Public Health Commons^™

The Benefits And Challenges Of Virtual Education For Interprofessional Teams In A Post-Covid Environment, Tiffany Champagne-Langabeer

Faculty, Staff and Student Publications

There have been a series of disruptions in the healthcare environment since 2019, starting with the global pandemic [...].

Exploration Of Occupational Safety And Health In Pakistan's Ship Breaking And Recycling Industry, Shehzad Akbar

World Maritime University Dissertations

No abstract provided.

Antibody Prevalence And Risk Factors Associated With Rickettsia Spp. In A Pediatric Cohort: Sfgr Remains Underdiagnosed And Underreported In El Salvador, Kyndall C. Dye-Braumuller, Marvin Stanley Rodríguez Aquino, Kia Zellars, Hanna Waltz, Madeleine Meyer, Lídua Gual-Gonzalez, Stella C.W. Self, Mufaro Kanyangarara, Melissa Nolan Ph.D., Mph

Faculty Publications

Spotted fever group rickettsioses (SFGR) are caused by a group of tick-borne pathogens that are increasing in incidence globally. These diseases are typically underreported and undiagnosed in low- and middle-income countries, and thus, have been classified as neglected bacterial pathogens. Countries with high poverty, low human development index score, and limited health infrastructure—like El Salvador in Central America—lack necessary surveillance for SFGR and other tick-borne pathogens. This paucity of baseline SFGR infection prevalence leaves vulnerable populations at risk of misdiagnosis. Further, tick-borne disease burdens in El Salvador are severely limited. To lay the foundation for tick-borne disease epidemiology in El …

Comparative Analysis Of All-Terrain Vehicles, Motorcycle And Automobile-Related Trauma In A Rural Border Community Of The Usa, Haissam S. Elzaim, Kristina Vatcheva, Annelyn Torres-Reveron, Gregery Pequeno, Monica Michelle Betancourt-Garcia

School of Mathematical & Statistical Sciences Faculty Publications

Introduction: There is widespread use of all-terrain vehicles (ATVs) in the USA for both work-related and recreational activities. In this study, we aimed to determine the difference in injury severity, Glasgow Coma scales and length of stay between ATV-related injuries and injuries sustained from motorcycles (MOTOs) and automobiles (AUTOs).

Methods: We retrospectively analysed ATV, MOTO and AUTO injuries from a Level 2 Trauma Center between 01 January 2015 and 31 August 2020. Proportional odds regression analyses, as well as multivariable regression models, were used to analyse the data.

Results: There were significantly more male and paediatric patients that suffered ATV-related …

Process Evaluation Methods And Results From The Health In Pregnancy And Postpartum (Hipp) Randomized Controlled Trial, Sarah Wilcox Phd, Alicia A. Dahl, Alycia K. Boutté, Jihong Liu Sc.D., Kelsey Day, Gabrielle Turner-Mcgrievy Ph.D., Rd, Ellen Wingard

Faculty Publications

Background

Excessive gestational weight gain has increased over time and is resistant to intervention, especially in women living with overweight or obesity. This study described the process evaluation methods and findings from a behavioral lifestyle intervention for African American and white women living with overweight and obesity that spanned pregnancy (≤ 16 weeks gestation) through 6 months postpartum.

Methods

The Health in Pregnancy and Postpartum (HIPP) study tested a theory-based behavioral intervention (vs. standard care) to help women (N = 219; 44% African American, 29.1 ± 4.8 years) living with overweight or obesity meet weight gain guidelines in pregnancy and …

The Impact Of Covid-19 On Opioid-Related Overdose Deaths In Texas, Karima Lalani, Christine Bakos-Block, Marylou Cardenas-Turanzas, Sarah Cohen, Bhanumathi Gopal, Tiffany Champagne-Langabeer

Faculty, Staff and Student Publications

Prior to the COVID-19 pandemic, the United States was facing an epidemic of opioid overdose deaths, clouding accurate inferences about the impact of the pandemic at the population level. We sought to determine the existence of increases in the trends of opioid-related overdose (ORO) deaths in the Greater Houston metropolitan area from January 2015 through December 2021, and to describe the social vulnerability present in the geographic location of these deaths. We merged records from the county medical examiner's office with social vulnerability indexes (SVIs) for the region and present geospatial locations of the aggregated ORO deaths. Time series analyses …

