimental studies do not indicate a significant detrimental effect of exposure to positive air ions on respiratory measures. Exposure to negative or positive air ions does not appear to play an appreciable role in respiratory function. PMID:24016271

Interest of the trajectory method for the evaluation of outcomes after in utero drug exposure: example of anxiolytics and hypnotics.

Science.gov (United States)

Hurault-Delarue, Caroline; Chouquet, Cécile; Savy, Nicolas; Lacroix, Isabelle; Beau, Anna-Belle; Montastruc, Jean-Louis; Damase-Michel, Christine

2017-05-01

The aim of this study was to examine the potential benefit to take into account duration and intensity of drug exposure using the recently published method based on individual drug trajectories. This approach was used to define profiles of exposure to anxiolytics/hypnotics during pregnancy and to evaluate the potential effect on newborn health. The study was performed in EFEMERIS database (54 918 mother-children pairs). An estimation of adaptation to extrauterine life was assessed using several criteria especially cardio-respiratory symptoms. A proxy variable called "neonatal pathology" was created. The occurrence of this event was studied using two approaches: The Standard Method comparing exposed and unexposed newborns, The Trajectory Method comparing the different profiles of exposure. Around 5% of newborns (n = 2768) were identified to be exposed to anxiolytics or hypnotics during pregnancy. Using the Standard Method, 6.2% of exposed newborns developed a "neonatal pathology" against 4.8% of unexposed newborns (odds ratios [OR] = 0.9[0.8-1.2], p = 0.7). With the Trajectory Method taking into account evolution of exposure during pregnancy and treatment intensity, four profiles of pregnant women were identified. A significant difference in the rates of "neonatal pathologies" was observed between profiles (p = 0.0002). Newborns of the two profiles exposed in utero to high constant level of anxiolytics or hypnotics were more at risk of developing "neonatal pathology" than unexposed newborns (OR 1  = 2.0 [1.0-3.9] and OR 2  = 7.6 [2.8-20.5]). The present study demonstrates the interest of this method based on individual drug trajectories for the evaluation of outcomes in pharmaco-epidemiological studies and more specifically during pregnancy. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Moderating the Effects of Childhood Exposure to Intimate Partner Violence: The Roles of Parenting Characteristics and Adolescent Peer Support.

Science.gov (United States)

Tajima, Emiko A; Herrenkohl, Todd I; Moylan, Carrie A; Derr, Amelia S

2011-06-01

We investigate parenting characteristics and adolescent peer support as potential moderators of the effects of childhood exposure to intimate partner violence (IPV) on adolescent outcomes. Lehigh Longitudinal Study (N=416) data include parent and adolescent reports of childhood IPV exposure. Exposure to IPV predicted nearly all adverse outcomes examined, however after accounting for co-occurring child abuse and early child behavior problems, IPV predicted only one outcome. Several moderator effects were identified. Parental "acceptance" of the child moderated the effects of IPV exposure on the likelihood of teenage pregnancy and running away from home. Both peer communication and peer trust moderated the relationship between exposure to IPV and depression and running from home. Peer communication also moderated the effects of IPV exposure on high school dropout. Interventions that influence parenting practices and strengthen peer support for youth exposed to IPV may increase protection and decrease risk of several tested outcomes.

Development of mild steel exposure chart for neutron radiography application

International Nuclear Information System (INIS)

Hafizal Yazid; Rafhayudi Jamro; Hishamuddin Husain; Muhammad Rawi Mohd Zin; Razali Kassim; Abd Aziz Mohamed; Azali Muhammad

2004-01-01

A neutron radiography exposure chart for mild steel was developed to facilitate the determination of exposure time when producing neutron radiographs for any given mild steel thickness. A mild steel sample in the form of step wedge (1-10 mm thick) was exposed to thermal neutron using Direct technique. This technique involves exposing x-ray film-Gadolinium converter housed in one film cassette simultaneously to thermal neutron beam. Gadolinium converters with thickness of 0.025 mm and 0.5 mm were used to observe the effect of converter thickness on radiographic density and exposure time. Collected radiographic density data is then calculated based on manufacturer's film characteristic chart and finally exposure chart for mild steel was plotted. This chart could later be used as a guide for estimating exposure time for any given sample thickness providing other conditions are similar (material, film processing, neutron flux, film density and converter thickness). (Author)

Overview of environmental and occupational vanadium exposure and associated health outcomes: an article based on a presentation at the 8th International Symposium on Vanadium Chemistry, Biological Chemistry, and Toxicology, Washington DC, August 15-18, 2012.

Science.gov (United States)

Fortoul, T I; Rojas-Lemus, M; Rodriguez-Lara, V; Gonzalez-Villalva, A; Ustarroz-Cano, M; Cano-Gutierrez, G; Gonzalez-Rendon, S E; Montaño, L F; Altamirano-Lozano, M

2014-01-01

Vanadium (V) has a variety of applications that make it suitable for use in ceramic production and decoration, production of pigments for a variety of products, an accelerator for drying paint, production of aniline black dye, and as a mordant in coloring textiles. Taking advantage of its hardness, resilience, ability to form alloys, and its resistance to corrosion, V is also used in the production of tools, steel, machinery, and surgical implants. V is employed in producing photographic developers, batteries, and semi-conductors, and in catalyst-based recycling processes. As technologies have evolved, the use of V has increased in jet aircraft and space technology, as well as in manufacture of ultraviolet filter glass to prevent radiation injury. Due to these myriad uses, the potential for occupational exposure to V is ever-evident. Similarly, there is an increased risk for environmental contamination by V agents themselves or as components of by-products released into the environment. For example, the use of V in sulfuric acid production results in the release of soot and/or fly ash rich in vanadium pentoxide. Petroleum refinery, smelting, welding, and cutting of V-rich steel alloy, the cleaning and repair of oil-fired boilers, and catalysis of chemical productions are other sources of increased airborne V-bearing particles in local/distant environments. Exposure of non-workers to V is an increasing health concern. Studies have demonstrated associations between exposure to airborne V-bearing particles (as part of air pollution) and increased risks of a variety of pathologies like hypertension, dysrhythmia, systemic inflammation, hyper-coagulation, cancers, and bronchial hyper-reactivity. This paper will provide a review of the history of V usage in occupational settings, documented exposure levels, environmental levels of V associated with pollution, epidemiologic data relating V exposure(s) to adverse health outcomes, and governmental responses to protect both

Protection of the public in situations of prolonged radiation exposure. The application of the Commission's system of radiological protection to controllable radiation exposure due to natural sources and long-lived radioactive residues.

Science.gov (United States)

1999-01-01

This report provides guidance on the application of the ICRP system of radiological protection to prolonged exposure situations affecting members of the public. It addresses the general application of the Commission's system to the control of prolonged exposures resulting from practices and to the undertaking of interventions in prolonged exposure situations. Additionally, it provides recommendations on generic reference levels for such interventions. The report also considers some specific situations and discusses a number of issues that have been of concern, namely: natural radiation sources that may give rise to high doses; the restoration and rehabilitation of sites where human activities involving radioactive substances have been carried out; the return to 'normality' following an accident that has released radioactive substances to the environment; and the global marketing of commodities for public consumption that contain radioactive substances. Annexes provide some examples of prolonged exposure situations and discuss the radiological protection quantities, radiation-induced health effects and aspects of the Commission's system of radiological protection relevant to prolonged exposure. Quantitative recommendations for prolonged exposures are provided in the report. They must be interpreted with extreme caution; Chapters 4 and 5 stress the upper bound nature of the following values: Generic reference levels for intervention, in terms of existing total annual doses, are given as < approximately 100 mSv, above which intervention is almost always justifiable (situations for which the annual dose threshold for deterministic effects in relevant organs is exceeded will almost always require intervention), and < approximately 10 mSv, below which intervention is not likely to be justifiable (and above which it may be necessary). Intervention exemption levels for commodities, especially building materials, are expressed as an additional annual dose of approximately 1

Data from three prospective longitudinal human cohorts of prenatal marijuana exposure and offspring outcomes from the fetal period through young adulthood

Directory of Open Access Journals (Sweden)

Gabrielle L. McLemore

2016-12-01

Full Text Available This article includes data from three prospective longitudinal human cohorts of prenatal marijuana exposure (PME and offspring outcomes from the fetal period through young adulthood. The table herein contains an overview of the major adverse effects associated with PME from the following human cohorts: (1 The Ottawa Prenatal Prospective Study (OPPS; (2 The Maternal Health Practices and Child Development Study (MHPCD; and (3 The Generation R Study (Gen R. In the OPPS, fetal gestational age was measured and age-appropriate standardized neuropsychological instruments were used to assess neonatal responses, and infant–child and adolescent–young adult cognitive and behavioral skills. In the MHPCD, birth length and weight, neonatal body length, and infant–child sleep, cognition, and behavioral parameters were measured. In the Gen R, birth weight and growth were measured, as were infant–child attention and aggression. The data in this article are in support of our report entitled “Prenatal Cannabis Exposure - The "First Hit" to the Endocannabinoid System” (K.A. Richardson, A.K. Hester, G.L. McLemore, 2016 [13].

Risk of impaired cognition after prenatal exposure to psychotropic drugs

DEFF Research Database (Denmark)

Wibroe, M A; Mathiasen, R; Pagsberg, A K

2017-01-01

OBJECTIVE: Prenatal exposure to psychotropic drugs may affect the trajectories of brain development. In a register study, we investigated whether such exposure is associated with long-term impaired cognitive abilities. METHOD: Individuals born in Denmark in 1995-2008 were included. As proxies...... of a neurological/mental disorder after prenatal exposure to psychoanaleptics (primarily antidepressants) (OR: 1.86[1.24-2.78). CONCLUSION: Prenatal exposure to psychotropic drugs affects proxy outcomes of cognitive disabilities at school age. Exposure to psycholeptics carries the largest risk. The role...

Smaller Cerebellar Growth and Poorer Neurodevelopmental Outcomes in Very Preterm Infants Exposed to Neonatal Morphine.

Science.gov (United States)

Zwicker, Jill G; Miller, Steven P; Grunau, Ruth E; Chau, Vann; Brant, Rollin; Studholme, Colin; Liu, Mengyuan; Synnes, Anne; Poskitt, Kenneth J; Stiver, Mikaela L; Tam, Emily W Y

2016-05-01

To examine the relationship between morphine exposure and growth of the cerebellum and cerebrum in very preterm neonates from early in life to term-equivalent age, as well as to examine morphine exposure and brain volumes in relation to neurodevelopmental outcomes at 18 months corrected age (CA). A prospective cohort of 136 very preterm neonates (24-32 weeks gestational age) was serially scanned with magnetic resonance imaging near birth and at term-equivalent age for volumetric measurements of the cerebellum and cerebrum. Motor outcomes were assessed with the Peabody Developmental Motor Scales, Second Edition and cognitive outcomes with the Bayley Scales of Infant and Toddler Development, Third Edition at 18 months CA. Generalized least squares models and linear regression models were used to assess relationships between morphine exposure, brain volumes, and neurodevelopmental outcomes. A 10-fold increase in morphine exposure was associated with a 5.5% decrease in cerebellar volume, after adjustment for multiple clinical confounders and total brain volume (P = .04). When infants exposed to glucocorticoids were excluded, the association of morphine was more pronounced, with an 8.1% decrease in cerebellar volume. Morphine exposure was not associated with cerebral volume (P = .30). Greater morphine exposure also predicted poorer motor (P growth. Morphine exposure in very preterm neonates is independently associated with impaired cerebellar growth in the neonatal period and poorer neurodevelopmental outcomes in early childhood. Alternatives to better manage pain in preterm neonates that optimize brain development and functional outcomes are urgently needed. Copyright © 2016 Elsevier Inc. All rights reserved.

Applicability of Long Duration Exposure Facility environmental effects data to the design of Space Station Freedom electrical power system

Science.gov (United States)

Christie, Robert J.; Lu, Cheng-Yi; Aronoff, Irene

1992-01-01

Data defining space environmental effects on the Long Duration Exposure Facility (LDEF) are examined in terms of the design of the electrical power system (EPS) of the Space Station Freedom (SSF). The significant effects of long-term exposure to space are identified with respect to the performance of the LDEF's materials, components, and systems. A total of 57 experiments were conducted on the LDEF yielding information regarding coatings, thermal systems, electronics, optics, and power systems. The resulting database is analyzed in terms of the specifications of the SSF EPS materials and subsystems and is found to be valuable in the design of control and protection features. Specific applications are listed for findings regarding the thermal environment, atomic oxygen, UV and ionizing radiation, debris, and contamination. The LDEF data are shown to have a considerable number of applications to the design and planning of the SSF and its EPS.

Value of electron beam tomography (EBT). II. non-cardiac applications and radiation exposure

International Nuclear Information System (INIS)

Enzweiler, C.N.H.; Lembcke, A.; Rogalla, P.; Taupitz, M.; Wiese, T.H.; Hamm, B.; Becker, C.R.; Bruening, R.; Reiser, M.F.; Schoepf, U.J.; Felix, R.; Knollmann, F.D.; Georgi, M.; Weisser, G.; Lehmann, K.J.

2004-01-01

Electron beam tomography (EBT) has been scientifically evaluated to a much lesser degree for non-cardiac indications than for cardiac purposes. Therefore, four groups of investigators in Berlin (2), Mannheim and Muenchen, which were supported by the Deutsche Forschungsgemeinschaft (DFG), included applications outside the heart in their evaluation of EBT technology. EBT has proven useful to look for pulmonary embolism and to assess other vessels (aorta, aortic branches, and intracranial arteries). Imaging of the lung parenchyma benefits from its intrinsic high contrast and from the fast data acquisition of EBT. Limited photon efficiency, higher radiation exposure, increased noise levels and other artifacts, however markedly reduce the value of EBT for imaging of low contrast objects compared to conventional spiral CT and multislice CT (MSCT), compromising, in particular, the morphologic depiction of parenchymal abdominal organs and the brain. Consequently, scientific studies to further evaluate EBT for scanning of the brain and parenchymal abdominal organs were not pursued. Radiation exposure for non-cardiac EBT studies is up to three times higher than that for respective spiral CT studies, and in children EBT can only be advocated in select cases. Radiation exposure for the various prospectively triggered cardiac examination protocols of EBT is lower than that for conventional coronary angiography. Radiation exposure in cardiac multislice CT exceeds severalfold that of EBT, but the dose efficiency of EBT and MSCT are similar due to higher spatial resolution and less image noise of MSCT. In addition, modifications of MSCT (ECG pulsing) can further reduce radiation exposure to the level of EBT. Technical improvements of the EBT successor scanner 'e-Speed' enable faster data acquisiton at higher spatial resolution. Within comparative studies, the 'e-Speed' will have to prove its value and competitiveness, particularly in comparison with multislice CT. After profound

Operator dermal exposure and protection provided by personal protective equipment and working coveralls during mixing/loading, application and sprayer cleaning in vineyards.

Science.gov (United States)

Thouvenin, Isabelle; Bouneb, Françoise; Mercier, Thierry

2017-06-01

The efficiency of a working coverall combined with personal protective equipment to protect operators against dermal exposure to plant protection products under field conditions was studied. Operators wore a non-certified water-repellent finish polyester/cotton coverall plus a certified gown during the mixing/loading and the cleaning phases. Insecticide foliar application to a vineyard was selected as the exposure scenario. The overall dermal residue levels measured in this study were in the range of data recently collected in Europe. The water-repellent finish working coverall reduced body exposure by a factor of approximately 95%. Wearing a Category III Type 3 partial body gown during mixing/loading and cleaning of the application equipment led to a further protective effect of 98.7%. The combination of a water-repellent finish working coverall and partial body protection during specific tasks provided satisfactory levels of protection and can be considered as suitable protection for the conditions of use studied.

Exposures of the elbow.

Science.gov (United States)

Axelrod, Terry S

2014-11-01

This article describes the basic bony, ligamentous, and neurologic anatomy of the structures about the elbow. The surgical exposures of the elbow joint are described, providing details of the various posterior, lateral, and medial approaches to the articular segments. Clinical applications describing the potential benefits of each surgical exposure are provided as examples. Copyright © 2014 Elsevier Inc. All rights reserved.

Phthalate exposure and childrens neurodevelopment: A systematic review

Energy Technology Data Exchange (ETDEWEB)

Ejaredar, Maede, E-mail: mejareda@ucalgary.ca [Department of Community Health Sciences, University of Calgary, Calgary, Alberta (Canada); Nyanza, Elias C. [Department of Community Health Sciences, University of Calgary, Calgary, Alberta (Canada); Ten Eycke, Kayla [Behavioral Research Unit, Department of Paediatrics, University of Calgary, Calgary, Alberta (Canada); Dewey, Deborah [Department of Community Health Sciences, University of Calgary, Calgary, Alberta (Canada); Behavioral Research Unit, Department of Paediatrics, University of Calgary, Calgary, Alberta (Canada); Alberta Children' s Hospital Research Institute for Child and Maternal Health, University of Calgary, Calgary, Alberta (Canada)

2015-10-15

Background: Emerging evidence from observational studies suggests that prenatal exposure to phthalates affects neurodevelopment in children. Objective: To conduct a systematic review of the existing literature on the association between urinary phthalate concentrations and children's neurodevelopment. Methods: We searched electronic bibliographic databases (MEDLINE, PubMed, EMBASE, PsycINFO, CINAHL, Global Health, CAB abstracts, and ERIC) (1910 to February 21st, 2014); reference lists of included articles, and conference abstracts (American Psychiatric Association, American Academy of Neurology, and Pediatric Academic Societies). Two independent reviewers screened abstracts and extracted data. We included original studies reporting on the association between prenatal or childhood urinary phthalate metabolites, and cognitive and behavioral outcomes (e.g., IQ scores, BASC-2 scores or equivalent) in children 0–12 years of age. Results: Of 2804 abstracts screened, 11 original articles met our criteria for inclusion. Conclusions: A systematic review of the literature supports the contention that prenatal exposure phthalates is associated with adverse cognitive and behavioral outcomes in children, including lower IQ, and problems with attention, hyperactivity, and poorer social communication. Further research characterizing the associations between specific phthalate metabolites and children's neurodevelopmental outcomes is needed to support the development of mitigation strategies and enhance the development of appropriate health policy. - Highlights: • Prenatal maternal urinary concentrations of phthalate metabolites appear to be associated with adverse cognitive and behavioral outcomes in children. • Both low molecular weight (e.g., monobutyl phthalate, MBP) and high molecular weight (e.g., di(2-ethylhexyl) phthalate, DEHP) phthalate metabolites are associated with adverse cognitive and behavioral outcomes. • Sex-specific effects from phthalate

Phthalate exposure and childrens neurodevelopment: A systematic review

International Nuclear Information System (INIS)

Ejaredar, Maede; Nyanza, Elias C.; Ten Eycke, Kayla; Dewey, Deborah

2015-01-01

Background: Emerging evidence from observational studies suggests that prenatal exposure to phthalates affects neurodevelopment in children. Objective: To conduct a systematic review of the existing literature on the association between urinary phthalate concentrations and children's neurodevelopment. Methods: We searched electronic bibliographic databases (MEDLINE, PubMed, EMBASE, PsycINFO, CINAHL, Global Health, CAB abstracts, and ERIC) (1910 to February 21st, 2014); reference lists of included articles, and conference abstracts (American Psychiatric Association, American Academy of Neurology, and Pediatric Academic Societies). Two independent reviewers screened abstracts and extracted data. We included original studies reporting on the association between prenatal or childhood urinary phthalate metabolites, and cognitive and behavioral outcomes (e.g., IQ scores, BASC-2 scores or equivalent) in children 0–12 years of age. Results: Of 2804 abstracts screened, 11 original articles met our criteria for inclusion. Conclusions: A systematic review of the literature supports the contention that prenatal exposure phthalates is associated with adverse cognitive and behavioral outcomes in children, including lower IQ, and problems with attention, hyperactivity, and poorer social communication. Further research characterizing the associations between specific phthalate metabolites and children's neurodevelopmental outcomes is needed to support the development of mitigation strategies and enhance the development of appropriate health policy. - Highlights: • Prenatal maternal urinary concentrations of phthalate metabolites appear to be associated with adverse cognitive and behavioral outcomes in children. • Both low molecular weight (e.g., monobutyl phthalate, MBP) and high molecular weight (e.g., di(2-ethylhexyl) phthalate, DEHP) phthalate metabolites are associated with adverse cognitive and behavioral outcomes. • Sex-specific effects from phthalate

Effects of exposure estimation errors on estimated exposure-response relations for PM2.5.

