{"title":"Social Determinants of Health and Cancer Survivorship.","authors":"Steven S Coughlin","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87298,"journal":{"name":"Journal of environment and health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8494398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39496499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-16DOI: 10.15436/2378-6841.20.3061
S. Coughlin, Marlo M. Vernon, Christos Hatzigeorgiou, Varghese George
Health literacy has been defined as the “degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions” (Nielsen-Bohlman et al., 2004). Low health literacy is associated with more hospitalizations, greater use of emergency care, decreased use of preventive services, poorer ability to interpret labels and health messages, poorer health status, higher mortality, and higher health care costs (Berkman et al., 2011). Functional health literacy extends beyond proficiency in reading, writing, and numeracy to include interpretation of images and oral communication (Magnani et al., 2018; Ousseine 2019). Communicative health literacy is essential to abstract skills such as evaluating and weighing treatment considerations and engaging in medical decision-making (Magnani et al., 2018; Ousseine 2019). Low health literacy negatively impacts disease self-management and individual health behaviors such as adherence with weight control and tobacco cessation interventions and cancer screening recommendations (Weiss & Smith-Simone, 2010; Bennett et al., 2009). Individuals with low health literacy are more likely to present with advanced illness, resulting in delayed diagnosis and treatment and poorer outcomes (Aljassim & Ostini, 2020).
健康素养被定义为“个人有能力获取、处理和理解做出适当健康决策所需的基本健康信息和服务的程度”(Nielsen-Bohlman et al.， 2004)。健康素养低与住院率高、急诊使用率高、预防服务使用率低、解读标签和健康信息能力差、健康状况差、死亡率高和医疗费用高有关(Berkman et al.， 2011)。功能性健康素养不仅包括阅读、写作和计算能力，还包括对图像的解读和口头交流(Magnani等人，2018;Ousseine 2019)。沟通健康素养对于评估和权衡治疗考虑以及参与医疗决策等抽象技能至关重要(Magnani等人，2018;Ousseine 2019)。低健康素养对疾病自我管理和个人健康行为(如坚持体重控制和戒烟干预措施以及癌症筛查建议)产生负面影响(Weiss & Smith-Simone, 2010;Bennett et al.， 2009)。健康素养低的个体更有可能出现晚期疾病，导致诊断和治疗延迟，结果更差(Aljassim & Ostini, 2020)。
{"title":"Health Literacy, Social Determinants of Health, and Disease Prevention and Control","authors":"S. Coughlin, Marlo M. Vernon, Christos Hatzigeorgiou, Varghese George","doi":"10.15436/2378-6841.20.3061","DOIUrl":"https://doi.org/10.15436/2378-6841.20.3061","url":null,"abstract":"Health literacy has been defined as the “degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions” (Nielsen-Bohlman et al., 2004). Low health literacy is associated with more hospitalizations, greater use of emergency care, decreased use of preventive services, poorer ability to interpret labels and health messages, poorer health status, higher mortality, and higher health care costs (Berkman et al., 2011). Functional health literacy extends beyond proficiency in reading, writing, and numeracy to include interpretation of images and oral communication (Magnani et al., 2018; Ousseine 2019). Communicative health literacy is essential to abstract skills such as evaluating and weighing treatment considerations and engaging in medical decision-making (Magnani et al., 2018; Ousseine 2019). Low health literacy negatively impacts disease self-management and individual health behaviors such as adherence with weight control and tobacco cessation interventions and cancer screening recommendations (Weiss & Smith-Simone, 2010; Bennett et al., 2009). Individuals with low health literacy are more likely to present with advanced illness, resulting in delayed diagnosis and treatment and poorer outcomes (Aljassim & Ostini, 2020).","PeriodicalId":87298,"journal":{"name":"Journal of environment and health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81135732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-17DOI: 10.15436/2378-6841.20.2675
S. Coughlin, Marlo M. Vernon, Ban A. Majeed, Catherine Clary, J. Moore, K. Islam, M. Tingen
Tobacco use remains the leading cause of preventable mortality and morbidity in the U.S., responsible for nearly 443,000 deaths annually (Fu et al., 2014; CDC, 2011). Cigarette smoking has been causally linked to numerous types of cancer (lung, mouth, nasal cavity, throat, laryngeal, esophageal, stomach, colon, liver, pancreatic, bladder, cervical, acute myeloid leukemia); cardiovascular disease (heart disease, stroke, aortic aneurysm); diabetes; rheumatoid arthritis; age-related macular degeneration; and respiratory illness (chronic bronchitis, emphysema) (NCI 2014). Smoking also contributes to respiratory infections (e.g., pneumonia) and, if a mother smokes while pregnant, to low birth weight and premature birth, the primary causes of infant mortality. Use of other tobacco products such as cigars or pipes and electronic cigarettes also increase the risk of cancer. In the U.S., cigarette smoking causes about 90% of lung cancers. According to the Centers for Disease Control and Prevention (CDC), tobacco smoke is a toxic mixture of more than 7,000 chemicals, of which at least 70 are known to cause cancer. In addition to nicotine, tobacco users are exposed to several classes of carcinogenic and other toxicants such as tobacco-specific nitrosamines (TSNAs), volatile organic compounds (VOC), and polycyclic aromatic hydrocarbons (PAHs), all of which have been linked to cancer, heart and lung diseases (U.S. Department of Health and Human Services, 2010). Individuals who smoke are 15–30 times more likely to develop lung cancer and die from lung cancer than people who do not smoke (NCI 2014).
