Cristian Pantea

Safety awareness among New York farmers.

BACKGROUND This study was conducted to assess the health status and safety practices among year-round adult farm workers and residents and included a telephone interview survey of 1,727 persons from 552 farms. METHODS Logistic regression was used to analyze four safety questions. RESULTS Among 541 farm owner/operators significant predictors of making substitutions in the use of chemicals and major changes to equipment include younger age, more persons assisting on the farm, and higher gross sales. Having training is associated with having more than a high school education. Among all participants the perception that personal protective equipment are useful is associated with being younger, male, an owner/operator or worker, and having at least a high school education. CONCLUSIONS These findings suggest that older and less educated farmers should be targeted for health and safety programs.

Cancer Incidence among Former Love Canal Residents

Background The Love Canal was a rectangular 16-acre, 10-ft-deep chemical waste landfill situated in a residential neighborhood in Niagara Falls, New York. This seriously contaminated site came to public attention in 1978. Only one prior study examined cancer incidence in former residents of the Love Canal neighborhood (LC). Objective In this study we aimed to describe cancer incidence in former LC residents from 1979 to 1996 and to investigate whether it differs from that of New York State (NYS) and Niagara County (NC). Methods From 1978 to 1982, we interviewed 6,181 former residents, and 5,052 were eligible to be included in this study. In 1996, we identified 304 cancer diagnoses in this cohort using the NYS Cancer Registry. We compared LC cancer incidence with that of NYS and NC using standardized incidence ratios (SIRs), and we compared risks within the LC group by potential exposure to the landfill using survival analysis. Results SIRs were elevated for cancers of the bladder [SIRNYS = 1.44; 95% confidence interval (CI), 0.91–2.16] and kidney (SIRNYS = 1.48; 95% CI, 0.76–2.58). Although CIs included 1.00, other studies have linked these cancers to chemicals similar to those found at Love Canal. We also found higher rates of bladder cancer among residents exposed as children, based on two cases. Conclusions In explaining these excess risks, the role of exposure to the landfill is unclear given such limitations as a relatively small and incomplete study cohort, imprecise exposure measurements, and the exclusion of cancers diagnosed before 1979. Given the relatively young age of the cohort, further surveillance is warranted.

An evaluation of transported pollution and respiratory–related hospital admissions in the state of New York

Human exposure to air pollution transported from the Midwest is evaluated in eight New York State (NYS) regions over ten summers (1997 – 2006) for association with respiratory–related hospital admissions. Days when pollution is transported into the Northeastern United States (U.S.) were identified by using back–trajectories from the eight regions. These back–trajectories help identify predominant meteorological patterns associated with “polluted” air parcels (originating in the Midwest where power plant emissions are known to be relatively high) and “clean” air parcels (originating from the North where pollution is known to be relatively low). Ambient ozone concentrations measurements were used to validate the classification of “polluted” and “clean” air parcels. These classifications were then used to define the days of high– versus low–exposure for populations residing within each region. The results of this analysis indicate that the risk of being hospitalized for respiratory–related illness in NYS is greater on those days when air is transported from the Midwest as compared to days when air is transported from the North. Using a refined method to examine air parcels moving through a boundary drawn around high–emitting power plants in the Midwestern U.S. resulted in stronger associations across more regions (significant odds ratios ranging from 1.06 to 1.16 for the entire study time period for six of the eight NYS regions). An assessment of temperature and its impact on the odds ratio calculation in the New York City metropolitan region indicates that temperature alone does not explain the increased association between air pollution and respiratory–related hospital admissions.

Mortality among former Love Canal residents.

Background The Love Canal is a rectangular 16-acre, 10-ft deep chemical waste landfill situated in a residential neighborhood in Niagara Falls, New York. This seriously contaminated site first came to public attention in 1978. No studies have examined mortality in the former residents of the Love Canal neighborhood (LC). Objective The aim of this study was to describe the mortality experience of the former LC residents from the years 1979–1996. Methods From 1978 to 1982, 6,181 former LC residents were interviewed. In 1996, 725 deaths from 1979–1996 were identified in this cohort, using state and national registries. We compared mortality rates with those of New York State (NYS) and Niagara County. Survival analysis examined risks by potential exposure to the landfill. Results We were unable to demonstrate differences in all-cause mortality for either comparison population for 1979 1996. Relative to NYS, the standardized mortality ratio (SMR) was elevated [SMR = 1.39; 95% confidence interval (CI), 1.16–1.66] for death from acute myocardial infarction (AMI), but not relative to Niagara County. Death from external causes of injury was also elevated relative to both NYS and Niagara County, especially among women (SMR = 1.95; 95% CI, 1.25 2.90). Conclusions The role of exposure to the landfill in explaining these excess risks is not clear given limitations such as multiple comparisons, a qualitative exposure assessment, an incomplete cohort, and no data on deaths prior to 1978. Lack of elevation for AMI when compared with Niagara County but not NYS suggests possible regional differences. However, direct cardiotoxic or neurotoxic effects from landfill chemicals or indirect effects mediated by psychological stress cannot be ruled out. Revisiting the cohort in the future could reveal patterns that are not yet apparent.