Science.gov (United States)

Cox, Louis Anthony Tony

2018-07-01

Associations between fine particulate matter (PM2.5) exposure concentrations and a wide variety of undesirable outcomes, from autism and auto theft to elderly mortality, suicide, and violent crime, have been widely reported. Influential articles have argued that reducing National Ambient Air Quality Standards for PM2.5 is desirable to reduce these outcomes. Yet, other studies have found that reducing black smoke and other particulate matter by as much as 70% and dozens of micrograms per cubic meter has not detectably affected all-cause mortality rates even after decades, despite strong, statistically significant positive exposure concentration-response (C-R) associations between them. This paper examines whether this disconnect between association and causation might be explained in part by ignored estimation errors in estimated exposure concentrations. We use EPA air quality monitor data from the Los Angeles area of California to examine the shapes of estimated C-R functions for PM2.5 when the true C-R functions are assumed to be step functions with well-defined response thresholds. The estimated C-R functions mistakenly show risk as smoothly increasing with concentrations even well below the response thresholds, thus incorrectly predicting substantial risk reductions from reductions in concentrations that do not affect health risks. We conclude that ignored estimation errors obscure the shapes of true C-R functions, including possible thresholds, possibly leading to unrealistic predictions of the changes in risk caused by changing exposures. Instead of estimating improvements in public health per unit reduction (e.g., per 10 µg/m 3 decrease) in average PM2.5 concentrations, it may be essential to consider how interventions change the distributions of exposure concentrations. Copyright © 2018 Elsevier Inc. All rights reserved.

Lifestyle and IVF Outcomes.

Science.gov (United States)

Hornstein, Mark D

2016-12-01

Whereas much has been written about the prognostic factors associated with outcomes of in vitro fertilization (IVF) such as female age, diagnosis, and ovarian reserve, relatively little attention has been devoted to patient-oriented lifestyles that may influence IVF outcomes. Patients are particularly interested in this topic because many patients wish to partner with their physicians and want to know specific behaviors to improve their chances of IVF success. This brief review is not intended as an exhaustive literature search of all possible lifestyles that may influence assisted reproductive outcome nor is it intended to be a comprehensive review of individual topics. It does give, however, a brief overview of a number of areas in which patient-specific behaviors may influence outcomes in assisted reproduction. Specifically, this review will look at the effects of smoking, alcohol consumption, caffeine, diet, exercise, and exposure to the reproductive toxin bisphenol A on IVF outcomes. © The Author(s) 2016.

Hydrocarbon solvent exposure data: compilation and analysis of the literature.

Science.gov (United States)

Caldwell, D J; Armstrong, T W; Barone, N J; Suder, J A; Evans, M J

2000-01-01

An occupational exposure database for hydrocarbon solvent end-use applications was constructed from the published literature. The database provides exposure assessment information for such purposes as regulatory risk assessments, support of industry product stewardship initiatives, and identification of applications in which limited exposure data are available. It is quantitative, documented, and based on credible data. Approximately 350 articles containing quantitative hydrocarbon solvent exposure data were identified using a search of computer databases of published literature. Many articles did not report sufficient details of the exposure data for inclusion in the database (e.g., full-shift exposure or task-based exposure data). Others were excluded because only limited summary statistics were provided, which precluded statistical analysis of the data (e.g., arithmetic mean concentration presented, but no sample number). Following evaluation, 16,880 hydrocarbon solvent exposure measurements from 99 articles were entered into a database for analysis. Methods used to identify and evaluate published solvent exposure data are described along with more detailed analysis of worker exposure to hydrocarbon solvents in three major end-use applications: painting and coating, printing, and adhesives. Solvent exposures were evaluated against current ACGIH threshold limit values (TLVs) and trends were identified. Limited quantitative data are available prior to 1970. In general, reported hydrocarbon solvent exposures decreased fourfold from 1960 to 1998, were below the TLVs applicable to specific hydrocarbon solvents at the time, and on average have been below 40% of the TLV since 1980. The database already has proved valuable; however, the utility of published exposure data could be further improved if authors consistently reported essential data elements and supporting information.

Exposure-in-vivo containing interventions to improve work functioning of workers with anxiety disorder: a systematic review

Directory of Open Access Journals (Sweden)

Nieuwenhuijsen Karen

2010-10-01

Full Text Available Abstract Background Anxiety disorders are associated with functional disability, sickness absence, and decreased productivity. Effective treatments of anxiety disorders can result in remission of symptoms. However the effects on work related outcomes are largely unknown. Exposure in vivo is potentially well fit to improve work-related outcomes. This study systematically reviews the effectiveness of exposure-in-vivo containing interventions in reducing work-related adverse outcomes in workers with anxiety disorders. Methods A systematic study search was conducted in Medline, Cinahl, Embase and Psycinfo. Two reviewers independently extracted data and from each study assessed the quality of evidence by using the GRADE approach. We performed a meta-analysis if data showed sufficient clinical homogeneity. Results Seven studies containing 11 exposure-in-vivo interventions were included. Four studies were focused on Obsessive Compulsive Disorder (OCD, two on Post Traumatic Stress Disorder (PTSD, and one on a mixed group of OCD and severe phobias. The studies were grouped according to type of anxiety disorder and subsequently according to type of comparisons. For OCD, exposure-in-vivo containing interventions can yield better work-related outcomes compared to medication (SSRIs and relaxation but not better compared to response prevention. The results on anxiety outcomes were similar. The net contribution of exposure in vivo in two OCD intervention programs is also presented as a meta-analysis and shows significant positive results on work role limitations. The calculated pooled effect size with 95% confidence interval was 0.72 (0.28, 1.15. For PTSD, exposure-in-vivo containing interventions can yield better work-related and anxiety-related outcomes compared to a waiting-list but not better compared to imaginal exposure. Conclusions Exposure in vivo as part of an anxiety treatment can reduce work-related adverse outcomes in workers with OCD and PTSD

Evaluating PTSD on Reproductive Outcomes: Women Deployed in Iraq and Afghanistan

Science.gov (United States)

2009-10-01

Center attacks and its effect on pregnancy outcome . Paediatric and Perinatal Epidemiology, 2005. 19(5): p. 334-41. 6. Xiong, X., et al., Exposure ...health system. Thus, the effect of women’s military service on reproductive outcomes is a key concern. Due to the unique situation of women in the... exposure to PTSD as a consequence of deployment is one example of recent concern. A recent study found women who had deployed to Iraq/Afghanistan

Agricultural pesticide use and adverse birth outcomes in the San Joaquin Valley of California.

Science.gov (United States)

Larsen, Ashley E; Gaines, Steven D; Deschênes, Olivier

2017-08-29

Virtually all agricultural communities worldwide are exposed to agricultural pesticides. Yet, the health consequences of such exposure are poorly understood, and the scientific literature remains ambiguous. Using individual birth and demographic characteristics for over 500 000 birth observations between 1997-2011 in the agriculturally dominated San Joaquin Valley, California, we statistically investigate if residential agricultural pesticide exposure during gestation, by trimester, and by toxicity influences birth weight, gestational length, or birth abnormalities. Overall, our analysis indicates that agricultural pesticide exposure increases adverse birth outcomes by 5-9%, but only among the population exposed to very high quantities of pesticides (e.g., top 5th percentile, i.e., ~4200 kg applied over gestation). Thus, policies and interventions targeting the extreme right tail of the pesticide distribution near human habitation could largely eliminate the adverse birth outcomes associated with agricultural pesticide exposure documented in this study.The health consequences of exposure to pesticides are uncertain and subject to much debate. Here, the effect of exposure during pregnancy is investigated in an agriculturally dominated residential area, showing that an increase in adverse birth outcomes is observed with very high levels of pesticide exposure.

Prenatal cocaine exposure and neonatal/infant outcomes.

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Cambell, Shelly

2003-01-01

Illegal drug use throughout the nation is a problem of epidemic proportion. Of particular concern is drug use among pregnant women. In most cases, these women have little hope of achieving a better life for themselves or their children. Illegal drugs, cocaine in particular, can have devastating effects on the neonate. These effects can last well into childhood and can exhibit themselves in academic, social, and family situations. Challenges for the neonatal nurse include early identification of these infants and use of available resources. This article addresses prenatal cocaine use and support services for drug-dependent women, effects of cocaine during the neonatal period, possible neonatal and infant outcomes, and implications for nursing practice.

Occupational exposure to electromagnetic fields in physiotherapy departments

International Nuclear Information System (INIS)

Macca, I.; Scapellato, M. L.; Carrieri, M.; Di Bisceglie, A. P.; Saia, B.; Bartolucci, G. B.

2008-01-01

To assess occupational exposure to electromagnetic fields, 11 microwave (MW), 4 short-wave diathermy and 15 magneto therapy devices were analysed in eight physiotherapy departments. Measurements taken at consoles and environmental mapping showed values above European Directive 2004/40/EC and ACGIH exposure limits at ∼50 cm from MW applicators (2.45 GHz) and above the Directive magnetic field limit near the diathermy unit (27.12 MHz). Levels in front of MW therapy applicators decreased rapidly with distance and reduction in power; this may not always occur in work environments where nearby metal structures (chairs, couches, etc.) may reflect or perturb electromagnetic fields. Large differences in stray field intensities were found for various MW applicators. Measurements of power density strength around MW electrodes confirmed radiation fields between 30 deg. and 150 deg., with a peak at 90 deg., in front of the cylindrical applicator and maximum values between 30 deg. and 150 deg. over the whole range of 180 deg. for the rectangular parabolic applicator. Our results reveal that although most areas show substantially low levels of occupational exposure to electromagnetic fields in physiotherapy units, certain cases of over-occupational exposure limits do exist. (authors)

Assessing the risk to green sturgeon from application of imidacloprid to control burrowing shrimp in Willapa Bay, Washington--Part II: controlled exposure studies.

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Frew, John A; Grue, Christian E

2015-11-01

The activities of 2 species of burrowing shrimp have a negative impact on the growth and survival of oysters reared on intertidal mudflats in Willapa Bay and Grays Harbor, Washington (USA). To maintain viable harvests, oyster growers proposed the application of the neonicotinoid insecticide imidacloprid onto harvested beds for the control of burrowing shrimp. In test applications, water column concentrations of imidacloprid were relatively low and dissipated rapidly. The foraging activities of the green sturgeon (listed in the US Endangered Species Act) could result in exposure to higher, more sustained imidacloprid concentrations within sediment porewater and from the consumption of contaminated shrimp. Controlled experiments were conducted using surrogate white sturgeon to determine acute and chronic effect concentrations, to examine overt effects at more environmentally realistic concentrations and durations of exposure, and to assess chemical depuration. The 96-h median lethal concentration was 124 mg L(-1) , and the predicted 35-d no-observed-adverse-effect concentration was 0.7 mg L(-1) . No overt effects were observed following environmentally relevant exposures. Imidacloprid half-life in plasma was greater than 32 h. Measured concentrations of imidacloprid in porewater were significantly lower than the derived acute and chronic effect concentrations for white sturgeon. Exposure risk quotients were calculated using the effect concentrations and estimated environmental exposure. The resulting values were considerably below the level of concern for direct effects from either acute or chronic exposure to an endangered species. © 2015 SETAC.

Potential exposures and risks from beryllium-containing products.

Science.gov (United States)

Willis, Henry H; Florig, H Keith

2002-10-01

Beryllium is the strongest of the lightweight metals. Used primarily in military applications prior to the end of the Cold War, beryllium is finding new applications in many commercial products, including computers, telecommunication equipment, and consumer and automotive electronics. The use of beryllium in nondefense consumer applications is of concern because beryllium is toxic. Inhalation of beryllium dust or vapor causes a chronic lung disease in some individuals at concentrations as low as 0.01 microg/m3 in air. As beryllium enters wider commerce, it is prudent to ask what risks this might present to the general public and to workers downstream of the beryllium materials industry. We address this question by evaluating the potential for beryllium exposure from the manufacturing, use, recycle, and disposal of beryllium-containing products. Combining a market study with a qualitative exposure analysis, we determine which beryllium applications and life cycle phases have the largest exposure potential. Our analysis suggests that use and maintenance of the most common types of beryllium-containing products do not result in any obvious exposures of concern, and that maintenance activities result in greater exposures than product use. Product disposal has potential to present significant individual risks, but uncertainties concerning current and future routes of product disposal make it difficult to be definitive. Overall, additional exposure and dose-response data are needed to evaluate both the health significance of many exposure scenarios, and the adequacy of existing regulations to protect workers and the public. Although public exposures to beryllium and public awareness and concern regarding beryllium risks are currently low, beryllium risks have psychometric qualities that may lead to rapidly heightened public concern.

Applicant attraction to organizations and job choice: a meta-analytic review of the correlates of recruiting outcomes.

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Chapman, Derek S; Uggerslev, Krista L; Carroll, Sarah A; Piasentin, Kelly A; Jones, David A

2005-09-01

Attracting high-performing applicants is a critical component of personnel selection and overall organizational success. In this study, the authors meta-analyzed 667 coefficients from 71 studies examining relationships between various predictors with job-organization attraction, job pursuit intentions, acceptance intentions, and job choice. The moderating effects of applicant gender, race, and applicant versus nonapplicant status were also examined. Results showed that applicant attraction outcomes were predicted by job-organization characteristics, recruiter behaviors, perceptions of the recruiting process, perceived fit, and hiring expectancies, but not recruiter demographics or perceived alternatives. Path analyses showed that applicant attitudes and intentions mediated the predictor-job choice relationships. The authors discuss the implications of these findings for recruiting theory, research, and practice. Copyright 2005 APA, all rights reserved.

Effect of Intraoperative mitomycin-c application in outcome of external dacryocystorhinostomy

International Nuclear Information System (INIS)

Jawad, M.; Ali, Z.; Aftab, H.

2015-01-01

Background: Patients develop postoperative fibrosis at the site of operation after dacryocystorhinostomy (DCR) which results in impairment of the osteum patency. This quasi-experimental study was undertaken to determine the role of intraoperative Mitomycin C (MMC) application in maintaining postoperative patency of the osteum. Methodology: The present study was conducted at the Eye department of Ayub Medical College, Abbottabad on patients in whom routine DCR was indicated. Subjects were divided into mitomycin C (Test) and non mitomycin C (Control) groups. In test group, Mitomycin C was applied to the anastomosed flaps and osteotomy site for 30 minutes. Postoperative patients were followed for up to 6 months and outcome of patency was documented. Results: A.total of 73 patients were included, divided into test (30) and control (43) groups. An overall success rate of 86.3 percentage was obtained for patent ostia; this was based on 96.67 percentage success in test group compared to 79.1 percentage in the control group (p=0.031). Conclusion: Intraoperative application of Mitomycin-C significantly improves the success rate in external dacryocystorhinostomy. (author)

Pediatric Exposure to E-Cigarettes, Nicotine, and Tobacco Products in the United States.

Science.gov (United States)

Kamboj, Alisha; Spiller, Henry A; Casavant, Marcel J; Chounthirath, Thiphalak; Smith, Gary A

2016-06-01

To investigate the epidemiologic characteristics and outcomes of exposures to electronic cigarettes (e-cigarettes), nicotine, and tobacco products among young children in the United States. A retrospective analysis of exposures associated with nicotine and tobacco products among children younger than 6 years old was conducted by using National Poison Data System data. From January 2012 through April 2015, the National Poison Data System received 29 141 calls for nicotine and tobacco product exposures among children younger than 6 years, averaging 729 child exposures per month. Cigarettes accounted for 60.1% of exposures, followed by other tobacco products (16.4%) and e-cigarettes (14.2%). The monthly number of exposures associated with e-cigarettes increased by 1492.9% during the study period. Children e-cigarettes had 5.2 times higher odds of a health care facility admission and 2.6 times higher odds of having a severe outcome than children exposed to cigarettes. One death occurred in association with a nicotine liquid exposure. The frequency of exposures to e-cigarettes and nicotine liquid among young children is increasing rapidly and severe outcomes are being reported. Swift government action is needed to regulate these products to help prevent child poisoning. Prevention strategies include public education; appropriate product storage and use away from children; warning labels; and modifications of e-cigarette devices, e-liquid, and e-liquid containers and packaging to make them less appealing and less accessible to children. Copyright © 2016 by the American Academy of Pediatrics.

Complexities of sibling analysis when exposures and outcomes change with time and birth order

OpenAIRE

Sudan, M; Kheifets, LI; Arah, OA; Divan, HA; Olsen, J

2014-01-01

In this study, we demonstrate the complexities of performing a sibling analysis with a re-examination of associations between cell phone exposures and behavioral problems observed previously in the Danish National Birth Cohort. Children (52,680; including 5441 siblings) followed up to age 7 were included. We examined differences in exposures and behavioral problems between siblings and non-siblings and by birth order and birth year. We estimated associations between cell phone exposures and b...

Environmental radioactivity and radiation exposure

International Nuclear Information System (INIS)

1980-01-01

In 1977 population exposure in the Federal Republic of Germany has not changed as compared to the previous years. The main share of the total exposure, nearly two thirds, is attributed to natural radioactive substances and cosmic radiation. The largest part (around 85%) of the artificial radiation exposure is caused by X-ray diagnostics. In comparison to this, radiation exposure from application of ionizing radiation in medical therapy, use of radioactive material in research and technology, or from nuclear facilities is small. As in the years before, population exposure caused by nuclear power plants and other nuclear facilities is distinctly less than 1% of the natural radiation exposure. This is also true for the average radiation exposure within a radius of 3 km around nuclear facilities. On the whole, the report makes clear that the total amount of artificial population exposure will substantially decrease only if one succeeds in reducing the high contribution to the radiation exposure caused by medical measures. (orig.) [de

Identification of fipronil metabolites by time-of-flight mass spectrometry for application in a human exposure study.

