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Background The majority of research documenting the public health impacts of natural disasters focuses on the well-being of adults and their living children. Negative effects may also occur in the unborn, exposed to disaster stressors when critical organ systems are developing and when the consequences of exposure are large. Methods We exploit spatial and temporal variation in hurricane behaviour as a quasi-experimental design to assess whether fetal death is dose-responsive in the extent of hurricane damage. Data on births and fetal deaths are merged with Parish-level housing wreckage data. Fetal outcomes are regressed on housing wreckage adjusting for the maternal, fetal, placental and other risk factors. The average causal effect of maternal exposure to hurricane destruction is captured by difference-indifferences analyses. Results The adjusted odds of fetal death are 1.40 (1.07–1.83) and 2.37 (1.684–3.327) times higher in parishes suffering 10–50% and >50% wreckage to housing stock, respectively. For every 1% increase in the destruction of housing stock, we observe a 1.7% (1.1–2.4%) increase in fetal death. Of the 410 officially recorded fetal deaths in these parishes, between 117 and 205 may be attributable to hurricane destruction and postdisaster disorder. The estimated fetal death toll is 17.4–30.6% of the human death toll. Conclusions The destruction caused by Hurricanes Katrina and Rita imposed significant measurable losses in terms of fetal death. Postdisaster migratory dynamics suggest that the reported effects of maternal exposure to hurricane destruction on fetal death may be conservative. [ABSTRACT FROM AUTHOR]

Background Previous studies link maternal blood lead (Pb) levels and pregnancy-related hypertensive disorders. Objective Assess the relationship between neighborhood soil Pb and maternal eclampsia risk. Methods Zip code summarized high density soil survey data of New Orleans collected before and after Hurricanes Katrina and Rita (HKR) were merged with pregnancy outcome data on 75,501 mothers from the Louisiana office of public health. Cross-sectional logistic regression analyses are performed testing the association between pre-HKR accumulation of Pb in soils in thirty-two neighborhoods and eclampsia risk. Then we examine whether measured declines in soil Pb following the flooding of the city resulted in corresponding reductions of eclampsia risk. Results Cross-sectional analyses show that a one standard deviation increase in soil Pb increases the odds of eclampsia by a factor of 1.48 (95% CI: 1.31, 1.66). Mothers in zip code areas with soil Pb>333 mg/kg were 4.00 (95% CI: 3.00, 5.35) times more likely to experience eclampsia than mothers residing in neighborhoods with soil Pb<50 mg/kg. Difference-in-differences analyses capturing the exogenous reduction in soil Pb following the 2005 flooding of New Orleans indicate that mothers residing in zip codes experiencing decrease in soil Pb (−387.9 to −33.6 mg/kg) experienced a significant decline in eclampsia risk (OR=0.619; 95% CI: 0.397, 0.963). Conclusions Mothers residing in neighborhoods with high accumulation of Pb in soils are at heightened risk of experiencing eclampsia. [ABSTRACT FROM AUTHOR]

In New Orleans a strong inverse association was previously identified between community soil lead and 4th grade school performance. This study extends the association to zinc, cadmium, nickel, manganese, copper, chromium, cobalt, and vanadium in community soil and their comparative effects on 4th grade school performance. Adjusting for poverty, food security, racial composition, and teacher-student ratios, regression results show that soil metals variously reduce and compress student scores. Soil metals account for 22%–24% while food insecurity accounts for 29%–37% of variation in school performance. The impact on grade point averages were Ni > Co > Mn > Cu ∼Cr ∼ Cd > Zn > Pb, but metals are mixtures in soils. The quantities of soil metal mixtures vary widely across the city with the largest totals in the inner city and smallest totals in the outer city. School grade point averages are lowest where the soil metal mixtures and food insecurity are highest. [Copyright &y& Elsevier]

Abstract: Previous studies identified a curvilinear association between aggregated blood lead (BL) and soil lead (SL) data in New Orleans census tracts. In this study we investigate the relationships between SL (mg/kg), age of child, and BL (μg/dL) of 55,551 children in 280 census tracts in metropolitan New Orleans, 2000 to 2005. Analyses include random effects regression models predicting BL levels of children (μg/dL) and random effects logistic regression models predicting the odds of BL in children exceeding 15, 10, 7, 5, and 3μg/dL as a function of age and SL exposure. Economic benefits of SL reduction scenarios are estimated. A unit raise in median SL0.5 significantly increases the BL level in children (b =0.214 p =<0.01), and a unit change in Age0.5 significantly increases child BL (b =0.401, p =<0.01). A unit change in Age0.5 increases the odds of a child BL exceeding 10μg/dL by a multiplicative factor of 1.23 (95% CI 1.21 to 1.25), and a unit (mg/kg) addition of SL increases the odds of child BL>10μg/dL by a factor of 1.13 (95% CI 1.12 to 1.14). Extrapolating from regression results, we find that a shift in SL regulatory standard from 400 to 100mg/kg provides each child with an economic benefit ranging from $4710 to $12,624 ($US 2000). Children''s BL is a curvilinear function of both age and level of exposure to neighborhood SL. Therefore, a change in SL regulatory standard from 400 to 100mg/kg provides children with substantial economic benefit. [Copyright &y& Elsevier]

Prior to Hurricanes Katrina and Rita (HKR), significant associations were noted between soil lead (SL) and blood lead (BL) in New Orleans. Engineering failure of New Orleans levees and canal walls after HKR set the stage for a quasi- experiment to evaluate BL responses by 13 306 children to reductions in SL High density soil surveying conducted in 46 census tracts before HKR was repeated after the flood. Paired t test results show that SL decreased from 328.54 to 203.33 mg/kg post-HKR (t= 3.296, p ≤ 0.01). Decreases in SL are associated with declines in children's BL response (r = 0.308, p ≤ 0.05). When SL decreased at least 1%, median children's BL declined 1.55 μg/dL Declines in median BL are largest in census tracts with ≥50% decrease in SL Also individual BL in children was predicted as a function of SL, adjusting for age, year of observation, and depth of flood waters. At the individual scale, BL decreased significantly in post-HKR as a function of SL with BL decreases ranging from b = -1.20 to -1.65 μg/dL, depending on the decline of SL end whether children were born in the post-HKR period. Our results support policy to improve soil conditions for children. [ABSTRACT FROM AUTHOR]