An Algorithm For Indoor Sars-Cov-2 Transmission, Daniel Maxin, Spencer Gannon

Journal of Mind and Medical Sciences

We propose a computer modeling approach for SARS-CoV-2 transmission that can be preferable to a purely mathematical framework. It is illustrated its functionality in a specific case of indoor transmission. Based on literature, we assume that infection is due to aerosols with viral particles that persist and accumulate for hours in the air even after the persons who produced them left the space. We incorporate also restricted opening hours as a mitigation measure and one possible behavioral change in response to this measure. It is shown via several examples how this algorithmic modeling approach can be used to run various …

Higher Adherence To A Mediterranean Diet Is Associated With Improved Insulin Sensitivity And Selected Markers Of Inflammation In Individuals Who Are Overweight And Obese Without Diabetes, Surbhi Sood, Jack Feehan, Catherine Itsiopoulos, Kirsty Wilson, Magdalena Plebanski, David Scott, James Hébert Scd, Nitin Shivappa Mbbs, Mph, Ph.D., Aya Mousa, Elena S. George, Barbora De Courten

Faculty Publications

Insulin resistance (IR) and chronic low-grade inflammation are risk factors for chronic diseases including type 2 diabetes (T2D) and cardiovascular disease. This study aimed to investigate two dietary indices: Mediterranean Diet Score (MDS) and Dietary Inflammatory Index (DII®), and their associations with direct measures of glucose metabolism and adiposity, and biochemical measures including lipids, cytokines and adipokines in overweight/obese adults. This cross-sectional study included 65 participants (males = 63%; age 31.3 ± 8.5 years). Dietary intake via 3-day food diaries was used to measure adherence to MDS (0–45 points); higher scores indicating adherence. Energy-adjusted DII (E-DII) scores were calculated with …

The Impact Of Meal Dietary Inflammatory Index On Exercise-Induced Changes In Airway Inflammation In Adults With Asthma, Katrina P. Mcdiarmid, Lisa G. Wood, John W. Upham, Lesley K. Macdonald-Wicks, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert Scd, Hayley A. Scott

Faculty Publications

Research suggests exercise may reduce eosinophilic airway inflammation in adults with asthma. The Dietary Inflammatory Index (DII®) quantifies the inflammatory potential of the diet and has been associated with asthma outcomes. This study aimed to determine whether the DII of a meal consumed either before or after exercise influences exercise-induced changes in airway inflammation. A total of 56 adults with asthma were randomised to (1) 30–45 min moderate–vigorous exercise, or (2) a control group. Participants consumed self-selected meals, two hours pre- and two hours post-intervention. Energy-adjusted DII (E-DIITM) was determined for each meal, with meals then characterised as “anti-inflammatory” or …

Metabolome-Wide Associations Of Gestational Weight Gain In Pregnant Women With Overweight And Obesity, Jin Dai, Nansi S. Boghossian, Mark Sarzynski Ph.D., Faha, Facsm, Feng Luo, Xiaoqian Sun, Jian Li, Oliver Fiehn, Jihong Liu Sc.D., Liwei Chen

Faculty Publications

Excessive gestational weight gain (GWG) is associated with adverse pregnancy outcomes. This metabolome-wide association study aimed to identify metabolomic markers for GWG. This longitudinal study included 39 Black and White pregnant women with a prepregnancy body mass index (BMI) of ≥ 25 kg/m². Untargeted metabolomic profiling was performed using fasting plasma samples collected at baseline (mean: 12.1 weeks) and 32 weeks of gestation. The associations of metabolites at each time point and changes between the two time points with GWG were examined by linear and least absolute shrinkage and selection operator (LASSO) regression analyses. Pearson correlations between the …

Linking Historical Redlining Maps To Present‐Day Environmental Hazards In St. Louis, Margaret Keller, Kenneth L. Brown

Annual Student Research Poster Session

Many of America’s cities were mapped by the Home Owners Loan Corporation (HOLC). This practice led to structurally racist housing policies and practices, namely redlining. The practice of redlining directed both public and private capital to native‐born, white families and away from Black, Latinx, and immigrant families that lived in these areas. While redlining is illegal today due to the Fair Housing Act of 1968, its impact is still evident in the structure of many U.S. cities including St. Louis (Hillier 2015). Today, redlined areas are particularly susceptible to environmental injustices because laws, regulations, governmental programs, and policies inadequately protect …

