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Conditional means regression, including ordinary least squares (OLS), provides an incomplete picture of exposure-response relationships particularly if the primary interest resides in the tail ends of the distribution of the outcome. Quantile regression (QR) offers an alternative methodological approach in which the influence of independent covariates on the outcome can be specified at any location along the distribution of the outcome. We implemented QR to examine heterogeneity in the influence of early childhood lead exposure on reading and math standardized fourth grade tests. In children from two urban school districts (n=1,076), lead exposure was associated with an 18.00 point decrease (95% CI: -48.72, -3.32) at the 10th quantile of reading scores, and a 7.50 point decrease (95% CI: -15.58, 2.07) at the 90th quantile. Wald tests indicated significant heterogeneity of the coefficients across the distribution of quantiles. Math scores did not show heterogeneity of coefficients, but there was a significant difference in the lead effect at the 10th (β=-17.00, 95% CI: -32.13, -3.27) versus 90th (β=-4.50, 95% CI: -10.55, 4.50) quantiles. Our results indicate that lead exposure has a greater effect for children in the lower tail of exam scores, a result that is masked by conditional means approaches., (Copyright © 2014 Elsevier Inc. All rights reserved.)

School suspensions are associated with negative student outcomes. Environmental lead exposure increases hyperactivity and sensory defensiveness, two traits likely to increase classroom misbehavior and subsequent discipline. Childhood Blood Lead Level (BLL) test results categorized urban fourth graders as exposed (2687; lifetime max BLL 10-20 µg/dL) or unexposed (1076; no lifetime BLL ≥5 µg/dL). Exposed children were over twice as likely as unexposed children to be suspended (OR=2.66, 95% CI=[2.12, 3.32]), controlling for covariates. African American children were more likely to be suspended than white children, but lead exposure explained 23% of the racial discipline gap. These results suggest that different rates of environmental lead exposure may contribute to the racial discipline gap., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Fish consumption may be beneficial for a developing human fetus, but fish may also contain contaminants that could be detrimental. Great Lakes sport-caught fish (GLSCF) are contaminated with polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethylene (DDE), but the effects of these contaminants on birth outcome are not clear. To distinguish potential contaminant effects, we examined (1) whether the decrease over time in contaminant levels in GLSCF is paralleled by an increase in birth weight of children of GLSCF-consuming mothers and (2) the relation between maternal serum concentrations of these contaminants and birth weight. Mothers (n=511) were interviewed from 1993 to 1995, and maternal serum was collected from 1994 to 1995 (n=143). Potential confounders considered were child gender, maternal age at delivery, maternal prepregnancy body mass index, maternal cigarette and alcohol use during pregnancy, maternal education level, maternal parity, and maternal breastfeeding. Children born during 1970-1977, 1978-1984, and 1985-1993 to mothers who ate more than 116 meals of GLSCF before pregnancy were, on average, 164 g lighter, 46 g heavier, and 134 g heavier, respectively, than children of mothers who ate no GLSCF before pregnancy (P trend=0.05). GLSCF-consuming mothers had higher serum PCB and DDE concentrations, but only increased DDE was associated with lower birth weight. The data suggest that fetal DDE exposure (as indicated by maternal serum DDE concentration) may decrease birth weight and that decreased birth weight effects associated with GLSCF consumption have decreased over time.

The purpose was to examine the effectiveness of low-cost abatement on children's blood lead levels. Blood lead was analyzed before and after abatement in 37 homes of children under 7 years old with initial blood lead levels of 25-44 microgram/dL. Ninety-five percent of homes were built before 1950. Abatement methods used were wet-scraping and repainting deteriorated surfaces and wrapping window wells with aluminum or vinyl. A control group was retrospectively selected. Control children were under 7 years old, had initial blood lead levels of 25-44 microgram/dL and a follow-up level at least 28 days afterward, and did not have abatements performed in their homes between blood lead levels. After abatement, statistically significant declines occurred in the intervention children's blood lead levels. The mean decline was 22%, 1 to 6 months after treatment. After adjustment for seasonality and child's age, the mean decline was 6.0 microgram/dL, or 18%. The control children's blood levels did not decline significantly. There was a mean decline of 0.25 microgram/dL, or 0.39%. After adjustment for seasonality and age, the mean decline for control children was 1.6 microgram/dL, or 1.8%. Low-cost abatement and education are effective short-term interim controls., (Copyright 1999 Academic Press.)

