Occupational Health and Industrial Hygiene Commons^™

User Perceptions Of Shared Sanitation Among Rural Households In Indonesia And Bangladesh, Kali B. Nelson, Jonathan Karver, Craig Kullman, Jay P. Graham

Environmental and Occupational Health Faculty Publications

Background

The practice of sharing sanitation facilities does not meet the current World Health Organization/UNICEF definition for what is considered improved sanitation. Recommendations have been made to categorize shared sanitation as improved sanitation if security, user access, and other conditions can be assured, yet limited data exist on user preferences with respect to shared facilities.

Objective

This study analyzed user perceptions of shared sanitation facilities in rural households in East Java, Indonesia, and Bangladesh.

Methods

Cross-sectional studies of 2,087 households in East Java and 3,000 households in Bangladesh were conducted using questionnaires and observational methods. Relative risks were calculated to …

Association Between District-Level Perceived Safety And Self-Rated Health: A Multilevel Study In Seoul, South Korea, Seung-Sup Kim, Jaesung Choi, Kisoo Park, Yeongseung Chung, Sangjo Park, Jongho Heo

Environmental and Occupational Health Faculty Publications

Objectives Several studies have reported the relationship between residents’ perceived neighbourhood safety and their health outcomes. However, those studies suffered from unreliability of neighbourhood safety measure and potential residual confounding related to crime rates. In this study, using multilevel analysis to account for the hierarchical structure of the data, we examined associations between district-level perceived safety and self-rated health after adjusting for potential confounders including the district-level crime rate.

Design Cross-sectional study.

Setting We used the first wave of Seoul Welfare Panel Study, which has 7761 individuals from 3665 households in 25 administrative districts in Seoul, South Korea. District-level perceived …

The Semen Microbiome And Its Relationship With Local Immunology And Viral Load In Hiv Infection, Cindy M. Liu, Brendan J.W. Osborne, Bruce A. Hungate, Kamnoosh Shahabi, Sanja Huibner, Richard Lester, Michael G. Dwan, Colin Kovacs, Tania L. Contente-Cuomo, Erika Benko, Maliha Aziz, Lance B. Price

Environmental and Occupational Health Faculty Publications

Semen is a major vector for HIV transmission, but the semen HIV RNA viral load (VL) only correlates moderately with the blood VL. Viral shedding can be enhanced by genital infections and associated inflammation, but it can also occur in the absence of classical pathogens. Thus, we hypothesized that a dysregulated semen microbiome correlates with local HIV shedding. We analyzed semen samples from 49 men who have sex with men (MSM), including 22 HIV-uninfected and 27 HIV-infected men, at baseline and after starting antiretroviral therapy (ART) using 16S rRNA gene-based pyrosequencing and quantitative PCR. We studied the relationship of semen …

Possible Pro-Carcinogenic Association Of Endotoxin On Lung Cancer Among Shanghai Women Textile Workers, H. Checkoway, J. I. Lundin, S. Costello, R. Ray, W. Li, E. A. Eisen, G. Astrakianakis, N. Seixas, Katie M. Applebaum, D. L. Gao, D. B. Thomas

Environmental and Occupational Health Faculty Publications

Background:

Endotoxin (lipopolysaccharide) is a widespread contaminant in many environmental settings. Since the 1970s, there has been generally consistent evidence indicating reduced risks for lung cancer associated with occupational endotoxin exposure.

Methods:

We updated a case–cohort study nested within a cohort of 267 400 female textile workers in Shanghai, China. We compared exposure histories of 1456 incident lung cancers cases diagnosed during 1989–2006 with those of a reference subcohort of 3022 workers who were free of lung cancer at the end of follow-up. We applied Cox proportional hazards modelling to estimate exposure–response trends, adjusted for age and smoking, for cumulative …

Multidrug-Resistant And Methicillin-Resistant Staphylococcus Aureus (Mrsa) In Hog Slaughter And Processing Plant Workers And Their Community In North Carolina (Usa), Ricardo Castillo Neyra, Jose A. Frisancho, Jessica L. Rinsky, Carol Resnick, Karen C. Carroll, Ana M. Rule, Tracy Ross, Yaqi You, Lance B. Price, Ellen K. Silbergeld

Environmental and Occupational Health Faculty Publications

Background: Use of antimicrobials in industrial food-animal production is associated with the presence of antimicrobial resistant Staphylococcus aureus among animals and humans. Hog slaughter/processing plants process large numbers of animals from industrial animal operations, and are environments conducive to the exchange of bacteria between animals and workers.