Utilization Of 18s Ribosomal Rna Lamp For Detecting Plasmodium Falciparum In Microscopy And Rapid Diagnostic Test Negative Patients, Enoch Aninagyei, Adjoa Agyemang Boakye, Clement Okraku Tettey, Kofi Adjei Nitri, Samuel Ohene Ofori, Comfort Dede Tetteh, Thelma Teley Alphour, Tanko Rufai

Faculty Publications

In this study, Plasmodium falciparum was detected in patients that were declared negative for malaria microscopy and rapid diagnostic test kit (mRDT), using Plasmodium 18s rRNA loop-mediated isothermal amplification (LAMP) technique. The main aim of this study was to assess the usefulness of LAMP assay for detecting pre-clinical malaria, when microscopy and mRDT were less sensitive. DNA was obtained from 100 μL of whole blood using the boil and spin method. Subsequently, the Plasmodium 18s rRNA LAMP assay was performed to amplify the specific Plasmodium 18s rRNA gene. Microscopy and mRDT negative samples [697/2223 (31.2%)] were used for this study. …

Examining The Association Between A Modified Quan Charlson Comorbidity Index (Qcci) And Viral Suppression: A Cross Sectional Analysis Of Dc Cohort Participants, Hasmin C. Ramirez, Lauren O’Connor, Morgan Byrne, Anne Monroe

Epidemiology Faculty Posters and Presentations

No abstract provided.

Quality Of Life In Older And Younger People With Hiv And Diabetes, Lauren F. O’Connor, La’Marcus Wingate, Sam Simmens, Amanda D. Castel, Anne K. Monroe

Epidemiology Faculty Posters and Presentations

No abstract provided.

Cancer Incidence And Stage At Diagnosis Among People With Psychotic Disorders: Systematic Review And Meta-Analysis., Jared C Wootten, Joshua C Wiener, Phillip S Blanchette, Kelly K. Anderson

Epidemiology and Biostatistics Publications

Research regarding the incidence of cancer among people with psychotic disorders relative to the general population is equivocal, although the evidence suggests that they have more advanced stage cancer at diagnosis. We conducted a systematic review and meta-analysis to examine the incidence and stage at diagnosis of cancer among people with, relative to those without, psychotic disorders. We searched the MEDLINE, EMBASE, PsycINFO, and CINAHL databases. Articles were included if they reported the incidence and/or stage at diagnosis of cancer in people with psychotic disorders. Random effects meta-analyses were used to determine risk of cancer and odds of advanced stage …

Urinary Schistosomiasis And Its Potential For Cancer And Hepato-Renal Function Alterations Among The Residents Of Asejire Dam, South-Western Nigeria, Omowumi O. Adewale, Monsurat O. Odebode, Maryam O. Mustapha, Oluwatosin A. Adetuyi, Monsuru A. Adeleke

Tanzania Journal of Science

Urinary schistosomiasis is of public health significance in sub-Saharan Africa with its prevalence being linked to carcinogenesis. However, there is a paucity of data to support this relationship. This study explored the prevalence and intensity of Schistosoma haematobium infections and its associations with cancer and hepatorenal function alterations in villages along the Asejire dam in the State of Osun, Nigeria. Urine samples from 152 consented participants (aged 18–75 years) from four communities were collected and examined for Schistosoma haematobium using the microscopy method. The blood serum of randomly selected infected and non-infected individuals (10 per group) was screened for tumor, …

Probing Mechanisms Of Binding And Allostery In The Sars-Cov-2 Spike Omicron Variant Complexes With The Host Receptor: Revealing Functional Roles Of The Binding Hotspots In Mediating Epistatic Effects And Communication With Allosteric Pockets, Gennady M. Verkhivker, Steve Agajanian, Ryan Kassab, Keerthi Krishnan

Mathematics, Physics, and Computer Science Faculty Articles and Research

In this study, we performed all-atom MD simulations of RBD–ACE2 complexes for BA.1, BA.1.1, BA.2, and BA.3 Omicron subvariants, conducted a systematic mutational scanning of the RBD–ACE2 binding interfaces and analysis of electrostatic effects. The binding free energy computations of the Omicron RBD–ACE2 complexes and comprehensive examination of the electrostatic interactions quantify the driving forces of binding and provide new insights into energetic mechanisms underlying evolutionary differences between Omicron variants. A systematic mutational scanning of the RBD residues determines the protein stability centers and binding energy hotpots in the Omicron RBD–ACE2 complexes. By employing the ensemble-based global network analysis, we …

