Accurate Exposure Measurement Research Articles

Neighborhood Light at Night and Noise Levels, and Long-Term Sleep Trajectories in the Southern Community Cohort Study.

While light at night (LAN) and noise levels have been linked to suboptimal sleep outcomes, little is known about the link between these factors and long-term suboptimal sleep trajectories. The current study examined the association of neighborhood LAN and nighttime noise with long-term sleep trajectories in a cohort of Black individuals and White individuals predominantly from low-income communities. We used data from the Southern Community Cohort Study (N = 28,759 Black individuals and 16,276 White individuals). Sleep duration was self-reported at baseline and after an average of five years of follow-up, based on which we constructed nine sleep trajectories: normal-normal (optimal, reference), short-short, long-long, short-long, long-short, normal-short, normal-long, short-normal, and long-normal. LAN and nighttime noise were derived from satellite imagery and model-based estimates, respectively. Multinomial logistic regression was used to determine the relationship between LAN and noise exposures and sleep trajectories. Higher exposures to LAN and nighttime noise were associated with multiple suboptimal long-term sleep trajectories. In the total sample, higher LAN was associated with higher odds of long-long (OR Q5 vs. Q1 = 1.23 (CI = 1.02, 1.48)) and long-short (OR = 1.35 (CI = 1.06, 1.72)) trajectories, while higher nighttime noise was associated with short-short (1.19 (1.07, 1.31)), long-short (1.31 (1.05, 1.64)), and normal-song (1.16 (1.01, 1.34)) trajectories. Black and White individual-specific results showed qualitatively similar patterns between Black individuals and White individuals, although we also observed suggestive evidence for Black-White individual differences. In conclusion, elevated LAN and nighttime noise levels were associated with various suboptimal long-term sleep trajectories. However, it is noteworthy that the light and noise measures in our study may not accurately reflect individual-level exposures, and residual confounding from other factors is a concern. Future studies should use more accurate exposure measurements, collect information on and control for a wider range of factors, and examine whether reductions in neighborhood light and noise levels may contribute to improved long-term sleep health.

Low-cost IoT sensors reveal adverse health outcomes associated with air pollution exposure

Abstract Background Air pollution is a major public health threat and has been linked to various adverse health effects including respiratory and cardiovascular diseases. Fine particulate matter (PM2.5) and coarse particulate matter (PM10) are two major components of air pollution that are significant contributors to these health outcomes. With the advent of low-cost sensors, accurate measurement of exposure has become possible, allowing for better assessment of the impact of air pollution exposure on human health. Methods To investigate the association between air pollution exposure and illnesses resulting in hospital visits, IoT sensors were deployed in Ulaanbaatar, Mongolia, to measure PM2.5 and PM10 levels from 2018-2021. Health data was obtained from the Mongolian National Center for Public Health. Multivariable logistic regression models were used to estimate overall odds ratios for the associations between daily PM2.5 and PM10 exposure and the occurrence of illnesses, adjusting for age and sex. Results The unadjusted odds ratio for the association between PM10 exposure and acute respiratory illnesses was 1.3, while the unadjusted odds ratio for PM2.5 exposure was 1.2; decreasing to 1.2 and 1.1 respectively after adjusting for age and sex (p < 0.05). These findings are consistent with previous studies and highlight the significant impact of air pollution on the occurrence of acute respiratory illnesses. The use of IoT sensors allowed for accurate assessment of air pollution exposure in the study population. Conclusions This study provides further evidence of the detrimental effects of air pollution on human health, particularly on the occurrence of acute respiratory illnesses. These findings highlight the importance of continued efforts to reduce air pollution levels. Accurate measurement of exposure rates using IoT sensors can aid in identifying and addressing sources of air pollution to improve the quality of life for individuals and communities affected by this health threat. Key messages • This study shows the significant impact of air pollution on acute respiratory illnesses, highlighting the importance of reducing air pollution levels. • Accurate measurement of air pollution exposure using IoT sensors can aid in identifying and addressing sources of air pollution to improve public health.

The Effect of Ambient Environmental Conditions on COVID-19 Mortality: A Systematic Review.

