Science.gov

Sample records for cumulative health risk

  1. Using exposomics to assess cumulative risks and promote health.

    PubMed

    Smith, Martyn T; de la Rosa, Rosemarie; Daniels, Sarah I

    2015-12-01

    Under the exposome paradigm all nongenetic factors contributing to disease are considered to be 'environmental' including chemicals, drugs, infectious agents, and psychosocial stress. We can consider these collectively as environmental stressors. Exposomics is the comprehensive analysis of exposure to all environmental stressors and should yield a more thorough understanding of chronic disease development. We can operationalize exposomics by studying all the small molecules in the body and their influence on biological pathways that lead to impaired health. Here, we describe methods by which this may be achieved and discuss the application of exposomics to cumulative risk assessment in vulnerable populations. Since the goal of cumulative risk assessment is to analyze, characterize, and quantify the combined risks to health from exposures to multiple agents or stressors, it seems that exposomics is perfectly poised to advance this important area of environmental health science. We should therefore support development of tools for exposomic analysis and begin to engage impacted communities in participatory exposome research. A first step may be to apply exposomics to vulnerable populations already studied by more conventional cumulative risk approaches. We further propose that recent migrants, low socioeconomic groups with high environmental chemical exposures, and pregnant women should be high priority populations for study by exposomics. Moreover, exposomics allows us to study interactions between chronic stress and environmental chemicals that disrupt stress response pathways (i.e., 'stressogens'). Exploring the impact of early life exposures and maternal stress may be an interesting and accessible topic for investigation by exposomics using biobanked samples.

  2. Cumulative Risk Assessment: An Overview of Methodological Approaches for Evaluating Combined Health Effects from Exposure to Multiple Environmental Stressors

    PubMed Central

    Sexton, Ken

    2012-01-01

    Systematic evaluation of cumulative health risks from the combined effects of multiple environmental stressors is becoming a vital component of risk-based decisions aimed at protecting human populations and communities. This article briefly examines the historical development of cumulative risk assessment as an analytical tool, and discusses current approaches for evaluating cumulative health effects from exposure to both chemical mixtures and combinations of chemical and nonchemical stressors. A comparison of stressor-based and effects-based assessment methods is presented, and the potential value of focusing on viable risk management options to limit the scope of cumulative evaluations is discussed. The ultimate goal of cumulative risk assessment is to provide answers to decision-relevant questions based on organized scientific analysis; even if the answers, at least for the time being, are inexact and uncertain. PMID:22470298

  3. Cumulative risk and developmental health: an argument for the importance of a family-wide science.

    PubMed

    Browne, Dillon T; Plamondon, Andre; Prime, Heather; Puente-Duran, Sofia; Wade, Mark

    2015-01-01

    A substantial body of research links social disadvantage and developmental health via a cascade running from poverty, to cumulative psychosocial risk, to disrupted family dynamics, to child biological regulatory systems and neurocognitive processing, and finally to morbidity across the lifespan. Most research in this area employs single-dyad or between-family methodology. While informative, there are limitations to this approach. Specifically, it is impossible to determine how risk alters psychosocial environments that are similar for all persons within a household, versus processes that are unique to particular children. This is important in light of literature citing the primacy of child-specific environments in driving developmental health. Methodologically speaking, there are both benefits and challenges to family-wide approaches that differentiate between- and within-family environments. This review describes literature linking cumulative risk and developmental health via family process, while articulating the importance of family-wide approaches. Areas of shortcoming and recommendations for a family-wide science are provided.

  4. Cumulative health risk assessment: integrated approaches for multiple contaminants, exposures, and effects

    SciTech Connect

    Rice, Glenn; Teuschler, Linda; MacDonel, Margaret; Butler, Jim; Finster, Molly; Hertzberg, Rick; Harou, Lynne

    2007-07-01

    Available in abstract form only. Full text of publication follows: As information about environmental contamination has increased in recent years, so has public interest in the combined effects of multiple contaminants. This interest has been highlighted by recent tragedies such as the World Trade Center disaster and hurricane Katrina. In fact, assessing multiple contaminants, exposures, and effects has long been an issue for contaminated sites, including U.S. Department of Energy (DOE) legacy waste sites. Local citizens have explicitly asked the federal government to account for cumulative risks, with contaminants moving offsite via groundwater flow, surface runoff, and air dispersal being a common emphasis. Multiple exposures range from ingestion and inhalation to dermal absorption and external gamma irradiation. Three types of concerns can lead to cumulative assessments: (1) specific sources or releases - e.g., industrial facilities or accidental discharges; (2) contaminant levels - in environmental media or human tissues; and (3) elevated rates of disease - e.g., asthma or cancer. The specific initiator frames the assessment strategy, including a determination of appropriate models to be used. Approaches are being developed to better integrate a variety of data, extending from environmental to internal co-location of contaminants and combined effects, to support more practical assessments of cumulative health risks. (authors)

  5. Modeling Joint Exposures and Health Outcomes for Cumulative Risk Assessment: the Case of Radon and Smoking

    EPA Science Inventory

    Community-based cumulative risk assessment requires characterization of exposures to multiple chemical and non-chemical stressors, with consideration of how the non-chemical stressors may influence risks from chemical stressors. Residential radon provides an interesting case exam...

  6. Cumulative health risk assessment of 17 perfluoroalkylated and polyfluoroalkylated substances (PFASs) in the Swedish population.

    PubMed

    Borg, Daniel; Lund, Bert-Ove; Lindquist, Nils-Gunnar; Håkansson, Helen

    2013-09-01

    Humans are simultaneously exposed to a multitude of chemicals. Human health risk assessment of chemicals is, however, normally performed on single substances, which may underestimate the total risk, thus bringing a need for reliable methods to assess the risk of combined exposure to multiple chemicals. Per- and polyfluoroalkylated substances (PFASs) is a large group of chemicals that has emerged as global environmental contaminants. In the Swedish population, 17 PFASs have been measured, of which the vast majority lacks human health risk assessment information. The objective of this study was to for the first time perform a cumulative health risk assessment of the 17 PFASs measured in the Swedish population, individually and in combination, using the Hazard Index (HI) approach. Swedish biomonitoring data (blood/serum concentrations of PFASs) were used and two study populations identified: 1) the general population exposed indirectly via the environment and 2) occupationally exposed professional ski waxers. Hazard data used were publicly available toxicity data for hepatotoxicity and reproductive toxicity as well as other more sensitive toxic effects. The results showed that PFASs concentrations were in the low ng/ml serum range in the general population, reaching high ng/ml and low μg/ml serum concentrations in the occupationally exposed. For those congeners lacking toxicity data with regard to hepatotoxicity and reproductive toxicity read-across extrapolations was performed. Other effects at lower dose levels were observed for some well-studied congeners. The risk characterization showed no concern for hepatotoxicity or reproductive toxicity in the general population except in a subpopulation eating PFOS-contaminated fish, illustrating that high local exposure may be of concern. For the occupationally exposed there was concern for hepatotoxicity by PFOA and all congeners in combination as well as for reproductive toxicity by all congeners in combination, thus a

  7. HEALTH AND ENVIRONMENTAL SCIENCES INSTITUTE'S EXPOSURE FACTORS DATABASE FOR AGGREGATE AND CUMULATIVE RISK ASSESSMENT

    EPA Science Inventory

    In recent years, the risk analysis community has broadened its use of complex aggregate and cumulative residential exposure models (e.g., to meet the requirements of the 1996 Food Quality Protection Act). The value of these models is their ability to incorporate a range of input...

  8. Modeling joint exposures and health outcomes for cumulative risk assessment: the case of radon and smoking.

    PubMed

    Chahine, Teresa; Schultz, Bradley D; Zartarian, Valerie G; Xue, Jianping; Subramanian, S V; Levy, Jonathan I

    2011-09-01

    Community-based cumulative risk assessment requires characterization of exposures to multiple chemical and non-chemical stressors, with consideration of how the non-chemical stressors may influence risks from chemical stressors. Residential radon provides an interesting case example, given its large attributable risk, effect modification due to smoking, and significant variability in radon concentrations and smoking patterns. In spite of this fact, no study to date has estimated geographic and sociodemographic patterns of both radon and smoking in a manner that would allow for inclusion of radon in community-based cumulative risk assessment. In this study, we apply multi-level regression models to explain variability in radon based on housing characteristics and geological variables, and construct a regression model predicting housing characteristics using U.S. Census data. Multi-level regression models of smoking based on predictors common to the housing model allow us to link the exposures. We estimate county-average lifetime lung cancer risks from radon ranging from 0.15 to 1.8 in 100, with high-risk clusters in areas and for subpopulations with high predicted radon and smoking rates. Our findings demonstrate the viability of screening-level assessment to characterize patterns of lung cancer risk from radon, with an approach that can be generalized to multiple chemical and non-chemical stressors.

  9. Modeling Joint Exposures and Health Outcomes for Cumulative Risk Assessment: The Case of Radon and Smoking

    PubMed Central

    Chahine, Teresa; Schultz, Bradley D.; Zartarian, Valerie G.; Xue, Jianping; Subramanian, SV; Levy, Jonathan I.

    2011-01-01

    Community-based cumulative risk assessment requires characterization of exposures to multiple chemical and non-chemical stressors, with consideration of how the non-chemical stressors may influence risks from chemical stressors. Residential radon provides an interesting case example, given its large attributable risk, effect modification due to smoking, and significant variability in radon concentrations and smoking patterns. In spite of this fact, no study to date has estimated geographic and sociodemographic patterns of both radon and smoking in a manner that would allow for inclusion of radon in community-based cumulative risk assessment. In this study, we apply multi-level regression models to explain variability in radon based on housing characteristics and geological variables, and construct a regression model predicting housing characteristics using U.S. Census data. Multi-level regression models of smoking based on predictors common to the housing model allow us to link the exposures. We estimate county-average lifetime lung cancer risks from radon ranging from 0.15 to 1.8 in 100, with high-risk clusters in areas and for subpopulations with high predicted radon and smoking rates. Our findings demonstrate the viability of screening-level assessment to characterize patterns of lung cancer risk from radon, with an approach that can be generalized to multiple chemical and non-chemical stressors. PMID:22016710

  10. Health risks of children's cumulative and aggregative exposure to metals and metalloids in a typical urban environment in China.

    PubMed

    Cao, Suzhen; Duan, Xiaoli; Zhao, Xiuge; Chen, Yiting; Wang, Beibei; Sun, Chengye; Zheng, Binghui; Wei, Fusheng

    2016-03-01

    Rapid development of industrialization and urbanization results in serious environmental contamination by metal(loid)s, which would consequently cause deleterious health effects to the exposed people through multi-pathways. Therefore, total health risk assessment for the population in urban environment is very important. Unfortunately, few studies to date investigate the cumulative health risks of metal(loid)s through aggregative pathways in Children who are often susceptible population. 12 metal(loid)s including Lead(Pb), Cadmium(Cd), Arsenic(As), Chromium(Cr), Zinc(Zn), Copper(Cu), Nickel(Ni), Manganese(Mn), Cobalt(Co), Selenium(Se), Antimony(Se) and Vanadium(V), were analyzed in PM10, drinking water, food, soil and indoor dust in this study. The cumulative and aggregative risks of these metal(loid)s among the local children were then evaluated on a field sampling and questionnaire-survey basis. The results showed that the environments were heavily polluted by metal(loid)s. For most metal(loid)s, food ingestion accounted for more than 80% of the total daily exposure dose. The non-cancer risks were up to 30 times higher than the acceptable level due to the food ingestion via Pb, Cr, Cu, Zn, As, Se, Cd and Sb, and the PM10 inhalation via Cr and Mn. While, the cancer risks were mainly attributed to Cr via food ingestion and As via food and dust ingestion, and approximately 100 times of the maximum acceptable level of 1.0 × 10(-4). The study highlights the cumulative and aggregative exposure assessment, instead of pollutant investigation to evaluate the potential health risks and emphasizes concerns to improve indoor hygienic and environmental quality and to decrease the potential harmful health effects of children living in urban area.

  11. Health risks of children's cumulative and aggregative exposure to metals and metalloids in a typical urban environment in China.

    PubMed

    Cao, Suzhen; Duan, Xiaoli; Zhao, Xiuge; Chen, Yiting; Wang, Beibei; Sun, Chengye; Zheng, Binghui; Wei, Fusheng

    2016-03-01

    Rapid development of industrialization and urbanization results in serious environmental contamination by metal(loid)s, which would consequently cause deleterious health effects to the exposed people through multi-pathways. Therefore, total health risk assessment for the population in urban environment is very important. Unfortunately, few studies to date investigate the cumulative health risks of metal(loid)s through aggregative pathways in Children who are often susceptible population. 12 metal(loid)s including Lead(Pb), Cadmium(Cd), Arsenic(As), Chromium(Cr), Zinc(Zn), Copper(Cu), Nickel(Ni), Manganese(Mn), Cobalt(Co), Selenium(Se), Antimony(Se) and Vanadium(V), were analyzed in PM10, drinking water, food, soil and indoor dust in this study. The cumulative and aggregative risks of these metal(loid)s among the local children were then evaluated on a field sampling and questionnaire-survey basis. The results showed that the environments were heavily polluted by metal(loid)s. For most metal(loid)s, food ingestion accounted for more than 80% of the total daily exposure dose. The non-cancer risks were up to 30 times higher than the acceptable level due to the food ingestion via Pb, Cr, Cu, Zn, As, Se, Cd and Sb, and the PM10 inhalation via Cr and Mn. While, the cancer risks were mainly attributed to Cr via food ingestion and As via food and dust ingestion, and approximately 100 times of the maximum acceptable level of 1.0 × 10(-4). The study highlights the cumulative and aggregative exposure assessment, instead of pollutant investigation to evaluate the potential health risks and emphasizes concerns to improve indoor hygienic and environmental quality and to decrease the potential harmful health effects of children living in urban area. PMID:26774306

  12. Social Determinants of Health in Environmental Justice Communities: Examining Cumulative Risk in Terms of Environmental Exposures and Social Determinants of Health

    PubMed Central

    Prochaska, John D.; Nolen, Alexandra B.; Kelley, Hilton; Sexton, Ken; Linder, Stephen H.; Sullivan, John

    2014-01-01

    Residents of environmental justice (EJ) communities may bear a disproportionate burden of environmental health risk, and often face additional burdens from social determinants of health. Accounting for cumulative risk should include measures of risk from both environmental sources and social determinants. This study sought to better understand cumulative health risk from both social and environmental sources in a disadvantaged community in Texas. Key outcomes were determining what data are currently available for this assessment, clarifying data needs, identifying data gaps, and considering how those gaps could be filled. Analyses suggested that the traditionally defined EJ community in Port Arthur may have a lower environmental risk from air toxics than the rest of the City of Port Arthur (although the entire city has a higher risk than the average for the state), but may have a larger burden from social determinants of health. However, the results should be interpreted in light of the availability of data, the definitions of community boundaries, and the areal unit utilized. Continued focus on environmental justice communities and the cumulative risks faced by their residents is critical to protecting these residents and, ultimately, moving towards a more equitable distribution and acceptable level of risk throughout society. PMID:24771993

  13. Social Determinants of Health in Environmental Justice Communities: Examining Cumulative Risk in Terms of Environmental Exposures and Social Determinants of Health.

    PubMed

    Prochaska, John D; Nolen, Alexandra B; Kelley, Hilton; Sexton, Ken; Linder, Stephen H; Sullivan, John

    2014-01-01

    Residents of environmental justice (EJ) communities may bear a disproportionate burden of environmental health risk, and often face additional burdens from social determinants of health. Accounting for cumulative risk should include measures of risk from both environmental sources and social determinants. This study sought to better understand cumulative health risk from both social and environmental sources in a disadvantaged community in Texas. Key outcomes were determining what data are currently available for this assessment, clarifying data needs, identifying data gaps, and considering how those gaps could be filled. Analyses suggested that the traditionally defined EJ community in Port Arthur may have a lower environmental risk from air toxics than the rest of the City of Port Arthur (although the entire city has a higher risk than the average for the state), but may have a larger burden from social determinants of health. However, the results should be interpreted in light of the availability of data, the definitions of community boundaries, and the areal unit utilized. Continued focus on environmental justice communities and the cumulative risks faced by their residents is critical to protecting these residents and, ultimately, moving towards a more equitable distribution and acceptable level of risk throughout society.

  14. Cumulative effects of anti-androgenic chemical mixtures and their relevance to human health risk assessment

    EPA Science Inventory

    Kembra L. Howdeshell and L. Earl Gray, Jr.Toxicological studies of defined chemical mixtures assist human health risk assessment by characterizing the joint action of chemicals. This presentation will review the effects of anti-androgenic chemical mixtures on reproductive tract d...

  15. Cumulative risk and child development.

    PubMed

    Evans, Gary W; Li, Dongping; Whipple, Sara Sepanski

    2013-11-01

    Childhood multiple risk factor exposure exceeds the adverse developmental impacts of singular exposures. Multiple risk factor exposure may also explain why sociodemographic variables (e.g., poverty) can have adverse consequences. Most research on multiple risk factor exposure has relied upon cumulative risk (CR) as the measure of multiple risk. CR is constructed by dichotomizing each risk factor exposure (0 = no risk; 1 = risk) and then summing the dichotomous scores. Despite its widespread use in developmental psychology and elsewhere, CR has several shortcomings: Risk is designated arbitrarily; data on risk intensity are lost; and the index is additive, precluding the possibility of statistical interactions between risk factors. On the other hand, theoretically more compelling multiple risk metrics prove untenable because of low statistical power, extreme higher order interaction terms, low robustness, and collinearity among risk factors. CR multiple risk metrics are parsimonious, are statistically sensitive even with small samples, and make no assumptions about the relative strengths of multiple risk factors or their collinearity. CR also fits well with underlying theoretical models (e.g., Bronfenbrenner's, 1979, bioecological model; McEwen's, 1998, allostasis model of chronic stress; and Ellis, Figueredo, Brumbach, & Schlomer's, 2009, developmental evolutionary theory) concerning why multiple risk factor exposure is more harmful than singular risk exposure. We review the child CR literature, comparing CR to alternative multiple risk measurement models. We also discuss strengths and weaknesses of developmental CR research, offering analytic and theoretical suggestions to strengthen this growing area of scholarship. Finally, we highlight intervention and policy implications of CR and child development research and theory. PMID:23566018

  16. Incorporating Nonchemical Stressors Into Cumulative Risk Assessments

    PubMed Central

    Rider, Cynthia V.; Dourson, Michael L.; Hertzberg, Richard C.; Mumtaz, Moiz M.; Price, Paul S.; Simmons, Jane Ellen

    2012-01-01

    The role of nonchemical stressors in modulating the human health risk associated with chemical exposures is an area of increasing attention. On 9 March 2011, a workshop titled “Approaches for Incorporating Nonchemical Stressors into Cumulative Risk Assessment” took place during the 50th Anniversary Annual Society of Toxicology Meeting in Washington D.C. Objectives of the workshop included describing the current state of the science from various perspectives (i.e., regulatory, exposure, modeling, and risk assessment) and presenting expert opinions on currently available methods for incorporating nonchemical stressors into cumulative risk assessments. Herein, distinct frameworks for characterizing exposure to, joint effects of, and risk associated with chemical and nonchemical stressors are discussed. PMID:22345310

  17. CUMULATIVE TRAUMAS AND RISK THRESHOLDS: 12-MONTH PTSD IN THE WORLD MENTAL HEALTH (WMH) SURVEYS

    PubMed Central

    Karam, Elie G.; Friedman, Matthew J.; Hill, Eric D.; Kessler, Ronald C.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C.; Bromet, Evelyn J.; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E.; Haro, Josep Maria; He, Yanling; Karam, Aimee N.; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne, Mark A. Oakley; Posada-Villa, José A.; Shalev, Arieh Y.; Stein, Dan J.; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C.

    2014-01-01

    Background Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Methods Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. Results 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyper-arousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. Conclusions A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more “complex” clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. Depression and Anxiety 31:130–142, 2014. PMID:23983056

  18. Cumulative health risk assessment of co-occurring mycotoxins of deoxynivalenol and its acetyl derivatives in wheat and maize: case study, Shanghai, China.

    PubMed

    Han, Zheng; Nie, Dongxia; Ediage, Emmanuel Njumbe; Yang, Xianli; Wang, Jianhua; Chen, Bo; Li, Shuguang; On, Stephen L W; De Saeger, Sarah; Wu, Aibo

    2014-12-01

    Humans are naturally and frequently exposed to a multitude of mycotoxins, but health risk assessments are usually performed on individual mycotoxins, which may underestimate the total risks. In this study, we assessed for the first time the cumulative health risks of concomitant exposure via dietary intake (DI) to multiple mycotoxins, namely deoxynivalenol (DON) and its acetyl derivatives of 3-acetyldeoxynivalenol (3-ADON) and 15-acetyldeoxynivalenol (15-ADON), based on the concentration addition (CA) concept. A cross-sectional study was conducted in seven districts in Shanghai, China with 1269 participants and 330 wheat and maize samples analyzed. After probabilistic analysis using Monte Carlo simulation, the results showed no health risks to the population in Shanghai considering individual mycotoxins. However, if the cumulative health risks were calculated based on the combined consideration of DON with either 3-ADON or 15-ADON or both, the DI values in 95th percentile were up to 1087 ng/kg body weight/day, exceeding the Provisional Maximum Tolerable Daily Intake (PMTDI) of 1000 ng/kg body weight/day and hence representing potential health risks to the population in Shanghai. The integrated study proposed here could be a model strategy for cumulative health risk assessment on the co-occurring hazards in the fields of food safety combined with environmental contaminants.

  19. Cumulative Risk: Toxicity and Interactions of Physical and Chemical Stressors

    EPA Science Inventory

    ABSTRACT Recent efforts to update cumulative risk assessment procedures to incorporate nonchemical stressors ranging from physical to psychosocial, reflect increased interest in consideratio of the totality of variables affecting human health and the growing desire to develop co...

  20. 76 FR 69726 - Pyrethrins/Pyrethroid Cumulative Risk Assessment; Notice of Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-09

    ... to consider available information concerning the cumulative effects on human health resulting from... used to further refine the very conservative nature of this cumulative risk assessment. DATES: Comments... stakeholders including environmental, human health, farm worker, and agricultural advocates; the...

  1. CUMULATIVE RISK ASSESSMENT FOR QUANTITATIVE RESPONSE DATA

    EPA Science Inventory

    The Relative Potency Factor approach (RPF) is used to normalize and combine different toxic potencies among a group of chemicals selected for cumulative risk assessment. The RPF method assumes that the slopes of the dose-response functions are all equal; but this method depends o...

  2. Cumulative health risk assessment of halogenated and parent polycyclic aromatic hydrocarbons associated with particulate matters in urban air.

    PubMed

    Sun, Jian-Lin; Jing, Xin; Chang, Wen-Jing; Chen, Zheng-Xia; Zeng, Hui

    2015-03-01

    Halogenated polycyclic aromatic hydrocarbons (HPAHs) have been reported to occur widely in urban air. Nevertheless, knowledge about the human health risk associated with inhalation exposure to HPAHs is scarce so far. In the present study, nine HPAHs and 16 PAHs were determined in atmospheric particulate matter (PM) collected from Shenzhen, China to address this issue. Concentrations of Σ9HPAHs varied from 0.1 to 1.5 ng/m(3) and from 0.09 to 0.4 ng/m(3) in PM10 and PM2.5 samples, respectively. As for individuals, 9-bromoanthracene, 7-bromobenz(a)anthracene, and 9,10-dibromoanthracene were the dominant congeners. Levels of Σ16PAHs in PM10 and PM2.5 samples ranged from 3.2 to 81 ng/m(3) and from 2.8 to 85 ng/m(3), respectively. Among individual PAHs, chrysene, benzo[b]fluoranthene, and indeno[1,2,3-c,d]pyrene were the main congeners. According to the season, concentrations of HPAHs and PAHs in atmospheric PM10/PM2.5 samples show a similar decreasing trend with an order: winter>autumn>spring>summer. The daily intake (DI) of PM10/PM2.5-bound HPAHs and PAHs were estimated. Our results indicated that children have the highest DI levels via inhalation exposure. The incremental lifetime cancer risk (ILCR) induced by PM10/PM2.5-bound HPAHs and PAHs were calculated. The ILCR values showed a similar decreasing trend with an order: adults>children>seniors>adolescent. Overall, the ILCR values induced by HPAHs and PAHs were far below the priority risk level (10(-4)), indicating no obvious cancer risk. To our knowledge, this is the first study to investigate the human health risk associated with inhalation exposure to PM10/PM2.5-bound HPAHs. PMID:25483369

  3. CUMULATIVE RISK ASSESSMENT: GETTING FROM TOXICOLOGY TO QUANTITATIVE ANALYSIS

    EPA Science Inventory

    INTRODUCTION: GETTING FROM TOXICOLOGY TO QUANTITATIVE ANALYSIS FOR CUMULATIVE RISK

    Hugh A. Barton1 and Carey N. Pope2
    1US EPA, Office of Research and Development, National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC
    2Department of...

  4. EPA/STAR Cumulative Risk Assessment Research

    EPA Science Inventory

    Exposure to different combinations of environmental stressors can contribute to increased risk for negative health consequences. Extensive studies show associations between disadvantaged communities and suboptimal health. Stressful social environments may also make a population t...

  5. Cumulative Risk Assessment Toolbox: Methods and Approaches for the Practitioner

    PubMed Central

    MacDonell, Margaret M.; Haroun, Lynne A.; Teuschler, Linda K.; Rice, Glenn E.; Hertzberg, Richard C.; Butler, James P.; Chang, Young-Soo; Clark, Shanna L.; Johns, Alan P.; Perry, Camarie S.; Garcia, Shannon S.; Jacobi, John H.; Scofield, Marcienne A.

    2013-01-01

    The historical approach to assessing health risks of environmental chemicals has been to evaluate them one at a time. In fact, we are exposed every day to a wide variety of chemicals and are increasingly aware of potential health implications. Although considerable progress has been made in the science underlying risk assessments for real-world exposures, implementation has lagged because many practitioners are unaware of methods and tools available to support these analyses. To address this issue, the US Environmental Protection Agency developed a toolbox of cumulative risk resources for contaminated sites, as part of a resource document that was published in 2007. This paper highlights information for nearly 80 resources from the toolbox and provides selected updates, with practical notes for cumulative risk applications. Resources are organized according to the main elements of the assessment process: (1) planning, scoping, and problem formulation; (2) environmental fate and transport; (3) exposure analysis extending to human factors; (4) toxicity analysis; and (5) risk and uncertainty characterization, including presentation of results. In addition to providing online access, plans for the toolbox include addressing nonchemical stressors and applications beyond contaminated sites and further strengthening resource accessibility to support evolving analyses for cumulative risk and sustainable communities. PMID:23762048

  6. A Longitudinal Analysis of Cumulative Risks, Cumulative Promotive Factors, and Adolescent Violent Behavior

    ERIC Educational Resources Information Center

    Stoddard, Sarah A.; Zimmerman, Marc A.; Bauermeister, Jose A.

    2012-01-01

    This study examined the effects of cumulative risk and promotive factors on violent behavior across the high school years of adolescence in a sample of predominately African American urban adolescents (N = 750). Cumulative risk and promotive factor indices represented individual characteristics, and peer, parental, and familial influences. Using…

  7. Children neglected: Where cumulative risk theory fails.

    PubMed

    O'Hara, Mandy; Legano, Lori; Homel, Peter; Walker-Descartes, Ingrid; Rojas, Mary; Laraque, Danielle

    2015-07-01

    Neglected children, by far the majority of children maltreated, experience an environment most deficient in cognitive stimulation and language exchange. When physical abuse co-occurs with neglect, there is more stimulation through negative parent-child interaction, which may lead to better cognitive outcomes, contrary to Cumulative Risk Theory. The purpose of the current study was to assess whether children only neglected perform worse on cognitive tasks than children neglected and physically abused. Utilizing LONGSCAN archived data, 271 children only neglected and 101 children neglected and physically abused in the first four years of life were compared. The two groups were assessed at age 6 on the WPPSI-R vocabulary and block design subtests, correlates of cognitive intelligence. Regression analyses were performed, controlling for additional predictors of poor cognitive outcome, including socioeconomic variables and caregiver depression. Children only neglected scored significantly worse than children neglected and abused on the WPPSI-R vocabulary subtest (p=0.03). The groups did not differ on the block design subtest (p=0.4). This study shows that for neglected children, additional abuse may not additively accumulate risk when considering intelligence outcomes. Children experiencing only neglect may need to be referred for services that address cognitive development, with emphasis on the linguistic environment, in order to best support the developmental challenges of neglected children. PMID:25869185

  8. Children neglected: Where cumulative risk theory fails.

    PubMed

    O'Hara, Mandy; Legano, Lori; Homel, Peter; Walker-Descartes, Ingrid; Rojas, Mary; Laraque, Danielle

    2015-07-01

    Neglected children, by far the majority of children maltreated, experience an environment most deficient in cognitive stimulation and language exchange. When physical abuse co-occurs with neglect, there is more stimulation through negative parent-child interaction, which may lead to better cognitive outcomes, contrary to Cumulative Risk Theory. The purpose of the current study was to assess whether children only neglected perform worse on cognitive tasks than children neglected and physically abused. Utilizing LONGSCAN archived data, 271 children only neglected and 101 children neglected and physically abused in the first four years of life were compared. The two groups were assessed at age 6 on the WPPSI-R vocabulary and block design subtests, correlates of cognitive intelligence. Regression analyses were performed, controlling for additional predictors of poor cognitive outcome, including socioeconomic variables and caregiver depression. Children only neglected scored significantly worse than children neglected and abused on the WPPSI-R vocabulary subtest (p=0.03). The groups did not differ on the block design subtest (p=0.4). This study shows that for neglected children, additional abuse may not additively accumulate risk when considering intelligence outcomes. Children experiencing only neglect may need to be referred for services that address cognitive development, with emphasis on the linguistic environment, in order to best support the developmental challenges of neglected children.

  9. Considering Environmental and Occupational Stressors in Cumulative Risk Assessments

    EPA Science Inventory

    While definitions vary across the global scientific community, cumulative risk assessments (CRAs) typically are described as exhibiting a population focus and analyzing the combined risks posed by multiple stressors. CRAs also may consider risk management alternatives as an anal...

  10. Incompatible Land Uses and the Topology of Cumulative Risk

    NASA Astrophysics Data System (ADS)

    Lejano, Raul P.; Smith, C. Scott

    2006-02-01

    The extensive literature on environmental justice has, by now, well defined the essential ingredients of cumulative risk, namely, incompatible land uses and vulnerability. Most problematic is the case when risk is produced by a large aggregation of small sources of air toxics. In this article, we test these notions in an area of Southern California, Southeast Los Angeles (SELA), which has come to be known as Asthmatown. Developing a rapid risk mapping protocol, we scan the neighborhood for small potential sources of air toxics and find, literally, hundreds of small point sources within a 2-mile radius, interspersed with residences. We also map the estimated cancer risks and noncancer hazard indices across the landscape. We find that, indeed, such large aggregations of even small, nondominant sources of air toxics can produce markedly elevated levels of risk. In this study, the risk profiles show additional cancer risks of up to 800 in a million and noncancer hazard indices of up to 200 in SELA due to the agglomeration of small point sources. This is significant (for example, estimates of the average regional point-source-related cancer risk range from 125 to 200 in a million). Most importantly, if we were to talk about the risk contour as if they were geological structures, we would observe not only a handful of distinct peaks, but a general “mountain range” running all throughout the study area, which underscores the ubiquity of risk in SELA. Just as cumulative risk has deeply embedded itself into the fabric of the place, so, too, must intervention seek to embed strategies into the institutions and practices of SELA. This has implications for advocacy, as seen in a recently initiated participatory action research project aimed at building health research capacities into the community in keeping with an ethic of care.

  11. Childhood Cumulative Risk Exposure and Adult Amygdala Volume and Function.

    PubMed

    Evans, Gary W; Swain, James E; King, Anthony P; Wang, Xin; Javanbakht, Arash; Ho, S Shaun; Angstadt, Michael; Phan, K Luan; Xie, Hong; Liberzon, Israel

    2016-06-01

    Considerable work indicates that early cumulative risk exposure is aversive to human development, but very little research has examined the neurological underpinnings of these robust findings. This study investigates amygdala volume and reactivity to facial stimuli among adults (mean 23.7 years of age, n = 54) as a function of cumulative risk exposure during childhood (9 and 13 years of age). In addition, we test to determine whether expected cumulative risk elevations in amygdala volume would mediate functional reactivity of the amygdala during socioemotional processing. Risks included substandard housing quality, noise, crowding, family turmoil, child separation from family, and violence. Total and left hemisphere adult amygdala volumes were positively related to cumulative risk exposure during childhood. The links between childhood cumulative risk exposure and elevated amygdala responses to emotionally neutral facial stimuli in adulthood were mediated by the corresponding amygdala volumes. Cumulative risk exposure in later adolescence (17 years of age), however, was unrelated to subsequent adult amygdala volume or function. Physical and socioemotional risk exposures early in life appear to alter amygdala development, rendering adults more reactive to ambiguous stimuli such as neutral faces. These stress-related differences in childhood amygdala development might contribute to the well-documented psychological distress as a function of early risk exposure.

  12. Tools to Assess Community-Based Cumulative Risk and Exposures

    EPA Science Inventory

    Multiple agents and stressors can interact in a given community to adversely affect human and ecological conditions. A cumulative risk assessment (CRA) analyzes, characterizes, and potentially quantifies the effects from multiple stressors, which include chemical agents (for exam...

  13. Aggregate Exposure and Cumulative Risk Assessment--Integrating Occupational and Non-occupational Risk Factors.

    PubMed

    Lentz, T J; Dotson, G S; Williams, P R D; Maier, A; Gadagbui, B; Pandalai, S P; Lamba, A; Hearl, F; Mumtaz, M

    2015-01-01

    Occupational exposure limits have traditionally focused on preventing morbidity and mortality arising from inhalation exposures to individual chemical stressors in the workplace. While central to occupational risk assessment, occupational exposure limits have limited application as a refined disease prevention tool because they do not account for all of the complexities of the work and non-occupational environments and are based on varying health endpoints. To be of greater utility, occupational exposure limits and other risk management tools could integrate broader consideration of risks from multiple exposure pathways and routes (aggregate risk) as well as the combined risk from exposure to both chemical and non-chemical stressors, within and beyond the workplace, including the possibility that such exposures may cause interactions or modify the toxic effects observed (cumulative risk). Although still at a rudimentary stage in many cases, a variety of methods and tools have been developed or are being used in allied risk assessment fields to incorporate such considerations in the risk assessment process. These approaches, which are collectively referred to as cumulative risk assessment, have potential to be adapted or modified for occupational scenarios and provide a tangible path forward for occupational risk assessment. Accounting for complex exposures in the workplace and the broader risks faced by the individual also requires a more complete consideration of the composite effects of occupational and non-occupational risk factors to fully assess and manage worker health problems. Barriers to integrating these different factors remain, but new and ongoing community-based and worker health-related initiatives may provide mechanisms for identifying and integrating risk from aggregate exposures and cumulative risks from all relevant sources, be they occupational or non-occupational. PMID:26583907

  14. Aggregate Exposure and Cumulative Risk Assessment—Integrating Occupational and Non-occupational Risk Factors

    PubMed Central

    Lentz, T. J.; Dotson, G. S.; Williams, P. R.D.; Maier, A.; Gadagbui, B.; Pandalai, S. P.; Lamba, A.; Hearl, F.; Mumtaz, M.

    2015-01-01

    Occupational exposure limits have traditionally focused on preventing morbidity and mortality arising from inhalation exposures to individual chemical stressors in the workplace. While central to occupational risk assessment, occupational exposure limits have limited application as a refined disease prevention tool because they do not account for all of the complexities of the work and non-occupational environments and are based on varying health endpoints. To be of greater utility, occupational exposure limits and other risk management tools could integrate broader consideration of risks from multiple exposure pathways and routes (aggregate risk) as well as the combined risk from exposure to both chemical and non-chemical stressors, within and beyond the workplace, including the possibility that such exposures may cause interactions or modify the toxic effects observed (cumulative risk). Although still at a rudimentary stage in many cases, a variety of methods and tools have been developed or are being used in allied risk assessment fields to incorporate such considerations in the risk assessment process. These approaches, which are collectively referred to as cumulative risk assessment, have potential to be adapted or modified for occupational scenarios and provide a tangible path forward for occupational risk assessment. Accounting for complex exposures in the workplace and the broader risks faced by the individual also requires a more complete consideration of the composite effects of occupational and non-occupational risk factors to fully assess and manage worker health problems. Barriers to integrating these different factors remain, but new and ongoing community-based and worker health-related initiatives may provide mechanisms for identifying and integrating risk from aggregate exposures and cumulative risks from all relevant sources, be they occupational or non-occupational. PMID:26583907

  15. Uncertainty in Mixtures and Cumulative Risk Assessment

    EPA Science Inventory

    Humans and environmental species are rarely exposed to single chemicals. These chemicals typically affect multiple tissues through multiple modes of action, which may depend on the dose. Mixtures risk assessment may employ dose response information from the mixture of interest,...

  16. Integrating Nonchemicals in Cumulative Risk Assessment (CRA):A Case Study of Particulate Matter (PM) and Heart Rate Variability (HRV)

    EPA Science Inventory

    Cumulative risk assessments (CRAs) quantitatively or qualitatively evaluate the risks of combined exposures to chemical and nonchemical stressors. CRAs also examine vulnerabilities (e.g., pre-existing health condition, genetic predisposition, poverty) as these may lead to variabi...

  17. Vulnerability as a Function of Individual and Group Resources in Cumulative Risk Assessment

    PubMed Central

    deFur, Peter L.; Evans, Gary W.; Hubal, Elaine A. Cohen; Kyle, Amy D.; Morello-Frosch, Rachel A.; Williams, David R.

    2007-01-01

    Background The field of risk assessment has focused on protecting the health of individual people or populations of wildlife from single risks, mostly from chemical exposure. The U.S. Environmental Protection Agency recently began to address multiple risks to communities in the “Framework for Cumulative Risk Assessment” [EPA/630/P02/001F. Washington DC:Risk Assessment Forum, U.S. Environmental Protection Agency (2003)]. Simultaneously, several reports concluded that some individuals and groups are more vulnerable to environmental risks than the general population. However, vulnerability has received little specific attention in the risk assessment literature. Objective Our objective is to examine the issue of vulnerability in cumulative risk assessment and present a conceptual framework rather than a comprehensive review of the literature. In this article we consider similarities between ecologic and human communities and the factors that make communities vulnerable to environmental risks. Discussion The literature provides substantial evidence on single environmental factors and simple conditions that increase vulnerability or reduce resilience for humans and ecologic systems. This observation is especially true for individual people and populations of wildlife. Little research directly addresses the topic of vulnerability in cumulative risk situations, especially at the community level. The community level of organization has not been adequately considered as an end point in either human or ecologic risk assessment. Furthermore, current information on human risk does not completely explain the level of response in cumulative risk conditions. Ecologic risk situations are similarly more complex and unpredictable for cases of cumulative risk. Conclusions Psychosocial conditions and responses are the principal missing element for humans. We propose a model for including psychologic and social factors as an integral component of cumulative risk assessment. PMID

  18. 78 FR 25440 - Request for Information and Citations on Methods for Cumulative Risk Assessment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-01

    ... environment. The EPA is developing guidelines for the assessment of cumulative risk as defined and..., characterization, and possible quantification of the combined risks to health or the environment from multiple... development of regulations and permits. This notice solicits information and citations pertaining...

  19. Evaluating cumulative risk assessment for environmental justice: a community case study.

    PubMed

    Fox, Mary A

    2002-04-01

    A key feature of cumulative risk assessment (CRA) is the ability to estimate differential health risks from environmental exposures within populations. Identifying populations at increased risk from environmental exposures is the first step toward mitigating such risks as required by the fair treatment mandate of environmental justice. CRA methods remain under development except for a limited application in pesticide regulations. The goals of this research were to advance CRA methods and to test their application in a community case study. We compared cumulative risk and health assessments for South and Southwest Philadelphia communities. The analysis found positive correlations between cumulative risk and mortality measurements for total mortality in Whites and non-Whites when we conducted the risk assessment using a multi-end point toxicological database developed for this project. Cumulative risk scores correlated positively with cause-specific mortality in non-Whites. Statistically significant increases in total and respiratory mortality rates were associated with incremental increases in the hazard ratio cumulative risk scores, with ranges of 2-6% for total and 8-23% for respiratory. Regression analyses controlled for percent non-White population and per capita income, indicating that risk scores represent an environmental effect on health independent of race and income. This case study demonstrated the successful application of CRA at the community level. CRA adds a health dimension to pollutant concentrations to produce a more comprehensive understanding of environmental inequities that can inform decision making. CRA is a viable tool to identify high-risk areas and to guide surveillance, research, or interventions.

  20. Cumulative risk hypothesis: Predicting and preventing child maltreatment recidivism.

    PubMed

    Solomon, David; Åsberg, Kia; Peer, Samuel; Prince, Gwendolyn

    2016-08-01

    Although Child Protective Services (CPS) and other child welfare agencies aim to prevent further maltreatment in cases of child abuse and neglect, recidivism is common. Having a better understanding of recidivism predictors could aid in preventing additional instances of maltreatment. A previous study identified two CPS interventions that predicted recidivism: psychotherapy for the parent, which was related to a reduced risk of recidivism, and temporary removal of the child from the parent's custody, which was related to an increased recidivism risk. However, counter to expectations, this previous study did not identify any other specific risk factors related to maltreatment recidivism. For the current study, it was hypothesized that (a) cumulative risk (i.e., the total number of risk factors) would significantly predict maltreatment recidivism above and beyond intervention variables in a sample of CPS case files and that (b) therapy for the parent would be related to a reduced likelihood of recidivism. Because it was believed that the relation between temporary removal of a child from the parent's custody and maltreatment recidivism is explained by cumulative risk, the study also hypothesized that that the relation between temporary removal of the child from the parent's custody and recidivism would be mediated by cumulative risk. After performing a hierarchical logistic regression analysis, the first two hypotheses were supported, and an additional predictor, psychotherapy for the child, also was related to reduced chances of recidivism. However, Hypothesis 3 was not supported, as risk did not significantly mediate the relation between temporary removal and recidivism.

  1. Cumulative risk hypothesis: Predicting and preventing child maltreatment recidivism.

    PubMed

    Solomon, David; Åsberg, Kia; Peer, Samuel; Prince, Gwendolyn

    2016-08-01

    Although Child Protective Services (CPS) and other child welfare agencies aim to prevent further maltreatment in cases of child abuse and neglect, recidivism is common. Having a better understanding of recidivism predictors could aid in preventing additional instances of maltreatment. A previous study identified two CPS interventions that predicted recidivism: psychotherapy for the parent, which was related to a reduced risk of recidivism, and temporary removal of the child from the parent's custody, which was related to an increased recidivism risk. However, counter to expectations, this previous study did not identify any other specific risk factors related to maltreatment recidivism. For the current study, it was hypothesized that (a) cumulative risk (i.e., the total number of risk factors) would significantly predict maltreatment recidivism above and beyond intervention variables in a sample of CPS case files and that (b) therapy for the parent would be related to a reduced likelihood of recidivism. Because it was believed that the relation between temporary removal of a child from the parent's custody and maltreatment recidivism is explained by cumulative risk, the study also hypothesized that that the relation between temporary removal of the child from the parent's custody and recidivism would be mediated by cumulative risk. After performing a hierarchical logistic regression analysis, the first two hypotheses were supported, and an additional predictor, psychotherapy for the child, also was related to reduced chances of recidivism. However, Hypothesis 3 was not supported, as risk did not significantly mediate the relation between temporary removal and recidivism. PMID:27352090

  2. Cumulative Experiences of Violence among High-Risk Urban Youth

    ERIC Educational Resources Information Center

    Taylor, Catherine A.; Boris, Neil W.; Heller, Sherryl Scott; Clum, Gretchen A.; Rice, Janet C.; Zeanah, Charles H.

    2008-01-01

    This study examines type-specific and cumulative experiences of violence among a vulnerable population of youth. Sixty high-risk, shelter-dwelling, urban youth were interviewed regarding their history of childhood maltreatment, exposure to community violence (ECV), and experience with intimate partner violence (IPV). Results show a high prevalence…

  3. Cumulative Risk, Maternal Responsiveness, and Allostatic Load among Young Adolescents

    ERIC Educational Resources Information Center

    Evans, Gary W.; Kim, Pilyoung; Ting, Albert H.; Tesher, Harris B.; Shannis, Dana

    2007-01-01

    The purpose of this study was to examine the impact of cumulative risk exposure in concert with maternal responsiveness on physiological indicators of chronic stress in children and youth. Middle-school children exposed to greater accumulated psychosocial (e.g., family turmoil, poverty) and physical (e.g., crowding, substandard housing) risk…

  4. HESI EXPOSURE FACTORS DATABASE FOR AGGREGATE AND CUMULATIVE RISK ASSESSMENT

    EPA Science Inventory

    In recent years, the risk analysis community has broadened its use of complex aggregate and cumulative residential exposure models (e.g., to meet the requirements of the 1996 Food Quality Protection Act). The value of these models is their ability to incorporate a range of inp...

  5. Cumulative Benefit Analysis for Ranking Risk Reduction Actions

    SciTech Connect

    Leverenz, Fred L.; Aysa Jimenez, Julio

    2007-04-25

    The Hazard and Operability (HAZOP) study approach, and other similar methods, are very effective ways to qualitatively identify a comprehensive set of accident scenarios for a facility. If these analyses are modified to incorporate a simple system for evaluating relative risk, such as an order-of-magnitude scoring system, the resultant study can be a very powerful input to developing risk reduction strategies. By adding the concept of Risk Reduction Worth evaluations for all accident Causes, Safeguards, and proposal Action Items, an analyst can then formulate a strategy to select the minimal set of risk reduction actions that maximizes risk reduction. One strategy for doing this involves the iterative evaluation of RRW after postulation of risk reduction actions, until the residual risk reaches a tolerable value, termed Cumulative Risk Benefit Analysis. This concept was developed for the evaluation of a set of pipeline pumping stations, and provided valuable insight into how to reduce risk in a sensible, prioritized fashion.

  6. Childhood Psychosocial Cumulative Risks and Carotid Intima-Media Thickness in Adulthood: The Cardiovascular Risk in Young Finns Study

    PubMed Central

    Hakulinen, Christian; Pulkki-Råback, Laura; Elovainio, Marko; Kubzansky, Laura D.; Jokela, Markus; Hintsanen, Mirka; Juonala, Markus; Kivimäki, Mika; Josefsson, Kim; Hutri-Kähönen, Nina; Kähönen, Mika; Viikari, Jorma; Keltikangas-Järvinen, Liisa; Raitakari, Olli T

    2015-01-01

    Objective Adverse experiences in childhood may influence cardiovascular risk in adulthood. We examined the prospective associations between types of psychosocial adversity as well as having multiple adversities (e.g., cumulative risk) with carotid intima-media thickness (IMT) and its progression among young adults. Higher cumulative risk score in childhood was expected to be associated with higher IMT and its progression. Methods Participants were 2265 men and women (age range: 24-39 years in 2001) from the on-going Cardiovascular Risk in Young Finns study whose carotid IMT were measured in 2001 and 2007. A cumulative psychosocial risk score, assessed at the study baseline in 1980, was derived from four separate aspects of the childhood environment that may impose risk (childhood stressful life-events, parental health behavior family, socioeconomic status, and childhood emotional environment). Results The cumulative risk score was associated with higher IMT in 2007 (b=.004; se=.001; p<.001) and increased IMT progression from 2001 to 2007 (b=.003; se=.001; p=.001). The associations were robust to adjustment for conventional cardiovascular risk factors in childhood and adulthood, including adulthood health behavior, adulthood socioeconomic status and depressive symptoms. Among the individual childhood psychosocial risk categories, having more stressful life-events was associated with higher IMT in 2001 (b=.007; se=.003; p=.016) and poorer parental health behavior predicted higher IMT in 2007 (b=.004; se=.002; p=.031) after adjustment for age, sex and childhood cardiovascular risk factors. Conclusions Early life psychosocial environment influences cardiovascular risk later in life and considering cumulative childhood risk factors may be more informative than individual factors in predicting progression of preclinical atherosclerosis in adulthood. PMID:26809108

  7. DESIGNING STUDIES AND COLLECTING DATA USEFUL FOR CUMULATIVE RISK ASSESSMENT

    EPA Science Inventory

    DESIGNING STUDIES AND COLLECTING DATA USEFUL FOR CUMULATIVE RISK ASSESSMENT. J E Simmons1, C Gennings2, M Casey2, M J Plewa3, E D Wagner3, W H Carter, Jr.2, A McDonald1,Y M Sey1, L K Teuschler3 1NHEERL, ORD, U.S. EPA, RTP NC, USA; 2VCU, Richmond, VA, USA;3Univ. Illinois, Urba...

  8. Young child socioemotional/behavioral problems and cumulative psychosocial risk.

    PubMed

    Weitzman, Carol; Edmonds, Diana; Davagnino, Judith; Briggs-Gowan, Margaret J

    2014-01-01

    Limited information is available about the rates and risk correlates of socioemotional/behavioral problems in young children in pediatric primary care settings serving low-income families. Our objective was to determine rates of clinically significant socioemotional/behavior problems in 12- to 48-month-olds from low-income families and identify associations between problems and individual and cumulative demographic and psychosocial risks. In this study, 378 Spanish- and English-speaking mothers attending a pediatric primary care practice serving low-income families were surveyed before well-child visits to assess socioemotional/behavioral problems (Brief Infant-Toddler Social-Emotional Assessment; M.J. Briggs-Gowan & A.S. Carter, ) and psychosocial and demographic risks (e.g., unemployment, low social support) (Parent Risk Questionnaire; D.I. Lowell, A.S. Carter, L. Godoy, B. Paulicin, & M.J. Briggs-Gowan, ). We found that 19.8% of children had clinically significant problems, and 53.2% experienced one or more psychosocial risks. Clinically significant socioemotional/behavioral problems were modestly to strongly associated with individual psychosocial risks, with the strongest associations with parental medical problems, parent depression/anxiety, and extreme parental distress, Adjusted Relative Risk (ARR) = 4.8-6.6, p < .0001. Cumulative demographic and psychosocial risk were uniquely associated with clinically significant problems, particularly among children experiencing three to four psychosocial risks, ARR = 3.0-11.6, p < .05. Psychosocial risks affect the majority of low-income families with young children, with a steep increase in likelihood of clinically significant socioemotional/behavioral problems as risks accumulate, underscoring the need to address both socioemotional/behavioral issues and psychosocial risk in young children.

  9. Cumulative risk assessment of pesticide residues in food.

    PubMed

    Boobis, Alan R; Ossendorp, Bernadette C; Banasiak, Ursula; Hamey, Paul Y; Sebestyen, Istvan; Moretto, Angelo

    2008-08-15

    There is increasing need to address the potential risks of combined exposures to multiple residues from pesticides in the diet. The available evidence suggests that the main concern is from dose addition of those compounds that act by the same mode of action. The possibility of synergy needs to be addressed on a case-by-case basis, where there is a biologically plausible hypothesis that it may occur at the levels of residues occurring in the diet. Cumulative risk assessment is a resource-intense activity and hence a tiered approach to both toxicological evaluation and intake estimation is recommended, and the European Food Safety Authority (EFSA) has recently published such a proposal. Where assessments have already been undertaken by some other authority, full advantage should be taken of these, subject of course to considerations of quality and relevance. Inclusion of compounds in a cumulative assessment group (CAG) should be based on defined criteria, which allow for refinement in a tiered approach. These criteria should include chemical structure, mechanism of pesticidal action, target organ and toxic mode of action. A number of methods are available for cumulating toxicity. These are all inter-related, but some are mathematically more complex than others. The most useful methods, in increasing levels of complexity and refinement, are the hazard index, the reference point index, the Relative Potency Factor method and physiologically based toxicokinetic modelling, although this last method would only be considered should a highly refined assessment be necessary. Four possible exposure scenarios are of relevance for cumulative risk assessment, acute and chronic exposure in the context of maximum residue level (MRL)-setting, and in relation to exposures from the actual use patterns, respectively. Each can be addressed either deterministically or probabilistically. Strategies for dealing with residues below the limit of detection, limit of quantification or limit

  10. [Cumulative risk assessment for consumers of agricultural crops polluted with one chemical class pesticide residues (case of triazole fungicides)].

    PubMed

    Koval'chuk, N M; Omel'chuk, S T

    2011-01-01

    Different indices of cumulative risk assessment of combination of residues of pesticides which may simultaneously be present in raw agricultural crops, based on toxic evaluation of such combination have been presented. Risk for population health due to consumption of raw agricultural crops with triazole residues is acceptable on hazard index, point of departure index and cumulative risk index, exceeds allowable level on criterion "total margin of exposure". PMID:22768736

  11. U.S. EPA Authority to Use Cumulative Risk Assessments in Environmental Decision-Making

    PubMed Central

    Alves, Sarah; Tilghman, Joan; Rosenbaum, Arlene; Payne-Sturges, Devon C.

    2012-01-01

    Conventionally, in its decision-making, the U.S. EPA has evaluated the effects and risks associated with a single pollutant in a single exposure medium. In reality, people are exposed to mixtures of pollutants or to the same pollutant through a variety of media, including the air, water, and food. It is now more recognized than before that environmental exposure to pollutants occurs via multiple exposure routes and pathways, including inhalation, ingestion, and dermal absorption. Moreover, chemical, biologic, radiologic, physical, and psychologic stressors are all acknowledged as affecting human health. Although many EPA offices attempt to consider cumulative risk assessment and cumulative effects in various ways, there is no Agency-wide policy for considering these risks and the effects of exposure to these risks when making environmental decisions. This article examines how U.S. courts might assess EPA’s general authority and discretion to use cumulative risk assessment as the basis for developing data in support of environmental decision-making, and how courts might assess the validity of a cumulative risk assessment methodology itself. PMID:22829786

  12. U.S. EPA authority to use cumulative risk assessments in environmental decision-making.

    PubMed

    Alves, Sarah; Tilghman, Joan; Rosenbaum, Arlene; Payne-Sturges, Devon C

    2012-06-01

    Conventionally, in its decision-making, the U.S. EPA has evaluated the effects and risks associated with a single pollutant in a single exposure medium. In reality, people are exposed to mixtures of pollutants or to the same pollutant through a variety of media, including the air, water, and food. It is now more recognized than before that environmental exposure to pollutants occurs via multiple exposure routes and pathways, including inhalation, ingestion, and dermal absorption. Moreover, chemical, biologic, radiologic, physical, and psychologic stressors are all acknowledged as affecting human health. Although many EPA offices attempt to consider cumulative risk assessment and cumulative effects in various ways, there is no Agency-wide policy for considering these risks and the effects of exposure to these risks when making environmental decisions. This article examines how U.S. courts might assess EPA's general authority and discretion to use cumulative risk assessment as the basis for developing data in support of environmental decision-making, and how courts might assess the validity of a cumulative risk assessment methodology itself.

  13. Cumulative Neighborhood Risk of Psychosocial Stress and Allostatic Load in Adolescents

    PubMed Central

    Theall, Katherine P.; Drury, Stacy S.; Shirtcliff, Elizabeth A.

    2012-01-01

    The authors examined the impact of cumulative neighborhood risk of psychosocial stress on allostatic load (AL) among adolescents as a mechanism through which life stress, including neighborhood conditions, may affect health and health inequities. They conducted multilevel analyses, weighted for sampling and propensity score-matched, among adolescents aged 12–20 years in the National Health and Nutrition Examination Survey (1999–2006). Individuals (first level, n = 11,886) were nested within families/households (second level, n = 6,696) and then census tracts (third level, n = 2,191) for examination of the contextual effect of cumulative neighborhood risk environment on AL. Approximately 35% of adolescents had 2 or more biomarkers of AL. A significant amount of variance in AL was explained at the neighborhood level. The likelihood of having a high AL was approximately 10% higher for adolescents living in medium-cumulative-risk neighborhoods (adjusted odds ratio (OR) = 1.09, 95% confidence interval (CI): 1.08, 1.09), 28% higher for those living in high-risk neighborhoods (adjusted OR = 1.28, 95% CI: 1.27, 1.30), and 69% higher for those living in very-high-risk neighborhoods (adjusted OR = 1.69, 95% CI: 1.68, 1.70) as compared with adolescents living in low-risk areas. Effect modification was observed by both individual- and neighborhood-level sociodemographic factors. These findings offer support for the hypothesis that neighborhood risks may culminate in a range of biologically mediated negative health outcomes detectable in adolescents. PMID:23035140

  14. 6.3 Incorporating Susceptibility Information into Cumulative Risk Assessment

    EPA Science Inventory

    In recent years, there has been an increased focus on understanding the differential health effects of environmental chemical exposures and on incorporating this information into risk assessments for environmental chemicals. Susceptibility is defined as increased likelihood of an...

  15. Cumulative Violence Exposure, Emotional Nonacceptance, and Mental Health Symptoms in a Community Sample of Women

    PubMed Central

    Sundermann, Jane M.; Chu, Ann T.; DePrince, Anne P.

    2012-01-01

    Women exposed to more types of violence (e.g., emotional, physical, or sexual violence) – referred to here as cumulative violence exposure – are at risk for more severe mental health symptoms compared to women who are exposed to a single type of violence or no violence. Women exposed to violence may also experience greater emotional nonacceptance compared to women with no exposure to violence. Emotional nonacceptance refers to an unwillingness to experience emotional states, including cognitive and behavioral attempts to avoid experiences of emotion. Given the links between cumulative violence exposure, emotional nonacceptance, and mental health symptoms among female victims of violence, the current study tested victims’ emotional nonacceptance as a partial mediator between cumulative violence exposure and the severity of three types of symptoms central to complex trauma responses: depression, dissociation, and Posttraumatic stress disorder (PTSD) symptoms. A non-treatment seeking community sample of women (N = 89; Mage = 30.70 years) completed self-report questionnaires and interviews. Bootstrap procedures were then used to test three mediation models for the separate predictions of depression, dissociation, and PTSD symptoms. Results supported our hypotheses that emotional nonacceptance would mediate the relationship between women’s cumulative violence exposure and severity for all symptom types. The current findings highlight the role that emotional nonacceptance may play in the development of mental health symptoms for chronically victimized women and point to the need for longitudinal research in such populations. PMID:23282048

  16. Cumulative violence exposure, emotional nonacceptance, and mental health symptoms in a community sample of women.

    PubMed

    Sundermann, Jane M; Chu, Ann T; DePrince, Anne P

    2013-01-01

    Women exposed to more types of violence (e.g., emotional, physical, or sexual violence)--referred to here as cumulative violence exposure--are at risk for more severe mental health symptoms compared to women who are exposed to a single type of violence or no violence. Women exposed to violence may also experience greater emotional nonacceptance compared to women with no exposure to violence. Emotional nonacceptance refers to an unwillingness to experience emotional states, including cognitive and behavioral attempts to avoid experiences of emotion. Given the links between cumulative violence exposure, emotional nonacceptance, and mental health symptoms among female victims of violence, the current study tested victims' emotional nonacceptance as a partial mediator between cumulative violence exposure and the severity of 3 types of symptoms central to complex trauma responses: depression, dissociation, and posttraumatic stress disorder (PTSD) symptoms. A non-treatment-seeking community sample of women (N = 89; M age = 30.70 years) completed self-report questionnaires and interviews. Bootstrap procedures were then used to test 3 mediation models for the separate predictions of depression, dissociation, and PTSD symptoms. Results supported our hypotheses that emotional nonacceptance would mediate the relationship between women's cumulative violence exposure and severity for all symptom types. The current findings highlight the role that emotional nonacceptance may play in the development of mental health symptoms for chronically victimized women and point to the need for longitudinal research in such populations.

  17. Separate and Cumulative Effects of Adverse Childhood Experiences in Predicting Adult Health and Health Care Utilization

    ERIC Educational Resources Information Center

    Chartier, Mariette J.; Walker, John R.; Naimark, Barbara

    2010-01-01

    Objectives: Objectives of this population-based study were: (1) to examine the relative contribution of childhood abuse and other adverse childhood experiences to poor adult health and increased health care utilization and (2) to examine the cumulative effects of adverse childhood experiences on adult health and health care utilization. Methods:…

  18. Project 6: Cumulative Risk Assessment (CRA) Methods and Applications

    EPA Science Inventory

    Project 6: CRA Methods and Applications addresses the need to move beyond traditional risk assessment practices by developing CRA methods to integrate and evaluate impacts of chemical and nonchemical stressors on the environment and human health. Project 6 has three specific obje...

  19. 76 FR 82296 - Pyrethrins/Pyrethroid Cumulative Risk Assessment; Extension of Comment Period

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-30

    ... AGENCY Pyrethrins/Pyrethroid Cumulative Risk Assessment; Extension of Comment Period AGENCY... established in the Federal Register of November 9, 2011 (76 FR 69726) (FRL-8888-9). In that notice, the Agency announced the availability of EPA's cumulative risk assessment for the pyrethroids. Based on this...

  20. A multimethodological analysis of cumulative risk and allostatic load among rural children.

    PubMed

    Evans, Gary W

    2003-09-01

    This study merged two theoretical constructs: cumulative risk and allostatic load. Physical (crowding, noise, housing quality) and psychosocial (child separation, turmoil, violence) aspects of the home environment and personal characteristics (poverty, single parenthood, maternal highschool dropout status) were modeled in a cumulative risk heuristic. Elevated cumulative risk was associated with heightened cardiovascular and neuroendocrine parameters, increased deposition of body fat, and a higher summary index of total allostatic load. Previous findings that children who face more cumulative risk have greater psychological distress were replicated among a sample of rural children and shown to generalize to lower perceptions of self-worth. Prior cumulative risk research was further extended through demonstration of self-regulatory behavior problems and elevated learned helplessness. PMID:12952404

  1. Non-Chemical Stressors and Cumulative Risk Assessment: An Overview of Current Initiatives and Potential Air Pollutant Interactions

    PubMed Central

    Lewis, Ari S.; Sax, Sonja N.; Wason, Susan C.; Campleman, Sharan L.