Cov-Inception: Covid-19 Detection Tool Using Chest X-Ray, Aswini Thota, Ololade Awodipe, Rashmi Patel

SMU Data Science Review

Since the pandemic started, researchers have been trying to find a way to detect COVID-19 which is a cost-effective, fast, and reliable way to keep the economy viable and running. This research details how chest X-ray radiography can be utilized to detect the infection. This can be for implementation in Airports, Schools, and places of business. Currently, Chest imaging is not a first-line test for COVID-19 due to low diagnostic accuracy and confounding with other viral pneumonia. Different pre-trained algorithms were fine-tuned and applied to the images to train the model and the best model obtained was fine-tuned InceptionV3 model …

Dietary Inflammatory Index And Mortality From All Causes, Cardiovascular Disease, And Cancer: A Prospective Study, Zhen Lin, Yanfei Feng, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert Scd, Xin Xu

Faculty Publications

The Energy-adjusted Dietary Inflammatory Index (E-DIITM) is a comprehensive, literature-derived index for assessing the effect of dietary constituents on inflammatory biomarkers and inflammation-related chronic diseases. Several studies have examined the association between E-DII scores and mortality, with results that vary across populations. Therefore, in the present study, we aimed to investigate the potential association between E-DII scores and all-cause, cardiovascular disease (CVD), and cancer mortality using data from the Prostate, Lung, Colorectal and Ovarian (PLCO) Screening Trial. E-DII scores, calculated based on a food-frequency questionnaire, were analyzed both as a continuous variable and after categorization into quintiles. A multivariate Cox …

Wastewater-Informed Public Health Intervention Playbook

Sustain Magazine

As the SARS-CoV-2 pandemic quickly spread from country to country and continent to continent in 2020, governments and scientists needed a way to track COVID-19 through populations in order to position public health interventions in the most impactful locations. Having a decision-based risk framework may help to guide policy creation that could minimize or prevent possible outbreaks and surges of infection within communities. The University of Louisville in partnership with Louisville’s Department of Public Health and Wellness tested this strategy in 2021 and 2022. This Wastewater-Informed Public Health Intervention Playbook describes the decisions and actions of that academic and public …

Availability Of Hospital-Based Cancer Services Before And After Rural Hospital Closure, 2008-2017, Whitney Zahnd Ph.D., Peiyin Hung Ph.D., Sylvia Kewei Shi, Anja Zgodic, Melinda A. Merrell Ph.D., Elizabeth L. Crouch, Janice C. Probst, Jan Eberth Ph.D.

Faculty Publications

Introduction

Rural populations have less access to cancer care services and experience higher cancer mortality rates than their urban counterparts, which may be exacerbated by hospital closures. Our objective was to examine the impact of hospital closures on access to cancer-relevant hospital services across hospital service areas (HSAs).

Methods

We used American Hospital Association survey data from 2008 to 2017 to examine the change in access to cancer-related screening and treatment services across rural HSAs that sustained hospitals over time, experienced any closures, or had all hospitals close. We performed a longitudinal analysis to assess the association between hospital closure …

Neighborhood Characteristics And Dementia Symptomology Among Community-Dwelling Older Adults With Alzheimer’S Disease, Dana M. Alhasan, Matthew C. Lohman Ph.D., Jana A. Hirsch, Margaret Chandlee Miller Ms, Ph.D., Bo Cai Ph.D., Chandra L. Jackson

Faculty Publications

Background: Neuropsychiatric symptoms (NPSs) lead to myriad poor health outcomes among individuals with Alzheimer’s disease (AD). Prior studies have observed associations between the various aspects of the home environment and NPSs, but macro-level environmental stressors (e.g., neighborhood income) may also disrupt the neuronal microenvironment and exacerbate NPSs. Yet, to our knowledge, no studies have investigated the relationship between the neighborhood environment and NPSs.

