PCBs in schools--where communities and science come together.

A novel aspect of the 8th International PCB Workshop at Woods Hole, MA, was the interaction between scientists and activists. While earlier workshops in this series had mentioned policy making, this Workshop focused on the problem of PCBs in schools. Focus on a problem brought an activist to give a plenary talk and facilitated a 1-day registration for other non-scientists to attend. The workshop was cohosted by the Superfund Research Programs at University of Iowa and Boston University and included active participation of each Program's Research Translation and Community Engagement Cores. A mandate of each National Institute of Environmental Health Science (NIEHS)-funded Superfund Research Program is bidirectional communication between scientists and community groups. The authors describe the events leading up to community involvement in the Workshop and the substance of the community engagement aspects of the workshop, in particular the participation by a parent-teacher group, Malibu Unites. The authors also discuss the value of such communication in terms of making important research accessible to those who are most affected by the results and poised to use it and the value of making scientists aware of the important role they play in society in addressing difficult questions that originate in community settings.

Balancing act: approaches to healthy eating and physical activity among Boston public housing residents.

Boston public housing residents are more likely to report fair or poor health status, been diagnosed with obesity, and to be physically inactive compared with other Boston residents (Digenis-Bury, Brooks, Chen, Ostrem, & Horsburgh, 2008 ). Little is known about perceptions of and opportunities for healthy eating and physical activity in this population. We conducted eight focus groups at public housing developments to explore residents' views regarding opportunities and barriers to healthy eating and physical activity. Sixty-seven English- and Spanish-speaking residents participated. Transcripts were analyzed using qualitative content analysis. All residents described the challenge of balancing considerations of food quality, access, and affordability. Other findings included underutilized nutritional resources; abundant availability of unhealthy food; and economic and structural barriers to exercise. Transportation-related challenges were a dominant theme. Building opportunities for physical activity and providing access to affordable and quality food choices may be important interventions for promoting health among public housing residents.

Effect of time-activity adjustment on exposure assessment for traffic-related ultrafine particles.

Exposures to ultrafine particles (<100 nm, estimated as particle number concentration, PNC) differ from ambient concentrations because of the spatial and temporal variability of both PNC and people. Our goal was to evaluate the influence of time-activity adjustment on exposure assignment and associations with blood biomarkers for a near-highway population. A regression model based on mobile monitoring and spatial and temporal variables was used to generate hourly ambient residential PNC for a full year for a subset of participants (n=140) in the Community Assessment of Freeway Exposure and Health study. We modified the ambient estimates for each hour using personal estimates of hourly time spent in five micro-environments (inside home, outside home, at work, commuting, other) as well as particle infiltration. Time-activity adjusted (TAA)-PNC values differed from residential ambient annual average (RAA)-PNC, with lower exposures predicted for participants who spent more time away from home. Employment status and distance to highway had a differential effect on TAA-PNC. We found associations of RAA-PNC with high sensitivity C-reactive protein and Interleukin-6, although exposure-response functions were non-monotonic. TAA-PNC associations had larger effect estimates and linear exposure-response functions. Our findings suggest that time-activity adjustment improves exposure assessment for air pollutants that vary greatly in space and time.

"No justice, no peace" and the right to self-determination: an interview with Gary Grant and Naeema Muhammed of the North Carolina Environmental Justice Network.

This is an interview with Gary Grant and Naeema Muhammed, leaders of the North Carolina Environmental Justice Network. Each of them talks about where they grew up, their politicization, how their paths crossed, their work together after Hurricane Floyd, and the unique challenges of organizing for social justice for black communities in the South. We learn of their fight against concentrated animal feeding operations (CAFOs), primarily for the hog trade, and they take us up to North Carolina's Moral Monday protests of 2013 against legislation that threatens voting rights, public education, access to medical services, unemployment benefits, workers rights, occupational and environmental health, and women's access to reproductive health care. We are grateful to these two friends of New Solutions for their contribution to the journal, and we hope that their insights regarding struggles for social and environmental justice can serve as guides for us all.

Sewer Gas: An Indoor Air Source of PCE to Consider During Vapor Intrusion Investigations.