    2011-01-01

    Regulatory agencies are under increased pressure to consider broader public health concerns that extend to multiple pollutant exposures, multiple exposure pathways, and vulnerable populations. Specifically, cumulative risk assessment initiatives have stressed the importance of considering both chemical and non-chemical stressors, such as socioeconomic status (SES) and related psychosocial stress, in evaluating health risks. The integration of non-chemical stressors into a cumulative risk assessment framework has been largely driven by evidence of health disparities across different segments of society that may also bear a disproportionate risk from chemical exposures. This review will discuss current efforts to advance the field of cumulative risk assessment, highlighting some of the major challenges, discussed within the construct of the traditional risk assessment paradigm. Additionally, we present a summary of studies of potential interactions between social stressors and air pollutants on health as an example of current research that supports the incorporation of non-chemical stressors into risk assessment. The results from these studies, while suggestive of possible interactions, are mixed and hindered by inconsistent application of social stress indicators. Overall, while there have been significant advances, further developments across all of the risk assessment stages (i.e., hazard identification, exposure assessment, dose-response, and risk characterization) are necessary to provide a scientific basis for regulatory actions and effective community interventions, particularly when considering non-chemical stressors. A better understanding of the biological underpinnings of social stress on disease and implications for chemical-based dose-response relationships is needed. Furthermore, when considering non-chemical stressors, an appropriate metric, or series of metrics, for risk characterization is also needed. Cumulative risk assessment research will benefit

  2. Cumulative Socioeconomic Status Risk, Allostatic Load, and Adjustment: A Prospective Latent Profile Analysis with Contextual and Genetic Protective Factors

    ERIC Educational Resources Information Center

    Brody, Gene H.; Yu, Tianyi; Chen, Yi-Fu; Kogan, Steven M.; Evans, Gary W.; Beach, Steven R. H.; Windle, Michael; Simons, Ronald L.; Gerrard, Meg; Gibbons, Frederick X.; Philibert, Robert A.

    2013-01-01

    The health disparities literature has identified a common pattern among middle-aged African Americans that includes high rates of chronic disease along with low rates of psychiatric disorders despite exposure to high levels of cumulative socioeconomic status (SES) risk. The current study was designed to test hypotheses about the developmental…

  3. PHYSIOLOGICALLY-BASED PHARMACOKINETICS/PHARMACODYNAMIC MODELING AND CUMULATIVE RISK ASSESSMENT: CASE STUDY FOR THE N-METHYL CARBMATE PESTICIDES

    EPA Science Inventory

    The Food Quality Protection Act of 1996 [PL 104-170: 110 STAT. 1513] requires EPA to consider potential cumulative human health risks resulting from aggregate exposure to pesticide chemicals acting through a common mechanism of toxicity. This includes all anticipated dietary e...

  4. Cumulative risk assessment of the exposure to pyrethroids through fruits consumption in China - Based on a 3-year investigation.

    PubMed

    Li, Zhixia; Nie, Jiyun; Lu, Zeqi; Xie, Hanzhong; Kang, Lu; Chen, Qiusheng; Li, An; Zhao, Xubo; Xu, Guofeng; Yan, Zhen

    2016-10-01

    In the present study, the long-term and short-term cumulative risks of pyrethroids exposured for the Chinese general population and children through fruits consumption were evaluated. A total of 1450 fruit samples and seven pyrethroids were included based on the pesticide residues monitoring programme of China from 2013 to 2015. The exposure was estimated using both deterministic approach and semi-probabilistic model for comparison. The hazard index approach was used to assess cumulative risk. 26% of samples contained pyrethroid residues with concentrations ranged from 0.0050 mg/kg to 1.2 mg/kg, of which 30% simultaneously with 2-4 mixture residues. Results demonstrated that the cumulative health risks were extremely low for both general population and children (1-6 years old) of China in the long term. Acute risk estimations calculated by deterministic method were several or many times overestimated than the results based on semi-probabilistic method. Acute cumulative exposure of children to pyrethroid compounds in 0.76% samples were exceeded 1 in worst case scenario. More detailed assessments with adequate data in the future use probabilistic method is expected to reduce the uncertainties of cumulative dietary exposure. PMID:27515867

  5. Epigenome: A Biomarker or Screening Tool to Evaluate Health Impact of Cumulative Exposure to Chemical and Non-Chemical Stressors.

    PubMed

    Olden, Kenneth; Lin, Yu-Sheng; Bussard, David

    2016-06-01

    Current risk assessment practices and toxicity information are hard to utilize for assessing the health impact of combined or cumulative exposure to multiple chemical and non-chemical stressors encountered in the "real world" environment. Non-chemical stressors such as heat, radiation, noise, humidity, bacterial and viral agents, and social factors, like stress related to violence and socioeconomic position generally cannot be currently incorporated into the risk assessment paradigm. The Science and Decisions report released by the National Research Council (NRC) in 2009 emphasized the need to characterize the effects of multiple stressors, both chemical and non-chemical exposures. One impediment to developing information relating such non-chemical stressors to health effects and incorporating them into cumulative assessment has been the lack of analytical tools to easily and quantitatively monitor the cumulative exposure to combined effects of stressors over the life course. PMID:27398233

  6. Epigenome: A Biomarker or Screening Tool to Evaluate Health Impact of Cumulative Exposure to Chemical and Non-Chemical Stressors.

    PubMed

    Olden, Kenneth; Lin, Yu-Sheng; Bussard, David

    2016-06-01

    Current risk assessment practices and toxicity information are hard to utilize for assessing the health impact of combined or cumulative exposure to multiple chemical and non-chemical stressors encountered in the "real world" environment. Non-chemical stressors such as heat, radiation, noise, humidity, bacterial and viral agents, and social factors, like stress related to violence and socioeconomic position generally cannot be currently incorporated into the risk assessment paradigm. The Science and Decisions report released by the National Research Council (NRC) in 2009 emphasized the need to characterize the effects of multiple stressors, both chemical and non-chemical exposures. One impediment to developing information relating such non-chemical stressors to health effects and incorporating them into cumulative assessment has been the lack of analytical tools to easily and quantitatively monitor the cumulative exposure to combined effects of stressors over the life course.

  7. Epigenome: A Biomarker or Screening Tool to Evaluate Health Impact of Cumulative Exposure to Chemical and Non-Chemical Stressors.

    PubMed

    Olden, Kenneth; Lin, Yu-Sheng; Bussard, David

    2016-04-01

    Current risk assessment practices and toxicity information are hard to utilize for assessing the health impact of combined or cumulative exposure to multiple chemical and non-chemical stressors encountered in the "real world" environment. Non-chemical stressors such as heat, radiation, noise, humidity, bacterial and viral agents, and social factors, like stress related to violence and socioeconomic position generally cannot be currently incorporated into the risk assessment paradigm. The Science and Decisions report released by the National Research Council (NRC) in 2009 emphasized the need to characterize the effects of multiple stressors, both chemical and non-chemical exposures. One impediment to developing information relating such non-chemical stressors to health effects and incorporating them into cumulative assessment has been the lack of analytical tools to easily and quantitatively monitor the cumulative exposure to combined effects of stressors over the life course.

  8. Epigenome: A Biomarker or Screening Tool to Evaluate Health Impact of Cumulative Exposure to Chemical and Non-Chemical Stressors.

    PubMed

    Olden, Kenneth; Lin, Yu-Sheng; Bussard, David

    2016-06-01

    Current risk assessment practices and toxicity information are hard to utilize for assessing the health impact of combined or cumulative exposure to multiple chemical and non-chemical stressors encountered in the "real world" environment. Non-chemical stressors such as heat, radiation, noise, humidity, bacterial and viral agents, and social factors, like stress related to violence and socioeconomic position generally cannot be currently incorporated into the risk assessment paradigm. The Science and Decisions report released by the National Research Council (NRC) in 2009 emphasized the need to characterize the effects of multiple stressors, both chemical and non-chemical exposures. One impediment to developing information relating such non-chemical stressors to health effects and incorporating them into cumulative assessment has been the lack of analytical tools to easily and quantitatively monitor the cumulative exposure to combined effects of stressors over the life course. PMID:27534725

  9. Epigenome: A Biomarker or Screening Tool to Evaluate Health Impact of Cumulative Exposure to Chemical and Non-Chemical Stressors

    PubMed Central

    Olden, Kenneth; Lin, Yu-Sheng; Bussard, David

    2016-01-01

    Current risk assessment practices and toxicity information are hard to utilize for assessing the health impact of combined or cumulative exposure to multiple chemical and non-chemical stressors encountered in the “real world” environment. Non-chemical stressors such as heat, radiation, noise, humidity, bacterial and viral agents, and social factors, like stress related to violence and socioeconomic position generally cannot be currently incorporated into the risk assessment paradigm. The Science and Decisions report released by the National Research Council (NRC) in 2009 emphasized the need to characterize the effects of multiple stressors, both chemical and non-chemical exposures. One impediment to developing information relating such non-chemical stressors to health effects and incorporating them into cumulative assessment has been the lack of analytical tools to easily and quantitatively monitor the cumulative exposure to combined effects of stressors over the life course. PMID:27398233

  10. CONSIDERATIONS FOR DEVELOPING A DOSIMETRY-BASED CUMULATIVE RISK ASSESSMENT APPROACH FOR MIXTURES OF ENVIRONMENTAL CONTAMINANTS (Final Report)

    EPA Science Inventory

    This final report, Considerations for Developing a Dosimetry-Based Cumulative Risk Assessment Approach for Mixtures of Environmental Contaminants, addresses the justification for developing physiologically based pharmacokinetic (PBPK) models for cumulative risk assessment....

  11. Low Fruit/Vegetable Consumption in the Home: Cumulative Risk Factors in Early Childhood

    ERIC Educational Resources Information Center

    Ward, Wendy L.; Swindle, Taren M.; Kyzer, Angela L.; Whiteside-Mansell, Leanne

    2015-01-01

    Cumulative risk theory suggests that a variety of social risk factors would have an additive effect on obesity risk. Multiple studies have suggested that obesity is related to basic resources such as transportation and financial resources. Additional research points to parental engagement and parental monitoring as additional sources of risk. This…

  12. Community, State, and Federal Approaches to Cumulative Risk Assessment: Challenges and Opportunities for Integration

    EPA Science Inventory

    Community, state, and federal approaches to conventional and cumulative risk assessment (CRA) were described and compared to assess similarities and differences, and develop recommendations for a consistent CRA approach, acceptable across each level as a rigorous scientific metho...

  13. Approaches and Sources of Uncertainty in Mixtures and Cumulative Risk Assessment

    EPA Science Inventory

    Approaches and Sources of Uncertainty in Mixtures and Cumulative Risk Assessment JC Lipscomb U.S. Environmental Protection Agency, Office of Research and Development, National Center for Environmental Assessment, Cincinnati, Ohio, USA Humans and environmental species are rarel...

  14. Using Secondary Data to Evaluate Diverse Groups of Chemical and Nonchemical Stressors in Cumulative Risk Assessment

    EPA Science Inventory

    A main impediment of performing cumulative risk assessments (CRAs) is having data for multiple chemical and nonchemical stressors in the same individuals or populations. Therefore, secondary data analysis can be utilized as a screening approach to integrate population characteri...

  15. A Summary of Publications on Methods and Tools for Assessing Cumulative Risk, Project Summary

    EPA Science Inventory

    This collection of eight publications on cumulative risk assessment was developed collaboratively among scientists within EPA’s Office of Research and Development and three other organizations. These include scientific collaborations through an Interagency Agreement with Argonne...

  16. When Dread Risks Are More Dreadful than Continuous Risks: Comparing Cumulative Population Losses over Time

    PubMed Central

    Bodemer, Nicolai; Ruggeri, Azzurra; Galesic, Mirta

    2013-01-01

    People show higher sensitivity to dread risks, rare events that kill many people at once, compared with continuous risks, relatively frequent events that kill many people over a longer period of time. The different reaction to dread risks is often considered a bias: If the continuous risk causes the same number of fatalities, it should not be perceived as less dreadful. We test the hypothesis that a dread risk may have a stronger negative impact on the cumulative population size over time in comparison with a continuous risk causing the same number of fatalities. This difference should be particularly strong when the risky event affects children and young adults who would have produced future offspring if they had survived longer. We conducted a series of simulations, with varying assumptions about population size, population growth, age group affected by risky event, and the underlying demographic model. Results show that dread risks affect the population more severely over time than continuous risks that cause the same number of fatalities, suggesting that fearing a dread risk more than a continuous risk is an ecologically rational strategy. PMID:23840503

  17. The Effect of Cumulative Risk on Paternal Engagement: Examining Differences among Adolescent and Older Couples

    ERIC Educational Resources Information Center

    Farrie, Danielle; Lee, Yookyong; Fagan, Jay

    2011-01-01

    This study examined the association between fathers' and mothers' risk factors and paternal engagement 1 and 3 years postbirth. Distinguishing between new and persistent risk factors, we tested whether cumulative risk has unique effects on couples where one or both parents are adolescents at birth. Results indicated that although fathers' and…

  18. Fetal Substance Exposure and Cumulative Environmental Risk in an African American Cohort

    ERIC Educational Resources Information Center

    Yumoto, Chie; Jacobson, Sandra W.; Jacobson, Joseph L.

    2008-01-01

    Two models of vulnerability to socioenvironmental risk were examined in 337 African American children (M = 7.8 years) recruited to overrepresent prenatal alcohol or cocaine exposure: The cumulative risk model predicted synergistic effects from exposure to multiple risk factors, and the fetal patterning of disease model predicted that prenatal…

  19. Language Delay in Severely Neglected Children: A Cumulative or Specific Effect of Risk Factors?

    ERIC Educational Resources Information Center

    Sylvestre, Audette; Merette, Chantal

    2010-01-01

    Objectives: This research sought to determine if the language delay (LD) of severely neglected children under 3 years old was better explained by a cumulative risk model or by the specificity of risk factors. The objective was also to identify the risk factors with the strongest impact on LD among various biological, psychological, and…

  20. Community, State, and Federal Approaches to Cumulative Risk Assessment: Challenges and Opportunities for Integration

    PubMed Central

    Barzyk, Timothy M.; Wilson, Sacoby; Wilson, Anthony

    2015-01-01

    Community, state, and federal approaches to conventional and cumulative risk assessment (CRA) were described and compared to assess similarities and differences, and develop recommendations for a consistent CRA approach, acceptable across each level as a rigorous scientific methodology, including partnership formation and solution development as necessary practices. Community, state, and federal examples were described and then summarized based on their adherence to CRA principles of: (1) planning, scoping, and problem formulation; (2) risk analysis and ranking, and (3) risk characterization, interpretation, and management. While each application shared the common goal of protecting human health and the environment, they adopted different approaches to achieve this. For a specific project-level analysis of a particular place or instance, this may be acceptable, but to ensure long-term applicability and transferability to other projects, recommendations for developing a consistent approach to CRA are provided. This approach would draw from best practices, risk assessment and decision analysis sciences, and historical lessons learned to provide results in an understandable and accepted manner by all entities. This approach is intended to provide a common ground around which to develop CRA methods and approaches that can be followed at all levels. PMID:25918910

  1. Cumulative Adversity Sensitizes Neural Response to Acute Stress: Association with Health Symptoms

    PubMed Central

    Seo, Dongju; Tsou, Kristen A; Ansell, Emily B; Potenza, Marc N; Sinha, Rajita

    2014-01-01

    Cumulative adversity (CA) increases stress sensitivity and risk of adverse health outcomes. However, neural mechanisms underlying these associations in humans remain unclear. To understand neural responses underlying the link between CA and adverse health symptoms, the current study assessed brain activity during stress and neutral-relaxing states in 75 demographically matched, healthy individuals with high, mid, and low CA (25 in each group), and their health symptoms using the Cornell Medical Index. CA was significantly associated with greater adverse health symptoms (P=0.01) in all participants. Functional magnetic resonance imaging results indicated significant associations between CA scores and increased stress-induced activity in the lateral prefrontal cortex, insula, striatum, right amygdala, hippocampus, and temporal regions in all 75 participants (p<0.05, whole-brain corrected). In addition to these regions, the high vs low CA group comparison revealed decreased stress-induced activity in the medial orbitofrontal cortex (OFC) in the high CA group (p<0.01, whole-brain corrected). Specifically, hypoactive medial OFC and hyperactive right hippocampus responses to stress were each significantly associated with greater adverse health symptoms (p<0.01). Furthermore, an inverse correlation was found between activity in the medial OFC and right hippocampus (p=0.01). These results indicate that high CA sensitizes limbic–striatal responses to acute stress and also identifies an important role for stress-related medial OFC and hippocampus responses in the effects of CA on increasing vulnerability to adverse health consequences. PMID:24051900

  2. Cumulative family risk predicts increases in adjustment difficulties across early adolescence.

    PubMed

    Buehler, Cheryl; Gerard, Jean M

    2013-06-01

    Family is an important socialization context for youth as they move through early adolescence. A significant feature of this complex socialization context is the accumulation of potential family risk factors that may compromise youth adjustment. This study examined cumulative family risk and adolescents' adjustment difficulties in 416 two-parent families using four waves of annual longitudinal data (51% female youth). Risk factors in four family domains were examined: socioeconomic, parents' psychological realm, marital, and parenting. Cumulative family risk experienced while in 6th grade was associated concurrently with daughters' higher internalizing problems and with increased internalizing problems during early adolescence. Cumulative family risk was associated concurrently with sons' higher externalizing problems and with daughters' increased externalizing problems over time. Cumulative family risk was associated concurrently with lower grades and with declining grades over time for both daughters and sons. The number of risk domains also was associated with youths' adjustment difficulties during early adolescence, providing evidence that risk in two-parent families involves more than ineffective parenting. These findings suggest a critical need to provide strong support for families in reducing a variety of stressors across multiple family domains as their children traverse early adolescence.

  3. Cumulative Risk and Teacher Well-Being in the Democratic Republic of the Congo

    ERIC Educational Resources Information Center

    Wolf, Sharon; Torrente, Catalina; McCoy, Marissa; Rasheed, Damira; Aber, J. Lawrence

    2015-01-01

    Remarkably little systematic research has examined the living and working conditions for teachers in sub-Saharan Africa and how such conditions predict teacher well-being. This study assesses how various risks across several domains of teachers' lives--measured as a "cumulative risk index"--predict motivation, burnout, and job…

  4. Cumulative Family Risk Predicts Increases in Adjustment Difficulties across Early Adolescence

    ERIC Educational Resources Information Center

    Buehler, Cheryl; Gerard, Jean M.

    2013-01-01

    Family is an important socialization context for youth as they move through early adolescence. A significant feature of this complex socialization context is the accumulation of potential family risk factors that may compromise youth adjustment. This study examined cumulative family risk and adolescents' adjustment difficulties in 416 two-parent…

  5. Predicting Cumulative Risk of Disease Onset by Re-distributing Weights

    PubMed Central

    Chen, Tianle; Ma, Yanyuan

    2015-01-01

    We propose a simple approach predicting the cumulative risk of disease accommodating predictors with time-varying effects and outcomes subject to censoring. We use a nonparametric function for the coefficient of the time-varying effect and handle censoring through self-consistency equations that redistribute the probability mass of censored outcomes to the right. The computational procedure is extremely convenient and can be implemented by standard software. We prove large sample properties of the proposed estimator and evaluate its finite sample performance through simulation studies. We apply the method to estimate the cumulative risk of developing Huntington’s disease (HD) from subjects with huntingtin gene mutation using a large collaborative HD study data and illustrate an inverse relationship between the cumulative risk of HD and the length of cytosine-adenine-guanine (CAG) repeats in the huntingtin gene. PMID:25847392

  6. Engaging Communities in Research on Cumulative Risk and Social Stress-Environment Interactions: Lessons Learned from EPA's STAR Program

    PubMed Central

    Korfmacher, Katrina Smith; Cory-Slechta, Deborah A.; Jimenez, Maria; Symanski, Elaine; Carr Shmool, Jessie L.; Dotson-Newman, Ogonnaya; Clougherty, Jane E.; French, Robert; Levy, Jonathan I.; Laumbach, Robert; Rodgers, Kathryn; Bongiovanni, Roseann; Scammell, Madeleine K.

    2015-01-01

    Abstract Studies have documented cumulative health effects of chemical and nonchemical exposures, particularly chronic environmental and social stressors. Environmental justice groups have advocated for community participation in research that assesses how these interactions contribute to health disparities experienced by low-income and communities of color. In 2009, the U.S. Environmental Protection Agency issued a request for research applications (RFA), “Understanding the Role of Nonchemical Stressors and Developing Analytic Methods for Cumulative Risk Assessments.” Seven research projects were funded to help address this knowledge gap. Each engaged with communities in different ways. We describe the community engagement approaches of the seven research projects, which ranged from outreach through shared leadership/participatory. We then assess the experiences of these programs with respect to the community engagement goals of the RFA. We present insights from these community engagement efforts, including how the grants helped to build or enhance the capacity of community organizations in addition to contributing to the research projects. Our analysis of project proposals, annual grantee reports, and participant observation of these seven projects suggests guidelines for the development of future funding mechanisms and for conducting community-engaged research on cumulative risk involving environmental and social stressors including: 1) providing for flexibility in the mode of community engagement; 2) addressing conflict between research timing and engagement needs, 3) developing approaches for communicating about the uniquely sensitive issues of nonchemical stressors and social risks; and 4) encouraging the evaluation of community engagement efforts. PMID:27688822

  7. Engaging Communities in Research on Cumulative Risk and Social Stress-Environment Interactions: Lessons Learned from EPA's STAR Program

    PubMed Central

    Korfmacher, Katrina Smith; Cory-Slechta, Deborah A.; Jimenez, Maria; Symanski, Elaine; Carr Shmool, Jessie L.; Dotson-Newman, Ogonnaya; Clougherty, Jane E.; French, Robert; Levy, Jonathan I.; Laumbach, Robert; Rodgers, Kathryn; Bongiovanni, Roseann; Scammell, Madeleine K.

    2015-01-01

    Abstract Studies have documented cumulative health effects of chemical and nonchemical exposures, particularly chronic environmental and social stressors. Environmental justice groups have advocated for community participation in research that assesses how these interactions contribute to health disparities experienced by low-income and communities of color. In 2009, the U.S. Environmental Protection Agency issued a request for research applications (RFA), “Understanding the Role of Nonchemical Stressors and Developing Analytic Methods for Cumulative Risk Assessments.” Seven research projects were funded to help address this knowledge gap. Each engaged with communities in different ways. We describe the community engagement approaches of the seven research projects, which ranged from outreach through shared leadership/participatory. We then assess the experiences of these programs with respect to the community engagement goals of the RFA. We present insights from these community engagement efforts, including how the grants helped to build or enhance the capacity of community organizations in addition to contributing to the research projects. Our analysis of project proposals, annual grantee reports, and participant observation of these seven projects suggests guidelines for the development of future funding mechanisms and for conducting community-engaged research on cumulative risk involving environmental and social stressors including: 1) providing for flexibility in the mode of community engagement; 2) addressing conflict between research timing and engagement needs, 3) developing approaches for communicating about the uniquely sensitive issues of nonchemical stressors and social risks; and 4) encouraging the evaluation of community engagement efforts.

  8. Childhood poverty and young adults' allostatic load: the mediating role of childhood cumulative risk exposure.

    PubMed

    Evans, Gary W; Kim, Pilyoung

    2012-09-01

    Childhood poverty is linked to a host of physical and psychological disorders during childhood and later in life. In the study reported here, we showed that the proportion of childhood spent in poverty from birth to age 9 was linked to elevated allostatic load, a marker of chronic physiological stress, in 17-year-olds. Furthermore, this prospective longitudinal relationship was mediated by cumulative risk exposure at age 13. The greater the duration of early life spent in poverty, the greater the exposure to cumulative risk. This, in turn, leads to elevated allostatic load. Multiple psychological, biological, and neurological pathways likely account for the social patterning of psychological and physical disease.

  9. Cumulative risk assessment for plasticizer-contaminated food using the hazard index approach.

    PubMed

    Chang, J W; Chen, C Y; Yan, B R; Chang, M H; Tseng, S H; Kao, Y M; Chen, J C; Lee, C C

    2014-06-01

    Phthalates strongly and adversely affect reproduction, development and liver function. We did a cumulative risk assessment for simultaneous exposure to nine phthalates using the hazard index (HI) and the levels of nine phthalates in 1200 foodstuff samples. DEHP (di-2-ethylhexyl phthalate) present the highest level (mean: 0.443 mg/kg) in 1200 samples, and the highest average daily dose (ADD) was found in DEHP, ΣDBP(i + n) (the sum of dibutyl phthalate [DBP] isomers [DnBP + DiBP]) posed the highest risk potential of all the phthalates. In seven phthalates, the 95th percentiles of the ADDs for ΣDBP(i + n) in 0-6-yr-old children accounted for 91% (79-107%) of the tolerable daily intake, and the 95th percentiles of the HIs for the anti-androgenic effects of five phthalates in 0-3-yr-old children and 4-6-yr-old girls were >1. We conclude that the health of younger Taiwanese may be adversely affected by overexposure of phthalate-contaminated foods.

  10. Cumulative Advantage in an Egalitarian Country? Socioeconomic Health Disparities over the Life Course in Sweden.

    PubMed

    Leopold, Liliya

    2016-06-01

    According to the cumulative advantage hypothesis, health gaps between socioeconomic groups widen with age. In the United States, studies have supported this hypothesis. Outside this context, evidence remains scarce. The present study tests the cumulative advantage hypothesis in Sweden, a society that contrasts sharply with the United States in terms of policies designed to reduce social disparities in health-related resources. I draw on longitudinal data from the Swedish Level of Living Survey (N = 9,412 person-years), spanning the period between 1991 and 2010. The results show that gaps in self-rated health increase from early to middle adulthood. This applies to differences between educational groups and between occupational classes. In older age, health gaps remain constant. Cross-cohort analyses reveal a rising importance of cumulative advantage between educational groups but not between occupational classes. I conclude that the forces of accumulation prevail even in one of the most egalitarian welfare states.

  11. Cumulative Advantage in an Egalitarian Country? Socioeconomic Health Disparities over the Life Course in Sweden.

    PubMed

    Leopold, Liliya

    2016-06-01

    According to the cumulative advantage hypothesis, health gaps between socioeconomic groups widen with age. In the United States, studies have supported this hypothesis. Outside this context, evidence remains scarce. The present study tests the cumulative advantage hypothesis in Sweden, a society that contrasts sharply with the United States in terms of policies designed to reduce social disparities in health-related resources. I draw on longitudinal data from the Swedish Level of Living Survey (N = 9,412 person-years), spanning the period between 1991 and 2010. The results show that gaps in self-rated health increase from early to middle adulthood. This applies to differences between educational groups and between occupational classes. In older age, health gaps remain constant. Cross-cohort analyses reveal a rising importance of cumulative advantage between educational groups but not between occupational classes. I conclude that the forces of accumulation prevail even in one of the most egalitarian welfare states. PMID:27284078

  12. Mothering and Peer Associations Mediate Cumulative Risk Effects for Latino Youth

    ERIC Educational Resources Information Center

    Loukas, Alexandra; Prelow, Hazel M.; Suizzo, Marie-Anne; Allua, Shane

    2008-01-01

    The present study examined whether positive parenting and deviant peer associations mediated the relations between a cumulative risk composite comprising financial strain, neighborhood problems, and maternal psychological distress and subsequent youth adjustment problems. Drawn from the Welfare, Children, and Families: A Three City Study, the…

  13. TESTING STRATEGIES TO ESTIMATE NEUROTOXIC RISK FOR CUMULATIVE EXPOSURE TO PYRETHROID MIXTURES.

    EPA Science Inventory

    The Food Quality Protection Act requires EPA to consider the cumulative risk of pesticides with

    a common mechanism-of-toxicity. Evidence supports a mechanistic commonality for pyrethroid

    insecticides: these chemicals all act on neuronal sodium channels. The lack of ...

  14. USING DOSE ADDITION TO ESTIMATE CUMULATIVE RISKS FROM EXPOSURES TO MULTIPLE CHEMICALS

    EPA Science Inventory

    The Food Quality Protection Act (FQPA) of 1996 requires the EPA to consider the cumulative risk from exposure to multiple chemicals that have a common mechanism of toxicity. Three methods, hazard index (HI), point-of-departure index (PODI), and toxicity equivalence factor (TEF), ...

  15. Estimating Greenspace Exposure and Benefits for Cumulative Risk Assessment Applications (Summary Report)

    EPA Science Inventory

    This document provides a summary of the technical meeting on greenspace (GS) and cumulative risk assessment convened May 4−5, 2015 in Cincinnati, OH, by the U.S. Environmental Protection Agency (EPA) Office of Research and Development (ORD) National Center for Environmental As...

  16. Effects of Cumulative Family Risk Factors on American Students' Academic Performance

    ERIC Educational Resources Information Center

    Dunst, Carl J.; Hamby, Deborah W.

    2016-01-01

    The relationships between cumulative family risk factors and American students' academic performance were examined in all 50 States and the District of Columbia. Data from the 2007 "American Community Survey" were used to ascertain the percent of birth to 18 year old children in the United States who experienced three or more risk…

  17. Observed Sensitivity during Family Interactions and Cumulative Risk: A Study of Multiple Dyads per Family

    ERIC Educational Resources Information Center

    Browne, Dillon T.; Leckie, George; Prime, Heather; Perlman, Michal; Jenkins, Jennifer M.

    2016-01-01

    The present study sought to investigate the family, individual, and dyad-specific contributions to observed cognitive sensitivity during family interactions. Moreover, the influence of cumulative risk on sensitivity at the aforementioned levels of the family was examined. Mothers and 2 children per family were observed interacting in a round robin…

  18. Tools Available to Communities for Conducting Cumulative Exposure and Risk Assessments

    EPA Science Inventory

    This paper summarizes and assesses over 70 tools that could aid with gathering information and taking action on environmental issues related to community-based cumulative risk assessments (CBCRA). Information on tool use, development and research needs, was gathered from websites...

  19. Cumulative Risk Disparities in Children's Neurocognitive Functioning: A Developmental Cascade Model

    ERIC Educational Resources Information Center

    Wade, Mark; Browne, Dillon T.; Plamondon, Andre; Daniel, Ella; Jenkins, Jennifer M.

    2016-01-01

    The current longitudinal study examined the role of cumulative social risk on children's theory of mind (ToM) and executive functioning (EF) across early development. Further, we also tested a cascade model of development in which children's social cognition at 18 months was hypothesized to predict ToM and EF at age 4.5 through intermediary…

  20. Cumulative Adverse Financial Circumstances: Associations with Patient Health Status and Behaviors

    ERIC Educational Resources Information Center

    Bisgaier, Joanna; Rhodes, Karin V.

    2011-01-01

    This article examines associations between cumulative adverse financial circumstances and patient health in a sample of 1,506 urban emergency department (ED) patients. Study participants completed a previously validated Social Health Survey between May and October 2009. Five categories of economic deprivation were studied: food insecurity, housing…

  1. Poor Child Health, Family Capital and Cumulative Inequality in Academic Achievement

    PubMed Central

    Jackson, Margot

    2015-01-01

    Our understanding of health and social stratification can be enriched by testing tenets of cumulative inequality theory that emphasize how the accumulation of inequality is dependent on the developmental stage being considered; the duration and stability of poor health; and the family resources available to children. I analyze longitudinal data from the British National Child Development Study (N=9,252) to ask: 1) if child health is a source of cumulative inequality in academic achievement; 2) whether this relationship depends on the timing and duration of poor health; and 3) whether trajectories are sensitive to levels of family capital. The results suggest that the relationship between health and academic achievement emerges very early in life and persists, and that whether we observe shrinking or widening inequality as children age depends on when we measure their health, and whether children have access to compensatory resources. PMID:25926564

  2. Predicting cumulative risk of bovine respiratory disease complex (BRDC) using feedlot arrival data and daily morbidity and mortality counts

    PubMed Central

    Babcock, Abram H.; White, Brad J.; Renter, David G.; Dubnicka, Suzanne R.; Scott, H. Morgan

    2013-01-01

    Although bovine respiratory disease complex (BRDC) is common in post-weaning cattle, BRDC prediction models are seldom analyzed. The objectives of this study were to assess the ability to predict cumulative cohort-level BRDC morbidity using on-arrival risk factors and to evaluate whether or not adding BRDC risk classification and daily BRDC morbidity and mortality data to the models enhanced their predictive ability. Retrospective cohort-level and individual animal health data were used to create mixed negative binomial regression (MNBR) models for predicting cumulative risk of BRDC morbidity. Logistic regression models were used to illustrate that the percentage of correctly (within |5%| of actual) classified cohorts increased across days, but the effect of day was modified by arrival weight, arrival month, and feedlot. Cattle arriving in April had the highest (77%) number of lots correctly classified at arrival and cattle arriving in December had the lowest (28%). Classification accuracy at arrival varied according to initial weight, ranging from 17% (< 182 kg) to 91% (> 409 kg). Predictive accuracy of the models improved from 64% at arrival to 74% at 8 days on feed (DOF) when risk code was known compared to 56% accuracy at arrival and 69% at 8 DOF when risk classification was not known. The results of this study demonstrate how the predictive ability of models can be improved by utilizing more refined data on the prior history of cohorts, thus making these models more useful to operators of commercial feedlots. PMID:23814354

  3. Study on the cumulative impact of reclamation activities on ecosystem health in coastal waters.

    PubMed

    Shen, Chengcheng; Shi, Honghua; Zheng, Wei; Li, Fen; Peng, Shitao; Ding, Dewen

    2016-02-15

    The purpose of this study is to develop feasible tools to investigate the cumulative impact of reclamations on coastal ecosystem health, so that the strategies of ecosystem-based management can be applied in the coastal zone. An indicator system and model were proposed to assess the cumulative impact synthetically. Two coastal water bodies, namely Laizhou Bay (LZB) and Tianjin coastal waters (TCW), in the Bohai Sea of China were studied and compared, each in a different phase of reclamations. Case studies showed that the indicator scores of coastal ecosystem health in LZB and TCW were 0.75 and 0.68 out of 1.0, respectively. It can be concluded that coastal reclamations have a historically cumulative effect on benthic environment, whose degree is larger than that on aquatic environment. The ecosystem-based management of coastal reclamations should emphasize the spatially and industrially intensive layout.

  4. A feasibility study of cumulative risk assessment methods for drinking water disinfection by-product mixtures.

    PubMed

    Teuschler, Linda K; Rice, Glenn E; Wilkes, Charles R; Lipscomb, John C; Power, Fred W

    Humans are exposed daily to complex mixtures of chemicals, including drinking water disinfection by-products (DBPs) via oral, dermal, and inhalation routes. Some positive epidemiological and toxicological studies suggest reproductive and developmental effects and cancer are associated with consumption of chlorinated drinking water. Thus, the U.S. Environmental Protection Agency (EPA) conducted research to examine the feasibility of evaluating simultaneous exposures to multiple DBPs via all three exposure routes. A cumulative risk assessment approach was developed for DBP mixtures by combining exposure modeling and physiologically based pharmacokinetic modeling results with a new mixtures risk assessment method, the cumulative relative potency factors (CRPF) approach. Internal doses were estimated for an adult female and an adult male, each of reproductive age, and for a child (age 6 yr) inclusive of oral, dermal, and inhalation exposures. Estimates of the daily internal doses were made for 13 major DBPs, accounting for activity patterns that affect the amount of human contact time with drinking water (e.g., tap water consumed, time spent showering), building characteristics (e.g., household air volumes), and physicochemical properties of the DBPs (e.g., inhalation rates, skin permeability rates, blood: air partition coefficients). A novel cumulative risk assessment method, the CRPF approach, is advanced that integrates the principles of dose addition and response addition to produce multiple-route, chemical mixture risk estimates using total absorbed doses. Research needs to improve this approach are presented.

  5. Calculating excess risk with age-dependent adjustment factors and cumulative doses: ethylene oxide case study.

    PubMed

    Sielken, Robert L; Flores, Ciriaco Valdez

    2009-10-01

    U.S. EPA's Supplemental Guidance in 2005 documented their procedure for incorporating age-dependent adjustment factors (ADAFs) into lifetime excess risk calculations. EPA's first attempt to implement an ADAF when the dose-response model had a cumulative dose metric was for ethylene oxide and that attempt (US EPA, 2006) failed to successfully follow EPA's own guidelines. The failure suggested that the incorporation of ADAFs would increase the lifetime excess risk for ethylene oxide by approximately 66%. However, if the procedure in the guidelines were followed correctly, then the increase would have only been 0.008% or approximately 8,000 fold less. Because cumulative exposure is a common dose metric in dose-response models of epidemiological data, a correct implementation of the guidelines is of widespread importance.

  6. Cumulative radiation exposure from imaging procedures and associated lifetime cancer risk for patients with lymphoma

    PubMed Central

    Fabritius, Grete; Brix, Gunnar; Nekolla, Elke; Klein, Stefan; Popp, Henning D.; Meyer, Mathias; Glatting, Gerhard; Hagelstein, Claudia; Hofmann, Wolf K.; Schoenberg, Stefan O.; Henzler, Thomas

    2016-01-01

    The aim of this study was to systematically evaluate the cumulative radiation exposure and the associated lifetime-cancer-risk from diagnostic imaging in patients with Hodgkin-lymphoma-(HL) or diffuse-large-B-cell-lymphoma (DLBCL). 99 consecutive patients (53-males) diagnosed with HL or DLBCL were included in the study and followed. Based on the imaging reports, organ and effective-doses-(ED) were calculated individually for each patient and the excess lifetime risks were estimated. The average ED in the first year after diagnosis was significantly different for men (59 ± 33 mSv) and women (744 ± 33 mSv)-(p < 0.05). The mean cumulative ED in each of the following 5 years was 16 ± 16 mSv without significant differences between men and women-(p > 0.05). Over all years, more than 90% of the ED resulted from CT. The average cumulative radiation risk estimated for the first year was significantly lower for men (0.76 ± 0.41%) as compared to women (1.28 ± 0.54%)-(p < 0.05). The same was found for each of the subsequent 5-years (men-0.18 ± 0.17%; women-0.28 ± 0.25%)-(p < 0.05). In conclusion, for HL and DLBCL patients investigated in this study, a cumulative radiation risk of about 1 excess cancer per 100 patients is estimated for diagnostic imaging procedures performed during both the first year after diagnosis and a follow-up period of 5 years. PMID:27748377

  7. [Recommendations for the analysis of cumulated data in antimicrobial susceptibility in health institutions].

    PubMed

    2010-04-01

    Due to the great variability in antimicrobial resistance patterns, local reports of cumulative antimicrobial susceptibility data are necessary in every health center. The purpose is to guide clinical decisions and the early detection of patterns that allow preventive measures to avoid dissemination of resistant strains. The main objective of this guide is to provide recommendations for the analysis of antimicrobial susceptibility data and elaboration of a local report. Recommendations provided in this guide are based on the Clinical and Laboratory Standards Institute (CLSI) document "Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data" (3). Key aspects related to information gathering and data processing, analysis and presentation are described.

  8. Lower cumulative stress is associated with better health for physically active adults in the community.

    PubMed

    Stults-Kolehmainen, Matthew A; Tuit, Keri; Sinha, Rajita

    2014-03-01

    Both cumulative adversity, an individual's lifetime exposure to stressors, and insufficient exercise are associated with poor health outcomes. The purpose of this study was to ascertain whether exercise buffers the association of cumulative adverse life events (CALE) with health in a community-wide sample of healthy adults (ages 18-50 years; women: n = 219, 29.5 ± 9.2 years; men: n = 176, 29.4 ± 8.7 years, mean ± standard deviation). Participants underwent the Cumulative Adversity Interview, which divides life events into three subsets: major life events (MLE), recent life events (RLE) and traumatic experiences (TLE). These individuals also completed the Cornell Medical Index and a short assessment for moderate or greater intensity exercise behavior, modified from the Nurses' Health Study. Results indicated that higher CALE was associated with greater total health problems (r = 0.431, p < 0.001). Interactions between stress and exercise were not apparent for RLE and TLE. However, at low levels of MLE, greater exercise was related to fewer total, physical, cardiovascular and psychological health problems (p value <0.05). Conversely, at high levels of MLE, the benefits of exercise appear to be absent. Three-way interactions were observed between sex, exercise and stress. Increased levels of exercise were related to better physical health in men, at all levels of CALE. Only women who reported both low levels of CALE and high levels of exercise had more favorable physical health outcomes. A similar pattern of results emerged for RLE. Together, these data suggest that increased exercise is related to better health, but these effects may vary by cumulative stress exposure and sex. PMID:24392966

  9. Methodological Considerations in Screening for Cumulative Environmental Health Impacts: Lessons Learned from a Pilot Study in California

    PubMed Central

    August, Laura Meehan; Faust, John B.; Cushing, Lara; Zeise, Lauren; Alexeeff, George V.

    2012-01-01

    Polluting facilities and hazardous sites are often concentrated in low-income communities of color already facing additional stressors to their health. The influence of socioeconomic status is not considered in traditional models of risk assessment. We describe a pilot study of a screening method that considers both pollution burden and population characteristics in assessing the potential for cumulative impacts. The goal is to identify communities that warrant further attention and to thereby provide actionable guidance to decision- and policy-makers in achieving environmental justice. The method uses indicators related to five components to develop a relative cumulative impact score for use in comparing communities: exposures, public health effects, environmental effects, sensitive populations and socioeconomic factors. Here, we describe several methodological considerations in combining disparate data sources and report on the results of sensitivity analyses meant to guide future improvements in cumulative impact assessments. We discuss criteria for the selection of appropriate indicators, correlations between them, and consider data quality and the influence of choices regarding model structure. We conclude that the results of this model are largely robust to changes in model structure. PMID:23202671

  10. Single-compound and cumulative risk assessment of mycotoxins present in breakfast cereals consumed by children from Lisbon region, Portugal.

    PubMed

    Assunção, Ricardo; Vasco, Elsa; Nunes, Baltazar; Loureiro, Susana; Martins, Carla; Alvito, Paula

    2015-12-01

    Humans can be exposed to multiple chemicals, but current risk assessment is usually carried out on one chemical at a time. Mycotoxins are commonly found in a variety of foods including those intended to consumption by children namely breakfast cereals. The present study aims to perform, the risk assessment of single and multiple mycotoxins present in breakfast cereals consumed by children (1-3 years old) from Lisbon region, Portugal. Daily exposure of children to ochratoxin A, fumonisins and trichothecenes showed no health risks to the children population considering individual mycotoxins, while exposure to aflatoxin B1 (AFB1) suggested a potential health concern for the high percentiles of intake (P90, P95 and P99). The combined exposure to fumonisins and trichothecenes are not expected to be of health concern. The combined margin of exposure (MoET) for the aflatoxins group could constitute a potential health concern and AFB1 was the main contributor for MoET. Legal limits and control strategies regarding the presence of multiple mycotoxins in foodstuffs is an urgent need. To the best of our knowledge, this is the first time a cumulative risk assessment was performed on multiple mycotoxins present in breakfast cereals consumed by children.

  11. Cumulative effects of mothers' risk and promotive factors on daughters' disruptive behavior.

    PubMed

    van der Molen, Elsa; Hipwell, Alison E; Vermeiren, Robert; Loeber, Rolf

    2012-07-01

    Little is known about the ways in which the accumulation of maternal factors increases or reduces risk for girls' disruptive behavior during preadolescence. In the current study, maternal risk and promotive factors and the severity of girls' disruptive behavior were assessed annually among girls' ages 7-12 in an urban community sample (N = 2043). Maternal risk and promotive factors were operative at different time points in girls' development. Maternal warmth explained variance in girls' disruptive behavior, even after controlling for maternal risk factors and relevant child and neighborhood factors. In addition, findings supported the cumulative hypothesis that the number of risk factors increased the chance on girls' disruptive behavior disorder (DBD), while the number of promotive factors decreased this probability. Daughters of mothers with a history of Conduct Disorder (CD) were exposed to more risk factors and fewer promotive factors compared to daughters of mothers without prior CD. The identification of malleable maternal factors that can serve as targets for intervention has important implications for intergenerational intervention. Cumulative effects show that the focus of prevention efforts should not be on single factors, but on multiple factors associated with girls' disruptive behavior.

  12. Cumulative Impact of HIV and Multiple Concurrent Human Papillomavirus Infections on the Risk of Cervical Dysplasia.

    PubMed

    Adler, David H; Wallace, Melissa; Bennie, Thola; Abar, Beau; Meiring, Tracy L; Williamson, Anna-Lise; Bekker, Linda-Gail

    2016-01-01

    Infection with HIV is known to increase the risk of cervical cancer. In addition, evidence suggests that concurrent infection with multiple human papillomavirus (HPV) genotypes increases the risk of cervical dysplasia more than infection with a single HPV genotype. However, the impact of the combination of HIV coinfection and presence of multiple concurrent HPV infections on the risk of cervical dysplasia is uncertain. We compared the results of HPV testing and Pap smears between HIV-infected and HIV-uninfected young women to assess the cumulative impact of these two conditions. We found that both HIV and the presence of multiple concurrent HPV infections are associated with increased risk of associated Pap smear abnormality and that the impact of these two risk factors may be additive. PMID:26997954

  13. Phthalates in Commercial Chinese Rice Wines: Concentrations and the Cumulative Risk Assessment to Adult Males in Shanghai.

    PubMed

    Huang, Yue; Lu, Wen Wei; Chen, Bo; You, Jie; Wu, Min; Li, Shu Guang

    2014-10-01

    The concentrations of 16 phthalates in 164 commercial Chinese rice wines (CRW) were detected by GC-MS, and consumption data on CRW in different packaging types was investigated from 634 adult males in Shanghai using a food frequency questionnaire. Based on the principles of probabilistic modelling and cumulative risk assessment, the exposure and health risk of phthalates from CRW to adult males in Shanghai was evaluated. DMP, DEP, DIBP, DnBP, BBP, and DEHP were detected in the samples, the range of detection frequency of individual phthalates varied from 6.10% for BBP to 15.24% for DIBP, and the detected concentrations were 51.06-200.34 ng/mL. All the respondents consumed CRW, 90.69% of them consumed CRW 0.01-49.9 mL/d, the minimum value of the average daily intake of CRW was 6.25 mL/d, the median was 13.72 mL/d and the maximum was 300 mL/d. The median exposure level of the 6 detected Phthalates to adult males in Shanghai were 6.58-7.10 ng/(d•kg), and the maximum exposure level were 137.38-540.47 ng/(d•kg). The cumulative exposure health risk index (HI) based on the median and maximum exposure level of the 6 Phthalates (DMP, DEP, DIBP, DnBP, BBP, and DEHP) were 0.001147 and 0.063396, both were far less than 1. In conclusion, CRW were generally consumed by the adult males in Shanghai, although multiple phthalates were detected in commercial CRW, health risk of such exposure levels from commercial CRW to the target adult males in Shanghai was very low. PMID:25341819

  14. Phthalates in Commercial Chinese Rice Wines: Concentrations and the Cumulative Risk Assessment to Adult Males in Shanghai.

    PubMed

    Huang, Yue; Lu, Wen Wei; Chen, Bo; You, Jie; Wu, Min; Li, Shu Guang

    2014-10-01

    The concentrations of 16 phthalates in 164 commercial Chinese rice wines (CRW) were detected by GC-MS, and consumption data on CRW in different packaging types was investigated from 634 adult males in Shanghai using a food frequency questionnaire. Based on the principles of probabilistic modelling and cumulative risk assessment, the exposure and health risk of phthalates from CRW to adult males in Shanghai was evaluated. DMP, DEP, DIBP, DnBP, BBP, and DEHP were detected in the samples, the range of detection frequency of individual phthalates varied from 6.10% for BBP to 15.24% for DIBP, and the detected concentrations were 51.06-200.34 ng/mL. All the respondents consumed CRW, 90.69% of them consumed CRW 0.01-49.9 mL/d, the minimum value of the average daily intake of CRW was 6.25 mL/d, the median was 13.72 mL/d and the maximum was 300 mL/d. The median exposure level of the 6 detected Phthalates to adult males in Shanghai were 6.58-7.10 ng/(d•kg), and the maximum exposure level were 137.38-540.47 ng/(d•kg). The cumulative exposure health risk index (HI) based on the median and maximum exposure level of the 6 Phthalates (DMP, DEP, DIBP, DnBP, BBP, and DEHP) were 0.001147 and 0.063396, both were far less than 1. In conclusion, CRW were generally consumed by the adult males in Shanghai, although multiple phthalates were detected in commercial CRW, health risk of such exposure levels from commercial CRW to the target adult males in Shanghai was very low.

  15. Cumulative effects of noise and odour annoyances on environmental and health related quality of life.

    PubMed

    Oiamo, Tor H; Luginaah, Isaac N; Baxter, Jamie

    2015-12-01

    Noise and odour annoyances are important considerations in research on health effects of air pollution and traffic noise. Cumulative exposures can occur via several chemical hazards or a combination of chemical and stressor-based hazards, and related health outcomes can be generalized as manifestations of physiological and/or psychological stress responses. A major research challenge in this field is to understand the combined health effects of physiological and psychological responses to exposure. The SF-12 Health Survey is a health related quality of life (HRQoL) instrument designed for the assessment of functional mental and physical health in clinical practice and therefore well suited to research on physiological health outcomes of exposure. However, previous research has not assessed its sensitivity to psychological stress as measured by noise annoyance and odour annoyance. The current study validated and tested this application of the SF-12 Health Survey in a cross-sectional study (n = 603) that included exposure assessment for traffic noise and air pollution in Windsor, Ontario, Canada. The results indicated that SF-12 scores in Windsor were lower than Canadian normative data. A structural equation model demonstrated that this was partially due to noise and odour annoyances, which were associated with covarying exposures to ambient nitrogen dioxide and traffic noise. More specifically, noise annoyance had a significant and negative effect on both mental and physical health factors of the SF-12 and there was a significant covariance between noise annoyance and odour annoyance. The study confirmed a significant effect of psychological responses to cumulative exposures on HRQoL. The SF-12 Health Survey shows promise with respect to assessing the cumulative health effects of outdoor air pollution and traffic noise.

  16. Modeling the cumulative genetic risk for multiple sclerosis from genome-wide association data

    PubMed Central

    2011-01-01

    Background Multiple sclerosis (MS) is the most common cause of chronic neurologic disability beginning in early to middle adult life. Results from recent genome-wide association studies (GWAS) have substantially lengthened the list of disease loci and provide convincing evidence supporting a multifactorial and polygenic model of inheritance. Nevertheless, the knowledge of MS genetics remains incomplete, with many risk alleles still to be revealed. Methods We used a discovery GWAS dataset (8,844 samples, 2,124 cases and 6,720 controls) and a multi-step logistic regression protocol to identify novel genetic associations. The emerging genetic profile included 350 independent markers and was used to calculate and estimate the cumulative genetic risk in an independent validation dataset (3,606 samples). Analysis of covariance (ANCOVA) was implemented to compare clinical characteristics of individuals with various degrees of genetic risk. Gene ontology and pathway enrichment analysis was done using the DAVID functional annotation tool, the GO Tree Machine, and the Pathway-Express profiling tool. Results In the discovery dataset, the median cumulative genetic risk (P-Hat) was 0.903 and 0.007 in the case and control groups, respectively, together with 79.9% classification sensitivity and 95.8% specificity. The identified profile shows a significant enrichment of genes involved in the immune response, cell adhesion, cell communication/signaling, nervous system development, and neuronal signaling, including ionotropic glutamate receptors, which have been implicated in the pathological mechanism driving neurodegeneration. In the validation dataset, the median cumulative genetic risk was 0.59 and 0.32 in the case and control groups, respectively, with classification sensitivity 62.3% and specificity 75.9%. No differences in disease progression or T2-lesion volumes were observed among four levels of predicted genetic risk groups (high, medium, low, misclassified). On the other

  17. Cumulative Risk and Continuity in Nonparental Care from Infancy to Early Adolescence

    PubMed Central

    Colwell, Malinda J.; Pettit, Gregory S.; Meece, Darrell; Bates, John E.; Dodge, Kenneth A.

    2009-01-01

    Variations in amounts of nonparental care across infancy, preschool, early elementary school, and early adolescence were examined in a longitudinal sample (N = 438). Of interest was (a) continuity in use of the different arrangements, (b) whether the arrangements were additively and cumulatively associated with children’s externalizing behavior problems, and (c) whether predictive relations were accounted for by social-ecological (socioeconomic status, mothers’ employment status, marital status) and social-experiential (parenting quality, exposure to aggressive peers) factors. Correlations among overall amounts of care provided little evidence of cross-time continuity. Consistent with the cumulative risk perspective, Grade 1 self-care and Grade 6 unsupervised peer contact incrementally predicted Grade 6 externalizing problems. Most of the predictive associations were accounted for by family background and social relationship factors. PMID:20046544

  18. A watershed-based cumulative risk impact analysis: environmental vulnerability and impact criteria.

    PubMed

    Osowski, S L; Swick, J D; Carney, G R; Pena, H B; Danielson, J E; Parrish, D A

    2001-01-01

    Swine Concentrated Animal Feeding Operations (CAFOs) have received much attention in recent years. As a result, a watershed-based screening tool, the Cumulative Risk Index Analysis (CRIA), was developed to assess the cumulative impacts of multiple CAFO facilities in a watershed subunit. The CRIA formula calculates an index number based on: 1) the area of one or more facilities compared to the area of the watershed subunit, 2) the average of the environmental vulnerability criteria, and 3) the average of the industry-specific impact criteria. Each vulnerability or impact criterion is ranked on a 1 to 5 scale, with a low rank indicating low environmental vulnerability or impact and a high rank indicating high environmental vulnerability or impact. The individual criterion ranks, as well as the total CRIA score, can be used to focus the environmental analysis and facilitate discussions with industry, public, and other stakeholders in the Agency decision-making process. PMID:11214349

  19. Barriers to success in parent training for young children with developmental delay: the role of cumulative risk.

    PubMed

    Bagner, Daniel M; Graziano, Paulo A

    2013-05-01

    The purpose of this study was to examine the effect of cumulative risk on dropout and treatment outcome in parent training. Participants were 44 families of young children (mean age of 49.59 months) who presented with elevated externalizing behavior problems and developmental delay or borderline developmental delay. All families were offered to receive Parent-Child Interaction Therapy (PCIT), an evidence-based, behavioral parent-training intervention, at a hospital-based outpatient clinic. Cumulative risk was calculated as a sum of risk variables, including socioeconomic disadvantage (poverty, low maternal education), family structure (single-parent household), and maternal risk characteristics (minority status, lower intelligence, and parental distress). Families with higher cumulative risk scores, especially those with three or more risks, were more likely to drop out of treatment and display diminished treatment response in child behavior and parenting skills compared with families with lower cumulative risk scores. However, only two individual risk factors (i.e., minority status and family structure) predicted dropout, and one individual risk factor (i.e., maternal education) predicted outcome. These findings suggest that it can be useful to conceptualize risk factors as having a cumulative, in addition to individual, influence on parent-training interventions for children with developmental delay and have significant implications for clinical practice. It is important for clinicians to regularly assess for risk factors, and future research should examine ways in which clinicians can improve retention and outcome of parent training in the presence of multiple risk factors.

  20. DOSE-RESPONSE MODELING FOR THE ASSESSMENT OF CUMULATIVE RISK DUE TO EXPOSURE TO N-METHYL CARBAMATE PESTICIDES

    EPA Science Inventory

    The US EPAs N-Methyl Carbamate Cumulative Risk Assessment (NMCRA) assesses the effect on acetylcholine esterase (AChE) activity of exposure to 10 N-methyl carbamate (NMC) pesticides through dietary, drinking water, and residential exposures.

  1. Observed sensitivity during family interactions and cumulative risk: A study of multiple dyads per family.

    PubMed

    Browne, Dillon T; Leckie, George; Prime, Heather; Perlman, Michal; Jenkins, Jennifer M

    2016-07-01

    The present study sought to investigate the family, individual, and dyad-specific contributions to observed cognitive sensitivity during family interactions. Moreover, the influence of cumulative risk on sensitivity at the aforementioned levels of the family was examined. Mothers and 2 children per family were observed interacting in a round robin design (i.e., mother-older sibling, mother younger-sibling and sibling-dyad, N = 385 families). Data were dyadic, in that there were 2 directional scores per interaction, and were analyzed using a multilevel formulation of the Social Relations Model. Variance partitioning revealed that cognitive sensitivity is simultaneously a function of families, individuals and dyads, though the importance of these components varies across family roles. Cognitive sensitivity for mothers was primarily attributable to individual differences, whereas cognitive sensitivity for children was predominantly attributable to family and dyadic differences, especially for youngest children. Cumulative risk explained family and individual variance in cognitive sensitivity, particularly when actors were older or in a position of relative competence or authority (i.e., mother to children, older to younger siblings). Overall, this study demonstrates that cognitive sensitivity operates across levels of family organization, and is negatively impacted by psychosocial risk. (PsycINFO Database Record

  2. Observed sensitivity during family interactions and cumulative risk: A study of multiple dyads per family.

    PubMed

    Browne, Dillon T; Leckie, George; Prime, Heather; Perlman, Michal; Jenkins, Jennifer M

    2016-07-01

    The present study sought to investigate the family, individual, and dyad-specific contributions to observed cognitive sensitivity during family interactions. Moreover, the influence of cumulative risk on sensitivity at the aforementioned levels of the family was examined. Mothers and 2 children per family were observed interacting in a round robin design (i.e., mother-older sibling, mother younger-sibling and sibling-dyad, N = 385 families). Data were dyadic, in that there were 2 directional scores per interaction, and were analyzed using a multilevel formulation of the Social Relations Model. Variance partitioning revealed that cognitive sensitivity is simultaneously a function of families, individuals and dyads, though the importance of these components varies across family roles. Cognitive sensitivity for mothers was primarily attributable to individual differences, whereas cognitive sensitivity for children was predominantly attributable to family and dyadic differences, especially for youngest children. Cumulative risk explained family and individual variance in cognitive sensitivity, particularly when actors were older or in a position of relative competence or authority (i.e., mother to children, older to younger siblings). Overall, this study demonstrates that cognitive sensitivity operates across levels of family organization, and is negatively impacted by psychosocial risk. (PsycINFO Database Record PMID:27337515

  3. VULNERABILITY AS A FUNCTION OF INDIVIDUAL AND GROUP RESOURCES IN CUMULATIVE RISK ASSESSMENT

    EPA Science Inventory

    Background: The field of risk assessment has focused on protecting the health of individual people or populations of wildlife from single risks, mostly from chemical exposure. The U.S. Environmental Protection Agency recently began to address multiple risks to communities in the ...

  4. Predicting Academic Achievement from Cumulative Home Risk: The Mediating Roles of Effortful Control, Academic Relationships, and School Avoidance

    ERIC Educational Resources Information Center

    Swanson, Jodi; Valiente, Carlos; Lemery-Chalfant, Kathryn

    2012-01-01

    Components of the home environment are associated with children's academic functioning. The accumulation of risks in the home are expected to prove more detrimental to achievement than any one risk alone, but the processes accounting for this relation are unclear. Using an index of cumulative home risk (CHR) inclusive of protective factors, as…

  5. Limiting Cumulative HIV Viremia Copy-Years by Early Treatment Reduces Risk of AIDS and Death

    PubMed Central

    Walker, A. Sarah; Suthar, Amitabh B.; Sabin, Caroline; Bucher, Heiner C.; Jarrin, Inma; Moreno, Santiago; Perez-Hoyos, Santiago; Porter, Kholoud; Ford, Deborah

    2016-01-01

    Background: Viremia copy-years (VCY), a time-updated measure of cumulative HIV exposure, predicts AIDS/death; although its utility in deciding when to start combination antiretroviral therapy (cART) remains unclear. We aimed to assess the impact of initiating versus deferring cART on risk of AIDS/death by levels of VCY both independent of and within CD4 cell count strata ≥500 cells per cubic millimeter. Methods: Using Concerted Action on Seroconversion to AIDS and Death in Europe (CASCADE) data, we created a series of nested “trials” corresponding to consecutive months for individuals ≥16 years at seroconversion after 1995 who were cART-naive and AIDS-free. Pooling across all trials, time to AIDS/death by CD4, and VCY strata was compared in those initiating vs. deferring cART using Cox models adjusted for: country, sex, risk group, seroconversion year, age, time since last HIV-RNA, and current CD4, VCY, HIV-RNA, and mean number of previous CD4/HIV-RNA measurements/year. Results: Of 9353 individuals, 5312 (57%) initiated cART and 486 (5%) acquired AIDS/died. Pooling CD4 strata, risk of AIDS/death associated with initiating vs. deferring cART reduced as VCY increased. In patients with high CD4 cell counts, ≥500 cells per cubic millimeter, there was a trend for a greater reduction for those initiating vs. deferring with increasing VCY (P = 0.09), with the largest benefit in the VCY ≥100,000 copy-years/mL group [hazard ratio (95% CI) = 0.41 (0.19 to 0.87)]. Conclusions: For individuals with CD4 ≥500 cells per cubic millimeter, limiting the cumulative HIV burden to <100,000 copy-years/mL through cART may reduce the risk of AIDS/death. PMID:27116045

  6. Do observed or perceived characteristics of the neighborhood environment mediate associations between neighborhood poverty and cumulative biological risk?