{"title":"Tobacco Cessation, Rural Residence, and Lung Cancer","authors":"S. Coughlin, Marlo M. Vernon, Ban A. Majeed, Catherine Clary, J. Moore, K. Islam, M. Tingen","doi":"10.15436/2378-6841.20.2675","DOIUrl":"https://doi.org/10.15436/2378-6841.20.2675","url":null,"abstract":"Tobacco use remains the leading cause of preventable mortality and morbidity in the U.S., responsible for nearly 443,000 deaths annually (Fu et al., 2014; CDC, 2011). Cigarette smoking has been causally linked to numerous types of cancer (lung, mouth, nasal cavity, throat, laryngeal, esophageal, stomach, colon, liver, pancreatic, bladder, cervical, acute myeloid leukemia); cardiovascular disease (heart disease, stroke, aortic aneurysm); diabetes; rheumatoid arthritis; age-related macular degeneration; and respiratory illness (chronic bronchitis, emphysema) (NCI 2014). Smoking also contributes to respiratory infections (e.g., pneumonia) and, if a mother smokes while pregnant, to low birth weight and premature birth, the primary causes of infant mortality. Use of other tobacco products such as cigars or pipes and electronic cigarettes also increase the risk of cancer. In the U.S., cigarette smoking causes about 90% of lung cancers. According to the Centers for Disease Control and Prevention (CDC), tobacco smoke is a toxic mixture of more than 7,000 chemicals, of which at least 70 are known to cause cancer. In addition to nicotine, tobacco users are exposed to several classes of carcinogenic and other toxicants such as tobacco-specific nitrosamines (TSNAs), volatile organic compounds (VOC), and polycyclic aromatic hydrocarbons (PAHs), all of which have been linked to cancer, heart and lung diseases (U.S. Department of Health and Human Services, 2010). Individuals who smoke are 15–30 times more likely to develop lung cancer and die from lung cancer than people who do not smoke (NCI 2014).","PeriodicalId":87298,"journal":{"name":"Journal of environment and health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85289252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Steven S Coughlin, Marlo Vernon, Ban Majeed, Catherine Clary, Justin Moore, K M Islam, Martha S Tingen
{"title":"Tobacco Cessation, Rural Residence, and Lung Cancer.","authors":"Steven S Coughlin, Marlo Vernon, Ban Majeed, Catherine Clary, Justin Moore, K M Islam, Martha S Tingen","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87298,"journal":{"name":"Journal of environment and health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7644114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38579227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Steven S Coughlin, Marlo Vernon, Christos Hatzigeorgiou, Varghese George
{"title":"Health Literacy, Social Determinants of Health, and Disease Prevention and Control.","authors":"Steven S Coughlin, Marlo Vernon, Christos Hatzigeorgiou, Varghese George","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87298,"journal":{"name":"Journal of environment and health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7889072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25382588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-16DOI: 10.15436/2378-6841.19.2639
S. Coughlin, Catherine Clary, J. A. Johnson, A. Berman, Vahé Heboyan, Teal W. Benevides, J. Moore, Varghese George, Ommega Internationals
Estimates of the total U.S. population living in non-metropolitan (rural) counties vary from 46.2 million to 59 million people. This represents 14% to 19% of the U.S. population. A recent AAMC report (Warshaw, 2017) addresses some of the challenges of rural health and associated health disparities affecting millions in the U.S. Rural populations are culturally heterogeneous, are spread broadly across large areas of the U.S., and have different demographics (Douthit et al., 2015). Compared to urban areas, rural communities face higher poverty rates, lower educational attainment, lack of transportation, a higher proportion of elderly individuals, and lack of access to health services (Hunsaker & Kantayya, 2010; Ricketts, 2000). Owing to these factors, rural communities face elevated rates of morbidity and mortality and greater percentages of excess deaths from the five leading causes of death including cancer and cardiovascular disease (Garcia et al., 2019).
