Cincinnati Area Research Articles

Electrochemical Method for Detection and Quantification of Lead Particulate in Tap Water

Quantification of lead particulates requires laborious sample acidification and/or digestion in acidic environment, therefore lead quantification is limited to laboratories with trained personnel and expensive instrumentation. These technologies are not easily accessible to the public, and the large number of portable methods available to public today are characterized by their qualitative nature, and requirement of additional reagents. Unlike labor intense expensive instruments, electrochemical methods are inexpensive, fast and portable but they are blind to non-electroactive lead species or particulate forms of lead. They are limited to the detection of ionic or electroactive analytes. This talk will report an electrochemical method for the detection and quantification of lead contaminant in drinking waters that results from particulate forms of lead, mostly present as scales. We will present the fundamentals of membrane electrolysis for reagent-free sample preparation and detection of Pb2+. Also, we will present the characterization of real particulates/scales extracted from lead service lines from the Cincinnati area. We think this method will contribute to the development of on-site, quantitative methods of lead detection, and can assist to the research and understanding of drinking water contamination. Perhaps it could help to determine what triggers lead intermittent release to residential tap water. This work has the potential to address the lack of that instrumentation because it employs a robust technology based on anionic exchange membrane and controlled electrolysis for in-situ generation of nitric acid, that eliminates the need of external reagent or sample treatments. For its trace detection, it employs a well stablished Anodic Striping Voltammetry method.

Examining associations between social vulnerability indices and COVID-19 incidence and mortality with spatial-temporal Bayesian modeling

This study compares two social vulnerability indices, the U.S. CDC SVI and SoVI (the Social Vulnerability Index developed at the Hazards Vulnerability & Resilience Institute at the University of South Carolina), on their ability to predict the risk of COVID-19 cases and deaths. We utilize COVID-19 cases and deaths data for the state of Indiana from the Regenstrief Institute in Indianapolis, Indiana, from March 1, 2020, to March 31, 2021. We then aggregate the COVID-19 data to the census tract level, obtain the input variables, domains (components), and composite measures of both CDC SVI and SoVI data to create a Bayesian spatial-temporal ecological regression model. We compare the resulting spatial-temporal patterns and relative risk (RR) of SARS-CoV-2 infection (COVID-19 cases) and associated death. Results show there are discernable spatial-temporal patterns for SARS-CoV-2 infections and deaths with the largest contiguous hotspot for SARS-CoV-2 infections found in the southwest of the Indianapolis metropolitan area. We also observed one large contiguous hotspot for deaths that stretches across Indiana from the Cincinnati area in the southeast to just east and north of Terre Haute (southeast to west central). The spatial-temporal Bayesian model shows that a 1-percentile increase in CDC SVI was significantly (p ≤ 0.05) associated with an increased risk of SARS-CoV-2 infection by 6 % (RR = 1.06, 95 %CI = 1.04 -1.08). Whereas a 1-percentile increase in SoVI was significantly predicted to increase the risk of COVID-19 death by 45 % (RR = 1.45, 95 %CI =1.38 – 1.53). Domain-specific variables related to socioeconomic status, age, and race/ethnicity were shown to increase the risk of SARS-CoV-2 infections and deaths. There were notable differences in the relative risk estimates for SARS-CoV-2 infections and deaths when each of the two indices were incorporated in the model. Observed differences between the two social vulnerability indices and infection and death are likely due to alternative methodologies of formation and differences in input variables. The findings add to the growing literature on the relationship between social vulnerability and COVID-19 and further the development of COVID-19-specific vulnerability indices by illustrating the utility of local spatial-temporal analysis.

Abstract TMP106: Decline In The Severity Of Hospitalized Ischemic Stroke 2005-2015: The Greater Cincinnati/Northern Kentucky Stroke Study

