Marta I. Gomez

The World Trade Center Residents’ Respiratory Health Study: New-Onset Respiratory Symptoms and Pulmonary Function

The destruction of the World Trade Center (WTC) on 11 September 2001 in New York City resulted in the massive release of pulverized dust and combustion products. The dust and smoke settled in the surrounding area, which encompassed a large residential community. We hypothesized that previously normal residents in the community surrounding the former WTC would have an increased incidence of persistent respiratory symptoms and abnormalities in screening spirometry. A hybrid cross-sectional and retrospective cohort study using a symptom-based questionnaire and onsite screening spirometry in residents in an exposed area and in a control area was performed 12 ± 4 months after the collapse. Surveys were analyzed from 2,812 residents. New-onset respiratory symptoms were described by 55.8% of residents in the exposed area, compared with 20.1% in the control area after the event. Persistent new-onset symptoms were identified in 26.4 versus 7.5% of residents in the exposed area versus control area, respectively. No differences in screening spirometry between the groups were detected. A small pilot study suggested the possibility of an increase in bronchial hyperresponsiveness in exposed participants with persistent symptoms. The data demonstrate an increased rate of new-onset and persistent respiratory health effects in residents near the former WTC compared with a control population.

Polychlorinated biphenyl exposure and neuropsychological status among older residents of upper Hudson River communities.

Background Polychlorinated biphenyls (PCBs) may accelerate the cognitive and motor dysfunction found in normal aging, but few studies have examined these outcomes and PCB exposure among older adults. Objective We evaluated neuropsychological status and low-level PCB exposure among older adults living along contaminated portions of the upper Hudson River in New York. Methods A total of 253 persons between 55 and 74 years of age were recruited and interviewed, and provided blood samples for congener-specific PCB analysis. Participants also underwent a neuropsychological battery consisting of 34 tests capable of detecting subtle deficits in cognition, motor function, affective state, and olfactory function. Results After adjustment for potential confounders, the results indicated that an increase in serum total PCB concentration from 250 to 500 ppb (lipid basis) was associated with a 6.2% decrease in verbal learning, as measured by California Verbal Learning Test trial 1 score (p = 0.035), and with a 19.2% increase in depressive symptoms, as measured by the Beck Depression Inventory (p = 0.007). Conclusions The results suggest that exposure to PCBs may be associated with some measures of memory and learning and depression among adults 55–74 years of age whose current body burdens are similar to those of the general population. Although the results are useful in delineating the neuropsychological effects of low-level exposure to PCBs, further studies of whether older men and women are a sensitive subpopulation are needed.

Hearing Conservation for Farmers: Source Apportionment of Occupational and Environmental Factors Contributing to Hearing Loss

Those who work on farms continue to have a strikingly high prevalence of hearing loss, despite efforts to promote hearing conservation in agriculture. To develop improved hearing conservation programs, we performed a source apportionment analysis for hearing loss in a large, multiphasic health survey, the New York Farm Family Health and Hazard Survey. We used information from audiometric, otoscopic, and tympanometric examinations; detailed general health and farm exposure interviews; and a second interview that focused on additional potential determinants of hearing loss. Hearing loss on audiometry was significantly associated with increased age, male gender, education through high school or less, lifetime years of hunting with guns, lifetime years of use of a grain dryer, and a history of spraying crops during the previous year. Hearing conservation programs for farmers should thus be directed toward reduction in noise exposure, both from occupational and non-occupational sources. Additional study is needed to evaluate the association seen between crop spraying and hearing loss.

