Last data update: Jul 01, 2024. (Total: 47134 publications since 2009)
Records 1-17 (of 17 Records) |
Query Trace: Dutton N [original query] |
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Changes in mood and health-related quality of life in Look AHEAD 6 years after termination of the lifestyle intervention
Wadden TA , Chao AM , Anderson H , Annis K , Atkinson K , Bolin P , Brantley P , Clark JM , Coday M , Dutton G , Foreyt JP , WGregg E , Hazuda HP , Hill JO , Hubbard VS , Jakicic JM , Jeffery RW , Johnson KC , Kahn SE , Knowler WC , Korytkowski M , Lewis CE , Laferrère B , Middelbeek RJ , Munshi MN , Nathan DM , Neiberg RH , Pilla SJ , Peters A , Pi-Sunyer X , Rejeski JW , Redmon B , Stewart T , Vaughan E , Wagenknecht LE , Walkup MP , Wing RR , Wyatt H , Yanovski SZ , Zhang P . Obesity (Silver Spring) 2021 29 (8) 1294-1308 OBJECTIVE: The Action for Health in Diabetes (Look AHEAD) study previously reported that intensive lifestyle intervention (ILI) reduced incident depressive symptoms and improved health-related quality of life (HRQOL) over nearly 10 years of intervention compared with a control group (the diabetes support and education group [DSE]) in participants with type 2 diabetes and overweight or obesity. The present study compared incident depressive symptoms and changes in HRQOL in these groups for an additional 6 years following termination of the ILI in September 2012. METHODS: A total of 1,945 ILI participants and 1,900 DSE participants completed at least one of four planned postintervention assessments at which weight, mood (via the Patient Health Questionnaire-9), antidepressant medication use, and HRQOL (via the Medical Outcomes Scale, Short Form-36) were measured. RESULTS: ILI participants and DSE participants lost 3.1 (0.3) and 3.8 (0.3) kg [represented as mean (SE); p = 0.10], respectively, during the 6-year postintervention follow-up. No significant differences were observed between groups during this time in incident mild or greater symptoms of depression, antidepressant medication use, or in changes on the physical component summary or mental component summary scores of the Short Form-36. In both groups, mental component summary scores were higher than physical component summary scores. CONCLUSIONS: Prior participation in the ILI, compared with the DSE group, did not appear to improve subsequent mood or HRQOL during 6 years of postintervention follow-up. |
Within-trial cost-effectiveness of a structured lifestyle intervention in adults with overweight/obesity and type 2 diabetes: Results from the Action for Health in Diabetes (Look AHEAD) Study
Zhang P , Atkinson KM , Bray G , Chen H , Clark JM , Coday M , Dutton GR , Egan C , Espeland MA , Evans M , Foreyt JP , Greenway FL , Gregg EW , Hazuda HP , Hill JO , Horton ES , Hubbard VS , Huckfeldt PJ , Jackson SD , Jakicic JM , Jeffery RW , Johnson KC , Kahn SE , Killean T , Knowler WC , Korytkowski M , Lewis CE , Maruthur NM , Michaels S , Montez MG , Nathan DM , Patricio J , Peters A , Pi-Sunyer X , Pownall H , Redmon B , Rushing JT , Steinburg H , Wadden TA , Wing RR , Wyatt H , Yanovski SZ . Diabetes Care 2020 44 (1) 67-74 OBJECTIVE: To assess the cost-effectiveness (CE) of an intensive lifestyle intervention (ILI) compared with standard diabetes support and education (DSE) in adults with overweight/obesity and type 2 diabetes, as implemented in the Action for Health in Diabetes study. RESEARCH DESIGN AND METHODS: Data were from 4,827 participants during their first 9 years of the study participation from 2001 to 2012. Information on Health Utilities Index Mark 2 (HUI-2) and HUI-3, Short-Form 6D (SF-6D), and Feeling Thermometer (FT), cost of delivering the interventions, and health expenditures was collected during the study. CE was measured by incremental CE ratios (ICERs) in costs per quality-adjusted life year (QALY). Future costs and QALYs were discounted at 3% annually. Costs were in 2012 U.S. dollars. RESULTS: Over the 9 years studied, the mean cumulative intervention costs and mean cumulative health care expenditures were $11,275 and $64,453 per person for ILI and $887 and $68,174 for DSE. Thus, ILI cost $6,666 more per person than DSE. Additional QALYs gained by ILI were not statistically significant measured by the HUIs and were 0.07 and 0.15, respectively, measured by SF-6D and FT. The ICERs ranged from no health benefit with a higher cost based on HUIs to $96,458/QALY and $43,169/QALY, respectively, based on SF-6D and FT. CONCLUSIONS: Whether ILI was cost-effective over the 9-year period is unclear because different health utility measures led to different conclusions. |