The United States Environmental Protection Agency (USEPA) is finalizing its vapor intrusion guidelines. One of the important issues related to vapor intrusion is background concentrations of volatile organic chemicals (VOCs) in indoor air, typically attributed to consumer products and building materials. Background concentrations can exist even in the absence of vapor intrusion and are an important consideration when conducting site assessments. In addition, the development of accurate conceptual models that depict pathways for vapor entry into buildings is important during vapor intrusion site assessments. Sewer gas, either as a contributor to background concentrations or as part of the site conceptual model, is not routinely evaluated during vapor intrusion site assessments. The research described herein identifies an instance where vapors emanating directly from a sanitary sewer pipe within a residence were determined to be a source of tetrachloroethylene (PCE) detected in indoor air. Concentrations of PCE in the bathroom range from 2.1 to 190 ug/m3 and exceed typical indoor air concentrations by orders of magnitude resulting in human health risk classified as an "Imminent Hazard" condition. The results suggest that infiltration of sewer gas resulted in PCE concentrations in indoor air that were nearly two-orders of magnitude higher as compared to when infiltration of sewer gas was not known to be occurring. This previously understudied pathway whereby sewers serve as sources of PCE (and potentially other VOC) vapors is highlighted. Implications for vapor intrusion investigations are also discussed.

Chronic kidney disease in Nicaragua: a qualitative analysis of semi-structured interviews with physicians and pharmacists.

BACKGROUND: Northwestern Nicaragua has a high prevalence of chronic kidney disease (CKD) of unknown cause among young adult men. In addition, frequent occurrence of urinary tract infections (UTI) among men and a dysuria syndrome described by sugarcane workers as "chistata" are both reported. This study examines health professionals´ perceptions regarding etiology of these conditions and their treatment approaches, including use of potentially nephrotoxic medications. METHODS: Nineteen in-person semi-structured interviews were conducted in November 2010 among ten physicians and nine pharmacists practicing in the region. RESULTS: Health professionals perceived CKD as a serious and increasing problem in the region, primarily affecting young men working as manual laborers. All interviewees regarded occupational and environmental exposure to sun and heat, and dehydration as critical factors associated with the occurrence of CKD. These factors were also considered to play a role in the occurrence of chistata in the region. Health professionals indicated that reluctance among workers to hydrate might be influenced by perceptions of water contamination. Symptoms often were treated with non-steroidal anti-inflammatory drugs (NSAIDs), diuretics and antibiotics. Physicians acknowledged that the diagnosis of UTI usually was not based on microbial culture and opined that the use of potentially nephrotoxic medications may be contributing to CKD. CONCLUSIONS: Interviews provided evidence suggesting that medications such as diuretics, antibiotics and NSAIDs are widely used and sold over the counter for symptoms that may be related to dehydration and volume depletion. These factors, alone or in combination, may be possible contributors to kidney damage. Acute kidney damage coupled with volume depletion and exposures including medications and infectious agents should be further evaluated as causal factors for CKD in this region.

Social disparities in exposures to bisphenol A and polyfluoroalkyl chemicals: a cross-sectional study within NHANES 2003-2006.

BACKGROUND: Bisphenol A (BPA) and polyfluoroalkyl chemicals (PFCs) are suspected endocrine disrupting compounds known to be ubiquitous in people's bodies. Population disparities in exposure to these chemicals have not been fully characterized. METHODS: We analyzed data from the 2003-2006 National Health and Nutrition Examination Survey. Using multivariable linear regression we examined the association between urinary concentrations of BPA, serum concentrations of four PFCs, and multiple measures of socioeconomic position (SEP): family income, education, occupation, and food security. We also examined associations with race/ethnicity. RESULTS: All four PFCs were positively associated with family income, whereas BPA was inversely associated with family income. BPA concentrations were higher in people who reported very low food security and received emergency food assistance than in those who did not. This association was particularly strong in children: 6-11 year-olds whose families received emergency food had BPA levels 54% higher (95% CI, 13 to 112%) than children of families who did not. For BPA and PFCs we saw smaller and less consistent associations with education and occupation. Mexican Americans had the lowest concentrations of any racial/ethnic group of both types of chemicals; for PFCs, Mexican Americans not born in the U.S. had much lower levels than those born in the U.S. CONCLUSIONS: People with lower incomes had higher body burdens of BPA; the reverse was true for PFCs. Family income with adjustment for family size was the strongest predictor of chemical concentrations among the different measures of SEP we studied. Income, education, occupation, and food security appear to capture different aspects of SEP that may be related to exposure to BPA and PFCs and are not necessarily interchangeable as measures of SEP in environmental epidemiology studies. Differences by race/ethnicity were independent of SEP.