Background: Monitoring changes in ischemic stroke severity at the population level is important as changes in risk factors and clinical treatments could influence stroke severity. We describe trends in the distribution of NIHSS across 3 time periods in a population-based epidemiologic stroke study. Methods: In 2005, 2010, and 2015 all adult acute ischemic strokes occurring within the Greater Cincinnati area presenting to 15 hospitals were ascertained using discharge codes (ICD-9 433-436; IDC-10 I63-I68, G45-46). Following physician verification, confirmed ischemic stroke cases underwent chart abstraction including estimation of a retrospective (rNIHSS) score at presentation. Descriptive statistics (rNIHSS median, IQR) were generated by survey year, demographics, and medical history. Using a binary definition of stroke severity (median rNIHSS score &gt 4 versus &lt 4), multivariable logistic regression was used to estimate changes in stroke severity over time, adjusting for potential confounders. Random effects were used to account for multiple admissions occurring in the same subject. Results: The number of ischemic stroke admissions in the 2005, 2010, and 2015 surveys was 1778, 1903, and 1933, respectively (Table). The median (IQR) rNIHSS scores were 3 (2-7), 3 (1-6), and 2 (1-6) across the 3 surveys, respectively; the proportion of admissions with rNIHSS &gt 4 was 48%, 39% and 37%, respectively. After adjusting for demographics, medical history and pre-stroke function, compared to 2005, the odds ratio for more severe stroke was 0.69 (95% CI= 0.60-0.79, p=0.001) in 2010 and 0.63 (95% CI= 0.55-0.73, p=0.001) in 2015. Conclusions: In this population- based study there was a statistically significant change in the severity of ischemic stroke hospitalizations with increases in the proportion of milder strokes over time. Potential reasons for this change need to be explored but could include changes in risk factors, clinical treatments or diagnostic approach.

Abstract WP184: Identifying Optimal Cut Points Of National Institutes Of Health Stroke Scale To Predict Mortality: A Population-based Assessment

Background: Ischemic stroke is the 5 th leading cause of death in the US. As a measure of stroke severity, initial NIHSS has been used to predict clinical outcome. We sought to identify the optimal cut-points of NIHSS at initial presentation that are associated with higher 30-day mortality. Methods: In 2005, 2010, and 2015 all hospitalized, first acute ischemic stroke events occurring within the Greater Cincinnati area were ascertained. Potential ischemic stroke cases underwent chart abstraction and physician adjudication, including retrospective NIHSS score (range 0 - 42) based on clinical findings at initial presentation. Descriptive statistics for NIHSS were estimated by study year, demographics, and medical history. Data regarding mortality was obtained from the National Death Index. The Contal and O’Quigley method based on a modified log-rank test statistic was used to determine cut-points of the NIHSS score associated with 30-day mortality, and hazard ratios were obtained from Cox models with adjustment for sex, race, and age. Results: In 2005, 2010, and 2015 there were 1704, 1818 and 1852 ischemic stroke events with 30-day mortality rates of 10.5%, 9.6% and 9.0%, respectively. Optimal cut-points of NIHSS <9, 9-16 and >16 were identified. Across all 3 periods, 3431 (84.5%) cases had NIHSS 0-8, 352 (8.7%) had NIHSS 9-16 and 274 (6.8%) >16. Kaplan Meier Survival Curves for the 3 NIHSS groups are shown in the Figure. Strokes with NIHSS >16 at initial presentation were associated with a 15-fold (HR with 95% CI: 13, 19) increase in the risk of death at 30-days compared to those with NIHSS <9. Discussion: NIH Stroke Scale scores are a reliable predictor of mortality, with higher NIHSS scores having higher risk of death. The cut points reported identify subgroups of stroke patients with dramatically different prognoses. Future studies should assess if this excess mortality risk among severe strokes persists after the more widespread implementation of thrombectomy beyond 2015.

Beyond Traditional TOD: Integrating Multiuse Paths and Bike Share into Public Transit to Address the First/Last Mile Issue

Transit-oriented development (TOD) has been promoted worldwide as an integrated land-use and transportation strategy to foster urban sustainability. Bike share provides people with a convenient and relatively affordable way to enlarge the spatial scale of TODs across urban communities, as a solution to the first/last mile (FLM) issue with respect to the transit nodes of TODs. Even though barriers to FLM have been frequently studied, few studies incorporate people’s perceptions of their barriers and/or the integration of multiuse paths (MUPs) into the network of bike share and public transit. Using a survey conducted in the Greater Cincinnati area, Ohio, this study aimed to answer the following questions: (1) What are people's major barriers to integrating different green transportation modes and/or facilities (bike share, MUPs, public transit)? (2) To what extent does the built environment around people’s residential location affect their integration level of MUPs, bike share, and public transit? (3) Which improvements would most likely encourage people to integrate them more often? With descriptive statistics, spatial analysis, and statistical comparison, we found that (1) the major barrier to integrating MUPs into the green transportation system was their lack of connection and availability to transit and bike share; (2) a person’s living environment is spatially related to whether a person integrates bike share; and (3) more respondents would use MUPs more often if an integrated green transportation system could be provided or improved. These findings suggest the potential of incorporating MUPs and bike share into TOD strategies to address the FLM issue.