    PubMed Central

    Schulz, Amy J.; Mentz, Graciela; Lachance, Laurie; Zenk, Shannon N.; Johnson, Jonetta; Stokes, Carmen; Mandell, Rebecca

    2013-01-01

    Objective To examine contributions of observed and perceived neighborhood characteristics in explaining associations between neighborhood poverty and cumulative biological risk (CBR) in an urban community. Methods Multilevel regression analyses were conducted using cross-sectional data from a probability sample survey (n=919), and observational and census data. Dependent variable: CBR. Independent variables: Neighborhood disorder, deterioration and characteristics; perceived neighborhood social environment, physical environment, and neighborhood environment. Covariates: Neighborhood and individual demographics, health-related behaviors. Results Observed and perceived indicators of neighborhood conditions were significantly associated with CBR, after accounting for both neighborhood and individual level socioeconomic indicators. Observed and perceived neighborhood environmental conditions mediated associations between neighborhood poverty and CBR. Conclusions Findings were consistent with the hypothesis that neighborhood conditions associated with economic divestment mediate associations between neighborhood poverty and CBR. PMID:24100238

  7. Cumulative risk assessment lessons learned: a review of case studies and issue papers.

    PubMed

    Gallagher, Sarah S; Rice, Glenn E; Scarano, Louis J; Teuschler, Linda K; Bollweg, George; Martin, Lawrence

    2015-02-01

    Cumulative risk assessments (CRAs) examine potential risks posed by exposure to multiple and sometimes disparate environmental stressors. CRAs are more resource intensive than single chemical assessments, and pose additional challenges and sources of uncertainty. CRAs may examine the impact of several factors on risk, including exposure magnitude and timing, chemical mixture composition, as well as physical, biological, or psychosocial stressors. CRAs are meant to increase the relevance of risk assessments, providing decision makers with information based on real world exposure scenarios that improve the characterization of actual risks and hazards. The U.S. Environmental Protection Agency has evaluated a number of CRAs, performed by or commissioned for the Agency, to seek insight into CRA concepts, methods, and lessons learned. In this article, ten case studies and five issue papers on key CRA topics are examined and a set of lessons learned are identified for CRA implementation. The lessons address the iterative nature of CRAs, importance of considering vulnerability, need for stakeholder engagement, value of a tiered approach, new methods to assess multiroute exposures to chemical mixtures, and the impact of geographical scale on approach and purpose.

  8. Pesticides and health risks.

    PubMed

    Gilden, Robyn C; Huffling, Katie; Sattler, Barbara

    2010-01-01

    Pesticides are a category of chemicals formulated to kill or repel a pest or halt its reproduction. In this article we review the toxicological and epidemiological literature; describe common potential pesticide exposures; and focus on the associated health risks to fetal development. Clinical implications are reviewed, and recommendations are made regarding the integration of this environmental health concern into nursing education, practice, research, and policy/advocacy work. Recommendations for pesticide elimination and reduction in health care settings are included. PMID:20409108

  9. Evaluating Exposures to Chemical and Non-Chemical Stressors in a Cumulative Risk Assessment

    EPA Science Inventory

    Characteristically toxicological and epidemiological studies involving chemical mixtures (e.g., multi-pollutant exposures) have been increasing. Human health assessment of chemical and nonchemical mixture risk remains rare. Recently, there has been an increased emphasis on integr...

  10. The EPA's Human Exposure Research Program for Assessing Cumulative Risk in Communities

    EPA Science Inventory

    Communities are faced with challenges in identifying and prioritizing environmental issues, taking actions to reduce their exposures, and determining their effectiveness for reducing human health risks. Additional challenges include determining what scientific tools are available...

  11. Cumulative incidence and risk factors for limber tail in the Dogslife labrador retriever cohort

    PubMed Central

    de C. Bronsvoort, B. M.; Handel, I. G.; Rose, E.; Summers, K.; Clements, D. N.

    2016-01-01

    Limber tail is a condition that typically affects larger working breeds causing tail limpness and pain, resolving without veterinary intervention. It is poorly understood and the disease burden has not been well characterised. Data collected from owners of the Dogslife cohort of Labrador Retrievers have been used to describe incidents and a case–control study was undertaken to elucidate risk factors with 38 cases and 86 controls. The cumulative incidence of unexplained tail limpness was 9.7 per cent. Swimming is not a necessary precursor for limber tail, but it is a risk factor (OR=4.7) and working dogs were more susceptible than non-working dogs (OR=5.1). Higher latitudes were shown to be a risk factor for developing the condition and the case dogs were more related to each other than might be expected by chance. This suggests that dogs may have an underlying genetic predisposition to developing the condition. This study is the first, large-scale investigation of limber tail and the findings reveal an unexpectedly high illness burden. Anecdotally, accepted risk factors have been confirmed and the extent of their impact has been quantified. Identifying latitude and a potential underlying genetic predisposition suggests avenues for future work on this painful and distressing condition. PMID:27353875

  12. A checklist for evaluating ergonomic risk factors associated with upper extremity cumulative trauma disorders.

    PubMed

    Keyserling, W M; Stetson, D S; Silverstein, B A; Brouwer, M L

    1993-07-01

    A two-page checklist for determining the presence of ergonomic risk factors associated with the development of upper extremity cumulative trauma disorders (e.g., repetitiveness, local mechanical contact stresses, forceful manual exertions, awkward postures, and hand tool usage) was developed and evaluated as part of a joint labour-management ergonomics intervention programme. This checklist was used by plant personnel at four work sites to assess the presence of upper extremity risk factors in 335 manufacturing and warehouse jobs. In addition, results generated by the checklist were compared to the results of ergonomic analyses performed by persons with advanced training (Masters degree) in occupational ergonomics for a subset of 51 jobs. Most of the jobs included in the survey were found to have significant exposures to upper extremity risk factors. Awkward work postures were common, with 90% of the jobs requiring wrist deviations outside the neutral range-of-motion. The jobs were also highly repetitive and frequently required workers to exert high hand forces. Results generated by the checklist were generally in agreement with results generated by the ergonomic analysts; however, the checklist was found to be more sensitive in identifying the presence of risk factors. The checklist was found to be an effective rapid-screening instrument for identifying jobs that expose workers to potentially harmful ergonomic stresses. However, the checklist methodology did not include sufficient documentation of work methods to identify specific job attributes associated with these exposures. PMID:8339720

  13. When Two Isn't Better than One: Predictors of Early Sexual Activity in Adolescence Using a Cumulative Risk Model

    ERIC Educational Resources Information Center

    Price, Myeshia N.; Hyde, Janet Shibley

    2009-01-01

    This study explored factors that may be associated with early initiation of sexual activity among adolescents. Using the cumulative risk model, we hypothesized that as exposure to risk factors increases, so does the likelihood of early sexual debut. A sample of 273 (53% girls, 90% European American) adolescents was followed longitudinally from age…

  14. Cumulative risk effects for the development of behaviour difficulties in children and adolescents with special educational needs and disabilities.

    PubMed

    Oldfield, Jeremy; Humphrey, Neil; Hebron, Judith

    2015-01-01

    Research has identified multiple risk factors for the development of behaviour difficulties. What have been less explored are the cumulative effects of exposure to multiple risks on behavioural outcomes, with no study specifically investigating these effects within a population of young people with special educational needs and disabilities (SEND). Furthermore, it is unclear whether a threshold or linear risk model better fits the data for this population. The sample included 2660 children and 1628 adolescents with SEND. Risk factors associated with increases in behaviour difficulties over an 18-month period were summed to create a cumulative risk score, with this explanatory variable being added into a multi-level model. A quadratic term was then added to test the threshold model. There was evidence of a cumulative risk effect, suggesting that exposure to higher numbers of risk factors, regardless of their exact nature, resulted in increased behaviour difficulties. The relationship between risk and behaviour difficulties was non-linear, with exposure to increasing risk having a disproportionate and detrimental impact on behaviour difficulties in child and adolescent models. Interventions aimed at reducing behaviour difficulties need to consider the impact of multiple risk variables. Tailoring interventions towards those exposed to large numbers of risks would be advantageous.

  15. Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores Among Urban Youth in the United States*

    PubMed Central

    Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

    2014-01-01

    Background The Institute of Medicine (2012) concluded that we must “strengthen schools as the heart of health.” To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement, and (2) examine cumulative effects of these assets on academic achievement. Methods Participants include 940 students (grades 5 and 6) from 12 schools randomly selected from an urban district. Data include physical assessments, fitness testing, surveys, and district records. Fourteen health indicators were gathered including physical health (eg, body mass index [BMI]), health behaviors (eg, meeting recommendations for fruit/vegetable consumption), family environment (eg, family meals), and psychological well-being (eg, sleep quality). Data were collected 3-6 months prior to standardized testing. Results On average, students reported 7.1 health assets out of 14. Those with more health assets were more likely to be at goal for standardized tests (reading/writing/mathematics), and students with the most health assets were 2.2 times more likely to achieve goal compared with students with the fewest health assets (both p < .001). Conclusions Schools that utilize nontraditional instructional strategies to improve student health may also improve academic achievement, closing equity gaps in both health and academic achievement. PMID:24320151

  16. The role of violent media preference in cumulative developmental risk for violence and general aggression.

    PubMed

    Boxer, Paul; Huesmann, L Rowell; Bushman, Brad J; O'Brien, Maureen; Moceri, Dominic

    2009-03-01

    The impact of exposure to violence in the media on the long-term development and short-term expression of aggressive behavior has been well documented. However, gaps in this literature remain, and in particular the role of violent media exposure in shaping violent and other serious antisocial behavior has not been investigated. Further, studies of violent media effects typically have not sampled from populations with confirmed histories of violent and/or nonviolent antisocial behavior. In this study, we analyzed data on 820 youth, including 390 juvenile delinquents and 430 high school students, to examine the relation of violent media use to involvement in violence and general aggression. Using criterion scores developed through cross-informant modeling of data from self, parent/guardian, and teacher/staff reports, we observed that childhood and adolescent violent media preferences contributed significantly to the prediction of violence and general aggression from cumulative risk totals. Findings represent a new and important direction for research on the role of violent media use in the broader matrix of risk factors for youth violence. PMID:19636754

  17. The role of violent media preference in cumulative developmental risk for violence and general aggression.

    PubMed

    Boxer, Paul; Huesmann, L Rowell; Bushman, Brad J; O'Brien, Maureen; Moceri, Dominic

    2009-03-01

    The impact of exposure to violence in the media on the long-term development and short-term expression of aggressive behavior has been well documented. However, gaps in this literature remain, and in particular the role of violent media exposure in shaping violent and other serious antisocial behavior has not been investigated. Further, studies of violent media effects typically have not sampled from populations with confirmed histories of violent and/or nonviolent antisocial behavior. In this study, we analyzed data on 820 youth, including 390 juvenile delinquents and 430 high school students, to examine the relation of violent media use to involvement in violence and general aggression. Using criterion scores developed through cross-informant modeling of data from self, parent/guardian, and teacher/staff reports, we observed that childhood and adolescent violent media preferences contributed significantly to the prediction of violence and general aggression from cumulative risk totals. Findings represent a new and important direction for research on the role of violent media use in the broader matrix of risk factors for youth violence.

  18. The Role of Violent Media Preference in Cumulative Developmental Risk for Violence and General Aggression

    PubMed Central

    Huesmann, L. Rowell; Bushman, Brad J.; O'Brien, Maureen; Moceri, Dominic

    2015-01-01

    The impact of exposure to violence in the media on the long-term development and short-term expression of aggressive behavior has been well documented. However, gaps in this literature remain, and in particular the role of violent media exposure in shaping violent and other serious antisocial behavior has not been investigated. Further, studies of violent media effects typically have not sampled from populations with confirmed histories of violent and/or nonviolent antisocial behavior. In this study, we analyzed data on 820 youth, including 390 juvenile delinquents and 430 high school students, to examine the relation of violent media use to involvement in violence and general aggression. Using criterion scores developed through cross-informant modeling of data from self, parent/guardian, and teacher/staff reports, we observed that childhood and adolescent violent media preferences contributed significantly to the prediction of violence and general aggression from cumulative risk totals. Findings represent a new and important direction for research on the role of violent media use in the broader matrix of risk factors for youth violence. PMID:19636754

  19. Predictors of re-entry into the child protection system in Singapore: a cumulative ecological-transactional risk model.

    PubMed

    Li, Dongdong; Chu, Chi Meng; Ng, Wei Chern; Leong, Wai

    2014-11-01

    This study examines the risk factors of re-entry for 1,750 child protection cases in Singapore using a cumulative ecological-transactional risk model. Using administrative data, the present study found that the overall percentage of Child Protection Service (CPS) re-entry in Singapore is 10.5% based on 1,750 cases, with a range from 3.9% (within 1 year) to 16.5% (within 8 years after case closure). One quarter of the re-entry cases were observed to occur within 9 months from case closure. Seventeen risk factors, as identified from the extant literature, were tested for their utility to predict CPS re-entry in this study using a series of Cox regression analyses. A final list of seven risk factors (i.e., children's age at entry, case type, case closure result, duration of case, household income, family size, and mother's employment status) was used to create a cumulative risk score. The results supported the cumulative risk model in that higher risk score is related to higher risk of CPS re-entry. Understanding the prevalence of CPS re-entry and the risk factors associated with re-entry is the key to informing practice and policy in a culturally relevant way. The results from this study could then be used to facilitate critical case management decisions in order to enhance positive outcomes of families and children in Singapore's care system.

  20. Cumulative Risk, Negative Emotionality, and Emotion Regulation as Predictors of Social Competence in Transition to School: A Mediated Moderation Model

    ERIC Educational Resources Information Center

    Chang, Hyein; Shelleby, Elizabeth C.; Cheong, JeeWon; Shaw, Daniel S.

    2012-01-01

    The goals of this study were to examine the additive and interactive effects of cumulative risk and child negative emotionality on children's social competence in the transition from preschool to school and to test whether these associations were mediated by child emotion regulation within a sample of 310 low-income, ethnically diverse boys.…

  1. Barriers to Success in Parent Training for Young Children with Developmental Delay: The Role of Cumulative Risk

    ERIC Educational Resources Information Center

    Bagner, Daniel M.; Graziano, Paulo A.

    2013-01-01

    The purpose of this study was to examine the effect of cumulative risk on dropout and treatment outcome in parent training. Participants were 44 families of young children (mean age of 49.59 months) who presented with elevated externalizing behavior problems and developmental delay or borderline developmental delay. All families were offered to…

  2. (BOSC) DOSE-RESPONSE MODELING FOR THE ASSESSMENT OF CUMULATIVE RISK DUE TO EXPOSURE TO N-METHYL CARBAMATE PRESTICIDES

    EPA Science Inventory

    THE US EPA'S N-METHYL CARBAMATE CUMULATIVE RISK ASSESSMENT (NMCRA) ASSESSES THE EFFECT ON ACETYLCHOLINE ESTERASE (AChE) ACTIVITY OF EXPOSURE TO 10 N-METHLY CARBAMATE (NMC)PESTICIDES THROUGH DIETARY, DRINKING WATER, AND RESIDENTIAL EXPOSURES. THESE DATA THUS INFORM, BUT DO NOT COM...

  3. Benchmark Dose Analysis from Multiple Datasets: The Cumulative Risk Assessment for the N-Methyl Carbamate Pesticides

    EPA Science Inventory

    The US EPA’s N-Methyl Carbamate (NMC) Cumulative Risk assessment was based on the effect on acetylcholine esterase (AChE) activity of exposure to 10 NMC pesticides through dietary, drinking water, and residential exposures, assuming the effects of joint exposure to NMCs is dose-...

  4. Risk perceptions and health behavior

    PubMed Central

    Ferrer, Rebecca; Klein, William M

    2015-01-01

    Risk perceptions – or an individual’s perceived susceptibility to a threat – are a key component of many health behavior change theories. Risk perceptions are often targeted in health behavior change interventions, and recent meta-analytic evidence suggests that interventions that successfully engage and change risk perceptions produce subsequent increases in health behaviors. Here, we review recent literature on risk perceptions and health behavior, including research on the formation of risk perceptions, types of risk perceptions (including deliberative, affective, and experiential), accuracy of risk perceptions, and associations and interactions among types of risk perceptions. Taken together, existing research suggests that disease risk perceptions are a critical determinant of health behavior, although the nature of the association among risk perceptions and health behavior may depend on the profile of different types of risk perceptions and the accuracy of such perceptions. PMID:26258160

  5. Cumulative biomedical risk and social cognition in the second year of life: prediction and moderation by responsive parenting.

    PubMed

    Wade, Mark; Madigan, Sheri; Akbari, Emis; Jenkins, Jennifer M

    2015-01-01

    At 18 months, children show marked variability in their social-cognitive skill development, and the preponderance of past research has focused on constitutional and contextual factors in explaining this variability. Extending this literature, the current study examined whether cumulative biomedical risk represents another source of variability in social cognition at 18 months. Further, we aimed to determine whether responsive parenting moderated the association between biomedical risk and social cognition. A prospective community birth cohort of 501 families was recruited at the time of the child's birth. Cumulative biomedical risk was measured as a count of 10 prenatal/birth complications. Families were followed up at 18 months, at which point social-cognitive data was collected on children's joint attention, empathy, cooperation, and self-recognition using previously validated tasks. Concurrently, responsive maternal behavior was assessed through observational coding of mother-child interactions. After controlling for covariates (e.g., age, gender, child language, socioeconomic variables), both cumulative biomedical risk and maternal responsivity significantly predicted social cognition at 18 months. Above and beyond these main effects, there was also a significant interaction between biomedical risk and maternal responsivity, such that higher biomedical risk was significantly associated with compromised social cognition at 18 months, but only in children who experienced low levels of responsive parenting. For those receiving comparatively high levels of responsive parenting, there was no apparent effect of biomedical risk on social cognition. This study shows that cumulative biomedical risk may be one source of inter-individual variability in social cognition at 18 months. However, positive postnatal experiences, particularly high levels of responsive parenting, may protect children against the deleterious effects of these risks on social cognition.

  6. Cumulative biomedical risk and social cognition in the second year of life: prediction and moderation by responsive parenting

    PubMed Central

    Wade, Mark; Madigan, Sheri; Akbari, Emis; Jenkins, Jennifer M.

    2015-01-01

    At 18 months, children show marked variability in their social-cognitive skill development, and the preponderance of past research has focused on constitutional and contextual factors in explaining this variability. Extending this literature, the current study examined whether cumulative biomedical risk represents another source of variability in social cognition at 18 months. Further, we aimed to determine whether responsive parenting moderated the association between biomedical risk and social cognition. A prospective community birth cohort of 501 families was recruited at the time of the child’s birth. Cumulative biomedical risk was measured as a count of 10 prenatal/birth complications. Families were followed up at 18 months, at which point social-cognitive data was collected on children’s joint attention, empathy, cooperation, and self-recognition using previously validated tasks. Concurrently, responsive maternal behavior was assessed through observational coding of mother–child interactions. After controlling for covariates (e.g., age, gender, child language, socioeconomic variables), both cumulative biomedical risk and maternal responsivity significantly predicted social cognition at 18 months. Above and beyond these main effects, there was also a significant interaction between biomedical risk and maternal responsivity, such that higher biomedical risk was significantly associated with compromised social cognition at 18 months, but only in children who experienced low levels of responsive parenting. For those receiving comparatively high levels of responsive parenting, there was no apparent effect of biomedical risk on social cognition. This study shows that cumulative biomedical risk may be one source of inter-individual variability in social cognition at 18 months. However, positive postnatal experiences, particularly high levels of responsive parenting, may protect children against the deleterious effects of these risks on social cognition. PMID

  7. Cumulative risk across family stressors: short- and long-term effects for adolescents.

    PubMed

    Forehand, R; Biggar, H; Kotchick, B A

    1998-04-01

    This study examined the relationship between number of family risk factors during adolescence and three areas of psychosocial adjustment (internalizing problems, externalizing problems, and academic achievement) in adolescence and 6 years later in young adulthood. Risk factors examined included parental divorce, interparental conflict, maternal physical health problems, maternal depressive mood, and mother-adolescent relationship difficulties. The findings indicated both concurrent and long-term associations between number of family risk factors and psychosocial adjustment; however, the results differed based on area of adjustment examined and whether concurrent or longitudinal data were considered. Furthermore, a steep increase in adjustment difficulties occurred when number of risk factors increased from three to four. The results are discussed in the framework of four hypotheses which were tested, and clinical implications are delineated.

  8. Phthalate metabolites in urine of Chinese young adults: Concentration, profile, exposure and cumulative risk assessment.

    PubMed

    Gao, Chong-Jing; Liu, Li-Yan; Ma, Wan-Li; Ren, Nan-Qi; Guo, Ying; Zhu, Ning-Zheng; Jiang, Ling; Li, Yi-Fan; Kannan, Kurunthachalam

    2016-02-01

    Phthalates are widely used in consumer products. People are frequently exposed to phthalates due to their applications in daily life. In this study, 14 phthalate metabolites were analyzed in 108 urine samples collected from Chinese young adults using high-performance liquid chromatography-tandem mass spectrometry. The total concentrations of 14 phthalate metabolites ranged from 71.3 to 2670 ng/mL, with the geometric mean concentration of 306 ng/mL. mBP and miBP were the two most abundant compounds, accounting for 48% of the total concentrations. Principal component analysis suggested two major sources of phthalates: one dominated by the DEHP metabolites and one by the group of mCPP, mBP and miBP metabolites. The estimated daily intakes of DMP, DEP, DBP, DiBP and DEHP were 1.68, 2.14, 4.12, 3.52 and 1.26-2.98 μg/kg-bw/day, respectively. In a sensitivity analysis, urinary concentration and body weight were the most influential variables for human exposure estimation. Furthermore, cumulative risk for hazard quotient (HQ) and hazard index (HI) were evaluated. Nearly half of Chinese young adults had high HI values exceeding the safe threshold. This is the first study on the occurrence and human exposure to urinary phthalate metabolites with Chinese young adults.

  9. Metals in residential soils and cumulative risk assessment in Yaqui and Mayo agricultural valleys, northern Mexico.

    PubMed

    Meza-Montenegro, Maria M; Gandolfi, A Jay; Santana-Alcántar, María Ernestina; Klimecki, Walter T; Aguilar-Apodaca, María Guadalupe; Del Río-Salas, Rafael; De la O-Villanueva, Margarita; Gómez-Alvarez, Agustín; Mendivil-Quijada, Héctor; Valencia, Martín; Meza-Figueroa, Diana

    2012-09-01

    This investigation examines the extent of soil metal pollution associated with the Green Revolution, relative to agricultural activities and associated risks to health in the most important agricultural region of Mexico. Metal contents in bulk soil samples are commonly used to assess contamination, and metal accumulations in soils are usually assumed to increase with decreasing particle size. This study profiled the spatial distribution of metals (Ni, Cr, Pb, Cu, Fe, Cd, V, Hg, Co, P, Se, and Mn) in bulk soil and fine-grained fractions (soil-derived dust) from 22 towns and cities. The contamination of soil was assessed through the use of a geoaccumulation index (Igeo) and pollution index (PI). The results of this study indicated that a number of towns and cities are moderately to highly polluted by soil containing Be, Co, Hg, P, S, V, Zn, Se, Cr, and Pb in both size fractions (coarse and fine). Hazard index in fine fraction (HI(children)=2.1) shows that risk assessment based on Co, Mn, V, and Ni spatially related to power plants, have the potential to pose health risks to local residents, especially children. This study shows that risk assessment based on metal content in bulk soil could be overestimated when compared to fine-grained fraction. Our results provide important information that could be valuable in establishing risk assessment associated with residential soils within agricultural areas, where children can ingest and inhale dust.

  10. Early Educational Intervention, Early Cumulative Risk, and the Early Home Environment as Predictors of Young Adult Outcomes within a High-Risk Sample

    ERIC Educational Resources Information Center

    Pungello, Elizabeth P.; Kainz, Kirsten; Burchinal, Margaret; Wasik, Barbara H.; Sparling, Joseph J.; Ramey, Craig T.; Campbell, Frances A.

    2010-01-01

    The extent to which early educational intervention, early cumulative risk, and the early home environment were associated with young adult outcomes was investigated in a sample of 139 young adults (age 21) from high-risk families enrolled in randomized trials of early intervention. Positive effects of treatment were found for education attainment,…

  11. Cumulative risk of false positive test in relation to breast symptoms in mammography screening: a historical prospective cohort study.

    PubMed

    Singh, Deependra; Pitkäniemi, Janne; Malila, Nea; Anttila, Ahti

    2016-09-01

    Mammography has been found effective as the primary screening test for breast cancer. We estimated the cumulative probability of false positive screening test results with respect to symptom history reported at screen. A historical prospective cohort study was done using individual screening data from 413,611 women aged 50-69 years with 2,627,256 invitations for mammography screening between 1992 and 2012 in Finland. Symptoms (lump, retraction, and secretion) were reported at 56,805 visits, and 48,873 visits resulted in a false positive mammography result. Generalized linear models were used to estimate the probability of at least one false positive test and true positive at screening visits. The estimates were compared among women with and without symptoms history. The estimated cumulative probabilities were 18 and 6 % for false positive and true positive results, respectively. In women with a history of a lump, the cumulative probabilities of false positive test and true positive were 45 and 16 %, respectively, compared to 17 and 5 % with no reported lump. In women with a history of any given symptom, the cumulative probabilities of false positive test and true positive were 38 and 13 %, respectively. Likewise, women with a history of a 'lump and retraction' had the cumulative false positive probability of 56 %. The study showed higher cumulative risk of false positive tests and more cancers detected in women who reported symptoms compared to women who did not report symptoms at screen. The risk varies substantially, depending on symptom types and characteristics. Information on breast symptoms influences the balance of absolute benefits and harms of screening. PMID:27496148

  12. Cumulative risk of false positive test in relation to breast symptoms in mammography screening: a historical prospective cohort study.

    PubMed

    Singh, Deependra; Pitkäniemi, Janne; Malila, Nea; Anttila, Ahti

    2016-09-01

    Mammography has been found effective as the primary screening test for breast cancer. We estimated the cumulative probability of false positive screening test results with respect to symptom history reported at screen. A historical prospective cohort study was done using individual screening data from 413,611 women aged 50-69 years with 2,627,256 invitations for mammography screening between 1992 and 2012 in Finland. Symptoms (lump, retraction, and secretion) were reported at 56,805 visits, and 48,873 visits resulted in a false positive mammography result. Generalized linear models were used to estimate the probability of at least one false positive test and true positive at screening visits. The estimates were compared among women with and without symptoms history. The estimated cumulative probabilities were 18 and 6 % for false positive and true positive results, respectively. In women with a history of a lump, the cumulative probabilities of false positive test and true positive were 45 and 16 %, respectively, compared to 17 and 5 % with no reported lump. In women with a history of any given symptom, the cumulative probabilities of false positive test and true positive were 38 and 13 %, respectively. Likewise, women with a history of a 'lump and retraction' had the cumulative false positive probability of 56 %. The study showed higher cumulative risk of false positive tests and more cancers detected in women who reported symptoms compared to women who did not report symptoms at screen. The risk varies substantially, depending on symptom types and characteristics. Information on breast symptoms influences the balance of absolute benefits and harms of screening.

  13. Cumulative Risk Assessment and Environmental Equity in Air Permitting: Interpretation, Methods, Community Participation and Implementation of a Unique Statute

    PubMed Central

    Ellickson, Kristie M.; Sevcik, Sarah M.; Burman, Shelley; Pak, Steven; Kohlasch, Frank; Pratt, Gregory C.

    2011-01-01

    In 2008, the statute authorizing the Minnesota Pollution Control Agency (MPCA) to issue air permits was amended to include a unique requirement to analyze and consider “cumulative levels and effects of past and current environmental pollution from all sources on the environment and residents of the geographic area within which the facility’s emissions are likely to be deposited.” Data describing the Statute Area suggest it is challenged by environmental and socioeconomic concerns, i.e., concerns which are often described by the phrase ‘environmental equity’. With input from diverse stakeholders, the MPCA developed a methodology for implementing a cumulative levels and effects analysis when issuing air permits in the designated geographic area. A Process Document was created defining explicit steps a project proposer must complete in the analysis. An accompanying Reference Document compiles all available environmental health data relevant to the Statute Area that could be identified. The final cumulative levels and effects methodology is organized by health endpoint and identifies hazard, exposure and health indices that require further evaluation. The resulting assessment is summarized and presented to decision makers for consideration in the regulatory permitting process. We present a description of the methodology followed by a case study summary of the first air permit processed through the “cumulative levels and effects analysis”. PMID:22163199

  14. Cumulative risk assessment and environmental equity in air permitting: interpretation, methods, community participation and implementation of a unique statute.

    PubMed

    Ellickson, Kristie M; Sevcik, Sarah M; Burman, Shelley; Pak, Steven; Kohlasch, Frank; Pratt, Gregory C

    2011-11-01

    In 2008, the statute authorizing the Minnesota Pollution Control Agency (MPCA) to issue air permits was amended to include a unique requirement to analyze and consider "cumulative levels and effects of past and current environmental pollution from all sources on the environment and residents of the geographic area within which the facility's emissions are likely to be deposited." Data describing the Statute Area suggest it is challenged by environmental and socioeconomic concerns, i.e., concerns which are often described by the phrase 'environmental equity'. With input from diverse stakeholders, the MPCA developed a methodology for implementing a cumulative levels and effects analysis when issuing air permits in the designated geographic area. A Process Document was created defining explicit steps a project proposer must complete in the analysis. An accompanying Reference Document compiles all available environmental health data relevant to the Statute Area that could be identified. The final cumulative levels and effects methodology is organized by health endpoint and identifies hazard, exposure and health indices that require further evaluation. The resulting assessment is summarized and presented to decision makers for consideration in the regulatory permitting process. We present a description of the methodology followed by a case study summary of the first air permit processed through the "cumulative levels and effects analysis".

  15. Relations of Growth in Effortful Control to Family Income, Cumulative Risk, and Adjustment in Preschool-age Children

    PubMed Central

    Lengua, Liliana J.; Moran, Lyndsey; Zalewski, Maureen; Ruberry, Erika; Kiff, Cara; Thompson, Stephanie

    2014-01-01

    The study examined growth in effortful control (executive control, delay ability) in relation to income, cumulative risk (aggregate of demographic and psychosocial risk factors), and adjustment in 306 preschool-age children (50% girls, 50% boys) from families representing a range of income (29% at- or near-poverty; 28% lower-income; 25% middle-income; 18% upper-income), with 4 assessments starting at 36–40 mos. Income was directly related to levels of executive control and delay ability. Cumulative risk accounted for the effects of income on delay ability but not executive control. Higher initial executive control and slope of executive control and delay ability predicted academic readiness, whereas levels, but not growth, of executive control and delay ability predicted social competence and adjustment problems. Low income is a marker for lower effortful control, which demonstrates additive or mediating effects in the relation of income to children’s preschool adjustment. PMID:25253079

  16. Cumulative Psychosocial and Medical Risk as Predictors of Early Infant Development and Parenting Stress in an African-American Preterm Sample

    ERIC Educational Resources Information Center

    Candelaria, Margo A.; O'Connell, Melissa A.; Teti, Douglas M.

    2006-01-01

    The present study examined predictive linkages between cumulative psychosocial and medical risk, assessed neonatally, and infant development and parenting stress at 4 months of infant corrected age. Predominantly low-income, African-American mothers and their preterm infants served as participants. Cumulative psychosocial risk predicted early…

  17. Cumulative Small Effect Genetic Markers and the Risk of Colorectal Cancer in Poland, Estonia, Lithuania, and Latvia

    PubMed Central

    Serrano-Fernandez, Pablo; Dymerska, Dagmara; Kurzawski, Grzegorz; Derkacz, Róża; Sobieszczańska, Tatiana; Banaszkiewicz, Zbigniew; Roomere, Hanno; Oitmaa, Eneli; Metspalu, Andres; Janavičius, Ramūnas; Elsakov, Pavel; Razumas, Mindaugas; Petrulis, Kestutis; Irmejs, Arvīds; Miklaševičs, Edvīns; Scott, Rodney J.; Lubiński, Jan

    2015-01-01

    The continued identification of new low-penetrance genetic variants for colorectal cancer (CRC) raises the question of their potential cumulative effect among compound carriers. We focused on 6 SNPs (rs380284, rs4464148, rs4779584, rs4939827, rs6983267, and rs10795668), already described as risk markers, and tested their possible independent and combined contribution to CRC predisposition. Material and Methods. DNA was collected and genotyped from 2330 unselected consecutive CRC cases and controls from Estonia (166 cases and controls), Latvia (81 cases and controls), Lithuania (123 cases and controls), and Poland (795 cases and controls). Results. Beyond individual effects, the analysis revealed statistically significant linear cumulative effects for these 6 markers for all samples except of the Latvian one (corrected P value = 0.018 for the Estonian, corrected P value = 0.0034 for the Lithuanian, and corrected P value = 0.0076 for the Polish sample). Conclusions. The significant linear cumulative effects demonstrated here support the idea of using sets of low-risk markers for delimiting new groups with high-risk of CRC in clinical practice that are not carriers of the usual CRC high-risk markers. PMID:26101521

  18. Plastics and health risks.

    PubMed

    Halden, Rolf U

    2010-01-01

    By 2010, the worldwide annual production of plastics will surpass 300 million tons. Plastics are indispensable materials in modern society, and many products manufactured from plastics are a boon to public health (e.g., disposable syringes, intravenous bags). However, plastics also pose health risks. Of principal concern are endocrine-disrupting properties, as triggered for example by bisphenol A and di-(2-ethylhexyl) phthalate (DEHP). Opinions on the safety of plastics vary widely, and despite more than five decades of research, scientific consensus on product safety is still elusive. This literature review summarizes information from more than 120 peer-reviewed publications on health effects of plastics and plasticizers in lab animals and humans. It examines problematic exposures of susceptible populations and also briefly summarizes adverse environmental impacts from plastic pollution. Ongoing efforts to steer human society toward resource conservation and sustainable consumption are discussed, including the concept of the 5 Rs--i.e., reduce, reuse, recycle, rethink, restrain--for minimizing pre- and postnatal exposures to potentially harmful components of plastics.

  19. Unraveling the Link between Trauma and Male Delinquency: The Cumulative Versus Differential Risk Perspectives

    ERIC Educational Resources Information Center

    Maschi, Tina

    2006-01-01

    This study examined how the cumulative (additive) versus differential (individual) effects of trauma influenced male delinquency. Using a comprehensive measure of trauma, a secondary data analysis was conducted on a nationally representative sample of male youths between the ages of 12 and 17. Logistic regression analyses revealed that all three…

  20. Exploration Health Risks: Probabilistic Risk Assessment

    NASA Technical Reports Server (NTRS)

    Rhatigan, Jennifer; Charles, John; Hayes, Judith; Wren, Kiley

    2006-01-01

    Maintenance of human health on long-duration exploration missions is a primary challenge to mission designers. Indeed, human health risks are currently the largest risk contributors to the risks of evacuation or loss of the crew on long-duration International Space Station missions. We describe a quantitative assessment of the relative probabilities of occurrence of the individual risks to human safety and efficiency during space flight to augment qualitative assessments used in this field to date. Quantitative probabilistic risk assessments will allow program managers to focus resources on those human health risks most likely to occur with undesirable consequences. Truly quantitative assessments are common, even expected, in the engineering and actuarial spheres, but that capability is just emerging in some arenas of life sciences research, such as identifying and minimize the hazards to astronauts during future space exploration missions. Our expectation is that these results can be used to inform NASA mission design trade studies in the near future with the objective of preventing the higher among the human health risks. We identify and discuss statistical techniques to provide this risk quantification based on relevant sets of astronaut biomedical data from short and long duration space flights as well as relevant analog populations. We outline critical assumptions made in the calculations and discuss the rationale for these. Our efforts to date have focussed on quantifying the probabilities of medical risks that are qualitatively perceived as relatively high risks of radiation sickness, cardiac dysrhythmias, medically significant renal stone formation due to increased calcium mobilization, decompression sickness as a result of EVA (extravehicular activity), and bone fracture due to loss of bone mineral density. We present these quantitative probabilities in order-of-magnitude comparison format so that relative risk can be gauged. We address the effects of

  1. Health Risks of Nuclear Power.

    ERIC Educational Resources Information Center

    Cohen, Bernard L.

    1978-01-01

    Deals with the wastes generated in nuclear power plants and the health risks involved as compared to those of wastes generated by coal-fired plants. Concludes that the risks of nuclear power plants are many times smaller than the risks from alternative energy resources. (GA)

  2. Health risks in perspective: Judging health risks of energy technologies

    SciTech Connect

    Rowe, M.D.

    1992-09-18

    Almost daily, Americans receive reports from the mass news media about some new and frightening risk to health and welfare. Most such reports emphasize the newsworthiness of the risks -- the possibility of a crisis, disagreements among experts, how things happened, who is responsible for fixing them, how much will it cost, conflict among parties involved, etc. As a rule, the magnitudes of the risks, or the difficulty of estimating those magnitudes, have limited newsworthiness, and so they are not mentioned. Because of this emphasis in the news media, most people outside the risk assessment community must judge the relative significance of the various risks to which we all are exposed with only that information deemed newsworthy by reporters. This information is biased and shows risks in isolation. There is no basis for understanding and comparing the relative importance of risks among themselves, or for comparing one risk, perhaps a new or newly-discovered one, in the field of all risks. The purpose of this report is to provide perspective on the various risks to which we are routinely exposed. It serves as a basis for understanding the meaning of quantitative risk estimates and for comparing new or newly-discovered risks with other, better-understood risks. Specific emphasis is placed on health risks of energy technologies.

  3. Health Risk of Radon

    MedlinePlus

    ... menu Learn the Issues Air Chemicals and Toxics Climate Change Emergencies Greener Living Health and Safety Land and Cleanup Pesticides Waste Water Science & Technology Air Climate Change Ecosystems Health Land, Waste and Cleanup Pesticides Substances ...

  4. METHODOLOGY FOR THE EVALUATION OF CUMULATIVE EPISODIC EXPOSURE TO CHEMICAL STRESSORS IN AQUATIC RISK ASSESSMENT.

    EPA Science Inventory

    An ecological risk assessment method was developed to evaluate the magnitude, duration, and episodic nature of chemical stressors on aquatic communities. The percent of an ecosystem's species at risk from a designated chemical exposure scenario is generated. In effects assessment...

  5. Contested Cumulations:

    PubMed Central

    Pickstone, John V.

    2007-01-01

    Summary The treatment of cancer through the twentieth century may be seen as the successive addition of modalities: first surgery; then radiotherapy, especially between the world wars; and then chemotherapy, from the 1960s. This paper explores some of the systematic differences between the modalities, and how these additions were negotiated in different countries, with different long-term consequences for the development of services and specialization. It focuses chiefly on the United Kingdom and the United States, the former exemplifying a centralized health polity, and the latter, liberal markets combined with large and crucial postwar inputs from government. The differences between health polities were especially important for interwar radiotherapy, which in its centralized form appeared as paradigmatic of the analytical/rationalizing mode in modern medicine. Chemotherapy exemplified a more inventive and experimentalist mode that became common after World War II, and that, through the practice of trials, shaped the new subprofession of medical oncology. The interactions of the modalities, at various levels, are modeled as contested cumulations showing strong path dependency. The paper ends by reviewing the present situation, especially for Britain, and by underlining the relevance of history. PMID:17369667

  6. Health Security and Risk Aversion.

    PubMed

    Herington, Jonathan

    2016-09-01

    Health security has become a popular way of justifying efforts to control catastrophic threats to public health. Unfortunately, there has been little analysis of the concept of health security, nor the relationship between health security and other potential aims of public health policy. In this paper I develop an account of health security as an aversion to risky policy options. I explore three reasons for thinking risk avoidance is a distinctly worthwhile aim of public health policy: (i) that security is intrinsically valuable, (ii) that it is necessary for social planning and (iii) that it is an appropriate response to decision-making in contexts of very limited information. Striking the right balance between securing and maximizing population health thus requires a substantive, and hitherto unrecognized, value judgment. Finally, I critically evaluate the current health security agenda in light of this new account of the concept and its relationship to the other aims of public health policy. PMID:26990349

  7. Health Security and Risk Aversion.

    PubMed

    Herington, Jonathan

    2016-09-01

    Health security has become a popular way of justifying efforts to control catastrophic threats to public health. Unfortunately, there has been little analysis of the concept of health security, nor the relationship between health security and other potential aims of public health policy. In this paper I develop an account of health security as an aversion to risky policy options. I explore three reasons for thinking risk avoidance is a distinctly worthwhile aim of public health policy: (i) that security is intrinsically valuable, (ii) that it is necessary for social planning and (iii) that it is an appropriate response to decision-making in contexts of very limited information. Striking the right balance between securing and maximizing population health thus requires a substantive, and hitherto unrecognized, value judgment. Finally, I critically evaluate the current health security agenda in light of this new account of the concept and its relationship to the other aims of public health policy.

  8. APPROACHES FOR INCORPORATING NON-CHEMICAL STRESSORS INTO CUMULATIVE RISK ASSESSMENTS

    EPA Science Inventory

    Over the past twenty years, the risk assessment paradigm has gradually shifted from an individual chemical approach to a community-based model. Inherent in community-based risk assessment is consideration of the totality of stressors affecting a defined population including both ...

  9. Cumulative Effects of Mothers' Risk and Promotive Factors on Daughters' Disruptive Behavior

    ERIC Educational Resources Information Center

    van der Molen, Elsa; Hipwell, Alison E.; Vermeiren, Robert; Loeber, Rolf

    2012-01-01

    Little is known about the ways in which the accumulation of maternal factors increases or reduces risk for girls' disruptive behavior during preadolescence. In the current study, maternal risk and promotive factors and the severity of girls' disruptive behavior were assessed annually among girls' ages 7-12 in an urban community sample (N = 2043).…

  10. Measuring the Combined Risk to Young Children's Cognitive Development: An Alternative to Cumulative Indices

    ERIC Educational Resources Information Center

    Hall, James E.; Sammons, Pam; Sylva, Kathy; Melhuish, Edward; Taggart, Brenda; Siraj-Blatchford, Iram; Smees, Rebecca

    2010-01-01

    In studies of child development, the combined effect of multiple risks acting in unison has been represented in a variety of ways. This investigation builds upon this preceding work and presents a new procedure for capturing the combined effect of multiple risks. A representative sample of 2,899 British children had their cognitive development…

  11. Cumulative Risk for Early Sexual Initiation among American Indian Youth: A Discrete-Time Survival Analysis

    ERIC Educational Resources Information Center

    Mitchell, Christina M.; Whitesell, Nancy Rumbaugh; Spicer, Paul; Beals, Janette; Kaufman, Carol E.

    2007-01-01

    Approximately 3 million teens are diagnosed with a sexually transmitted disease (STD) annually; STDs rates for American Indian young adults are among the highest of any racial/ethnic group. An important risk factor for STDs is early initiation of sex. In this study, we examined risk for early initiation with 474 American Indian youth ages 14-18,…

  12. Children of Incarcerated Parents: Cumulative Risk and Children's Living Arrangements. JCPR Working Paper.

    ERIC Educational Resources Information Center

    Johnson, Elizabeth Inez; Waldfogel, Jane

    This paper examines risk factors that exist in the lives of incarcerated parents and their children, focusing on the living arrangements of the children. It uses data from the 1997 Survey of Inmates in State and Federal Correctional Facilities to address three issues: risk factors present in the lives of incarcerated parents and their children,…

  13. Unknown age in health disorders: A method to account for its cumulative effect and an application to feline viruses interactions.

    PubMed

    Hellard, Eléonore; Pontier, Dominique; Siberchicot, Aurélie; Sauvage, Frank; Fouchet, David

    2015-06-01

    Parasite interactions have been widely evidenced experimentally but field studies remain rare. Such studies are essential to detect interactions of interest and access (co)infection probabilities but face methodological obstacles. Confounding factors can create statistical associations, i.e. false parasite interactions. Among them, host age is a crucial covariate. It influences host exposition and susceptibility to many infections, and has a mechanical effect, older individuals being more at risk because of a longer exposure time. However, age is difficult to estimate in natural populations. Hence, one should be able to deal at least with its cumulative effect. Using a SI type dynamic model, we showed that the cumulative effect of age can generate false interactions theoretically (deterministic modeling) and with a real dataset of feline viruses (stochastic modeling). The risk to wrongly conclude to an association was maximal when parasites induced long-lasting antibodies and had similar forces of infection. We then proposed a method to correct for this effect (and for other potentially confounding shared risk factors) and made it available in a new R package, Interatrix. We also applied the correction to the feline viruses. It offers a way to account for an often neglected confounding factor and should help identifying parasite interactions in the field, a necessary step towards a better understanding of their mechanisms and consequences. PMID:25979281

  14. Cumulative coffee consumption and reduced risk of oral and oropharyngeal cancer.

    PubMed

    Biazevic, Maria Gabriela Haye; Toporcov, Tatiana Natasha; Antunes, José Leopoldo Ferreira; Rotundo, Ligia Drovandi Braga; Brasileiro, Rosana Sarmento; de Carvalho, Marcos Brasilino; de Góis Filho, José Francisco; Kowalski, Luiz Paulo

    2011-01-01

    We examined the association between coffee consumption and oral cancer in a hospital-based case-control study comprising 143 patients with oral and oropharyngeal squamous cell carcinoma attended at 3 major hospitals in Sao Paulo, Brazil, and 240 controls without cancer, recruited from outpatient units of the same hospitals and matched with cases by sex and age. Associations were assessed by multivariate logistic regression conditioned on sociodemographic and behavioral characteristics. Tobacco smoking, alcohol drinking, and higher intake of bacon and deep-fried foods were directly related to disease; the inverse was observed to family income and salad intake. Coffee consumption and tobacco smoking were partially correlated (Spearman correlation coefficient 0.14 among cases, 0.31 among controls). When adjusted for all covariates, a cumulative coffee consumption higher than 18.0 daily liters × year during lifetime was indicated to be protective against disease (adjusted odds ratio 0.39, 95% confidence interval 0.16-0.94, P = 0.037). This observation may have pharmacological implications for clinical medication of these cancers and is relevant to programs aimed at reducing the burden of disease.

  15. Rethinking cumulative exposure in epidemiology, again.

    PubMed

    de Vocht, Frank; Burstyn, Igor; Sanguanchaiyakrit, Nuthchyawach

    2015-01-01

    The use of cumulative exposure, the product of intensity and duration, has enjoyed great popularity in epidemiology of chronic diseases despite numerous known caveats in its interpretation. We briefly review the history of use of cumulative exposure in epidemiology and propose an alternative method for relating time-integrated exposures to health risks. We argue, as others before us have, that cumulative exposure metrics obscures the interplay of exposure intensity and duration. We propose to use a computationally simple alternative in which duration and intensity of exposure are modelled as a main effect and their interaction, cumulative exposure, only be added if there is evidence of deviation from this additive model. We also consider the Lubin-Caporaso model of interplay of exposure intensity and duration. The impact of measurement error in intensity on model selection was also examined. The value of this conceptualization is demonstrated using a simulation study and further illustrated in the context of respiratory health and occupational exposure to latex dust. We demonstrate why cumulative exposure has been so popular because the cumulative exposure metric per se gives a robust answer to the existence of an association, regardless of the underlying true mechanism of disease. Treating cumulative exposure as the interaction of main effects of exposure duration and intensity enables epidemiologists to derive more information about mechanism of disease then fitting cumulative exposure metric by itself, and without the need to collect additional data. We propose that the practice of fitting duration, intensity and cumulative exposure separately to epidemiologic data should lead to conceptualization of cumulative exposure as interaction of main effects of duration and intensity of exposure. PMID:25138292

  16. An Overview of Measurement Method Tools Available to Communities for Conducting Exposure and Cumulative Risk Assessments

    EPA Science Inventory

    Community-based programs for assessing and mitigating nvironmental risks represent a challenge to participants because each brings a different level of understanding of the issues affecting the community. These programs often require the collaboration of several community sectors...

  17. Grouping of Diverse Stressors for Cumulative Risk Analysis (CRA) by Media, Time and Toxicity

    EPA Science Inventory

    CRAs may address multiple chemical, physical, biological or psychosocial stressors. Approaches for grouping diverse stressors prior to risk analysis can simplify some complexities associated with CRAs. For CRAs involving chemical mixtures, this entails developing CRA exposure gr...

  18. The risk of cumulative radiation exposure in chest imaging and the advantage of bedside ultrasound.

    PubMed

    Gargani, Luna; Picano, Eugenio

    2015-01-01

    The increasing use and complexity of imaging techniques have not been matched by increasing awareness and knowledge by prescribers and practitioners. Imaging examinations that expose to ionizing radiation provide immense benefits when appropriate, yet they may result in an increased incidence of radiation-induced cancer in the long-term. The radiation issue is relevant not only for the individual patient but also for the community because small individual risks multiplied by millions of examinations become a significant population risk. As recently highlighted by recent European and American Guidelines, the long-term risk associated with radiation exposure should be considered in the risk-benefit assessment behind appropriate prescription of diagnostic testing. PMID:25883779

  19. The Association between Cumulative Psychosocial Risk and Cervical HPV Infection Among Female Adolescents in a Free Vaccination Program

    PubMed Central

    Linares, Lourdes Oriana; Shankar, Viswanathan; Diaz, Angela; Nucci-Sack, Anne; Strickler, Howard D.; Peake, Ken; Weiss, Jocelyn; Burk, Robert D.; Schlecht, Nicolas F.

    2016-01-01

    Objective This study investigated the association of cervical Human Papillomavirus (HPV) infection with cumulative psychosocial risk reflecting family disadvantage, psychological distress, and unhealthy life style. Methods The sample (N=745) was comprised of sexually-active female adolescent patients (12-19 years), primarily ethnic minorities, enrolled in a free HPV vaccination program. Subjects completed questionnaires and provided cervical swabs for HPV DNA testing. Unweighted and weighted Principal Component Analyses (PCA) for categorical data were used to derive multi-systemic psychosocial risk indices using nine indicators: low socioeconomic status, lack of adult involvement, not attending high-school/college, history of treatment for depression/anxiety, antisocial/delinquent behavior, number of recent sexual partners, use of alcohol, use of drugs, and dependency risk for alcohol/drugs. The association between cervical HPV (any-type, high risk-types, vaccine-types) assayed by polymerase chain reaction and self-reported number of psychosocial risk indicators was estimated using multivariable logistic regression. Results Subjects had a median of three psychosocial risk indicators. Multiple logistic regression analyses showed associations with unweighted and weighted number of psychosocial indicators for HPV any-type (adjusted odds ratio [aOR]=1.1; 95% confidence interval [CI]: 1.0-1.2 ); with the strongest associations between weighted drug/alcohol use, drug/alcohol dependency risk, and antisocial/delinquent behavior and detection of HPV vaccine-types (aOR=1.5; 95%CI: 1.1-2.0) independent of number of recent sexual partners and vaccine dose (0-3). Conclusion Increased HPV infections including HPV vaccine-types were associated with greater number of psychosocial risk indicators even after controlling for demographics, sexual behavior, history of chlamydia, and vaccine dose. PMID:25985216

  20. When two isn't better than one: predictors of early sexual activity in adolescence using a cumulative risk model.

    PubMed

    Price, Myeshia N; Hyde, Janet Shibley

    2009-09-01

    This study explored factors that may be associated with early initiation of sexual activity among adolescents. Using the cumulative risk model, we hypothesized that as exposure to risk factors increases, so does the likelihood of early sexual debut. A sample of 273 (53% girls, 90% European American) adolescents was followed longitudinally from age 13 to 15. The results indicate that, for girls, increased television viewing, low self-esteem, poor parental relationships, living in a non-intact household, higher levels of externalizing behavior (ADHD symptomology), low academic achievement, and parents with low education levels were associated with earlier sexual debut. For boys, advanced pubertal development, increased television viewing, higher rates of externalizing behaviors (ADHD and ODD symptoms), and poor parental relationships were associated with earlier sexual debut. As hypothesized, predictive power increases with the accumulation of these risks; girls are 1.56 times more likely to become sexually active with an increase of only one risk and boys are 1.90 times more likely. PMID:19636771

  1. Establishing sitewide risk perspectives due to cumulative impacts from AB, EP, and NEPA hazard analyses

    SciTech Connect

    Olinger, S.J.; Foppe, T.L.

    1998-06-01

    With the end of the Cold War in 1992, the mission for the Rocky Flats Environmental Technology Site (Site) was changed from production of nuclear weapon components to special nuclear materials (SNM) and waste management, accelerated cleanup, reuse and closure of the Site. This change in mission presents new hazards and risk management challenges. With today`s shrinking DOE budget, a balance needs to be achieved between controlling those hazards related to SNM and waste management and interim storage, and those hazards related to accelerated closure of the Site involving deactivation, decontamination, and decommissioning (DD and D) of surplus nuclear facilities. This paper discusses how risk assessments of normal operations and potential accidents have provided insights on the risks of current operations and planned closure activities.

  2. Do Risk Factors for Problem Behaviour Act in a Cumulative Manner? An Examination of Ethnic Minority and Majority Children through an Ecological Perspective

    ERIC Educational Resources Information Center

    Atzaba-Poria, Naama; Pike, Alison; Deater-Deckard, Kirby

    2004-01-01

    Background: Extensive research has identified risk factors for problem behaviour in childhood. However, most of this research has focused on isolated variables, ignoring possible additive influences. The purpose of this study was to examine whether risk factors for problem behaviour act in a cumulative manner, and to investigate whether cumulative…

  3. Multilevel Mediation: Cumulative Contextual Risk, Maternal Differential Treatment, and Children's Behavior within Families

    ERIC Educational Resources Information Center

    Meunier, Jean Christophe; Boyle, Michael; O'Connor, Thomas G.; Jenkins, Jennifer M.

    2013-01-01

    This study tests the hypothesis that links between contextual risk and children's outcomes are partially explained by differential parenting. Using multi-informant measurement and including up to four children per family (M[subscript age] = 3.51, SD = 2.38) in a sample of 397 families, indirect effects (through maternal differential…

  4. Tsunami, War, and Cumulative Risk in the Lives of Sri Lankan Schoolchildren

    ERIC Educational Resources Information Center

    Catani, Claudia; Gewirtz, Abigail H.; Wieling, Elizabeth; Schauer, Elizabeth; Elbert, Thomas; Neuner, Frank

    2010-01-01

    This study examines the impact of children's exposure to natural disaster against the backdrop of exposure to other traumatic events and psychosocial risks. One thousand three hundred ninety-eight Sri Lankan children aged 9-15 years were interviewed in 4 cross-sectional studies about exposure to traumatic life events related to the war, the…

  5. Cumulative environmental risk in substance abusing women: early intervention, parenting stress, child abuse potential and child development☆

    PubMed Central

    Schuler, Maureen E.; Black, Maureen M.; Kettinger, Laurie; Harrington, Donna

    2011-01-01

    Objective To assess the relationship between cumulative environmental risks and early intervention, parenting attitudes, potential for child abuse and child development in substance abusing mothers. Method We studied 161 substance-abusing women, from a randomized longitudinal study of a home based early intervention, who had custody of their children through 18 months. The intervention group received weekly home visits in the first 6 months and biweekly visits from 6 to 18 months. Parenting stress and child abuse potential were assessed at 6 and 18 months postpartum. Children’s mental and motor development (Bayley MDI and PDI) and language development (REEL) were assessed at 6, 12, and 18 months postpartum. Ten maternal risk factors were assessed: maternal depression, domestic violence, nondomestic violence, family size, incarceration, no significant other in home, negative life events, psychiatric problems, homelessness, and severity of drug use. Level of risk was recoded into four categories (2 or less, 3, 4, and 5 or more), which had adequate cell sizes for repeated measures analysis. Data analysis Repeated measures analyses were run to examine how level of risk and group (intervention or control) were related to parenting stress, child abuse potential, and children’s mental, motor and language development over time. Results Parenting stress and child abuse potential were higher for women with five risks or more compared with women who had four or fewer risks; children’s mental, motor, and language development were not related to level of risk. Children in the intervention group had significantly higher scores on the PDI at 6 and 18 months (107.4 vs. 103.6 and 101.1 vs. 97.2) and had marginally better scores on the MDI at 6 and 12 months (107.7 vs. 104.2 and 103.6 vs. 100.1), compared to the control group. Conclusion Compared to drug-abusing women with fewer than five risks, women with five or more risks found parenting more stressful and indicated greater

  6. Assessing Cumulative Impact and Risk - Approaches at the U.S. Environmental Protection Agency

    EPA Science Inventory

    The U.S. Environmental Protection Agency (EPA) has a mission and regulatory mandate to protect human health and the environment. EPA’s primary role is to implement environmental laws by developing and enforcing national regulation. Cogent to the goals of this workshop, key envi...

  7. Biological risk and occupational health.

    PubMed

    Corrao, Carmela Romana Natalina; Mazzotta, Adele; La Torre, Giuseppe; De Giusti, Maria

    2012-01-01

    Many work activities include hazards to workers, and among these biological risk is particularly important, mostly because of different types of exposure, contact with highly dangerous agents, lack of limit values able to compare all exposures, presence of workers with defective immune systems and therefore more susceptible to the risk. Bioaerosols and dust are considered important vehicles of microganisms at workplaces and interaction with other occupational agents is assumed. Moreover, biological risk can be significant in countries with increasing economic development or particular habits and some biological agents are also classified as carcinogenic to human. Specific emerging biological risks have been recently pointed out by Risk Observatory of the European Agency for Safety and Health at work, and we must consider the worker's attitude and behaviour, influenced by his own perception of risk more than his real knowledge, that could over-underestimate the risk itself. Therefore, biological risk at work requires a complex approach in relation to risk assessment and risk management, made more difficult due to the wide variety of biological agents, working environments and working techniques that can determine the exposures. PMID:22785422

  8. Biological risk and occupational health.

    PubMed

    Corrao, Carmela Romana Natalina; Mazzotta, Adele; La Torre, Giuseppe; De Giusti, Maria

    2012-01-01

    Many work activities include hazards to workers, and among these biological risk is particularly important, mostly because of different types of exposure, contact with highly dangerous agents, lack of limit values able to compare all exposures, presence of workers with defective immune systems and therefore more susceptible to the risk. Bioaerosols and dust are considered important vehicles of microganisms at workplaces and interaction with other occupational agents is assumed. Moreover, biological risk can be significant in countries with increasing economic development or particular habits and some biological agents are also classified as carcinogenic to human. Specific emerging biological risks have been recently pointed out by Risk Observatory of the European Agency for Safety and Health at work, and we must consider the worker's attitude and behaviour, influenced by his own perception of risk more than his real knowledge, that could over-underestimate the risk itself. Therefore, biological risk at work requires a complex approach in relation to risk assessment and risk management, made more difficult due to the wide variety of biological agents, working environments and working techniques that can determine the exposures.

  9. Health risks of energy systems.

    PubMed

    Krewitt, W; Hurley, F; Trukenmüller, A; Friedrich, R

    1998-08-01

    Health risks from fossil, renewable and nuclear reference energy systems are estimated following a detailed impact pathway approach. Using a set of appropriate air quality models and exposure-effect functions derived from the recent epidemiological literature, a methodological framework for risk assessment has been established and consistently applied across the different energy systems, including the analysis of consequences from a major nuclear accident. A wide range of health impacts resulting from increased air pollution and ionizing radiation is quantified, and the transferability of results derived from specific power plants to a more general context is discussed. PMID:9775447

  10. Repeated exposure to high-frequency spanking and child externalizing behavior across the first decade: a moderating role for cumulative risk.

    PubMed

    MacKenzie, Michael J; Nicklas, Eric; Brooks-Gunn, Jeanne; Waldfogel, Jane

    2014-12-01

    This study used the Fragile Families and Child Well-Being Study to examine the effects of repeated exposure to harsh parenting on child externalizing behavior across the first decade of life, and a moderating role for cumulative ecological risk. Maternal report of harsh parenting, defined as high frequency spanking, was assessed at age 1, 3, 5, and 9, along with child externalizing at age 9 (N=2,768). Controlling for gender, race, maternal nativity, and city of residence, we found a cumulative risk index to significantly moderate the effects of repeated harsh parenting on child behavior, with the effects of repeated high-frequency spanking being amplified for those experiencing greater levels of cumulative risk. Harsh parenting, in the form of high frequency spanking, remains a too common experience for children, and results demonstrate that the effects of repeated exposure to harsh parenting across the first decade are amplified for those children already facing the most burden.

  11. The health risk of radon

    SciTech Connect

    Conrath, S.M.; Kolb, L.

    1995-10-01

    Although radon is the second leading cause of lung cancer in the United States, second only to cigarette smoking, many members of the public are not aware that radon is one of the most serious environmental cancer risks in the US. Based on extensive data from epidemiological studies of underground miners, radon has been classified as a known human carcinogen. In contrast to most pollutants, the assessment of human risk from radon is based on human occupational exposure data rather than animal data. That radon causes lung cancer has been well established by the scientific community. More is known about radon than most other cancer causing environmental carcinogens. While there are some uncertainties involved when estimating radon risk to the public, it is important to recognize that the risk information is based on human data and that the uncertainties have been addressed in the risk assessment. The US Environmental Protection Agency (EPA) estimates that the number of annual US lung cancer deaths due to residential radon exposures is approximately 14,000 with an uncertainty range of 7,000 to 30,000. The abundant information on radon health risks that supports EPA`s risk assessment indicates that recommendations for public action by the federal government and other public health organizations constitute prudent public policy.

  12. Resource Asymmetries and Cumulative Advantages: Canadian and US Research Universities and the Field of Global Health

    ERIC Educational Resources Information Center

    Oleksiyenko, Anatoly; Sa, Creso M.

    2010-01-01

    Global health is becoming an important area of inquiry and learning in North American research universities, stemming from on-going and new commitments to the field by multiple governmental and non-governmental agents. External demands for research and education in global health require enhanced inter-disciplinary, inter-sectoral and international…

  13. Understanding the Relation of Low Income to HPA-Axis Functioning in Preschool Children: Cumulative Family Risk and Parenting As Pathways to Disruptions in Cortisol

    PubMed Central

    Lengua, Liliana J.; Kiff, Cara J.; Fisher, Philip A.

    2013-01-01

    This study examined the relation of low income and poverty to cortisol levels, and tested potential pathways from low income to disruptions in cortisol through cumulative family risk and parenting. The sample of 306 mothers and their preschool children included 29 % families at or near poverty, 27 % families below the median income, and the remaining families at middle and upper income. Lower income was related to lower morning cortisol levels, and cumulative risk predicted a flatter diurnal slope, with a significant indirect effect through maternal negativity, suggesting that parenting practices might mediate an allostatic effect on stress physiology. PMID:22528032

  14. Tsunami, war, and cumulative risk in the lives of Sri Lankan schoolchildren.

    PubMed

    Catani, Claudia; Gewirtz, Abigail H; Wieling, Elizabeth; Schauer, Elizabeth; Elbert, Thomas; Neuner, Frank

    2010-01-01

    This study examines the impact of children's exposure to natural disaster against the backdrop of exposure to other traumatic events and psychosocial risks. One thousand three hundred ninety-eight Sri Lankan children aged 9-15 years were interviewed in 4 cross-sectional studies about exposure to traumatic life events related to the war, the tsunami experience, and family violence. Symptoms of posttraumatic stress disorder, somatic complaints, psychosocial functioning, and teacher reports of school grades served as outcome measures. A global outcome variable of "positive adaptation" was created from a combination of these measures. Data showed extensive exposure to adversity and traumatic events among children in Sri Lanka. Findings of regression analyses indicated that all 3 event types--tsunami and disaster, war, and family violence--significantly contributed to poorer child adaptation.