Science.gov (United States)

McMahen, Rebecca L; Strynar, Mark J; Dagnino, Sonia; Herr, David W; Moser, Virginia C; Garantziotis, Stavros; Andersen, Erik M; Freeborn, Danielle L; McMillan, Larry; Lindstrom, Andrew B

2015-05-01

Fipronil is a phenylpyrazole insecticide commonly used in residential and agricultural applications. To understand more about the potential risks for human exposure associated with fipronil, urine and serum from dosed Long Evans adult rats (5 and 10mg/kg bw) were analyzed to identify metabolites as potential biomarkers for use in human biomonitoring studies. Urine from treated rats was found to contain seven unique metabolites, two of which had not been previously reported-M4 and M7 which were putatively identified as a nitroso compound and an imine, respectively. Fipronil sulfone was confirmed to be the primary metabolite in rat serum. The fipronil metabolites identified in the respective matrices were then evaluated in matched human urine (n=84) and serum (n=96) samples from volunteers with no known pesticide exposures. Although no fipronil or metabolites were detected in human urine, fipronil sulfone was present in the serum of approximately 25% of the individuals at concentrations ranging from 0.1 to 4ng/mL. These results indicate that many fipronil metabolites are produced following exposures in rats and that fipronil sulfone is a useful biomarker in human serum. Furthermore, human exposure to fipronil may occur regularly and require more extensive characterization. Published by Elsevier Ltd.

Radiation protection: occupational exposure

International Nuclear Information System (INIS)

Shah, G.A.

1990-01-01

The basis of the occupational exposure limit of 50 mSv recommended by the ICRP is questioned. New dosimetry at Hiroshima and Nagasaki, the fact that the dose-response curve may be non-linear and that the relative risk model may be applicable, are some of the arguments advanced to support a reduction in the occupational exposure dose limits. 5 refs., 2 tabs., 3 figs

Analysis of Longitudinal Studies With Repeated Outcome Measures: Adjusting for Time-Dependent Confounding Using Conventional Methods.

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Keogh, Ruth H; Daniel, Rhian M; VanderWeele, Tyler J; Vansteelandt, Stijn

2018-05-01

Estimation of causal effects of time-varying exposures using longitudinal data is a common problem in epidemiology. When there are time-varying confounders, which may include past outcomes, affected by prior exposure, standard regression methods can lead to bias. Methods such as inverse probability weighted estimation of marginal structural models have been developed to address this problem. However, in this paper we show how standard regression methods can be used, even in the presence of time-dependent confounding, to estimate the total effect of an exposure on a subsequent outcome by controlling appropriately for prior exposures, outcomes, and time-varying covariates. We refer to the resulting estimation approach as sequential conditional mean models (SCMMs), which can be fitted using generalized estimating equations. We outline this approach and describe how including propensity score adjustment is advantageous. We compare the causal effects being estimated using SCMMs and marginal structural models, and we compare the two approaches using simulations. SCMMs enable more precise inferences, with greater robustness against model misspecification via propensity score adjustment, and easily accommodate continuous exposures and interactions. A new test for direct effects of past exposures on a subsequent outcome is described.

Pesticide exposure and end-stage renal disease risk among wives of pesticide applicators in the Agricultural Health Study.

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Lebov, Jill F; Engel, Lawrence S; Richardson, David; Hogan, Susan L; Sandler, Dale P; Hoppin, Jane A

2015-11-01

Pesticide exposure has been found to cause renal damage and dysfunction in experimental studies, but epidemiological research on the renal effects of chronic low-level pesticide exposure is limited. We investigated the relationships between end-stage renal disease (ESRD) among wives of licensed pesticide applicators (N=31,142) in the Agricultural Health Study (AHS) and (1) personal pesticide use, (2) exposure to the husband's pesticide use, and (3) other pesticide-associated farming and household activities. AHS participants reported pesticide exposure via self-administered questionnaires at enrollment (1993-1997). ESRD cases were identified via linkage to the United States Renal Data System. Associations between ESRD and pesticide exposures were estimated with Cox proportional hazard regression models controlling for age at enrollment. Models of associations with farming and household factors were additionally adjusted for personal use of pesticides. We identified 98 ESRD cases diagnosed between enrollment and 31 December 2011. Although women who ever applied pesticides (56% of cohort) were less likely than those who did not apply to develop ESRD (Hazard Ratio (HR): 0.42; 95% CI: 0.28, 0.64), among women who did apply pesticides, the rate of ESRD was significantly elevated among those who reported the highest (vs. lowest) cumulative general pesticide use (HR: 4.22; 95% CI: 1.26, 14.20). Among wives who never applied pesticides, ESRD was associated with husbands' ever use of paraquat (HR=1.99; 95% CI: 1.14, 3.47) and butylate (HR=1.71; 95% CI: 1.00, 2.95), with a positive exposure-response pattern for husband's cumulative use of these pesticides. ESRD may be associated with direct and/or indirect exposure to pesticides among farm women. Future studies should evaluate indirect exposure risk among other rural populations. Published by Elsevier Inc.

Use of dose constraints in public exposure

International Nuclear Information System (INIS)

Tageldein, Amged

2015-02-01

An overview of the dose constraints in public exposures has been carried out in this project. The establishment, development and the application of the concept of dose constraints are reviewed with regards to public exposure. The role of dose constraints in the process of optimization of radiation protection was described and has been showed that the concept of the dose constraints along with many other concept of radiation protection is widely applied in the optimization of exposure to radiation. From the beginning of the establishment of dose constraints as a concept in radiation protection, the International Commission of Radiological Protection (ICRP) has published a number of documents that provides detailed application related to radiation protection and safety of public exposure from ionizing radiation. This work provides an overview of such publications and related documents with special emphasis on optimization of public exposure using dose constraints. (au)

A paediatric X-ray exposure chart

Energy Technology Data Exchange (ETDEWEB)

Knight, Stephen P, E-mail: stephen.knight@health.qld.gov.au [Department of Medical Imaging, Royal Children' s Hospital, Brisbane, Queensland (Australia)

2014-09-15

The aim of this review was to develop a radiographic optimisation strategy to make use of digital radiography (DR) and needle phosphor computerised radiography (CR) detectors, in order to lower radiation dose and improve image quality for paediatrics. This review was based on evidence-based practice, of which a component was a review of the relevant literature. The resulting exposure chart was developed with two distinct groups of exposure optimisation strategies – body exposures (for head, trunk, humerus, femur) and distal extremity exposures (elbow to finger, knee to toe). Exposure variables manipulated included kilovoltage peak (kVp), target detector exposure and milli-ampere-seconds (mAs), automatic exposure control (AEC), additional beam filtration, and use of antiscatter grid. Mean dose area product (DAP) reductions of up to 83% for anterior–posterior (AP)/posterior–anterior (PA) abdomen projections were recorded postoptimisation due to manipulation of multiple-exposure variables. For body exposures, the target EI and detector exposure, and thus the required mAs were typically 20% less postoptimisation. Image quality for some distal extremity exposures was improved by lowering kVp and increasing mAs around constant entrance skin dose. It is recommended that purchasing digital X-ray equipment with high detective quantum efficiency detectors, and then optimising the exposure chart for use with these detectors is of high importance for sites performing paediatric imaging. Multiple-exposure variables may need to be manipulated to achieve optimal outcomes.

Neonatal outcome following exposure to organophosphorous pesticides

Directory of Open Access Journals (Sweden)

Đorđević M.

2010-01-01

Full Text Available The aim of our study was to determine the neonatal outcome in mothers and children exposed to organophosphorous pesticides (OP. We found that 22.4% pregnant women were exposed to organophosphorous pesticides. OP pesticide concentration was higher in breast milk, newborn sera than maternal sera. Newborn parameters such as birth weight, birth length, head circumference, Apgar score and presence of meconium, as well as gestational age of delivery, showed no significant difference between the two groups. However, postpartum weight loss, hospitalization duration, levels of newborn bilirubin and glycaemia differed significantly between the two groups. Morbidity and presence of CNS disorders were six times and more than twelve times higher, respectively, in the OP-exposed than in the OP pesticide non-exposed group.

Risks to the offspring from parental occupational exposures

International Nuclear Information System (INIS)

Haas, J.F.; Schottenfeld, D.

1979-01-01

Risks to the offspring of workers with occupational chemical exposures may derive from mutagenic, teratogenic or carcinogenic effects of industrial agents to which the parents are exposed. Evidence for impaired pregnancies and hazards to the offspring of working populations with chemical exposures is, however, very limited. Evidence is reviewed for hazards to the offspring resulting from parental occupational exposure to vinyl chloride, benzene, chloroprene, radiation and petroleum-derived hydrocarbons. Other environmental and behavioral factors with major effects on pregnancy outcome are considered. These include smoking, alcohol, and drug exposures. An approach to surveillance for chromosomal abnormalities in offspring of occupationally exposed parents is outlined

Early childhood exposure to media violence: What parents and policymakers ought to know

Directory of Open Access Journals (Sweden)

Caroline Fitzpatrick

2016-11-01

Full Text Available We review the state of evidence supporting a link between violent media exposure in preschool- aged children and subsequent well-being outcomes. We searched through four decades (1971–2011 of literature for enlightening details on the relationship between early exposure to media violence and health outcomes in later childhood and adolescence. Evidence suggests that preschool exposure may be linked to increased aggression and self-regulation problems. Results are discussed in the context of displacement, social cognitive and overstimulation theories. We recommend increasing efforts towards developing guidelines for families and professionals concerned with the well-being of children.

Association of Neurodevelopmental Outcomes and Neonatal Morbidities of Extremely Premature Infants With Differential Exposure to Antenatal Steroids.

Science.gov (United States)

Chawla, Sanjay; Natarajan, Girija; Shankaran, Seetha; Pappas, Athina; Stoll, Barbara J; Carlo, Waldemar A; Saha, Shampa; Das, Abhik; Laptook, Abbot R; Higgins, Rosemary D

2016-12-01

Many premature infants are born without exposure to antenatal steroids (ANS) or with incomplete courses. This study evaluates the dose-dependent effect of ANS on rates of neonatal morbidities and early childhood neurodevelopmental outcomes of extremely premature infants. To compare rates of neonatal morbidities and 18- to 22-month neurodevelopmental outcomes of extremely premature infants exposed to no ANS or partial or complete courses of ANS. In this observational cohort study, participants were extremely premature infants (birth weight range, 401-1000 g; gestational age, 22-27 weeks) who were born at participating centers of the National Institute of Child Health and Human Development Neonatal Research Network between January 2006 and December 2011. Data were analyzed between October 2013 and May 2016. Rates of death or neurodevelopmental impairment at 18 to 22 months' corrected age. Neurodevelopmental impairment was defined as the presence of any of the following: moderate to severe cerebral palsy, a cognitive score less than 85 on the Bayley Scales of Infant and Toddler Development III, blindness, or deafness. There were 848 infants in the no ANS group, 1581 in the partial ANS group, and 3692 in the complete ANS group; the mean (SD) birth weights were 725 (169), 760 (173), and 753 (170) g, respectively, and the mean (SD) gestational ages were 24.5 (1.4), 24.9 (2), and 25.1 (1.1) weeks. Of 6121 eligible infants, 4284 (70.0%) survived to 18- to 22-month follow-up, and data were available for 3892 of 4284 infants (90.8%). Among the no, partial, and complete ANS groups, there were significant differences in the rates of mortality (43.1%, 29.6%, and 25.2%, respectively), severe intracranial hemorrhage among survivors (23.3%, 19.1%, and 11.7%), death or necrotizing enterocolitis (48.1%, 37.1%, and 32.5%), and death or bronchopulmonary dysplasia (74.9%, 68.9%, and 65.5%). Additionally, death or neurodevelopmental impairment occurred in 68.1%, 54.4%, and 48.1% of

Effect of prenatal alcohol exposure on childhood academic outcomes: contrasting maternal and paternal associations in the ALSPAC study.

Directory of Open Access Journals (Sweden)

Rosa Alati

Full Text Available The impact of low-to-moderate levels of alcohol consumption during pregnancy on child cognitive outcomes has been of recent concern. This study has tested the hypothesis that low-to-moderate maternal alcohol use in pregnancy is associated with lower school test scores at age 11 in the offspring via intrauterine mechanisms.We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC, a birth cohort study based in the South West of England. Analyses were conducted on 7062 participants who had complete data on: maternal and paternal patterns of alcohol use in the first trimester and at 18 weeks' gestation, child's academic outcomes measured at age 11, gender, maternal age, parity, marital status, ethnicity, household crowding, home ownership status and parental education. We contrasted the association of mother's alcohol consumption during pregnancy with child's National Curriculum Key Stage 2 (KS2 test scores with the association for father's alcohol consumption (during the time the mother was pregnant with child's National Curriculum Key Stage 2 (KS2 test scores. We used multivariate linear regression to estimate mean differences and 95% confidence intervals [CI] in KS2 scores across the exposure categories and computed f statistics to compare maternal and paternal associations.Drinking up to 1 unit of alcohol a day during pregnancy was not associated with lower test scores. However, frequent prenatal consumption of 4 units (equivalent to 32 grams of alcohol on each single drinking occasion was associated with reduced educational attainment [Mean change in offspring KS2 score was -0.68 (-1.03, -0.33 for maternal alcohol categories compared to 0.27 (0.07, 0.46 for paternal alcohol categories]. Frequent consumption of 4 units of alcohol during pregnancy may adversely affect childhood academic outcomes via intrauterine mechanisms.

Recent Progress in Virtual Reality Exposure Therapy for Phobias: A Systematic Review.

Science.gov (United States)

Botella, Cristina; Fernández-Álvarez, Javier; Guillén, Verónica; García-Palacios, Azucena; Baños, Rosa

2017-07-01

This review is designed to systematically examine the available evidence about virtual reality exposure therapy's (VRET) efficacy for phobias, critically describe some of the most important challenges in the field and discuss possible directions. Evidence reveals that virtual reality (VR) is an effective treatment for phobias and useful for studying specific issues, such as pharmacological compounds and behavioral manipulations, that can enhance treatment outcomes. In addition, some variables, such as sense of presence in virtual environments, have a significant influence on outcomes, but further research is needed to better understand their role in therapeutic outcomes. We conclude that VR is a useful tool to improve exposure therapy and it can be a good option to analyze the processes and mechanisms involved in exposure therapy and the ways this strategy can be enhanced. In the coming years, there will be a significant expansion of VR in routine practice in clinical contexts.

Prenatal cigarette smoke exposure: Pregnancy outcome and gestational changes in plasma nicotine concentration, hematocrit, and carboxyhemoglobin in a newly standardized rat model

International Nuclear Information System (INIS)

Farkas, Svetlana; Hussein, Jabeen; Ariano, Robert E.; Sitar, Daniel S.; Hasan, Shabih U.

2006-01-01

Epidemiological studies support an association between perinatal cigarette smoke (CS) exposure and a number of severe pre- and postnatal complications. However, the mechanisms through which CS enhances such risks largely remain unknown. One of the reasons for our inability to discover such mechanisms has been the unavailability of a clinically relevant and physiologically concordant animal model. A number of studies have previously used nicotine (Nic) as surrogate for CS. We sought to (1) establish the amount of CS exposure to achieve plasma Nic concentrations observed among moderate to heavy smokers (20-60 ng/ml) (2) investigate the temporal changes in plasma Nic concentrations, carboxyhemoglobin, and hematocrit with advancing pregnancy, and (3) elucidate the effects of CS exposure on pregnancy outcome. Pregnant Sprague-Dawley rats were exposed to various doses of CS or room air (Sham) from days 6 to 21 of gestation. Exposure to 6000 ml/day of CS led to very high plasma Nic concentrations and increased maternal and fetal mortality (P < 0.001). The plasma Nic concentrations remained higher than those observed in moderate smokers until the CS dose was reduced to 1000 ml/day and showed dose-dependent temporal changes with advancing gestational age. Significant increases in carboxyhemoglobin and hematocrit were observed in the CS group as compared with the Sham group (P < 0.001). In addition, prenatally CS exposed fetuses had lower birth weight as compared with the Sham group (P = 0.04). Our current study establishes a newly standardized and physiologically relevant model to investigate the mechanisms of CS-mediated adverse effects during the critical period of fetal development

Eslicarbazepine acetate exposure in pregnant women with epilepsy.

Science.gov (United States)

Costa, Raquel; Magalhães, Luís M; Graça, Joana; Vieira, Mariana; Gama, Helena; Moreira, Joana; Rocha, José F; Soares-da-Silva, Patrício

2018-05-01

Epilepsy is a common neurologic disorder requiring continued treatment during pregnancy. Treatment with antiepileptic drugs (AEDs) is needed for seizure control, but the risk of adverse events has to be minimized for both mother and foetus. Available data on pregnancy and foetal/postnatal outcomes following eslicarbazepine acetate (ESL) exposure via parent is herein presented for the first time. ESL's global safety database was reviewed to identify pregnancy cases with exposure to ESL reported up to October 21st, 2017. The EMBASE™ and MEDLINE ® databases were searched to identify literature reports of such cases published between May 1st, 2009 and October 21st, 2017. Overall, 91 notifications of pregnancy were identified, of which 79 involved ESL exposure: 28 during clinical trials and 51 from 8-years of post-marketing surveillance. Thirty pregnancies resulted in live birth without congenital anomalies; in 25 pregnancies the outcome was ongoing and 3 was unknown; 18 cases resulted in abortion (10 spontaneous and 8 induced) and congenital anomalies were identified in 5 cases (no clear relationship with ESL was established). ESL was used concomitantly to other AEDs in 11 of the 15 pregnancies for which the outcome was spontaneous abortion and congenital anomaly. Literature review did not yield additional information. Available data are insufficient to draw conclusions regarding ESL use during pregnancy. Although no particular safety problem was identified, ESL exposure during pregnancy will continue to be monitored and evaluated. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

[The interactive neuroanatomical simulation and practical application of frontotemporal transsylvian exposure in neurosurgery].

Science.gov (United States)

Balogh, Attila; Czigléczki, Gábor; Papal, Zsolt; Preul, Mark C; Banczerowski, Péter

2014-11-30

There is an increased need for new digital education tools in neurosurgical training. Illustrated textbooks offer anatomic and technical reference but do not substitute hands-on experience provided by surgery or cadaver dissection. Due to limited availability of cadaver dissections the need for development of simulation tools has been augmented. We explored simulation technology for producing virtual reality-like reconstructions of simulated surgical approaches on cadaver. Practical application of the simulation tool has been presented through frontotemporal transsylvian exposure. The dissections were performed on two cadaveric heads. Arteries and veins were prepared and injected with colorful silicon rubber. The heads were rigidly fixed in Mayfield headholder. A robotic microscope with two digital cameras in inverted cone method of image acquisition was used to capture images around a pivot point in several phases of dissections. Multilayered, high-resolution images have been built into interactive 4D environment by custom developed software. We have developed the simulation module of the frontotemporal transsylvian approach. The virtual specimens can be rotated or tilted to any selected angles and examined from different surgical perspectives at any stage of dissections. Important surgical issues such as appropriate head positioning or surgical maneuvers to expose deep situated neuroanatomic structures can be simulated and studied by using the module. The simulation module of the frontotemporal transsylvian exposure helps to examine effect of head positioning on the visibility of deep situated neuroanatomic structures and study surgical maneuvers required to achieve optimal exposure of deep situated anatomic structures. The simulation program is a powerful tool to study issues of preoperative planning and well suited for neurosurgical training.

Blood-borne biomarkers and bioindicators for linking exposure to health effects in environmental health science.