The Anniston Community Health Survey
Cusack C , Pavuk M , Dutton N , Yang E , Serio T . J Environ Health 2020 83 (2) 38-41 The article discusses the Anniston Community Health Survey (ACHS) I and ACHS Follow-Up and Dioxin Analyses (ACHSII) that were conducted by the Anniston Environmental Health Research Consortium in 2005-2007 and in 2014, respectively, to determine effects of polychlorinated biphenyl exposure (PCB) on the health of residents in Anniston, Alabama. Also mentioned is the use of age and race as essential determinants of PCB exposure and contamination among residents. |
Using search-constrained inverse distance weight modeling for near real-time riverine flood modeling: Harris County, Texas, USA before, during, and after Hurricane Harvey
Berens AS , Palmer T , Dutton ND , Lavery A , Moore M . Nat Hazards (Dordr) 2020 105 (1) 277-292 Flooding poses a serious public health hazard throughout the world. Flood modeling is an important tool for emergency preparedness and response, but some common methods require a high degree of expertise or may be unworkable due to poor data quality or data availability issues. The conceptually simple method of inverse distance weight modeling offers an alternative. Using stream gauges as inputs, this study interpolated stream elevation via inverse distance weight modeling under 15 different model input parameter scenarios for Harris County, Texas, USA, from August 25th to September 15th, 2017 (before, during, and after Hurricane Harvey inundated the county). A digital elevation model was used to identify areas where modeled stream elevation exceeded ground elevation, indicating flooding. Imagery and observed high water marks were used to validate the models’ outputs. There was a high degree of agreement (between 79 and 88%) between imagery and model outputs of parameterizations visually validated. Quantitative validations based on high water marks were also positive, with a Nash–Sutcliffe efficiency of in excess of.6 for all parameterizations relative to a Nash–Sutcliffe efficiency of the benchmark of 0.56. Inverse distance weight modeling offers a simple, accurate method for first-order estimations of riverine flooding in near real-time using readily available data, and outputs are robust to some alterations to input parameters. |
Weight change 2 years after termination of the intensive lifestyle intervention in the Look AHEAD Study
Chao AM , Wadden TA , Berkowitz RI , Blackburn G , Bolin P , Clark JM , Coday M , Curtis JM , Delahanty LM , Dutton GR , Evans M , Ewing LJ , Foreyt JP , Gay LJ , Gregg EW , Hazuda HP , Hill JO , Horton ES , Houston DK , Jakicic JM , Jeffery RW , Johnson KC , Kahn SE , Knowler WC , Kure A , Michalski KL , Montez MG , Neiberg RH , Patricio J , Peters A , Pi-Sunyer X , Pownall H , Reboussin D , Redmon B , Rejeski WJ , Steinburg H , Walker M , Williamson DA , Wing RR , Wyatt H , Yanovski SZ , Zhang P . Obesity (Silver Spring) 2020 28 (5) 893-901 OBJECTIVE: This study evaluated weight changes after cessation of the 10-year intensive lifestyle intervention (ILI) in the Look AHEAD (Action for Health in Diabetes) study. It was hypothesized that ILI participants would be more likely to gain weight during the 2-year observational period following termination of weight-loss-maintenance counseling than would participants in the diabetes support and education (DSE) control group. METHODS: Look AHEAD was a randomized controlled trial that compared the effects of ILI and DSE on cardiovascular morbidity and mortality in participants with overweight/obesity and type 2 diabetes. Look AHEAD was converted