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1. Removing lead from the global economy

Author: Luby, Stephen P, Forsyth, Jenna E, Fatmi, Zafar, Rahman, Mahbubur, Sultana, Jesmin, Plambeck, Erica L, Miller, N Grant, Bendavid, Eran, Winch, Peter J, Hu, Howard, Lanphear, Bruce, and Landrigan, Philip J
Abstract: Lead, an element toxic to countless biological processes, occurs naturally in the earth's lithosphere and is geologically sequestered from the biosphere at the earth's surface. When humans remove lead from the lithosphere and distribute it throughout the economy, its toxic effects impact throughout the web of life. Lead mining and manufacturing is a small industry that generates enormous harms. Lead impairs the growth, development, and reproduction of microbes, insects, plants, and animals. The annual human costs of lead exposure include 5·5 million premature adult deaths from cardiovascular disease and US$1·4 trillion in losses to the global economy from lead impairing children's cognitive development. Although the lead industry touts lead as the most recycled metal, most recycling occurs within countries that are incapable of enforcing environmental regulations. Millions of metric tonnes of lead are dispersed into the environment each year, disproportionately in low-income and middle-income countries. Substitutes for lead in the economy are available and we should act in the best interests of the planet and human health by eliminating lead from the global economy by 2035.
Published: 2024
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2. Early life exposure to lead and its association with parent-reported aggression and conduct problems during childhood and adolescence

Author: Reyes Sánchez, Jaime D., Trejo-Valdivia, Belem, Schnaas, Lourdes, Osorio-Valencia, Erika, Lamadrid-Figueroa, Héctor, Bautista-Arredondo, Luis F., Peterson, Karen E., Hu, Howard, and Téllez-Rojo, Martha M.
Abstract: An association between lead (Pb) exposure and antisocial behaviors has been documented, but findings have been inconclusive. We aimed to estimate the association between prenatal, early childhood, and preadolescent/adolescent (periadolescent) Pb exposure and aggression and conduct problems in periadolescent residents of Mexico City.
Published: 2022
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3. Critical windows of fetal lead exposure: adverse impacts on length of gestation and risk of premature delivery

Author: Cantonwine, David, Hu, Howard, Sanchez, Brisa N., Lamadrid-Figueroa, Hector, Smith, Donald, Ettinger, Adrienne S., Mercado-Garcia, Adriana, Hernandez-Avila, Mauricio, Wright, Robert O., and Tellez-Rojo, Martha Maria
Subjects: Lead in the body -- Demographic aspects, Lead in the body -- Research, Occupational health and safety -- Demographic aspects, Occupational health and safety -- Patient outcomes, Occupational health and safety -- Research, Premature birth -- Risk factors, Premature birth -- Research, Prenatal influences -- Demographic aspects, Prenatal influences -- Research, Gestational age -- Demographic aspects, Gestational age -- Research, Environmental issues, Health
Published: 2010

4. Maternal MTHFR genotype and haplotype predict deficits in early cognitive development in a lead-exposed birth cohort in Mexico City

Author: Pilsner, J. Richard, Hu, Howard, Wright, Robert O., Kordas, Katarzyna, Ettinger, Adrienne S., Sanchez, Brisa N., Cantonwine, David, Lazarus, Alicia L., Cantoral, Alejandra, Schnaas, Lourdes, Tellez-Rojo, Martha Maria, and Hernandez-Avila, Mauricio
Subjects: Child development deviations -- Risk factors, Child development deviations -- Genetic aspects, Child development deviations -- Demographic aspects, Child development deviations -- Research, Developmental disabilities -- Risk factors, Developmental disabilities -- Genetic aspects, Developmental disabilities -- Demographic aspects, Developmental disabilities -- Research, Folic acid -- Health aspects, Folic acid -- Genetic aspects, Folic acid -- Research, Genetic polymorphisms -- Research, Lead poisoning -- Complications and side effects, Lead poisoning -- Demographic aspects, Lead poisoning -- Research, Food/cooking/nutrition, Health
Abstract: Background: Maternal folate nutritional status and prenatal lead exposure can influence fetal development and subsequent health. The methylenetetrahydrofolate reductase (MTHFR) gene is important for folate metabolism, and 2 common polymorphisms, C677T and A1298C, reduce enzymatic activity; C677T is present at high penetrance in Mexican populations. Objective: The objective of this study was to examine potential links between maternal and child MTHFR polymorphisms and child neurodevelopment in a lead-exposed population. Design: Data regarding MTHFR polymorphisms C677T and A1298C, peri- and postnatal lead measures, and Bayley Mental Development Index at 24 mo of age (MDI-24) scores were available for 255 mother-child pairs who participated in the ELEMENT (Early Life Exposures in Mexico to Environmental Toxicants) study during 1994-1995. Results: In covariate-adjusted regression models, maternal MTHFR 677 genotype predicted MDI-24 scores, in which each copy of the maternal MTHFR 677T variant allele was associated with lower MDI-24 scores ([beta] = -3.52; 95% CI: -6.12, -0.93; P = 0.004). Maternal MTHFR haplotype also predicted MDI-24 scores (mean [+ or -] SE: 93.3 [+ or -] 1.2 for 677C-1298A compared with 89.9 [+ or -] 0.8 for 677T-1298A; P < 0.05). MDI-24 scores were not associated with maternal MTHFR 1298 genotype or child MTHFR genotypes. We did not observe significant MTHFR genotype x lead interactions with respect to any of the subject biomarkers of lead exposure. Conclusions: The maternal MTHFR 677T allele is an independent predictor of poorer child neurodevelopment at 24 mo. These results suggest that maternal genetic variations in folate metabolism during pregnancy may program offspring neurodevelopment trajectories. Further research is warranted to determine the generalizability of these results across other populations. Am J Clin Nutr 2010;92:226-34. doi: 10.3945/ajcn.2009.28839.
Published: 2010

5. Bone lead level prediction models and their application to examine the relationship of lead exposure and hypertension in the third national health and nutrition examination survey

Author: Park, Sung Kyun, Mukherjee, Bhramar, Xia, Xi, Sparrow, David, Weisskopf, Marc G., Nie, Huiling, and Hu, Howard
Subjects: Lead in the body -- Measurement, Lead in the body -- Surveys, Hypertension -- Risk factors, Hypertension -- Surveys, Occupational health and safety -- Surveys, Health risk assessment -- Models, Environmental issues, Health
Published: 2009

6. Bone lead and endogenous exposure in an environmentally exposed elderly population: The Normative Aging Study

Author: Nie, Huiling, Sanchez, Brisa N., Wilker, Elissa, Weisskopf, Marc G., Schwartz, Joel, Sparrow, David, and Hu, Howard
Subjects: Occupational health and safety -- Demographic aspects, Occupational health and safety -- Research, Lead in the body -- Demographic aspects, Lead in the body -- Research, Bone resorption -- Research, Environmental issues, Health
Published: 2009

7. Fruit, vegetable, and fish consumption and heart rate variability: the Veterans Administration Normative Aging Study

Author: Park, Sung Kyun, Tucker, Katherine L., O'Neill, Marie S., Sparrow, David, Vokonas, Pantel S., Hu, Howard, and Schwartz, Joel
Subjects: Food consumption -- Health aspects, Food consumption -- Research, Food habits -- Health aspects, Food habits -- Research, Cardiac arrest -- Prevention, Arrhythmia -- Prevention, Food/cooking/nutrition, Health
Abstract: Background: Higher intakes of fruit, vegetables, and dark fish may prevent sudden cardiac death and arrhythmias, but the exact mechanisms are not fully understood. Objective: We examined whether high consumption of fruit, vegetables, and dark fish would be associated with beneficial changes in heart rate variability (HRV). Design: HRV variables were measured among 586 older men with 928 total observations from November 2000 to June 2007 in the Normative Aging Study, a community-based longitudinal study of aging. Dietary intake was evaluated with a self-administered semi-quantitative food-frequency questionnaire and categorized into quartiles. Results: After controlling for potential confounders, intake of green leafy vegetables was positively associated with normalized high-frequency power and inversely associated with normalized low-frequency power (P for trend < 0.05). These significant associations were retained after further adjustment for healthy lifestyle factors, such as physical activity and use of multivitamins. No significant association was seen between HRV measures and intakes of other fruit and vegetables, vitamin C, carotenoids, tuna and dark-meat fish, or n-3 (omega-3) fatty acids. An effect modification of intake of noncitrus fruit by obesity and of total vegetables and cruciferous vegetables by cigarette smoking was seen, which warrants further investigation. Conclusion: These findings suggest that higher intake of green leafy vegetables may reduce the risk of cardiovascular disease through favorable changes in cardiac autonomic function.
Published: 2009

8. Pollution and health: a progress update

Author: Fuller, Richard, Landrigan, Philip J, Balakrishnan, Kalpana, Bathan, Glynda, Bose-O'Reilly, Stephan, Brauer, Michael, Caravanos, Jack, Chiles, Tom, Cohen, Aaron, Corra, Lilian, Cropper, Maureen, Ferraro, Greg, Hanna, Jill, Hanrahan, David, Hu, Howard, Hunter, David, Janata, Gloria, Kupka, Rachael, Lanphear, Bruce, Lichtveld, Maureen, Martin, Keith, Mustapha, Adetoun, Sanchez-Triana, Ernesto, Sandilya, Karti, Schaefli, Laura, Shaw, Joseph, Seddon, Jessica, Suk, William, Téllez-Rojo, Martha María, and Yan, Chonghuai
Abstract: The LancetCommission on pollution and health reported that pollution was responsible for 9 million premature deaths in 2015, making it the world's largest environmental risk factor for disease and premature death. We have now updated this estimate using data from the Global Burden of Diseases, Injuriaes, and Risk Factors Study 2019. We find that pollution remains responsible for approximately 9 million deaths per year, corresponding to one in six deaths worldwide. Reductions have occurred in the number of deaths attributable to the types of pollution associated with extreme poverty. However, these reductions in deaths from household air pollution and water pollution are offset by increased deaths attributable to ambient air pollution and toxic chemical pollution (ie, lead). Deaths from these modern pollution risk factors, which are the unintended consequence of industrialisation and urbanisation, have risen by 7% since 2015 and by over 66% since 2000. Despite ongoing efforts by UN agencies, committed groups, committed individuals, and some national governments (mostly in high-income countries), little real progress against pollution can be identified overall, particularly in the low-income and middle-income countries, where pollution is most severe. Urgent attention is needed to control pollution and prevent pollution-related disease, with an emphasis on air pollution and lead poisoning, and a stronger focus on hazardous chemical pollution. Pollution, climate change, and biodiversity loss are closely linked. Successful control of these conjoined threats requires a globally supported, formal science–policy interface to inform intervention, influence research, and guide funding. Pollution has typically been viewed as a local issue to be addressed through subnational and national regulation or, occasionally, using regional policy in higher-income countries. Now, however, it is increasingly clear that pollution is a planetary threat, and that its drivers, its dispersion, and its effects on health transcend local boundaries and demand a global response. Global action on all major modern pollutants is needed. Global efforts can synergise with other global environmental policy programmes, especially as a large-scale, rapid transition away from all fossil fuels to clean, renewable energy is an effective strategy for preventing pollution while also slowing down climate change, and thus achieves a double benefit for planetary health.
Published: 2022
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9. Interaction of the (delta)-aminolevulinic acid dehydratase polymorphism and lead burden on cognitive function: the VA normative aging study

Author: Rajan, Pradeep, Kelsey, Karl T., Schartz, Joel D., Bellinger, David C., Weuve, Jennifer, Spiro, Avron, III, Sparrow, David, Smith, Thomas J., Nie, Huiling, Weisskopf, Marc G., Hu, Howard, and Wright, Robert O.
Subjects: Genetic polymorphisms -- Research, Lead in the body -- Research, Cognition -- Research, Environmental issues, Health
Published: 2008

10. Relationship of bone and blood lead levels to psychiatric symptoms: the Normative Aging Study

Author: Rhodes, Daniel, Spiro, Avron, III, Aro, Antonio, and Hu, Howard
Subjects: Lead in the body -- Measurement, Lead poisoning -- Psychological aspects, Environmental issues, Health
Published: 2003

11. Effect of maternal bone lead on length and head circumference of newborns and 1-month-old infants

Author: Hernandez-Avila, Mauricio, Peterson, Karen E., Gonzalez-Cossio, Teresa, Sanin, Luz H., Aro, Antonio, Schnaas, Lourdes, and Hu, Howard
Subjects: Bones -- Composition, Infants (Newborn) -- Physiological aspects, Pregnant women -- Physiological aspects, Lead in the body -- Physiological aspects, Environmental issues, Health
Abstract: The authors evaluated the effects that maternal bone lead stores have in anthropometry at birth in 223 mother-infant pairs. The participants were recruited between April and November 1994. Anthropometric data were collected within the first 12 hr following delivery. Maternal information was obtained 1 mo after delivery occurred. Bone lead burden was determined with in-vivo K-x-ray fluorescence of the tibia (cortical bone) and the patella (trabecular bone). The authors transformed anthropometric measurements to an ordinal 5-category scale, and the association of measurements with other factors was evaluated with ordinal logistic-regression models. Mean bone lead levels were 9.8 [micro]g/gm bone mineral and 14.4 [micro]g/gm bone mineral for the tibia and patella, respectively. Birth length of newborns decreased as tibia lead levels increased. Compared with women in the lower quintiles of the distribution of tibia lead, those in the upper quintile had a 79% increase in risk of having a lower birth length newborn (odds ratio = 1.79; 95% confidence interval = 1.10, 3.22). The authors adjusted by birth weight, and the effect was attenuated--but nonetheless significant. Patella lead was positively and significantly related to the risk of a low head circumference score; this score remained unaffected by inclusion of birth weight. The authors estimated the increased risk to be 1.02 per [micro]g lead/gm bone mineral (95% confidence interval = 1.01, 1.04 per [micro]g lead/gm bone mineral). Odds ratios did not vary substantially after the authors adjusted for birth weight and other important determinants of head circumference., ACCUMULATING EVIDENCE suggests that mobilization of endogenous bone lead stores can cause the continuation of lead exposure for years following removal of the primary source of exposure. (1) The skeleton [...]
Published: 2002

