Search PubMed⌕ Search

Biomedical subjects

L R Goldman

Publications and source records attributed to L R Goldman.

At least 37 records · Page 2Linked to original sources
PubMed1995

Children--unique and vulnerable. Environmental risks facing children and recommendations for response.

Children may be more susceptible to exposures to environmental toxins than adults and may be more vulnerable to their effects. Because of this, the health care community and those responsible for children need to be alert to possible environmental factors in identifying and responding to the health problems of children. Their focus should be on the causes of the health problem, emphasizing environmental sources, and not on simply treating the symptoms.

Adult↗
PubMed1993

Reduced severity of eosinophilia-myalgia syndrome associated with the consumption of vitamin-containing supplements before illness.

OBJECTIVE: To determine if the severity of subacute symptoms in eosinophilia-myalgia syndrome (EMS) was affected by medical history or use of nutritional supplements other than tryptophan before illness. DESIGN AND STUDY POPULATION: A case-control study was conducted of EMS cases systematically sampled from all those reported to a statewide surveillance system in California in 1989. Excluding two previous EMS-related deaths, interviews were completed in 73% (57/78) of the eligible case patients sampled. MAIN OUTCOME MEASURES: The severity of any myalgia(s), dyspnea, or walking impairment during each of the first 3 months of EMS was quantified by means of self-reported integer scores ranging from 0 (asymptomatic) to 10 (severe symptoms). Case patients in the top tercile of combined, unweighted monthly scores were defined as having severe symptoms. RESULTS: All interviewees (57 of 57) had consumed supplemental tryptophan before illness; 89% (51/57) were female. The odds of severe symptoms were not significantly associated with gender, age, previous antidepressant use, or cumulative amounts of supplemental tryptophan consumed before or after EMS onset (P > .1). Previous consumption of any multivitamin(s), however, was associated with significantly lower odds of severe symptoms (adjusted odds ratio, 0.05; 95% confidence limits, 0.007, 0.4; P = .006). CONCLUSIONS: The consumption of multivitamin-containing supplements before EMS appears to have modified the severity of subacute symptoms in this sample of cases from California.

Adult↗
PubMed1993

Lead screening.

Explore the source record for details and available documents.

Child↗
PubMed1991

A follow-up study of the community near the McColl waste disposal site.

To assess the effect of interim clean-up measures on the current health of a community, we conducted a follow-up survey of 193 residents living near the McColl waste disposal site and a comparison area located approximately 5 miles from the site. Results from this survey were compared with results from a similar survey conducted 7 years earlier. Odors were detected at least once per week by 32.7% of "high-exposed" respondents in 1988 compared with 68.5% in 1981, but prevalence odds ratios (PORs) comparing symptom reporting between "high-exposed" and comparison-area respondents were greater than that of the 1981 survey for 89% of symptoms. PORs comparing symptom reporting between these two areas were greater than 2.0 for 64% of symptoms assessed in the current survey. Symptoms reported in excess did not represent a single organ system or suggest a mechanism of response. PORs comparing respondents who were very worried about the environment and those reporting no worry were greater than 2.0 for 86% of symptoms. These finding, along with environmental data from the area, suggest that living near the waste disposal site and being very worried about the environment, rather than a toxicologic effect of chemical from the site, explain excess symptom reporting found in this follow-up study.

Adult↗
PubMed1990

Micronucleated erythrocytes as an index of cytogenetic damage in humans: demographic and dietary factors associated with micronucleated erythrocytes in splenectomized subjects.

Erythrocytes containing micronuclei serve as an indicator of genotoxic exposure in splenectomized individuals. Micronucleated erythrocytes, derived from cytogenetically damaged RBC precursors, are not selectively removed from peripheral blood in individuals who lack splenic function. The relationship between micronucleated cell frequencies and demographic, environmental, and dietary factors was examined in 44 subjects with previous splenectomy due to trauma. Their micronucleated cell counts fit a log-normal distribution, with geometric means of 3.3 micronucleus-containing cells/1000 reticulocytes and 2.7/1000 normochromatic erythrocytes. A multiple regression analysis showed that drinking five cups of coffee or tea/day (relative to none) was associated with an approximately 2-fold higher frequency of micronucleated cells. Weaker statistical associations were also noted with micronucleus frequency and the consumption of calcium supplements (associated with a higher frequency) and vitamins A, C, or E (lower frequency). An apparent trend of higher micronucleus counts with age was attenuated when other factors were considered in the regression. Cigarette smoking and decaffeinated coffee consumption were among the factors not associated with elevated micronucleated cell frequencies. Because the occurrence of micronuclei in reticulocytes reflects cytotoxic exposures within the past 3-8 days, it may be possible to test directly the relationship of these factors to micronucleus formation through intervention studies.

