Research and Faculty

Int J Environ Res Public Health. 2023 Nov 23;20(23):7104. doi: 10.3390/ijerph20237104.

ABSTRACT

Phthalate use and the concentrations of their metabolites in humans vary by geographic region, race, ethnicity, sex, product use and other factors. Exposure during pregnancy may be associated with detrimental reproductive and developmental outcomes. No studies have evaluated the predictors of exposure to a wide range of phthalate metabolites in a large, diverse population. We examined the determinants of phthalate metabolites in a cohort of racially/ethnically diverse nulliparous pregnant women. We report on urinary metabolites of nine parent phthalates or replacement compounds-Butyl benzyl phthalate (BBzP), Diisobutyl phthalate (DiBP), Diethyl phthalate (DEP), Diisononyl phthalate (DiNP), D-n-octyl phthalate (DnOP), Di-2-ethylhexyl terephthalate (DEHTP), Di-n/i-butyl phthalate (DnBP), Di-isononyl phthalate (DiNP) and Di-(2-ethylhexyl) phthalate (DEHP) from urine collected up to three times from 953 women enrolled in the Nulliparous Mothers To Be Study. Phthalate metabolites were adjusted for specific gravity. Generalized estimating equations (GEEs) were used to identify the predictors of each metabolite. Overall predictors include age, race and ethnicity, education, BMI and clinical site of care. Women who were Non-Hispanic Black, Hispanic or Asian, obese or had lower levels of education had higher concentrations of selected metabolites. These findings indicate exposure patterns that require policies to reduce exposure in specific subgroups.

PMID:38063534 | PMC:PMC10706567 | DOI:10.3390/ijerph20237104

Appl Ergon. 2023 Dec 2;116:104185. doi: 10.1016/j.apergo.2023.104185. Online ahead of print.

ABSTRACT

Target acquisition tasks quantify human motor and perceptual abilities while performing discrete tasks to support interface design and sensorimotor assessments. This study investigated the effects of display, Touchscreen and Augmented Reality (AR), on a standardized 2D multidirectional target acquisition task. Thirty-two participants performed the target acquisition task with both modality types and at two indexes of difficulty. The touchscreen modality yielded improved performance over AR as measured by accuracy, precision, error rates, throughput, and movement time. Throughput using the nominal index of difficulty was 10.12 bits/s for touchscreen and 3.11 bits/s for AR. AR designers can use the results to improve performance when designing AR interfaces by selecting larger buttons when accuracy and efficiency are required and by embedding perception cues to button target surfaces such as depth and proximity cues.

PMID:38043456 | DOI:10.1016/j.apergo.2023.104185

medRxiv. 2023 Nov 7:2023.11.03.23297930. doi: 10.1101/2023.11.03.23297930. Preprint.

ABSTRACT

BACKGROUND: Per- and poly-fluoroalkyl substances (PFAS) exposure can occur through ingestion of contaminated food and water, and inhalation of indoor air contaminated with these chemicals from consumer and industrial products. Prenatal PFAS exposures may confer risk for pregnancy-related outcomes such as hypertensive and metabolic disorders, preterm birth, and impaired fetal development through intermediate metabolic and inflammation pathways.

OBJECTIVE: Estimate associations between maternal pregnancy PFAS exposure (individually and as a mixture) and bioactive lipids.

METHODS: Our study included pregnant women in the Environmental influences on Child Health Outcomes Program: Chemicals in our Bodies cohort (CiOB, n=73), Illinois Kids Developmental Study (IKIDS, n=287), and the ECHO-PROTECT cohort (n=54). We measured twelve PFAS in serum and 50 plasma bioactive lipids (parent fatty acids and eicosanoids derived from cytochrome p450, lipoxygenase, and cyclooxygenase) during pregnancy (median 17 gestational weeks). Pairwise associations across cohorts were estimated using linear mixed models and meta-analysis. Associations between the PFAS mixture and individual bioactive lipids were estimated using quantile g-computation.

RESULTS: PFDeA, PFOA, and PFUdA were associated (p<0.05) with changes in bioactive lipid levels in all three enzymatic pathways (cyclooxygenase [n=6 signatures]; cytochrome p450 [n=5 signatures]; lipoxygenase [n=7 signatures]) in at least one combined cohort analysis. The strongest signature indicated that a doubling in PFOA corresponded with a 24.3% increase (95% CI [7.3%, 43.9%]) in PGD2 (cyclooxygenase pathway) in the combined cohort. In the mixtures analysis, we observed nine positive signals across all pathways associated with the PFAS mixture. The strongest signature indicated that a quartile increase in the PFAS mixture was associated with a 34% increase in PGD2 (95% CI [8%, 66%]), with PFOS contributing most to the increase.