12. Season modifies the relationship between bone and blood lead levels: the normative aging study

Author: Oliveira, Steve, Aro, Antonio, Sparrow, David, and Hu, Howard
Subjects: Lead in the body -- Physiological aspects, Bones -- Composition, Seasonal variations (Diseases) -- Research, Environmental issues, Health
Abstract: Bone serves as a repository for 75% and 90-95% of lead in children and adults, respectively. Bone lead mobilization heightens during times of increased bone turnover, such as pregnancy, lactation, hyperthyroidism, and the rapid growth of childhood. Blood lead levels show seasonal periodicity. Children demonstrate peak blood lead levels in midsummer and a secondary peak in late winter. Pregnant women demonstrate the highest mean blood lead levels in winter (January-March) and the lowest in summer (July-September). This fluctuation in blood lead levels may be related to seasonal patterns of environmental exposures, but it may also be partially related to the increased mobilization of bone lead stores during the winter months. We performed bone lead measurements using a K-x-ray fluorescent instrument to determine micrograms of lead per gram of bone mineral (parts per million) in middle-aged and elderly men who participated in the Normative Aging Study. We obtained measurements of blood and bone lead during the high sun exposure months of May-August (summer; n = 290); the intermediate sun exposure months of March, April, September, and October (spring/fall; n = 283); and the low sun exposure months of November-February (winter; n = 191). Mean blood lead concentrations were 5.8 [micro]g/dl, 6.1 [micro]g/dl, and 6.6 [micro]g/dl for the summer, spring/fall, and winter, respectively. Mean patella (trabecular bone) lead concentrations were 34.3 [micro]g/gm, 29.7 [micro]g/gm, and 29.0 [micro]g/gm for the summer, spring/fall, and winter time periods, respectively. In multivariate regression models, adjusted for age, smoking, alcohol ingestion, and dietary intake of iron and vitamin C, the authors found a strong interaction between season and bone lead level--with bone lead levels exerting an almost 2-fold greater influence on blood levels during the winter months than the summer months. The authors concluded that elevated blood lead levels in winter may be related to increased mobilization of endogenous bone lead stores, potentially from decreased exposure to sunlight, lower levels of activated vitamin D, and enhanced bone resorption., LEAD is arguably the most heavily investigated toxin in environmental health, yet lead exposure and toxicity have remained a major focus of research because of persistent gaps in our knowledge [...]
Published: 2002

13. Risk factors for multisymptom illness in US army veterans of the Gulf War

Author: Wolfe, Jessica, Proctor, Susan P., Erickson, Darin J., and Hu, Howard
Subjects: Persian Gulf War veterans -- Diseases, Environmental issues, Health
Published: 2002

14. Lead toxicity in older adults

Author: Vig, Elizabeth K. and Hu, Howard
Subjects: Gerontology -- Research, Aging -- Health aspects, Aged -- Health aspects, Lead in the body -- Demographic aspects, Occupational health and safety -- Research, Senile dementia -- Risk factors, Bones -- Aging, Lead -- Environmental aspects, Lead based paint -- Environmental aspects, Hypertension -- Risk factors, Chronic kidney failure -- Risk factors, Health risk assessment -- Observations, Osteoporosis -- Drug therapy, Toxicological interactions -- Research, Health, Seniors
Abstract: Lead toxicity as it relates to older adults is discussed. Lead, even at low levels, in relative terms, can harm the elderly as well as others. The elderly may have been exposed to lead in work or in other ways over most of a lifetime. Blood and bone lead levels, it is beginning to appear, are associated with hypertension, renal insufficiency and cognitive impairment, even when exposures are relatively modest. Medical treatments to slow rate of bone resorption may keep lead in bones. Chart shows pathways of lead from environment to humans and occupations with risk of lead exposure are listed.
Published: 2000

15. Fitness for duty evaluations in hazardous materials firefighters

Author: Kales, Stephen N., Aldrich, Jon M., Polyhronopoulos, Gerry N., Artzerounian, David, Gassert, Thomas, Hu, Howard, Kelsey, Karl, Sweet, Charles, and Christiani, David C.
Subjects: Fire fighters -- Medical examination, Hazardous occupations -- Standards, Environmental issues, Health
Published: 1998

16. Long-term health and employment outcomes of occupational asthma and their determinants

Author: Gassert, Thomas H., Hu, Howard, Kelsey, Karl T., and Christiani, David C.
Subjects: Occupational diseases -- Prognosis, Asthma -- Prognosis, Blue collar workers -- Diseases, Environmental issues, Health
Published: 1998

17. Longitudinal relationship between dentin lead levels in childhood and bone lead levels in young adulthood

Author: Kim, Rokho, Hu, Howard, Rotnitzky, Andrea, Bellinger, David, and Needleman, Herbert
Subjects: Lead in the body -- Measurement, Lead -- Health aspects, Lead poisoning -- Models, Environmental issues, Health
Abstract: A retrospective cohort study was conducted to examine the relationship between tooth lead in children and bone lead levels in young adults. Members of a cohort of young adults were reassessed 13 y after initial examination at an ambulatory clinical research center. Dentin lead levels were measured by anodic stripping voltammetry during the years 1975-1978, and bone lead levels of the tibia and patella were measured by K-x-ray fluorescence technique during 1989 and 1990. A total of 63 subjects who had no history of chelation or had no missing information on potential confounders were studied. The median follow-up interval was 13.2 y. Dentin lead levels averaged 13.4 [mu]g/g (SD = 4.4 [mu]g/g, range = 9-3 [mu]g/g) increase means, and bone lead levels averaged [mu]g/g range for tibia and range for patella. The authors controlled for age, sex, race, and mothers socioeconomic status, and dentin lead levels were predictive of higher tibia, patella, and mean bone lead levels in 32 subjects (follow-up interval of 11.8-13.2 y). A correction for measurement errors in dentin lead measurements was made, and it was determined that a 10-[mu]g/g increase in dentin lead levels in childhood was predictive of a increase in tibia lead levels, a S@ increase in patella lead levels, and a 3-[mu]g/g increase in mean bone lead levels among the young adults. it was concluded, therefore, that lead exposure in early life may be used to predict elevated body burden up to 13 y later., CONCENTRATION OF LEAD in the circumpulpal dentin of deciduous teeth has been a useful biomarker of cumulative lead exposure in studies of chronic toxicity of lead.[1-8] However, whether tooth lead [...]
Published: 1996

18. Levels of lead in blood and bone of women giving birth in a Boston hospital

Author: Hu, Howard, Hashimoto, Dean, and Besser, Mitchell
Subjects: Lead -- Health aspects, Maternal-fetal exchange -- Environmental aspects, Lead in the body -- Measurement, Environmental issues, Health
Abstract: Blood lead levels declined among Americans aged 1-74 y between the years 1976 and 1991 (National Health and Examination Survey INHANES (fil). in 1990, umbilical cord blood lead levels were surveyed among 223 women who gave birth in a Boston hospital obstetrical service. in a survey conducted 10 y earlier, women had a mean umbilical cord blood lead level of 6.56 [mu]g/dl (standard deviation = 3.19). in another subgroup of 41 women who were 1-4 wk postpartum, bone lead levels were surveyed with a K-x-ray fluorescence instrument and by analysis of venous blood lead levels. in 1990, umbilical cord blood lead levels were very low (i.e., mean and median of 1. 1 9 [standard deviation = 1.321 and 1.0 [mu]g/dl, respectively). In the subgroup of postpartum women, lead levels in cortical bone (i.e., tibia) and trabecular bone (i.e., patelia) were also low (i.e., tibia mean and median of 4.5 [standard deviation = 4.01 and 4 [mu]g/g bone mineral, respectively; patelia mean and median of 5.8 [standard deviation = 4.51 and 5 [mu]g/g, respectively). Maternal age was the only factor associated (i.e., borderline [p = .0761) with bone lead. Umbilical cord blood lead levels among women served by this Biston hospital from 1980 to 1990 declined dramatically, thus parallering the National Health and Examination Survey. Bone lead levels were also low, but lead remains a reproductive hazard to women in select high-risk groups.
Published: 1996

19. Attentional correlates of dentin and bone lead levels in adolescents

Author: Bellinger, David, Hu, Howard, Titlebaum, Libby, and Needleman, Herbert L.
Subjects: Teenagers -- Psychological aspects, Lead in the body -- Health aspects, Attention-deficit hyperactivity disorder -- Risk factors, Environmental issues, Health
Abstract: In an effort to determine whether specific aspects of attention are impaired by lead, the performance of 79 subjects (aged 19 and 20 y) on a neuropsychologically based battery of tests of attention was examined in relation to lead levels in deciduous teeth (dentin), current blood, and tibia and patella bones measured by K-X-ray fluorescence. Dentin lead levels averaged 14 [mu]g/g. Most bone lead levels were less than 10 [mu]g/g. Dentin lead levels were related inversely to scores on two of four attention factors: focus-execute (ability to select and respond to critical information) and shift (ability to shift focus adaptively). Few significant associations were observed between bone lead levels and performance. Five individuals with the ALA-D 1-2 isozyme phenotype tended to achieve more optimal scores. Executive and self-regulation functions may be among the cognitive skills targeted by lead., THE MAJOR ENDPOINT examined in nearly all studies of low-level lead neurotoxicity is IQ, a familiar global index of impairment. IQ reflects largely neuropsychological product rather than process, performance rather [...]
Published: 1994

20. Predicting the climate impact of healthcare facilities using gradient boosting machines

Author: Yin, Hao, Sharma, Bhavna, Hu, Howard, Liu, Fei, Kaur, Mehak, Cohen, Gary, McConnell, Rob, and Eckel, Sandrah P.
Abstract: Health care accounts for 9–10% of greenhouse gas (GHG) emissions in the United States. Strategies for monitoring these emissions at the hospital level are needed to decarbonize the sector. However, data collection to estimate emissions is challenging. We explored the potential of gradient boosting machines (GBM) to impute missing data on resource consumption in the 2020 survey of a consortium of 283 hospitals participating in Practice Greenhealth. GBM imputed missing values for selected variables in order to predict electricity use (R2 = 0.82) and beef consumption (R2 = 0.82) and anesthetic gas desflurane use (R2 = 0.51), using administrative and financial data readily available for most hospitals. After imputing missing consumption data, estimated GHG emissions associated with these three examples totaled over 3 million metric tons of CO2equivalent emissions (MTCO2e). Specifically, electricity consumption had the largest total carbon footprint (2.4 MTCO2e), followed by beef (0.6 million MTCO2e) and desflurane consumption (0.03 million MTCO2e) across the 283 hospitals. The approach should be applicable to other sources of hospital GHGs in order to estimate total emissions of individual hospitals and to refine survey questions to help develop better intervention strategies.
Published: 2024
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21. X-ray fluorescence measurements of lead burden in subjects with low-level community lead exposure

Author: Hu, Howard, Milder, Fredric L., and Burger, Douglas E.
Subjects: X-ray spectroscopy, Lead in the body -- Measurement, Lead -- Health aspects, Lead poisoning -- Diagnosis, Environmental issues, Health
Abstract: As public awareness and environmental controls increase, acute lead intoxication levels and symptoms of lead toxicity are decreasing. More attention is now being directed toward identifying, measuring and eliminating sources of chronic exposure to absorbable lead. X-ray fluorescence (XRF) estimation of chronically absorbed bone lead content is being considered as a reliable means of obtaining measurements and as a useful method for population studies. This technique was evaluated in assessing the status of persons who were not subjected to either industrial or occupational lead exposure, but who acquired their lead burden by living in an industrialized society. The 34 subjects, who were employed by a biomedical company, completed questionnaires on history of lead exposure or intoxication and hobbies, previous lifestyles or habitation that may have caused exposure. K-XRF measurements were made at the mid shaft of the tibia (lower leg bone) for 30 minutes. This instrument is organized and calibrated to operate at a distance of 2.5 centimeters, and give direct readings of bone lead content. Sixteen subjects were found to have lead levels of up to 21 micrograms of lead per gram of bone material. Eighteen had readings below the measurement uncertainty. Older participants had higher lead levels than younger individuals. Questionnaire responses indicated that residing in homes built before 1955 or homes with lead-soldered plumbing contributed to some of the elevated levels. The results support the use of the XRF instrument and testing procedures in the assessment of low-level lead loading in population studies. (Consumer Summary produced by Reliance Medical Information, Inc.), AS THE LEVEL of lead exposure associated with adverse health outcomes continues to decline with advances in research, increased attention is being directed to finding an integrated measure of chronic [...]
Published: 1990