to an observational study in September 2012. RESULTS: Two years after the end of the intervention (EOI), ILI and DSE participants lost a mean (SE) of 1.2 (0.2) kg and 1.8 (0.2) kg, respectively (P = 0.003). In addition, 31% of ILI and 23.9% of DSE participants gained >/= 2% (P < 0.001) of EOI weight, whereas 36.3% and 45.9% of the respective groups lost >/= 2% of EOI weight (P = 0.001). Two years after the EOI, ILI participants reported greater use of weight-control behaviors than DSE participants. CONCLUSIONS: Both groups lost weight during the 2-year follow-up period, but more ILI than DSE participants gained >/= 2% of EOI weight. Further understanding is needed of factors that affected long-term weight change in both groups. |
Evaluation of rapid syphilis testing using the Syphilis Health Check in Florida, 2015-2016
Richards J , Matthias J , Baker C , Wilson C , Peterman TA , Brown CP , Dutton M , Dokurugu Y . Fla Public Health Rev 2019 16 The Syphilis Health Check (SHC) had low estimated specificity (91.5%) in one Florida county. We investigated use of SHC by a range of Florida publicly-funded programs between 2015 and 2016 to estimate specificity, positive predictive value (PPV), field staff acceptance, and impacts on programmatic outcomes. All reported SHC results were extracted from routinely collected program data. Field staff were surveyed about SHC's utility. Analyses investigated differences between SHC and traditional syphilis testing outcomes. Of 3,630 SHC results reported, 442 were reactive; 92 (20.8%) had prior diagnoses of syphilis; 7 (1.6%) had no further testing. Of the remaining 343; 158 (46.0%) were confirmed cases, 168 (49.0%) were considered false-positive, and 17 (5.0%) were not cases but not clearly false-positive. Estimated specificity of SHC was 95.0%. Overall, 48.5% of positives became confirmed cases (PPV). PPV varied according to prevalence of syphilis in populations tested. Staff (90%) thought SHC helped identify new cases but expressed concern regarding discordance between reactive SHC and lab-based testing. Programmatic outcomes assessment showed shorter time to treatment and increased numbers of partners tested for the SHC group; these enhanced outcomes may better mitigate the spread of syphilis compared to traditional syphilis testing alone, but more research is needed. |
Finding inhabited settlements and tracking vaccination progress: the application of satellite imagery analysis to guide the immunization response to confirmation of previously-undetected, ongoing endemic wild poliovirus transmission in Borno State, Nigeria
Higgins J , Adamu U , Adewara K , Aladeshawe A , Aregay A , Barau I , Berens A , Bolu O , Dutton N , Iduma N , Jones B , Kaplan B , Meleh S , Musa M , Wa Nganda G , Seaman V , Sud A , Vouillamoz S , Wiesen E . Int J Health Geogr 2019 18 (1) 11 BACKGROUND: Four wild polio-virus cases were reported in Borno State, Nigeria 2016, 1 year after Nigeria had been removed from the list of polio endemic countries by the World Health Organization. Resulting from Nigeria's decade long conflict with Boko Haram, health officials had been unable to access as much as 60% of the settlements in Borno, hindering vaccination and surveillance efforts. This lack of accessibility made it difficult for the government to assess the current population distribution within Borno. This study aimed to use high resolution, visible band satellite imagery to assess the habitation of inaccessible villages in Borno State. METHODS: Using high resolution (31-50 cm) imagery from DigitalGlobe, analysts evaluated the habitation status of settlements in Borno State identified by Nigeria's Vaccination Tracking System. The analysts looked at imagery of each settlement and, using vegetation (overgrowth vs. cleared) as a proxy for human habitation, classified settlements into three categories: inhabited, partially abandoned, and abandoned. Analysts also classified the intact percentage of each settlement starting at 0% (totally destroyed since last assessment) and increasing in 25% intervals through 100% (completely intact but not expanded) up to 