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Biomedical subjects

J L Pirkle

Publications and source records attributed to J L Pirkle.

At least 19 recordsLinked to original sources

Exposure of the US population to environmental tobacco smoke: the Third National Health and Nutrition Examination Survey, 1988 to 1991.

OBJECTIVE: To estimate the extent of exposure of the US population to environmental tobacco smoke and the contribution of the home and workplace environment to environmental tobacco smoke exposure. DESIGN: Nationally representative cross-sectional survey including questionnaire information from persons aged 2 months and older (n=16818) and measurements of serum cotinine (a metabolite of nicotine) from persons aged 4 years and older (n=10642). SETTING/PARTICIPANTS: Participants in the Third National Health and Nutrition Examination Survey, October 25, 1988, to October 21, 1991. RESULTS: Of US children aged 2 months to 11 years, 43% lived in a home with at least 1 smoker, and 37% of adult non-tobacco users lived in a home with at least 1 smoker or reported environmental tobacco smoke exposure at work. Serum cotinine levels indicated more widespread exposure to nictoine. Of non-tobacco users, 87.9% had detectable levels of serum cotinine. Both the number of smokers in the household and the hours exposed at work were significantly and independently associated (P<.001, multiple regression t test) with increased serum cotinine levels. Serum cotinine levels of children, non-Hispanic blacks, and males indicated that these groups had higher exposure to environmental tobacco smoke. Dietary variables showed no consistent association with serum cotinine levels, and dietary contribution to serum cotinine level, if any, appeared to be extremely small. CONCLUSIONS: The high proportion of the population with detectable serum cotinine levels indicates widespread exposure to environmental tobacco smoke in the US population. Both the home and workplace environments significantly contribute to environmental tobacco smoke exposure in the United States.

Adolescent

Pharmacokinetics of TCDD in veterans of Operation Ranch Hand: 10-year follow-up.

Using multiple measurements from serum collected over 10 yr (1982, 1987, and 1992), we estimated the half-life of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in 213 veterans of Operation Ranch Hand, the Air Force unit responsible for the aerial spraying of Agent Orange in Vietnam. The potential influences of age, percent body fat, and changes in percent body fat on the half-life estimate were also examined. The mean decay rate of TCDD for these veterans is 0.0797 per year with 95% confidence interval 0.0727 to 0.0868 per year; the corresponding half-life estimate is 8.7 yr with 95% confidence interval 8.0-9.5 yr. Half-life increased significantly with increasing body fat, but not with age or relative changes in percent body fat.

Adipose Tissue

Using biological monitoring to assess human exposure to priority toxicants.

Scientifically valid exposure assessment is crucial to risk assessment, risk management, and prevention of environmental disease. Scientists have used three tools to assess exposure: exposure history/questionnaire, environmental monitoring (including personal monitoring), and biological monitoring. Combinations of these tools usually provide the exposure information needed to meet objectives of human studies evaluating the exposure-health effect relationship. Biological monitoring is a capable exposure assessment tool that has provided important information used in public health decisions. We briefly describe how risk assessment and risk management decisions for lead, dioxin, and volatile organic compounds have substantially benefited from exposure information obtained from biological monitoring.

Dioxins

The priority toxicant reference range study: interim report.

The relationship between human exposure to environmental toxicants and health effects is of utmost interest to public health scientists. To define this relationship, these scientists need accurate and precise methods for assessing human exposure and effects. One of the most accurate and precise means of assessing exposure is to measure the level of the toxicant or its primary metabolite in a biologic specimen; this has been defined as measuring the internal dose. This measurement must be quantitative to best study the dose-response relationship. Pertinent questions asked during an exposure assessment include "How do the levels of a given toxicant in a particular population compare with the levels of that toxicant in other populations?" and "What is the prevalence of exposure to that toxicant in other populations?" To answer these questions for two chemical classes of environmental toxicants, we developed state-of-the-art analytic methods and then applied them to measure the levels of 44 environmental toxicants in biologic specimens from 1000 United States residents who participated in the Third National Health and Nutrition Examination Survey (NHANES III). These 1000 people are a cross-sectional subset of the NHANES III population and were selected from urban and rural communities in four regions of the United States; all were between 20 and 59 years of age. This subset is not a probability-based sample.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Blood lead levels in the US population. Phase 1 of the Third National Health and Nutrition Examination Survey (NHANES III, 1988 to 1991)