居住在非大都市(农村)县的美国总人口估计从4620万到5900万不等。这占美国人口的14%到19%。最近的一份AAMC报告(Warshaw, 2017)解决了影响美国数百万人的农村卫生和相关健康差距的一些挑战。农村人口在文化上是异质的，广泛分布在美国的大片地区，并且具有不同的人口结构(Douthit et al.， 2015)。与城市地区相比，农村社区面临着较高的贫困率、较低的受教育程度、缺乏交通工具、老年人比例较高以及缺乏获得医疗服务的机会(Hunsaker & Kantayya, 2010;特,2000)。由于这些因素，农村社区面临着较高的发病率和死亡率，以及癌症和心血管疾病等五大主要死因造成的超额死亡比例更高(Garcia等人，2019年)。
{"title":"Continuing Challenges in Rural Health in the United States","authors":"S. Coughlin, Catherine Clary, J. A. Johnson, A. Berman, Vahé Heboyan, Teal W. Benevides, J. Moore, Varghese George, Ommega Internationals","doi":"10.15436/2378-6841.19.2639","DOIUrl":"https://doi.org/10.15436/2378-6841.19.2639","url":null,"abstract":"Estimates of the total U.S. population living in non-metropolitan (rural) counties vary from 46.2 million to 59 million people. This represents 14% to 19% of the U.S. population. A recent AAMC report (Warshaw, 2017) addresses some of the challenges of rural health and associated health disparities affecting millions in the U.S. Rural populations are culturally heterogeneous, are spread broadly across large areas of the U.S., and have different demographics (Douthit et al., 2015). Compared to urban areas, rural communities face higher poverty rates, lower educational attainment, lack of transportation, a higher proportion of elderly individuals, and lack of access to health services (Hunsaker & Kantayya, 2010; Ricketts, 2000). Owing to these factors, rural communities face elevated rates of morbidity and mortality and greater percentages of excess deaths from the five leading causes of death including cancer and cardiovascular disease (Garcia et al., 2019).","PeriodicalId":87298,"journal":{"name":"Journal of environment and health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85778300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-29DOI: 10.15436/2378-6841.19.2455
S. Coughlin, Vahé Heboyan, K. Sullivan, M. Krengel, C. Wilson, Stacey E Iobst, N. Klimas
Recent clinical studies have identified exercise-induced transient postural tachycardia and abnormal heart-rate variability in patients with Gulf War Illness (GWI) (Rayhan et al. 2013; Garner et al. 2018; Blanchard et al. 2018). Altered heart rate variability may reflect autonomic dysfunction and atrophy in the cardio-regulatory regions of the brainstem (Rayhan et al. 2013). However, the long-term cardiovascular effects of abnormal autonomic nervous system functioning in patients with GWI are unknown (Blanchard et al. 2018). In additional clinical research studies, veterans with GWI have been found to have higher levels of cytokines such as interleukins (Coughlin 2017), which are inflammatory factors associated with increased risk of coronary heart disease and other chronic diseases (Lampert et al. 2006). Using data from the Veterans Affairs (VA) Cooperative Studies Program 585 Gulf War Era Cohort and Biorepository (Khalil et al. 2018), this study examined the prevalence of cardiovascular disease among female veterans who served during the Gulf War or Gulf War Era. A total of 301 women veterans participated in the survey. Mean ages in 2016 were 53 years among women who were deployed and 54 years among women who were not deployed. About one-fifth of the participants were > 60 years of age. About three-quarters of the participants were white, 17–20% were Black or African American, and the remainder were American Indian/Alaska Native, Asian/Pacific Islander, or other race. About 6–8% of the participants were Hispanic or Latino. The majority of the participants had completed some college or received a college degree. In this sample, 12–13% of the participants were current cigarette smokers, 35% self-reported high blood