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PubMed2004

Lead, zinc, copper, and cadmium in fish and sediments from the Big River and Flat River Creek of Missouri's Old Lead Belt.

The Old Lead Belt of Missouri was a major lead-producing region for over a century. Several large tailings piles and other industrial wastes remain behind, though mining operations in the region ceased in 1972. Samples of stream sediments and fish were collected from established sites on the Big River and Flat River Creek over a 3-year period from 1998 to 2000 to evaluate ongoing remediation efforts and determine the current impact of residual mining wastes. Benthic sediments and fish taken in the vicinity of inactive industrial sites were found to contain elevated concentrations of Pb, Zn, Cu, and Cd. Concentrations of Pb and Zn in fillets of suckers and sunfish, as well as in whole bodies of sunfish, correlate well with metal concentrations observed in surficial sediments. The results of analyses provide valuable quantitative information regarding specific sources, current levels of contamination, potential risk to public health, and will allow more accurate assessment of continuing remediation efforts.

Animals↗
PubMed1997

Smoking during pregnancy: Missouri longitudinal study.

Maternal smoking during pregnancy has been shown to be associated with reduced birthweight and increased fetal and infant mortality. This paper examines these patterns in first and second maternally-linked singleton pregnancies from 1978 to 1990 among 176,843 Missouri resident women with known smoking status in both pregnancies. Generally women were more likely to smoke in their second pregnancies (27.4%), than in their first (25.8%). This pattern was strongest among those whose first pregnancies occurred as teenagers, and for black women. The relationships of smoking during the first and second pregnancies to outcomes in the second pregnancies were examined primarily through multivariate logistic regression. The adjusted relative risk (RR) of low birthweight (< 2500 g) in the second pregnancy to not smoking in either pregnancy was 1.82 for those who smoked during the second pregnancy only, and 1.87 for those who smoked in both pregnancies. For those who smoked in the first pregnancy only, the RR was 0.97, not significantly different from 1. Adjusted smoking RRs for small-for-gestational age were larger, while adjusted RRs for fetal and neonatal mortality were smaller than the smoking RRs for low birthweight.

Female↗
PubMed1997

Factors associated with repetition of low birthweight: Missouri longitudinal study.

The tendency to repeat low birthweight (LBW < 2500 g) was studied in 182,285 linked first and second birth Missouri livebirths for 1978-90, of which 10,701 had first birth LBW. We examined the likelihood of LBW repetition by first birth birthweight, preterm delivery, and small-for-gestational-age (SGA) status by race, and the odd ratios (ORs) of repeat LBW for risk factors such as smoking, in comparison with ORs of second birth LBW among women with normal-weight first births. We found a strong tendency to repeat LBW (21%), especially following more extreme LBW first births. Adjusted ORs for repeat LBW were 10.1 for births that were preterm and SGA; 7.9 for preterm non-SGA; and 6.3 for SGA term births. Significant ORs of LBW repetition were found for smoking (1.52 and 1.85 for smoking in second pregnancy only and both pregnancies, respectively), short interpregnancy interval (1.33), and advanced maternal age (1.17), but the ORs were generally lower than those for women with normal-weight first births. Low pre-pregnancy weight was a significant risk factor for LBW repetition.

Birth Order↗
PubMed1999

Mohs micrographic surgery referral patterns: the University of Missouri experience.

BACKGROUND: Mohs micrographic surgery (MMS) provides a higher cure rate for nonmelanoma skin cancer (NMSC) than other forms of therapy. The American Academy of Dermatology has published recommended guidelines for MMS referral. However, factors other than the location, size, and type of NMSC may often affect the referral process. OBJECTIVE: To tabulate and analyze the rates of referral of NMSC for MMS by the dermatology clinics within the University of Missouri system. Data obtained for every biopsy-proven basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) diagnosed at each of our four dermatology clinics during the 3-year period of October 1993-September 1996 were cross-referenced with our Mohs surgery clinic logbook to identify which patients had been referred for MMS. RESULTS: During the study period, 19.2% of NMSC patients diagnosed were referred for MMS. However, there was significant disparity in referral rates among our four clinics. When the skewed data from our Veterans Administration Hospital clinic were discounted, the overall referral rate from the other clinics was found to be 30.8%. CONCLUSION: Our finding of a 30.8% referral rate of NMSC for MMS (27. 4% for SCC and 32.9% for BCC) within our university dermatology system is similar to the rates found in previous studies by the Mayo Clinic and Brooke Army Medical Center. MMS referral patterns are affected by many factors besides whether the NMSC meets MMS criteria, including the preference of each individual referring physician, patient, and involved insurance carrier.

