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Impact of environmental inequity on health outcome: where is the epidemiological evidence?

A significant amount of evidence reveals a presence of environmental inequity. Although there is a disproportionate distribution of waste treatment, storage and disposal facilities, and chemical and manufacturing plants in minority and low-income communities in the United States, little research has been devoted to show any associations based on analytic epidemiological methods. To date, attempts to quantify health disparities have included demographic data, race, sex, income, other socioeconomic factors, and broad symptomatic survey instruments. To study this, we examined the latest epidemiological evidence documenting the existence of adverse health impacts resulting from environmental inequity. We observed that the overwhelming majority of studies were descriptive in nature and lacked comparison populations. As a result, we believe that further research based on analytic epidemiological methods would further contribute to the determination of the cause-effect relationship between environmental exposure and health outcome.

Causality↗

[The assessment of disease risk in the proximity of a source of environmental pollution: a review].

An increasingly common public health problem is the perception that disease incidence has increased or a cluster of disease has occurred in a community. In most cases, a local factor (e.g. the location of a nuclear installation) is hypothesized to be associated with the disease. The paper presents a review of the main statistical methods used to assess disease risk near a putative source of environmental pollution. Both techniques based on counts in area units (e.g. administrative units) and case-control studies are considered.

Environmental Monitoring↗

Prevalence of adverse pregnancy outcomes around hazardous industrial sites in Cumbria, north-west England, 1950-93.

The objective of this study was to investigate the risk of stillbirth, neonatal death and lethal congenital anomaly in relation to proximity to hazardous industrial facilities at the time of birth in Cumbria, 1950-93. A retrospective cohort study was carried out using all 4325 stillbirths, 3430 neonatal deaths and 1569 deaths from congenital anomaly among the 287 993 births to mothers living in Cumbria between 1950 and 1993. Logistic regression was used to investigate the risk of each outcome in relation to proximity at birth to hazardous industrial sites, stratifying the analysis by time period and adjusting for social class, year of birth, birth order and multiple births. Continuous odds ratios for trend with proximity to sites were estimated. No significantly increased risk was found for stillbirth, lethal congenital anomaly or neonatal deaths in relation to proximity to hazardous industrial facilities, except for deaths from congenital heart defects in 1983-93. Overall, there was no evidence to suggest an increased risk of adverse lethal pregnancy outcome among babies whose mothers lived closer to hazardous industrial sites. The significantly increased risk of lethal congenital heart defects with proximity to these sites was likely to be a chance finding, given the large number of outcome groups and time periods analysed. However, effective environmental monitoring of industrial processes is required to enable studies to investigate the potential health risks of industrial pollution.

England↗

Toxicological effects of dietary arsenic exposure in lake whitefish (Coregonus clupeaformis).

Adult lake whitefish were fed As contaminated diets at nominal concentrations of 0, 1, 10, and 100 microg As/g food (dry weight) for 10, 30, and 64 days. Reduced feed consumption was observed in lake whitefish fed the 100 microg As/g food, beginning on day 45 of exposure. The accumulation and distribution of As in these fish are described in the previous manuscript [Pedlar, R.M., Klaverkamp, J.F., 2001. The accumulation and distribution of dietary arsenic in lake whitefish (Coregonus clupeaformis). Aquat. Toxicol., in press]. At the molecular level of organization, metallothionein (MT) induction occurred in lake whitefish fed the 100 microg As/g food after 10 and 30 days, and in fish fed the 1 and 10 microg As/g diets for 64 days. Dietary As exposure did not have a significant effect on plasma lipid peroxide (LPO) concentrations. At the tissue and organ level, mean liver somatic index decreased significantly in lake whitefish fed the 100 microg As/g food for 64 days. Blood parameters (hematocrit, hemoglobin concentration, red blood cell count, mean cell volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration) were not affected by exposure to As contaminated diets. Liver and gallbladder histopathologies were observed in lake whitefish fed all As contaminated diets after each duration of exposure. Histopathology observed in liver included nuclear, architectural and structural alterations, areas of inflammation, and focal necrosis. Sloughing of the epithelium, dilation of vascular elements, inflammation, edema, fibrosis, and increased width of the submucosa were some of the alterations observed in gallbladders of lake whitefish fed As contaminated diets. Both organs were sensitive to As exposure, as damage occurred with exposure to dietary concentrations of As as low as 1 microg/g. Whole organism parameters were unaltered by dietary As exposure. Based on the results of this study, histopathological alterations in liver and gallbladder, and hepatic MT induction may be useful indicators of As toxicity in environmental monitoring programs that also measure As concentrations in those tissues.

Administration, Oral↗

Environmental contaminants in liver and kidney of free-ranging northern goshawks (Accipiter gentilis) from three regions of Germany.