  15. Cumulative contextual risk, maternal responsivity, and social cognition at 18 months.

    PubMed

    Wade, Mark; Moore, Chris; Astington, Janet Wilde; Frampton, Kristen; Jenkins, Jennifer M

    2015-02-01

    By 18 months children demonstrate a range of social-cognitive skills that can be considered important precursors to more advanced forms of social understanding such as theory of mind. Although individual differences in social cognition have been linked to neurocognitive maturation, sociocultural models of development suggest that environmental influences operate in the development of children's social-cognitive outcomes. In the current study of 501 children and their mothers, we tested and found support for a model in which distal environmental risk, assessed when children were newborns, was indirectly associated with children's social-cognitive competency at 18 months through mothers' responsivity at 18 months. Part of this effect also operated through children's concomitant language skills, suggesting both a language-mediated and a language-independent mechanism of social-cognitive development. These findings are discussed with respect to the Vygotskian themes of internalization and semiotic mediation.

  16. Health risks at the Hajj.

    PubMed

    Ahmed, Qanta A; Arabi, Yaseen M; Memish, Ziad A

    2006-03-25

    Annually, millions of Muslims embark on a religious pilgrimage called the "Hajj" to Mecca in Saudi Arabia. The mass migration during the Hajj is unparalleled in scale, and pilgrims face numerous health hazards. The extreme congestion of people and vehicles during this time amplifies health risks, such as those from infectious diseases, that vary each year. Since the Hajj is dictated by the lunar calendar, which is shorter than the Gregorian calendar, it presents public-health policy planners with a moving target, demanding constant preparedness. We review the communicable and non-communicable hazards that pilgrims face. With the rise in global travel, preventing disease transmission has become paramount to avoid the spread of infectious diseases, including SARS (severe acute respiratory syndrome), avian influenza, and haemorrhagic fever. We examine the response of clinicians, the Saudi Ministry of Health, and Hajj authorities to these unique problems, and list health recommendations for prospective pilgrims. PMID:16564364

  17. Health risks at the Hajj.

    PubMed

    Ahmed, Qanta A; Arabi, Yaseen M; Memish, Ziad A

    2006-03-25

    Annually, millions of Muslims embark on a religious pilgrimage called the "Hajj" to Mecca in Saudi Arabia. The mass migration during the Hajj is unparalleled in scale, and pilgrims face numerous health hazards. The extreme congestion of people and vehicles during this time amplifies health risks, such as those from infectious diseases, that vary each year. Since the Hajj is dictated by the lunar calendar, which is shorter than the Gregorian calendar, it presents public-health policy planners with a moving target, demanding constant preparedness. We review the communicable and non-communicable hazards that pilgrims face. With the rise in global travel, preventing disease transmission has become paramount to avoid the spread of infectious diseases, including SARS (severe acute respiratory syndrome), avian influenza, and haemorrhagic fever. We examine the response of clinicians, the Saudi Ministry of Health, and Hajj authorities to these unique problems, and list health recommendations for prospective pilgrims.

  18. Quantifying Chronic Stress Exposure for Cumulative Risk Assessment: Lessons Learned from a Case Study of Allostatic Load

    EPA Science Inventory

    Although multiple methods of quantifying environmental chemical exposures have been validated for use in human health risk assessment, quantifying chronic stress exposure is more challenging. Stress is a consequence of perceiving an “exposure” (e.g., violence, poverty) as more th...

  19. Using Marginal Structural Modeling to Estimate the Cumulative Impact of an Unconditional Tax Credit on Self-Rated Health.

    PubMed

    Pega, Frank; Blakely, Tony; Glymour, M Maria; Carter, Kristie N; Kawachi, Ichiro

    2016-02-15

    In previous studies, researchers estimated short-term relationships between financial credits and health outcomes using conventional regression analyses, but they did not account for time-varying confounders affected by prior treatment (CAPTs) or the credits' cumulative impacts over time. In this study, we examined the association between total number of years of receiving New Zealand's Family Tax Credit (FTC) and self-rated health (SRH) in 6,900 working-age parents using 7 waves of New Zealand longitudinal data (2002-2009). We conducted conventional linear regression analyses, both unadjusted and adjusted for time-invariant and time-varying confounders measured at baseline, and fitted marginal structural models (MSMs) that more fully adjusted for confounders, including CAPTs. Of all participants, 5.1%-6.8% received the FTC for 1-3 years and 1.8%-3.6% for 4-7 years. In unadjusted and adjusted conventional regression analyses, each additional year of receiving the FTC was associated with 0.033 (95% confidence interval (CI): -0.047, -0.019) and 0.026 (95% CI: -0.041, -0.010) units worse SRH (on a 5-unit scale). In the MSMs, the average causal treatment effect also reflected a small decrease in SRH (unstabilized weights: β = -0.039 unit, 95% CI: -0.058, -0.020; stabilized weights: β = -0.031 unit, 95% CI: -0.050, -0.007). Cumulatively receiving the FTC marginally reduced SRH. Conventional regression analyses and MSMs produced similar estimates, suggesting little bias from CAPTs.

  20. Cumulative and residual effects of potato cropping system management strategies on crop and soil health parameters

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Soil and crop management practices can greatly affect parameters related to soil health, as well as crop productivity and disease development, and may provide options for more sustainable production. Different 3-yr potato cropping systems focused on specific management goals of soil conservation (SC...

  1. Cumulative organophosphate pesticide exposure and risk assessment among pregnant women living in an agricultural community: a case study from the CHAMACOS cohort.

    PubMed Central

    Castorina, Rosemary; Bradman, Asa; McKone, Thomas E; Barr, Dana B; Harnly, Martha E; Eskenazi, Brenda

    2003-01-01

    Approximately 230,000 kg of organophosphate (OP) pesticides are applied annually in California's Salinas Valley. These activities have raised concerns about exposures to area residents. We collected three spot urine samples from pregnant women (between 1999 and 2001) enrolled in CHAMACOS (Center for the Health Assessment of Mothers and Children of Salinas), a longitudinal birth cohort study, and analyzed them for six dialkyl phosphate metabolites. We used urine from 446 pregnant women to estimate OP pesticide doses with two deterministic steady-state modeling methods: method 1, which assumed the metabolites were attributable entirely to a single diethyl or dimethyl OP pesticide; and method 2, which adapted U.S. Environmental Protection Agency (U.S. EPA) draft guidelines for cumulative risk assessment to estimate dose from a mixture of OP pesticides that share a common mechanism of toxicity. We used pesticide use reporting data for the Salinas Valley to approximate the mixture to which the women were exposed. Based on average OP pesticide dose estimates that assumed exposure to a single OP pesticide (method 1), between 0% and 36.1% of study participants' doses failed to attain a margin of exposure (MOE) of 100 relative to the U.S. EPA oral benchmark dose(10) (BMD(10)), depending on the assumption made about the parent compound. These BMD(10) values are doses expected to produce a 10% reduction in brain cholinesterase activity compared with background response in rats. Given the participants' average cumulative OP pesticide dose estimates (method 2) and regardless of the index chemical selected, we found that 14.8% of the doses failed to attain an MOE of 100 relative to the BMD(10) of the selected index. An uncertainty analysis of the pesticide mixture parameter, which is extrapolated from pesticide application data for the study area and not directly quantified for each individual, suggests that this point estimate could range from 1 to 34%. In future analyses, we

  2. Assessing Nonchemical factors in Cumulative Risk Assessment (CRA): A Case Study of the Association between Lower Heart Rate Variability and Particulate Matter

    EPA Science Inventory

    There has been increased interest in the integration of chemicals (e.g. particulate matter, lead) and nonchemicals (e.g., genetics, gender, lifestyle) in cumulative risk assessment (CRA). Because few toxicological or epidemiological studies on these complex mixtures have been con...

  3. Understanding the Relation of Low Income to HPA-Axis Functioning in Preschool Children: Cumulative Family Risk and Parenting as Pathways to Disruptions in Cortisol

    ERIC Educational Resources Information Center

    Zalewski, Maureen; Lengua, Liliana J.; Kiff, Cara J.; Fisher, Philip A.

    2012-01-01

    This study examined the relation of low income and poverty to cortisol levels, and tested potential pathways from low income to disruptions in cortisol through cumulative family risk and parenting. The sample of 306 mothers and their preschool children included 29 % families at or near poverty, 27 % families below the median income, and the…

  4. Health risks to fire fighters.

    PubMed

    Matticks, C A; Westwater, J J; Himel, H N; Morgan, R F; Edlich, R F

    1992-01-01

    Fire fighters work in varied and dangerous environments and face unique health hazards that increase their risk for line-of-duty injury and death. While working with sophisticated equipment within such environments, the fire fighter is exposed to high noise levels, changing thermal conditions, and hazardous breathing atmospheres. In addition, his or her protective equipment can impose limitations on efficiency and performance. These conditions have been related to specific physical performance requirements that will reduce line-of-duty injury, disability, and even death. Physical fitness and health maintenance programs that reduce the risk for cardiovascular disease and musculoskeletal injuries have been prescribed for fire fighters. These programs are essential components of any modern fire service. PMID:1587923

  5. Stigmatized Biologies: Examining the Cumulative Effects of Oral Health Disparities for Mexican American Farmworker Children

    PubMed Central

    Horton, Sarah; Barker, Judith C.

    2012-01-01

    Severe early childhood caries (ECC) can leave lasting effects on children’s physical development, including malformed oral arches and crooked permanent dentition. This article examines the way that ECC sets up Mexican American farm worker children in the United States for lasting dental problems and social stigma as young adults. We examine the role of dietary and environmental factors in contributing to what we call “stigmatized biologies,” and that of market-based dental public health insurance systems in cementing their enduring effects. We adapt Margaret Lock’s term, local biology, to illustrate the way that biology differs not only because of culture, diet, and environment but also because of disparities in insurance coverage. By showing the long-term effects of ECC and disparate dental treatment on farmworker adults, we show how the interaction of immigrant caregiving practices and underinsurance can have lasting social effects. An examination of the long-term effects of farm worker children’s ECC illustrates the ways that market-based health care systems can create embodied differences that in turn reproduce a system of social inequality. PMID:20550093

  6. Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores among Urban Youth in the United States

    ERIC Educational Resources Information Center

    Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

    2014-01-01

    Background: The Institute of Medicine (2012) concluded that we must "strengthen schools as the heart of health." To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement,…

  7. Prenatal cocaine exposure: the role of cumulative environmental risk and maternal harshness in the development of child internalizing behavior problems in kindergarten.

    PubMed

    Eiden, Rina D; Godleski, Stephanie; Colder, Craig R; Schuetze, Pamela

    2014-01-01

    This study examined the associations between prenatal exposure to cocaine and other substances and child internalizing behavior problems at kindergarten. We investigated whether maternal harshness or cumulative environmental risk mediated or moderated this association. Participants consisted of 216 (116 cocaine exposed, 100 non-cocaine exposed) mother-infant dyads participating in an ongoing longitudinal study of prenatal cocaine exposure. Results indicated that, as hypothesized, maternal harshness moderated the association between prenatal cocaine exposure to child internalizing in kindergarten such that prenatal cocaine exposure increased risk for internalizing problems at high levels of maternal harshness from 7 to 36months and decreased risk at low levels of harshness. Contrary to hypothesis, the association between prenatal cocaine exposure and child internalizing in kindergarten was not mediated by maternal harshness or cumulative environmental risk. However, cumulative environmental risk (from 1month of child age to kindergarten) was predictive of child internalizing behavior problems at kindergarten. Results have implications for parenting interventions that may be targeted toward reducing maternal harshness in high risk samples characterized by maternal substance use in pregnancy.

  8. Cumulative Risk of Guillain–Barré Syndrome Among Vaccinated and Unvaccinated Populations During the 2009 H1N1 Influenza Pandemic

    PubMed Central

    Iqbal, Shahed; Stewart, Brock; Tokars, Jerome; DeStefano, Frank

    2014-01-01

    Objectives. We sought to assess risk of Guillain–Barré syndrome (GBS) among influenza A (H1N1) 2009 monovalent (pH1N1) vaccinated and unvaccinated populations at the end of the 2009 pandemic. Methods. We applied GBS surveillance data from a US population catchment area of 45 million from October 15, 2009, through May 31, 2010. GBS cases meeting Brighton Collaboration criteria were included. We calculated the incidence density ratio (IDR) among pH1N1 vaccinated and unvaccinated populations. We also estimated cumulative GBS risk using life table analysis. Additionally, we used vaccine coverage data and census population estimates to calculate denominators. Results. There were 392 GBS cases; 64 (16%) occurred after pH1N1vaccination. The vaccinated population had lower average risk (IDR = 0.83, 95% confidence interval = 0.63, 1.08) and lower cumulative risk (6.6 vs 9.2 cases per million persons, P = .012) of GBS. Conclusions. Our findings suggest that at the end of the influenza season cumulative GBS risk was less among the pH1N1vaccinated than the unvaccinated population, suggesting the benefit of vaccination as it relates to GBS. The observed potential protective effect on GBS attributed to vaccination warrants further study. PMID:24524517

  9. Associations between the distance traveled from sale barns to commercial feedlots in the United States and overall performance, risk of respiratory disease, and cumulative mortality in feeder cattle during 1997 to 2009.

    PubMed

    Cernicchiaro, N; White, B J; Renter, D G; Babcock, A H; Kelly, L; Slattery, R

    2012-06-01

    Most beef cattle are transported at least once during their lives, and this potentially stressful practice may affect subsequent health and performance. Limited research is available quantifying the effects of transport on feedlot performance and health, and particularly the risk of bovine respiratory disease complex (BRD), which is the most common disease of weaned calves after arrival to the feedlot. The objective of this retrospective study was to determine potential associations between distance traveled (DTV) during transportation with health (cumulative BRD morbidity and mortality of all causes) and performance (ADG and HCW) parameters in cattle cohorts (n = 14,601) that arrived to 21 U.S. commercial feedlots from 1997 to 2009. Multivariable mixed-effects negative binomial and linear regression models were employed to determine associations between health and performance outcomes with DTV and other cohort-level demographic variables. Cattle were transported a median of 552 km from origin to feedlot with a mean (± SEM) of 698 ± 4.4 km. The mean (±SEM) cumulative BRD morbidity was 4.9% ± 0.01% (median = 1.1%; range: 0 to 100%) whereas the mean (±SEM) cumulative mortality due to all causes was 1.3% ± 0.01% (median = 0.8%; range: 0 to 28.7%). Distance traveled was significantly associated (P < 0.05) with BRD morbidity, overall mortality, HCW and ADG, and its effects were modified by demographic characteristics (i.e., cohort region of origin, mean arrival BW, gender, and the season of the year) of the cohort. Knowledge of the distance traveled during transportation could allow a more precise prediction of cattle feedlot health and performance.

  10. Ultraviolet Radiation: Human Exposure and Health Risks.

    ERIC Educational Resources Information Center

    Tenkate, Thomas D.

    1998-01-01

    Provides an overview of human exposure to ultraviolet radiation and associated health effects as well as risk estimates for acute and chronic conditions resulting from such exposure. Demonstrates substantial reductions in health risk that can be achieved through preventive actions. Also includes a risk assessment model for skin cancer. Contains 36…

  11. Risk.

    PubMed

    Cole, Stephen R; Hudgens, Michael G; Brookhart, M Alan; Westreich, Daniel

    2015-02-15

    The epidemiologist primarily studies transitions between states of health and disease. The purpose of the present article is to define a foundational parameter for such studies, namely risk. We begin simply and build to the setting in which there is more than 1 event type (i.e., competing risks or competing events), as well as more than 1 treatment or exposure level of interest. In the presence of competing events, the risks are a set of counterfactual cumulative incidence functions for each treatment. These risks can be depicted visually and summarized numerically. We use an example from the study of human immunodeficiency virus to illustrate concepts. PMID:25660080

  12. Health risk of chrysotile revisited

    PubMed Central

    Dunnigan, Jacques; Hesterberg, Thomas; Brown, Robert; Velasco, Juan Antonio Legaspi; Barrera, Raúl; Hoskins, John; Gibbs, Allen

    2013-01-01

    This review provides a basis for substantiating both kinetically and pathologically the differences between chrysotile and amphibole asbestos. Chrysotile, which is rapidly attacked by the acid environment of the macrophage, falls apart in the lung into short fibers and particles, while the amphibole asbestos persist creating a response to the fibrous structure of this mineral. Inhalation toxicity studies of chrysotile at non-lung overload conditions demonstrate that the long (>20 µm) fibers are rapidly cleared from the lung, are not translocated to the pleural cavity and do not initiate fibrogenic response. In contrast, long amphibole asbestos fibers persist, are quickly (within 7 d) translocated to the pleural cavity and result in interstitial fibrosis and pleural inflammation. Quantitative reviews of epidemiological studies of mineral fibers have determined the potency of chrysotile and amphibole asbestos for causing lung cancer and mesothelioma in relation to fiber type and have also differentiated between these two minerals. These studies have been reviewed in light of the frequent use of amphibole asbestos. As with other respirable particulates, there is evidence that heavy and prolonged exposure to chrysotile can produce lung cancer. The importance of the present and other similar reviews is that the studies they report show that low exposures to chrysotile do not present a detectable risk to health. Since total dose over time decides the likelihood of disease occurrence and progression, they also suggest that the risk of an adverse outcome may be low with even high exposures experienced over a short duration. PMID:23346982

  13. [Psychosocial risks at work and occupational health].

    PubMed

    Gil-Monte, Pedro R

    2012-06-01

    The changes on work processes and job design in recent decades are focused in the demographic, economic, political, and technological aspects. These changes have created new psychosocial risks at work that affect the health and quality of workplace, increasing stress levels among workers. The aim of this study is to present such risks, their consequences, and some recommendations to promote health at the workplace as a strategy to improve public health of the population. The study is divided into five points in which: (1) introduces the concept of risk factors and psychosocial work, (2) describes the main emerging psychosocial risks labor, (3) provides some information on the prevalence of psychosocial risks at work in Europe and its consequences, (4) recommendations for health promotion in the workplace, and (5) describes the objective of Occupational Health Psychology and concludes with the recommendations to promote psychosocial health in the workplace as a strategy to improve public health of the population.

  14. Risk management frameworks for human health and environmental risks.

    PubMed

    Jardine, Cindy; Hrudey, Steve; Shortreed, John; Craig, Lorraine; Krewski, Daniel; Furgal, Chris; McColl, Stephen

    2003-01-01

    A comprehensive analytical review of the risk assessment, risk management, and risk communication approaches currently being undertaken by key national, provincial/state, territorial, and international agencies was conducted. The information acquired for review was used to identify the differences, commonalities, strengths, and weaknesses among the various approaches, and to identify elements that should be included in an effective, current, and comprehensive approach applicable to environmental, human health and occupational health risks. More than 80 agencies, organizations, and advisory councils, encompassing more than 100 risk documents, were examined during the period from February 2000 until November 2002. An overview was made of the most important general frameworks for risk assessment, risk management, and risk communication for human health and ecological risk, and for occupational health risk. In addition, frameworks for specific applications were reviewed and summarized, including those for (1)contaminated sites; (2) northern contaminants; (3) priority substances; (4) standards development; (5) food safety; (6) medical devices; (7) prescription drug use; (8) emergency response; (9) transportation; (10) risk communication. Twelve frameworks were selected for more extensive review on the basis of representation of the areas of human health, ecological, and occupational health risk; relevance to Canadian risk management needs; representation of comprehensive and well-defined approaches; generalizability with their risk areas; representation of "state of the art" in Canada, the United States, and/or internationally; and extent of usage of potential usage within Canada. These 12 frameworks were: 1. Framework for Environmental Health Risk Management (US Presidential/Congressional Commission on Risk Assessment and Risk Management, 1997). 2. Health Risk Determination: The Challenge of Health Protection (Health and Welfare Canada, 1990). 3. Health Canada Decision

  15. [Cumulative exposure to pesticide residues in food].

    PubMed

    Kostka, Grazyna; Urbanek-Olejnik, Katarzyna; Liszewska, Monika

    2011-01-01

    The results of food monitoring studies indicate that humans are constantly exposed to residues ofplant protection products (pesticides) in marketed food products. Hence, assessment of the risk to consumers associated with the consumption of products containing residues of the active substances of pesticides is a key stage in both the registration of pesticides and official control of foodstuffs. However there are frequent cases of exposure not only to individual active substances but also to mixtures of pesticide residues. These levels are usually low, below of effective action, and interaction such as synergism orpotentiation is not expected to occur At the same time, literature data indicate that for mixtures sharing a common MOA (Mode of Action/Mechanism of Action), the probability of additive effects is high, even after adjusting for the low levels of the mixed pesticide residues present. Accordingly, health risk assessment for consumers exposed to such mixtures (cumulative/aggregate risk) has become an issue of topical importance. EU-level initiatives regarding the development of appropriate methodology for the estimation of cumulative/aggregate risk have brought about considerable progress in this area. The article discusses various aspects of estimation of cumulative risk for consumers associated with exposure to mixtures of pesticide residues in food.

  16. Health risks of alcohol use

    MedlinePlus

    Alcoholism - risks; Alcohol abuse - risks; Alcohol dependence - risks; Risky drinking ... Beer, wine, and liquor all contain alcohol. If you are drinking any of these, you are using alcohol. Your drinking patterns may vary, depending on who you are with ...

  17. Can Public Health Risk Assessment Using Risk Matrices Be Misleading?

    PubMed Central

    Vatanpour, Shabnam; Hrudey, Steve E.; Dinu, Irina

    2015-01-01

    The risk assessment matrix is a widely accepted, semi-quantitative tool for assessing risks, and setting priorities in risk management. Although the method can be useful to promote discussion to distinguish high risks from low risks, a published critique described a problem when the frequency and severity of risks are negatively correlated. A theoretical analysis showed that risk predictions could be misleading. We evaluated a practical public health example because it provided experiential risk data that allowed us to assess the practical implications of the published concern that risk matrices would make predictions that are worse than random. We explored this predicted problem by constructing a risk assessment matrix using a public health risk scenario—Tainted blood transfusion infection risk—That provides negative correlation between harm frequency and severity. We estimated the risk from the experiential data and compared these estimates with those provided by the risk assessment matrix. Although we validated the theoretical concern, for these authentic experiential data, the practical scope of the problem was limited. The risk matrix has been widely used in risk assessment. This method should not be abandoned wholesale, but users must address the source of the problem, apply the risk matrix with a full understanding of this problem and use matrix predictions to inform, but not drive decision-making. PMID:26287224

  18. Profiles of Risk: Maternal Health, Socioeconomic Status, and Child Health

    PubMed Central

    Hardie, Jessica Halliday; Landale, Nancy S.

    2013-01-01

    Child health is fundamental to well-being and achievement throughout the life course. Prior research has demonstrated strong associations between familial socioeconomic resources and children’s health outcomes, with especially poor health outcomes among disadvantaged youth who experience a concentration of risks, yet little is known about the influence of maternal health as a dimension of risk for children. This research used nationally representative U.S. data from the National Health Interview Surveys in 2007 and 2008 (N = 7,361) to evaluate the joint implications of maternal health and socioeconomic disadvantage for youth. Analyses revealed that maternal health problems were present in a substantial minority of families, clustered meaningfully with other risk factors, and had serious implications for children’s health. These findings support the development of health policies and interventions aimed at families. PMID:23794751

  19. Addressing Risks to Advance Mental Health Research

    PubMed Central

    Iltis, Ana S.; Misra, Sahana; Dunn, Laura B.; Brown, Gregory K.; Campbell, Amy; Earll, Sarah A.; Glowinski, Anne; Hadley, Whitney B.; Pies, Ronald; DuBois, James M.

    2015-01-01

    Objective Risk communication and management are essential to the ethical conduct of research, yet addressing risks may be time consuming for investigators and institutional review boards (IRBs) may reject study designs that appear too risky. This can discourage needed research, particularly in higher risk protocols or those enrolling potentially vulnerable individuals, such as those with some level of suicidality. Improved mechanisms for addressing research risks may facilitate much needed psychiatric research. This article provides mental health researchers with practical approaches to: 1) identify and define various intrinsic research risks; 2) communicate these risks to others (e.g., potential participants, regulatory bodies, society); 3) manage these risks during the course of a study; and 4) justify the risks. Methods As part of a National Institute of Mental Health (NIMH)-funded scientific meeting series, a public conference and a closed-session expert panel meeting were held on managing and disclosing risks in mental health clinical trials. The expert panel reviewed the literature with a focus on empirical studies and developed recommendations for best practices and further research on managing and disclosing risks in mental health clinical trials. IRB review was not required because there were no human subjects. The NIMH played no role in developing or reviewing the manuscript. Results Challenges, current data, practical strategies, and topics for future research are addressed for each of four key areas pertaining to management and disclosure of risks in clinical trials: identifying and defining risks, communicating risks, managing risks during studies, and justifying research risks. Conclusions Empirical data on risk communication, managing risks, and the benefits of research can support the ethical conduct of mental health research and may help investigators better conceptualize and confront risks and to gain IRB approval. PMID:24173618

  20. New Mexico Adolescent Health Risks Survey.

    ERIC Educational Resources Information Center

    Antle, David

    To inform students of health risks (posed by behavior, environment, and genetics) and provide schools with collective risk appraisal information as a basis for planning/evaluating health and wellness initiatives, New Mexico administered the Teen Wellness Check in 1985 to 1,573 ninth-grade students from 7 New Mexico public schools. Subjects were…

  1. Air pollution ranks as largest health risk

    NASA Astrophysics Data System (ADS)

    Wendel, JoAnna

    2014-04-01

    The World Health Organization (WHO) reports that 7 million people died in 2012 from air-pollution-related sicknesses, marking air pollution as the single largest environmental health risk. This finding, a result of better knowledge and assessment of the diseases, is more than double previous estimates of the risk of death from air pollution.

  2. [Forest health ecological risk assessment in China].

    PubMed

    Xiao, Fengjin; Ouyang, Hua; Cheng, Shulan; Zhang, Qiang

    2004-02-01

    Forest health ecological risk assessment is an important factor in forest resources management. In this paper, we selected forest fire, forest disease-pest disasters and acid rain as main risk sources, described the risk resources by probability, intensity and distributing, and mapped each risk source. The endpoints were the damages that the risk acceptor might and these damages might cause ecosystems' organization and function changing under the uncertainty risk sources. Endpoints of forest might compose of productivity descent, reducing biodiversity, forest degrading, forest ecological function declining, furthermore, forest disappearing. We described exposure in terms of intensity, space, and time. In the exposure and hazard analysis, we used fragile index to show frangibility or resistibility (resistibility is reverse to frangibility), and analyzed the damages by different risk sources. Risk assessment and management was the integrated phase of the research. Because of the spatial heterogeneity of risk sources, all risk index were overlaid in the China map by GIS, which divided the region into 30 ecological risk sub-zones (provinces), according to risk index of each risk sub-zone, and the forest in China was divided into six levels of risk zones. In every level of risk zones, we also put forward the countermeasures for forest health ecological risk management. The result of assessment could provide scientific basis for forest management.

  3. What roles do contemporaneous and cumulative incomes play in the income-child health gradient for young children? Evidence from an Australian panel.

    PubMed

    Khanam, Rasheda; Nghiem, Hong Son; Connelly, Luke Brian

    2014-08-01

    The literature to date shows that children from poorer households tend to have worse health than their peers, and the gap between them grows with age. We investigate whether and how health shocks (as measured by the onset of chronic conditions) contribute to the income-child health gradient and whether the contemporaneous or cumulative effects of income play important mitigating roles. We exploit a rich panel dataset with three panel waves called the Longitudinal Study of Australian children. Given the availability of three waves of data, we are able to apply a range of econometric techniques (e.g. fixed and random effects) to control for unobserved heterogeneity. The paper makes several contributions to the extant literature. First, it shows that an apparent income gradient becomes relatively attenuated in our dataset when the cumulative and contemporaneous effects of household income are distinguished econometrically. Second, it demonstrates that the income-child health gradient becomes statistically insignificant when controlling for parental health and health-related behaviours or unobserved heterogeneity.

  4. What roles do contemporaneous and cumulative incomes play in the income-child health gradient for young children? Evidence from an Australian panel.

    PubMed

    Khanam, Rasheda; Nghiem, Hong Son; Connelly, Luke Brian

    2014-08-01

    The literature to date shows that children from poorer households tend to have worse health than their peers, and the gap between them grows with age. We investigate whether and how health shocks (as measured by the onset of chronic conditions) contribute to the income-child health gradient and whether the contemporaneous or cumulative effects of income play important mitigating roles. We exploit a rich panel dataset with three panel waves called the Longitudinal Study of Australian children. Given the availability of three waves of data, we are able to apply a range of econometric techniques (e.g. fixed and random effects) to control for unobserved heterogeneity. The paper makes several contributions to the extant literature. First, it shows that an apparent income gradient becomes relatively attenuated in our dataset when the cumulative and contemporaneous effects of household income are distinguished econometrically. Second, it demonstrates that the income-child health gradient becomes statistically insignificant when controlling for parental health and health-related behaviours or unobserved heterogeneity. PMID:23780648

  5. Work stress and health risk behavior.

    PubMed

    Siegrist, Johannes; Rödel, Andreas

    2006-12-01

    This contribution discusses current knowledge of associations between psychosocial stress at work and health risk behavior, in particular cigarette smoking, alcohol consumption and overweight, by reviewing findings from major studies in the field published between 1989 and 2006. Psychosocial stress at work is measured by the demand-control model and the effort-reward imbalance model. Health risk behavior was analyzed in the broader context of a health-related Western lifestyle with socially and economically patterned practices of consumption. Overall, the review, based on 46 studies, only modestly supports the hypothesis of a consistent association between work stress and health risk behavior. The relatively strongest relationships have been found with regard to heavy alcohol consumption among men, overweight, and the co-manifestation of several risks. Suggestions for further research are given, and the need to reduce stressful experience in the framework of worksite health promotion programs is emphasized.

  6. Health effects of risk-assessment categories

    SciTech Connect

    Kramer, C.F.; Rybicka, K.; Knutson, A.; Morris, S.C.

    1983-10-01

    Environmental and occupational health effects associated with exposures to various chemicals are a subject of increasing concern. One recently developed methodology for assessing the health impacts of various chemical compounds involves the classification of similar chemicals into risk-assessment categories (RACs). This report reviews documented human health effects for a broad range of pollutants, classified by RACs. It complements other studies that have estimated human health effects by RAC based on analysis and extrapolation of data from animal research.

  7. The health risks of decommissioning nuclear facilities.

    PubMed

    Dodic-Fikfak, M; Clapp, R; Kriebel, D

    1999-01-01

    The health risks facing workers involved in decommissioning nuclear facilities are a critical concern as the nuclear weapons complex and nuclear power plants begin to be dismantled. In addition to risks from exposure to radioactive materials, there are risks from other common industrial materials like crystalline silica dust and asbestos. We discuss these issues in the context of recent research on the risk of low-level ionizing radiation, the classification of crystalline silica as a carcinogen, and early experience with decommissioning nuclear facilities in the United States. Health and safety advocates will need to be vigilant to prevent worker exposure. PMID:17208791

  8. The health risks of decommissioning nuclear facilities.

    PubMed

    Dodic-Fikfak, M; Clapp, R; Kriebel, D

    1999-01-01

    The health risks facing workers involved in decommissioning nuclear facilities are a critical concern as the nuclear weapons complex and nuclear power plants begin to be dismantled. In addition to risks from exposure to radioactive materials, there are risks from other common industrial materials like crystalline silica dust and asbestos. We discuss these issues in the context of recent research on the risk of low-level ionizing radiation, the classification of crystalline silica as a carcinogen, and early experience with decommissioning nuclear facilities in the United States. Health and safety advocates will need to be vigilant to prevent worker exposure.

  9. The role of romantic attachment security and dating identity exploration in understanding adolescents' sexual attitudes and cumulative sexual risk-taking.

    PubMed

    McElwain, Alyssa D; Kerpelman, Jennifer L; Pittman, Joe F

    2015-02-01

    This study addressed how two normative developmental factors, attachment and identity, are associated with adolescents' sexual attitudes and sexual risk-taking behavior. The sample consisted of 2029 adolescents (mean age = 16.2 years) living in the Southeast United States. Path analysis was used to test the hypotheses. Higher levels of attachment anxiety predicted more dating identity exploration and less healthy sexual attitudes. Higher levels of attachment avoidance predicted less dating identity exploration and indirectly predicted less healthy sexual attitudes through dating identity exploration. Females with dating or sexual experience showed the weakest associations between the attachment dimensions and dating identity exploration. More dating identity exploration predicted healthier sexual attitudes; this association was strongest for non-virgins. Finally, higher levels of attachment avoidance were associated with higher cumulative sexual risk scores, but only among non-virgin males. Results are interpreted in light of theory and research on attachment, identity exploration, and adolescent sexual relationships.

  10. The Relationship between Rural Status, Individual Characteristics, and Self-Rated Health in the Behavioral Risk Factor Surveillance System

    ERIC Educational Resources Information Center

    Bethea, Traci N.; Lopez, Russell P.; Cozier, Yvette C.; White, Laura F.; McClean, Michael D.

    2012-01-01

    Purpose: To examine rural status and social factors as predictors of self-rated health in community-dwelling adults in the United States. Methods: This study uses multinomial logistic and cumulative logistic models to evaluate the associations of interest in the 2006 US Behavioral Risk Factor Surveillance System, a cross-sectional survey of…

  11. Project 6: Cumulative Risk Assessment Methods and Applications: Task 6.3. Applying Genetic and Epigenetic Data to Inform Susceptibility

    EPA Science Inventory

    Susceptibility is defined by the NRC (2009) as the capacity to be affected. A person can be at greater or less risk relative to population median risk because of susceptibility factors such as life stage, sex, genetics, socioeconomic status, prior exposure to chemicals, and non-c...

  12. Health Risk Behaviors and Academic Achievement

    MedlinePlus

    ... 2009 † Health-Risk Behaviors Percentage of U.S. high school students who engaged in each risk behavior, by type of grades mostly earned A’s B’s C’s D’s/F’s Unintentional Injury and Violence-Related Behaviors Rarely or never wore a seat ...

  13. The Analysis of Cumulative Influence of Factors of Environment on a State of Health of the Population of Vladimir Region

    PubMed Central

    Trifonova, Tatyana Anatolyevna; Shirkin, Leonid Alekseevich

    2015-01-01

    There was investigated the contribution of factors of environment to formation of health for adult population on indicators of mid-annual rates of growth/decrease of disease of system of blood circulation and of some interfaced nosology on an example of the population of Vladimir region. The differential criterion of primary disease of system of blood circulation is considered as an indicator, integrally reflecting degree of adaptation to environment conditions on population and suitable for construction short-term prognostic estimations. It is shown that business factors or the factors of a standard of living characterized by economic indicators, are leading risk factors in disease of system of blood circulation in Vladimir region which contribution is estimated by size of 38 %. With use of regressive equations were received look-ahead estimations of annual rates of primary disease of system of blood circulation. In the regional centre Vladimir was observed more intense situation on rates of disease of system of blood circulation, than in Vladimir region. PMID:25948468

  14. Comparative Risks of Cancer from Drywall Finishing Based on Stochastic Modeling of Cumulative Exposures to Respirable Dusts and Chrysotile Asbestos Fibers.

    PubMed

    Boelter, Fred W; Xia, Yulin; Dell, Linda

    2015-05-01

    Sanding joint compounds is a dusty activity and exposures are not well characterized. Until the mid 1970s, asbestos-containing joint compounds were used by some people such that sanding could emit dust and asbestos fibers. We estimated the distribution of 8-h TWA concentrations and cumulative exposures to respirable dusts and chrysotile asbestos fibers for four worker groups: (1) drywall specialists, (2) generalists, (3) tradespersons who are bystanders to drywall finishing, and (4) do-it-yourselfers (DIYers). Data collected through a survey of experienced contractors, direct field observations, and literature were used to develop prototypical exposure scenarios for each worker group. To these exposure scenarios, we applied a previously developed semi-empirical mathematical model that predicts area as well as personal breathing zone respirable dust concentrations. An empirical factor was used to estimate chrysotile fiber concentrations from respirable dust concentrations. On a task basis, we found mean 8-h TWA concentrations of respirable dust and chrysotile fibers are numerically highest for specialists, followed by generalists, DIYers, and bystander tradespersons; these concentrations are estimated to be in excess of the respective current but not historical Threshold Limit Values. Due to differences in frequency of activities, annual cumulative exposures are highest for specialists, followed by generalists, bystander tradespersons, and DIYers. Cumulative exposure estimates for chrysotile fibers from drywall finishing are expected to result in few, if any, mesothelioma or excess lung cancer deaths according to recently published risk assessments. Given the dustiness of drywall finishing, we recommend diligence in the use of readily available source controls.

  15. Exposure to phthalates in 5-6 years old primary school starters in Germany--a human biomonitoring study and a cumulative risk assessment.

    PubMed

    Koch, Holger M; Wittassek, Matthias; Brüning, Thomas; Angerer, Jürgen; Heudorf, Ursel

    2011-06-01

    We determined the internal exposure of 111 German primary school starters by analyzing urinary metabolites of six phthalates: butyl benzyl phthalate (BBzP), di-iso-butyl phthalate (DiBP), di-n-butyl phthalate (DnBP), di (2-ethylhexyl) phthalate (DEHP), di-iso-nonyl phthalate (DiNP) and di-iso-decylphthalate (DiDP). From the urinary metabolite levels, we calculated daily intakes and related these values to Tolerable Daily Intake (TDI) values. By introducing the concept of a relative cumulative Tolerable Daily Intake (TDI(cum)) value, we tried to account for the cumulative exposure to several of the above-mentioned phthalates. The TDI(cum) was derived as follows: the daily intake (DI) calculated from the metabolite level was divided by the TDI for each phthalate; this ratio was multiplied by 100% indicating the TDI percentage for which the DI accounted. Finally the % TDIs of the different phthalates were totalled to get the TDI(cum). A TDI(cum) above 100% is a potential cause for concern. We confirmed the ubiquitous exposure of the children to all phthalates investigated. Exposures were within range of levels previously reported for GerES, albeit slightly lower. Regarding daily intakes, two children exceeded the TDI for DnBP, whereas one child closely approached the TDI for DEHP. 24% of the children exceeded the TDI(cum) for the three most critical phthalates: DEHP, DnBP and DiBP. Furthermore, 54% of the children had total exposures that used up more than 50% the TDI(cum). Therefore, the overall exposure to a number of phthalates, and the knowledge that these phthalates (and other anti-androgens) act in a dose-additive manner, urgently warrants a cumulative risk assessment approach.

  16. Environmental Risk to Health of the Population

    ERIC Educational Resources Information Center

    Anopchenko, Tatiana Y.; Murzin, Anton D.; Kandrashina, Elena A.; Kosyakova, Inessa V.; Surnina, Olga E.

    2016-01-01

    Researches of the last years in the field of ecological epidemiology and the analysis of risk for health allow to claim with confidence that the polluted environment is one of the important factors defining changes of a state of health of the population. Expert opinions on the scale of this influence differ considerably now. These estimations vary…

  17. The role of cumulative physical work load in lumbar spine disease: risk factors for lumbar osteochondrosis and spondylosis associated with chronic complaints

    PubMed Central

    Seidler, A; Bolm-Audorff, U; Heiskel, H; Henkel, N; Roth-Kuver, B; Kaiser, U; Bickeboller, R; Willingstorfer, W; Beck, W; Elsner, G

    2001-01-01

    OBJECTIVES—To investigate the relation with a case-control study between symptomatic osteochondrosis or spondylosis of the lumbar spine and cumulative occupational exposure to lifting or carrying and to working postures with extreme forward bending.
METHODS—From two practices and four clinics were recruited 229 male patients with radiographically confirmed osteochondrosis or spondylosis of the lumbar spine associated with chronic complaints. Of these 135 had additionally had acute lumbar disc herniation. A total of 197 control subjects was recruited: 107 subjects with anamnestic exclusion of lumbar spine disease were drawn as a random population control group and 90 patients admitted to hospital for urolithiasis who had no osteochondrosis or spondylosis of the lumbar spine radiographically were recruited as a hospital based control group. Data were gathered in a structured personal interview and analysed using logistic regression to control for age, region, nationality, and other diseases affecting the lumbar spine. To calculate cumulative forces to the lumbar spine over the entire working life, the Mainz-Dortmund dose model (MDD), which is based on an overproportional weighting of the lumbar disc compression force relative to the respective duration of the lifting process was applied with modifications: any objects weighing ⩾5 kg were included in the calculation and no minimum daily exposure limits were established. Calculation of forces to the lumbar spine was based on self reported estimates of occupational lifting, trunk flexion, and duration.
RESULTS—For a lumbar spine dose >9×106 Nh (Newton×hours), the risk of having radiographically confirmed osteochondrosis or spondylosis of the lumbar spine as measured by the odds ratio (OR) was 8.5 (95% confidence interval (95% CI) 4.1 to 17.5) compared with subjects with a load of 0 Nh. To avoid differential bias, forces to the lumbar spine were also calculated on the basis of an internal job

  18. Acrylamide in Romanian food using HPLC-UV and a health risk assessment.

    PubMed

    Oroian, Mircea; Amariei, Sonia; Gutt, Gheorghe

    2015-01-01

    The aim of this study was to investigate the level of acrylamide from coffee, potato chips and French fries in Romanian food. According to the European Food Safety Authority, coffee beans, potato chips and French fries have the highest levels of acrylamide. For this survey, 50 samples of coffee beans, 50 samples of potato chips and 25 samples of French fries were purchased from different producers from the Romanian market. Acrylamide levels have been quantified using high-performance liquid chromatography with a diode array detector (HPLC-DAD) method, using water as mobile phase. Health risk assessment was achieved by computing the average daily intake, hazard quotient, cumulative risk, carcinogenic risk and cancer risk. For coffee, potato chips and French fries, acrylamide was not shown to pose a health risk in Romanian food. PMID:25753750

  19. Acrylamide in Romanian food using HPLC-UV and a health risk assessment.

    PubMed

    Oroian, Mircea; Amariei, Sonia; Gutt, Gheorghe

    2015-01-01

    The aim of this study was to investigate the level of acrylamide from coffee, potato chips and French fries in Romanian food. According to the European Food Safety Authority, coffee beans, potato chips and French fries have the highest levels of acrylamide. For this survey, 50 samples of coffee beans, 50 samples of potato chips and 25 samples of French fries were purchased from different producers from the Romanian market. Acrylamide levels have been quantified using high-performance liquid chromatography with a diode array detector (HPLC-DAD) method, using water as mobile phase. Health risk assessment was achieved by computing the average daily intake, hazard quotient, cumulative risk, carcinogenic risk and cancer risk. For coffee, potato chips and French fries, acrylamide was not shown to pose a health risk in Romanian food.

  20. Health and environmental risks of energy systems

    SciTech Connect

    Hamilton, L.D.

    1984-01-01

    This paper gives four examples of health risk assessments of energy systems: (1) Comparative risk assessment of the health effects of the coal and nuclear fuel cycles. Estimates differ from previous values chiefly by inclusion of ranges of uncertainty, but some coal-cycle numbers were re-estimated. Upper-boundary public disease risks of air pollution from coal-fired plants dominate. Reactors probably account for most of the potential effect of major nuclear accidents. Accidental death rates in electricity generation are low for reactors and higher for coal. (2) Upper boundary air pollution health risks of existing fossil-based energy technologies in the United States. Preliminary mortality estimates were obtained combining potential impacts of three index pollutants - SO/sub 4/, NO/sub 2/, and CO - as independent measures of risk. Four fuel cycle trajectories leading to three end-uses were analyzed. Example results: domestic wood burning has substantial potential impact, with an upper boundary exceeding that of coal; upper-boundary air pollution impacts of gas can exceed those of oil, because of NO/sub 2/. (3) Health risks of acid deposition and other transported air pollutants, carried out as part of an assessment of the US Congress Office of Technology Assessment (OTA) Acid Rain and Transported Air Pollutants - Implications for Public Policy. Three scenarios were examined, leading to estimates of 40,000 to 50,000 annual premature deaths, depending on year (1978 vs 2000) and scenario (holding total emissions constant vs 30% reduction). (4) health effects of uranium mill tailings piles. Mortality risk is estimated to be minuscule (8.7 x 10/sup -9/ average individual lifetime cancer risk from a model mill, compared with 9.5 x 10/sup -4/ for background radiation). Methods that sum risks over the indefinite future are shown to be to be unrealistic. 39 references, 7 figures, 15 tables.

  1. Real Time Radiation Exposure And Health Risks

    NASA Technical Reports Server (NTRS)

    Hu, Shaowen; Barzilla, Janet E.; Semones, Edward J.

    2015-01-01

    Radiation from solar particle events (SPEs) poses a serious threat to future manned missions outside of low Earth orbit (LEO). Accurate characterization of the radiation environment in the inner heliosphere and timely monitoring the health risks to crew are essential steps to ensure the safety of future Mars missions. In this project we plan to develop an approach that can use the particle data from multiple satellites and perform near real-time simulations of radiation exposure and health risks for various exposure scenarios. Time-course profiles of dose rates will be calculated with HZETRN and PDOSE from the energy spectrum and compositions of the particles archived from satellites, and will be validated from recent radiation exposure measurements in space. Real-time estimation of radiation risks will be investigated using ARRBOD. This cross discipline integrated approach can improve risk mitigation by providing critical information for risk assessment and medical guidance to crew during SPEs.

  2. MTHFR gene A1298C polymorphisms are associated with breast cancer risk among Chinese population: evidence based on an updated cumulative meta-analysis

    PubMed Central

    Wang, Yadong; Yang, Haiyan; Duan, Guangcai

    2015-01-01

    Objectives: Published studies on the association between methylenetetrahydrofolate reductase (MTHFR) gene A1298C polymorphisms and breast cancer risk among Chinese population have yielded conflicting results. The purpose of this study was to clarify the association between MTHFR gene A1298C polymorphisms and breast cancer risk among Chinese population. Methods: Systematic searches were performed through the database of Medline/PubMed, Science Direct, Elsevier, CNKI and Wanfang Medical Online. Results: Overall, a significantly increased risk of breast cancer was observed among the subjects carrying MTHFR gene A1298C AC+CC genotype (odds ratio [OR]=1.05 with 95% confidence interval [CI]: 1.01-1.10) as compared to those carrying AA genotype among total Chinese population. We did not observe any significant association between MTHFR gene A1298C polymorphisms and the risk of breast cancer under the additional genetic models of AC vs. AA, CC vs. AA and C-allele vs. A-allele (OR=1.00 with 95% CI: 0.97-1.02, OR=1.01 with 95% CI: 1.00-1.02 and OR=1.00 with 95% CI: 0.99-1.02, respectively). The cumulative meta-analysis showed similar results. In subgroup analysis, we observed subjects carrying AC+CC genotype had an increased breast cancer risk compared with those carrying AA genotype among the studies of sample size less than 1000. We did not observe any significant association between MTHFR gene A1298C polymorphisms and breast cancer risk in additional subgroup analyses. Conclusions: Our results suggest that MTHFR gene A1298C AC+CC genotype may be a risk factor for the development of breast cancer among Chinese population. Well-designed studies with a large sample size are needed to further confirm our findings. PMID:26884927

  3. Affiliation buffers stress: cumulative genetic risk in oxytocin–vasopressin genes combines with early caregiving to predict PTSD in war-exposed young children

    PubMed Central

    Feldman, R; Vengrober, A; Ebstein, R P

    2014-01-01

    Research indicates that risk for post-traumatic stress disorder (PTSD) is shaped by the interaction between genetic vulnerability and early caregiving experiences; yet, caregiving has typically been assessed by adult retrospective accounts. Here, we employed a prospective longitudinal design with real-time observations of early caregiving combined with assessment of genetic liability along the axis of vasopressin–oxytocin (OT) gene pathways to test G × E contributions to PTSD. Participants were 232 young Israeli children (1.5–5 years) and their parents, including 148 living in zones of continuous war and 84 controls. A cumulative genetic risk factor was computed for each family member by summing five risk alleles across three genes (OXTR, CD38 and AVPR1a) previously associated with psychopathology, sociality and caregiving. Child PTSD was diagnosed and mother–child interactions were observed in multiple contexts. In middle childhood (7–8 years), child psychopathology was re-evaluated. War exposure increased propensity to develop Axis-I disorder by threefold: 60% of exposed children displayed a psychiatric disorder by middle childhood and 62% of those showed several comorbid disorders. On the other hand, maternal sensitive support reduced risk for psychopathology. G × E effect was found for child genetic risk: in the context of war exposure, greater genetic risk on the vasopressin–OT pathway increased propensity for psychopathology. Among exposed children, chronicity of PTSD from early to middle childhood was related to higher child, maternal and paternal genetic risk, low maternal support and greater initial avoidance symptoms. Child avoidance was predicted by low maternal support and reduced mother–child reciprocity. These findings underscore the saliency of both genetic and behavioral facets of the human affiliation system in shaping vulnerability to PTSD as well as providing an underlying mechanism of post-traumatic resilience. PMID:24618689

  4. Migration, refugees, and health risks.

    PubMed Central

    Carballo, M.; Nerukar, A.

    2001-01-01

    Migration both voluntary and forced is increasing all over the world. People are moving in larger numbers faster and further than at any other time in history. This is happening at a time when many countries are ill-prepared to deal with a changing demography and when policies and attitudes to population movement and immigration are hardening. The health implications of this are many, and, in some cases, illness and death rates associated with migration are exacerbated by a lack of policies needed to make migration a healthy and socially productive process. From a public health point of view, this is having and will continue to have serious ramifications for the people that move, the family they leave behind, and the communities that host the newcomers. PMID:11485671

  5. Migration, refugees, and health risks.

    PubMed

    Carballo, M; Nerukar, A

    2001-01-01

    Migration both voluntary and forced is increasing all over the world. People are moving in larger numbers faster and further than at any other time in history. This is happening at a time when many countries are ill-prepared to deal with a changing demography and when policies and attitudes to population movement and immigration are hardening. The health implications of this are many, and, in some cases, illness and death rates associated with migration are exacerbated by a lack of policies needed to make migration a healthy and socially productive process. From a public health point of view, this is having and will continue to have serious ramifications for the people that move, the family they leave behind, and the communities that host the newcomers.

  6. Putting risk in its place: methodological considerations for investigating extreme event health risk.

    PubMed

    Smoyer, K E

    1998-12-01

    Health is affected by the places in which people live, work and interact, yet many epidemiological studies overlook the characteristics of places and instead focus solely on the people who inhabit them. Place-based investigations of disparities in health outcomes are concerned with the healthiness of places and not merely the healthiness of the populations in these places. A place-based approach has been used within medical geography and medical sociology, typically in the study of health differentials associated with long-term, cumulative exposures to a wide range of environmental variables. This approach has rarely been extended, however, to health research that looks at the effects of extreme events (such as industrial accidents or hurricanes). The purpose of this paper is to incorporate a place-based framework into extreme event health research. The paper first discusses methodological considerations for a place-based approach and then illustrates the use of spatial analysis techniques as the first step in identifying place-based risk factors in mortality associated with heat waves. The study centers on St. Louis, Missouri, a city where heat waves are frequent and heat-related mortality is high. The results show that heat-related mortality rates during the most severe heat waves were generally higher in the warmer, less stable and more disadvantaged areas of St. Louis and lower in the cooler and more affluent parts of the city. During the milder years analyzed, there was little evidence of a relationship between place-based characteristics and the distribution of heat-related mortality. These findings about extreme event mortality risk would not have been evident from a population-based analysis. Ongoing dialog between epidemiologists and social scientists can help to bring place into the arena of extreme event research and to increase understanding of the role of place in risk.

  7. Cumulative Environmental Risk in Substance Abusing Women: Early Intervention, Parenting Stress, Child Abuse Potential and Child Development.

    ERIC Educational Resources Information Center

    Kelley, Susan J.

    2003-01-01

    A study of 161 substance-abusing mothers assessed 10 maternal risk factors: maternal depression; domestic violence; nondomestic violence; family size; incarceration; no significant other at home; negative life events; psychiatric problems; homelessness; and drug use severity. Parenting stress and child abuse potential was higher for women with…

  8. Integrating Etiological Models of Social Anxiety and Depression in Youth: Evidence for a Cumulative Interpersonal Risk Model

    ERIC Educational Resources Information Center

    Epkins, Catherine C.; Heckler, David R.

    2011-01-01

    Models of social anxiety and depression in youth have been developed separately, and they contain similar etiological influences. Given the high comorbidity of social anxiety and depression, we examine whether the posited etiological constructs are a correlate of, or a risk factor for, social anxiety and/or depression at the symptom level and the…

  9. Cumulative Risk, the Mother-Child Relationship, and Social-Emotional Competence in Latino Head Start Children

    ERIC Educational Resources Information Center

    Martí, Maria; Bonillo, Albert; Jané, Maria Claustre; Fisher, Elisa M.; Duch, Helena

    2016-01-01

    Research Findings: Supportive mother-child interactions promote the development of social-emotional competence. Poverty and other associated psychosocial risk factors have a negative impact on mother-child interaction. In spite of Latino children being disproportionately represented among children living in poverty, research on mother-child…

  10. Space Radiation and Risks to Human Health

    NASA Technical Reports Server (NTRS)

    Huff, Janice L.; Patel, Zarana S.; Simonsen, Lisa C.

    2014-01-01

    The radiation environment in space poses significant challenges to human health and is a major concern for long duration manned space missions. Outside the Earth's protective magnetosphere, astronauts are exposed to higher levels of galactic cosmic rays, whose physical characteristics are distinct from terrestrial sources of radiation such as x-rays and gamma-rays. Galactic cosmic rays consist of high energy and high mass nuclei as well as high energy protons; they impart unique biological damage as they traverse through tissue with impacts on human health that are largely unknown. The major health issues of concern are the risks of radiation carcinogenesis, acute and late decrements to the central nervous system, degenerative tissue effects such as cardiovascular disease, as well as possible acute radiation syndromes due to an unshielded exposure to a large solar particle event. The NASA Human Research Program's Space Radiation Program Element is focused on characterization and mitigation of these space radiation health risks along with understanding these risks in context of the other biological stressors found in the space environment. In this overview, we will provide a description of these health risks and the Element's research strategies to understand and mitigate these risks.

  11. Health risks and benefits of bottled water.

    PubMed

    Napier, Gena L; Kodner, Charles M

    2008-12-01

    Health and safety concerns have dramatically increased the consumption of bottled water in developed countries, including the United States. The economic and environmental impact of the many different bottled water products on the market is considerable, and the role and impact of bottled water for routine use is unclear, outside the setting of emergencies or natural disasters, when routine water sources may be unsafe. Evidence for routine health risks or benefits from using bottled water is limited. Patients who have specific health needs may wish to use bottled or filtered water. Physicians can use background information regarding the regulation, production, and possible health impact of bottled water to counsel patients.

  12. An instrument for broadened risk assessment in antenatal health care including non-medical issues

    PubMed Central

    Vos, Amber A.; van Veen, Mieke J.; Birnie, Erwin; Denktaş, Semiha; Steegers, Eric A.P.; Bonsel, Gouke J.

    2015-01-01

    Introduction Growing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed a non-invasive, standardized instrument for comprehensive antenatal risk assessment. The current study presents the application-oriented development of a risk screening instrument for early antenatal detection of risk factors and tailored prevention in an integrated care setting. Methods A review of published instruments complemented with evidence from cohort studies. Selection and standardization of risk factors associated with small for gestational age, preterm birth, congenital anomalies and perinatal mortality. Risk factors were weighted to obtain a cumulative risk score. Responses were then connected to corresponding care pathways. A cumulative risk threshold was defined, which can be adapted to the population and the availability of preventive facilities. A score above the threshold implies multidisciplinary consultation between caregivers. Results The resulting digital score card consisted of 70 items, subdivided into four non-medical and two medical domains. Weighing of risk factors was based on existing evidence. Pilot-evidence from a cohort of 218 pregnancies in a multi-practice urban setting showed a cut-off of 16 points would imply 20% of all pregnant women to be assessed in a multidisciplinary setting. A total of 28 care pathways were defined. Conclusion The resulting score card is a universal risk screening instrument which incorporates recent evidence on non-medical risk factors for adverse pregnancy outcomes and enables systematic risk management in an integrated antenatal health care setting. PMID:25780351

  13. Cumulative risks of foster care placement by age 18 for U.S. children, 2000-2011.

    PubMed

    Wildeman, Christopher; Emanuel, Natalia

    2014-01-01

    Foster care placement is among the most tragic events a child can experience because it more often than not implies that a child has experienced or is at very high risk of experiencing abuse or neglect serious enough to warrant state intervention. Yet it is unclear how many children will experience foster care placement at some point between birth and age 18. Using synthetic cohort life tables and data from the Adoption and Foster Care Analysis and Reporting System (AFCARS), we estimated how many U.S. children were placed in foster care between birth and age 18, finding support for three conclusions. First, up to 5.91% of all U.S. children were ever placed in foster care between their birth and age 18. Second, Native American (up to 15.44%) and Black (up to 11.53%) children were at far higher risk of placement. Foster care is thus quite common in the U.S., especially for historically disadvantaged racial/ethnic groups. Third, differences in foster care placement were minimal between the sexes, indicating that the high risks of foster care placement are shared almost equally by boys and girls.

  14. Assessment of health risks of policies

    SciTech Connect

    Ádám, Balázs; Molnár, Ágnes; Ádány, Róza; Bianchi, Fabrizio; Bitenc, Katarina; Chereches, Razvan; Cori, Liliana; Fehr, Rainer; Kobza, Joanna; Kollarova, Jana; and others

    2014-09-15

    The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals.

  15. Predicting Stroke Risk Based on Health Behaviours: Development of the Stroke Population Risk Tool (SPoRT)

    PubMed Central

    Manuel, Douglas G.; Tuna, Meltem; Perez, Richard; Tanuseputro, Peter; Hennessy, Deirdre; Bennett, Carol; Rosella, Laura; Sanmartin, Claudia; van Walraven, Carl; Tu, Jack V.

    2015-01-01

    Background Health behaviours, important factors in cardiovascular disease, are increasingly a focus of prevention. We appraised whether stroke risk can be accurately assessed using self-reported information focused on health behaviours. Methods Behavioural, sociodemographic and other risk factors were assessed in a population-based survey of 82 259 Ontarians who were followed for a median of 8.6 years (688 000 person-years follow-up) starting in 2001. Predictive algorithms for 5-year incident stroke resulting in hospitalization were created and then validated in a similar 2007 survey of 28 605 respondents (median 4.2 years follow-up). Results We observed 3 236 incident stroke events (1 551 resulting in hospitalization; 1 685 in the community setting without hospital admission). The final algorithms were discriminating (C-stat: 0.85, men; 0.87, women) and well-calibrated (in 65 of 67 subgroups for men; 61 of 65 for women). An index was developed to summarize cumulative relative risk of incident stroke from health behaviours and stress. For men, each point on the index corresponded to a 12% relative risk increase (180% risk difference, lowest (0) to highest (9) scores). For women, each point corresponded to a 14% relative risk increase (340% difference, lowest (0) to highest (11) scores). Algorithms for secondary stroke outcomes (stroke resulting in death; classified as ischemic; excluding transient ischemic attack; and in the community setting) had similar health behaviour risk hazards. Conclusion Incident stroke can be accurately predicted using self-reported information focused on health behaviours. Risk assessment can be performed with population health surveys to support population health planning or outside of clinical settings to support patient-focused prevention. PMID:26637172

  16. Merging the fields of mental health and social enterprise: lessons from abroad and cumulative findings from research with homeless youths.

    PubMed

    Ferguson, Kristin M

    2012-08-01

    Despite the growing integration of supported employment within the mental health system in the United States as well as the widespread use of social enterprises abroad, the fields of mental health and social enterprises remain largely separate in the USA. The mental health field currently lacks a response that strengthens homeless youths' existing human and social capital, provides them with marketable job skills and employment, and impacts their mental health. To address this gap, this paper establishes a case for using social enterprises with homeless youths, drawing on both global precedents and findings from a mixed-methods study of a social enterprise intervention with homeless youths. Recommendations are offered for how to integrate social enterprises with mental health treatment as well as how to evaluate their impact on mental health outcomes.

  17. Physical Activity, Health Benefits, and Mortality Risk

    PubMed Central

    Kokkinos, Peter

    2012-01-01

    A plethora of epidemiologic evidence from large studies supports unequivocally an inverse, independent, and graded association between volume of physical activity, health, and cardiovascular and overall mortality. This association is evident in apparently healthy individuals, patients with hypertension, type 2 diabetes mellitus, and cardiovascular disease, regardless of body weight. Moreover, the degree of risk associated with physical inactivity is similar to, and in some cases even stronger than, the more traditional cardiovascular risk factors. The exercise-induced health benefits are in part related to favorable modulations of cardiovascular risk factors observed by increased physical activity or structured exercise programs. Although the independent contribution of the exercise components, intensity, duration, and frequency to the reduction of mortality risk is not clear, it is well accepted that an exercise volume threshold defined at caloric expenditure of approximately 1,000 Kcal per week appears to be necessary for significant reduction in mortality risk. Further reductions in risk are observed with higher volumes of energy expenditure. Physical exertion is also associated with a relatively low and transient increase in risk for cardiac events. This risk is significantly higher for older and sedentary individuals. Therefore, such individuals should consult their physician prior to engaging in exercise. “Walking is man’s best medicine”Hippocrates PMID:23198160

  18. The risks of innovation in health care.

    PubMed

    Enzmann, Dieter R

    2015-04-01

    Innovation in health care creates risks that are unevenly distributed. An evolutionary analogy using species to represent business models helps categorize innovation experiments and their risks. This classification reveals two qualitative categories: early and late diversification experiments. Early diversification has prolific innovations with high risk because they encounter a "decimation" stage, during which most experiments disappear. Participants face high risk. The few decimation survivors can be sustaining or disruptive according to Christensen's criteria. Survivors enter late diversification, during which they again expand, but within a design range limited to variations of the previous surviving designs. Late diversifications carry lower risk. The exception is when disruptive survivors "diversify," which amplifies their disruption. Health care and radiology will experience both early and late diversifications, often simultaneously. Although oversimplifying Christensen's concepts, early diversifications are likely to deliver disruptive innovation, whereas late diversifications tend to produce sustaining innovations. Current health care consolidation is a manifestation of late diversification. Early diversifications will appear outside traditional care models and physical health care sites, as well as with new science such as molecular diagnostics. They warrant attention because decimation survivors will present both disruptive and sustaining opportunities to radiology. Radiology must participate in late diversification by incorporating sustaining innovations to its value chain. Given the likelihood of disruptive survivors, radiology should seriously consider disrupting itself rather than waiting for others to do so. Disruption entails significant modifications of its value chain, hence, its business model, for which lessons may become available from the pharmaceutical industry's current simultaneous experience with early and late diversifications.