200+% (more than doubled in size) by looking for destroyed buildings. These assessments were then used to adjust previously established population estimates for each settlement. These new population distributions were compared to vaccination efforts to determine the number of children under 5 unreached by vaccination teams. RESULTS: Of the 11,927 settlements assessed 3203 were assessed as abandoned (1892 of those completely destroyed), 662 as partially abandoned, and 8062 as fully inhabited as of December of 2017. Comparing the derived population estimates from the new assessments to previous assessment and the activities of vaccination teams shows that an estimated 180,155 of the 337,411 under five children who were unreached in 2016 were reached in 2017 (70.5% through vaccination efforts in previously inaccessible areas, 29.5% through displacement to accessible areas). CONCLUSIONS: This study's methodology provides important planning and situation awareness information to health workers in Borno, Nigeria, and may serve as a model for future data gathering efforts in inaccessible regions. |
Physical function following a long-term lifestyle intervention among middle aged and older adults with type 2 diabetes: The Look AHEAD Study
Houston DK , Neiberg RH , Miller ME , Hill JO , Jakicic JM , Johnson KC , Gregg EW , Hubbard VS , Pi-Sunyer X , Rejeski WJ , Wing RR , Bantle JP , Beale E , Berkowitz RI , Cassidy-Begay M , Clark JM , Coday M , Delahanty LM , Dutton G , Egan C , Foreyt JP , Greenway FL , Hazuda HP , Hergenroeder A , Horton ES , Jeffery RW , Kahn SE , Kure A , Knowler WC , Lewis CE , Martin CK , Michaels S , Montez MG , Nathan DM , Patricio J , Peters A , Pownall H , Regensteiner J , Steinburg H , Wadden TA , White K , Yanovski SZ , Zhang P , Kritchevsky SB . J Gerontol A Biol Sci Med Sci 2018 73 (11) 1552-1559 Background: Lifestyle interventions have been shown to improve physical function over the short term; however, whether these benefits are sustainable is unknown. The long-term effects of an intensive lifestyle intervention (ILI) on physical function were assessed using a randomized post-test design in the Look AHEAD trial. Methods: Overweight and obese (body mass index >/= 25 kg/m2) middle-aged and older adults (aged 45-76 years at enrollment) with type 2 diabetes enrolled in Look AHEAD, a trial evaluating an ILI designed to achieve weight loss through caloric restriction and increased physical activity compared to diabetes support and education (DSE), underwent standardized assessments of performance-based physical function including a 4- and 400-m walk, lower extremity physical performance (expanded Short Physical Performance Battery, SPPBexp), and grip strength approximately 11 years postrandomization and 1.5 years after the intervention was stopped (n = 3,783). Results: Individuals randomized to ILI had lower odds of slow gait speed (<0.8 m/s) compared to those randomized to DSE (adjusted OR [95% CI]: 0.84 [0.71 to 0.99]). Individuals randomized to ILI also had faster gait speed over 4- and 400-m (adjusted mean difference [95% CI]: 0.019 [0.007 to 0.031] m/s, p = .002, and 0.023 [0.012 to 0.034] m/sec, p < .0001, respectively) and higher SPPBexp scores (0.037 [0.011 to 0.063], p = .005) compared to those randomized to DSE. The intervention effect was slightly larger for SPPBexp scores among older versus younger participants (0.081 [0.038 to 0.124] vs 0.013 [-0.021 to 0.047], p = .01). Conclusions: An intensive lifestyle intervention has modest but significant long-term benefits on physical function in overweight and obese middle-aged and older adults with type 2 diabetes. ClinicalTrials.gov Identifier: NCT00017953. |
Readiness for an increase in congenital Zika virus infections in the United States: Geographic distance to pediatric subspecialist care