The northern goshawk (Accipiter gentilis) is a top predator in the terrestrial food web of large parts of the Holarctic. Due to its sedentary nature and well-investigated feeding ecology, it represents the most suitable bird of prey species in continental Europe for monitoring environmental pollutants. We analyzed the levels of organochlorine pesticides, polychlorinated biphenyls (PCB), and nonessential heavy metals in organ samples of 62 free-ranging northern goshawks found dead or injured in Germany from 1995 to 2001. Our results indicate significant differences in the contaminant burden of northern goshawks between three regions in Germany. Presumably, these differences were caused by different application periods and legislative restrictions before the German reunion, especially for the use of DDT in agriculture and forestry. Extraordinarily high residues of PCBs and DDE, the main metabolite of DDT, were found mainly in livers of northern goshawks inhabiting Berlin. Body condition is highly negatively correlated with the contamination level of the individual, especially for the persistent and lipophilic organochlorines and for mercury. PCB concentrations in hepatic tissue increase rapidly with age, and birds in their first summer had significantly lower levels than birds in their first winter or older. Adult female northern goshawks from Berlin had significantly higher hepatic concentrations of most of the higher-chlorinated PCBs and of cadmium than males from the same region. Cadmium residues were in general higher in renal tissue than in hepatic tissue, and cadmium levels in kidneys increased with age. Lead concentrations indicative of acute lead poisoning were detected in one bird and suggested in two others. All other heavy metal concentrations were low and represent background levels for birds of prey in Germany.

Animals↗

Review of the chemical elements and environmental chemistry--strategies and tactics.

Inspite of advanced technology and the availability of adequate basic analytical instrumentation there is a need to improve the quality of data obtained in many programmes of environmental monitoring. Really new approaches are required based upon interdisciplinary, as distinct from pluridisciplinary cooperation; during the early stages individual disciplines need to extend some degree of charity. Scientists have to acknowledge the social implications of many of their studies and face up to controversial issues particularly in relation to pollution of the environment. Today we do not know the significance of levels of most contaminants and pollutants found in the environment, and many have not even been identified. Besides large releases of pollutants, a fundamental problem concerns man's biological response to low doses of various substances over long periods of time; the interval between an initial insult and the detection of detrimental effects for many physical and chemical agents can amount to between 10-30 years. In the absence of an objective interdisciplinary approach the expertise developed in an individual discipline is not available to others in which it may be of value. Many types of instrumentation and techniques developed in one discipline are unknown, or untried, in another; centralised facilities provide an adequate spectrum of tools and skills which are essential in tackling current problems. This approach has been shown to be rewarding in industry and in several private research organisations. In this paper the versatility of some types of modern instrumentation is illustrated in several fields of environmental chemistry and some of the substantial problems are discussed.

Air Pollutants↗

Measurement of acetylcholine receptor function in microcircuit-coupled myoblasts.

An electrophysiological measurement principle for long-term, noninvasive monitoring of the nicotinic acetylcholine receptor (nAChR) function is described. The measurement is based on the ability to record agonist-induced depolarizations of clonal myoblasts that have formed high impedance seals with extracellular microcircuit electrodes. The technique appears promising for several types of assays and environmental monitoring applications.

Animals↗

[Environmental Survey for Children-- the environmental module of KiGGS. I. Design and research program].

The German Environmental Survey for Children (GerES IV) is the environment-oriented module of the National Health Interview and Examination Survey for Children and Adolescents (KiGGS) which is being performed nationwide in Germany. From 2003 to 2006, a random subsample of 1800 children aged 3-14 years is being studied with regard to their body burden and health impairments linked to housing conditions and the personal environment- and health-relevant behaviour. The basic study programme includes the analysis of blood, urine, tap water and house dust as well as the application of an extensive questionnaire. The data gained from this population sample, which is representative for Germany's children, are the basis for deriving reference values to characterise the background exposure of children aged 3-14 years. Trends over time can be detected and the success of environmental policies verified by comparing the data with those of the German Environmental Survey 1990/92 (GerES II), also conducted in close cooperation with the National Health Survey, which included children aged 6-14 years. By linking the data from the Environmental and the Health Surveys, health-relevant environmental exposures can be detected and different scientific hypotheses can be tested. The main subjects that are being dealt with using subcollectives of GerES IV are 'VOC and eye and nasopharynx irritation', 'indoor allergens and allergic diseases of the respiratory system', 'chromium, nickel, fragrances and contact allergens', and 'noise, hearing capacity and stress hormones'.

Adolescent↗

Cryptosporidium parvum and Cyclospora cayetanensis: a review of laboratory methods for detection of these waterborne parasites.

