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Bove F.J.,Agency for Toxic Substances and Disease Registry ATSDR | Ruckart P.Z.,Agency for Toxic Substances and Disease Registry ATSDR | Maslia M.,ATSDR | Larson T.C.,Agency for Toxic Substances and Disease Registry ATSDR
Environmental Health: A Global Access Science Source | Year: 2014

Background: Two drinking water systems at U.S. Marine Corps Base Camp Lejeune, North Carolina were contaminated with solvents during 1950s-1985. Methods. We conducted a retrospective cohort mortality study of 4,647 civilian, full-time workers employed at Camp Lejeune during 1973-1985 and potentially exposed to contaminated drinking water. We selected a comparison cohort of 4,690 Camp Pendleton workers employed during 1973-1985 and unexposed to contaminated drinking water. Mortality follow-up period was 1979-2008. Cause-specific standardized mortality ratios utilized U.S. age-, sex-, race-, and calendar period-specific mortality rates as reference. We used survival analysis to compare mortality rates between Camp Lejeune and Camp Pendleton workers and assess the effects of estimated cumulative contaminant exposures within the Camp Lejeune cohort. Ground water contaminant fate/transport and distribution system models provided monthly estimated contaminant levels in drinking water serving workplaces at Camp Lejeune. The confidence interval (CI) indicated precision of effect estimates. Results: Compared to Camp Pendleton, Camp Lejeune workers had mortality hazard ratios (HRs) >1.50 for kidney cancer (HR = 1.92, 95% CI: 0.58, 6.34), leukemias (HR = 1.59, 95% CI: 0.66, 3.84), multiple myeloma (HR = 1.84, 95% CI: 0.45, 7.58), rectal cancer (HR = 1.65, 95% CI: 0.36, 7.44), oral cavity cancers (HR = 1.93, 95% CI: 0.34, 10.81), and Parkinson's disease (HR = 3.13, 95% CI: 0.76, 12.81). Within the Camp Lejeune cohort, monotonic exposure-response relationships were observed for leukemia and vinyl chloride and PCE, with mortality HRs at the high exposure category of 1.72 (95% CI: 0.33, 8.83) and 1.82 (95% CI: 0.36, 9.32), respectively. Cumulative exposures were above the median for most deaths from cancers of the kidney, esophagus, rectum, prostate, and Parkinson's disease, but small numbers precluded evaluation of exposure-response relationships. Conclusion: The study found elevated HRs in the Camp Lejeune cohort for several causes of death including cancers of the kidney, rectum, oral cavity, leukemias, multiple myeloma, and Parkinson's disease. Only 14% of the Camp Lejeune cohort died by end of follow-up, producing small numbers of cause-specific deaths and wide CIs. Additional follow-up would be necessary to comprehensively assess drinking water exposure effects at the base. © 2014 Bove et al.; licensee BioMed Central Ltd. Source


Bowler R.M.,San Francisco State University | Beseler C.L.,Colorado State University | Gocheva V.V.,San Francisco State University | Colledge M.,ATSDR | And 5 more authors.
Science of the Total Environment | Year: 2016

Background: Manganese (Mn) inhalation has been associated with neuropsychological and neurological sequelae in exposed workers. Few environmental epidemiologic studies have examined the potentially neurotoxic effects of Mn exposure in ambient air on motor function and hand tremor in adult community residents. Mn exposed residents were recruited in two Ohio towns: Marietta, a town near a ferro-manganese smelter, and East Liverpool, a town adjacent to a facility processing, crushing, screening, and packaging Mn products. Methods: Chronic (≥. 10 years) exposure to ambient air Mn in adult residents and effects on neuropsychological and neurological outcomes were investigated. Participants from Marietta (n. = 100) and East Liverpool (n. = 86) were combined for analyses. AERMOD dispersion modeling of fixed-site outdoor air monitoring data estimated Mn inhalation over a ten year period. Adult Mn-exposed residents' psychomotor ability was assessed using Finger Tapping, Hand Dynamometer, Grooved Pegboard, and the Computerized Adaptive Testing System (CATSYS) Tremor system. Bayesian structural equation modeling was used to assess associations between air-Mn and motor function and tremor. Results: Air-Mn exposure was significantly correlated in bivariate analyses with the tremor test (CATSYS) for intensity, center frequency and harmonic index. The Bayesian path analysis model showed associations of air-Mn with the CATSYS non-dominant center frequency and harmonic index; while the Bayesian structural equation model revealed associations between air-Mn and lower Finger Tapping scores. Household income was significantly associated with motor dysfunction but not with tremor. Conclusion: Tremor and motor function were associated with higher exposure to airborne Mn. © 2015 Elsevier B.V. Source


Bowler R.M.,San Francisco State University | Adams S.W.,San Francisco State University | Wright C.W.,San Francisco State University | Kim Y.,University of Ulsan | And 4 more authors.
International Journal of Environmental Health Research | Year: 2016

