Mohammad Z. Al-Hamdan

The Public Health Exposome: A Population-Based, Exposure Science Approach to Health Disparities Research

The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures “get under the skin”. The public health exposome approach has led our team to develop a taxonomy and bioinformatics infrastructure to integrate health outcomes data with thousands of sources of exogenous exposure, organized in four broad domains: natural, built, social, and policy environments. With the input of a transdisciplinary team, we have borrowed and applied the methods, tools and terms from various disciplines to measure the effects of environmental exposures on personal and population health outcomes and disparities, many of which may not manifest until many years later. As is customary with a paradigm shift, this approach has far reaching implications for research methods and design, analytics, community engagement strategies, and research training.

Using the surface reflectance MODIS Terra product to estimate turbidity in Tampa Bay, Florida.

Abstract: Turbidity is a commonly-used index of the factors that determine light penetration in the water column. Consistent estimation of turbidity is crucial to design environmental and restoration management plans, to predict fate of possible pollutants, and to estimate sedimentary fluxes into the ocean. Traditional methods monitoring fixed geographical locations at fixed intervals may not be representative of the mean water turbidity in estuaries between intervals, and can be expensive and time consuming. Although remote sensing offers a good solution to this limitation, it is still not widely used due in part to required complex processing of imagery. There are satellite-derived products, including the Moderate Resolution Imaging Spectroradiometer (MODIS) Terra surface reflectance daily product (MOD09GQ) Band 1 (620–670 nm) which are now routinely available at 250 m spatial resolution and corrected for atmospheric effect. This study shows this product to be useful to estimate turbidity in Tampa Bay, Florida, after rainfall events

Fine Particulate Matter and Incident Cognitive Impairment in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Cohort

Studies of the effect of air pollution on cognitive health are often limited to populations living near cities that have air monitoring stations. Little is known about whether the estimates from such studies can be generalized to the U.S. population, or whether the relationship differs between urban and rural areas. To address these questions, we used a satellite-derived estimate of fine particulate matter (PM2.5) concentration to determine whether PM2.5 was associated with incident cognitive impairment in a geographically diverse, biracial US cohort of men and women (n = 20,150). A 1-year mean baseline PM2.5 concentration was estimated for each participant, and cognitive status at the most recent follow-up was assessed over the telephone using the Six-Item Screener (SIS) in a subsample that was cognitively intact at baseline. Logistic regression was used to determine whether PM2.5 was related to the odds of incident cognitive impairment. A 10 µg/m3 increase in PM2.5 concentration was not reliably associated with an increased odds of incident impairment, after adjusting for temperature, season, incident stroke, and length of follow-up [OR (95% CI): 1.26 (0.97, 1.64)]. The odds ratio was attenuated towards 1 after adding demographic covariates, behavioral factors, and known comorbidities of cognitive impairment. A 10 µg/m3 increase in PM2.5 concentration was slightly associated with incident impairment in urban areas (1.40 [1.06–1.85]), but this relationship was also attenuated after including additional covariates in the model. Evidence is lacking that the effect of PM2.5 on incident cognitive impairment is robust in a heterogeneous US cohort, even in urban areas.

Environmental Public Health Applications Using Remotely Sensed Data

We describe a remote sensing and geographic information system (GIS)-based study that has three objectives: (1) characterize fine particulate matter (PM2.5), insolation and land surface temperature (LST) using NASA satellite observations, Environmental Protection Agency (EPA) ground-level monitor data and North American Land Data Assimilation System (NLDAS) data products on a national scale; (2) link these data with public health data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) national cohort study to determine whether these environmental risk factors are related to cognitive decline, stroke and other health outcomes and (3) disseminate the environmental datasets and public health linkage analyses to end users for decision-making through the Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) system. This study directly addresses a public health focus of the NASA Applied Sciences Program, utilization of Earth Sciences products, by addressing issues of environmental health to enhance public health decision-making.