Cryptosporidium and Cyclospora are obligate, intracellular, coccidian protozoan parasites that infest the gastrointestinal tract of humans and animals causing severe diarrhea illness. In this paper, we present an overview of the conventional and more novel techniques that are currently available to detect Cryptosporidium and Cyclospora in water. Conventional techniques and new immunological and genetic/molecular methods make it possible to assess the occurrence, prevalence, virulence (to a lesser extent), viability, levels, and sources of waterborne protozoa. Concentration, purification, and detection are the three key steps in all methods that have been approved for routine monitoring of waterborne oocysts. These steps have been optimized to such an extent that low levels of naturally occurring Cryptosporidium oocysts can be efficiently recovered from water. The filtration systems developed in the US and Europe trap oocysts more effectively and are part of the standard methodologies for environmental monitoring of Cryptosporidium oocysts in source and treated water. Purification techniques such as immunomagnetic separation and flow cytometry with fluorescent activated cell sorting impart high capture efficiency and selective separation of oocysts from sample debris. Monoclonal antibodies with higher avidity and specificity to oocysts in water concentrates have significantly improved the detection and enumeration steps. To date, PCR-based detection methods allow us to differentiate the human pathogenic Cryptosporidium parasites from those that do not infect humans, and to track the source of oocyst contamination in the environment. Cell culture techniques are now used to examine oocyst viability. While fewer studies have focused on Cyclospora cayetanensis, the parasite has been successfully detected in drinking water and wastewater using current methods to recover Cryptosporidium oocysts. More research is needed for monitoring of Cyclospora in the environment. Meanwhile, molecular methods (e.g. molecular markers such as intervening transcribed spacer regions), which can identify different genotypes of C. cayetanensis, show good promise for detection of this emerging coccidian parasite in water.

Animals↗

A reusable flow-through polymerase chain reaction instrument for the continuous monitoring of infectious biological agents.

Continuous monitoring of the environment for infectious diseases and related biowarfare agents requires the implementation of practical cost-effective methodologies that are highly sensitive and specific. One compatible method employed in clinical diagnostics is real-time polymerase chain reaction (PCR) analysis. The utility of this technique for environmental monitoring is limited, however, by the utilization of single-use consumables in commercial PCR instruments. This greatly increases mechanical complexity, because sophisticated robotic mechanisms must replenish the disposable elements. An alternative strategy develops an autonomous monitoring system consisting of reusable modules that readily interface with fluidic circuitry in a flow-through scheme. The reduced complexity should increase reliability while decreasing operating costs. In this report, we describe a reusable, flow-through PCR module that functions as one component in such a system. This module was rigorously evaluated with Bacillus anthracis genomic DNA and demonstrated high repeatability, sensitivity, and efficiency, with no evidence of sample-to-sample carryover.

Algorithms↗

Acrylonitrile induces autolysis Bacillus subtilis.

Acrylonitrile (AN) is an industrial chemical used in the manufacture of plastics and other polymers. AN has been reported to be an acute toxin and is a known carcinogen in rodents. When AN was mixed with suspensions of Bacillus subtilis, the bacteria began autolysis. It was determined that AN is partially converted to cyanide, a strong protonophore in B. subtilis. Autolytic enzymes in B. subtilis become active when the protonmotive force is dissipated. The amount of cyanide produced from AN, however, was not enough to promote autolysis in exponential B. subtilis. This is the first report showing that AN may induce autolytic reactions in bacteria. It is suggested the autolysis of B. subtilis may be useful in the environmental monitoring of AN. In addition, the metabolism of AN by bacilli may be useful in bioremediation.

Acrylonitrile↗

Concerns of microbial pathogens in association with dairy foods.

Recent outbreaks of foodborne disease linked to Salmonella, Listeria, and Yersinia have highlighted consumer awareness of microbiological problems in the food supply. Such outbreaks affirm the need for improved testing, environmental monitoring, and epidemiological surveillance. This paper reviews the entry of microbial pathogens into foods, with an emphasis on dairy products, by examining the contribution of the processing environment to microbial contamination. Numerous surveys, including a recent audit of dairy processing plants in Vermont, have revealed common foci of environmental contamination by Listeria and Yersinia persistent within dairy processing environments. With respect to dairy products, the bacterial pathogens discussed in this manuscript share a common source, raw milk. Characteristics possessed by Salmonella, Listeria, and Yersinia are compared and contrasted. In the case of Listeria, this bacterium's role as a newly emerged foodborne pathogen is discussed. Finally, the economic consequences associated with foodborne disease are highlighted, and future prospects related to foodborne illness are presented.

Animals↗

[Chiral safety of the biosphere as a biophysical problem].

The biosphere with its inherent chiral asymmetry fixed in the process of biological evolution at the level of L-amino acids and D-hydrocarbons and some other biologically active compounds of biogenic origin is under strong pressure of chiral substances produced by chemical, pharmaceutical, and other branches of industry and agriculture. Effective use of enantiomers is accompanied by toxic and even mutagenic effects of their mirror-image enantiomorphs. Only small amounts of products are tested for chiral purity; there is no system of global biosphere monitoring as well as no common standards of permissible concenrations. The investigation of the molecular basis of chiral stereospecificity of enzymes and cell receptors is of great interest from the point of view of fundamental biophysics. On the other hand, the development of chiral-selective sensors for environmental monitoring is important from the viewpoint of applied biophysics.

