Characteristics of K-12 Teachers Considering Leaving Due to COVID-19 and for Other Reasons

BACKGROUND

The COVID-19 pandemic has had drastic effects on K-12 teachers. Researchers partnered with a teacher advisory board to identify factors associated with K-12 teachers' consideration of leaving teaching during Fall 2020.

METHODS

A web-based survey focused on teachers' working experiences was emailed to school union membership listservs in Indiana, Kentucky, and Ohio. A logistic regression model was developed to identify working conditions associated with teachers considering leaving the profession.

RESULTS

Among 5873 K-12 teachers, 27% (n = 1319) were considering leaving the profession either because of COVID-19 (10%), for other reasons (6%) or were undecided (11%). Teachers who were midcareer, having taught 6-10 years, who perceived less supervisor support, whose job duties had changed significantly, who were dissatisfied with the COVID-19 related decision-making, who reported poor or fair mental health, and who were mostly or extremely afraid that a household member would get COVID-19 had higher odds of considering leaving teaching or being undecided about future career plans.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE AND EQUITY

Understanding factors influencing teachers' career decisions will help school leaders improve teacher retention amid challenging circumstances.

CONCLUSION

In this study in 3 midwestern US states, limited supervisor support, significant job duty change, dissatisfaction with COVID-19-related decision-making, poor or fair mental health, and fear that a household member would get COVID-19 were associated with teachers' consideration of leaving the profession or being undecided about future career plans.

Child and Adolescent Manganese Biomarkers and Adolescent Postural Balance in Marietta CARES Cohort Participants

BACKGROUND

Manganese (Mn) plays a significant role in both human health and global industries. Epidemiological studies of exposed populations demonstrate a dose-dependent association between Mn and neuromotor effects ranging from subclinical effects to a clinically defined syndrome. However, little is known about the relationship between early life Mn biomarkers and adolescent postural balance.

OBJECTIVES

This study investigated the associations between childhood and adolescent Mn biomarkers and adolescent postural balance in participants from the longitudinal Marietta Communities Actively Researching Exposures Study (CARES) cohort.

METHODS

Participants were recruited into CARES when they were 7-9 y old, and reenrolled at 13-18 years of age. At both time points, participants provided samples of blood, hair, and toenails that were analyzed for blood Mn and lead (Pb), serum cotinine, hair Mn, and toenail Mn. In adolescence, participants completed a postural balance assessment. Greater sway indicates postural instability (harmful effect), whereas lesser sway indicates postural stability (beneficial effect). Multivariable linear regression models were conducted to investigate the associations between childhood and adolescent Mn biomarkers and adolescent postural balance adjusted for age, sex, height-weight ratio, parent/caregiver intelligence quotient, socioeconomic status, blood Pb, and serum cotinine.

RESULTS

CARES participants who completed the adolescent postural balance assessment (n = 123 ) were 98% White and 54% female and had a mean age of 16 y (range: 13-18 y). In both childhood and adolescence, higher Mn biomarker concentrations were significantly associated with greater adolescent sway measures. Supplemental analyses revealed sex-specific associations; higher childhood Mn biomarker concentrations were significantly associated with greater sway in females compared with males.

DISCUSSION

This study found childhood and adolescent Mn biomarkers were associated with subclinical neuromotor effects in adolescence. This study demonstrates postural balance as a sensitive measure to assess the association between Mn biomarkers and neuromotor function. https://doi.org/10.1289/EHP13381.

Screen-Printed Sensors Modified with Nafion and Mesoporous Carbon for Electrochemical Detection of Lead in Blood

Lead (Pb) has long been acknowledged as a systemic toxicant, with pronounced health impacts observed even at low exposure levels, particularly in children. Adverse effects include diminished cognitive function, altered behavior, and developmental delays. Consequently, it is imperative to conduct regular monitoring of Blood Lead Levels (BLLs). In this work, we report on an electrochemical sensor based on screen-printed carbon electrode (SPCE) coated with Nafion and mesoporous carbon (MC). The sensor system uses simple sample preparation (acidification and dilution of whole blood), minimal sample volume (a few blood drops, 200 μl), and swift time-to-results (1 h). A limit of quantitation (LOQ) of 0.3 μg dL-1 Pb was achieved in whole blood. To demonstrate the practical utility of our sensor system, we evaluated its performance in the analysis of blood samples collected from children (n = 25). Comparative analysis with the laboratory-based gold standard method of inductively coupled plasma mass spectrometry (ICP-MS) demonstrated approximately 77% accuracy and 94% precision. We anticipate that our approach will serve as a valuable tool for more frequent BLL monitoring, particularly in communities where access to laboratory testing is impractical or expensive.

PFAS soil concentrations surrounding a hazardous waste incinerator in East Liverpool, Ohio, an environmental justice community

Per- and polyfluoroalkyl substances (PFAS) are a class of synthetic compounds widely used in industrial and consumer products. While PFAS provide product durability, these chemicals are ubiquitous, persistent, bioaccumulative, and toxic. These characteristics make the ultimate disposal of PFAS a challenge. One current disposal method is incineration; however, little research has been conducted on the safety and effectiveness of PFAS incineration. The characteristics of communities with hazardous waste incinerators that have received PFAS shipments indicate that more individuals with lower incomes and individuals with less education than the US average are at higher risk of exposure, which presents important environmental justice and health equity concerns of PFAS incineration. Situated in eastern Ohio, East Liverpool is an Appalachian community that is home to a large hazardous-waste incinerator, operated by Heritage WTI, that began accepting PFAS in 2019. Residents are concerned that the disposal lacks the research necessary to assure safety for the residents. Due to both community interest and data gaps regarding PFAS incineration, our research team conducted a pilot study to examine the distribution and concentration of PFAS in soil samples surrounding the incinerator. All 35 soil samples had measurable amounts of PFAS including perfluorobutanesulfonic acid (PFBS), perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and hexafluoropropylene oxide dimer acid (HFPO-DA)/GenX. PFOS was measured in the majority of soil samples (97%) with a range of 50-8,300 ng/kg. PFOA was measured in 94% of soil samples with a range of 51 ng/kg to 1300 ng/kg. HFPO-DA/GenX was measurable in 12 soil samples with concentrations of ranging from 150 ng/kg to 1500 ng/kg. Further research on PFAS disposal will advance knowledge and action related to regulatory requirements and exposure prevention, ultimately improving individual and community protections and health equity.

Health Research in the Wake of Disasters: Challenges and Opportunities for Sensor Science

BACKGROUND

Disaster events adversely affect the health of millions of individuals each year. They create exposure to physical, chemical, biological, and psychosocial hazards while simultaneously exploiting community and individual-level vulnerabilities that allow such exposures to exert harm. Since 2013, the National Institute of Environmental Health Sciences (NIEHS) has led the development of the Disaster Research Response (DR2) program and infrastructure; however, research exploring the nature and effects of disasters on human health is lacking. One reason for this research gap is the challenge of developing and deploying cost-effective sensors for exposure assessment during disaster events.

