Community Health and Preventive Medicine Commons^™

What’S In Wildfire Smoke?: A Toxicologist Explains The Health Risks And Which Masks Can Help, Luke Montrose

Public Health and Population Science Faculty Publications and Presentations

Smoke is turning the sky hazy across a large swath of the country as dozens of large fires burn, and a lot of people are wondering what’s in the air they’re breathing.

As an environmental toxicologist, I study the effects of wildfire smoke and how they differ from other sources of air pollution. We know that breathing wildfire smoke can be harmful. Less clear is what the worsening wildfire landscape will mean for public health in the future, but research is raising red flags.

Exploring The Structural Relationships Between Course Design Factors, Learner Commitment, Self-Directed Learning, And Intentions For Further Learning In A Self-Paced Mooc, Dongho Kim, Eulho Jung, Meehyun Yoon, Yunjeong Chang, Sanghoon Park, Dongsim Kim, Fatih Demir

Public Health and Population Science Faculty Publications and Presentations

The open and massive characteristics of Massive Open Online Course (MOOC) lead to a lack of instructor presence, which potentially hinders learners' commitment and learning processes. As a result, the effectiveness of MOOCs is contingent upon the extent to which learners direct their own learning. However, learners' self-directed learning and commitment are largely influenced by course design factors due to lack of direct learner-instructor interactions. In order to address the current gap in the literature with regard to how course design factors influence learning processes and outcomes, this study investigated the relationships between MOOC design factors, learner commitment, self-directed learning, …

Measurement Of Urinary Pesticide Biomarkers Among Latina Farmworkers In Southwestern Idaho, Cynthia L. Curl, Lisa Meierotto, Rebecca L. Som Castellano, Meredith R. Spivak, Kurunthachalam Kannan

Public Health and Population Science Faculty Publications and Presentations

Background Women who work in agriculture may have greater risk of pesticide exposure than men who share this occupation. Despite an increase in the fraction of the agricultural workforce comprised by women, few studies have characterized pesticide exposure in the USA with a focus on among these workers.

Objective This pilot study aimed to describe pesticide exposure in a cohort of Latina farmworkers in farming communities in southwestern Idaho.

Methods We collected urine samples from 29 Latina farmworkers, which were analyzed for 11 pesticide biomarkers. We evaluated the effect of pesticide spray season on urinary biomarker levels, and explored the …

Grower Perceptions Of Safety Hazards And Associated Injuries Among Farmworkers Involved In Northwest Potato Production, Cynthia Curl, Karin Adams, Rachel Phinney, Matthew Blua

Public Health and Population Science Faculty Publications and Presentations

Background: Potatoes are a vital part of the Pacific Northwest’s agricultural economy. As in many agricultural industries, workers involved in potato production may be at risk for illness and injuries.

Methods: A Hazard Perception Survey (HPS) was completed by 63 potato growers in Washington (n = 26) and Idaho (n = 37) during the fall and winter of 2017–2018. Participants were asked to indicate their level of concern regarding the frequency and severity of injuries associated with various potato production tasks. Descriptive statistical analyses were used to identify operations and tasks that potato growers perceived to be most …

Organophosphate Pesticide Dose Estimation From Spot And 24-Hr Urine Samples Collected From Children In An Agricultural Community, Carly Hyland, Katherine Kogut, Robert B. Gunier, Rosemary Castorina, Cynthia Curl, Brenda Eskenazi, Asa Bradman

Public Health and Population Science Faculty Publications and Presentations

Background: Spot urine samples are often used to assess exposure to organophosphate (OP) pesticides in place of “gold standard” 24-hr samples, which are cumbersome to collect. Assessment of non-persistent chemicals using spot urine samples may result in exposure misclassification that could bias epidemiological analyses towards the null. Few studies have examined the validity of measurements of urinary metabolites in spot samples to estimate daily OP dose or the potential implications of reliance on spot samples for risk assessments.

