During the latter part of the 20th century, a transition away from coal as a major energy source in developed countries was accompanied by a notable decrease in air pollution-related deaths in those countries. Currently the same phenomenon is being observed in developing nations like China and India. However, many areas that do still rely on coal for their energy production or industrial needs also reflect a gap in research on the effects of those specific processes on local populations. Located in Nepal at the foot of the Himalayan Plateau, Kathmandu represents one such location. The local economy of Kathmandu and the surrounding area relies heavily on the production of bricks using coal-fired kilns, which produce large amounts of particulate matter. This particulate matter contains a characteristic mix of metals. This unique fingerprint can be used to identify and track kiln emissions in ambient samples. We collected hourly samples of ambient metal concentrations over a period of three months at the start of 2019. We then used these data to perform positive matrix factorization (PMF) to identify several factors contributing to the ambient air pollution of the sampled area, each representing a source type. The PMF output included the chemical ‘fingerprint’ of each factor as well as hourly variation of each factor. We were able to isolate the fraction of PM2.5 contributed by coal and estimate the health effects attributable to this fraction using a modified risk ratio of 1.05 to reflect the higher toxicity of coal emissions. We found that the current estimates of health impacts in Nepal underestimate the true impact of coal by 416 deaths per year.

Child mortality in sub-Saharan Africa is reducing but the levels remain high with subnational within-country variations. Birth weight is a key predictor of child survival and monitoring birth weight outcomes, in particular, prevalence of low birth weights, is important for resource allocation to improve child survival outcomes. Past research in sub-Saharan Africa has found that different individual-level factors are associated with birth weight including BMI of mother, sex of baby, educational level of mother, and wealth index of household. Some environmental factors are found to be associated with birth outcomes. However, past findings regarding the association of birth weight with household air pollution (HAP) resulting from cooking fuels are non-conclusive. In this study, we analyze variability in birth weights subnationally for Ghana and assess its association with household air pollution resulting from cooking fuels, accounting for variation due to other factors including maternal and household predictors, as well as geographical location. The analysis was based on birth weights for 1310 births, obtained from data collected in 2014 in the Demographic and Health Survey (DHS). We use Bayesian spatial regression models to estimate associations and capture spatial variation. Spatial variation was captured with a conditional autoregressive (CAR) model. Based on various models, we do not find evidence to suggest that cooking fuel is associated with birth weight. After accounting for covariates, the average birth weights per district ranged from 2823g (95% CI: 2613g, 3171g) in Ketu district to 3243g (95% CI: 3083g, 3358g) in Ashanti Akim North district. Across Ghana, difference in birth weight attributable to district spatial effects range from -33g in Lawra district in Upper West region of Ghana to 11g in Ho in the Volta region.

“We carry our histories in our bodies, how could we not?” – Nancy Krieger In the United States and abroad, socioeconomic status (income, education, and occupation) greatly impacts health outcomes for a given population. There is a strong and consistent socioeconomic gradient within health outcomes which has been documented as far back as in Ancient Egypt and China (Krieger, Willains, & Moss, 1997; Liberatos, Link, & Kelsey, 1988) The general trend shows that individuals with higher socioeconomic status generally enjoy lower rates of morbidity (disease) and disability, which can ultimately lead to higher mortality rates (House et al. (1992) and House et al. (1994); Williams & Collins, 1995). Most of the literature focuses on the impact of race or gender on socioeconomic status and therefore health status, but rarely is the intersectionality of both race and gender—a factor in the lives of all Afro-American women—the focus of this inquiry. This research views socioeconomic factors in light of historical and sociological conditions which shape present urban environments in which Black women lives and grow. The goal of this thesis is to analyze the ways in which socioeconomic (particularly educational attainment) inequities lead to decreased health status of Afro-American women living in urban slums who fail to graduate high school. This research investigates the long-term effects of a) residential and educational segregation (b) racism and sexism within the educational system (c) racism and sexism within the healthcare system and (d) implications for morbidity and mortality rates amongst Afro-American women with respect to differences in educational attainment and high school dropout status. More research on this topic is necessary to better understand the direct correlation between educational attainment and health status among minority groups in the United States.

