Harmful Exposure Research Articles

An assessment of temporal, spatial and taxonomic trends in harmful algal toxin exposure in stranded marine mammals from the U.S. New England coast.

Despite a long-documented history of severe harmful algal blooms (HABs) in New England coastal waters, corresponding HAB-associated marine mammal mortality events in this region are far less frequent or severe relative to other regions where HABs are common. This long-term survey of the HAB toxins saxitoxin (STX) and domoic acid (DA) demonstrates significant and widespread exposure of these toxins in New England marine mammals, across multiple geographic, temporal and taxonomic groups. Overall, 19% of the 458 animals tested positive for one or more toxins, with 15% and 7% testing positive for STX and DA, respectively. 74% of the 23 different species analyzed demonstrated evidence of toxin exposure. STX was most prevalent in Maine coastal waters, most frequently detected in common dolphins (Delphinus delphis), and most often detected during July and October. DA was most prevalent in animals sampled in offshore locations and in bycaught animals, and most frequently detected in mysticetes, with humpback whales (Megaptera novaeangliae) testing positive at the highest rates. Feces and urine appeared to be the sample matrices most useful for determining the presence of toxins in an exposed animal, with feces samples having the highest concentrations of STX or DA. No relationship was found between the bloom season of toxin-producing phytoplankton and toxin detection rates, however STX was more likely to be present in July and October. No relationship between marine mammal dietary preference and frequency of toxin detection was observed. These findings are an important part of a framework for assessing future marine mammal morbidity and mortality events, as well as monitoring ecosystem health using marine mammals as sentinel organisms for predicting coastal ocean changes.

Harm Perceptions of Tobacco/Nicotine Products and Child Exposure: Differences between Non-Users, Cigarette-Exclusive, and Electronic Cigarette-Exclusive Users

Objective:This study examined caregiver perception of harm and child secondhand exposure to nicotine in a sample of e-cigarette-exclusive, cigarette-exclusive, and non-tobacco/nicotine users (non-users).Methods:Cigarette-exclusive (n = 19), e-cigarette-exclusive (n = 12), and non-users (n = 20) and their children (N = 51, Mage = 10.47) completed self-report questionnaires about perceptions of harm, child secondhand exposure, and provided urine to assess child nicotine exposure (cotinine). ANOVAs examined differences between caregiver use status on tobacco harm perceptions and child cotinine levels. Independent samples t-test compared differences in caregiver-reported child secondhand exposure in the home and car.Results:All 3 caregiver groups rated cigarettes as highly harmful (P = .14), but e-cigarette users rated all 3 types of e-cigarette products (Cartridge-based: P < .001; Tank: P < .001; Box Mod: P < .001) as less harmful than cigarette users and non-users. Caregivers from the e-cigarette user group reported greater child secondhand exposure than caregivers using cigarettes (past 7-day in-home exposure (P = .03); past 7-day exposure in-home + in-car exposure (P = .02); in-home exposure by caregivers and other people exposure (P = .02)). Children from the cigarette user group had significantly higher levels of cotinine (M = 16.6, SD = 21.7) compared to children from the Non-User group (M = .43, SD = .95; P = .001), but no significant difference when compared to children from the E-Cigarette User group (M = 6.5, SD = 13.5).Discussion:In this sample, caregivers who used e-cigarettes perceived them as less harmful, reported using them more frequently at home and in the car, even when their children were present, compared to cigarette users. As a result, children appear to be exposed to nicotine at levels similar to children living with cigarette users. Future caregiver prevention and intervention efforts should target education around the potential harms of secondhand e-cigarette aerosol to children.

Public Health Thinking Around Alcohol-Related Harm: Why Does Per Capita Consumption Matter?