Objectives: To compare the prevalence of methicillin-resistant S. aureus (MRSA) and multidrug resistant S. aureus(MDRSA) carriage between processing plant workers, their household members, and community residents.

Methods: We conducted a cross-sectional study of hog slaughter/processing plant workers, their household members, and community residents in North Carolina. Participants responded to a questionnaire and …

Temporal Trends In Phthalate Exposures: Findings From The National Health And Nutrition Examination Survey, 2001-2010, Ami R. Zota, Antonia M. Calafat, Tracey J. Woodruff

Environmental and Occupational Health Faculty Publications

Background: Phthalates are ubiquitous environmental contaminants. Because of potential adverse effects on human health, butylbenzyl phthalate [BBzP; metabolite, monobenzyl phthalate (MBzP)], di-n-butyl phthalate [DnBP; metabolite, mono-n-butyl phthalate (MnBP)], and di(2-ethylhexyl) phthalate (DEHP) are being replaced by substitutes including other phthalates; however, little is known about consequent trends in population-level exposures.

Objective: We examined temporal trends in urinary concentrations of phthalate metabolites in the general U.S. population and whether trends vary by sociodemographic characteristics.

Methods: We combined data on 11 phthalate metabolites for 11,071 participants from five cycles of the National Health and Nutrition Examination Survey (2001–2010). …

Strategies To Reduce The Harmful Effects Of Extreme Heat Events: A Four-City Study, Jalonne L. White-Newsome, Sabrina Mccormick, Natalie R. Sampson, Miatta A. Buxton, Marie S. O'Neill, Carina J. Gronlund, Kathryn C. Conlon, Edith A. Parker

Environmental and Occupational Health Faculty Publications

Extreme heat events (EHEs) are becoming more intense, more frequent and longer lasting in the 21st century. These events can disproportionately impact the health of low-income, minority, and urban populations. To better understand heat-related intervention strategies used by four U.S. cities, we conducted 73 semi-structured interviews with government and non-governmental organization leaders representing public health, general social services, emergency management, meteorology, and the environmental planning sectors in Detroit, MI; New York City, NY; Philadelphia, PA and Phoenix, AZ—cities selected for their diverse demographics, climates, and climate adaptation strategies. We identified activities these leaders used to reduce the harmful effects of …

Inconclusive Findings: Now You See Them, Now You Don't, Christopher J. Porter, Lynn R. Goldman, Bernard D. Goldman

Environmental and Occupational Health Faculty Publications

No abstract provided.

Trends In Access To Water Supply And Sanitation In 31 Major Sub-Saharan African Cities: An Analysis Of Dhs Data From 2000 To 2012, Mike R. Hopewell, Jay P. Graham

Environmental and Occupational Health Faculty Publications

Background

By 2050, sub-Saharan Africa’s (SSA) urban population is expected to grow from 414 million to over 1.2 billion. This growth will likely increase challenges to municipalities attempting to provide access to water supply and sanitation (WS&S). This study aims to characterize trends in access to WS&S in SSA cities and identify factors affecting those trends.

Methods

DHS data collected between 2000 and 2012 were used for this analysis of thirty-one cities in SSA. Four categories of household access to WS&S were studied using data from demographic and health surveys – these included: 1) household access to an improved water …

A Case Control Study Of Environmental And Occupational Exposures Associated With Methicillin Resistant Staphylococcus Aureus Nasal Carriage In Patients Admitted To A Rural Tertiary Care Hospital In A High Density Swine Region, Leah Schinasi, Steve Wing, Kerri L. Augustino, Keith M. Ramsey, Delores L. Nobles, David B. Richardson, Lance B. Price, Maliha Aziz, Pia Macdonald, Jill R. Stewart

Environmental and Occupational Health Faculty Publications

Background

Distinct strains of methicillin resistant Staphylococcus aureus (MRSA) have been identified on livestock and livestock workers. Industrial food animal production may be an important environmental reservoir for human carriage of these pathogenic bacteria. The objective of this study was to investigate environmental and occupational exposures associated with nasal carriage of MRSA in patients hospitalized at Vidant Medical Center, a tertiary hospital serving a region with intensive livestock production in eastern North Carolina.