Science.gov (United States)

Wallace, M Ariel Geer; Kormos, Tzipporah M; Pleil, Joachim D

2016-01-01

Environmental health science aims to link environmental pollution sources to adverse health outcomes to develop effective exposure intervention strategies that reduce long-term disease risks. Over the past few decades, the public health community recognized that health risk is driven by interaction between the human genome and external environment. Now that the human genetic code has been sequenced, establishing this "G × E" (gene-environment) interaction requires a similar effort to decode the human exposome, which is the accumulation of an individual's environmental exposures and metabolic responses throughout the person's lifetime. The exposome is composed of endogenous and exogenous chemicals, many of which are measurable as biomarkers in blood, breath, and urine. Exposure to pollutants is assessed by analyzing biofluids for the pollutant itself or its metabolic products. New methods are being developed to use a subset of biomarkers, termed bioindicators, to demonstrate biological changes indicative of future adverse health effects. Typically, environmental biomarkers are assessed using noninvasive (excreted) media, such as breath and urine. Blood is often avoided for biomonitoring due to practical reasons such as medical personnel, infectious waste, or clinical setting, despite the fact that blood represents the central compartment that interacts with every living cell and is the most relevant biofluid for certain applications and analyses. The aims of this study were to (1) review the current use of blood samples in environmental health research, (2) briefly contrast blood with other biological media, and (3) propose additional applications for blood analysis in human exposure research.

Human Exposure Model (HEM): A modular, web-based application to characterize near-field chemical exposures and releases

Science.gov (United States)

The U.S. EPA’s Chemical Safety and Sustainability research program is developing the Human Exposure Model (HEM) to assess near-field exposures to chemicals that occur in various populations over the entire life cycle of a consumer product. The model will be implemented as a...

Low lifetime stress exposure is associated with reduced stimulus–response memory

Science.gov (United States)

Goldfarb, Elizabeth V.; Shields, Grant S.; Daw, Nathaniel D.; Slavich, George M.; Phelps, Elizabeth A.

2017-01-01

Exposure to stress throughout life can cumulatively influence later health, even among young adults. The negative effects of high cumulative stress exposure are well-known, and a shift from episodic to stimulus–response memory has been proposed to underlie forms of psychopathology that are related to high lifetime stress. At the other extreme, effects of very low stress exposure are mixed, with some studies reporting that low stress leads to better outcomes, while others demonstrate that low stress is associated with diminished resilience and negative outcomes. However, the influence of very low lifetime stress exposure on episodic and stimulus–response memory is unknown. Here we use a lifetime stress assessment system (STRAIN) to assess cumulative lifetime stress exposure and measure memory performance in young adults reporting very low and moderate levels of lifetime stress exposure. Relative to moderate levels of stress, very low levels of lifetime stress were associated with reduced use and retention (24 h later) of stimulus–response (SR) associations, and a higher likelihood of using context memory. Further, computational modeling revealed that participants with low levels of stress exhibited worse expression of memory for SR associations than those with moderate stress. These results demonstrate that very low levels of stress exposure can have negative effects on cognition. PMID:28298555

Improved cortisol exposure-time profile and outcome in patients with adrenal insufficiency: a prospective randomized trial of a novel hydrocortisone dual-release formulation.

Science.gov (United States)

Johannsson, G; Nilsson, A G; Bergthorsdottir, R; Burman, P; Dahlqvist, P; Ekman, B; Engström, B E; Olsson, T; Ragnarsson, O; Ryberg, M; Wahlberg, J; Biller, B M K; Monson, J P; Stewart, P M; Lennernäs, H; Skrtic, S

2012-02-01

Patients with treated adrenal insufficiency (AI) have increased morbidity and mortality rate. Our goal was to improve outcome by developing a once-daily (OD) oral hydrocortisone dual-release tablet with a more physiological exposure-time cortisol profile. The aim was to compare pharmacokinetics and metabolic outcome between OD and the same daily dose of thrice-daily (TID) dose of conventional hydrocortisone tablets. We conducted an open, randomized, two-period, 12-wk crossover multicenter trial with a 24-wk extension at five university hospital centers. The trial enrolled 64 adults with primary AI; 11 had concomitant diabetes mellitus (DM). The same daily dose of hydrocortisone was administered as OD dual-release or TID. We evaluated cortisol pharmacokinetics. Compared with conventional TID, OD provided a sustained serum cortisol profile 0-4 h after the morning intake and reduced the late afternoon and the 24-h cortisol exposure. The mean weight (difference = -0.7 kg, P = 0.005), systolic blood pressure (difference = -5.5 mm Hg, P = 0.0001) and diastolic blood pressure (difference: -2.3 mm Hg; P = 0.03), and glycated hemoglobin (absolute difference = -0.1%, P = 0.0006) were all reduced after OD compared with TID at 12 wk. Compared with TID, a reduction in glycated hemoglobin by 0.6% was observed in patients with concomitant DM during OD (P = 0.004). The OD dual-release tablet provided a more circadian-based serum cortisol profile. Reduced body weight, reduced blood pressure, and improved glucose metabolism were observed during OD treatment. In particular, glucose metabolism improved in patients with concomitant DM.

[Occupational exposure to nanoparticles. Assessment of workplace exposure].

Science.gov (United States)

Bujak-Pietrek, Stella

2010-01-01

Nanotechnology is currently one of the most popular branch of science. It is a technology that enables designing, manufacturing and application of materials and structures of very small dimensions, and its products are applied in almost every field of life. Nanoparticles are the structures having one or more dimensions of the order of 100 nm or less. They are used in precise mechanics, electronics, optics, medicine, pharmacy, cosmetics and many other spheres. Due to their very small size, nanostructures have completely different and specific properties, unknown for the bulk of materials. Fast-growing nanotechnology provides a wide spectrum of applications, but it also brings about new and unknown danger to human health. Nanotechnology is the branch that has developed rather recently, and much information about health risk and its influence on the environment is beyond our knowledge. Nanoparticles, released in many technological processes, as well as manufactured nanoparticles can induce occupational hazards to workers. The lack of regulations and standards, compulsory in the manufacture and use ofnanoparticles is a fundamental problem faced in the evaluation of exposure. Another problem is the choice of proper measurement equipment for surveying of very small particles - their number, mass and surface area in the workpost air. In this article, the possibility and scope of exposure assessment is discussed and a brief specification of available instrumentation for counting and assessing the parameters essential for classifying the exposure to nanoparticles is presented.

Nanoparticle exposure biomonitoring: exposure/effect indicator development approaches

Science.gov (United States)

Marie-Desvergne, C.; Dubosson, M.; Lacombe, M.; Brun, V.; Mossuz, V.

2015-05-01

The use of engineered nanoparticles (NP) is more and more widespread in various industrial sectors. The inhalation route of exposure is a matter of concern (adverse effects of air pollution by ultrafine particles and asbestos). No NP biomonitoring recommendations or standards are available so far. The LBM laboratory is currently studying several approaches to develop bioindicators for occupational health applications. As regards exposure indicators, new tools are being implemented to assess potentially inhaled NP in non-invasive respiratory sampling (nasal sampling and exhaled breath condensates (EBC)). Diverse NP analytical characterization methods are used (ICP-MS, dynamic light scattering and electron microscopy coupled to energy-dispersive X-ray analysis). As regards effect indicators, a methodology has been developed to assess a range of 29 cytokines in EBCs (potential respiratory inflammation due to NP exposure). Secondly, collaboration between the LBM laboratory and the EDyp team has allowed the EBC proteome to be characterized by means of an LC-MS/MS process. These projects are expected to facilitate the development of individual NP exposure biomonitoring tools and the analysis of early potential impacts on health. Innovative techniques such as field-flow fractionation combined with ICP-MS and single particle-ICPMS are currently being explored. These tools are directly intended to assist occupational physicians in the identification of exposure situations.

Nanoparticle exposure biomonitoring: exposure/effect indicator development approaches

International Nuclear Information System (INIS)

Marie-Desvergne, C; Dubosson, M; Mossuz, V; Lacombe, M; Brun, V

2015-01-01

The use of engineered nanoparticles (NP) is more and more widespread in various industrial sectors. The inhalation route of exposure is a matter of concern (adverse effects of air pollution by ultrafine particles and asbestos). No NP biomonitoring recommendations or standards are available so far. The LBM laboratory is currently studying several approaches to develop bioindicators for occupational health applications. As regards exposure indicators, new tools are being implemented to assess potentially inhaled NP in non-invasive respiratory sampling (nasal sampling and exhaled breath condensates (EBC)). Diverse NP analytical characterization methods are used (ICP-MS, dynamic light scattering and electron microscopy coupled to energy-dispersive X-ray analysis). As regards effect indicators, a methodology has been developed to assess a range of 29 cytokines in EBCs (potential respiratory inflammation due to NP exposure). Secondly, collaboration between the LBM laboratory and the EDyp team has allowed the EBC proteome to be characterized by means of an LC-MS/MS process. These projects are expected to facilitate the development of individual NP exposure biomonitoring tools and the analysis of early potential impacts on health. Innovative techniques such as field-flow fractionation combined with ICP-MS and single particle-ICPMS are currently being explored. These tools are directly intended to assist occupational physicians in the identification of exposure situations. (paper)

Medical radiation exposure and its impact on occupational practices in Korean radiologic technologists

Energy Technology Data Exchange (ETDEWEB)

Ko, Seul Ki; Lee, Won Jin [Dept. of Preventive Medicine, Korea University College of Medicine, Seoul (Korea, Republic of)

2016-12-15

The use of radiology examinations in medicine has been growing worldwide. Annually an estimated 3.1 billion radiologic exams are performed. According to this expansion of medical radiation exposure, it has been hard to pay no attention to the effects of medical radiation exposures in the exposure from different types of radiation source. This study, therefore, was aimed to assess the association of medical and occupational radiation exposure in Korean radiologic technologists and evaluate necessity for its consideration in occupational studies. This study did not show the strong association between medical radiation exposure and occupational radiation exposure except several modalities with specific frequency. These results are preliminary but certainly meaningful for interpretation of epidemiologic finding, therefore, we need further evaluation specially for the repeatedly exposed imaging tests and high dose procedures that presented somewhat weak relationship in this study linked with health outcomes of radiation exposure. This study did not show the strong association between medical radiation exposure and occupational radiation exposure except several modalities with specific frequency. These results are preliminary but certainly meaningful for interpretation of epidemiologic finding, therefore, we need further evaluation specially for the repeatedly exposed imaging tests and high dose procedures that presented somewhat weak relationship in this study linked with health outcomes of radiation exposure.

Medical radiation exposure and its impact on occupational practices in Korean radiologic technologists

International Nuclear Information System (INIS)

Ko, Seul Ki; Lee, Won Jin

2016-01-01

The use of radiology examinations in medicine has been growing worldwide. Annually an estimated 3.1 billion radiologic exams are performed. According to this expansion of medical radiation exposure, it has been hard to pay no attention to the effects of medical radiation exposures in the exposure from different types of radiation source. This study, therefore, was aimed to assess the association of medical and occupational radiation exposure in Korean radiologic technologists and evaluate necessity for its consideration in occupational studies. This study did not show the strong association between medical radiation exposure and occupational radiation exposure except several modalities with specific frequency. These results are preliminary but certainly meaningful for interpretation of epidemiologic finding, therefore, we need further evaluation specially for the repeatedly exposed imaging tests and high dose procedures that presented somewhat weak relationship in this study linked with health outcomes of radiation exposure. This study did not show the strong association between medical radiation exposure and occupational radiation exposure except several modalities with specific frequency. These results are preliminary but certainly meaningful for interpretation of epidemiologic finding, therefore, we need further evaluation specially for the repeatedly exposed imaging tests and high dose procedures that presented somewhat weak relationship in this study linked with health outcomes of radiation exposure.

The Exposure of Mortgage Borrowers to Interest Rate Risk, Income Risk and House Price Risk – Evidence from Swiss Loan Application Data

OpenAIRE

Guin, Benjamin; Brown, Martin

2015-01-01

We study the exposure of mortgage borrowers in Switzerland to interest rate, income and house price risks and examine how the households’ choice of risky mortgages is related to individual interest rate expectations and risk-aversion. Our analysis is based on a unique data set of household mortgage applications from September 2012 until January 2014. Our assessment of risk exposure among mortgage borrowers in Switzerland is highly sensitive to the underlying assumptions on mortgage costs, hou...

Unmatched U.S. Allopathic Seniors in the 2015 Main Residency Match: A Study of Applicant Behavior, Interview Selection, and Match Outcome.

Science.gov (United States)

Liang, Mei; Curtin, Laurie S; Signer, Mona M; Savoia, Maria C

2017-07-01

The application and interview behaviors of unmatched U.S. allopathic medical school senior students (U.S. seniors) participating in the 2015 National Resident Matching Program (NRMP) Main Residency Match were studied in conjunction with their United States Medical Licensing Examination (USMLE) Step 1 scores and ranking preferences to understand their effects on Match outcome. USMLE Step 1 score and preferred specialty information were reviewed for U.S. seniors who responded to the 2015 NRMP Applicant Survey. Unmatched U.S. seniors were categorized as "strong," "solid," "marginal," or "weak" based on the perceived competitiveness of their Step 1 scores compared with U.S. seniors who matched in the same preferred specialty. The numbers of applications sent, interviews obtained, and programs ranked also were examined by Match outcome. Strong unmatched U.S. seniors submitted significantly more applications to achieve and attend approximately the same number of interviews as strong matched U.S. seniors. Strong unmatched seniors ranked fewer programs than their matched counterparts. As a group, unmatched U.S. seniors were less likely than their matched counterparts to rank a mix of competitive and less competitive programs and more likely to rank programs based on their perceived likelihood of matching. A small number of unmatched U.S. seniors would have matched if they had ranked programs that ranked them. U.S. seniors' Match outcomes may be affected by applicant characteristics that negatively influence their selection for interviews, and their difficulties may be exacerbated by disadvantageous ranking behaviors.

Maternal diet, prenatal exposure to dioxin-like compounds and birth outcomes in a European prospective mother-child study (NewGeneris).

Science.gov (United States)

Papadopoulou, Eleni; Kogevinas, Manolis; Botsivali, Maria; Pedersen, Marie; Besselink, Harrie; Mendez, Michelle A; Fleming, Sarah; Hardie, Laura J; Knudsen, Lisbeth E; Wright, John; Agramunt, Silvia; Sunyer, Jordi; Granum, Berit; Gutzkow, Kristine B; Brunborg, Gunnar; Alexander, Jan; Meltzer, Helle Margrete; Brantsæter, Anne Lise; Sarri, Katerina; Chatzi, Leda; Merlo, Domenico F; Kleinjans, Jos C; Haugen, Margaretha

2014-06-15

Maternal diet can result in exposure to environmental contaminants including dioxins which may influence foetal growth. We investigated the association between maternal diet and birth outcomes by defining a dioxin-rich diet. We used validated food frequency questionnaires to assess the diet of pregnant women from Greece, Spain, United Kingdom, Denmark and Norway and estimated plasma dioxin-like activity by the Dioxin-Responsive Chemically Activated LUciferase eXpression (DR-CALUX®) bioassay in 604 maternal blood samples collected at delivery. We applied reduced rank regression to identify a dioxin-rich dietary pattern based on dioxin-like activity (DR-CALUX®) levels in maternal plasma, and calculated a dioxin-diet score as an estimate of adherence to this dietary pattern. In the five country population, dioxin-diet score was characterised by high consumption of red and white meat, lean and fatty fish, low-fat dairy and low consumption of salty snacks and high-fat cheese, during pregnancy. The upper tertile of the dioxin-diet score was associated with a change in birth weight of -121g (95% confidence intervals: -232, -10g) compared to the lower tertile after adjustment for confounders. A small non-significant reduction in gestational age was also observed (-1.4days, 95% CI: -3.8, 1.0days). Our results suggest that maternal diet might contribute to the exposure of the foetus to dioxins and dioxin-like compounds and may be related to reduced birth weight. More studies are needed to develop updated dietary guidelines for women of reproductive age, aiming to the reduction of dietary exposure to persistent organic pollutants as dioxins and dioxin-like compounds. Copyright © 2014 Elsevier B.V. All rights reserved.

Pesticide exposure and end-stage renal disease risk among wives of pesticide applicators in the Agricultural Health Study✩

Science.gov (United States)

Lebov, Jill F.; Engel, Lawrence S.; Richardson, David; Hogan, Susan L.; Sandler, Dale P.; Hoppin, Jane A.

2015-01-01

Background Pesticide exposure has been found to cause renal damage and dysfunction in experimental studies, but epidemiological research on the renal effects of chronic low-level pesticide exposure is limited. We investigated the relationships between end-stage renal disease (ESRD) among wives of licensed pesticide applicators (N = 31,142) in the Agricultural Health Study (AHS) and (1) personal pesticide use, (2) exposure to the husband's pesticide use, and (3) other pesticide-associated farming and household activities. Methods AHS participants reported pesticide exposure via self-administered questionnaires at enrollment (1993–1997). ESRD cases were identified via linkage to the United States Renal Data System. Associations between ESRD and pesticide exposures were estimated with Cox proportional hazard regression models controlling for age at enrollment. Models of associations with farming and household factors were additionally adjusted for personal use of pesticides. Results We identified 98 ESRD cases diagnosed between enrollment and 31 December 2011. Although women who ever applied pesticides (56% of cohort) were less likely than those who did not apply to develop ESRD (Hazard Ratio (HR): 0.42; 95% CI: 0.28, 0.64), among women who did apply pesticides, the rate of ESRD was significantly elevated among those who reported the highest (vs. lowest) cumulative general pesticide use (HR: 4.22; 95% CI: 1.26, 14.20). Among wives who never applied pesticides, ESRD was associated with husbands' ever use of paraquat (HR = 1.99; 95% CI: 1.14, 3.47) and butylate (HR = 1.71; 95% CI: 1.00, 2.95), with a positive exposure–response pattern for husband’s cumulative use of these pesticides. Conclusions ESRD may be associated with direct and/or indirect exposure to pesticides among farm women. Future studies should evaluate indirect exposure risk among other rural populations. PMID:26505650

Trends in Teenagers' Nonopiod Substance Exposures Reported to Poison Control Centers, 2010-2015.

Science.gov (United States)

Wright, Brad; Mestan, Samantha; Ahrens, Monica; Bottei, Edward

2018-05-01

To describe current trends in nonopioid substance exposures and associated outcomes among teenagers nationwide. In this cross-sectional study, we used 2010-2015 data from the American Association of Poison Control Centers' National Poison Data System and Poisson tests to document trends in the rate of calls to poison control centers involving adolescents stratified by sex, exposures by substance category, proportion of intentional exposures, and severity of exposures. The number of calls per 1000 persons increased from 5.7 to 6.8 for teenage girls and decreased from 4.7 to 4.3 for boys. Reported exposures to prescription and over-the-counter medications and illicit street drugs increased between 24% and 73%, and reported opioid exposures decreased by 16%. Among teenage girls, intentional exposures increased from 57% to 68%, with cases increasingly managed in health care facilities and more likely to result in worse health outcomes. The increase in intentional nonopioid substance exposures among teenage girls, with serious and potentially life-threatening consequences, is a matter of serious concern. Similar trends were not observed among teenage boys. Copyright © 2017 Elsevier Inc. All rights reserved.

Exposure to radon

International Nuclear Information System (INIS)

1988-01-01

Part 3 is given of the Code of Practice approved by the UK Health and Safety Commission with the consent of the Secretary of State for the purpose of providing practical guidance with respect to the provisions of the Ionising Radiations Regulations 1985. Part 3 gives specific guidance on the application of the Regulations to certain work involving exposure to isotopes of radon and their decay products. Aspects covered in the Regulations include restriction of exposure, dose limits, controlled areas, radiation protection advisers and supervisors, dosimetry and area monitoring. (U.K.)