OBJECTIVES

The objective of this commentary is to synergize the consensus findings and recommendations from a panel of experts on sensor science in support of DR2.

METHODS

The NIEHS convened the workshop, "Getting Smart about Sensors for Disaster Response Research" on 28 and 29 July 2021 to discuss current gaps and recommendations for moving the field forward. The workshop invited full discussion from multiple viewpoints, with the goal of identifying recommendations and opportunities for further development of this area of research. The panel of experts included leaders in engineering, epidemiology, social and physical sciences, and community engagement, many of whom had firsthand experience with DR2.

DISCUSSION

The primary finding of this workshop is that exposure science in support of DR2 is severely lacking. We highlight unique barriers to DR2, such as the need for time-sensitive exposure data, the chaos and logistical challenges that ensue from a disaster event, and the lack of a robust market for sensor technologies in support of environmental health science. We highlight a need for sensor technologies that are more scalable, reliable, and versatile than those currently available to the research community. We also recommend that the environmental health community renew efforts in support of DR2 facilitation, collaboration, and preparedness. https://doi.org/10.1289/EHP12270.

Quantitative fluoride imaging of teeth using CaF emission by laser induced breakdown spectroscopy

In this work, we propose the use of molecular emission of calcium fluoride (CaF) by laser induced breakdown spectroscopy (LIBS) to obtain quantitative fluoride distribution images of teeth. LIBS has proved to be an efficient technique to detect low amounts of fluoride in solids, and human teeth have the advantage being a matrix rich in calcium. We used new calibration material from sintered hydroxyapatite pellets doped with fluoride to determine the optimized LIBS conditions of argon flow at 1 L min-1 and using the green emission bands of CaF in 530 nm, and obtained a calibration curve between 0 and 400 μg g-1, and LOD of 18 μg g-1. This methodology was applied within a rat model of fluoride exposure and showed increasing tooth-fluoride with increased exposure dose. To demonstrate applicability of this method in human teeth, we quantified fluoride distribution in teeth from three children from non-fluorinated and fluorinated water regions. Samples from children living in fluoridated water regions showed higher fluoride concentrations in dentine formed after birth, compared to a child from a non-fluoridated region. Teeth have been used as biomarkers for environmental exposure and this new method opens the opportunity in epidemiology research to study critical windows of early life exposure to fluoride as well.

Electrochemical Determination of Manganese in Whole Blood with Indium Tin Oxide Electrode

In this work, we demonstrate accurate and precise measurement of manganese (Mn) concentration in human whole blood with indium tin oxide (ITO) electrode using square wave stripping voltammetry. While an essential trace metal for human health, elevated levels of Mn due to environmental or occupational exposure have been associated with severe neuromotor dysfunction characterized by parkinsonism and cognitive dysfunction making the monitoring of Mn in whole blood necessary. Pediatric populations are particularly susceptible to Mn given their developing brain and potential long-term impacts on neurodevelopment. The current gold standard for whole blood Mn measurements is by ICP-MS, which is costly and time consuming. The electrochemical detection with ITO working electrode in this work showed a limit of detection of 0.5 μg l^-1 and a linear range of 5 to 500 μg l^-1, which encompasses the physiological Mn levels in human whole blood (5-18 μg l^-1). Our results of Mn measurement in whole blood show an average precision of 96.5% and an average accuracy of 90.3% compared to ICP-MS for both the normal range (5-18 μg l^-1) and the elevated levels (>36 μg l^-1) that require medical intervention. These results demonstrate the feasibility of Mn measurements in human blood with electrochemical sensors.

Co-exposure to manganese and lead and pediatric neurocognition in East Liverpool, Ohio

Exposure to metal mixtures may lead to health impacts greater than the effects associated with singular exposures. Two common childhood environmental exposures, manganese (Mn) and lead (Pb), are associated with similar adverse neurodevelopmental effects; however, the effects surrounding concurrent exposure to both metals remain unclear. We study the impact of joint exposure to Mn and Pb on cognitive performance in school-aged children participating in the Communities Actively Researching Exposure Study (CARES) based in East Liverpool, Ohio. Blood Pb levels were measured for each child (geometric mean (GM) = 1.13 μg/dL, range 0.30 μg/dL - 6.64 μg/dL). Mn was measured in participant blood, hair, and toenails with GMs of 10.1 μg/L, 360 ng/g, 0.974 μg/g, respectively. Trained team members administered the Wechsler Intelligence Scale for Children-IV (WISC-IV) to assess intelligence quotient (IQ). The WISC-IV provides scores for Full Scale IQ, Perceptual Reasoning, Processing Speed, Working Memory, and Verbal Comprehension. Interactions between blood Pb and all Mn biomarkers were tested in linear models adjusted for child sex, household income, and serum cotinine. Separate regression models were run for each of the Mn biomarkers. The cohort was comprised of 106 children with a mean age of 8.4 years. Interactions between blood Pb and hair Mn were significant (p < 0.05) for four out of the five IQ domains. The effect of blood Pb on IQ was more pronounced at higher levels of hair and toenail Mn. No significant associations were observed when characterizing the main effect of Mn using blood. Uncovering the health impacts associated with exposure mixtures is critical to understanding the impact of real-life conditions. Our findings suggest that joint exposure to Mn and Pb may produce heightened neurocognitive impacts even at blood Pb levels below the CDC reference concentration of 5 μg/dL.

Disinfectant use by K-12 school staff to combat SARS-CoV-2

K-12 school staff from Indiana, Kentucky and Ohio were asked about their use of disinfectants to mitigate the spread of COVID-19 in schools. Survey participants (n = 1,555) reported frequent use of disinfectants, often using unknown products, and were provided little to no training on safe and effective use. Participant concerns included student involvement in disinfection, inadequate ventilation, surface contact time, and potential health effects.

Survey of airborne organic compounds in residential communities near a natural gas compressor station: Response to community concern

INTRODUCTION

Natural gas compressor stations are located throughout the country and are used to maintain gas flow and ensure continuous distribution through the pipeline network. Compressor stations emit many air contaminants including volatile organic compounds (VOCs) and semi-volatile organic compounds (SVOCs). While the serious health effects associated with the inhalation of elevated pollutant levels are clear, the relationship between proximity to natural gas compressor stations and residential health effects is not well understood. Community members living near a natural gas compressor station in Eastern Ohio expressed concerns regarding their air quality; therefore, the objective of this study was to assess exposure to airborne organics in residential air near the compressor station.

METHODS

Our team conducted a 24-hour air sampling campaign to assess outdoor and indoor air contaminant levels at 4 homes near the Williams Salem Compressor Station in Jefferson County, Ohio. Air quality was assessed using two techniques: 1) summa canisters to quantify VOC concentrations and 2) passive air samplers to evaluate a broader panel of VOCs and SVOCs.

RESULTS

Among the three homes situated < 2 km from the compressor station, indoor benzene levels were 2-17 times greater than the Ohio Environmental Protection Agency (EPA) indoor standard due to vapor intrusion. Multiple other VOCs, including ethylbenzene, 1,2,4-trimethylbenzene, 1,2 dichloroethane, 1,3 butadiene, chloroform, and naphthalene also exceeded state standards for indoor concentrations. Several SVOCs were also detected inside and outside participants' homes, including benzene and naphthalene derivatives.