Methods

MRSA nasal carriage was identified via nasal swabs collected within 24 hours of hospital admission. MRSA carriers (cases) were gender and age matched to non-carriers (controls). …

Ending Open Defecation In Rural Tanzania: Which Factors Facilitate Latrine Adoption?, Stephen Sara, Jay P. Graham

Environmental and Occupational Health Faculty Publications

Diarrheal diseases account for 7% of deaths in children under five years of age in Tanzania. Improving sanitation is an essential step towards reducing these deaths. This secondary analysis examined rural Tanzanian households’ sanitation behaviors and attitudes in order to identify barriers and drivers to latrine adoption. The analysis was conducted using results from a cross-sectional study of 1000 households in five rural districts of Tanzania. Motivating factors, perceptions, and constraints surrounding open defecation and latrine adoption were assessed using behavioral change theory. Results showed a significant association between use of improved sanitation and satisfaction with current sanitation facility (OR: …

Internet And Telephonic Ivr Mixed-Mode Survey For Longitudinal Studies: Choice, Retention, And Data Equivalency, Santosh K. Verma, Theodore K. Courtney, David A. Lombardi, Wen-Ruey Chang, Yueng-Hsiang Huang, Melanye J. Brennan, Melissa J. Perry

Environmental and Occupational Health Faculty Publications

Purpose

This study examined data equivalency and loss to follow-up rates from Internet and interactive voice response (IVR) system surveys in a prospective-cohort study.

Methods

475 limited-service restaurant workers participating in the 12-week study were given a choice to report their weekly slipping experience by either IVR or Internet. Demographic differences, loss to follow-up, self-reported rates of slipping, and selection of first and last choices were compared.

Results

Loss to follow-up rates were slightly higher for those choosing the IVR mode. Rates of slipping and selection of first and last choices were not significantly different between survey modes. Propensity to …

The Epidemic Of Extended-Spectrum-Β-Lactamase-Producing Escherichia Coli St131 Is Driven By A Single Highly Pathogenic Subclone, H30-Rx, Lance B. Price, James R. Johnson, Maliha Aziz, Connie Clabots, Brian Johnston, Veronika Tchesnokova, Lora Nordstrom, Maria Billig, Sujay Chattopadhyay, Marc Stegger, Paal S. Andersen, Talima Pearson, Kim Riddell, Peggy Rogers, Delia Scholes, Barbara Kahl, Paul Keim, Evgeni V. Sokurenko

Environmental and Occupational Health Faculty Publications

The Escherichia coli sequence type 131 (ST131) clone is notorious for extraintestinal infections, fluoroquinolone resistance, and extended-spectrum beta-lactamase (ESBL) production, attributable to a CTX-M-15-encoding mobile element. Here, we applied pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing to reconstruct the evolutionary history of the ST131 clone. PFGE-based cluster analyses suggested that both fluoroquinolone resistance and ESBL production had been acquired by multiple ST131 sublineages through independent genetic events. In contrast, the more robust whole-genome-sequence-based phylogenomic analysis revealed that fluoroquinolone resistance was confined almost entirely to a single, rapidly expanding ST131 subclone, designated H30-R. Strikingly, 91% of the CTX-M-15-producing isolates also …

Molecular Epidemiology Of Escherichia Coli Sequence Type 131 And Its H30 And H30-Rx Subclones Among Extended-Spectrum-Β-Lactamase-Positive And -Negative E. Coli Clinical Isolates From The Chicago Region, 2007 To 2010, Ritu Banerjee, Ari Robicsek, Michael A. Kusikowski, Stephen Porter, Brian D. Johnston, Evgeni Sokurenko, Veronika Tchesnokova, Lance B. Price, James R. Johnson

Environmental and Occupational Health Faculty Publications

We assessed Escherichia coli ST131 and its H30 and H30-Rx subclones for virulence genes, antimicrobial resistance, and extended-spectrum beta-lactamase (ESBL) type. Although both subclones were associated with ESBL production, H30-Rx isolates had higher resistance scores and were associated specifically with CTX-M-15. Three virulence genes (iha, sat, and iutA) were more prevalent among H30 than non-H30 ST131 isolates. Thus, the H30 and H30-Rx subclones are more antimicrobial resistant and have virulence profiles that are distinct from those of non-H30 ST131 isolates.