22. Blood lead levels in low-income and middle-income countries: a systematic review

Author: Ericson, Bret, Hu, Howard, Nash, Emily, Ferraro, Greg, Sinitsky, Julia, and Taylor, Mark Patrick
Abstract: Since the global phase-out of leaded petrol, reports have suggested that lead exposure remains substantial or is increasing in some low-income and middle-income countries (LMICs). However, few studies have attempted to systematically assess blood lead levels over the full range of LMICs. We aimed to describe values for blood lead level in LMICs.
Published: 2021
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23. Blood DNA methylation biomarkers of cumulative lead exposure in adults

Author: Colicino, Elena, Just, Allan, Kioumourtzoglou, Marianthi-Anna, Vokonas, Pantel, Cardenas, Andres, Sparrow, David, Weisskopf, Marc, Nie, Linda H., Hu, Howard, Schwartz, Joel D., Wright, Robert O., and Baccarelli, Andrea A.
Abstract: Background: Lead is a ubiquitous toxicant following three compartment kinetics with the longest half-life found in bones. Patella and tibia lead levels—validated measures of cumulative exposure—require specialized X-ray-fluorescence-spectroscopy available only in a few centers worldwide. We developed minimally invasive biomarkers reflecting individual cumulative lead exposure using blood DNA methylation profiles—obtainable via Illumina 450K or IlluminaEPIC bead-chip assays. Methods: We developed and tested two methylation-based biomarkers from 348 Normative Aging Study (NAS) elderly men. We selected methylation sites with strong associations with bone lead levels via robust regressions analysis and constructed the biomarkers using elastic nets. Results were validated in a NAS subset, reporting specificity, and sensitivity. Findings: Participants were 73 years old on average (standard deviation, SD?=?6), with moderate lead levels of (mean?±?SD patella: 27?±?18?µg/g; tibia:21?±?13?µg/g). Methylation-based biomarkers for lead in patella and tibia included 59 and 138 DNA methylation sites, respectively. Estimated lead levels were significantly correlated with actual measured values, (r?=?0.62 patella, r?=?0.59 tibia) and had low mean square error (MSE) (MSE?=?0.68 patella, MSE?=?0.53 tibia). Means and distributions of the estimated and actual lead levels were not significantly different across patella and tibia bones (p?>?0.05). Methylation-based biomarkers discriminated participants highly exposed (>median) to lead with a specificity of 74 and 73% for patella and tibia lead levels, respectively, with 70% sensitivity. Interpretation: DNA methylation-based lead biomarkers are novel tools that can be used to reconstruct decades’ worth of individual cumulative lead exposure using only blood DNA methylation profiles and may help identify the consequences of cumulative exposure.
Published: 2021
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24. Increasing the Impact of Environmental Epidemiology in the Global Burden of Disease Project

Author: Causey, Kate, Burkart, Katrin, Collman, Gwen, Hu, Howard, Brauer, Michael, and London, Stephanie J
Published: 2021
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25. Prenatal Lead Exposure, Type 2 Diabetes, and Cardiometabolic Risk Factors in Mexican Children at Age 10–18 Years

Author: Liu, Yun, Ettinger, Adrienne S, Téllez-Rojo, Martha, Sánchez, Brisa N, Zhang, Zhenzhen, Cantoral, Alejandra, Hu, Howard, and Peterson, Karen E
Published: 2020
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26. Fluoride Content in Foods and Beverages From Mexico City Markets and Supermarkets

Author: Cantoral, Alejandra, Luna-Villa, Lynda Cristina, Mantilla-Rodriguez, Andres A., Mercado, Adriana, Lippert, Frank, Liu, Yun, Peterson, Karen E., Hu, Howard, Téllez-Rojo, Martha M., and Martinez-Mier, Esperanza A.
Abstract: Background: Sources of fluoride exposure for Mexicans include foods, beverages, fluoridated salt, and naturally fluoridated water. There are no available data describing fluoride content of foods and beverages consumed in Mexico.Objective: To measure the content of fluoride in foods and beverages typically consumed and to compare their content to that of those from the United States and the United Kingdom.Methods: Foods and beverages reported as part of the Mexican Health and Nutrition Survey (n = 182) were purchased in the largest supermarket chains and local markets in Mexico City. Samples were analyzed for fluoride, at least in duplicate, using a modification of the hexamethyldisiloxane microdiffusion method. Value contents were compared to those from the US Department of Agriculture and UK fluoride content tables.Results: The food groups with the lowest and highest fluoride content were eggs (2.32 µg/100 g) and seafood (371 µg/100 g), respectively. When estimating the amount of fluoride per portion size, the lowest content corresponded to eggs and the highest to fast foods. Meats and sausages, cereals, fast food, sweets and cakes, fruits, dairy products, legumes, and seafood from Mexico presented higher fluoride contents than similar foods from the United States or the United Kingdom. Drinks and eggs from the United States exhibited the highest contents, while this was the case for pasta, soups, and vegetables from the United Kingdom.Conclusion: The majority of items analyzed contained higher fluoride contents than their US and UK counterparts. Data generated provide the first and largest table on fluoride content, which will be useful for future comparisons and estimations.
Published: 2019
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27. Determinants of Blood Lead Levels across the Menopausal Transition

Author: HERNANDEZ-AVILA, MAURICIO, VILLALPANDO, CLICERIO GONZALES, PALAZUELOS, EDUARDO, HU, HOWARD, VILLALPANDO, MARIA ELENA GONZALES, and MARTINEZ, DAVID RIVERA
Subjects: Lead in the body -- Measurement, Menopause -- Health aspects, Environmental issues, Health
Abstract: In this study, the authors sought to evaluate the impact of menopause on lead remobilization from bone-lead stores. The study was conducted between 1993 and 1995 in Mexico City and included 903 women (mean age = 46.8 y [standard deviation = 8.2 y]). Participants provided information about reproductive variables and known risk factors for high PbB levels. PbB levels were determined with graphite furnace atomic absorption spectrophotometry. The authors used linear-regression models to describe the relationship between PbB levels and variables of interest. PbB levels ranged from 1.0 [micro]g/dl to 43.8 [micro]g/dl (mean = 11.0 [micro]g/dl). Menopausal women at baseline had the highest PbB levels; the mean difference between pre- and postmenopausal women was 0.76 [micro]g/dl (95% confidence interval = 0.024, 1.48). We observed an inverted U-shaped relationship between PbB level and age. The highest PbB levels were observed in women aged 47-50 y. Other important predictors of PbB levels were use of lead-glazed ceramics, number of pregnancies, history of cigarette smoking, and height. Our results support the hypothesis that bone lead may be mobilized during menopause and may constitute an important source of exposure., THE RESULTS OF AUTOPSY STUDIES have demonstrated that 95% of lead in the human adult is concentrated in bone.[1] In the past, investigators assumed that lead uptake in bone had [...]
Published: 2000

28. Relationship of Lead in Drinking Water to Bone Lead Levels Twenty Years Later in Boston Men: The Normative Aging Study

Author: Potula, Vijayalakshmi, Serrano Elias, Jorge Antonio, Sparrow, David, and Hu, Howard
Subjects: Boston, Massachusetts -- Health aspects, Drinking water -- Lead content, Lead in the body -- Measurement, Environmental issues, Health
Published: 1999

29. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author: Stanaway, Jeffrey D, Afshin, Ashkan, Gakidou, Emmanuela, Lim, Stephen S, Abate, Degu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbasi, Nooshin, Abbastabar, Hedayat, Abd-Allah, Foad, Abdela, Jemal, Abdelalim, Ahmed, Abdollahpour, Ibrahim, Abdulkader, Rizwan Suliankatchi, Abebe, Molla, Abebe, Zegeye, Abera, Semaw F, Abil, Olifan Zewdie, Abraha, Haftom Niguse, Abrham, Aklilu Roba, Abu-Raddad, Laith Jamal, Abu-Rmeileh, Niveen ME, Accrombessi, Manfred Mario Kokou, Acharya, Dilaram, Acharya, Pawan, Adamu, Abdu A, Adane, Akilew Awoke, Adebayo, Oladimeji M, Adedoyin, Rufus Adesoji, Adekanmbi, Victor, Ademi, Zanfina, Adetokunboh, Olatunji O, Adib, Mina G, Admasie, Amha, Adsuar, Jose C, Afanvi, Kossivi Agbelenko, Afarideh, Mohsen, Agarwal, Gina, Aggarwal, Anju, Aghayan, Sargis Aghasi, Agrawal, Anurag, Agrawal, Sutapa, Ahmadi, Alireza, Ahmadi, Mehdi, Ahmadieh, Hamid, Ahmed, Muktar Beshir, Aichour, Amani Nidhal, Aichour, Ibtihel, Aichour, Miloud Taki Eddine, Akbari, Mohammad Esmaeil, Akinyemiju, Tomi, Akseer, Nadia, Al-Aly, Ziyad, Al-Eyadhy, Ayman, Al-Mekhlafi, Hesham M, Alahdab, Fares, Alam, Khurshid, Alam, Samiah, Alam, Tahiya, Alashi, Alaa, Alavian, Seyed Moayed, Alene, Kefyalew Addis, Ali, Komal, Ali, Syed Mustafa, Alijanzadeh, Mehran, Alizadeh-Navaei, Reza, Aljunid, Syed Mohamed, Alkerwi, Ala'a, Alla, François, Alsharif, Ubai, Altirkawi, Khalid, Alvis-Guzman, Nelson, Amare, Azmeraw T, Ammar, Walid, Anber, Nahla Hamed, Anderson, Jason A, Andrei, Catalina Liliana, Androudi, Sofia, Animut, Megbaru Debalkie, Anjomshoa, Mina, Ansha, Mustafa Geleto, Antó, Josep M, Antonio, Carl Abelardo T, Anwari, Palwasha, Appiah, Lambert Tetteh, Appiah, Seth Christopher Yaw, Arabloo, Jalal, Aremu, Olatunde, Ärnlöv, Johan, Artaman, Al, Aryal, Krishna K, Asayesh, Hamid, Ataro, Zerihun, Ausloos, Marcel, Avokpaho, Euripide F G A, Awasthi, Ashish, Ayala Quintanilla, Beatriz Paulina, Ayer, Rakesh, Ayuk, Tambe B, Azzopardi, Peter S, Babazadeh, Arefeh, Badali, Hamid, Badawi, Alaa, Balakrishnan, Kalpana, Bali, Ayele Geleto, Ball, Kylie, Ballew, Shoshana H, Banach, Maciej, Banoub, Joseph Adel Mattar, Barac, Aleksandra, Barker-Collo, Suzanne Lyn, Bärnighausen, Till Winfried, Barrero, Lope H, Basu, Sanjay, Baune, Bernhard T, Bazargan-Hejazi, Shahrzad, Bedi, Neeraj, Beghi, Ettore, Behzadifar, Masoud, Behzadifar, Meysam, Béjot, Yannick, Bekele, Bayu Begashaw, Bekru, Eyasu Tamru, Belay, Ezra, Belay, Yihalem Abebe, Bell, Michelle L, Bello, Aminu K, Bennett, Derrick A, Bensenor, Isabela M, Bergeron, Gilles, Berhane, Adugnaw, Bernabe, Eduardo, Bernstein, Robert S, Beuran, Mircea, Beyranvand, Tina, Bhala, Neeraj, Bhalla, Ashish, Bhattarai, Suraj, Bhutta, Zulfiqar A, Biadgo, Belete, Bijani, Ali, Bikbov, Boris, Bilano, Ver, Bililign, Nigus, Bin Sayeed, Muhammad Shahdaat, Bisanzio, Donal, Biswas, Tuhin, Bjørge, Tone, Blacker, Brigette F, Bleyer, Archie, Borschmann, Rohan, Bou-Orm, Ibrahim R, Boufous, Soufiane, Bourne, Rupert, Brady, Oliver J, Brauer, Michael, Brazinova, Alexandra, Breitborde, Nicholas J K, Brenner, Hermann, Briko, Andrey Nikolaevich, Britton, Gabrielle, Brugha, Traolach, Buchbinder, Rachelle, Burnett, Richard T, Busse, Reinhard, Butt, Zahid A, Cahill, Leah E, Cahuana-Hurtado, Lucero, Campos-Nonato, Ismael R, Cárdenas, Rosario, Carreras, Giulia, Carrero, Juan J, Carvalho, Félix, Castañeda-Orjuela, Carlos A, Castillo Rivas, Jacqueline, Castro, Franz, Catalá-López, Ferrán, Causey, Kate, Cercy, Kelly M, Cerin, Ester, Chaiah, Yazan, Chang, Hsing-Yi, Chang, Jung-Chen, Chang, Kai-Lan, Charlson, Fiona J, Chattopadhyay, Aparajita, Chattu, Vijay Kumar, Chee, Miao Li, Cheng, Ching-Yu, Chew, Adrienne, Chiang, Peggy Pei-Chia, Chimed-Ochir, Odgerel, Chin, Ken Lee, Chitheer, Abdulaal, Choi, Jee-Young J, Chowdhury, Rajiv, Christensen, Hanne, Christopher, Devasahayam J, Chung, Sheng-Chia, Cicuttini, Flavia M, Cirillo, Massimo, Cohen, Aaron J, Collado-Mateo, Daniel, Cooper, Cyrus, Cooper, Owen R, Coresh, Josef, Cornaby, Leslie, Cortesi, Paolo Angelo, 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Khafaie, Morteza Abdullatif, Khajavi, Alireza, Khalid, Nauman, Khalil, Ibrahim A, Khan, Gulfaraz, Khan, Muhammad Shahzeb, Khan, Muhammad Ali, Khang, Young-Ho, Khater, Mona M, Khazaei, Mohammad, Khazaie, Habibolah, Khoja, Abdullah T, Khosravi, Ardeshir, Khosravi, Mohammad Hossein, Kiadaliri, Aliasghar A, Kiirithio, Daniel N, Kim, Cho-Il, Kim, Daniel, Kim, Young-Eun, Kim, Yun Jin, Kimokoti, Ruth W, Kinfu, Yohannes, Kisa, Adnan, Kissimova-Skarbek, Katarzyna, Kivimäki, Mika, Knibbs, Luke D, Knudsen, Ann Kristin Skrindo, Kochhar, Sonali, Kokubo, Yoshihiro, Kolola, Tufa, Kopec, Jacek A, Kosen, Soewarta, Koul, Parvaiz A, Koyanagi, Ai, Kravchenko, Michael A, Krishan, Kewal, Krohn, Kristopher J, Kromhout, Hans, Kuate Defo, Barthelemy, Kucuk Bicer, Burcu, Kumar, G Anil, Kumar, Manasi, Kuzin, Igor, Kyu, Hmwe Hmwe, Lachat, Carl, Lad, Deepesh P, Lad, Sheetal D, Lafranconi, Alessandra, Lalloo, Ratilal, Lallukka, Tea, Lami, Faris Hasan, Lang, Justin J, Lansingh, Van C, Larson, Samantha Leigh, Latifi, 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Mete, Sayyah, Mehdi, Schaeffner, Elke, Schmidt, Maria Inês, Schneider, Ione J C, Schöttker, Ben, Schutte, Aletta Elisabeth, Schwebel, David C, Schwendicke, Falk, Scott, James G, Seedat, Soraya, Sekerija, Mario, Sepanlou, Sadaf G, Serre, Marc L, Serván-Mori, Edson, Seyedmousavi, Seyedmojtaba, Shabaninejad, Hosein, Shaddick, Gavin, Shafieesabet, Azadeh, Shahbazi, Mehdi, Shaheen, Amira A, Shaikh, Masood Ali, Shamah Levy, Teresa, Shams-Beyranvand, Mehran, Shamsi, Mohammadbagher, Sharafi, Heidar, Sharafi, Kiomars, Sharif, Mehdi, Sharif-Alhoseini, Mahdi, Sharifi, Hamid, Sharma, Jayendra, Sharma, Meenakshi, Sharma, Rajesh, She, Jun, Sheikh, Aziz, Shi, Peilin, Shibuya, Kenji, Shiferaw, Mekonnen Sisay, Shigematsu, Mika, Shin, Min-Jeong, Shiri, Rahman, Shirkoohi, Reza, Shiue, Ivy, Shokraneh, Farhad, Shoman, Haitham, Shrime, Mark G, Shupler, Matthew S, Si, Si, Siabani, Soraya, Sibai, Abla Mehio, Siddiqi, Tariq J, Sigfusdottir, Inga Dora, Sigurvinsdottir, Rannveig, Silva, Diego Augusto Santos, Silva, João Pedro, Silveira, Dayane Gabriele Alves, Singh, Jasvinder A, Singh, Narinder Pal, Singh, Virendra, Sinha, Dhirendra Narain, Skiadaresi, Eirini, Skirbekk, Vegard, Smith, David L, Smith, Mari, Sobaih, Badr Hasan, Sobhani, Soheila, Somayaji, Ranjani, Soofi, Moslem, Sorensen, Reed J D, Soriano, Joan B, Soyiri, Ireneous N, Spinelli, Angela, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Srinivasan, Vinay, Starodubov, Vladimir I, Steckling, Nadine, Stein, Dan J, Stein, Murray B, Stevanovic, Goran, Stockfelt, Leo, Stokes, Mark A, Sturua, Lela, Subart, Michelle L, Sudaryanto, Agus, Sufiyan, Mu'awiyyah Babale, Sulo, Gerhard, Sunguya, Bruno F, Sur, Patrick John, Sykes, Bryan L, Szoeke, Cassandra E I, Tabarés-Seisdedos, Rafael, Tabuchi, Takahiro, Tadakamadla, Santosh Kumar, Takahashi, Ken, Tandon, Nikhil, Tassew, Segen Gebremeskel, Tavakkoli, Mohammad, Taveira, Nuno, Tehrani-Banihashemi, Arash, Tekalign, Tigist Gashaw, Tekelemedhin, Shishay Wahdey, Tekle, Merhawi Gebremedhin, Temesgen, Habtamu, Temsah, Mohamad-Hani, Temsah, Omar, Terkawi, Abdullah Sulieman, Tessema, Belay, Teweldemedhin, Mebrahtu, Thankappan, Kavumpurathu Raman, Theis, Andrew, Thirunavukkarasu, Sathish, Thomas, Hannah J, Thomas, Matthew Lloyd, Thomas, Nihal, Thurston, George D, Tilahun, Binyam, Tillmann, Taavi, To, Quyen G, Tobollik, Myriam, Tonelli, Marcello, Topor-Madry, Roman, Torre, Anna E, Tortajada-Girbés, Miguel, Touvier, Mathilde, Tovani-Palone, Marcos Roberto, Towbin, Jeffrey A, Tran, Bach Xuan, Tran, Khanh Bao, Truelsen, Thomas Clement, Truong, Nu Thi, Tsadik, Afewerki Gebremeskel, Tudor Car, Lorainne, Tuzcu, E Murat, Tymeson, Hayley D, Tyrovolas, Stefanos, Ukwaja, Kingsley N, Ullah, Irfan, Updike, Rachel L, Usman, Muhammad Shariq, Uthman, Olalekan A, Vaduganathan, Muthiah, Vaezi, Afsane, Valdez, Pascual R, Van Donkelaar, Aaron, Varavikova, Elena, Varughese, Santosh, Vasankari, Tommi Juhani, Venkateswaran, Vidhya, Venketasubramanian, Narayanaswamy, Villafaina, Santos, Violante, Francesco S, Vladimirov, Sergey Konstantinovitch, Vlassov, Vasily, Vollset, Stein Emil, Vos, Theo, Vosoughi, Kia, Vu, Giang Thu, Vujcic, Isidora S, Wagnew, Fasil Shiferaw, Waheed, Yasir, Waller, Stephen G, Walson, Judd L, Wang, Yafeng, Wang, Yanping, Wang, Yuan-Pang, Weiderpass, Elisabete, Weintraub, Robert G, Weldegebreal, Fitsum, Werdecker, Andrea, Werkneh, Adhena Ayaliew, West, J Jason, Westerman, Ronny, Whiteford, Harvey A, Widecka, Justyna, Wijeratne, Tissa, Winkler, Andrea Sylvia, Wiyeh, Alison B, Wiysonge, Charles Shey, Wolfe, Charles D A, Wong, Tien Yin, Wu, Shouling, Xavier, Denis, Xu, Gelin, Yadgir, Simon, Yadollahpour, Ali, Yahyazadeh Jabbari, Seyed Hossein, Yamada, Tomohide, Yan, Lijing L, Yano, Yuichiro, Yaseri, Mehdi, Yasin, Yasin Jemal, Yeshaneh, Alex, Yimer, Ebrahim M, Yip, Paul, Yisma, Engida, Yonemoto, Naohiro, Yoon, Seok-Jun, Yotebieng, Marcel, Younis, Mustafa Z, Yousefifard, Mahmoud, Yu, Chuanhua, Zaidi, Zoubida, Zaman, Sojib Bin, Zamani, Mohammad, Zavala-Arciniega, Luis, Zhang, Anthony Lin, Zhang, Hao, Zhang, Kai, Zhou, Maigeng, Zimsen, Stephanie R M, Zodpey, Sanjay, and Murray, Christopher J L
Abstract: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk–outcome associations.
Published: 2018
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30. XRF-measured bone lead (Pb) as a biomarker for Pb exposure and toxicity among children diagnosed with Pb poisoning

Author: Specht, Aaron J., Lin, Yanfen, Weisskopf, Marc, Yan, Chonghuai, Hu, Howard, Xu, Jian, and Nie, Linda H.
Abstract: AbstractChildhood lead (Pb) poisoning remains a global issue, especially in industrial areas. In this study, 115 children with average age 5.7 years were recruited as either patient diagnosed with Pb poisoning or controls at Xinhua Hospital in China. The subjects’ bone Pb was measured with a K-shell X-ray fluorescence (KXRF) and a portable X-ray fluorescence (XRF) system. A significant correlation between KXRF bone Pb and blood Pb and portable XRF and KXRF measurements were observed. The half-life of blood-lead was calculated to be 9.96 ± 3.92 d. Our results indicate that bone is a useful biomarker for Pb in children.
Published: 2016
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31. Prenatal Maternal Occupational Exposure and Postnatal Child Exposure to Elemental Mercury

