An alternative early childhood caries risk surveillance methodology for public policy and practice advancements.

OBJECTIVES: Early childhood caries (ECC) negatively impacts many child health outcomes and can lead to greater costs for medical and dental care as well as negatively impact future oral health wellness. ECC risk factors are rooted in many social determinants of health. Addressing ECC at the population-level is a national public health priority. The purpose of this study was to identify the South Carolina counties with the greatest risk for ECC. As policy-makers seek to address inequities stemming from early childhood caries, documenting its prevalence is essential. METHODS: Since no county level ECC rates were published for South Carolina, we identified an opportunity to strengthen ECC surveillance through public use data, so as to properly equip policy-makers and pediatric providers with an evidence based understanding of the scope of the problem. As a result we sought to develop an overall county level prevalence measure for ECC risk through an ecological analysis of public use data. RESULTS: Ten counties with the greatest overall risk for ECC were all rural as hypothesized. Additionally, seven of the 10 highest risk counties fell into what is often referred to as the "Corridor of Shame." CONCLUSIONS: We have found an affordable way of measuring county level risk for ECC that allows pediatric advocates and policy-makers to develop population level interventions to reduce and measure risk with public-use data.

Impact of Marcellus Shale natural gas development in southwest Pennsylvania on volatile organic compound emissions and regional air quality.

The Marcellus Shale is the largest natural gas deposit in the U.S. and rapid development of this resource has raised concerns about regional air pollution. A field campaign was conducted in the southwestern Pennsylvania region of the Marcellus Shale to investigate the impact of unconventional natural gas (UNG) production operations on regional air quality. Whole air samples were collected throughout an 8050 km(2) grid surrounding Pittsburgh and analyzed for methane, carbon dioxide, and C1-C10 volatile organic compounds (VOCs). Elevated mixing ratios of methane and C2-C8 alkanes were observed in areas with the highest density of UNG wells. Source apportionment was used to identify characteristic emission ratios for UNG sources, and results indicated that UNG emissions were responsible for the majority of mixing ratios of C2-C8 alkanes, but accounted for a small proportion of alkene and aromatic compounds. The VOC emissions from UNG operations accounted for 17 ± 19% of the regional kinetic hydroxyl radical reactivity of nonbiogenic VOCs suggesting that natural gas emissions may affect compliance with federal ozone standards. A first approximation of methane emissions from the study area of 10.0 ± 5.2 kg s(-1) provides a baseline for determining the efficacy of regulatory emission control efforts.