Alexander V. Sergeev

Hospitalization Rates for Coronary Heart Disease in Relation to Residence Near Areas Contaminated with Persistent Organic Pollutants and Other Pollutants

Exposure to environmental pollutants may contribute to the development of coronary heart disease (CHD). We determined the ZIP codes containing or abutting each of the approximately 900 hazardous waste sites in New York and identified the major contaminants in each. Three categories of ZIP codes were then distinguished: those containing or abutting sites contaminated with persistent organic pollutants (POPs), those containing only other types of wastes (“other waste”), and those not containing any identified hazardous waste site (“clean”). Effects of residence in each of these ZIP codes on CHD and acute myocardial infarction (AMI) hospital discharge rates were assessed with a negative binomial model, adjusting for age, sex, race, income, and health insurance coverage. Patients living in ZIP codes contaminated with POPs had a statistically significant 15.0% elevation in CHD hospital discharge rates and a 20.0% elevation in AMI discharge rates compared with clean ZIP codes. In neither of the comparisons were rates in other-waste sites significantly greater than in clean sites. In a subset of POP ZIP codes along the Hudson River, where average income is higher and there is less smoking, better diet, and more exercise, the rate of hospitalization for CHD was 35.8% greater and for AMI 39.1% greater than in clean sites. Although the cross-sectional design of the study prevents definite conclusions on causal inference, the results indirectly support the hypothesis that living near a POP-contaminated site constitutes a risk of exposure and of development of CHD and AMI.

Residential proximity to environmental sources of persistent organic pollutants and first-time hospitalizations for myocardial infarction with comorbid diabetes mellitus: a 12-year population-based study.

OBJECTIVES Environmental exposure to persistent organic pollutants (POPs) has been associated with an increased risk of both acute myocardial infarction (AMI) and diabetes mellitus (DM). A study of first-time hospitalizations for AMI with DM as a comorbidity in populations presumed to be exposed or not exposed on the basis of residence near POPs sites was conducted to investigate whether exposure to POPs increases the environmental burden of disease. MATERIALS AND METHODS We examined the association between residential proximity to environmental sources of POPs and hospitalization rates for first-time AMI with comorbid DM in 31,428 patients aged 25-74 years, using the New York Statewide Planning and Research Cooperative System data for a 12-year period (1993-2004). Environmental exposure status was assessed based on the zip code of residence. Adjusted relative risks (RR) of AMI hospitalization were estimated by multivariate Poisson regression. RESULTS Hospitalization rates for first-time AMI with comorbid DM were significantly greater in populations living near POPs sites (adjusted RR = 1.169, 95% CI: 1.014-1.347, p < 0.05). These rates were also significantly higher in African Americans than in Caucasians (adjusted RR = 1.902, 95% CI: 1.659-2.180, p < 0.001), in males (adjusted RR = 1.767, 95% CI: 1.695-1.843, p < 0.001), and for older ages (p for trend < 0.001). These findings, consistent with established non-modifiable risk factors, support the plausibility of our model. CONCLUSIONS Residential proximity to environmental sources of POPs is associated with a significant increase in hospitalization rates for first-time AMI with comorbid DM, compared to respective rates in populations not exposed to POPs.

Geospatial patterns of hospitalization rates for stroke with comorbid hypertension in relation to environmental sources of persistent organic pollutants: results from a 12-year population-based study

