Correction: Ferguson et al. Soil, Hand, and Body Adherence Measures across Four Beach Areas: Potential Influence on Exposure to Oil Spill Chemicals. Int. J. Environ. Res. Public Health 2020, 17, 4196.

In the original publication [...].

Integrating microbial source tracking with quantitative microbial risk assessment to evaluate site specific risk based thresholds at two South Florida beaches.

Quantitative microbial risk assessment (QMRA) can be used to evaluate health risks associated with recreational beach use. This study developed a site-specific risk assessment using a novel approach that combined quantitative PCR-based measurement of microbial source tracking (MST) genetic markers (human, dog, and gull fecal bacteria) with a QMRA analysis of potential pathogen risk. Water samples (n = 24) from two recreational beaches were collected and analyzed for MST markers as part of a broader Beach Exposure And Child Health Study that examined child behavior interactions with the beach environment. We report here the measurements of fecal bacteria MST markers in the environmental DNA extracts of those samples and a QMRA analysis of potential health risks utilizing the results from the MST measurements in the water samples. Human-specific Bacteroides was enumerated by the HF183 Taqman qPCR assay, gull-specific Catellicoccus was enumerated by the Gull2 qPCR assay, and dog-specific Bacteroides was enumerated by the DogBact qPCR assay. Derived reference pathogen doses, calculated from the MST marker concentrations detected in recreational waters, were used to estimate the risk of gastrointestinal illness for both children and adults. Dose-response equations were used to estimate the probability of the risk of infection (Pinf) per a swimming exposure event. Based on the QMRA simulations presented in this study, the GI risk from swimming or playing in water containing a mixture of human and non-human fecal sources appear to be primarily driven by the human fecal source. However, the estimated median GI health risk for both beaches never exceeded the U.S. EPA risk threshold of 32 illnesses per 1,000 recreation events. Our research suggests that utilizing QMRA together with MST can further extend our understanding of potential recreational bather risk by identifying the source contributing the greatest risk in a particular location, therefore informing beach management responses and decision-making.

Meeting the Water and Sanitation Challenges of Underbounded Communities in the U.S.

Water and sanitation (wastewater) infrastructure in the United States is aging and deteriorating, with massive underinvestment over the past several decades. For many years, lack of attention to water and sanitation infrastructure has combined with racial segregation and discrimination to produce uneven access to water and wastewater services resulting in growing threats to human and environmental health. In many metropolitan areas in the U.S., those that often suffer disproportionately are residents of low-income, minority communities located in urban disadvantaged unincorporated areas on the margins of major cities. Through the process of underbounding (the selective expansion of city boundaries to exclude certain neighborhoods often based on racial demographics or economics), residents of these communities are disallowed municipal citizenship and live without piped water, sewage lines, and adequate drainage or flood control. This Perspective identifies the range of water and sanitation challenges faced by residents in these communities. We argue that future investment in water and sanitation should prioritize these communities and that interventions need to be culturally context sensitive. As such, approaches to address these problems must not only be technical but also social and give attention to the unique geographic and political setting of local infrastructures.

PAH depletion in weathered oil slicks estimated from modeled age-at-sea during the Deepwater Horizon oil spill.

During time-periods oil slicks are in the marine environment (age-at-sea), weathering causes significant changes in composition and mass loss (depletion) of oil spill chemicals including the more toxic polycyclic aromatic hydrocarbons (PAHs). The goal of this study was to estimate the age-at-sea of weathered oil slicks using the oil spill module of the Connectivity Modeling System and to use this age to interpret PAH concentration measurements. Percent depletion (PD) for each measurement was computed as the percentage difference between the original and measured PAH concentration in the crude oil and weathered oil slicks, normalized upon the mass losses relative to hopane. Mean PD increased with estimated age-at-sea for all PAHs. Less PD was observed for alkylated than for parent PAHs, likely due to decreasing vapor pressure with increasing degree of alkylation. We conclude that estimated age-at-sea can be used to explain PAH depletion in weathered oil slicks. We propose PAH vapor pressure can be coupled with the model to expand capacity for predicting concentration distributions of individual parent and alkylated PAHs in weathered oil along the coastline. This new module will advance the science supporting oil spill response by providing more certain estimates of health risks from oil spills.

