Asthma has been reported in children as a leading chronic illness in the US and around the world. It is also the third leading cause of hospitalization among children under the age of 15, and is also one of the most common causes of school absenteeism. Children are at higher risk of asthma attacks and they pose a higher burden on health care system. Nearly 20.6% of middle and high school children in Florida have been told they have asthma, this prevalence has grown over 3% from 2006 to 2012. Changes in air pollutant levels are often related to health outcomes, e.g. prevalence of chronic asthma. Exposure to ambient air pollutants have been reported to exacerbate asthma attacks especially in children. Often agencies and governing bodies utilize national level health impact assessments (HIAs) to estimate local levels of health impacts. The US EPA (Environmental Protection Agency) developed the Benefit Mapping and Analysis Program (BenMAP) to estimate impacts on health due to changes in air pollution. Recent studies have shown that assessment of regional exposure is important to understand health impacts of pollutants at the local level. To use BenMAP effectively for HIA in Florida, one may have to update the prevalence rates and concentration response (CR) functions in BenMAP with Florida data. The main purpose of the research was to develop a method which can estimate impact of change in criteria pollutants on childhood asthma outcomes in Florida. The rates present in BenMAP are based on national estimates, which are higher than the rates for Florida. If these rates are used for the HIA method then the change in asthma emergency department visits estimated by BenMAP may be an overestimate with higher uncertainties. There are no baseline rates for asthma exacerbation ED visits in BenMAP, an asthma exacerbation is a more severe and poorly managed case of asthma. Asthma ED visit prevalence rates will tend to overestimate the asthma exacerbation rates by 64%, if used. Detailed review of US-EPA’s BenMAP software and peer reviewed literature was performed to identify the gaps in BenMAP for asthma assessments. The CR functions were developed using local pollutant and outcomes data. CR functions were added to BenMAP to bridge the gaps. The baseline prevalence and exacerbation rates at county level by age group, gender and race ethnicity were developed. This study highlights that an increase of 10 µg/m3 of PM2.5 contributes about 2% to asthma ED visit rate, in children 5-12 and is lower, for 13-18 olds (0.6%). The baseline prevalence and exacerbation rates at county level for asthma in children differed by race/ethnicity. This study publishes the ED rates by county and by gender, race and ethnicity from 2010 to 2014, which are recent rates and have not been published to such granularity by the State or by any other researcher. Current pollutant data in BenMAP is only available through 2008, and EPA has recommended it should be updated for analysis purposes. This study has updated the monitor data in BenMAP for Florida counties for 2010-2014. There are three major contributions of this study. Firstly, the study contributes to publishing childhood emergency department prevalence rates for asthma and exacerbation in the State of Florida by age group, race/ethnicity and gender. Secondly, development of concentration response functions specific to Florida using the time series analysis to show the impact of PM2.5 on asthma exacerbation emergency department visits, incorporating both temporal and spatial variability of PM2.5 during the study period. Finally, the study demonstrates the utility of using local (county-level) baseline asthma prevalence rates and local pollutant data for State HIA in Florida. The local PM2.5 data in BenMAP can be used for other health outcome assessments, researchers will only have to update the prevalence rates for the health outcome used in their study. Estimation using local data will be less prone to uncertainties using National level data, the use of local data has been emphasized by several researchers. The study recommends future work in refining spatial grid resolution in BenMAP to zip code level to facilitate studies at neighborhood level. Another recommendation is to further design research to study SES in context to dietary changes and better understand social injustices in areas with diverse population. A population-based study in conjunction with Florida Asthma Coalition (FAC) asthma cases from doctors’ offices is recommended which will be able to control for misclassifications, and include weather and allergens in analysis while studying individual pattern of exposure and diet.

Marine plastics are not just a problem, they are a silent, sinister epidemic. Marine plastics are the largest economic and ecological threat to our marine ecosystems, particularly marine plastics derived from lost and or discarded fishing gear, which affects sensitive marine communities, the chemical composition of the ocean water, and the physical makeup of the seafloor. With 6.4 million tons of marine debris entering our oceans annually, a third of which is lost fishing gear, it is estimated that, by weight, in 2050 there will be an accumulation of more plastic than fish in the ocean (Heath, 2018; Wilcox, 2015). Marine litter derived from plastic fishing gear, primarily passive gear, when lost in the ocean causes a series of consequences to the marine ecosystem, that of which increases when there are high concentrations of fishing activity in the geographic area. Arctic countries have some of the most abundant fisheries, that of which is projected to increase due to anthropogenic climate change. In the context of climate change affecting the Arctic ecosystem, in this thesis, we will review the consequences of plastics derived from fishing gear for the Arctic marine ecosystem, estimate the potential influx of derelict gear plastics originating from data obtained in Alaska and Iceland, and then confidently present effective forms of remediation, prevention, and mitigation strategized from models of sustainable fisheries to resolve the ramifications of lost and or discarded gear in Arctic communities.