Biophysical Phenomena↗

Use of a heminested reverse transcriptase PCR assay for detection of astrovirus in environmental swabs from an outbreak of gastroenteritis in a pediatric primary immunodeficiency unit.

An outbreak of astrovirus gastroenteritis occurred in the Primary Immunodeficiency Unit at Newcastle General Hospital in March 2004. Environmental swabbing of the unit was undertaken after the outbreak, with multiple sites swabbed pre- and postcleaning. Astroviruses were detected in four environmental swabs and from two patient fecal samples using heminested reverse transcriptase PCR. An astrovirus genotype 3 strain was identified in both environmental swabs and fecal specimens and was the strain identified as being responsible for the outbreak. Environmental transmission of the virus was thought to have occurred by contamination of a syringe pump outside the laminar-flow curtain of a patient who was admitted with astrovirus gastroenteritis. This was subsequently transmitted to a cubicle next door and to a television/games console in a parents' room in the ward. Environmental monitoring of surfaces/equipment, using PCR assays for gastroenteric viruses in hospital situations where infection can give rise to serious clinical complications, may have a role in controlling and monitoring cleaning and the subsequent prevention of nosocomial transmission of gastroenteritis.

Astroviridae Infections↗

Intracellular acid-base responses to environmental hyperoxia and normoxic recovery in rainbow trout.

Exposure of rainbow trout to environmental hyperoxia (PIO2 approximately 530 Torr) resulted in an extracellular respiratory acidosis which was fully compensated by 72 h; return to normoxia (PIO2 approximately 145 Torr) at this time induced a metabolic alkalosis which was corrected by 24 h. Intracellular pHi ([14C]DMO method), fluid volumes [3H]PEG-4000 method), and electrolytes were monitored. Environmental hypercapnia (PICO2 approximately 6.5 Torr) was employed to confirm that intracellular responses were specific to respiratory acidosis. Gill pHi did not change during respiratory acidosis despite a very low non-HCO3- buffer capacity, but gill ICFV decreased markedly. A large loss of gill intracellular [Cl-]i in excess of [Na+]i, combined with a substantial gain in [K+]i, contributed to gill pHi regulation by raising branchial [SID]i. In weakly buffered brain tissue, active adjustment of pHi started within 3 h, but two well buffered tissues, RBC and white muscle, exhibited compounding metabolic acidoses during the first 12-24 h. The muscle response was associated with small increases in ICFV and [Cl-]i, and a large decrease in [K+]i which reduced muscle [SID]i. We hypothesize that this initial export of K+ and basic equivalents served to regulate pH in more critical compartments (e.g. gills, brain) at the expense of muscle acidosis. By 48 h, pHi restoration in all tissues was complete, in advance of pHe regulation (72 h). Return to normoxia at 72 h elevated muscle, brain, and gill pHi, but there was no evidence of a comparable 'altruistic' role of muscle during this metabolic alkalosis. Regulation of pHi was complete by 24 h recovery, accompanied by partial or complete restoration of intracellular ions and fluid volumes.

Acid-Base Equilibrium↗

Analysis of DNA adduct, S-[2-(N7-guanyl)ethyl]glutathione, by liquid chromatography/mass spectrometry and liquid chromatography/tandem mass spectrometry.

Sensitive and specific isotope dilution liquid chromatography/mass spectrometry (LC/MS) and liquid chromatography/tandem mass spectrometry (LC/MS/MS) methods were developed for the detection and quantitative analysis of S-[2-(N7-guanyl)ethyl]glutathione as a DNA adduct formed upon exposure of animals to carcinogenic 1,2-dihaloethanes. Separation and analysis were performed using microbore HPLC coupled in-line to an electrospray ionization triple quadrupole mass spectrometer. S-[2-(N7-guanyl)[2H4]-ethyl] glutathione was synthesized and used as internal standard. These methods provide structural confirmation of the adduct as well as quantitative analysis with the accuracy and precision necessary to measure biologically relevant levels in small tissue sample sizes (< 1 g). The sample detection limits in in vivo tissue extracts were 100 pg and 5 pg on-column for LC/MS and LC/MS/MS methods, respectively. Selected-ion monitoring mode was used to monitor the product ions of the doubly charged molecular ion. The application of these methods was demonstrated by measuring the DNA adduct levels in rat and fish samples after exposure to 1,2-dihaloethanes. The method has application in studies of DNA adduct formation as a biological marker of exposure to carcinogens and for environmental monitoring of 1,2-dihaloethanes.

Animals↗