This report describes the use of medications as a proxy when medical record reviews are unavailable, to study the health effects of residents environmentally exposed to air-manganese (n = 185) compared to unexposed residents (n = 90). Participants’ current medication lists and medication questionnaire responses were collected in clinical interviews and categorized into 13 domains. Exposed participants reported fewer hours of sleep than controls (6.6 vs. 7.0). The exposed used significantly more medications than unexposed participants (82.2 % vs. 67.8 %) and, when adjusting for age, education, and personal income, also for pain (aOR = 2.40) and hypothyroidism (aOR = 7.03). Exposed participants with higher air-Mn concentrations, monitored for 10 years by the U.S. Environmental Protection Agency, were 1.5 times more likely to take pain medications. The exposed participants take significantly more medications than unexposed participants in the categories of hypothyroidism, pain, supplements, and total medications. © 2016 Informa UK Limited, trading as Taylor & Francis Group Source


Bove F.J.,Agency for Toxic Substances and Disease Registry ATSDR | Ruckart P.Z.,Agency for Toxic Substances and Disease Registry ATSDR | Maslia M.,ATSDR | Larson T.C.,Agency for Toxic Substances and Disease Registry ATSDR
Environmental Health: A Global Access Science Source | Year: 2014

Background: Two drinking water systems at U.S. Marine Corps Base Camp Lejeune, North Carolina were contaminated with solvents during 1950s-1985. Methods. We conducted a retrospective cohort mortality study of Marine and Naval personnel who began service during 1975-1985 and were stationed at Camp Lejeune or Camp Pendleton, California during this period. Camp Pendleton's drinking water was uncontaminated. Mortality follow-up was 1979-2008. Standardized Mortality Ratios were calculated using U.S. mortality rates as reference. We used survival analysis to compare mortality rates between Camp Lejeune (N = 154,932) and Camp Pendleton (N = 154,969) cohorts and assess effects of cumulative exposures to contaminants within the Camp Lejeune cohort. Models estimated monthly contaminant levels at residences. Confidence intervals (CIs) indicated precision of effect estimates. Results: There were 8,964 and 9,365 deaths respectively, in the Camp Lejeune and Camp Pendleton cohorts. Compared to Camp Pendleton, Camp Lejeune had elevated mortality hazard ratios (HRs) for all cancers (HR = 1.10, 95% CI: 1.00, 1.20), kidney cancer (HR = 1.35, 95% CI: 0.84, 2.16), liver cancer (HR = 1.42, 95% CI: 0.92, 2.20), esophageal cancer (HR = 1.43 95% CI: 0.85, 2.38), cervical cancer (HR = 1.33, 95% CI: 0.24, 7.32), Hodgkin lymphoma (HR = 1.47, 95% CI: 0.71, 3.06), and multiple myeloma (HR = 1.68, 95% CI: 0.76, 3.72). Within the Camp Lejeune cohort, monotonic categorical cumulative exposure trends were observed for kidney cancer and total contaminants (HR, high cumulative exposure = 1.54, 95% CI: 0.63, 3.75; log 10 β = 0.06, 95% CI: -0.05, 0.17), Hodgkin lymphoma and trichloroethylene (HR, high cumulative exposure = 1.97, 95% CI: 0.55, 7.03; β = 0.00005, 95% CI: -0.00003, 0.00013) and benzene (HR, high cumulative exposure = 1.94, 95% CI: 0.54, 6.95; β = 0.00203, 95% CI: -0.00339, 0.00745). Amyotrophic Lateral Sclerosis (ALS) had HR = 2.21 (95% CI: 0.71, 6.86) at high cumulative vinyl chloride exposure but a non-monotonic exposure-response relationship (β = 0.0011, 95% CI: 0.0002, 0.0020). Conclusion: The study found elevated HRs at Camp Lejeune for several causes of death including cancers of the kidney, liver, esophagus, cervix, multiple myeloma, Hodgkin lymphoma and ALS. CIs were wide for most HRs. Because <6% of the cohort had died, long-term follow-up would be necessary to comprehensively assess effects of drinking water exposures at the base. © 2014 Bove et al.; licensee BioMed Central Ltd. Source


Chou S.,ATSDR
Proceedings of the Air and Waste Management Association's Annual Conference and Exhibition, AWMA | Year: 2010

The Agency for Toxic Substances and Disease Registry's (ATSDR) mission is to serve the public by using the best science, taking responsive public health actions, and providing trusted health information to prevent harmful exposures and disease related to toxic substances. A discussion on ATSDR activities on H 2S health effects covers the Priority List of Hazardous Substances; determining levels of exposure that present a significant risk to human health; research areas with data gaps; public health assessment; health consultations; and exposure investigation; and sources of H 2S, e.g., oil fields. This is an abstract of a paper presented at the 103rd AWMA Annual Conference and Exhibition (Calgary, Alberta, Canada 6/22-25/2010). Source

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