The average age-adjusted incidence and mortality rates of lung and bronchus cancer is 55% and 56% higher in Kentucky than the national averages in the United States, respectively. Populations with low income and educational attainment, and those who live close to the mining regions across Kentucky are more affected by the high prevalence and resulting mortality rates of lung and bronchus cancer. This study was conducted because of the high incidence of lung and bronchus cancer and resulting mortality rates in the state of Kentucky that may not be caused solely by social and demographic factors. The theoretical foundation for this study was the social-ecological model (SEM). This quantitative cross-sectional study assessed whether the association between geographic factors and incidence, and mortality rate of lung and bronchus cancer is significant in Kentucky, controlling for social and demographic factors respectively. The sample size was n = 960. Bivariate analysis and ordinal regression were used to address the research questions. The outcome of the study revealed that populations that reside in rural zones are significantly (p < .05) more likely to be exposed to trace elements with less access to effective care, and higher mortality as compared to populations living in metropolitan and micropolitan zones. Healthy individuals promote healthy families, which in turn promote healthy communities. This could improve the local work force, investments, and development which could enhance self-esteem and social change in each county across Kentucky.

Background: Workers in outdoor occupations are expected to be at high risk of increased morbidity and mortality, and diminished productivity, as a result of global warming in the 21st century. A previous modelling study of geographic variations in heat-related mortality risk in projected U.S. populations mid-century showed the states of Tennessee, Kentucky and North Carolina to be highly vulnerable. Methods: Under both the RCP4.5 and RCP8.5 emissions scenarios of IPCC AR5, we evaluate the effect of future warming on estimated Wet Bulb Globe Thermometer (WBGT) temperatures using model-simulated future climate variables that were dynamically downscaled by a regional meteorology model for years 2049-2052. Select Appalachian counties in the three states that are presently dependent upon agricultural crop production are the focus of this analysis. Results: Using predicted WBGT temperatures, together with estimated work loads for hand harvesting of crops, alterations in work-rest routines under heat stress prevention guidelines are presented. Conclusions: Assumptions needed to translate these altered work-rest routines into measures of productivity and economic loss are discussed. Issues in extending the modelling to heat-related morbidity and mortality in outdoor worker populations are considered in terms of data gaps and major sources of uncertainty.

The U.S. military currently uses a flag system based on wet-bulb globe temperature (WBGT) and metabolic rate to recommend heat stress exposure limits. This paper addresses the ability of the flag system to recommend safe heat exposures in a non-military population. Two progressive heat stress studies provided data on 528 observations of safe or unsafe exposures of 4 hours over a range of WBGT conditions and metabolic rates using 29 participants wearing woven cotton clothing. For the two studies, range of WBGT conditions was 25 to 42C, and the range of metabolic rates was 100 to 650 watts. These exposures were compared with the flag system’s recommendations of safe exposure to determine the sensitivity and specificity of the flag system. A separate study provided 62 observations with participants undergoing a time-limited protocol at constant WBGT conditions. Observed durations of safe exposure time were compared to the flag system’s recommended safe limits to determine sensitivity and specificity. Based on the progressive protocol, sensitivity and specificity of the flag system for five ranges of WBGT and three categories of metabolic rate were 0.98 and 0.25, respectively. For the time-limited protocol, which applied only to the highest range of WBGT and light and moderate metabolic rate, both sensitivity and specificity were zero. This study suggests that the flag system has high sensitivity but low specificity for long duration exposures, along with low sensitivity and specificity for time-limited exposures. However, the WBGT exposures in the time-limited trials were substantially higher than the threshold for the highest WBGT range in the flag system, which may account for the system’s unexpected performance in the time-limited protocol.

No description available.