Author: Xu, Jian, Yan, Chong-huai, Hu, Howard, Wu, Mei-qin, and Shen, Xiao-ming
Published: 2016
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32. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Author: Forouzanfar, Mohammad H, Alexander, Lily, Anderson, H Ross, Bachman, Victoria F, Biryukov, Stan, Brauer, Michael, Burnett, Richard, Casey, Daniel, Coates, Matthew M, Cohen, Aaron, Delwiche, Kristen, Estep, Kara, Frostad, Joseph J, KC, Astha, Kyu, Hmwe H, Moradi-Lakeh, Maziar, Ng, Marie, Slepak, Erica Leigh, Thomas, Bernadette A, Wagner, Joseph, Aasvang, Gunn Marit, Abbafati, Cristiana, Ozgoren, Ayse Abbasoglu, Abd-Allah, Foad, Abera, Semaw F, Aboyans, Victor, Abraham, Biju, Abraham, Jerry Puthenpurakal, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M E, Aburto, Tania C, Achoki, Tom, Adelekan, Ademola, Adofo, Koranteng, Adou, Arsène K, Adsuar, José C, Afshin, Ashkan, Agardh, Emilie E, Al Khabouri, Mazin J, Al Lami, Faris H, Alam, Sayed Saidul, Alasfoor, Deena, Albittar, Mohammed I, Alegretti, Miguel A, Aleman, Alicia V, Alemu, Zewdie A, Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Ali, Mohammed K, Alla, François, Allebeck, Peter, Allen, Peter J, Alsharif, Ubai, Alvarez, Elena, Alvis-Guzman, Nelson, Amankwaa, Adansi A, Amare, Azmeraw T, Ameh, Emmanuel A, Ameli, Omid, Amini, Heresh, Ammar, Walid, Anderson, Benjamin O, Antonio, Carl Abelardo T, Anwari, Palwasha, Cunningham, Solveig Argeseanu, Arnlöv, Johan, Arsenijevic, Valentina S Arsic, Artaman, Al, Asghar, Rana J, Assadi, Reza, Atkins, Lydia S, Atkinson, Charles, Avila, Marco A, Awuah, Baffour, Badawi, Alaa, Bahit, Maria C, Bakfalouni, Talal, Balakrishnan, Kalpana, Balalla, Shivanthi, Balu, Ravi Kumar, Banerjee, Amitava, Barber, Ryan M, Barker-Collo, Suzanne L, Barquera, Simon, Barregard, Lars, Barrero, Lope H, Barrientos-Gutierrez, Tonatiuh, Basto-Abreu, Ana C, Basu, Arindam, Basu, Sanjay, Basulaiman, Mohammed O, Ruvalcaba, Carolina Batis, Beardsley, Justin, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L, Benjet, Corina, Bennett, Derrick A, Benzian, Habib, Bernabé, Eduardo, Beyene, Tariku J, Bhala, Neeraj, Bhalla, Ashish, Bhutta, Zulfiqar A, Bikbov, Boris, Abdulhak, Aref A Bin, Blore, Jed D, Blyth, Fiona M, Bohensky, Megan A, Başara, Berrak Bora, Borges, Guilherme, Bornstein, Natan M, Bose, Dipan, Boufous, Soufiane, Bourne, Rupert R, Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J, Brenner, Hermann, Briggs, Adam D M, Broday, David M, Brooks, Peter M, Bruce, Nigel G, Brugha, Traolach S, Brunekreef, Bert, Buchbinder, Rachelle, Bui, Linh N, Bukhman, Gene, Bulloch, Andrew G, Burch, Michael, Burney, Peter G J, Campos-Nonato, Ismael R, Campuzano, Julio C, Cantoral, Alejandra J, Caravanos, Jack, Cárdenas, Rosario, Cardis, Elisabeth, Carpenter, David O, Caso, Valeria, Castañeda-Orjuela, Carlos A, Castro, Ruben E, Catalá-López, Ferrán, Cavalleri, Fiorella, Çavlin, Alanur, Chadha, Vineet K, Chang, Jung-chen, Charlson, Fiona J, Chen, Honglei, Chen, Wanqing, Chen, Zhengming, Chiang, Peggy P, Chimed-Ochir, Odgerel, Chowdhury, Rajiv, Christophi, Costas A, Chuang, Ting-Wu, Chugh, Sumeet S, Cirillo, Massimo, Claßen, Thomas KD, Colistro, Valentina, Colomar, Mercedes, Colquhoun, Samantha M, Contreras, Alejandra G, Cooper, Cyrus, Cooperrider, Kimberly, Cooper, Leslie T, Coresh, Josef, Courville, Karen J, Criqui, Michael H, Cuevas-Nasu, Lucia, Damsere-Derry, James, Danawi, Hadi, Dandona, Lalit, Dandona, Rakhi, Dargan, Paul I, Davis, Adrian, Davitoiu, Dragos V, Dayama, Anand, de Castro, E Filipa, De la Cruz-Góngora, Vanessa, De Leo, Diego, de Lima, Graça, Degenhardt, Louisa, del Pozo-Cruz, Borja, Dellavalle, Robert P, Deribe, Kebede, Derrett, Sarah, Jarlais, Don C Des, Dessalegn, Muluken, deVeber, Gabrielle A, Devries, Karen M, Dharmaratne, Samath D, Dherani, Mukesh K, Dicker, Daniel, Ding, Eric L, Dokova, Klara, Dorsey, E Ray, Driscoll, Tim R, Duan, Leilei, Durrani, Adnan M, Ebel, Beth E, Ellenbogen, Richard G, Elshrek, Yousef M, Endres, Matthias, Ermakov, Sergey P, Erskine, Holly E, Eshrati, Babak, Esteghamati, Alireza, Fahimi, Saman, Faraon, Emerito Jose A, Farzadfar, Farshad, Fay, Derek F J, Feigin, Valery L, Feigl, Andrea B, Fereshtehnejad, Seyed-Mohammad, Ferrari, Alize J, Ferri, Cleusa P, Flaxman, Abraham D, Fleming, Thomas D, Foigt, Nataliya, Foreman, Kyle J, Paleo, Urbano Fra, Franklin, Richard C, Gabbe, Belinda, Gaffikin, Lynne, Gakidou, Emmanuela, Gamkrelidze, Amiran, Gankpé, Fortuné G, Gansevoort, Ron T, García-Guerra, Francisco A, Gasana, Evariste, Geleijnse, Johanna M, Gessner, Bradford D, Gething, Pete, Gibney, Katherine B, Gillum, Richard F, Ginawi, Ibrahim A M, Giroud, Maurice, Giussani, Giorgia, Goenka, Shifalika, Goginashvili, Ketevan, Dantes, Hector Gomez, Gona, Philimon, de Cosio, Teresita Gonzalez, González-Castell, Dinorah, Gotay, Carolyn C, Goto, Atsushi, Gouda, Hebe N, Guerrant, Richard L, Gugnani, Harish C, Guillemin, Francis, Gunnell, David, Gupta, Rahul, Gupta, Rajeev, Gutiérrez, Reyna A, Hafezi-Nejad, Nima, Hagan, Holly, Hagstromer, Maria, Halasa, Yara A, Hamadeh, Randah R, Hammami, Mouhanad, Hankey, Graeme J, Hao, Yuantao, Harb, Hilda L, Haregu, Tilahun Nigatu, Haro, Josep Maria, Havmoeller, Rasmus, Hay, Simon I, Hedayati, Mohammad T, Heredia-Pi, Ileana B, Hernandez, Lucia, Heuton, Kyle R, Heydarpour, Pouria, Hijar, Martha, Hoek, Hans W, Hoffman, Howard J, Hornberger, John C, Hosgood, H Dean, Hoy, Damian G, Hsairi, Mohamed, Hu, Guoqing, Hu, Howard, Huang, Cheng, Huang, John J, Hubbell, Bryan J, Huiart, Laetitia, Husseini, Abdullatif, Iannarone, Marissa L, Iburg, Kim M, Idrisov, Bulat T, Ikeda, Nayu, Innos, Kaire, Inoue, Manami, Islami, Farhad, Ismayilova, Samaya, Jacobsen, Kathryn H, Jansen, Henrica A, Jarvis, Deborah L, Jassal, Simerjot K, Jauregui, Alejandra, Jayaraman, Sudha, Jeemon, Panniyammakal, Jensen, Paul N, Jha, Vivekanand, Jiang, Fan, Jiang, Guohong, Jiang, Ying, Jonas, Jost B, Juel, Knud, Kan, Haidong, Roseline, Sidibe S Kany, Karam, Nadim E, Karch, André, Karema, Corine K, Karthikeyan, Ganesan, Kaul, Anil, Kawakami, Norito, Kazi, Dhruv S, Kemp, Andrew H, Kengne, Andre P, Keren, Andre, Khader, Yousef S, Khalifa, Shams Eldin Ali Hassan, Khan, Ejaz A, Khang, Young-Ho, Khatibzadeh, Shahab, Khonelidze, Irma, Kieling, Christian, Kim, Daniel, Kim, Sungroul, Kim, Yunjin, Kimokoti, Ruth W, Kinfu, Yohannes, Kinge, Jonas M, Kissela, Brett M, Kivipelto, Miia, Knibbs, Luke D, Knudsen, Ann Kristin, Kokubo, Yoshihiro, Kose, M Rifat, Kosen, Soewarta, Kraemer, Alexander, Kravchenko, Michael, Krishnaswami, Sanjay, Kromhout, Hans, Ku, Tiffany, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kuipers, Ernst J, Kulkarni, Chanda, Kulkarni, Veena S, Kumar, G Anil, Kwan, Gene F, Lai, Taavi, Balaji, Arjun Lakshmana, Lalloo, Ratilal, Lallukka, Tea, Lam, Hilton, Lan, Qing, Lansingh, Van C, Larson, Heidi J, Larsson, Anders, Laryea, Dennis O, Lavados, Pablo M, Lawrynowicz, Alicia E, Leasher, Janet L, Lee, Jong-Tae, Leigh, James, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Liang, Juan, Liang, Xiaofeng, Lim, Stephen S, Lindsay, M Patrice, Lipshultz, Steven E, Liu, Shiwei, Liu, Yang, Lloyd, Belinda K, Logroscino, Giancarlo, London, Stephanie J, Lopez, Nancy, Lortet-Tieulent, Joannie, Lotufo, Paulo A, Lozano, Rafael, Lunevicius, Raimundas, Ma, Jixiang, Ma, Stefan, Machado, Vasco M P, MacIntyre, Michael F, Magis-Rodriguez, Carlos, Mahdi, Abbas A, Majdan, Marek, Malekzadeh, Reza, Mangalam, Srikanth, Mapoma, Christopher C, Marape, Marape, Marcenes, Wagner, Margolis, David J, Margono, Christopher, Marks, Guy B, Martin, Randall V, Marzan, Melvin B, Mashal, Mohammad T, Masiye, Felix, Mason-Jones, Amanda J, Matsushita, Kunihiro, Matzopoulos, Richard, Mayosi, Bongani M, Mazorodze, Tasara T, McKay, Abigail C, McKee, Martin, McLain, Abigail, Meaney, Peter A, Medina, Catalina, Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Mekonnen, Wubegzier, Melaku, Yohannes A, Meltzer, Michele, Memish, Ziad A, Mendoza, Walter, Mensah, George A, Meretoja, Atte, Mhimbira, Francis Apolinary, Micha, Renata, Miller, Ted R, Mills, Edward J, Misganaw, Awoke, Mishra, Santosh, Ibrahim, Norlinah Mohamed, Mohammad, Karzan A, Mokdad, Ali H, Mola, Glen L, Monasta, Lorenzo, Hernandez, Julio C Montañez, Montico, Marcella, Moore, Ami R, Morawska, Lidia, Mori, Rintaro, Moschandreas, Joanna, Moturi, Wilkister N, Mozaffarian, Dariush, Mueller, Ulrich O, Mukaigawara, Mitsuru, Mullany, Erin C, Murthy, Kinnari S, Naghavi, Mohsen, Nahas, Ziad, Naheed, Aliya, Naidoo, Kovin S, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Narayan, KM Venkat, Nash, Denis, Neal, Bruce, Nejjari, Chakib, Neupane, Sudan P, Newton, Charles R, Ngalesoni, Frida N, de Dieu Ngirabega, Jean, Nguyen, Grant, Nguyen, Nhung T, Nieuwenhuijsen, Mark J, Nisar, Muhammad I, Nogueira, José R, Nolla, Joan M, Nolte, Sandra, Norheim, Ole F, Norman, Rosana E, Norrving, Bo, Nyakarahuka, Luke, Oh, In-Hwan, Ohkubo, Takayoshi, Olusanya, Bolajoko O, Omer, Saad B, Opio, John Nelson, Orozco, Ricardo, Pagcatipunan, Rodolfo S, Pain, Amanda W, Pandian, Jeyaraj D, Panelo, Carlo Irwin A, Papachristou, Christina, Park, Eun-Kee, Parry, Charles D, Caicedo, Angel J Paternina, Patten, Scott B, Paul, Vinod K, Pavlin, Boris I, Pearce, Neil, Pedraza, Lilia S, Pedroza, Andrea, Stokic, Ljiljana Pejin, Pekericli, Ayfer, Pereira, David M, Perez-Padilla, Rogelio, Perez-Ruiz, Fernando, Perico, Norberto, Perry, Samuel A L, Pervaiz, Aslam, Pesudovs, Konrad, Peterson, Carrie B, Petzold, Max, Phillips, Michael R, Phua, Hwee Pin, Plass, Dietrich, Poenaru, Dan, Polanczyk, Guilherme V, Polinder, Suzanne, Pond, Constance D, Pope, C Arden, Pope, Daniel, Popova, Svetlana, Pourmalek, Farshad, Powles, John, Prabhakaran, Dorairaj, Prasad, Noela M, Qato, Dima M, Quezada, Amado D, Quistberg, D Alex A, Racapé, Lionel, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Sajjad Ur, Raju, Murugesan, Rakovac, Ivo, Rana, Saleem M, Rao, Mayuree, Razavi, Homie, Reddy, K Srinath, Refaat, Amany H, Rehm, Jürgen, Remuzzi, Giuseppe, Ribeiro, Antonio L, Riccio, Patricia M, Richardson, Lee, Riederer, Anne, Robinson, Margaret, Roca, Anna, Rodriguez, Alina, Rojas-Rueda, David, Romieu, Isabelle, Ronfani, Luca, Room, Robin, Roy, Nobhojit, Ruhago, George M, Rushton, Lesley, Sabin, Nsanzimana, Sacco, Ralph L, Saha, Sukanta, Sahathevan, Ramesh, Sahraian, Mohammad Ali, Salomon, Joshua A, Salvo, Deborah, Sampson, Uchechukwu K, Sanabria, Juan R, Sanchez, Luz Maria, Sánchez-Pimienta, Tania G, Sanchez-Riera, Lidia, Sandar, Logan, Santos, Itamar S, Sapkota, Amir, Satpathy, Maheswar, Saunders, James E, Sawhney, Monika, Saylan, Mete I, Scarborough, Peter, Schmidt, Jürgen C, Schneider, Ione J C, Schöttker, Ben, Schwebel, David C, Scott, James G, Seedat, Soraya, Sepanlou, Sadaf G, Serdar, Berrin, Servan-Mori, Edson E, Shaddick, Gavin, Shahraz, Saeid, Levy, Teresa Shamah, Shangguan, Siyi, She, Jun, Sheikhbahaei, Sara, Shibuya, Kenji, Shin, Hwashin H, Shinohara, Yukito, Shiri, Rahman, Shishani, Kawkab, Shiue, Ivy, Sigfusdottir, Inga D, Silberberg, Donald H, Simard, Edgar P, Sindi, Shireen, Singh, Abhishek, Singh, Gitanjali M, Singh, Jasvinder A, Skirbekk, Vegard, Sliwa, Karen, Soljak, Michael, Soneji, Samir, Søreide, Kjetil, Soshnikov, Sergey, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stapelberg, Nicolas J C, Stathopoulou, Vasiliki, Steckling, Nadine, Stein, Dan J, Stein, Murray B, Stephens, Natalie, Stöckl, Heidi, Straif, Kurt, Stroumpoulis, Konstantinos, Sturua, Lela, Sunguya, Bruno F, Swaminathan, Soumya, Swaroop, Mamta, Sykes, Bryan L, Tabb, Karen M, Takahashi, Ken, Talongwa, Roberto T, Tandon, Nikhil, Tanne, David, Tanner, Marcel, Tavakkoli, Mohammad, Te Ao, Braden J, Teixeira, Carolina M, Téllez Rojo, Martha M, Terkawi, Abdullah S, Texcalac-Sangrador, José Luis, Thackway, Sarah V, Thomson, Blake, Thorne-Lyman, Andrew L, Thrift, Amanda G, Thurston, George D, Tillmann, Taavi, Tobollik, Myriam, Tonelli, Marcello, Topouzis, Fotis, Towbin, Jeffrey A, Toyoshima, Hideaki, Traebert, Jefferson, Tran, Bach X, Trasande, Leonardo, Trillini, Matias, Trujillo, Ulises, Dimbuene, Zacharie Tsala, Tsilimbaris, Miltiadis, Tuzcu, Emin Murat, Uchendu, Uche S, Ukwaja, Kingsley N, Uzun, Selen B, van de Vijver, Steven, Van Dingenen, Rita, van Gool, Coen H, van Os, Jim, Varakin, Yuri Y, Vasankari, Tommi J, Vasconcelos, Ana Maria N, Vavilala, Monica S, Veerman, Lennert J, Velasquez-Melendez, Gustavo, Venketasubramanian, N, Vijayakumar, Lakshmi, Villalpando, Salvador, Violante, Francesco S, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Wagner, Gregory R, Waller, Stephen G, Wallin, Mitchell T, Wan, Xia, Wang, Haidong, Wang, JianLi, Wang, Linhong, Wang, Wenzhi, Wang, Yanping, Warouw, Tati S, Watts, Charlotte H, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Werdecker, Andrea, Wessells, K Ryan, Westerman, Ronny, Whiteford, Harvey A, Wilkinson, James D, Williams, Hywel C, Williams, Thomas N, Woldeyohannes, Solomon M, Wolfe, Charles D A, Wong, John Q, Woolf, Anthony D, Wright, Jonathan L, Wurtz, Brittany, Xu, Gelin, Yan, Lijing L, Yang, Gonghuan, Yano, Yuichiro, Ye, Pengpeng, Yenesew, Muluken, Yentür, Gökalp K, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z, Younoussi, Zourkaleini, Yu, Chuanhua, Zaki, Maysaa E, Zhao, Yong, Zheng, Yingfeng, Zhou, Maigeng, Zhu, Jun, Zhu, Shankuan, Zou, Xiaonong, Zunt, Joseph R, Lopez, Alan D, Vos, Theo, and Murray, Christopher J
Abstract: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution.
Published: 2015
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33. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Author: Vos, Theo, Barber, Ryan M, Bell, Brad, Bertozzi-Villa, Amelia, Biryukov, Stan, Bolliger, Ian, Charlson, Fiona, Davis, Adrian, Degenhardt, Louisa, Dicker, Daniel, Duan, Leilei, Erskine, Holly, Feigin, Valery L, Ferrari, Alize J, Fitzmaurice, Christina, Fleming, Thomas, Graetz, Nicholas, Guinovart, Caterina, Haagsma, Juanita, Hansen, Gillian M, Hanson, Sarah Wulf, Heuton, Kyle R, Higashi, Hideki, Kassebaum, Nicholas, Kyu, Hmwe, Laurie, Evan, Liang, Xiofeng, Lofgren, Katherine, Lozano, Rafael, MacIntyre, Michael F, Moradi-Lakeh, Maziar, Naghavi, Mohsen, Nguyen, Grant, Odell, Shaun, Ortblad, Katrina, Roberts, David Allen, Roth, Gregory A, Sandar, Logan, Serina, Peter T, Stanaway, Jeffrey D, Steiner, Caitlyn, Thomas, Bernadette, Vollset, Stein Emil, Whiteford, Harvey, Wolock, Timothy M, Ye, Pengpeng, Zhou, Maigeng, Ãvila, Marco A, Aasvang, Gunn Marit, Abbafati, Cristiana, Ozgoren, Ayse Abbasoglu, Abd-Allah, Foad, Aziz, Muna I Abdel, Abera, Semaw F, Aboyans, Victor, Abraham, Jerry P, Abraham, Biju, Abubakar, Ibrahim, Abu-Raddad, Laith J, Abu-Rmeileh, Niveen ME, Aburto, Tania C, Achoki, Tom, Ackerman, Ilana N, Adelekan, Ademola, Ademi, Zanfina, Adou, Arsène K, Adsuar, Josef C, Arnlov, Johan, Agardh, Emilie E, Al Khabouri, Mazin J, Alam, Sayed Saidul, Alasfoor, Deena, Albittar, Mohammed I, Alegretti, Miguel A, Aleman, Alicia V, Alemu, Zewdie A, Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Alla, Francois, Allebeck, Peter, Allen, Peter J, AlMazroa, Mohammad AbdulAziz, Alsharif, Ubai, Alvarez, Elena, Alvis-Guzman, Nelson, Ameli, Omid, Amini, Heresh, Ammar, Walid, Anderson, Benjamin O, Anderson, H. Ross, Antonio, Carl Abelardo T, Anwari, Palwasha, Apfel, Henry, Arsenijevic, Valentain S Arsic, Artaman, Al, Asghar, Rana J, Assadi, Reza, Atkins, Lydia S, Atkinson, Charles, Badawi, Alaa, Bahit, Maria C, Bakfalouni, Talal, Balakrishnan, Kalpana, Balalla, Shivanthi, Banerjee, Amitava, Barker-Collo, Suzanne L, Barquera, Simon, Barregard, Lars, Barrero, Lope H, Basu, Sanjay, Basu, Arindam, Baxter, Amanda, Beardsley, Justin, Bedi, Neeraj, Beghi, Ettore, Bekele, Tolesa, Bell, Michelle L, Benjet, Corina, Bennett, Derrick A, Bensenor, Isabela M, Benzian, Habib, Bernabe, Eduardo, Beyene, Tariku J, Bhala, Neeraj, Bhalla, Ashish, Bhutta, Zulfiqar, Bienhoff, Kelly, Bikbov, Boris, Abdulhak, Aref Bin, Blore, Jed D, Blyth, Fiona M, Bohensky, Megan A, Basara, Berrak Bora, Borges, Guilherme, Bornstein, Natan M, Bose, Dipan, Boufous, Soufiane, Bourne, Rupert R, Boyers, Lindsay N, Brainin, Michael, Brauer, Michael, Brayne, Carol EG, Brazinova, Alexandra, Breitborde, Nicholas JK, Brenner, Hermann, Briggs, Adam DM, Brooks, Peter M, Brown, Jonathan, Brugha, Traolach S, Buchbinder, Rachelle, Buckle, Geoffrey C, Bukhman, Gene, Bulloch, Andrew G, Burch, Michael, Burnett, Richard, Cardenas, Rosario, Cabral, Norberto L, Nonato, Ismael R Campos, Campuzano, Julio C, Carapetis, Jonathan R, Carpenter, David O, Caso, Valeria, Castaneda-Orjuela, Carlos A, Catala-Lopez, Ferran, Chadha, Vineet K, Chang, Jung-Chen, Chen, Honglei, Chen, Wanqing, Chiang, Peggy P, Chimed-Ochir, Odgerel, Chowdhury, Rajiv, Christensen, Hanne, Christophi, Costas A, Chugh, Sumeet S, Cirillo, Massimo, Coggeshall, Megan, Cohen, Aaron, Colistro, Valentina, Colquhoun, Samantha M, Contreras, Alejandra G, Cooper, Leslie T, Cooper, Cyrus, Cooperrider, Kimberly, Coresh, Josef, Cortinovis, Monica, Criqui, Michael H, Crump, John A, Cuevas-Nasu, Lucia, Dandona, Rakhi, Dandona, Lalit, Dansereau, Emily, Dantes, Hector G, Dargan, Paul I, Davey, Gail, Davitoiu, Dragos V, Dayama, Anand, De la Cruz-Gongora, Vanessa, de la Vega, Shelley F, De Leo, Diego, del Pozo-Cruz, Borja, Dellavalle, Robert P, Deribe, Kebede, Derrett, Sarah, Des Jarlais, Don C, Dessalegn, Muluken, deVeber, Gabrielle A, Dharmaratne, Samath D, Diaz-Torne, Cesar, Ding, Eric L, Dokova, Klara, Dorsey, E R, Driscoll, Tim R, Duber, Herbert, Durrani, Adnan M, Edmond, Karen M, Ellenbogen, Richard G, Endres, Matthias, Ermakov, Sergey P, Eshrati, Babak, Esteghamati, Alireza, Estep, Kara, Fahimi, Saman, Farzadfar, Farshad, Fay, Derek FJ, Felson, David T, Fereshtehnejad, Seyed-Mohammad, Fernandes, Jefferson G, Ferri, Cluesa P, Flaxman, Abraham, Foigt, Nataliya, Foreman, Kyle J, Fowkes, F Gerry R, Franklin, Richard C, Furst, Thomas, Futran, Neal D, Gabbe, Belinda J, Gankpe, Fortune G, Garcia-Guerra, Francisco A, Geleijnse, Johanna M, Gessner, Bradford D, Gibney, Katherine B, Gillum, Richard F, Ginawi, Ibrahim A, Giroud, Maurice, Giussani, Giorgia, Goenka, Shifalika, Goginashvili, Ketevan, Gona, Philimon, de Cosio, Teresita Gonzalez, Gosselin, Richard A, Gotay, Carolyn C, Goto, Atsushi, Gouda, Hebe N, Guerrant, Richard l, Gugnani, Harish C, Gunnell, David, Gupta, Rajeev, Gupta, Rahul, Gutierrez, Reyna A, Hafezi-Nejad, Nima, Hagan, Holly, Halasa, Yara, Hamadeh, Randah R, Hamavid, Hannah, Hammami, Mouhanad, Hankey, Graeme J, Hao, Yuantao, Harb, Hilda L, Haro, Josep Maria, Havmoeller, Rasmus, Hay, Roderick J, Hay, Simon, Hedayati, Mohammad T, Pi, Ileana B Heredia, Heydarpour, Pouria, Hijar, Martha, Hoek, Hans W, Hoffman, Howard J, Hornberger, John C, Hosgood, H. Dean, Hossain, Mazeda, Hotez, Peter J, Hoy, Damian G, Hsairi, Mohamed, Hu, Howard, Hu, Guoqing, Huang, John J, Huang, Cheng, Huiart, Laetitia, Husseini, Abdullatif, Iannarone, Marissa, Iburg, Kim M, Innos, Kaire, Inoue, Manami, Jacobsen, Kathryn H, Jassal, Simerjot K, Jeemon, Panniyammakal, Jensen, Paul N, Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jonas, Jost B, Joseph, Jonathan, Juel, Knud, Kan, Haidong, Karch, Andre, Karimkhani, Chante, Karthikeyan, Ganesan, Katz, Ronit, Kaul, Anil, Kawakami, Norito, Kazi, Dhruv S, Kemp, Andrew H, Kengne, Andre P, Khader, Yousef S, Khalifa, Shams Eldin AH, Khan, Ejaz A, Khan, Gulfaraz, Khang, Young-Ho, Khonelidze, Irma, Kieling, Christian, Kim, Daniel, Kim, Sungroul, Kimokoti, Ruth W, Kinfu, Yohannes, Kinge, Jonas M, Kissela, Brett M, Kivipelto, Miia, Knibbs, Luke, Knudsen, Ann Kristin, Kokubo, Yoshihiro, Kosen, Soewarta, Kramer, Alexander, Kravchenko, Michael, Krishnamurthi, Rita V, Krishnaswami, Sanjay, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kuipers, Ernst J, Kulkarni, Veena S, Kumar, Kaushalendra, Kumar, G Anil, Kwan, Gene F, Lai, Taavi, Lalloo, Ratilal, Lam, Hilton, Lan, Qing, Lansingh, Van C, Larson, Heidi, Larsson, Anders, Lawrynowicz, Alicia EB, Leasher, Janet L, Lee, Jong-Tae, Leigh, James, Leung, Ricky, Levi, Miriam, Li, Bin, Li, Yichong, Li, Yongmei, liang, Juan, Lim, Stephen, Lin, Hsien-Ho, Lind, Margaret, Lindsay, M Patrice, Lipshultz, Steven E, Liu, Shiwei, Lloyd, Belinda K, Ohno, Summer Lockett, Logroscino, Giancarlo, Looker, Katharine J, Lopez, Alan D, Lopez-Olmedo, Nancy, Lortet-Tieulent, Joannie, Lotufo, Paulo A, Low, Nicola, Lucas, Robyn M, Lunevicius, Raimundas, Lyons, Ronan A, Ma, Jixiang, Ma, Stefan, Mackay, Mark T, Majdan, Marek, Malekzadeh, Reza, Mapoma, Christopher C, Marcenes, Wagner, March, Lyn M, Margono, Chris, Marks, Guy B, Marzan, Melvin B, Masci, Joseph R, Mason-Jones, Amanda J, Matzopoulos, Richard G, Mayosi, Bongani M, Mazorodze, Tasara T, McGill, Neil W, McGrath, John J, McKee, Martin, McLain, Abby, McMahon, Brian J, Meaney, Peter A, Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Mekonnen, Wubegzier, Melaku, Yohannes A, Meltzer, Michele, Memish, Ziad A, Mensah, George, Meretoja, Atte, Mhimbira, Francis A, Micha, Renata, Miller, Ted R, Mills, Edward J, Mitchell, Philip B, Mock, Charles N, Moffitt, Terrie E, Ibrahim, Norlinah Mohamed, Mohammad, Karzan A, Mokdad, Ali H, Mola, Glen L, Monasta, Lorenzo, Montico, Marcella, Montine, Thomas J, Moore, Ami R, Moran, Andrew E, Morawska, Lidia, Mori, Rintaro, Moschandreas, Joanna, Moturi, Wilkister N, Moyer, Madeline, Mozaffarian, Dariush, Mueller, Ulrich O, Mukaigawara, Mitsuru, Murdoch, Michele E, Murray, Joseph, Murthy, Kinnari S, Naghavi, Paria, Nahas, Ziad, Naheed, Aliya, Naidoo, Kovin S, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Narayan, K.M. Venkat, Nash, Denis, Nejjari, Chakib, Neupane, Sudan P, Newman, Lori M, Newton, Charles R, Ng, Marie, Ngalesoni, Frida N, Nhung, Nguyen T, Nisar, Muhammad I, Nolte, Sandra, Norheim, Ole F, Norman, Rosana E, Norrving, Bo, Nyakarahuka, Luke, Oh, In Hwan, Ohkubo, Takayoshi, Omer, Saad B, Opio, John Nelson, Ortiz, Alberto, Pandian, Jeyaraj D, Panelo, Carlo Irwin A, Papachristou, Christina, Park, Eun-Kee, Parry, Charles D, Caicedo, Angel J Paternina, Patten, Scott B, Paul, Vinod K, Pavlin, Boris I, Pearce, Neil, Pedraza, Lilia S, Pellegrini, Carlos A, Pereira, David M, Perez-Ruiz, Fernando P, Perico, Norberto, Pervaiz, Aslam, Pesudovs, Konrad, Peterson, Carrie B, Petzold, Max, Phillips, Michael R, Phillips, David, Phillips, Bryan, Piel, Frederic B, Plass, Dietrich, Poenaru, Dan, Polanczyk, Guilherme V, Polinder, Suzanne, Pope, C A, Popova, Svetlana, Poulton, Richie G, Pourmalek, Farshad, Prabhakaran, Dorairaj, Prasad, Noela M, Qato, Dima, Quistberg, D A, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Sajjad ur, Raju, Murugesan, Rakovac, Ivo, Rana, Saleem M, Razavi, Homie, Refaat, Amany, Rehm, Jurgen, Remuzzi, Giuseppe, Resnikoff, Serge, Ribeiro, Antonio L, Riccio, Patricia M, Richardson, Lee, Richardus, Jan Hendrik, Riederer, Anne M, Robinson, Margot, Roca, Anna, Rodriguez, Alina, Rojas-Rueda, David, Ronfani, Luca, Rothenbacher, Dietrich, Roy, Nobhojit, Ruhago, George M, Sabin, Nsanzimana, Sacco, Ralph L, Ksoreide, Kjetil, Saha, Sukanta, Sahathevan, Ramesh, Sahraian, Mohammad Ali, Sampson, Uchechukwu, Sanabria, Juan R, Sanchez-Riera, Lidia, Santos, Itamar S, Satpathy, Maheswar, Saunders, James E, Sawhney, Monika, Saylan, Mete I, Scarborough, Peter, Schoettker, Ben, Schneider, Ione JC, Schwebel, David C, Scott, James G, Seedat, Soraya, Sepanlou, Sadaf G, Serdar, Berrin, Servan-Mori, Edson E, Shackelford, Katya, Shaheen, Amira, Shahraz, Saeid, Levy, Teresa Shamah, Shangguan, Siyi, She, Jun, Sheikhbahaei, Sara, Shepard, Donald S, Shi, Peilin, Shibuya, Kenji, Shinohara, Yukito, Shiri, Rahman, Shishani, Kawkab, Shiue, Ivy, Shrime, Mark G, Sigfusdottir, Inga D, Silberberg, Donald H, Simard, Edgar P, Sindi, Shireen, Singh, Jasvinder A, Singh, Lavanya, Skirbekk, Vegard, Sliwa, Karen, Soljak, Michael, Soneji, Samir, Soshnikov, Sergey S, Speyer, Peter, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stoeckl, Heidi, Stathopoulou, Vasiliki Kalliopi, Steckling, Nadine, Stein, Murray B, Stein, Dan J, Steiner, Timothy J, Stewart, Andrea, Stork, Eden, Stovner, Lars J, Stroumpoulis, Konstantinos, Sturua, Lela, Sunguya, Bruno F, Swaroop, Mamta, Sykes, Bryan L, Tabb, Karen M, Takahashi, Ken, Tan, Feng, Tandon, Nikhil, Tanne, David, Tanner, Marcel, Tavakkoli, Mohammad, Taylor, Hugh R, Te Ao, Braden J, Temesgen, Awoke Misganaw, Have, Margreet Ten, Tenkorang, Eric Yeboah, Terkawi, Abdullah Sulieman, Theadom, Alice M, Thomas, Elissa, Thorne-Lyman, Andrew L, Thrift, Amanda G, Tleyjeh, Imad M, Tonelli, Marcello, Topouzis, Fotis, Towbin, Jeffrey A, Toyoshima, Hideaki, Traebert, Jefferson, Tran, Bach X, Trasande, Leonardo, Trillini, Matias, Truelsen, Thomas, Trujillo, Ulises, Tsilimbaris, Miltiadis, Tuzcu, Emin M, Ukwaja, Kingsley N, Undurraga, Eduardo A, Uzun, Selen B, van Brakel, Wim H, van de Vijver, Steven, Dingenen, Rita Van, van Gool, Coen H, Varakin, Yuri Y, Vasankari, Tommi J, Vavilala, Monica S, Veerman, Lennert J, Velasquez-Melendez, Gustavo, Venketasubramanian, Narayanaswamy, Vijayakumar, Lakshmi, Villalpando, Salvador, Violante, Francesco S, Vlassov, Vasiliy V, Waller, Stephen, Wallin, Mitchell T, Wan, Xia, Wang, Linhong, Wang, JianLi, Wang, Yanping, Warouw, Tati S, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Werdecker, Andrea, Wessells, K. Ryan R, Westerman, Ronny, Wilkinson, James D, Williams, Hywel C, Williams, Thomas N, Woldeyohannes, Solomon M, Wolfe, Charles DA, Wong, John Q, Wong, Haidong, Woolf, Anthony D, Wright, Jonathan L, Wurtz, Brittany, Xu, Gelin, Yang, Gonghuan, Yano, Yuichiro, Yenesew, Muluken A, Yentur, Gokalp K, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa, Yu, Chuanhua, Kim, Kim Yun, Zaki, Maysaa El Sayed, Zhang, Yong, Zhao, Zheng, Zhao, Yong, Zhu, Jun, Zonies, David, Zunt, Joseph R, Salomon, Joshua A, and Murray, Christopher JL
Abstract: Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013.
Published: 2015
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34. Quality control and statistical modeling for environmental epigenetics: A study on in uterolead exposure and DNA methylation at birth

