Correlations between Educational Struggle, Toxic Sites by School District and Demographic Variables, with Geographical Information System Projections.

This correlational study associated data on children enrolled in individualized educational plans in their K-12 schools (IEP) and an algorithm-calculated score of neurotoxins at contaminated sites located in each school district. The study also mapped and projected the correlations using Geographical Information System (GIS) technology. These data were populated in ArcMap 10.5 (a GIS software) for generating maps and data to conduct geospatial analysis. A total of 1 Superfund site and 39 CERCLA sites were identified as contaminated sites for this analysis. The majority of contaminants were heavy metals such as lead, arsenic, mercury, and cadmium. The mean toxic score of all contaminated sites combined was 13.4 (SD 14.4). Correlational analysis between the IEP numbers from each school district and toxic scores from the contaminated school district sites exhibited a positive relationship (F = 23.7, p < 0.0001). Correlations were also seen among higher toxics scores, IEP numbers, and children under the age of 10 (p < 0.00052) as well as higher proportions of black students in areas with high toxics scores (p = 0.0032). Black students were also far more likely to be enrolled in an IEP (p < 0.0001). Household income and poverty percentage in contaminated areas were also correlated (p = 0.0002). Individuals without college degrees were overrepresented in high toxic score school districts (p < 0.0001). The important low socio-economic status indicator of free and reduced lunch programs also correlated with increasing toxic scores (p = 0.0012) and IEP numbers (p = 0.0416). This study emphasizes the need to account for multiple exposures to wholistically appreciate environmental factors contributing to negative health outcomes.

New questions and insights into nitrate/nitrite and human health effects: a retrospective cohort study of private well users' immunological and wellness status.

The retrospective cohort study described in this article examined 150 Iowa private well users' (aged 1-60 years) drinking water below the 10 parts per million nitrate-nitrogen (nitrate-N) maximum contaminant level and analyzed health history data and blood samples including hemoglobin fractions and immunological parameters. Positive associations existed (bivariate fit) between higher nitrate exposure and body mass index, lower recreational activity, perceived poorer health, and perceptions of susceptibility to illness. A directly proportionate relationship was seen between methemoglobin level in the blood and nitrate ingestion. High tumor necrosis factor-beta (TNF-beta) expression was also seen (bivariate fit, f = 3.76, p = .05). Complaints of stomach/ intestinal difficulties (heartburn/reflux > 50%; f = 5.274, p = .0231) and bone, muscle, and nerve complaints (osteoarthritis [rheumatoid excluded] = 47%; f = 6.0533, p = .0150) were found with increasing nitrate exposure. In vivo exposures of nitrate-N associated with complaints of bone/joint disorders or with altered ex vivo production of TNF-beta or Th2/Treg cytokine interleukin-10 have not been previously illustrated with environmental exposures.

Reliability of the Children's Attitudes Toward the Environment Scale.

The Children's Attitudes toward the Environment Scale, developed by Musser and Malkus (1994), gave Cronbach alpha .73 and .83 at pretest and 3-wk. later for 274 children and a test-retest r of only .47. While Cronbach alpha was similar to the value reported by the test developers, it is close to the low end of acceptability.

Roma health issues: a review of the literature and discussion.

OBJECTIVES: Roma health issues are under-studied from a comprehensive, epidemiological perspective. The Roma peoples (including 'Travellers') have been living in and around Central and Eastern Europe for centuries, and may be one of the oldest systematically oppressed minority groups in Europe. This review examines the research literature in regard to the health and epidemiology of this group with the aim of examining the breadth and depth of the literature and reflecting on the primary and applied research needed to address the health needs of Roma groups. DESIGN: Internet, database and ancestral searches were conducted via such electronic databases as Medline and PubMed. Ancestral searches involved consulting previous literature reviews in select topical areas and obtaining all appropriate, primary literature. The time parameters of the search began with the year 1990 to current but was later expanded to 1985-2003 in order to capture slightly older published work. RESULTS: This paper describes what is known concerning Roma health via a review of the published studies, with special emphasis on population health and epidemiological studies. One hundred and twenty-nine articles are reviewed and discussed. The majority of research (50%) examines the genetic characteristics of this group. CONCLUSIONS: Surveillance and population health indices for this international minority population is scarce to lacking in the published literature. Concluding comments focus on the unique character of the study population and the need for scientific studies of Roma health issues and the cultural concerns which might affect them.