  19. Health risks in perspective: Judging health risks of energy technologies. Revision 5/94

    SciTech Connect

    Rowe, M.D.

    1992-09-01

    The purpose of this report is to provide perspective on the various risks to which man is routinely exposed. It serves as a basis for understanding the meaning of quantitative risk estimates and for comparing new or newly-discovered risks with other, better-understood risks. Specific emphasis is placed on health risks of energy technologies. This report is not a risk assessment; nor does it contain instructions on how to do a risk assessment. Rather, it provides background information on how most of us think about risks and why it is difficult to do it rationally, it provides a philosophy and data with which to do a better job of judging risks more rationally, and it provides an overview of where risks of energy technologies fit within the spectrum of all risks. Much of the quantitative information provided here is on relative risk of dying of various causes. This is not because risk of dying is seen as the most important kind of risk, but because the statistics on mortality rates by cause are the highest quality data available on health risks in the general population.

  20. Prioritizing environmental health risks in the UAE.

    PubMed

    Willis, Henry H; Gibson, Jacqueline MacDonald; Shih, Regina A; Geschwind, Sandra; Olmstead, Sarah; Hu, Jianhui; Curtright, Aimee E; Cecchine, Gary; Moore, Melinda

    2010-12-01

    This article presents the results of a comparative environmental risk-ranking exercise that was conducted in the United Arab Emirates (UAE) to inform a strategic planning process led by the Environment Agency-Abu Dhabi (EAD). It represents the first national-level application of a deliberative method for comparative risk ranking first published in this journal. The deliberative method involves a five-stage process that includes quantitative risk assessment by experts and deliberations by groups of stakeholders. The project reported in this article considered 14 categories of environmental risks to health identified through discussions with EAD staff: ambient and indoor air pollution; drinking water contamination; coastal water pollution; soil and groundwater contamination; contamination of fruits, vegetables, and seafood; ambient noise; stratospheric ozone depletion; electromagnetic fields from power lines; health impacts from climate change; and exposure to hazardous substances in industrial, construction, and agricultural work environments. Results from workshops involving 73 stakeholders who met in five separate groups to rank these risks individually and collaboratively indicated strong consensus that outdoor and indoor air pollution are the highest priorities in the UAE. Each of the five groups rated these as being among the highest risks. All groups rated soil and groundwater contamination as being among the lowest risks. In surveys administered after the ranking exercises, participants indicated that the results of the process represented their concerns and approved of using the ranking results to inform policy decisions. The results ultimately shaped a strategic plan that is now being implemented.

  1. Human health risk associated with exposure to toxic elements in mainstream and sidestream cigarette smoke.

    PubMed

    Behera, Sailesh N; Xian, Huang; Balasubramanian, Rajasekhar

    2014-02-15

    Toxic particulate elements present in cigarette smoke pose health threats to the life of smokers due to direct inhalation and at the same time increase health risks to non-smokers present in the vicinity of smokers because of their exposure. This study conducted a series of experiments using a controlled experimental chamber, equipped with simulated smoking conditions for characterization of particulate trace elements in mainstream and sidestream cigarette smoke. Four popular commercial cigarette brands available in Singapore market were used in this study. The target elements for extraction and analysis were Al, As, B, Ba, Be, Bi, Ca, Cd, Co, Cr, Cs, Cu, Fe, Ga, Hg, K, Li, Mg, Mn, Na, Ni, Pb, Rb, Se, Sn, Sr, Te, Tl and Zn of both water-soluble and total constituents. The human health risk assessment results showed that the sidestream smoke had higher concentrations of toxic elements than those in the mainstream smoke. However, risk assessment analysis revealed that the sidestream smoke resulted in less human health risks compared to the mainstream smoke due to the influence of dilution of particulate emissions in sidestream smoke prior to inhalation exposure experienced by non-smokers. The cumulative non-cancer and cancer risks of toxic elements varied from 2.0 to 3.1 and from 398.4×10(-6) to 626.1×10(-6) due to inhalation of cigarette smoke by an active smoker. In the case of non-smokers, the risks were estimated under three possible cases of exposure. The cumulative cancer risks under three different cases were greater than the permissible limits. Therefore, it could be concluded that the toxic particulate elements present in cigarette smoke have significant carcinogenic and non-carcinogenic health effects due to inhalation exposure in the environment.

  2. Racial/Ethnic Disparities in Cumulative Environmental Health Impacts in California: Evidence From a Statewide Environmental Justice Screening Tool (CalEnviroScreen 1.1)

    PubMed Central

    Faust, John; August, Laura Meehan; Cendak, Rose; Wieland, Walker; Alexeeff, George

    2015-01-01

    Objectives. We used an environmental justice screening tool (CalEnviroScreen 1.1) to compare the distribution of environmental hazards and vulnerable populations across California communities. Methods. CalEnviroScreen 1.1 combines 17 indicators created from 2004 to 2013 publicly available data into a relative cumulative impact score. We compared cumulative impact scores across California zip codes on the basis of their location, urban or rural character, and racial/ethnic makeup. We used a concentration index to evaluate which indicators were most unequally distributed with respect to race/ethnicity and poverty. Results. The unadjusted odds of living in one of the 10% most affected zip codes were 6.2, 5.8, 1.9, 1.8, and 1.6 times greater for Hispanics, African Americans, Native Americans, Asian/Pacific Islanders, and other or multiracial individuals, respectively, than for non-Hispanic Whites. Environmental hazards were more regressively distributed with respect to race/ethnicity than poverty, with pesticide use and toxic chemical releases being the most unequal. Conclusions. Environmental health hazards disproportionately burden communities of color in California. Efforts to reduce disparities in pollution burden can use simple screening tools to prioritize areas for action. PMID:26378826

  3. Psychophysiological assessment of stress and screening of health risk in peacekeeping operations.

    PubMed

    Nikolova, Rouja; Aleksiev, Lyubomir; Vukov, Mircho

    2007-01-01

    Medical surveillance for military personnel participating in peacekeeping missions (PKMs) is required to define the effect of stress on health status. The aim of this study was to determine the effect of stress on the autonomic cardiovascular control and health risk of 72 Bulgarian peacekeepers participating in a PKM in Kosovo. The assessment of psychophysiological stress and determination of stress characteristics were implemented with analysis of heart rate variability and personal interviews. As a response to the cumulative exposure to the effect of stress on cognitive function, we observed reductions in parasympathetic function and baroreceptor modulation of heart rhythm. The alteration in cardiovascular control was registered as decreases in short-term variability and spectral powers of cardiointervals in the respiratory sinus arrhythmia and Traube-Hering-Mayer bands. The advantage of psychophysiological stress assessment and screening of health risk in PKMs is that results indicate the mechanisms of the effects of stress on cognitive function and health status. PMID:17274265

  4. Identification and Quantification of Cumulative Factors that Increase Environmental Exposures and Impacts

    EPA Science Inventory

    Evaluating the combined adverse effects of multiple stressors upon human health is an imperative component of cumulative risk assessment (CRA)1. In addition to chemical stressors, other non-chemical factors are also considered. For examples, smoking will elevate the risks of havi...

  5. Critical Thinking for Environmental Health Risk Education.

    ERIC Educational Resources Information Center

    Gregory, Robin

    1991-01-01

    Proposes an approach for helping school-age children to think critically about environmental health risks. Discusses elements of a school curriculum--defining a decision perspective, making choices under uncertainty, and thinking about consequences--and recommends classroom implementation procedures. (Author/JOW)

  6. Evaluating Potential Health Risks in Relocatable Classrooms.

    ERIC Educational Resources Information Center

    Katchen, Mark; LaPierre, Adrienne; Charlin, Cary; Brucker, Barry; Ferguson, Paul

    2001-01-01

    Only limited data exist describing potential exposures to chemical and biological agents when using portable classrooms or outlining how to assess and reduce associated health risks. Evaluating indoor air quality involves examining ventilating rates, volatile organic compounds, and microbiologicals. Open communication among key stakeholders is…

  7. The association of the CYP1A1 Ile462Val polymorphism with head and neck cancer risk: evidence based on a cumulative meta-analysis

    PubMed Central

    Wang, Yadong; Yang, Haiyan; Duan, Guangcai; Wang, Haiyu

    2016-01-01

    Objective The aim of this study was to address the association between the Ile462Val polymorphism in the gene encoding cytochrome P450 1A1 (CYP1A1) and the risk of head and neck cancer (HNC). Materials and methods The Medline/PubMed, EMBASE, and Web of Science databases were searched. The strength of the association was evaluated by calculating the odds ratio (OR) with a 95% confidence interval (CI). Results Overall, we observed an increased risk of HNC in patients with the Ile/Val+Val/Val genotype compared to those with the Ile/Ile genotype among the 6,367 cases and 6,395 controls evaluated in the 34 eligible studies, with a pooled OR of 1.284 (95% CI: 1.119–1.473). In addition, we observed an increased risk of HNC in patients with the Ile/Val+Val/Val genotype compared to those with the Ile/Ile genotype in the subgroup analyses (OR =1.362, 95% CI: 1.102–1.685 for laryngeal cancer; OR =1.519, 95% CI: 1.253–1.843 for pharyngeal cancer; OR =1.371, 95% CI: 1.111–1.693 for Asians; and OR =1.329, 95% CI: 1.138–1.551 for patients in studies using hospital-based controls). Conclusion This cumulative meta-analysis suggests that the CYP1A1 Ile462Val polymorphism might contribute to the risk of HNC, particularly for pharyngeal cancer and laryngeal cancer. PMID:27274286

  8. [Environment and child health: from health transition to shared risk?].

    PubMed

    Revault, P; Monjour, L

    2003-01-01

    Children under the age of 18 account for almost half of the world's population, with most living in developing countries. Young people are especially sensitive to acute and chronic environmental conditions and 43% of environmental diseases occur in the 12% of the world's population under age 5. The main environmental threats to the health of children in developing countries are inadequate access to clean water for drinking and hygiene, exposure to air pollution: primarily indoors and secondarily outdoors, risk of accidents and wounds, and poisoning due to toxic products. Recent data suggest that the number and diversity of environmental risk factors affecting child health is increasing as a result of increasing malnutrition, pollution, and violence and consequently that the level of health and quality of life of future generations will decrease. Due to the complexity of the interactions between environmental factors and socio-economic determinants, the epidemiological transition model is poorly suited to analyzing and predicting the concurring risks of infectious disease and chronic disease (diabetes, cancer...). This article presents a number of recommendations for training health professional, developing environmental reference centers, implementing risk assessment, coordinating decentralized activities and policy, and involving parents and children in the decisional process with emphasis on divulgating study findings and developing interfaces between the various stakeholders.

  9. Health risks of photovoltaic energy technologies

    NASA Astrophysics Data System (ADS)

    Moskowitz, P. D.; Hamilton, L. D.; Morris, S. C.; Novak, K. M.; Robinson, C. V.; Rowe, M. D.

    1981-12-01

    Health risks of photovoltaic energy technologies arise from mining, processing and refining of raw materials, and fabrication, installation, operation, and disposal of devices used to convert sunlight into useful energy. Using an accounting approach, public and occupational health risks are examined for four different photovoltaic cell alternatives: silicon single-crystal cells produced by an ingot process; silicon metal/insulator/semiconductor cells produced by ribbon growing; cadmium sulfide backwall cells produced by spray deposition; and gallium arsenide cells produced by modified ingot-growing. These alternatives cover a range of manufacturing options (e.g., ingot versus spray deposition) and materials (silicon versus arsenic) which might be used in future commercialization efforts. Most occupational mortality and morbidity effects probably relate to industrial risks similar to those encountered in the day-to-day operation of any industrial operation. Material supply, installation, and operation appear to contribute substantial portions of the damage.

  10. Pesticide residues in cashew apple, guava, kaki and peach: GC-μECD, GC-FPD and LC-MS/MS multiresidue method validation, analysis and cumulative acute risk assessment.

    PubMed

    Jardim, Andréia Nunes Oliveira; Mello, Denise Carvalho; Goes, Fernanda Caroline Silva; Frota Junior, Elcio Ferreira; Caldas, Eloisa Dutra

    2014-12-01

    A multiresidue method for the determination of 46 pesticides in fruits was validated. Samples were extracted with acidified ethyl acetate, MgSO4 and CH3COONa and cleaned up by dispersive SPE with PSA. The compounds were analysed by GC-FPD, GC-μECD or LC-MS/MS, with LOQs from 1 to 8 μg/kg. The method was used to analyse 238 kaki, cashew apple, guava, and peach fruit and pulp samples, which were also analysed for dithiocarbamates (DTCs) using a spectrophotometric method. Over 70% of the samples were positive, with DTC present in 46.5%, λ-cyhalothrin in 37.1%, and omethoate in 21.8% of the positive samples. GC-MS/MS confirmed the identities of the compounds detected by GC. None of the pesticides found in kaki, cashew apple and guava was authorised for these crops in Brazil. The risk assessment has shown that the cumulative acute intake of organophosphorus or pyrethroid compounds from the consumption of these fruits is unlikely to pose a health risk to consumers. PMID:24996324

  11. Pesticide residues in cashew apple, guava, kaki and peach: GC-μECD, GC-FPD and LC-MS/MS multiresidue method validation, analysis and cumulative acute risk assessment.

    PubMed

    Jardim, Andréia Nunes Oliveira; Mello, Denise Carvalho; Goes, Fernanda Caroline Silva; Frota Junior, Elcio Ferreira; Caldas, Eloisa Dutra

    2014-12-01

    A multiresidue method for the determination of 46 pesticides in fruits was validated. Samples were extracted with acidified ethyl acetate, MgSO4 and CH3COONa and cleaned up by dispersive SPE with PSA. The compounds were analysed by GC-FPD, GC-μECD or LC-MS/MS, with LOQs from 1 to 8 μg/kg. The method was used to analyse 238 kaki, cashew apple, guava, and peach fruit and pulp samples, which were also analysed for dithiocarbamates (DTCs) using a spectrophotometric method. Over 70% of the samples were positive, with DTC present in 46.5%, λ-cyhalothrin in 37.1%, and omethoate in 21.8% of the positive samples. GC-MS/MS confirmed the identities of the compounds detected by GC. None of the pesticides found in kaki, cashew apple and guava was authorised for these crops in Brazil. The risk assessment has shown that the cumulative acute intake of organophosphorus or pyrethroid compounds from the consumption of these fruits is unlikely to pose a health risk to consumers.

  12. Emerging Radiation Health-Risk Mitigation Technologies

    NASA Astrophysics Data System (ADS)

    Wilson, J. W.; Cucinotta, F. A.; Schimmerling, W.

    2004-02-01

    Past space missions beyond the confines of the Earth's protective magnetic field have been of short duration and protection from the effects of solar particle events was of primary concern. The extension of operational infrastructure beyond low-Earth orbit to enable routine access to more interesting regions of space will require protection from the hazards of the accumulated exposures of Galactic Cosmic Rays (GCR). There are significant challenges in providing protection from the long-duration exposure to GCR: the human risks to the exposures are highly uncertain and safety requirements places unreasonable demands in supplying sufficient shielding materials in the design. A vigorous approach to future radiation health-risk mitigation requires a triage of techniques (using biological and technical factors) and reduction of the uncertainty in radiation risk models. The present paper discusses the triage of factors for risk mitigation with associated materials issues and engineering design methods.

  13. Emerging Radiation Health-Risk Mitigation Technologies

    SciTech Connect

    Wilson, J.W.; Cucinotta, F.A.; Schimmerling, W.

    2004-02-04

    Past space missions beyond the confines of the Earth's protective magnetic field have been of short duration and protection from the effects of solar particle events was of primary concern. The extension of operational infrastructure beyond low-Earth orbit to enable routine access to more interesting regions of space will require protection from the hazards of the accumulated exposures of Galactic Cosmic Rays (GCR). There are significant challenges in providing protection from the long-duration exposure to GCR: the human risks to the exposures are highly uncertain and safety requirements places unreasonable demands in supplying sufficient shielding materials in the design. A vigorous approach to future radiation health-risk mitigation requires a triage of techniques (using biological and technical factors) and reduction of the uncertainty in radiation risk models. The present paper discusses the triage of factors for risk mitigation with associated materials issues and engineering design methods.

  14. A feasibility study on assessing public health impacts of cumulative air pollution reduction activities in a small geographic area

    EPA Science Inventory

    Background and Objective: The rnain objective ofthis study was to examine the feasibility ofconducting a local (e.g., city level) assessment ofthe public health impacts ofcumulative air pollution reduction activities (a.k.a. accountability) from the federal, state, local and vo...

  15. The Cumulative Effect of Gene-Gene and Gene-Environment Interactions on the Risk of Prostate Cancer in Chinese Men

    PubMed Central

    Liu, Ming; Shi, Xiaohong; Yang, Fan; Wang, Jianye; Xu, Yong; Wei, Dong; Yang, Kuo; Zhang, Yaoguang; Wang, Xin; Liang, Siying; Chen, Xin; Sun, Liang; Zhu, Xiaoquan; Zhao, Chengxiao; Zhu, Ling; Tang, Lei; Zheng, Chenguang; Yang, Ze

    2016-01-01

    Prostate cancer (PCa) is a multifactorial disease involving complex genetic and environmental factors interactions. Gene-gene and gene-environment interactions associated with PCa in Chinese men are less studied. We explored the association between 36 SNPs and PCa in 574 subjects from northern China. Body mass index (BMI), smoking, and alcohol consumption were determined through self-administered questionnaires in 134 PCa patients. Then gene-gene and gene-environment interactions among the PCa-associated SNPs were analyzed using the generalized multifactor dimensionality reduction (GMDR) and logistic regression methods. Allelic and genotypic association analyses showed that six variants were associated with PCa and the cumulative effect suggested men who carried any combination of 1, 2, or ≥3 risk genotypes had a gradually increased PCa risk (odds ratios (ORs) = 1.79–4.41). GMDR analysis identified the best gene-gene interaction model with scores of 10 for both the cross-validation consistency and sign tests. For gene-environment interactions, rs6983561 CC and rs16901966 GG in individuals with a BMI ≥ 28 had ORs of 7.66 (p = 0.032) and 5.33 (p = 0.046), respectively. rs7679673 CC + CA and rs12653946 TT in individuals that smoked had ORs of 2.77 (p = 0.007) and 3.11 (p = 0.024), respectively. rs7679673 CC in individuals that consumed alcohol had an OR of 4.37 (p = 0.041). These results suggest that polymorphisms, either individually or by interacting with other genes or environmental factors, contribute to an increased risk of PCa. PMID:26828504

  16. Multimorbidity in elderly hospitalised patients and risk of Clostridium difficile infection: a retrospective study with the Cumulative Illness Rating Scale (CIRS)

    PubMed Central

    Ticinesi, Andrea; Nouvenne, Antonio; Folesani, Giuseppina; Prati, Beatrice; Morelli, Ilaria; Guida, Loredana; Turroni, Francesca; Ventura, Marco; Lauretani, Fulvio; Maggio, Marcello; Meschi, Tiziana

    2015-01-01

    Objectives To identify the role of chronic comorbidities, considered together in a literature-validated index (Cumulative Illness Rating Scale, CIRS), and antibiotic or proton-pump inhibitor (PPI) treatments as risk factors for hospital-acquired Clostridium difficile infection (CDI) in elderly multimorbid hospitalised patients. Design Retrospective cohort study. Setting Subacute hospital geriatric care ward in Italy. Participants 505 (238 male (M), 268 female (F)) elderly (age ≥65) multimorbid patients. Main outcome measures The relationship between CDI and CIRS Comorbidity Score, number of comorbidities, antibiotic, antifungal and PPI treatments, and length of hospital stay was assessed through age-adjusted and sex-adjusted and multivariate logistic regression models. The CIRS Comorbidity Score was handled after categorisation in quartiles. Results Mean age was 80.7±11.3 years. 43 patients (22 M, 21 F) developed CDI. The prevalence of CDI increased among quartiles of CIRS Comorbidity Score (3.9% first quartile vs 11.1% fourth quartile, age-adjusted and sex-adjusted p=0.03). In the multivariate logistic regression analysis, patients in the highest quartile of CIRS Comorbidity Score (≥17) carried a significantly higher risk of CDI (OR 5.07, 95% CI 1.28 to 20.14, p=0.02) than patients in the lowest quartile (<9). The only other variable significantly associated with CDI was antibiotic therapy (OR 2.62, 95% CI 1.21 to 5.66, p=0.01). PPI treatment was not associated with CDI. Conclusions Multimorbidity, measured through CIRS Comorbidity Score, is independently associated with the risk of CDI in a population of elderly patients with prolonged hospital stay. PMID:26503394

  17. Risk Analysis for Environmental Health Triage

    SciTech Connect

    Bogen, K T

    2005-11-18

    The Homeland Security Act mandates development of a national, risk-based system to support planning for, response to and recovery from emergency situations involving large-scale toxic exposures. To prepare for and manage consequences effectively, planners and responders need not only to identify zones of potentially elevated individual risk, but also to predict expected casualties. Emergency response support systems now define ''consequences'' by mapping areas in which toxic chemical concentrations do or may exceed Acute Exposure Guideline Levels (AEGLs) or similar guidelines. However, because AEGLs do not estimate expected risks, current unqualified claims that such maps support consequence management are misleading. Intentionally protective, AEGLs incorporate various safety/uncertainty factors depending on scope and quality of chemical-specific toxicity data. Some of these factors are irrelevant, and others need to be modified, whenever resource constraints or exposure-scenario complexities require responders to make critical trade-off (triage) decisions in order to minimize expected casualties. AEGL-exceedance zones cannot consistently be aggregated, compared, or used to calculate expected casualties, and so may seriously misguide emergency response triage decisions. Methods and tools well established and readily available to support environmental health protection are not yet developed for chemically related environmental health triage. Effective triage decisions involving chemical risks require a new assessment approach that focuses on best estimates of likely casualties, rather than on upper plausible bounds of individual risk. If risk-based consequence management is to become a reality, federal agencies tasked with supporting emergency response must actively coordinate to foster new methods that can support effective environmental health triage.

  18. Women brothel workers and occupational health risks

    PubMed Central

    Cwikel, J; Ilan, K; Chudakov, B

    2003-01-01

    Study objectives: This study examined working conditions, reported morbidity, symptoms of post-traumatic stress disorder (PTSD) and depression and their relation to an index of occupational health risk among women working in brothels in Israel. Design: Personal structured interviews with a scale of occupational risk that included seven self report items reflecting past and present morbidity and symptoms. Participants and setting: A purposive sample of 55 women in three cities in Israel, between the ages of 18–38. Main results: Most (82%) women were trafficked into Israel to work illegally in prostitution, effectively deriving them of access to discretionary health care. A third of the sample (32%) had a high score (between 3 to 6) on the index of occupational risk factors. A high score was not related to recent physician or gynaecological visits and was more common among illegal workers than those with residence status. A set of regression analyses showed that the most significant predictors of reporting a high level of occupational risk symptoms were starting sex work at an early age, the number of hours worked in a day, a history of suicide attempts and PTSD symptoms. Conclusions: High occupational risk was found to be unrelated to recent physician or gynaecological visits, indicating that these visits were most probably controlled by the brothel owners and not by medical need as perceived by the women themselves. Furthermore, occupational risk factors were associated with some of the working and background conditions reported by women brothel workers. There is an urgent need for medical care for this high risk group. PMID:14573588

  19. Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Sex

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2011

    2011-01-01

    The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

  20. Cumulative psychosocial stress, coping resources, and preterm birth.

    PubMed

    McDonald, Sheila W; Kingston, Dawn; Bayrampour, Hamideh; Dolan, Siobhan M; Tough, Suzanne C

    2014-12-01

    Preterm birth constitutes a significant international public health issue, with implications for child and family well-being. High levels of psychosocial stress and negative affect before and during pregnancy are contributing factors to shortened gestation and preterm birth. We developed a cumulative psychosocial stress variable and examined its association with early delivery controlling for known preterm birth risk factors and confounding environmental variables. We further examined this association among subgroups of women with different levels of coping resources. Utilizing the All Our Babies (AOB) study, an ongoing prospective pregnancy cohort study in Alberta, Canada (n = 3,021), multinomial logistic regression was adopted to examine the independent effect of cumulative psychosocial stress and preterm birth subgroups compared to term births. Stratified analyses according to categories of perceived social support and optimism were undertaken to examine differential effects among subgroups of women. Cumulative psychosocial stress was a statistically significant risk factor for late preterm birth (OR = 1.73; 95 % CI = 1.07, 2.81), but not for early preterm birth (OR = 2.44; 95 % CI = 0.95, 6.32), controlling for income, history of preterm birth, pregnancy complications, reproductive history, and smoking in pregnancy. Stratified analyses showed that cumulative psychosocial stress was a significant risk factor for preterm birth at <37 weeks gestation for women with low levels of social support (OR = 2.09; 95 % CI = 1.07, 4.07) or optimism (OR = 1.87; 95 % CI = 1.04, 3.37). Our analyses suggest that early vulnerability combined with current anxiety symptoms in pregnancy confers risk for preterm birth. Coping resources may mitigate the effect of cumulative psychosocial stress on the risk for early delivery.

  1. An assessment of health hazard/health risk appraisal.

    PubMed Central

    Wagner, E H; Beery, W L; Schoenbach, V J; Graham, R M

    1982-01-01

    A state-of-the-art review of a widely-used health promotion technique, the health hazard/health risk appraisal (HHA/HRA), was conducted. The review included preparing a 212-item annotated bibliography, compiling an inventory of 217 programs that have used HHA/HRA, holding discussions with HHA/HRA developers and users, conducting formal site visits to 15 HHA/HRA programs, and consultation with experts on epidemiology, biostatistics, and behavioral science as well as developers and users of HHA/HRA. Programs use HHA/HRA primarily as a promotional device, as a tool for structuring education about health-related behaviors, and as a motivational device for stimulating behavioral change. The scientific basis for HHA/HRA risk predictions is problematic, but their arithmetic imprecision is of less concern than insufficiency of the scientific evidence for certain behavioral recommendations, and inaccuracies in client-supplied data. Widely-held beliefs in HHA/HRA's efficacy for motivating behavioral change cannot be substantiated from available evidence, nor can the assumed absence of adverse effects. The importance of this particular health promotion technique appears to have been exaggerated. PMID:7065313

  2. Adolescent cigarette smoking and health risk behavior.

    PubMed

    Busen, N H; Modeland, V; Kouzekanani, K

    2001-06-01

    During the past 30 years, tobacco use among adolescents has substantially increased, resulting in major health problems associated with tobacco consumption. The purpose of this study was to identify adolescent smoking behaviors and to determine the relationship among smoking, specific demographic variables, and health risk behaviors. The sample consisted of 93 self-selecting adolescents. An ex post facto design was used for this study and data were analyzed by using nonparametric statistics. Findings included a statistically significant relationship between lifetime cigarette use and ethnicity. Statistically significant relationships were also found among current cigarette use and ethnicity, alcohol use, marijuana use, suicidal thoughts, and age at first sexual intercourse. Nurses and other providers must recognize that cigarette smoking may indicate other risk behaviors common among adolescents.

  3. Identifying the health risks from very low-dose sparsely ionizing radiation.

    PubMed Central

    Dreyer, N A; Friedlander, E

    1982-01-01

    The health risks from low-dose sparsely ionizing (low-LET) radiation have been the subject of continued debate. At present, quantitative estimates of risk are extremely uncertain due to the controversy surrounding both the dosimetry for A-bomb survivor data and the choice of mathematical models for extrapolating risk from high to low doses. Nevertheless, much can be learned about the nature of the health risks by reviewing the epidemiologic literature. We present a summary of diseases which have been associated with low-LET radiation (less than 1000 rad) in at least two independent studies, according to the mean cumulative organ dose at which the disease was observed. At organ doses of less than or equal to 50 rad, the only diseases that have been reported consistently are thyroid cancer, salivary gland tumors, and leukemia. The first two diseases were observed in association with x-ray epilation of the scalp for tinea capitis, a therapy which is no longer employed. On the other hand, leukemia has been observed repeatedly to occur at cumulative doses of greater than or equal to 30 rad low-LET radiation. PMID:7041660

  4. Cumulative Use of Strong Anticholinergic Medications and Incident Dementia

    PubMed Central

    Gray, Shelly L.; Anderson, Melissa L.; Dublin, Sascha; Hanlon, Joseph T.; Hubbard, Rebecca; Walker, Rod; Yu, Onchee; Crane, Paul; Larson, Eric B.

    2015-01-01

    IMPORTANCE Many medications have anticholinergic effects. The general view is that anticholinergic-induced cognitive impairment is reversible upon medication discontinuation. However, a few studies suggest that anticholinergic medications may be associated with increased dementia risk. OBJECTIVE To examine whether cumulative anticholinergic medication use is associated with a higher risk of incident dementia. DESIGN Prospective population-based cohort study using data from the Adult Changes in Thought Study. SETTING Group Health, an integrated health-care delivery system, Seattle, Washington PARTICIPANTS 3,434 participants aged 65 and older with no dementia at study entry. Initial recruitment occurred between 1994 and 1996 or 2000 and 2003. Beginning in 2004, continuous replacement for deaths occurred. All participants received follow-up every two years. EXPOSURE Using computerized pharmacy dispensing data, cumulative anticholinergic exposure was defined as the total standardized daily doses (TSDD) dispensed in the past 10 years. The most recent 12 months of use was excluded to avoid use related to prodromal symptoms. Cumulative exposure was time-varying. MAIN OUTCOMES AND MEASURES Incident dementia and Alzheimer’s disease using standard diagnostic criteria. Statistical analyses used Cox proportional hazards models, adjusted for demographic, health behaviors and health status including comorbidities. RESULTS The most common anticholinergic drug classes used were tricyclic antidepressants, first generation antihistamines and bladder antimuscarinics. Over a mean follow-up of 7.3 years, 797 participants (23%) developed dementia (637 developed Alzheimer’s). A 10-year cumulative dose-response relationship was observed for both dementia and Alzheimer’s disease (test for trend, p<0.001). For dementia, adjusted hazard ratios (HRs) and 95% confidence interval (CI) for cumulative anticholinergic use was 0.92 (95% CI, 0.74-1.16) for 1-90 TSDD; 1.19 (CI, 0.94-1.51) for

  5. Risk factors, health risks, and risk management for aircraft personnel and frequent flyers.

    PubMed

    Kim, Jeoum Nam; Lee, Byung Mu

    2007-01-01

    Health risks associated with long periods of time in flight are of concern to astronauts, crew members, and passengers. Many epidemiological studies showed that occupational and frequent flyers may be susceptible to ocular, cardiovascular, neurological, pulmonary, gastrointestinal, sensory, immunological, physiological, and even developmental disorders. In addition, the incidences of cancer and food poisoning are expected to be higher in such individuals. This article reviews health risks and risk factors associated with air travel, and discusses risk management strategies. To reduce adverse health risks, risk factors such as radiation, infection, stress, temperature, pressure, and circadian rhythm need to be avoided or reduced to levels that are as low as technologically achievable to protect flight personnel and passengers.

  6. Risk factors, health risks, and risk management for aircraft personnel and frequent flyers.

    PubMed

    Kim, Jeoum Nam; Lee, Byung Mu

    2007-01-01

    Health risks associated with long periods of time in flight are of concern to astronauts, crew members, and passengers. Many epidemiological studies showed that occupational and frequent flyers may be susceptible to ocular, cardiovascular, neurological, pulmonary, gastrointestinal, sensory, immunological, physiological, and even developmental disorders. In addition, the incidences of cancer and food poisoning are expected to be higher in such individuals. This article reviews health risks and risk factors associated with air travel, and discusses risk management strategies. To reduce adverse health risks, risk factors such as radiation, infection, stress, temperature, pressure, and circadian rhythm need to be avoided or reduced to levels that are as low as technologically achievable to protect flight personnel and passengers. PMID:17454553

  7. Environmental and health risk studies at HHWCFs

    SciTech Connect

    Kehoe, C.

    1995-09-01

    Sanitary Fill Company is proposing to expand San Francisco`s household hazardous waste facility. This paper describes our proposal and discusses the environmental review and public involvement processes that are now required. Planning this expansion has been long and expensive. To my knowledge we are among the first programs to conduct a detailed study of the potential health risks associated with household facilities. I will present a summary of our planning process and compare the process to the outcome.

  8. Oil shale health and environmental risk analysis

    SciTech Connect

    Gratt, L.B.

    1983-04-01

    The potential human health and environmental risks of hypothetical one-million-barrels-per-day oil shale industry have been analyzed to serve as an aid in the formulation and management of a program of environmental research. The largest uncertainties for expected fatalities are in the public sector from air pollutants although the occupational sector is estimated to have 60% more expected fatalities than the public sector. Occupational safety and illness have been analyzed for the oil shale fuel cycle from extraction to delivery of products for end use. Pneumoconiosis from the dust environment is the worker disease resulting in the greatest number of fatalities, followed by chronic bronchitis, internal cancer, and skin cancers, respectively. Research recommendations are presented for reducing the uncertainties in the risks analyzed and to fill data gaps to estimate other risks.

  9. A toolbox for health risk related decisions

    SciTech Connect

    Easterly, C.E.; Jones, T.D.

    1996-10-01

    Development efforts since the late 1970s have resulted in a generalized method for ranking health hazards. This method provides the basis for a wide range of applications where decisions are needed for allocating resources on the basis of health risk considerations. It has been used for more than a decade to solve real problems, and it is supported by 23 publications in the open literature. The diversity of this generalized methodology allows us to provide support in a great number of problem areas. we give four examples in this manuscript: the relative toxicities of petroleum mixtures; a method to derive Emergency Response Planning Guides; an estimate of the possible carcinogenic potency of tungsten, an alternative material to depleted uranium for heavy armor penetrators; and an approach to low dose extrapolation. Our experience suggests that many more applications of the original concept and variations on it can be of utility in military situations. Some potentially fruitful areas may be in the: development of a health-risk-ranking system for alternative solutions to manufacturing, waste management, and remediation; provision of a basis for identifying levels of hazardous agents which are below health concerns, or which should be of concern; development of a framework for evaluating chemicals and radioactive materials on the same basis, and in the development of a battery of in vitro bioassays which could take the place of long-term whole animal tests.

  10. The prevalence of infections and patient risk factors in home health care: A systematic review

    PubMed Central

    Shang, Jingjing; Ma, Chenjuan; Poghosyan, Lusine; Dowding, Dawn; Stone, Patricia

    2015-01-01

    Background Home health care (HHC) has been the fastest growing health care sector for the past 3 decades. The uncontrolled home environment, increased use of indwelling devices, and the complexity of illnesses among HHC patients lead to increased risk for infections. Methods A systematic review of studies evaluating infection prevalence and risk factors among adult patients who received HHC services was conducted and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Literature was searched using Medline, PubMed, and the Cumulative Index to Nursing and Allied Health as well as hand searching. Two reviewers independently assessed study quality using validated quality assessment checklists. Results Twenty-five studies met the inclusion criteria and were reviewed. The infection rates and identified risk factors for infections varied dramatically between studies. In general, patients receiving home parental nutrition treatments had higher infection rates than patients receiving home infusion therapy. The identified risk factors were limited by small sample sizes and other methodologic flaws. Conclusions Establishing a surveillance system for HHC infections, identifying patients at high risk for infections, tailoring HHC and patient education based on patient living conditions, and facilitating communication between different health care facilities will enhance infection control in HHC settings. Future studies should use a nationally representative sample and multivariate analysis for the identification of risk factors for infections. PMID:24656786

  11. Effect Modification of the Association of Cumulative Exposure and Cancer Risk by Intensity of Exposure and Time Since Exposure Cessation: A Flexible Method Applied to Cigarette Smoking and Lung Cancer in the SYNERGY Study

    PubMed Central

    Vlaanderen, Jelle; Portengen, Lützen; Schüz, Joachim; Olsson, Ann; Pesch, Beate; Kendzia, Benjamin; Stücker, Isabelle; Guida, Florence; Brüske, Irene; Wichmann, Heinz-Erich; Consonni, Dario; Landi, Maria Teresa; Caporaso, Neil; Siemiatycki, Jack; Merletti, Franco; Mirabelli, Dario; Richiardi, Lorenzo; Gustavsson, Per; Plato, Nils; Jöckel, Karl-Heinz; Ahrens, Wolfgang; Pohlabeln, Hermann; Tardón, Adonina; Zaridze, David; Field, John K.; 't Mannetje, Andrea; Pearce, Neil; McLaughlin, John; Demers, Paul; Szeszenia-Dabrowska, Neonila; Lissowska, Jolanta; Rudnai, Peter; Fabianova, Eleonora; Stanescu Dumitru, Rodica; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Boffetta, Paolo; Forastiere, Francesco; Bueno-de-Mesquita, Bas; Peters, Susan; Brüning, Thomas; Kromhout, Hans; Straif, Kurt; Vermeulen, Roel

    2014-01-01

    The indiscriminate use of the cumulative exposure metric (the product of intensity and duration of exposure) might bias reported associations between exposure to hazardous agents and cancer risk. To assess the independent effects of duration and intensity of exposure on cancer risk, we explored effect modification of the association of cumulative exposure and cancer risk by intensity of exposure. We applied a flexible excess odds ratio model that is linear in cumulative exposure but potentially nonlinear in intensity of exposure to 15 case-control studies of cigarette smoking and lung cancer (1985–2009). Our model accommodated modification of the excess odds ratio per pack-year of cigarette smoking by time since smoking cessation among former smokers. We observed negative effect modification of the association of pack-years of cigarette smoking and lung cancer by intensity of cigarette smoke for persons who smoked more than 20–30 cigarettes per day. Patterns of effect modification were similar across individual studies and across major lung cancer subtypes. We observed strong negative effect modification by time since smoking cessation. Application of our method in this example of cigarette smoking and lung cancer demonstrated that reducing a complex exposure history to a metric such as cumulative exposure is too restrictive. PMID:24355332

  12. Effect modification of the association of cumulative exposure and cancer risk by intensity of exposure and time since exposure cessation: a flexible method applied to cigarette smoking and lung cancer in the SYNERGY Study.

    PubMed

    Vlaanderen, Jelle; Portengen, Lützen; Schüz, Joachim; Olsson, Ann; Pesch, Beate; Kendzia, Benjamin; Stücker, Isabelle; Guida, Florence; Brüske, Irene; Wichmann, Heinz-Erich; Consonni, Dario; Landi, Maria Teresa; Caporaso, Neil; Siemiatycki, Jack; Merletti, Franco; Mirabelli, Dario; Richiardi, Lorenzo; Gustavsson, Per; Plato, Nils; Jöckel, Karl-Heinz; Ahrens, Wolfgang; Pohlabeln, Hermann; Tardón, Adonina; Zaridze, David; Field, John K; 't Mannetje, Andrea; Pearce, Neil; McLaughlin, John; Demers, Paul; Szeszenia-Dabrowska, Neonila; Lissowska, Jolanta; Rudnai, Peter; Fabianova, Eleonora; Stanescu Dumitru, Rodica; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Boffetta, Paolo; Forastiere, Francesco; Bueno-de-Mesquita, Bas; Peters, Susan; Brüning, Thomas; Kromhout, Hans; Straif, Kurt; Vermeulen, Roel

    2014-02-01

    The indiscriminate use of the cumulative exposure metric (the product of intensity and duration of exposure) might bias reported associations between exposure to hazardous agents and cancer risk. To assess the independent effects of duration and intensity of exposure on cancer risk, we explored effect modification of the association of cumulative exposure and cancer risk by intensity of exposure. We applied a flexible excess odds ratio model that is linear in cumulative exposure but potentially nonlinear in intensity of exposure to 15 case-control studies of cigarette smoking and lung cancer (1985-2009). Our model accommodated modification of the excess odds ratio per pack-year of cigarette smoking by time since smoking cessation among former smokers. We observed negative effect modification of the association of pack-years of cigarette smoking and lung cancer by intensity of cigarette smoke for persons who smoked more than 20-30 cigarettes per day. Patterns of effect modification were similar across individual studies and across major lung cancer subtypes. We observed strong negative effect modification by time since smoking cessation. Application of our method in this example of cigarette smoking and lung cancer demonstrated that reducing a complex exposure history to a metric such as cumulative exposure is too restrictive.

  13. Excessive Alcohol Use and Risks to Women's Health

    MedlinePlus

    ... Spectrum Disorders (FASDs) Impaired Driving Fact Sheets - Excessive Alcohol Use and Risks to Women's Health Recommend on Facebook Tweet Share Compartir Excessive Alcohol Use and Risks to Women’s Health Although men ...

  14. Excessive Alcohol Use and Risks to Men's Health

    MedlinePlus

    ... Spectrum Disorders (FASDs) Impaired Driving Fact Sheets - Excessive Alcohol Use and Risks to Men's Health Recommend on Facebook Tweet Share Compartir Excessive Alcohol Use and Risks to Men's Health Men are ...

  15. The emerging threats of climate change on tropical coastal ecosystem services, public health, local economies and livelihood sustainability of small islands: Cumulative impacts and synergies.

    PubMed

    Hernández-Delgado, E A

    2015-12-15

    Climate change has significantly impacted tropical ecosystems critical for sustaining local economies and community livelihoods at global scales. Coastal ecosystems have largely declined, threatening the principal source of protein, building materials, tourism-based revenue, and the first line of defense against storm swells and sea level rise (SLR) for small tropical islands. Climate change has also impacted public health (i.e., altered distribution and increased prevalence of allergies, water-borne, and vector-borne diseases). Rapid human population growth has exacerbated pressure over coupled social-ecological systems, with concomitant non-sustainable impacts on natural resources, water availability, food security and sovereignty, public health, and quality of life, which should increase vulnerability and erode adaptation and mitigation capacity. This paper examines cumulative and synergistic impacts of climate change in the challenging context of highly vulnerable small tropical islands. Multiple adaptive strategies of coupled social-ecological ecosystems are discussed. Multi-level, multi-sectorial responses are necessary for adaptation to be successful.

  16. The emerging threats of climate change on tropical coastal ecosystem services, public health, local economies and livelihood sustainability of small islands: Cumulative impacts and synergies.

    PubMed

    Hernández-Delgado, E A

    2015-12-15

    Climate change has significantly impacted tropical ecosystems critical for sustaining local economies and community livelihoods at global scales. Coastal ecosystems have largely declined, threatening the principal source of protein, building materials, tourism-based revenue, and the first line of defense against storm swells and sea level rise (SLR) for small tropical islands. Climate change has also impacted public health (i.e., altered distribution and increased prevalence of allergies, water-borne, and vector-borne diseases). Rapid human population growth has exacerbated pressure over coupled social-ecological systems, with concomitant non-sustainable impacts on natural resources, water availability, food security and sovereignty, public health, and quality of life, which should increase vulnerability and erode adaptation and mitigation capacity. This paper examines cumulative and synergistic impacts of climate change in the challenging context of highly vulnerable small tropical islands. Multiple adaptive strategies of coupled social-ecological ecosystems are discussed. Multi-level, multi-sectorial responses are necessary for adaptation to be successful. PMID:26455783

  17. Cumulative Inequality and Racial Disparities in Health: Private Insurance Coverage and Black/White Differences in Functional Limitations

    PubMed Central

    Taylor, Miles G.

    2014-01-01

    Objectives. To test different forms of private insurance coverage as mediators for racial disparities in onset, persistent level, and acceleration of functional limitations among Medicare age-eligible Americans. Method. Data come from 7 waves of the Health and Retirement Study (1996–2008). Onset and progression latent growth models were used to estimate racial differences in onset, level, and growth of functional limitations among a sample of 5,755 people aged 65 and older in 1996. Employer-provided insurance, spousal insurance, and market insurance were next added to the model to test how differences in private insurance mediated the racial gap in physical limitations. Results. In baseline models, African Americans had larger persistent level of limitations over time. Although employer-provided, spousal provided, and market insurances were directly associated with lower persistent levels of limitation, only differences in market insurance accounted for the racial disparities in persistent level of limitations. Discussion. Results suggest private insurance is important for reducing functional limitations, but market insurance is an important mediator of the persistently larger level of limitations observed among African Americans. PMID:24569001

  18. Energy production and the risk to human health and life

    SciTech Connect

    Hamilton, L.D.

    1981-01-01

    Current issues in health-risk assessment of energy production and factors in developing countries affecting risk analysis are discussed. Information is presented on the relative risks of coal and nuclear fuel cycles. (JGB)

  19. Multi-Risk Infants: Predicting Attachment Security from Sociodemographic, Psychosocial, and Health Risk among African-American Preterm Infants

    ERIC Educational Resources Information Center

    Candelaria, Margo; Teti, Douglas M.; Black, Maureen M.

    2011-01-01

    Background: Ecological and transactional theories link child outcomes to accumulated risk. This study hypothesized that cumulative risk was negatively related to attachment, and that maternal sensitivity mediated linkages between risk and attachment. Methods: One hundred and twelve high-risk African-American premature infant-mother dyads…

  20. Human Health Risks of Engineered Nanomaterials

    NASA Astrophysics Data System (ADS)

    Elder, A.; Lynch, I.; Grieger, K.; Chan-Remillard, S.; Gatti, A.; Gnewuch, H.; Kenawy, E.; Korenstein, R.; Kuhlbusch, T.; Linker, F.; Matias, S.; Monteiro-Riviere, N.; Pinto, V. R. S.; Rudnitsky, R.; Savolainen, K.; Shvedova, A.

    There are currently hundreds of available consumer products that contain nanoscale materials. Human exposure is, therefore, likely to occur in occupational and environmental settings. Mounting evidence suggests that some nanomaterials exert toxicity in cultured cells or following in vivo exposures, but this is dependent on the physicochemical characteristics of the materials and the dose. This Working Group report summarizes the discussions of an expert scientific panel regarding the gaps in knowledge that impede effective human health risk assessment for nanomaterials, particularly those that are suspended in a gas or liquid and, thus, deposit on skin or in the respiratory tract. In addition to extensive descriptions of material properties, the Group identified as critical research areas: external and internal dose characterization, mechanisms of response, identification of sensitive subpopulations, and the development of screening strategies and technology to support these investigations. Important concepts in defining health risk are reviewed, as are the specific kinds of studies that will quickly reduce the uncertainties in the risk assessment process.

  1. Health-risk behaviors in early adolescence.

    PubMed

    Rew, Lynn; Horner, Sharon D; Brown, Adama

    2011-01-01

    The major morbidities and mortalities of adolescents are related to preventable risky behaviors, but how, when, and in whom these behaviors develop in early adolescence is unknown. The purpose of this study was to determine which set of risk factors and protective resources of school-age children were best predictors of health-risk behaviors in early adolescence. A longitudinal, cohort sequential design was used with a diverse sample of 1,934 children in grades 4 through 8. Parents provided demographic and neighborhood data for children through a mailed survey. Children completed valid scales annually at schools, using audio-computer-assisted self-interviewing (A-CASI) technology. Significant gender and racial/ethnic differences were found in carrying a weapon and using alcohol. Higher perceived levels of stress increased the risk for alcohol use as did riding in a car with a driver who was drinking. Health behaviors exhibited while in 4th through 6th grades protected early adolescents from alcohol use and riding in a car with a driver who was drinking. A parent's education and perceived safety in neighborhood protected against carrying a weapon and smoking. Many findings are similar to those of national samples, but others show positive differences in this localized sample, over 50% of whom were Latino. Protective resources suggest numerous nursing interventions to promote healthy adolescent development.

  2. Secure e-Health: managing risks to patient health data.

    PubMed

    Kluge, Eike-Henner W

    2007-01-01

    e-Health, as an inter-jurisdictional enterprise, presents risks to patient health data that involve not only technology and professional protocols but also laws, regulations and professional security cultures. The USA Patriot Act is one example of how national laws can shape these concerns. Secure e-Health therefore requires not only national standardization of professional education and protocols but also global interoperability of regulations and laws. Some progress in this regard has been made in the European context; however, even here developments are incomplete, and nothing similar has been accomplished on a global scale. Professional health information organizations must take the lead in developing appropriate high-level principles for professional certification and security protocols and in harmonizing these on a global basis, so that they can provide a firm and consistent foundation for international treaties. Such developments should occur in concert with other health professions, so that coordinated requirements are integrated into revisions of the relevant codes of ethics. This presentation identifies and addresses some of the ethical and legal issues and proposes a series of recommendations.

  3. Health risk assessment of personal inhalation exposure to volatile organic compounds in Tianjin, China.

    PubMed

    Zhou, Jian; You, Yan; Bai, Zhipeng; Hu, Yandi; Zhang, Jiefeng; Zhang, Nan

    2011-01-01

    Volatile Organic Compounds (VOCs) exposure can induce a range of adverse human health effects. To date, however, personal VOCs exposure and residential indoor and outdoor VOCs levels have not been well characterized in the mainland of China, less is known about health risk of personal exposure to VOCs. In this study, personal exposures for 12 participants as well as residential indoor/outdoor, workplace and in vehicle VOCs concentrations were measured simultaneously in Tianjin, China. All VOCs samples were collected using passive samplers for 5 days and were analyzed using Thermal Desorption GC-MS method. U.S. Environmental Protect Agency's Inhalation Unit Risks were used to calculate the inhalation cancer health risk. To assess uncertainty of health risk estimate, Monte Carlo simulation and sensitivity analysis were implemented. Personal exposures were greater than residential indoor exposures as expected with the exception of carbon tetrachloride. Exposure assessment showed modeled and measured concentrations are statistically linearly correlated for all VOCs (P<0.01) except chloroform, confirming that estimated personal exposure using time-weighted model can provide reasonable estimate of personal inhalation exposure to VOCs. Indoor smoking and recent renovation were identified as two major factors influencing personal exposure based on the time-activity pattern and factor analysis. According to the cancer risk analysis of personal exposure, benzene, chloroform, carbon tetrachloride and 1,3-butadiene had median upper-bound lifetime cancer risks that exceeded the U.S. EPA benchmark of 1 per one million, and benzene presented the highest median risks at about 22 per one million population. The median cumulative cancer risk of personal exposure to 5 VOCs was approximately 44 per million, followed by indoor exposure (37 per million) and in vehicle exposure (36 per million). Sensitivity analysis suggested that improving the accuracy of exposure measurement in further

  4. Assessing chronic and climate-induced water risk through spatially distributed cumulative deficit measures: A new picture of water sustainability in India

    NASA Astrophysics Data System (ADS)

    Devineni, Naresh; Perveen, Shama; Lall, Upmanu

    2013-04-01

    India is a poster child for groundwater depletion and chronic water stress. Often, water sustainability is measured through an estimate of the difference between the average supply and demand in a region. However, water supply and demand are highly variable in time and space. Hence, measures of scarcity need to reflect temporal imbalances even for a fixed location. We introduce spatially distributed indices of water stress that integrate over time variations in water supply and demand. The indices reflect the maximum cumulative deficit in a regional water balance within year and across years. This can be interpreted as the amount that needs to be drawn from external storage (either aquifers or surface reservoirs or interarea transfers) to meet the current demand pattern given a variable climate and renewable water supply. A simulation over a long period of record (historical or projected) provides the ability to quantify risk. We present an application at a district level in India considering more than a 100 year data set of rainfall as the renewable supply, and the recent water use pattern for each district. Consumption data are available through surveys at the district level, and consequently, we use this rather than river basins as the unit of analysis. The rainfall endogenous to each district is used as a potentially renewable water supply to reflect the supply-demand imbalances directly at the district level, independent of potential transfers due to upstream-induced runoff or canals. The index is useful for indicating whether small or large surface storage will suffice, or whether the extent of groundwater storage or external transfers, or changes in demand are needed to achieve a sustainable solution. Implications of the analysis for India and for other applications are discussed.

  5. Foster Kids Face Higher Risk of Health Problems

    MedlinePlus

    ... foster care face increased risks of physical and mental health issues, from asthma to ADHD to depression, a new ... or federal policy. More Health News on: Child Mental Health Children's Health Family Issues Recent Health News Related MedlinePlus Health Topics Child ...

  6. [Health risks in the biotechnological industry].

    PubMed

    Colombi, A; Maroni, M; Foà, V

    1989-01-01

    Biotechnology has been defined as the application of biological organisms, systems or processes to manufacturing and service industries. In considering health aspects of biotechnological development it must be underlined that the use of microorganisms in traditional industries, such as the production of food, bread, beer and dairy products, has not added significantly to the more usual industrial hazards. The risk factors encountered in the biotechnology industry can be defined as general, i.e., common to other industrial activities, and specific, i.e., depending on the presence of microorganisms and/or their metabolic products. The specific health risks vary according to the type of process, but can be grouped into three main categories: immunological diseases, toxic effects; pathological effects of microorganisms. Allergic immunological diseases such as bronchial asthma, contact dermatitis, oculo-rhinitis and extrinsic allergic alveolitis are by far the most frequent and well known diseases occurring among workers employed on biotechnological production. Toxic effects were observed among workers employed on the production of antibiotics and hormones or single cell proteins, where absorption of endotoxins has been described. Infectious diseases may arise from uncontrolled dissemination of pathogenic microorganisms through aerosols, dusts, aqueous and semisolid sludge effluents from biotechnological plants. The greatest risks occur in the production of antiviral vaccines, in research laboratories and in waste-water treatment plants. Risk of pathogenic effects has also been speculated from exposure to engineered microorganisms in laboratory and environmental or agricultural applications. Safety precautions consisting of protective measures, and effective barriers of containment (both physical and biological) have to be advised according to the hazardous characteristics of the organisms.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. An outbreak of hepatitis A among health care workers: risk factors for transmission.

    PubMed Central

    Doebbeling, B N; Li, N; Wenzel, R P

    1993-01-01

    OBJECTIVES. The purpose of this study was to investigate a nosocomial outbreak of hepatitis A that occurred in the burn treatment center of a referral hospital. METHODS. Retrospective cohort and case-control studies were performed to determine acquisition rates and risk factors for transmission. Adjusted infection rates were calculated by week of exposure. A case-control study was conducted to determine potential mechanisms for nosocomial acquisition. Recently infected health care workers were defined as case patients; exposed, serosusceptible health care workers without infection served as controls. RESULTS. The outbreak of hepatitis A affected 11 health care workers and 1 other burn patient (1 secondary patient case). All 11 health care workers became ill after the admission of a man and his 8-month-old son who developed hepatitis A while in the hospital. The cumulative incidence risk ratio was elevated for health care workers caring for either the infant or the father during the same week of exposure. The case-control study implicated the behavior of eating on the hospital ward as the single most important risk factor for infection. CONCLUSION. Inadequate hand-washing and subsequent oral contamination appear responsible for the outbreak. Hospitals may witness other institutional outbreaks if health care workers regularly eat on the wards. PMID:8259794

  8. Cyanobacterial toxins: risk management for health protection.

    PubMed

    Codd, Geoffrey A; Morrison, Louise F; Metcalf, James S

    2005-03-15

    This paper reviews the occurrence and properties of cyanobacterial toxins, with reference to the recognition and management of the human health risks which they may present. Mass populations of toxin-producing cyanobacteria in natural and controlled waterbodies include blooms and scums of planktonic species, and mats and biofilms of benthic species. Toxic cyanobacterial populations have been reported in freshwaters in over 45 countries, and in numerous brackish, coastal, and marine environments. The principal toxigenic genera are listed. Known sources of the families of cyanobacterial toxins (hepato-, neuro-, and cytotoxins, irritants, and gastrointestinal toxins) are briefly discussed. Key procedures in the risk management of cyanobacterial toxins and cells are reviewed, including derivations (where sufficient data are available) of tolerable daily intakes (TDIs) and guideline values (GVs) with reference to the toxins in drinking water, and guideline levels for toxigenic cyanobacteria in bathing waters. Uncertainties and some gaps in knowledge are also discussed, including the importance of exposure media (animal and plant foods), in addition to potable and recreational waters. Finally, we present an outline of steps to develop and implement risk management strategies for cyanobacterial cells and toxins in waterbodies, with recent applications and the integration of Hazard Assessment Critical Control Point (HACCP) principles. PMID:15737680

  9. Cyanobacterial toxins: risk management for health protection

    SciTech Connect

    Codd, Geoffrey A.; Morrison, Louise F.; Metcalf, James S

    2005-03-15

    This paper reviews the occurrence and properties of cyanobacterial toxins, with reference to the recognition and management of the human health risks which they may present. Mass populations of toxin-producing cyanobacteria in natural and controlled waterbodies include blooms and scums of planktonic species, and mats and biofilms of benthic species. Toxic cyanobacterial populations have been reported in freshwaters in over 45 countries, and in numerous brackish, coastal, and marine environments. The principal toxigenic genera are listed. Known sources of the families of cyanobacterial toxins (hepato-, neuro-, and cytotoxins, irritants, and gastrointestinal toxins) are briefly discussed. Key procedures in the risk management of cyanobacterial toxins and cells are reviewed, including derivations (where sufficient data are available) of tolerable daily intakes (TDIs) and guideline values (GVs) with reference to the toxins in drinking water, and guideline levels for toxigenic cyanobacteria in bathing waters. Uncertainties and some gaps in knowledge are also discussed, including the importance of exposure media (animal and plant foods), in addition to potable and recreational waters. Finally, we present an outline of steps to develop and implement risk management strategies for cyanobacterial cells and toxins in waterbodies, with recent applications and the integration of Hazard Assessment Critical Control Point (HACCP) principles.

  10. Brownfields and health risks--air dispersion modeling and health risk assessment at landfill redevelopment sites.

    PubMed

    Ofungwu, Joseph; Eget, Steven

    2006-07-01

    Redevelopment of landfill sites in the New Jersey-New York metropolitan area for recreational (golf courses), commercial, and even residential purposes seems to be gaining acceptance among municipal planners and developers. Landfill gas generation, which includes methane and potentially toxic nonmethane compounds usually continues long after closure of the landfill exercise phase. It is therefore prudent to evaluate potential health risks associated with exposure to gas emissions before redevelopment of the landfill sites as recreational, commercial, and, especially, residential properties. Unacceptably high health risks would call for risk management measures such as limiting the development to commercial/recreational rather than residential uses, stringent gas control mechanisms, interior air filtration, etc. A methodology is presented for applying existing models to estimate residual landfill hazardous compounds emissions and to quantify associated health risks. Besides the toxic gas constituents of landfill emissions, other risk-related issues concerning buried waste, landfill leachate, and explosive gases were qualitatively evaluated. Five contiguously located landfill sites in New Jersey intended for residential and recreational redevelopment were used to exemplify the approach.

  11. [Mass gatherings - health risks and preventive strategies].

    PubMed

    Steffen, Robert

    2013-06-01

    Experience from mass gatherings - usually attended by at least 25'000 persons - shows that approximately one in a thousand participants will consult with an on-site medical emergency service. Communicable diseases usually play a minor role. Historically outbreaks of meningococcal disease were recorded after the hajj, but this has been well controlled in the past few years subsequent to vaccinations and other measures required by the Kingdom of Saudi Arabia health authorities. Major stress of the regional public health system is associated with accidents and non-communicable diseases, the majority being trivial. Host and environmental risk factors can result in a dramatic increase in the rate of consultations: Age and pre-existing illness play a decisive role particularly in pilgrims, be that in Mecca or Lourdes. Emotional factors may influence behavior; aggressions can develop. Alcohol and drugs, also the duration of an event may play a decisive role. Extreme climatic conditions, both heat and cold, also exhaustion result in a dramatic increase of emergency consultations. Infrastructure must be adapted for the crowd size, particularly stampede associated disasters can be avoided. The World Health Organization and other interested expert groups have in the past few years formulated interdisciplinary programs for prevention.

  12. Occupational Health Promotion Programs to Reduce Cardiovascular Risk.

    ERIC Educational Resources Information Center

    Glasgow, Russell E.; Terborg, James R.

    1988-01-01

    Surveys literature on worksite health promotion programs targeting cardiovascular risk factors. Reviews findings on health-risk appraisal, hypertension control, smoking cessation, weight reduction, exercise, and programs addressing multiple risk factors. Discusses current knowledge, highlights exemplary studies, and identifies problems and…

  13. Brain health and shared risk factors for dementia and stroke.

    PubMed

    Gardener, Hannah; Wright, Clinton B; Rundek, Tatjana; Sacco, Ralph L

    2015-11-01

    Impaired brain health encompasses a range of clinical outcomes, including stroke, dementia, vascular cognitive impairment, cognitive ageing, and vascular functional impairment. Conditions associated with poor brain health represent leading causes of global morbidity and mortality, with projected increases in public health burden as the population ages. Many vascular risk factors are shared predictors for poor brain health. Moreover, subclinical brain MRI markers of vascular damage are risk factors shared between stroke and dementia, and can be used for risk stratification and early intervention. The broad concept of brain health has resulted in a conceptual shift from vascular risk factors to determinants of brain health. Global campaigns to reduce cardiovascular diseases by targeting modifiable risk factors are necessary and will have a broad impact on brain health. Research is needed on the distinct and overlapping aetiologies of brain health conditions, and to define MRI markers to help clinicians identify patients who will benefit from aggressive prevention measures.