Adverse Birth Outcomes and Maternal Exposure to Trichloroethylene and Tetrachloroethylene through Soil Vapor Intrusion in New York State

Background: Industrial spills of volatile organic compounds (VOCs) in Endicott, New York (USA), have led to contamination of groundwater, soil, and soil gas. Previous studies have reported an increase in adverse birth outcomes among women exposed to VOCs in drinking water. Objective: We investigated the prevalence of adverse birth outcomes among mothers exposed to trichloroethylene (TCE) and tetrachloroethylene [or perchloroethylene (PCE)] in indoor air contaminated through soil vapor intrusion. Methods: We examined low birth weight (LBW), preterm birth, fetal growth restriction, and birth defects among births to women in Endicott who were exposed to VOCs, compared with births statewide. We used Poisson regression to analyze births and malformations to estimate the association between maternal exposure to VOCs adjusting for sex, mother’s age, race, education, parity, and prenatal care. Two exposure areas were identified based on environmental sampling data: one area was primarily contaminated with TCE, and the other with PCE. Results: In the TCE-contaminated area, adjusted rate ratios (RRs) were significantly elevated for LBW [RR = 1.36; 95% confidence interval (CI): 1.07, 1.73; n = 76], small for gestational age (RR = 1.23; 95% CI: 1.03, 1.48; n = 117), term LBW (RR = 1.68; 95% CI: 1.20, 2.34; n = 37), cardiac defects (RR = 2.15; 95% CI: 1.27, 3.62; n = 15), and conotruncal defects (RR = 4.91; 95% CI: 1.58, 15.24; n = 3). In the PCE-contaminated area, RRs for cardiac defects (five births) were elevated but not significantly. Residual socioeconomic confounding may have contributed to elevations of LBW outcomes. Conclusions: Maternal residence in both areas was associated with cardiac defects. Residence in the TCE area, but not the PCE area, was associated with LBW and fetal growth restriction.

Polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs) and neuropsychological status among older adults in New York

Polybrominated diphenyl ethers (PBDEs) are emerging environmental contaminants, but little is known about their possible human health effects. The objective of this study is to evaluate the association between exposure to PBDEs and neuropsychological function among older adults and the possibility of effect modification with polychlorinated biphenyls (PCBs). Serum samples were analyzed for concentrations of 9 PBDE and 30 PCB congeners and 34 tests of cognitive and motor function, affective state, and olfactory function were assessed among 144 men and women of 55-74 years of age. After adjustment for relevant confounders, no overall associations were observed between the sum of the PBDE congener concentrations in serum (∑ PBDE) and scores on the neuropsychological tests. However, statistically significant interactions were found between PBDEs and PCBs for some measures of verbal learning and memory. Among persons with ∑ PCB concentrations at or above the median of 467ppb (lipid basis), an increase in ∑ PBDE concentrations from the 25th to 75th percentile was associated with decreases between 7% and 12% on scores for certain subscales of the California Verbal Learning Test. In contrast, no statistically significant associations were observed for PBDEs among persons with ∑ PCB levels below the median. The results suggest that PBDEs and PCBs may interact to affect verbal memory and learning among persons 55-74 years old. This is the first study to evaluate the neuropsychological effects of PBDEs in adults and the possibility of synergy with PCBs in humans.

Variation in Blood Lead and Hematocrit Levels during Pregnancy in a Socioeconomically Disadvantaged Population

Abstract Lead is a long-recognized human toxicant that crosses the placenta. Fetal sensitivity to environmental agents can vary with stage of development; therefore, how maternal blood lead levels change during pregnancy and how fetal exposure is influenced provide useful knowledge. In this study, the authors describe longitudinal changes in blood lead levels during the course of pregnancy in a sample of socioeconomically disadvantaged pregnant women. The women were recruited early in pregnancy when they sought care at one of two obstetrics clinics in Albany, New York. Maternal blood lead levels changed between the 1st and 2nd trimesters, from 1.99 μmlg/dl to 1.69 μmlg/dl (hematocrit corrected, 1.70–1.62); between the 2nd and 3rd trimester from 1.78 μmlg/dl to 1.86 μmlg/dl (hematocrit corrected, 1.65–1.72); and between 3rd trimester and delivery from 1.80 μmlg/dl to 2.17 μmlg/dl (hematocrit corrected, 1.70–1.86). These changes were statistically significant and were corrected for secular trends. The rate of change per day in lead levels averaged −36.6% from trimester 1 to trimester 2, 18.3% from trimester 2 to trimester 3, and −40.8% from trimester 3 to delivery. The patterns in our study were consistent with the patterns reported in a few other longitudinal studies of change in lead level during pregnancy. Findings reveal significant associations between maternal blood lead levels and both hematocrit and trimester of pregnancy. Clinicians who interpret test results should take into account the dynamics of these variables when determining appropriate care for both mother and neonate.