Rapid Differentiation Between Livestock-Associated And Livestock-Independent Staphylococcus Aureus Cc398 Clades, Marc Stegger, Cindy M. Liu, Jesper Larsen, Katerina Soldanova, Maliha Aziz, Tania Contente-Cuomo, Andreas Petersen, Stien Vandendriessche, Judy N. Jiménez, Caterina Mammina, Alex Van Belkum, Saara Salmenlinna, Frederic Laurent, Robert L. Skov, Anders R. Larsen, Paal S. Andersen, Lance B. Price

Environmental and Occupational Health Faculty Publications

Staphylococcus aureus clonal complex 398 (CC398) isolates cluster into two distinct phylogenetic clades based on single-nucleotide polymorphisms (SNPs) revealing a basal human clade and a more derived livestock clade. The scn and tet(M) genes are strongly associated with the human and the livestock clade, respectively, due to loss and acquisition of mobile genetic elements. We present canonical single-nucleotide polymorphism (canSNP) assays that differentiate the two major host-associated S. aureus CC398 clades and a duplex PCR assay for detection of scn and tet(M). The canSNP assays correctly placed 88 S. aureusCC398 isolates from a reference collection into …

Epidemiology Of Esophageal Cancer, Yuwei Zhang

Environmental and Occupational Health Faculty Publications

Esophageal cancer (EsC) is one of the least studied and deadliest cancers worldwide because of its extremely aggressive nature and poor survival rate. It ranks sixth among all cancers in mortality. In retrospective studies of EsC, smoking, hot tea drinking, red meat consumption, poor oral health, low intake of fresh fruit and vegetables, and low socioeconomic status have been associated with a higher risk of esophageal squamous cell carcinoma. Barrett’s esophagus is clearly recognized as a risk factor for EsC, and dysplasia remains the only factor useful for identifying patients at increased risk, for the development of esophageal adenocarcinoma in …

Allostatic Load Amplifies The Effect Of Blood Lead Levels On Elevated Blood Pressure Among Middle-Aged U.S. Adults: A Cross-Sectional Study, Ami R. Zota, Edmond R. Shenassa, Rachel Morello-Frosch

Environmental and Occupational Health Faculty Publications

Background

Scientists and regulators have sought to understand whether and how physiologic dysregulation due to chronic stress exposure may enhance vulnerability to the adverse health effects of toxicant exposures. We conducted a cross-sectional study to determine whether allostatic load (AL), a composite measure of physiologic response to chronic exposure to stress, amplifies the effect of lead exposure on blood pressure among middle-aged adults.

Methods

We analyzed associations between blood lead levels and blood pressure in a nationally representative sample of 8,194 U.S. adults (aged 40-65 years) participating in the National Health and Nutritional Examination Survey, 1999--2008. Outcomes were elevated systolic …

Livestock-Associated Methicillin And Multidrug Resistant Staphylococcus Aureus Is Present Among Industrial, Not Antibiotic-Free Livestock Operation Workers In North Carolina, Jessica L. Rinsky, Maya Nadimpalli, Steve Wing, Devon Hall, Dothula Baron, Lance B. Price, Jesper Larsen, Marc Stegger, Jill Stewart, Christopher D. Heaney

Environmental and Occupational Health Faculty Publications

Objectives

Administration of antibiotics to food animals may select for drug-resistant pathogens of clinical significance, such as methicillin-resistant Staphylococcus aureus (MRSA). In the United States, studies have examined prevalence of MRSA carriage among individuals exposed to livestock, but prevalence of multidrug-resistant S. aureus (MDRSA) carriage and the association with livestock raised with versus without antibiotic selective pressure remains unclear. We aimed to examine prevalence, antibiotic susceptibility, and molecular characteristics of S. aureus among industrial livestock operation (ILO) and antibiotic-free livestock operation (AFLO) workers and household members in North Carolina.

