Modeling Joint Health Effects of Environmental Exposure Mixtures With Bayesian Additive Regression Trees.

Studying the association between mixtures of environmental exposures and health outcomes can be challenging due to issues such as correlation among the exposures and non-linearities or interactions in the exposure-response function. For this reason, one common strategy is to fit flexible nonparametric models to capture the true exposure-response surface. However, once such a model is fit, further decisions are required when it comes to summarizing the marginal and joint effects of the mixture on the outcome.

Prenatal Nitrogen Oxide (NO) and Its Potential Impact on Infant Metabolism during the First Month of Life: Evidence from Two Distinct Cohorts─The Atlanta African American Maternal-Child Cohort and the Southern California Mother's Milk Study.

Exposure to traffic-related air pollution (TRAP) during pregnancy has been linked with adverse health outcomes, yet the biological mechanisms remain poorly understood. High-resolution metabolomics offers a promising approach to examine how TRAP influences infant health. However, few studies have focused on Black and Latino populations, who are disproportionately exposed to TRAP.

Liquefied Petroleum Gas or Biomass for Cooking and Effects on Blood Pressure: Results from the Household Air Pollution Intervention Network (HAPIN) Trial.

Background: Exposure to household air pollution from burning coal and biomass for cooking is associated with higher blood pressure and other adverse indicators of cardiovascular disease, the leading cause of death worldwide. Evidence demonstrating that switching from biomass to liquefied petroleum gas (LPG) will reduce blood pressure is limited.

Methods: As part of a larger trial of 3200 households, we conducted a randomized trial of 342 women aged 40 to 79 years who lived in households using biomass for cooking in rural areas of Guatemala, India, Peru, and Rwanda to assess the effects of a free LPG stove and fuel intervention.

Wildland Fire-Related Smoke PM and Cardiovascular Disease Emergency Department Visits in the Western United States.

Background: The impact of short-term exposure to fine particulate matter with a diameter ≤2.5 μm (PM) due to wildland fire smoke on the risk of cardiovascular disease (CVD) remains unclear. We investigated the association between short-term exposure to wildfire smoke PM and emergency department visits for acute CVD in the western United States from 2007 to 2018.

Longitudinal insights into the natural history of Type 2 diabetes among Koreans: A 20-year community-based prospective cohort study.

Objective: To investigate the natural history of diabetes mellitus (DM) based on metabolic phenotypes of prediabetes in a community-based prospective study.

Methods: Individuals aged 40-69 years without DM were followed for 20 years. Glycemic parameters, including the 75 g oral glucose tolerance test, were assessed at baseline and biennially thereafter.

The influence of ambient air pollution during folliculogenesis, endometrial development, and spermatogenesis on fertility: A study among patients using vitrified donor oocyte in vitro fertilization.

Background: Air pollution is associated with reduced fertility; however, the independent effects of air pollution exposure during folliculogenesis, endometrial development, and spermatogenesis on human reproduction remains unclear.

Objective: We investigated the associations between air pollution during critical windows and clinical outcomes of in vitro fertilization (IVF) using patients undergoing vitrified donor oocyte IVF.

Methods: We included 551 non-identified oocyte donors and 1353 recipients who underwent 2533 embryo transfers at Reproductive Biology Associates in Atlanta, Georgia (2008-2019).

Familial Differences in Personal PM Exposure within a Rural African Community Explained with Spatiotemporal Exposure Apportionment.

Exposure to fine particulate matter (PM) from solid-fuel combustion is a major determinant of global morbidity and mortality. However, variations in exposure remain uncertain across many high-risk populations. This work describes personal PM exposures among household members (adult men, adult women, and children) in rural sub-Saharan Africa, where biomass fuel is the primary household energy source.

Identifying county-level effect modifiers of the association between heat waves and preterm birth using a Bayesian spatial meta regression approach.

High temperature is associated with adverse health outcomes, particularly for vulnerable subpopulations including pregnant individuals and their unborn babies. Several recent studies have investigated the association between temperature and preterm birth at different geographic scales and across different spatial locations. However, there has been less focus on characterizing spatial heterogeneity in risks and identifying modifiable factors that contribute to the observed variation.