Gene expression in the mouse brain following early pregnancy exposure to ethanol

Directory of Open Access Journals (Sweden)

Christine R. Zhang

2016-12-01

Full Text Available Exposure to alcohol during early embryonic or fetal development has been linked with a variety of adverse outcomes, the most common of which are structural and functional abnormalities of the central nervous system [1]. Behavioural and cognitive deficits reported in individuals exposed to alcohol in utero include intellectual impairment, learning and memory difficulties, diminished executive functioning, attention problems, poor motor function and hyperactivity [2]. The economic and social costs of these outcomes are substantial and profound [3,4]. Improvement of neurobehavioural outcomes following prenatal alcohol exposure requires greater understanding of the mechanisms of alcohol-induced damage to the brain. Here we use a mouse model of relatively moderate ethanol exposure early in pregnancy and profile gene expression in the hippocampus and caudate putamen of adult male offspring. The effects of offspring sex and age on ethanol-sensitive hippocampal gene expression were also examined. All array data are available at the Gene Expression Omnibus (GEO repository under accession number GSE87736.

Neuropsychological Outcomes of Army Personnel Following Deployment to the Iraq War

Science.gov (United States)

2006-08-02

Neuropsychological Outcomes · Model 1: Core Covariates p Diroction of Effect Outcome Variable No. ~(95%Cl)t Value of DeploymCflt+ &.ojectivo OUICOOlO R::iros MQ... consequences . (l!l outcome domain with high relevance to occupational and psy- chosocial functioning and highly sen- sitive to brain dysfunction. The memory...eg. cardiovascu- lar) and mental (eg, IXlsllraumalic stress disorder) health disorders_ Epidemiological investigations of exposure - outcome

A study protocol to evaluate the relationship between outdoor air pollution and pregnancy outcomes.

Science.gov (United States)

Ribeiro, Manuel C; Pereira, Maria J; Soares, Amílcar; Branquinho, Cristina; Augusto, Sofia; Llop, Esteve; Fonseca, Susana; Nave, Joaquim G; Tavares, António B; Dias, Carlos M; Silva, Ana; Selemane, Ismael; de Toro, Joaquin; Santos, Mário J; Santos, Fernanda

2010-10-15

The present study protocol is designed to assess the relationship between outdoor air pollution and low birth weight and preterm births outcomes performing a semi-ecological analysis. Semi-ecological design studies are widely used to assess effects of air pollution in humans. In this type of analysis, health outcomes and covariates are measured in individuals and exposure assignments are usually based on air quality monitor stations. Therefore, estimating individual exposures are one of the major challenges when investigating these relationships with a semi-ecologic design. Semi-ecologic study consisting of a retrospective cohort study with ecologic assignment of exposure is applied. Health outcomes and covariates are collected at Primary Health Care Center. Data from pregnant registry, clinical record and specific questionnaire administered orally to the mothers of children born in period 2007-2010 in Portuguese Alentejo Litoral region, are collected by the research team. Outdoor air pollution data are collected with a lichen diversity biomonitoring program, and individual pregnancy exposures are assessed with spatial geostatistical simulation, which provides the basis for uncertainty analysis of individual exposures. Awareness of outdoor air pollution uncertainty will improve validity of individual exposures assignments for further statistical analysis with multivariate regression models. Exposure misclassification is an issue of concern in semi-ecological design. In this study, personal exposures are assigned to each pregnant using geocoded addresses data. A stochastic simulation method is applied to lichen diversity values index measured at biomonitoring survey locations, in order to assess spatial uncertainty of lichen diversity value index at each geocoded address. These methods assume a model for spatial autocorrelation of exposure and provide a distribution of exposures in each study location. We believe that variability of simulated exposure values at

A study protocol to evaluate the relationship between outdoor air pollution and pregnancy outcomes

Directory of Open Access Journals (Sweden)

Selemane Ismael

2010-10-01

Full Text Available Abstract Background The present study protocol is designed to assess the relationship between outdoor air pollution and low birth weight and preterm births outcomes performing a semi-ecological analysis. Semi-ecological design studies are widely used to assess effects of air pollution in humans. In this type of analysis, health outcomes and covariates are measured in individuals and exposure assignments are usually based on air quality monitor stations. Therefore, estimating individual exposures are one of the major challenges when investigating these relationships with a semi-ecologic design. Methods/Design Semi-ecologic study consisting of a retrospective cohort study with ecologic assignment of exposure is applied. Health outcomes and covariates are collected at Primary Health Care Center. Data from pregnant registry, clinical record and specific questionnaire administered orally to the mothers of children born in period 2007-2010 in Portuguese Alentejo Litoral region, are collected by the research team. Outdoor air pollution data are collected with a lichen diversity biomonitoring program, and individual pregnancy exposures are assessed with spatial geostatistical simulation, which provides the basis for uncertainty analysis of individual exposures. Awareness of outdoor air pollution uncertainty will improve validity of individual exposures assignments for further statistical analysis with multivariate regression models. Discussion Exposure misclassification is an issue of concern in semi-ecological design. In this study, personal exposures are assigned to each pregnant using geocoded addresses data. A stochastic simulation method is applied to lichen diversity values index measured at biomonitoring survey locations, in order to assess spatial uncertainty of lichen diversity value index at each geocoded address. These methods assume a model for spatial autocorrelation of exposure and provide a distribution of exposures in each study location

Causal inference with missing exposure information: Methods and applications to an obstetric study.

Science.gov (United States)

Zhang, Zhiwei; Liu, Wei; Zhang, Bo; Tang, Li; Zhang, Jun

2016-10-01

Causal inference in observational studies is frequently challenged by the occurrence of missing data, in addition to confounding. Motivated by the Consortium on Safe Labor, a large observational study of obstetric labor practice and birth outcomes, this article focuses on the problem of missing exposure information in a causal analysis of observational data. This problem can be approached from different angles (i.e. missing covariates and causal inference), and useful methods can be obtained by drawing upon the available techniques and insights in both areas. In this article, we describe and compare a collection of methods based on different modeling assumptions, under standard assumptions for missing data (i.e. missing-at-random and positivity) and for causal inference with complete data (i.e. no unmeasured confounding and another positivity assumption). These methods involve three models: one for treatment assignment, one for the dependence of outcome on treatment and covariates, and one for the missing data mechanism. In general, consistent estimation of causal quantities requires correct specification of at least two of the three models, although there may be some flexibility as to which two models need to be correct. Such flexibility is afforded by doubly robust estimators adapted from the missing covariates literature and the literature on causal inference with complete data, and by a newly developed triply robust estimator that is consistent if any two of the three models are correct. The methods are applied to the Consortium on Safe Labor data and compared in a simulation study mimicking the Consortium on Safe Labor. © The Author(s) 2013.

Exposure to methyl bromide during greenhouse fumigation on Crete, Greece

NARCIS (Netherlands)

Vreede, J.A.F. de; Boeft, J. den; Hemmen, J.J. van

1998-01-01

In agricultural areas where greenhouses and dwellings are intermixed, the general population as well as the professional applicators may be exposed to pesticides. In a field study on Crete, exposure to methyl bromide during soil fumigation was assessed. Exposure of applicators (both contractors and

A biokinetic model of inhaled Cm compounds in dogs: Application to human exposure data

International Nuclear Information System (INIS)

Guilmette, R.A.; Mewhinney, J.A.

1989-01-01

Curium isotopes are major by-products in irradiated nuclear reactor fuel and comprise a significant fraction of the alpha-emitting radionuclide inventory. Although little use is currently being made of purified Cm sources, such usage is possible if reprocessing of spent fuel becomes feasible. Because little information is available on the biokinetics and dosimetry of inhaled Cm compounds, a study was conducted in which adult beagle dogs received a single inhalation exposure to either a monodisperse aerosol of 244Cm2O3 (1.4 micron activity median aerodynamic diameter [AMAD]; sigma g = 1.16) or a polydisperse aerosol of 244Cm (NO3)3 (1.1 micron AMAD; sigma g = 1.74). At times ranging from 4 h to 2 y after exposure, animals were sacrificed and their tissues analyzed for Cm content. The data describing the uptake and retention of 244Cm in the different organs and tissues and the measured rates of excretion of these dogs formed the basis on which a biokinetic model of Cm metabolism was constructed. This Cm model was based on a previously published model of the biokinetics of 241Am that was shown to be applicable to data from human cases of inhalation exposure to 241Am aerosols. This Cm model was found to be adequate to describe the biological distribution of Cm in dogs and was also applied to the sparse data from humans. Reasonable agreement was found between the model predictions for lung retention of Cm and for urinary excretion patterns in humans

Characteristics of peaks of inhalation exposure to organic solvents

NARCIS (Netherlands)

Preller, L.; Burstyn, I.; Pater, N. de; Kromhout, H.

2004-01-01

Objectives: To determine which exposure metrics are sufficient to characterize 'peak' inhalation exposure to organic solvents (OS) during spraying operations. Methods: Personal exposure measurements (n = 27; duration 5-159 min) were collected during application of paints, primers, resins and glues

Effectiveness of the 'Home-but not Alone' mobile health application educational programme on parental outcomes: a randomized controlled trial, study protocol.

Science.gov (United States)

Shorey, Shefaly; Ng, Yvonne Peng Mei; Danbjørg, Dorthe Boe; Dennis, Cindy-Lee; Morelius, Evalotte

2017-01-01

The aim of this study was to describe a study protocol that evaluates the effectiveness of the 'Home-but not Alone' educational programme delivered via a mobile health application in improving parenting outcomes. The development in mobile-based technology gives us the opportunity to develop an accessible educational programme that can be potentially beneficial to new parents. However, there is a scarcity of theory-based educational programmes that have incorporated technology such as a mobile health application in the early postpartum period. A randomized controlled trial with a two-group pre-test and post-test design. The data will be collected from 118 couples. Eligible parents will be randomly allocated to either a control group (receiving routine care) or an intervention group (routine care plus access to the 'Home-but not Alone' mobile health application. Outcome measures comprise of parenting self-efficacy, social support, parenting satisfaction and postnatal depression. Data will be collected at the baseline (on the day of discharge) and at four weeks postpartum. This will be an empirical study that evaluates a theory-based educational programme delivered via an innovative mobile health application on parental outcomes. Results from this study will enhance parenting self-efficacy, social support and parenting satisfaction, which may then reduce parental risks of postnatal depression. © 2016 John Wiley & Sons Ltd.

Quantitative exposure assessment in community-based studies

NARCIS (Netherlands)

Peters, S.M.

2012-01-01

Occupational epidemiology focuses on the associations between exposures at the workplace and disease outcomes, essentially concerned with the prevention of disease. Basically two types of studies can be distinguished in occupational epidemiology: industry-based studies which study a population at

Biological monitoring of radiation exposure

Science.gov (United States)

Horneck, G.

1998-11-01

Complementary to physical dosimetry, biological dosimetry systems have been developed and applied which weight the different components of environmental radiation according to their biological efficacy. They generally give a record of the accumulated exposure of individuals with high sensitivity and specificity for the toxic agent under consideration. Basically three different types of biological detecting/monitoring systems are available: (i) intrinsic biological dosimeters that record the individual radiation exposure (humans, plants, animals) in measurable units. For monitoring ionizing radiation exposure, in situ biomarkers for genetic (e.g. chromosomal aberrations in human lymphocytes, germ line minisatellite mutation rates) or metabolic changes in serum, plasma and blood (e.g. serum lipids, lipoproteins, lipid peroxides, melatonin, antibody titer) have been used. (ii) Extrinsic biological dosimeters/indicators that record the accumulated dose in biological model systems. Their application includes long-term monitoring of changes in environmental UV radiation and its biological implications as well as dosimetry of personal UV exposure. (iii) Biological detectors/biosensors for genotoxic substances and agents such as bacterial assays (e.g. Ames test, SOS-type test) that are highly sensitive to genotoxins with high specificity. They may be applicable for different aspects in environmental monitoring including the International Space Station.

Collaborative writing applications in healthcare: effects on professional practice and healthcare outcomes.

Science.gov (United States)

Archambault, Patrick M; van de Belt, Tom H; Kuziemsky, Craig; Plaisance, Ariane; Dupuis, Audrey; McGinn, Carrie A; Francois, Rebecca; Gagnon, Marie-Pierre; Turgeon, Alexis F; Horsley, Tanya; Witteman, William; Poitras, Julien; Lapointe, Jean; Brand, Kevin; Lachaine, Jean; Légaré, France

2017-05-10

Collaborative writing applications (CWAs), such as wikis and Google Documents, hold the potential to improve the use of evidence in both public health and healthcare. Although a growing body of literature indicates that CWAs could have positive effects on healthcare, such as improved collaboration, behavioural change, learning, knowledge management, and adaptation of knowledge to local context, this has never been assessed systematically. Moreover, several questions regarding safety, reliability, and legal aspects exist. The objectives of this review were to (1) assess the effects of the use of CWAs on process (including the behaviour of healthcare professionals) and patient outcomes, (2) critically appraise and summarise current evidence on the use of resources, costs, and cost-effectiveness associated with CWAs to improve professional practices and patient outcomes, and (3) explore the effects of different CWA features (e.g. open versus closed) and different implementation factors (e.g. the presence of a moderator) on process and patient outcomes. We searched CENTRAL, MEDLINE, Embase, and 11 other electronic databases. We searched the grey literature, two trial registries, CWA websites, individual journals, and conference proceedings. We also contacted authors and experts in the field. We did not apply date or language limits. We searched for published literature to August 2016, and grey literature to September 2015. We included randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-and-after (CBA) studies, interrupted time series (ITS) studies, and repeated measures studies (RMS), in which CWAs were used as an intervention to improve the process of care, patient outcomes, or healthcare costs. Teams of two review authors independently assessed the eligibility of studies. Disagreements were resolved by discussion, and when consensus was not reached, a third review author was consulted. We screened 11,993 studies identified

Impact of Air Pollutants on Outpatient Visits for Acute Respiratory Outcomes

Directory of Open Access Journals (Sweden)

Ran Li

2017-01-01

Full Text Available The air pollution in China is a severe problem. The aim of our study was to investigate the impact of air pollutants on acute respiratory outcomes in outpatients. Outpatient data from 2 December 2013 to 1 December 2014 were collected, as well as air pollutant data including ozone (O3, nitrogen dioxide (NO2, carbon monoxide (CO, sulfur dioxide (SO2, and particulate matter (PM2.5 and PM10. We screened six categories of acute respiratory outcomes and analyzed their associations with different air pollutant exposures, including upper respiratory tract infection (URTI, acute bronchitis (AB, community-acquired pneumonia (CAP, acute exacerbation of chronic obstructive pulmonary disease (AECOPD, acute exacerbation of asthma (AE-asthma, and acute exacerbation of bronchiectasis (AEBX. A case-crossover design with a bidirectional control sampling approach was used for statistical analysis. A total of 57,144 patients were enrolled for analysis. PM2.5, PM10, NO2, SO2, and CO exposures were positively associated with outpatient visits for URTI, AB, CAP, and AEBX. PM10, SO2, and CO exposures were positively associated with outpatient visits for AECOPD. Exposure to O3 was positively associated with outpatient visits for AE-asthma, but negatively associated with outpatient visits for URTI, CAP, and AEBX. In conclusion, air pollutants had acute effects on outpatient visits for acute respiratory outcomes, with specific outcomes associated with specific pollutants.

Emotion dysregulation mediates the relationship between trauma exposure, post-migration living difficulties and psychological outcomes in traumatized refugees.

Science.gov (United States)

Nickerson, Angela; Bryant, Richard A; Schnyder, Ulrich; Schick, Matthis; Mueller, Julia; Morina, Naser

2015-03-01

While emotion dysregulation represents an important mechanism underpinning psychological responses to trauma, little research has investigated this in refugees. In the current study, we examined the mediating role of emotion dysregulation in the relationship between refugee experiences (trauma and living difficulties) and psychological outcomes. Participants were 134 traumatized treatment-seeking refugees who completed measures indexing trauma exposure, post-migration living difficulties, difficulties in emotion regulation, posttraumatic stress disorder, depression, and explosive anger. Findings revealed distinctive patterns of emotion dysregulation associated with each of these psychological disorders. Results also indicated that emotion regulation difficulties mediated the association between both trauma and psychological symptoms, and living difficulties and psychological symptoms. Limitations include a cross-sectional design and the use of measures that had not been validated across all cultural groups in this study. These findings underscore the key role of emotion dysregulation in psychological responses of refugees, and highlight potential directions for treatment interventions for traumatized refugees. Copyright © 2014 Elsevier B.V. All rights reserved.

A dose-effect analysis of children's exposure to dental amalgam and neuropsychological function: the New England Children's Amalgam Trial.

Science.gov (United States)

Bellinger, David C; Trachtenberg, Felicia; Daniel, David; Zhang, Annie; Tavares, Mary A; McKinlay, Sonja

2007-09-01

The New England Children's Amalgam Trial (NECAT) was a five-year randomized trial of 534 6- to 10-year-old children that compared the neuropsychological outcomes of those whose caries were restored using dental amalgam with the outcomes of those those whose caries were restored using mercury-free resin-based composite. The primary intention-to-treat analyses did not reveal significant differences between the treatment groups on the primary or secondary outcomes of the administered psychological tests: Full-Scale IQ score on the Wechsler Intelligence Scale for Children-Third Edition, General Memory Index of the Wide Range Assessment of Memory and Learning, and Visual-Motor Composite of the Wide Range Assessment of Visual Motor Abilities. To determine whether treatment group assignment, a dichotomous measure of exposure, was sufficiently sensitive to detect associations between mercury exposure and these outcomes, the authors conducted analyses to evaluate the associations between the primary and secondary outcomes and two continuously distributed indexes of potential exposure, surface-years of amalgam and urinary mercury excretion. Neither index of mercury exposure was significantly associated with any of the three outcomes. The authors found no evidence that exposure to mercury from dental amalgam was associated with any adverse neuropsychological effects over the five-year period after placement of amalgam restorations. Analyses of the outcomes of the NECAT study indicate that use of dental amalgam was not associated with an increase in children's risk of experiencing neuropsychological dysfunction.

Potential exposure to endocrine disrupting chemicals and selected adverse pregnancy outcomes

DEFF Research Database (Denmark)

Bengtsson, Jessica; Thygesen, Pernille Søgaard; Kaerlev, Linda

2017-01-01

potential occupational exposure to endocrine disrupting chemicals (EDC) of the mother during pregnancy is associated with preterm birth and low birth weight. Methods: Pregnant women referred to an Occupational Health Clinic (OHC) in two Danish regions (Copenhagen or Aarhus) between 1984 and 2010, suspected...

Development of acute exposure guideline levels for airborne exposures to hazardous substances.

Science.gov (United States)

Krewski, Daniel; Bakshi, Kulbir; Garrett, Roger; Falke, Ernest; Rusch, George; Gaylor, David

2004-04-01

Hazardous substances can be released into the atmosphere due to industrial and transportation accidents, fires, tornadoes, earthquakes, and terrorists, thereby exposing workers and the nearby public to potential adverse health effects. Various enforceable guidelines have been set by regulatory agencies for worker and ambient air quality. However, these exposure levels generally are not applicable to rare lifetime acute exposures, which possibly could occur at high concentrations. Acute exposure guideline levels (AEGLs) provide estimates of concentrations for airborne exposures for an array of short durations that possibly could cause mild (AEGL-1), severe, irreversible, potentially disabling adverse health effects (AEGL-2), or life threatening effects (AEGL-3). These levels can be useful for emergency responders and planners in reducing or eliminating potential risks to the public. Procedures and methodologies for deriving AEGLs are reviewed in this paper that have been developed in the United States, with direct input from international representatives of OECD member-countries, by the National Advisory Committee for Acute Exposure Guidelines for Hazardous Substances and reviewed by the National Research Council. Techniques are discussed for the extrapolation of effects across different exposure durations. AEGLs provide a viable approach for assisting in the prevention, planning, and response to acute airborne exposures to toxic agents.