Objective: Examine the validity of using first morning void (FMV) and random non-FMV urine samples to estimate cumulative 24-hr OP pesticide dose …

Assessment Of Electrostatic Potential Resulting From Friction Between Fabric Samples Made Of Natural And Synthetic Fibers, Uwe Reischl, Budimir Mijovic

Public Health and Population Science Faculty Publications and Presentations

Synthetic fibers are known to be a major source of electrostatic potential occurring on clothing. The electrical properties of fibers are determined by their chemical composition and polymer structure. Environmental factors such as humidity, temperature, and friction intensity can influence these properties. Due to the insulative characteristics of most fabrics, fibers are able to keep their charge for relatively long periods. This can result in clothing to cling to each other, attract dust, and create discharge shocks. To reduce these issues, suggestions have been proposed to mix garment layers made of natural fibers with garment layers made of synthetic fibers. …

Understanding Challenges To Well-Being Among Latina Farmworkers In Rural Idaho Using In An Interdisciplinary, Mixed-Methods Approach, Cynthia L. Curl, Lisa Meierotto, Rebecca L. Som Castellano

Public Health and Population Science Faculty Publications and Presentations

The aim of this study was to identify social, cultural and workplace-related risk factors affecting well-being among Latina farmworkers in rural Idaho. We recruited 70 Latina farmworkers from southwestern Idaho in 2019. We employed an inter-disciplinary, mixed-methods approach—including surveys, focus groups, interviews, and pesticide biomonitoring—to characterize multiple domains that influence well-being, including food security and access, housing conditions, social supports, access to medical care, and workplace safety. Six major themes emerged as primary challenges to Latina farmworkers’ well-being. In the public sphere, study participants identified these challenges as long working hours, concerns regarding pesticide exposure, and lack of enforcement of …

Influence Of Woodsmoke Exposure On Molecular Mechanisms Underlying Alzheimer’S Disease: Existing Literature And Gaps In Our Understanding, Adam Schuller, Luke Montrose

Public Health and Population Science Faculty Publications and Presentations

Woodsmoke poses a significant health risk as a growing component of ambient air pollution in the United States. While there is a long history of association between woodsmoke exposure and diseases of the respiratory, circulatory, and cardiovascular systems, recent evidence has linked woodsmoke exposure to cognitive dysfunction, including Alzheimer’s disease dementia. Alzheimer’s disease is a progressive neurodegenerative disorder with largely idiopathic origins and no known cure. Here, we explore the growing body of literature which relates woodsmoke-generated and ambient air pollution particulate matter exposure to Alzheimer’s disease (AD) onset or exacerbation, in the context of an inflammation-centric view of AD. …

Smoke From Wildfires Can Worsen Covid-19 Risk, Putting Firefighters In Even More Danger, Luke Montrose

Public Health and Population Science Faculty Publications and Presentations

Two forces of nature are colliding in the western United States, and wildland firefighters are caught in the middle.

Emerging research suggests that the smoke firefighters breathe on the front lines of wildfires is putting them at greater risk from the new coronavirus, with potentially lethal effects.

At the same time, firefighting conditions make precautions such as social distancing and hand-washing difficult, increasing the chance that, once the virus enters a fire camp, it could quickly spread.

As an environmental toxicologist, I have spent the last decade expanding our understanding of how wood smoke exposure impacts human health. Much of …

Neonatal Lead (Pb) Exposure And Dna Methylation Profiles In Dried Bloodspots, Luke Montrose

Public Health and Population Science Faculty Publications and Presentations

Lead (Pb) exposure remains a major concern in the United States (US) and around the world, even following the removal of Pb from gasoline and other products. Environmental Pb exposures from aging infrastructure and housing stock are of particular concern to pregnant women, children, and other vulnerable populations. Exposures during sensitive periods of development are known to influence epigenetic modifications which are thought to be one mechanism of the Developmental Origins of Health and Disease (DOHaD) paradigm. To gain insights into early life Pb exposure-induced health risks, we leveraged neonatal dried bloodspots in a cohort of children from Michigan, US …

What’S In Wildfire Smoke, And Why Is It So Bad For Your Lungs?, Luke Montrose

Public Health and Population Science Faculty Publications and Presentations

If I dare to give the coronavirus credit for anything, I would say it has made people more conscious of the air they breathe.

A friend texted me recently after going for a jog in the foothills near Boise, Idaho, writing: “My lungs are burning … explain what’s happening!!!”

A wildfire was burning to the east of town – one of hundreds of fires that were sending smoke and ash through communities in hot, dry western states. As an environmental toxicologist, I research how air pollution, particularly wood smoke, impacts human health and disease.

Cancer Rates Not Explained By Smoking: A County-Level Analysis, Douglas J. Myers, Polly Hoppin, Molly Jacobs, Richard Clapp, David Kriebel

Public Health and Population Science Faculty Publications and Presentations

Background: Debates over the importance of “lifestyle” versus “environment” contributions to cancer have been going on for over 40 years. While it is clear that cigarette smoking is the most significant cancer risk factor, the contributions of occupational and environmental carcinogens in air, water and food remain controversial. In practice, most cancer prevention messaging focuses on reducing cigarette smoking and changing other personal behaviors with little mention of environmental chemicals, despite widespread exposure to many known carcinogens. To inform decision-making on cancer prevention priorities, we evaluated the potential impact of smoking cessation on cancer rates.