A Bayesian spatial-temporal varying coefficients model for estimating excess deaths associated with respiratory infections.

Disease surveillance data are used for monitoring and understanding disease burden, which provides valuable information in allocating health programme resources. Statistical methods play an important role in estimating disease burden since disease surveillance systems are prone to undercounting. This paper is motivated by the challenge of estimating mortality associated with respiratory infections (e.

Long-Term Wildfire Smoke Exposure and Increased Risk of Heart Failure in Older Adults.

Background: Fine particulate matter, defined as particles <2.5 μm in diameter (PM), is the most important environmental risk factor for global mortality. Wildfires have been increasing globally, posing a global health challenge.

Case-crossover assessment of the modifying effects of home medication use on acute kidney-related morbidity due to elevated ambient heat exposure in Atlanta, GA, from 2013 to 2019.

Background: Elevated ambient temperatures increase the risk for acute kidney-related morbidity, and medication use may increase vulnerability to heat exposure. This study examines whether medication use, and combination medication use (ie, polypharmacy), modifies the risk for temperature-related volume depletion (VD) and acute kidney injury (AKI).

Methods: This study uses patient-level emergency department (ED) visit data from four Atlanta-area hospitals during the warm season from 2013 to 2019.

Associations Between Temperature and Location of Injury or Condition Among Heat-Related Emergency Department Visits.

High ambient temperature poses significant health risk globally. However, the relative importance of different exposure pathways leading to health risks remains unclear. For 9 US states during 2016-2018, ED visit records for heat exhaustion and heat stroke (HEAT), fluid and electrolyte imbalance (FEI), volume depletion (VD), and acute kidney injury (AKI) were identified via diagnosis codes.

Modeling Time-varying Dispersion to Improve Estimation of the Short-term Health Effect of Environmental Exposure in a Time-series Design.

Background: Time-series models for count outcomes are routinely used to estimate short-term health effects of environmental exposures. The dispersion parameter is universally assumed to be constant over the study period.

Objective: The aim is to examine whether dispersion depends on time-varying covariates in a case study of emergency department visits in Atlanta during 1999-2009 and to evaluate approaches for addressing time-varying dispersion.

A Time-Series Approach for Estimating Emergency Department Visits Attributable to Seasonal Influenza: Results from Six U.S. Cities, 2005-06 to 2016-17 Seasons.

Emergency department (ED) visits during influenza seasons represent a critical yet less examined indicator of the acute burden of influenza. This study investigates the burden of influenza-associated ED visits in six U.S.

Sensitive periods for exposure to indoor air pollutants and psychosocial factors in association with symptoms of psychopathology at school-age in a South African birth cohort.

Exposure to environmental toxicants and psychosocial stressors during gestation and early life are particularly harmful and may impact brain development. Specifically, exposure to indoor air pollutants (IAP) and psychosocial factors (PF) during these sensitive periods has been shown to predict childhood psychopathology. Here, we investigated sensitive periods for the individual and joint effects of IAP and PF on childhood psychopathology at 6.

Patterns of non-fatal overdose and injection-related bacterial infections during pregnancy and the postpartum year among New York State residents.

Objectives: Overdoses are a leading cause of maternal mortality in the US, but limited evidence exists about patterns of nonfatal overdose, a key risk factor for subsequent fatal overdose, or of other drug-related harms. Here, we estimate prevalences of nonfatal overdose and injection-related endocarditis and abscesses/cellulitis across the 21 months spanning pregnancy and the postpartum year.

Methods: Among people who experienced an in-hospital birth in New York State between 9/1/2016 and 1/1/2018 (N=330,872), we estimated the prevalences of hospital-based diagnoses of nonfatal overdose and of injection-related bacterial infections (i.

Estimating the Association Between Outdoor Temperature and Acute Kidney Injury Using Alternative Case Definitions.

Objective: This study aimed to improve estimates of the association between acute kidney injury (AKI) and ambient heat exposure through better case ascertainment and by isolating community-acquired AKI.

