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Antaya TC, Espino-Alvarado PH, Oiamo T, Wilk P, Speechley KN, Burneo JG. Association of outdoor air and noise pollution with unprovoked seizures and new onset epilepsy: A systematic review and meta-analysis. Epilepsia 2024. [PMID: 38776166 DOI: 10.1111/epi.18010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/24/2024]
Abstract
Research has indicated that certain environmental exposures may increase the risk of unprovoked seizures and new onset epilepsy. This study aimed to synthesize the literature that has estimated the associations between short- and long-term exposure to outdoor air and noise pollution and the risk of unprovoked seizures and new onset epilepsy. We searched Embase, MEDLINE, Scopus, Web of Science, BIOSIS Previews, Latin American and Caribbean Health Sciences Literature, Proquest Dissertations and Theses, conference abstracts, and the gray literature and conducted citation tracing in June 2023. Observational and ecological studies assessing the associations of air and noise pollution with unprovoked seizures or new onset epilepsy were eligible. One reviewer extracted summary data. Using fixed and random effects models, we calculated the pooled risk ratios (RRs) for the studies assessing the associations between short-term exposure to air pollution and unprovoked seizures. Seventeen studies were included, 16 assessing the association of air pollution with seizures and one with epilepsy. Eight studies were pooled quantitatively. Ozone (O3; RR = .99, 95% confidence interval [CI] = .99-.99) and nitrogen dioxide (NO2) exposure adjusted for particulate matter (RR = 1.02, 95% CI = 1.01-1.02) on the same day, and carbon monoxide (CO) exposure 2 days prior (RR = 1.12, 95% CI = 1.02-1.22), were associated with seizure risk. A single study of air pollution and epilepsy did not report a significant association. The risk of bias and heterogeneity across studies was moderate or high. Short-term exposure to O3, NO2, and CO may affect the risk of seizures; however, the effect estimates for O3 and NO2 were minimal. Additional research should continue to explore these and the associations between outdoor air pollution and epilepsy and between noise pollution and seizures and epilepsy.
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Affiliation(s)
- Tresah C Antaya
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Neuroepidemiology Research Unit, Western University, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Poul H Espino-Alvarado
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Tor Oiamo
- Department of Geography and Environmental Studies, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Piotr Wilk
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Paediatrics, Western University, London, Ontario, Canada
| | - Kathy N Speechley
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Paediatrics, Western University, London, Ontario, Canada
| | - Jorge G Burneo
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Neuroepidemiology Research Unit, Western University, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
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Gwenzi W, Marumure J, Makuvara Z, Simbanegavi TT, Njomou-Ngounou EL, Nya EL, Kaetzl K, Noubactep C, Rzymski P. The pit latrine paradox in low-income settings: A sanitation technology of choice or a pollution hotspot? THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 879:163179. [PMID: 37003330 DOI: 10.1016/j.scitotenv.2023.163179] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/04/2023] [Accepted: 03/26/2023] [Indexed: 05/17/2023]
Abstract
Pit latrines are widely promoted to improve sanitation in low-income settings, but their pollution and health risks receive cursory attention. The present narrative review presents the pit latrine paradox; (1) the pit latrine is considered a sanitation technology of choice to safeguard human health, and (2) conversely, pit latrines are pollution and health risk hotspots. Evidence shows that the pit latrine is a 'catch-all' receptacle for household disposal of hazardous waste, including; (1) medical wastes (COVID-19 PPE, pharmaceuticals, placenta, used condoms), (2) pesticides and pesticide containers, (3) menstrual hygiene wastes (e.g., sanitary pads), and (4) electronic wastes (batteries). Pit latrines serve as hotspot reservoirs that receive, harbour, and then transmit the following into the environment; (1) conventional contaminants (nitrates, phosphates, pesticides), (2) emerging contaminants (pharmaceuticals and personal care products, antibiotic resistance), and (3) indicator organisms, and human bacterial and viral pathogens, and disease vectors (rodents, houseflies, bats). As greenhouse gas emission hotspots, pit latrines contribute 3.3 to 9.4 Tg/year of methane, but this could be an under-estimation. Contaminants in pit latrines may migrate into surface water, and groundwater systems serving as drinking water sources and pose human health risks. In turn, this culminates into the pit latrine-groundwater-human continuum or connectivity, mediated via water and contaminant migration. Human health risks of pit latrines, a critique of current evidence, and current and emerging mitigation measures are presented, including isolation distance, hydraulic liners/ barriers, ecological sanitation, and the concept of a circular bioeconomy. Finally, future research directions on the epidemiology and fate of contaminants in pit latrines are presented. The pit latrine paradox is not meant to downplay pit latrines' role or promote open defaecation. Rather, it seeks to stimulate discussion and research to refine the technology to enhance its functionality while mitigating pollution and health risks.