Use of Remotely Sensed Data to Evaluate the Relationship between Living Environment and Blood Pressure

Background Urbanization has been correlated with hypertension (HTN) in developing countries undergoing rapid economic and environmental transitions. Objectives We examined the relationships among living environment (urban, suburban, and rural), day/night land surface temperatures (LST), and blood pressure in selected regions from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Also, the linking of data on blood pressure from REGARDS with National Aeronautics and Space Administration (NASA) science data is relevant to NASA’s strategic goals and missions, particularly as a primary focus of the agency’s Applied Sciences Program. Methods REGARDS is a national cohort of 30,228 people from the 48 contiguous United States with self-reported and measured blood pressure levels. Four metropolitan regions (Philadelphia, PA; Atlanta, GA; Minneapolis, MN; and Chicago, IL) with varying geographic and health characteristics were selected for study. Satellite remotely sensed data were used to characterize the LST and land cover/land use (LCLU) environment for each area. We developed a method for characterizing participants as living in urban, suburban, or rural living environments, using the LCLU data. These data were compiled on a 1-km grid for each region and linked with the REGARDS data via an algorithm using geocoding information. Results REGARDS participants in urban areas have higher systolic and diastolic blood pressure than do those in suburban or rural areas, and also a higher incidence of HTN. In univariate models, living environment is associated with HTN, but after adjustment for known HTN risk factors, the relationship was no longer present. Conclusion Further study regarding the relationship between HTN and living environment should focus on additional environmental characteristics, such as air pollution. The living environment classification method using remotely sensed data has the potential to facilitate additional research linking environmental variables to public health concerns.

Using remote sensing to monitor the influence of river discharge on watershed outlets and adjacent coral Reefs: Magdalena River and Rosario Islands, Colombia

a b s t r a c t Worldwide, coral reef ecosystems are being increasingly threatened by sediments loads from river dis- charges, which in turn are influenced by changing rainfall patterns due to climate change and by growing human activity in their watersheds. In this case study, we explored the applicability of using remote sensing (RS) technology to detect and monitor the relationship between water quality at the coral reefs around the Rosario Islands, in the Caribbean Sea and the rainfall patterns in the Magdalena River water- shed. From the Moderate Resolution Imaging Spectroradiometer (MODIS), this study used the water surface reflectance product (MOD09GQ) to estimate water surface reflectance as a proxy for sediment concentration and the land cover product (MCD12Q1 V51) to characterize land cover of the watershed. Rainfall was estimated by using the 3B43 V7 product from the Tropical Rainforest Measuring Mission (TRMM). For the first trimester of each year, we investigated the inter-annual temporal variation in water surface reflectance at the Rosario Islands and at the three main mouths of the Magdalena River water- shed. No increasing or decreasing trends of water surface reflectance were detected for any of the sites for the study period 2001-2014 (p > 0.05) but significant correlations were detected among the trends of each site at the watershed mouths (r = 0.57-0.90, p < 0.05) and between them and the inter-annual variation in rainfall on the watershed (r = 0.63-0.67, p < 0.05). Those trimesters with above-normal water surface reflectance at the mouths and above-normal rainfall at the watershed coincided with La Ni ˜ na conditions while the opposite was the case during El Niconditions. Although, a preliminary analysis of inter-annual land cover trends found only cropland cover in the watershed to be significantly correlated with water surface reflectance at two of the watershed mouths (r = 0.58 and 0.63, p < 0.05), the validation analysis draw only a 40.7% of accuracy in this land cover classification. This requires further analysis to confirm the impact of the cropland on the water quality at the watershed outlets. Spatial analysis with MOD09GQ imagery detected the overpass of river plumes from Barbacoas Bay over the Rosario Islands waters.