Using satellite-based AOD and ground-based measurements to evaluate the impact of the DWH oil spill on coastal air quality.

The 2010 DWH disaster generated atmospheric pollutants of health concern which reached the Gulf Coast. This study evaluated whether changes in coastal air quality due to the disaster were captured by aerosol optical depth (AOD) estimated using satellite data and by ground-based monitoring of air pollution, including fine particulate matter ≤2.5 µm in aerodynamic diameter (PM2.5), benzene and naphthalene. Mean monthly AOD levels were higher in May 2010 [during oil spill time], (mean AOD = 0.355), than for the prior (mean AOD = 0.258) and following years (mean AOD = 0.252) (p < 0.05). PM2.5 concentrations and AOD were significantly correlated (R2 = 0.59, p < 0.05), for one study area. Elevated PM2.5, benzene, and naphthalene concentrations coincided with downwind directions from the location of the oil slicks. A fully-coupled oil fate and transport atmospheric transport model of oil spill emissions, integrated with AOD and more extensive ground-based measurements, is recommended to predict coastal population exposures during oil spills.

Combined Effect of Lead Exposure and Allostatic Load on Cardiovascular Disease Mortality-A Preliminary Study.

This study explores the combined effect of lead (Pb) exposure and an index of chronic physiological stress on cardiovascular disease mortality using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2008 linked to 1999-2014 National Death Index data. Chronic physiological stress was measured using the allostatic load (AL) index, which was formed by analyzing markers from the cardiovascular, inflammatory, and metabolic systems, with Pb levels, assessed using blood lead levels (BLL). The dataset was analyzed with statistical techniques to explore (a) the relationship between Pb exposure and AL, and (b) the combined role of Pb and AL on cardiovascular disease mortality. Results indicated that AL was more elevated in those with BLLs above the 50th percentile in the US population and that those with elevated AL were more likely to have high BLL. Finally, the interaction of AL and BLL significantly increased the likelihood of cardiovascular disease mortality. These findings highlight the need for considering the totality of exposures experienced by populations to build holistic programs to prevent Pb exposure and reduce stressors to promote optimal health outcomes and reduce cardiovascular mortality risk.

Quantified Activity Patterns for Young Children in Beach Environments Relevant for Exposure to Contaminants.

In a study to evaluate beach play activities, 120 children were videotaped to observe and quantify factors that could influence their exposure to contaminants in the beach environment. Children aged 1 to 6 years were followed by researchers with video cameras at beaches (two in Miami, Florida and two in Galveston, Texas) for approximately one hour each. Factors evaluated included time spent in various beach locations, various activities engaged in, and various surfaces contacted (including contacts by hand and mouth). Activities recorded in the videos were transcribed to text files to allow for quantitative analyses. Across all sexes, age groups, and beaches, Wading was the most common activity and Seawater was the most common location where children played. The left hand was found to not be in contact with objects most of the time, while the right hand, considered the most dominant hand in most cases, contacted Plastic-Toys the most. Although activity patterns collection through videotaping and videotranslation can be labor-intensive, once collected, they can be widely useful for estimates of exposures to all contaminants in the beach environment (e.g., microorganisms and chemicals) as well as UV exposure, with considerations for whether the contaminants are found in water, sand or both. These activity patterns were collected to potentially look at exposures following the Deepwater Horizon 2010 Spill.

Towards integrated modeling of the long-term impacts of oil spills.

Although great progress has been made to advance the scientific understanding of oil spills, tools for integrated assessment modeling of the long-term impacts on ecosystems, socioeconomics and human health are lacking. The objective of this study was to develop a conceptual framework that could be used to answer stakeholder questions about oil spill impacts and to identify knowledge gaps and future integration priorities. The framework was initially separated into four knowledge domains (ocean environment, biological ecosystems, socioeconomics, and human health) whose interactions were explored by gathering stakeholder questions through public engagement, assimilating expert input about existing models, and consolidating information through a system dynamics approach. This synthesis resulted in a causal loop diagram from which the interconnectivity of the system could be visualized. Results of this analysis indicate that the system naturally separates into two tiers, ocean environment and biological ecosystems versus socioeconomics and human health. As a result, ocean environment and ecosystem models could be used to provide input to explore human health and socioeconomic variables in hypothetical scenarios. At decadal-plus time scales, the analysis emphasized that human domains influence the natural domains through changes in oil-spill related laws and regulations. Although data gaps were identified in all four model domains, the socioeconomics and human health domains are the least established. Considerable future work is needed to address research gaps and to create fully coupled quantitative integrative assessment models that can be used in strategic decision-making that will optimize recoveries from future large oil spills.