Methods: We conducted a case-crossover study using data on AKI-related emergency department (ED) visits in Atlanta. Daymet meteorology was used to assess exposure.

Ambient temperature in relation to ovarian reserve and early outcomes following ovarian stimulation and in vitro fertilization.

Introduction: There is limited epidemiologic evidence on the associations between ambient temperature and early outcomes of in vitro fertilization (IVF). This study examined the association between ambient temperature exposures during spermatogenesis in males and folliculogenesis in females with early IVF outcomes.

Methods: This retrospective cohort study included 529 oocyte donors linked to male partners of 1154 recipient couples who underwent 1379 oocyte thaw cycles between 2008 and 2020 at an IVF clinic in Atlanta, Georgia, USA.

Dust Storms and Emergency Department Visits in 3 Southwestern States Using NWS Storm Reports.

Importance: Dust storms are projected to increase with climate change. The short-term health outcomes associated with dust storms in the US are not well characterized, especially for morbidity outcomes.

Objective: To estimate associations between dust storms and diagnosis-specific emergency department (ED) visits during 2005 to 2018.

A time-to-event analysis of the association between ambient air pollution and risk of spontaneous abortion using vital records in the U.S. state of Georgia (2005-2014).

We examined the association between ambient air pollution exposure and risk of spontaneous abortion (SAB) using Georgia state-wide fetal death records from 2005-2014. Each SAB case was matched to four non-SAB pregnancies by maternal residential county and conception month. Daily concentrations of ten pollutants were estimated and linked to maternal residential census tracts.

State-Level Influenza Hospitalization Burden in the United States, 2022-2023.

To develop a method leveraging hospital-based surveillance to estimate influenza-related hospitalizations by state, age, and month as a means of enhancing current US influenza burden estimation efforts. Using data from the Influenza Hospitalization Surveillance Network (FluSurv-NET), we extrapolated monthly FluSurv-NET hospitalization rates after adjusting for testing practices and diagnostic test sensitivities to non-FluSurv-NET states. We used a Poisson zero-inflated model with an overdispersion parameter within the Bayesian hierarchical framework and accounted for uncertainty and variability between states and across time.

Exposure Contrasts of Women Aged 40-79 Years during the Household Air Pollution Intervention Network Randomized Controlled Trial.

Exposure to household air pollution has been linked to adverse health outcomes among women aged 40-79. Little is known about how shifting from biomass cooking to a cleaner fuel like liquefied petroleum gas (LPG) could impact exposures for this population. We report 24-h exposures to particulate matter (PM), black carbon (BC), and carbon monoxide (CO) among women aged 40 to <80 years participating in the Household Air Pollution Intervention Network trial.

Air Pollution and Cognitive Impairment Among the Chinese Elderly Population: An Analysis of the Chinese Longitudinal Healthy Longevity Survey (CLHLS).

Cognitive impairment and dementia have long been recognized as growing public health threats. Studies have found that air pollution is a potential risk factor for dementia, but the literature remains inconclusive. This study aimed to evaluate the association between three major air pollutants (i.

Spatial associations between measures of public transportation and diabetic foot ulcer outcomes in the state of Georgia: 2016-2019.

Introduction: There are limited data regarding the associations between public transportation reliance, availability, and diabetic foot ulcer (DFU)-related amputations.

Research Design And Methods: We used visit-level data from the Georgia 2016-2019 Healthcare Cost and Utilization Project database and obtained transportation variables from open sources. Using Bayesian spatial-temporal models, we assessed the associations between transportation and DFU-related amputations within each quartile of poverty status indicators at the ZIP code tabulation area (ZCTA) level.

The direct and urinary electrolyte-mediated effects of ambient temperature on population blood pressure: A causal mediation analysis.

High ambient heat can directly influence blood pressure (BP) through the vasodilation of the skin vasculature and indirectly by affecting urinary volume and electrolyte levels. We evaluated the direct and urine electrolyte-mediated effects of ambient temperature on BP. We pooled 5,624 person-visit data from a community-based stepped-wedge randomized control trial in southwest coastal Bangladesh from December 2016 to May 2017.