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Affiliation(s)
- Willis Gwenzi
- Grassland Science and Renewable Plant Resources, Faculty of Organic Agricultural Sciences, Universität Kassel, Steinstraße 19, D-37213 Witzenhausen, Germany; Leibniz-Institut für Agrartechnik und Bioökonomie e.V. (ATB), Max-Eyth-Allee 100, 14469 Potsdam, Germany.
| | - Jerikias Marumure
- Department of Physics, Geography and Environmental Sciences, School of Natural Sciences, Great Zimbabwe University, Off Old Great Zimbabwe Road, P.O. Box 1235, Masvingo, Zimbabwe; Department of Life and Consumer Sciences, School of Agriculture and Life Sciences, College of Agriculture and Environmental Sciences, University of South Africa, South Africa
| | - Zakio Makuvara
- Department of Physics, Geography and Environmental Sciences, School of Natural Sciences, Great Zimbabwe University, Off Old Great Zimbabwe Road, P.O. Box 1235, Masvingo, Zimbabwe; Department of Life and Consumer Sciences, School of Agriculture and Life Sciences, College of Agriculture and Environmental Sciences, University of South Africa, South Africa
| | - Tinoziva T Simbanegavi
- Department of Soil Science and Environment, Faculty of Agriculture, Environment, and Food Systems, University of Zimbabwe, Mount Pleasant, Harare P.O. Box MP 167, Zimbabwe
| | | | - Esther Laurentine Nya
- Faculty of Arts, Letters and Social Sciences, University of Maroua, P.O. Box 644, Maroua, Cameroon
| | - Korbinian Kaetzl
- Grassland Science and Renewable Plant Resources, Faculty of Organic Agricultural Sciences, Universität Kassel, Steinstraße 19, D-37213 Witzenhausen, Germany.
| | - Chicgoua Noubactep
- Centre for Modern Indian Studies (CeMIS), University of Göttingen, Waldweg 26, 37073 Göttingen, Germany; Department of Applied Geology, University of Göttingen, Goldschmidtstraße 3, D-37077 Göttingen, Germany; School of Earth Science and Engineering, Hohai University, Fo Cheng Xi Road 8, 211100 Nanjing, PR China.
| | - Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland.
