Linking exposure assessment science with policy objectives for environmental justice and breast cancer advocacy: the northern California household exposure study

Participant perspectives related to individual chemical exposure report-back approaches in three environmental health studies

Returning results to participants of environmental exposure studies has become more common in recent years. Despite evidence of benefits for study participants, there are challenges in communicating results to people with limited resources or capacity to mitigate chemical exposures. We interviewed N = 54 participants and compared exposure report-back conducted in 2010-2013 across three susceptible study populations: 1) low-income pregnant individuals in the Chemicals in Our Bodies (CIOB) study; 2) the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) cohort; and 3) early childhood educators (ECE). Report-back differed between the cross-sectional studies (CIOB and ECE), which offered an opportunity to consult with research staff by phone or email, and the prospective cohort study (CHAMACOS), which allowed for participants to discuss individual and group-level results directly with researchers at a community meeting. Participants in all three studies were motivated to participate by children's health and wanted more information about health implications and exposure reduction strategies, with cost and limited resources cited as common barriers to change. We observed overall positive experiences with report-back across studies, with improved environmental health literacy and constructive learning experiences that were most evident in CHAMACOS. While many noted individual actions they had made or intended to make to reduce exposures, CHAMACOS participants were more likely to mention systems-level changes achieved through actions such as contacting decision-makers and raising community awareness. Our findings suggest that researchers may have a unique opportunity to support environmental health literacy and informed action at both the individual and community or policy levels through long-term study engagement, various forms of direct consultation with study participants, and thoughtful report-back methods that leverage existing tools and are sensitive to barriers faced by specific study populations. This work informs best practices for communicating chemical exposure results among sensitive or highly exposed communities.

A machine learning interpretation of the correlation between poverty and air pollution in the contiguous United States

The correlation between poverty and air pollution in the contiguous United States is a widely debated issue, often suggesting that impoverished areas suffer higher pollution levels due to socioeconomic disparities. However, existing studies frequently lack the integration of advanced analytical techniques and fail to account for a comprehensive range of variables. This research paper addresses these gaps by employing sophisticated machine learning models to analyze an extensive dataset encompassing various socioeconomic and environmental metrics. Utilizing linear regression, decision trees, and neural networks, we rigorously examined the data. While the variables were able to predict county-wide poverty rates to reasonably low RMSE and MAE values, our results indicate no significant correlation between poverty levels alone with air pollution indices. The latter finding challenges conventional understanding and highlights the complexity of the relationship between socioeconomic status and environmental quality. By offering a data-driven perspective, our study encourages policymakers to reconsider the factors influencing environmental justice and to look beyond economic status alone. Our work underscores the necessity for further investigation into other potential determinants of pollution, contributing to the discourse on environmental equity. This research provides a fresh, nuanced view that questions established beliefs and underscores the multifaceted nature of socioeconomic-environmental interactions.

Ethical, Legal, and Social Implications of Gene-Environment Interaction Research

Many complex disorders are impacted by the interplay of genetic and environmental factors. In gene-environment interactions (GxE), an individual's genetic and epigenetic makeup impacts the response to environmental exposures. Understanding GxE can impact health at the individual, community, and population levels. The rapid expansion of GxE research in biomedical studies for complex diseases raises many unique ethical, legal, and social implications (ELSIs) that have not been extensively explored and addressed. This review article builds on discussions originating from a workshop held by the National Institute of Environmental Health Sciences (NIEHS) and the National Human Genome Research Institute (NHGRI) in January 2022, entitled: "Ethical, Legal, and Social Implications of Gene-Environment Interaction Research." We expand upon multiple key themes to inform broad recommendations and general guidance for addressing some of the most unique and challenging ELSI in GxE research. Key takeaways include strategies and approaches for establishing sustainable community partnerships, incorporating social determinants of health and environmental justice considerations into GxE research, effectively communicating and translating GxE findings, and addressing privacy and discrimination concerns in all GxE research going forward. Additional guidelines, resources, approaches, training, and capacity building are required to further support innovative GxE research and multidisciplinary GxE research teams.

Environmental Health Assessment by Local Environmental Justice Experts for Evidence-based Decision-making in an Agricultural Community of Northern California

Environmental justice research driven by academics and policymakers often overlooks the valuable insights and leadership of the communities most impacted by environmental hazards. When institution-led research approaches are employed, inadequate community ownership and limited institutional accountability hinder the effectiveness of environmental public health interventions. In contrast, a community-owned and -managed approach to environmental justice research can guide community members in developing evidence-based interventions. This paper outlines a community-led environmental health assessment survey (sample= 100) and resulting community actions over six years (2017 to 2023) in a Northern California farmworker community with a perceived high prevalence of cancer and exposure to environmental hazards in households, neighborhoods, and job sites. Local resident experts in Knights Landing, CA, documented community risk factors and exposures in collaboration with interdisciplinary undergraduate and graduate student-researchers. The survey instrument focused on environmental hazards identified by local resident experts including vehicular and agricultural pollution, occupational pesticide contact, and sun exposure. Survey findings highlighted the need for targeted interventions to reduce environmental health risks, such as academic outreach programs, county investments in public services, and community-led mutual aid initiatives. Despite academic reservations about our non-random sampling method and data collection by local resident experts, our project sparked substantial actions and investments with minimal personnel and financial resources. Local leaders working with student-researchers developed more effective environmental public health interventions through a community-owned and -managed approach that went beyond the efforts of local regulatory and research institutions.

Economic Determinants of Health Disparities and the Role of the Primary Care Provider

The economic determinants of adverse personal health outcomes and population level disparities pose a daunting challenge for primary care providers in promoting health for persons experiencing poverty and neighborhood deprivation. Until they are addressed, however, the health and economic well-being of persons experiencing neighborhood deprivation is not likely to be improved. There is growing evidence of effective interventions that primary care providers can adopt to address social and economic determinants of health. Primary care providers can participate in clinic and community-based approaches that target individual, neighborhood and social level drives of health and disparities.

Moving Forward with Reporting Back Individual Environmental Health Research Results

BACKGROUND

The practice of reporting back individual results to participants in environmental health research has evolved significantly over the past 20 years. Research findings support the potential of report-back to enhance the ethics, quality, and impact of environmental health research. Nonetheless, implementation of environmental health report-back practices is not yet routine.

OBJECTIVES

We propose a framework for institutionalizing appropriate report-back to participants of their individual results across the environmental health research enterprise. We provide a brief overview of the rationales for report-back, social science research on report-back experiences over the past two decades, and recent efforts to synthesize guidance in this field. We also describe barriers to be addressed in moving toward widespread implementation of report-back.

DISCUSSION

Report-back of individual results is increasingly recognized as an ethical responsibility and essential component of impactful environmental health research. Experience shows that when personal results are returned with appropriate contextual information, report-back can increase environmental health literacy, promote individual actions, and enhance engagement in policy change. Therefore, report-back can promote environmental justice and reduce disparities in access to science. Despite this evidence base, report-back is not widely implemented. We recommend the collaborative development of guidelines, training, and resources to build capacity for appropriate report-back to study participants across the environmental health research enterprise, and we identify research priorities to advance the field. Development of tools and shared infrastructure for report-back holds promise for reducing barriers while ensuring high-quality personalized reports. Disseminating successful case studies could also advance excellence. We recommend including diverse scientific disciplines, community partners, representatives of study populations, clinicians, institutional review boards (IRBs), legal experts, public health professionals, and government officials in further developing this critical aspect of environmental health research. https://doi.org/10.1289/EHP12463.

The Effect of Individual or Study-Wide Report-Back on Knowledge, Concern, and Exposure-Reducing Behaviors Related to Endocrine-Disrupting Chemicals

BACKGROUND

To make informed decisions about endocrine-disrupting chemicals (EDCs), people need functional understanding of exposures and health and an ability to act on their knowledge. The return of biomonitoring results is an opportunity to educate people about EDCs and motivate exposure reduction.