OBJECTIVE: To determine mean blood lead levels and their sociodemographic correlates in the US population. DESIGN: Nationally representative cross-sectional health examination survey that included measurements of venous blood lead. PARTICIPANTS: A total of 13,201 persons aged 1 year and older examined during phase 1 of the third National Health and Nutrition Examination Survey (1988 to 1991). RESULTS: The overall mean blood lead level for the US population was 0.14 mumol/L (2.8 micrograms/dL). Blood lead levels were consistently higher for younger children than for older children, for older adults than for younger adults, for males than for females, for blacks than for whites, and for central-city residents than for non-central-city residents. Other correlates of higher blood lead levels included low income, low educational attainment, and residence in the Northeast region of the United States. National estimates for children 1 to 5 years of age indicate that 8.9%, or approximately 1.7 million children, have blood lead levels 0.48 mumol/L (10 micrograms/dL) or greater. These levels are high enough to be of health concern under 1991 Centers for Disease Control and Prevention guidelines. CONCLUSIONS: The low overall mean blood lead levels demonstrate a major public health success in primary prevention efforts. However, exposure to lead at levels that may adversely affect the health of children remains a problem especially for those who are minority, urban, and from low-income families. Strategies to identify the most vulnerable risk groups are necessary to further reduce lead exposure in the United States.

Adolescent

The decline in blood lead levels in the United States. The National Health and Nutrition Examination Surveys (NHANES)

OBJECTIVE: To describe trends in blood lead levels for the US population and selected population subgroups during the time period between 1976 and 1991. DESIGN: Two nationally representative cross-sectional surveys and one cross-sectional survey representing Mexican Americans in the southwestern United States. SETTING/PARTICIPANTS: Participants in two national surveys that included blood lead measurements: the second National Health and Nutrition Examination Survey, 1976 to 1980 (n = 9832), and phase 1 of the third National Health and Nutrition Examination Survey, 1988 to 1991 (n = 12,119). Also, Mexican Americans participating in the Hispanic Health and Nutrition Examination Survey, 1982 to 1984 (n = 5682). RESULTS: The mean blood lead level of persons aged 1 to 74 years dropped 78%, from 0.62 to 0.14 mumol/L (12.8 to 2.8 micrograms/dL). Mean blood lead levels of children aged 1 to 5 years declined 77% (0.66 to 0.15 mumol/L [13.7 to 3.2 micrograms/dL]) for non-Hispanic white children and 72% (0.97 to 0.27 mumol/L [20.2 to 5.6 micrograms/dL]) for non-Hispanic black children. The prevalence of blood lead levels 0.48 mumol/L (10 micrograms/dL) or greater for children aged 1 to 5 years declined from 85.0% to 5.5% for non-Hispanic white children and from 97.7% to 20.6% for non-Hispanic black children. Similar declines were found in population subgroups defined by age, sex, race/ethnicity, income level, and urban status. Mexican Americans also showed similar declines in blood lead levels of a slightly smaller magnitude over a shorter time. CONCLUSIONS: The results demonstrate a substantial decline in blood lead levels of the entire US population and within selected subgroups of the population. The major cause of the observed decline in blood lead levels is most likely the removal of 99.8% of lead from gasoline and the removal of lead from soldered cans. Although these data indicate major progress in reducing lead exposure, they also show that the same sociodemographic factors continue to be associated with higher blood lead levels, including younger age, male sex, non-Hispanic black race/ethnicity, and low income level. Future efforts to remove other lead sources (eg, paint, dust, and soil) are needed but will be more difficult than removing lead from gasoline and soldered cans.

Adolescent

Determinants of TCDD half-life in veterans of operation ranch hand.

The half-life of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) changed significantly with body fat and age in 337 members of Operation Ranch Hand, the Air Force unit responsible for the aerial spraying of Agent Orange in Vietnam. Using paired TCDD measurements derived from serum collected in 1982 and in 1987, we investigated how TCDD half-life varied with percent body fat (PBF), relative changes in PBF, and age. We found that half-life increased significantly with increasing PBF and decreased significantly with increasing relative change in PBF and with age. The median observed half-life of TCDD for these 337 veterans is 11.3 yr with a nonparametric 95% confidence interval of 10.0-14.1 yr.

Adipose Tissue

Technical and scientific developments in exposure marker methodology.