Weather conditions may have an impact on SARS-CoV-2 virus transmission, as has been shown for seasonal influenza. Virus transmission most likely favors low temperature and low humidity conditions. This systematic review aimed to collect evidence on the impact of temperature and humidity on COVID-19 mortality. This review was registered with PROSPERO (registration no. CRD42020196055). We searched the Pubmed, Embase, and Cochrane COVID-19 databases for observational epidemiological studies. Two independent reviewers screened the title/abstracts and full texts of the studies. Two reviewers also performed data extraction and quality assessment. From 5051 identified studies, 11 were included in the review. Although the results were inconsistent, most studies imply that a decrease in temperature and humidity contributes to an increase in mortality. To establish the association with greater certainty, future studies should consider accurate exposure measurements and important covariates, such as government lockdowns and population density, sufficient lag times, and non-linear associations.

Risk of Cancer in Association with Ranitidine and Nizatidine vs Other H2 Blockers: Analysis of the Japan Medical Data Center Claims Database 2005-2018.

In September 2019, ranitidine and nizatidine were suggested to contain N-nitrosodimethylamine, a carcinogenic substance. People have since been concerned about the potential impact of ranitidine/nizatidine use on the risk of cancer. The objective of this study was to investigate the risk of cancer among people receiving ranitidine or nizatidine compared with other histamine 2 receptor antagonists (H2 blockers) [cimetidine, famotidine, roxatidine, and lafutidine]. In the Japan Medical Data Center claims database (comprising people aged < 75years) from 2005 to 2018, we identified new adult users of H2 blockers and classified them into ranitidine/nizatidine users and other H2 blocker users. We estimated the incidence of cancer diagnosis in each group and conducted a multivariable Cox regression analysis. We identified 113,745 new users of ranitidine/nizatidine (median age 41.2years [interquartile range 31.7-51.1]; 49.1% men; median follow-up 2.4years [1.1-4.5]) and 503,982 new users of other H2 blockers (median age 40.9years [31.1-51.2]; 51.0% men; median follow-up 2.3years [0.9-4.2]). The incidence rate of cancer diagnosis was 6.39 (95% confidence interval 6.13-6.66) cases per 1000 person-years (top three sites: breast 14.8%; colorectal 14.6%; and stomach 11.5%) in the ranitidine/nizatidine group and 6.17 (6.05-6.30) cases per 1000 person-years (colorectal 14.7%; breast 13.5%; and stomach 11.2%) in the other H2 blockers group. The adjusted hazard ratio (ranitidine/nizatidine users vs other H2 blocker users) was 1.02 (0.98-1.07). The results were similar by follow-up length, by cancer site, and when ranitidine and nizatidine users were separately compared with the other H2 blockers group. By cumulative dose, the adjusted hazard ratio (95% confidence interval) was 1.03 (0.98-1.08) from 1 to 180 defined daily doses (DDDs), 1.00 (0.73-1.39) from 181 to 365 DDDs, 0.95 (0.61-1.48) from 366 to 730 DDDs, and 0.83 (0.45-1.55) at > 730 DDDs. We found no evidence that ranitidine/nizatidine is associated with an increased risk of cancer, although further studies with more accurate measurement of exposure, inclusion of older people, and longer follow-up may be needed.

Proposal for the automatic evaluation of workers' exposure to acoustic noise following task-based approach

Accurate measurement of exposure to noise in the workplace is important for employee health prevention as well as cost implications for employers. Standard ISO 9612 employs an engineering methodology for estimating noise exposure levels including levels of uncertainty. In this procedure some aspects are left to the discretion of the operator. Beginning with preliminary studies on the determination of the measurement intervals for evaluating workers' exposure to noise, this paper proposes an innovative approach to estimating work conditions for bus drivers. Measurement results are analysed and compared to the estimations based on both the ISO 9612 and the continuous acquisition analysis showing the feasibility of the proposal for accurately measuring the exposure to acoustic noise in a typical work situation.

Surface Coal Mining and Human Health: Evidence from West Virginia

This article presents the first panel‐data evidence of a human health externality from the air pollution generated by surface coal mining. In West Virginia, a standard deviation increase in a county's exposure to surface coal mining is associated with 9.85 more asthma hospitalizations per 100,000 residents in a given quarter. Interpreted causally, this suggests over $11 million in hospitalization costs over the 6‐year study period. The study builds on earlier cross‐sectional research by controlling for unobserved county‐level heterogeneity, and by defining more accurate measures of exposure. Both methods are shown to reduce the bias associated with earlier estimates of coal mining's effect on health. Young and elderly women demonstrate the largest sensitivities to surface mining. Falsification tests reveal that neither hernias nor bone fractures demonstrate any relationship with surface mining activity.