  14. Biomarkers: Dynamic "Tools" for Health and Safety Risk Assessment

    EPA Science Inventory

    Today informational flow from biomarkers contributes importantly to various types of health effects research, risk assessment and risk management decisions that impact, or have the potential to impact, public health and safety. Therefore, dependent upon the nature of the health r...

  15. The role of health-risk appraisals in disease management.

    PubMed

    Hudson, Laurel R; Pope, James E

    2006-02-01

    Managed care organizations and disease management vendors often find themselves in the position of responding to employers who want to administer a health-risk appraisal (HRA) without committing to implementation of a comprehensive health promotion program. The assumption appears to be that information on health risks is sufficient to motivate employees to change their health behaviors in order to reduce estimated health risks. A review of the relevant literature does not substantiate the efficacy of a stand-alone HRA for motivating behavior change. The challenge is to engage employers in informed conversations on what works in health promotion and achieve cost-effective benefits.

  16. Editorial: Lead Risk Assessment and Health Effects.

    PubMed

    Mielke, Howard W

    2016-01-01

    In 1980, Clair C. Patterson stated: "Sometime in the near future it probably will be shown that the older urban areas of the United States have been rendered more or less uninhabitable by the millions of tons of poisonous industrial lead residues that have accumulated in cities during the past century". We live in the near future about which this quote expressed concern. This special volume of 19 papers explores the status of scientific evidence regarding Dr. Patterson's statement on the habitability of the environments of communities. Authors from 10 countries describe a variety of lead issues in the context of large and small communities, smelter sites, lead industries, lead-based painted houses, and vehicle fuel treated with lead additives dispersed by traffic. These articles represent the microcosm of the larger health issues associated with lead. The challenges of lead risk require a concerted global action for primary prevention. PMID:27314364

  17. Poor periodontal health: A cancer risk?

    PubMed Central

    Rajesh, K. S.; Thomas, Deepak; Hegde, Shashikanth; Kumar, M. S. Arun

    2013-01-01

    Evidence indicates that chronic infections and inflammation are associated with increased risk of cancer development. There has also been considerable evidence that proves the interrelationship between bacterial and viral infections and carcinogenesis. Periodontitis is a chronic oral infection thought to be caused by gram-negative anaerobic bacteria in the dental biofilm. Periodontal bacteria and viruses may act synergistically to cause periodontitis. Many studies have shown that periodontal pockets may act as reservoirs for human papilloma virus, cytomegalovirus, Epstein Barr virus, and suspected agents associated with oral cancer. Periodontitis, characterized by epithelial proliferation and migration, results in a chronic release of inflammatory cytokines, chemokines, growth factors, prostaglandins, and enzymes, all of which are associated with cancer development. This review article intends to shed light on the association between periodontal health and carcinogenesis. PMID:24554877

  18. Editorial: Lead Risk Assessment and Health Effects

    PubMed Central

    Mielke, Howard W.

    2016-01-01

    In 1980, Clair C. Patterson stated: “Sometime in the near future it probably will be shown that the older urban areas of the United States have been rendered more or less uninhabitable by the millions of tons of poisonous industrial lead residues that have accumulated in cities during the past century”. We live in the near future about which this quote expressed concern. This special volume of 19 papers explores the status of scientific evidence regarding Dr. Patterson’s statement on the habitability of the environments of communities. Authors from 10 countries describe a variety of lead issues in the context of large and small communities, smelter sites, lead industries, lead-based painted houses, and vehicle fuel treated with lead additives dispersed by traffic. These articles represent the microcosm of the larger health issues associated with lead. The challenges of lead risk require a concerted global action for primary prevention. PMID:27314364

  19. Methodological challenges in health risk assessment. Final report

    SciTech Connect

    Not Available

    1987-10-12

    Risk assessment, a major activity of both health and regulatory agencies, is subject to large and unavoidable uncertainties. Thus, different teams of knowledgeable experts can come to different conclusions about risks to human health from various sorts of hazards. This report examines and compares analyses by two or more agencies of ten health hazards or potential hazards: ethylene dibromide, formaldehyde, Tris, dioxin (limited to cancer risks of contaminated soil), lead (reproductive effects), cotton dust, noise (long-term hearing impairment), passive smoking, dietary fat (cancer risks), and the radiation hazards of mammography. Each set of risk assessments is analyzed in depth. The report then turns to cross-cutting analyses of such matters as setting priorities for risk assessment, approaches and methods used to evaluate different kinds of risks, and the relationships between risk assessment and risk management. Overall, the report found large differences among risk assessments of the same hazard, but these differences are often quite appropriate.

  20. Assessment of Cumulative Trauma Disorder (CTD) Risk for 3 Different Tasks Constructing and Repairing Multi-Layer Insulation (MLI) Blankets, Preparing the Dough for a Pizza, and Operating the Becton-Dickinson FACSAria Flow Cytometer

    NASA Technical Reports Server (NTRS)

    Gentzler, Marc; Kline, Martin; Palmer, Andrew; Terrone, Mark

    2007-01-01

    The Cumulative Trauma Disorder (CTD) risks for three different tasks using McCauley-Bell and Badiru's (1993) formula based on task, personal, and organizational factors were examined. For the Multi-Layer Insulation (MLI) blanket task, the results showed that the task, personal, and organizational risks were at about the same level. The personal risk factors for this task were evaluated using a hypothetical female employee age 52. For the pizza dough task, it was shown that the organizational risk was particularly high, with task related factors also at quite dangerous levels. On the other hand, there was a very low level of personal risk factors, based on a female age 17. The flow cytometer task was assessed with three different participants, a11 of whom had quite disparate levels of personal risk, which slightly affected the overall CTD risk. This reveals how individual difference variables certainly need to be considered. The task and organizational risks for this task were rated at about the same moderate level. The overall CTD risk averaged across the three participants was .335, indicating some risk. Compruing across the tasks revealed that the pizza dough task created the greatest overall CTD risk by far (.568), with the MLI (.325) and flow cytometer task (.335) having some risk associated with them. Future research should look into different tasks for more of a comparison

  1. [Cell phones: health risks and prevention].

    PubMed

    Talamanca, I Figà; Giliberti, C; Salerno, S

    2012-01-01

    The paper describes first of all the electromagnetic radiation of cellular phones and presents the physical parameters used to measure and evaluate the absorption of emissions of radio stations and cellular phones. It then presents selected research results of the experimental studies in vivo and in vitro which examine the biological effects of the emissions of cellular phones. The review of the epidemiologic evidence focuses in particular the epidemiologic studies on the use of cell phones and brain tumours, identifying some of the reasons of the conflicting results obtained. Studies dealing with the health risks involved in the increasing use of cellular phones by adolescents and children, more sensitive to this exposure, are also presented showing the need for special caution. The problem of hypersensitivity observed in some individuals is also briefly discussed. Finally the paper presents a summary of the main prevention measures necessary in order to reduce the risks in the framework of the "precautionary principle" including prevention policies and exposure limits in various countries.

  2. [International adoption: children's health risk evolution].

    PubMed

    Dartiguenave, C

    2012-05-01

    The socioeconomic and sanitary conditions in many countries make it necessary to weigh as precisely as possible the uncertainties which might affect the health of internationally adopted children, which is one of the key drivers to adoption decision. Indeed, health troubles are more and more frequent among children proposed by countries, at a time when there are fewer children to be adopted. Hence the institutions and the actors in the field of international adoption are compelled to frequently update their professional practices, so as to cope both with the declining offer for adoptable children and with the increasing pressure from the birth countries of children to make host countries adopt children with high age or with special needs. It also requires from the administrations the will to provide better initial information and to implement the demand for an agreement. Meanwhile, in spite of those growing constraints, adopting families have been more and more risk adverse during the latest decades, this being a common trend in our developed countries.

  3. Assessing the health risks of aluminum.

    PubMed

    Orme, J; Ohanian, E V

    1990-03-01

    Aluminum is a ubiquitous substance with over 4,000 uses. Aluminum, as aluminum sulfate, is commonly used in the United States as a coagulant in the treatment of drinking water. For many years aluminum was not considered to be toxic to humans. However, reports associating aluminum with several skeletal and neurological disorders in humans suggest that exposure to aluminum may pose a health hazard. In 1983 the US Environmental Protection Agency (EPA) announced plans to regulate a number of substances, including aluminum, in drinking water. Aluminum was considered because of its occurrence and apparent toxicity. Upon further evaluation of the health effects data the EPA proposed not to regulate aluminum as a result of the uncertainty of the toxicity of ingested aluminum. Putative causal associations between aluminum exposure and neurological disorders such as Alzheimer's disease have yet to be substantiated. Although several issues regarding the toxicity of ingested aluminum are unresolved, aluminum has been specified in the 1986 Amendments to the Safe Drinking Water Act, as one of 83 substances in drinking water to be regulated by 1989. Additional data are needed before the potential risk of aluminum can be assessed; therefore the EPA has deferred possible regulation until 1991. PMID:24202565

  4. The Relation between Adolescent Self Assessment of Health and Risk Behaviours: Could a Global Measure of Health Provide Indications of Health Risk Exposures?

    ERIC Educational Resources Information Center

    Nkansah-Amankra, Stephen; Walker, Ashley Dawn

    2012-01-01

    Objective: Self-rated health (SRH) has become a key organizing construct for assessing multiple dimensions of populations' physical and psychosocial health functioning. However, it is unclear how adolescents' subjective self assessment of health reflects health risk exposures, co-occurring health risks (problem behaviours) and other pre-existing…

  5. [Managing health risks of workers in business trip].

    PubMed

    Gevorkian, E V

    2014-01-01

    The article presents data of prospective observation over the risk management system concerning health of international oil and gas company workers in business trips. The management system included training and screening of workers under risk, specific prophylaxis and other measures. The authors described problems of the risk management system implementation, suggested recommendations to control risks connected with business trips.

  6. Characterization of SNPs Associated with Prostate Cancer in Men of Ashkenazic Descent from the Set of GWAS Identified SNPs: Impact of Cancer Family History and Cumulative SNP Risk Prediction

    PubMed Central

    Agalliu, Ilir; Wang, Zhaoming; Wang, Tao; Dunn, Anne; Parikh, Hemang; Myers, Timothy

    2013-01-01

    Background Genome-wide association studies (GWAS) have identified multiple SNPs associated with prostate cancer (PrCa). Population isolates may have different sets of risk alleles for PrCa constituting unique population and individual risk profiles. Methods To test this hypothesis, associations between 31 GWAS SNPs of PrCa were examined among 979 PrCa cases and 1,251 controls of Ashkenazic descent using logistic regression. We also investigated risks by age at diagnosis, pathological features of PrCa, and family history of cancer. Moreover, we examined associations between cumulative number of risk alleles and PrCa and assessed the utility of risk alleles in PrCa risk prediction by comparing the area under the curve (AUC) for different logistic models. Results Of the 31 genotyped SNPs, 8 were associated with PrCa at p≤0.002 (corrected p-value threshold) with odds ratios (ORs) ranging from 1.22 to 1.42 per risk allele. Four SNPs were associated with aggressive PrCa, while three other SNPs showed potential interactions for PrCa by family history of PrCa (rs8102476; 19q13), lung cancer (rs17021918; 4q22), and breast cancer (rs10896449; 11q13). Men in the highest vs. lowest quartile of cumulative number of risk alleles had ORs of 3.70 (95% CI 2.76–4.97); 3.76 (95% CI 2.57–5.50), and 5.20 (95% CI 2.94–9.19) for overall PrCa, aggressive cancer and younger age at diagnosis, respectively. The addition of cumulative risk alleles to the model containing age at diagnosis and family history of PrCa yielded a slightly higher AUC (0.69 vs. 0.64). Conclusion These data define a set of risk alleles associated with PrCa in men of Ashkenazic descent and indicate possible genetic differences for PrCa between populations of European and Ashkenazic ancestry. Use of genetic markers might provide an opportunity to identify men at highest risk for younger age of onset PrCa; however, their clinical utility in identifying men at highest risk for aggressive cancer remains limited

  7. Accuracy of Parents' Perceptions of Their College Student Children's Health and Health Risk Behaviors

    ERIC Educational Resources Information Center

    Bylund, Carma L.; Imes, Rebecca S.; Baxter, Leslie A.

    2005-01-01

    The authors compared parents' perceptions of their college student children's health and health risk behaviors with the college students' own reports. One hundred sixty-four parent-college student child dyads completed questionnaires regarding the students' health, illness status, and health risk behaviors. Parents tended to be overoptimistic…

  8. Catalogue of Risks: Natural, Technical, Social and Health Risks

    NASA Astrophysics Data System (ADS)

    Ebi, Kristie L.

    2009-01-01

    Financial, geophysical, and terrorist-related disasters have been headline news in the past few months. As amply demonstrated on a regular basis, the recognition and evaluation of risks are skills that could be more widespread. As such, Proske's Catalogue of Risks is timely and of potential interest. The book is a revised and expanded version of an earlier German publication that aims to provide an encyclopedic discussion of issues related to risks and disasters, with a goal of facilitating an understanding of the components and assessment of risk. The book includes chapters that discuss the difficulty of coming to a consensus on a definition of risk, a comprehensive range of risks and disasters, objective risk measures, subjective risk judgment, quality of life measures, and legal aspects of risk. The book ends with an example of applying the concepts discussed to ship impacts against bridges.

  9. Exclusionary health policy: responding to the risk of poor health among sexual minority youth in Canada.

    PubMed

    Ylioja, Thomas; Craig, Shelley L

    2014-01-01

    Measuring indicators of health status and demographics are essential in the population health approach. In Canada, sexual minority youth face increased risk for poor health outcomes in behavioral and mental health indicators, yet the health policy response has been severely lacking. The current population health approach exacerbates the social exclusion of a vulnerable, at-risk population. The authors examine health status through the social determinants of health to highlight the need for including sexual identity, attraction, and behavior in youth population health surveys. Additional interventions that address the social determinants of health are needed.

  10. Estimation of health risks from radiation exposures

    SciTech Connect

    Randolph, M.L.

    1983-08-01

    An informal presentation is given of the cancer and genetic risks from exposures to ionizing radiations. The risks from plausible radiation exposures are shown to be comparable to other commonly encountered risks.

  11. Health Risk Assessment for Exposure to Benzene in Petroleum Refinery Environments

    PubMed Central

    Edokpolo, Benjamin; Yu, Qiming Jimmy; Connell, Des

    2015-01-01

    The health risk resulting from benzene exposure in petroleum refineries was calculated using data from the scientific literature from various countries throughout the world. The exposure data was collated into four scenarios from petroleum refinery environments and plotted as cumulative probability distributions (CPD) plots. Health risk was evaluated for each scenario using the Hazard Quotient (HQ) at 50% (CEXP50) and 95% (CEXP95) exposure levels. Benzene levels were estimated to pose a significant risk with HQ50 > 1 and HQ95 > 1 for workers exposed to benzene as base estimates for petroleum refinery workers (Scenario 1), petroleum refinery workers evaluated with personal samplers in Bulgarian refineries (Scenario 2B) and evaluated using air inside petroleum refineries in Bulgarian refineries (Scenario 3B). HQ50 < 1 were calculated for petroleum refinery workers with personal samplers in Italian refineries (Scenario 2A), air inside petroleum refineries (Scenario 3A) and air outside petroleum refineries (Scenario 4) in India and Taiwan indicating little possible adverse health effects. Also, HQ95 was < 1 for Scenario 4 however potential risk was evaluated for Scenarios 2A and 3A with HQ95 > 1. The excess Cancer risk (CR) for lifetime exposure to benzene for all the scenarios was evaluated using the Slope Factor and Overall Risk Probability (ORP) methods. The result suggests a potential cancer risk for exposure to benzene in all the scenarios. However, there is a higher cancer risk at 95% (CEXP95) for petroleum refinery workers (2B) with a CR of 48,000 per 106 and exposure to benzene in air inside petroleum refineries (3B) with a CR of 28,000 per 106. PMID:25588154

  12. Health risk assessment for exposure to benzene in petroleum refinery environments.

    PubMed

    Edokpolo, Benjamin; Yu, Qiming Jimmy; Connell, Des

    2015-01-12

    The health risk resulting from benzene exposure in petroleum refineries was calculated using data from the scientific literature from various countries throughout the world. The exposure data was collated into four scenarios from petroleum refinery environments and plotted as cumulative probability distributions (CPD) plots. Health risk was evaluated for each scenario using the Hazard Quotient (HQ) at 50% (CEXP50) and 95% (CEXP95) exposure levels. Benzene levels were estimated to pose a significant risk with HQ50 > 1 and HQ95 > 1 for workers exposed to benzene as base estimates for petroleum refinery workers (Scenario 1), petroleum refinery workers evaluated with personal samplers in Bulgarian refineries (Scenario 2B) and evaluated using air inside petroleum refineries in Bulgarian refineries (Scenario 3B). HQ50 < 1 were calculated for petroleum refinery workers with personal samplers in Italian refineries (Scenario 2A), air inside petroleum refineries (Scenario 3A) and air outside petroleum refineries (Scenario 4) in India and Taiwan indicating little possible adverse health effects. Also, HQ95 was < 1 for Scenario 4 however potential risk was evaluated for Scenarios 2A and 3A with HQ95 > 1. The excess Cancer risk (CR) for lifetime exposure to benzene for all the scenarios was evaluated using the Slope Factor and Overall Risk Probability (ORP) methods. The result suggests a potential cancer risk for exposure to benzene in all the scenarios. However, there is a higher cancer risk at 95% (CEXP95) for petroleum refinery workers (2B) with a CR of 48,000 per 106 and exposure to benzene in air inside petroleum refineries (3B) with a CR of 28,000 per 106.

  13. Accumulating Research: A Systematic Account of How Cumulative Meta-Analyses Would Have Provided Knowledge, Improved Health, Reduced Harm and Saved Resources

    PubMed Central

    Clarke, Mike; Brice, Anne; Chalmers, Iain

    2014-01-01

    Background “Cumulative meta-analysis” describes a statistical procedure to calculate, retrospectively, summary estimates from the results of similar trials every time the results of a further trial in the series had become available. In the early 1990s, comparisons of cumulative meta-analyses of treatments for myocardial infarction with advice promulgated through medical textbooks showed that research had continued long after robust estimates of treatment effects had accumulated, and that medical textbooks had overlooked strong, existing evidence from trials. Cumulative meta-analyses have subsequently been used to assess what could have been known had new studies been informed by systematic reviews of relevant existing evidence and how waste might have been reduced. Methods and Findings We used a systematic approach to identify and summarise the findings of cumulative meta-analyses of studies of the effects of clinical interventions, published from 1992 to 2012. Searches were done of PubMed, MEDLINE, EMBASE, the Cochrane Methodology Register and Science Citation Index. A total of 50 eligible reports were identified, including more than 1,500 cumulative meta-analyses. A variety of themes are illustrated with specific examples. The studies showed that initially positive results became null or negative in meta-analyses as more trials were done; that early null or negative results were over-turned; that stable results (beneficial, harmful and neutral) would have been seen had a meta-analysis been done before the new trial; and that additional trials had been much too small to resolve the remaining uncertainties. Conclusions This large, unique collection of cumulative meta-analyses highlights how a review of the existing evidence might have helped researchers, practitioners, patients and funders make more informed decisions and choices about new trials over decades of research. This would have led to earlier uptake of effective interventions in practice, less

  14. A Screening Method for Assessing Cumulative Impacts

    PubMed Central

    Alexeeff, George V.; Faust, John B.; August, Laura Meehan; Milanes, Carmen; Randles, Karen; Zeise, Lauren; Denton, Joan

    2012-01-01

    The California Environmental Protection Agency (Cal/EPA) Environmental Justice Action Plan calls for guidelines for evaluating “cumulative impacts.” As a first step toward such guidelines, a screening methodology for assessing cumulative impacts in communities was developed. The method, presented here, is based on the working definition of cumulative impacts adopted by Cal/EPA [1]: “Cumulative impacts means exposures, public health or environmental effects from the combined emissions and discharges in a geographic area, including environmental pollution from all sources, whether single or multi-media, routinely, accidentally, or otherwise released. Impacts will take into account sensitive populations and socio-economic factors, where applicable and to the extent data are available.” The screening methodology is built on this definition as well as current scientific understanding of environmental pollution and its adverse impacts on health, including the influence of both intrinsic, biological factors and non-intrinsic socioeconomic factors in mediating the effects of pollutant exposures. It addresses disparities in the distribution of pollution and health outcomes. The methodology provides a science-based tool to screen places for relative cumulative impacts, incorporating both the pollution burden on a community- including exposures to pollutants, their public health and environmental effects- and community characteristics, specifically sensitivity and socioeconomic factors. The screening methodology provides relative rankings to distinguish more highly impacted communities from less impacted ones. It may also help identify which factors are the greatest contributors to a community’s cumulative impact. It is not designed to provide quantitative estimates of community-level health impacts. A pilot screening analysis is presented here to illustrate the application of this methodology. Once guidelines are adopted, the methodology can serve as a screening

  15. Enrichment of heavy metals in fine particles of municipal solid waste incinerator (MSWI) fly ash and associated health risk.

    PubMed

    Zhou, Jizhi; Wu, Simiao; Pan, Yun; Zhang, Lingen; Cao, Zhenbang; Zhang, Xiaoqiao; Yonemochi, Shinichi; Hosono, Shigeo; Wang, Yao; Oh, Kokyo; Qian, Guangren

    2015-09-01

    During the pretreatment and recycling processes, the re-suspended dust from municipal solid waste incinerator (MSWI) fly ash might pose a significant health risk to onsite workers due to its toxic heavy metal content. In this work, the morphological and mineralogical characteristics of fly ash in different particle sizes are presented. The concentrations of seven trace elements (Zn, Pb, Cu, Cd, Cr, Fe and Mn) in these samples were determined. The results show that volatile metals, such as Zn, Pb, Cu and Cd, were easily concentrated in the fine particles, especially in Dp2.5-1 and Dp1, with soluble and exchangeable substances as the main chemical species. The health risk assessment illustrated that the cumulative hazard indexes for non-carcinogenic metals in Dp10-5, Dp5-2.5, Dp2.5-1, and Dp1 were 1.69, 1.41, 1.78 and 2.64, respectively, which were higher than the acceptable threshold values (1.0). The cumulative carcinogenic risk was also higher than the threshold value (10(-6)). For the onsite workers, the relatively apparent non-carcinogenic and carcinogenic effects were from Pb and Cr, respectively. The above findings suggest that fine-grained fly ash contained a considerable amount of heavy metals and exhibited a great health risk. PMID:26148642

  16. Environment, Safety, and Health Risk Assessment Program (ESHRAP)

    SciTech Connect

    Eide, Steven Arvid; Thomas Wierman

    2003-12-01

    The Environment, Safety and Health Risk Assessment Program (ESHRAP) models human safety and health risk resulting from waste management and environmental restoration activities. Human safety and health risks include those associated with storing, handling, processing, transporting, and disposing of radionuclides and chemicals. Exposures to these materials, resulting from both accidents and normal, incident-free operation, are modeled. In addition, standard industrial risks (falls, explosions, transportation accidents, etc.) are evaluated. Finally, human safety and health impacts from cleanup of accidental releases of radionuclides and chemicals to the environment are estimated. Unlike environmental impact statements and safety analysis reports, ESHRAP risk predictions are meant to be best estimate, rather than bounding or conservatively high. Typically, ESHRAP studies involve risk predictions covering the entire waste management or environmental restoration program, including such activities as initial storage, handling, processing, interim storage, transportation, and final disposal. ESHRAP can be used to support complex environmental decision-making processes and to track risk reduction as activities progress.

  17. The Effect of Genetic Risk Information and Health Risk Assessment on Compliance with Preventive Behaviors.

    ERIC Educational Resources Information Center

    Bamberg, Richard; And Others

    1990-01-01

    Results from a study of 82 males provide no statistical support and limited encouragement that genetic risk information may motivate persons to make positive changes in preventive health behaviors. Health risk assessments were used to identify subjects at risk for coronary heart disease or lung cancer because of genetic factors. (IAH)

  18. Air toxics concentrations, source identification, and health risks: An air pollution hot spot in southwest Memphis, TN

    NASA Astrophysics Data System (ADS)

    Jia, Chunrong; Foran, Jeffery

    2013-12-01

    Southwest Memphis is a residential region surrounded by fossil fuel burning, steel, refining, and food processing industries, and considerable mobile sources whose emissions may pose adverse health risks to local residents. This study characterizes cancer and non-cancer risks resulting from exposure to ambient air toxics in southwest Memphis. Air toxics samples were collected at a central location every 6 days from June 5, 2008 to January 8, 2010. Volatile organic compounds (VOCs) were collected in evacuated stainless-steel canisters and aldehydes by DNPH cartridges, and samples were analyzed for 73 target compounds. A total of 60 compounds were detected and 39 were found in over 86% of the samples. Mean concentrations of many compounds were higher than those measured in many industrial communities throughout the U.S. The cumulative cancer risk associated with exposure to 13 carcinogens found in southwest Memphis air was 2.3 × 10-4, four times higher than the national average of 5.0 × 10-5. Three risk drivers were identified: benzene, formaldehyde, and acrylonitrile, which contributed 43%, 19%, and 14% to the cumulative risk, respectively. This is the first field study to confirm acrylonitrile as a potential risk driver. Mobile, secondary, industrial, and background sources contributed 57%, 24%, 14%, and 5% of the risk, respectively. The results of this study indicate that southwest Memphis, a region of significant income, racial, and social disparities, is also a region under significant environmental stress compared with surrounding areas and communities.

  19. Implementation of health risk assessments with family health history: barriers and benefits.

    PubMed

    Wu, R Ryanne; Orlando, Lori A

    2015-09-01

    Health risk assessments provide an opportunity to emphasise health promotion and disease prevention for individuals and populations at large. A key component of health risk assessments is the detailed collection of family health history information. This information is helpful in determining risk both for common chronic conditions and more rare diseases as well. While the concept of health risk assessments has been around since the Framingham Heart Study was launched in the 1950s, and such assessments are commonly performed in the workplace today, the US healthcare system has been slow to embrace them and the emphasis on prevention that they represent. Before wider implementation of health risk assessments within healthcare can be seen, several concerns must be addressed: (1) provider impact, (2) patient impact, (3) validity of patient-entered data and (4) health outcomes effect. Here, we describe recent developments in health risk assessment design that are helping to address these issues.

  20. Can Pregnancy Problems Foretell Future Health Risks?

    MedlinePlus

    ... 21, 2016 HealthDay Copyright (c) 2016 HealthDay . All rights reserved. News stories are provided by HealthDay and do not reflect the views of MedlinePlus, the National Library of Medicine, the ...

  1. Clean Slate transportation and human health risk assessment

    SciTech Connect

    1997-02-01

    Public concern regarding activities involving radioactive material generally focuses on the human health risk associated with exposure to ionizing radiation. This report describes the results of a risk analysis conducted to evaluate risk for excavation, handling, and transport of soil contaminated with transuranics at the Clean Slate sites. Transportation risks were estimated for public transport routes from the Tonopah Test Range (TTR) to the Envirocore disposal facility or to the Area 3 Radioactive Waste Management Site (RWMS) at the Nevada Test Site (NTS) for both radiological risk and risk due to traffic accidents. Human health risks were evaluated for occupational and radiation-related health effects to workers. This report was generated to respond to this public concern, to provide an evaluation of the risk, and to assess feasibility of transport of the contaminated soil for disposal.

  2. Perceived and calculated health risks: do the impacts differ

    SciTech Connect

    Payne, B.A.; Williams, R.G.

    1986-01-23

    In many cases of radioactive and hazardous waste management, some members of the general public perceive that human health risks associated with the wastes are higher than the calculated risks. Calculated risks are projections that have been derived from models, and it is these risks that are usually used as the basis for waste management. However, for various reasons, the calculated risks are often considered by the public as too low or inappropriate. The reasons that calculated risks are not perceived as accurate and the factors that affect these perceptions are explored in this paper. Also discussed are the impacts related to the perceived and calculated health risks: what they are, and if and how they differ. The kinds of potential impacts examined are health effects, land value changes, and social, transportation, and economic effects. The paper concludes with a discussion of the implications of incorporating these different risk perspectives in decisions on waste management.

  3. A new approach to criteria for health risk assessment

    SciTech Connect

    Spickett, Jeffery; Katscherian, Dianne; Goh, Yang Miang

    2012-01-15

    Health Impact Assessment (HIA) is a developing component of the overall impact assessment process and as such needs access to procedures that can enable more consistent approaches to the stepwise process that is now generally accepted in both EIA and HIA. The guidelines developed during this project provide a structured process, based on risk assessment procedures which use consequences and likelihood, as a way of ranking risks to adverse health outcomes from activities subjected to HIA or HIA as part of EIA. The aim is to assess the potential for both acute and chronic health outcomes. The consequences component also identifies a series of consequences for the health care system, depicted as expressions of financial expenditure and the capacity of the health system. These more specific health risk assessment characteristics should provide for a broader consideration of health consequences and a more consistent estimation of the adverse health risks of a proposed development at both the scoping and risk assessment stages of the HIA process. - Highlights: Black-Right-Pointing-Pointer A more objective approach to health risk assessment is provided. Black-Right-Pointing-Pointer An objective set of criteria for the consequences for chronic and acute impacts. Black-Right-Pointing-Pointer An objective set of criteria for the consequences on the health care system. Black-Right-Pointing-Pointer An objective set of criteria for event frequency that could impact on health. Black-Right-Pointing-Pointer The approach presented is currently being trialled in Australia.

  4. Weighing health benefit and health risk information when consuming sport-caught fish.

    PubMed

    Knuth, Barbara A; A Connelly, Nancy; Sheeshka, Judy; Patterson, Jacqueline

    2003-12-01

    Fish consumers may incur benefits and risks from eating fish. Health advisories issued by states, tribes, and other entities typically include advice about how to limit fish consumption or change other behaviors (e.g., fish cleaning or cooking) to reduce health risks from exposure to contaminants. Eating fish, however, may provide health benefits. Risk communicators and fish consumers have suggested the importance of including risk comparison information, as well as health risk-benefit comparisons in health advisory communications. To improve understanding about how anglers fishing in waters affected by health advisories may respond to such risk-risk or risk-benefit information, we surveyed Lake Ontario (NY, USA) anglers. We interviewed by telephone 4,750 anglers, 2,593 of which had fished Lake Ontario in the past 12 months and were sent a detailed mail questionnaire (1,245 responded). We posed questions varying the magnitude of health risks and health benefits to be gained by fish consumption, and varied the population affected by these risks and benefits (anglers, children, women of childbearing age, and unborn children). Respondents were influenced by health benefit and health risk information. When risks were high, most respondents would eat less fish regardless of the benefit level. When risks were low, the magnitude of change in fish consumption was related to level of benefit. Responses differed depending on the question wording order, that is, whether "risks" were posed before "benefits." For a given risk-benefit level, respondents would give different advice to women of childbearing age versus children, with more conservative advice (eat less fish) provided to women of childbearing age. Respondents appeared to be influenced more strongly by risk-risk comparisons (e.g., risks from other foods vs. risks from fish) than by risk-benefit comparisons (e.g., risks from fish vs. benefits from fish). Risk analysts and risk communicators should improve efforts to

  5. TOXICOPROTEOMICS AND ITS APPLICATION TO HUMAN HEALTH RISK ASSESSMENT

    EPA Science Inventory

    Humans are exposed to a variety of environmental toxicants, and this together with a large number of interacting factors can contribute to an individual's risk for health. To understand the toxic mechanisms and/or modes of action for human health risk assessment, molecular charac...

  6. Rural Adolescent Health Risk Behaviors: Age, Gender, and Ethnic Differences.

    ERIC Educational Resources Information Center

    Salzman, Stephanie A.; Girvan, James T.

    A survey of health risk behaviors was administered to a representative sample of 7,776 Idaho students in grades 8-12. Respondents were 86% White, 6% Hispanic, 4% American Indian, 3% Asian, and 2% Black. These rural adolescents reported that they had engaged in some health risk behaviors at rates comparable to those of other U.S. adolescents: 57%…

  7. Nuclear power — is the health risk too great?

    PubMed Central

    Wynne, B E

    1982-01-01

    Apparently objective and value-free `scientific' assessments of health risks are often highly value-laden and incorporate contentious social assumptions. Mr Wynne exposes some of the complexities underlying attempts to compare the health risks of nuclear and other sources of energy. PMID:7108912

  8. Dose-Response Relationship between Cumulative Occupational Lead Exposure and the Associated Health Damages: A 20-Year Cohort Study of a Smelter in China.

    PubMed

    Wu, Yue; Gu, Jun-Ming; Huang, Yun; Duan, Yan-Ying; Huang, Rui-Xue; Hu, Jian-An

    2016-03-01

    Long-term airborne lead exposure, even below official occupational limits, has been found to cause lead poisoning at higher frequencies than expected, which suggests that China's existing occupational exposure limits should be reexamined. A retrospective cohort study was conducted on 1832 smelting workers from 1988 to 2008 in China. These were individuals who entered the plant and came into continuous contact with lead at work for longer than 3 months. The dose-response relationship between occupational cumulative lead exposure and lead poisoning, abnormal blood lead, urinary lead and erythrocyte zinc protoporphyrin (ZPP) were analyzed and the benchmark dose lower bound confidence limits (BMDLs) were calculated. Statistically significant positive correlations were found between cumulative lead dust and lead fumes exposures and workplace seniority, blood lead, urinary lead and ZPP values. A dose-response relationship was observed between cumulative lead dust or lead fumes exposure and lead poisoning (p < 0.01). The BMDLs of the cumulative occupational lead dust and fumes doses were 0.68 mg-year/m³ and 0.30 mg-year/m³ for lead poisoning, respectively. The BMDLs of workplace airborne lead concentrations associated with lead poisoning were 0.02 mg/m³ and 0.01 mg/m³ for occupational exposure lead dust and lead fume, respectively. In conclusion, BMDLs for airborne lead were lower than occupational exposure limits, suggesting that the occupational lead exposure limits need re-examination and adjustment. Occupational cumulative exposure limits (OCELs) should be established to better prevent occupational lead poisoning. PMID:26999177

  9. Dose-Response Relationship between Cumulative Occupational Lead Exposure and the Associated Health Damages: A 20-Year Cohort Study of a Smelter in China

    PubMed Central

    Wu, Yue; Gu, Jun-Ming; Huang, Yun; Duan, Yan-Ying; Huang, Rui-Xue; Hu, Jian-An

    2016-01-01

    Long-term airborne lead exposure, even below official occupational limits, has been found to cause lead poisoning at higher frequencies than expected, which suggests that China’s existing occupational exposure limits should be reexamined. A retrospective cohort study was conducted on 1832 smelting workers from 1988 to 2008 in China. These were individuals who entered the plant and came into continuous contact with lead at work for longer than 3 months. The dose-response relationship between occupational cumulative lead exposure and lead poisoning, abnormal blood lead, urinary lead and erythrocyte zinc protoporphyrin (ZPP) were analyzed and the benchmark dose lower bound confidence limits (BMDLs) were calculated. Statistically significant positive correlations were found between cumulative lead dust and lead fumes exposures and workplace seniority, blood lead, urinary lead and ZPP values. A dose-response relationship was observed between cumulative lead dust or lead fumes exposure and lead poisoning (p < 0.01). The BMDLs of the cumulative occupational lead dust and fumes doses were 0.68 mg-year/m3 and 0.30 mg-year/m3 for lead poisoning, respectively. The BMDLs of workplace airborne lead concentrations associated with lead poisoning were 0.02 mg/m3 and 0.01 mg/m3 for occupational exposure lead dust and lead fume, respectively. In conclusion, BMDLs for airborne lead were lower than occupational exposure limits, suggesting that the occupational lead exposure limits need re-examination and adjustment. Occupational cumulative exposure limits (OCELs) should be established to better prevent occupational lead poisoning. PMID:26999177

  10. Dose-Response Relationship between Cumulative Occupational Lead Exposure and the Associated Health Damages: A 20-Year Cohort Study of a Smelter in China.

    PubMed

    Wu, Yue; Gu, Jun-Ming; Huang, Yun; Duan, Yan-Ying; Huang, Rui-Xue; Hu, Jian-An

    2016-03-16

    Long-term airborne lead exposure, even below official occupational limits, has been found to cause lead poisoning at higher frequencies than expected, which suggests that China's existing occupational exposure limits should be reexamined. A retrospective cohort study was conducted on 1832 smelting workers from 1988 to 2008 in China. These were individuals who entered the plant and came into continuous contact with lead at work for longer than 3 months. The dose-response relationship between occupational cumulative lead exposure and lead poisoning, abnormal blood lead, urinary lead and erythrocyte zinc protoporphyrin (ZPP) were analyzed and the benchmark dose lower bound confidence limits (BMDLs) were calculated. Statistically significant positive correlations were found between cumulative lead dust and lead fumes exposures and workplace seniority, blood lead, urinary lead and ZPP values. A dose-response relationship was observed between cumulative lead dust or lead fumes exposure and lead poisoning (p < 0.01). The BMDLs of the cumulative occupational lead dust and fumes doses were 0.68 mg-year/m³ and 0.30 mg-year/m³ for lead poisoning, respectively. The BMDLs of workplace airborne lead concentrations associated with lead poisoning were 0.02 mg/m³ and 0.01 mg/m³ for occupational exposure lead dust and lead fume, respectively. In conclusion, BMDLs for airborne lead were lower than occupational exposure limits, suggesting that the occupational lead exposure limits need re-examination and adjustment. Occupational cumulative exposure limits (OCELs) should be established to better prevent occupational lead poisoning.

  11. mHealth Apps and Their Risks - Taking Stock.

    PubMed

    Albrecht, Urs-Vito; von Jan, Ute

    2016-01-01

    Despite the popularity of health related apps and the great potential they hold for improving health care, the risks as well as potential hazards posed by such apps are often not adequately appreciated by users. Based on an analysis of scientific literature as well as anecdotal evidence, this contribution addresses the most common risks and pitfalls of health related apps (e.g. related to physical integrity as well as bodily and mental wellbeing) that users may encounter and sketches some remedies. While certainly not exhaustive, the mentioned aspects may serve as a starting point to raise awareness about potential risks of health related apps. PMID:27350511

  12. [Health risk assessment of coke oven PAHs emissions].

    PubMed

    Bo, Xin; Wang, Gang; Wen, Rou; Zhao, Chun-Li; Wu, Tie; Li, Shi-Bei

    2014-07-01

    Polycyclic aromatic hydrocarbons (PAHs) produced by coke oven are with strong toxicity and carcinogenicity. Taken typical coke oven of iron and steel enterprises as the case study, the dispersion and migration of 13 kinds of PAHs emitted from coke oven were analyzed using AERMOD dispersion model, the carcinogenic and non-carcinogenic risks at the receptors within the modeling domain were evaluated using BREEZE Risk Analyst and the Human Health Risk Assessment Protocol for Hazardous Waste Combustion (HHRAP) was followed, the health risks caused by PAHs emission from coke oven were quantitatively evaluated. The results indicated that attention should be paid to the non-carcinogenic risk of naphthalene emission (the maximum value was 0.97). The carcinogenic risks of each single pollutant were all below 1.0E-06, while the maximum value of total carcinogenic risk was 2.65E-06, which may have some influence on the health of local residents.

  13. A longitudinal perspective on health plan-provider risk contracting.

    PubMed

    Hurley, Robert; Grossman, Joy; Lake, Timothy; Casalino, Lawrence

    2002-01-01

    During the past decade many health plans adopted risk-contracting arrangements that transferred substantial financial risk and care management responsibility to physician groups and hospital-sponsored integrated delivery systems. Risk transfer arrangements are now believed to be in steep decline, but there is little empirical evidence on this topic, particularly at the local-market level. Data from the Community Tracking Study were used to examine changes in risk contracting from 1996 to 2000. A decline in reliance on risk contracting is evident in nearly all markets. However, retrenchment in risk contracting has followed different patterns ranging from refinements in the scope of risk transfer to reduced use of risk arrangements to total rejection of risk-sharing arrangements. Modified risk-transfer agreements remain viable in several markets, but continued refinement in the nature and scope of risk sharing will be necessary.

  14. The Impact of an Incentive-Based Worksite Health Promotion Program on Modifiable Health Risk Factors.

    ERIC Educational Resources Information Center

    Poole, Kathleen; Kumpfer, Karol; Pett, Marjorie

    2001-01-01

    Examined the impact of participating in an incentive-based employee health promotion program on modifiable health risk factors over 4 years. Data from physiological and self-report measures indicated that modifiable health risks improved over time (smoking, physical activity, systolic and diastolic blood pressure, and seat belt use). Cholesterol…

  15. Mental Health and Health Risk Behaviours of Homeless Adolescents and Youth: A Mixed Methods Study

    ERIC Educational Resources Information Center

    Oppong Asante, Kwaku; Meyer-Weitz, Anna; Petersen, Inge

    2016-01-01

    Background: Homeless youth, as a vulnerable population are susceptible to various mental and health risk behaviours. However, less is known of the mental health status of these homeless youth and its role in risky sexual behaviours; neither do we understand the reasons homeless youth give for their engagement in various health risk behaviour.…

  16. The Measurement of Health Behavior Change: The Health Behavior Risk Factor Prevalence Instrument.

    ERIC Educational Resources Information Center

    Sutherland, Mary; And Others

    This paper addresses some issues concerning the use of written instruments for measuring health behavior change. A description is given of the Health Behavior Risk Factor Prevalence Survey which was developed to identify group members' risk-taking behaviors. This instrument was used to measure the health behaviors of a group of employees in the…

  17. Reduction in health risks and disparities with participation in an employer-sponsored health promotion program.

    PubMed

    Burton, Wayne N; Chen, Chin-Yu; Li, Xingquan; Schultz, Alyssa B; Edington, Dee W

    2013-08-01

    There is an increasing awareness among employers and health care providers that health care needs to be tailored to address the diversity of the workforce. Population-based data have shown significant differences in health behaviors and health risks among different racial/ethnic groups in the United States. The purpose of this study was to examine health risks and changes in health risks over time in an employed population at a financial services corporation. This large financial services corporation is naturally concerned about any disparities in health among employees. The study population consists of employees who participated in the organization's medical plan and also the annual health risk appraisal questionnaire in both 2009 and 2010. Significant demographic differences exist among the four ethnic groups studied: whites, African Americans, Hispanics, and Asians. At baseline, African American employees had a significantly higher average number of health risks measured by the health risk appraisal, but they also experienced the greatest improvement in health risks by time 2. There were differences in the health risk profiles of the ethnic groups, with certain risk factors being more prevalent among some ethnicities than among others. The health care costs were not significantly different among the groups studied here. It is likely that other large employers may also find health risk differences among employees belonging to various ethnicities. Future research in this field should seek to understand the reasons behind differences in health among ethnic groups and how best to address them so that all employees can achieve a high level of health and wellness. PMID:23924828

  18. Reduction in health risks and disparities with participation in an employer-sponsored health promotion program.

    PubMed

    Burton, Wayne N; Chen, Chin-Yu; Li, Xingquan; Schultz, Alyssa B; Edington, Dee W

    2013-08-01

    There is an increasing awareness among employers and health care providers that health care needs to be tailored to address the diversity of the workforce. Population-based data have shown significant differences in health behaviors and health risks among different racial/ethnic groups in the United States. The purpose of this study was to examine health risks and changes in health risks over time in an employed population at a financial services corporation. This large financial services corporation is naturally concerned about any disparities in health among employees. The study population consists of employees who participated in the organization's medical plan and also the annual health risk appraisal questionnaire in both 2009 and 2010. Significant demographic differences exist among the four ethnic groups studied: whites, African Americans, Hispanics, and Asians. At baseline, African American employees had a significantly higher average number of health risks measured by the health risk appraisal, but they also experienced the greatest improvement in health risks by time 2. There were differences in the health risk profiles of the ethnic groups, with certain risk factors being more prevalent among some ethnicities than among others. The health care costs were not significantly different among the groups studied here. It is likely that other large employers may also find health risk differences among employees belonging to various ethnicities. Future research in this field should seek to understand the reasons behind differences in health among ethnic groups and how best to address them so that all employees can achieve a high level of health and wellness.

  19. Health Promotion and Risk Behaviors among Adolescents in Turkey

    ERIC Educational Resources Information Center

    Ortabag, Tulay; Ozdemir, Serpil; Bakir, Bilal; Tosun, Nuran

    2011-01-01

    Adolescents experience the onset and development of several health-related behaviors. The purpose of this study is to determine health risk and promotion behaviors of adolescents between the ages of 11 and 19 who were attending and to test the reliability and validity analysis of the Turkish version of Adolescent Health Promotion Scale (AHPS). The…

  20. 75 FR 70009 - Development of Health Risk Assessment Guidance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Development of Health Risk Assessment Guidance AGENCY: Centers for Disease Control and Prevention (CDC), Department of Health and Human Services...

  1. Risk and uncertainty in health investment.

    PubMed

    Asano, Takao; Shibata, Akihisa

    2011-02-01

    Extending the Grossman (J Polit Econ 80:223-255, 1972) model of health capital into a stochastic one, we analyze how the presence of Knightian uncertainty about the efficacy of health care affects the optimal health investment behavior of individuals. Using Gilboa and Schmeidler's (J Math Econ 18:141-153, 1989) model of max/min expected utility (MMEU) with multiple priors, we show that an agent retains the initial level of health capital if the price of health care lies within a certain range. We also show that the no-investment range expands as the degree of Knightian uncertainty rises.

  2. Rural Latino adolescent health: preliminary examination of health risks and cultural correlates.

    PubMed

    Nelson, Timothy D; Kidwell, Katherine M; Armenta, Brian E; Crockett, Lisa J; Carlo, Gustavo; Whitbeck, Les B

    2014-06-01

    Latino adolescents living in rural settings may be at increased risk of health problems; however, data describing the health status of this population are limited. This study examined 60 rural Latino adolescents and found high rates of health risk, including at-risk/clinical results for hemoglobin A1C (23.3%), high-density lipoprotein cholesterol (55%), systolic blood pressure (21.7%), and overweight/obesity (55%). Time in sedentary behaviors was high and physical activity was limited. Adolescent language use was associated with health risk status, with greater use of English associated with lower risk. Health psychologists could promote improved health by providing health behavior interventions to this underserved population. PMID:23520352

  3. Pathways to Health Risk Exposure in Adult Film Performers

    PubMed Central

    Ryan, Gery; Margold, William; Torres, Jacqueline; Gelberg, Lillian

    2008-01-01

    Despite being part of a large and legal industry in Los Angeles, little is known about adult film performers’ exposure to health risks and when and how these risks might occur. The objective was to identify exposure to physical, mental, and social health risks and the pathways to such risks among adult film performers and to determine how risks differ between different types of performers, such as men and women. Semi-structured in-depth interviews were conducted with 18 female and ten male performers as well as two key informants from the industry. Performers and key informants were recruited through Protecting Adult Welfare, adult film venues, and snowball sampling. Performers engaged in risky health behaviors that included high-risk sexual acts that are unprotected, substance abuse, and body enhancement. They are exposed to physical trauma on the film set. Many entered and left the industry with financial insecurity and suffered from mental health problems. Women were more likely than men to be exposed to health risks. Adult film performers, especially women, are exposed to health risks that accumulate over time and that are not limited to sexually transmitted diseases. PMID:18709554

  4. The impact of an integrated population health enhancement and disease management program on employee health risk, health conditions, and productivity.

    PubMed

    Loeppke, Ron; Nicholson, Sean; Taitel, Michael; Sweeney, Matthew; Haufle, Vince; Kessler, Ronald C

    2008-12-01

    This study evaluated the impact of an integrated population health enhancement program on employee health risks, health conditions, and productivity. Specifically, we analyzed changes in these measures among a cohort of 543 employees who completed a health risk assessment in both 2003 and 2005. We compared these findings with 2 different sets of employees who were not offered health enhancement programming. We found that the DIRECTV cohort showed a significant reduction in health risks after exposure to the program. Relative to a matched comparison group, the proportion of low-risk employees at DIRECTV in 2005 was 8.2 percentage points higher; the proportion of medium-risk employees was 7.1 percentage points lower; and the proportion of high-risk employees was 1.1 percentage points lower (p < 0.001). The most noticeable changes in health risk were a reduction in the proportion of employees with high cholesterol; an improvement in diet; a reduction of heavy drinking; management of high blood pressure; improved stress management; increased exercise; fewer smokers; and a drop in obesity rates. We also found that a majority of employees who improved their risk levels from 2003 to 2005 maintained their gains in 2006. Employees who improved their risks levels also demonstrated relative improvement in absenteeism. Overall, this study provides additional evidence that integrated population health enhancement positively impacts employees' health risk and productivity; it also reinforces the view that "good health is good business."

  5. Occupational health and safety: Designing and building with MACBETH a value risk-matrix for evaluating health and safety risks

    NASA Astrophysics Data System (ADS)

    Lopes, D. F.; Oliveira, M. D.; Costa, C. A. Bana e.

    2015-05-01

    Risk matrices (RMs) are commonly used to evaluate health and safety risks. Nonetheless, they violate some theoretical principles that compromise their feasibility and use. This study describes how multiple criteria decision analysis methods have been used to improve the design and the deployment of RMs to evaluate health and safety risks at the Occupational Health and Safety Unit (OHSU) of the Regional Health Administration of Lisbon and Tagus Valley. ‘Value risk-matrices’ (VRMs) are built with the MACBETH approach in four modelling steps: a) structuring risk impacts, involving the construction of descriptors of impact that link risk events with health impacts and are informed by scientific evidence; b) generating a value measurement scale of risk impacts, by applying the MACBETH-Choquet procedure; c) building a system for eliciting subjective probabilities that makes use of a numerical probability scale that was constructed with MACBETH qualitative judgments on likelihood; d) and defining a classification colouring scheme for the VRM. A VRM built with OHSU members was implemented in a decision support system which will be used by OHSU members to evaluate health and safety risks and to identify risk mitigation actions.

  6. Trends in the Health Status of Medicare Risk Contract Enrollees

    PubMed Central

    Riley, Gerald; Zarabozo, Carlos

    2006-01-01

    Previous research has found Medicare risk contract enrollees to be healthier than beneficiaries in fee-for-service (FFS). Medicare Current Beneficiary Survey (MCBS) data were used to examine trends in health and functional status measures among risk contract and FFS enrollees from 1991 to 2004. Risk contract enrollees reported better health and functioning, but the differences tended to narrow over time. Most of the differences in trends were observed for functional status measures and institutionalization; differences in trends for perceived health status and prevalence rates of chronic conditions tended to be small or non-existent. The narrowing of functional and health status differences between the risk contract and FFS populations may have implications for payment policy, as well as implications for the role of private health plans in Medicare. PMID:17427847

  7. Community Health Risk Assessment of Primary Aluminum Smelter Emissions

    PubMed Central

    Larivière, Claude

    2014-01-01

    Objective: Primary aluminum production is an industrial process with high potential health risk for workers. We consider in this article how to assess community health risks associated with primary aluminum smelter emissions. Methods: We reviewed the literature on health effects, community exposure data, and dose–response relationships of the principal hazardous agents emitted. Results: On the basis of representative measured community exposure levels, we were able to make rough estimates on health risks associated with specific agents and categorize these as none, low, medium, or high. Conclusions: It is possible to undertake a rough-estimate community Health Risk Assessment for individual smelters on the basis of information available in the epidemiological literature and local community exposure data. PMID:24806724

  8. The risk of infections in hematologic patients treated with rituximab is not influenced by cumulative rituximab dosage - a single center experience

    PubMed Central

    2014-01-01

    Background Rituximab, a monoclonal antibody directed against CD20, is approved for the treatment of CD20-positive B-cell Non-Hodgkin’s lymphoma and rheumatologic disorders. Due to its potent activity in depleting CD20-positive lymphocytes, the influence on opportunistic infections is still under discussion. Thus, we analyzed the impact of rituximab either as monotherapy or in combination with other chemotherapeutic regimens to elucidate its role in contributing to infectious complications. Methods The records of consecutive patients (n = 125, 141 treatment episodes) treated with rituximab alone or in combination with chemotherapy and corticosteroids were analyzed retrospectively for the incidence, spectrum and outcome of infections during treatment and 6 months after the last course of rituximab. Univariate analysis of cofactors such as steroid medication, antiinfective prophylaxis, underlying disease and remission status were performed. Results Altogether 80 therapy episodes were associated with infections, the median number of infections per patient being 1 (range 1–7). The number of infectious complications was significantly higher in patients receiving a combination of rituximab and chemotherapy compared to rituximab monotherapy (p < 0.001). There was no statistically significant difference regarding number of rituximab courses or cumulative rituximab dosage between episodes with and without infections, respectively.Mean cumulative prednisone dosage between the cohort with infections and the one without infections showed a trend towards higher dosage of prednisone in the patients with infections (mean difference 441 mg, p > 0.14). Conclusions Rituximab in induction treatment, either as monotherapy or combined with chemotherapy by itself does not increase the incidence or change the spectrum of infections in hematologic patients. However the possible influence of higher dosages of concomitant steroid medication on frequency of infections

  9. The Relationship of Depression to Health Risk Behaviors and Health Perceptions in Korean College Students.

    ERIC Educational Resources Information Center

    Kim, Oksoo

    2002-01-01

    Investigates the relationship of depression to health risk behaviors and health perceptions in Korean college students. The level of students' depression predicted alcohol consumption, symptom pattern, and physical health. Students who were more depressed reported more symptoms and perceived their health as worse than those who were less…

  10. CUMBIN - CUMULATIVE BINOMIAL PROGRAMS

    NASA Technical Reports Server (NTRS)

    Bowerman, P. N.

    1994-01-01

    The cumulative binomial program, CUMBIN, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, CUMBIN, NEWTONP (NPO-17556), and CROSSER (NPO-17557), can be used independently of one another. CUMBIN can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. CUMBIN calculates the probability that a system of n components has at least k operating if the probability that any one operating is p and the components are independent. Equivalently, this is the reliability of a k-out-of-n system having independent components with common reliability p. CUMBIN can evaluate the incomplete beta distribution for two positive integer arguments. CUMBIN can also evaluate the cumulative F distribution and the negative binomial distribution, and can determine the sample size in a test design. CUMBIN is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. The program is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. The CUMBIN program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. CUMBIN was developed in 1988.

  11. Cumulative Timers for Microprocessors

    NASA Technical Reports Server (NTRS)

    Battle, John O.

    2007-01-01

    It has been proposed to equip future microprocessors with electronic cumulative timers, for essentially the same reasons for which land vehicles are equipped with odometers (total-distance-traveled meters) and aircraft are equipped with Hobbs meters (total-engine-operating time meters). Heretofore, there has been no way to determine the amount of use to which a microprocessor (or a product containing a microprocessor) has been subjected. The proposed timers would count all microprocessor clock cycles and could only be read by means of microprocessor instructions but, like odometers and Hobbs meters, could never be reset to zero without physically damaging the chip.

  12. A Modeling System to Examine Near-Road and Near-Source Air Toxics for Community-Scale Cumulative Assessments.

    EPA Science Inventory

    Cumulative assessments consider a range of potential stressors that might impact the health of a receptor, such as a local neighborhood or wetland area. When receptors are located near pollution sources such as highways or ports (within 500-1,000 m), then they could be at risk of...

  13. Health Risks Information Reaches Secondary School Smokers

    ERIC Educational Resources Information Center

    Ridout, Fran; Charlton, Anne; Hutchison, Iain

    2008-01-01

    This cross-sectional study aimed to assess smoking prevention and cessation education delivered as part of the UK National Curriculum and to evaluate the relative effectiveness of health, social influence and other/non-health components. In all, 1789 students aged 11-15 from 12 secondary schools completed online surveys assessing smoking status,…

  14. [Smoking: what are the health risks?].

    PubMed

    Perriot, Jean; Underner, Michel; Doly-Kuchcik, Ludivine

    2012-03-01

    Smoking is the primary cause of avoidable deaths in developing countries; it is the principal cause of many illnesses and is risk factor or aggravated cause. Cigarettes or smokeless tobacco have a direct or indirect toxicity effect on practically every organ. The induced diseases are cardiovascular, cancers, respiratory complaints and many consequences less well known but often serious. There is no smoking without risk; however, stopping smoking at any age is beneficial.

  15. Applying risk perception theory to public health workforce preparedness training.

    PubMed

    Barnett, Daniel J; Balicer, Ran D; Blodgett, David W; Everly, George S; Omer, Saad B; Parker, Cindy L; Links, Jonathan M

    2005-11-01

    Since 9/11, public health has seen a progressive culture change toward a 24/7 emergency response organizational model. This transition entails new expectations for public health workers, including (1) a readiness and willingness to report to duty in emergencies and (2) an ability to effectively communicate risk to an anxious public about terrorism or naturally occurring disasters. To date, however, research on readiness education for health department workers has focused little attention upon the risk perceptions that may influence their willingness to report to duty during disasters, as well as their ability to provide effective emergency risk communication to the public. Here, we apply risk perception factors to explore the potential barriers and remedies to effective public health workforce emergency response.

  16. CROSSER - CUMULATIVE BINOMIAL PROGRAMS

    NASA Technical Reports Server (NTRS)

    Bowerman, P. N.

    1994-01-01

    The cumulative binomial program, CROSSER, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, CROSSER, CUMBIN (NPO-17555), and NEWTONP (NPO-17556), can be used independently of one another. CROSSER can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. CROSSER calculates the point at which the reliability of a k-out-of-n system equals the common reliability of the n components. It is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. The program is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. It also lists the number of iterations of Newton's method required to calculate the answer within the given error. The CROSSER program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. CROSSER was developed in 1988.

  17. Educated guesses: health risk assessment in environmental impact statements.

    PubMed

    Harvey, P D

    1990-01-01

    Environmental pollution threatens public health. The search for solutions has advanced the frontiers of science and law. Efforts to protect the environment and public health begin with describing potential adverse consequences of human activities and characterizing the predicted risk. The National Environmental Policy Act requires the preparation of environmental impact statements to describe the effects of proposed federal projects and provide information for agency decisionmakers and the public. Risks to public health are particularly difficult to quantify because of uncertainty about the relation between exposure to environmental contamination and disease. Risk assessment is the current scientific tool to present estimates of risk. The methodology has created controversy, however, when underlying assumptions and uncertainties are not clearly presented. Critics caution that the methodology is vulnerable to bias. This Note evaluates the use of risk assessment in the environmental impact statement process and offers recommendations to ensure informed decisions.

  18. Educated guesses: health risk assessment in environmental impact statements.

    PubMed

    Harvey, P D

    1990-01-01

    Environmental pollution threatens public health. The search for solutions has advanced the frontiers of science and law. Efforts to protect the environment and public health begin with describing potential adverse consequences of human activities and characterizing the predicted risk. The National Environmental Policy Act requires the preparation of environmental impact statements to describe the effects of proposed federal projects and provide information for agency decisionmakers and the public. Risks to public health are particularly difficult to quantify because of uncertainty about the relation between exposure to environmental contamination and disease. Risk assessment is the current scientific tool to present estimates of risk. The methodology has created controversy, however, when underlying assumptions and uncertainties are not clearly presented. Critics caution that the methodology is vulnerable to bias. This Note evaluates the use of risk assessment in the environmental impact statement process and offers recommendations to ensure informed decisions. PMID:2278245

  19. Uncertainties associated with assessing the public health risk from Legionella

    PubMed Central

    Whiley, Harriet; Keegan, Alexandra; Fallowfield, Howard; Ross, Kirstin

    2014-01-01

    Legionella is an opportunistic pathogen of public health concern. Current regulatory and management guidelines for the control of this organism are informed by risk assessments. However, there are many unanswered questions and uncertainties regarding Legionella epidemiology, strain infectivity, infectious dose, and detection methods. This review follows the EnHealth Risk Assessment Framework, to examine the current information available regarding Legionella risk and discuss the uncertainties and assumptions. This review can be used as a tool for understanding the uncertainties associated with Legionella risk assessment. It also serves to highlight the areas of Legionella research that require future focus. Improvement of these uncertainties will provide information to enhance risk management practices for Legionella, potentially improving public health protection and reducing the economic costs by streamlining current management practices. PMID:25309526

  20. Risk assessment of human health for geogenic chromium and nickel in soils derived from serpentines

    NASA Astrophysics Data System (ADS)

    Hseu, Zeng-Yei; Lai, Yun-Jie

    2016-04-01

    Concentrations of Cr and Ni are extremely high in serpentine soils compared to soils from the other parent materials. Three serpentine sites in Taiwan were selected to determine health risk of Cr and Ni as cumulative carcinogenic and non-carcinogenic risks via the multiple routes of ingestion, dermal contact, inhalation, and diet on adults and children. The mean levels of Cr and Ni were higher than the soil control standards of heavy metals in Taiwan (250 and 200 mg/kg of Cr and Ni). For adults and children, the total dose of chronic daily intake (mg/kg/d) was the highest for Ni, followed in descending order by Cr(III) and Cr(VI) at all sites. Regardless inhabitant age, the total carcinogenic risk was much lower than 1.0E-6. However, the hazard index (HI) of non-carcinogenic risk exceeded 1.0 for adults at all sites, which was mainly contributed in Ni by eating rice.

  1. Project 6: Cumulative Risk Assessment Methods and ApplicationsTask 6.3: Applying Genetic and Epigenetic Data to Inform Susceptibility

    EPA Science Inventory

    Susceptibility is defined as the capacity to be affected; an individual can be at greater or less risk relative to population median risk because of susceptibility factors such as life stage, sex, genetics, socioeconomic status, prior exposure to chemicals, and non-chemical stres...

  2. Glutaraldehyde: a potential health risk to nurses

    SciTech Connect

    Newman, M.A.; Kachuba, J.B.

    1992-06-01

    This article discusses the potential toxicity of glutaraldehyde, a chemical commonly used in endoscopy units. The literature review cites adverse health effects experienced by workers exposed to glutaraldehyde. The sampling methodology for glutaraldehyde relative to the Occupational Safety and Health standard for glutaraldehyde is presented. Air monitoring should be performed to assess employee exposure to airborne glutaraldehyde in endoscopy departments. Recommendations for reducing exposure to glutaraldehyde in endoscopy units are included.