A novel method to evaluate chemical concentrations in muddy and sandy coastal regions before and after oil exposures.

Oil spills can result in changes in chemical concentrations along coastlines. In prior work, these concentration changes were used to evaluate the date sediment was impacted by oil (i.e., oil exposure date). The objective of the current study was to build upon prior work by using the oil exposure date to compute oil spill chemical (OSC) concentrations in shoreline sediments before and after exposure. The new method was applied to OSC concentration measures collected during the Deepwater Horizon oil spill with an emphasis on evaluating before and after concentrations in muddy versus sandy regions. The procedure defined a grid that overlaid coastal areas with chemical concentration measurement locations. These grids were then aggregated into clusters to allow the assignment of chemical concentration measurements to a uniform coastal type. Performance of the method was illustrated for ten chemicals individually by cluster, and collectively for all chemicals and all clusters. Results show statistically significant differences between chemical concentrations before and after the calculated oil exposure dates (p < 0.04 for each of the 10 chemicals within the identified clusters). When aggregating all chemical measures collectively across all clusters, chemical concentrations were lower before oil exposure in comparison to after (p < 0.0001). Sandy coastlines exhibited lower chemical concentrations relative to muddy coastlines (p < 0.0001). Overall, the method developed is a useful first step for establishing baseline chemical concentrations and for assessing the impacts of disasters on sediment quality within different coastline types. Results may be also useful for assessing added ecological and human health risks associated with oil spills.

Soil-skin adherence measures from hand press trials in a Gulf study of exposures.

Marine oil spills and the resulting environmental contamination is common along coastal areas; however, information is lacking about the safety of impacted beaches for public use, especially for the most vulnerable population: children. One route of exposure for children at oil impacted beaches is through contact with sands. The purpose of this study was to evaluate beach sand skin adherence for children under the age of seven. Each of 122 children participated in a hand press trial conducted at one of four different U.S. beaches (two in Miami, FL, and two in Galveston, TX USA). During the hand press trials, hand conditions of the children were randomized (dry, wet, or with sunscreen), and soil adherence (mass of sand per palmar surface area of the hand) and the maximum pressure applied (force applied per area of hand) was measured and calculated. Each child was instructed to press their hands on a soil laden tray for 5 s and pressure of contact was measured using a scale. Results (n = 98) showed that the average soil adherence for both palmar hands across the four beaches ranged from 0.200 to 234 mg/cm2 with an average of 35.7 mg/cm2, with boys (40.4 mg/cm2) showing slightly higher means than girls (31.7 mg/cm2), but these differences were not significant even after adjusting for age. Among the three conditions evaluated, the highest loading was measured for children with wet hands (mean 65.3 mg/cm2), followed by dry hands (mean 24.5 mg/cm2). Sunscreen hands (mean 23.2 mg/cm2) had the lowest loadings. The pressure of contact ranged from 0.180 to 1.69 psi and varied by age groups and by height and weight, where pressure of contact did not have a significant influence on soil adherence. The average adhered sand grain size and average ambient sand grain size both had a statistically significant impact on hand soil adherence. Overall results from this study can be utilized in exposure and risk assessment models to evaluate the possible health impacts from contaminants found in beach sands.

Review of methods to determine hand surface area of children less than six years old: a case study.