Methods: Using cancer …

Wildfire Smoke Worsens Coronavirus Risk, Putting Firefighters In Extra Danger, Luke Montrose

Public Health and Population Science Faculty Publications and Presentations

As summer approaches, two forces of nature are on a collision course, and wildland firefighters will be caught in the middle.

New research suggests that the smoke firefighters breathe on the front lines of wildfires is putting them at greater risk from the new coronavirus, with potentially lethal effects.

At the same time, firefighting conditions make precautions such as social distancing and hand-washing difficult, increasing the chance that, once the virus enters a fire camp, it could quickly spread.

As an environmental toxicologist, I have spent the last decade expanding our understanding of how wood smoke exposure impacts human health. …

Synthetic Pesticides And Health In Vulnerable Populations: Agricultural Workers, Cynthia L. Curl, Meredith Spivak, Rachel Phinney, Luke Montrose

Public Health and Population Science Faculty Publications and Presentations

Purpose of Review: This review aims to summarize epidemiological literature published between May 15, 2018 and May 14, 2019 that examines the relationship between exposure to synthetic pesticides and health of agricultural workers.

Recent Findings: Current research suggests that exposure to synthetic pesticides may be associated with adverse health outcomes. Agricultural workers represent a potentially vulnerable population, due to a combination of unique social and cultural risk factors as well as exposure to hazards inherent in farm work. Pesticide exposure among agricultural workers has been linked to certain cancers, DNA damage, oxidative stress, neurological disorders, as well as respiratory, metabolic, …

Support For Rural Practice: Female Physicians And The Life–Career Interface, Kimberly Stutzman, Ruth Ray Karpen, Pragna Naidoo, Sarah E. Toevs, Amanda Weidner, Ed Baker, David Schmitz

Public Health and Population Science Faculty Publications and Presentations

Introduction: The need for family physicians in rural areas across the USA and Canada is a longstanding issue that has been well documented. Since family physicians constitute the largest population of rural practitioners, the problem has been exacerbated by a sharp decline in medical students’ interest in the field of family medicine and the aging of the current rural workforce. Previous research has shown that female physicians in rural areas need strong support networks to maintain a healthy work–life balance. The purpose of this study was to better understand the types of support they need and how they find it, …

Covid-19 Personal Protective Equipment Sterilization System, Uwe Reischl

Public Health and Population Science Faculty Publications and Presentations

A portable system based on a non-destructive sterilization method was developed that consists of a chamber producing ozone concentration levels reported in the scientific literature to deactivate 99.9% of all microorganisms. The system includes a small cordless 30mg/h ozone generator placed inside a 20L enclosed chamber. Personal protective equipment is loaded into the chamber and automatically exposed to an ozone concentration up to 18 ppm for 30 minutes. PPE is then removed and ventilated in open air to allow residual ozone to degrade to oxygen. The paper describes the design and performance characteristics of this technology.

Implementing The Icelandic Model For Preventing Adolescent Substance Use, Alfgeir L. Kristjansson, Michael J. Mann, Jon Sigfusson, Ingibjorg E. Thorisdottir, John P. Allegrante, Inga Dora Sigfusdottir

Public Health and Population Science Faculty Publications and Presentations

This is the second in a two-part series of articles about the Icelandic Model for Primary Prevention of Substance Use (IPM) in this volume of Health Promotion Practice. IPM is a community collaborative approach that has demonstrated remarkable effectiveness in reducing substance use initiation among youth in Iceland over the past 20 years. While the first article focused attention on the background context, theoretical orientation, evaluation and evidence of effectiveness, and the five guiding principles of the model, this second article describes the 10 core steps to practical implementation. Steps 1 to 3 focus on building and maintaining community …

Development And Guiding Principles Of The Icelandic Model For Preventing Adolescent Substance Use, Alfgeir L. Kristansson, Michael J. Mann, Jon Sigfusson, Ingibjorg E. Thorisdottir, John P. Allegrante, Inga Dora Sigfusdottir

Public Health and Population Science Faculty Publications and Presentations

Adolescent substance use—the consumption of alcohol, tobacco, and other harmful drugs—remains a persistent global problem and has presented ongoing challenges for public health authorities and society. In response to the high rates of adolescent substance use during the 1990s, Iceland has pioneered in the development of the Icelandic Model for Primary Prevention of Substance Use—a theory-based approach that has demonstrated effectiveness in reducing substance use in Iceland over the past 20 years. In an effort to document our approach and inform potentially replicable practice-based processes for implementation in other country settings, we outline in a two-part series of articles the …