Alcohol per capita consumption (APC) is used for monitoring harmful alcohol exposure in populations and assessing progress with goals set internationally and nationally. Recently, the alcohol industry challenged the use of this indicator. Here, we assessed the validity of APC as an indicator for reducing alcohol-related harm. We conducted a narrative review of association between population-level drinking and harm rates, and the underlying mechanisms of this association. A substantial literature demonstrates quite consistently close associations between APC and population harm levels for various types of health and social harms. Across populations with different total consumption, the distribution of consumption displays a fairly fixed shape, with no clear distinction between heavy drinkers and other drinkers. The mean consumption in a population is closely associated with the prevalence of heavy drinking; an increase in APC arises from a change in the whole distribution, heavy drinkers included. Although risk of harms from drinking increases with consumption, it seems that for many harm types the majority of drinkers, who do not drink heavily, account for a large proportion of harms from alcohol. By reducing APC, decreases in drinking among heavy drinkers as well as among ordinary drinkers will lead to fewer alcohol-related harms. The evidence strongly suggests public health gains from universal policies targeting APC. Reducing APC is furthermore an investment in future public health, as it is likely an efficient way of preventing people from becoming very heavy drinkers, who may cause themselves and others severe health and social problems.

Reporting Results of a Community-Based In-Home Exposure Monitoring Study: Developing Methods and Materials.

Reporting exposure results to study participants provides information that can ideally be used to decrease harmful exposures, improve health, and prevent disease. In reality, we often do not fully understand how an environmental exposure contributes to disease. This is the case when reporting back indoor air exposures in the absence of regulations. We reported nitrogen dioxide (NO2) and fine particulate matter (PM2.5) results back to individual participants of an in-home study in Chelsea, Massachusetts. We aimed to provide participants with information on the pollutant concentrations in their homes and in their community and to suggest strategies for decreasing in-home exposures. Our goals were to improve environmental health literacy and empower residents to take action on air quality issues in their community. The main objective of this paper is to describe how we developed our report back process and materials. Our team of academic and community partners developed a two-part report back process. The first part included a mailing tailored to every home containing daily indoor and outdoor NO2 and PM2.5 concentrations, community averages, outdoor standards and guidelines, and results from other indoor air quality studies for comparison. The second part included a community meeting for participants. Our report back process and materials benefitted from the contributions of multiple diverse stakeholders. We recommend at least a two-part strategy for facilitating communication within the community and between community and academic researchers. The materials and methods can be easily adapted by other researchers to report back exposure results in other community-specific contexts.

Computer vision based medical waste separator

In this study we have aimed to build an automatic computer vision based medical waste separator that detects the presence of medical waste and categorizes them into one of the four categories namely gloves, mask, syringe and cotton. This embedded system uses transfer learning on the AlexNet deep learning network to train a model which classifies medical waste. The hardware set up is designed to detect the movement of the lid of the input bin and then capture an image of the waste object dropped into the bin. This image is then fed to our trained model which classifies the object with a 86.17\% validation accuracy. Once the model classifies it, the waste object is dropped into the correct bin with the help of servo motors. This embedded system has been tested with different types of gloves, mask, syringe and cotton samples and presents a convenient way to segregate medical waste successfully. Thus this system aims to eliminate the need for manual labour to segregate hazardous medical waste and avoids harmful exposure to contaminated waste.

Health Disparities in Pulmonary Arterial Hypertension and the Impact of the COVID-19 Pandemic

Health Disparities in Pulmonary Arterial Hypertension and the Impact of the COVID-19 Pandemic

Correlating oxygen delivery on cardiopulmonary bypass with Society of Thoracic Surgeons outcomes following cardiac surgery

BackgroundThe relationship between low oxygen delivery (DO2) on cardiopulmonary bypass and morbidity and mortality following cardiac surgery remains unexamined. MethodsWe reviewed patients undergoing Society of Thoracic Surgeons index procedures from March 2019 to July 2020, coincident with implementation of a new electronic perfusion record that provides for continuous recording of DO2 and flow parameters. Continuous perfusion variables were analyzed using area-over-the-curve (AOC) calculations below predefined thresholds (DO2 <280 mL O2/min/m2, cardiac index <2.2 L/min, hemoglobin < baseline, and mean arterial pressure <65 mm Hg) to quantify depth and duration of potentially harmful exposures. Multivariable logistic regression adjusted by Society of Thoracic Surgeons predicted-risk scores were used to assess for relationship of perfusion variables with the primary composite outcome of any Society of Thoracic Surgeons index procedure, as well as individual Society of Thoracic Surgeons secondary outcomes (eg, mortality, renal failure, prolonged ventilation >24 hours, stroke, sternal wound infection, and reoperation). ResultsEight hundred thirty-four patients were included; 42.7% (356) underwent isolated coronary artery bypass grafting (CABG), whereas 57.3% underwent nonisolated CABG (eg, valvular or combined CABG/valvular operations). DO2 <280-AOC trended toward association with the primary outcome across all cases (P = .07), and was significantly associated for all nonisolated CABG cases (P = .02)—more strongly than for cardiac index <2.2-AOC (P = .04), hemoglobin <7-AOC (P = .51), or mean arterial pressure <65-AOC (P = .11). Considering all procedures, DO2 <280-AOC was independently associated prolonged ventilation >24 hours (P = .04), an effect again most pronounced in nonisolated-CABG cases (P = .002), as well as acute kidney injury <72 hours (P = .04). Patients with glomerular filtration rate <65 mL/min and baseline hemoglobin <12.5 g/dL appeared especially vulnerable. ConclusionsLow DO2 on bypass may be associated with morbidity/mortality following cardiac surgery, particularly in patients undergoing nonisolated CABG. These results underscore the importance of goal-directed perfusion strategies.