Various methods exist to determine the surface area of hands. The consistency of these methods is essential given that risk assessments utilize hand surface area (HSA) to quantify exposure to environmental contaminants. HSA is also utilized in the clinical setting to estimate size of burns, and to determine specific treatments and medication dosages. A reliable method of surface area measurement is important to guide these decisions, especially in children who are vulnerable to environmental contaminants and medication side effects. Despite this, fewer HSA-determining studies have been performed for children compared to adults. In this study, 122 children completed hand tracings, and the tracings were digitized using an ImageJ program to determine HSA. Six previously published methods of determining HSA were utilized based on the child's height, weight, and length and width of hand. Children were analyzed by age group including 0-2, 3-4, and 5-6 years. The HSA measurements determined by five of the six methods were statistically different from HSA determined using direct hand tracings/Image J methodology (p < 0.001). The single remaining study that did not differ significantly from the hand tracing method provided a uniform hand to total body surface area (TBSA) ratio for children of all ages. Based on these results, we propose a novel age-group-specific ratio utilizing the HSA results from hand tracings and TBSA calculations. The percentages of TBSA that reflect HSA for children aged 0-2, 3-4 and 5-6 years were 0.91%, 0.90% and 0.87%, respectively. These percentages should be considered for use in risk assessments and the clinical setting to guide treatment and prognosis.

Estimating Health Risks to Children Associated with Recreational Play on Oil Spill-Contaminated Beaches.

The human health impact from exposure to contaminated shorelines following an oil spill event has been investigated to some extent. However, the health risks to children have largely been characterized through the use of surveys and extrapolation from adult health outcomes. There is limited information on children's behaviors during beach play requiring assumptions made based on observations from play activities in home settings. The Beach Exposure and Child Health Study (BEACHES) quantified specific beach activities that can be used to inform human health risk assessments of children playing on beaches impacted by oil spills. The results of this study characterize children's risk of cancer from exposure to oil spill chemicals by incorporating exposure-related information collected from the BEACHES study and by assuming oral, dermal, and inhalation exposure routes. Point risk estimates are compared with a previous, similar study that applied default exposure parameter values obtained from the published literature. The point risk estimates informed by BEACHES data are one order of magnitude lower compared with the previous risk assessment, with dermal exposures the overall risk driver in both. Additional Monte Carlo simulations evaluating the BEACHES data provide ranges of health risks with the highest estimates associated with dermal and oral exposure routes.

Children's Abrasions in Recreational Beach Areas and a Review of Possible Wound Infections.

The Beach Exposure and Child Health Study (BEACHES) quantified the behavior of children at recreational beach areas to evaluate how various behaviors might affect their exposure to environmental contaminants such as bacteria and chemicals. Due to limited information in the study about abrasions, we conducted a literature review to examine how marine bacteria cause infections in open wounds. The literature review revealed possible adverse health effects from the bacterium Vibrio vulnificus due to its increasing prevalence and the severity of infection. We used data from the BEACHES study to review children's behavior and their susceptibility to abrasions. Children six years of age and younger were evaluated before and after 1 hour of play for open or healing abrasions at two beaches in Miami-Dade County, Florida (Crandon and Haulover), and two beaches in Galveston County, Texas (Stewart and Seawall). The children were videotaped to monitor their activities and to determine the behavior that would increase their susceptibility to obtaining abrasions. Overall, 58.2% of the children had at least one existing abrasion before playing at the beach, while 8.2% of the children acquired a new abrasion during their time at the beach. Children who acquired new abrasions most often played in the sea water, with new abrasions most frequently occurring on exposed skin surfaces such as the knees. Proper wound care before and after visiting the beach should be encouraged to minimize the risk of bacterial infection, especially considering the possible detrimental impacts that can be caused by some bacterial pathogens through wound exposures.

Soil, Hand, and Body Adherence Measures across Four Beach Areas: Potential Influence on Exposure to Oil Spill Chemicals.

Skin adherence (SA) of soil affects exposure from soil contaminants through dermal routes via loading on the skin and through ingestion routes through hand to mouth activities. The objectives of this study were to evaluate the relationships between adherence versus child-specific and environmental factors. Two sets of soil-to-skin adherence were evaluated. The first was based on loading on hands following hand presses (Hand SA). The second was based on body rinses following one hour of play activities on the beach (Body SA). Results for 98-119 children conducted at four beach sites show that mean Hand SA was 35.7 mg/cm2 (std. dev. 41.8 mg/cm2), while Body SA based on full coverage was 352.3 mg/cm2 (std. dev. 250.4 mg/cm2). Statistically significant differences in Body SA were observed between male (419.2 mg/cm2) and female (300.4 mg/cm2) children (p < 0.05). No significant difference by sex was found for Hand SA. Other statistically different observations were that Hand SA (p < 0.05), but not Body SA, differed across the four beaches (p < 0.05). For Hand SA, this difference was associated soil size variability across the beaches. Hand and Body SA values measured during this study are recommended for use in risk assessments that evaluate beach exposures to oil spill chemicals for young children.