OBJECTIVES

This study investigates environmental health knowledge about EDCs, concerns about health effects, and exposure-reducing behaviors before and after the return of individual-level exposure results or only study-wide results.

METHODS

Women in the Child Health and Development Studies who were biomonitored for 42 EDCs were randomly assigned to receive a report with personal chemical results or only study-wide findings. We interviewed participants before and after report-back about their knowledge and concerns about EDCs and how frequently they performed exposure-related behaviors. We investigated baseline differences by education and race and examined changes after report-back by race and report type.

RESULTS

Participants (n = 135 ) demonstrated general understanding of exposure pathways and health impacts of EDCs. For 9 out of 20 knowledge questions, more than 90% of participants (n ≥ 124 ) gave correct responses at baseline, including for questions about chemicals' persistence in the body and effects of early-life exposure. Most participants held two misconceptions-about chemical safety testing in the United States and what doctors can infer from EDC results-although errors decreased after report-back. Initially, concern was higher for legacy pollutants, but report-back increased concern for consumer product chemicals. After report-back, participants took some actions to reduce exposures, particularly to per- and polyfluoroalkyl substances, and total behavior was associated with knowledge and concern but not race, education, or report type.

DISCUSSION

This study demonstrated that participants had foundational knowledge about EDCs and that report-back further built their environmental health literacy. We conclude that future communications should target misconceptions about chemicals regulation in the United States, because information about regulations is crucial for people to evaluate risks posed by consumer product chemicals and decide whether to engage with public policy. https://doi.org/10.1289/EHP12565.

Occurrence and Risk Assessment of Personal PM2.5-Bound Phthalates Exposure for Adults in Hong Kong

We performed personal PM_2.5 monitoring involving 56 adult residents in Hong Kong. Additionally, paired personal and residential indoor fine particle (PM_2.5) samples were collected from 26 homes and from 3 fixed monitoring locations (i.e., outdoor samples). Six PM_2.5-bound phthalate esters (PAEs)-including dimethyl phthalate (DMP), diethyl phthalate (DEP), di-n-butyl phthalate (DnBP), butyl benzyl phthalate (BBP), di(2-ethylhexyl) phthalate (DEHP), and di-n-octyl phthalate (DnOP)-were measured using a thermal desorption-gas chromatography/mass spectrometer method. Average ∑₆PAEs (i.e., summation of six PAE congeners) concentrations in personal PM_2.5 exposure (699.4 ng/m³) were comparable with those in residential indoors (646.9 ng/m³), and both were slightly lower than the outdoor levels. DEHP was the most abundant PAE congener (80.3%-85.0%) and found at the highest levels in different exposure categories, followed by BBP, DnBP, and DnOP. Strong correlations were observed between DEHP with DnBP (r_s: 0.81-0.90; p < 0.01), BBP (r_s: 0.81-0.90; p < 0.01), and DnOP (r_s: 0.87-0.93; p < 0.01) in each exposure category. However, no apparent intercorrelations were shown for PAE congeners. Higher indoor concentrations and a stronger correlation between DMP and DEP were found compared with outdoor concentrations. Principal component analysis affirmed heterogeneous distribution and notable variations in PAE sources across different exposure categories. The average daily intakes of ∑₆PAEs and DEHP via inhalation were 0.14-0.17 and 0.12-0.16 μg/kg-day for adults in Hong Kong. A time-weighted model was used to estimate PAE exposures incorporating residential indoor and outdoor exposure and time activities. The inhalation cancer risks attributable to measured and estimated personal exposure to DEHP exceeded the U.S. EPA's benchmark (1 × 10^-6). The results provide critical information for mitigation strategies, suggesting that PAEs from both ambient and indoor sources should be considered when exploring the inhalation health risks of PAEs exposure.

Engaging communities in addressing air quality: a scoping review

BACKGROUND

Exposure to air pollution has a detrimental effect on health and disproportionately affects people living in socio-economically disadvantaged areas. Engaging with communities to identify concerns and solutions could support organisations responsible for air quality control, improve environmental decision-making, and widen understanding of air quality issues associated with health. This scoping review aimed to provide an overview of approaches used to engage communities in addressing air quality and identify the outcomes that have been achieved.

METHODS

Searches for studies that described community engagement in air quality activities were conducted across five databases (Academic Search Complete, CABI, GreenFILE, MEDLINE, Web of Science). Data on study characteristics, community engagement approach, and relevant outcomes were extracted. The review process was informed by a multi-stakeholder group with an interest in and experience of community engagement in air quality. Thirty-nine papers from thirty studies were included in the final synthesis.

CONCLUSION

A range of approaches have been used to engage communities in addressing air quality, most notably air quality monitoring. Positive outcomes included increased awareness, capacity building, and changes to organisational policy and practice. Longer-term projects and further exploration of the impact of community engagement on improving air quality and health are needed as reporting on these outcomes was limited.

Air pollution exposure assessment at schools and playgrounds in Williamsburg Brooklyn NYC, with a view to developing a set of policy solutions

Community science offers unique opportunities for non-professional involvement of volunteers in the scientific process, not just during the data acquisition, but also in other phases, like problem definition, quality assurance, data analysis and interpretation, and the dissemination of results. Moreover, community science can be a powerful tool for public engagement and empowerment during policy formulation. This paper aims to present a pilot study on personal exposure to fine particulate matter (PM2.5) and raises awareness of the hazards of air pollution. As part of data acquisition conducted in 2019, high school students gathered data at their schools, schoolyards, and playgrounds using low-cost monitors AirBeam2. The data was automatically uploaded every second onto the AirCasting mobile app. Besides, a stationary network of air monitors (fixed stations) was deployed in the neighborhood to collect real-time ambient air concentrations of PM2.5. Students involved in the project attended workshops, training sessions, and researched to better understand air pollution, as part of their science class curriculum and portfolio. This air quality monitoring was incorporated into the "Our Air/Nuestro Aire" - El Puente grassroots campaign. The main goals of this campaign included sharing the data collected with the community, engaging academic partners to develop a set of policy and urban design solutions, and to be considered into a 5-point policy platform.

Exposure monitoring toward environmental justice

Executive Order 14008, signed on 27 January 2021, established environmental justice (EJ) as a core priority of the Biden Administration. There is a need for state and federal regulators, as well as industry, to enhance risk assessment methods and exposure monitoring approaches to be more inclusive of EJ community involvement and more representative of EJ community exposures. Cumulative risk assessment models are critical for understanding the unique interaction between chemical exposures and nonchemical stressors that EJ communities encounter daily. Enhanced environmental monitoring with personal and portable sensors, especially when deployed using community partnerships, can capture chemical exposures with sufficient resolution to characterize exposures down to the neighborhood level. Use of internet-linked sensors will also require thoughtful advances in management of big data to inform meaningful and time-sensitive decisions. Integr Environ Assess Manag 2022;18:858-862. © 2021 SETAC.

Selecting Data Analytic and Modeling Methods to Support Air Pollution and Environmental Justice Investigations: A Critical Review and Guidance Framework

Given the serious adverse health effects associated with many pollutants, and the inequitable distribution of these effects between socioeconomic groups, air pollution is often a focus of environmental justice (EJ) research. However, EJ analyses that aim to illuminate whether and how air pollution hazards are inequitably distributed may present a unique set of requirements for estimating pollutant concentrations compared to other air quality applications. Here, we perform a scoping review of the range of data analytic and modeling methods applied in past studies of air pollution and environmental injustice and develop a guidance framework for selecting between them given the purpose of analysis, users, and resources available. We include proxy, monitor-based, statistical, and process-based methods. Upon critically synthesizing the literature, we identify four main dimensions to inform method selection: accuracy, interpretability, spatiotemporal features of the method, and usability of the method. We illustrate the guidance framework with case studies from the literature. Future research in this area includes an exploration of increasing data availability, advanced statistical methods, and the importance of science-based policy.