Assessing Functional and Comprehensive Health Literacy in a Syrian Refugee Community

Newly resettled refugees have poorly managed acute and chronic health conditions as a result of their migration experience. To add to an already complex experience, poor health literacy complicates effective utilization of healthcare among these communities (Wångdahl et al., 2014). Health literacy has been described in the literature as one of the key determinants of and potential barriers to optimal health (Kickbusch, 2001). Anecdotally, health literacy curricula have been implemented in other low-literacy communities with success. Yet there are very few known structured curricula built into the resettlement experience in the United States (U.S.), and even fewer have been described in the literature.
 In collaboration with Closing the Health Gap and Refuge Collaborative, a six-week health literacy curriculum was developed and disseminated in adult Syrian refugee populations within the Greater Cincinnati Area. Using a pre-post intervention design, I aimed to assess the baseline health literacy of newly resettled adult refugees in the Greater Cincinnati Area and evaluate the effectiveness of the health literacy curriculum in improving the functional health literacy of these communities. This pilot study informed the development of a health literacy curriculum aimed at high school refugee students enrolled in Cincinnati Public Schools.
 Establishing the effectiveness of such a curriculum has the potential to have far-reaching impacts on other refugee communities undergoing the resettlement experience. Other communities experiencing low health literacy, such as African Americans, may also benefit from a similar curriculum. Most importantly, improved health literacy can indirectly translate into more effective health care utilization and lead to overall better health outcomes for disadvantaged communities.

Perinatal Outcomes of Fetuses and Infants Diagnosed with Trisomy 13 or Trisomy 18

To identify factors associated with prenatal, perinatal, and postnatal outcomes, and determine medical care use for fetuses and infants with trisomy 13 (T13) and trisomy 18 (T18). This population-based retrospective cohort study included all prenatal and postnatal diagnoses of T13 or T18 in the greater Cincinnati area from January 1, 2012, to December 31, 2018. Overall survival, survival to hospital discharge, medical management, and maternal, fetal, and neonatal characteristics are analyzed. There were 124 pregnancies (125 fetuses) that were identified, which resulted in 72 liveborn infants. Male fetal sex and hydrops were associated with a higher rate of spontaneous loss. The median length of survival was 7 and 29days, for infants with T13 and T18, respectively. Of the 27 infants alive at 1month of age, 13 (48%) were alive at 1year of age. Only trisomy type (T13), goals of care (comfort care), and extremely low birthweight were associated with a shorter length of survival. A high degree of variability existed in the use of medical services, with 28% of infants undergoing at least 1 surgical procedure and some children requiring repeated (≤29) or prolonged (>1year) hospitalizations. Although many infants with T13 or T18 did not survive past the first week of life, nearly 20% lived for more than 1year with varying degrees of medical support. The length of survival for an infant cannot be easily predicted, and surviving infants have high health care use throughout their lifespans.

Clustering and Regression-Based Analysis of PM2.5 Sensitivity to Meteorology in Cincinnati, Ohio

This study identified the meteorological parameters that influence PM2.5 concentrations in the Greater Cincinnati area by employing principal components analysis and multi-variable regression. Meteorological and PM2.5 data were collected over several years to derive statistical relationships about the seasonal variability of meteorological parameters and quantify their influence on PM2.5. We studied the effect of meteorological parameters by seasons and by k-means clustering. The results show that outdoor temperature (OT), planetary boundary height (HPBL) and visibility (VIS) have the strongest effect on PM2.5. The distribution of PM2.5 concentrations in each cluster and season was evaluated using the Kolmogorov–Smirnov test with data fitting using the lognormal and gamma distributions. To our observation, we found the PM2.5 concentration fits the gamma distribution marginally better than the lognormal distribution.

Risk perception and communal coping in families affected by type 2 diabetes

Despite a recent decline, rates of type 2 diabetes remain high among older adults. Preventing and delaying the onset of the condition with lifestyle changes is key to reducing disease burden in the population. Type 2 diabetes is a complex disease, likely a result from the joint effect of genetic, socio-environmental and lifestyle risk factors that are clustered in families. As such, the prevention of type 2 diabetes is a communal coping process, where individuals communicate about risk and establish routines to facilitate one another’s health habits and compliance with therapeutics. This poster investigates how such a process is affected by one’s perception of risk based on his/her knowledge about family health history (FHH). We collected family network data from families of different racial backgrounds in the greater Cincinnati area (28 white and 17 black/ African American households; 127 participants). The analysis focuses on how the density of diabetes diagnosis in one’s FHH affects communication about shared risk for type 2 diabetes and encouragement to maintain or adopt a healthy lifestyle. Results suggest a higher concentration of diabetes diagnosis in one’s FHH is associated with a higher number of risk communication ties in all families. With regards to encouragement ties, high rates of diabetes diagnosis in FHH are associated with an increased number of encouragement ties only in families of black/African heritage. The findings highlight the need and promise of using FHH to motivate co-encouragement to maintain/adopt a healthier lifestyle in families of black/African heritage.