Coffee consumption and risk of non-Hodgkin's lymphoma: evidence from the Italian multicentre case-control study.

Several investigations have analysed the association between coffee intake and risk of cancer. Contradictory results were reported by the studies conducted in non-Hodgkin's lymphomas (NHL) few of which report results according to main NHL subgroups. The present study is aimed at evaluating the association between coffee consumption and the risk of NHL by analysing data from a large Italian multicentre case-control study that included 1,418 interviewed cases (1,301 B cell and 117 T cell NHL), diagnosed between 1990 and 1993, and 1,774 population healthy controls. The association was evaluated by standard logistic regression analysis. Odds ratio (OR) estimates were adjusted for gender, age, residence area, educational level, previous chemotherapy treatment, smoking habit and exposure to electromagnetic fields, radiation, pesticides and aromatic hydrocarbons. For all B cell lymphomas, an increased risk (OR 1.6, 95% CI 1.2-2.0) was observed in the highest exposure category (consumption >4 cups per day for at least 30years), but without a clear dose-response trend. Subgroup analyses highlighted an increased risk for drinkers of at least four cups per day for follicular lymphoma (OR 2.0, 95% CI 1.2-3.4). The risk increased with years of exposure and was more elevated among current smokers. Consumption of more than four cups of coffee per day enhances the risk of lymphoma, especially the follicular subtype. Further investigations based on large cohorts and accurate measures of exposure are needed to confirm the observed associations.

Invited Commentary: Quantifying the Added Value of Repeated Measurements.

Meaningful inference in epidemiology relies on accurate exposure measurement. In longitudinal observational studies, having more exposure data in the form of repeated measurements in the same individuals adds useful information. But exactly how much do repeated measurements add, incremental to the information provided by baseline measurements? In this issue of the Journal, Paige et al. (Am J Epidemiol. 2017;186(8):899-907 have quantified the value of adding repeated cholesterol and blood pressure measurements to baseline measurements in a meta-analysis of individual participant data from 38 longitudinal cohort studies. Repeated measurements improve prediction significantly, but the magnitude of this gain in information may be less than expected. In research studies and clinical practice, quality of measurement is more important than quantity.

Increased sensitivity of OSHA method analysis of diacetyl and 2,3-pentanedione in air

ABSTRACTGas chromatography/mass spectrometry (GC/MS) operated in selected ion monitoring mode was used to enhance the sensitivity of OSHA Methods 1013/1016 for measuring diacetyl and 2,3-pentanedione in air samples. The original methods use flame ionization detection which cannot achieve the required sensitivity to quantify samples at or below the NIOSH recommended exposure limits (REL: 5 ppb for diacetyl and 9.3 ppb for 2,3-pentanedione) when sampling for both diacetyl and 2,3-pentanedione. OSHA Method 1012 was developed to measure diacetyl at lower levels but requires an electron capture detector, and a sample preparation time of 36 hours. Using GC/MS allows detection of these two alpha-diketones at lower levels than OSHA Method 1012 for diacetyl and OSHA Method 1016 for 2,3-pentanedione. Acetoin and 2,3-hexanedione may also be measured using this technique. Method quantification limits were 1.1 ppb for diacetyl (22% of the REL), 1.1 ppb for 2,3-pentanedione (12% of the REL), 1.1 ppb for 2,3-hexanedione, and 2.1 ppb for acetoin. Average extraction efficiencies above the limit of quantitation were 100% for diacetyl, 92% for 2,3-pentanedione, 89% for 2,3-hexanedione, and 87% for acetoin. Mass spectrometry with OSHA Methods 1013/1016 could be used by analytical laboratories to provide more sensitive and accurate measures of exposure to diacetyl and 2,3-pentanedione.

Predicting Crashes Using Traffic Offences. A Meta-Analysis that Examines Potential Bias between Self-Report and Archival Data.