Reproductive outcomes among former Love Canal residents, Niagara Falls, New York.

Love Canal, located in Niagara Falls, NY, and among the earliest and most significant hazardous waste sites in the United States, first came to public attention in 1978. In this study, researchers evaluated 1,799 live births from 1960 through 1996 to 980 women who formerly lived in the Love Canal Emergency Declaration Area and were of reproductive age sometime during that time period. Using Upstate New York and Niagara County as external comparison populations, standardized incidence ratios with 95% confidence intervals were calculated for low birth weight, preterm birth, small for gestational age, and congenital malformations, and unadjusted proportions of male to female births were calculated. Internal comparisons among the infants were also performed according to several measures of potential exposure using generalized estimating equations. The results indicated a statistically significant elevated risk of preterm birth among children born on the Love Canal prior to the time of evacuation and relocation of residents from the Emergency Declaration Area, using Upstate New York as the standard population (standardized incidence ratio=1.40; 95% confidence interval: 1.01, 1.90). Additionally, the ratio of male to female births was lower for children conceived in the Emergency Declaration Area (sex ratio=0.94 versus sex ratio=1.05 in the standard population) and the frequency of congenital malformations was greater than expected among Love Canal boys born from 1983 to 1996 (standardized incidence ratio=1.50 when compared to Upstate New York), although in both cases the 95% confidence interval included the null value. Finally, increased risk for low birth weight infants among mothers who lived closest to the Canal as children was found (odds ratio=4.68; 95% confidence interval: 1.24, 17.66), but this estimate was limited due to small numbers (n=4). The study adds to the knowledge of the possible reproductive effects from exposure to chemicals arising from hazardous waste; however, given the small number of some events, the qualitative nature of the exposure assessment, and possibility of spurious associations due to multiple comparisons, the findings should be interpreted cautiously.

Concentrations of selected organochlorines and chlorobenzenes in the serum of former Love Canal residents, Niagara Falls, New York.

BACKGROUND Love Canal, in Niagara Falls, NY is among the earliest and most significant hazardous waste sites in the USA, but no study has ever measured chemical body burdens in nearby residents to document that human exposure occurred. This study measured concentrations of selected organochlorines and chlorinated benzenes in archived serum samples collected from former Love Canal residents. METHODS We analyzed serum samples collected from 373 former residents in 1978-1979 for compounds disposed of at Love Canal, and we compared their concentrations according to surrogate indicators of exposure such as residential proximity, adjusting for potential confounders. RESULTS Three compounds were detectable in the serum of most participants: 1,2,4-trichlorobenzene (1,2,4-TCB), beta-hexachlorocyclohexane (beta-HCH) and 1,2-dichlorobenzene (1,2-DCB). Concentrations of 1,2,4-TCB and 1,2-DCB were 2-14 times greater among persons who at the time their blood was collected lived closest to the Canal compared to those living further away. We found no consistent trends for beta-HCH with respect to any exposure definition. CONCLUSIONS These results provide evidence that residential proximity to Love Canal contributed to the body burden of certain contaminants, and helps validate the use of surrogate exposure measures in health effect studies. Further surveillance of the Love Canal cohort is warranted.

Childhood Asthma Hospitalizations and Ambient Air Sulfur Dioxide Concentrations in Bronx County, New York

The association between asthma hospitalizations and ambient sulfur dioxide (SO2) concentrations was examined in a case-control study in Bronx County, New York. Cases comprised 2629 children aged 0-14 yr who were admitted to hospitals for asthma. There were 2236 controls who were admitted for reasons other than asthma. Daily ambient SO2 concentrations were categorized into quartiles of both average and maximum levels and various exposure windows (i.e., day of admission and 1-, 2-, and 3-d lags). Cases were exposed to higher daily average concentrations of SO2 than controls. The authors compared the highest exposure quartile with the lowest, and the odds ratios were 1.66, 1.90, 2.05, and 2.21 (all p0.01 for same-day, 1-, 2-, and 3-d lags, respectively), with a similar finding for daily SO2 maximum exposure. The results suggest a consistent positive association between SO2 exposure and hospitalizations for childhood asthma.