CONCLUSIONS: Bioactive lipids were revealed as biomarkers of PFAS exposure and could provide mechanistic insights into PFAS’ influence on pregnancy outcomes, informing more precise risk estimation and prevention strategies.

PMID:37961525 | PMC:PMC10635258 | DOI:10.1101/2023.11.03.23297930

Workplace Health Saf. 2023 Dec;71(12):617. doi: 10.1177/21650799231206389. Epub 2023 Nov 9.

NO ABSTRACT

PMID:37942996 | DOI:10.1177/21650799231206389

PLoS One. 2023 Nov 8;18(11):e0291605. doi: 10.1371/journal.pone.0291605. eCollection 2023.

ABSTRACT

Telehealth has helped to increase access to rehabilitative services such as occupational and physical therapy. The early COVID-19 pandemic amplified the need for remote access to care, and the rapid implementation of telehealth systems provided a unique opportunity to learn from clinicians’ experiences adopting telehealth for telerehabilitation applications. To understand these experiences, a self-administered online survey was conducted to capture perspectives on ease of telerehabilitation use and adoption from occupational and physical therapists. The survey captured retrospective views on telerehabilitation use pre-pandemic as well as real-time perspectives on telerehabilitation during the early stages of the pandemic (July to August 2020). The survey gathered information on clinician demographics (N = 109), clinicians’ experiences with adopting or utilizing telerehabilitation systems, and their perceptions on remotely performing cognitive, emotional, and physical assessments via video-conferencing (a common mode of telehealth). Responses demonstrated a modest increase in telerehabilitation as a care setting (rate increase from 3.4% to 19.3%), and telerehabilitation was more generally tried during the early stages of the pandemic (41 clinicians explicitly reported telerehabilitation use). However, technology access and acceptance remained low, with 38 clinicians (35%) expressing concerns that technology was ineffective or impractical, unavailable, not covered by insurance, or not desired by their patients. Video-conferencing technology was perceived as generally ill-equipped to support clinicians in performing remote assessment tasks. Physical assessment tasks were considered particularly difficult, with 55% of clinicians rating their ability to perform these tasks in the range of moderately difficult to unable to perform. To address these difficulties and better augment clinical care, clinicians require more robust assessment methods that may combine video, mobile, and wearable technologies that would be accessible to a patient at home. When designing future telerehabilitation tools, information captured through these modes must be task-relevant, standardized, and understandable to a remote clinician.

PMID:37939089 | PMC:PMC10631673 | DOI:10.1371/journal.pone.0291605

Environ Health. 2023 Oct 26;22(1):74. doi: 10.1186/s12940-023-01026-2.

ABSTRACT

BACKGROUND: Fluoride is ubiquitous in the United States (US); however, data on biomarkers and patterns of fluoride exposure among US pregnant women are scarce. We examined specific gravity adjusted maternal urinary fluoride (MUFsg) in relation to sociodemographic variables and metal co-exposures among pregnant women in Los Angeles, California.

METHODS: Participants were from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) cohort. There were 293 and 490 women with MUFsg measured during first and third trimesters, respectively. An intra-class correlation coefficient examined consistency of MUFsg between trimesters. Kruskal-Wallis and Mann-Whitney U tests examined associations of MUFsg with sociodemographic variables. Covariate adjusted linear regression examined associations of MUFsg with blood metals and specific gravity adjusted urine metals among a subsample of participants within and between trimesters. A False Discovery Rate (FDR) correction accounted for multiple comparisons.

RESULTS: Median (IQR) MUFsg was 0.65 (0.5) mg/L and 0.8 (0.59) mg/L, during trimesters one and three respectively. During both trimesters, MUFsg was higher among older participants, those with higher income, and White, non-Hispanic participants than Hispanic participants. MUFsg was also higher for White, non-Hispanic participants than for Black, non-Hispanic participants in trimester three, and for those with graduate training in trimester one. MUFsg was negatively associated with blood mercury in trimester one and positively associated with blood lead in trimester three. MUFsg was positively associated with various urinary metals, including antimony, barium, cadmium, cobalt, copper, lead, nickel, tin, and zinc in trimesters one and/or three.

