The importance of toxicity in determining the impact of hazardous air pollutants on the respiratory health of children in Tennessee.

Respiratory diseases, exacerbated through point source pollution, are currently among the leading causes of hospitalization of children in the United States. This paper investigates the relationship between the proximity of hazardous air pollutants (HAPs) emitted from Toxic Release Inventory (TRI) facilities and the number of children diagnosed in hospitals with a respiratory disease in Tennessee. The importance of controlling for toxicity of those HAPs is of particular interest. Hospital discharge, socioeconomic, TRI emission, and HAP toxicity data are used to estimate, via Generalized Linear Methods, a logistic regression model describing the relationship between the percent of children living in a zip code area treated for respiratory illness and the average annual emissions over the previous 10 years of HAPs from TRI sites in that area. Controlling for area socioeconomic characteristics, we find that accounting for toxicity is important in uncovering the relationship between HAP emissions and respiratory health of children. A one standard deviation increase in toxicity-weighted emissions per 100 square miles is associated with an increase in the number of children diagnosed with asthma (chronic bronchitis) by about 1205 (260). The evidence suggests that, with a goal to improving children's respiratory health, monitoring the toxicity of chemicals being emitted is at least as important as simply monitoring total emission levels. This suggests that the EPA should consider making efforts toward establishing toxicity adjusted emission guidelines.

Pharmaceuticals and personal care products in the environment: what are the big questions?

BACKGROUND: Over the past 10-15 years, a substantial amount of work has been done by the scientific, regulatory, and business communities to elucidate the effects and risks of pharmaceuticals and personal care products (PPCPs) in the environment. OBJECTIVE: This review was undertaken to identify key outstanding issues regarding the effects of PPCPs on human and ecological health in order to ensure that future resources will be focused on the most important areas. DATA SOURCES: To better understand and manage the risks of PPCPs in the environment, we used the "key question" approach to identify the principle issues that need to be addressed. Initially, questions were solicited from academic, government, and business communities around the world. A list of 101 questions was then discussed at an international expert workshop, and a top-20 list was developed. Following the workshop, workshop attendees ranked the 20 questions by importance. DATA SYNTHESIS: The top 20 priority questions fell into seven categories: a) prioritization of substances for assessment, b) pathways of exposure, c) bioavailability and uptake, d) effects characterization, e) risk and relative risk, f ) antibiotic resistance, and g) risk management. CONCLUSIONS: A large body of information is now available on PPCPs in the environment. This exercise prioritized the most critical questions to aid in development of future research programs on the topic.

The effect of oil spills on workers involved in containment and abatement: the role of the occupational health nurse.

The Deepwater Horizon oil spill is the most recent manmade disaster to challenge occupational health nurses caring for a unique worker population. The effects of oil spills on wildlife, marine life, and the ecosystem are well studied and documented, but the effects on workers who contain and abate such disasters are not. These workers can suffer from a multitude of illnesses and injuries, such as ataxia, migraines, and various lung diseases, which can be a challenge for occupational health nurses.