Author: Goodrich, Jaclyn M, Sánchez, Brisa N, Dolinoy, Dana C, Zhang, Zhenzhen, Hernández-Ávila, Mauricio, Hu, Howard, Peterson, Karen E, and Téllez-Rojo, Martha M
Abstract: DNA methylation data assayed using pyrosequencing techniques are increasingly being used in human cohort studies to investigate associations between epigenetic modifications at candidate genes and exposures to environmental toxicants and to examine environmentally-induced epigenetic alterations as a mechanism underlying observed toxicant-health outcome associations. For instance, in uterolead (Pb) exposure is a neurodevelopmental toxicant of global concern that has also been linked to altered growth in human epidemiological cohorts; a potential mechanism of this association is through alteration of DNA methylation (e.g., at growth-related genes). However, because the associations between toxicants and DNA methylation might be weak, using appropriate quality control and statistical methods is important to increase reliability and power of such studies. Using a simulation study, we compared potential approaches to estimate toxicant-DNA methylation associations that varied by how methylation data were analyzed (repeated measures vs. averaging all CpG sites) and by method to adjust for batch effects (batch controls vs. random effects). We demonstrate that correcting for batch effects using plate controls yields unbiased associations, and that explicitly modeling the CpG site-specific variances and correlations among CpG sites increases statistical power. Using the recommended approaches, we examined the association between DNA methylation (in LINE-1 and growth related genes IGF2, H19and HSD11B2) and 3 biomarkers of Pb exposure (Pb concentrations in umbilical cord blood, maternal tibia, and maternal patella), among mother-infant pairs of the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) cohort (n = 247). Those with 10 μg/g higher patella Pb had, on average, 0.61% higher IGF2methylation (P= 0.05). Sex-specific trends between Pb and DNA methylation (P< 0.1) were observed among girls including a 0.23% increase in HSD11B2methylation with 10 μg/g higher patella Pb.
Published: 2015
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35. Determination of the total arsenic concentration in human urine by inductively coupled plasma mass spectrometry: a comparison of the accuracy of three analytical methods

