scholarly journals Environmental exposures contribute to respiratory and allergic symptoms among women living in the banana growing regions of Costa Rica

2021 ◽  
pp. oemed-2021-107611
Author(s):  
Brooke Alhanti ◽  
Berna van Wendel de Joode ◽  
Manuel Soto Martinez ◽  
Ana M Mora ◽  
Leonel Córdoba Gamboa ◽  
...  
Keyword(s):  
Costa Rica ◽  
Regression Models ◽  
Pesticide Exposure ◽  
Environmental Exposures ◽  
Pesticide Use ◽  
High Exposure ◽  
Logistic Regression Models ◽  
Urinary Levels ◽  
Polycyclic Aromatic ◽  
Health Cohort Study

ObjectivesThis research evaluates whether environmental exposures (pesticides and smoke) influence respiratory and allergic outcomes in women living in a tropical, agricultural environment.MethodsWe used data from 266 mothers from the Infants’ Environmental Health cohort study in Costa Rica. We evaluated environmental exposures in women by measuring seven pesticide and two polycyclic aromatic hydrocarbons metabolites in urine samples. We defined ‘high exposure’ as having a metabolite value in the top 75th percentile. We collected survey data on respiratory and allergic outcomes in mothers as well as on pesticides and other environmental exposures. Using logistic regression models adjusted for obesity, we assessed the associations of pesticide exposure with multiple outcomes (wheeze, doctor-diagnosed asthma, high (≥2) asthma score based on symptoms, rhinitis, eczema and itchy rash).ResultsCurrent pesticide use in the home was positively associated with diagnosed asthma (OR=1.99 (95% CI=1.05 to 3.87)). High urinary levels of 5-hydroxythiabendazole (thiabendazole metabolite) and living in a neighbourhood with frequent smoke from waste burning were associated with a high asthma score (OR=1.84 (95%CI=1.05 to 3.25) and OR=2.31 (95%CI=1.11 to 5.16), respectively). Women who worked in agriculture had a significantly lower prevalence of rhinitis (0.19 (0.01 to 0.93)), but were more likely to report eczema (OR=2.54 (95%CI=1.33 to 4.89)) and an itchy rash (OR=3.17 (95%CI=1.24 to 7.73)).ConclusionsWhile limited by sample size, these findings suggest that environmental exposure to both pesticides and smoke may impact respiratory and skin-related allergic outcomes in women.

scholarly journals Variability and predictors of weekly pesticide exposure in applicators from organic, sustainable and conventional smallholder farms in Costa Rica

2019 ◽  
Vol 77 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Samuel Fuhrimann ◽  
Philipp Staudacher ◽  
Christian Lindh ◽  
Berna van Wendel de Joode ◽  
Ana M Mora ◽  
...  
Keyword(s):  
Costa Rica ◽  
Pesticide Exposure ◽  
Intraclass Correlation ◽  
Pesticide Use ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Smallholder Farms ◽  
Middle Income ◽  
Pesticide Exposures

ObjectiveEstimates of pesticide exposure among applicators from low- and middle-income countries (LMICs) are scarce, and exposure assessment methods are sometimes costly or logistically unfeasible. We examined the variability in weeklong pesticide exposure among applicators in Costa Rica and its predictors.MethodsWe conducted a cross-sectional survey among 221 pesticide applicators from organic, sustainable and conventional farms in 2016. We administered structured questionnaires to assess pesticide application practices at two time points (4–6 weeks apart). We adapted an existing algorithm to fit the context of smallholders and derive weekly pesticide exposure scores. We used linear mixed-effect models to examine within-worker and between-worker score variability. We then identified sociodemographic and occupational predictors of weekly pesticide exposure scores.ResultsWe observed high within-worker and between-worker variability in weekly pesticide exposures (eg, up to 180-fold and 70-fold differences in average weekly exposures within and between workers, respectively; intraclass correlation coefficient=0.4). Applicators working on conventional and sustainable farms had exposure scores twofold and 1.5-fold higher than those working in organic farms, respectively. Farm workers who received training on pesticide use had weekly pesticide exposure scores of 33% (95% CI 1% to 55%) lower than those who did not receive any training.ConclusionsIn this study of applicators from smallholder farms in Costa Rica, we determined the importance of collecting questionnaire data on self-reported pesticide use repeatedly due to its high variability within workers and absence of application records. Our questionnaire-based exposure algorithm could allow the calculation of semiquantitative estimates of average pesticide exposure for applicators from other LMICs.