Qualitative environmental health research: an analysis of the literature, 1991-2008.

Qualitative research uses nonnumeric data to understand people's opinions, motives, understanding, and beliefs about events or phenomena. In this analysis, I report the use of qualitative methods and data in the study of the relationship between environmental exposures and human health. A primary search for peer-reviewed journal articles dated from 1991 through 2008 included the following three terms: qualitative, environ*, and health. Searches resulted in 3,155 records. Data were extracted and findings of articles analyzed to determine where and by whom qualitative environmental health research is conducted and published, the types of methods and analyses used in qualitative studies of environmental health, and the types of information qualitative data contribute to environmental health. The results highlight a diversity of disciplines and techniques among researchers who used qualitative methods to study environmental health. Nearly all of the studies identified increased scientific understanding of lay perceptions of environmental health exposures. This analysis demonstrates the potential of qualitative data to improve understanding of complex exposure pathways, including the influence of social factors on environmental health, and health outcomes.

Qualitative environmental health research: an analysis of the literature, 1991-2008 / Pesquisa qualitativa de saúde ambiental: uma análise da literatura, 1991-2008

Qualitative research uses nonnumeric data to understand people's opinions, motives, understanding, and beliefs about events or phenomena. In this analysis, I report the use of qualitative methods and data in the study of the relationship between environmental exposures and human health. A primary search for peer-reviewed journal articles dated from 1991 through 2008 included the following three terms: qualitative, environ*, and health. Searches resulted in 3,155 records. Data were extracted and findings of articles analyzed to determine where and by whom qualitative environmental health research is conducted and published, the types of methods and analyses used in qualitative studies of environmental health, and the types of information qualitative data contribute to environmental health. The results highlight a diversity of disciplines and techniques among researchers who used qualitative methods to study environmental health. Nearly all of the studies identified increased scientific understanding of lay perceptions of environmental health exposures. This analysis demonstrates the potential of qualitative data to improve understanding of complex exposure pathways, including the influence of social factors on environmental health, and health outcomes.

Pesquisa qualitativa usa dados não numéricos para entender opiniões, motivos e crenças sobre eventos e fenômenos. Nesta análise, o uso de métodos e de dados qualitativos é reportado no estudo da relação entre exposição ambiental e saúde humana. Uma pesquisa preliminar por artigos de 1991 a 2008 incluiu os três seguintes termos: qualitativo, ambiente e saúde. A pesquisa resultou em 3.155 registros. Dados foram extraídos e artigos analisados para determinar onde e por quem a pesquisa de saúde ambiental foi conduzida e publicada, os tipos de métodos e análises usados em estudos qualitativos de saúde ambiental e os tipos de dados de informação qualitativa que contribuem para a saúde ambiental. Os resultados ressaltam uma diversidade de disciplinas e técnicas entre pesquisadores que usaram métodos qualitativos para estudar saúde ambiental. Quase todos os estudos identificaram um aumento da compreensão científica de percepções de exposições de saúde ambiental. A análise demonstra o potencial de dados qualitativos para melhorar a compreensão de caminhos de exposição complexos, incluindo a influência de fatores sociais em saúde ambiental e resultados.

Qualitative environmental health research: an analysis of the literature, 1991-2008.