pressure, and 40–41% self-reported high cholesterol. Compared to women veterans not deployed to the Gulf, deployed women veterans were not more likely to report cardiovascular disease (heart attack, coronary artery disease, congestive heart failure, stroke, or peripheral vascular disease). About 6.9% percent of the women who were deployed to the Gulf reported cardiovascular disease as compared to 11.2% of the women who were not deployed (odds ratio = 0.6, 95% confidence interval 0.3–1.4, P < 0.2). Twenty-seven years after the 1990–1991 Gulf War, women veterans who were deployed to the Gulf continue to report similar levels of cardiovascular disease risk factors (cigarette smoking, high blood pressure, high cholesterol) as non-deployed women veterans who served during the Gulf War era. Women veterans deployed to the 1990–1991 Gulf War do not appear to be at increased risk of cardiovascular disease, although studies with longer duration of follow-up and larger sample sizes are needed.
最近的临床研究发现，在海湾战争病(GWI)患者中，运动引起的短暂性体位性心动过速和心率变异性异常(Rayhan et al. 2013;Garner et al. 2018;Blanchard et al. 2018)。心率变异性的改变可能反映了脑干心脏调节区域的自主神经功能障碍和萎缩(Rayhan et al. 2013)。然而，自主神经系统功能异常对GWI患者的长期心血管影响尚不清楚(Blanchard et al. 2018)。在其他临床研究中，发现患有GWI的退伍军人的白细胞介素等细胞因子水平较高(Coughlin 2017)，这是与冠心病和其他慢性疾病风险增加相关的炎症因子(Lampert et al. 2006)。本研究使用退伍军人事务(VA)合作研究计划585海湾战争时期队列和生物库(Khalil et al. 2018)的数据，调查了在海湾战争或海湾战争时期服役的女性退伍军人心血管疾病的患病率。共有301名女退伍军人参与了调查。2016年，被派遣的女性平均年龄为53岁，未被派遣的女性平均年龄为54岁。大约五分之一的参与者年龄在60岁左右。大约四分之三的参与者是白人，17-20%是黑人或非裔美国人，其余的是美国印第安人/阿拉斯加原住民，亚洲/太平洋岛民或其他种族。大约6-8%的参与者是西班牙裔或拉丁裔。大多数参与者都完成了大学学业或获得了大学学位。在这个样本中，12-13%的参与者目前是吸烟者，35%的人自我报告有高血压，40-41%的人自我报告有高胆固醇。与没有被派往海湾的女退伍军人相比，被派往海湾的女退伍军人报告心血管疾病(心脏病发作、冠状动脉疾病、充血性心力衰竭、中风或周围血管疾病)的可能性并不更高。被部署到海湾地区的妇女中约有6.9%报告有心血管疾病，而未被部署的妇女中有11.2%报告有心血管疾病(优势比= 0.6,95%可信区间为0.3-1.4,P < 0.2)。1990-1991年海湾战争结束27年后，被部署到海湾地区的女退伍军人报告的心血管疾病风险因素(吸烟、高血压、高胆固醇)水平与在海湾战争时期服役的未部署的女退伍军人相似。参加1990-1991年海湾战争的女性退伍军人患心血管疾病的风险似乎没有增加，尽管需要更长的随访时间和更大的样本量。
{"title":"Cardiovascular Disease among Female Veterans of the 1991 Gulf War Era","authors":"S. Coughlin, Vahé Heboyan, K. Sullivan, M. Krengel, C. Wilson, Stacey E Iobst, N. Klimas","doi":"10.15436/2378-6841.19.2455","DOIUrl":"https://doi.org/10.15436/2378-6841.19.2455","url":null,"abstract":"Recent clinical studies have identified exercise-induced transient postural tachycardia and abnormal heart-rate variability in patients with Gulf War Illness (GWI) (Rayhan et al. 2013; Garner et al. 2018; Blanchard et al. 2018). Altered heart rate variability may reflect autonomic dysfunction and atrophy in the cardio-regulatory regions of the brainstem (Rayhan et al. 2013). However, the long-term cardiovascular effects of abnormal autonomic nervous system functioning in patients with GWI are unknown (Blanchard et al. 2018). In additional clinical research studies, veterans with GWI have been found to have higher levels of cytokines such as interleukins (Coughlin 2017), which are inflammatory factors associated with increased risk of coronary heart disease and other chronic diseases (Lampert et al. 2006). \u0000 \u0000Using data from the Veterans Affairs (VA) Cooperative Studies Program 585 Gulf War Era Cohort and Biorepository (Khalil et al. 2018), this study examined the prevalence of cardiovascular disease among female veterans who served during the Gulf War or Gulf War Era. A total of 301 women veterans participated in the survey. Mean ages in 2016 were 53 years among women who were deployed and 54 years among women who were not deployed. About one-fifth of the participants were > 60 years of age. About three-quarters of the participants were white, 17–20% were Black or African American, and the remainder were American