Occupational pesticide use and self-reported olfactory impairment in US farmers

2020 ◽  
pp. oemed-2020-106818
Author(s):  
Srishti Shrestha ◽  
David M Umbach ◽  
Laura E Beane Freeman ◽  
Stella Koutros ◽  
Michael C R Alavanja ◽  
...  
Keyword(s):  
Pesticide Exposure ◽  
Epidemiological Studies ◽  
Health Study ◽  
Dichlorophenoxyacetic Acid ◽  
Pesticide Use ◽  
Response Patterns ◽  
Logistic Regression Models ◽  
Petroleum Distillates ◽  
Olfactory Impairment ◽  
2,4 Dichlorophenoxyacetic Acid

ObjectivesPesticide exposure may impair human olfaction, but empirical evidence is limited. We examined associations between occupational use of 50 specific pesticides and olfactory impairment, both self-reported, among 20 409 participants in the Agricultural Health Study, a prospective cohort of pesticide applicators (mostly farmers, 97% male).MethodsWe used logistic regression models to estimate odds ratios (OR) and 95% confidence intervals (CI) for associations between pesticide use at enrolment (1993–1997) and olfactory impairment reported two decades later (2013–2016), adjusting for baseline covariates.ResultsAbout 10% of participants reported olfactory impairment. The overall cumulative days of any pesticide use at enrolment were associated with a higher odds of reporting olfactory impairment (OR (highest vs lowest quartile): 1.17 (95% CI: 1.02 to 1.34), p-trend = 0.003). In the analyses of 50 specific pesticides, ever-use of 20 pesticides showed modest associations with olfactory impairment, with ORs ranging from 1.11 to 1.33. Of these, higher lifetime days of use of 12 pesticides were associated with higher odds of olfactory impairment compared with never use (p-trend ≤ 0.05), including two organochlorine insecticides (dichlorodiphenyltrichloroethane and lindane), two organophosphate insecticides (diazinon and malathion), permethrin, the fungicide captan and six herbicides (glyphosate, petroleum distillates, 2,4-dichlorophenoxyacetic acid, 2,4,5-trichlorophenoxyacetic acid and metribuzin), although many of these did not exhibit clear, monotonic exposure-response patterns.ConclusionOverall, we found relatively broad associations between pesticides and olfactory impairment, involving many individual pesticides and covering several chemical classes, suggesting that pesticides could affect olfaction through multiple pathways. Future epidemiological studies with objective measurement of olfaction are required to confirm these findings.

scholarly journals Health Symptoms Related to Pesticide Use in Farmers and Laborers of Ecological and Conventional Banana Plantations in Ecuador

2021 ◽  
Vol 18 (3) ◽  
pp. 1126
Author(s):  
Hans-Peter Hutter ◽  
Michael Poteser ◽  
Kathrin Lemmerer ◽  
Peter Wallner ◽  
Michael Kundi ◽  
...  
Keyword(s):  
Pesticide Exposure ◽  
Gastrointestinal Symptoms ◽  
Subjective Health ◽  
Exposed Group ◽  
Pesticide Use ◽  
Safety Measures ◽  
High Exposure ◽  
P Values ◽  
Health Symptoms ◽  
Systemic Symptoms