Methods

Participants in this cross-sectional study were interviewed and provided a …

Exploring Changes In Open Defecation Prevalence In Sub-Saharan Africa Based On National Level Indices, Deise I. Galan, Seung-Sup Kim, Jay P. Graham

Environmental and Occupational Health Faculty Publications

Background

In sub-Saharan Africa, it is estimated that 215 million people continue to engage in open defecation. This practice facilitates the transmission of diarrheal diseases – one of the leading causes of mortality in children under 5 in sub-Saharan Africa. The main purpose of this study is to: estimate changes in open defecation prevalence between 2005 and 2010 across countries in sub-Saharan Africa; examine the association between national level indices and changes in open defecation prevalence; and assess how many countries can achieve ‘open defecation free status’ by 2015.

Methods

After applying selection criteria, this study analyzed country-level data for …

Genome Analysis Of Staphylococcus Aureus St291, A Double Locus Variant Of St398, Reveals A Distinct Genetic Lineage, Marc Stegger, Maliha Aziz, Tomsz Chroboczek, Lance B. Price, Troels Ronco, Kristoffer Kiil, Robert L. Skov, Frederic Laurent, Paal S. Andersen

Environmental and Occupational Health Faculty Publications

Staphylococcus aureus ST291 has been reported as a homologue recombinant double locus variant of the livestock associated S. aureus ST398. However, whole genome sequencing show that ST291 is a unique genetic lineage with highly variable content within its accessory genome compared to both human and livestock associated genome sequenced CC398s.

Male Circumcision Significantly Reduces Prevalence And Load Of Genital Anaerobic Bacteria, Cindy M. Liu, Bruce A. Hungate, Aaron A.R. Tobian, David Serwadda, Jacques Ravel, Richard Lester, Godfrey Kigozi, Maliha Aziz, Ronald M. Galiwango, Fred Nalugoda, Tania L. Contente-Cuomo, Maria J. Wawer, Paul Keim, Ronald H. Gray, Lance B. Price

Environmental and Occupational Health Faculty Publications

Male circumcision reduces female-to-male HIV transmission. Hypothesized mechanisms for this protective effect include decreased HIV target cell recruitment and activation due to changes in the penis microbiome. We compared the coronal sulcus microbiota of men from a group of uncircumcised controls (n= 77) and from a circumcised intervention group (n = 79) at enrollment and year 1 follow-up in a randomized circumcision trial in Rakai, Uganda. We characterized microbiota using16S rRNA gene-based quantitative PCR (qPCR) and pyrosequencing, log response ratio (LRR), Bayesian classification, nonmetric multidimensional scaling (nMDS), and permutational multivariate analysis of variance (PerMANOVA). At baseline, men …

Fall Safety Assessment At The New School Of Public Health And Health Services Building, Amanda Mcqueen, Seung-Sup Kim, Melissa J. Perry

GW Research Days 2013

Objective: Falls are one of the leading causes of workplace death, lost work time, and costs to industry, particularly in construction. The public health burden of falls is significant, as approximately 25% of nonfatal injuries and 38% of fatalities in the general construction industry are due to falls. The goal of this study is to develop an assessment tool to evaluate fall safety in general construction and to evaluate fall safety among five skilled construction trades (i.e. electricians, painters, carpenters, welders, and roofers) throughout different stages of a new building construction project. The project is the new School of Public …

Access To Chemical Data Used In Regulatory Decision Making, Lynn R. Goldman, Ellen K. Silbergeld, Randall Lutter, Craig Barrow, Christopher J. Borgert, James W. Conrad Jr., Debra Edwards, Allan Felsot

Environmental and Occupational Health Faculty Publications

No abstract provided.

Pit Latrines And Their Impacts On Groundwater Quality: A Systematic Review, Jay P. Graham, Matthew L. Polizzotto

Environmental and Occupational Health Faculty Publications

Background: Pit latrines are one of the most common human excreta disposal systems in low-income countries, and their use is on the rise as countries aim to meet the sanitation-related target of the Millennium Development Goals. There is concern, however, that discharges of chemical and microbial contaminants from pit latrines to groundwater may negatively affect human health.

Objectives: Our goals were to a) calculate global pit latrine coverage, b) systematically review empirical studies of the impacts of pit latrines on groundwater quality, c) evaluate latrine siting standards, and d) identify knowledge gaps regarding the potential for …

Open-Source Collaboration For Global Health: Science And Practice, Ariel Pablos-Méndez, Michael Klag, Lynn R. Goldman

Environmental and Occupational Health Faculty Publications

No abstract provided.