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Lusk JB, Hoffman MN, Clark AG, Bae J, Luedke MW, Hammill BG. Association Between Neighborhood Socioeconomic Status and 30-Day Mortality and Readmission for Patients With Common Neurologic Conditions. Neurology 2023; 100:e1776-e1786. [PMID: 36792379 PMCID: PMC10136022 DOI: 10.1212/wnl.0000000000207094] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 01/10/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Patients of low individual socioeconomic status (SES) are at a greater risk of unfavorable health outcomes. However, the association between neighborhood socioeconomic deprivation and health outcomes for patients with neurologic disorders has not been studied at the population level. Our objective was to determine the association between neighborhood socioeconomic deprivation and 30-day mortality and readmission after hospitalization for various neurologic conditions. METHODS This was a retrospective study of nationwide Medicare claims from 2017 to 2019. We included patients older than 65 years hospitalized for the following broad categories based on diagnosis-related groups (DRGs): multiple sclerosis and cerebellar ataxia (DRG 058-060); stroke (061-072); degenerative nervous system disorders (056-057); epilepsy (100-101); traumatic coma (082-087), and nontraumatic coma (080-081). The exposure of interest was neighborhood SES, measured by the area deprivation index (ADI), which uses socioeconomic indicators, such as educational attainment, unemployment, infrastructure access, and income, to estimate area-level socioeconomic deprivation at the level of census block groups. Patients were grouped into high, middle, and low neighborhood-level SES based on ADI percentiles. Adjustment covariates included age, comorbidity burden, race/ethnicity, individual SES, and sex. RESULTS After exclusions, 905,784 patients were included in the mortality analysis and 915,993 were included in the readmission analysis. After adjustment for age, sex, race/ethnicity, comorbidity burden, and individual SES, patients from low SES neighborhoods had higher 30-day mortality rates compared with patients from high SES neighborhoods for all disease categories except for multiple sclerosis: magnitudes of the effect ranged from an adjusted odds ratio of 2.46 (95% CI 1.60-3.78) for the nontraumatic coma group to 1.23 (95% CI 1.19-1.28) for the stroke group. After adjustment, no significant differences in readmission rates were observed for any of the groups. DISCUSSION Neighborhood SES is strongly associated with 30-day mortality for many common neurologic conditions even after accounting for baseline comorbidity burden and individual SES. Strategies to improve health equity should explicitly consider the effect of neighborhood environments on health outcomes.
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Affiliation(s)
- Jay B Lusk
- From the Duke University School of Medicine (J.B.L., B.G.H.); Duke University Fuqua School of Business (J.B.L.); Duke University Department of Population Health Sciences (M.N.H., A.G.C., B.G.H.); Duke University Health System (J.B.); Duke University Department of Medicine (J.B.); and Duke University Department of Neurology (M.W.L.), Durham, NC
| | - Molly N Hoffman
- From the Duke University School of Medicine (J.B.L., B.G.H.); Duke University Fuqua School of Business (J.B.L.); Duke University Department of Population Health Sciences (M.N.H., A.G.C., B.G.H.); Duke University Health System (J.B.); Duke University Department of Medicine (J.B.); and Duke University Department of Neurology (M.W.L.), Durham, NC
| | - Amy G Clark
- From the Duke University School of Medicine (J.B.L., B.G.H.); Duke University Fuqua School of Business (J.B.L.); Duke University Department of Population Health Sciences (M.N.H., A.G.C., B.G.H.); Duke University Health System (J.B.); Duke University Department of Medicine (J.B.); and Duke University Department of Neurology (M.W.L.), Durham, NC
| | - Jonathan Bae
- From the Duke University School of Medicine (J.B.L., B.G.H.); Duke University Fuqua School of Business (J.B.L.); Duke University Department of Population Health Sciences (M.N.H., A.G.C., B.G.H.); Duke University Health System (J.B.); Duke University Department of Medicine (J.B.); and Duke University Department of Neurology (M.W.L.), Durham, NC
| | - Matthew W Luedke
- From the Duke University School of Medicine (J.B.L., B.G.H.); Duke University Fuqua School of Business (J.B.L.); Duke University Department of Population Health Sciences (M.N.H., A.G.C., B.G.H.); Duke University Health System (J.B.); Duke University Department of Medicine (J.B.); and Duke University Department of Neurology (M.W.L.), Durham, NC
| | - Bradley G Hammill
- From the Duke University School of Medicine (J.B.L., B.G.H.); Duke University Fuqua School of Business (J.B.L.); Duke University Department of Population Health Sciences (M.N.H., A.G.C., B.G.H.); Duke University Health System (J.B.); Duke University Department of Medicine (J.B.); and Duke University Department of Neurology (M.W.L.), Durham, NC.