A nested case-control study of methemoglobinemia risk factors in children of Transylvania, Romania.

In this nested case-control study, we investigated the risk factors for methemoglobinemia (MHG) in 71 children in the Transylvania region of Romania. This study was unique in that the exposures for cases and controls were calculated as continuous values and were reported in milligrams per kilogram per day of nitrate/nitrite based on careful dietary reconstruction and environmental sampling. This procedure allowed us to compare point estimates of nitrate/nitrite exposure with other continuous, categoric, and ranked risk factors such as the presence or absence of diarrheal disease, reported severity of diarrheal disease, the use of vitamin supplements, the presence, absence, and/or duration of breast-feeding, and whether or not first-generation relatives experienced MHG. Analysis of these factors and exposure levels using both univariate and multivariate whole-model tests was performed to understand the relative significance of risk factors at varying levels of exposure to the development of MHG. Univariate and multifactorial analysis of risk factors for MHG underscored that, for this population, MHG is most strongly associated with nitrate/nitrite exposure through the dietary route (p = 0.0318), via feeding of formula and tea made with water containing high levels of nitrates, and that breast-feeding protects infants younger than 6 months of age (p = 0.0244). Our findings also raise questions about the role of diarrheal disease in the development of MHG, as likelihood ratios (likelihood 4.323, p = 0.0376) and multifactorial analysis indicated a significant role for diarrheal disease for some individuals.

Exposure methodology and findings for dietary nitrate exposures in children of Transylvania, Romania.

AIMS: The primary focus of this exposure assessment work involved developing an exposure model and determining a numerical point estimate of the amount of biologically relevant nitrate/nitrite exposure that occurred for each child in the study. This assessment was done in support of two epidemiological studies. The first study was an epidemiological cohort study (three cohorts based on nitrate/nitrite exposure) that explored the relationship between high nitrate/nitrite exposure and neuropsychological development. The second study was a nested case/control study (cases of methemoglobinemia versus disease-free controls) that sought to explore the relationship between MHG and various risk factors for the disease. METHODS: This work uses both dietary survey and environmental sampling and modeling in order to develop two point estimates of nitrate exposure in milligrams per kilogram per day of nitrite (the biologically active form of the hemoglobin-oxidizing agent) for the first 6 months of the child's life (2-months-of-age and 6-months-of-age point estimates). Methodologies included proxy interviews of primary caregivers, review of existing medical and environmental sampling and analysis. RESULTS: Exposure to nitrate--nitrogen (with final calculations converted to the biologically active form of the toxin, nitrite) was categorized as high, medium, and low as determined from the distribution of the data derived from final exposure calculations at both the 2-months-of-age point estimate and at the 6-months-of-age point estimate. These tertiles correspond to greater-than-or-equal1.5 mg/kg/day nitrite-nitrogen for high-exposure individuals, <1.5-> or = 0.1 mg/kg/day for medium-exposure individuals, and <0.1 mg/kg/day for low-exposure individuals. Analyses illustrate that over 90% of the nitrate exposure occurred through the consumption of liquids (water) at the 2-months-of-age point estimate while at the 6-months-of-age point estimate, a 10-fold change in the amount of solid consumables occurred. CONCLUSIONS: Final exposure calculations were well differentiated into three tertiles based on a point estimate of average daily intake of nitrite in milligrams per kilogram body weight per day at roughly 2 and 6 months of age. These categories of exposure, based on the exposure model point estimate, correspond well with the exposure estimates as estimated only on the basis of cohort status and their corresponding nitrate/nitrite well water levels. Comparisons of these two sets of data illustrate that following the MHG incident, Cohort II shifted places with Cohort I to become the high-exposure cohort. Further, the predictive ability of the exposure assessment in regard to the outcome of MHG was estimated using a Likelihood Ratio and Pearson's Crosstab analysis. This was performed on the 2-month-of-age point estimate. Likelihood Ratio and Pearson's chi-square were 39.40 and 33.74, respectively, with a probability of achieving these fits by chance alone of <0.0001. This indicates clearly that the children who experienced MHG were also the children at the 2-month-of-age point estimate who had received the highest exposure to nitrate/nitrite through their diet.