Outcomes from Returning Individual versus Only Study-Wide Biomonitoring Results in an Environmental Exposure Study Using the Digital Exposure Report-Back Interface (DERBI)

BACKGROUND

Study participants want to receive their biomonitoring results for environmental chemicals, and ethics guidelines encourage reporting back. However, few studies have quantitively assessed participants' responses to individual exposure reports, and digital methods have not been evaluated.

OBJECTIVES

We isolated effects of receiving personal results vs. only study-wide findings and investigated whether effects differed for Black participants.

METHODS

We randomly assigned a subset of 295 women from the Child Health and Development Studies, half of whom were Black, to receive a report with personal environmental chemical results or only study-wide (aggregate) findings. Reports included results for 42 chemicals and lipids and were prepared using the Digital Exposure Report-Back Interface (DERBI). Women were interviewed before and after viewing their report. We analyzed differences in website activity, emotional responses, and intentions to participate in future research by report type and race using Wilcoxon rank sum tests, Wilcoxon-Pratt signed ranks tests, and multiple regression.

RESULTS

The personal report group spent approximately twice as much time on their reports as the aggregate group before the post-report-back interview. Among personal-report participants (n=93), 84% (78) viewed chemical group information for at least one personal result highlighted on their home page; among aggregate-report participants (n=94), 66% (62) viewed any chemical group page. Both groups reported strong positive feelings (curious, informed, interested, respected) about receiving results before and after report-back and mild negative feelings (helpless, scared, worried). Although most participants remained unworried after report-back, worry increased by a small amount in both groups. Among Black participants, higher post report-back worry was associated with having high levels of chemicals.

CONCLUSIONS

Participants were motivated by their personal results to access online information about chemical sources and potential health effects. Report-back was associated with a small increase in worry, which could motivate appropriate action. Personal report-back increased engagement with exposure reports among Black participants. https://doi.org/10.1289/EHP9072.

Interdisciplinary community-based participatory health research across the industrial region of the Étang de Berre : The EPSEAL Fos Crau study

BACKGROUND

We conducted a community-based participatory environmental health study in three towns: two in the heart of Marseille's industrial zone (Fos-sur-Mer and Port-Saint-Louis-du-Rhône), and one on the periphery located about 30 km away (Saint-Martin-de-Crau).

METHODS

We first conducted a cross-sectional survey of a random sample of residents in each of the three towns. We asked study participants to self-report a wide variety of health issues (Port-Saint-Louis: n = 272, Fos-sur-Mer: n = 543, Saint-Martin-de-Crau: n = 439). We then conducted focus groups with residents and other stakeholders to share preliminary data in order to propose areas of reflection and collaboratively produce contextually-situated knowledge of their health and environment. We directly standardized the prevalences (by age and gender) to the French metropolitan population to make our results more comparable.

RESULTS

Study participants who lived closer to the core industrial zone (residents of Fos-sur-Mer and Port-Saint-Louis-du-Rhone) had higher prevalences of eye irritation, nose and throat problems, chronic skin problems and headaches than people who lived further away (residents of Saint-Martin-de-Crau). Residents also offered diverse qualitative insights about their environment and health experiences.

DISCUSSION

We observed elevated prevalences of diseases that affected residents across the industrial zone (Fos-sur-Mer and Port-Saint-Louis-du-Rhône) compared to those living outside (Saint-Martin-de-Crau), and qualitative evidence of how residents made sense of their health experiences strengthening an understanding of their own empirical observations which helps to produce knowledge about health in an industrial context. The results of the workshops show an important benefit from the co-production of local knowledge.

CONCLUSION

We encourage future researchers to do in-depth, community-based research to comprehensively describe the health of residents in other heavily polluted zones, product local knowledge and to help identify policy solutions, engender trust among the local people, and identify opportunities for intervention.

Spatial Distribution of Polycyclic Aromatic Hydrocarbon Contaminants after Hurricane Harvey in a Houston Neighborhood

BACKGROUND

Hurricane Harvey made landfall along the Texas Gulf Coast as a Category 4 hurricane on August 25, 2017, producing unprecedented precipitation that devastated coastal areas. Catastrophic flooding in the City of Houston inundated industrial and residential properties resulting in the displacement and transfer of soil, sediment, and debris and heightening existing environmental justice (EJ) concerns.

OBJECTIVES

The primary aim of this study was to evaluate the presence, distribution, and potential human health implications of polycyclic aromatic hydrocarbons (PAHs) in a residential neighborhood of Houston, Texas following a major hurricane.

METHODS

Concentrations of PAHs in 40 soil samples collected from a residential neighborhood in Houston, Texas were measured. Spatial interpolation was applied to determine the distribution of PAHs. Potential human health risks were evaluated by calculating toxicity equivalency quotients (TEQs) and incremental excess lifetime cancer risk (IELCR).

RESULTS

Total priority PAH concentrations varied across samples (range: 9.7 × 10¹ ng/g-1.6 × 10⁴ ng/g; mean: 3.0 × 10³ ng/g ± 3.6 × 10³ standard deviation). Spatial analysis indicated a variable distribution of PAH constituents and concentrations. The IELCR analysis indicated that nine of the 40 samples were above minimum standards.

CONCLUSIONS

Findings from this study highlight the need for fine scale soil testing in residential areas as well as the importance of site-specific risk assessment.

COMPETING INTERESTS

The authors declare no competing financial interests.

Ten questions concerning occupant health in buildings during normal operations and extreme events including the COVID-19 pandemic

Even before the COVID-19 pandemic, people spent on average around 90% of their time indoors. Now more than ever, with work-from-home orders in place, it is crucial that we radically rethink the design and operation of buildings. Indoor Environmental Quality (IEQ) directly affects the comfort and well-being of occupants. When IEQ is compromised, occupants are at increased risk for many diseases that are exacerbated by both social and economic forces. In the U.S. alone, the annual cost attributed to sick building syndrome in commercial workplaces is estimated to be between $10 billion to $70 billion. It is imperative to understand how parameters that drive IEQ can be designed properly and how buildings can be operated to provide ideal IEQ to safeguard health. While IEQ is a fertile area of scholarship, there is a pressing need for a systematic understanding of how IEQ factors impact occupant health. During extreme events, such as a global pandemic, designers, facility managers, and occupants need pragmatic guidance on reducing health risks in buildings. This paper answers ten questions that explore the effects of buildings on the health of occupants. The study establishes a foundation for future work and provides insights for new research directions and discoveries.

"Freedom to Breathe": Youth Participatory Action Research (YPAR) to Investigate Air Pollution Inequities in Richmond, CA

Air pollution is a major contributor to human morbidity and mortality, potentially exacerbated by COVID-19, and a threat to planetary health. Participatory research, with a structural violence framework, illuminates exposure inequities and refines mitigation strategies. Home to profitable oil and shipping industries, several census tracts in Richmond, CA are among the most heavily impacted by aggregate burdens statewide. Formally trained researchers from the Center for Environmental Research and Children's Health (CERCH) partnered with the RYSE youth justice center to conduct youth participatory action research on air quality justice. Staff engaged five youth researchers in: (1) collaborative research using a network of passive air monitors to quantify neighborhood disparities in nitrogen dioxide (NO2) and sulfur dioxide (SO2), noise pollution and community risk factors; (2) training in environmental health literacy and professional development; and (3) interpretation of findings, community outreach and advocacy. Inequities in ambient NO2, but not SO2, were observed. Census tracts with higher Black populations had the highest NO2. Proximity to railroads and major roadways were associated with higher NO2. Greenspace was associated with lower NO2, suggesting investment may be conducive to improved air quality, among many additional benefits. Youth improved in measures of empowerment, and advanced community education via workshops, Photovoice, video, and "zines".