PurposeRecent evidence indicates that exposure to persistent organic pollutants (POPs) is emerging as an important risk factor for atherosclerosis-related diseases, including stroke. Hypertension (HTN) is a major risk factor for stroke, and some studies suggest that exposure to POPs is also a risk factor for HTN. We hypothesized that POPs increase the environmental burden of stroke with comorbid HTN.MethodsA population-based study of hospitalization rates for stroke with comorbid HTN in populations presumably exposed to POPs, based on the zip code of residence, was conducted. Data on hospitalizations for stroke with comorbid HTN were obtained from the New York Statewide Planning and Research Cooperative System for 1993–2004. Relative risks, with 95% confidence intervals (RR, 95% CI), of hospitalization were estimated by multiple Poisson regression analysis.ResultsRR of hospitalization for stroke with comorbid HTN was 13.4% higher in populations residing in zip codes containing or abutting environmental sources of POPs (RR = 1.134; 95% CI, 1.036–1.241; p = 0.006). Also, hospitalization rates were significantly higher in males than in females (RR = 1.397; 95% CI, 1.357–1.437; p < 0.001), in African Americans than in Caucasians (RR = 3.902; 95% CI, 3.617–4.208; p < 0.001), and in older age groups (p for trend < 0.001). These statistically significant findings of the effect of demographic factors are highly consistent with the current knowledge of stroke and serve as indirect quality indicators for our model.ConclusionsResults of our study support the hypothesis that exposure to POPs increases the environmental burden of both stroke and HTN.

Increased Hospitalizations for Ischemic Stroke with Comorbid Diabetes and Residential Proximity to Sources of Organic Pollutants: A 12-Year Population-Based Study

Background: Evidence is emerging that exposure to persistent organic pollutants (POP) is a risk factor for atherosclerosis-related diseases and for diabetes mellitus (DM). We hypothesized that residential proximity to sources of POP will be associated with an increase in hospitalization rates for ischemic stroke (IS) with comorbid DM (IS-DM). Methods: We examined IS-DM hospitalization rates in the New York State (exclusive of New York City) during a 12-year period. POP exposure status was assessed based on residency in a zip code containing or abutting environmental sources of POP. Adjusted relative risks (RR) of IS-DM hospitalization were estimated by multivariate Poisson regression. Results: A statistically significant 10% increase in IS-DM hospitalization rates was observed in populations environmentally exposed to POP (adjusted RR 1.10, 95% confidence interval, CI, 1.01–1.20; p = 0.031). IS-DM hospitalization rates were also higher in males (adjusted RR 1.34, 95% CI 1.30–1.39; p < 0.001), in blacks (adjusted RR 4.54, 95% CI 4.16–4.94; p < 0.001) and in older age groups (p for trend <0.001). Conclusions: Residential proximity to sources of POP is associated with an increase in RR of IS-DM hospitalization. Our findings support the hypothesis of POP being a risk factor for IS. Further studies are warranted.

Exposure to Persistent Organic Pollutants Increases Hospitalization Rates for Myocardial Infarction with Comorbid Hypertension

Studies suggest that environmental exposure to persistent organic pollutants (POPs) may be an emerging risk factor for ischemic heart disease, including acute myocardial infarction (AMI). However, some studies indicate that exposure to POPs may also be a risk factor for hypertension, a well-established risk factor for AMI. To investigate effect of POPs on the environmental burden of cardiovascular disease, a study of AMI with comorbid hypertension in populations environmentally exposed to persistent organic pollutants, based on the zip code of residence, was conducted. Data on hospital discharges for AMI with comorbid hypertension were obtained from the New York Statewide Planning and Research Cooperative System for 1993-2004. Patients residing in zip codes containing or abutting POPs contaminated sites were considered environmentally exposed. Relative risks (RR) - with corresponding 95% confidence intervals (95% CI) - of hospitalization for AMI with comorbid hypertension were estimated by Poisson regression, adjusting for known confounders. Adjusted hospitalization rates for AMI with comorbid hypertension were 12.4% higher in populations residing in proximity to a POPs site (adjusted RR = 1.124, 95% CI 1.025-1.233, p < 0.05), compared to not in proximity to a POPs site. Also, hospitalization rates for AMI with comorbid hypertension were higher in males than in females (adjusted RR = 2.157, 95% CI 2.100-2.215, p < 0.05), in African Americans than in Caucasians (adjusted RR = 1.631, 95% CI 1.483-1.794, p < 0.05), and in older age groups (p for trend <0.05). These findings are consistent with the established effects of non-modifiable risk factors and serve as indirect quality indicators for our model. In conclusion, our results support the hypothesis that environmental exposure to POPs increases the burden of cardiovascular disease in exposed populations.