Bertolli J , Holbrook J , Dutton ND , Jones B , Dowling NF , Peacock G . Disaster Med Public Health Prep 2018 13 (3) 1-11 OBJECTIVE: The study's purpose was to investigate readiness for an increase in the congenital Zika infection (CZI) by describing the distribution of pediatric subspecialists needed for the care of children with CZI. METHODS: We applied county-level subspecialist counts to US maps, overlaying the geocoded locations of children's hospitals to assess the correlation of hospital and subspecialist locations. We calculated travel distance from census tract centroids to the nearest in-state children's hospital by state (with/without > 100 reported adult Zika virus cases) and by regions corresponding to the likely local Zika virus transmission area and to the full range of the mosquito vector. Travel distance percentiles reflect the population of children 100 miles. CONCLUSION: The travel distance to pediatric subspecialty care varies widely by state and is likely to be an access barrier in some areas, particularly states bordering the Gulf of Mexico, which may have increasing numbers of CZI cases. (Disaster Med Public Health Preparedness. 2018 page 1 of 11). |
Liver Disease in a Residential Cohort With Elevated Polychlorinated Biphenyl Exposures.
Clair HB , Pinkston CM , Rai SN , Pavuk M , Dutton ND , Brock G , Prough RA , Falkner KC , McClain CJ , Cave MC . Toxicol Sci 2018 164 (1) 39-49 ![]() Endocrine and metabolism disrupting chemicals (EDCs/MDCs) have been associated with environmental liver diseases including toxicant-associated steatohepatitis (TASH). TASH has previously been characterized by hepatocellular necrosis, disrupted intermediary metabolism, and liver inflammation. Polychlorinated biphenyls (PCBs) are environmental EDCs/MDCs associated with the genesis and progression of steatohepatitis in animal models and human liver injury in epidemiology studies. The cross-sectional Anniston Community Health Survey (ACHS) investigates ortho-substituted PCB exposures and health effects near a former PCB manufacturing complex. The rates of obesity, diabetes, and dyslipidemia were previously determined to be high in ACHS. In this study, 738 ACHS participants were categorized by liver disease status using the serum cytokeratin 18 biomarker. Associations between PCB exposures and mechanistic biomarkers of intermediary metabolism, inflammation, and hepatocyte death were determined. The liver disease prevalence was high (60.2%), and 80.7% of these individuals were categorized as having TASH. Sex and race/ethnicity differences were noted. TASH was associated with increased exposures to specific PCB congeners, insulin resistance, dyslipidemia, pro-inflammatory cytokines, and liver necrosis. These findings are consistent with PCB-related steatohepatitis. SigmaPCBs was inversely associated with insulin resistance/production, leptin, and hepatocyte apoptosis, while other adipocytokines were increased. This is possibly the largest environmental liver disease study applying mechanistic biomarkers ever performed and the most comprehensive analysis of PCBs and adipocytokines. It provides insight into the mechanisms of PCB-related endocrine and metabolic disruption in liver disease and diabetes. In the future, associations between additional exposures and liver disease biomarkers will be evaluated in the ACHS and follow-up ACHS-II studies. |
ADHD medication use during pregnancy and risk for selected birth defects: National Birth Defects Prevention Study, 1998-2011
Anderson KN , Dutton AC , Broussard CS , Farr SL , Lind JN , Visser SN , Ailes EC , Shapira SK , Reefhuis J , Tinker SC . J Atten Disord 2018 24 (3) 1087054718759753 OBJECTIVE: The objective of this study was to examine the prevalence of, and maternal characteristics associated with, ADHD medication use before and during pregnancy, and associations between early pregnancy ADHD medication use and risk for 12 selected birth defects. METHOD: We used data from the National Birth Defects Prevention Study (1998-2011), a U.S. population-based case-control study examining risk factors for major structural birth defects. RESULTS: There was an increase in ADHD medication use from 1998-1999 (0.2%) to 2010-2011 (0.5%; p < .001). Early pregnancy ADHD medication use was more commonly reported by mothers of infants/fetuses with gastroschisis (crude odds ratio [cOR]: 2.9, 95% confidence interval [CI] = [1.2, 6.9]), omphalocele (cOR: 4.0, 95% CI = [1.2, 13.6]), and transverse limb deficiency (cOR: 3.3, 95% CI = [1.1, 9.6]). CONCLUSION: ADHD medication use before and during pregnancy was rare, but the prevalence of use has increased over time. In this analysis, early pregnancy ADHD medication use was associated with three of 12 selected birth defects. |