CONCLUSIONS: MUFsg levels observed were comparable to those found in pregnant women in Mexico and Canada that have been associated with poorer neurodevelopmental outcomes. Lower urinary fluoride levels among Hispanic and non-Hispanic Black participants in MADRES compared to non-Hispanic White participants may reflect lower tap water consumption or lower fluoride exposure from other sources. Additional research is needed to examine whether MUFsg levels observed among pregnant women in the US are associated with neurodevelopmental outcomes.

PMID:37880740 | PMC:PMC10601173 | DOI:10.1186/s12940-023-01026-2

Environ Health Perspect. 2023 Oct;131(10):101302. doi: 10.1289/EHP13528. Epub 2023 Oct 18.

NO ABSTRACT

PMID:37851583 | PMC:PMC10584042 | DOI:10.1289/EHP13528

Fertil Steril. 2023 Oct 10:S0015-0282(23)01926-X. doi: 10.1016/j.fertnstert.2023.10.008. Online ahead of print.

ABSTRACT

Modifiable factors, such as environmental exposures, can impact human fertility. The objective of this review is to summarize the potential effects of exposure to important endocrine disrupting chemicals on male reproductive health. The vast majority of experimental and animal data demonstrates strong evidence for negative effects of exposure to phenols, phthalates, pesticides and per- and poly-fluoroalkyl substances (PFAS) on male reproductive health. While evidence of negative associations in humans was overall strong for phthalates and pesticides, limited and inconclusive relationships were found for the other examined chemical biomarkers. Reasons for the discrepancies in results include, but are not limited to, differences in study populations, exposure concentrations, number of sample collected, sample sizes, study design and residual confounding. Additional studies are needed, particularly for newer phenols and PFAS, given the scarce literature on the topic and increasing exposures over time.

PMID:37827483 | DOI:10.1016/j.fertnstert.2023.10.008

Fertil Steril. 2023 Dec;120(6):1138-1149. doi: 10.1016/j.fertnstert.2023.10.008. Epub 2023 Oct 11.

ABSTRACT

Modifiable factors, such as environmental exposures, can impact human fertility. The objective of this review is to summarize the potential effects of exposure to important endocrine-disrupting chemicals on male reproductive health. Most experimental and animal data demonstrate strong evidence for the negative effects of exposure to phenols, phthalates, pesticides, and perfluoroalkyl and polyfluoroalkyl substances on male reproductive health. Although evidence of negative associations in humans was overall strong for phthalates and pesticides, limited and inconclusive relationships were found for the other examined chemical biomarkers. Reasons for the discrepancies in results include but are not limited to, differences in study populations, exposure concentrations, number of samples collected, sample sizes, study design, and residual confounding. Additional studies are needed, particularly for newer phenols and perfluoroalkyl and polyfluoroalkyl substances, given the scarce literature on the topic and increasing exposures over time.

PMID:37827483 | DOI:10.1016/j.fertnstert.2023.10.008

Environ Int. 2023 Oct;180:108230. doi: 10.1016/j.envint.2023.108230. Epub 2023 Sep 25.

ABSTRACT

Green vegetation may protect against heat-related death by improving thermal comfort. Few studies have investigated associations of green vegetation with heat-related mortality in Latin America or whether associations are modified by the spatial configuration of green vegetation. We used data from 323 Latin American cities and meta-regression models to estimate associations between city-level greenness, quantified using population-weighted normalized difference vegetation index values and modeled as three-level categorical terms, and excess deaths from heat (heat excess death fractions [heat EDFs]). Models were adjusted for city-level fine particulate matter concentration (PM_2.5), social environment, and country group. In addition to estimating overall associations, we derived estimates of association stratified by green space clustering by including an interaction term between a green space clustering measure (dichotomized at the median of the distribution) and the three-level greenness variable. We stratified analyses by climate zone (arid vs. temperate and tropical combined). Among the 79 arid climate zone cities, those with moderate and high greenness levels had modestly lower heat EDFs compared to cities with the lowest greenness, although protective associations were more substantial in cities with moderate versus high greenness levels and confidence intervals (CI) crossed the null (Beta: -0.41, 95% CI: -1.06, 0.25; Beta -0.23, 95% CI: -0.95, 0.49, respectively). In 244 non-arid climate zone cities, associations were approximately null. We did not observe evidence of effect modification by green space clustering. Our results suggest that greenness may offer modest protection against heat-related mortality in arid climate zone Latin American cities.

PMID:37776620 | PMC:PMC10594062 | DOI:10.1016/j.envint.2023.108230