Search

Background: Technological burden and medical complexity are significant drivers of clinician burnout. Electronic health record(EHR)-based population health management tools can be used to identify high-risk patient populations and implement prophylactic health practices. Their impact on clinician burnout, however, is not well understood. Our objective was to assess the relationship between ratings of EHR-based population health management tools and clinician burnout. Methods: We conducted cross-sectional analyses of 2018 national Veterans Health Administration(VA) primary care personnel survey, administered as an online survey to all VA primary care personnel (n = 4257, response rate = 17.7%), using bivariate and multivariate logistic regressions. Our analytical sample included providers (medical doctors, nurse practitioners, physicians' assistants) and nurses (registered nurses, licensed practical nurses). The outcomes included two items measuring high burnout. Primary predictors included importance ratings of 10 population health management tools (eg. VA risk prediction algorithm, recent hospitalizations and emergency department visits, etc.). Results: High ratings of 9 tools were associated with lower odds of high burnout, independent of covariates including VA tenure, team role, gender, ethnicity, staffing, and training. For example, clinicians who rated the risk prediction algorithm as important were less likely to report high burnout levels than those who did not use or did not know about the tool (OR 0.73; CI 0.61-0.87), and they were less likely to report frequent burnout (once per week or more) (OR 0.71; CI 0.60-0.84). Conclusions: Burned-out clinicians may not consider the EHR-based tools important and may not be using them to perform care management. Tools that create additional technological burden may need adaptation to become more accessible, more intuitive, and less burdensome to use. Finding ways to improve the use of tools that streamline the work of population health management and/or result in less workload due to patients with poorly managed chronic conditions may alleviate burnout. More research is needed to understand the causal directional of the association between burnout and ratings of population health management tools. [ABSTRACT FROM AUTHOR]

Over the past century, conscientiousness has become seen as the preeminent trait for predicting performance. This consensus is due in part to these employees' ability to work with traditional 20th-century technology. Such pairings balance the systematic nature of conscientious employees with the technology's need for user input and direction to perform tasks--resulting in a complementary match. However, the 21st century has seen the incorporation of intelligent machines (e.g., artificial intelligence, robots, and algorithms) into employees' jobs. Unlike traditional technology, these new machines are equipped with the capability to make decisions autonomously. Thus, their nature overlaps with the orderliness subdimension of conscientious employees--resulting in a non-complementary mismatch. This calls into question whether the consensus about conscientious employees' effectiveness with 20th-century technology applies to 21st-century jobs. Integrating complementarity and role theory, we refine this consensus. Across three studies using distinct samples (an experience sampling study, a field experiment, and an online experiment from working adults in Malaysia, Taiwan, and the United States), each focused on a different type of intelligent machine, we show not only that using intelligent machines has benefits and consequences, but, importantly, that conscientious (i.e., orderly) employees are less likely to benefit from working with them. [ABSTRACT FROM AUTHOR]

Highlights the racist history and continued struggles of two nations to end racism through the assistance and advocacy of antiracist multicultural education. Internationalization has been the key to promoting curriculum transformation through exploring antiracist views and scholarship. Both South Africa and the United States have far to go. (Contains 55 references.) (MLH)

Head and neck cancer (HNC) risk prediction models based on risk factor profiles have not yet been developed. We took advantage of the large database of the International Head and Neck Cancer Epidemiology (INHANCE) Consortium, including 14 US studies from 1981–2010, to develop HNC risk prediction models. Seventy percent of the data were used to develop the risk prediction models; the remaining 30% were used to validate the models. We used competing-risk models to calculate absolute risks. The predictors included age, sex, education, race/ethnicity, alcohol drinking intensity, cigarette smoking duration and intensity, and/or family history of HNC. The 20-year absolute risk of HNC was 7.61% for a 60-year-old woman who smoked more than 20 cigarettes per day for over 20 years, consumed 3 or more alcoholic drinks per day, was a high school graduate, had a family history of HNC, and was non-Hispanic white. The 20-year risk for men with a similar profile was 6.85%. The absolute risks of oropharyngeal and hypopharyngeal cancers were generally lower than those of oral cavity and laryngeal cancers. Statistics for the area under the receiver operating characteristic curve (AUC) were 0.70 or higher, except for oropharyngeal cancer in men. This HNC risk prediction model may be useful in promoting healthier behaviors such as smoking cessation or in aiding persons with a family history of HNC to evaluate their risks. [ABSTRACT FROM AUTHOR]