Canada Should Move Toward Adopting Harmonized Evidence-Based OELs to Consistently and Adequately Protect Workers.

Due to the way occupational exposure limits (OELs) are set in Canada, workers across the country are not equally and adequately protected from harmful workplace exposures. This disparity is illustrated in the case of exposure to diesel engine exhaust (DEE). Based on the findings of a recent pan-Canadian and international scan of OELs for DEE, we recommend that Canada overcome these current disparities by moving towards harmonized, evidence-based OELs. To achieve this, Canada should adopt a centralized framework for setting OELs that considers the most recent scientific evidence as well as feasibility of implementation in the Canadian context. We assert that harmonizing OELs across Canada would allow for expertise and resources to be consolidated and is a crucial step to ensuring that all workers are consistently protected from harmful workplace exposures.

Surveillance for Harmful Algal Bloom Events and Associated Human and Animal Illnesses - One Health Harmful Algal Bloom System, United States, 2016-2018.

Harmful algal bloom events can result from the rapid growth, or bloom, of photosynthesizing organisms in natural bodies of fresh, brackish, and salt water. These events can be exacerbated by nutrient pollution (e.g., phosphorus) and warming waters and other climate change effects (1); have a negative impact on the health of humans, animals, and the environment; and damage local economies (2,3). U.S. harmful algal bloom events of public health concern are centered on a subset of phytoplankton: diatoms, dinoflagellates, and cyanobacteria (also called blue-green algae). CDC launched the One Health Harmful Algal Bloom System (OHHABS) in 2016 to inform efforts to prevent human and animal illnesses associated with harmful algal bloom events. A total of 18 states reported 421 harmful algal bloom events, 389 cases of human illness, and 413 cases of animal illness that occurred during 2016-2018. The majority of harmful algal bloom events occurred during May-October (413; 98%) and in freshwater bodies (377; 90%). Human and animal illnesses primarily occurred during June-September (378; 98%) and May-September (410; 100%). Gastrointestinal or generalized illness signs or symptoms were the most frequently reported (>40% of human cases and >50% of animal cases); however, multiple other signs and symptoms were reported. Surveillance data from harmful algal bloom events, exposures, and health effects provide a systematic description of these occurrences and can be used to inform control and prevention of harmful algal bloom-associated illnesses.

House characteristics and condition as determinants of visible mold and musty odor: Results from three New Zealand House Condition Surveys in 2005, 2010, and 2015.

This study assessed associations between house characteristics and mold and musty odor, using data from three consecutive (2005, 2010, and 2015) New Zealand House Condition Surveys, involving a total of 1616 timber-framed houses. Mold, musty odor, and house characteristics were assessed by independent building inspectors. We used multivariate logistic regression analyses mutually adjusted for other house characteristics for each survey separately. Positive and independent associations were found with tenure, ventilation, insulation, and envelope condition for both mold in living and bedrooms and musty odor. In particular, we found significant dose-response associations with envelope condition, ventilation, and insulation. Odds of mold increased 2.4-15.9 times (across surveys) in houses with the worst building envelope condition (BEC; p<0.05-0.001 for trend); optimal ventilation reduced the risk of mold by 60% and the risk of musty odor by 70%-90% (p<0.01 for trend). Other factors associated with mold and musty odor included: tenure, with an approximate doubling of odds of mold across surveys; and insulation with consistent dose-response patterns in all outcomes and surveys tested (p<0.05 for trend in two surveys with mold and one survey for odor). In conclusion, this study showed the importance of BEC, ventilation, and insulation to avoiding harmful damp-related exposures.