Author: J. Amarasiriwardena, Chitra, Lupoli, Nicola, Korrick, Susan, Hu, Howard, Potula, Vijayalakshmi, Korrick, Susan, and Hu, Howard
Abstract: Measurement of arsenic (As) in biological samples such as urine has important clinical applications and is being undertaken more frequently in epidemiologic studies because of concern about the carcinogenicity of low to moderate levels of As exposure. The objective of this study was to evaluate and improve the accuracy of As determination in urine by inductively coupled plasma mass spectrometry (ICP-MS). Determination of As in biological samples by ICP-MS is difficult for two reasons: the formation of the molecular ion 40Ar35Cl, which overlaps with monoisotopic As at a mass-to-charge ratio (m/z) of 75 (causing spectral interference), and signal enhancement due to organic matrix (nonspectral interference).Available procedures were examined, including the application of different correction procedures using 40Ar37Cl and 16O35Cl molecular-ion formation; the addition of N2 into plasma or nebulizer gas flows; and the addition of organic molecules to the sample and to calibration standards to eliminate or correct for interference due to molecular-ion formation.The accuracy and precision of determination of As [m/z 75, ionization potential (IP) 9.81 eV] with use of an internal standard was also investigated. Three elements were studied as candidate internal standards: germanium (Ge: m/z 74, IP 7.90 eV), indium (In: m/z 115, IP 5.79 eV), and tellurium (Te: m/z 128, IP 9.01 eV). It was found that these three elements performed more or less equally well with Ar–N2 plasma; it was also found that accuracy was significantly improved when Te was used as the internal standard instead of Ge or In for ethanol-added samples.Our results indicate that accurate and precise measurement of As in urine by ICP-MS can be obtained by either of two methods (<5% error, ≈2% RSD, limit of detection 0.1 ng ml–1): (1) the addition of 1% N2 to plasma gas flow or 3% N2 to nebulizer gas flow, along with use of any of the internal standards tested, or (2) the addition of ethanol to the sample and to calibration standards, with use of Te as the internal standard. The most accurate results (<1% error) for National Institute of Standard and Technology Standard Reference Material (NIST SRM) 2670 (toxic elements in urine) were obtained with Ar–N2 plasma with either Te or In as the internal standard
Published: 1998
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36. Comparison of digestion procedures and methods for quantification of trace lead in breast milk by isotope dilution inductively coupled plasma mass spectrometry

Author: Amarasiriwardena, Chitra J., Jayawardene, Innocent, Lupoli, Nicola, Barnes, Ramon M., Hernandez-Avila, Mauricio, Hu, Howard, and Ettinger, Adrienne S.
Abstract: Measurement of lead in breast milk is an important public health consideration and can be technically quite challenging. The reliable and accurate determination of trace lead in human breast milk is difficult for several reasons including: potential for contamination during sample collection, storage, and analysis; complexities related to the high fat content of human milk; and poor analytic sensitivity at low concentrations. Breast milk lead levels from previous published studies should therefore be reviewed with caution. Due to the difficulty in identifying a method that would successfully digest samples with 100% efficiency, we evaluated three different digestion procedures including: (1) dry ashing in a muffle furnace, (2) microwave oven digestion, and (3) digestion in high pressure asher. High temperature, high pressure asher digestion was selected as the procedure of choice for the breast milk samples. Trace lead analysis was performed using isotope dilution (ID) inductively coupled plasma mass spectrometry (ICP-MS). Measured lead concentrations in breast milk samples (n= 200) from Mexico ranged from 0.2 to 6.7 ng ml−1. The precision for these measurements ranged from 0.27–7.8% RSD. Use of strict contamination control techniques and of a very powerful digestion procedure, along with an ID-ICP-MS method for lead determination, enables us to measure trace lead levels as low as 0.2 ng ml−1in milk (instrument detection limit = 0.01 ng ml−1).
Published: 2013
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37. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