Despite advances in mosquito management, mosquito-borne disease in the United States is still of relevant public health concern and vector control is a top priority in preventing transmission of pathogens. Insecticide barrier sprays have become a common tool for suppression of mosquitoes in single-homeowner backyards. The application of the synthetic pyrethroid, lambda-cyhalothrin to perimeter vegetation with a backpack sprayer has been shown to significantly suppress mosquito levels for around 6 weeks. In an attempt to lengthen the effective duration of treatment, the IGR, pyriproxyfen, was added to a backpack mist blower with lambda-cyhalothrin, as adult mosquitoes exposed to pyriproxyfen have been shown to disseminate it to oviposition sites and to experience lowered fecundity. This treatment was compared to lambda-cyhalothrin alone and to a water control. Mosquito populations were sampled using CO2-baited CDC light traps, CDC gravid traps, human landing rates, and ovitraps. Leaf bioassays were performed. The following summer, the same treatments were applied with a truck-mounted mist blower to tree lines in Central Kentucky, to test the efficacy of an application method that could be used on large properties. Finally, bioassays were performed with water sampled from pyriproxyfen-treated containers, exposed to field conditions to test for residual efficacy.

The rising global temperatures are a consequence of the increasing concentrations of the greenhouse gases (GHG) in our atmosphere. This unprecedented yet steady increase in GHG concentrations has led to an increase in the incidence of adverse high-temperature weather phenomena. The aim of this study was to perform a detailed and systematic literature review to study the global dynamic between elevated ambient Page 28 2016 Appalachian Student Research Forum temperatures and heat-related mortality. The review also aimed at exploring the effect of pollutants as possible confounders, to identify vulnerable populations and to study population adaptations to heat that might mitigate heat-related mortality in urban settings. The review was performed exclusively on PubMed. Only epidemiological studies were selected. A time constraint ranging from 2009 to 2015 was applied to the review findings. Only peer-reviewed journals published in the English language were included. The following key terms were used for heat-related mortality associations - heat, high temperature and mortality. Additional keywords were used for the confounders, vulnerable populations and adaptations sections, such as “ozone”, “vulnerable subgroups” or “adaptations”. Studies reporting data on cold effects were excluded from the review. The search resulted in a total of 83 studies, which were included in the review based on the selection criteria. These studies were categorized and presented in four sections - heatmortality associations, effects of pollutants as confounders, vulnerable populations and adaptations. It was found that elevated ambient temperature was associated with high mortality. Additionally, risks of mortality were found to be higher for certain populations, particularly the elderly (65 years or older), infants and the socioeconomically disadvantaged groups. In conclusion, the heat-associated risks of mortality have increased with the escalating climate-change scenario. However, it is important to note that these risks are dependent on factors such as geographical location, socioeconomic status, age, and occupational status. Adaptations to heat are possible in the form of increased use of air-conditioning and promotion of “green” living spaces.

Background In some cross-sectional epidemiologic studies the shape of the association between serum concentrations of perfluoroalkyl acids (PFAAs) and lipids suggests departures from linearity. Objectives We used statistical approaches allowing for non-linearity to determine associations of prenatal exposures of perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) with lipid concentrations. Methods PFAAs were measured in serum from pregnant women collected in 1991–1992 at enrollment in the Avon Longitudinal Study of Parents and Children and lipids in serum from their daughters at ages 7 (n = 111) and 15 (n = 88). The associations of PFAAs with lipids were first explored by cubic splines, followed by piecewise linear regressions by tertiles to obtain regression coefficients (β) and their 95% confidence limits (95% CL) (in mg/dL per 1 ng/mL). Results At age 7, total cholesterol was positively associated with prenatal PFOA concentrations in the lower tertile (β = 15.01; 95% CL = 2.34, 27.69) but not with PFOA concentrations in the middle (β = − 3.63; 95% CL = − 17.43, 10.16) and upper (β = − 1.58; 95% CL = − 4.58, 1.42) tertiles. At age 15, a similar pattern was noted as well. Positive associations between LDL-C and prenatal PFOA concentration in the lower tertile were observed in daughters at ages 7 (β = 14.91; 95% CL = 3.53, 28.12) and 15 (β = 13.93; 95% CL = 0.60, 27.26). LDL-C was not associated with PFOA concentrations in the middle or upper tertile at any age. Neither HDL-C nor triglycerides was associated with prenatal PFOA exposure. Non-linear patterns of association of total cholesterol and LDL-C with prenatal PFOS were less consistently noted. Conclusion Exposure to low levels of PFOA during prenatal development may alter lipid metabolism later in life. Given the small sample size further replication of the association in large independent cohorts is important.