Relationship between particulate matter exposure and female breast cancer incidence and mortality: a systematic review and meta-analysis

OBJECTIVES

The associations of PM with the risk and prognosis of breast cancer have not been determined. This systematic review aimed to provide an updated understanding of the relationship between PM exposure level and breast cancer incidence and mortality.

METHODS

Articles from Web of Science and PubMed databases were methodically inspected until March 8, 2020. In final, 15 studies were kept for analysis, which provided necessary information to estimate the impact of PM on breast cancer risk and prognosis. These studies were combined for quantitative analyses to evaluate the effect of per 10 μg /m³ increment exposure of PM_2.5 (< 2.5 μm in aerodynamic diameter) and PM₁₀ (< 10 μm in aerodynamic diameter) using random-effects model.

RESULTS

PM_2.5 exposure was associated with increased breast cancer mortality (relative risk [RR] = 1.09; 95% confidence interval [CI]: 1.02, 1.16; P_Q-test = 0.158). No association of PM_2.5 (1.02; 0.97, 1.18; 0.308) and PM₁₀ (1.03; 0.98, 1.09; 0.009) with the increase incidence of breast cancer was observed. Stratified analysis suggested that PM_2.5 was associated with the increase mortality of breast cancer (1.10; 1.03, 1.17; 0.529) in subgroup of developed country. PM₁₀ was associated with breast cancer incidence based on studies published after 2017 (1.08; 1.00, 1.15; 0.157) and European studies (1.15; 1.06, 1.25; 0.502).

CONCLUSIONS

Our study indicated that PM_2.5 exposure was related to breast cancer mortality. Further researches in this field are needed to validate the conclusion.

Photopaper as a Tool for Community-Level Monitoring of Industrially Produced Hydrogen Sulfide and Corrosion

Scientific instrumentation driven by academic, military, and industrial applications tends to be high cost, designed for expert use, and "black boxed". Community-led citizen science (CLCS) is creating different research instruments with different measurement goals and processes. This paper identifies four design attributes for CLCS tools: affordability, accessibility, builds community efficacy and provides actionable data through validating a community method for monitoring the neurotoxic and corrosive gas Hydrogen Sulfide (H2S). For $1 per sample, the semi-quantitative method provides an affordable and easily interpretable data for communities to compare H2S concentrations and silver corrosion in their home environments to those in a major municipal sewage treatment plant. H2S is a leading cause of workplace injury in the U.S. and commonly found in oil and gas production, sewage treatment plants, and concentrated animal feeding operations (CAFOs). Communities neighboring such sources tend to be socio-economically marginalized with little access to scientific or political resources. Consequently, health risks and material degradation from corrosion are well studied in workplaces while community exposures are under-studied. Existing commercial H2S detection methods are prohibitively expensive for low-income communities and often require the support of professional scientists. This paper describes a simple and inexpensive semi-quantitative H2S measurement method that uses photopaper. Photopaper passively measures H2S as its silver halide layer linearly reacts with H2S between concentrations of 60 ppb to 1 ppm, discoloring the paper from white to brown. We develop a colorimetric scale for this discoloration for visual estimation of H2S concentration and overall corrosion. The scale is based on comparing silver sulfide (Ag2S) measured by Purafil Corrosion Classification Coupons (CCCs) and H2S concentrations measured with the industry standard tool a Jerome Meter to silver and sulfur bound to the photopaper as measured with X-Ray Fluorescence (XRF). We conduct our validation studies in a major municipal sewage treatment plant to provide real-world occupational benchmarks for comparison to community results. This community science method is affordable, accessible, designed to build collective efficacy and to create actionable data to flag the need for follow-up research.

Privacy Risks of Sharing Data from Environmental Health Studies

BACKGROUND

Sharing research data uses resources effectively; enables large, diverse data sets; and supports rigor and reproducibility. However, sharing such data increases privacy risks for participants who may be re-identified by linking study data to outside data sets. These risks have been investigated for genetic and medical records but rarely for environmental data.

OBJECTIVES

We evaluated how data in environmental health (EH) studies may be vulnerable to linkage and we investigated, in a case study, whether environmental measurements could contribute to inferring latent categories (e.g., geographic location), which increases privacy risks.

METHODS

We identified 12 prominent EH studies, reviewed the data types collected, and evaluated the availability of outside data sets that overlap with study data. With data from the Household Exposure Study in California and Massachusetts and the Green Housing Study in Boston, Massachusetts, and Cincinnati, Ohio, we used k-means clustering and principal component analysis to investigate whether participants' region of residence could be inferred from measurements of chemicals in household air and dust.

RESULTS

All 12 studies included at least two of five data types that overlap with outside data sets: geographic location (9 studies), medical data (9 studies), occupation (10 studies), housing characteristics (10 studies), and genetic data (7 studies). In our cluster analysis, participants' region of residence could be inferred with 80%-98% accuracy using environmental measurements with original laboratory reporting limits.

DISCUSSION

EH studies frequently include data that are vulnerable to linkage with voter lists, tax and real estate data, professional licensing lists, and ancestry websites, and exposure measurements may be used to identify subgroup membership, increasing likelihood of linkage. Thus, unsupervised sharing of EH research data potentially raises substantial privacy risks. Empirical research can help characterize risks and evaluate technical solutions. Our findings reinforce the need for legal and policy protections to shield participants from potential harms of re-identification from data sharing. https://doi.org/10.1289/EHP4817.

Promoting Scientist-Advocate Collaborations in Cancer Research: Why and How

Advocates bring unique and important viewpoints to the cancer research process, ensuring that scientific and medical advances are patient-centered and relevant. In this article, we discuss the benefits of engaging advocates in cancer research and underscore ways in which both the scientific and patient communities can facilitate this mutually beneficial collaboration. We discuss how to establish and nurture successful scientist-advocate relationships throughout the research process. We review opportunities that are available to advocates who want to obtain training in the evaluation of cancer research. We also suggest practical solutions that can strengthen communication between scientists and advocates, such as introducing scientist-advocate interactions at the trainee level. Finally, we highlight the essential role social media can play in disseminating patient-supported cancer research findings to the patient community and in raising awareness of the importance of promoting cancer research. Our perspective offers a model that Georgetown Breast Cancer Advocates have found effective and which could be one option for those interested in developing productive, successful, and sustainable collaborations between advocates and scientists in cancer research. Cancer Res; 78(20); 5723-8. ©2018 AACR.

Community-based participatory research for the study of air pollution: a review of motivations, approaches, and outcomes

Neighborhood level air pollution represents a long-standing issue for many communities that, until recently, has been difficult to address due to the cost of equipment and lack of related expertise. Changes in available technology and subsequent increases in community-based participatory research (CBPR) have drastically improved the ability to address this issue. However, much still needs to be learned as these types of studies are expected to increase in the future. To assist, we review the literature in an effort to improve understanding of the motivations, approaches, and outcomes of air monitoring studies that incorporate CBPR and citizen science (CS) principles. We found that the primary motivations for conducting community-based air monitoring were concerns for air pollution health risks, residing near potential pollution sources, urban sprawl, living in "unmonitored" areas, and a general quest for improved air quality knowledge. Studies were mainly conducted using community led partnerships. Fixed site monitoring was primarily used, while mobile, personal, school-based, and occupational sampling approaches were less frequent. Low-cost sensors can enable thorough neighborhood level characterization; however, keeping the community involved at every step, understanding the limitations and benefits of this type of monitoring, recognizing potential areas of debate, and addressing study challenges are vital for achieving harmony between expected and observed study outcomes. Future directions include assessing currently unregulated pollutants, establishing long-term neighborhood monitoring sites, performing saturation studies, evaluating interventions, and creating CS databases.

Short-term exposure to PM2.5 and vanadium and changes in asthma gene DNA methylation and lung function decrements among urban children

Background

Both short and long-term exposure to traffic-related air pollutants have been associated with asthma and reduced lung function. We hypothesized that short-term indoor exposure to fine particulate matter <2.5 μm (PM_2.5) and vanadium (V) would be associated with altered buccal cell DNA methylation of targeted asthma genes and decreased lung function among urban children in a nested subcohort of African American and Dominican children.