  3. Human health risk assessment of heavy metals in urban stormwater.

    PubMed

    Ma, Yukun; Egodawatta, Prasanna; McGree, James; Liu, An; Goonetilleke, Ashantha

    2016-07-01

    Toxic chemical pollutants such as heavy metals (HMs) are commonly present in urban stormwater. These pollutants can pose a significant risk to human health and hence a significant barrier for urban stormwater reuse. The primary aim of this study was to develop an approach for quantitatively assessing the risk to human health due to the presence of HMs in stormwater. This approach will lead to informed decision making in relation to risk management of urban stormwater reuse, enabling efficient implementation of appropriate treatment strategies. In this study, risks to human health from heavy metals were assessed as hazard index (HI) and quantified as a function of traffic and land use related parameters. Traffic and land use are the primary factors influencing heavy metal loads in the urban environment. The risks posed by heavy metals associated with total solids and fine solids (<150μm) were considered to represent the maximum and minimum risk levels, respectively. The study outcomes confirmed that Cr, Mn and Pb pose the highest risks, although these elements are generally present in low concentrations. The study also found that even though the presence of a single heavy metal does not pose a significant risk, the presence of multiple heavy metals could be detrimental to human health. These findings suggest that stormwater guidelines should consider the combined risk from multiple heavy metals rather than the threshold concentration of an individual species. Furthermore, it was found that risk to human health from heavy metals in stormwater is significantly influenced by traffic volume and the risk associated with stormwater from industrial areas is generally higher than that from commercial and residential areas.

  4. Human health risk assessment of heavy metals in urban stormwater.

    PubMed

    Ma, Yukun; Egodawatta, Prasanna; McGree, James; Liu, An; Goonetilleke, Ashantha

    2016-07-01

    Toxic chemical pollutants such as heavy metals (HMs) are commonly present in urban stormwater. These pollutants can pose a significant risk to human health and hence a significant barrier for urban stormwater reuse. The primary aim of this study was to develop an approach for quantitatively assessing the risk to human health due to the presence of HMs in stormwater. This approach will lead to informed decision making in relation to risk management of urban stormwater reuse, enabling efficient implementation of appropriate treatment strategies. In this study, risks to human health from heavy metals were assessed as hazard index (HI) and quantified as a function of traffic and land use related parameters. Traffic and land use are the primary factors influencing heavy metal loads in the urban environment. The risks posed by heavy metals associated with total solids and fine solids (<150μm) were considered to represent the maximum and minimum risk levels, respectively. The study outcomes confirmed that Cr, Mn and Pb pose the highest risks, although these elements are generally present in low concentrations. The study also found that even though the presence of a single heavy metal does not pose a significant risk, the presence of multiple heavy metals could be detrimental to human health. These findings suggest that stormwater guidelines should consider the combined risk from multiple heavy metals rather than the threshold concentration of an individual species. Furthermore, it was found that risk to human health from heavy metals in stormwater is significantly influenced by traffic volume and the risk associated with stormwater from industrial areas is generally higher than that from commercial and residential areas. PMID:27046140

  5. [Health alert management and emerging risk].

    PubMed

    Pillonel, J

    2010-12-01

    Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens. PMID:21051258

  6. [Health alert management and emerging risk].

    PubMed

    Pillonel, J

    2010-12-01

    Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens.

  7. Who comes to a workplace health risk assessment?

    PubMed

    Dobbins, T A; Simpson, J M; Oldenburg, B; Owen, N; Harris, D

    1998-01-01

    Workplace health promotion initiatives have proliferated, but there are difficulties in recruiting employees of lower socioeconomic status and at higher risk of disease. A survey of health behaviors and attitudes was administered in 20 worksites and the opportunity to attend a health risk assessment promoted. Those more likely to attend were women, those of higher occupational prestige, and those from a non-English-speaking background. After adjustment for these variables, the only health behavior associated with attendance was smoking status. Perceived risk of lung cancer was significant, even after adjustment for smoking status. Stage of readiness to change health behaviors was associated with attendance, with those in the preparation stage being more likely to attend than those in the precontemplation stage. However, this association was statistically significant only for fruit and vegetable consumption. There was no relation between attendance and support for health promotion, perceived general health, or other perceived risk of disease. These findings suggest that additional risk communication strategies and environmental support are required to involve those with less prestigious occupations.

  8. Environmental risks and children's health: what can PRAMS tell us?

    PubMed

    Korfmacher, Katrina Smith; Suter, Barbara J; Cai, Xueya; Brownson, Susan A; Dozier, Ann M

    2014-07-01

    Environmental exposures during pregnancy have a lasting impact on children's health. We combined environmental and maternal risk factor survey data to inform efforts to protect children's health. We made recommendations for future use of such data. A modified version of the Pregnancy Risk Assessment Monitoring System (PRAMS) mail survey was conducted based on weighted sampling design with low-income and non-low income women in Monroe County, NY (1,022 respondents). A series of environmental questions were included in the questionnaire. Data were analyzed using Chi square tests and Poisson loglinear regression model to identify patterns in environmental health risk and sociodemographic characteristics. We identified women who rented their homes, had lower incomes, and lived in inner city zip codes as "high environmental health risk" (HEHR). HEHR respondents were more likely to report that a health care provider talked with them about lead and on average reported more behaviors to protect their children from lead poisoning. Combining environmental and perinatal risk factor data could yield important recommendations for medical practice, health education, and policy development. However, at present PRAMS gathers only limited and inconsistent environmental data. We found that existing PRAMS environmental questions are insufficient. Further work is needed to develop updated and more comprehensive environmental health survey questions and implement them consistently across the country. PMID:23955384

  9. Health Risk Behavior and Sexual Assault among Ethnically Diverse Women

    ERIC Educational Resources Information Center

    Littleton, Heather L.; Grills-Taquechel, Amie E.; Buck, Katherine S.; Rosman, Lindsey; Dodd, Julia C.

    2013-01-01

    Sexual assault is associated with a number of health risk behaviors in women. It has been hypothesized that these risk behaviors, such as hazardous drinking, may represent women's attempts to cope with psychological distress, such as symptoms of depression and anxiety. However, extant research has failed to evaluate these relationships among…

  10. INCORPORATING HUMAN INTERINDIVIDUAL BIOTRANSFORMATION VARIANCE IN HEALTH RISK ASSESSMENT

    EPA Science Inventory

    The protection of sensitive individuals within a population dictates that measures other than central tendencies be employed to estimate risk. The refinement of human health risk assessments for chemicals metabolized by the liver to reflect data on human variability can be accom...

  11. Weight Misperception and Health Risk Behaviors among Early Adolescents

    ERIC Educational Resources Information Center

    Pasch, Keryn E.; Klein, Elizabeth G.; Laska, Melissa N.; Velazquez, Cayley E.; Moe, Stacey G.; Lytle, Leslie A.

    2011-01-01

    Objectives: To examine associations between weight misperception and youth health risk and protective factors. Methods: Three thousand ten US seventh-graders (72.1% white, mean age: 12.7 years) self-reported height, weight, risk, and protective factors. Analyses were conducted to determine cross-sectional and longitudinal associations between…

  12. Victimization and Health Risk Factors among Weapon-Carrying Youth

    ERIC Educational Resources Information Center

    Stayton, Catherine; McVeigh, Katharine H.; Olson, E. Carolyn; Perkins, Krystal; Kerker, Bonnie D.

    2011-01-01

    Objective: To compare health risks of 2 subgroups of weapon carriers: victimized and nonvictimized youth. Methods: 2003-2007 NYC Youth Risk Behavior Surveys were analyzed using bivariate analyses and multinomial logistic regression. Results: Among NYC teens, 7.5% reported weapon carrying without victimization; 6.9% reported it with victimization.…

  13. Risk distribution across multiple health insurance funds in rural Tanzania

    PubMed Central

    Chomi, Eunice Nahyuha; Mujinja, Phares Gamba; Enemark, Ulrika; Hansen, Kristian; Kiwara, Angwara Dennis

    2014-01-01

    Introduction Multiple insurance funds serving different population groups may compromise equity due to differential revenue raising capacity and an unequal distribution of high risk members among the funds. This occurs when the funds exist without mechanisms in place to promote income and risk cross-subsidisation across the funds. This paper analyses whether the risk distribution varies across the Community Health Fund (CHF) and National Health Insurance Fund (NHIF) in two districts in Tanzania. Specifically we aim to 1) identify risk factors associated with increased utilisation of health services and 2) compare the distribution of identified risk factors among the CHF, NHIF and non-member households. Methods Data was collected from a survey of 695 households. A multivariate logisitic regression model was used to identify risk factors for increased health care utilisation. Chi-square tests were performed to test whether the distribution of identified risk factors varied across the CHF, NHIF and non-member households. Results There was a higher concentration of identified risk factors among CHF households compared to those of the NHIF. Non-member households have a similar wealth status to CHF households, but a lower concentration of identified risk factors. Conclusion Mechanisms for broader risk spreading and cross-subsidisation across the funds are necessary for the promotion of equity. These include risk equalisation to adjust for differential risk distribution and revenue raising capacity of the funds. Expansion of CHF coverage is equally important, by addressing non-financial barriers to CHF enrolment to encourage wealthy non-members to join, as well as subsidised membership for the poorest. PMID:25574326

  14. Assessing human health risk in the USDA forest service

    SciTech Connect

    Hamel, D.R.

    1990-12-31

    This paper identifies the kinds of risk assessments being done by or for the US Department of Agriculture (USDA) Forest Service. Summaries of data sources currently in use and the pesticide risk assessments completed by the agency or its contractors are discussed. An overview is provided of the agency`s standard operating procedures for the conduct of toxicological, ecological, environmental fate, and human health risk assessments.

  15. Epidemiology of fine particulate air pollution and human health: biologic mechanisms and who's at risk?

    PubMed Central

    Pope, C A

    2000-01-01

    This article briefly summarizes the epidemiology of the health effects of fine particulate air pollution, provides an early, somewhat speculative, discussion of the contribution of epidemiology to evaluating biologic mechanisms, and evaluates who's at risk or is susceptible to adverse health effects. Based on preliminary epidemiologic evidence, it is speculated that a systemic response to fine particle-induced pulmonary inflammation, including cytokine release and altered cardiac autonomic function, may be part of the pathophysiologic mechanisms or pathways linking particulate pollution with cardiopulmonary disease. The elderly, infants, and persons with chronic cardiopulmonary disease, influenza, or asthma are most susceptible to mortality and serious morbidity effects from short-term acutely elevated exposures. Others are susceptible to less serious health effects such as transient increases in respiratory symptoms, decreased lung function, or other physiologic changes. Chronic exposure studies suggest relatively broad susceptibility to cumulative effects of long-term repeated exposure to fine particulate pollution, resulting in substantive estimates of population average loss of life expectancy in highly polluted environments. Additional knowledge is needed about the specific pollutants or mix of pollutants responsible for the adverse health effects and the biologic mechanisms involved. PMID:10931790

  16. Health-risk assessment of trichlorofluoromethane in California drinking water

    SciTech Connect

    Reed, N.R.; Reed, W.; Weir, K.; Beltran, K.; Babapour, R.

    1988-12-22

    Existing literature is reviewed that is pertinent to the health risk posed by the use of Freon-11 contaminated drinking water, an estimation of the Freon-11 exposure for California residents based on the most recent data on Freon-11 concentrations in California drinking-water supplies, and a delineation of the level of Freon-11 that may cause a noncarcinogenic health effect.

  17. Physical Activity Protects against the Health Risks of Obesity.

    ERIC Educational Resources Information Center

    Welk, Gregory J.; Blair, Steven N.

    2000-01-01

    This paper reviews the relationships between physical fitness and body composition and their combined effect on health. After discussing the epidemiologic evidence for a protective effect of physical fitness on the health risks associated with obesity, it describes the Aerobics Center Longitudinal Study, an ongoing observational study that…

  18. Evaluation of health risks for contaminated aquifers.

    PubMed Central

    Piver, W T; Jacobs, T L; Medina, M A

    1997-01-01

    This review focuses on progress in the development of transport models for heterogeneous contaminated aquifers, the use of predicted contaminant concentrations in groundwater for risk assessment for heterogeneous human populations, and the evaluation of aquifer remediation technologies. Major limitations and areas for continuing research for all methods presented in this review are identified. Images Figure 2. PMID:9114282

  19. Evaluation of health risks for contaminated aquifers.

    PubMed

    Piver, W T; Jacobs, T L; Medina, M A

    1997-02-01

    This review focuses on progress in the development of transport models for heterogeneous contaminated aquifers, the use of predicted contaminant concentrations in groundwater for risk assessment for heterogeneous human populations, and the evaluation of aquifer remediation technologies. Major limitations and areas for continuing research for all methods presented in this review are identified.

  20. NEWTONP - CUMULATIVE BINOMIAL PROGRAMS

    NASA Technical Reports Server (NTRS)

    Bowerman, P. N.

    1994-01-01

    The cumulative binomial program, NEWTONP, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, NEWTONP, CUMBIN (NPO-17555), and CROSSER (NPO-17557), can be used independently of one another. NEWTONP can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. NEWTONP calculates the probably p required to yield a given system reliability V for a k-out-of-n system. It can also be used to determine the Clopper-Pearson confidence limits (either one-sided or two-sided) for the parameter p of a Bernoulli distribution. NEWTONP can determine Bayesian probability limits for a proportion (if the beta prior has positive integer parameters). It can determine the percentiles of incomplete beta distributions with positive integer parameters. It can also determine the percentiles of F distributions and the midian plotting positions in probability plotting. NEWTONP is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. NEWTONP is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. It also lists the number of iterations of Newton's method required to calculate the answer within the given error. The NEWTONP program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. NEWTONP was developed in 1988.

  1. Comparison of health risk behavior, awareness, and health benefit beliefs of health science and non-health science students: An international study.

    PubMed

    Peltzer, Karl; Pengpid, Supa; Yung, Tony K C; Aounallah-Skhiri, Hajer; Rehman, Rehana

    2016-06-01

    This study determines the differences in health risk behavior, knowledge, and health benefit beliefs between health science and non-health science university students in 17 low and middle income countries. Anonymous questionnaire data were collected in a cross-sectional survey of 13,042 undergraduate university students (4,981 health science and 8,061 non-health science students) from 17 universities in 17 countries across Asia, Africa, and the Americas. Results indicate that overall, health science students had the same mean number of health risk behaviors as non-health science university students. Regarding addictive risk behavior, fewer health science students used tobacco, were binge drinkers, or gambled once a week or more. Health science students also had a greater awareness of health behavior risks (5.5) than non-health science students (4.6). Linear regression analysis found a strong association with poor or weak health benefit beliefs and the health risk behavior index. There was no association between risk awareness and health risk behavior among health science students and an inverse association among non-health science students.

  2. Cumulative Incidence of Cancer among HIV-infected Individuals in North America

    PubMed Central

    Silverberg, Michael J.; Lau, Bryan; Achenbach, Chad J.; Jing, Yuezhou; Althoff, Keri N.; D’Souza, Gypsyamber; Engels, Eric A.; Hessol, Nancy; Brooks, John T.; Burchell, Ann N.; Gill, M. John; Goedert, James J.; Hogg, Robert; Horberg, Michael A.; Kirk, Gregory D.; Kitahata, Mari M.; Korthuis, Phillip T.; Mathews, William C.; Mayor, Angel; Modur, Sharada P.; Napravnik, Sonia; Novak, Richard M.; Patel, Pragna; Rachlis, Anita R.; Sterling, Timothy R.; Willig, James H.; Justice, Amy C.; Moore, Richard D.; Dubrow, Robert

    2016-01-01

    Background Cancer is increasingly common among HIV patients given improved survival. Objective To examine calendar trends in cumulative cancer incidence and hazard rate by HIV status. Design Cohort study Setting North American AIDS Cohort Collaboration on Research and Design during 1996–2009 Patients 86,620 HIV-infected and 196,987 uninfected adults Measurements We estimated cancer-type-specific cumulative incidence by age 75 years by HIV status and calendar era, and examined calendar trends in cumulative incidence and hazard rates. Results Cumulative incidences (%) of cancer by age 75 (HIV+/HIV−) were: Kaposi sarcoma (KS), 4.4/0.01; non-Hodgkin’s lymphoma (NHL), 4.5/0.7; lung, 3.4/2.8; anal, 1.5/0.1; colorectal, 1.0/1.5; liver, 1.1/0.4; Hodgkin lymphoma (HL), 0.9/0.1; melanoma, 0.5/0.6; and oral cavity/pharyngeal, 0.8/0.8. Among HIV-infected subjects, we observed decreasing calendar trends in cumulative incidence and hazard rate for KS and NHL. For anal, colorectal and liver cancers, increasing cumulative incidence, but not hazard rate trends, were due to the decreasing mortality rate trend (−9% per year), allowing greater opportunity to be diagnosed with these cancer types. Despite decreasing hazard rate trends for lung, HL, and melanoma, we did not observe cumulative incidence trends due to the compensating effect of the declining mortality rate on cumulative incidence. Limitations Secular trends in screening, smoking, and viral co-infections were not evaluated. Conclusions Our analytic approach helped disentangle the effects of improved survival and changing cancer-specific hazard rates on cumulative incidence trends among HIV patients. Cumulative cancer incidence by age 75, approximating lifetime risk in HIV patients, may have clinical utility in this population. The high cumulative incidences by age 75 for KS, NHL, and lung cancer supports early and sustained ART and smoking cessation. Primary Funding Source National Institutes of Health PMID:26436616

  3. Modelling microbial health risk of wastewater reuse: A systems perspective.

    PubMed

    Beaudequin, Denise; Harden, Fiona; Roiko, Anne; Stratton, Helen; Lemckert, Charles; Mengersen, Kerrie

    2015-11-01

    There is a widespread need for the use of quantitative microbial risk assessment (QMRA) to determine reclaimed water quality for specific uses, however neither faecal indicator levels nor pathogen concentrations alone are adequate for assessing exposure health risk. The aim of this study was to build a conceptual model representing factors contributing to the microbiological health risks of reusing water treated in maturation ponds. This paper describes the development of an unparameterised model that provides a visual representation of theoretical constructs and variables of interest. Information was collected from the peer-reviewed literature and through consultation with experts from regulatory authorities and academic disciplines. In this paper we explore how, considering microbial risk as a modular system, following the QMRA framework enables incorporation of the many factors influencing human exposure and dose response, to better characterise likely human health impacts. By using and expanding upon the QMRA framework we deliver new insights into this important field of environmental exposures. We present a conceptual model of health risk of microbial exposure which can be used for maturation ponds and, more importantly, as a generic tool to assess health risk in diverse wastewater reuse scenarios. PMID:26277638

  4. Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Race/Ethnicity

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2011

    2011-01-01

    The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

  5. Risk equalisation and voluntary health insurance: The South Africa experience.

    PubMed

    McLeod, Heather; Grobler, Pieter

    2010-11-01

    South Africa intends implementing major reforms in the financing of healthcare. Free market reforms in private health insurance in the late 1980s have been reversed by the new democratic government since 1994 with the re-introduction of open enrolment, community rating and minimum benefits. A system of national health insurance with income cross-subsidies, risk-adjusted payments and mandatory membership has been envisaged in policy papers since 1994. Subsequent work has seen the design of a Risk Equalisation Fund intended to operate between competing private health insurance funds. The paper outlines the South African health system and describes the risk equalisation formula that has been developed. The risk factors are age, gender, maternity events, numbers with certain chronic diseases and numbers with multiple chronic diseases. The Risk Equalisation Fund has been operating in shadow mode since 2005 with data being collected but no money changing hands. The South African experience of risk equalisation is of wider interest as it demonstrates an attempt to introduce more solidarity into a small but highly competitive private insurance market. The measures taken to combat over-reporting of chronic disease should be useful for countries or funders considering adding chronic disease to their risk equalisation formulae. PMID:20619476

  6. [Risk communication in analysis of occupational health risk for industrial workers].

    PubMed

    Barg, A O; Lebedeva-Nesevrya, N A

    2015-01-01

    The article covers problems of risk communication system function on industrial enterprise. Sociologic study in machinery construction enterprise of Perm area helped to consider main procedures of informing on occupational risk for health of workers exposed to occupational hazards, to describe features and mechanisms of risk communication, to specify its model. The authors proved that main obstacles for efficient system of occupational risks communication are insufficiently thorough legal basis, low corporative social responsibility of the enterprise and low social value of health for workers. This article was prepared with the support of the Russian Humanitarian Science Foundation (Project No. 14-16-59011). PMID:26596113

  7. Health Warnings on Alcoholic Beverages: Perceptions of the Health Risks and Intentions towards Alcohol Consumption

    PubMed Central

    Wigg, Sophie; Stafford, Lorenzo D.

    2016-01-01

    Objectives Research has demonstrated that packaging which includes pictorial health warnings are more effective in altering smokers’ perceptions and intentions as well as changing smoking behaviours compared to text-only health warnings. However, very few studies have investigated the effectiveness of health warnings on alcoholic beverages Methods Participants (N = 60) viewed alcoholic beverages presenting one of three health warnings (No health warning, Text-only, Pictorial) and then responded to questions relating to level of fear arousal and their perceptions toward alcohol use. Results We found that pictorial health warnings were associated with significantly higher fear arousal, increased perceptions of the health risks of consuming alcohol as well as greater intentions to reduce and quit alcohol consumption compared to the control. Conclusions These novel findings suggest pictorial health warnings on alcoholic beverages may be an important way of making the public aware of the health risks of alcohol consumption. PMID:27105210

  8. Integrating Risk Adjustment and Enrollee Premiums in Health Plan Payment

    PubMed Central

    McGuire, Thomas G.; Glazer, Jacob; Newhouse, Joseph P.; Normand, Sharon-Lise; Shi, Julie; Sinaiko, Anna D.; Zuvekas, Samuel

    2013-01-01

    In two important health policy contexts – private plans in Medicare and the new state-run “Exchanges” created as part of the Affordable Care Act (ACA) – plan payments come from two sources: risk-adjusted payments from a Regulator and premiums charged to individual enrollees. This paper derives principles for integrating risk-adjusted payments and premium policy in individual health insurance markets based on fitting total plan payments to health plan costs per person as closely as possible. A least squares regression including both health status and variables used in premiums reveals the weights a Regulator should put on risk adjusters when markets determine premiums. We apply the methods to an Exchange-eligible population drawn from the Medical Expenditure Panel Survey (MEPS). PMID:24308878

  9. Life Course Socioeconomic Position and C-Reactive Protein: Mediating Role of Health-Risk Behaviors and Metabolic Alterations. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

    PubMed Central

    Camelo, Lidyane V.; Giatti, Luana; Neves, Jorge Alexandre Barbosa; Lotufo, Paulo A.; Benseñor, Isabela M.; Chor, Dóra; Griep, Rosane Härter; da Fonseca, Maria de Jesus Mendes; Vidigal, Pedro Guatimosim; Kawachi, Ichiro; Schmidt, Maria Inês; Barreto, Sandhi Maria

    2014-01-01

    Background Chronic inflammation has been postulated to be one mediating mechanism explaining the association between low socioeconomic position (SEP) and cardiovascular disease (CVD). We sought to examine the association between life course SEP and C-reactive protein (CRP) levels in adulthood, and to evaluate the extent to which health-risk behaviors and metabolic alterations mediate this association. Additionally, we explored the possible modifying influence of gender. Methods and Findings Our analytical sample comprised 13,371 participants from ELSA-Brasil baseline, a multicenter prospective cohort study of civil servants. SEP during childhood, young adulthood, and adulthood were considered. The potential mediators between life course SEP and CRP included clusters of health-risk behaviors (smoking, low leisure time physical activity, excessive alcohol consumption), and metabolic alterations (obesity, hypertension, low HDL, hypertriglyceridemia, and diabetes). Linear regression models were performed and structural equation modeling was used to evaluate mediation. Although lower childhood SEP was associated with higher levels of CRP in adult life, this association was not independent of adulthood SEP. However, CRP increased linearly with increasing number of unfavorable social circumstances during the life course (p trend <0.001). The metabolic alterations were the most important mediator between cumulative SEP and CRP. This mediation path accounted for 49.5% of the total effect of cumulative SEP on CRP among women, but only 20.2% among men. In consequence, the portion of the total effect of cumulative SEP on CRP that was mediated by risk behaviors and metabolic alterations was higher among women (55.4%) than among men (36.8%). Conclusions Cumulative SEP across life span was associated with elevated systemic inflammation in adulthood. Although health-risk behaviors and metabolic alterations were important mediators of this association, a sizable fraction of this

  10. Draugen HSE-case - occupational health risk management

    SciTech Connect

    Glas, J.J.P.; Kjaer, E.

    1996-12-31

    The Draugen HSE-Case serves as a risk management tool. Originally, risk management included only major safety hazards to personnel, environment and assets. Work Environment risks such as ergonomics, psycho-social factors and exposure to chemicals and noise, was not given the same attention. The Draugen HSE-Case addresses this weakness and extends all work environment risks. In order to promote line responsibility and commitment, relevant personnel is involved in the Case development. {open_quotes}THESIS{degrees}, a software application, is used to systematize input and to generate reports. The Draugen HSE-case encompasses: HSE risk analyses related to specific activities; Control of risk related to work environment; Established tolerability criteria; Risk reducing measures; Emergency contingency measures; and Requirements for Competence and Follow-up. The development of Draugen HSE-Case is a continuous process. It will serve to minimize the potential of occupational illnesses, raise general awareness, and make occupational health management more cost-effective.

  11. The association of GSTT1 deletion polymorphism with lung cancer risk among Chinese population: evidence based on a cumulative meta-analysis

    PubMed Central

    Wang, Yadong; Yang, Haiyan; Wang, Haiyu

    2015-01-01

    Objective Previous studies investigating the relationship between glutathione S-transferase T1 (GSTT1) gene deletion polymorphism and lung cancer risk among Chinese population produced inconsistent results. To obtain a precise conclusion, we performed this meta-analysis to evaluate the association between GSTT1 deletion polymorphism and lung cancer risk among Chinese population. Methods The databases of Medline/PubMed, Embase, Web of Science, Wanfang Med Online, and Chinese National Knowledge Infrastructure were searched. The strength of the association was assessed by odds ratio (OR) with 95% confidence intervals (95% CI). Results Overall, we found an increased lung cancer risk among subjects carrying GSTT1 null genotype compared with those carrying present genotype (OR =1.31, 95% CI: 1.12–1.52) on the basis of 20 studies with 3,351 cases and 4,683 controls. We also observed an increased risk of lung cancer among subjects carrying GSTT1 null genotype compared with those carrying present genotype in stratified analyses (OR =1.31, 95% CI: 1.11–1.55 for healthy subjects-based control; OR =2.29, 95% CI: 1.84–2.85 for squamous cell carcinoma and OR =1.47, 95% CI: 1.22–1.77 for adenocarcinoma, respectively). Conclusion This meta-analysis suggested that GSTT1 deletion polymorphism might contribute to lung cancer risk among Chinese population. PMID:26491361

  12. Health risk assessment of irradiated topaz

    SciTech Connect

    Nelson, J.W.; Baum, J.W.

    1993-01-01

    Irradiated topaz gemstones are currently processed for color improvement by subjecting clear stones to neutron or high-energy electron irradiations, which leads to activation of trace elements in the stones. Assessment of the risk to consumers required the identification and quantification of the resultant radionuclides and the attendant exposure. Representative stones from Brazil, India, Nigeria, Sri Lanka were irradiated and analyzed for gamma ray and beta particle emissions, using sodium iodide and germanium spectrometers; and Geiger-Muller, plastic and liquid scintillation, autoradiography, and thermoluminescent-dosimetry measurement techniques. Based on these studies and other information derived from published literature, dose and related risk estimates were made for typical user conditions. New criteria and methods for routine assays for acceptable release, based on gross beta and gross photon emissions from the stones, were also developed.

  13. Multipathway human health risk assessment concerning air emissions from combustion of Orimulsion fuel

    SciTech Connect

    Teaf, C.M.; Coleman, R.M.; Manning, M.J.; Covert, D.J.; Phelps, J.L.

    1995-12-31

    A multipathway human health risk assessment was conducted concerning air emissions from the combustion of Orimulsion. Exposure was considered for nearby residents who might be exposed by oral, dermal or inhalation pathways, including ingestion of analytes that may be present in meat and agricultural products from nearby areas. Occupational exposure were evaluated via the same intake pathways, except for potential ingestion of food products. Pathways included airborne exposures, deposition on crops, exposures to soils, and uptake by livestock and plants. Livestock intake included ingestion of analytes retained by plants and inhalation of soil-bound particulates. Analytes of potential concern included compounds identified as combustion products of the orimulsion fuel. Air concentrations of analytes, and the areal distribution of these concentrations resulting from stack emissions, were predicted using transport and deposition models. A worst cast scenario for air and cumulative soil concentrations was considered to represent the entire facility project lifetime (20 years) for dry deposition as well as predicted air concentrations occurring at continuous 100% facility operating capacity. Potential exposures to sulfuric acid mist and lead were shown to be much less than levels protective of human populations. Based upon the airborne emissions estimates and the deposition estimates for other constituents of interest, as well as the strongly conservative estimates of the potential for human intake, local health risks contributed from the combustion of Orimulsion fuel at the facility were judged to be negligible.

  14. [Application and benefit evaluation of tiered health risk assessment approach on site contaminated by benzene].

    PubMed

    Jiang, Lin; Zhong, Mao-Sheng; Liang, Jin; Yao, Jue-Jun; Xia, Tian-Xiang; Fan, Yan-Ling; Li, Jing-Dong; Tang, Zheng-Qiang

    2013-03-01

    The procedures of implementing tiered health risk assessment approach were introduced in detail, and took a large-scale site polluted by benzene in Beijing as an example, the difference on the remediation target of benzene in soil, as well as the corresponding soil remediation volume and costs, were compared. The results indicate that the benzene concentration in soil within 1.5 m in depth and the one below should be remediated to 0.26 mg x kg(-1) and 0.15 mg x kg(-1), respectively, in order to keep the cumulative carcinogenic health risk below 1 x 10(-6) based on tiered II assessment. However, according to tiered III assessment result, which is based on the benzene in soil gas within the contaminated areas in the investigated site, the soil in the corresponding depth should only be remediated to 2.6 mg x kg(-1) and 1.5 mg x kg(-1), respectively. That means the soil remediation volume delimited on tiered III assessment result is less than the one on tiered II by 139 537 m3 and the corresponding remediation costs will be reduced by 57 million Yuan, meaning the enormous economic benefits compared to the costs (around 100 thousands Yuan) spent to carry out tiered III assessment in the site.

  15. Health risk appraisal: review of evidence for effectiveness.

    PubMed Central

    Schoenbach, V J; Wagner, E H; Beery, W L

    1987-01-01

    Since its introduction some two decades ago, health risk appraisal (HRA) has become a standard offering in the health promotion repertoire. The technique's distinctive feature is its use of epidemiologic data to generate quantitative risk messages for the client. Yet despite the dedication and considerable investments that have gone into HRA's development, dissemination, and use, there is only limited empirical evidence that these quantitative risk messages have any effect on clients. There do not appear to be any formal studies of HRA's effect on participation in health promotion programs, although increasing recruitment is regarded as a major benefit of using HRA. There are few indications of HRA effects on health beliefs. Most positive reports of effects on behavior change come from uncontrolled studies; several randomized controlled trials have yielded ambiguous findings. Virtually no data exist concerning the impact of the quantitative risk messages that distinguish HRA from other assessment techniques and that have motivated the substantial efforts toward developing and refining HRA. HRA has evident appeal and is probably a useful health education device for middle-class, middle-aged, nonminority clients. It may well have desirable effects on health-related beliefs, attitudes, and behaviors when accompanied by counseling or education, but available evidence has not established its effectiveness. Given the difficulty of obtaining definitive evidence of the effectiveness of HRA and specifically of its use of quantitative risk projections, the need for such evidence is debatable. An adequately funded and reviewed research program to examine whether projections of absolute risk affect knowledge, beliefs, attitudes, and intention to change is recommended as the most fruitful next step. Epidemiologically based HRA procedures that provide feedback in terms of qualitative statements or relative risk may be a promising approach to prospective health assessment. PMID

  16. Health risks for marine mammal workers.

    PubMed

    Hunt, Tania D; Ziccardi, Michael H; Gulland, Frances M D; Yochem, Pamela K; Hird, David W; Rowles, Teresa; Mazet, Jonna A K

    2008-08-19

    Marine mammals can be infected with zoonotic pathogens and show clinical signs of disease, or be asymptomatic carriers of such disease agents. While isolated cases of human disease from contact with marine mammals have been reported, no evaluation of the risks associated with marine mammal work has been attempted. Therefore, we designed a survey to estimate the risk of work-related injuries and illnesses in marine mammal workers and volunteers. The 17-question survey asked respondents to describe their contact with marine mammals, injuries sustained, and/or illnesses acquired during their period of marine mammal exposure. Most respondents, 88% (423/483), were researchers and rehabilitators. Of all respondents, 50% (243/483) reported suffering an injury caused by a marine mammal, and 23% (110/483) reported having a skin rash or reaction. Marine mammal work-related illnesses commonly reported included: 'seal finger' (Mycoplasma spp. or Erysipelothrix rhusiopathiae), conjunctivitis, viral dermatitis, bacterial dermatitis, and non-specific contact dermatitis. Although specific diagnoses could not be confirmed by a physician through this study, severe illnesses were reported and included tuberculosis, leptospirosis, brucellosis, and serious sequelae to seal finger. Risk factors associated with increased odds of injury and illness included prolonged and frequent exposure to marine mammals; direct contact with live marine mammals; and contact with tissue, blood, and excretions. Diagnosis of zoonotic disease was often aided by veterinarians; therefore, workers at risk should be encouraged to consult with a marine mammal veterinarian as well as a physician, especially if obtaining a definitive diagnosis for an illness becomes problematic.

  17. Biomarkers of bone health and osteoporosis risk.

    PubMed

    Eastell, Richard; Hannon, Rosemary A

    2008-05-01

    The assay features of biochemical markers of bone turnover have markedly improved in the past few years. The most sensitive and specific markers of bone formation include serum bone alkaline phosphatase, total osteocalcin (including the intact molecule and the large N-mid fragment) and the procollagen type I N-terminal propeptide assay. Among the various markers of bone resorption, measurements of the urinary excretion of N- and C-terminal cross-linked telopeptides) and of serum C-terminal cross-linked telopeptides are the most sensitive and specific. Markers of bone turnover can be used to predict the rate of bone loss in post-menopausal women and can also be used to assess the risk of fractures. In osteoporosis-treatment studies (with alendronate, risedronate, raloxifene) markers of bone turnover appear even more strongly associated with fracture risk reduction than bone mineral density (BMD). These observations support the use of markers of bone turnover as surrogates for fracture risk reduction, perhaps even more so than BMD. Bone markers can also be used to monitor the efficacy of antiresorptive therapy such as hormone-replacement therapy, raloxifene and bisphosphonates in individual patients. Furthermore, they have also proved to be helpful in monitoring the response to nutritional interventions and have the advantage over BMD in that they provide information about mechanism of effect and changes are often observed much more rapidly.

  18. Human Health Risk Assessment of Trichloroethylene from Industrial Complex A

    PubMed Central

    Sin, Saemi

    2012-01-01

    This study investigated the human health risks of trichloroethylene from Industrial Complex A. The excessive carcinogenic risks for central tendency exposure were 1.40 × 10?5 for male and female residents in the vicinity of Industrial Complex A. The excessive cancers risk for reasonable maximum exposure were 2.88 × 10?5 and 1.97 × 10?5 for males and females, respectively. These values indicate that there are potential cancer risks for exposure to these concentrations. The hazard index for central tendency exposure to trichloroethylene was 1.71 for male and female residents. The hazard indexes for reasonable maximum exposure were 3.27 and 2.41 for males and females, respectively. These values were over one, which is equivalent to the threshold value. This result showed that adverse cancer and non-cancer health effects may occur and that some risk management of trichloroethylene from Industrial Complex A was needed. PMID:24278607

  19. In vitro assessment of equivalence of occupational health risk: welders.

    PubMed Central

    Stern, R M

    1983-01-01

    The possibility of using in vitro testing to determine the equivalence of risk for various occupational groups is discussed. In the absence of epidemiological evidence or relevant animal in vivo bioassays on which to determine the health effects of specific occupational exposures, it is proposed to use similarities in the in vitro response to substances with known (or strongly suspected) and unknown risk to demonstrate their risk equivalence. Identification and evaluation of a high risk "hot spot" due to exposure to Cr(VI) for stainless steel welders is discussed in terms of recent developments in collection, analysis and bioassay of welding fumes. PMID:6641655

  20. [Economic evaluation and rationale for human health risk management decisions].

    PubMed

    Fokin, S G; Bobkova, T E

    2011-01-01

    The priority task of human health maintenance and improvement is risk management using the new economic concepts based on the assessment of potential and real human risks from exposure to poor environmental factors and on the estimation of cost-benefit and cost-effectiveness ratios. The application of economic tools to manage a human risk makes it possible to assess various measures both as a whole and their individual priority areas, to rank different scenarios in terms of their effectiveness, to estimate costs per unit of risk reduction and benefit increase (damage decrease).

  1. Compounding conservatisms: EPA's health risk assessment methods

    SciTech Connect

    Stackelberg, K. von; Burmaster, D.E. )

    1993-03-01

    Superfund conjures up images of hazardous waste sites, which EPA is spending billions of dollars to remediate. One of the law's most worrisome effects is that it drains enormous economic resources without returning commensurate benefits. In a Sept. 1, 1991, front page article in The New York Times, experts argued that most health dangers at Superfund sites could be eliminated for a fraction of the billions that will be spent cleaning up the 1,200 high-priority sites across the country. Even EPA has suggested that the Superfund program may receive disproportionate resources, compared with other public health programs, such as radon in houses, the diminishing ozone layer and occupational diseases. Public opinion polls over the last decade consistently have mirrored the public's vast fear of hazardous waste sites, a fear as great as that held for nuclear power plants. Fear notwithstanding, the high cost of chosen remedies at given sites may have less to do with public health goals than with the method EPA uses to translate them into acceptable contaminant concentrations in soil, groundwater and other environmental media.

  2. Health Risk Assessment of Irradiated Topaz

    NASA Astrophysics Data System (ADS)

    Nelson, Kevin Lyle

    1991-06-01

    Radiation-produced blue topaz, indistinguishable from natural blue topaz, is produced by several different techniques. Published information on radionuclides present, activity levels, equipment necessary to detect activated nuclides and dosimetric assessment is lacking. Using a 60 megawatt nuclear reactor, fifty-one samples of colorless topaz from Nigeria, Sri Lanka, India and Brazil were irradiated with thermal and fast neutron fluences ranging from 1.8 times 10 13 to 9.2 times 1018 neutrons cm^{-2}. Seventeen MeV electrons produced by a linear accelerator were also used to irradiate 36 colorless topaz from the same countries. Gamma ray or positron-emitting nuclides were identified using calibrated well-type NaI or germanium detectors. For germanium detectors having relative efficiencies of approximately 20 percent, an analysis time of one hour or more was needed. Geiger Mueller (G-M) detectors, scintillators (plastic and liquid), gas flow proportional counters, a ZnS detector and autoradiography techniques were used to measure charged particle activity. Isotopes produced from neutron activation included 182Ta, ^ {59}Fe, 46Sc, 51Cr, 54Mn, 124Sb, ^{32 }P, 77As, ^ {183}Ta, 77Ge, 72Ga, and ^{24 }Na. Possible nuclides produced from 17 MeV electron treatment include ^{68 }Ga, 64Cu, ^ {49}Cr, and 18F. Positive identification of the electron activated nuclides was not possible because of the short half-lives involved (<1 day). Of the possible pure beta emitters activated during neutron bombardment, 32P and 35S are the most likely to be produced. The identification of 32P was made using a three point beta absorption analysis with a G-M detector. Skin and breast cancer risk estimates were calculated for various sized topaz containing NRC exempt concentration levels. When compared to a negligible individual risk level (NIRL) of 10^{-7}, the risk of an irradiated topaz in contact with the skin or three inches from breast tissue was a small fraction of the NIRL. At a risk

  3. Risk adjustment for high utilizers of public mental health care.

    PubMed

    Kapur, Kanika; Young, Alexander S.; Murata, Dennis

    2000-09-01

    BACKGROUND: Publicly funded mental health systems are increasingly implementing managed care systems, such as capitation, to control costs. Capitated contracts may increase the risk for disenrollment or adverse outcomes among high cost clients with severe mental illness. Risk-adjusted payments to providers are likely to reduce providers' incentives to avoid or under-treat these people. However, most research has focused on Medicare and private populations, and risk adjustment for individuals who are publicly funded and severely mentally ill has received far less attention. AIMS OF THE STUDY: Risk adjustment models for this population can be used to improve contracting for mental health care. Our objective is to develop risk adjustment models for individuals with severe mental illness and assess their performance in predicting future costs. We apply the risk adjustment model to predict costs for the first year of a pilot capitation program for the severely mentally ill that was not risk adjusted. We assess whether risk adjustment could have reduced disenrollment from this program. METHODS: This analysis uses longitudinal administrative data from the County of Los Angeles Department of Mental Health for the fiscal years 1991 to 1994. The sample consists of 1956 clients who have high costs and are severely mentally ill. We estimate several modified two part models of 1993 cost that use 1992 client-based variables such as demographics, living conditions, diagnoses and mental health costs (for 1992 and 1991) to explain the variation in mental health and substance abuse costs. RESULTS: We find that the model that incorporates demographic characteristics, diagnostic information and cost data from two previous years explains about 16 percent of the in-sample variation and 10 percent of the out-of-sample variation in costs. A model that excludes prior cost covariates explains only 5 percent of the variation in costs. Despite the relatively low predictive power, we find some

  4. Health risk assessment for inhalation exposure to arsenic.

    PubMed

    Fabiánová, E; Hettychová, L; Koppová, K; Hrubá, F; Marko, M; Maroni, M; Grech, G; Bencko, V

    2000-02-01

    Health risk assessment was used as the formal process to estimate the likelihood and magnitude of the health effects occurring in humans as a result of environmental and occupational exposure to polluting agents. This study was focused at estimating the human health risk of the general and working population living in the region polluted by arsenic for more than 40 years, from combustion of coal with high arsenic content in the power plant. The exposure to arsenic from inhalation was under investigation. A study period of 40 years (1973-1993) was chosen. The study period was defined taking into account, besides the availability of data, the temporal patterns of the technological processes and the trends over time of environmental concentrations. The results from the arsenic risk assessment study were used for the evaluation of the health risk for different population groups in the polluted areas and for different professions of workers exposed to As in a power plant. The results are applicable for the evaluation of risk in real conditions, for health surveillance and for remedial changes and a potential suggestion on technological improvement.

  5. Public Health Risk Conditioned by Chemical Composition of Ground Water

    NASA Astrophysics Data System (ADS)

    Yankovich, E.; Osipova, N.; Yankovich, K.; Matveenko, I.

    2016-03-01

    The article studies the public health potential risk originated from water consumption and estimated on the basis of the groundwater chemical composition. We have processed the results of chemical groundwater analysis in different aquifers of Tomsk district (Tomsk Oblast, Russia). More than 8400 samples of chemical groundwater analyses were taken during long-term observation period. Human health risk assessment of exposure to contaminants in drinking water was performed in accordance with the risk assessment guidance for public health concerning chemical pollution of the environment (Russian reference number: 2.1.10.1920-04-M, 2004). Identified potential risks were estimated for consuming water of each aquifer. The comparative analysis of water quality of different aquifers was performed on the basis of the risk coefficient of the total non-carcinogenic effects. The non-carcinogenic risk for the health of the Tomsk district population due to groundwater consumption without prior sanitary treatment was admitted acceptable. A rather similar picture is observed for all aquifers, although deeper aquifers show lower hazard coefficients.

  6. A continuum of risk? The management of health, physical and emotional risks by female sex workers.

    PubMed

    Sanders, Teela

    2004-07-01

    This paper describes the findings from a 10-month ethnographic study of the female sex industry in a large British city. I argue that sex workers construct a continuum of risk which prioritizes certain types of dangers depending on the perceived consequences and the degree of control individuals consider they have over minimising the likelihood of a risk occurring. Although health-related matters are a real concern to many women, because they generally have comprehensive strategies to manage health risks at work, this risk category is given a low priority compared with other risks. The risk of violence is considered a greater anxiety because of the prevalence of incidents in the sex work community. However, because of comprehensive screening and protection strategies to minimise violence, this type of harm is not given the same level of attention that emotional risks receive. By using a continuum of risk to understand how sex workers perceive occupational hazards in prostitution, further understanding can be gained about the nature of risk in prostitution, sex workers' routines and the organisational features of the sex industry. In addition, the implications for health policy are discussed, suggesting that the emotional consequences of selling sex should be considered as much as the tangible, physical risks of prostitution.

  7. A public health context for residual risk assessment and risk management under the clean air act.

    PubMed

    Charnley, G; Goldstein, B D

    1998-09-01

    The 1990 amendments to the Clean Air Act required the EPA to institute new pollution control technology requirements for industrial sources of air pollution. In part because agreement could not be reached on the best way for the EPA to determine whether any significant risks to human health will remain after the technology controls are in place, the amendments also created a Commission on Risk Assessment and Risk Management and gave the commission a broad mandate to review and make recommendations concerning risk assessment and risk management in federal regulatory programs. In its March 1997 final report to Congress and the administration, the commission recommended a tiered approach to assessing such residual risks. That approach included the idea that when decisions about managing residual risks are made, emissions should be evaluated in the context of other sources of air pollution. Evaluating risks in their larger contexts is consistent with what the commission called a public health approach to environmental risk management. This paper describes the public health approach and how it applies to evaluating residual risks under the Clean Air Act. PMID:9721251

  8. Food safety risks and consumer health.

    PubMed

    Chassy, Bruce M

    2010-11-30

    The major food safety risks are not eating a healthy diet, and failure to avoid foodborne illness. Over one billion people in the world suffer from food insecurity and malnutrition. Nutritionally enhanced transgenic crops such as Golden Rice are one potential strategy for reducing malnutrition in the world. Transgenic crops are subjected to a rigorous pre-market safety assessment. The safety of novel proteins and other products is established, and through compositional analysis and animal studies, the safety of any observed changes is evaluated. These studies provide evidence that the new product is as safe as, or safer than, comparable varieties. It must be asked, however, if this rigorous analysis is necessary, because unregulated crops produced by other breeding methods also undergo genetic changes and contain unintended effects. Golden Rice poses infinitesimally small, if any, risk to consumers whilst it has the potential to spare millions of lives each year. However, because it is a transgenic crop, it cannot be deployed without years of expensive pre-market safety review. Paradoxically, if Golden Rice had been produced by less precise conventional methods of breeding, it would already be in the hands of poor farmers. It is concluded that the hyper-precautionary regulatory process applied to transgenic crops works to the extreme disadvantage of the hungry and the poor.

  9. A PHYSIOLOGICALLY BASED PHARMACOKINETIC/PHARMACODYNAMIC (PBPK/PD) MODEL FOR ESTIMATION OF CUMULATIVE RISK FROM EXPOSURE TO THREE N-METHYL CARBAMATES: CARBARYL, ALDICARB, AND CARBOFURAN

    EPA Science Inventory

    A physiologically-based pharmacokinetic (PBPK) model for a mixture of N-methyl carbamate pesticides was developed based on single chemical models. The model was used to compare urinary metabolite concentrations to levels from National Health and Nutrition Examination Survey (NHA...

  10. Review of health risks of low testosterone and testosterone administration

    PubMed Central

    Jia, Huanguang; Sullivan, Charles T; McCoy, Sean C; Yarrow, Joshua F; Morrow, Matthew; Borst, Stephen E

    2015-01-01

    Hypogonadism is prevalent in older men and testosterone replacement therapy (TRT) for older hypogonadal men is a promising therapy. However, a number of important clinical concerns over TRT safety remain unsolved due to a lack of large-scale randomized clinical trials directly comparing the health risks of untreated hypogonadism vs long-term use of TRT. Meta-analyses of clinical trials of TRT as of 2010 have identified three major adverse events resulting from TRT: polycythemia, an increase in prostate-related events, and a slight reduction in serum high-density lipoprotein cholesterol. There are other purported health risks but their incidence can be neither confirmed nor denied based on the small number of subjects that have been studied to date. Furthermore, subsequent literature is equivocal with regard to the safety and utility of TRT and this topic has been subject to contentious debate. Since January 2014, the United States Food and Drug Administration has released two official announcements regarding the safety of TRT and clinical monitoring the risks in TRT users. Additionally, the health risks related to the clinical presentation of low or declining testosterone levels not been resolved in the current literature. Because TRT is prescribed in the context of putative risks resulting from reduced testosterone levels, we reviewed the epidemiology and reported risks of low testosterone levels. We also highlight the current information about TRT utilization, the risks most often claimed to be associated with TRT, and current or emerging alternatives to TRT. PMID:25879005

  11. Health, safety and environmental risk management in laboratory fields

    PubMed Central

    Yarahmadi, Rasoul; Moridi, Parvin; Roumiani, YarAllah

    2016-01-01

    Background: Research project risks are uncertain contingent events or situations that, if transpire, will have positive or negative effects on objectives of a project. The Management of Health and Safety at Work (MHSW) Regulations 1999 require all employers and the self-employed persons to assess the risks from their work on anyone who may be affected by their activities. Risk assessment is the first step in risk-management procedure, and due to its importance, it has been deemed to be a vital process while having a unique place in the researchbased management systems. Methods: In this research, a two-pronged study was carried out. Firstly, health and safety issues were studied and analyzed by means of ISO 14121. Secondly, environmental issues were examined with the aid of Failure Mode and Effect Analysis. Both processes were utilized to determine the risk level independently for each research laboratory and corrective measure priorities in each field (laboratory). Results: Data analysis showed that the total main and inherent risks in laboratory sites reduced by 38% to 86%. Upon comparing the average risk levels before and after implementing the control and protective actions utilizing risk management approaches which were separate from health, safety and environmental aspects, a highly effective significance (p<0.001) was obtained for inherent risk reduction. Analysis of health, safety and environmental control priorities with the purpose of comparing the ratio of the number of engineering measures to the amount of management ones showed a relatively significant increase. Conclusion: The large number of engineering measures was attributed to the employment of a variety of timeworn machinery (old technologies) along with using devices without basic protection components. PMID:27284544

  12. Child Social Exclusion Risk and Child Health Outcomes in Australia

    PubMed Central

    Mohanty, Itismita; Edvardsson, Martin; Abello, Annie; Eldridge, Deanna

    2016-01-01

    Introduction This paper studies the relationship between the risk of child social exclusion, as measured by the Child Social Exclusion (CSE) index and its individual domains, and child health outcomes at the small area level in Australia. The CSE index is Australia’s only national small-area index of the risk of child social exclusion. It includes five domains that capture different components of social exclusion: socio-economic background, education, connectedness, housing and health services. Methods The paper used data from the National Centre for Social and Economic Modelling (NATSEM), University of Canberra for the CSE Index and its domains and two key Australian Institute of Health and Welfare (AIHW) data sources for the health outcome measures: the National Hospital Morbidity Database and the National Mortality Database. Results The results show positive associations between rates of both of the negative health outcomes: potentially preventable hospitalisations (PPH) and avoidable deaths, and the overall risk of child social exclusion as well as with the index domains. This analysis at the small-area level can be used to identify and study areas with unexpectedly good or bad health outcomes relative to their estimated risk of child social exclusion. We show that children’s health outcomes are worse in remote parts of Australia than what would be expected solely based on the CSE index. Conclusions The results of this study suggest that developing composite indices of the risk of child social exclusion can provide valuable guidance for local interventions and programs aimed at improving children’s health outcomes. They also indicate the importance of taking a small-area approach when conducting geographic modelling of disadvantage. PMID:27152596

  13. Cumulative dietary exposure of the population of Denmark to pesticides.

    PubMed

    Jensen, Bodil Hamborg; Petersen, Annette; Nielsen, Elsa; Christensen, Tue; Poulsen, Mette Erecius; Andersen, Jens Hinge

    2015-09-01

    We used the Hazard Index (HI) method to carry out a cumulative risk assessment after chronic dietary exposure to all monitored pesticides in fruit, vegetables and cereals for various consumer groups in Denmark. Residue data for all the pesticides were obtained from the Danish monitoring programme during the period 2004-2011. Food consumption data were obtained from DANSDA (the DAnish National Survey of Diet and physical Activity) for the period 2005-2008. The calculations were made using three different models to cope with residues below the limit of reporting (LOR). We concluded that a model that included processing factors and set non-detects to ½ LOR, but limited the correction (Model 3), gave the most realistic exposure estimate. With Model 3 the HI was calculated to be 0.44 for children and 0.18 for adults, indicating that there is no risk of adverse health effects following chronic cumulative exposure to the pesticides found in fruit, vegetables and cereals on the Danish market. The HI was below 1 even for consumers who eat more than 550 g of fruit and vegetables per day, corresponding to 1/3 of the population. Choosing Danish-produced commodities whenever possible could reduce the HI by a factor of 2.

  14. Relationship of Serum Vitamin D Concentrations and Allostatic Load as a Measure of Cumulative Biological Risk among the US Population: A Cross-Sectional Study

    PubMed Central

    Frei, Regina; Haile, Sarah R.; Mutsch, Margot; Rohrmann, Sabine

    2015-01-01

    Introduction The allostatic load (AL) index is a multi-systemic measure of physiologic dysregulation known to be associated with chronic exposure to stress and adverse health outcomes. We examined the relationship between AL and serum 25-hydroxyvitamin D (25(OH)D) concentration in non-institutionalized US adults. Methods Data from the Third National Health and Nutrition Examination Survey (NHANES III, 1988–94) were used to calculate two versions of AL including 9 biomarkers and another two with 14 biomarkers (systolic and diastolic blood pressure, pulse rate, serum cholesterol, serum HDL-cholesterol, glycated hemoglobin, sex-specific waist-to-hip ratio, serum albumin, and serum C-reactive protein for AL1, and, additionally body mass index, serum triglyceride, serum creatinine, and serum herpes I & II antibodies for AL2), each set defined by predefined cut-offs or by quartiles. Serum vitamin D concentration was ranked into quartiles. Logistic regression, Poisson regression and linear regression were used to examine the association of serum 25(OH)D concentrations on AL, after adjusting for biological, physiological, socioeconomic, lifestyle, and health variables. Results Odds Ratios (OR) for high AL of the lowest 25(OH)D serum quartile were between 1.45 (95% CI: 1.28, 1.67) and 1.79 (95% CI: 1.39, 2.32) for the fully adjusted model, depending on AL version. Inverse relationships between vitamin D serum concentrations were observed for all AL versions and every adjustment. This relationship was consistent after stratification by sex, age or ethnic background. Sensitivity to low 25(OH)D concentrations was highest among the youngest group (20–39 years) with an OR of 2.11 (95% CI: 1.63, 2.73) for the lowest vitamin D quartile Q1. Conclusions Vitamin D had a consistent and statistically significant inverse association with all tested models of high AL, which remained consistent after adjusting for biological, socioeconomic, lifestyle and health variables. Our study

  15. Lifetime risk of stroke and impact of hypertension: estimates from the adult health study in Hiroshima and Nagasaki.

    PubMed

    Takahashi, Ikuno; Geyer, Susan M; Nishi, Nobuo; Ohshita, Tomohiko; Takahashi, Tetsuya; Akahoshi, Masazumi; Fujiwara, Saeko; Kodama, Kazunori; Matsumoto, Masayasu

    2011-05-01

    Very few reports have been published on lifetime risk (LTR) of stroke by blood pressure (BP) group. This study included participants in the Radiation Effects Research Foundation Adult Health Study who have been followed up by biennial health examinations since 1958. We calculated the LTR of stroke for various BP-based groups among 7847 subjects who had not been diagnosed with stroke before the index age of 55 years using cumulative incidence analysis adjusting for competing risks. By 2003, 868 subjects had suffered stroke (512 (58.9%) were women and 542 (62.4%) experienced ischemic stroke). BP was a significant factor in determining risk of stroke for men and women, with distributions of cumulative risk for stroke significantly different across BP groups. The LTR of all-stroke for normotension (systolic BP/diastolic BP < 120/80 mm Hg), prehypertension (120-139/80-89 mm Hg), stage 1 hypertension (140-159/90-99 mm Hg) and stage 2 hypertension (> 160/100 mm Hg) were 13.8-16.9-25.8-25.8% in men and 16.0-19.9-24.0-30.5% in women, respectively (P < 0.001 among BP groups in both sexes). The estimates did not differ significantly (P = 0.16) between normotensive and prehypertensive subjects. One in five Japanese atomic bomb survivor subjects experienced stroke over their lifetime from the age of 55 years. Long-term stroke risks were elevated in those with hypertension (> 140/90 mm Hg) at any of the index ages of 45, 55, 65 and 75 years.

  16. Lifetime risk of stroke and impact of hypertension: estimates from the adult health study in Hiroshima and Nagasaki.

    PubMed

    Takahashi, Ikuno; Geyer, Susan M; Nishi, Nobuo; Ohshita, Tomohiko; Takahashi, Tetsuya; Akahoshi, Masazumi; Fujiwara, Saeko; Kodama, Kazunori; Matsumoto, Masayasu

    2011-05-01

    Very few reports have been published on lifetime risk (LTR) of stroke by blood pressure (BP) group. This study included participants in the Radiation Effects Research Foundation Adult Health Study who have been followed up by biennial health examinations since 1958. We calculated the LTR of stroke for various BP-based groups among 7847 subjects who had not been diagnosed with stroke before the index age of 55 years using cumulative incidence analysis adjusting for competing risks. By 2003, 868 subjects had suffered stroke (512 (58.9%) were women and 542 (62.4%) experienced ischemic stroke). BP was a significant factor in determining risk of stroke for men and women, with distributions of cumulative risk for stroke significantly different across BP groups. The LTR of all-stroke for normotension (systolic BP/diastolic BP < 120/80 mm Hg), prehypertension (120-139/80-89 mm Hg), stage 1 hypertension (140-159/90-99 mm Hg) and stage 2 hypertension (> 160/100 mm Hg) were 13.8-16.9-25.8-25.8% in men and 16.0-19.9-24.0-30.5% in women, respectively (P < 0.001 among BP groups in both sexes). The estimates did not differ significantly (P = 0.16) between normotensive and prehypertensive subjects. One in five Japanese atomic bomb survivor subjects experienced stroke over their lifetime from the age of 55 years. Long-term stroke risks were elevated in those with hypertension (> 140/90 mm Hg) at any of the index ages of 45, 55, 65 and 75 years. PMID:21326305

  17. Associations between multiple health risk behaviors and mental health among Chinese college students.

    PubMed

    Ye, Yong-ling; Wang, Pei-gang; Qu, Geng-cong; Yuan, Shuai; Phongsavan, Philayrath; He, Qi-qiang

    2016-01-01

    Although there is substantial evidence that health risk behaviors increase risks of premature morbidity and mortality, little is known about the multiple health risk behaviors in Chinese college students. Here, we investigated the prevalence of multiple health risk behaviors and its relation to mental health among Chinese college students. A cross-sectional study was conducted in Wuhan, China from May to June 2012. The students reported their health risk behaviors using self-administered questionnaires. Depression and anxiety were assessed using the self-rating depression scale and self-rating anxiety scale, respectively. A total of 2422 college students (1433 males) aged 19.7 ± 1.2 years were participated in the study. The prevalence of physical inactivity, sleep disturbance, poor dietary behavior, Internet addiction disorder (IAD), frequent alcohol use and current smoking was 62.0, 42.6, 29.8, 22.3, 11.6 and 9.3%, respectively. Significantly increased risks for depression and anxiety were found among students with frequent alcohol use, sleep disturbance, poor dietary behavior and IAD. Two-step cluster analysis identified two different clusters. Participants in the cluster with more unhealthy behaviors showed significantly increased risk for depression (odds ratio (OR): 2.21; 95% confidence interval (CI): 1.83, 2.67) and anxiety (OR: 2.32; 95% CI: 1.85, 2.92). This study indicates that a relatively high prevalence of multiple health risk behaviors was found among Chinese college students. Furthermore, the clustering of health risk behaviors was significantly associated with increased risks for depression and anxiety.

  18. Antibiotics exposure and health risks: chloramphenicol.

    PubMed

    Hanekamp, Jaap C; Bast, Aalt

    2015-01-01

    The antibiotic chloramphenicol (CAP) is banned from food production. Besides being a medicinal product, CAP is also a natural product, produced by Streptomyces Venezuelae. The lack of scientific data hampers setting of an Acceptable Daily Intake (ADI). Consequently, a maximum residue limit (MRL) in food could not be established. This was then translated into a zero tolerance using the so-called Minimum Required Performance Limit (MRPL) level, viz. the achievable detection limit in food, to guide the zero tolerance policy. The MRPL is clearly not relevant to food safety and human health but is solely related to analytical technological capabilities. The increase in the latter enables detection at ever-lower levels and ignores toxicological relevance. We here provide arguments to use a Threshold of Toxicological Concern (TTC) for CAP that can accommodate developing toxicological insights. PMID:25528412

  19. A 21st century roadmap for human health risk assessment.

    PubMed

    Pastoor, Timothy P; Bachman, Ammie N; Bell, David R; Cohen, Samuel M; Dellarco, Michael; Dewhurst, Ian C; Doe, John E; Doerrer, Nancy G; Embry, Michelle R; Hines, Ronald N; Moretto, Angelo; Phillips, Richard D; Rowlands, J Craig; Tanir, Jennifer Y; Wolf, Douglas C; Boobis, Alan R

    2014-08-01

    The Health and Environmental Sciences Institute (HESI)-coordinated Risk Assessment in the 21st Century (RISK21) project was initiated to develop a scientific, transparent, and efficient approach to the evolving world of human health risk assessment, and involved over 120 participants from 12 countries, 15 government institutions, 20 universities, 2 non-governmental organizations, and 12 corporations. This paper provides a brief overview of the tiered RISK21 framework called the roadmap and risk visualization matrix, and articulates the core principles derived by RISK21 participants that guided its development. Subsequent papers describe the roadmap and matrix in greater detail. RISK21 principles include focusing on problem formulation, utilizing existing information, starting with exposure assessment (rather than toxicity), and using a tiered process for data development. Bringing estimates of exposure and toxicity together on a two-dimensional matrix provides a clear rendition of human safety and risk. The value of the roadmap is its capacity to chronicle the stepwise acquisition of scientific information and display it in a clear and concise fashion. Furthermore, the tiered approach and transparent display of information will contribute to greater efficiencies by calling for data only as needed (enough precision to make a decision), thus conserving animals and other resources.