Effects of Spatial and Spectral Resolutions on Fractal Dimensions in Forested Landscapes

Recent work has shown that more research is needed in applying fractal analysis to multi-resolution remote sensing data for landscape characterization. The purpose of this study was to closely examine the impacts that spatial and spectral resolutions have on fractal dimensions using real-world multi-resolution remotely sensed data as opposed to the more conventional single resolution and aggregation approach. The study focused on fractal analysis of forested landscapes in the southeastern United States and Central America. Initially, the effects of spatial resolution on the computed fractal dimensions were examined using data from three instruments with different spatial resolutions. Based on the criteria of mean value and variation within the accepted ranges of fractal dimensions, it was determined that 30-m Landsat TM data were best able to capture the complexity of a forested landscape in Central America compared to 4-m IKONOS data and 250-m MODIS data. Also, among the spectral bands of Landsat TM images of four national forests in the southeastern United States, tests showed that the spatial indices of fractal dimensions are much more distinguishable in the visible bands than they are in the near-mid infrared bands. Thus, based solely on the fractal analysis, the fractal dimensions could have relatively higher chances to distinguish forest characteristics (e.g., stand sizes and species) in the Landsat TM visible wavelength bands than in the near-mid infrared bands. This study has focused on a relative comparison between visible and near-mid infrared wavelength bands; however it will be important to study in the future the effect of a combination of those bands such as the Normalized Difference Vegetation Index (NDVI) on fractal dimensions of forested landscapes.

Short‐ and long‐term sunlight radiation and stroke incidence

Examine whether long‐ and short‐term sunlight radiation is related to stroke incidence.

Relationship Between Watershed Land-Cover/Land-Use Change and Water Turbidity Status of Tampa Bay Major Tributaries, Florida, USA

The extent and change of land cover/land use (LCLU) across the Tampa Bay watershed, Florida, was characterized for the time period between 1996 and 2006. Likewise, the water turbidity trend was determined at a site near the Bay for each of four major tributaries to Tampa Bay (Hillsborough River, the Alafia River, the Little Manatee River, and the Manatee River). This study identifies consistent changes in LCLU across the Tampa Bay watershed and a decrease in water turbidity. LCLU change analysis as a percent of the total Tampa Bay watershed revealed an increase of 2.6% in developed area followed by a 0.9% in bare land and a 0.6% in water cover. A decrease of 1.8% of the total Tampa Bay watershed was found in agriculture, followed in order by 1.1% in wetland and 1.4% in scrub/shrub. Other land classes changed less than 0.2% of the total watershed. A linear mixed model (SAS procedure PROC MIXED) revealed an overall decreasing trend in water turbidity (p = 0.003, slope estimate = −0.02) across the four major Tampa Bay tributaries considered. This study suggests that development (urbanization) could be associated with decreasing water turbidity in Tampa Bay. Finally, although these results may help explain similar effects on other water bodies with similar conditions of adjacent urbanization and low slope, more analysis are needed considering a larger number of watersheds with similar scales and longer time period in order to confirm that the findings of this study are generally evident.

Application of citizen science risk communication tools in a vulnerable urban community

A public participatory geographical information systems (PPGIS) demographic, environmental, socioeconomic, health status portal was developed for the Stambaugh-Elwood (SE) community in Columbus, OH. We hypothesized that soil at SE residences would have metal concentrations above natural background levels. Three aims were developed that allowed testing of this hypothesis. Aim 1 focused on establishing partnerships between academia, state agencies and communities to assist in the development of a community voice. Aim 2 was to design and conduct soil sampling for residents of the SE community. Aim 3 was to utilize our interactive, customized portal as a risk communication tool by allowing residents to educate themselves as to the potential risks from industrial sources in close proximity to their community. Multiple comparisons of means were used to determine differences in soil element concentration by sampling location at p < 0.05. The results demonstrated that eight metals (As, Cd, Cu, Pb, Mo, Se, Tl, Zn) occurred at statistically-significantly greater levels than natural background levels, but most were below risk-based residential soil screening levels. Results were conveyed to residents via an educational, risk-communication informational card. This study demonstrates that community-led coalitions in collaboration with academic teams and state agencies can effectively address environmental concerns.