CONCLUSION

Our results validate the community members' concerns and necessitate a more comprehensive epidemiological investigation into the exposures associated with natural gas compressor stations and methods to mitigate elevated exposures.Alarming levels of VOCS were detected inside of homes. Further research is needed to determine the source of VOC exposure and potential health effects.

Association of Manganese Biomarker Concentrations with Blood Pressure and Kidney Parameters among Healthy Adolescents: NHANES 2013-2018

Deficiency or excess exposure to manganese (Mn), an essential mineral, may have potentially adverse health effects. The kidneys are a major organ of Mn site-specific toxicity because of their unique role in filtration, metabolism, and excretion of xenobiotics. We hypothesized that Mn concentrations were associated with poorer blood pressure (BP) and kidney parameters such as estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN), and albumin creatinine ratio (ACR). We conducted a cross-sectional analysis of 1931 healthy U.S. adolescents aged 12-19 years participating in National Health and Nutrition Examination Survey cycles 2013-2014, 2015-2016, and 2017-2018. Blood and urine Mn concentrations were measured using inductively coupled plasma mass spectrometry. Systolic and diastolic BP were calculated as the average of available readings. eGFR was calculated from serum creatinine using the Bedside Schwartz equation. We performed multiple linear regression, adjusting for age, sex, body mass index, race/ethnicity, and poverty income ratio. We observed null relationships between blood Mn concentrations with eGFR, ACR, BUN, and BP. In a subset of 691 participants, we observed that a 10-fold increase in urine Mn was associated with a 16.4 mL/min higher eGFR (95% Confidence Interval: 11.1, 21.7). These exploratory findings should be interpreted cautiously and warrant investigation in longitudinal studies.

Direct injection analysis of per and polyfluoroalkyl substances in surface and drinking water by sample filtration and liquid chromatography-tandem mass spectrometry

We developed and validated a method for direct determination of per- and polyfluoroalkylated substances (PFASs) in environmental water samples without prior sample concentration. Samples are centrifuged and supernatants passed through an Acrodisc Filter (GXF/GHP 0.2  um, 25  mm diameter). After addition of ammonium acetate, samples are analyzed by UPLC-MS/MS using an AB Sciex 6500 plus Q-Trap mass spectrometer operated in negative multiple reaction-monitoring (MRM) mode. The instrument system incorporates a delay column between the pumps and autosampler to mitigate interference from background PFAS. The method monitors eight short-/long-chain PFAS which are identified by monitoring specific precursor product ion pairs and by their retention times and quantified using isotope mass-labeled internal standard based calibration plots. Average spiked recoveries (n = 8) of target analytes ranged from 84 to 110% with 4-9% relative standard deviation (RSD). The mean spiked recoveries (n = 8) of four surrogates were 94-106% with 3-8% RSD. For continuous calibration verification (CCV), average spiked recoveries (n = 8) for target analytes ranged from 88 to 114% with 4-11% RSD and for surrogates ranged from 104-112% with 3-11% RSD. The recoveries (n = 6) of matrix spike (MX), matrix spike duplicate (MXD), and field reagent blank (FRB) met our acceptance criteria. The limit of detection for the target analytes was between 0.007 and 0.04 ng/mL. The method was used to measure PFAS in tap water and surface water.

AERMOD modeling of ambient manganese for residents living near a ferromanganese refinery in Marietta, OH, USA

Elevated exposure to ambient manganese (Mn) is associated with adverse health outcomes. In Marietta, Ohio, the primary source of ambient Mn exposure is from the longest operating ferromanganese refinery in North America. In this study, the US EPA air dispersion model, AERMOD, was used to estimate ambient air Mn levels near the refinery for the years 2008-2013. Modeled air Mn concentrations for 2009-2010 were compared to concentrations obtained from a stationary air sampler. Census block population data were used to estimate population sizes exposed to an annual average air Mn > 50 ng/m3, the US EPA guideline for chronic exposure, for each year. Associations between modeled air Mn, measured soil Mn, and measured indoor dust Mn in the modeled area were also examined. Median modeled air Mn concentrations ranged from 6.3 to 43 ng/m3 across the years. From 12,000-56,000 individuals, including over 2000 children aged 0-14 years, were exposed to respirable annual average ambient air Mn levels exceeding 50 ng/m3 in five of the six years. For 2009-2010, the median modeled air Mn concentration at the stationary site was 20 ng/m3, compared to 18 ng/m3 measured with the stationary air sampler. All model performance measures for monthly modeled concentrations compared to measured concentrations were within acceptable limits. The study shows that AERMOD modeling of ambient air Mn is a viable method for estimating exposure from refinery emissions and that the Marietta area population was at times exposed to Mn levels that exceeded US EPA guidelines.

Impact of the COVID-19 Shutdown on Mental Health in Appalachia by Working Status

Introduction

To slow the spread of COVID-19 in the United States, businesses shutdown in Spring 2020. Research has indicated the impact on frontline workers, yet little is known about the impact on those who were not working outside the home or switched to working remotely.

Purpose

The purpose of this report is to identify the financial and healthcare issues and mental health impact of the COVID-19 shutdown on Appalachians by worker categories.

Methods

An online survey was administered from May 8 – June 6, 2020 to a convenience sample of previous research participants and shared through social media networks, i.e., snowball sampling. Questions investigated mental health, financial and healthcare issues, and employment status. Survey responses were summarized by percentages overall and by working categories.

Results

Of the 751 participants, 276 (42%) resided in Appalachia. After removing 17 who lost their job due to COVID-19, 59 (23%) indicated not working outside the home prior to COVID-19, whereas 111 (43%) and 89 (34%) switched to working remotely and continued working outside the home during the shutdown. Respondents were predominately Caucasian and female. Nearly a quarter of participants had lost or reduced income due to the shutdown. Approximately half missed or postponed healthcare appointments. Mental health impacts were similar across the groups, with half of the respondents reporting anxiety due to COVID-19.

Implications

Further research is needed to explore health outcomes associated with missed healthcare appointments during the shutdown. Mental health support may be needed equally by those isolated at home and frontline workers.

Manganese Exposure and Neurologic Outcomes in Adult Populations

A review of published articles examining the effects of manganese exposure to workers and community residents shows adverse neurologic outcomes. Innovative biomarkers, including those from neuroimaging, were incorporated into many of these studies to assess both manganese exposure and neurologic outcomes. A variety of health effects were evaluated, including cognitive and motor impairments. Studies of community participants residing near manganese point sources show variability in outcomes, reflecting the complexities of exposure measurement, individual absorption, and assessment of neurologic effects. The aging population provides insight into the impacts of chronic exposure in younger populations.