BACKGROUND: Recent articles have advocated for the use of qualitative methods in environmental health research. Qualitative research uses nonnumeric data to understand people's opinions, motives, understanding, and beliefs about events or phenomena. OBJECTIVE: In this analysis of the literature, I report the use of qualitative methods and data in the study of the relationship between environmental exposures and human health. DATA SOURCES: A primary search on ISI Web of Knowledge/Web of Science for peer-reviewed journal articles dated from 1991 through 2008 included the following three terms: qualitative, environ*, and health. Inclusion and exclusion criteria are described. DATA EXTRACTION: Searches resulted in 3,155 records. Data were extracted and findings of articles analyzed to determine where and by whom qualitative environmental health research is conducted and published, the types of methods and analyses used in qualitative studies of environmental health, and the types of information qualitative data contribute to environmental health. DATA SYNTHESIS: Ninety-one articles met inclusion criteria. These articles were published in 58 different journals, with a maximum of eight for a single journal. The results highlight a diversity of disciplines and techniques among researchers who used qualitative methods to study environmental health, with most studies relying on one-on-one interviews. Details of the analyses were absent from a large number of studies. Nearly all of the studies identified increased scientific understanding of lay perceptions of environmental health exposures. DISCUSSION AND CONCLUSIONS: Qualitative data are published in traditionally quantitative environmental health studies to a limited extent. However, this analysis demonstrates the potential of qualitative data to improve understanding of complex exposure pathways, including the influence of social factors on environmental health, and health outcomes.

"Serving two masters"--an interview with school teacher and union organizer Debra Askwith.

Debra Askwith is a teacher, union member, and environmental health and safety activist in the public schools of Springfield, Massachusetts. In the following interview, she talks about her experiences organizing around the right to public information as a teacher and a union member. Working with the assistance of lawyers, she has learned to maneuver in the hierarchy of city and school administrators as well as the city's department of education, finding allies and meeting resistance in a variety of places. She has worked on asbestos, mold, indoor air quality, infectious disease, and civil rights to protect all students and workers.

A new spin on research translation: the Boston Consensus Conference on Human Biomonitoring.

BACKGROUND: Translating research to make it more understandable and effective (research translation) has been declared a priority in environmental health but does not always include communication to the public or residents of communities affected by environmental hazards. Their unique perspectives are also commonly missing from discussions about science and technology policy. The consensus conference process, developed in Denmark, offers a way to address this gap. OBJECTIVES: The Boston Consensus Conference on Human Biomonitoring, held in Boston, Massachusetts, in the fall of 2006, was designed to educate and elicit input from 15 Boston-area residents on the scientifically complex topic of human biomonitoring for environmental chemicals. This lay panel considered the many ethical, legal, and scientific issues surrounding biomonitoring and prepared a report expressing their views. DISCUSSION: The lay panel's findings provide a distinct and important voice on the expanding use of biomonitoring. In some cases, such as a call for opt-in reporting of biomonitoring results to study participants, they mirror recommendations raised elsewhere. Other conclusions have not been heard previously, including the recommendation that an individual's results should be statutorily exempted from the medical record unless permission is granted, and the opportunity to use biomonitoring data to stimulate green chemistry. CONCLUSION: The consensus conference model addresses both aspects of a broader conception of research translation: engaging the public in scientific questions, and bringing their unique perspectives to bear on public health research, practice, and policy. In this specific application, a lay panel's recommendations on biomonitoring surveillance, communication, and ethics have practical implications for the conduct of biomonitoring studies and surveillance programs.

Tangible evidence, trust and power: public perceptions of community environmental health studies.

Communities with environmental health concerns in the USA frequently request studies from their local or state departments of public health. This paper presents findings from three focus groups conducted in communities north of Boston that have been the subject of two different environmental health studies. The focus groups were designed to elicit residents' perceptions of environmental health, and of the particular studies conducted in their communities. In all focus groups, participants had difficulty accepting the findings of health studies that contradicted their own experiences of environmental exposures and illness. Our results suggest that lay knowledge, informed in varying degrees by the experience of what we term "tangible evidence," creates a lens through which communities interpret a health study's findings. The differences in reliance on tangible evidence were related to participants' sense of trust in public officials, and the institutions responsible for conducting health studies. Participants from the wealthier, predominantly white communities discussed trust in study design and methodologies used. In contrast, participants from the lower-income, higher-minority communities assessed health studies with reference to their trust (or lack thereof) in study sponsors and public health institutions. Participants' experience of tangible evidence, trust or distrust in health agencies and research institutions, and a sense of relative community power, influence how they assess the findings of environmental health studies and may have implications for pubic health.