BackgroundTraffic offences have been considered an important predictor of crash involvement, and have often been used as a proxy safety variable for crashes. However the association between crashes and offences has never been meta-analysed and the population effect size never established. Research is yet to determine the extent to which this relationship may be spuriously inflated through systematic measurement error, with obvious implications for researchers endeavouring to accurately identify salient factors predictive of crashes.Methodology and Principal FindingsStudies yielding a correlation between crashes and traffic offences were collated and a meta-analysis of 144 effects drawn from 99 road safety studies conducted. Potential impact of factors such as age, time period, crash and offence rates, crash severity and data type, sourced from either self-report surveys or archival records, were considered and discussed. After weighting for sample size, an average correlation of r = .18 was observed over the mean time period of 3.2 years. Evidence emerged suggesting the strength of this correlation is decreasing over time. Stronger correlations between crashes and offences were generally found in studies involving younger drivers. Consistent with common method variance effects, a within country analysis found stronger effect sizes in self-reported data even controlling for crash mean.SignificanceThe effectiveness of traffic offences as a proxy for crashes may be limited. Inclusion of elements such as independently validated crash and offence histories or accurate measures of exposure to the road would facilitate a better understanding of the factors that influence crash involvement.

Biochemical Screening for in utero Drug Exposure.

Licit and illicit drug use is a common complication of pregnancy. Accurate information on drug use is difficult to obtain for many reasons as women fear self-disclosure or consenting for drug testing due to stigma, guilt, and fear of social and legal harm. As information about drug use is clinically very important, biochemical testing is an important adjunct to careful maternal history. In addition, research studies depend on accurate measures of exposure when reporting risks of a substance. This paper delineates available matrices for and methods of biochemical drug testing in pregnant women and neonates.

Environmental Chemical Exposures and Autism Spectrum Disorders: A Review of the Epidemiological Evidence

In the past decade, the number of epidemiological publications addressing environmental chemical exposures and autism has grown tremendously. These studies are important because it is now understood that environmental factors play a larger role in causing autism than previously thought and because they address modifiable risk factors that may open up avenues for the primary prevention of the disability associated with autism. In this review, we covered studies of autism and estimates of exposure to tobacco, air pollutants, volatile organic compounds and solvents, metals (from air, occupation, diet, dental amalgams, and thimerosal-containing vaccines), pesticides, and organic endocrine-disrupting compounds such as flame retardants, non-stick chemicals, phthalates, and bisphenol A. We included studies that had individual-level data on autism, exposure measures pertaining to pregnancy or the 1st year of life, valid comparison groups, control for confounders, and adequate sample sizes. Despite the inherent error in the measurement of many of these environmental exposures, which is likely to attenuate observed associations, some environmental exposures showed associations with autism, especially traffic-related air pollutants, some metals, and several pesticides, with suggestive trends for some volatile organic compounds (e.g., methylene chloride, trichloroethylene, and styrene) and phthalates. Whether any of these play a causal role requires further study. Given the limited scope of these publications, other environmental chemicals cannot be ruled out, but have not yet been adequately studied. Future research that addresses these and additional environmental chemicals, including their most common routes of exposures, with accurate exposure measurement pertaining to several developmental windows, is essential to guide efforts for the prevention of the neurodevelopmental damage that manifests in autism symptoms.

Validation of drinking water disinfection by-product exposure assessment for rural areas in the National Children's Study.

The objective of this study was to provide evidence to evaluate the proposed National Children's Study (NCS) protocol for household water sampling in rural study areas. Day-to-day variability in total trihalomethane (TTHM) concentrations in community water supplies (CWS) in rural areas was determined, and the correlation between TTHM concentrations from household taps and CWS monitoring reports was evaluated. Daily water samples were collected from 7 households serviced by 7 different CWS for 15 days. Coefficients of variation for TTHM concentration over 15 days ranged from 8% to 20% depending on the household. Correlations were tested between TTHM household concentrations and the closest date- and location-matched CWS monitoring reports for the 15-day mean (R=0.85, P<0.01). To simulate the NCS-proposed protocol, correlations were tested for 30 additional NCS household samples (polynomial fit: R=0.74, P=0.04). CWS reported TTHM concentrations >50 μg/l corresponded to measured NCS household concentrations ranging from 2 to 60 μg/l. TTHM concentrations were higher in CWS than NCS samples (11.2±3.2 μg/l, mean difference±SE, P<0.01). These results show that in rural areas there is high variability within households and poor correlation at higher concentrations, suggesting that TTHM concentrations from CWS monitoring reports are not an accurate measure of exposure in the household.