Impact of NO x emissions reduction policy on hospitalizations for respiratory disease in New York State

To date, only a limited number of studies have examined the impact of ambient pollutant policy on respiratory morbidities. This accountability study examined the effect of a regional pollution control policy, namely, the US Environmental Protection Agencys (EPA) nitrogen oxides (NOx) Budget Trading Program (NBP), on respiratory health in New York State (NYS). Time-series analysis using generalized additive models was applied to assess changes in daily hospitalizations for respiratory diseases in NYS after the implementation of the NBP policy. Respiratory end points in the summers during the baseline period (1997–2000) were compared with those during the post-intervention period (2004–2006). Stratified analyses were also conducted to examine whether health impacts of the NBP differed by socio-demographic, regional, or clinical characteristics. Following the implementation of EPAs NBP policy, there were significant reductions in mean ozone levels (−2% to −9%) throughout NYS. After adjusting for time-varying variables, PM2.5 concentration, and meteorological factors, significant post-intervention declines in respiratory admissions were observed in the Central (−10.18, 95% confidence interval (CI): −14.18, −6.01), Lower Hudson (−11.05, 95% CI: −16.54, −5.19), and New York City Metro regions (−5.71, 95% CI: −7.39, −4.00), consistent with wind trajectory patterns. Stratified analyses suggest that admissions for asthma, chronic airway obstruction, among those 5–17 years old, self-payers, Medicaid-covered, and rural residents declined the most post-NBP. This study suggests that the NOx control policy may have had a positive impact on both air pollution levels statewide and respiratory health in some NYS regions. However, the effect varied by disease subgroups, region, and socio-demographic characteristics.

Prevalence and Clinical Attributes of Congenital Microcephaly - New York, 2013-2015.

Congenital Zika virus infection can cause microcephaly and other severe fetal neurological anomalies (1). To inform microcephaly surveillance efforts and assess ascertainment sources, the New York State Department of Health and the New York City Department of Health and Mental Hygiene sought to determine the prevalence of microcephaly in New York during 2013-2015, before known importation of Zika virus infections. Suspected newborn microcephaly diagnoses were identified from 1) reports submitted by birth hospitals in response to a request and 2) queries of a hospital administrative discharge database for newborn microcephaly diagnoses. Anthropometric measurements, maternal demographics, and pregnancy characteristics were abstracted from newborn records from both sources. Diagnoses were classified using microcephaly case definitions developed by CDC and the National Birth Defects Prevention Network (NBDPN) (2). During 2013-2015, 284 newborns in New York met the case definition for severe congenital microcephaly (prevalence = 4.2 per 10,000 live births). Most newborns with severe congenital microcephaly were identified by both sources; 263 (93%) were identified through hospital requests and 256 (90%) were identified through administrative discharge data. The proportions of newborns with severe congenital microcephaly who were black (30%) or Hispanic (31%) were higher than the observed proportions of black (15%) or Hispanic (23%) infants among New York live births. Fifty-eight percent of newborns with severe congenital microcephaly were born to mothers with pregnancy complications or who had in utero or perinatal infections or teratogenic exposures, genetic disorders, or family histories of birth defects.

Development of a heat vulnerability index for New York State

OBJECTIVES The frequency and intensity of extreme heat events are increasing in New York State (NYS) and have been linked with increased heat-related morbidity and mortality. But these effects are not uniform across the state and can vary across large regions due to regional sociodemographic and environmental factors which impact an individuals response or adaptive capacity to heat and in turn contribute to vulnerability among certain populations. We developed a heat vulnerability index (HVI) to identify heat-vulnerable populations and regions in NYS. STUDY DESIGN Census tract level environmental and sociodemographic heat-vulnerability variables were used to develop the HVI to identify heat-vulnerable populations and areas. METHODS Variables were identified from a comprehensive literature review and climate-health research in NYS. We obtained data from 2010 US Census Bureau and 2011 National Land Cover Database. We used principal component analysis to reduce correlated variables to fewer uncorrelated components, and then calculated the cumulative HVI for each census tract by summing up the scores across the components. The HVI was then mapped across NYS (excluding New York City) to display spatial vulnerability. The prevalence rates of heat stress were compared across HVI score categories. RESULTS Thirteen variables were reduced to four meaningful components representing 1) social/language vulnerability; 2) socioeconomic vulnerability; 3) environmental/urban vulnerability; and 4) elderly/ social isolation. Vulnerability to heat varied spatially in NYS with the HVI showing that metropolitan areas were most vulnerable, with language barriers and socioeconomic disadvantage contributing to the most vulnerability. Reliability of the HVI was supported by preliminary results where higher rates of heat stress were collocated in the regions with the highest HVI. CONCLUSIONS The NYS HVI showed spatial variability in heat vulnerability across the state. Mapping the HVI allows quick identification of regions in NYS that could benefit from targeted interventions. The HVI will be used as a planning tool to help allocate appropriate adaptation measures like cooling centers and issue heat alerts to mitigate effects of heat in vulnerable areas.