Addressing Challenges To The Reliable, Large-Scale Implementation Of Effective School Health Education, Michael J. Mann, David K. Lohrmann

Public Health and Population Science Faculty Publications and Presentations

The long-held priority of teaching young people the knowledge and skills needed for healthy living has recently been diminished in many preK-12 schools. Driven by federal and state priorities, laws, and policies associated with high-stakes testing, instruction in untested subjects has been reduced or eliminated in most schools in order to devote more attention to tested subjects, like reading, math, writing, and science. This article proposes a pathway to ensure that all children are able to learn what society knows about health. To that end, four challenges to the reliable, large-scale implementation of effective school health education are identified: (1) …

Effect Of A 24-Week Randomized Trial Of An Organic Produce Intervention On Pyrethroid And Organophosphate Pesticide Exposure Among Pregnant Women, Cynthia L. Curl, Jessica Porter, Ian Penwell, Rachel Phinney, Marai Ospina, Antonia M. Calafat

Public Health and Population Science Faculty Publications and Presentations

Background: Introduction of an organic diet can significantly reduce exposure to some classes of pesticides in children and adults, but no long-term trials have been conducted. Objectives: To assess the effect of a long-term (24-week) organic produce intervention on pesticide exposure among pregnant women.

Methods: We recruited 20 women from the Idaho Women, Infants, and Children (WIC) program during their first trimester of pregnancy. Eligible women were nonsmokers aged 18–35 years who reported eating exclusively conventionally grown food. We randomly assigned participants to receive weekly deliveries of either organic or conventional fruits and vegetables throughout their second or third trimesters …

Organic Food Health Benefits Have Been Hard To Assess, But That Could Change, Cynthia Curl

Public Health and Population Science Faculty Publications and Presentations

“Organic” is more than just a passing fad. Organic food sales totaled a record US$45.2 billion in 2017, making it one of the fastest-growing segments of American agriculture. While a small number of studies have shown associations between organic food consumption and decreased incidence of disease, no studies to date have been designed to answer the question of whether organic food consumption causes an improvement in health.

I’m an environmental health scientist who has spent over 20 years studying pesticide exposures in human populations. Last month, my research group published a small study that I believe suggests a path forward …

Outcomes Of Participation In A Community-Based Physical Activity Program, Michelle Arnett, Sarah E. Toevs, Laura Bond, Elisabeth Hannah

Public Health and Population Science Faculty Publications and Presentations

Fit and Fall Proof^TM (FFP) program, established in 2004, is a peer volunteer-led collaboration between state and local public health organizations. The goal is to bring sustainable physical activity programs to underserved populations, including those in rural and frontier communities. FFP program is designed to help older adults maintain independence by improving mobility and function and providing opportunities for social engagement. The aim of this study was to evaluate the impact of participation in the program. A 6-month longitudinal study evaluated physical, social, and emotional outcomes among participants. The FES-I, SF-36v2, and Timed Up and Go (TUG) were collected. …

Environmental Health Sciences In A Translational Research Framework: More Than Benches And Bedsides, Joel D. Kaufman, Cynthia L. Curl

Public Health and Population Science Faculty Publications and Presentations

Background: Environmental health scientists may find it challenging to fit the structure of the questions addressed in their discipline into the prevailing paradigm for translational research.

Objective: We aim to frame the translational science paradigm to address the stages of scientific discovery, knowledge acquisition, policy development, and evaluation in a manner relevant to the environmental health sciences. Our intention is to characterize differences between environmental health sciences and clinical medicine, and to orient this effort towards public health goals.

Discussion: Translational research is usually understood to have evolved from the bench-to-bedside framework by which basic science transitions to clinical treatment. …

Evaluation Of Food Insecurity In Adults And Children With Cystic Fibrosis: Community Case Study, Sarah E. Toevs, Tiffany A. Robb

Public Health and Population Science Faculty Publications and Presentations

Advances in the care and treatment of cystic fibrosis (CF) have led to improved mortality rates; therefore, considerably more individuals with CF are living into adulthood. With an increased number of CF patients advancing into adulthood, there is the need for more research that surrounds the aging adult CF patient. It is important to conduct research and collect results on the aging CF population to help better prepare the CF patient, who is dealing with the heavy treatment and financial burden of their disease, build autonomy and increase their quality of life. Of note, research has found that social, behavioral, …

Lived Experiences And Insights Into The Advantages Important To Rural Recruitment And Retention Of General Practitioners, Daniel R. Terry, Hoang B. Nguyen, David Schmitz, Ed Baker

Public Health and Population Science Faculty Publications and Presentations

Introduction: Despite existing studies in this field, community factors behind recruiting and retaining rural general practitioners (GPs) are not fully understood. To address this issue, the Community Apgar Questionnaire (CAQ) was developed to extend the understanding of communities’ assets and capabilities that impact GP recruitment and retention. However, more in-depth insights are vital to develop a comprehensive approach.