Methods

Six day integrated levels of air pollutants were measured from children’s homes (age 9–14; n = 163), repeated 6 months later (n = 98). Buccal samples were collected repeatedly during visits. CpG promoter loci of asthma genes (i.e., interleukin 4 (IL4), interferon gamma (IFNγ), inducible nitric oxide synthase (NOS2A), arginase 2 (ARG2)) were pyrosequenced and lung function was assessed.

Results

Exposure to V, but not PM_2.5, was associated with lower DNA methylation of IL4 and IFNγ. In exploratory analyses, V levels were associated with lower methylation of the proinflammatory NOS2A-CpG⁺⁵⁰⁹⁹ among asthmatic overweight or obese children but not nonasthmatics. Short-term exposure to PM_2.5, but not V, appeared associated with lower lung function (i.e., reduced z-scores for forced expiratory volume in one second (FEV₁, FEV₁/ forced vital capacity [FEV₁/FVC] and forced expiratory flow at 25–75% of FVC [FEF_25–75]).

Conclusions

Exposure to V was associated with altered DNA methylation of allergic and proinflammatory asthma genes implicated in air pollution related asthma. However, short-term exposure to PM_2.5, but not V, appeared associated with decrements in lung function among urban children.

Electronic supplementary material

The online version of this article (doi:10.1186/s12931-017-0550-9) contains supplementary material, which is available to authorized users.

DERBI: A Digital Method to Help Researchers Offer "Right-to-Know" Personal Exposure Results

Researchers and clinicians in environmental health and medicine increasingly show respect for participants and patients by involving them in decision-making. In this context, the return of personal results to study participants is becoming ethical best practice, and many participants now expect to see their data. However, researchers often lack the time and expertise required for report-back, especially as studies measure greater numbers of analytes, including many without clear health guidelines. In this article, our goal is to demonstrate how a prototype digital method, the Digital Exposure Report-Back Interface (DERBI), can reduce practical barriers to high-quality report-back. DERBI uses decision rules to automate the production of personalized summaries of notable results and generates graphs of individual results with comparisons to the study group and benchmark populations. Reports discuss potential sources of chemical exposure, what is known and unknown about health effects, strategies for exposure reduction, and study-wide findings. Researcher tools promote discovery by drawing attention to patterns of high exposure and offer novel ways to increase participant engagement. DERBI reports have been field tested in two studies. Digital methods like DERBI reduce practical barriers to report-back thus enabling researchers to meet their ethical obligations and participants to get knowledge they can use to make informed choices.

Researcher and institutional review board perspectives on the benefits and challenges of reporting back biomonitoring and environmental exposure results

As the number of personal exposure studies expands and trends favor greater openness and transparency in the health sciences, ethical issues arise around reporting back individual results for contaminants without clear health guidelines. Past research demonstrates that research participants want their results even when the health implications are not known. The experiences of researchers and institutional review boards (IRBs) in studies that have reported personal chemical exposures can provide insights about ethical and practical approaches while also revealing areas of continued uncertainty. We conducted semi-structured interviews with 17 researchers and nine IRB members from seven personal exposure studies across the United States to investigate their experiences and attitudes about the report-back process. Researchers reported multiple benefits of report-back, including increasing retention and recruitment, advancing environmental health literacy, empowering study participants to take actions to reduce exposures, encouraging shifts in government and industry practices, and helping researchers discover sources of exposure through participant consultation. Researchers also reported challenges, including maintaining ongoing contact with participants, adopting protocols for notification of high exposures to chemicals without health guidelines, developing meaningful report-back materials, and resource limitations. IRB members reported concern for potential harm to participants, such as anxiety about personal results and counterproductive behavior changes. In contrast, researchers who have conducted personal report-back in their studies said that participants did not appear overly alarmed and noted that worry can be a positive outcome to motivate action to reduce harmful exposures. While key concerns raised during the early days of report-back have been substantially resolved for scientists with report-back experience, areas of uncertainty remain. These include ethical tensions surrounding the responsibility of researchers to leverage study results and resources to assist participants in policy or community-level actions to reduce chemical exposures, and how to navigate report-back to vulnerable populations.

The Socio-Exposome: Advancing Exposure Science and Environmental Justice in a Post-Genomic Era

We propose the socio-exposome as a conceptual framework for integrative environmental health research. Environmental scientists coined the term "exposome" with the goal of inventorying and quantifying environmental exposures as precisely as scientists measure genes and gene expression. To date, the exposome's proponents have not thoroughly engaged social scientific theoretical and methodological expertise, although the exclusion of sociological expertise risks molecularizing complex social phenomena and limiting the possibility of collective action to improve environmental conditions. As a corrective, and to demonstrate how "omic" technologies could be made more relevant to public health, our socio-exposome framework blends insights from sociological and public health research with insights from environmental justice scholarship and activism. We argue that environmental health science requires more comprehensive data on more and different kinds of environmental exposures, but also must consider the socio-political conditions and inequalities that allow hazards to continue unchecked. We propose a multidimensional framework oriented around three axes: individual, local, and global, and suggest some sociomarkers and data sources that could identify exposures at each level. This framework could also guide policy, by creating a predictive framework that helps communities understand the repercussions of corporate and regulatory practices for public health and social justice.

Redesigning a Participatory Health Study for a French Industrial Context

The Marseille, France, metropolitan area is home to a heavily concentrated industrial region directly adjacent to residential communities. These towns have been subjected to a wide variety of social science and public health studies, but residents continue to have many questions about health concerns for which they currently have primarily anecdotal evidence. Reflecting on our in-progress research in two of these towns, we argue that community-based participatory research that draws from both social science and public health science can be successfully adapted to the French political and cultural context and is key for developing environmental health research that is relevant for community residents and local leaders. Understanding and working within the customs of the local values and practices culture is critical for community-based participatory research regardless of location but is particularly paramount when working in non-United States contexts, since local values and practices will shape the particular techniques used within the community-based participatory research framework.

The Legal Implications of Report Back in Household Exposure Studies

BACKGROUND

Scientists conducting research into household air or dust pollution must decide whether, when, and how to disclose to study participants their individual results. A variety of considerations factor into this decision, but one factor that has not received attention until now is the possibility that study participants' receipt of their results might create legal duties under environmental, property, landlord-tenant, or other laws.

OBJECTIVES

This article examines relevant laws and regulations and explores the scope of participants' legal duties and the resulting legal and ethical consequences for researchers. Participants could be required in some situations to disclose the presence of certain chemicals when selling or renting their homes or to frequent visitors. The article discusses hypothetical case studies involving the reporting back of results regarding lead, polychlorinated biphenyls, and phthalates.

DISCUSSION

The potential legal duties of study participants have both ethical and legal implications for researchers. Issues include whether the legal consequences for participants should affect the decision whether to report back individual results, how researchers should disclose the legal risks to participants during the informed consent process, and whether researchers would be liable to study participants for legal or economic harm arising from reporting study results to them. The review provides recommendations for language that researchers could use in the informed consent process to disclose the legal risks.

CONCLUSIONS

Researchers should still report back to participants who want to see their results, but they should disclose the risks of obtaining the information as part of the informed consent process. Citation: Goho SA. 2016. The legal implications of report back in household exposure studies. Environ Health Perspect 124:1662-1670; http://dx.doi.org/10.1289/EHP187.