Conventional banana farming is pesticide-intensive and leads to high exposure of farmworkers. Ecuador is the world’s biggest exporter of bananas. In this field study in 5 communities in Ecuador, we recorded potentially pesticide-associated subjective health symptoms in farmworkers and compared pesticide users to workers in organic farming. With one exception, symptom rates were always higher in the pesticide-exposed group. Significance was reached in 8 out of 19 investigated symptoms with the highest odds ratios (and smallest p-values) for local irritation like skin and eye irritation (OR = 3.58, CI 1.10–11.71, and 4.10, CI 1.37–12.31, respectively) as well as systemic symptoms like dizziness (OR = 4.80, CI 1.55–14.87) and fatigue (OR = 4.96, CI 1.65–14.88). Moreover, gastrointestinal symptoms were reported more frequently by pesticide users: nausea (OR = 7.5, CI 1.77–31.77) and diarrhea (OR = 6.43, CI 1.06–30.00). The majority of farmworkers were not adequately protected from pesticide exposure. For example, only 3 of 31 farmworkers that had used pesticides recently reported using gloves and only 6 reported using masks during active spraying. Improved safety measures and a reduction in pesticide use are necessary to protect the health of banana farmworkers.

scholarly journals Exposure to Welding Fumes, Hexavalent Chromium, or Nickel and Risk of Lung Cancer

2019 ◽  
Vol 188 (11) ◽  
pp. 1984-1993 ◽  
Author(s):  
Beate Pesch ◽  
Benjamin Kendzia ◽  
Hermann Pohlabeln ◽  
Wolfgang Ahrens ◽  
Heinz-Erich Wichmann ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Hexavalent Chromium ◽  
Regression Models ◽  
Welding Process ◽  
Cumulative Exposure ◽  
Welding Fumes ◽  
Odds Ratios ◽  
Case Control Studies ◽  
High Exposure ◽  
Logistic Regression Models

Abstract To investigate the risk of lung cancer after exposure to welding fumes, hexavalent chromium (Cr(VI)), and nickel, we analyzed 3,418 lung cancer cases and 3,488 controls among men from 2 German case-control studies (1988–1996). We developed a welding-process exposure matrix from measurements of these agents, and this was linked with welding histories from a job-specific questionnaire to calculate cumulative exposure variables. Logistic regression models were fitted to estimate odds ratios with confidence intervals conditional on study, and they adjusted for age, smoking, and working in other at-risk occupations. Additionally, we mutually adjusted for the other exposure variables under study. Overall, 800 cases and 645 controls ever worked as regular or occasional welders. Odds ratios for lung cancer with high exposure were 1.55 (95% confidence interval (CI): 1.17, 2.05; median, 1.8 mg/m3 × years) for welding fumes, 1.85 (95% CI: 1.35, 2.54; median, 1.4 μg/m3 × years) for Cr(VI), and 1.60 (95% CI: 1.21, 2.12; median, 9 μg/m3 × years) for nickel. Risk estimates increased with increasing cumulative exposure to welding fumes and with increasing exposure duration for Cr(VI) and nickel. Our results showed that welding fumes, Cr(VI), and nickel might contribute independently to the excess lung cancer risk associated with welding. However, quantitative exposure assessment remains challenging.

scholarly journals Reproductive and environmental exposures and the breast cancer risk in Taiwanese women

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hui-Chen Wu ◽  
Hwai-I. Yang ◽  
Po-Han Lin ◽  
Chien-Jen Chen ◽  
Regina M. Santella ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Regression Models ◽  
Data Linkage ◽  
Conditional Logistic Regression ◽  
Age At Menarche ◽  
Logistic Regression Models ◽  
Taiwanese Women ◽  
Polycyclic Aromatic ◽  
Nested Case Control ◽  
Control Study