Brain manganese and the balance between essential roles and neurotoxicity

Manganese (Mn) is an essential micronutrient required for the normal development of many organs, including the brain. Although its roles as a cofactor in several enzymes and in maintaining optimal physiology are well-known, the overall biological functions of Mn are rather poorly understood. Alterations in body Mn status are associated with altered neuronal physiology and cognition in humans, and either overexposure or (more rarely) insufficiency can cause neurological dysfunction. The resultant balancing act can be viewed as a hormetic U-shaped relationship for biological Mn status and optimal brain health, with changes in the brain leading to physiological effects throughout the body and vice versa. This review discusses Mn homeostasis, biomarkers, molecular mechanisms of cellular transport, and neuropathological changes associated with disruptions of Mn homeostasis, especially in its excess, and identifies gaps in our understanding of the molecular and biochemical mechanisms underlying Mn homeostasis and neurotoxicity.

Assessing the national capacity for disaster research response (DR2) within the NIEHS Environmental Health Sciences Core Centers

INTRODUCTION

Disaster research response (DR2) is necessary to answer scientific questions about the environmental health impacts of disasters and the effectiveness of response and recovery strategies. This research explores the preparedness and capacity of National Institute of Environmental Health Sciences (NIEHS) P30 Core Centers (CCs) to conduct DR2 and engage with communities in the context of disasters.

METHODS

In early 2018, we conducted an online survey of CC Directors (n = 16, 69.5% response rate) to identify their DR2 relevant scientific assets, capabilities, and activities. Summary statistics were calculated. We also conducted in-depth, semi-structured interviews with 16 (69.5%) CC Community Engagement Core directors to identify facilitators and barriers of DR2 community engagement. Interview notes were coded and thematically analyzed.

RESULTS

Survey: While 56% of responding CCs reported prior participation in DR2 and preparedness to repurpose funding to support DR2, less than one third reported development of a disaster-specific data collection protocol, deployment plan, or concept of operations plan, participation in an exercise to test DR2 capacity, development of academic partnerships to conduct DR2, development of a process for fast-tracking institutional review board approvals for DR2, or maintenance of formal agreements with state, local, or community-based partner(s). A number of CCs reported developing or considering developing capacity in these areas. Barriers to, and tools and resources to enhance, CC engagement in DR2 were identified. Interviews: Four key components for community engaged DR2 were identified: pre-existing community relationships, responsive research that benefits communities, coordination among researchers, and coordination with community response partners. Several roles for, benefits of, and barriers to Community Engagement Rapid Response Teams (CERRT) were described.

CONCLUSIONS

CCs have significant scientific assets and community partnerships that can be leveraged for DR2; however, additional planning is necessary to ensure that these scientific assets and community partnerships are leveraged when disasters strike.

Public Participation in Air Sampling and Water Quality Test Kit Development to Enable Citizen Science

BACKGROUND

Public participation in environmental data collection is a rapidly growing approach providing opportunity for hands-on public engagement in environmental field studies. This methodology is important when addressing community-identified exposure concerns.

OBJECTIVES

Our goal was to establish an academic-community partnership between University of Cincinnati (UC) researchers and local officials and residents of Guernsey County, Ohio, to address their interest in assessing environmental quality near proposed and operating natural gas extraction (NGE) waste sites.

METHODS

A pilot research study was developed using community-based participatory research principles. A community resident was trained to collect air samples. Air was sampled at 10 locations for 63 volatile organic compounds (VOCs). Water quality test kits were developed in partnership with local middle and high school teachers.

RESULTS

Community partners were involved throughout the project. VOCs were detected at all locations. Nineteen unique VOCs were detected; one was above the recommended exposure level. Findings were reported back to local officials and community members. Water quality test kits were developed and then piloted in middle school and high school classrooms.

CONCLUSIONS

Academic-community partnerships were instrumental in the identification of sampling locations, obtaining the participation of landowners, and conducting sampling. Measuring the impact of NGE activities on air quality is challenging owing to competing exposures, limited resources, and access to sites. Water quality test kits were found by Guernsey County teachers to be useful tools in the classroom.

Delivering health knowledge and wisdom from the hills and hollows of Appalachia

There is knowledge in the pages of Appalachia's hills. This journal is positioned to find and publish those translations. It grows from a need to provide an outlet for scholarship about Appalachia's health so that knowledge, and occasionally wisdom, is shared with those who care about and are committed to improving the region's health.

Trimester specific PM2.5 exposure and fetal growth in Ohio, 2007-2010

BACKGROUND

Exposure to particulate matter, particularly with aerodynamic diameter < 2.5 µm (PM_2.5), may increase inflammation and oxidative stress in pregnant women and affect fetal growth. We examined trimester specific PM_2.5 exposure levels and small for gestational age (SGA) using the statewide birth registry of Ohio from 2007 to 2010.

METHODS

Exposure to PM_2.5 in each trimester and for each gestational week was determined using data from 57 Environmental Protection Agency network monitoring stations across the state of Ohio. We restricted the data to 224,921 singleton live births, with a gestational age of 20-42 weeks, no genetic disorders or congenital abnormalities, and who had home addresses within a 10 km radius of any PM_2.5 monitoring station. We estimated odds ratios of SGA using Generalized Linear Models (GLMs) and Distributed Lag Models (DLMs), and adjustment for maternal age, race, education, parity, body mass index, insurance type, tobacco use, prenatal care initiation, birth year, season of birth, and sex of the baby.

RESULTS

Mean PM_2.5 levels during the entire pregnancy were 13.03 µg/m³ with a standard deviation of 1.57 µg/m³. Covariates adjusted odds ratios and 95% confidence intervals of a 10 µg/m³ increase in PM_2.5 levels with a 10 km buffer radius for SGA and trimesters modeled separately were 0.94 (0.88, 1.00) for the first trimester, 0.93 (0.86, 1.00) for the second trimester, 1.07 (1.00, 1.15) for the third trimester, and 0.92 (0.81, 1.06) for the entire pregnancy. When a 5 km buffer radius was used, adjusted odds ratios and 95% confidence intervals for SGA were 0.97 (0.89, 1.05) for the first trimester, 0.96 (0.88, 1.05) for the second trimester, 1.09 (1.02, 1.17) for the third trimester, and 0.99 (0.85, 1.14) for the overall pregnancy, indicating sensitivity to buffer choice. DLMs showed gestational weeks 30-35 to be a particular window of vulnerability.

CONCLUSION

Increasing exposure to PM_2.5 during the third trimester of pregnancy was associated with a small increase in risk of SGA in this population-based study. Selection of a buffer radius significantly impacted our results in the first trimester, but not in the third trimester.