Heavy Metals and Neurodevelopment of Children in Low and Middle-Income Countries: A Systematic Review

Background: The presence of harmful environmental exposures contributes to &gt;25% of deaths and diseases worldwide. Child neurodevelopment is negatively impacted by environmental exposures, such as certain heavy metals. In low and middle-income countries, where numerous risk factors for poor neurodevelopment exist, it is unclear if this negative impact persists. Our objective with this systematic review is to evaluate the association between heavy metals and the neurodevelopment of children in low-and-middle income countries. &#x0D; &#x0D; Methods: We conducted a search on PubMed MEDLINE, Embase, Cochrane Library, CINAHL, PsychInfo, Scopus, and Web of Science for articles that included individuals below the age of 18, quantitively measured exposure to a heavy metal and used a standardized measurement of neurodevelopment. &#x0D; &#x0D; Results: Of the 15,250 screened articles, 292 full-text articles were reviewed, and 96 articles met inclusion criteria. These studies were conducted in 18 countries and included 46,080 participants ranging from birth – 18 years old. At least one domain of neurodevelopment was inversely correlated with 8/11 of arsenic studies, 3/3 of cadmium studies, 29/32 of lead studies, 11/11 of manganese studies, 9/18 of mercury studies, and 21/21 studies with multiple metals. There was no consistent evidence of arsenic affecting behavior; mercury negatively affected neurodevelopment in only half the studies, indicating that the benefits of consuming mercury-containing fish might outweigh the negative impact of mercury exposure; ethylmercury did not affect neurodevelopment; hair manganese was a much more consistent biomarker of manganese exposure than blood; and the neurotoxicity of lead was amplified in the presence of manganese. &#x0D; &#x0D; Conclusions and potential impact: In low and middle-income countries, heavy metals have a significantly detrimental effect on the neurodevelopment of children, highlighting the need for more regulation.

Using Feedback to Improve Accountability in Global Environmental Health and Engineering.

Engineered environmental health interventions and services in low-income and resource-limited settings-such as water supply and treatment, sanitation, and cleaner household energy services-have had a less than expected record of sustainability and have sometimes not delivered on their potential to improve health. These interventions require both effectively functioning technologies as well as supporting financial, political, and human resource systems, and may depend on user behaviors as well as professionalized service delivery to reduce harmful exposures. In this perspective, we propose that the application of smarter, more actionable monitoring and decision support systems and aligned financial incentives can enhance accountability between donors, implementers, service providers, governments, and the people who are the intended beneficiaries of development programming. Made possible in part by new measurement techniques, including emerging sensor technologies, rapid impact evaluation, citizen science, and performance-based contracting, such systems have the potential to propel the development of solutions that can work over the long-term, allowing the benefits of environmental health improvements to be sustained in settings where they are most critical by improving trust and mutual accountability among stakeholders.

Hormesis in Health and Disease: Molecular Mechanisms

BACKGROUND: Hormesis was initially defined as a phenomenon where a small dose of harmful agent exposure to living organisms gives beneficial effects. The dose and time of this ‘tress’ exposure has become the object of investigation across the broad range of biomedical studies.CONTENT: Hormesis characterized by the biphasic dose-effect or time-effect relationship for any substance. Some hormetic mechanisms performed biological plasticity, involve oxidative damage which instead induce antioxidant enzyme production in various cells. Early-life stress can increase resilience in later life and lack of stress can lead to vulnerability. Many stressors like dietary factors and natural environmental toxins can be occupied for healthy growth or homeostasis, which exemplifies how illness is the doorway to health.SUMMARY: Hormesis reconcile many paradoxical phenomena exert opposite effects of the same substance, either a xenobiotic or an endogenous substance, a hormone or a metabolite, a genetic manipulation or an epigenetic alteration, an experimental intervention or a natural event. Human bodies are highly adaptive. A resilient body would be resulted after the ‘training’. In this review, we will elucidate the hormesis’ definition, mechanisms and pathways, and also how hormesis impacts in human health and lifespan.KEYWORDS: biphasic, cell signaling, dose response, hormesis, preconditioning

Associations between Traumatic Brain Injury, Drug Abuse, Alcohol Use, Adverse Childhood Events, and Aggression Levels in Individuals with Foster Care History.