Polychlorinated biphenyls, indicators of thyroid function and thyroid autoantibodies in the Anniston Community Health Survey I (ACHS-I)
Benson K , Yang E , Dutton N , Sjodin A , Rosenbaum PF , Pavuk M . Chemosphere 2017 195 156-165 In this study, we examined associations between serum concentrations of 35 polychlorinated biphenyl (PCB) congeners, pesticides, and indicators of thyroid function in participants of the Anniston Community Health Survey (ACHS). Study subjects lived in the vicinity of a former PCB production facility and had PCB concentrations 2 to 3 times higher than similar age and race groups from the general population. We investigated associations among serum levels of thyroid hormones (thyroxin [T4], free thyroxin [fT4], triiodothyronine [T3], thyroid stimulation hormone [TSH]) and auto-antibodies (thyroglobulin antibody [TgAb] or thyroperoxidase antibody [TPOAb]) and combined indicators of thyroid function with the sum of PCBs, varying PCB groups, individual PCB congeners, and 8 pesticides. Logistic and linear regression models were adjusted for log10 transformed total lipids, age, sex, ethnicity, BMI, smoking, and family history of thyroid disease. We also performed analyses stratified by ethnicity and sex. Linear regression showed inverse associations between TT3 and thyroid-like PCBs (sum of PCBs 28, 52, 74, 101, 105, and 118; p = .0004), two pesticides (hexachlorobenzene, and pp'-DDE), and individual congeners (PCBs 74, 105). Null associations were observed between PCBs, pesticides, TSH, TT4, and fT4. Logistic regression analyses did not provide support for TT3 findings and found no association with other thyroid hormones, antibodies, or combined indicator of thyroid function. These results suggest there is little evidence that these chemicals have any major clinical effect on thyroid function in this highly PCB exposed population. |
Response to correction of refractive errors and hypoaccommodation in children with congenital Zika syndrome
Ventura LO , Lawrence L , Ventura CV , Dutton GN , Marinho P , Ferro PF , Gois AL , Dias NC , Ventura L , Moore CA , Hyvarinen L . J AAPOS 2017 21 (6) 480-484 e1 PURPOSE: To describe the immediate response to correction of refractive errors and hypoaccommodation in children with congenital Zika syndrome (CZS). METHODS: Children born between May and December 2015 with a confirmed diagnosis of CZS and enrolled in a multidisciplinary early intervention program were included in this study. All children received a comprehensive ophthalmic examination, including dynamic retinoscopy and cycloplegic refraction. Children were prescribed their full correction if they met the criteria for refractive error, and additional plus 3.00 overcorrection for strabismus, accommodative dysfunction, and/or low vision. Monocular and binocular visual responses to Lea Grating Test at 30 cm, with and without eyeglasses, were measured on day 1 of glasses wear. RESULTS: A total of 60 children were evaluated (mean age at evaluation, 11.5 +/- 1.1 months; range, 9.0-16.0 months). Lea Grating Test responses were abnormal in all children prior to spectacle correction. Hypoaccommodation was present in 17 of 21 children (81%). Overcorrection was prescribed for all children. Visual responses were subnormal even with glasses use; however, immediate improvement in binocular vision was found in 37 children (62%) and in 74 of 119 eyes (62.2%). For the monocular visual improvement, 27 of 115 eyes (23.5%) had structural abnormalities, and 44 of 115 eyes (38.3%) were structurally normal. There was a statistical difference between the cycloplegic refraction of the children in August and in November, including emmetropia (P = 0.001), hyperopia (P = 0.000), myopia (P = 0.007), and astigmatism (P = 0.004). CONCLUSIONS: Eyeglasses can improve visual acuity in children with CZS. Significant changes in their refractive status over time requires periodic updates. |