The Work Environment Disability-Adjusted Life Year For Use With Life Cycle Assessment: A Methodological Approach, Kelly A. Scanlon, George M. Gray, Royce A. Francis, Shannon M. Lloyd, Peter Lapuma

Environmental and Occupational Health Faculty Publications

Background

Life cycle assessment (LCA) is a systems-based method used to determine potential impacts to the environment associated with a product throughout its life cycle. Conclusions from LCA studies can be applied to support decisions regarding product design or public policy, therefore, all relevant inputs (e.g., raw materials, energy) and outputs (e.g., emissions, waste) to the product system should be evaluated to estimate impacts. Currently, work-related impacts are not routinely considered in LCA. The objectives of this paper are: 1) introduce the work environment disability-adjusted life year (WE-DALY), one portion of a characterization factor used to express the magnitude of …

Foodborne Urinary Tract Infections: A New Paradigm For Antimicrobial-Resistant Foodborne Illness, Lora Nordstrom, Cindy M. Liu, Lance B. Price

Environmental and Occupational Health Faculty Publications

Urinary tract infections (UTIs) are among the most common bacterial infections worldwide. Disproportionately affecting women, UTIs exact a substantial public burden each year in terms of direct medical expenses, decreased quality of life, and lost productivity. Increasing antimicrobial resistance among strains of extraintestinal pathogenic Escherichia colichallenges successful treatment of UTIs. Community-acquired UTIs were long considered sporadic infections, typically caused by the patients’ native gastrointestinal microbiota; however, the recent recognition of UTI outbreaks with probable foodborne origins has shifted our understanding of UTI epidemiology. Along with this paradigm shift come new opportunities to disrupt the infection process and possibly quell …

Assuring Access To Data For Chemical Evaluations, Lynn R. Goldman, Ellen K. Silbergeld

Environmental and Occupational Health Faculty Publications

Background: A database for studies used for U.S. Environmental Protection Agency (EPA) pesticide and chemical reviews would be an excellent resource for increasing transparency and improving systematic assessments of pesticides and chemicals. There is increased demand for disclosure of raw data from studies used by the U.S. EPA in these reviews.

Objectives: Because the Information Quality Act (IQA) of 2001 provides an avenue for request of raw data, we reviewed all IQA requests to the U.S. EPA in 2002–2012 and the U.S. EPA’s responses. We identified other mechanisms to access such data: public access databases, the Freedom of Information Act …

Prevalence Of Antibiotic-Resistant E. Coli In Retail Chicken: Comparing Conventional, Organic, Kosher, And Raised Without Antibiotics, Jack M. Millman, Kara Waits, Heidi Grande, Ann R. Marks, Jane C. Marks, Lance B. Price, Bruce A. Hungate

Environmental and Occupational Health Faculty Publications

Retail poultry products are known sources of antibiotic-resistant Escherichia coli, a major human health concern. Consumers have a range of choices for poultry, including conventional, organic, kosher, and raised without antibiotics (RWA) – designations that are perceived to indicate differences in quality and safety. However, whether these categories vary in the frequency of contamination with antibiotic-resistant E. coli is unknown. We examined the occurrence of antibiotic-resistant E. coli on raw chicken marketed as conventional, organic, kosher and RWA. From April – June 2012, we purchased 213 samples of raw chicken from 15 locations in the New York City metropolitan …

Perception Of Slipperiness And Prospective Risk Of Slipping At Work, Theodore K. Courtney, Santosh K. Verma, Wen-Ruey Chang, Yueng-Hsiang Huang, David A. Lombardi, Melanye J. Brennan, Melissa J. Perry

Environmental and Occupational Health Faculty Publications

Objectives: Falls are a leading cause of injury at work, and slipping is the predominant cause of falling. Prior research has suggested a modest correlation between objective measures (such as coefficient of friction, COF) and subjective measures of slipperiness (such as worker perceptions) in the workplace. However, the degree of association between subjective measures and the actual risk of slipping at the workplace is unknown. This study examined the association between perception of slipperiness and the risk of slipping.

Methods: 475 workers from 36 limited-service restaurants participated in a 12-week prospective cohort study. At baseline, demographic information was collected, participants …