Nearly 50,000 Canadian children live in foster care. Compared with their peers, foster children experience greater independence and decreased guidance, predisposing them to harmful exposures such as traumatic brain injury (TBI), illicit drugs, and alcohol. Foster children also report a higher level of childhood abuse compared with the general population. This study aimed to: 1) investigate substance/alcohol use disorder, adverse childhood events (ACE), TBI, aggression levels, and the difference between normalized percentages of brain regions of interest (ROIs) in a sample of Canadian youths with and without foster care history; 2) determine the prevalence of substance/alcohol use disorder, ACE, and aggression levels within individuals with foster care history when stratified by likelihood of TBI; and 3) determine the significant correlates of elevated aggression levels within this population. Participants completed standardized questionnaires that measured the prevalence of TBI, substance and alcohol use disorder, ACE, and aggression. Magnetic resonance imaging (MRI) was used to measure differences in brain ROI. Regression and network analysis were used to study interactions between variables. Seventy-four participants (51 individuals with foster care history and 23 age-matched controls from the general population) completed standardized questionnaires. Fifty-five of these individuals (39 foster participants and 16 controls) underwent brain MRI. Foster participants had higher prevalence of substance use disorder (p < 0.001), alcohol use disorder (p = 0.003), ACE (p < 0.001), and elevated aggression levels (p < 0.001) than healthy controls. No significant difference was found among brain ROI. The prevalence of TBI in foster participants was 65%. Foster participants with moderate or high likelihood of TBI exposure had higher levels of drug use and aggression than those with no or low likelihood of exposure. Brain volumes were not associated with substance/alcohol use disorder or ACE. No significant associations were found between aggression levels and the studied variables.

A Fundamental Study on Estimating the Concentration of Carbon Monoxide (CO) By Fabric-Based Colorimetric Analysis Using an Optical RGB Color Sensor

We propose a sensitive colorimetric sensing system for estimating the concentration of Carbon Monoxide (CO) using an optical RGB color sensor. Tasteless and odorless hazardous gas, such as carbon monoxide (CO), can be life-threatening, even at prolonged exposure at low concentrations. Early detection of these gases under low concentration conditions is a difficult problem. Thus, studying environmental health, monitoring of air quality, and the safety of people from harmful gas exposures have motivated increasing efforts to develop low cost and high-performance various sensors[1-2]. A detection method using the visual and optical device is relatively easy to apply because they are widely used and cheaper than in the past. This method can effectively detect harmful substances with reactive dyes. Potassium disulfide dye is suitable as a reactive dye because it has a property of discoloration in response to CO. Therefore, we used this to detect the optical response of the fabric discoloration process and perform quantitative gas concentration estimation. The chemical reaction of CO gas and disulfide potassium dyes is as shown in Formula 1, and the fabric exposed to the reaction turns black. The discoloration information for the fabric was collected from chambers that can control the gas concentration, and the concentration of CO gas considered in the experiment is 0-600 ppm. The time to reach full discoloration was recorded according to each gas concentration condition, and an RGB sensor was used to detect discoloration information. We used Moving-median filtering to remove noise caused by sensor characteristics of the collected data. To estimate the gas concentration, a curve fitting model using a least-squares method was applied. This method of converting to a power law scale and then use poly fitted to fit a linear curve to data. In the process of discoloration, we observed the difference in the discoloration progression rate according to the gas level and time. Also, under each gas concentration condition, the spending times from 20% progression to 80% progression in the whole discoloration process have a significant difference. These characteristics were applied to approach algorithms for estimate concentrations. Results show that the spending time to discolor from 20 % to 80 % progression at 200, 400, and 600 ppm was 275, 163.8 and 151.4 seconds, respectively in Figure 1. In the low concentration section, a significant time difference was observed compared to the high concentration section. The time characteristics of each section were extracted and applied to the concentration estimation algorithm. Except for outliers, the actual measurement data applied to the estimation algorithm, the concentration estimated were about 95%, 77% and 72% accuracy at 200, 400 and 600 ppm. As a result, we could estimate the concentration of CO gas by analyzing some of the discolored sections. This result is since the response time of discoloration varies depending on the gas concentration level. As future work, the gas concentration estimation method in this study could be improved by machine learning and data processing methods. The early detect system on dyed fabric color by gases exposes can be applied to for the next generation of the smart industrial safety system and intelligent clothing.AcknowledgementThis study has been conducted with the support of the Korea Institute of Industrial Technology.