Anniston Community Health Survey: Follow-up and dioxin analyses (ACHS-II) - methods
Birnbaum LS , Dutton ND , Cusack C , Mennemeyer ST , Pavuk M . Environ Sci Pollut Res Int 2016 23 (3) 2014-21 High serum concentrations of polychlorinated biphenyls (PCBs) have been reported previously among residents of Anniston, Alabama, where a PCB production facility was located in the past. As the second of two cross-sectional studies of these Anniston residents, the Anniston Community Health Survey: Follow-Up and Dioxin Analyses (ACHS-II) will yield repeated measurements to be used to evaluate changes over time in ortho-PCB concentrations and selected health indicators in study participants. Dioxins, non-ortho PCBs, other chemicals, heavy metals, and a variety of additional clinical tests not previously measured in the original ACHS cohort will be examined in ACHS-II. The follow-up study also incorporates a questionnaire with extended sections on diet and occupational history for a more comprehensive assessment of possible exposure sources. Data collection for ACHS-II from 359 eligible participants took place in 2014, 7 to 9 years after ACHS. |
Are schools safe from indoor radon?
Foster S , Dent A , Bryant J , Tencza B , Adams E , Dutton ND . J Environ Health 2015 77 (10) 38-40 The U.S. Environmental Protection Agency (U.S. EPA) estimates approximately 21,000 lung cancer deaths are attributable to radon exposure (U.S. EPA, 2003). This number is approximately seven times greater than the number of lung cancer deaths due to secondhand smoke exposure and about twice as many deaths caused by drunk drivers (Centers for Disease Control and Prevention, 2015; Foundation for Advancing Alcohol Responsibility, 2013; National Cancer Institute, 2012). Despite these startling statistics, very few programs are in place to monitor or evaluate indoor radon levels in homes and public buildings in the U.S. Since radon gas is colorless, odorless, and tasteless, testing is the only way to determine its presence (Agency for Toxic Substances and Disease Registry [ATSDR], 2012; U.S. EPA, 2003; U.S. Geological Survey, 1993). When testing reveals levels greater than 4 picocuries per liter (pCi/L), mitigation is recommended by U.S. EPA and several effective strategies for reducing indoor radon levels exist (American Association of Radon Scientists and Technologists, 2014; U.S. EPA, 2010). Given the absence of a national program for radon surveillance and the ubiquitous nature of radon gas, we have undertaken a series of activities to understand the extent to which indoor radon may be a risk for Americans, specifically for children attending public schools, in hopes of increasing awareness about the importance of radon testing. | In 2013, we began a study of the scope and extent of regular and standard radon testing programs in schools across the nation. We learned that many states have active radon testing and mitigation programs. For example, in the last eight years New Jersey has tested 1,705 (51%) public schools (New Jersey Department of Environmental Protection, 2014). We also learned, however, that laws and regulations for reducing radon in schools were scarce (Bernstein, 2013). Additionally, we were surprised to uncover the variations in requirements among different laws. Since our original inquiries, some states have lost funding to support their legislation. Other states have added language in support of testing or radon-resistant new construction practices (Environmental Law Institute, 2014). Policies for radon testing in schools and radon-resistant new construction continue to be uncommon and moving targets. |
Predictors of serum polychlorinated biphenyl concentrations in Anniston residents
