Amanda Sue Niskar

Prevalence of Self-Reported Diabetes and Exposure to Organochlorine Pesticides among Mexican Americans: Hispanic Health and Nutrition Examination Survey, 1982–1984

Background The prevalence of diabetes is higher among Mexican Americans than among non-Hispanic whites. Higher serum levels of organochlorine pesticides in Mexican Americans have been reported. Few studies have explored the association between pesticide exposure and diabetes. Objectives We set out to examine the association between self-reported diabetes and serum concentrations of organochlorine pesticides among Mexican Americans residing in the southwestern United States from 1982 to 1984. Methods This study was conducted among a sample of 1,303 Mexican Americans 20–74 years of age from the Hispanic Health and Nutrition Examination Survey. Serum concentrations were available for seven pesticides or pesticide metabolites at quantifiable levels in at least 1% of the study population: p,p′-DDT (dichlorodiphenyltrichloroethane), p,p′-DDE (dichlorodiphenyldichloro-ethylene), dieldrin, oxychlordane, β-hexachlorocyclohexane, hexachlorobenzene, and trans-nonachlor. We used logistic regression to evaluate the association of self-reported diabetes with exposure to organochlorine pesticides, with and without adjustment for total serum lipids. Nonfasting serum glucose values were compared among exposure groups. Results Self-reported diabetes was significantly associated with serum levels above the detectable limit for trans-nonachlor, oxychlordane, and β-hexachlorocyclohexane and among those with the highest level of exposure to p,p′-DDT and p,p′-DDE. On adjustment for total serum lipids, the association with p,p′-DDT remained significant. Serum glucose levels were elevated among those exposed to trans-nonachlor and β-hexachlorocyclohexane. Conclusion This study suggests that higher serum levels of certain organochlorine pesticides may be associated with increased prevalence of diabetes. Additional studies with more extensive clinical assessment are needed to confirm this association.

National Environmental Public Health Tracking Program: Bridging the Information Gap

In January 2001 the Pew Environmental Health Commission called for the creation of a coordinated public health system to prevent disease in the United States by tracking and combating environmental health threats. In response, the Centers for Disease Control and Prevention initiated the Environmental Public Health Tracking (EPHT) Program to integrate three distinct components of hazard monitoring and exposure and health effects surveillance into a cohesive tracking network. Uniform and acceptable data standards, easily understood case definitions, and improved communication between health and environmental agencies are just a few of the challenges that must be addressed for this network to be effective. The nascent EPHT program is attempting to respond to these challenges by drawing on a wide range of expertise from federal agencies, state health and environmental agencies, nongovernmental organizations, and the program’s academic Centers of Excellence. In this mini-monograph, we present innovative strategies and methods that are being applied to the broad scope of important and complex environmental public health problems by developing EPHT programs. The data resulting from this program can be used to identify areas and populations most likely to be affected by environmental contamination and to provide important information on the health and environmental status of communities. EPHT will develop valuable data on possible associations between the environment and the risk of noninfectious health effects. These data can be used to reduce the burden of adverse health effects on the American public.

Serum selenium levels in the US population: Third National Health and Nutrition Examination Survey, 1988-1994.

The published literature on serum selenium levels in the US population describes studies on small samples that may not be representative of the US population. This analysis provides the first nationally representative serum selenium levels in the US population by age group, sex, race-ethnicity, poverty income ratio (PIR), geographic region, and urban status. The Third National Health and Nutrition Examination Survey (NHANES III) is a national population-based cross-sectional survey with an in-person interview and serum selenium measurements.For the 18,597 persons for whom serum selenium values were available in NHANES III, the mean concentration was 1.58 µmol/L and the median concentration was 1.56 µmol/L. Mean serum selenium levels differed by age group, sex, race-ethnicity, PIR, and geographic region. The US population has slight differences in serum selenium levels by demographic factors.

Mean and median hearing thresholds among children 6 to 19 years of age: the Third National Health And Nutrition Examination Survey, 1988 to 1994, United States.

Objective: The objective of this study was to provide the first national representative values for mean and median hearing thresholds among US children 6 to 19 yrs of age. Methods: Hearing thresholds were obtained from 6166 children in the Third National Health and Nutrition Examination Survey (1988 to 1994), a national, population-based cross-sectional survey with household interview and audiometric testing at 0.5 to 8 kHz. Means, medians, and standard errors of the mean were obtained and reported by ear, frequency, sex, and age. Results: The mean and median thresholds ranged from 3.0 to 11.8 dB HL and −1.0 to 10.8 dB HL, respectively. The highest (poorest) thresholds were obtained at test frequencies above 4000 Hz. Similar mean and median thresholds were found between boys and girls at all frequencies. Conclusions: These data indicate that the mean thresholds fall below the standard screening guidelines recommended by the American Speech-Language-Hearing Association (≤20 dB HL for the frequencies from 1000≤20 dB HL for the frequencies from 2000, and 4000 Hz). The results of this study suggest the need to include the test frequency of 6000 Hz in screening protocols for children.