Indian/Alaska Native, Asian/Pacific Islander, or other race. About 6–8% of the participants were Hispanic or Latino. The majority of the participants had completed some college or received a college degree. In this sample, 12–13% of the participants were current cigarette smokers, 35% self-reported high blood pressure, and 40–41% self-reported high cholesterol. Compared to women veterans not deployed to the Gulf, deployed women veterans were not more likely to report cardiovascular disease (heart attack, coronary artery disease, congestive heart failure, stroke, or peripheral vascular disease). About 6.9% percent of the women who were deployed to the Gulf reported cardiovascular disease as compared to 11.2% of the women who were not deployed (odds ratio = 0.6, 95% confidence interval 0.3–1.4, P < 0.2). \u0000 \u0000Twenty-seven years after the 1990–1991 Gulf War, women veterans who were deployed to the Gulf continue to report similar levels of cardiovascular disease risk factors (cigarette smoking, high blood pressure, high cholesterol) as non-deployed women veterans who served during the Gulf War era. Women veterans deployed to the 1990–1991 Gulf War do not appear to be at increased risk of cardiovascular disease, although studies with longer duration of follow-up and larger sample sizes are needed.","PeriodicalId":87298,"journal":{"name":"Journal of environment and health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74802584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-28DOI: 10.15436/2378-6841.19.2039
Varghese George, G. Kapuku, Santu Ghosh, V. Doshi, Patricia Hall, W. Strong, F. Treiber, D. Pollock, J. Pollock, R. Harris, J. Halbert, G. Harshfield, Ommega Internationals
Objective: The Augusta Heart Study is a NIH-funded multiracial longitudinal project, started in 1985, that examines cardiovascular health of children and adolescents in the Metro Augusta area. The objective was to develop a longitudinal cohort starting in childhood that would identify precursors and underlying pathophysiologic mechanisms that contribute to preclinical manifestations of cardiovascular disease (CVD). The focus was initially on sociodemographic factors, ethnicity, physical activity and obesity. In 2002, an additional focus on stress-related mechanisms of hypertension risk was initiated. The main objective of this paper is to introduce the rich database of this longitudinal multiracial cohort to researchers interested in assessing risk factors of lifetime development of CVD. Methods: Overall, 585 youth were recruited during 1985-2002. This cohort was maintained, and new age-matching participants were added so that, by 2007, the participant pool included 300 African Americans and 307 European Americans. Results: Valuable data, including childhood and young adulthood cardiovascular phenotypes and genotypes, were collected over a thirty-year span. Data were carefully curated and a comprehensive database was created to store data in digital format. As an illustration of the valuable research potential of the database, we performed a longitudinal analysis of the left ventricular mass using a mixed effect growth curve model. Conclusions: The database allows longitudinal analysis of precursors of cardiovascular disease and their underlying mechanisms, allowing to explore beyond simple epidemiology and orienting toward translational research. This cohort may also be used to evaluate the development of other disease processes. Our analysis of the left ventricular mass points out to the early onset and rapid elevation of blood pressure and cardiac mass in African Americans compared to European Americans, and males compared to females.