Quantification of seven microbial volatile organic compounds in human serum by solid-phase microextraction gas chromatography-tandem mass spectrometry

Microbial volatile organic compounds (MVOCs) are primary and secondary metabolites of fungal and bacterial growth. Changes in environmental conditions (e.g., humidity, light, oxygen, and carbon dioxide) influence microbial growth in indoor environments. Prolonged human exposure to MVOCs has been directly associated with sick building syndrome (SBS), respiratory irritation, and asthma-like symptoms. However, no method exists for assessing MVOC exposure by quantifying them in human serum. We developed a novel, high-throughput automated method for quantifying seven MVOCs (3-methylfuran, 2-hexanone, 2-heptanone, 3-octanone, 1-octen-3-ol, 2-ethyl-1-hexanol, and geosmin) in human serum. The method quantifies the target analytes using solid-phase microextraction gas chromatography-tandem mass spectrometry at low parts-per-billion levels. Limits of detection ranged from 0.076 to 2.77 μg/L. This method provides excellent linearity over the concentration range for the analytes, with coefficients of determination >0.992. Recovery in human serum was between 84.5% and 113%, and analyte precision ranged from 0.38% to 8.78%. The intra-day and inter-day reproducibility showed coefficients of variation ≤11% and ≤8%, respectively. Accurate and precise quantification of MVOCs is necessary for detecting and quantifying harmful human exposures in environments with active microbial growth. The method is well suited for high-throughput analysis to aid investigations of unhealthy exposures to microbial emissions.

Population Level Contribution of Clonal Hematopoiesis of Indeterminate Potential to Myeloid Neoplasm Development: Pooled Analysis and Population Attributable Risk Percent Determination from Case-Control and Cohort Studies

Background. Clonal hematopoiesis of indeterminate potential (CHIP) represents a precursor state of myeloid leukemogenesis. Several studies thus far have convincingly demonstrated that presence of CHIP is associated with increased risks of myeloid neoplasm (MN) development. These findings have important intrinsic utility; however, there has been lack of attempts to translate this knowledge into estimates of disease burden suitable for determining its potential at population level. Therefore, the aim of this analysis was to estimate the population attributable fraction (PAF) for MNs associated with CHIP using risk ratio estimates derived from pooled analysis of observational studies. Methods. Eligible studies were case-control (n=3) and cohort (n=3) studies with dichotomous outcome (MN or no MN) and the presence or absence of the risk factor (CHIP). Mantel-Haenszel method for calculating the weighted pooled odds ratio (OR) under the fixed effects model was used, using software RevMan 5.3. OR being the key statistic for case-control studies was the preferred risk estimate to measure association between CHIP and MN in the selected case-control studies. We used OR as risk estimate for cohort studies as well, since MN occurred in less than 10% of the CHIP negative population, and therefore, OR provided a reasonable approximation of the relative risk. From the pooled OR, estimate of population attributable risk% (PAR%) was calculated using the formula: 100*(Px*(OR-1))/(1+(Px*(OR-1))), where Px represented estimate of population exposure (proportion of CHIP positive cases in the population). Results. 23,983 participants with 345 MN cases in six studies were included in the pooled analyses (Figure 1). In the CHIP positive population, there were total 230 MN cases of the total 2304 participants. There were 115 MN cases in the CHIP negative population (n= 21,679). For all studies, the pooled OR for those with CHIP compared with those without was 5.45 (95% CI, 4.06-7.30) with low overall heterogeneity (I2=2%, Fig. 1). Estimate of population exposure (Px) was 0.088 (2074/23638). PAR% calculated using formula 100*(Px*(OR-1))/(1+(Px*(OR-1))), was 28.14%, suggesting that of all the MN cases, including those with or without CHIP, 28.14% could be attributed to CHIP. Conclusion. CHIP's strong association with myeloid neoplasm development was confirmed in this pooled analysis. Individuals with MN were 5.45 times more likely to be CHIP positive than those without MN. Further, in this analysis, we estimate population level contribution of CHIP to MN development. We estimate that 28% of MNs were attributable to positive CHIP status, thus representing 28% of the cases in the total population that can be prevented by intervening against the exposure- CHIP. Determining PAR% is an especially useful and often underutilized first step in designing public health interventions directed against harmful exposures. These findings also brings forth an important consideration, that CHIP though an important risk factor is not obligatory for MN development. Majority of MNs can not attributed to positive CHIP status. Therefore, importance of traditionally known risk factors such as smoking, chemotherapy and radiation exposure need appropriate quantification, especially as they can be entirely preventable and are established risk factors for CHIP positivity as well. Disclosures No relevant conflicts of interest to declare.