Pavuk M , Olson JR , Wattigney WA , Dutton ND , Sjodin A , Shelton C , Turner WE , Bartell SM . Sci Total Environ 2014 496 624-634 The Anniston Community Health Survey was a community-based cross-sectional study of Anniston, Alabama, residents who live in close proximity to a former PCB production facility to identify factors associated with serum PCB levels. The survey comprises 765 Anniston residents who completed a questionnaire interview and provided a blood sample for analysis in 2005-2007. Several reports based on data from the Anniston survey have been previously published, including associations between PCB exposure and diabetes and blood pressure. In this study we examine demographic, behavioral, dietary, and occupational characteristics of Anniston survey participants as predictors of serum PCB concentrations. Of the 765 participants, 54% were White and 45% were African-American; the sample was predominantly female (70%), with a mean age of 55 years. Serum PCB concentrations varied widely between participants (range for sum of 35 PCBs: 0.11-170.4ng/g wet weight). Linear regression models with stepwise selection were employed to examine factors associated with serum PCBs. Statistically significant positive associations were observed between serum PCB concentrations and age, race, residential variables, current smoking, and local fish consumption, as was a negative association with education level. Age and race were the most influential predictors of serum PCB levels. A small age by sex interaction was noted, indicating that the increase in PCB levels with age was steeper for women than for men. Significant interaction terms indicated that the associations between PCB levels and having ever eaten locally raised livestock and local clay were much stronger among African-Americans than among White participants. In summary, demographic variables and past consumption of locally produced foods were found to be the most important predictors of PCB concentrations in residents living in the vicinity of a former PCB manufacturing facility. |
Serum concentrations of polychlorinated biphenyls (PCBs) in participants of the Anniston Community Health Survey
Pavuk M , Olson JR , Sjodin A , Wolff P , Turner WE , Shelton C , Dutton ND , Bartell S . Sci Total Environ 2013 473-474c 286-297 Serum concentrations of 35 ortho-substituted polychlorinated biphenyl congeners (PCBs) were measured in 765 adults from Anniston, Alabama, where PCBs were manufactured between 1929 and 1971. As part of the Anniston Community Health Survey (ACHS), demographic data, questionnaire information, and blood samples were collected from participants in 2005-2007. Forty-six percent of study participants were African-American, 70% were female, and the median age was 56 years. The median concentration of the sum of 35 PCB congeners (SigmaPCBs) was 528ng/g lipid, with a 90th percentile of 2600ng/g lipid, minimum of 17.0ng/g lipid, and maximum of 27,337ng/g lipid. The least square geometric mean SigmaPCBs was more than 2.5 times higher for African-American participants than for White participants (866ng/g lipid vs. 331ng/g lipid); this difference did not change materially after adjustment for age, sex, body mass index (BMI) and current smoking. In spite of large differences in absolute PCB levels, relative contributions of individual congeners to SigmaPCBs were quite similar between race groups. Nevertheless, while percent contributions to SigmaPCBs for most of the most abundant penta- to heptachlorobiphenyls were higher among African-Americans, the percentages were higher in Whites for the lower-chlorinated PCBs 28 and 74 and for octa- to decachlorinated PCBs. No major differences were observed in geometric mean SigmaPCBs between women and men when adjusted for age, race, BMI and current smoking (516ng/g lipid vs. 526ng/g lipid). Principal component analysis revealed groups of co-varying congeners that appear to be determined by chlorine substitution patterns. These congener groupings were similar between ACHS participants and the National Health and Nutrition Examination Survey (NHANES) 2003-04 sample of the general United States population, despite ACHS participants having serum concentrations of SigmaPCBs two to three times higher than those in comparable age and race groups from NHANES. |
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