Chromosome Aberrations↗
PubMedDate not supplied

The four county study of childhood cancer: clusters in context.

Observations of childhood 'cancer clusters' in small communities in central California prompted us to examine the distribution of childhood cancer in communities throughout the region to see if the overall cancer rate or the distribution of 'cancer clusters' was unusual for agricultural towns where pesticide exposure might be elevated. The distribution of rates was evaluated using a variety of methods: comparison of rates to the regional average, evaluation of the empirical observed versus expected Poisson distribution of events, and multivariate modelling using Poisson regression. These analyses suggest that there were no previously undiscovered communities with excess rates, although the index community which prompted the initial investigation does stand out as unusual. We discuss the impact of a range of forces of morbidity on the likelihood of 'cancer clusters' and the distributions of observed and expected numbers of cancers in a population of locales.

Adolescent↗
PubMedDate not supplied

New approaches for assessing the etiology and risks of developmental abnormalities from chemical exposure.

Developmental toxicants, insidious in modes of action and effects, strike the very origin of our lives: the developing embryo, fetus, neonate, and child; they cause spontaneous abortions, stillbirths, malformations, early postnatal mortality, reduced birth weight, mental retardation, sensory loss as well as other functional or physical changes, including subclinical effects having far reaching social and economic impacts. The large majority of developmental defects have unknown etiologies. With this uncertainty, EPA and the scientific community world-wide give high priority to finding new approaches for assessing etiology and risks of developmental effects. The United Nations Conference on Environment and Development (UNCED) and Agenda 21 mobilized the international community to focus on risks posed by chemicals in the environment, including developmental risks. The international harmonization of test and risk assessment guidelines for developmental effects are priorities. Lead, persistent organic pollutants (POPs), endocrine disruptors, and the improvement of quantitative risk assessment methodologies, particularly for children, are priorities. EPA reinvented its research agenda of assure wide involvement of the National Science Foundation, other federal agencies, and national experts in research to address the U.S.'s public health and environmental priorities.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

Aldicarb food poisonings in California, 1985-1988: toxicity estimates for humans.

Three outbreaks of food poisoning involving watermelons or cucumbers and caused by the carbamate pesticide aldicarb occurred in California between 1985 and 1988. For each outbreak, and for an outbreak of aldicarb poisoning associated with English cucumbers previously reported in the literature, dosages of aldicarb sulfoxide that caused the illnesses were estimated. Estimated dosages ranged between 0.0023 [corrected] and 0.06 mg/kg body weight, and most were well below the 0.025 mg/kg Lowest Observed Effect Level (LOEL) for subclinical blood cholinesterase depression previously reported for humans. These findings are consistent with aldicarb sulfoxide (ASO) illnesses that have occurred in other states. Aldicarb appears to be more toxic than previously suspected. Scientific and regulatory implications are discussed.

Adolescent↗
PubMedDate not supplied

Pesticide food poisoning from contaminated watermelons in California, 1985.

Aldicarb, a carbamate pesticide, is the most potent pesticide in the market and has a LD50 of 1 mg/kg. In the United States it is illegal to use aldicarb on certain crops, e.g., watermelons, because it is incorporated into the flesh of the fruit. Once an accidental or illegal use of such a potent pesticide occurs, there is no easy way for the agricultural or public health system to protect the populace. This paper describes the impact of one such event upon the health of individuals and the institutions of California. On July 4, 1985, California and other western states experienced the largest known outbreak of food-borne pesticide illness ever to occur in North America. This was attributed to watermelons contaminated through the illegal or accidental use of aldicarb by a few farmers in one part of the state. Within California, a total of 1,376 illnesses resulting from consumption of watermelons was reported to the California Department of Health Services (CDHS). Of the 1,376 illnesses, 77% were classified as being probable or possible carbamate illnesses. Many of the case reports involved multiple illnesses associated with the same melon among unrelated individuals. Seventeen individuals required hospitalization. There were 47 reports of illness involving pregnant women, two of whom reported having subsequent stillbirths. Thirty-five of the remaining pregnant women were followed-up 9 mo after the epidemic; no additional stillbirths were found.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

A study of current residents' knowledge of a former environmental health survey of their community.