Arsenic Exposure and Type 2 Diabetes: MicroRNAs as Mechanistic Links?

OpenAIRE

Beck, Rowan; Styblo, Miroslav; Sethupathy, Praveen

2017-01-01

Purpose of Review The goal of this review is to delineate the following: (1) the primary means of inorganic arsenic (iAs) exposure for human populations, (2) the adverse public health outcomes associated with chronic iAs exposure, (3) the pathophysiological connection between arsenic and type 2 diabetes (T2D), and (4) the incipient evidence for microRNAs as candidate mechanistic links between iAs exposure and T2D. Recent Findings Exposure to iAs in animal models has been associated with the d...

Impact of subspecialty elective exposures on outcomes on the American board of internal medicine certification examination

Directory of Open Access Journals (Sweden)

Shanmugam Victoria K

2012-10-01

Full Text Available Abstract Background The American Board of Internal Medicine Certification Examination (ABIM-CE is one of several methods used to assess medical knowledge, an Accreditation Council for Graduate Medical Education (ACGME core competency for graduating internal medicine residents. With recent changes in graduate medical education program directors and internal medicine residents are seeking evidence to guide decisions regarding residency elective choices. Prior studies have shown that formalized elective curricula improve subspecialty ABIM-CE scores. The primary aim of this study was to evaluate whether the number of subspecialty elective exposures or the specific subspecialties which residents complete electives in impact ABIM-CE scores. Methods ABIM-CE scores, elective exposures and demographic characteristics were collected for MedStar Georgetown University Hospital internal medicine residents who were first-time takers of the ABIM-CE in 2006–2010 (n=152. Elective exposures were defined as a two-week period assigned to the respective subspecialty. ABIM-CE score was analyzed using the difference between the ABIM-CE score and the standardized passing score (delta-SPS. Subspecialty scores were analyzed using percentage of correct responses. Data was analyzed using GraphPad Prism version 5.00 for Windows. Results Paired elective exposure and ABIM-CE scores were available in 131 residents. There was no linear correlation between ABIM-CE mean delta-SPS and the total number of electives or the number of unique elective exposures. Residents with ≤14 elective exposures had higher ABIM-CE mean delta-SPS than those with ≥15 elective exposures (143.4 compared to 129.7, p=0.051. Repeated electives in individual subspecialties were not associated with significant difference in mean ABIM-CE delta-SPS. Conclusions This study did not demonstrate significant positive associations between individual subspecialty elective exposures and ABIM-CE mean delta

ASSESSING CHILDREN'S EXPOSURES TO PESTICIDES: AN IMPORTANT APPLICATION OF THE STOCHASTIC HUMAN EXPOSURE AND DOSE SIMULATION MODEL (SHEDS)

Science.gov (United States)

Accurately quantifying human exposures and doses of various populations to environmental pollutants is critical for the Agency to assess and manage human health risks. For example, the Food Quality Protection Act of 1996 (FQPA) requires EPA to consider aggregate human exposure ...

Teleconference versus face-to-face scientific peer review of grant application: effects on review outcomes.

Directory of Open Access Journals (Sweden)

Stephen A Gallo

Full Text Available Teleconferencing as a setting for scientific peer review is an attractive option for funding agencies, given the substantial environmental and cost savings. Despite this, there is a paucity of published data validating teleconference-based peer review compared to the face-to-face process. Our aim was to conduct a retrospective analysis of scientific peer review data to investigate whether review setting has an effect on review process and outcome measures. We analyzed reviewer scoring data from a research program that had recently modified the review setting from face-to-face to a teleconference format with minimal changes to the overall review procedures. This analysis included approximately 1600 applications over a 4-year period: two years of face-to-face panel meetings compared to two years of teleconference meetings. The average overall scientific merit scores, score distribution, standard deviations and reviewer inter-rater reliability statistics were measured, as well as reviewer demographics and length of time discussing applications. The data indicate that few differences are evident between face-to-face and teleconference settings with regard to average overall scientific merit score, scoring distribution, standard deviation, reviewer demographics or inter-rater reliability. However, some difference was found in the discussion time. These findings suggest that most review outcome measures are unaffected by review setting, which would support the trend of using teleconference reviews rather than face-to-face meetings. However, further studies are needed to assess any correlations among discussion time, application funding and the productivity of funded research projects.

Teleconference versus Face-to-Face Scientific Peer Review of Grant Application: Effects on Review Outcomes

Science.gov (United States)

Gallo, Stephen A.; Carpenter, Afton S.; Glisson, Scott R.

2013-01-01

Teleconferencing as a setting for scientific peer review is an attractive option for funding agencies, given the substantial environmental and cost savings. Despite this, there is a paucity of published data validating teleconference-based peer review compared to the face-to-face process. Our aim was to conduct a retrospective analysis of scientific peer review data to investigate whether review setting has an effect on review process and outcome measures. We analyzed reviewer scoring data from a research program that had recently modified the review setting from face-to-face to a teleconference format with minimal changes to the overall review procedures. This analysis included approximately 1600 applications over a 4-year period: two years of face-to-face panel meetings compared to two years of teleconference meetings. The average overall scientific merit scores, score distribution, standard deviations and reviewer inter-rater reliability statistics were measured, as well as reviewer demographics and length of time discussing applications. The data indicate that few differences are evident between face-to-face and teleconference settings with regard to average overall scientific merit score, scoring distribution, standard deviation, reviewer demographics or inter-rater reliability. However, some difference was found in the discussion time. These findings suggest that most review outcome measures are unaffected by review setting, which would support the trend of using teleconference reviews rather than face-to-face meetings. However, further studies are needed to assess any correlations among discussion time, application funding and the productivity of funded research projects. PMID:23951223

Industrial production and professional application of manufactured nanomaterials-enabled end products in Dutch industries: potential for exposure.

Science.gov (United States)

Bekker, Cindy; Brouwer, Derk H; Tielemans, Erik; Pronk, Anjoeka

2013-04-01

In order to make full use of the opportunities while responsibly managing the risks of working with manufactured nanomaterials (MNM), we need to gain insight into the potential level of exposure to MNM in the industry. Therefore, the goal of this study was to obtain an overview of the potential MNM exposure scenarios within relevant industrial sectors, applied exposure controls, and number of workers potentially exposed to MNM in Dutch industrial sectors producing and applying MNM-enabled end products in the Netherlands. A survey was conducted in three phases: (i) identification of MNM-enabled end products; (ii) identification of relevant industrial sectors; and (iii) a tiered telephone survey to estimate actual use of the products among 40 sector organizations/knowledge centres (Tier 1), 350 randomly selected companies (Tier 2), and 110 actively searched companies (Tier 3). The most dominant industrial sectors producing or applying MNM-enabled end products (market penetration >5%) are shoe repair shops, automotive, construction, paint, metal, and textile cleaning industry. In the majority of the companies (76%), potential risks related to working with MNM are not a specific point of interest. The total number of workers potentially exposed to MNM during the production or application of MNM-enabled end products was estimated at approximately 3000 workers in the Netherlands. The results of this study will serve as a basis for in-depth exposure and health surveys that are currently planned in the Netherlands. In addition, the results can be used to identify the most relevant sectors for policy makers and future studies focussing on evaluating the risks of occupational exposure to MNM.

Developmental differences in stress responding after repeated underwater trauma exposures in rats.

Science.gov (United States)

Altman, Daniel E; Simmons, Laurence P; Vuong, Chau T; Taylor, Rachel M; Sousa, Jason C; Marcsisin, Sean R; Zottig, Victor E; Moore, Nicole L T

2018-05-01

Adolescence is a distinct developmental period characterized by behavioral and physiological maturation. Rapid ongoing changes during neurodevelopment in particular present potential opportunities for stress to have lasting effects on longitudinal outcomes of behavioral and neuroendocrine function. While adult stress effects on outcomes during adulthood have been characterized, little is known about the lasting effects of adolescent repeated stressor exposure on outcomes during adolescence. We have previously reported different stress responses in adolescent rats relative to adult rats, including a blunted fear response outcome in adulthood in rats stressed during adolescence. The present study characterized the ontogeny of behavioral and neuroendocrine responses to eight underwater trauma (UWT) exposures in rats over a two week poststress time period during adolescence (P34) or adulthood (P83) relative to age-matched control groups that underwent eight swimming episodes without UWT. Repeated UWT exposures starting in adolescence, but not adulthood, resulted in adverse behavioral responses on the elevated plus maze 1 day post-stress. Corticosterone responses did not differ between UWT-exposed and controls for either age group at 1 day or at 7 days poststress, although there was an effect of age on corticosterone levels. We conclude that repeated UWT stress events have a lasting, negative behavioral effect on adolescent rats that is not observed in adult rats after the two-week exposure window. These results suggest that neurophysiological mechanisms underlying recovery from a repeated stressor are immature in adolescence relative to adulthood in rats.

Oral Exposure of a Child to a Lithium Ion Battery.

Science.gov (United States)

Townsend, Janice A; Curran, Ronald

2016-01-01

Battery exposure has the potential for severe morbidity and possible mortality. Accidental exposure is rising with the increased use of button batteries, and young children and older adults are at highest risk for accidental exposure. The purpose of this paper is to report a case of mouth exposure to a lithium ion battery in a boy. A review of the current literature on incidence, diagnosis, and outcomes of battery exposure is presented. When symptoms such as diarrhea, vomiting, and abdominal distress of non-specific origin are present, battery ingestion should be included in the differential diagnosis. Dentists may be the first health professionals to encounter battery exposure, especially in the case of mouth exposures. Knowledge of signs and symptoms are necessary to properly diagnose and refer for medical management.

Radiation exposure modeling and project schedule visualization

International Nuclear Information System (INIS)

Jaquish, W.R.; Enderlin, V.R.

1995-10-01

This paper discusses two applications using IGRIP (Interactive Graphical Robot Instruction Program) to assist environmental remediation efforts at the Department of Energy (DOE) Hanford Site. In the first application, IGRIP is used to calculate the estimated radiation exposure to workers conducting tasks in radiation environments. In the second, IGRIP is used as a configuration management tool to detect interferences between equipment and personnel work areas for multiple projects occurring simultaneously in one area. Both of these applications have the capability to reduce environmental remediation costs by reducing personnel radiation exposure and by providing a method to effectively manage multiple projects in a single facility

Left truncation results in substantial bias of the relation between time-dependent exposures and adverse events

NARCIS (Netherlands)

Hazelbag, Christijan M; Klungel, Olaf H; van Staa, Tjeerd P; de Boer, Anthonius; Groenwold, Rolf H H

PURPOSE: To assess the impact of random left truncation of data on the estimation of time-dependent exposure effects. METHODS: A simulation study was conducted in which the relation between exposure and outcome was based on an immediate exposure effect, a first-time exposure effect, or a cumulative

Left truncation results in substantial bias of the relation between time-dependent exposures and adverse events

NARCIS (Netherlands)

Hazelbag, Christijan M.; Klungel, Olaf H.; van Staa, Tjeerd P.; de Boer, Anthonius; Groenwold, Rolf H H

2015-01-01

PURPOSE: To assess the impact of random left truncation of data on the estimation of time-dependent exposure effects. METHODS: A simulation study was conducted in which the relation between exposure and outcome was based on an immediate exposure effect, a first-time exposure effect, or a cumulative

Fetal Exposure to Montelukast and Congenital Anomalies

DEFF Research Database (Denmark)

Cavero-Carbonell, Clara; Vinkel-Hansen, Anne; Rabanque-Hernández, Mª José

2017-01-01

BACKGROUND: The objective was to study pregnancy outcomes between groups of Danish women, with pregnancy ending between 1998 and 2009, according to their exposure to montelukast. METHODS: Cross-sectional observational study in Danish women, selecting live births and stillbirths (Birth Registry) a...

Effect of medical x-ray exposure on subsequent reproductive outcomes in scoliosis patients

International Nuclear Information System (INIS)

Visscher, W.A.

1987-01-01

A retrospective cohort study was done which was designed to assess the effects of medical x-ray exposure on cancer incidence among scoliosis patients. Although the primary purpose of the study was to assess cancer incidence, a secondary goal was to investigate whether diagnostic x-ray exposure is related to adverse reproductive events in the female subjects. A series of case-control analyses were done which were designed to assess these effects. Radiation exposure was measured both by total films received and by an estimate of the number of films received and by an estimate of the number of films which involved ovarian irradiation. Radiation appeared to increase a woman's risk of any adverse event in the overall analysis and her risk of a premature or low birth weight infant in the separate analyses. Radiation did not appear to be related to spontaneous abortion, complications of pregnancy or delivery or birth defects, although the results of the pregnancy complications analysis was suggestive

Integrating Quality and Safety Competencies to Improve Outcomes: Application in Infusion Therapy Practice.

Science.gov (United States)

Sherwood, Gwen; Nickel, Barbara

Despite intense scrutiny and process improvement initiatives, patient harm continues to occur in health care with alarming frequency. The Quality and Safety Education for Nursing (QSEN) project provides a roadmap to transform nursing by integrating 6 competencies: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. As front-line caregivers, nurses encounter inherent risks in their daily work. Infusion therapy is high risk with multiple potential risks for patient harm. This study examines individual and system application of the QSEN competencies and the Infusion Nurses Society's 2016 Infusion Therapy Standards of Practice in the improvement of patient outcomes.

Feasibility of smartphone application and social media intervention on breast cancer survivors' health outcomes.

Science.gov (United States)

Pope, Zachary; Lee, Jung Eun; Zeng, Nan; Lee, Hee Yun; Gao, Zan

2018-02-17

Breast cancer survivors are at risk for poor health, with physical activity a possible treatment. Little research has examined how technology might promote breast cancer survivor physical activity or health. The aim of this study is to investigate the feasibility of employing a commercially available mobile health application- and social media-based health education intervention to improve breast cancer survivor physical activity or health.Ten breast cancer survivors (X̅ age = 45.80 ± 10.23 years; X̅ weight = 79.51 ± 20.85 kg) participated in this 10-week single-group pilot study from 2015 to 2016. Participants downloaded the MapMyFitness application, documented all physical activity with MapMyFitness, and were enrolled in a Social Cognitive Theory-based, Facebook-delivered health education intervention. Objectively measured physical activity, weight or body composition, cardiovascular fitness, psychosocial constructs, and quality of life indices were measured at baseline and 10 weeks. Intervention use and acceptability was evaluated during and following the intervention. Descriptive statistics were calculated for all study outcomes, with qualitative analyses performed regarding use and acceptability. At postintervention, average daily moderate-to-vigorous physical activity and steps increased by 2.6 min and 1,657, respectively, with notable decreases in weight (2.4 kg) and body fat percentage (2.3%). Physical activity-related social support and ability to engage in social roles or activity demonstrated the greatest improvements among all psychosocial and quality of life indices, respectively. Participants enjoyed the feedback and tracking features of MapMyFitness, with most finding the Facebook component helpful. All participants recommended the intervention for future use.Physical activity interventions combining commercially available mobile health applications and theoretically based social media-delivered health interventions may promote certain

An Updated Algorithm for Estimation of Pesticide Exposure Intensity in the Agricultural Health Study

Directory of Open Access Journals (Sweden)

Aaron Blair

2011-12-01

Full Text Available An algorithm developed to estimate pesticide exposure intensity for use in epidemiologic analyses was revised based on data from two exposure monitoring studies. In the first study, we estimated relative exposure intensity based on the results of measurements taken during the application of the herbicide 2,4-dichlorophenoxyacetic acid (2,4-D (n = 88 and the insecticide chlorpyrifos (n = 17. Modifications to the algorithm weighting factors were based on geometric means (GM of post-application urine concentrations for applicators grouped by application method and use of chemically-resistant (CR gloves. Measurement data from a second study were also used to evaluate relative exposure levels associated with airblast as compared to hand spray application methods. Algorithm modifications included an increase in the exposure reduction factor for use of CR gloves from 40% to 60%, an increase in the application method weight for boom spray relative to in-furrow and for air blast relative to hand spray, and a decrease in the weight for mixing relative to the new weights assigned for application methods. The weighting factors for the revised algorithm now incorporate exposure measurements taken on Agricultural Health Study (AHS participants for the application methods and personal protective equipment (PPE commonly reported by study participants.

An Increase in Dietary Supplement Exposures Reported to US Poison Control Centers.

Science.gov (United States)

Rao, Nisha; Spiller, Henry A; Hodges, Nichole L; Chounthirath, Thiphalak; Casavant, Marcel J; Kamboj, Amrit K; Smith, Gary A

2017-09-01

The objective of this study was to investigate the epidemiology of dietary supplement exposures in the USA. A retrospective analysis was conducted of out-of-hospital dietary supplement exposures reported to the National Poison Data System from 2000 through 2012. There were 274,998 dietary supplement exposures from 2000 through 2012. The annual rate of dietary supplement exposures per 100,000 population increased by 46.1% during 2000-2002, decreased 8.8% during 2002-2005, and then increased again by 49.3% from 2005 to 2012. These trends were influenced by the decrease in ma huang exposures starting in 2002. Miscellaneous dietary supplements accounted for 43.9% of all exposures, followed by botanicals (31.9%), hormonal products (15.1%), and other supplements (5.1%). The majority of dietary supplement exposures (70.0%) occurred among children younger than 6 years old and were acute (94.0%) and unintentional (82.9%). Serious medical outcomes accounted for 4.5% of exposures and most (95.0%) occurred among individuals 6 years and older. Ma huang products, yohimbe, and energy products were the categories associated with the greatest toxicity. There was an overall increase in the rate of dietary supplement exposures from 2000 through 2012. Although the majority of these exposures did not require treatment at a health care facility or result in serious medical outcomes, exposures to yohimbe and energy products were associated with considerable toxicity. Our results demonstrate the success of the FDA ban on ma huang products and the need for FDA regulation of yohimbe and energy products in the USA.

Optimization of exposure procedures for sub-quarter-micron CMOS applications

Science.gov (United States)

Hotta, Shoji; Onozuka, Toshihiko; Fukumoto, Keiko; Shirai, Seiichiro; Okazaki, Shinji

1998-06-01

We investigated various exposure procedures to minimize the Critical Dimension (CD) variation for the patterning of sub- quarter micron gates. To examine dependence of the CD variation on the pattern pitch and defocus conditions, the light intensity profiles of four different mask structures: (1) a binary mask with clear field, (2) a binary mask with dark field, (3) a phase-edge type phase-shifting mask (a phase-edge PSM) with clear field, and (4) a halftone phase- shifting mask (a halftone PSM) were compared, where exposure wavelength was 248 nm and numerical aperture (NA) of KrF stepper was 0.55. For 200-nm gate patterns, dependence of the CD variation on the pattern pitch and defocus conditions was minimized by a phase-edge PSM with clear field. By optimizing the illumination condition for a phase-edge PSM exposure, we obtained the CD variation of 10 nm at the minimum gate pitch of 0.8 micrometer and the defocus condition of plus or minus 0.4 micrometer. Applying the optimized exposure procedure to the device fabrication process, we obtained the total CD variation of plus or minus 27 nm.

