Publications

July 2024
Prenatal exposure to environmental phenols and fetal growth across pregnancy in the LIFECODES fetal growth study
John D Meeker

Environ Int. 2024 Jul 2;190:108866. doi: 10.1016/j.envint.2024.108866. Online ahead of print.

ABSTRACT

INTRODUCTION: Environmental phenols are endocrine disrupting chemicals hypothesized to affect early life development. Previous research examining the effects of phenols on fetal growth has focused primarily on associations with measures of size at delivery. Few have included ultrasound measures to examine growth across pregnancy.

OBJECTIVE: Investigate associations between prenatal exposure to phenols and ultrasound and delivery measures of fetal growth.

METHODS: Using the LIFECODES Fetal Growth Study (n = 900), a case-cohort including 248 small-for-gestational-age, 240 large-for-gestational age, and 412 appropriate-for-gestational-age births, we estimated prenatal exposure to 12 phenols using three urine samples collected during pregnancy (median 10, 24, and 35 weeks gestation). We abstracted ultrasound and delivery measures of fetal growth from medical records. We estimated associations between pregnancy-average phenol biomarker concentrations and repeated ultrasound measures of fetal growth using linear mixed effects models and associations with birthweight using linear regression models. We also used logistic regression models to estimate associations with having a small- or large-for-gestational birth.

RESULTS: We observed positive associations between 2,4-dichlorophenol, benzophenone-3, and triclosan (TCS) and multiple ultrasound measures of fetal growth. For example, TCS was associated with a 0.09 (95 % CI: 0.01, 0.18) higher estimated fetal weight z-score longitudinally across pregnancy. This effect size corresponds to a 21 g increase in estimated fetal weight at 30 weeks gestation. Associations with delivery measures of growth were attenuated, but TCS remained positively associated with birthweight z-scores (mean difference: 0.13, 95 % CI: 0.02, 0.25). Conversely, methylparaben was associated with higher odds of a small-for-gestational age birth (odds ratio: 1.45, 95 % CI: 1.06, 1.98).

DISCUSSION: We observed associations between some biomarkers of phenol exposure and ultrasound measures of fetal growth, though associations at the time of delivery were attenuated. These findings are consistent with hypotheses that phenols have the potential to affect growth during the prenatal period.

PMID:38968832 | DOI:10.1016/j.envint.2024.108866

July 2024
Organophosphate Ester Flame Retardants and Plasticizers in Relation to Fetal Growth in the LIFECODES Fetal Growth Study
John D Meeker

Environ Health Perspect. 2024 Jul;132(7):77001. doi: 10.1289/EHP14647. Epub 2024 Jul 5.

ABSTRACT

BACKGROUND: Organophosphate esters (OPEs), used ubiquitously as flame retardants and plasticizers in consumer products, are suspected of having developmental toxicity.

OBJECTIVES: Our study aimed to estimate associations between prenatal exposure to OPEs and fetal growth, including both ultrasound (head circumference, abdominal circumference, femur length, and estimated fetal weight) and delivery [birth weight z-score, small-for-gestational age (SGA), and large-for-gestational age (LGA)] measures of growth.

METHODS: In the LIFECODES Fetal Growth Study (2008-2018), an enriched case-cohort of 900 babies born at the small and large ends of the growth spectrum, we quantified OPE biomarkers in three urine samples per pregnant participant and abstracted ultrasound and delivery measures of fetal growth from medical records. We estimated associations between pregnancy-averaged log-transformed OPE biomarkers and repeated ultrasound measures of fetal growth using linear mixed-effects models, and delivery measures of fetal growth using linear (birth weight) and logistic (SGA and LGA) regression models.

RESULTS: Most OPE biomarkers were positively associated with at least one ultrasound measure of fetal growth, but associations with delivery measures were largely null. For example, an interquartile range (IQR; 1.31 ng/mL) increase in bis(2-chloroethyl) phosphate concentration was associated with larger z-scores in head circumference [mean difference (difference): 0.09; 95% confidence interval (CI): 0.01, 0.17], abdominal circumference (difference: 0.10; 95% CI: 0.02, 0.18), femur length (difference: 0.11; 95% CI: 0.03, 0.19), and estimated fetal weight (difference: 0.13; 95% CI: 0.04, 0.22) but not birth weight (difference: 0.04; 95% CI: 0.08, 0.17). At delivery, an IQR (1.00 ng/mL) increase in diphenyl phosphate (DPHP) concentration was associated with an SGA birth (odds ratio: 1.46; 95% CI: 1.10, 1.94).