The Pivotal Role of the Social Sciences in Environmental Health Sciences Research

Environmental health sciences research seeks to elucidate environmental factors that put human health at risk. A primary aim is to develop strategies to prevent or reduce exposures and disease occurrence. Given this primary focus on prevention, environmental health sciences research focuses on the populations most at risk such as communities of color and/or low socioeconomic status. The National Institute of Environmental Health Sciences research programs incorporate the principles of Community-Based Participatory Research to study health disparities. These programs promote community engagement, culturally appropriate communications with a variety of stakeholders, and consideration of the social determinants of health that interact with environmental factors to increase risk. Multidisciplinary research teams that include social and behavioral scientists are essential to conduct this type of research. This article outlines the history of social and behavioral research funding at National Institute of Environmental Health Sciences and offers examples of National Institute of Environmental Health Sciences-funded projects that exemplify the value of social science to the environmental health sciences.

The Exposure Experience: Ohio River Valley Residents Respond to Local Perfluorooctanoic Acid (PFOA) Contamination

This article explores the "exposure experience" of participants who received their personal results in a biomonitoring study for perfluorooctanoic acid. Exposure experience is the process of identifying, understanding, and responding to chemical contamination. When biomonitoring studies report results to participants, those participants generate an exposure experience that identifies hidden contaminants and helps level informational imbalances between polluters and affected communities. Participants welcomed the opportunity to learn their exposure results, reporting no psychological harm following report-back. They wove health, economic, and political considerations into their interpretation of results and their present views of past impact. Participants framed their experiences by a half-century of dependence on the chemical industry's economic benefits, leading them to considerable acceptance of chemical exposure as a tradeoff for jobs and the local economy. Our findings show that the exposure experience is an ongoing process that influences social action, with new activism being generated by exposure and health studies.

Engaging Communities in Research on Cumulative Risk and Social Stress-Environment Interactions: Lessons Learned from EPA's STAR Program

Studies have documented cumulative health effects of chemical and nonchemical exposures, particularly chronic environmental and social stressors. Environmental justice groups have advocated for community participation in research that assesses how these interactions contribute to health disparities experienced by low-income and communities of color. In 2009, the U.S. Environmental Protection Agency issued a request for research applications (RFA), "Understanding the Role of Nonchemical Stressors and Developing Analytic Methods for Cumulative Risk Assessments." Seven research projects were funded to help address this knowledge gap. Each engaged with communities in different ways. We describe the community engagement approaches of the seven research projects, which ranged from outreach through shared leadership/participatory. We then assess the experiences of these programs with respect to the community engagement goals of the RFA. We present insights from these community engagement efforts, including how the grants helped to build or enhance the capacity of community organizations in addition to contributing to the research projects. Our analysis of project proposals, annual grantee reports, and participant observation of these seven projects suggests guidelines for the development of future funding mechanisms and for conducting community-engaged research on cumulative risk involving environmental and social stressors including: 1) providing for flexibility in the mode of community engagement; 2) addressing conflict between research timing and engagement needs, 3) developing approaches for communicating about the uniquely sensitive issues of nonchemical stressors and social risks; and 4) encouraging the evaluation of community engagement efforts.

Social Science Collaboration with Environmental Health

BACKGROUND

Social science research has been central in documenting and analyzing community discovery of environmental exposure and consequential processes. Collaboration with environmental health science through team projects has advanced and improved our understanding of environmental health and justice.

OBJECTIVE

We sought to identify diverse methods and topics in which social scientists have expanded environmental health understandings at multiple levels, to examine how transdisciplinary environmental health research fosters better science, and to learn how these partnerships have been able to flourish because of the support from National Institute of Environmental Health Sciences (NIEHS).

METHODS

We analyzed various types of social science research to investigate how social science contributes to environmental health. We also examined NIEHS programs that foster social science. In addition, we developed a case study of a community-based participation research project in Akwesasne in order to demonstrate how social science has enhanced environmental health science.

RESULTS

Social science has informed environmental health science through ethnographic studies of contaminated communities, analysis of spatial distribution of environmental injustice, psychological experience of contamination, social construction of risk and risk perception, and social impacts of disasters. Social science-environmental health team science has altered the way scientists traditionally explore exposure by pressing for cumulative exposure approaches and providing research data for policy applications.

CONCLUSIONS

A transdisciplinary approach for environmental health practice has emerged that engages the social sciences to paint a full picture of the consequences of contamination so that policy makers, regulators, public health officials, and other stakeholders can better ameliorate impacts and prevent future exposure.

CITATION

Hoover E, Renauld M, Edelstein MR, Brown P. 2015. Social science collaboration with environmental health. Environ Health Perspect 123:1100-1106; http://dx.doi.org/10.1289/ehp.1409283.

Community, state, and federal approaches to cumulative risk assessment: challenges and opportunities for integration

Community, state, and federal approaches to conventional and cumulative risk assessment (CRA) were described and compared to assess similarities and differences, and develop recommendations for a consistent CRA approach, acceptable across each level as a rigorous scientific methodology, including partnership formation and solution development as necessary practices. Community, state, and federal examples were described and then summarized based on their adherence to CRA principles of: (1) planning, scoping, and problem formulation; (2) risk analysis and ranking, and (3) risk characterization, interpretation, and management. While each application shared the common goal of protecting human health and the environment, they adopted different approaches to achieve this. For a specific project-level analysis of a particular place or instance, this may be acceptable, but to ensure long-term applicability and transferability to other projects, recommendations for developing a consistent approach to CRA are provided. This approach would draw from best practices, risk assessment and decision analysis sciences, and historical lessons learned to provide results in an understandable and accepted manner by all entities. This approach is intended to provide a common ground around which to develop CRA methods and approaches that can be followed at all levels.

Semivolatile organic compounds in homes: strategies for efficient and systematic exposure measurement based on empirical and theoretical factors

Residential exposure can dominate total exposure for commercial chemicals of health concern; however, despite the importance of consumer exposures, methods for estimating household exposures remain limited. We collected house dust and indoor air samples in 49 California homes and analyzed for 76 semivolatile organic compounds (SVOCs)--phthalates, polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), and pesticides. Sixty chemicals were detected in either dust or air and here we report 58 SVOCs detected in dust for the first time. In dust, phthalates (bis(2-ethylhexyl) phthalate, benzyl butyl phthalate, di-n-butyl phthalate) and flame retardants (PBDE 99, PBDE 47) were detected at the highest concentrations relative to other chemicals at the 95th percentile, while phthalates were highest at the median. Because SVOCs are found in both gas and condensed phases and redistribute from their original source over time, partitioning models can clarify their fate indoors. We use empirical data to validate air-dust partitioning models and use these results, combined with experience in SVOC exposure assessment, to recommend residential exposure measurement strategies. We can predict dust concentrations reasonably well from measured air concentrations (R(2) = 0.80). Partitioning models and knowledge of chemical Koa elucidate exposure pathways and suggest priorities for chemical regulation. These findings also inform study design by allowing researchers to select sampling approaches optimized for their chemicals of interest and study goals. While surface wipes are commonly used in epidemiology studies because of ease of implementation, passive air sampling may be more standardized between homes and also relatively simple to deploy. Validation of passive air sampling methods for SVOCs is a priority.

Communicating results in post-Belmont era biomonitoring studies: lessons from genetics and neuroimaging research

BACKGROUND

Biomonitoring is a critical tool to assess the effects of chemicals on health, as scientists seek to better characterize life-course exposures from diverse environments. This trend, coupled with increased institutional support for community-engaged environmental health research, challenge established ethical norms related to biomonitoring results communication and data sharing between scientists, study participants, and their wider communities.

METHODS

Through a literature review, participant observation at workshops, and interviews, we examine ethical tensions related to reporting individual data from chemical biomonitoring studies by drawing relevant lessons from the genetics and neuroimaging fields.

RESULTS

In all three fields ethical debates about whether/how to report-back results to study participants are precipitated by two trends. First, changes in analytical methods have made more data accessible to stakeholders. For biomonitoring, improved techniques enable detection of more chemicals at lower levels, and diverse groups of scientists and health advocates now conduct exposure studies. Similarly, innovations in genetics have catalyzed large-scale projects and broadened the scope of who has access to genetic information. Second, increasing public interest in personal medical information has compelled imaging researchers to address demands by participants to know their personal data, despite uncertainties about their clinical significance. Four ethical arenas relevant to biomonitoring results communication emerged from our review: tensions between participants' right-to-know their personal results versus their ability or right-to-act to protect their health; whether and how to report incidental findings; informed consent in biobanking; and open-access data sharing.