Methods: Using 2010 data among older adults with AD collected from a sample of the South Carolina Alzheimer’s Disease Registry, we estimated cross-sectional associations between neighborhood characteristics and NPSs in the overall population and by race/ethnicity. Neighborhood …

Yin And Yang Of Cannabinoid Cb1 Receptor: Cb1 Deletion In Immune Cells Causes Exacerbation While Deletion In Non-Immune Cells Attenuates Obesity, Kathryn Miranda, William Becker, Philip B. Busbee, Nicholas Dopkins, Osama A. Abdulla, Yin Zhong, Jiajia Zhang Ph.D., Mitzi Nagarkatti, Prakash S. Nagarkatti

Faculty Publications

While blockade of cannabinoid receptor 1 (CB1) has been shown to attenuate diet-induced obesity (DIO), its relative role in different cell types has not been tested. The current study investigated the role of CB1 in immune vs non-immune cells during DIO by generating radiation-induced bone marrow chimeric mice that expressed functional CB1 in all cells except the immune cells or expressed CB1 only in immune cells. CB1^-/- recipient hosts were resistant to DIO, indicating that CB1 in non-immune cells is necessary for induction of DIO. Interestingly, chimeras with CB1^-/- in immune cells showed exacerbation in DIO combined with …

Delineating Covid-19 Immunological Features Using Single-Cell Rna Sequencing, Wendao Liu, Johnathan Jia, Yulin Dai, Wenhao Chen, Guangsheng Pei, Qiheng Yan, Zhongming Zhao

Faculty, Staff and Student Publications

Understanding the molecular mechanisms of coronavirus disease 2019 (COVID-19) pathogenesis and immune response is vital for developing therapies. Single-cell RNA sequencing has been applied to delineate the cellular heterogeneity of the host response toward COVID-19 in multiple tissues and organs. Here, we review the applications and findings from over 80 original COVID-19 single-cell RNA sequencing studies as well as many secondary analysis studies. We describe that single-cell RNA sequencing reveals multiple features of COVID-19 patients with different severity, including cell populations with proportional alteration, COVID-19-induced genes and pathways, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in single cells, and adaptation …

Geographic Proximity To Primary Care Providers As A Risk-Assessment Criterion For Quality Performance Measures, Nathaniel Bell, Ana Lopez-De Fede Ph.D., Bo Cai Ph.D., John Brooks Ph.D.

Publications

Importance Previous studies have found a mixed association between Patient-Centered Medical Home (PCMH) designation and improvements in primary care quality indicators, including avoidable pediatric emergency department (ED) encounters. Whether these associations persist after accounting for the geographic locations of providers relative to where patients reside is unknown. Objective To examine the association between geographic proximity to primary care providers versus hospitals and risk of avoidable and potentially avoidable ED visits among children with pre-existing diagnosis of attention-deficit/hyperactivity disorder or asthma. Methods Retrospective cohort study of a panel of pediatric Medicaid claims data from the South Carolina from 2016–2018 for 2,959 …

Quantifying The Relationship Between Sub-Population Wastewater Samples And Community-Wide Sars-Cov-2 Seroprevalence., Ted Smith, Rochelle H. Holm, Rachel J. Keith, Alok R. Amraotkar, Chance R. Alvarado, Krzysztof Banecki, Boseung Choi, Ian Santisteban, Adrienne M. Bushau-Sprinkle, Kathleen T. Kitterman, Joshua Fuqua, Krystal T. Hamorsky, Kenneth E. Palmer, J. Michael Brick, Aruni Bhatnagar, Grzegorz A. Rempala

Faculty and Staff Scholarship

Robust epidemiological models relating wastewater to community disease prevalence are lacking. Assessments of SARS-CoV-2 infection rates have relied primarily on convenience sampling, which does not provide reliable estimates of community disease prevalence due to inherent biases. This study conducted serial stratified randomized samplings to estimate the prevalence of SARS-CoV-2 antibodies in 3717 participants and obtained weekly samples of community wastewater for SARS-CoV-2 concentrations in Jefferson County, KY (USA) from August 2020 to February 2021. Using an expanded Susceptible-Infected-Recovered model, the longitudinal estimates of the disease prevalence were obtained and compared with the wastewater concentrations using regression analysis. The model analysis …

Cardiorespiratory Fitness And The Risk Of All-Cause, Cardiovascular And Cancer Mortality In Men With Hypercholesterolemia, Xuemei Sui M.D., M.P.H., Ph.D., Mark A. Sarzynski Facsm, Nicole Gribben, Jiajia Zhang Ph.D., Carl J. Lavie