Environmental and individual PAH exposures near rural natural gas extraction

Natural gas extraction (NGE) has expanded rapidly in the United States in recent years. Despite concerns, there is little information about the effects of NGE on air quality or personal exposures of people living or working nearby. Recent research suggests NGE emits polycyclic aromatic hydrocarbons (PAHs) into air. This study used low-density polyethylene passive samplers to measure concentrations of PAHs in air near active (n = 3) and proposed (n = 2) NGE sites. At each site, two concentric rings of air samplers were placed around the active or proposed well pad location. Silicone wristbands were used to assess personal PAH exposures of participants (n = 19) living or working near the sampling sites. All samples were analyzed for 62 PAHs using GC-MS/MS, and point sources were estimated using the fluoranthene/pyrene isomer ratio. ∑PAH was significantly higher in air at active NGE sites (Wilcoxon rank sum test, p < 0.01). PAHs in air were also more petrogenic (petroleum-derived) at active NGE sites. This suggests that PAH mixtures at active NGE sites may have been affected by direct emissions from petroleum sources at these sites. ∑PAH was also significantly higher in wristbands from participants who had active NGE wells on their properties than from participants who did not (Wilcoxon rank sum test, p < 0.005). There was a significant positive correlation between ∑PAH in participants' wristbands and ∑PAH in air measured closest to participants' homes or workplaces (simple linear regression, p < 0.0001). These findings suggest that living or working near an active NGE well may increase personal PAH exposure. This work also supports the utility of the silicone wristband to assess personal PAH exposure.

A Community-Academic Partnership to Reduce Lead Exposure From an Elevated Roadway Demolition, Cincinnati, Ohio, 2012

Disseminating public health recommendations to community members is an important step in protecting the public's health. We describe a community-academic partnership comprising health-based organizations, community groups, academia, and government organizations. This partnership undertook an iterative process to develop an outreach plan, educational materials, and activities to bring lead-poisoning prevention recommendations from a health impact assessment of a roadway demolition/construction project to the residents of an affected neighborhood in Cincinnati, Ohio, in 2012. Community partners played a key role in developing outreach and prevention activities. As a result of this project, activities among members of the partnership continue.

Impact of air manganese on child neurodevelopment in East Liverpool, Ohio

BACKGROUND

East Liverpool, Ohio, the site of a hazardous waste incinerator and a manganese (Mn) processor, has had air Mn concentrations exceeding United States Environmental Protection Agency reference levels for over a decade. Save Our County, Inc., a community organization, was formed to address community environmental health concerns related to local industry. Researchers from the University of Cincinnati partnered with Save Our County to determine if air Mn had an impact on the neurocognitive function of children in the community.

METHODS

Children 7-9 years of age from East Liverpool and its surrounding communities, were enrolled (N=106) in the Communities Actively Researching Exposure Study from between March 2013-June 2014. Blood and hair were analyzed for Mn and lead, and serum was analyzed for cotinine. We used linear regression to assess associations between biological measures and IQ subscale scores.

RESULTS

Geometric mean blood lead (n=67), blood Mn (n=66), hair Mn (n=98), and serum cotinine (n=69) concentrations were 1.13±1.96μg/dL, 10.06±1.30μg/L, and 360.22±2.17ng/g, 0.76±6.12μg/L respectively. After adjusting for potential confounders, hair Mn was negatively associated with Full Scale IQ.

CONCLUSIONS

Hair Mn was negatively associated with child IQ scores. Community partners were instrumental in the conception and implementation of this study.

Development and Evaluation of a Manganese and Iron Food Frequency Questionnaire for Pediatrics

Manganese (Mn) is an essential nutrient, but overexposure can lead to neurotoxicity. Given the essentiality of Mn in the diet, particularly during children's growth and development, it is imperative to quantify dietary Mn intake in populations that may be exposed to industrial sources of Mn. Dietary absorption of Mn is inversely associated with iron (Fe) stores, yet there is currently no food frequency questionnaire (FFQ) to assess dietary Mn and Fe intake. The study objective was to develop and evaluate the validity of a FFQ to measure dietary Mn and Fe intake in pediatrics by comparing the estimated intakes of Mn and Fe with biomarkers: Mn in blood and hair and Fe in serum. This study utilized a subset of the Communities Actively Researching Exposure Study (CARES) population residing in Guernsey County, Ohio. Dietary Mn was not correlated with either blood or hair Mn; however, dietary Mn and serum ferritin were significantly correlated, with a correlation coefficient of 0.51, p < 0.01. Moreover, dietary Fe and serum ferritin were also significantly correlated, with a correlation coefficient of 0.51, p < 0.01. This FFQ is a valid measurement tool for Fe intake as measured by serum ferritin; however, Mn intake did not correlate with either blood or hair Mn.

Determination of Lead with a Copper-Based Electrochemical Sensor

This work demonstrates determination of lead (Pb) in surface water samples using a low-cost copper (Cu)-based electrochemical sensor. Heavy metals require careful monitoring due to their toxicity, yet current methods are too complex or bulky for point-of-care (POC) use. Electrochemistry offers a convenient alternative for metal determination, but the traditional electrodes, such as carbon or gold/platinum, are costly and difficult to microfabricate. Our copper-based sensor features a low-cost electrode material-copper-that offers simple fabrication and competitive performance in electrochemical detection. For anodic stripping voltammetry (ASV) of Pb, our sensor shows 21 nM (4.4 ppb) limit of detection, resistance to interfering metals such as cadmium (Cd) and zinc (Zn), and stable response in natural water samples with minimum sample pretreatment. These results suggest this electrochemical sensor is suitable for environmental and potentially biological applications, where accurate and rapid, yet inexpensive, on-site monitoring is necessary.

Pathways of inhalation exposure to manganese in children living near a ferromanganese refinery: A structural equation modeling approach

Manganese (Mn) is both essential element and neurotoxicant. Exposure to Mn can occur from various sources and routes. Structural equation modeling was used to examine routes of exposure to Mn among children residing near a ferromanganese refinery in Marietta, Ohio. An inhalation pathway model to ambient air Mn was hypothesized. Data for model evaluation were obtained from participants in the Communities Actively Researching Exposure Study (CARES). These data were collected in 2009 and included levels of Mn in residential soil and dust, levels of Mn in children's hair, information on the amount of time the child spent outside, heat and air conditioning in the home and level of parent education. Hair Mn concentration was the primary endogenous variable used to assess the theoretical inhalation exposure pathways. The model indicated that household dust Mn was a significant contributor to child hair Mn (0.37). Annual ambient air Mn concentration (0.26), time children spent outside (0.24) and soil Mn (0.24) significantly contributed to the amount of Mn in household dust. These results provide a potential framework for understanding the inhalation exposure pathway for children exposed to ambient air Mn who live in proximity to an industrial emission source.

Comparison of stationary and personal air sampling with an air dispersion model for children's ambient exposure to manganese

Manganese (Mn) is ubiquitous in the environment and essential for normal growth and development, yet excessive exposure can lead to impairments in neurological function. This study modeled ambient Mn concentrations as an alternative to stationary and personal air sampling to assess exposure for children enrolled in the Communities Actively Researching Exposure Study in Marietta, OH. Ambient air Mn concentration values were modeled using US Environmental Protection Agency's Air Dispersion Model AERMOD based on emissions from the ferromanganese refinery located in Marietta. Modeled Mn concentrations were compared with Mn concentrations from a nearby stationary air monitor. The Index of Agreement for modeled versus monitored data was 0.34 (48 h levels) and 0.79 (monthly levels). Fractional bias was 0.026 for 48 h levels and -0.019 for monthly levels. The ratio of modeled ambient air Mn to measured ambient air Mn at the annual time scale was 0.94. Modeled values were also time matched to personal air samples for 19 children. The modeled values explained a greater degree of variability in personal exposures compared with time-weighted distance from the emission source. Based on these results modeled Mn concentrations provided a suitable approach for assessing airborne Mn exposure in this cohort.