Use of chemical concentration changes in coastal sediments to compute oil exposure dates.

Oil spills can result in changes in chemical contaminant concentrations along coastlines. When concentrations are measured along the Gulf of Mexico over time, this information can be used to evaluate oil spill shoreline exposure dates. The objective of this research was to identify more accurate oil exposure dates based on oil spill chemical concentrations changes (CCC) within sediments in coastal zones after oil spills. The results could be used to help improve oil transport models and to improve estimates of oil landings within the nearshore. The CCC method was based on separating the target coastal zone into segments and then documenting the timing of large increases in concentration for specific oil spill chemicals (OSCs) within each segment. The dataset from the Deepwater Horizon (DWH) oil spill was used to illustrate the application of the method. Some differences in exposure dates were observed between the CCC method and between oil spill trajectories. Differences may have been caused by mixing at the freshwater and sea water interface, nearshore circulation features, and the possible influence of submerged oil that is unaccounted for by oil spill trajectories. Overall, this research highlights the benefit of using an integrated approach to confirm the timing of shoreline exposure.

Categorization of nearshore sampling data using oil slick trajectory predictions.

Oil Spill Chemicals (OSCs) represent a risk to the environment and human health, especially in nearshore environments used for recreational purposes. Importantly, the starting point for human health risk assessment is to define the concentration of OSCs at nearshore locations. The objective of this study was to evaluate nearshore sampling data of OSC concentrations in different environmental matrices within time-space specific categories. The categories correspond to OSC concentration values for samples collected prior to nearshore oiling, post nearshore oiling and at no time impacted by oil as predicted by historic oil spill trajectories generated by an Oil Spill Trajectory Model. In general, concentration values for the post category were higher than prior which were higher than unimpacted. Results show differences in PAH concentration patterns within each matrix and for each category. Concentration frequency distributions for most chemicals in each category were log-normally distributed.

Assessment for oil spill chemicals: Current knowledge, data gaps, and uncertainties addressing human physical health risk.

Limited models are available to estimate human physical health risks (e.g., probability of outcomes such as lung disease, cancer, skin disease) from exposure to chemicals resulting from oil spills that may occur offshore and later impact coastline spills. An approach is presented to assess physical health risks from oil spills that involves establishing a platform capable of assessing aggregate health risk (via inhalation, ingestion, and dermal exposure routes). Gaps include the need to develop models reflecting oil spill concentration distributions given the influence from environmental, physical, biological and chemical factors. Human activities need to be quantified for different populations including emergency response workers, fishermen, shellfish consumers, and children who play at beaches that may be impacted by oil spills. Work is also needed in developing comprehensive toxicological profiles for the majority of chemicals - including dispersants found in oil spills - and to estimate toxicity from mixtures.

Children Exposure-Related Behavior Patterns and Risk Perception Associated with Recreational Beach Use.

BACKGROUND: Oil spill chemicals (OSCs) result not only from the crude oil components but also from dispersants used in the clean-up activities, where some may result in adverse health effects under certain exposure and dosage conditions. One of the main populations of concern for exposure to OSCs are children, who are frequent beach users. Activities such as ingestion of and digging in sand can increase dermal and ingestion exposure. Longer times spent at the beach can also increase exposures for all routes. OBJECTIVES: The Beach Exposure and Child Health Study (BEaCHeS) was initiated to evaluate the risk of exposure to children from oil contaminants. Reported here are results for surveys collected, as a part of the project, to address exposure-related behavior patterns and risk perception for parents or guardians who visit the beach. METHODS: Over 400 parental surveys were collected at four beaches, two in Miami and two in Texas, to evaluate children's exposure related activities. Surveys consisted of three general sections: demographics, exposure, and risk perception. Surveys were analyzed in REDcap and Stata to evaluate demographic and regional differences on activities related to beach behavior and potential exposures to oil contaminants (e.g., how much time spent on beach, cleaning habits following beach activities). The statistical analysis included the mean and standard errors, along with regressions to evaluate associations between parameters. RESULTS: Overall, the data showed high variability in how children play on the beach, influenced more by age and less by gender. Variations were also seen in certain variables by beach region (e.g., hygiene practices). By race, variations were seen in income, distance of travel to beach, and preferred method of communication for beach warning. Other important findings are reflected in the article. DISCUSSION: The data presented here may prove useful for those evaluating children exposures to a variety of contaminants, chemical, or bacterial in origin. In addition, coastal managers may find the risk perception and general behaviors useful for planning and maintenance of beach areas.