Exposure Assessment and Inflammatory Response Among Workers Producing Calcium Carbonate Nanomaterials

Science.gov (United States)

Cui, Ling

Problem: Nanotechnology is one of the most rapidly growing fields of science and engineering, and its applications have expanded to numerous research and industrial sectors, from consumer products to medicine to energy. Nano-materials and nanotechnology promise substantial benefits. However, there are many uncertainties and concerns regarding human health and the environment. Numerous toxicological studies on animals and cells in vitro have demonstrated that nanomaterials could cause various adverse health effects, including inflammation, oxidative stress, fibrosis and mutagenesis in the lungs, and cardiovascular and nervous system impairment. Objectives: The overall objective of this study was to characterize particulate exposures in a calcium carbonate nanoparticle manufacturing facility, investigate possible respiratory and cardiovascular effects, and explore the plausibility of an inflammatory mechanism. The associations between exposure level and various health outcomes were investigated. Methodology: Each job was characterized by mass, number and surface area concentration. Job classification was performed based on ranking of the exposure level and statistical models. Lung function tests, exhaled NO and blood pressure (BP) were measured before and after the workshift in the year of 2011. Inflammatory cytokines from induced sputum were measured cross-sectionally in the year of 2011. Data of lung function tests and blood pressure were collected cross-sectionally in the year of 2012. The associations between each exposure metric and health measures in 2012 were investigated. Only mass concentration was linked to both 2011 and 2012 health outcomes. Results: The sampling and analytic methodology used in the study presents the potential to characterize nanoparticle exposure for a variety of operational processes. We found the highest mass exposure occurred at bagging job whereas the highest number and surface area concentration was found at modification

A Method for Quantifying the Acute Health Impacts of Residential Non-Biological Exposure Via Inhalation

Energy Technology Data Exchange (ETDEWEB)

Logue, Jennifer M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sherman, Max H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Singer, Bret C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2014-08-01

The inability to monetize the health costs of acute exposures in homes and the benefits of various control options is a barrier to justifying policies and approaches that can reduce exposure and improve health.We synthesized relationships between short-term outdoor concentration changes and health outcomes to estimate the health impacts of short-term in-home exposures. Damage and cost impacts of specific health outcomes were taken from the literature. We assessed the impact of vented and non-vented residential natural gas cooking burners on Southern California occupants for two pollutants (NO₂ and CO).

Application and outcomes of therapy combining transcranial direct current stimulation and virtual reality: a systematic review.

Science.gov (United States)

Massetti, Thais; Crocetta, Tânia Brusque; Silva, Talita Dias da; Trevizan, Isabela Lopes; Arab, Claudia; Caromano, Fátima Aparecida; Monteiro, Carlos Bandeira de Mello

2017-08-01

To evaluate the methods and major outcomes of transcranial direct current stimulation (tDCS) combined with virtual reality (VR) therapy in randomized controlled trials. A systematic review was performed following PRISMA guidelines using PubMed, PubMed Central, Web of Science and CAPES periodic databases, with no time restriction. The studies were screened for the following inclusion criteria: human subjects, combination of VR and tDCS methods, and randomized controlled study design. All potentially relevant articles were independently reviewed by two researchers, who reached a consensus on which articles met the inclusion criteria. The PEDro scale was used to evaluate the studies. Eleven studies were included, all of which utilized a variety of tDCS and VR application methods. The main outcomes were found to be beneficial in intervention groups of different populations, including improvements in body sway, gait, stroke recovery, pain management and vegetative reactions. The use of tDCS combined with VR showed positive results in both healthy and impaired patients. Future studies with larger sample sizes and homogeneous participants are required to confirm the benefits of tDCS and VR. Implications for Rehabilitation tDCS with VR intervention can be an alternative to traditional rehabilitation programs. tDCS with VR is a promising type of intervention with a variety of positive effects. Application of tDCS with VR is appropriated to both healthy and impaired patients. There is no consensus of tDCS with VR application.

Transformational leadership: application of magnet's new empiric outcomes.

Science.gov (United States)

Meredith, Erin K; Cohen, Elaine; Raia, Lucille V

2010-03-01

The many benefits to hospitals throughout the world that achieved Magnet designation is well documented. This status of recognition demands the support of leadership during the Magnet journey. In 2008, the American Nurses Credentialing Center (ANCC) announced a new model for the Magnet Recognition Program that translates the original 14 Forces of Magnetism into Five Model Components. Specifically, this new model includes sources of evidence and empiric outcomes that by definition accentuates transformational nursing leadership. The day-to-day impact of this change places an even greater emphasis on demonstrated outcomes and innovation that may potentially transform nursing practice, quality and safety of care, and the population served. This article provides tangible examples and outcomes for reaching nursing excellence through leadership support and engagement. Published by Elsevier Inc.

The effect of mobile application interventions on influencing healthy maternal behaviour and improving perinatal health outcomes: a systematic review protocol.

Science.gov (United States)

Daly, Lisa M; Horey, Dell; Middleton, Philippa F; Boyle, Frances M; Flenady, Vicki

2017-02-08

Perinatal morbidity and mortality remain significant public health issues globally, with enduring impact on the health and well-being of women and their families. Pregnant women who adopt, practice and maintain healthy behaviours can potentially improve the health of themselves and their babies. Mobile applications are an increasingly popular mode of accessing, storing and sharing health information among pregnant women. The main objective of this review is to evaluate the effects of mobile application interventions during pregnancy on maternal behaviour and associated maternal and infant outcomes. This review will include randomised and non-randomised studies which tested use of mobile applications designed to improve either maternal knowledge or behaviours to address known risk factors associated with adverse perinatal health outcomes. This review will include studies which included pregnant women and/or women during birth. The search strategy will utilise a combination of keywords and MeSH terms. Literature databases such as PubMed, Embase, The Cochrane Library, CINAHL and WHO Global Health Library will be searched. Two reviewers will independently screen retrieved citations to determine if they meet inclusion criteria. Studies will be selected that provide information about interventions commenced in early pregnancy, late pregnancy or labour. Comparisons to be made include mobile applications versus interventions relying on paper-based or text-messaging-based communication; interpersonal communication such as face-to-face or telephone conversation; and no intervention or standard care. Quality assessment of included randomised studies will utilise established guidelines provided in the Cochrane Handbook for Systematic Reviews of Interventions. Quality assessment of non-randomised studies will be based on the Risk of Bias in Non-randomised Studies-of Interventions (ROBINS-I) assessment tool. Quality of the evidence will be evaluated using the Grades of

Review of the state of the art of human biomonitoring for chemical substances and its application to human exposure assessment for food safety

DEFF Research Database (Denmark)

Choi, Judy; Mørck, Thit Aarøe; Polcher, Alexandra

2015-01-01

Human biomonitoring (HBM) measures the levels of substances in body fluids and tissues. Many countries have conducted HBM studies, yet little is known about its application towards chemical risk assessment, particularly in relation to food safety. Therefore a literature search was performed...... in several databases and conference proceedings for 2002 – 2014. Definitions of HBM and biomarkers, HBM techniques and requirements, and the possible application to the different steps of risk assessment were described. The usefulness of HBM for exposure assessment of chemical substances from food source...... safety areas (namely exposure assessment), and for the implementation of a systematic PMM approach. But further work needs to be done to improve usability. Major deficits are the lack of HBM guidance values on a considerable number of substance groups, for which health based guidance values (HBGVs) have...

Development of regulatory criteria applicable to control of radiation exposures to the population from products containing radioactive material

Energy Technology Data Exchange (ETDEWEB)

Rogers, L R; Western, F [U.S. Atomic Energy Commission, Germantown, MD (United States)

1969-07-01

Under the Atomic Energy Act of 1954 as amended, the Atomic Energy Commission is responsible for regulating the possession, use and transfer of byproduct, source and special nuclear materials in accordance with safety standards established by rule of the Commission to protect health and minimize danger to life and property. This paper describes some of the basic considerations in establishing safety criteria and regulations for authorizing the transfer and use of byproduct material (radioisotopes) in products for distribution to the general public. It discusses problems encountered in extending the broad guidance provided by the Federal Radiation Council (FRC) and by the International Commission of Radiological Protection and the National Council on Radiation Protection and Measurements (ICRP-NCRP), which is limited to total exposures of individuals and population groups to radiation from many sources, to appropriate controls on radioactivity in an individual consumer product which represents only one source of population exposures. The paper also discusses possible approaches to accomplishing the regulatory objectives of providing reasonable assurance that (1) the contribution of an individual product to total exposures that might be permitted under FRC and ICRP-NCRP guidance should not be disproportionate to the benefits to be derived, and (2) appropriate efforts are made to limit exposures to the population from individual classes of sources of exposure as far as practicable. Existing criteria and regulations pertaining to the control of radiation exposure to the population from products into which radioactive material is purposely introduced are described, and additional considerations which must be taken into account for the development of further criteria and regulations which are applicable to the possible wide-scale distribution of products containing radioactive material as a result of the Plowshare Programs are explored. (author)

Development of regulatory criteria applicable to control of radiation exposures to the population from products containing radioactive material

International Nuclear Information System (INIS)

Rogers, L.R.; Western, F.

1969-01-01

Under the Atomic Energy Act of 1954 as amended, the Atomic Energy Commission is responsible for regulating the possession, use and transfer of byproduct, source and special nuclear materials in accordance with safety standards established by rule of the Commission to protect health and minimize danger to life and property. This paper describes some of the basic considerations in establishing safety criteria and regulations for authorizing the transfer and use of byproduct material (radioisotopes) in products for distribution to the general public. It discusses problems encountered in extending the broad guidance provided by the Federal Radiation Council (FRC) and by the International Commission of Radiological Protection and the National Council on Radiation Protection and Measurements (ICRP-NCRP), which is limited to total exposures of individuals and population groups to radiation from many sources, to appropriate controls on radioactivity in an individual consumer product which represents only one source of population exposures. The paper also discusses possible approaches to accomplishing the regulatory objectives of providing reasonable assurance that (1) the contribution of an individual product to total exposures that might be permitted under FRC and ICRP-NCRP guidance should not be disproportionate to the benefits to be derived, and (2) appropriate efforts are made to limit exposures to the population from individual classes of sources of exposure as far as practicable. Existing criteria and regulations pertaining to the control of radiation exposure to the population from products into which radioactive material is purposely introduced are described, and additional considerations which must be taken into account for the development of further criteria and regulations which are applicable to the possible wide-scale distribution of products containing radioactive material as a result of the Plowshare Programs are explored. (author)

Unemployment and psychosocial outcomes to age 30: A fixed-effects regression analysis.

Science.gov (United States)

Fergusson, David M; McLeod, Geraldine F; Horwood, L John

2014-08-01

We aimed to examine the associations between exposure to unemployment and psychosocial outcomes over the period from 16 to 30 years, using data from a well-studied birth cohort. Data were collected over the course of the Christchurch Health and Development Study, a longitudinal study of a birth cohort of 1265 children, born in Christchurch in 1977, who have been studied to age 30. Assessments of unemployment and psychosocial outcomes (mental health, substance abuse/dependence, criminal offending, adverse life events and life satisfaction) were obtained at ages 18, 21, 25 and 30. Prior to adjustment, an increasing duration of unemployment was associated with significant increases in the risk of all psychosocial outcomes. These associations were adjusted for confounding using conditional, fixed-effects regression techniques. The analyses showed significant (p unemployment and major depression (p = 0.05), alcohol abuse/dependence (p = 0.043), illicit substance abuse/dependence (p = 0.017), property/violent offending (p unemployment. The findings suggested that the association between unemployment and psychosocial outcomes was likely to involve a causal process in which unemployment led to increased risks of adverse psychosocial outcomes. Effect sizes were estimated using attributable risk; exposure to unemployment accounted for between 4.2 and 14.0% (median 10.8%) of the risk of experiencing the significant psychosocial outcomes. The findings of this study suggest that exposure to unemployment had small but pervasive effects on psychosocial adjustment in adolescence and young adulthood. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Comparison of modeling approaches to prioritize chemicals based on estimates of exposure and exposure potential.

Science.gov (United States)

Mitchell, Jade; Arnot, Jon A; Jolliet, Olivier; Georgopoulos, Panos G; Isukapalli, Sastry; Dasgupta, Surajit; Pandian, Muhilan; Wambaugh, John; Egeghy, Peter; Cohen Hubal, Elaine A; Vallero, Daniel A

2013-08-01

While only limited data are available to characterize the potential toxicity of over 8 million commercially available chemical substances, there is even less information available on the exposure and use-scenarios that are required to link potential toxicity to human and ecological health outcomes. Recent improvements and advances such as high throughput data gathering, high performance computational capabilities, and predictive chemical inherency methodology make this an opportune time to develop an exposure-based prioritization approach that can systematically utilize and link the asymmetrical bodies of knowledge for hazard and exposure. In response to the US EPA's need to develop novel approaches and tools for rapidly prioritizing chemicals, a "Challenge" was issued to several exposure model developers to aid the understanding of current systems in a broader sense and to assist the US EPA's effort to develop an approach comparable to other international efforts. A common set of chemicals were prioritized under each current approach. The results are presented herein along with a comparative analysis of the rankings of the chemicals based on metrics of exposure potential or actual exposure estimates. The analysis illustrates the similarities and differences across the domains of information incorporated in each modeling approach. The overall findings indicate a need to reconcile exposures from diffuse, indirect sources (far-field) with exposures from directly, applied chemicals in consumer products or resulting from the presence of a chemical in a microenvironment like a home or vehicle. Additionally, the exposure scenario, including the mode of entry into the environment (i.e. through air, water or sediment) appears to be an important determinant of the level of agreement between modeling approaches. Copyright © 2013 Elsevier B.V. All rights reserved.

Comparison of modeling approaches to prioritize chemicals based on estimates of exposure and exposure potential

Science.gov (United States)

Mitchell, Jade; Arnot, Jon A.; Jolliet, Olivier; Georgopoulos, Panos G.; Isukapalli, Sastry; Dasgupta, Surajit; Pandian, Muhilan; Wambaugh, John; Egeghy, Peter; Cohen Hubal, Elaine A.; Vallero, Daniel A.

2014-01-01

While only limited data are available to characterize the potential toxicity of over 8 million commercially available chemical substances, there is even less information available on the exposure and use-scenarios that are required to link potential toxicity to human and ecological health outcomes. Recent improvements and advances such as high throughput data gathering, high performance computational capabilities, and predictive chemical inherency methodology make this an opportune time to develop an exposure-based prioritization approach that can systematically utilize and link the asymmetrical bodies of knowledge for hazard and exposure. In response to the US EPA’s need to develop novel approaches and tools for rapidly prioritizing chemicals, a “Challenge” was issued to several exposure model developers to aid the understanding of current systems in a broader sense and to assist the US EPA’s effort to develop an approach comparable to other international efforts. A common set of chemicals were prioritized under each current approach. The results are presented herein along with a comparative analysis of the rankings of the chemicals based on metrics of exposure potential or actual exposure estimates. The analysis illustrates the similarities and differences across the domains of information incorporated in each modeling approach. The overall findings indicate a need to reconcile exposures from diffuse, indirect sources (far-field) with exposures from directly, applied chemicals in consumer products or resulting from the presence of a chemical in a microenvironment like a home or vehicle. Additionally, the exposure scenario, including the mode of entry into the environment (i.e. through air, water or sediment) appears to be an important determinant of the level of agreement between modeling approaches. PMID:23707726

Psychiatric symptomatology in persons with organic solvent exposure.

Science.gov (United States)

Morrow, L A; Kamis, H; Hodgson, M J

1993-02-01

This study investigated psychiatric symptomatology, self-concept, locus of control, and daily events in persons with a history of exposure to mixtures of organic solvents. Exposed subjects were more likely than controls to report depression, anxiety, fatigue, confusion, and somatic concerns, which in turn were associated with certain exposure-related variables (e.g., cacosmia). There were no differences between the groups in self-concept, locus of control, or ratings of daily hassles and uplifts. Exposed persons may be able to accurately identify what they perceive as changes that are due to the exposure (e.g., anxiety) without attributing these specific adverse outcomes to dispositional variables.

Observations on health outcome studies of exposure of the worker and the general population during the nuclear reactor accident at three mile island

International Nuclear Information System (INIS)

Fabrikant, J.I.

1988-01-01

The nuclear reactor accident at Three Mile Island in March 1979 resulted in the release of radioactivity to the environment. Radiation exposure of the workers and the general population living in the vicinity of the damaged nuclear reactor was estimated based on dose measurements, meteorological conditions, demographic characteristics, reconstruction of the source term, and a number of other factors. The projected estimates of potential delayed health effects in the worker and general population, notable cancer, developmental abnormalities of the newborn, and genetic ill-health, were carefully estimated based on then-current knowledge of radiation risks and statistical techniques of analysis. Almost a decade later, we now have epidemiological and statistical data on certain of these health outcomes in the exposed populations at risk. Discussion includes the reliability of the initial radiation risk estimates, the major illnesses of concern, the mental stress and behavioral effects at the time of and following the accident, and the current findings of the ongoing studies of the health outcomes of the vulnerable populations at risk

Internet-Delivered Exposure Therapy for Fibromyalgia: A Randomized Controlled Trial.

Science.gov (United States)

Hedman-Lagerlöf, Maria; Hedman-Lagerlöf, Erik; Axelsson, Erland; Ljótsson, Brjánn; Engelbrektsson, Johanna; Hultkrantz, Sofia; Lundbäck, Karolina; Björkander, Daniel; Wicksell, Rikard K; Flink, Ida; Andersson, Erik

2018-06-01

Fibromyalgia (FM) is a common and disabling chronic pain disorder, for which existing pharmacological and psychological treatments have yet yielded insufficient effects. Previous literature has shown that exposure therapy may be an effective treatment for chronic pain. This study constitutes the first randomized controlled trial evaluating exposure therapy for FM. A total of 140 participants with diagnosed FM were randomized to a 10-week Internet-delivered exposure treatment (iExp; n=70) or a waitlist control condition (WLC; n=70). Primary outcome measure were FM symptoms and impact, and secondary outcome measures were fatigue, disability, quality of life, pain-related distress and avoidance behaviors, insomnia, depression, and anxiety. Data retention was high (100% data completion at posttreatment for primary outcome, 96% at 6-month follow-up and 94% at 12-month follow-up). Results showed that participants in the iExp group made large and superior improvements compared with WLC on FM symptoms and impact (B, -1.93; z, -10.14; P<0.001, between-group Cohen d=0.90), as well as all secondary outcomes (between-group Cohen d ranging from 0.44 to 1.38) with sustained results. We conclude that iExp seems to be an efficacious treatment for FM compared with no treatment, and the results also highlight the potential increase of accessibility by using the Internet format to deliver psychological treatments for these patients. Future trials with active control conditions are warranted.

Measuring sun exposure in epidemiological studies: Matching the method to the research question.