{"title":"The Augusta Heart Study","authors":"Varghese George, G. Kapuku, Santu Ghosh, V. Doshi, Patricia Hall, W. Strong, F. Treiber, D. Pollock, J. Pollock, R. Harris, J. Halbert, G. Harshfield, Ommega Internationals","doi":"10.15436/2378-6841.19.2039","DOIUrl":"https://doi.org/10.15436/2378-6841.19.2039","url":null,"abstract":"Objective: The Augusta Heart Study is a NIH-funded multiracial longitudinal project, started in 1985, that examines cardiovascular health of children and adolescents in the Metro Augusta area. The objective was to develop a longitudinal cohort starting in childhood that would identify precursors and underlying pathophysiologic mechanisms that contribute to preclinical manifestations of cardiovascular disease (CVD). The focus was initially on sociodemographic factors, ethnicity, physical activity and obesity. In 2002, an additional focus on stress-related mechanisms of hypertension risk was initiated. The main objective of this paper is to introduce the rich database of this longitudinal multiracial cohort to researchers interested in assessing risk factors of lifetime development of CVD.\u0000\u0000Methods: Overall, 585 youth were recruited during 1985-2002. This cohort was maintained, and new age-matching participants were added so that, by 2007, the participant pool included 300 African Americans and 307 European Americans.\u0000\u0000Results: Valuable data, including childhood and young adulthood cardiovascular phenotypes and genotypes, were collected over a thirty-year span. Data were carefully curated and a comprehensive database was created to store data in digital format. As an illustration of the valuable research potential of the database, we performed a longitudinal analysis of the left ventricular mass using a mixed effect growth curve model.\u0000\u0000Conclusions: The database allows longitudinal analysis of precursors of cardiovascular disease and their underlying mechanisms, allowing to explore beyond simple epidemiology and orienting toward translational research. This cohort may also be used to evaluate the development of other disease processes. Our analysis of the left ventricular mass points out to the early onset and rapid elevation of blood pressure and cardiac mass in African Americans compared to European Americans, and males compared to females.","PeriodicalId":87298,"journal":{"name":"Journal of environment and health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45089677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-09DOI: 10.15436/2378-6841.19.2429
S. Coughlin, A. Szema
Since the beginning of the current conflicts in Southwest Asia, more than 2 million service members have deployed in support of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) Sharkey (Sharkey et al. 2016). Service members can be exposed to a variety of environmental hazards during deployment including pollutants from unregulated industry, particulate matter from desert environments, exhaust from military vehicles, and emissions from open-air burn pits. Exposure to emissions from burn pits has been a cause for concern because of the potential for respiratory health conditions (asthma, bronchitis, chronic obstructive pulmonary disease, constrictive bronchiolitis) and other chronic health conditions (Sharkey et al. 2016; IOM 2011). Burn pits, widely used in combat zones before 2009, are open areas for burning solid waste. Burn pit emissions can include harmful particulates and chemicals including dioxins, furans, lead, mercury, volatile organic compounds, and polcyclic aromatic hydrocarbons (Liu et al. 2016). Despite