Overweight and Obesity Among School Bus Drivers in Rural Arkansas.

INTRODUCTION: Obesity is a major public health concern. Compared with other occupational groups, transportation workers, such as school bus drivers, have higher rates of obesity. However, little is known about the body weight and related health behaviors of these drivers, and opportunities for intervention are undetermined. METHODS: We collected multilevel data from school bus drivers working from 4 school bus garages in Little Rock, Arkansas, and their work environment from January through July of 2017. Data on weight, height, sociodemographic characteristics, work factors, weight-related behaviors, and psychosocial variables were collected from 45 drivers. Analyses explored associations between body mass index (BMI; weight in kg/ height in m2) and sociodemographic characteristics, work factors, weight-related behaviors, and psychosocial variables. Two focus groups with a total of 20 drivers explored drivers' perspectives about healthy weight. Observational data at the bus and garage levels were collected through 2 "ride-alongs" and an environmental scan. RESULTS: Drivers in our sample were predominately overweight or obese (91.1%), and most did not meet dietary or physical activity guidelines. Drivers who were currently dieting had higher BMIs (36.4; standard deviation [SD], 8.2) than drivers who were not dieting (28.5; SD, 7.7); drivers who reported eating less to lose weight had higher BMIs (38.1; SD, 8.5) than those who did not report eating less (29.5; SD, 6.0). Drivers who did not meet physical activity recommendations had higher BMIs (36.5; SD, 9.8) than those who met recommendations (30.9; SD, 4.8). Structural barriers and work stress were significant barriers to achieving a healthy weight. Resources for healthful eating and physical activity were limited in the garage. CONCLUSION: Our study provides preliminary data on the prevalence, risk factors, and perceptions of overweight and obesity among school bus drivers. Study data on drivers' body weight, health-related behaviors, and psychosocial characteristics could serve as a basis for worksite interventions to improve drivers' health.

Risk Assessment for Children Exposed to Arsenic on Baseball Fields with Contaminated Fill Material.

Children can be exposed to arsenic through play areas which may have contaminated fill material from historic land use. The objective of the current study was to evaluate the risk to children who play and/or spend time at baseball fields with soils shown to have arsenic above background levels. Arsenic in soils at the study sites located in Miami, FL, USA showed distinct distributions between infield, outfield, and areas adjacent to the fields. Using best estimates of exposure factors for children baseball scenarios, results show that non-cancer risks depend most heavily upon the age of the person and the arsenic exposure level. For extreme exposure scenarios evaluated in this study, children from 1 to 2 years were at highest risk for non-cancer effects (Hazard Quotient, HQ > 2.4), and risks were higher for children exhibiting pica (HQ > 9.7) which shows the importance of testing fill for land use where children may play. At the study sites, concentration levels of arsenic resulted in a range of computed cancer risks that differed by a factor of 10. In these sites, the child's play position also affected risk. Outfield players, with a lifetime exposure to these arsenic levels, could have 10 times more increased chance of experiencing cancers associated with arsenic (i.e., lung, bladder, skin) in comparison to infielders. The distinct concentration distributions observed between these portions of the baseball fields emphasize the need to delineate contaminated areas in public property where citizens may spend more free time. This study also showed a need for more tools to improve the risk estimates for child play activities. For instance, more refined measurements of exposure factors for intake (e.g., inhalation rates under rigorous play activities, hand to mouth rates), exposure frequency (i.e., time spent in various activities) and other exposure factors (e.g., soil particulate emission rates at baseball play fields) can help pinpoint risk on baseball fields where arsenic levels may be a concern.