Science.gov (United States)

King, Laura; Xiang, Fan; Swaminathan, Ashwin; Lucas, Robyn M

2015-12-01

Sun exposure has risks and benefits for health. Testing these associations requires tools for measuring sun exposure that are feasible and relevant to the time-course of the health outcome. Recent sun exposure, e.g. the last week, is best captured by dosimeters and sun diaries. These can also be used for medium-term sun exposure e.g. over several weeks, but incur a high participant burden. Self-reported data on "typical time outdoors" for working and non-working days, is less detailed and not influenced by day-to-day variation. Over a longer period, e.g. the lifetime, or for particular life stages, proxies of sun exposure, such as latitude of residence or ambient ultraviolet (UV) radiation levels (from satellites or ground-level monitoring) can be used, with additional detail provided by lifetime sun exposure calendars that include locations of residence, usual time outdoors, and detail of sunburn episodes. Objective measures of lifetime sun exposure include microtopography of sun-exposed skin (e.g. using silicone casts) or conjunctival UV autofluorescence. Potential modifiers of the association between sun exposure and the health outcome, such as clothing coverage and skin colour, may also need to be measured. We provide a systematic approach to selecting sun exposure measures for use in epidemiological health research. Copyright © 2015 Elsevier B.V. All rights reserved.

Retrospective Occupational Exposure Assessment in Community-Based Studies Made Easier

International Nuclear Information System (INIS)

Fritschi, L.; Girschik, J.; Friesen, M.C.; Glass, D.; Monash, G.B.; Sadkowsky, T.

2010-01-01

Occ DEAS Assessing occupational exposure in retrospective community-based case-control studies is difficult as measured exposure data are very seldom available. The expert assessment method is considered the most accurate way to attribute exposure but it is a time consuming and expensive process and may be seen as subjective, non reproducible, and non transparent. In this paper, we describe these problems and outline our solutions as ope rationalized in a web-based software application (Occ DEAS). The novel aspects of Occ DEAS are combining all steps in the assessment into one software package; enmeshing the process of assessment into the development of questionnaires; selecting the exposure(s) of interest; specifying rules for exposure assignment; allowing manual or automatic assessments; ensuring that circumstances in which exposure is possible for an individual are highlighted for review; providing reports to ensure consistency of assessment. Development of this application has the potential to make high-quality occupational assessment more efficient and accessible for epidemiological studies

Long-term outcome after transvaginal mesh repair of pelvic organ prolapse.

Science.gov (United States)

Heinonen, Pia; Aaltonen, Riikka; Joronen, Kirsi; Ala-Nissilä, Seija

2016-07-01

The aim of this study was to report long-term subjective and objective outcomes after the transvaginal mesh (TVM) procedure in long-term. Possible late-onset complications were of particular interest. This was a retrospective analysis of TVM performed using Prolift™ transvaginal mesh measuring subjective outcome using validated questionnaires. Objective outcome was assessed using the Pelvic Organ Prolapse Quantification (POP-Q) system using two definitions: POP-Q stage ≤ 1, and vaginal wall prolapse at or above the hymen or vaginal apex not descending below the upper third of the vagina. Complications were reported with the Prosthesis/Graft Complication Classification Code designed by the International Continence Society/International Urogynecological Association (ICS/IUGA). Of 195 patients, 161 (82.6 %) participated this study after a median of 7 years. The scores in questionnaires evaluating urinary (UI) or anal incontinence and constipation or pelvic floor symptoms were low, indicating favorable surgical outcomes. Altogether, 80.1 % of patients were satisfied with the procedure. Anatomical cure was 56.4 % and 69.3 % depending on the definition used. Reoperation due to POP in any compartment was performed in 16.2 % of patients. Mesh exposure rate was 23 %, most of these being asymptomatic and of late onset. Outcome of the TVM procedure was satisfactory. Anatomical cure was inferior to subjective cure. Mesh exposure rate was high; most exposures observed in the long-term were of late onset and were asymptomatic.

Mechanisms involved in the neurotoxic and cognitive effects of developmental methamphetamine exposure.

Science.gov (United States)

Jablonski, Sarah A; Williams, Michael T; Vorhees, Charles V

2016-06-01

Methamphetamine exposure in utero leads to a variety of higher-order cognitive deficits, such as decreased attention and working, and spatial memory impairments in exposed children (Piper et al., 2011; Roussotte et al., 2011; Kiblawi et al., 2011). As with other teratogens, the timing of methamphetamine exposure greatly determines its effects on both neuroanatomical and behavioral outcomes. Methamphetamine exposure in rodents during the third trimester human equivalent period of brain development results in distinct and long-lasting route-based and spatial navigation deficits (Williams et al., 2003; Vorhees et al., 2005, 2008, 2009;). Here, we examine the impact of neonatal methamphetamine-induced neurotoxicity on behavioral outcomes, neurotransmission, receptor changes, plasticity proteins, and DNA damage. Birth Defects Research (Part C) 108:131-141, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

[Knowledge produced from the outcomes of the "Nursing Outcomes Classification--NOC": integrative review].

Science.gov (United States)

da Silva, Natália Chantal Magalhães; de Souza Oliveira, Ana Railka; de Carvalho, Emília Campos

2015-12-01

To identify the knowledge produced from the outcomes of the Nursing Outcomes Classification (NOC). A literature review using the integrative databases: Latin American and Caribbean Health Sciences (LILACS), US National Library of Medicine (PubMed), Cumulative Index to Nursing & Allied Health Literature (CINAHL) and Scopus Info Site (SCOPUS), during the months of August and September 2014. The review consisted of 21 articles that addressed different issues: Translation and Cultural adaptation (4.77%); Applicability in clinical practice (33.33%); and, Validation (63.90%). Analysis of these articles showed that the knowledge produced from the Nursing Outcomes Classification includes translation and cultural adaptation, evaluation of applicability and validation of its items. Considering the continuous evolution of this classification, periodic reviews should be carried out to identify the knowledge, use and effects of the NOC.

Application of radioactive substances in research in nuclear medicine: current trends and radiation exposure to the study subjects

International Nuclear Information System (INIS)

Minkov, V.; Schwarz, E.R.; Bauer, B.; Nosske, D.; Erzberger, A.; Brix, G.

2001-01-01

Aim: Analysis of the application of radioactive substances in research in the field of nuclear medicine in human beings and of the resulting radiation exposure to study subjects. Methods: Assessment of applications for approval submitted in accordance with Paragraph 41 of the Radiation Protection Ordinance, evaluated by the Federal office for Radiation Protection together with the Federal Institute for Pharmaceuticals and Medical Products, within the period from 1997 to 1999. Results: The focus of the studies on the diagnostic application of radioactive substances in medicine evaluated has, since 1998, shifted from oncological to neurological and psychological aspects, while, at the same time, the number of PET studies increased constantly The proportion of healthy study subjects included in the diagnostic studies increased from 7 to 22%. The number of therapeutic applications of radioactive substances has, since 1997, undergone a three-fold increase, and in the process of this, the focus of attention lay within the area of radioimmuno-therapy and endovascular brachytherapy. The effective dose was, among up to 49% of the investigated healthy study subjects higher than 5 mSv, and among up to 6% of these subjects was at levels of over 20 mSv. Up to 22% of the patients received, within the scope of diagnostic studies, an effective dose of between 20 and 50 mSv. An exceeding of the 50 mSv limit occurred among up to 3% of the patients. Conclusions: In spite of the increasing numbers of PET applications, conventional nuclear medicine has maintained its importance in the field of medical research. Further developments in the areas of radiochemistry and molecular biology led to an increase in the importance of radio-immuno therapy. The evaluation of new radiopharmaceuticals and the extension of basic biomedical research, resulted in an increase in the proportion of healthy study subjects included in the studies. The radiation exposure among subjects resulting directly from

Infant media exposure and toddler development.

Science.gov (United States)

Tomopoulos, Suzy; Dreyer, Benard P; Berkule, Samantha; Fierman, Arthur H; Brockmeyer, Carolyn; Mendelsohn, Alan L

2010-12-01

To determine whether duration and content of media exposure in 6-month-old infants are associated with development at age 14 months. Longitudinal analysis of 259 mother-infant dyads participating in a long-term study related to early child development, from November 23, 2005, through January 14, 2008. An urban public hospital. Mothers with low socioeconomic status and their infants. Duration and content of media exposure at age 6 months. Cognitive and language development at age 14 months. Of 259 infants, 249 (96.1%) were exposed to media at age 6 months, with mean (SD) total exposure of 152.7 (124.5) min/d. In unadjusted and adjusted analyses, duration of media exposure at age 6 months was associated with lower cognitive development at age 14 months (unadjusted: r = -0.17, P development (r = -0.16, P cognitive and language development at age 14 months. No significant associations were seen with exposure to young child-oriented educational or noneducational content. This study is the first, to our knowledge, to have longitudinally assessed associations between media exposure in infancy and subsequent developmental outcomes in children from families with low socioeconomic status in the United States. Findings provide strong evidence in support of the American Academy of Pediatrics recommendations of no media exposure prior to age 2 years, although further research is needed.

Physiologic changes associated with violence and abuse exposure: an examination of related medical conditions.

Science.gov (United States)

Keeshin, Brooks R; Cronholm, Peter F; Strawn, Jeffrey R

2012-01-01

Although the extant evidence is replete with data supporting linkages between exposure to violence or abuse and the subsequent development of medical illnesses, the underlying mechanisms of these relationships are poorly defined and understood. Physiologic changes occurring in violence- or abuse-exposed individuals point to potentially common biological pathways connecting traumatic exposures with medical outcomes. Herein, the evidence describing the long-term physiologic changes in abuse- and violence-exposed populations and associated medical illnesses are reviewed. Current data support that (a) specific neurobiochemical changes are associated with exposure to violence and abuse; (b) several biological pathways have the potential to lead to the development of future illness; and (c) common physiologic mechanisms may moderate the severity, phenomenology, or clinical course of medical illnesses in individuals with histories of exposure to violence or abuse. Importantly, additional work is needed to advance our emerging understanding of the biological mechanisms connecting exposure to violence and abuse and negative health outcomes.

Navajo birth outcomes in the Shiprock uranium mining area

International Nuclear Information System (INIS)

Shields, L.M.; Wiese, W.H.; Skipper, B.J.; Charley, B.; Benally, L.

1992-01-01

The role of environmental radiation in the etiology of birth defects, stillbirths, and other adverse outcomes of pregnancy was evaluated for 13,329 Navajos born at the Public Health Service/Indian Health Service Hospital in the Shiprock, NM, uranium mining area (1964-1981). More than 320 kinds of defective congenital conditions were abstracted from hospital records. Using a nested case-control design, families of 266 pairs of index and control births were interviewed. The only statistically significant association between uranium operations and unfavorable birth outcome was identified with the mother living near tailings or mine dumps. Among the fathers who worked in the mines, those of the index cases had histories of more years of work exposure but not necessarily greater gonadal dosage of radiation. Also, birth defects increased significantly when either parent worked in the Shiprock electronics assembly plant. Overall, the associations between adverse pregnancy outcome and exposure to radiation were weak and must be interpreted with caution with respect to implying a biogenetic basis

Environmental risk factors of pregnancy outcomes: a summary of recent meta-analyses of epidemiological studies.

Science.gov (United States)

Nieuwenhuijsen, Mark J; Dadvand, Payam; Grellier, James; Martinez, David; Vrijheid, Martine

2013-01-15

Various epidemiological studies have suggested associations between environmental exposures and pregnancy outcomes. Some studies have tempted to combine information from various epidemiological studies using meta-analysis. We aimed to describe the methodologies used in these recent meta-analyses of environmental exposures and pregnancy outcomes. Furthermore, we aimed to report their main findings. We conducted a bibliographic search with relevant search terms. We obtained and evaluated 16 recent meta-analyses. The number of studies included in each reported meta-analysis varied greatly, with the largest number of studies available for environmental tobacco smoke. Only a small number of the studies reported having followed meta-analysis guidelines or having used a quality rating system. Generally they tested for heterogeneity and publication bias. Publication bias did not occur frequently.The meta-analyses found statistically significant negative associations between environmental tobacco smoke and stillbirth, birth weight and any congenital anomalies; PM2.5 and preterm birth; outdoor air pollution and some congenital anomalies; indoor air pollution from solid fuel use and stillbirth and birth weight; polychlorinated biphenyls (PCB) exposure and birth weight; disinfection by-products in water and stillbirth, small for gestational age and some congenital anomalies; occupational exposure to pesticides and solvents and some congenital anomalies; and agent orange and some congenital anomalies. The number of meta-analyses of environmental exposures and pregnancy outcomes is small and they vary in methodology. They reported statistically significant associations between environmental exposures such as environmental tobacco smoke, air pollution and chemicals and pregnancy outcomes.

Environmental risk factors of pregnancy outcomes: a summary of recent meta-analyses of epidemiological studies

Directory of Open Access Journals (Sweden)

Nieuwenhuijsen Mark J

2013-01-01

Full Text Available Abstract Background Various epidemiological studies have suggested associations between environmental exposures and pregnancy outcomes. Some studies have tempted to combine information from various epidemiological studies using meta-analysis. We aimed to describe the methodologies used in these recent meta-analyses of environmental exposures and pregnancy outcomes. Furthermore, we aimed to report their main findings. Methods We conducted a bibliographic search with relevant search terms. We obtained and evaluated 16 recent meta-analyses. Results The number of studies included in each reported meta-analysis varied greatly, with the largest number of studies available for environmental tobacco smoke. Only a small number of the studies reported having followed meta-analysis guidelines or having used a quality rating system. Generally they tested for heterogeneity and publication bias. Publication bias did not occur frequently. The meta-analyses found statistically significant negative associations between environmental tobacco smoke and stillbirth, birth weight and any congenital anomalies; PM2.5 and preterm birth; outdoor air pollution and some congenital anomalies; indoor air pollution from solid fuel use and stillbirth and birth weight; polychlorinated biphenyls (PCB exposure and birth weight; disinfection by-products in water and stillbirth, small for gestational age and some congenital anomalies; occupational exposure to pesticides and solvents and some congenital anomalies; and agent orange and some congenital anomalies. Conclusions The number of meta-analyses of environmental exposures and pregnancy outcomes is small and they vary in methodology. They reported statistically significant associations between environmental exposures such as environmental tobacco smoke, air pollution and chemicals and pregnancy outcomes.

Perseverative Cognitions and Stress Exposure: Comparing Relationships With Psychological Health Across a Diverse Adult Sample.

Science.gov (United States)

Zawadzki, Matthew J; Sliwinski, Martin J; Smyth, Joshua M

2018-03-29

Both exposure to stress and perseverative cognitions (PCs)-repetitive cognitive representations of real or imagined stressors-are linked with poor psychological health. Yet, stress exposure and PCs are correlated, thus potentially obscuring any unique effects. The purpose of this paper is to concurrently test associations between stress exposure and PCs and psychological health to examine the independent relationship of each with psychological health. Moreover, we examined whether these relationships are similar across sex, age, and race. An adult community sample (n = 302) completed a measure of stress exposure, three PCs scales, and questionnaires assessing self-reported psychological health, including emotional well-being, vitality, social functioning, role limitations due to personal problems, subjective well-being, depressive symptoms, and poor sleep quality. Structural equation modeling was used to test a model in which both stress exposure and PCs predict psychological health. PCs consistently predicted all the psychological health outcomes, but stress was largely unrelated to the outcomes despite bivariate correlations suggesting a relationship. A follow-up model identified indirect effects of stress exposure on psychological health via PCs. Results were fairly consistent regardless of one's sex, age, or race. PCs robustly predicted all of the psychological health outcomes, intimating PCs as a common pathway to poor psychological health. Results have implications for stress interventions, including the need to address PCs after experiencing stress.

Texas Bull Nettle (Cnidoscolus texanus) Exposures Reported to Texas Poison Centers.

Science.gov (United States)

Forrester, Mathias B

2017-06-01

Texas bull nettle (Cnidoscolus texanus) is covered in bristly hairs similar to stinging nettle. Contact with the plant may result in intense dermal pain, burning, itching, cellulitis, and allergic reaction. This study characterizes C texanus exposures reported to a large state-wide poison center system. Cases were C texanus exposures reported to Texas poison centers during 2000-2015. The distribution of cases was determined for patient demographics, exposure circumstances, and patient outcome. A total of 140 C texanus exposures were identified. Twenty percent of the patients were aged ≤5 years, 21% were 6 to 12 years, 5% were 13 to 19 years, and 51% were ≥20years; and 51% of the patients were male. Eighty-one percent of the exposures occurred at the patient's own residence, 11% in a public area, 2% at another residence, and 1% at school. Seventy-eight percent of the patients were managed on site, 13% were already at or en route to a health care facility, and 6% were referred to a health care facility. Eighty-eight percent of the exposures resulted in dermal effects: irritation or pain (56%), erythema or flushing (31%), edema (27%), pruritus (24%), rash (19%), puncture or wound (19%), and hives or welts (11%). C texanus exposures reported to Texas poison centers were most likely to be unintentional and occur at the patient's own residence. The outcomes of the exposures tended not to be serious and could be managed successfully outside of health care facilities. Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Impact of noise and air pollution on pregnancy outcomes.

Science.gov (United States)

Gehring, Ulrike; Tamburic, Lillian; Sbihi, Hind; Davies, Hugh W; Brauer, Michael

2014-05-01

Motorized traffic is an important source of both air pollution and community noise. While there is growing evidence for an adverse effect of ambient air pollution on reproductive health, little is known about the association between traffic noise and pregnancy outcomes. We evaluated the impact of residential noise exposure on small size for gestational age, preterm birth, term birth weight, and low birth weight at term in a population-based cohort study, for which we previously reported associations between air pollution and pregnancy outcomes. We also evaluated potential confounding of air pollution effects by noise and vice versa. Linked administrative health data sets were used to identify 68,238 singleton births (1999-2002) in Vancouver, British Columbia, Canada, with complete covariate data (sex, ethnicity, parity, birth month and year, income, and education) and maternal residential history. We estimated exposure to noise with a deterministic model (CadnaA) and exposure to air pollution using temporally adjusted land-use regression models and inverse distance weighting of stationary monitors for the entire pregnancy. Noise exposure was negatively associated with term birth weight (mean difference = -19 [95% confidence interval = -23 to -15] g per 6 dB(A)). In joint air pollution-noise models, associations between noise and term birth weight remained largely unchanged, whereas associations decreased for all air pollutants. Traffic may affect birth weight through exposure to both air pollution and noise.

When is exposure to a natural disaster traumatic? Comparison of a trauma questionnaire and disaster exposure inventory.

Science.gov (United States)

Harville, Emily W; Jacobs, Marni; Boynton-Jarrett, Renée

2015-01-01

Few studies have compared the sensitivity of trauma questionnaires to disaster inventories for assessing the prevalence of exposure to natural disaster or associated risk for post-disaster psychopathology. The objective of this analysis was to compare reporting of disaster exposure on a trauma questionnaire (Brief Trauma Questionnaire [BTQ]) to an inventory of disaster experience. Between 2011 and 2014, a sample of 841 reproductive-aged southern Louisiana women were interviewed using the BTQ and completed a detailed inventory about exposure to hurricanes and flooding. Post-traumatic stress disorder (PTSD) symptomology was measured with the Post-Traumatic Stress Checklist, and depression with the Edinburgh Depression Scale. The single question addressing disaster exposure on the BTQ had a sensitivity of between 65% and 70% relative to the more detailed questions. Reporting disaster exposure on the BTQ was more likely for those who reported illness/injury due to a hurricane or flood (74%-77%) or danger (77-79%), compared to those who reported damage (69-71%) or evacuation (64-68%). Reporting disaster exposure on the BTQ was associated with depression (odds ratio [OR] 2.29, 95% confidence interval [CI] 1.43-3.68). A single question is unlikely to be useful for assessing the degree of exposure to disaster across a broad population, and varies in utility depending on the mental health outcome of interest: the single trauma question is useful for assessing depression risk.