Author: Lim, Stephen S, Vos, Theo, Flaxman, Abraham D, Danaei, Goodarz, Shibuya, Kenji, Adair-Rohani, Heather, AlMazroa, Mohammad A, Amann, Markus, Anderson, H Ross, Andrews, Kathryn G, Aryee, Martin, Atkinson, Charles, Bacchus, Loraine J, Bahalim, Adil N, Balakrishnan, Kalpana, Balmes, John, Barker-Collo, Suzanne, Baxter, Amanda, Bell, Michelle L, Blore, Jed D, Blyth, Fiona, Bonner, Carissa, Borges, Guilherme, Bourne, Rupert, Boussinesq, Michel, Brauer, Michael, Brooks, Peter, Bruce, Nigel G, Brunekreef, Bert, Bryan-Hancock, Claire, Bucello, Chiara, Buchbinder, Rachelle, Bull, Fiona, Burnett, Richard T, Byers, Tim E, Calabria, Bianca, Carapetis, Jonathan, Carnahan, Emily, Chafe, Zoe, Charlson, Fiona, Chen, Honglei, Chen, Jian Shen, Cheng, Andrew Tai-Ann, Child, Jennifer Christine, Cohen, Aaron, Colson, K Ellicott, Cowie, Benjamin C, Darby, Sarah, Darling, Susan, Davis, Adrian, Degenhardt, Louisa, Dentener, Frank, Des Jarlais, Don C, Devries, Karen, Dherani, Mukesh, Ding, Eric L, Dorsey, E Ray, Driscoll, Tim, Edmond, Karen, Ali, Suad Eltahir, Engell, Rebecca E, Erwin, Patricia J, Fahimi, Saman, Falder, Gail, Farzadfar, Farshad, Ferrari, Alize, Finucane, Mariel M, Flaxman, Seth, Fowkes, Francis Gerry R, Freedman, Greg, Freeman, Michael K, Gakidou, Emmanuela, Ghosh, Santu, Giovannucci, Edward, Gmel, Gerhard, Graham, Kathryn, Grainger, Rebecca, Grant, Bridget, Gunnell, David, Gutierrez, Hialy R, Hall, Wayne, Hoek, Hans W, Hogan, Anthony, Hosgood, H Dean, Hoy, Damian, Hu, Howard, Hubbell, Bryan J, Hutchings, Sally J, Ibeanusi, Sydney E, Jacklyn, Gemma L, Jasrasaria, Rashmi, Jonas, Jost B, Kan, Haidong, Kanis, John A, Kassebaum, Nicholas, Kawakami, Norito, Khang, Young-Ho, Khatibzadeh, Shahab, Khoo, Jon-Paul, Kok, Cindy, Laden, Francine, Lalloo, Ratilal, Lan, Qing, Lathlean, Tim, Leasher, Janet L, Leigh, James, Li, Yang, Lin, John Kent, Lipshultz, Steven E, London, Stephanie, Lozano, Rafael, Lu, Yuan, Mak, Joelle, Malekzadeh, Reza, Mallinger, Leslie, Marcenes, Wagner, March, Lyn, Marks, Robin, Martin, Randall, McGale, Paul, McGrath, John, Mehta, Sumi, Memish, Ziad A, Mensah, George A, Merriman, Tony R, Micha, Renata, Michaud, Catherine, Mishra, Vinod, Hanafiah, Khayriyyah Mohd, Mokdad, Ali A, Morawska, Lidia, Mozaffarian, Dariush, Murphy, Tasha, Naghavi, Mohsen, Neal, Bruce, Nelson, Paul K, Nolla, Joan Miquel, Norman, Rosana, Olives, Casey, Omer, Saad B, Orchard, Jessica, Osborne, Richard, Ostro, Bart, Page, Andrew, Pandey, Kiran D, Parry, Charles DH, Passmore, Erin, Patra, Jayadeep, Pearce, Neil, Pelizzari, Pamela M, Petzold, Max, Phillips, Michael R, Pope, Dan, Pope, C Arden, Powles, John, Rao, Mayuree, Razavi, Homie, Rehfuess, Eva A, Rehm, Jürgen T, Ritz, Beate, Rivara, Frederick P, Roberts, Thomas, Robinson, Carolyn, Rodriguez-Portales, Jose A, Romieu, Isabelle, Room, Robin, Rosenfeld, Lisa C, Roy, Ananya, Rushton, Lesley, Salomon, Joshua A, Sampson, Uchechukwu, Sanchez-Riera, Lidia, Sanman, Ella, Sapkota, Amir, Seedat, Soraya, Shi, Peilin, Shield, Kevin, Shivakoti, Rupak, Singh, Gitanjali M, Sleet, David A, Smith, Emma, Smith, Kirk R, Stapelberg, Nicolas JC, Steenland, Kyle, Stöckl, Heidi, Stovner, Lars Jacob, Straif, Kurt, Straney, Lahn, Thurston, George D, Tran, Jimmy H, Van Dingenen, Rita, van Donkelaar, Aaron, Veerman, J Lennert, Vijayakumar, Lakshmi, Weintraub, Robert, Weissman, Myrna M, White, Richard A, Whiteford, Harvey, Wiersma, Steven T, Wilkinson, James D, Williams, Hywel C, Williams, Warwick, Wilson, Nicholas, Woolf, Anthony D, Yip, Paul, Zielinski, Jan M, Lopez, Alan D, Murray, Christopher JL, and Ezzati, Majid
Abstract: Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time.
Published: 2012
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38. Alzheimers Disease and Environmental Exposure to Lead: The Epidemiologic Evidence and Potential Role of Epigenetics

Author: M. Bakulski, Kelly, S. Rozek, Laura, C. Dolinoy, Dana, L. Paulson, Henry, and Hu, Howard
Abstract: Several lines of evidence indicate that the etiology of late-onset Alzheimers disease (LOAD) is complex, with significant contributions from both genes and environmental factors. Recent research suggests the importance of epigenetic mechanisms in defining the relationship between environmental exposures and LOAD. In epidemiologic studies of adults, cumulative lifetime lead (Pb) exposure has been associated with accelerated declines in cognition. In addition, research in animal models suggests a causal association between Pb exposure during early life, epigenetics, and LOAD. There are multiple challenges to human epidemiologic research evaluating the relationship between epigenetics, LOAD, and Pb exposure. Epidemiologic studies are not well-suited to accommodate the long latency period between exposures during early life and onset of Alzheimers disease. There is also a lack of validated circulating epigenetics biomarkers and retrospective biomarkers of Pb exposure. Members of our research group have shown bone Pb is an accurate measurement of historical Pb exposure in adults, offering an avenue for future epidemiologic studies. However, this would not address the risk of LOAD attributable to early-life Pb exposures. Future studies that use a cohort design to measure both Pb exposure and validated epigenetic biomarkers of LOAD will be useful to clarify this important relationship.
Published: 2012

39. Early Postnatal Blood Manganese Levels and Children's Neurodevelopment

Author: Claus Henn, Birgit, Ettinger, Adrienne S., Schwartz, Joel, Téllez-Rojo, Martha María, Lamadrid-Figueroa, Héctor, Hernández-Avila, Mauricio, Schnaas, Lourdes, Amarasiriwardena, Chitra, Bellinger, David C., Hu, Howard, and Wright, Robert O.
Abstract: Recent evidence suggests that low-level environmental exposure to manganese adversely affects child growth and neurodevelopment. Previous studies have addressed the effects of prenatal exposure, but little is known about developmental effects of early postnatal exposure.
Published: 2010
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40. Maternal Blood Manganese Levels and Infant Birth Weight

Author: Zota, Ami R., Ettinger, Adrienne S., Bouchard, Maryse, Amarasiriwardena, Chitra J., Schwartz, Joel, Hu, Howard, and Wright, Robert O.
Abstract: Manganese is both an essential element and a known neurotoxicant to children. High manganese exposures have been associated with negative reproductive outcomes in animals, but few epidemiologic studies have examined the effects of human fetal manganese exposure.
Published: 2009
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41. All lead exposures matter – Authors' reply

Author: Ericson, Bret, Hu, Howard, Nash, Emily, Ferraro, Greg, Sinitsky, Julia, and Taylor, Mark Patrick
Published: 2021
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42. Bone Lead Levels and Blood Pressure Endpoints

Author: Navas-Acien, Ana, Schwartz, Brian S., Rothenberg, Stephen J., Hu, Howard, Silbergeld, Ellen K., and Guallar, Eliseo
Abstract: Previous reviews have shown increases in blood pressure and hypertension associated with increases in lead levels in blood. We performed a meta-analysis of the association of bone lead levels with systolic blood pressure, diastolic blood pressure, and hypertension using published data.
Published: 2008
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43. Air Pollution and Heart Rate Variability

Author: Park, Sung Kyun, O'Neill, Marie S., Vokonas, Pantel S., Sparrow, David, Wright, Robert O., Coull, Brent, Nie, Huiling, Hu, Howard, and Schwartz, Joel
Abstract: Outdoor air pollution and lead exposure can disturb cardiac autonomic function, but the effects of both these exposures together have not been studied.
Published: 2008
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44. Outcome-Dependent Sampling

Author: Zhou, Haibo, Chen, Jianwei, Rissanen, Tiina H., Korrick, Susan A., Hu, Howard, Salonen, Jukka T., and Longnecker, Matthew P.
Abstract: To characterize the relation between an exposure and a continuous outcome, the sampling of subjects can be done much as it is in a case–control study, such that the sample is enriched with subjects who are especially informative. In an outcome-dependent sampling design, observations made on a judiciously chosen subset of the base population can provide nearly the same statistical efficiency as observing the entire base population. Reaping the benefits of such sampling, however, requires use of an analysis that accounts for the outcome-dependent sampling. In this report, we examine the statistical efficiency of a plain random sample analyzed with standard methods, compared with that of data collected with outcome-dependent sampling and analyzed by either of 2 appropriate methods. In addition, 3 real datasets were analyzed using an outcome-dependent sampling approach. The results demonstrate the improved statistical efficiency obtained by using an outcome-dependent sampling, and its applicability in a wide range of settings. This design, coupled with an appropriate analysis, offers a cost-efficient approach to studying the determinants of a continuous outcome.
Published: 2007
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45. Cumulative Lead Exposure and Cognitive Performance Among Elderly Men

Author: Weisskopf, Marc G., Proctor, Susan P., Wright, Robert O., Schwartz, Joel, Spiro, Avron, Sparrow, David, Nie, Huiling, and Hu, Howard
Abstract: Recent evidence suggests that cumulative lead exposure among adults in nonoccupational settings can adversely affect cognitive function. Which cognitive domains are affected has not been explored in detail.
Published: 2007
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46. Dietary Calcium as a Potential Modifier of the Relationship of Lead Burden to Blood Pressure

Author: Elmarsafawy, Sahar F., Jain, Nitin B., Schwartz, Joel, Sparrow, David, Nie, Huiling, and Hu, Howard
Abstract: Cumulative lead burden and low dietary calcium have been independently associated with increased risk of hypertension. There is evidence of an interaction between these factors. We tested the hypothesis that dietary calcium intake modifies the relationship between lead burden and hypertension.
Published: 2006
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47. Predictors of plasma lead among lithographic print shop workers in Mexico City

Author: Juárez‐Pérez, Cuauhtémoc Arturo, Aguilar‐Madrid, Guadalupe, Smith, Donald R., Lacasaña‐Navarro, Marina, Téllez‐Rojo, Martha María, Piacitteli, Gregory, Hu, Howard, and Hernández‐Avila, Mauricio
Published: 2004
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48. Apolipoprotein E Genotype Predicts 24-Month Bayley Scales Infant Development Score

Author: WRIGHT, ROBERT O., HU, HOWARD, SILVERMAN, EDWIN K., TSAIH, SHIRNG W., SCHWARTZ, JOEL, BELLINGER, DAVID, PALAZUELOS, EDUARDO, WEISS, SCOTT T., AND, and HERNANDEZ-AVILA, MAURICIO
Abstract: Apolipoprotein E (APOE) regulates cholesterol and fatty acid metabolism, and may mediate synaptogenesis during neurodevelopment. To our knowledge, the effects of APOE4 isoforms on infant development have not been studied. This study was nested within a cohort of mother-infant pairs living in and around Mexico City. A multiple linear regression model was constructed using the 24-mo Mental Development Index (MDI) of the Bayley Scale as the primary outcome and infant APOE genotype as the primary risk factor of interest. Regression models stratified on APOE genotype were constructed to explore effect modification. Of 311 subjects, 53 (17) carried at least one copy of the APOE4 allele. Mean (SD) MDI scores among carriers with at least one copy of APOE4 were 94.1 (14.3) and among E3/E2 carriers were 91.2 (14.0). After adjustment for covariates, APOE4 carrier status was associated with a 4.4 point (95 confidence interval 0.1-8.7; p0.04) higher24-mo MDI. In the stratified regression models, the negative effects for umbilical cord blood lead level on 24-mo MDI score was approximately 4-fold greater among APOE3/APOE2 carriers than among APOE4 carriers. These results suggest that subjects with the E4 isoform of APOE may have advantages over those with the E2 or E3 isoforms with respect to early life neuronal/brain development.
Published: 2003
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49. Lead Exposure Biomarkers and Mini-Mental Status Exam Scores in Older Men

Author: Wright, Robert O., Tsaih, Shirng Wern, Schwartz, Joel, Spiro, Avron, McDonald, Karen, Weiss, Scott T., and Hu, Howard
Abstract: Lead is neurotoxic; yet, whether cognitive decline in older persons is associated with lead exposure is unknown. We studied whether lead exposure biomarkers are associated with cognitive test scores, as well as the modifying effects of age on the lead-cognition relationship.
Published: 2003
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50. Dietary Calcium Supplements to Lower Blood Lead Levels in Lactating Women A Randomized Placebo-Controlled Trial

Author: Hernandez-Avila, Mauricio, Gonzalez-Cossio, Teresa, Hernandez-Avila, Juan E., Romieu, Isabelle, Peterson, Karen E., Aro, Antonio, Palazuelos, Eduardo, and Hu, Howard
Abstract: Pregnancy and breastfeeding mobilize lead stored in bone, which may be a hazard for the fetus and infant. We tested the hypothesis that in lactating women a dietary calcium supplement will lower blood lead levels.
Published: 2003
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