AbstractBreast cancer (BC) incidence is increasing around the globe, including in Taiwan, though the cause of the increasing incidence is less clear. We followed up 11,296 Taiwanese females who did not have BC at baseline, and ascertained new invasive BC (N = 351) through data linkage to the National Cancer Registry from 1991 to 2018 to examine whether reproductive, lifestyle and environmental risk factors including polycyclic aromatic hydrocarbons (PAH) were associated with BC risk. We conducted a nested case–control study using baseline blood available from a total of 305 women with BC and 598 women without BC matched on time in cohort. We examined the association of PAH-albumin adducts and BC risk using conditional logistic regression models. Age at menarche (HR 0.6 (95% CI 0.5–0.9) for ≥ 15 vs. < 13 years) and multiparity were associated with BC risk (HR 2.0 (95% CI 1.4–2.8), 2.8 (1.9–4.2), and 2.4 (1.0–5.0) for 3–4, 1–2 and 0 live birth, compared with women ≥ 5 births). PAH-albumin adducts were not associated with BC risk. Given the increasing BC incidence in Taiwan, there is a need to identify environmental factors that are important to this population.

The impact of SPY angiography on intraoperative decision making and outcomes for post-mastectomy reconstruction

2019 ◽  
pp. 1-5
Keyword(s):  
Decision Making ◽  
Logistic Regression ◽  
Skin Necrosis ◽  
Regression Models ◽  
Multivariable Analysis ◽  
P Value ◽  
Flap Necrosis ◽  
Single Institution ◽  
Logistic Regression Models ◽  
The Impact

Objective: While the use of intraoperative laser angiography (SPY) is increasing in mastectomy patients, its impact in the operating room to change the type of reconstruction performed has not been well described. The purpose of this study is to investigate whether SPY angiography influences post-mastectomy reconstruction decisions and outcomes. Methods and materials: A retrospective analysis of mastectomy patients with reconstruction at a single institution was performed from 2015-2017.All patients underwent intraoperative SPY after mastectomy but prior to reconstruction. SPY results were defined as ‘good’, ‘questionable’, ‘bad’, or ‘had skin excised’. Complications within 60 days of surgery were compared between those whose SPY results did not change the type of reconstruction done versus those who did. Preoperative and intraoperative variables were entered into multivariable logistic regression models if significant at the univariate level. A p-value <0.05 was considered significant. Results: 267 mastectomies were identified, 42 underwent a change in the type of planned reconstruction due to intraoperative SPY results. Of the 42 breasts that underwent a change in reconstruction, 6 had a ‘good’ SPY result, 10 ‘questionable’, 25 ‘bad’, and 2 ‘had areas excised’ (p<0.01). After multivariable analysis, predictors of skin necrosis included patients with ‘questionable’ SPY results (p<0.01, OR: 8.1, 95%CI: 2.06 – 32.2) and smokers (p<0.01, OR:5.7, 95%CI: 1.5 – 21.2). Predictors of any complication included a change in reconstruction (p<0.05, OR:4.5, 95%CI: 1.4-14.9) and ‘questionable’ SPY result (p<0.01, OR: 4.4, 95%CI: 1.6-14.9). Conclusion: SPY angiography results strongly influence intraoperative surgical decisions regarding the type of reconstruction performed. Patients most at risk for flap necrosis and complication post-mastectomy are those with questionable SPY results.

Demographic factors associated with missed follow-up among solid tumor patients treated at a large multi-site academic institution

2020 ◽  
Vol 16 (32) ◽  
pp. 2635-2643
Author(s):  
Samantha L Freije ◽  
Jordan A Holmes ◽  
Saleh Rachidi ◽  
Susannah G Ellsworth ◽  
Richard C Zellars ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Odds Ratio ◽  
Regression Models ◽  
Tumor Patients ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Follow Up Care ◽  
Risk Patients ◽  
African American Race

Aim: To identify demographic predictors of patients who miss oncology follow-up, considering that missed follow-up has not been well studies in cancer patients. Methods: Patients with solid tumors diagnosed from 2007 to 2016 were analyzed (n = 16,080). Univariate and multivariable logistic regression models were constructed to examine predictors of missed follow-up. Results: Our study revealed that 21.2% of patients missed ≥1 follow-up appointment. African–American race (odds ratio [OR] 1.33; 95% CI: 1.17–1.51), Medicaid insurance (OR 1.59; 1.36–1.87), no insurance (OR 1.66; 1.32–2.10) and rural residence (OR 1.78; 1.49–2.13) were associated with missed follow-up. Conclusion: Many cancer patients miss follow-up, and inadequate follow-up may influence cancer outcomes. Further research is needed on how to address disparities in follow-up care in high-risk patients.