Whole-body vibration knowledge survey of U.S. occupational safety and health professionals.

PROBLEM Whole-body vibration (WBV) is an occupational issue of concern due to adverse health effects or simple discomfort and annoyance. Unlike in Europe, WBV is an emerging topic in the U.S. safety and health (S&H) professional community. We hypothesized that at least one-half of the U.S. occupational S&H professionals knew little or nothing about WBV. METHOD We conducted a cross-sectional study (survey) of WBV knowledge among members of the American Society of Safety Engineers. A Likert scale (1-none to 5-expert) was used to determine WBV topic knowledge levels (KL(1-5)). RESULTS Analysis of 2,764 responses revealed that 69.5% of the participants self-reported a less than basic WBV understanding. The WBV KL(1-5) mean for all participants was 1.94+/-1.00, corresponding to an awareness of WBV without a depth of understanding. SUMMARY Many at-risk U.S. workers may not be supported by occupational S&H professionals with adequate WBV knowledge. IMPACT ON INDUSTRY A significant number of U.S. workers may be exposed to unhealthy levels of whole-body vibration. However, the U.S. occupational safety and health community is generally unprepared to anticipate, monitor, and control the whole-body vibration hazard.

“Whatdunit?” Developmental changes in children's syntactically based sentence interpretation abilities and sensitivity to word order

Aim 1 of this study was to examine the developmental changes in typically developing English-speaking childrens syntactically based sentence interpretation abilities and sensitivity to word order. Aim 2 was to determine the psychometric standing of the novel sentence interpretation task developed for this study, because we wish to use it later with children with specific language impairment. Children listened to semantically implausible sentences in which noun animacy and the natural affordance between the nouns were removed, thus controlling for event probability. Using this novel “whatdunit?” agent selection task, 256 children 7–11 years old listened to two structures with canonical word order and two with noncanonical word order. After each sentence, children selected as quickly as possible the picture of the noun they believed was “doing the action.” Children interpreted sentences with canonical word order with greater accuracy and speed than those with noncanonical word order. Older children (mean age = 10 years, 8 months) were more accurate and faster than younger children (mean age = 8 years, 1 month) across all sentence forms. Both older and younger children demonstrated similar error patterns across sentence type. The “whatdunit?” task also proved to have strong validity and reliability, making it suitable for studies with children with specific language impairment.

Increase in metabolic syndrome-related hospitalizations in relation to environmental sources of persistent organic pollutants.

Evidence from cell studies indicates that persistent organic pollutants (POP) can induce insulin resistance, an essential component of the metabolic syndrome (MetS). We hypothesized that residential proximity to environmental sources of POP would be associated with the MetS in the population. The present study examined the association between residency in a zip code containing or abutting environmental sources of POP and MetS-related hospitalization rates. Hospitalization data were obtained from the New York Statewide Planning and Research Cooperative System. Relative risks (RR) were calculated as hospitalization rate ratios. Adjusted RR and their 95% confidence intervals (CI) were estimated by multivariable Poisson regression. A higher proportion of African Americans resided in POP zip codes compared to Caucasians (25.9% and 24.3%, respectively, p < 0.01). Residence in POP zip codes was associated with a statistically significant 39.2% increase in MetS-related hospitalization rates, adjusted for race, gender, and age (adjusted RR = 1.392, 95% CI: 1.032–1.879, p = 0.030). Increase in age was independently associated with higher MetS-related hospitalization rates (p for trend < 0.001). Our findings contribute to the body of evidence supporting the hypothesis of POP constituting an environmental risk factor for the MetS. Further studies investigating exposure to POP and insulin resistance are warranted.