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.

PCB Exposure and in Vivo CYP1A2 Activity among Native Americans

Cytochrome P-450 1A2 (CYP1A2) is an enzyme involved in the metabolic activation of some carcinogens and is believed to be induced by xenobiotics. Very few studies, however, have investigated the association between environmental exposures and in vivo CYP1A2 activity in humans. To address this issue, a study was conducted of CYP1A2 activity among Native Americans exposed to polychlorinated biphenyls (PCBs) from the consumption of fish from the St. Lawrence River. At the Mohawk Nation at Akwesasne (in New York and in Ontario and Quebec, Canada), 103 adults were interviewed, and they donated blood for serum PCB analysis and underwent the caffeine breath test (CBT), a safe and noninvasive procedure that uses caffeine as a probe for CYP1A2 activity in vivo. The results supported the findings of other studies that CBT values are higher among smokers and men and lower among women who use oral contraceptives. Despite a relatively low average total PCB body burden in this population, the sum of serum levels for nine mono- or di-ortho-substituted PCB congeners showed positive associations with CBT values (p = 0.052 wet weight and p = 0.029 lipid adjusted), as did toxic equivalent quantities (TEQs; p = 0.091 for wet weight and 0.048 for lipid adjusted). Regarding individual congeners, serum levels of PCB-153, PCB-170, and PCB-180 were significantly correlated with CBT values. The results support the notion that CYP1A2 activity may be a marker of an early biological effect of exposure to PCBs in humans and that the CBT may be a useful tool to monitor such effects.

Polychlorinated biphenyls (PCBs) in indoor air and in serum among older residents of upper Hudson River communities

A study was conducted to evaluate the association between PCBs in residential indoor air and in the serum of older, long time residents of three upper Hudson River communities. Samples of indoor air and of serum were collected from 170 persons 55 to 74 years of age, and analyzed for PCBs using glass capillary gas chromatography. After adjusting for age, BMI, cigarette smoking, and Hudson River fish consumption with multiple linear regression analysis, the results indicated statistically significant associations between concentrations in indoor air and serum for PCB-28, a lightly chlorinated congener common in air that accumulates in serum, and PCB-105. Duration of exposure was an important factor, since among persons who had lived in their home for 39 years or more, 11 of the 12 most commonly detected congeners were significantly correlated, as was their sum (∑ PCB). Significant associations between indoor air and serum PCB concentrations also were more likely when collected in cooler months and if the two samples were collected within 20 d of each other. The study is among the first to indicate that PCB concentrations characteristic of residential indoor air are associated with a detectable increase in body burden.

Respiratory and Cardiovascular Hospitalizations After the World Trade Center Disaster

ABSTRACT The objective of this study was to determine whether there were increases in respiratory and cardiovascular hospital admissions among residents of lower Manhattan after the destruction of the World Trade Center. The authors used hospital admission records from 1991 to 2001 with a diagnosis of respiratory, cardiovascular, or cerebrovascular illness and a residential address in lower Manhattan or Queens. The authors assessed the change in admissions by comparing lower Manhattan to Queens (the control area) and before and after 9/11 admissions in lower Manhattan. They found the following significant increases in hospital admissions: for respiratory illnesses during the weeks of 9/11/01 and 10/16/01; asthma during the week of 9/11/01; cardiovascular during the weeks of 9/18/01 and 10/9/01; cerebrovascular during the weeks of 9/11/01, 9/18/01, 10/2/01, and 10/9/01. There was an immediate increase in respiratory admissions after the disaster and a delayed increase in cardiovascular and cerebrovascular admissions.