Emissions of Polycyclic Aromatic Hydrocarbons from Natural Gas Extraction into Air

Natural gas extraction, often referred to as "fracking", has increased rapidly in the United States in recent years. To address potential health impacts, passive air samplers were deployed in a rural community heavily affected by the natural gas boom. Samplers were analyzed for 62 polycyclic aromatic hydrocarbons (PAHs). Results were grouped based on distance from each sampler to the nearest active well. Levels of benzo[a]pyrene, phenanthrene, and carcinogenic potency of PAH mixtures were highest when samplers were closest to active wells. PAH levels closest to natural gas activity were comparable to levels previously reported in rural areas in winter. Sourcing ratios indicated that PAHs were predominantly petrogenic, suggesting that PAH levels were influenced by direct releases from the earth. Quantitative human health risk assessment estimated the excess lifetime cancer risks associated with exposure to the measured PAHs. At sites closest to active wells, the risk estimated for maximum residential exposure was 0.04 in a million, which is below the U.S. Environmental Protection Agency's acceptable risk level. Overall, risk estimates decreased 30% when comparing results from samplers closest to active wells to those farthest from them. This work suggests that natural gas extraction is contributing PAHs to the air, at levels that would not be expected to increase cancer risk.

Emissions of Polycyclic Aromatic Hydrocarbons from Natural Gas Extraction into Air

Natural gas extraction, often referred to as "fracking", has increased rapidly in the United States in recent years. To address potential health impacts, passive air samplers were deployed in a rural community heavily affected by the natural gas boom. Samplers were analyzed for 62 polycyclic aromatic hydrocarbons (PAHs). Results were grouped based on distance from each sampler to the nearest active well. Levels of benzo[a]pyrene, phenanthrene, and carcinogenic potency of PAH mixtures were highest when samplers were closest to active wells. PAH levels closest to natural gas activity were comparable to levels previously reported in rural areas in winter. Sourcing ratios indicated that PAHs were predominantly petrogenic, suggesting that PAH levels were influenced by direct releases from the earth. Quantitative human health risk assessment estimated the excess lifetime cancer risks associated with exposure to the measured PAHs. At sites closest to active wells, the risk estimated for maximum residential exposure was 0.04 in a million, which is below the U.S. Environmental Protection Agency's acceptable risk level. Overall, risk estimates decreased 30% when comparing results from samplers closest to active wells to those farthest from them. This work suggests that natural gas extraction is contributing PAHs to the air, at levels that would not be expected to increase cancer risk.

Community Engagement and Data Disclosure in Environmental Health Research

Federal funding agencies increasingly support stakeholder participation in environmental health studies, and yet there is very little published research on engagement of community members in the development of data disclosure (DD) strategies. The Ohio Environmental Protection Agency reported airborne manganese (Mn) concentrations in East Liverpool, Ohio, 30 times higher than the reference concentration, which led to an academic–community research partnership to address community concern about Mn exposure, particularly among children. Children and their families were recruited to participate in a pilot study. Samples of blood and hair were collected from the children and analyzed for metals. DD mechanisms were developed using an iterative approach between community and academic partners. Individual DD letters were mailed to each participating family, and a community meeting was held. A post-meeting survey was administered to gauge community perception of the DD strategies. The purpose of this article is to demonstrate the effectiveness of engaging community partners in the conduct of environmental health research and in the development of DD strategies for individuals and the community at large. Scientists should include community partners in the development of DD strategies to enhance translation of the research findings and support the right of study participants to know their individual results.

Exposure to airborne particulate matter during pregnancy is associated with preterm birth: a population-based cohort study

BACKGROUND

Test the hypothesis that exposure to fine particulate matter in the air (PM2.5) is associated with increased risk of preterm birth (PTB).

METHODS

Geo-spatial population-based cohort study using live birth records from Ohio (2007-2010) linked to average daily measures of PM2.5, recorded by 57 EPA network monitoring stations across the state. Geographic coordinates of the home residence for births were linked to the nearest monitoring station using ArcGIS. Association between PTB and high PM2.5 levels (above the EPA annual standard of 15 μg/m(3)) was estimated using GEE, with adjustment for age, race, education, parity, insurance, tobacco, birth season and year, and infant gender. An exchangeable correlation matrix for the monitor stations was used in the models. Analyses were limited to non-anomalous singleton births at 20-42weeks with no known chromosome abnormality occurring within 10 km of a monitor station.

RESULTS

The frequency of PTB was 8.5 % in the study cohort of 224,921 singleton live births. High PM2.5 exposure (>EPA recommended maximum) occurred frequently during the study period, with 24,662 women (11 %) having high exposure in all three trimesters. Pregnancies with high PM2.5 exposure through pregnancy had increased PTB risk even after adjustment for coexisting risk factors, adjOR 1.19 (95 % CI 1.09-1.30). Assessed per trimester, high 3(rd) trimester PM2.5 exposure resulted in the highest PTB risk, adjOR 1.28 (95 % CI 1.20-1.37).

CONCLUSIONS

Exposure to high levels of particulate air pollution, PM2.5, in pregnancy is associated with a 19 % increased risk of PTB; with greatest risk with high 3(rd) trimester exposure. Although the risk increase associated with high PM2.5 levels is modest, the potential impact on overall PTB rates is robust as all pregnant women are potentially at risk. This exposure may in part contribute to the higher preterm birth rates in Ohio compared to other states in the US, especially in urban areas.

Manganese Exposure and Neurocognitive Outcomes in Rural School-Age Children: The Communities Actively Researching Exposure Study (Ohio, USA)

BACKGROUND

Manganese (Mn) plays a vital role in brain growth and development, yet excessive exposure can result in neurotoxicity. Marietta, Ohio, is home to the nation's longest-operating ferromanganese refinery, and community concern about exposure led to the development of the research study.

OBJECTIVES

Our overall goal was to address the community's primary research question: "Does Mn affect cognitive development of children?" We evaluated the relationships between Mn exposure as measured by blood and hair Mn, along with other neurotoxicants including blood lead (Pb) and serum cotinine, and child cognition.

METHODS

Children 7-9 years of age were enrolled (n = 404) in the Communities Actively Researching Exposure Study (CARES) from Marietta and Cambridge, Ohio, and their surrounding communities from October 2008 through March 2013. Blood and hair were analyzed for Mn and Pb, and serum was analyzed for cotinine. We used penalized splines to assess potential nonlinear associations between biological measures and IQ subscale scores, followed by multivariable regression models with categorical variables based on quartiles of the distribution for biological measures with nonlinear associations and continuous variables for biological measures with linear associations.