CONCLUSIONS: In a large prospective cohort, gestational OPE exposures were associated with larger fetal size during pregnancy, but associations at delivery were null. DPHP concentrations were associated with heightened risk of an SGA birth. These findings suggest that OPE exposure may affect fetal development. https://doi.org/10.1289/EHP14647.

PMID:38968089 | PMC:PMC11225970 | DOI:10.1289/EHP14647

June 2024
The Michigan Farmworker Project: A Community-Based Participatory Approach to Research on Precarious Employment and Labor Exploitation of Farmworkers
Marie S O'Neill

Labor Stud J. 2023 Dec;48(4):336-362. doi: 10.1177/0160449×231196227. Epub 2023 Aug 30.

ABSTRACT

Precarious employment is an important social determinant of health inequities. Through in-depth qualitative interviews (n = 35), we examine precarious employment and labor exploitation, their potential impact on the working environment, and, ultimately, the health of farmworkers. We present results from the community-based participatory Michigan Farmworker Project. Our analysis identified dimensions of precarious employment and labor exploitation that involved lacking access to fundamental labor and social rights-including dehumanization-discriminatory occupational practices, and insufficient access to health care and social benefits. Policy reform is needed to address precarious employment and labor exploitation among farmworkers due to their potential long-lasting health effects.

PMID:38939876 | PMC:PMC11210576 | DOI:10.1177/0160449×231196227

June 2024
The Michigan Farmworker Project: A Community-Based Participatory Approach to Research on Precarious Employment and Labor Exploitation of Farmworkers
Alexis J Handal

Labor Stud J. 2023 Dec;48(4):336-362. doi: 10.1177/0160449×231196227. Epub 2023 Aug 30.

ABSTRACT

Precarious employment is an important social determinant of health inequities. Through in-depth qualitative interviews (n = 35), we examine precarious employment and labor exploitation, their potential impact on the working environment, and, ultimately, the health of farmworkers. We present results from the community-based participatory Michigan Farmworker Project. Our analysis identified dimensions of precarious employment and labor exploitation that involved lacking access to fundamental labor and social rights-including dehumanization-discriminatory occupational practices, and insufficient access to health care and social benefits. Policy reform is needed to address precarious employment and labor exploitation among farmworkers due to their potential long-lasting health effects.

PMID:38939876 | PMC:PMC11210576 | DOI:10.1177/0160449×231196227

June 2024
Associations between urinary hydroxylated polycyclic aromatic hydrocarbon biomarker concentrations and measures of timing of delivery and infant size at birth
John D Meeker

Environ Int. 2024 Jun 22;190:108848. doi: 10.1016/j.envint.2024.108848. Online ahead of print.

ABSTRACT

Preterm birth is a leading cause of neonatal mortality and presents significant public health concerns. Environmental chemical exposures during pregnancy may be partially to blame for disrupted delivery timing. Polycyclic aromatic hydrocarbons (PAHs) are products of incomplete combustion, exposure to which occurs via inhalation of cigarette smoke and automobile exhaust, and ingestion of charred meats. Exposure to PAHs in the US population is widespread, and pregnant women represent a susceptible population to adverse effects of PAHs. We aimed to investigate associations between gestational exposure to PAHs and birth outcomes, including timing of delivery and infant birth size. We utilized data from the PROTECT birth cohort where pregnant women provided spot urine samples at up to three study visits (median 16, 20, and 24 weeks gestation). Urine samples were assayed for eight hydroxylated PAH concentrations. Associations between PAHs and birth outcomes were calculated using linear/logistic regression models, with adjustment for maternal age, education, pre-pregnancy BMI, and daily exposure to environmental tobacco smoke. Models accounted for urine dilution using specific gravity. We also explored effect modification by infant sex. Interquartile range (IQR) increases in all averaged PAH exposures during the second trimester were associated with reduced gestational age at delivery and increased odds of overall PTB, although these associations were not statistically significant (p > 0.05). Most PAHs at the second study visit were most strongly associated with earlier delivery and increased odds of overall and spontaneous PTB, with visit 2 2-hydroxynapthalene (2-NAP) being significantly associated with increased odds of overall PTB (OR:1.55; 95 %CI: 1.05,2.29). Some PAHs resulted in earlier timing of delivery among only female fetuses, specifically 2-NAP on overall PTB (female OR:1.52 95 %CI: 1.02,2.27; male OR:0.78, 95 %CI: 0.53,1.15). Future work should more deeply investigate differential physiological impacts of PAH exposure between pregnancies with male and female fetuses, and on varying developmental processes occurring at different points through pregnancy.