A Mass Transfer Model to Predict the Performance of Tube-type Passive Samplers for Exposure Determination of Volatile Organic Compounds

In past decades, due to its cost-effectiveness and convenience, passive samplers have been frequently employed to investigate spatial and long-term temporal trends of volatile organic compounds (VOCs) at local, regional scales and to assess people’s exposure to VOCs (Raw et al., 2004; Vardoulakis et al., 2011). Uptake rates (URs) of passive samplers have been verified to be the main source of the uncertainty of measurement (Plaisance et al., 2008; Martin et al., 2010; Walgraeve et al., 2011). Thus it is necessary to determinate the uptake behaviors of passive samplers and keep the URs stable for accurate exposure measurement. Some models have been developed to predict the URs of passive samplers. However, these models have been limited either by neglecting parts of the mass transfer processes of passive uptake or by considering only a small subset of VOCs, which are not sufficient for the design and sorbent selection of passive samplers for different VOCs (Palmes et al., 1973; Coutant et al., 1985; Tolnai et al., 2001). The objective of this study is to build a general model based on the mass transfer processes of tube-type passive samplers which are popular in environmental monitoring. By using the finite difference method, the model can be solved coupling with mass conservation equations applied at the boundaries. The model could be used to calculate the effective URs of tube-type passive samplers under various conditions and to select the proper sorbents which can be effective for different VOCs. The kinetic resistance within the sorbents results in two distinct uptake processes for passive sampling; diffusion coefficients D and partition coefficients K of VOCs between the sorbents and the air phase are the main influencing factors. Temperature dependence of URs may be described by the model once the temperature dependence of D and K is available.

Population vulnerability assessment based on scenario simulation of rainstorm-induced waterlogging: a case study of Xuhui District, Shanghai City

Waterlogging is one of the most serious hazards in cities. People are the core of the human social system and the main group affected by disasters. This research introduces a method of scenario simulation which provides a basis for the accurate measurement of exposure to waterlogging. Then based on the concept and structure of vulnerability, representative indicators are selected to develop an indicator system based on objective weights derived from principal components analysis. The method is then used to conduct a population vulnerability assessment in Xuhui District of Shanghai city based on scenario simulation of rainstorm-induced waterlogging over a 50-year period. The final assessment results show that the population vulnerability is greatest for Tianlin Street, Lingyun Street, Changqiao Street, Fenglin Street, and Caohejing Street, while Tianping Street, Xujiahui Street, and Xietulu Street have medium levels of vulnerability. Hongmei Road Street, Healthy Village Street, Longhua Street, and Hunan Road Street have low levels of vulnerability, and Huajing Town is the area with the lowest population vulnerability. The results provide both necessary information and guidance for the government to improve the flood management.

Epigenome-Wide Association Studies (EWAS) in cancer

After completion of the human genome, genome-wide association studies were conducted to identify single nucleotide polymorphisms (SNPs) associated with cancer initiation and progression. Most of the studies identified SNPs that were located outside the coding region, and the odds ratios were too low to implement in clinical practice. Although the genome gives information about genome sequence and structure, the human epigenome provides functional aspects of the genome. Epigenome-wide association studies (EWAS) provide an opportunity to identify genome-wide epigenetic variants that are associated with cancer. However, there are problems and issues in implementing EWAS to establish an association between epigenetic profiles and cancer. Few challenges include selection and handling of samples, choice of population and sample size, accurate measurement of exposure, integrating data, and insufficient information about the role of repeat sequences. The current status of EWAS, challenges in the field, and their potential solutions are discussed in this article.

Epigenome-Wide Association Studies (EWAS) in Cancer

After completion of the human genome, genome-wide association studies were conducted to identify single nucleotide polymorphisms (SNPs) associated with cancer initiation and progression. Most of the studies identified SNPs that were located outside the coding region, and the odds ratios were too low to implement in clinical practice. Although the genome gives information about genome sequence and structure, the human epigenome provides functional aspects of the genome. Epigenome-wide association studies (EWAS) provide an opportunity to identify genome-wide epigenetic variants that are associated with cancer. However, there are problems and issues in implementing EWAS to establish an association between epigenetic profiles and cancer. Few challenges include selection and handling of samples, choice of population and sample size, accurate measurement of exposure, integrating data, and insufficient information about the role of repeat sequences. The current status of EWAS, challenges in the field, and their potential solutions are discussed in this article.