RESULTS

Geometric mean blood (n = 327) and hair Mn (n = 370) concentrations were 9.67 ± 1.27 μg/L and 416.51 ± 2.44 ng/g, respectively. After adjusting for potential confounders, both low and high blood and hair Mn concentrations were associated with lower Full Scale IQ and subscale scores, with significant negative associations between the highest quartile and middle two quartiles of blood Mn (β -3.51; 95% CI: -6.64, -0.38) and hair Mn (β -3.66; 95% CI: -6.9, -0.43%) and Full Scale IQ.

CONCLUSIONS

Both low and high Mn concentrations in blood and hair were negatively associated with child IQ scores. Serum cotinine was negatively associated with child cognitive function.

Secondhand Tobacco Smoke Exposure and Neuromotor Function in Rural Children

OBJECTIVE

To investigate the relationship between secondhand tobacco smoke (SHS) exposure and neuromotor function in children.

STUDY DESIGN

We studied 404 children aged 7-9 years who were exposed to SHS and other environmental neurotoxicants. Parents reported smoking habits, and serum cotinine levels were measured in children to determine SHS exposure. The Halstead-Reitan Finger Oscillation Test, Purdue Grooved Pegboard Test-Kiddie version, and Bruininks-Oseretsky Test of Motor Proficiency 2-Short Form were used to assess neuromotor function. Multivariable regression models that accounted for potential confounders were used to evaluate the associations.

RESULTS

Approximately 50% of the children were exposed to SHS based on serum cotinine measures. Exposure to SHS was significantly associated with motor impairment in children, including diminished visuomotor coordination (P = .01), fine motor integration (P = .01), balance (P = .02), and strength (P = .04) after adjusting for exposures to lead and manganese, age, sex, body mass index, measures of parental cognitive abilities, parental education, and quality of home environment.

CONCLUSION

SHS is a neurotoxicant that may be associated with impaired childhood neuromotor function.

Impact of natural gas extraction on PAH levels in ambient air

Natural gas extraction, often referred to as "fracking," has increased rapidly in the U.S. in recent years. To address potential health impacts, passive air samplers were deployed in a rural community heavily affected by the natural gas boom. Samplers were analyzed for 62 polycyclic aromatic hydrocarbons (PAHs). Results were grouped based on distance from each sampler to the nearest active well. PAH levels were highest when samplers were closest to active wells. Additionally, PAH levels closest to natural gas activity were an order of magnitude higher than levels previously reported in rural areas. Sourcing ratios indicate that PAHs were predominantly petrogenic, suggesting that elevated PAH levels were influenced by direct releases from the earth. Quantitative human health risk assessment estimated the excess lifetime cancer risks associated with exposure to the measured PAHs. Closest to active wells, the risk estimated for maximum residential exposure was 2.9 in 10 000, which is above the U.S. EPA's acceptable risk level. Overall, risk estimates decreased 30% when comparing results from samplers closest to active wells to those farthest. This work suggests that natural gas extraction may be contributing significantly to PAHs in air, at levels that are relevant to human health.

NIH grant awards as a metric of clinical and translational research training effectiveness

The number of clinical research training programs has increased over the past 5-10 years, but few studies have quantitatively evaluated the effectiveness of these programs. The goal of this study was to evaluate the clinical and translational research training program at the University of Cincinnati by comparing the number of National Institutes of Health grants awarded to pediatric fellows who graduated from the MS degree program between 1995 and 2013 versus fellows who did not pursue an MS degree. Among 394 pediatric fellows, 16 of 81 (20%) MS alumni were awarded at least one NIH grant, as compared with 28 of 313 (9%) fellows who did not obtain an MS degree (p < 0.02). In multivariable analysis, MS alumni were more than three times as likely to have received at least one grant than were non-MS fellows (OR = 3.5, 95% CI [1.7-7.2]; C-statistic = 0.71) and MS alumni were more likely to obtain at least one K-series (OR = 4.1, 95% CI [1.6-10.2]; C-statistic = 0.74), M-series (OR = 11.8, 95% CI [3.4-41.4]; C-statistic = 0.81), or R-series (OR = 10.1, 95% CI [2.4-42.8]; C-statistic = 0.74) grant than were non-MS fellows. These findings suggest that graduate training in clinical and translational research prepares graduates for the highly competitive field of clinical and translational research.

Copper-based electrochemical sensor with palladium electrode for cathodic stripping voltammetry of manganese

In this work, we report on the development of a palladium-based, microfabricated point-of-care electrochemical sensor for the determination of manganese using square wave cathodic stripping voltammetry. Heavy metals require careful monitoring, yet current methods are too complex for a point-of-care system. Voltammetry offers an attractive approach to metal detection on the microscale, but traditional carbon, gold, or platinum electrodes are difficult or expensive to microfabricate, preventing widespread use. Our sensor uses palladium working and auxiliary electrodes and integrates them with a copper-based reference electrode for simple fabrication and compatibility with microfabrication and printed circuit board processing, while maintaining competitive performance in electrochemical detection. Copper electrodes were prepared on glass substrate using a combination of microfabrication procedures followed by electrodeposition of palladium. The disposable sensor system was formed by bonding a poly(dimethylsiloxane) (PDMS) well to the glass substrate. Cathodic stripping voltammetry of manganese using our new disposable palladium-based sensors exhibited 334 nM (18.3 ppb) limit of detection in borate buffer. The sensor was used to demonstrate manganese determination in natural water samples from a pond in Burnet Woods, located in Cincinnati, OH, and the Ohio River.

Efficacy of Environmental Health E-Training for Journalists

Communities report a low level of trust in environmental health media coverage. In order to support risk communication objectives, the goals of the research study were to identify whether or not there is a gap in environmental reporting training for journalists, to outline journalists' methods for gathering environmental health news, to observe journalists' attitudes toward environmental health training and communication, and to determine if electronic training (online/e-training) can effectively train journalists in environmental health topics. The results indicated that environmental journalists have very little to no formal environmental journalism training. In addition, a significant percentage of journalists do not have any formal journalism education. Respondents most preferred to receive continuing environmental journalism training online. Online instruction was also perceived as effective in increasing knowledge and providing necessary reporting tools, even among participants adverse to online instructional methods. Our findings highlight the changing media climate's need for an increase in electronic journalism education opportunities to support environmental health journalism competencies among working professional journalists.