Guidance to Reduce the Cardiovascular Burden of Ambient Air Pollutants: A Policy Statement From the American Heart Association.

In 2010, the American Heart Association published a statement concluding that the existing scientific evidence was consistent with a causal relationship between exposure to fine particulate matter and cardiovascular morbidity and mortality, and that fine particulate matter exposure is a modifiable cardiovascular risk factor. Since the publication of that statement, evidence linking air pollution exposure to cardiovascular health has continued to accumulate and the biological processes underlying these effects have become better understood. This increasingly persuasive evidence necessitates policies to reduce harmful exposures and the need to act even as the scientific evidence base continues to evolve. Policy options to mitigate the adverse health impacts of air pollutants must include the reduction of emissions through action on air quality, vehicle emissions, and renewable portfolio standards, taking into account racial, ethnic, and economic inequality in air pollutant exposure. Policy interventions to improve air quality can also be in alignment with policies that benefit community and transportation infrastructure, sustainable food systems, reduction in climate forcing agents, and reduction in wildfires. The health care sector has a leadership role in adopting policies to contribute to improved environmental air quality as well. There is also potentially significant private sector leadership and industry innovation occurring in the absence of and in addition to public policy action, demonstrating the important role of public-private partnerships. In addition to supporting education and research in this area, the American Heart Association has an important leadership role to encourage and support public policies, private sector innovation, and public-private partnerships to reduce the adverse impact of air pollution on current and future cardiovascular health in the United States.

Lung cancer risk in painters: results from the SYNERGY pooled case–control study consortium

ObjectivesWe evaluated the risk of lung cancer associated with ever working as a painter, duration of employment and type of painter by histological subtype as well as joint effects with...

Identifying patterns in environmental mixtures: a Bayesian approach and application to endocrine disrupting chemicals

Environmental health researchers may aim to identify sources (i.e., patterns), such as product use or behaviors, that give rise to mixtures of potentially harmful environmental exposures such as endocrine disrupting chemicals (EDCs). Existing methods are limited by user-specified number and interpretability of patterns in terms of human understanding.We adapted a non-parametric Bayesian Non-negative Matrix Factorization (npBNMF) to identify patterns of chemical exposures when the number of patterns is not known a priori. We placed strictly positive continuous priors on pattern loadings and individual scores, making both interpretable as concentrations, and used a non-parametric prior to estimate the pattern number. To validate this method, we simulated 300 datasets with increasing levels of complexity: (1) distinct underlying patterns, (2) overlapping patterns, and (3) overlapping patterns and correlated scores. We compared npBNMF performance with non-negative matrix factorization (NMF), principal component analysis (PCA), and factor analysis (FA). After validation, we applied npBNMF to 51 EDCs in 569 pregnant mothers in the Columbia Center for Children’s Environmental Health “Mothers and Newborns Cohort.”In simulations, npBNMF out-performed traditional methods and estimated the true number of patterns in 98% of runs, something no other known method can do. npBNMF and NMF provided non-negative scores and loadings with no orthogonality constraint, thus providing more interpretable results than PCA, whose mutually uncorrelated patterns are implausible in environmental health, or FA, whose negative scores and loadings are incomprehensible as concentrations.We identified three patterns of EDC exposure in pregnant mothers, corresponding well with known EDC classes. Additionally, we observed pattern associations with measured behaviors, such as personal care product use.npBNMF successfully identified EDC patterns that correspond well with current understanding of EDC sources. In future research, we will examine associations between patterns and health outcomes to inform interventions. npBNMF may be used to identify patterns in environmental mixtures.