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SThe Relationship between Environmental Air Pollution, Meteorological Factors, and Emergency Service Admissions for Epileptic Attacks in Children. Epilepsy Res 2022; 187:107026. [DOI: 10.1016/j.eplepsyres.2022.107026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 09/09/2022] [Accepted: 09/22/2022] [Indexed: 11/20/2022]
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Air Pollution and Hospital Admission for Epilepsy in Kerman, Iran. HEALTH SCOPE 2022. [DOI: 10.5812/jhealthscope-124245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: This study aimed to investigate the relation between air pollution and epilepsy admissions in Kerman, Iran. Methods: In this ecological study, the concentrations of ambient air pollutants and meteorological data were obtained from Kerman Environmental Protection Agency and Kerman Meteorology Organization, respectively. Additionally, epilepsy admission data were obtained from Kerman’s Shafa hospital epilepsy registry. Generalized additive models with lags up to 7 days were used to estimate rate ratios (RRs). Results: Within 2008 to 2020, 894 epilepsy admissions occurred in Kerman, 498 cases (55.7%) of whom were male. The strongest relations of epilepsy admission were observed in the over 59-year group for carbon monoxide (CO) in lag 0 (RR = 2.1455, 95% CI: 1.5823 - 2.9091), nitrogen dioxide (NO2) in lag 0 (RR = 1.0409, 95% CI: 1.0282 - 1.0537), and particulate matter under 2.5 microns (PM2.5) in lag 5 (RR = 1.0157, 95% CI: 1.0062 - 1.0252). There were also significant associations for particulate matter under 10 microns (PM10) in the under 18-year group in lag 2 (RR = 1.0064, 95% CI: 1.0029 - 1.0098), ozone in lag 0 (RR = 0.9671, 95% CI: 0.9581 - 0.9761), and sulfur dioxide in lag 5 (RR = 0.9937, 95% CI: 0.9891 - 0.9983). Conclusions: Exposure to CO, NO2, PM2.5, or PM10 air pollutants might be a risk factor for epilepsy admissions in Kerman. Epilepsy patients should better stay away from exposure to polluted air. Staying at home on polluted days or residing in areas with less air pollution might be an option.
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Almetwally AA, Bin-Jumah M, Allam AA. Ambient air pollution and its influence on human health and welfare: an overview. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:24815-24830. [PMID: 32363462 DOI: 10.1007/s11356-020-09042-2] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/23/2020] [Indexed: 05/22/2023]
Abstract
Human health is closely related to his environment. The influence of exposure to air pollutants on human health and well-being has been an interesting subject and gained much volume of research over the last 50 years. In general, polluted air is considered one of the major factors leading to many diseases such as cardiovascular and respiratory disease and lung cancer for the people. Besides, air pollution adversely affects the animals and deteriorates the plant environment. The overarching objective of this review is to explore the previous researches regarding the causes and sources of air pollution, how to control it and its detrimental effects on human health. The definition of air pollution and its sources were introduced extensively. Major air pollutants and their noxious effects were detailed. Detrimental impacts of air pollution on human health and well-being were also presented.
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Affiliation(s)
- Alsaid Ahmed Almetwally
- Textile Engineering Department, Textile Research Division, National Research Centre, Dokki, Cairo, Egypt.
| | - May Bin-Jumah
- Biology Department, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Ahmed A Allam
- Department of Zoology, Faculty of Science, Beni-Suef University, Beni-Suef, 65211, Egypt
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Fernandes MJS, Carletti CO, Sierra de Araújo LF, Santos RC, Reis J. Respiratory gases, air pollution and epilepsy. Rev Neurol (Paris) 2019; 175:604-613. [PMID: 31519304 DOI: 10.1016/j.neurol.2019.07.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 07/21/2019] [Accepted: 07/23/2019] [Indexed: 12/29/2022]
Abstract
A growing number of studies have shown that exposure to air pollutants such as particulate matter and gases can cause cardiovascular, neurodegenerative and psychiatric diseases. The severity of the changes depends on several factors such as exposure time, age and gender. Inflammation has been considered as one of the main factors associated with the generation of these diseases. Here we present some cellular mechanisms activated by air pollution that may represent risk factors for epilepsy and drug resistance associated to epilepsy.