Basal Cell Carcinoma↗
PubMed2001

Disrupting evolutionary processes: the effect of habitat fragmentation on collared lizards in the Missouri Ozarks.

Humans affect biodiversity at the genetic, species, community, and ecosystem levels. This impact on genetic diversity is critical, because genetic diversity is the raw material of evolutionary change, including adaptation and speciation. Two forces affecting genetic variation are genetic drift (which decreases genetic variation within but increases genetic differentiation among local populations) and gene flow (which increases variation within but decreases differentiation among local populations). Humans activities often augment drift and diminish gene flow for many species, which reduces genetic variation in local populations and prevents the spread of adaptive complexes outside their population of origin, thereby disrupting adaptive processes both locally and globally within a species. These impacts are illustrated with collared lizards (Crotaphytus collaris) in the Missouri Ozarks. Forest fire suppression has reduced habitat and disrupted gene flow in this lizard, thereby altering the balance toward drift and away from gene flow. This balance can be restored by managed landscape burns. Some have argued that, although human-induced fragmentation disrupts adaptation, it will also ultimately produce new species through founder effects. However, population genetic theory and experiments predict that most fragmentation events caused by human activities will facilitate not speciation, but local extinction. Founder events have played an important role in the macroevolution of certain groups, but only when ecological opportunities are expanding rather than contracting. The general impact of human activities on genetic diversity disrupts or diminishes the capacity for adaptation, speciation, and macroevolutionary change. This impact will ultimately diminish biodiversity at all levels.

Adaptation, Physiological↗
PubMedDate not supplied

A pilot epidemiologic study of possible health effects associated with 2,3,7,8-tetrachlorodibenzo-p-dioxin contaminations in Missouri.

In 1971, 2,3,7,8-tetrachlorodibenzodioxin (TCDD)-containing waste oils were sprayed for dust control on residential, recreational, and work areas in Missouri. In several of these areas, the magnitude and the extent of this environmental contamination were not known until late 1982 or 1983. In the first phase of the investigation, a group of persons considered to be at highest risk of exposure and an appropriate comparison group were selected from reviews of Health Effects Survey screening questionnaires. These persons received complete medical examinations and a series of laboratory tests focused on detecting presymptomatic effects in key target organ systems (i.e., hepatic, dermatologic, immunologic, and neurologic effects). Comparisons of these two groups did not produce any firm indications of increased disease prevalence directly related to the putative exposures; of significance is the fact that no cases of chloracne or porphyria cutanea tarda were seen. Nevertheless, no overall definitive conclusion should be based just on this initial pilot study. Insights were provided that are being examined in more refined epidemiologic studies using different designs and strategies--especially of larger, more homogeneous population groups in which exposure status can be better characterized--focused primarily on discerning any potential effects on the urinary tract, liver, neurological, and immune systems. Concurrently, research into the development of replicable laboratory analytical methods and reference ranges for measuring TCDD body burden are being pursued.

Adolescent↗
PubMedDate not supplied

Health effects in family pets and 2,3,7,8-TCDD contamination in Missouri: a look at potential animal sentinels.

In 1971, waste oils containing 2,3,7,8:tetrachlorodibenzodioxin (TCDD) were sprayed in Missouri for dust control. To determine if pets could serve as sentinels of human health risks associated with this contamination, we asked pet owners in a pilot study of exposed human populations about their pets' illnesses. Of 13 pets with owner-reported illnesses, 8 had potential TCDD exposures and 5 did not (p less than .05 by Mantel-Haenzel chi-square analysis stratified by age). Owner-reported illnesses in 2 of 8 illness categories were associated with TCDD contamination after adjusting for age. Although these findings suggest that pets in TCDD-contaminated areas may have greater health risks, the small sample size, unlikely pathologic groupings, and unconfirmed nature of the data fail to support a relationship between pet illnesses and possible TCDD exposure and thus make extrapolation to human populations inappropriate. The limited validity found for owner-reported pet illnesses should caution against using such data in future environmental health studies.

Animals↗
PubMed2001

Outbreak of cyclosporiasis associated with basil in Missouri in 1999.