Faculty Publications

Background: Whether higher cardiorespiratory fitness (CRF) confers protection against cardiovascular disease (CVD) in individuals with manifest hypercholesterolemia is poorly understood. Methods: Participants were 8920 men aged 20–82 years with hypercholesterolemia but no history of CVD and/or cancer and who received a preventive examination at the Cooper Clinic in Dallas, TX, USA, during 1974–2001. CRF was quantified as maximal treadmill test duration and was grouped for analysis as low, moderate, or high based on the traditional Aerobics Center Longitudinal Study cutpoints. Using Cox regression analyses, we computed hazard ratios and 95% confidence intervals for risk of mortality based on CRF. Results: …

Processed Food As A Risk Factor For The Development And Perpetuation Of Crohn's Disease-The Enigma Study, Gina L. Trakman, Winnie Y.Y. Lin, Amy L. Hamilton, Amy L. Wilson-O'Brien, Annalise Stanley, Jessica Y. Ching, Jun Yu, Joyce W.Y. Mak, Yang Sun, Junkin Niu, Yinglei Miao, Xiaoqing Lin, Rui Feng, Minhu Chen, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert Scd, Mark Morrison, Siew C, Ng, Michael A. Kamm

Faculty Publications

(1) Background: Developing countries have experienced a rapid recent rise in Inflammatory Bowel Disease (IBD) incidence and emerging evidence suggests processed foods and food additives may predispose one to the development and perpetuation of Crohn’s disease (CD). The aim of this study was to evaluate processed food and food additive intake in CD patients and controls, in Australia (high CD incidence), Hong Kong (intermediate incidence) and mainland China (emerging incidence). (2) Methods: In 274 CD patients (CD), 82 first-degree relatives (FDR), 83 household members (HM) and 92 healthy unrelated controls (HC) from Australia (n = 180), Hong Kong (HK) (n …

Cancer Incidence And Stage At Diagnosis Among People With Recent-Onset Psychotic Disorders: A Retrospective Cohort Study Using Health Administrative Data From Ontario, Canada., Jared C Wootten, Lucie Richard, Phillip S Blanchette, Joshua C. Wiener, Kelly K. Anderson

Epidemiology and Biostatistics Publications

OBJECTIVE: Prior evidence on the relative risk of cancer among people with psychotic disorders is equivocal. The objective of this study was to compare incidence and stage at diagnosis of cancer for people with psychotic disorders relative to the general population.

METHOD: We constructed a retrospective cohort of people with a first diagnosis of non-affective psychotic disorder and a comparison group from the general population using linked health administrative databases in Ontario, Canada. The cohort was followed for incident diagnoses of cancer over a 25-year period. We used Poisson and logistic regression models to compare cancer incidence and stage at …

Biomonitoring Of Polybrominated Dioxins & Furans, Polychlorinated Dioxins & Furans, And Dioxin Like Polychlorinated Biphenyls In Vietnamese Female Electronic Waste Recyclers, Jenevieve S. Peecher, Arnold J. Schecter, Helen Lu, Hoang Trong Quynh, Arnold Stromberg, Jiaying Weng, Riley Crandall, Linda S. Birnbaum

Statistics Faculty Publications

Objective: E-waste is rising globally. This is a follow up to our study reporting metals/polybrominated diphenyl ethers (PBDE’s)/polychlorinated biphenyls (PCBs) in female e-waste recyclers. Here we report polybrominated, polychlorinated dioxins/furans, and dioxin-like polychlorinated biphenyls in these same workers. Methods: Female Vietnamese recyclers and non-recyclers recruited; blood samples collected. Polybrominated, polychlorinated dioxins/ furans, and dioxin-like polychlorinated biphenyls levels compared in recyclers, non-recyclers, and National Health and Nutrition Examination Surveys (NHANES). Results: Recyclers >non-recyclers: 12378-PBDD, 2378-TBDF, 12378-PCDF, 123478-HxCDF, 123678-HxCDF, 1234678-HpCDF, PCB-126. Non-recyclers >NHANES: 123478-HxCDF, 123678-HxCDF, 234678- HxCDF, PCB-126, PCB-169. NHANES >non-recyclers: 12378-PCDD, 123478-HxCDD, 123678-HxCDD, 123789-HxCDD, 1234678-HpCDD, 123789-HxCDF, 1234678-HpCDF, 1234789-HpCDF, OCDF, PCB-81, PCB-114, …