PMID:38936064 | DOI:10.1016/j.envint.2024.108848

June 2024
Bipolar Disorder in the Working Population: The Occupational Health Nurse’s Role
Marie-Anne S Rosemberg

Workplace Health Saf. 2024 Jun 20:21650799241261081. doi: 10.1177/21650799241261081. Online ahead of print.

NO ABSTRACT

PMID:38899563 | DOI:10.1177/21650799241261081

June 2024
Nonpharmacological pain management approaches among U.S. construction workers: A cross-sectional pilot study
Aurora B Le

Am J Ind Med. 2024 Jun 20. doi: 10.1002/ajim.23630. Online ahead of print.

ABSTRACT

BACKGROUND: U.S. construction workers experience high rates of injury that can lead to chronic pain. This pilot study examined nonpharmacological (without medication prescribed by healthcare provider) and pharmacological (e.g., prescription opioids) pain management approaches used by construction workers.

METHODS: A convenience sample of U.S. construction workers was surveyed, in partnership with the U.S. National Institute for Occupational Safety and Health (NIOSH) Construction Sector Program. Differences in familiarity and use of nonpharmacological and pharmacological pain management approaches, by demographics, were assessed using logistic regression models. A boosted regression tree model examined the most influential factors related to pharmacological pain management use, and potential reductions in use were counterfactually modeled.

RESULTS: Of 166 (85%) of 195 participants reporting pain/discomfort in the last year, 72% reported using pharmacological pain management approaches, including 19% using opioids. There were significant differences in familiarity with nonpharmacological approaches by gender, education, work experience, and job title. Among 37 factors that predicted using pharmacological and non-pharmacological pain management approaches, training on the risks of opioids, job benefits for unpaid leave and paid disability, and familiarity with music therapy, meditation or mindful breathing, and body scans were among the most important predictors of potentially reducing use of pharmacological approaches. Providing these nonpharmacological approaches to workers could result in an estimated 23% (95% CI: 16%-30%) reduction in pharmacological pain management approaches.

CONCLUSION: This pilot study suggests specific factors related to training, job benefits, and worker familiarity with nonpharmacological pain management approaches influence use of these approaches.

PMID:38899539 | DOI:10.1002/ajim.23630

May 2024
Cross-shift changes in pulmonary function and occupational exposure to particulate matter among e-waste workers in Ghana
Stuart A Batterman

Front Public Health. 2024 May 9;12:1368112. doi: 10.3389/fpubh.2024.1368112. eCollection 2024.

ABSTRACT

INTRODUCTION: Little is known on the association between cross-shift changes in pulmonary function and personal inhalation exposure to particulate matter (PM) among informal electronic-waste (e-waste) recovery workers who have substantial occupational exposure to airborne pollutants from burning e-waste.

METHODS: Using a cross-shift design, pre- and post-shift pulmonary function assessments and accompanying personal inhalation exposure to PM (sizes <1, <2.5 μm, and the coarse fraction, 2.5-10 μm in aerodynamic diameter) were measured among e-waste workers (n = 142) at the Agbogbloshie e-waste site and a comparison population (n = 65) in Accra, Ghana during 2017 and 2018. Linear mixed models estimated associations between percent changes in pulmonary function and personal PM.