scholarly journals COVID-19 Preventive Behaviours in Cameroon: A Six-Month Online National Survey

2021 ◽  
Vol 18 (5) ◽  
pp. 2554
Author(s):  
Joseph Nelson Siewe Fodjo ◽  
Leonard Ngarka ◽  
Wepnyu Y. Njamnshi ◽  
Leonard N. Nfor ◽  
Michel K. Mengnjo ◽  
...  
Keyword(s):  
Regression Models ◽  
Health Personnel ◽  
Online Survey ◽  
Preventive Measures ◽  
Face Mask ◽  
Logistic Regression Models ◽  
Adherence Score ◽  
Preventive Behaviour ◽  
Predictors Of Adherence

Since March 2020, the Cameroonian government implemented nationwide measures to stall COVID-19 transmission. However, little is known about how well these unprecedented measures are being observed as the pandemic evolves. We conducted a six-month online survey to assess the preventive behaviour of Cameroonian adults during the COVID-19 outbreak. A five-point adherence score was constructed based on self-reported observance of the following preventive measures: physical distancing, face mask use, hand hygiene, not touching one’s face, and covering the mouth when coughing or sneezing. Predictors of adherence were investigated using ordinal logistic regression models. Of the 7381 responses received from all ten regions, 73.3% were from male respondents and overall mean age was 32.8 ± 10.8 years. Overall mean adherence score was 3.96 ± 1.11 on a scale of 0–5. Mean weekly adherence scores were initially high, but gradually decreased over time accompanied by increasing incidence of COVID-19 during the last study weeks. Predictors for higher adherence included higher age, receiving COVID-19 information from health personnel, and agreeing with the necessity of lockdown measures. Meanwhile, experiencing flu-like symptoms was associated with poor adherence. Continuous observance of preventive measures should be encouraged among Cameroonians in the medium- to long-term to avoid a resurgence in COVID-19 infections.

scholarly journals Behavioral and Attitudinal Correlates of Trusted Sources of COVID-19 Vaccine Information in the US

2021 ◽  
Vol 11 (4) ◽  
pp. 56
Author(s):  
Carl A. Latkin ◽  
Lauren Dayton ◽  
Jacob R. Miller ◽  
Grace Yi ◽  
Afareen Jaleel ◽  
...  
Keyword(s):  
Regression Models ◽  
Logistic Regression Models ◽  
The Public ◽  
Public Health Systems ◽  
Online Study ◽  
News Sources ◽  
The Us ◽  
Vulnerable People ◽  
Two Factors ◽  
Vaccine Information

There is a critical need for the public to have trusted sources of vaccine information. A longitudinal online study assessed trust in COVID-19 vaccine information from 10 sources. A factor analysis for data reduction revealed two factors. The first factor contained politically conservative sources (PCS) of information. The second factor included eight news sources representing mainstream sources (MS). Multivariable logistic regression models were used. Trust in Dr. Fauci was also examined. High trust in MS was associated with intention to encourage family members to get COVID-19 vaccines, altruistic beliefs that more vulnerable people should have vaccine priority, and belief that racial minorities with higher rates of COVID-19 deaths should have priority. High trust in PCS was associated with intention to discourage friends from getting vaccinated. Higher trust in PCS was also associated with participants more likely to disagree that minorities with higher rates of COVID-19 deaths should have priority for a vaccine. High trust in Dr. Fauci as a source of COVID-19 vaccine information was associated with factors similar to high trust in MS. Fair, equitable, and transparent access and distribution are essential to ensure trust in public health systems’ abilities to serve the population.

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