Recent advances in techniques to measure markers of exposure to environmental toxicants in humans are changing the ways in which environmental scientists, epidemiologists, and policymakers characterize and interpret such exposure. In this article we review some major technical and scientific developments in exposure marker methodology for estimating internal dose, with special reference to studies conducted at the US Centers for Disease Control and Prevention. We consider important characteristics of laboratory methods, advances in laboratory technology, analytical standards, and quality assurance of laboratory measurements; comparisons with indirect methods for estimating exposures, such as exposure indices and questionnaires; human pharmacokinetic data; sampling problems; surveillance of human exposures to toxicants; and interpretation of measurements. With a view to increasing the reliability of exposure assessment, we make recommendations for obtaining more data on human exposure to toxicants.

Biomarkers

Performance characteristics of a composite multivariate quality control system.

We present the results of an evaluation of the performance characteristics of a composite multivariate quality control (CMQC) system that incorporates quality control rules for univariate, multivariate, and correlation conditions. The CMQC system evaluated is designed to help analysts detect unacceptable trends and systematic error in one or more variables, unacceptable random error in one or more variables, and unacceptable changes in the correlation structure of any pair of variables. It is also designed to be tolerant of missing data, to allow analysts to reject as few as one or as many as all variables in a run, and to provide analysts with control statistics and graphics that logically relate to sources of analytical error. We show that the various components of the CMQC system have adequate statistical power to detect systematic errors, random errors, and correlation changes under the conditions likely to be encountered with multivariate analytical measurement systems: (1) a single variable with increased systematic or random error; (2) all variables or a subgroup of variables affected by a common problem that increases systematic or random error; and (3) missing data for one or more variables in a run. We also show that the power of the multivariate component of the CMQC system to detect systematic and random errors is higher than the power of an alternative multivariate test criterion.

Chemistry Techniques, Analytical

Assessing the direction of causality in cross-sectional studies.

Interpretation of observational studies is difficult, particularly in cross-sectional studies, because the direction of cause and effect may be difficult to assess: Did the "outcome" affect the measured exposure level, or did the exposure affect the outcome? In this paper, the authors describe a pattern, the "checkmark pattern," which can arise in cross-sectional studies. This pattern is characterized by higher levels of the outcome in an unexposed comparison group than in some subgroups of the exposed. The pattern, if seen in certain types of observational studies, suggests that the "outcome" variable may have affected the measured exposure level. Recognition of the pattern may help the epidemiologist to decipher the causal sequence. Two examples illustrate the issues involved.

Adipose Tissue

Investigation of TCDD half-life heterogeneity in veterans of Operation Ranch Hand.

The half-life of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), the contaminant of Agent Orange, has been recently estimated in 36 members of Operation Ranch Hand, the Air Force unit responsible for the aerial spraying of Agent Orange in Vietnam, as 7.1 yr with a 95% [corrected] confidence interval of 5.8-9.6 yr. We investigated the variability of TCDD half-life with percent body fat in these 36 Ranch Hand veterans who have two TCDD assay results from serum drawn in 1982 and 1987. Using a repeated measures linear model, we found a marginally significant change in half-life with percentage of body fat (p = .09) and no statistically significant change in half-life with relative changes in percentage of body fat from 1982 to 1987 (p = .60).

Body Composition

Composite multivariate quality control using a system of univariate, bivariate, and multivariate quality control rules.

We propose a composite multivariate quality control (CMQC) system to control simultaneously measured variables. This system is designed to detect unacceptable trends and systematic error in one or more variables, unacceptable random error in one or more variables, and unacceptable changes in the correlation structure in any pair of variables. It is also designed to be tolerant of missing data, to be capable of rejecting as few as one or as many as all variables in a run, and to provide the analyst with control statistics and graphics that logically relate to sources of analytical error. Quality control rules for univariate, multivariate, and correlation conditions are incorporated in the system, as are plots displaying CMQC statistic values and control limits for univariate, multivariate, and correlation parameters. We also discuss advantages of the CMQC over the T2 and principal component multivariate quality control methods. We demonstrate the CMQC procedure using data from a laboratory process in which 40 variables were measured during 40 characterization runs and 23 runs analyzing unknowns.

Chemistry Techniques, Analytical

Estimates of the half-life of 2,3,7,8-tetrachlorodibenzo-p-dioxin in Vietnam Veterans of Operation Ranch Hand.