During the summer of 1999, an outbreak of cyclosporiasis occurred among attendees of 2 events held on 24 July in different counties in Missouri. We conducted retrospective cohort studies of the 2 clusters of cases, which comprised 62 case patients. The chicken pasta salad served at one event (relative risk [RR], 4.25; 95% confidence interval [CI], 1.80-10.01) and the tomato basil salad served at the other event (RR, 2.95; 95% CI, 1.72-5.07) were most strongly associated with illness. The most likely vehicle of infection was fresh basil, which was included in both salads and could have been grown either in Mexico or the United States. Leftover chicken pasta salad was found to be positive for Cyclospora DNA by means of polymerase chain reaction analysis, and 1 sporulated Cyclospora oocyst was found by use of microscopy. This is the second documented outbreak of cyclosporiasis in the United States linked to fresh basil and the first US outbreak for which Cyclospora has been detected in an epidemiologically implicated food item.

Adolescent↗
PubMed2002

Infection rates of Amblyomma americanum and Dermacentor variabilis by Ehrlichia chaffeensis and Ehrlichia ewingii in southwest Missouri.

Both Ehrlichia chaffeensis and Ehrlichia ewingii are causative agents of human ehrlichiosis. Both pathogens are transmitted to humans through the bite of an infected lone star tick (Amblyomma americanum). Since Missouri has a high incidence of human monocytic ehrlichiosis, we investigated the prevalence of E. chaffeensis- and E. ewingii-infected A. americanum and Dermacentor variabilis (American dog tick) ticks to help assess the relative risk for humans exposed to these vectors. We used a nested polymerase chain reaction assay for the detection of ehrlichial DNA in the collected ticks. Infection rates for both ehrlichial species were calculated from the assay results for each of the tick species. E. chaffeensis was found to be present in 9.8% of adult A. americanum ticks (57 of 579) and 6.7% of D. variabilis ticks (eight of 120). E. ewingii DNA was present at an infection rate of 5.4% in adult A. americanum (31 of 579) and 3.3% of D. variabilis ticks (four of 120). A minimum infection rate for nymph pools of A. americanum was 1.7% for E. chaffeensis and 0.6% for E. ewingii.

Animals↗
PubMed1976

The incidence of anemia in residents of Missouri.

A state-wide nutritional health survey of Missouri residents conducted in 1973 included hemoglobin, hematocrit, and serum iron determinations on approximately 1,164 persons and dietary iron intake estimates, based on a diet history, for 530 persons. Based on the criteria used for interpretation of the Ten-State Nutrition Survey data, over 19% of all preschool age white children and over 10% of the white children six to 10 years old had low or deficient hemoglobin levels. Between 8 and 17% of the white males between 10 and 60 years old and over 30% of the white males over 59 years old were anemic. Between 3 and 9% of all white females over 9 years of age had low or deficient hemoglobin levels. The levels of anemia for most age and sex groups of Negroes were at least twice as great as for corresponding groups of white persons. Low or deficient hemoglobin levels within the age and sex groups were associated with low hematocrit and serum iron levels; suggesting that some of the anemia was a reflection of iron deficiency. Estimates of the dietary intake of iron indicated that less that 20% of the females 10 to 35 years old and less than 60% of older females and boys under 17 years of age were consuming the Recommended Dietary Allowances. Over 35% of the preschool children and females between 10 and 60 years old were consuming less than two-thirds of their Recommended Dietary Allowances for iron. At least part of the iron deficiency was, therefore, indicated to be related to insufficient dietary intake.

Adolescent↗
PubMed1978

Nutritional status of elderly residents in Missouri.

Nutritional assessment of white persons over 59 who participated in the 1973 Missouri Nutrition Survey was based upon biochemical measurements, dietary intakes using food frequency histories, anthropometric measurements, and a dental examination. There were three major nutritionally related problems: poor dental health, obesity, and anemia. The mean for DMF, periodental index, and oral hygiene index for males was 20.5, 4.9, and 3.9, respectively; for females, 17.6, 3.6, and 2.5. Over one-half of both sexes were edentulous. Of the women 59% were greater than 119% of desirable weight compared to 22% of the men. Using guidelines from the Ten-State Nutrition Survey, the following percentages of men had low blood levels: 20, hemoglobin and serum iron; 2, plasma vitamin A; 6, plasma carotene; 1, serum vitamin C; and 0, serum albumin. The percent of women with low biochemical levels were: 11, hemoglobin; 10, serum iron; 7, plasma vitamin A; 1, serum vitamin C; and 2, serum albumin. None of the subjects had low or deficient levels of erythrocyte glutathione reductase. One-half of the women compared to one-fifth of the men had consumed diets with one or more nutrients below 67% of the 1974 Recommended Dietary Allowances.

Aged↗
PubMed1979

The association of obesity with socioeconomic factors in Missouri.