CONCLUSION

Ethically engaging participants in biomonitoring studies requires consideration of several issues, including scientific uncertainty about health implications and exposure sources, the ability of participants to follow up on potentially problematic results, tensions between individual and community research protections, governance and consent regarding secondary use of tissue samples, and privacy challenges in open access data sharing.

Urinary biomonitoring of phosphate flame retardants: levels in California adults and recommendations for future studies

Phosphate flame retardants (PFRs) are abundant and found at the highest concentrations relative to other flame retardant chemicals in house dust; however, little is known about the biological levels of PFRs and their relationship with house dust concentrations. These relationships provide insight into major exposure pathways and potential health risks. We analyzed urine samples from 16 California residents in 2011 for 6 chlorinated and nonchlorinated dialkyl or diaryl phosphates (DAPs), the expected major metabolites of the most prominent PFRs, and qualitatively screened for 18 other metabolites predicted from in vitro studies. We detected all 6 DAPs within the range of previously reported levels, although very few comparisons are available. We found weakly positive nonsignificant correlations between urine and dust concentrations and maxima urine corresponding to maxima dust for the pairs bis(1,3-dichloro-2-propyl) phosphate (BDCIPP)-tris(1,3-dichloro-isopropyl) phosphate (TDCIPP) and bis(2-chloroethyl) phosphate (BCEP)-tris(2-chloroethyl) phosphate (TCEP). Metabolite levels of PFRs were correlated for many PFR combinations, suggesting they commonly co-occur. As far as we know, this is the first study to measure these 6 DAP metabolites simultaneously and to detect other PFR metabolites in US urine samples. We recommend biomonitoring studies include these 6 DAPs as well as several additional compounds detected through qualitative screening and previous ADME studies. PFRs represent a class of poorly studied commercial chemicals with widespread exposure and raise concerns for health effects including carcinogenicity and neurotoxicity.

Promoting integrated approaches to reducing health inequities among low-income workers: applying a social ecological framework

BACKGROUND

Nearly one of every three workers in the United States is low-income. Low-income populations have a lower life expectancy and greater rates of chronic diseases compared to those with higher incomes. Low- income workers face hazards in their workplaces as well as in their communities. Developing integrated public health programs that address these combined health hazards, especially the interaction of occupational and non-occupational risk factors, can promote greater health equity.

METHODS

We apply a social-ecological perspective in considering ways to improve the health of the low-income working population through integrated health protection and health promotion programs initiated in four different settings: the worksite, state and local health departments, community health centers, and community-based organizations.

RESULTS

Examples of successful approaches to developing integrated programs are presented in each of these settings. These examples illustrate several complementary venues for public health programs that consider the complex interplay between work-related and non work-related factors, that integrate health protection with health promotion and that are delivered at multiple levels to improve health for low-income workers.

CONCLUSIONS

Whether at the workplace or in the community, employers, workers, labor and community advocates, in partnership with public health practitioners, can deliver comprehensive and integrated health protection and health promotion programs. Recommendations for improved research, training, and coordination among health departments, health practitioners, worksites and community organizations are proposed.

Communicating pesticide neurotoxicity research findings and risks to decision-makers and the public

The extensive research findings on neurotoxic risks of pesticides tend to remain in academic publications rather than being comprehensibly communicated to decision-makers and the public. Protecting health and promoting risk reduction, particularly in developing countries, requires access to current findings in a format that can inform policy, regulations, behaviour change and risk reduction. Successfully communicating research findings may require multiple strategies depending on the target audience's varying comprehension skills (e.g., numeracy literacy, visual literacy) and ability to interpret scientific data. To illustrate the complexities of risk communication, a case study of exposure to neurotoxic street pesticides amongst poor, urban South African communities attempting to control poverty related pests, is presented. What remains a challenge is how to communicate neurotoxicity research findings consistently and in a meaningful manner for a lay audience, consisting of both the general public and decision makers. A further challenge is to identify who will monitor and evaluate the ways in which these findings are communicated to ensure quality is maintained. Ultimately, researchers should carry the responsibility of knowledge translation and engaging with communication specialists when appropriate. Additionally, institutions should reward this as part of promotion and academic accolade systems, and funders should fund the translational process. Ethics review boards should also play an instrumental role in ensuring that knowledge translation is part of the ethics review requirement, while professional societies should take more responsibility for disseminating research findings to non-academics.

Integrating medical and environmental sociology with environmental health: crossing boundaries and building connections through advocacy

This article reviews the personal and professional processes of developing an interdisciplinary approach to understanding the complex issues of environmental health in their community, political-economic, social science, and scientific contexts. This interdisciplinary approach includes a synthesis of research, policy work, and advocacy. To examine multiple forms of interdisciplinarity, I examine pathways of integrating medical and environmental sociology via three challenges to the boundaries of traditional research: (1) crossing the boundaries of medical and environmental sociology, (2) linking social science and environmental health science, and (3) crossing the boundary of research and advocacy. These boundary crossings are discussed in light of conceptual and theoretical developments of popular epidemiology, contested illnesses, and health social movements. This interdisciplinary work offers a more comprehensive sociological lens for understanding complex problems and a practical ability to join with scientists, activists, and officials to meet public health needs for amelioration and prevention of environmental health threats.

The Three R's: How Community Based Participatory Research Strengthens the Rigor, Relevance and Reach of Science

In the last few decades, community based participatory research (CBPR) has emerged as an important approach that links environmental health and justice advocates with research institutions to understand and address environmental health problems. CBPR has generally been evaluated for its impact on policy, regulation, and its support of community science. However, there has been less emphasis on assessing the ways in which CBPR (re)shapes and potentially improves the scientific enterprise itself. This commentary focuses on this under-emphasized aspect of CBPR-how it can strengthen science. Using two case studies of environmental health CBPR research-the Northern California Exposure Study, and the San Joaquin Valley Drinking Water Study-we posit that CBPR helps improve the "3 R's"of science-rigor, relevance and reach-and in so doing benefits the scientific enterprise itself.

After the PBDE phase-out: a broad suite of flame retardants in repeat house dust samples from California

Higher house dust levels of PBDE flame retardants (FRs) have been reported in California than other parts of the world, due to the state's furniture flammability standard. However, changing levels of these and other FRs have not been evaluated following the 2004 U.S. phase-out of PentaBDE and OctaBDE. We analyzed dust collected in 16 California homes in 2006 and again in 2011 for 62 FRs and organohalogens, which represents the broadest investigation of FRs in homes. Fifty-five compounds were detected in at least one sample; 41 in at least 50% of samples. Concentrations of chlorinated OPFRs, including two (TCEP and TDCIPP) listed as carcinogens under California's Proposition 65, were found up to 0.01% in dust, higher than previously reported in the U.S. In 75% of the homes, we detected TDBPP, or brominated "Tris," which was banned in children's sleepwear because of carcinogenicity. To our knowledge, this is the first report on TDBPP in house dust. Concentrations of Firemaster 550 components (EH-TBB, BEH-TEBP, and TPHP) were higher in 2011 than 2006, consistent with its use as a PentaBDE replacement. Results highlight the evolving nature of FR exposures and suggest that manufacturers continue to use hazardous chemicals and replace chemicals of concern with chemicals with uncharacterized toxicity.

Endocrine disruptors and asthma-associated chemicals in consumer products

BACKGROUND

Laboratory and human studies raise concerns about endocrine disruption and asthma resulting from exposure to chemicals in consumer products. Limited labeling or testing information is available to evaluate products as exposure sources.