Global climate change is anticipated to raise the overall temperatures and is likely to increase future mortality attributable to heat. China, a rapid developing nation with the world's largest population, has experienced noticeable changes in climate over the past century, with an annual increase in air temperature by 0.5-0.8°C. While increasing evidence is suggesting that climate change has posed significant health risks to Chinese population, including heat-related mortality, the extent to which climate change will affect future mortality and the sources of uncertainty in projecting prospective changes in mortality remain unexplored. Using GIS (Geographic Information System) and epidemiological approaches, this study estimates excess future premature deaths in large urban areas in China resulting from potential increases in temperature under climate change. Our projection includes 51 large Chinese cities in this study, which cover approximately one third of the total population in China. We use ArcGIS to combine temperature predictions from climate models, local temperature-mortality relationship and population forecasting and project the future excess mortality attributed to higher temperature during warm season. The study focuses on future temperature change during 2040-2050 relative to the baseline period 1950-2000 in the 51 cities selected. For future temperature projection, we ensemble outputs from 19 climate models used in the IPCC 5th Report, including outputs related to all four AR5 emission scenarios (RCPs 2.6, 4.5, 6.0 and 8.5). The results of this study inform decision makers of the direct health benefits of climate mitigation.

Global climate change is anticipated to raise the overall temperatures and is likely to increase future mortality attributable to heat. China, a rapid developing nation with the world’s largest population, has experienced noticeable changes in climate over the past century, with an annual increase in air temperature by 0.5–0.8°C. While increasing evidence is suggesting that climate change has posed significant health risks to Chinese population, including heat-related mortality, the extent to which climate change will affect future mortality and the sources of uncertainty in projecting prospective changes in mortality remain unexplored. This working-in-progress study aims at estimating excess future premature deaths in large urban areas in China resulting from potential increases in temperature under climate change and investigating sources of uncertainty. We include 51 large Chinese cities in this study, which approximately one third of the total population in China. We use an integrated approach, which combines temperature predictions from climate models, local temperature-mortality relationship and population forecasting, to project the future excess mortality attributed to higher temperature during warm season. The poster presents the results of predicting temperature change during 2040-2050 relative to the baseline period 1950-2000 in the 51 cities selected. We ensemble outputs from 19 climate models used in the IPCC 5th Report, including outputs related to all four AR5 emission scenarios (RCPs 2.6, 4.5, 6.0 and 8.5).

Background: Fatty acids (FA) have a role on energy storage and membrane formation. FA consists of an aliphatic chain with varying number of carbon and a carboxylic functional group. Perfluorooctanoic acid (PFOA) exhibits a similar structure to that of the FA. Given their structural resemblance, we hypothesized that alterations in FA metabolism could arise from competition with PFOA for endogenous FA binding sites in transport and with FA binding proteins. Objectives: Explore associations of serum concentrations of perfluorooctanoic acid (PFOA) with serum concentrations of linoleic (LA), eicosapentanoic (EPA), and docosapentanoic (DHA) acid in adults. Methods: We analyzed data from 1,829, 20-80 years old participants in the 2003–2004 National Health and Nutrition Examination Survey (NHANES). Linear regression models were used to estimate adjusted predicted means of the FA (in µmol/L) for quartiles of PFOA (in ng/mL) and explore linear trends. Results: Increasing concentrations of PFOA were not associated with adjusted predicted means of serum LA (Q1 3534, Q2 3445, Q3 3778, Q4 3399) (p trends=0.6460). Increasing concentrations of PFOA, however, were associated with increasing trends in adjusted predicted means of serum EPA (Q1 49.8, Q2 51.5, Q3 60.9, Q4 55.7).

Studies of the adverse impacts of high temperature on human health have been primarily focusing on urban areas, due in part to the facts that urban centers generally have higher population density and are often significantly warmer than its surrounding rural areas (Heat Island Effect), and thus urban areas are considered to be more vulnerable to summer heat. However, heat vulnerability can also be affected by other population characteristics such as age, education, income and social isolation, which are likely to mark greater vulnerability among rural population. Here we explore the vulnerability to heat-related mortality in rural areas through a systematic review and meta-analysis of existing evidence. We searched studies that examined the association between high ambient temperature and morality in rural areas published in English between 2000 and 2016. Heat-mortality effect estimates from selected studies are grouped into two: (1) Rural effect estimates (RRrural) and their corresponding urban effect estimates (RRurban), from studies that reported risk estimates for both urban and their surrounding rural areas (7 studies included); (2) Rural effect estimates only (12 studies included). For Group 1, we performed a meta-analysis of the ratio of the rural estimate to the urban estimate in order to compare the magnitude of effects in rural versus urban areas. For Group 2, we performed a meta-analysis of the effect estimates in rural areas only. The pooled ratio estimate (RRrural/RRurban) for Group 1 is 1.051 (95% CI: 0.954, 1.160), which indicates the rural relative risk is about 5% larger than the urban relative risk. The pooled estimate for Group 2 is 1.191 (95% CI: 1.13, 1.251). Our preliminary results suggest that vulnerability to heat in rural areas may be similar to or even higher than urban areas, indicating that more studies are needed to understand rural vulnerability to heat-related hazards.