considerable media coverage and anecdotal reports from concerned service members, epidemiologic evidence of adverse health effects from burn pits exposure has been lacking until recently. For example, as recently as 2014, Abraham et al. noted that “no study has identified an association between burn pit emissions exposure and post deployment chronic lung conditions.” Similarly, the Institute of Medicine concluded in 2011 that there was insufficient evidence to develop firm conclusions about what long-term health effects might be seen in service members exposed to burn pits. Several factors suggest that this situation is likely to change. First, the number of veterans who have participated in the Airborne Hazards and Open Burn Pit Registry has steadily increased, making it feasible to conduct registry-based epidemiologic studies (Liu et al. 2016). A public law mandated by Congress in in 2013 required the Department of Veterans Affairs to establish a registry for veterans with potential burn pit exposure in Iraq or Afghanistan. Participation in the registry is accomplished by completing its online self-assessment questionnaire, which was designed to obtain a broad picture of the participants’ military exposures and health (Liu et al. 2016). Secondly, two recent epidemiologic studies have found that exposure to burn pits and deployment to Kabul, Afghanistan is associated with chronic respiratory conditions (Liu et al. 2016; Sharkey et al. 2016). Liu et al. (2016) examined associations between assumed geographic and self-reported burn pit emissions exposure and respiratory and cardiovascular outcomes in participants of the Airborne Hazards and Open Burn Pit Registry. The authors found significant dose-response associations for higher risk of self-reported emphysema, chronic bronchitis, or chronic obstructive pulmonary disease with increased days of deployment within 2 miles of selected burn pits (P-trend = 0.01)
自当前西南亚冲突开始以来，已有超过200万名服务人员部署支持持久自由行动(OEF)和伊拉克自由行动(OIF) Sharkey (Sharkey et al. 2016)。服役人员在部署期间可能会暴露在各种环境危害中，包括来自不受管制的工业的污染物，来自沙漠环境的颗粒物质，军用车辆的废气以及露天燃烧坑的排放物。暴露于烧伤坑的排放物一直是一个令人担忧的问题，因为它可能导致呼吸系统疾病(哮喘、支气管炎、慢性阻塞性肺病、缩窄性细支气管炎)和其他慢性疾病(Sharkey等人，2016;国际移民组织2011)。2009年以前在战区广泛使用的燃烧坑是用于燃烧固体废物的开放区域。燃烧坑排放可能包括有害微粒和化学物质，包括二恶英、呋喃、铅、汞、挥发性有机化合物和多环芳烃(Liu et al. 2016)。尽管有大量的媒体报道和有关服役人员的轶事报告，但直到最近才有关于接触烧伤坑对健康不利影响的流行病学证据。例如，早在2014年，Abraham等人就指出，“没有研究确定烧伤坑排放暴露与部署后慢性肺病之间的关联。”同样，美国医学研究所(Institute of Medicine)在2011年得出结论，没有足够的证据来得出确凿的结论，说明暴露于烧伤坑的服役人员可能会对健康产生什么样的长期影响。有几个因素表明，这种情况可能会改变。首先，参加空气传播危害和露天烧伤坑登记的退伍军人人数稳步增加，这使得开展基于登记的流行病学研究成为可能(Liu et al. 2016)。2013年，国会授权的一项公法要求退伍军人事务部(Department of Veterans Affairs)为在伊拉克或阿富汗可能接触过烧伤坑的退伍军人建立一个登记处。参与登记是通过完成其在线自我评估问卷来完成的，该问卷旨在全面了解参与者的军事暴露和健康状况(Liu et al. 2016)。其次，最近的两项流行病学研究发现，暴露于烧伤坑并部署到阿富汗喀布尔与慢性呼吸系统疾病有关(Liu et al. 2016;Sharkey et al. 2016)。Liu等人(2016)研究了假定的地理和自我报告的烧伤坑排放暴露与空气危害和露天烧伤坑登记参与者的呼吸和心血管结果之间的关系。作者发现，自报肺气肿、慢性支气管炎或慢性阻塞性肺病的高风险与在选定烧伤坑2英里内部署天数增加(p趋势= 0.01)和自报烧伤坑烟雾暴露(p趋势= 0.0005)有关。Sharkey等人(2016)进行了一项回顾性队列研究，调查部署到阿富汗喀布尔与美国军事人员随后的呼吸健康之间的关系。研究对象包括部署在喀布尔的人员、选定的持久自由行动地点的人员、驻扎在大韩民国的人员以及驻美人员。在统计上，与美国驻扎人员相比，部署在喀布尔的人员哮喘发病率较高(IRR 1.61;95% CI, 1.22-2.12)，这与Szema et al.(2010)早先报道的研究结果一致。第三，由于在战斗中暴露于烧伤坑的时间越来越长，潜伏期可能接近于足以在流行病学研究中发现与肺气肿的关联。进行流行病学研究以检查与恶性肿瘤和一般人群中不常见的肺部疾病(例如，脑胶质母细胞瘤，缩窄性细支气管炎)的关联也可能是可行的(King et al. 2011)。对Burn Pits 360度登记处数据的比例死亡率分析(这是一项假设生成研究)发现，与慢性呼吸系统疾病死亡相比，恶性肿瘤死亡的比例过高(未发表的观察结果，Sunil Halder, 2018)。除了对暴露于烧伤坑有毒烟雾的退伍军人的慢性健康状况进行额外的基于人群和基于登记的流行病学研究外，还需要进行纵向研究，包括肺功能的系列测量和暴露于多氯二苯并对二恶英/二苯并呋烷的新型生物标志物(Woeller等，2016)。
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Pub Date : 2019-01-18DOI: 10.15436/2378-6841.19.2402