A follow-up survey of current residents who live near the McColl waste disposal site was conducted to assess community knowledge of an environmental health survey that occurred in the same neighborhood 7 y earlier. Of the 193 eligible adults who participated in an interview (response rate = 73.4%), 35.8% reported having heard of the 1981 health survey; 48% of these (n = 33) reported hearing or seeing the results of the survey. Knowledge of the earlier survey was reported by 34.6%, 40.6%, and 35.7% of respondents in the high-exposure, low-exposure, and comparison areas, respectively. Recall was significantly associated with age (i.e., greater than 55 y), college education, and residence prior to 1981. Our findings suggest that both long-term and recent residents in the study areas know about the McColl waste-disposal site, but the majority of current residents in this sample do not know that the health of the community was assessed in 1981 and that no serious health effects associated with the site were identified. Future efforts to communicate findings of similar health studies should focus on individuals who have less education and on communication with residents who move into an area after a study has been conducted. Creative public participation and media relations should be developed to assure that the results of such studies reach the public.

Age Factors↗
PubMedDate not supplied

Use of exposure databases for status and trends analysis.

Exposure databases are useful for monitoring status and trends in environmental health. However, other supporting data are usually needed to infer human exposure or internal dose. Program planning and evaluation, environmental health surveillance, epidemiologic research, and contributions to international efforts are four major purposes for monitoring environmental exposure status and trends. Although databases play an important role in monitoring human exposure, certain methodological problems need to be overcome. The work group developed six criteria for meeting information needs for human exposure assessment. Areas that need attention are (1) specification of location, (2) specification of facility and chemical identifiers, (3) documentation of special populations at risk, (4) provision of early warning of new problems, (5) monitoring changes over time, and (6) enhancement of documentation. We tested these criteria by examining six available databases that might be used for monitoring exposure to contaminants in drinking water. Available data fell short of information needs. We drew four conclusions and offered several recommendations for each. First, available data systems lack adequate measures of human exposure. Second, data for monitoring exposures for many important population subgroups and environmental settings are inadequate. Third, an "early warning" system that monitors human exposures is needed. Fourth, designers of data-collection systems should consider the needs of users who monitor status and trends of human exposure.

Data Collection↗
PubMedDate not supplied

Malathion and malaoxon environmental levels used for exposure assessment and risk characterization of aerial applications to residential areas of southern California, 1989-1990.

Between August 1989 and July 1990, California conducted a Mediterranean fruit fly eradication project in southern California which included repeated aerial applications of malathion bait to urban areas where approximately 1.6 million people resided. Concern about the safety of these applications prompted the California Department of Health Services to prepare a risk assessment. The current work presents the estimates of environmental levels of malathion and malaoxon, derived from mass deposition rates during application and monitoring of air. We estimated short and long-term malathion and malaoxon levels on outdoor surfaces, plants, and soils (0.1 and 1.0 cm mixing depth), using a simple first-order exponential decay model and literature half-life values ranging from three to nine days. Direct monitoring data were used to characterize short-term air levels. Average and upper-bound malathion levels immediately following an application were 0.091 microgram/m3 and 0.207 microgram/m3 in air; 22 and 52 mg/m2 on outdoor surfaces; 3.8 and 9.6 micrograms/g in plants; and 1.5 and 3.5 micrograms/g in soil (1 cm mixing depth). Malaoxon levels were 0.039 microgram/m3 and 0.110 microgram/m3 in air; 0.15 and 0.46 mg/m2, 0.03 and 0.09 microgram/g, and 0.01 and 0.03 microgram/g, respectively. Estimates of average and upper-bound levels over the duration of the eradication program were roughly one-third the immediate levels in all media. No field measurements were available for co-products other than malaoxon, for environmental persistence, or for concentrations on surfaces, soil, or plants after repeated applications. Because of limited monitoring data, and the likelihood that similar pest-eradication programs will be conducted, additional studies are warranted to more accurately characterize the environmental fate of malathion and human exposures after aerial application to residential communities.

Animals↗