Personal exposure to average weekly ultrafine particles, lung function, and respiratory symptoms in asthmatic and non-asthmatic adolescents.

An increasing amount of evidence suggests ultrafine particles (UFPs) are linked to adverse health effects, especially in those with chronic conditions such as asthma, due to their small size and physicochemical characteristics. Toxicological and experimental studies have demonstrated these properties, and the mechanisms by which they deposit and translocate in the body result in increased toxicity in comparison to other air pollutants. However, current epidemiological literature is limited due to exposure misclassification and thus identifying health outcomes associated with UFPs. The objective of this study was to investigate the association between weekly personal UFP exposure with lung function and respiratory symptoms in 117 asthmatic and non-asthmatic adolescents between 13 and 17years of age in the Cincinnati area. Between 2017 and 2019, participants collected weekly UFP concentrations by sampling for 3h a day in their home, school, and during transit. In addition, pulmonary function was evaluated at the end of the sampling week, and respiratory symptoms were logged on a mobile phone application. Multivariable linear regression and zero-inflated Poisson (ZIP) models were used to estimate the association between personal UFP and respiratory outcomes. The average median weekly UFP exposure of all participants was 4340 particles/cm3 (p/cc). Results of fully adjusted regression models revealed a negative association between UFPs and percent predicted forced expiratory volume/forced vital capacity ratio (%FEV1/FVC) (β:-0.03, 95% CI [-0.07, 0.02]). Prediction models estimated an association between UFPs and respiratory symptoms, which was greater in asthmatics compared to non-asthmatics. Our results indicate an interaction between asthma status and the likelihood of experiencing respiratory symptoms when exposed to UFPs, indicating an exacerbation of this chronic condition. More research is needed to determine the magnitude of the role UFPs play on respiratory health.

Emergency Nursing Review Questions: September 2021

These review questions are based on the Emergency Nursing Core Curriculum and other pertinent resources to emergency nursing practice. They offer emergency nurses an opportunity to test their knowledge about their practice. Carrie A. McCoy, Cincinnati Area Chapter, is Professor Emerita of Nursing Northern Kentucky University, Highland Heights, KY.

Per-and Polyfluoroalkyl Substances (PFAS) Concentrations in Serum and Drinking Water in Pregnant Women from the Greater Cincinnati Area HOME Study

BACKGROUND AND AIM: The occurrence, fate, and transport of PFAS in the environment is understood, but the contribution of drinking water to serum PFAS concentrations in humans is poorly defined. METHODS: We examined data from a prospective pregnancy and birth cohort (HOME Study) in Cincinnati, Ohio. We quantified PFOA and PFOS in sera of 227 pregnant women at 16 weeks gestation between 2003 and 2006. Tap water was collected from the participants’ homes within one month of blood collection. We mapped serum and tap water PFAS concentrations using ArcGIS and examined clustering via spatial hotspot analyses for each participant. RESULTS:The median (range) of PFOA serum concentration in pregnant HOME Study participants between 2003-2006 was 5.4 (0.5-24.5) ng/ml, which is over twice the geometric mean serum concentration of 2.4 ng/l as measured in a representative sample of pregnant women in NHANES 2003 and 2004. Median PFOA drinking water concentrations in samples collected from participants’ homes were 3.7 ng/l in 2003, 4.5 ng/l in 2004, 6.4 ng/l in 2005 and 11.0 ng/l in 2006. For each doubling of water PFOA concentration, serum PFOA increased by 0.6 ng/l (95% CI: 0.02, 1.20) after adjusting for water source type (bottled/filtered vs tap water). For every doubling of water PFOS, serum PFOS increased 0.95 ng/l (95%CI: -0.10, 2.00). CONCLUSIONS:Drinking water is an important contributing source of PFAS exposure in pregnant women. This research adds to the literature, helping to delineate the relationship between drinking water and circulating serum concentrations of PFAS in pregnant women. The views expressed in this abstract are those of the authors and do not necessarily reflect the views or policies of the U.S. EPA. KEYWORDS: PFAS, drinking water, pregnant women, HOME Study, Cincinnati

Nasalance Scores for Normal Speakers of American English Obtained by the Nasometer II Using the MacKay-Kummer SNAP-R Test.