The half-life of 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD; commonly known as dioxin) in serum has been measured in 36 Air Force Vietnam veterans of Operation Ranch Hand, which was the operation that aerially sprayed the herbicide Agent Orange in Vietnam. From serum specimens taken in 1982 and 1987, the median half-life of 2,3,7,8-TCDD in these Ranch Hand veterans was found to be 7.1 yr (95% confidence interval about the median of 5.8-9.6 yr). These veterans reported no civilian exposure to dioxin or herbicides. Concentrations of 2,3,7,8-TCDD in the 1982 serum specimens from these veterans ranged from 16.9 to 423 parts per trillion on a lipid weight basis. The half-life estimates were not associated with the concentration of 2,3,7,8-TCDD in the 1982 serum specimens. This half-life of 7.1 yr is much longer than the half-life of 2,3,7,8-TCDD reported in animals but is consistent with recent evidence from other human exposures to 2,3,7,8-TCDD.

Adult

2,3,7,8-Tetrachlorodibenzo-p-dioxin levels in adipose tissue of exposed and control persons in Missouri. An interim report.

The compound 2,3,7,8-tetrachlorodibenzo-p-dioxin, commonly known as dioxin, was measured in the adipose tissue of 39 persons with a history of residential, recreational, or occupational exposure in Missouri and in 57 persons in a control group. All participants had detectable levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin in their adipose tissue, but the exposed group had significantly higher levels. Levels of six of the exposed persons were more than five times greater than the level of the highest control. Measuring 2,3,7,8-tetrachlorodibenzo-p-dioxin in adipose tissue provides a much improved index of exposure, an important advance for research studies evaluating the possible health effects of this compound.

Adipose Tissue

The relationship between blood lead levels and blood pressure and its cardiovascular risk implications.

The relationship between blood pressure and blood lead levels in the second National Health and Nutrition Examination Survey (1976-1980) has been examined for white males aged 40-59 years. After adjustment for age, body mass index, nutritional factors, and blood biochemistries in a multiple linear regression model, the relationship of systolic and diastolic blood pressures to blood lead levels was statistically significant (p less than 0.01). There was no evidence of a threshold blood lead level for this relationship. Although these data alone do not prove a casual relationship between low blood lead levels and blood pressure, the findings are consistent with current epidemiologic and animal studies, indicating that a causal relationship is probable. To examine the potential health risks, the multiple logistic risk factor coefficients from the Pooling Project and Framingham studies were used to predict the impact of the 37% decrease in mean blood lead levels which occurred in adult white males from 1976 to 1980. As a result of this blood lead decrease, the calculations predicted a 4.7% decrease in the incidence of fatal and nonfatal myocardial infarction over 10 years, a 6.7% decrease in the incidence of fatal and nonfatal strokes over 10 years, and a 5.5% decrease in the incidence of death from all causes over 11.5 years. In addition, as a result of this blood lead decrease, the predicted number of white males in this age group with hypertension (diastolic blood pressure greater than or equal to 90 mmHg) decreased by 17.5%.

Adult

Chronological trend in blood lead levels between 1976 and 1980.

Analysis of a chronological trend in data from the second National Health and Nutrition Examination Survey indicated that average blood lead levels in the United States dropped approximately 37 per cent (5.4 micrograms per deciliter) from February 1976 through February 1980. There was no evidence that this trend was due to errors in laboratory measurement or to the design of the survey. The trend was present even after accounting for differences in race, sex, age, region of the country, season, income, and degree of urbanization. Changes in exposure to lead in paint or in the diet are unlikely explanations of the trend. However, the correlation of blood lead levels with the lead level in gasoline was highly significant (P less than 0.001) overall and in population subgroups defined by race, sex, and age. Although strong correlation does not prove cause and effect, the most likely explanation for the fall in blood lead levels is a reduction in the lead content of gasoline during this period.

Adolescent

Pulse nuclear magnetic resonance measurements of water exchange across the erythrocyte membrane employing a low Mn concentration.

A simple, precise, and rapid pulse nuclear magnetic resonance technique for measuring the rate of water exchange across the erythrocyte membrane is presented. The technique is based upon the nonlinear fit of Carr-Purcell-Meiboom-Gill (CPMG) transverse relaxation time data of blood doped with 1.7 mM MnCl2 to the general two-compartment exchange condition. Previous approaches using CPMG data required high MnCl2 concentrations (25-53 nM), shown in this work to induce systematic errors ranging from 35 to 45%. At 23 degrees C the average residence time of a water molecule inside the erythrocyte (tau a) is 21.0 +/- 0.6 ms (SE). The Arrhenius plot for water exchange is linear over the range of 3 degrees - 37 degrees C and th Arrhenius activation energy is 4.79 +/- 0.03 kcal (SE). This value does not differ significantly from the energy required for bulk water flow. Results are compared with previous determinations, and sources of systematic error in tau a and the activation energy are evaluated.

Body Water