The refrain "Delay, Deny, Wait Till They Die" is more than a slogan for disabled American veterans. It is a battle cry for soldiers, sailors, and airmen who have long put aside their armaments but remain entangled in the unending appeals process of the Department of Veterans Affairs' (VA) disability benefits system. When Congress created a system for the fair and equitable distribution of military benefits, it did so with the intent that the system be non-adversarial. Congress did not want disabled veterans pitted against the nation that they had sought to defend in litigation over disability benefits. However, defining the contours of that non-adversarial system has proven to be more difficult than Congress ever anticipated. The paternalistic and protective features of the system designed to insulate veterans from the burdens of adversarial litigation have left veterans without legal recourse to address system failures. Using the VA's process for developing expert medical testimony as an example, this article examines the costs and benefits of the non-adversarial process and argues that adversarial procedures must be woven into the fabric of the veteran-friendly system to ensure that veterans' rights are protected. This article concludes that, without adversarial processes to compliment the veteran-friendly rules, the VA model relegates disabled veterans to a substandard process for adjudicating disability benefits. [ABSTRACT FROM AUTHOR]

Dry bean (Phaseolus vulgaris L.) seeds are a major protein, carbohydrate and mineral source in the human diet of peoples in multiple regions of the world. Seed mineral biofortification is an ongoing objective to improve this important food source. The objective of this research was to assess the seed mineral concentration of five macroelements and eight microelements in a large panel (n = 277) of modern race Durango and race Mesoamerica genotypes to determine if variability existed that could be exploited for targeted seed biofortification. Varieties that derive from these races are found in many diets throughout the world. The panel was grown in replicated trials under typical production conditions in the major bean growing regions of the United States and a subset of the panel was also grown in replicated trials at three locations under control and terminal drought conditions. Except for K, seed mineral concentrations were higher for race Mesoamerica genotypes. Significantly higher seed concentrations for the majority of the minerals were observed for white-seeded genotypes and race Durango genotypes with the now preferred indeterminate, upright growth habit. Modern genotypes (since 1997) had equal or increased mineral concentrations compared with older genotypes. Drought affected mineral content differentially, having no effect on the microelement content but increased Co, Fe and Ni concentrations. The correlation of Ca and Mn concentrations suggests that these elements may share seed deposition mechanisms. The high heritability for seed mineral concentration implies that breeding progress can be achieved by parental selection from this panel. [ABSTRACT FROM AUTHOR]

The Higher Education Act (HEA) is due to be reauthorized by Congress and the higher education policy community is working hard to be a part of those efforts. The National Association of Student Financial Aid Administrators (NASFAA) plays a unique role in this process, as the HEA contains the legislation behind all of the federal student financial aid programs. As partisan politics infiltrate Washington D.C., NASFAA is working with its members and association colleagues to put forth innovative recommendations to shape and inform the reauthorization process. This paper examines the reauthorization process; highlights NASFAA's specific work, including policy recommendations; and explains how NASFAA utilizes its members and operates within the broader Washington D.C. higher education policy community to influence policy. [ABSTRACT FROM AUTHOR]

The United States Environmental Protection Agency ( USEPA) is finalizing its vapor intrusion guidelines. One of the important issues related to vapor intrusion is background concentrations of volatile organic compounds ( VOCs) in indoor air, typically attributed to consumer products and building materials. Background concentrations can exist even in the absence of vapor intrusion and are an important consideration when conducting site assessments. In addition, the development of accurate conceptual models that depict pathways for vapor entry into buildings is important during vapor intrusion site assessments. Sewer gas, either as a contributor to background concentrations or as part of the site conceptual model, is not routinely evaluated during vapor intrusion site assessments. The research described herein identifies an instance where vapors emanating directly from a sanitary sewer pipe within a residence were determined to be a source of tetrachloroethylene ( PCE) detected in indoor air. Concentrations of PCE in the bathroom range from 2.1 to 190 µg/m3 and exceed typical indoor air concentrations by orders of magnitude resulting in human health risk classified as an 'Imminent Hazard' condition. The results suggest that infiltration of sewer gas resulted in PCE concentrations in indoor air that were nearly two orders of magnitude higher as compared to when infiltration of sewer gas was not known to be occurring. This previously understudied pathway whereby sewers serve as sources of PCE (and potentially other VOC) vapors is highlighted. Implications for vapor intrusion investigations are also discussed. [ABSTRACT FROM AUTHOR]