The prevalence of obesity and underweight was estimated for residents of Missouri more than 9 years old on the basis of age, sex, household income, educational attainment, and population density from the results of a survey conducted in 1973. The incidence of overweight was greatest among children 10 to 16 years old and the least for adults 17 to 35 years old. Four percent of the girls 10 to 16 were greater than 159% of average weight for height. Among women greater than 59 years old the incidence of overweight and underweight were high. The proportion of adult women who were overweight as defined by average weight for height and body mass index (W/H2) was inversely related to household income and education. The same was true for adult men in relation to income but the reverse results were observed for education. A larger proportion of urban men were overweight as defined by body mass index compared to rural men. The incidence of obesity among males of all ages and females greater than 59 years old appeared to be related to residence in specific types of communities.

Adolescent↗
PubMed1993

Pertussis in Missouri: evaluation of nasopharyngeal culture, direct fluorescent antibody testing, and clinical case definitions in the diagnosis of pertussis.

No diagnostic test for pertussis in routine use in the United States has both high sensitivity and high specificity. During a statewide increase in the incidence of pertussis in Missouri, we studied the clinical features of 153 patients with suspected pertussis in the Greater St. Louis area from whom a specimen for pertussis culture had been taken between 15 May and 19 September 1989. In this cross-sectional study, nasopharyngeal cultures were more likely to be positive for persons whose specimens were collected < 21 days after cough onset (adjusted rate ratio [RRa] and 95% confidence interval = 3.4; 1.5-8.0) and who were not receiving erythromycin/sulfamethoxazole prior to the culture [RRa = 5.8; 0.8-40.6], who had received fewer than three prior doses of pertussis vaccine [RRa = 1.8; 0.8-4.2], and whose specimen was in transit to the laboratory for < 4 days [RRa = 2.0; 0.8-5.5]. Among children < 5 years of age, spasmodic cough plus a lymphocytosis of > 10,000/mm3 was the acute symptom complex associated with the highest predictive value for a positive culture result (67%). Cough for > or = 14 days plus whoop was sensitive (81%) and specific (58%) for identifying children with culture-confirmed pertussis. Direct fluorescent antibody staining performed well as a screening test for pertussis but requires substantial commitment of personnel and resources. In the absence of a positive culture result, clinical case definitions should be used for decision making (e.g., initiation of antimicrobial therapy and routine case reporting).

Adolescent↗
PubMed2006

Mating patterns of black oak Quercus velutina (Fagaceae) in a Missouri oak-hickory forest.

Wind-pollinated forest trees usually have high outcrossing rates, but allogamy does not necessarily translate into high pollen movement. The goal of this study was to determine the outcrossing rates, pollen pool genetic structure, and the size of the effective pollination neighborhood in a population of black oak, Quercus velutina, in a Missouri oak-hickory forest. Based on 6 allozyme loci, 12 maternal trees, and 439 progenies sampled along a transect of 1300 m, we found complete outcrossing (t(m) = 1.000, P < 0.001) and small amounts of biparental inbreeding. Using a TwoGener analysis of the pollen gene pool, we found significant structure across maternal plants (Phi(FT) = 0.078, P < 0.001), which when corrected for adult inbreeding translates into Phi(FT) = 0.066 that corresponds to an effective number of pollen donors of 7.5 individuals. Assuming a bivariate normal distribution and an adult density of 16.25 trees ha(-1), we estimated that the effective pollination neighborhood area had a radius of 41.9 m. Even assuming that our estimates may be conservative, these findings join a growing body of evidence that suggest that the local neighborhood of wind-pollinated forest tree populations may be relatively small creating opportunities for local selection and genetic drift.

Crosses, Genetic↗
PubMed1997

Some factors affecting infestation of white-tailed deer by blacklegged ticks and winter ticks (Acari:Ixodidae) in southeastern Missouri.

A total of 5,669 ticks of 4 species was collected from 515 hunter killed, white-tailed deer. Odocoileus virginianus (Zimmerman), in southeastern Missouri from 1993 through 1995. The American dog tick, Dermacentor variabilis (Say) (4 adults), the lone star tick, Amblyomma americanum (L.) (57 adults, 2 nymphs), the blacklegged tick, Ixodes scapularis (Say) (3,120 adults), and the winter tick, Dermacentor albipictus (Packard) (2.059 adults, 436 nymphs, 1 larva) were collected. Patterns of adult D. albipictus and I. scapularies infesting deer were analyzed with respect to upland versus lowland habitat, county, and host sex. Prevalence and intensity of infestation by D. albipictus were higher on bucks than does, and a higher infestation prevalence was recorded for this tick on deer from upland than from lowland habitats. Mean intensities for D. albipictus were not significantly different between counties. Prevalence and mean intensity of infestation for I. scapularis were significantly higher on deer from uplands than lowlands and on bucks than does; mean intensities also differed between counties for this tick. Because adjacent populations, as well as the sex of the host, can differ in infestation rates, differences between local populations of I. scapularis should be recognized to optimize tick surveys and population models.