  20. The health risks of saccharin revisited.

    PubMed

    Ellwein, L B; Cohen, S M

    1990-01-01

    Almost from its discovery in 1879, the use of saccharin as an artificial, non-nutritive sweetener has been the center of several controversies regarding potential toxic effects, most recently focusing on the urinary bladder carcinogenicity of sodium saccharin in rats when fed at high doses in two-generation studies. No carcinogenic effect has been observed in mice, hamsters, or monkeys, and numerous epidemiological studies provide no clear or consistent evidence to support the assertion that sodium saccharin increases the risk of bladder cancer in the human population. Mechanism of action studies in the one susceptible species, the rat, continue to provide information useful in assessing potential risk to the human from saccharin consumption. Unlike typical carcinogens which interact with DNA, sodium saccharin is not genotoxic, but leads to an increase in cell proliferation of the urothelium, the only target tissue. It also appears that the effect of saccharin is modified by the salt form in which it is administered, despite equivalent concentrations of saccharin in the urine. The chemical form of saccharin in the urine is unaffected, and there is no evidence for a specific cell receptor for the saccharin molecule. Changes in several urinary parameters, such as pH, sodium, protein, silicates, volume, and others, appear to influence the reaction of the urothelium to sodium saccharin administration. Silicon-containing precipitate and/or crystals appear to be generated in the urine under specific circumstances, acting as microabrasive, cytotoxic material. Using a mathematical model of carcinogenesis, which encompasses the temporal dynamics and complexity of the process at a cellular level, including spontaneous genetic transitions, it has been shown that the effects of sodium saccharin can be explained entirely in terms of its non-genotoxic influence on cell proliferation. In interpreting these analytical studies in the human context, particularly as they pertain to

  1. Racial/Ethnic Disparities in Midlife Depressive Symptoms: The Role of Cumulative Disadvantage Across the Life Course

    PubMed Central

    Garbarski, Dana

    2014-01-01

    This study examines the role of cumulative disadvantage mechanisms across the life course in the production of racial and ethnic disparities in depressive symptoms at midlife, including the early life exposure to health risk factors, the persistent exposure to health risk factors, and varying mental health returns to health risk factors across racial and ethnic groups. Using data from the over-40 health module of the National Longitudinal Study of Youth (NLSY) 1979 cohort, this study uses regression decomposition techniques to attend to differences in the composition of health risk factors across racial and ethnic groups, differences by race and ethnicity in the association between depressive symptoms and health risk factors, and how these differences combine within racial and ethnic groups to produce group-specific levels of—and disparities in—depressive symptoms at midlife. While the results vary depending on the groups being compared across race/ethnicity and gender, the study documents how racial and ethnic mental health disparities at midlife stem from life course processes of cumulative disadvantage through both unequal distribution and unequal associations across racial and ethnic groups. PMID:26047842

  2. 42 CFR 457.560 - Cumulative cost-sharing maximum.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Cumulative cost-sharing maximum. 457.560 Section 457.560 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO...

  3. 42 CFR 457.560 - Cumulative cost-sharing maximum.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Cumulative cost-sharing maximum. 457.560 Section 457.560 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO...

  4. A Model for Risk Assessment in Health Care.

    PubMed

    Prijatelj, Vesna; Rajkovič, Vladislav; Šušteršič, Olga

    2016-01-01

    The purpose of our research is to reduce risks and hence prevent errors in the health care process. The aim is to design an organizational information model using error prevention methods for risk assessment in a clinical setting. The model is based on selected indicators of quality nursing care, resulting from the world-known theoretical and practical models combined with experience in the Slovenian health care. The proposed organizational information model and software solution has a significant impact on the professional attention, communication and information, critical thinking, experience and knowledge. PMID:27332383

  5. Rural Community Leaders’ Perceptions of Environmental Health Risks

    PubMed Central

    Larsson, Laura S.; Butterfield, Patricia; Christopher, Suzanne; Hill, Wade

    2015-01-01

    Qualitative description was used to explore how rural community leaders frame, interpret, and give meaning to environmental health issues affecting their constituents and communities. Six rural community leaders discussed growth, vulnerable families, and the action avoidance strategies they use or see used in lieu of adopting health-promoting behaviors. Findings suggest intervention strategies should be economical, use common sense, be sensitive to regional identity, and use local case studies and “inside leadership.” Occupational health nurses addressing the disparate environmental health risks in rural communities are encouraged to use agenda-neutral, scientifically based risk communication efforts and foster collaborative relationships among nurses, planners, industry, and other community leaders. PMID:16562621

  6. Health of North American forests: Stress and risk assessment

    SciTech Connect

    Smith, W.H. )

    1990-01-01

    The 1980s will be remembered by forest professionals as a decade of intense and widespread societal concern for the vitality and integrity of forest systems. Daily reports of tropical deforestation and temperate forest decline have heightened social consciousness of forest health. It is therefore appropriate, as we enter the 1990s, to assess the health of our forests and propose new initiatives in this critically important area. Making generalizations about the health of North American forests is difficult because of the extraordinary diversity of forests, management regimes, and stress factors. This overview article summarizes forest health fundamentals, significant health risks, and priorities in future forest health management for temperate forests of the United States.

  7. Methylcyclopentadienyl manganese tricarbonyl: health risk uncertainties and research directions.

    PubMed Central

    Davis, J M

    1998-01-01

    With the way cleared for increased use of the fuel additive methylcyclopentadienyl manganese tricarbonyl (MMT) in the United States, the issue of possible public health impacts associated with this additive has gained greater attention. In assessing potential health risks of particulate Mn emitted from the combustion of MMT in gasoline, the U.S. Environmental Protection Agency not only considered the qualitative types of toxic effects associated with inhaled Mn, but conducted extensive exposure-response analyses using various statistical approaches and also estimated population exposure distributions of particulate Mn based on data from an exposure study conducted in California when MMT was used in leaded gasoline. Because of limitations in available data and the need to make several assumptions and extrapolations, the resulting risk characterization had inherent uncertainties that made it impossible to estimate health risks in a definitive or quantitative manner. To support an improved health risk characterization, further investigation is needed in the areas of health effects, emission characterization, and exposure analysis. PMID:9539013

  8. Algorithm Calculates Cumulative Poisson Distribution

    NASA Technical Reports Server (NTRS)

    Bowerman, Paul N.; Nolty, Robert C.; Scheuer, Ernest M.

    1992-01-01

    Algorithm calculates accurate values of cumulative Poisson distribution under conditions where other algorithms fail because numbers are so small (underflow) or so large (overflow) that computer cannot process them. Factors inserted temporarily to prevent underflow and overflow. Implemented in CUMPOIS computer program described in "Cumulative Poisson Distribution Program" (NPO-17714).

  9. Cardiovascular Health Informatics: Risk Screening and Intervention

    PubMed Central

    Hartley, Craig J.; Naghavi, Morteza; Parodi, Oberdan; Pattichis, Constantinos S.; Poon, Carmen C. Y.; Zhang, Yuan-Ting

    2014-01-01

    Despite enormous efforts to prevent cardiovascular disease (CVD) in the past, it remains the leading cause of death in most countries worldwide. Around two-thirds of these deaths are due to acute events, which frequently occur suddenly and are often fatal before medical care can be given. New strategies for screening and early intervening CVD, in addition to the conventional methods, are therefore needed in order to provide personalized and pervasive healthcare. In this special issue, selected emerging technologies in health informatics for screening and intervening CVDs are reported. These papers include reviews or original contributions on 1) new potential genetic biomarkers for screening CVD outcomes and high-throughput techniques for mining genomic data; 2) new imaging techniques for obtaining faster and higher resolution images of cardiovascular imaging biomarkers such as the cardiac chambers and atherosclerotic plaques in coronary arteries, as well as possible automatic segmentation, identification, or fusion algorithms; 3) new physiological biomarkers and novel wearable and home healthcare technologies for monitoring them in daily lives; 4) new personalized prediction models of plaque formation and progression or CVD outcomes; and 5) quantifiable indices and wearable systems to measure them for early intervention of CVD through lifestyle changes. It is hoped that the proposed technologies and systems covered in this special issue can result in improved CVD management and treatment at the point of need, offering a better quality of life to the patient. PMID:22997187

  10. Health risks of genetically modified foods.

    PubMed

    Dona, Artemis; Arvanitoyannis, Ioannis S

    2009-02-01

    As genetically modified (GM) foods are starting to intrude in our diet concerns have been expressed regarding GM food safety. These concerns as well as the limitations of the procedures followed in the evaluation of their safety are presented. Animal toxicity studies with certain GM foods have shown that they may toxically affect several organs and systems. The review of these studies should not be conducted separately for each GM food, but according to the effects exerted on certain organs it may help us create a better picture of the possible health effects on human beings. The results of most studies with GM foods indicate that they may cause some common toxic effects such as hepatic, pancreatic, renal, or reproductive effects and may alter the hematological, biochemical, and immunologic parameters. However, many years of research with animals and clinical trials are required for this assessment. The use of recombinant GH or its expression in animals should be re-examined since it has been shown that it increases IGF-1 which may promote cancer.

  11. Air pollution and health risks due to vehicle traffic.

    PubMed

    Zhang, Kai; Batterman, Stuart

    2013-04-15

    Traffic congestion increases vehicle emissions and degrades ambient air quality, and recent studies have shown excess morbidity and mortality for drivers, commuters and individuals living near major roadways. Presently, our understanding of the air pollution impacts from congestion on roads is very limited. This study demonstrates an approach to characterize risks of traffic for on- and near-road populations. Simulation modeling was used to estimate on- and near-road NO2 concentrations and health risks for freeway and arterial scenarios attributable to traffic for different traffic volumes during rush hour periods. The modeling used emission factors from two different models (Comprehensive Modal Emissions Model and Motor Vehicle Emissions Factor Model version 6.2), an empirical traffic speed-volume relationship, the California Line Source Dispersion Model, an empirical NO2-NOx relationship, estimated travel time changes during congestion, and concentration-response relationships from the literature, which give emergency doctor visits, hospital admissions and mortality attributed to NO2 exposure. An incremental analysis, which expresses the change in health risks for small increases in traffic volume, showed non-linear effects. For a freeway, "U" shaped trends of incremental risks were predicted for on-road populations, and incremental risks are flat at low traffic volumes for near-road populations. For an arterial road, incremental risks increased sharply for both on- and near-road populations as traffic increased. These patterns result from changes in emission factors, the NO2-NOx relationship, the travel delay for the on-road population, and the extended duration of rush hour for the near-road population. This study suggests that health risks from congestion are potentially significant, and that additional traffic can significantly increase risks, depending on the type of road and other factors. Further, evaluations of risk associated with congestion must

  12. Human Health Risk Assessment Calculator. In: SMARTe20ll, EPA/600/C-10/007

    EPA Science Inventory

    This calculator is aimed at supporting a human health risk assessment. Risk scenarios can be built by combining various health effects, exposure pathways, exposure parameters, and analytes. Scenario risk are calculated for each exposure pathway and analyte combination. The out...

  13. Exploring Mexican adolescents' perceptions of environmental health risks: a photographic approach to risk analysis.

    PubMed

    Börner, Susanne; Albino, Juan Carlos Torrico; Caraveo, Luz María Nieto; Tejeda, Ana Cristina Cubillas

    2015-05-01

    The objective of this study was to explore Mexican adolescents' perceptions of environmental health risks in contaminated urban areas, and to test the environmental photography technique as a research tool for engaging adolescents in community-based health research. The study was conducted with 74 adolescents from two communities in the city of San Luis Potosi, Mexico. Participants were provided with disposable cameras and asked to take photographs of elements and situations which they believed affected their personal health both at home and outside their homes. They were also asked to describe each photograph in writing. Photographs and written explanations were analyzed by using quantitative and qualitative content analysis. Risk perception plays a crucial role in the development of Risk Communication Programs (RCPs) aimed at the improvement of community health. The photography technique opens up a promising field for environmental health research since it affords a realistic and concise impression of the perceived risks. Adolescents in both communities perceived different environmental health risks as detrimental to their well-being, e.g. waste, air pollution, and lack of hygiene. Yet, some knowledge gaps remain which need to be addressed. PMID:26017963

  14. Exploring Mexican adolescents' perceptions of environmental health risks: a photographic approach to risk analysis.

    PubMed

    Börner, Susanne; Albino, Juan Carlos Torrico; Caraveo, Luz María Nieto; Tejeda, Ana Cristina Cubillas

    2015-05-01

    The objective of this study was to explore Mexican adolescents' perceptions of environmental health risks in contaminated urban areas, and to test the environmental photography technique as a research tool for engaging adolescents in community-based health research. The study was conducted with 74 adolescents from two communities in the city of San Luis Potosi, Mexico. Participants were provided with disposable cameras and asked to take photographs of elements and situations which they believed affected their personal health both at home and outside their homes. They were also asked to describe each photograph in writing. Photographs and written explanations were analyzed by using quantitative and qualitative content analysis. Risk perception plays a crucial role in the development of Risk Communication Programs (RCPs) aimed at the improvement of community health. The photography technique opens up a promising field for environmental health research since it affords a realistic and concise impression of the perceived risks. Adolescents in both communities perceived different environmental health risks as detrimental to their well-being, e.g. waste, air pollution, and lack of hygiene. Yet, some knowledge gaps remain which need to be addressed.

  15. Motivators and barriers to incorporating climate change-related health risks in environmental health impact assessment.

    PubMed

    Turner, Lyle R; Alderman, Katarzyna; Connell, Des; Tong, Shilu

    2013-03-22

    Climate change presents risks to health that must be addressed by both decision-makers and public health researchers. Within the application of Environmental Health Impact Assessment (EHIA), there have been few attempts to incorporate climate change-related health risks as an input to the framework. This study used a focus group design to examine the perceptions of government, industry and academic specialists about the suitability of assessing the health consequences of climate change within an EHIA framework. Practitioners expressed concern over a number of factors relating to the current EHIA methodology and the inclusion of climate change-related health risks. These concerns related to the broad scope of issues that would need to be considered, problems with identifying appropriate health indicators, the lack of relevant qualitative information that is currently incorporated in assessment and persistent issues surrounding stakeholder participation. It was suggested that improvements are needed in data collection processes, particularly in terms of adequate communication between environmental and health practitioners. Concerns were raised surrounding data privacy and usage, and how these could impact on the assessment process. These findings may provide guidance for government and industry bodies to improve the assessment of climate change-related health risks.

  16. A cross-cultural longitudinal examination of the effect of cumulative adversity on the mental and physical health of older adults.

    PubMed

    Palgi, Yuval; Shrira, Amit

    2016-03-01

    Self-oriented adversity refers to traumatic events that primarily inflict the self, whereas other-oriented adversity refers to events that affect the self by primarily targeting others. The present study aimed to examine whether cultural background moderates the effects of self-oriented and other-oriented adversity on mental and physical health of older adults. Using longitudinal data from the Israeli component of the Survey of Health and Retirement, we focused on 370 Jews and 239 Arabs who reported their exposure to various adversities across the life span, and completed questionnaires regarding mental and physical health. Results showed that the effect of self-oriented adversity on health did not differ among Jews and Arabs. However, other-oriented adversity showed a stronger effect on Arabs' mental and physical health than on Jews' health. Our findings suggest that the accumulation of adverse events that affect the self by primarily targeting others may have a stronger impact in collectivist cultures than in individualist cultures.

  17. Health risks from increases in methylmercury exposure.

    PubMed Central

    Mottet, N K; Shaw, C M; Burbacher, T M

    1985-01-01

    Our present knowledge of the human health effects of methylmercury exposure is derived from study of major outbreaks of human poisonings in Japan and Iraq and experimental studies on primates. Methylmercury readily passes through such physiological barriers as the blood-brain barrier, blood-testes barrier, and the placenta. Its major pathological effects are on the nervous and reproductive systems and the developing embryo/fetus. The neurotoxicity of methylmercury is well established in both humans and non-human primates. Lesions in the cerebral and cerebellar gray matter consist of necrosis and lysis of neurons, phagocytosis and gliosis. The changes are most prominent in the deep sulci and may have a vascular component. A late effect is cerebral atrophy. At high dose levels the liver, kidneys, and other organs may also have degenerative changes. Although not yet described in humans, a major effect of exposure of female primates is an adverse effect on pregnancy. Maternal female M. fascicularis blood mercury levels above 1 ppm are associated with a decreased pregnancy rate and increased abortion rate. To date our experimental data lack sufficient numbers to detect infrequent pregnancy effects below 1 ppm. Preliminary studies also reveal that methylmercury may also decrease the number and function (swim speed) of sperm. Both human and primate studies demonstrate deleterious effects of methylmercury on the developing embryo/fetus. Autopsies on human and primate infants reveal retarded brain development and the occurrence of a cerebral palsy-like behavior in the newborns, whereas the mother may be free of signs and symptoms of methylmercury toxicity. The fetal blood level of mercury is higher than the maternal level.(ABSTRACT TRUNCATED AT 250 WORDS) Images FIGURE 1. FIGURE 2. FIGURE 3. FIGURE 5. PMID:3908085

  18. Health risk assessment of occupational exposure to hazardous volatile organic compounds in swine gestation, farrowing and nursery barns.

    PubMed

    Akdeniz, Neslihan; Jacobson, Larry D; Hetchler, Brian P

    2013-03-01

    Livestock producers are exposed to a high number of airborne pollutants during their daily duties of cleaning, feeding and maintenance activities. Hazardous air pollutants (HAPs) are a major group of pollutants that may cause cancer or other serious health effects including neurological, respiratory, reproductive and developmental disorders. In this study, health risks of occupational exposure to eight hazardous VOCs (phenol, p-cresol, o/m-cresol, benzene, toluene, ethylbenzene, o-xylene, and m/pxylene) that are most likely to be emitted from swine buildings were assessed using Monte Carlo simulation. The purpose of the study was to calculate emission rates and to quantify cancer and hazard risks of the target VOCs. Cancer and hazard risks were calculated for workers A, B, and C, who spent six hours in the gestation, farrowing and nursery barns, respectively, and one hour in the office space every day. Concentrations of the target VOCs did not exceed their recommended exposure limits (RELs). But, concentrations of p-cresol and benzene exceeded their preliminary remediation goals (PRGs). The highest emission rates in mg s(-1) were measured from the gestation rooms while the highest emission rates in mg per s per head were measured from the farrowing rooms. Cancer risks of ethylbenzene, benzene and p-cresol were higher than EPA's benchmark of one per million. Hazard risks of benzene, toluene, p-cresol, and o/m-cresol were higher than the maximum acceptable risk threshold (10(-4)). Worker B (farrowing) had the highest cumulative cancer (16.6 in one million) and hazard (11 342 in one million) risks. It was followed by workers A (gestation) and C (nursery). Sensitivity analysis showed that inhalation unit risk (IUR) had the highest impact on cancer risk assessment while recommended exposure limit (REL) had the highest impact on hazard risk assessment.

  19. Dietary insulin index and insulin load in relation to endometrial cancer risk in the Nurses’ Health Study

    PubMed Central

    Prescott, Jennifer; Bao, Ying; Viswanathan, Akila N.; Giovannucci, Edward L.; Hankinson, Susan E.; De Vivo, Immaculata

    2014-01-01

    Background While unopposed estrogen exposure is considered the main driver of endometrial carcinogenesis, factors associated with states of insulin resistance and hyperinsulinemia are independently associated with endometrial cancer risk. We used dietary insulin load and insulin index scores to represent the estimated insulin demand of overall diets and assessed their association with endometrial cancer risk in the prospective Nurses’ Health Study. Methods We estimated incidence rate ratios (RRs) and 95% confidence intervals (CI) for risk of invasive endometrial cancer using Cox proportional hazards models. Between the baseline dietary questionnaire (1980) and 2010, we identified a total of 798 incident invasive epithelial endometrial adenocarcinomas over 1,417,167 person-years of follow-up. Results Dietary insulin scores were not associated with overall risk of endometrial cancer. Comparing women in the highest to the lowest quintile, the multivariable-adjusted RRs of endometrial cancer were 1.07 (95% CI: 0.84, 1.35) for cumulative average dietary insulin load and 1.03 (95% CI: 0.82, 1.31) for cumulative average dietary insulin index. Findings did not vary substantially by alcohol consumption, total dietary fiber intake, or BMI and/or physical activity (Pheterogeneity ≥ 0.10). Conclusions Intake of a diet predicted to stimulate a high postprandial insulin response was not associated with endometrial cancer risk in this large prospective study. Considering the complex interplay of diet, lifestyle and genetic factors contributing to the hyperinsulinemic state, dietary measures alone may not sufficiently capture absolute long-term insulin exposure. Impact This study is the first to investigate dietary insulin scores in relation to endometrial cancer risk. PMID:24859872

  20. The relationship between rural status, individual characteristics, and self-rated health in the Behavioral Risk Factor Surveillance System

    PubMed Central

    Bethea, Traci N.; Lopez, Russell P.; Cozier, Yvette C.; White, Laura F.; McClean, Michael D.

    2012-01-01

    Purpose To examine rural status and social factors as predictors of self-rated health in community-dwelling adults in the United States. Methods This study uses multinomial logistic and cumulative logistic models to evaluate the associations of interest in the 2006 US Behavioral Risk Factor Surveillance System, a cross-sectional survey of 347,790 non-institutionalized adults. Findings Self-rated health was poorer among rural residents, compared to urban residents (OR = 1.77, 95% CI: 1.54, 1.90). However, underlying risk factors such as obesity, low income, and low educational attainment were found to vary by rural status and account for the observed increased risk (OR = 1.03, 95% CI: 0.94, 1.12). There was little evidence of effect modification by rural status, though the association between obesity and self-rated health was stronger among urban residents (OR = 2.50, 95% CI: 2.38, 2.64) than among rural residents (OR = 2.18, 95% CI: 2.03, 2.34). Conclusions Our findings suggest that differences in self-rated health by rural status were attributable to differential distributions of participant characteristics and not due to differential effects of those characteristics. PMID:23083079

  1. Environmental health risk assessment and management for global climate change

    NASA Astrophysics Data System (ADS)

    Carter, P.

    2014-12-01

    This environmental health risk assessment and management approach for atmospheric greenhouse gas (GHG) pollution is based almost entirely on IPCC AR5 (2014) content, but the IPCC does not make recommendations. Large climate model uncertainties may be large environmental health risks. In accordance with environmental health risk management, we use the standard (IPCC-endorsed) formula of risk as the product of magnitude times probability, with an extremely high standard of precaution. Atmospheric GHG pollution, causing global warming, climate change and ocean acidification, is increasing as fast as ever. Time is of the essence to inform and make recommendations to governments and the public. While the 2ºC target is the only formally agreed-upon policy limit, for the most vulnerable nations, a 1.5ºC limit is being considered by the UNFCCC Secretariat. The Climate Action Network International (2014), representing civil society, recommends that the 1.5ºC limit be kept open and that emissions decline from 2015. James Hansen et al (2013) have argued that 1ºC is the danger limit. Taking into account committed global warming, its millennial duration, multiple large sources of amplifying climate feedbacks and multiple adverse impacts of global warming and climate change on crops, and population health impacts, all the IPCC AR5 scenarios carry extreme environmental health risks to large human populations and to the future of humanity as a whole. Our risk consideration finds that 2ºC carries high risks of many catastrophic impacts, that 1.5ºC carries high risks of many disastrous impacts, and that 1ºC is the danger limit. IPCC AR4 (2007) showed that emissions must be reversed by 2015 for a 2ºC warming limit. For the IPCC AR5 only the best-case scenario RCP2.6, is projected to stay under 2ºC by 2100 but the upper range is just above 2ºC. It calls for emissions to decline by 2020. We recommend that for catastrophic environmental health risk aversion, emissions decline

  2. Relative Pesticide and Exposure Route Contribution to Aggregate and Cumulative Dose in Young Farmworker Children

    PubMed Central

    Beamer, Paloma I.; Canales, Robert A.; Ferguson, Alesia C.; Leckie, James O.; Bradman, Asa

    2012-01-01

    The Child-Specific Aggregate Cumulative Human Exposure and Dose (CACHED) framework integrates micro-level activity time series with mechanistic exposure equations, environmental concentration distributions, and physiologically-based pharmacokinetic components to estimate exposure for multiple routes and chemicals. CACHED was utilized to quantify cumulative and aggregate exposure and dose estimates for a population of young farmworker children and to evaluate the model for chlorpyrifos and diazinon. Micro-activities of farmworker children collected concurrently with residential measurements of pesticides were used in the CACHED framework to simulate 115,000 exposure scenarios and quantify cumulative and aggregate exposure and dose estimates. Modeled metabolite urine concentrations were not statistically different than concentrations measured in the urine of children, indicating that CACHED can provide realistic biomarker estimates. Analysis of the relative contribution of exposure route and pesticide indicates that in general, chlorpyrifos non-dietary ingestion exposure accounts for the largest dose, confirming the importance of the micro-activity approach. The risk metrics computed from the 115,000 simulations, indicate that greater than 95% of these scenarios might pose a risk to children’s health from aggregate chlorpyrifos exposure. The variability observed in the route and pesticide contributions to urine biomarker levels demonstrate the importance of accounting for aggregate and cumulative exposure in establishing pesticide residue tolerances in food. PMID:22470279

  3. Occupational HIV risk for health care workers: risk factor and the risk of infection in the course of professional activities

    PubMed Central

    Wyżgowski, Przemysław; Rosiek, Anna; Grzela, Tomasz; Leksowski, Krzysztof

    2016-01-01

    Virtually created panic among health care workers about pandemic acquired immune deficiency syndrome prompted us to review the scientific literature to investigate the risk of human immunodeficiency virus (HIV) transmission in the daily works of health care workers, especially surgeons and anesthesiologists. In this review, we report worldwide valuations of the number of HIV infections that may occur from unsafe daily work in health care. We also present how to minimize the risk of infection by taking precautions and how to utilize postexposure prophylaxis in accordance with the latest reports of the Centers for Disease Control and Prevention. HIV-infected patients will be aging, and most of them will become the candidates for procedures such as major vascular reconstruction and artery bypass grafting, where the risks of blood contact and staff injury are high. For these reasons, all health care workers need to know how to prevent, and fight following the accidental exposure to HIV. PMID:27366077

  4. Smoking and HIV: prevalence, health risks, and cessation strategies.

    PubMed

    Lifson, Alan R; Lando, Harry A

    2012-09-01

    Health hazards due to smoking may undermine benefits of HIV treatment on morbidity and mortality. Over 40% of persons with HIV are current smokers. Health risks of smoking include increases in some HIV-associated infections, cardiovascular disease, some cancers, bacterial pneumonia and other lung disease, and overall mortality. Proven strategies for smoking cessation include various counseling approaches, nicotine replacement therapy and other pharmacotherapy; approaches may need to be individualized to address specific client needs and comorbidities. HIV clinicians and other service providers can have an influential role in screening their patients for smoking and promoting cessation programs to improve health.

  5. [Urbanization--a factor that increases the risk for health].

    PubMed

    Fridman, K B; Kriukova, T V

    2015-01-01

    The negative impact of urbanization on public health is obvious. However; due to the comprehensiveness and polymorphicity of its manifestations there are not established criteria for them. Health risk methodology allows, in principle, to obtain quantitative indices of the separate results of the impact on the health status of the citizens of metropolis that can be extremely effective in this area. The total cross-media riskfrom traffic pollution, drinking water quality, open ponds, noise, etc. permits to use of hygiene criteria in urban planning, insurance, taxation, etc. PMID:26031033

  6. [The operational role of the occupational health physician in the assessment and management of health risks related to night risks].

    PubMed

    Mucci, Nicola; Giorgi, Gabriele; Gonnelli, Irene Margherita; Garbarino, Sergio; Cupelli, Vincenzo; Arcangelil, Giulio

    2016-01-01

    The operational role of the occupational health physician in the assessment and management of health risks related to night work. Night work, in the last 30-40 years, has been extended to almost all areas of employment. The potential effects on workers' health--related to the disruption of circadian rhythms--are now well defined and studied in the Literature. All issues about the protection of safety and health for night workers are governed by the Italian Legislative Decree no. 66/2003 and subsequent amendments. The management of night work hasn't been included into the main Law on Occupational Safety and Health (Italian Legislative Decree no. 81/2008 and subsequent amendments) and a coordination between the two disciplines is desirable. The occupational health physician, as a global consultant for the protection of all health issues into a company, has to evaluate the potential effects of night work on health, both individually and as a group of workers. In this way, the physician may use either traditional tools (history, physical examination, blood tests) or innovative tools (questionnaires, health promotion programs, interventions on shift schedules). In the management of night work is useful to employ schedules that respect both psychophysical integrity and social welfare of workers and the needs of the production. The occupational health physician plays a significant role in information and training of workers, both individually and as a group of workers, and in the organization of health promotion programs (whit a voluntary participation by the workers). PMID:27311142

  7. Communicating Health Risks under Pressure: Homeland Security Applications

    SciTech Connect

    Garrahan, K.G.; Collie, S.L.

    2006-07-01

    The U.S. Environmental Protection Agency's (EPA) Office of Research and Development (ORD) Threat and Consequence Assessment Division (TCAD) within the National Homeland Security Research Center (NHSRC) has developed a tool for rapid communication of health risks and likelihood of exposure in preparation for terrorist incidents. The Emergency Consequence Assessment Tool (ECAT) is a secure web-based tool designed to make risk assessment and consequence management faster and easier for high priority terrorist threat scenarios. ECAT has been designed to function as 'defensive play-book' for health advisors, first responders, and decision-makers by presenting a series of evaluation templates for priority scenarios that can be modified for site-specific applications. Perhaps most importantly, the risk communication aspect is considered prior to an actual release event, so that management or legal advisors can concur on general risk communication content in preparation for press releases that can be anticipated in case of an actual emergency. ECAT serves as a one-stop source of information for retrieving toxicological properties for agents of concern, estimating exposure to these agents, characterizing health risks, and determining what actions need to be undertaken to mitigate the risks. ECAT has the capability to be used at a command post where inputs can be checked and communicated while the response continues in real time. This front-end planning is intended to fill the gap most commonly identified during tabletop exercises: a need for concise, timely, and informative risk communication to all parties. Training and customization of existing chemical and biological release scenarios with modeling of exposure to air and water, along with custom risk communication 'messages' intended for public, press, shareholders, and other partners enable more effective communication during times of crisis. For DOE, the ECAT could serve as a prototype that would be amenable to

  8. Contribution of parental and school personnel smoking to health risk behaviours among Finnish adolescents

    PubMed Central

    Virtanen, Marianna; Pietikäinen, Minna; Kivimäki, Mika; Luopa, Pauliina; Jokela, Jukka; Elovainio, Marko; Vahtera, Jussi

    2009-01-01

    Background This study compared parental smoking with school personnel smoking in relation to adolescents' smoking behaviours, alcohol use, and illicit drug use. Methods A cross-sectional survey for 24,379 adolescents was linked to a survey for 1946 school employees in 136 Finnish schools in 2004-2005. Surveys included smoking prevalence reported by school staff, adolescents' reports of school staff and parental smoking, adolescents' own smoking behaviours, alcohol use, and illicit drug use. Multilevel analyses were adjusted for individual and school-level confounding factors. Results Parental smoking was associated with all health risk behaviours among both sexes (risk range 1.39 to 1.95 for other outcomes; Odds Ratio OR for smoking cessation 0.64, 95% Confidence Interval CI: 0.57, 0.72 among boys, 0.72; 0.64, 0.81 among girls). Among boys, high vs. low smoking prevalence among school personnel was associated with higher probability of smoking (OR 1.19; 95% CI 1.01,1.41), higher frequency of smoking during school time (Cumulative Odds Ratio COR 1.81; 95% CI 1.32, 2.48), frequent alcohol use (OR 1.23; 95% CI 1.01, 1.50), illicit drug use (OR 1.40; 95% CI 1.16, 1.69), and higher odds of reporting adults smoking at school (COR 1.51; 95% CI 1.09, 2.09). Among girls, high smoking prevalence among school personnel was related to higher odds of smoking (OR 1.18; 95% CI 1.02, 1.37) and lower odds of smoking cessation (OR 0.84; 95% CI 0.72, 0.99). Conclusion Parental smoking and school personnel smoking are both associated with adolescents' health risk behaviours but the association of parental smoking seems to be stronger. PMID:19818130

  9. Assessment of long-term health risks after accidental exposure using haemoglobin adducts of epichlorohydrin.

    PubMed

    Wollin, Klaus-Michael; Bader, Michael; Müller, Michael; Lilienblum, Werner; Csicsaky, Michael

    2014-12-15

    On September 9th, 2002, two goods trains collided in Bad Münder, Lower Saxony, causing the release of more than 40 metric tonnes of epichlorohydrin (1-chloro-2,3-epoxypropane) into the environment. A human biomonitoring study was performed to evaluate the accidental exposure to epichlorohydrin and to assess the possible long-term, i.e. carcinogenic health effects. This was done on the basis of a biochemical effect monitoring using the N-(3-chloro-2-hydroxypropyl)valine and the N-(2,3-dihydroxypropyl)valine haemoglobin adducts of epichlorohydrin in blood to respond to missing ambient monitoring immediately after the crash. N-(3-chloro-2-hydroxypropyl)valine adduct levels above the LOQ (25 pmol/g globin) ranged from 32.0 to 116.4 pmol/g globin in 6 out of 628 samples. The N-(2,3-dihydroxypropyl)valine adduct was not detected above the LOD (10 pmol/g globin) in any of the blood samples. Based on the quantified N-(3-chloro-2-hydroxypropyl)valine adduct values, the body doses after two days of exposure were estimated to be in the range of 1.7-6.2 nmol/kg body weight. The reverse estimation of the external exposure leads to cumulative additional lifetime cancer risks ranging from 2.61×10(-8) to 9.48×10(-8). The estimated excess lifetime cancer risks have to be assessed as extremely low. Our biomonitoring study facilitated the dialogue between individuals and groups concerned and authorities, because suspected or occurred exposures and risks to human health could be quantified and interpreted in a sound manner.

  10. Health Status and Health Risks of the "Hidden Majority" of Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Emerson, Eric

    2011-01-01

    Little is known about the health status of and health risks faced by adults with intellectual disability who do not use intellectual disability services. Self-report data collected from 1,022 people with mild intellectual disability in England indicated that people who do not use intellectual disability services are more likely to smoke tobacco…

  11. Environmental Health and Aging: Activity, Exposure and Biological Models to Improve Risk Assessment and Health Promotion

    EPA Science Inventory

    The US Environmental Protection Agency (EPA) and other public health agencies are concerned that the environmental health of America’s growing population of older adults has not been taken into consideration in current approaches to risk assessment. The reduced capacity to respo...

  12. Older Women: A Population at Risk for Mental Health Problems.

    ERIC Educational Resources Information Center

    Wisniewski, Wendy; Cohen, Donna

    The expanding population of older women relative to older men or the "feminization of aging" is a significant demographic trend with important implications for the future. Older women are at risk for extended years of widowhood, living alone, institutionalization, poverty, and mental health problems. Although the dementias of late life appear to…

  13. Health and Risk Behaviors of Massachusetts Youth, 2007: The Report

    ERIC Educational Resources Information Center

    Massachusetts Department of Elementary and Secondary Education, 2008

    2008-01-01

    This paper presents the results of two coordinated surveys of Massachusetts adolescents, the 2007 Massachusetts Youth Risk Behavior Survey (ESE) and the Massachusetts Youth Health Survey (DPH). These two surveys were supported by funding from the Centers for Disease Control and Prevention (CDC) and administered in a random selection of 124 public…

  14. Youth "At Risk"? Young People, Sexual Health and Consent

    ERIC Educational Resources Information Center

    Powell, Anastasia

    2007-01-01

    In Australia, there is a growing expectation that sexuality education should reduce the risks associated with youth sex by providing young people with information on protecting their sexual health. However, this information may be insufficient to ensure that young people make choices that support their sexual safety and autonomy. This paper…

  15. [Evaluating occupational health risk in titanium alloys production workers].

    PubMed

    Bazarova, E L

    2007-01-01

    The authors present data on evaluation of personified and non-personified occupational risk of health disorders in titanium alloys production workers, concerning hygienic, medical and biologic, social and psychologic criteria. One-digit assessment of the work conditions is suggested.

  16. Environmental Epigenetics: Potential Application in Human Health Risk Assessment

    EPA Science Inventory

    Although previous studies have shown a significant involvement of epigenetic dysregulation in human diseases, the applicability of epigenetic data in the current human health risk assessment paradigm is unclear. The goals of this study are to compare the relative sensitivities of...

  17. Contextual Stress and Health Risk Behaviors among African American Adolescents

    ERIC Educational Resources Information Center

    Copeland-Linder, Nikeea; Lambert, Sharon F.; Chen, Yi-Fu; Ialongo, Nicholas S.

    2011-01-01

    This study examined the longitudinal association between contextual stress and health risk behaviors and the role of protective factors in a community epidemiologically-defined sample of urban African American adolescents (N = 500; 46.4% female). Structural equation modeling was used to create a latent variable measuring contextual stress…

  18. Tattooing: another adolescent risk behavior warranting health education.

    PubMed

    Armstrong, M L; Murphy, K P

    1997-11-01

    A cross-sectional, convenient sample of adolescents (N = 2101) from 8 states were queried regarding interest in tattooing. Permanent markings and blood-borne diseases were reasons respondents refrain from tattooing, yet 55% (n = 1159) expressed an interest in tattooing. Tattooed adolescents in the sample (10%, n = 213) responded with their experiences. Tattooing was frequently done around the 9th grade and as early as 8 years of age; over half (56%, n = 120) report academic grades of As and Bs. Potential health risks and definite psychosocial findings of purchase and possession risks were evident, building on data from a similar 1994 study by Armstrong and McConnell. Health providers and educators should initiate applicable health education and become community adolescent advocates regarding this risk-taking behavior. Findings indicate that adolescents who want a tattoo will obtain one, regardless of money, regulations, or risks. Adolescents view the tattoos as objects of self-identity and body art, whereas adults perceive the markings as deviant behavior. Informed decision-making could be promoted in health education by incorporating information about the possibility of blood-borne diseases, permanent markings, and themselves as growing and changing people. PMID:9419914

  19. A 21st Century Roadmap for Human Health Risk Assessment

    EPA Science Inventory

    For decades human health risk assessment has depended primarily on animal testing to predict adverse effects in humans, but that paradigm has come under question because of calls for more accurate information, less use of animals, and more efficient use of resources. Moreover, t...

  20. Health risk for children and adults consuming apples with pesticide residue.

    PubMed

    Lozowicka, Bozena

    2015-01-01

    The presence of pesticide residues in apples raises serious health concerns, especially when the fresh fruits are consumed by children, particularly vulnerable to the pesticide hazards. This study demonstrates the results from nine years of investigation (2005-2013) of 696 samples of Polish apples for 182 pesticides using gas and liquid chromatography and spectrophotometric techniques. Only 33.5% of the samples did not contain residues above the limit of detection. In 66.5% of the samples, 34 pesticides were detected, of which maximum residue level (MRL) was exceeded in 3%. Multiple residues were present in 35% of the samples with two to six pesticides, and one sample contained seven compounds. A study of the health risk for children, adults and the general population consuming apples with these pesticides was performed. The pesticide residue data have been combined with the consumption of apples in the 97.5 percentile and the mean diet. A deterministic model was used to assess the chronic and acute exposures that are based on the average and high concentrations of residues. Additionally, the "worst-case scenario" and "optimistic case scenario" were used to assess the chronic risk. In certain cases, the total dietary pesticide intake calculated from the residue levels observed in apples exceeds the toxicological criteria. Children were the group most exposed to the pesticides, and the greatest short-term hazard stemmed from flusilazole at 624%, dimethoate at 312%, tebuconazole at 173%, and chlorpyrifos methyl and captan with 104% Acute Reference Dose (ARfD) each. In the cumulative chronic exposure, among the 17 groups of compounds studied, organophosphate insecticides constituted 99% acceptable daily intake (ADI). The results indicate that the occurrence of pesticide residues in apples could not be considered a serious public health problem. Nevertheless, an investigation into continuous monitoring and tighter regulation of pesticide residues is recommended.

  1. Risk Protection, Service Use, and Health Outcomes under Colombia's Health Insurance Program for the Poor.

    PubMed

    Miller, Grant; Pinto, Diana; Vera-Hernández, Marcos

    2013-10-01

    Unexpected medical care spending imposes considerable financial risk on developing country households. Based on managed care models of health insurance in wealthy countries, Colombia's Régimen Subsidiado is a publicly financed insurance program targeted to the poor, aiming both to provide risk protection and to promote allocative efficiency in the use of medical care. Using a "fuzzy" regression discontinuity design, we find that the program has shielded the poor from some financial risk while increasing the use of traditionally under-utilized preventive services - with measurable health gains.

  2. Risk Protection, Service Use, and Health Outcomes under Colombia's Health Insurance Program for the Poor.

    PubMed

    Miller, Grant; Pinto, Diana; Vera-Hernández, Marcos

    2013-10-01

    Unexpected medical care spending imposes considerable financial risk on developing country households. Based on managed care models of health insurance in wealthy countries, Colombia's Régimen Subsidiado is a publicly financed insurance program targeted to the poor, aiming both to provide risk protection and to promote allocative efficiency in the use of medical care. Using a "fuzzy" regression discontinuity design, we find that the program has shielded the poor from some financial risk while increasing the use of traditionally under-utilized preventive services - with measurable health gains. PMID:25346799

  3. University of Minnesota Duluth, gasifier health risk assessment

    SciTech Connect

    Meyer, H.R.; O'Donnell, F.R.; Van Hoesen, S.D.; Etnier, E.L.

    1984-09-01

    This document describes an investigation of potential public and occupational health impacts associated with operation of the small, low Btu gasifier at the University of Minnesota, Duluth (UMD). The purpose of this study is to identify and quantify, within the uncertainty limits imposed by the available data, major contributors to such impacts. Consequently, we have estimated potential occupational health impacts and the gasifier's potential for producing certain health endpoints in the general public. Endpoints are specifically noncancer acute and chronic effects (threshold effects), and cancer and SO/sub x/-related mortalities (linear, nonthreshold effects) associated with atmospheric releases (no direct releases to aquatic systems occur at the facility) and subsequent inhalation exposure to representatives of three classes of released materials - metals, organics, and criteria pollutants. Other potential pathways to public exposure (atmospherically-contaminated drinking water, ingestion of locally produced foods, etc.) should not be responsible for a significant fraction of estimated risk, given the high dilution potential of the city's drinking water source (Lake Superior), and the fact that a relatively small quantity of food is grown locally. The report is organized to provide the reader with: (1) discussion and estimation, as feasible, of gasifier worker health risks, (2) source term (release rate) data, environmental transport and population exposure information, and (3) an assessment of the general population health risk based on these exposure estimates. 82 references, 1 figure, 9 tables.

  4. Children's health and their mothers' risk of divorce or separation.

    PubMed

    Joesch, J M; Smith, K R

    1997-01-01

    The purpose of this study is to determine how children's health conditions are related to their mothers' risk of divorce or separation. The study is based on data from over 7,000 children born to once-married mothers identified in the 1988 Child Health Supplement to the National Health Interview Survey. The effects of 15 childhood health conditions on the mothers' risk of divorce are estimated with Cox's proportional hazard models. Controlling for demographic, marital, and reproductive measures, we find that mothers' prospects for divorce are affected both positively or negatively by their children's health status, depending on the type of childhood condition and, in the case of low birth weight children, timing within the marriage. Women whose children have congenital heart disease, cerebral palsy, are blind, or had low birth weight appear to have higher risks of marital disruption than mothers of healthy children. In contrast, mothers whose children have migraines, learning disabilities, respiratory allergies, missing/deformed digits or limbs, or asthma have somewhat lower rates of divorce.

  5. Associations of muscular fitness with psychological positive health, health complaints, and health risk behaviors in Spanish children and adolescents.

    PubMed

    Padilla-Moledo, Carmen; Ruiz, Jonatan R; Ortega, Francisco B; Mora, Jesús; Castro-Piñero, José

    2012-01-01

    We examined the association of muscular fitness with psychological positive health, health complaints, and health risk behaviors in 690 (n = 322 girls) Spanish children and adolescents (6-17.9 years old). Lower body muscular strength was assessed with the standing long jump test, and upper-body muscular strength was assessed with the throw basketball test. A muscular fitness index was computed by means of standardized measures of both tests. Psychosocial positive health, health complaints, and health risk behaviors were self-reported using the items of the Health Behavior in School-aged Children questionnaire. Psychological positive health indicators included the following: perceived health status, life satisfaction, quality of family relationships, quality of peer relationships, and academic performance. We computed a health complaints index from 8 registered symptoms: headache, stomach ache, backache, feeling low, irritability or bad temper, feeling nervous, difficulties getting to sleep, and feeling dizzy. The health risk behavior indicators studied included tobacco use, alcohol use, and getting drunk. Children and adolescents with low muscular fitness (below the mean) had a higher odds ratio (OR) of reporting fair (vs. excellent) perceived health status, low life satisfaction (vs. very happy), low quality of family relationships (vs. very good), and low academic performance (vs. very good). Likewise, children and adolescents having low muscular fitness had a significantly higher OR of reporting smoking tobacco sometimes (vs. never), drinking alcohol sometimes (vs. never), and getting drunk sometimes (vs. never). The results of this study suggest a link between muscular fitness and psychological positive health and health risk behavior indicators in children and adolescents.

  6. [Tobacco cadmium health risk assessment and reduction techniques: A review].

    PubMed

    Cao, Chen-liang; Ma, Yi-bing; Li, Ju-mei; Wei, Dong-pu; Shi, Yi

    2015-04-01

    Tobacco is one of the cadmium accumulation and tolerance plants. Decreasing cadmium content of tobacco contributes to environmental safety and human health. Three aspects on tobacco cadmium research were reviewed in this paper, i.e. uptake and distribution of cadmium in tobacco, and health risk assessment of cadmium in tobacco and reduction measures. The current situations and existing challenges in the research field were discussed. The cadmium tolerance mechanisms of tobacco were reviewed, the factors on cadmium uptake were analyzed, and the general distribution of cadmium in tobacco was summarized. From the point of health risk assessment, the lack of cadmium limits in tobacco was identified, the recommended formula to calculate cadmium limits of tobacco based on atmosphere cadmium limits and digestion cadmium limits was provided and the cadmium limits of tobacco were estimated using each formula, and suggestions on cadmium limits in tobacco were presented. At last, we put forward several effective reduction measures to lower cadmium level in tobacco leaves.

  7. Managing risk: a taxonomy of error in health policy.

    PubMed

    Joyce, Paul; Boaden, Ruth; Esmail, Aneez

    2005-12-01

    This paper discusses the current initiatives on error and adverse events within healthcare, with a particular focus on the NHS, within the context of health policy. One of the key features of the paper is the proposal for an emergent taxonomy of the medical error literature, developed from the ideologies and rationales that underpin their approaches. This taxonomy provides details of three categories--empiricists, organisational rationalists and reformers of professional culture--and these act as an organising framework for the exploration of the potential consequences of current policy on errors and adverse events. This discussion highlights the tension between optimising health outcomes for patients and managing the health system as effectively as possible. In particular, the inherent tension between explicit managerial formulations of risk and implicit risk management strategies associated with medical professionalism are considered. PMID:16435469

  8. Managing pesticide chronic health risks: U.S. policies.

    PubMed

    Goldman, Lynn R

    2007-01-01

    This paper provides an overview of U.S. government pesticide risk management efforts over time and in recent years, relevant to chronic health risks of pesticides. Pesticides are in widespread usage in the U.S. With hundreds of active ingredients and thousands of products on the market, management of pesticide risks has been a daunting challenge. The first legislation providing federal authority for regulating pesticides was enacted in 1910. With the establishment of the U.S. Environmental Protection Agency in 1970 and amendments to the pesticide law in 1972, the federal government was for the first time given the authority to regulate health and environmental risks of pesticides. However, older pesticide risks were not addressed until legislation was enacted in 1988, requiring "reregistration" and 1996, requiring that pesticide food standards are safe for children. In result, the U.S. has seen an expansion of development of pesticide products that are registered as "reduced risk" or are biologicals. Additionally a large number of older pesticides have been cancelled or reduced from the market and/or from individual food uses. Through biomonitoring data, the U.S. may now be seeing trends in reduction of exposure to certain pesticides, the organophosphate insecticides. However, pesticide sales data through 2001 do not provide evidence for such trends. PMID:18032337

  9. Toward a national health risk management approach in Australia.

    PubMed

    O'Donnell, Carol

    2002-01-01

    There has been increasing international consensus about the importance of competition for achieving national growth and community well-being. The Australian government accordingly has introduced policies to promote such competition. Major legislative review and many public inquiries have assisted implementation of national competition policy and the development of national goals and standards related to international agreements to promote health and sustainable development. Since the 1980s, Australia has had legislation that requires the identification and control of health risks arising at work. The management structures necessary for coordinated delivery of national programs designed for effective identification and control of health risks arising in communities to achieve national health and development goals are still being developed, however. Major difficulties related to this development are discussed. National health development programs should be approached primarily through establishment of regional partnerships between bodies responsible for managing community health, local government, and employment placement, in consultation with other relevant organizations and the community. Related research and evaluation programs are required. PMID:11905388

  10. Aeronautical Engineering: 1983 cumulative index

    NASA Technical Reports Server (NTRS)

    1984-01-01

    This bibliography is a cumulative index to the abstracts contained in NASA SP-7037 (158) through NASA SP-7037 (169) of Aeronautical Engineering: A Continuing Bibliography. NASA SP-7037 and its supplements have been compiled through the cooperative efforts of the American Institute of Aeronautics and Astronautics (AIAA) and the National Aeronautics and Space Administration (NASA). This cumulative index includes subject, personal author, corporate source, contract, report number, and accession number indexes.

  11. An Integrated Approach to Assess Exposure and Health-Risk from Polycyclic Aromatic Hydrocarbons (PAHs) in a Fastener Manufacturing Industry

    PubMed Central

    Hsu, Hsin-I; Lin, Ming-Yeng; Chen, Yu-Cheng; Chen, Wang-Yi; Yoon, Chungsik; Chen, Mei-Ru; Tsai, Perng-Jy

    2014-01-01

    An integrated approach was developed to assess exposure and health-risk from polycyclic aromatic hydrocarbons (PAHs) contained in oil mists in a fastener manufacturing industry. One previously developed model and one new model were adopted for predicting oil mist exposure concentrations emitted from metal work fluid (MWF) and PAHs contained in MWF by using the fastener production rate (Pr) and cumulative fastener production rate (CPr) as predictors, respectively. By applying the annual Pr and CPr records to the above two models, long-term workplace PAH exposure concentrations were predicted. In addition, true exposure data was also collected from the field. The predicted and measured concentrations respectively served as the prior and likelihood distributions in the Bayesian decision analysis (BDA), and the resultant posterior distributions were used to determine the long-term exposure and health-risks posed on workers. Results show that long term exposures to PAHs would result in a 3.1%, 96.7%, and 73.4% chance of exceeding the PEL-TWA (0.2 mg/m3), action level (0.1 mg/m3), and acceptable health risk (10−3), respectively. In conclusion, preventive measures should be taken immediately to reduce workers’ PAH exposures. PMID:25226413

  12. A predictive Bayesian approach to risk analysis in health care

    PubMed Central

    Aven, Terje; Eidesen, Karianne

    2007-01-01

    Background The Bayesian approach is now widely recognised as a proper framework for analysing risk in health care. However, the traditional text-book Bayesian approach is in many cases difficult to implement, as it is based on abstract concepts and modelling. Methods The essential points of the risk analyses conducted according to the predictive Bayesian approach are identification of observable quantities, prediction and uncertainty assessments of these quantities, using all the relevant information. The risk analysis summarizes the knowledge and lack of knowledge concerning critical operations and other activities, and give in this way a basis for making rational decisions. Results It is shown that Bayesian risk analysis can be significantly simplified and made more accessible compared to the traditional text-book Bayesian approach by focusing on predictions of observable quantities and performing uncertainty assessments of these quantities using subjective probabilities. Conclusion The predictive Bayesian approach provides a framework for ensuring quality of risk analysis. The approach acknowledges that risk cannot be adequately described and evaluated simply by reference to summarising probabilities. Risk is defined by the combination of possible consequences and associated uncertainties. PMID:17714597

  13. Health risks from indoor formaldehyde exposures in northwest weatherized residences

    SciTech Connect

    Mellinger, P.J.; Sever, L.E.

    1986-10-01

    Conflicting opinions on the potential hazards associated with formaldehyde exposure triggered a national workshop to address the toxicological questions concerning the health effects of formaldehyde. Since quantitative human data are not available to derive a dose-response curve for formaldehyde risk assessment, nonhuman data are used. In the case of formaldehyde, data from animals exposed to high concentrations are used to estimate human risk at much lower concentrations. This study presents the several steps that make up a risk assessment and examines any additional data that might alter significantly the risk estimates presented in the 1984 EIS. Rat inhalation chronic bioassay data from a study sponsored by the Chemical Industry Institute of Toxicology (CIIT) have been used to develop a risk equation that was subsequently used by BPA in its EIS. The CIIT data base remains the only acceptable animal data that can support the estimation of a dose-response curve. The development of mathematical models continues with a great deal of energy, and the use of different models is largely responsible for the great variability of the formaldehyde risk estimates. While one can calculate different values for carcinogenic risk associated with formaldehyde exposure than were presented earlier in the BPA EIS, they are not likely to be any better.

  14. Comparative analysis of health risk assessments for municipal waste combustors

    SciTech Connect

    Levin, A.; Fratt, D.B.; Leonard, A.; Bruins, R.J.F.; Fradkin, L.

    1991-01-01

    Quantitative health risk assessments have been performed for a number of proposed municipal waste combustor (MWC) facilities over the past several years. The article presents the results of a comparative analysis of a total of 21 risk assessments, focusing on seven of the most comprehensive methodologies. The analysis concentrates on stack emissions of noncriteria pollutants and is comparative rather than critical in nature. Overall, the risk assessment methodologies used were similar whereas the assumptions and input values used varied from study to study. Some of the variability results directly from differences in site-specific characteristics, but much of it is due to absence of data, lack of field validation, lack of specific guidelines from regulatory agencies, and reliance on professional judgment. The results indicate that carcinogenic risks are more significant than chronic non-carcinogenic risks. In most instances polychlorodibenzodioxins, polychlorodibenzofurans, and cadmium contribute more significantly to the total carcinogenic risk from MWC stack emissions than other contaminants. In addition, the contribution to total risk of all indirect routes of exposure (ingestion and dermal contact) exceeds that of the direct inhalation route for most studies reviewed.

  15. Comparative analysis of health risk assessments for municipal waste combustors.

    PubMed

    Levin, A; Fratt, D B; Leonard, A; Bruins, R J; Fradkin, L

    1991-01-01

    Quantitative health risk assessments have been performed for a number of proposed municipal waste combustor (MWC) facilities over the past several years. This article presents the results of a comparative analysis of a total of 21 risk assessments, focusing on seven of the most comprehensive methodologies. The analysis concentrates on stack emissions of noncriteria pollutants and is comparative rather than critical in nature. Overall, the risk assessment methodologies used were similar whereas the assumptions and input values used varied from study to study. Some of this variability results directly from differences in site-specific characteristics, but much of it is due to absence of data, lack of field validation, lack of specific guidelines from regulatory agencies, and reliance on professional judgment. The results indicate that carcinogenic risks are more significant than chronic non-carcinogenic risks. In most instances polychlorodibenzodioxins, polychlorodibenzofurans, and cadmium contribute more significantly to the total carcinogenic risk from MWC stack emissions than other contaminants. In addition, the contribution to total risk of all indirect routes of exposure (ingestion and dermal contact) exceeds that of the direct inhalation route for most studies reviewed.

  16. Comparative analysis of health risk assessments for municipal waste combustors

    SciTech Connect

    Levin, A.; Fratt, D.B.; Leonard, A.; Bruins, R.J.; Fradkin, L. )

    1991-01-01

    Quantitative health risk assessments have been performed for a number of proposed municipal waste combustor (MWC) facilities over the past several years. This article presents the results of a comparative analysis of a total of 21 risk assessments, focusing on seven of the most comprehensive methodologies. The analysis concentrates on stack emissions of noncriteria pollutants and is comparative rather than critical in nature. Overall, the risk assessment methodologies used were similar whereas the assumptions and input values used varied from study to study. Some of this variability results directly from differences in site-specific characteristics, but much of it is due to absence of data, lack of field validation, lack of specific guidelines from regulatory agencies, and reliance on professional judgment. The results indicate that carcinogenic risks are more significant than chronic non-carcinogenic risks. In most instances polychlorodibenzodioxins, polychlorodibenzofurans, and cadmium contribute more significantly to the total carcinogenic risk from MWC stack emissions than other contaminants. In addition, the contribution to total risk of all indirect routes of exposure (ingestion and dermal contact) exceeds that of the direct inhalation route for most studies reviewed. 42 refs.

  17. Risk factors for latex sensitization among health care workers.

    PubMed

    Vila, L; Sánchez, G; Añó, M; Uasuf, C G; Sanz, M L

    1999-01-01

    Health care workers, children with spina bifida and rubber industry workers show higher prevalence of latex sensitization compared to the general population, and they are considered at-risk groups. Our aim was to establish the prevalence of latex allergy among health care workers at the Clínica Universitaria of Navarra and to analyze potential risk factors, including personal and family history of atopy, sex, as well as factors leading to enhanced exposure to latex, such as being a nurse, belonging to surgical departments, having undergone previous surgery and the number of gloves employed per week. Health care workers (n = 1,150) (doctors, nurses, assistant nurses, laboratory technicians and practicing medical and nursing students) were evaluated using a questionnaire and skin prick test (SPT). Serum specific IgE was determined by CAP-FEIA (Pharmacia, Sweden) in those with positive SPT. The participation index was 26.17%: 301 volunteers answered the questionnaire and underwent SPT. Fifteen subjects presented positive SPT to latex. It was found that 5% of the health care workers from the Clínica Universitaria were sensitized to latex allergens. Thirteen were females and two males. Mean age was 38.4 (+/- 7.09) years. Nine were nurses, three assistant nurses, one nursing student and two medical doctors. Eight belonged to medical, five to surgical and two to laboratory departments. There were no significant differences among the subjects in the prevalence of latex sensitization. Fourteen reported symptoms related to latex, mostly pruritus, dryness and/or redness of the hands (n = 12) and rhinitis (n = 6). Only one subject reported no symptoms when using latex products. Eight were atopic; personal history of atopy was the only significant (odds ratio = 5.10, p < 0.01) risk factor for latex sensitization. It was concluded that atopic health care workers show a more increased risk of latex sensitization than those who are nonatopic. PMID:10664929

  18. Acceptability of mobile health interventions to reduce inactivity-related health risk in central Pennsylvania adults.

    PubMed

    Yang, Chih-Hsiang; Maher, Jaclyn P; Conroy, David E

    2015-01-01

    Insufficient physical activity and excessive sedentary behavior elevate health risk. Mobile applications (apps) provide one mode for delivering interventions to modify these behaviors and reduce health risk. The purpose of this study was to characterize the need for and acceptability of health behavior interventions among rural adults and evaluate the interest in and the value of app-based interventions in this population. Central Pennsylvania adults with smartphones (N = 258) completed a brief web survey in October-November 2012. Most adults report one or both inactivity-related behavioral risk factors, would use a free app to modify those risk behaviors, and would pay a small amount for that app. Low-cost, efficacious apps to increase physical activity or reduce sedentary behavior should be promoted in public health practice. User experience should be at the forefront of this process to increase value and minimize burden in the service of long-term engagement, behavior change, and health risk reduction. PMID:26844135

  19. Survey of Ambient Air Pollution Health Risk Assessment Tools.

    PubMed

    Anenberg, Susan C; Belova, Anna; Brandt, Jørgen; Fann, Neal; Greco, Sue; Guttikunda, Sarath; Heroux, Marie-Eve; Hurley, Fintan; Krzyzanowski, Michal; Medina, Sylvia; Miller, Brian; Pandey, Kiran; Roos, Joachim; Van Dingenen, Rita

    2016-09-01

    Designing air quality policies that improve public health can benefit from information about air pollution health risks and impacts, which include respiratory and cardiovascular diseases and premature death. Several computer-based tools help automate air pollution health impact assessments and are being used for a variety of contexts. Expanding information gathered for a May 2014 World Health Organization expert meeting, we survey 12 multinational air pollution health impact assessment tools, categorize them according to key technical and operational characteristics, and identify limitations and challenges. Key characteristics include spatial resolution, pollutants and health effect outcomes evaluated, and method for characterizing population exposure, as well as tool format, accessibility, complexity, and degree of peer review and application in policy contexts. While many of the tools use common data sources for concentration-response associations, population, and baseline mortality rates, they vary in the exposure information source, format, and degree of technical complexity. We find that there is an important tradeoff between technical refinement and accessibility for a broad range of applications. Analysts should apply tools that provide the appropriate geographic scope, resolution, and maximum degree of technical rigor for the intended assessment, within resources constraints. A systematic intercomparison of the tools' inputs, assumptions, calculations, and results would be helpful to determine the appropriateness of each for different types of assessment. Future work would benefit from accounting for multiple uncertainty sources and integrating ambient air pollution health impact assessment tools with those addressing other related health risks (e.g., smoking, indoor pollution, climate change, vehicle accidents, physical activity).

  20. A framework for the animal health risk analysis of biotechnology-derived animals: a Canadian perspective.

    PubMed

    Moreau, P I; Jordan, L T

    2005-04-01

    This paper describes the framework used by the Canadian Food Inspection Agency to assess the risks to animal health associated with biotechnology-derived animals and their products. In Canada the risks to animal health associated with biotechnology-derived animals are one consideration among several other regulatory concerns (e.g. human health, the environment). The risk analysis process begins with hazard identification, includes a risk assessment for each hazard, and concludes with risk management and risk communication.