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Affiliation(s)
- M J S Fernandes
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
| | - C O Carletti
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - L F Sierra de Araújo
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - R C Santos
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - J Reis
- Service de Neurologie, Centre Hospitalier Universitaire, Hôpital de Hautepierre, 1, avenue Molière, 67200 Strasbourg, France
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Fluegge K. Structural brain alterations in autism and environmental exposure to nitrous oxide. Epilepsy Behav 2018; 83:247-248. [PMID: 29661644 DOI: 10.1016/j.yebeh.2018.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 03/01/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118, USA.
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Air pollution and Crohn's disease risk. Am J Gastroenterol 2018; 113:915. [PMID: 29686275 DOI: 10.1038/s41395-018-0063-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Fluegge K, Fluegge K. Environmental factors influencing the link between childhood ADHD and risk of adult coronary artery disease. Med Hypotheses 2017; 110:83-85. [PMID: 29317076 DOI: 10.1016/j.mehy.2017.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/14/2017] [Indexed: 01/09/2023]
Abstract
Yorbik et al. reported novel findings regarding a hypothesized relationship between childhood attention-deficit hyperactivity disorder (ADHD) and later risk for coronary heart disease in adulthood. The authors found that mean platelet volume (MPV), a marker of platelet reactivity and a presumable biomarker in patients with cardiovascular disease, was significantly elevated in children with ADHD compared to healthy controls. The mechanistic importance of this novel discovery remains unknown and warrants clarification. We have made the novel proposition that environmental exposure to the agricultural and combustion air pollutant, nitrous oxide (N2O), may be an etiological contributor to neurodevelopmental disorders. Clinical studies suggest that N2O may enhance platelet hyperaggregation, possibly via its biphasic role as an MAO inhibitor especially at trace levels of exposure or via the generation of oxidative stress. Therefore, this correspondence briefly details the hypothesis that altered biochemical profiles in neurodevelopmental disorders, derived from chronic environmental exposure to the agricultural and combustion air pollutant, N2O, may promote coronary artery disease in adulthood.
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Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118, USA.
| | - Kyle Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118, USA; New York City Department of Health and Mental Hygiene, New York 11101-4132 USA
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Fluegge K, Fluegge K. Use of anthropogenic nitrogen fertilizers in agriculture is associated with per capita ethanol consumption. Med Hypotheses 2017; 107:65-71. [PMID: 28915966 DOI: 10.1016/j.mehy.2017.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 07/13/2017] [Accepted: 07/19/2017] [Indexed: 10/19/2022]
Abstract
It has previously been demonstrated that emissions of the agricultural pollutant, nitrous oxide (N2O), may be a confounder to the relationship between herbicide use and psychiatric impairments, including ADHD. This report attempts to extend this hypothesis by testing whether annual use of anthropogenic nitrogen-based fertilizers in U.S. agriculture (thought to be the most reliable indicator of environmental N2O emissions) is associated with per capita ethanol consumption patterns, a behavior often comorbid with ADHD. State estimates of anthropogenic nitrogen fertilizers from the United States Geological Survey (USGS) were obtained for the years between 1987 and 2006. Our dependent variable was annual per capita ethanol consumption. Ethanol consumption was categorized as beer, wine, spirits, and all alcoholic beverages. Least squares dummy variable method using two-ways fixed effects was utilized. Among states above the 50th percentile in farm use of anthropogenic nitrogen for all years (i.e., agricultural states), a one log-unit increase in farm use of anthropogenic nitrogen fertilizers is associated with a 0.13 gallon increase in total per capita ethanol consumption (p<0.0125). No statistically significant association between farm use of anthropogenic nitrogen and per capita ethanol consumption was found in states below the 50th percentile in farm use of anthropogenic nitrogen. The new findings are in agreement with both behavioral human studies demonstrating a link between N2O preference and alcohol and drug use history as well as molecular studies elucidating shared mechanisms between trace N2O antinociception and alcohol-seeking related behaviors.
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Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118, USA.
| | - Kyle Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118, USA; New York City Department of Health and Mental Hygiene, New York 11101-4132, USA
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