RESULTS: Declines in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) per hour were not significantly associated with increases in PM (all sizes) among either study population, despite breathing zone concentrations of PM (all sizes) that exceeded health-based guidelines in both populations. E-waste workers who worked “yesterday” did, however, have larger cross-shift declines in FVC [-2.4% (95%CI: -4.04%, -0.81%)] in comparison to those who did not work “yesterday,” suggesting a possible role of cumulative exposure.

DISCUSSION: Overall, short-term respiratory-related health effects related to PM exposure among e-waste workers were not seen in this sample. Selection bias due to the “healthy worker” effect, short shift duration, and inability to capture a true “pre-shift” pulmonary function test among workers who live at the worksite may explain results and suggest the need to adapt cross-shift studies for informal settings.

PMID:38784567 | PMC:PMC11111984 | DOI:10.3389/fpubh.2024.1368112

May 2024
Cross-shift changes in pulmonary function and occupational exposure to particulate matter among e-waste workers in Ghana
Marie S O'Neill

Front Public Health. 2024 May 9;12:1368112. doi: 10.3389/fpubh.2024.1368112. eCollection 2024.

ABSTRACT

INTRODUCTION: Little is known on the association between cross-shift changes in pulmonary function and personal inhalation exposure to particulate matter (PM) among informal electronic-waste (e-waste) recovery workers who have substantial occupational exposure to airborne pollutants from burning e-waste.

METHODS: Using a cross-shift design, pre- and post-shift pulmonary function assessments and accompanying personal inhalation exposure to PM (sizes <1, <2.5 μm, and the coarse fraction, 2.5-10 μm in aerodynamic diameter) were measured among e-waste workers (n = 142) at the Agbogbloshie e-waste site and a comparison population (n = 65) in Accra, Ghana during 2017 and 2018. Linear mixed models estimated associations between percent changes in pulmonary function and personal PM.

RESULTS: Declines in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) per hour were not significantly associated with increases in PM (all sizes) among either study population, despite breathing zone concentrations of PM (all sizes) that exceeded health-based guidelines in both populations. E-waste workers who worked “yesterday” did, however, have larger cross-shift declines in FVC [-2.4% (95%CI: -4.04%, -0.81%)] in comparison to those who did not work “yesterday,” suggesting a possible role of cumulative exposure.

DISCUSSION: Overall, short-term respiratory-related health effects related to PM exposure among e-waste workers were not seen in this sample. Selection bias due to the “healthy worker” effect, short shift duration, and inability to capture a true “pre-shift” pulmonary function test among workers who live at the worksite may explain results and suggest the need to adapt cross-shift studies for informal settings.

PMID:38784567 | PMC:PMC11111984 | DOI:10.3389/fpubh.2024.1368112

May 2024
The impact of safety behavior, perceived risk, and workplace resources on COVID outcomes for U.S. Aircraft Rescue and Firefighting personnel
Aurora B Le

Work. 2024 May 21. doi: 10.3233/WOR-230316. Online ahead of print.

ABSTRACT

BACKGROUND: Aircraft rescue and firefighting (ARFF) personnel are first responders located at airports in the United States who provide emergency response, mitigation, evacuation, and rescue of passengers and crew of aircraft at airports. The nature of their work puts ARFF personnel in close contact with travelers on a regular basis and at elevated risk for COVID-19 exposure.

OBJECTIVE: In this study, we focused on safety behavior, perceived risk, and workplace resources to understand COVID-19 outcomes in the early pandemic among the overlooked worker population of ARFF personnel. The goal of this study was to examine how a self-reported positive COVID test were associated with safety behavior, perceived risk, and workplace resources.

METHODS: Cross-sectional survey data were collected among ARFF personnel a year into the COVID-19 pandemic.

RESULTS: Regression results showed that each additional unit increase in perceived susceptibility to COVID-19 was associated with a 133% increase in the odds of testing positive for COVID-19 (OR = 2.33, p < 0.05), and with each additional unit increase in perceived severity level, the odds of getting COVID-19 decreased by 47% (OR = 0.53, p < 0.05).

CONCLUSIONS: Infection control among first responders may be improved by providing relevant information physical and emotional resources, and support that help shape perceptions of risk and adoption of prevention behaviors.

PMID:38788107 | DOI:10.3233/WOR-230316