Michael Bevington, Ommega Internationals
Some surveys have identified people who have restricted access to work in environments with man-made electromagnetic exposures. This study attempts to determine their prevalence, an aspect not previously investigated in its own right. It is based on analyses of the two different types of surveys of people with Idiopathic Environmental Intolerance attributed to Electromagnetic Fields (IEI-EMF), or Electromagnetic Hyper-Sensitivity (EHS), either of the general population or of people with IEI-EMF/EHS. In addition, there are different definitions of IEI-EMF/EHS, with a range of subconscious, mild, moderate or severe symptoms, potentially leading in three stages to hyper-sensitivity. The current evidence is assessed as indicating that, in addition to subconscious sensitivity, the prevalence of IEI-EMF/EHS is between about 5.0 and 30 per cent of the general population for mild cases, 1.5 and 5.0 per cent for moderate cases and < 1.5 per cent for severe cases. The prevalence of people restricted in their access to work in a man-made electromagnetic environment is estimated at 0.65 per cent of the general population, at about 18% of the general population with moderate IEI-EMF/EHS. The estimate of 0.65% equates to 435,500 people in the UK’s population of 67 million. Some reasons for possible under-reporting are discussed. Adjustments can enable some people with this disability to remain in employment, suggesting that rates of restriction in access to work may fall as employers become aware of what adjustments are needed.
{"title":"The Prevalence of People With Restricted Access to Work in Man-Made Electromagnetic Environments","authors":"Michael Bevington, Ommega Internationals","doi":"10.15436/2378-6841.19.2402","DOIUrl":"https://doi.org/10.15436/2378-6841.19.2402","url":null,"abstract":"Some surveys have identified people who have restricted access to work in environments with man-made electromagnetic exposures. This study attempts to determine their prevalence, an aspect not previously investigated in its own right. It is based on analyses of the two different types of surveys of people with Idiopathic Environmental Intolerance attributed to Electromagnetic Fields (IEI-EMF), or Electromagnetic Hyper-Sensitivity (EHS), either of the general population or of people with IEI-EMF/EHS. In addition, there are different definitions of IEI-EMF/EHS, with a range of subconscious, mild, moderate or severe symptoms, potentially leading in three stages to hyper-sensitivity. The current evidence is assessed as indicating that, in addition to subconscious sensitivity, the prevalence of IEI-EMF/EHS is between about 5.0 and 30 per cent of the general population for mild cases, 1.5 and 5.0 per cent for moderate cases and < 1.5 per cent for severe cases. The prevalence of people restricted in their access to work in a man-made electromagnetic environment is estimated at 0.65 per cent of the general population, at about 18% of the general population with moderate IEI-EMF/EHS. The estimate of 0.65% equates to 435,500 people in the UK’s population of 67 million. Some reasons for possible under-reporting are discussed. Adjustments can enable some people with this disability to remain in employment, suggesting that rates of restriction in access to work may fall as employers become aware of what adjustments are needed.","PeriodicalId":87298,"journal":{"name":"Journal of environment and health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47631033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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