To establish nasalance score norms for adolescent and young adult native speakers of American English and also determine age-group and gender differences using the Simplified Nasometric Assessment Procedures (SNAP) Test-R and Nasometer II. Prospective study using a randomly selected sample of participants. Greater Cincinnati area and Miami University of Ohio. Participants had a history of normal speech and language development and no history of speech therapy. Participants in the adolescent group were recruited from schools in West Clermont and Hamilton County, whereas the young adults were recruited from Miami University of Ohio. The participants of both groups were residents of Cincinnati, Ohio or Oxford, Ohio and spoke midland American English dialect. Mean nasalance scores for the SNAP Test-R. Normative nasalance scores were obtained for the Syllable Repetition/Prolonged Sounds, Picture-Cued, and Paragraph subtests. Results showed statistically significant nasalance score differences between adolescents and young adults in the Syllable Repetition, Picture-Cued, and Paragraph subtests, and between males and females in the Syllable Repetition and the Sound-Prolonged subtests. A significant univariate effect was found for the syllables and sentences containing nasal consonants and high vowels compared to syllables and sentences containing oral consonants and low vowels. Across all the SNAP Test-R subtests, the females' nasalance scores were higher than the males. A significant univariate effect was also found across nasal syllables, and high vowels such that the females' nasalance scores were higher than the males. Tables of normative data are provided that may be useful for clinical purposes. Norms obtained demonstrated nasalance score differences according to age and gender, particularly in the Syllable Repetition/Prolonged Sound subtest. These differences were discussed in light of potential reasons for their existence and implications for understanding velopharyngeal function. In addition, nasalance scores are affected by the vowel type and place of articulation of the consonant. These facts should be considered when nasometry is used clinically and for research purposes.

Factors Contributing to Landslide Susceptibility of the Kope Formation, Cincinnati, Ohio

ABSTRACT The objective of this study was to evaluate the factors that contribute to the high frequency of landslides in the Kope Formation and the overlying colluvial soil present in the Cincinnati area, southwestern Ohio. The Kope Formation consists of approximately 80 percent shale inter-bedded with 20 percent limestone. The colluvium that forms from the weathering of the shale bedrock consists of a low-plasticity clay. Based on field observations, LiDAR data, and information gathered from city and county agencies, we created a landslide inventory map for the Cincinnati area, identifying 842 landslides. From the inventory map, we selected 10 landslides that included seven rotational and three translational slides for detailed investigations. Representative samples were collected from the landslide sites for determining natural water content, Atterberg limits, grain size distribution, shear strength parameters, and slake durability index. For the translational landslides, strength parameters were determined along the contact between the bedrock and the overlying colluvium. The results of the study indicate that multiple factors contribute to landslide susceptibility of the Kope Formation and the overlying colluvium, including low shear strength of the colluvial soil, development of porewater pressure within the slope, human activity such as loading the top or cutting the toe of a slope, low to very low durability of the bedrock that allows rapid disintegration of the bedrock and accumulation of colluvial soil, undercutting of the slope toe by stream water, and steepness of the slopes.

Emergency Nursing Review Questions: March 2021

These review questions are based on the Emergency Nursing Core Curriculum and other pertinent resources to emergency nursing practice. They offer emergency nurses an opportunity to test their knowledge about their practice. Carrie A. McCoy, Member, Cincinnati Area Chapter, is a Professor of Nursing, Northern Kentucky University, Highland Heights, KY.

Associations Between Early Structural Magnetic Resonance Imaging, Hammersmith Infant Neurological Examination, and General Movements Assessment in Infants Born Very Preterm