OBJECTIVES

We analytically quantified endocrine disruptors and asthma-related chemicals in a range of cosmetics, personal care products, cleaners, sunscreens, and vinyl products. We also evaluated whether product labels provide information that can be used to select products without these chemicals.

METHODS

We selected 213 commercial products representing 50 product types. We tested 42 composited samples of high-market-share products, and we tested 43 alternative products identified using criteria expected to minimize target compounds. Analytes included parabens, phthalates, bisphenol A (BPA), triclosan, ethanolamines, alkylphenols, fragrances, glycol ethers, cyclosiloxanes, and ultraviolet (UV) filters.

RESULTS

We detected 55 compounds, indicating a wide range of exposures from common products. Vinyl products contained > 10% bis(2-ethylhexyl) phthalate (DEHP) and could be an important source of DEHP in homes. In other products, the highest concentrations and numbers of detects were in the fragranced products (e.g., perfume, air fresheners, and dryer sheets) and in sunscreens. Some products that did not contain the well-known endocrine-disrupting phthalates contained other less-studied phthalates (dicyclohexyl phthalate, diisononyl phthalate, and di-n-propyl phthalate; also endocrine-disrupting compounds), suggesting a substitution. Many detected chemicals were not listed on product labels.

CONCLUSIONS

Common products contain complex mixtures of EDCs and asthma-related compounds. Toxicological studies of these mixtures are needed to understand their biological activity. Regarding epidemiology, our findings raise concern about potential confounding from co-occurring chemicals and misclassification due to variability in product composition. Consumers should be able to avoid some target chemicals-synthetic fragrances, BPA, and regulated active ingredients-using purchasing criteria. More complete product labeling would enable consumers to avoid the rest of the target chemicals.

Measuring the success of community science: the northern California Household Exposure Study

BACKGROUND

Environmental health research involving community participation has increased substantially since the National Institute of Environmental Health Sciences (NIEHS) environmental justice and community-based participatory research (CBPR) partnerships began in the mid-1990s. The goals of these partnerships are to inform and empower better decisions about exposures, foster trust, and generate scientific knowledge to reduce environmental health disparities in low-income, minority communities. Peer-reviewed publication and clinical health outcomes alone are inadequate criteria to judge the success of projects in meeting these goals; therefore, new strategies for evaluating success are needed.

OBJECTIVES

We reviewed the methods used to evaluate our project, "Linking Breast Cancer Advocacy and Environmental Justice," to help identify successful CBPR methods and to assist other teams in documenting effectiveness. Although our project precedes the development of the NIEHS Evaluation Metrics Manual, a schema to evaluate the success of projects funded through the Partnerships in Environmental Public Health (PEPH), our work reported here illustrates the record keeping and self-reflection anticipated in NIEHS's PEPH.

DISCUSSION

Evaluation strategies should assess how CBPR partnerships meet the goals of all partners. Our partnership, which included two strong community-based organizations, produced a team that helped all partners gain organizational capacity. Environmental sampling in homes and reporting the results of that effort had community education and constituency-building benefits. Scientific results contributed to a court decision that required cumulative impact assessment for an oil refinery and to new policies for chemicals used in consumer products. All partners leveraged additional funding to extend their work.

CONCLUSIONS

An appropriate evaluation strategy can demonstrate how CBPR projects can advance science, support community empowerment, increase environmental health literacy, and generate individual and policy action to protect health.

Reflexive Research Ethics for Environmental Health and Justice: Academics and Movement-Building

Community-engaged research on environmental problems has reshaped researcher-participant relationships, academic-community interaction, and the role of community partners in human subjects protection and ethical oversight. We draw on our own and others' research collaborations with environmental health and justice social movement organizations to discuss the ethical concerns that emerge in community-engaged research. In this paper we introduce the concept of reflexive research ethics: ethical guidelines and decision-making principles that depend on continual reflexivity concerning the relationships between researchers and participants. Seeing ethics in this way can help scientists conduct research that simultaneously achieves a high level of professional conduct and protects the rights, well-being, and autonomy of both researchers and the multiple publics affected by research. We highlight our research with community-based organizations in Massachusetts, California, and Alaska, and discuss the potential impacts of the community or social movement on the research process and the potential impacts of research on community or social movement goals. We conclude by discussing ways in which the ethical concerns that surface in community-engaged research have led to advances in ethical research practices. This type of work raises ethical questions whose answers are broadly relevant for social movement, environmental, and public health scholars.

Moving environmental justice indoors: understanding structural influences on residential exposure patterns in low-income communities

OBJECTIVES

The indoor environment has not been fully incorporated into the environmental justice dialogue. To inform strategies to reduce disparities, we developed a framework to identify the individual and place-based drivers of indoor environment quality.

METHODS

We reviewed empirical evidence of socioeconomic disparities in indoor exposures and key determinants of these exposures for air pollutants, lead, allergens, and semivolatile organic compounds. We also used an indoor air quality model applied to multifamily housing to illustrate how nitrogen dioxide (NO(2)) and fine particulate matter (PM(2.5)) vary as a function of factors known to be influenced by socioeconomic status.

RESULTS

Indoor concentrations of multiple pollutants are elevated in low-socioeconomic status households. Differences in these exposures are driven by the combined influences of indoor sources, outdoor sources, physical structures, and residential activity patterns. Simulation models confirmed indoor sources' importance in determining indoor NO(2) and PM(2.5) exposures and showed the influence of household-specific determinants.

CONCLUSIONS

Both theoretical models and empirical evidence emphasized that disparities in indoor environmental exposure can be significant. Understanding key determinants of multiple indoor exposures can aid in developing policies to reduce these disparities.

Understanding the cumulative impacts of inequalities in environmental health: implications for policy

Racial or ethnic minority groups and low-income communities have poorer health outcomes than others. They are more frequently exposed to multiple environmental hazards and social stressors, including poverty, poor housing quality, and social inequality. Researchers are grappling with how best to characterize the cumulative effects of these hazards and stressors in order to help regulators and decision makers craft more-effective policies to address health and environmental disparities. In this article we synthesize the existing scientific evidence regarding the cumulative health implications of higher rates of exposure to environmental hazards, along with individual biological susceptibility and social vulnerability. We conclude that current environmental policy, which is focused narrowly on pollutants and their sources, should be broadened to take into account the cumulative impact of exposures and vulnerabilities encountered by people who live in neighborhoods consisting largely of racial or ethnic minorities or people of low socioeconomic status.

Developing a bidirectional academic-community partnership with an Appalachian-American community for environmental health research and risk communication

BACKGROUND

Marietta, Ohio, is an Appalachian-American community whose residents have long struggled with understanding their exposure to airborne manganese (Mn). Although community engagement in research is strongly endorsed by the National Institutes of Health and the National Institute of Environmental Health Sciences in particular, little has been documented demonstrating how an academic-community partnership that implements the community-based participatory research (CBPR) principles can be created and mobilized for research.

OBJECTIVES

We created a bidirectional, academic-community partnership with an Appalachian-American community to a) identify the community's thoughts and perceptions about local air quality, its effect on health, and the perception of risk communication sources and b) jointly develop and conduct environmental health research.

METHODS

We formed a community advisory board (CAB), jointly conducted pilot research studies, and used the results to develop a community-driven research agenda.

RESULTS

Persons in the community were "very concerned" to "concerned" about local air quality (91%) and perceived the air quality to have a direct impact on their health and on their children's health (93% and 94%, respectively). The CAB identified the primary research question: "Does Mn affect the cognition and behavior of children?" Although the community members perceived research scientists as the most trusted and knowledgeable regarding risks from industrial emissions, they received very little risk information from research scientists.

CONCLUSIONS

Engaging a community in environmental health research from its onset enhanced the quality and relevance of the research investigation. The CBPR principles were a useful framework in building a strong academic-community partnership. Because of the current disconnect between communities and research scientists, academic researchers should consider working collaboratively with community-based risk communication sources.