Purpose: To examine rural status and social factors as predictors of self-rated health in community-dwelling adults in the United States. Methods: This study uses multinomial logistic and cumulative logistic models to evaluate the associations of interest in the 2006 US Behavioral Risk Factor Surveillance System, a cross-sectional survey of 347,709 noninstitutionalized adults. Findings: Self-rated health was poorer among rural residents, compared to urban residents (OR = 1.77, 95% CI: 1.54, 1.90). However, underlying risk factors such as obesity, low income, and low educational attainment were found to vary by rural status and account for the observed increased risk (OR = 1.03, 95% CI: 0.94, 1.12). There was little evidence of effect modification by rural status, though the association between obesity and self-rated health was stronger among urban residents (OR = 2.50, 95% CI: 2.38, 2.64) than among rural residents (OR = 2.18, 95% CI: 2.03, 2.34). Conclusions: Our findings suggest that differences in self-rated health by rural status were attributable to differential distributions of participant characteristics and not due to differential effects of those characteristics. [ABSTRACT FROM AUTHOR]

The new recreational designer drugs known as “bath salts” are synthetic cathinones (e.g., mephedrone, 3,4-methylenedioxypyrovalerone, methylone) that are being abused as stimulants. Bath salts have similar effects as amphetamine, cocaine, and MDMA (3,4-methylenedioxymethamphetamine, also known as ecstasy). Cathinone is a naturally occurring phenylalkylamine alkaloid present in the khat plant that has been used for centuries, but in Western countries, they are primary used by “young clubbers.” In this review, the pharmacology and neurotoxicity of bath salts will be discussed and the prevalence and pattern of bath salt use will be presented. The U.S. Poison Control Center received an increasing number of calls regarding bath salt intoxication in 2011, which led to an emergency temporary ban in September 2011. Despite the ban, the use of bath salts has continued. Multiple reports have described the clinical features of bath salt intoxication and withdrawal symptoms, as well as the potential for abuse and the development of dependence. There are reports of bath salts causing hallucinations, delirium, and psychosis. For patients presenting with bath salt intoxication, management includes using medications for behavioral control and other symptomatic support. In this review, we will report the use of bath salts in a patient with a history of schizophrenia and comorbid methamphetamine dependence. His clinical course will be discussed. In order to prevent the further abuse of bath salts, we need to encourage the continuing ban on the sale of bath salts and also educate both clinicians and patients about the risks of using such drugs. [ABSTRACT FROM PUBLISHER]

The article discusses the concerns in context to the U.S. Defense Base Act (DBA) insurance system. It depicts the problems faced by injured contractors after returning from war, and suggests a new DBA acquisition strategy for the U.S. Congress and the U.S. Department of Defense (DoD) in order to resolve the problem. It provides information on a multiple-provider strategy which deals with concerns relating to DBA insurance costs and claims processing.