Methods: This mixed methods study was administered using face-to-face structured interviews with a total of 40 health service representatives. All interviews lasted 35–40 minutes and were audio-taped. Qualitative data were generated from the extended responses to the structured questions of the CAQ …

Social Networks, Social Relationships, And Their Effects On The Aging Mind And Brain, Sato Ashida, Ellen J. Schafer

Public Health and Population Science Faculty Publications and Presentations

Key Points

• Increasing evidence shows the behavioral, perceptual, and biological pathways by which social relationships and social networks positively impact health outcomes, including those for the aging mind and brain.

•The facilitation of healthy aging, in turn, has been shown to increase social participation among older adults through community-based interventions and contributes to societal well-being.

Cost Benefit Analysis Of Idaho’S Fit And Fall Proof Program, Susie Bergeron, Michelle Arnett, Sarah Toevs, Tami Cirerol, Rihana Hartung, Linda Petersen, Trina Stolp, Zijada Sulejmanovic, Maria Tellez, Hailee Tilton, Nicole Tuffield, Kenzie Wilson

Public Health and Population Science Faculty Publications and Presentations

Falls are common among the elderly population. Almost 30% of Idahoans aged 65+ fall at least one time per year (Bergen, Stevens, & Burns, 2016). Falls are a significant source of morbidity, mortality, and healthcare expense. Fall-related injuries often result in expensive hospitalizations with progression into costly long-term care facilities (CDC, 2015). In Idaho, estimated fall-related medical costs are estimated at $253 million annually (CDC, 2016; Mirel & Carper, 2014).

Fit and Fall Proof^TM (FFP), is a fall prevention program serving approximately 2500 community dwelling seniors throughout the state of Idaho. It is an exercise program led by peer …

Pressure Thresholds And Stiffness On The Plantar Surface Of The Human Foot, Thilina W. Weerasinghe, Ravindra S. Goonetilleke, Uwe Reischl

Public Health and Population Science Faculty Publications and Presentations

The objective was to develop a methodology to assess Pressure Discomfort Thresholds (PDT), Pressure Pain Thresholds (PPT), and tissue stiffness on the plantar surface of the foot. Ten male and ten female participants volunteered for the study. Foot landmarks were used to create a standardized grid-type template of 95 points. For each test point, PPT and PDT values were obtained, and stiffness was calculated for each of the twenty participants. Cluster analyses were performed to determine the regions of similarity for the three dependent variables, PPT, PDT and stiffness. Moran’s-I-index was used to determine the spatial auto correlations. The use …

Identifying Factors Associated With Participation In T1d Support Program For Young Adults, Taylor L. Neher, Samuel D. Towne Jr., Sarah E. Toevs

Public Health and Population Science Faculty Publications and Presentations

Objective: Type 1 diabetes (T1D) has been shown to have a significant and stressful impact on an individual’s transition into young adulthood. Young adults are often experiencing new levels of independence and decision-making at this time. Insufficient research has been conducted on the use and impact of T1D support programs tailored to young adults in relation to the emotional impacts of the disease, access to programming, and desired outcomes of programs. his study assesses awareness, utilization, and emotional needs of T1D support programs tailored to young adults.

Research Design and Methods: A cross-sectional analysis was performed on surveys collected through …

Community Assets And Capabilities To Recruit And Retain Gps: The Community Apgar Questionnaire In Rural Victoria, Daniel R. Terry, Ed Baker, David Schmitz

Public Health and Population Science Faculty Publications and Presentations

Introduction: Rural communities continue to experience significant challenges recruiting and retaining physicians. The Community Apgar Questionnaire (CAQ) was developed in Idaho in the USA to comprehensively assess the characteristics associated with successful recruitment and retention of rural physicians. The CAQ has been utilised and validated across the USA; however, its value in rural Australia has not been examined. The objective of this study was to use the CAQ in rural Australia to examine its utility and develop a greater understanding of the community factors that impact general practitioner (GP) recruitment and retention.

Method: The project conducted structured face-to-face interviews with …