Great Lakes (GL) sport fish consumption is a potential human exposure route for polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethene (DDE). Because of fish tissue contamination, frequent consumers of Great Lakes sport caught fish (GLSCF) may be at risk for PCB and DDE accumulation. To examine this problem, the Health Departments of Wisconsin, Illinois, Indiana, Ohio, and Michigan formed a health assessment consortium. Participants were contacted by telephone to complete a detailed demographic and fish consumption survey. Frequent and infrequent GLSCF consumers were identified, and a participant subset was then asked to donate blood for PCB and DDE analysis. Analysis of variance (ANOVA) was done to study exposure group mean differences, while correlation and regression analyses were performed to examine relationships between demographic characteristics, GLSCF consumption, PCB, and DDE body burdens. A total of 4206 individuals participated in the study. Of these, 2542 were habitual GLSCF consumers (mean greater than 35 meals/year males; greater than 27 meals/year females), while 1664 did not eat GLSCF. A subset of 538 participants donated blood and included 439 frequent and 99 infrequent GLSCF consumers. PCB levels were significantly higher in the group of GLSCF consumers (geometric mean: 4.8 ppb males, 2.1 ppb females) when compared to their referents (geometric mean: 1.5 ppb males, 0.9 ppb females), while DDE levels were also higher for GLSCF consumers. PCB and DDE body burdens varied by exposure group, gender, and great lake (Michigan, Huron, Erie). PCB and DDE levels were significantly correlated to age, body mass index, and sport fish and Great Lakes sport fish consumption histories. Regression analysis identified years of consuming sport caught fish as the most robust predictor of PCBs (r2=25%), while age was the best predictor of DDE levels (r2=21%). This study corroborated previous findings relating frequent GLSCF consumption to a higher body burden for PCBs and DDE., (Copyright 1999 Academic Press.)

Dioxins, furans, and polychlorinated biphenyls (PCBs) are toxic, persist in the environment, and bioaccumulate to concentrations that can be harmful to humans. Sport anglers may be exposed to these residues via consumption of contaminated Great Lakes (GL) fish. The Health Departments of five GL states, Wisconsin, Michigan, Ohio, Illinois, and Indiana, formed a consortium to study body burden levels of chemical residues in fish consumers of Lakes Michigan, Huron, and Erie. In Fall 1993, a telephone survey was administered to sport angler households to obtain fish consumption habits and demographics. A blood sample was obtained from a portion of the study subjects. One hundred serum samples were analyzed for 8 dioxin, 10 furan, and 4 coplanar PCB congeners. Multiple linear regression was conducted to assess the predictability of the following covariates: GL sport fish species, age, BMI, gender, years sport fish consumed, and lake. Of the 100 subjects, there were 58 men; 35 consumed sport fish from Lake Michigan, 29 from Lake Huron, and 36 from Lake Erie. The overall average number of GL sport fish meals consumed in the previous 12 months was 43. Lake Erie male and female consumers, on average, ate more GL sport fish, a mean of 57 and 42 meals, respectively, than men and women from the other two lake subgroups. Median total dioxin toxic equivalents (TEq), total furan TEq, and total coplanar PCB TEq were higher among all men than all women (P=0.0001). Lake trout, salmon, age, BMI, and gender were significant regression predictors of log(total coplanar PCBs). Lake trout, age, gender, and lake were significant regression predictors of log(total furans). Age was the only significant predictor of total dioxin levels., (Copyright 1999 Academic Press.)

Prenatal exposure to polychlorinated biphenyls (PCBs) and reproductive outcome was determined in a population of 1112 women during 1987-1989. The women studied were from the Green Bay, Wisconsin area, thereby providing a population with potential PCB exposure from Lake Michigan sport fish consumption. All women with positive pregnancy tests from two Green Bay prenatal clinics were asked to complete a self-administered questionnaire on fish consumption, health and reproductive history, and other relevant issues and to provide blood samples for PCB analysis. A positive correlation was found between the amount of Lake Michigan fish mothers claimed to consume and their PCB serum levels. After the pregnancy period, reproductive outcome measures (fetal wastage; stillbirths; and birth weight, birth length, head circumference, ponderal index, and birth weight percentiles for live births) were abstracted from hospital labor reports. Typical negative associations between birth size measures and consumption of caffeine, smoking, and alcohol were found. Birth size was positively associated with gestational age, birth order, weight gain during pregnancy, male babies, and rural residence. Birth size was also associated with PCB exposure; however contrary to expectations, a positive association was found (P < 0.044) for most mothers (the exception being those mothers who gained more than 34 lb during their pregnancy). PCB exposures were lower than the other studies that found that birth size was negatively associated with PCB exposure.