Risk of Injury in Basketball, Football, and Soccer Players, Ages 15 Years and Older, 2003–2007

A major challenge in the field of sports injury epidemiology is identifying the appropriate denominators for injury rates. To characterize risk of injury from participation in basketball, football, and soccer in the United States, using hours of participation as the measure of exposure, and to compare these rates with those derived using population estimates in the denominator. Descriptive epidemiology study. United States, 2003-2007. People ages 15 years and older who experienced an emergency department-treated injury while playing basketball, football, or soccer. Rates of emergency department-treated injuries resulting from participation in basketball, football, or soccer. Injury rates were calculated for people ages 15 and older for the years 2003-2007 using the U.S. population and hours of participation as the denominators. The risk of injury associated with each of these sports was compared for all participants and by sex. From 2003 through 2007, annual injury rates per 1000 U.S. population were as follows: 1.49 (95% confidence interval [CI] = 1.30, 1.67) in basketball, 0.93 (95% CI = 0.82, 1.04) in football, and 0.43 (95% CI = 0.33, 0.53) in soccer. When the denominator was hours of participation, the injury rate in football (5.08 [95% CI = 4.46, 5.69]/10 000 hours) was almost twice as high as that for basketball (2.69 [95% CI = 2.35, 3.02]/10 000 hours) and soccer (2.69 [95% CI = 2.07, 3.30]/10 000 hours). Depending on the choice of denominator, interpretation of the risk of an emergency department-treated injury in basketball, football, or soccer varies greatly. Using the U.S. population as the denominator produced rates that were highest in basketball and lowest in soccer. However, using hours of participation as a more accurate measure of exposure demonstrated that football had a higher rate of injury than basketball or soccer for both males and females.

Effect of ambient air pollution on daily mortality rates in Guangzhou, China

We aimed to investigate the effects of ambient air pollutants on daily mortality in a relatively stable and homogeneous population in Guangzhou, China. Daily mortality, air pollution, and weather data between 2006 and 2009 were collected. The generalized additive model with poison regression was used to estimate the excessive risks (ERs) of air pollutants (PM10, SO2, and NO2) on total, cardiovascular and respiratory mortality. The effects of lag0–1 were the greatest for total non-accidental and cardiovascular deaths. The increments of 10 μg m−3 in SO2, NO2, and PM10 were associated with ERs of 1.54% (95%CI: 1.03–2.06%), 1.42% (95%CI: 1.06–1.78%), and 1.26% (95%CI: 0.86–1.66%) respectively for total non-accidental deaths, and 2.28% (95%CI: 1.40–3.16%), 1.81% (95%CI: 1.20–2.41%), and 1.79% (95%CI: 1.11–2.47%) respectively for cardiovascular deaths. For persons who died from respiratory disease, however, the maximum effects occurred at lag0. The ERs for SO2, NO2, and PM10 were 1.36% (95%CI: 0.23–2.50%), 1.47% (95%CI: 0.66–2.29%) and 0.93% (95%CI: 0.03–1.83%), respectively. The effects of the three air pollutants on mortality were stronger in elderly and in women. The ERs in the present study were higher than those reported in Europe, the U.S., and most other Asian cities. Our findings show relatively higher ERs of daily mortality by ambient air pollutants in the center of Guangzhou, China, compared with estimates in other cities. Further studies with accurate exposure measurement among homogeneous population are needed to evaluate the precise magnitudes of the effects of the air pollutants.

Preliminary Evaluation of the Childhood Experiences of Violence Questionnaire Short Form

Despite advances in child maltreatment research, accurate measurement of exposure remains a key issue. In this study, we evaluated a short form (CEVQ-SF) of the Childhood Experiences of Violence Questionnaire (CEVQ) in a sample of adolescents involved with child protection services in an urban city in Ontario, Canada. Focusing on the two most readily defined maltreatment types, physical and sexual abuse, we evaluated the short form's comparability with the full version of the CEVQ. Both versions had good internal consistency and moderate-to-good 2-week test-retest reliability. The criterion validity of the two CEVQ versions in comparison with the Childhood Trauma Questionnaire was satisfactory. Construct validity for both versions was demonstrated: physically and sexually abused youth had higher odds of reporting clinical traumatic symptoms compared with either type alone. The CEVQ-SF is as reliable and valid as its full version. Implications for its use in large population-based surveys are discussed.