Exposure of firefighters to particulates and polycyclic aromatic hydrocarbons

Firefighting continues to be among the most hazardous yet least studied occupations in terms of exposures and their relationship to occupational disease. Exposures are complex, involving mixtures of particles and chemicals such as polycyclic aromatic hydrocarbons (PAHs). Adverse health effects associated with these agents include elevated incidences of coronary heart disease and several cancers. PAHs have been detected at fire scenes, and in the firehouse rest area and kitchen, routinely adjoining the truck bay, and where firefighters spend a major part of each shift. An academic-community partnership was developed with the Cincinnati Fire Department with the goal of understanding active firefighters' airborne and dermal PAH exposure. PAHs were measured in air and particulates, and number and mass concentrations, respectively, of submicron (0.02-1 μm) and PM2.5 (2.5 μm diameter and less) particles during overhaul events in two firehouses and a University of Cincinnati administrative facility as a comparison location. During overhaul firefighters evaluate partially combusted materials for re-ignition after fire extinguishment and commonly remove Self-Contained Breathing Apparatus (SCBA). Face and neck wipes were also collected at a domestic fire scene. Overhaul air samples had higher mean concentrations of PM2.5 and submicron particles than those collected in the firehouse, principally in the truck bay and kitchen. Among the 17 PAHs analyzed, only naphthalene and acenaphthylene were generally detectable. Naphthalene was present in 7 out of 8 overhaul activities, in 2 out of 3 firehouse (kitchen and truck bay) samples, and in none collected from the control site. In firefighter face and neck wipes a greater number of PAHs were found, several of which have carcinogenic activity, such as benzofluoranthene, an agent also found in overhaul air samples. Although the concentration for naphthalene, and all other individual PAHs, was very low, the potential simultaneous exposure to multiple chemicals even in small quantities in combination with high ultrafine particle exposure deserves further study. It is recommended that personal respiratory and skin protection be worn throughout the overhaul process.

Childhood exposure to manganese and postural instability in children living near a ferromanganese refinery in Southeastern Ohio

Airborne manganese (Mn) exposure can result in neurotoxicity and postural instability in occupationally exposed workers, yet few studies have explored the association ambient exposure to Mn in children and postural stability. The goal of this study was to determine the association between Mn and lead (Pb) exposure, as measured by blood Pb, blood and hair Mn and time weighted distance (TWD) from a ferromanganese refinery, and postural stability in children. A subset of children ages 7-9 years enrolled in the Marietta Community Actively Researching Exposure Study (CARES) were invited to participate. Postural balance was conducted on 55 children residing in Marietta, Ohio and the surrounding area. Samples of blood were collected and analyzed for Mn and Pb, and samples of hair were analyzed for Mn. Neuromotor performance was assessed using postural balance testing with a computer force platform system. Pearson correlations were calculated to identify key covariates. Associations between postural balance testing conditions and Mn and Pb exposure were estimated with linear regression analyses adjusting for gender, age, parent IQ, and parent age. Mean blood Mn was 10 μg/L (SEM=0.36), mean blood Pb was 0.85 μg/dL (SEM=0.05), and mean hair Mn was 0.76 μg/g (SEM=0.16). Mean residential distance from the refinery was 11.5 km (SEM=0.46). All three measures of Mn exposure were significantly associated with poor postural balance. In addition, low-level blood Pb was also negatively associated with balance outcomes. We conclude that Mn exposure and low-level blood Pb are significantly associated with poor postural balance.

Publication track records as a metric of clinical research training effectiveness

Clinical research training programs exist across the country, but no quantitative studies have been performed to evaluate the effectiveness of these programs. The goal of this study was to evaluate the success of the clinical research training program at the University of Cincinnati by comparing the publication histories of pediatric fellows who graduated from the clinical and translational research Master of Science (MS) degree programs between 1995 and 2011 with fellows who did not pursue an MS degree. Among 296 pediatric fellows, 44 of 54 graduates (81%) published at least 1 first-authored paper, as compared with 149 of 242 (62%) fellows who did not obtain an MS degree (P < 0.01). In multivariable analysis, 3-4 years after program completion, MS graduates published more papers overall (R(2) = 0.10) and more first-authored papers than did non-MS graduates (R(2) = 0.04). These findings suggest that graduate training in clinical and translational research is related to an increase in research productivity as assessed by publication rates.

Clinical and translational scientist career success: metrics for evaluation

Despite the increased emphasis on formal training in clinical and translational research and the growth in the number and scope of training programs over the past decade, the impact of training on research productivity and career success has yet to be fully evaluated at the institutional level. In this article, the Education Evaluation Working Group of the Clinical and Translational Science Award Consortium introduces selected metrics and methods associated with the assessment of key factors that affect research career success. The goals in providing this information are to encourage more consistent data collection across training sites, to foster more rigorous and systematic exploration of factors associated with career success, and to help address previously identified difficulties in program evaluation.

Perceptions of genetic research in three rural Appalachian Ohio communities

Appalachian Americans are an underserved population with increased risk for diseases having strong genetic and environmental precursors. The purpose of this study is to understand the thoughts and perceptions of genetic research of Appalachian Americans residing in eastern Ohio prior to conducting a genetic research study with this population. A genetic survey was developed and completed by 180 participants from Marietta, Cambridge and East Liverpool, Ohio. The majority of respondents were Caucasian women with a median age of 37.5 years. We found that participants had a high interest in participating in 80 %, allowing their children to participate in 78 %, and learning more about genetic research studies (90 %); moreover, they thought that genetic research studies are useful to society (93 %). When asked what information would be useful when deciding to participate in a genetic research study, the following were most important: how environmental pollutants affect their genes and their child's genes (84 %), types of biological specimens needed for genetic research studies (75 %) and who will have access to their samples (75 %). Of the 20 % who responded that they were "unsure" about participating in a genetic research study, the leading reason was "I don't have enough information about genetic research to make a decision" (56 %). We also asked respondents to choose their preferred method for receiving genetic information, and the principal response was to read a brochure (40 %). Findings from this study will improve community education materials and dissemination methods that are tailored for underserved populations engaged in genetic research.

Assessment of personal exposure to manganese in children living near a ferromanganese refinery

Airborne exposure to manganese (Mn) can result in neurologic effects. Stationary air sampling is the traditional technique to assess Mn exposure for communities, yet may not accurately reflect children's personal exposure. The goal of the study was to characterize personal exposure to Mn and PM(2.5) in a cohort of children ages 7-9 years residing near a ferromanganese refinery. A subset of children living in non-smoking households ages 7-9 enrolled in the Marietta Community Actively Researching Exposure Study during March-June 2009 and 2010 were invited to participate. Blood and hair were collected and analyzed for Mn. Participants wore a PM(2.5) sampler (Personal Modular Impactor) for 48 h. TWD was based on time spent at home and school and the distance of each from the refinery. Stationary outdoor air sampling was conducted 8 km from the refinery using a Harvard-type PM(2.5) impactor. The relationship between personal Mn exposure and TWD was examined by multiple regression adjusting for stationary air Mn concentration, wind speed and direction, and precipitation. Complete personal air sampling data were collected on 38 children. TWD ranged from 4.7 km to 28.5 km with a mean distance of 11.1 (4.7 sd) km. Mn concentration in personal air samples ranged from 1.5 ng/m3 to 54.5 ng/m3 (geometric mean, 8.1 ng/m3). TWD was a significant predictor of natural log personal air Mn concentration (lnMn) with an associated decrease of 0.075 lnMn for each km TWD (p<0.05, 95% CI -0.13 to -0.01). Personal Mn exposures were positively associated with stationary air Mn levels and inversely associated with wind speed. A child's location (home and school) relative to the refinery is a significant predictor of personal Mn exposure. Wind speed is also an important contributor to personal Mn exposure.