Autism Spectrum Disorders (ASD) are a complex array of neurological disorders with a diverse presentation, multiple etiologies, and long-term ramifications. Prevalence of ASD in the United States is about 1 in 50 children as of 2013, making it a significant public health problem. The etiology is not understood, and it is widely accepted that it is multicausal, with genetic and environmental influences. Prior research suggests an association between water source and ASD. Contaminants such as lead, arsenic, mercury, pharmaceuticals and pesticides found in water are associated with developmental disorders suggesting that a systematic review focused on water source was warranted. Following the integrative model of environmental health (IMEH), this study explored the relationship of water source and ASD prevalence among children in Lane County, Oregon. This cross-sectional study utilized retrospective data of 91 open cases in April 2014. The study used chi square and geographical information systems (GIS) aided by cluster analysis to generate risk maps. Investigation of sociodemographic variables allowed comparisons to national data by zip code. Findings indicated no significant relationships or clusters of ASD populations by zip code, and no significant relationships to comorbidities between private or municipal water supplies. The IMEH framework enabled an in-depth data characterization of ASD and underscored the need for additional environmental data and universally standardized comorbidity definitions. Implication for positive social change include recognizing the importance of using social services data in the search for ASD risk factors.

Space debris is a growing threat to operational satellites and satellite manufacturing organizations. Leaders in satellite manufacturing organizations lacking adequate knowledge on the space debris risks could be at a competitive disadvantage. The purpose of this explorative case study was to explore strategies leaders in satellite manufacturing organizations use to mitigate risks through the conceptual lens of stakeholder theory, contingency theory, and general system theory. The research questions addressed strategies to mitigate the debris threat from the perspectives of both ongoing concerns and long-term risk resolution. Data were collected via in-depth interviews with 12 leaders, purposively selected, in satellite manufacturing organizations, and supplemented with documentation from the literature and archival records from NASA. Member checking was used to validate the transcribed data subsequently coded into 6 themes that included: meeting requirements; using analytical techniques; using shielding to protect satellites; implementing material and process innovation; developing satellite services; and generating end of mission requirements. Recommendations include maintaining and developing analytical competencies, funding research and development, and establishing standardization. Using strategies that facilitate risk mitigation and the preservation of the space environment, business leaders could benefit by developing strategic road maps that ensure continued access to space. Implications for social change include contributing to social stability, technology advancement, increased knowledge base, economic growth, higher education, and improved standard of living.

Synthetic xenoestrogens have differential estrogenic properties. Research has shown that exposures to xenoestrogens could promote breast cancer by disrupting normal function of the human epidermal growth factor receptor 2 (Her2) gene. Although animal models demonstrated a connection between xenoestrogen exposure and Her2 activity, no study using human cells has systematically examined their carcinogenic potential influencing the Her2 gene expression. Furthermore, breast cancer cells are phenotypically disparate (ER+, Her2+), with some phenotypes (Her2+), leading to more aggressive disease. This study aimed to dosimetrically assess the carcinogenic potential of commonly used xenoestrogens influencing Her2 gene expression, and delineate cellular phenotypes at greater risk of more aggressive disease. The study assessed whether the composition, concentrations, and exposure duration of BPA, EE, NPH, and DDT significantly altered Her2 copy numbers in estrogen and Her2 receptor positive or negative breast cancer lines. Each line was randomly assigned to cases (exposed) and control (unexposed) groups using a randomized block design. Fluorescent in-situ hybridization measured Her2 gene copies. Mann Whitney, Kruskal Wallis, and Incidence Rate Ratios revealed Her2 copy gains in all 4 xenoestrogens and receptor types with persistent exposures. A 44% increase in Her2 was observed in the normal ER and Her2 line, marking a shift in its Her2 status, and a 30-times greater risk was noted in the Her2+ lines. These findings promote positive social change by revealing all 4 xenoestrogens as risk factors for breast cancer. This information can be used by breast cancer advocacy groups, health educators, and steering committees to educate women and formulating policies.

Cache County and the Wasatch Front, Utah have persistently experienced some of the nation’s worst air quality over the past decade. Elevated PM2.5 concentrations during wintertime “red air day” episodes frequently exceed the National Ambient Air Quality Standards (NAAQS). We investigate the possible effects of two different economic policies in controlling these regional problems. Adapting a model originally developed to calculate the social investment necessary to control nationwide disease outbreaks, we estimate an optimal preventative capital stock (for example, investment in public transportation) of between $4.1 million and $14.1 million to control red air day episodes in Cache County, and $133 million to $1.6 billion dollars to control such episodes in the Wasatch Front. Further, we find that a seasonal gasoline tax rate of roughly $8 per gallon is necessary for policy makers in the Wasatch Front to impose at the pump if their goal is to maintain concentrations below the NAAQS on average during a typical winter-inversion season. This rate is roughly $2 more than the rate calculated for Cache County in a previously published study.