Animals↗
PubMed1993

Saturated fat intake and lung cancer risk among nonsmoking women in Missouri.

BACKGROUND: Although the vast majority of lung cancer cases in women are caused by smoking, 9%-20% of cases occur in nonsmokers. Previous epidemiologic research on the relationship between lung cancer and diet has shown that fruit and vegetable consumption may confer a protective effect against lung cancer, while a diet rich in cholesterol and fat may increase risk. PURPOSE: The purpose of this case-control study was to examine the effects of a broad range of dietary factors on the risk of lung cancer in a population of nonsmoking white women 30-84 years of age. METHODS: A telephone-administered questionnaire was used to determine and/or verify eligibility with regard to age, gender, race, and smoking status. In a second interview at the participant's home, a widely used food frequency questionnaire was filled out, and logistic regression was subsequently used to analyze the responses. We obtained dietary information on 429 case subjects who had a diagnosis of lung cancer reported to the Missouri Cancer Registry between June 1, 1986, and June 1, 1991, and 1021 control subjects. If a case subject had died or was too ill to be interviewed, next-of-kin familiar with the woman's diet were interviewed instead. Of the 429 women with lung cancer, 211 (49%) had lung adenocarcinoma. RESULTS: A strongly increasing trend in lung cancer risk was observed with increased saturated fat consumption among these non-smoking women; the relative risk was more than sixfold greater for the highest quintile of consumption than for the lowest quintile. The effect of saturated fat was more pronounced for adenocarcinoma than for other cell types. Weekly servings of beans and peas were significantly related to decreased lung cancer risk, while citrus fruit and juice showed a twofold increase in risk; this trend was also significant. CONCLUSION: By focusing on non-smoking women with lung cancer, including a large number with adenocarcinoma, we observed a clear association with saturated fat consumption that may have been masked in earlier studies of lung cancer involving a high percentage of smokers.

Adult↗
PubMed1985

Foodborne streptococcal pharyngitis Kansas City, Missouri.

A foodborne outbreak of streptococcal pharyngitis occurred in association with a meeting of regional blood banking personnel held at a hotel in Kansas City, Missouri, on May 31-June 1, 1984. The incriminated meal was a salad buffet luncheon served on May 31. Of 106 persons identified as eating the luncheon, 60 (56.6 per cent) became ill. The most probable source of infection was an assortment of mousse desserts (p = 0.0532).

Disease Outbreaks↗
PubMed1994

Retrospective study of the impact of lead-based paint hazard remediation on children's blood lead levels in St. Louis, Missouri.

A retrospective follow-up study was conducted to evaluate the effectiveness of lead-based paint hazard remediation in reducing children's blood lead levels. The authors reviewed existing St. Louis, Missouri, City Health Department records, identified 185 children younger than age 6 years who had blood lead levels > or = 25 micrograms/dl during 1989 or 1990, and compared changes in blood lead levels among children whose dwellings did and those whose dwellings did not undergo remediation. Among 54 children who had not moved or received chelation therapy and whose blood lead levels were measured 10-14 months after diagnosis, the geometric mean blood lead level decreased 23% among children living in remediated dwellings (n = 37) and 12% among children in nonremediated dwellings (n = 17) (p = 0.07, t test). The estimated size of the remediation effect was similar using multiple regression (-13%; 95% confidence interval (CI) -25 to 1; p = 0.06) and an approach based on generalized estimating equations (-16%, 95% CI -25 to -7; p = 0.002), when adjusted for covariates. The effect of remediation was greater among children whose blood lead levels at diagnosis were > or = 35 micrograms/dl (-22%) than among those whose blood lead levels at diagnosis were between 25 and 34 micrograms/dl (-1%). Among lead-poisoned children in St. Louis, children whose dwellings undergo lead-based paint hazard remediation have a greater decline in geometric mean blood lead level than do children whose dwellings do not, but the effect of remediation may be influenced by the blood lead level at diagnosis.

Child, Preschool↗