To evaluate the prevalence and associations between structural magnetic resonance imaging (sMRI) injury/abnormality at term-equivalent age and absent fidgety General Movements Assessment (GMA) and abnormal Hammersmith Infant Neurological Examination (HINE) scores among infants born very preterm at 3-4months of corrected age. This prospective cohort study enrolled 392 infants born ≤2weeks of gestation from 5 neonatal intensive care units in the greater Cincinnati area between September 2016 and October 2019. Infants completed sMRI at term-equivalent age and GMA and HINE at 3-4months of corrected age. All assessors were blinded. Of 392 infants, 375 (96%) had complete data. Of these, 44 (12%) exhibited moderate or severe brain abnormalities, 17 (4.5%) had abnormal GMA, and 77 (20.3%) had abnormal HINE. Global and regional abnormality scores on sMRI were significantly correlated with GMA (R2 range 0.05-0.17) and HINE at 3-4months of corrected age (R2 range 0.01-0.17). These associations remained significant in multivariable analyses after adjusting for gestational age and sex. There was a significant but low correlation (R2 0.14) between GMA and HINE. We observed a low prevalence of moderate or severe brain abnormalities in survivors born very preterm in this geographically defined cohort. The much greater prevalence of abnormal motor examination on the HINE compared with GMA and their low correlation suggests that these tests evaluate different constructs and, thus, should be used in combination with sMRI rather than interchangeably.

Mary C. Mahoney, MD, President, Radiological Society of North America, 2021.

Mary C. Mahoney, MD, President, Radiological Society of North America, 2021.

The influence of remote learning on sleep patterns of teenagers

A healthy sleep pattern is crucial to the overall health and wellbeing of teenagers, and poor sleep patterns can harm school performance. Due to stay-at-home orders mandated by the governor of Ohio in March 2020, students were converted to remote learning. The purpose of this study was to compare the sleep patterns of teenagers before the stay-at-home orders and during remote learning. Individual chronotypes impact peak productivity, and remote learning imposed by the COVID-19 pandemic provides a unique opportunity to study how teenagers may take advantage of their chronotype for optimal learning. Data was collected using an online survey distributed to teenagers in the Greater Cincinnati area. The survey completed by 141 participants compared teenagers' overall sleep habits and attitude towards school before and during the remote learning period. During the stay-at-home orders, teenagers participating in remote learning extended their sleep duration by 1-2 hours, resulting in 83% of surveyed teenagers receiving healthy sleep amounts and 55% reporting feeling more rested. Sleep patterns of teenagers were also altered by the stay-at-home orders, as seen by the significant shift to later bedtimes and wake times. Later wake times and bedtimes align with the self-reported night owl chronotype reported by a majority of respondents. These results can help create more effective learning periods for adolescents that optimize personal chronotype.

Per- and Polyfluoroalkyl Substances (PFAS) Concentrations in Serum and Drinking Water in Pregnant Women from the Greater Cincinnati Area HOME Study

Background: The occurrence, fate, and transport of PFAS in the environment is understood, but the contribution of drinking water to serum PFAS concentrations in humans is poorly defined. Methods: We examined data from a prospective pregnancy and birth cohort (HOME Study) in Cincinnati, Ohio. We quantified PFOA and PFOS in sera of 227 pregnant women at 16 weeks gestation between 2003 and 2006. Tap water was collected from the participants’ homes within one month of blood collection. We mapped serum and tap water PFAS concentrations using ArcGIS and examined clustering via spatial hotspot analyses for each participant. Results: The median (range) of PFOA serum concentration in pregnant HOME Study participants between 2003-2006 was 5.4 (0.5-24.5) ng/ml, which is over twice the geometric mean serum concentration of 2.4 ng/l as measured in a representative sample of pregnant women in NHANES 2003 and 2004. Median PFOA drinking water concentrations in samples collected from participants’ homes were 3.7 ng/l in 2003, 4.5 ng/l in 2004, 6.4 ng/l in 2005 and 11.0 ng/l in 2006. For each doubling of water PFOA concentration, serum PFOA increased by 0.6 ng/l (95% CI: 0.02, 1.20) after adjusting for water source type (bottled/filtered vs tap water). For every doubling of water PFOS, serum PFOS increased 0.95 ng/l (95%CI: -0.10, 2.00).Conclusions: Drinking water is an important contributing source of PFAS exposure in pregnant women. This research adds to the literature, helping to delineate the relationship between drinking water and circulating serum concentrations of PFAS in pregnant women.The views expressed in this abstract are those of the authors and do not necessarily reflect the views or policies of the U.S. EPA.

Do Right! Nutrition Train the Trainer: an African American Community–Based Nutrition Education Initiative

Do Right! Nutrition Train the Trainer is an 8-week series designed to educate participants on the importance of nutrition. The purpose of this study was to examine the effectiveness of program delivery in a community-based setting. Post-session evaluations were utilized to examine participant health knowledge and behaviors attained as a result of programming. Participants were African American residents who resided throughout the Greater Cincinnati Area. Post-session evaluations showed substantial knowledge/skill attainment. Program outcomes show Nutrition Train the Trainer to be an effective community-based model in delivering nutrition health education.