As jet fuel is a common occupational exposure among military and civilian populations, this study was conducted to characterize jet fuel (JP8) exposure among active duty U.S. Air Force personnel. Personnel (n = 24) were divided a priori into high, moderate, and low exposure groups. Questionnaires and personal air samples (breathing zone) were collected from each worker over 3 consecutive days (72 worker-days) and analyzed for total hydrocarbons (THC), benzene, toluene, ethylbenzene, xylenes, and naphthalene. Air samples were collected from inside the fuel tank and analyzed for the same analytes. Linear mixed-effects models were used to evaluate the exposure data. Our results show that the correlation of THC (a measure of overall JP8 inhalation exposure) with all other analytes was moderate to strong in the a priori high and moderate exposure groups combined. Inhalation exposure to all analytes varied significantly by self-reported JP8 exposure (THC levels higher among workers reporting JP8 exposure), a priori exposure group (THC levels in high group > moderate group > low group), and more specific job task groupings (THC levels among workers in fuel systems hangar group > refueling maintenance group > fuel systems office group > fuel handling group > clinic group), with task groupings explaining the most between-worker variability. Among highly exposed workers, statistically significant job task-related predictors of inhalation exposure to THC indicated that increased time in the hangar, working close to the fuel tank (inside > less than 25 ft > greater than 25 ft), primary job (entrant > attendant/runner/fireguard > outside hangar), and performing various tasks near the fuel tank, such as searching for a leak, resulted in higher JP8 exposure. This study shows that while a priori exposure groups were useful in distinguishing JP8 exposure levels, job task-based categories should be considered in epidemiologic study designs to improve exposure classification. Finally, the strong correlation of THC with naphthalene suggests that naphthalene may be an appropriate surrogate of JP8 exposure. [Supplementary materials are available for this article. Go to the publisher's online edition of the Journal of Occupational and Environmental Hygiene for the following free supplemental resource: a pdf file containing a table detailing concentrations of JP8 components.] [ABSTRACT FROM AUTHOR]

Background: Exposure of the U.S. population to polybrominated diphenyl ethers (PBDEs) is thought to be via exposure to dust and diet. However, little work has been done to empirically link body burdens of these compounds to either route of exposure. Objectives: The primary goal of this research was to evaluate the dietary contribution to PBDE body burdens in the United States by linking serum levels to food intake. Method s: We used two dietary instruments - a 24-hr food recall (24FR) and a 1-year food frequency questionnaire (FFQ) - to examine food intake among participants of the 2003-2004 National Health and Nutrition Examination Survey. We regressed serum concentrations of five PBDEs (BDE congeners 28, 47, 99, 100, and 153) and their sum (SPBDE) against diet variables while adjusting for age, sex, race/ethnicity, income, and body mass index. Results: SPBDE serum concentrations among vegetarians were 23% (p = 0.006) and 27% (p = 0.009) lower than among omnivores for 24FR and 1-year FFQ, respectively. Serum levels of five PBDE congeners were associated with consumption of poultry fat: Low, medium, and high intake corresponded to geometric mean SPBDE concentrations of 40.6, 41.9, and 48.3 ng/g lipid, respectively (p = 0.0005). We observed similar trends for red meat fat, which were statistically significant for BDE-100 and BDE-153. No association was observed between serum PBDEs and consumption of dairy or fish. Results were similar for both dietary instruments but were more robust using 24FR. Conclusions: Intake of contaminated poultry and red meat contributes significantly to PBDE body burdens in the United States. [ABSTRACT FROM AUTHOR]

The article discusses the observational study, which was conducted by the U.S. Department of Energy (DOE), to identify work-related factors associated with likelihood of having beryllium sensitization (BeS) among former workers at the Nevada Test Site (NTS). To identify categories of related tasks associated with BeS, DOE administered work history questionnaires and utilized principal components analysis. It found that 23 had a confirmed positive result out of the 1,876 respondents and that the incidence of BeS among the participating former NTS workers was 1.3 percent. The researchers concluded that former workers with specific job tasks maybe at higher risk of developing such nonmagnetic metal sensitization.

The article evaluates the decision of the U.S. Securities and Exchange Commission (SEC) to regulate the hedge funds. Even though the SEC has claimed the change as the mildest possible, it has caused a controversy. Republican leaders along with President George W. Bush opposed the new rule. The fund managers are threatening a mass exodus from U.S. to overseas destinations. Hedge funds had a tremendous growth during 90's and by the turn of the century the number had grown to 6000. The near collapse of a hedge fund raised the need for public scrutiny and the SEC began to research and analyze the hedge fund industry which led to the present enactment.

Describes exposures to crystalline silica and the effectiveness of a commercially available dust collection system designed for tuckpointing tools. Effect of respirable crystalline silica exposure; Utilization of the National Institute for Occupational Safety and Health Recommended Exposure Limit and the American Conference of Governmental Industrial Hygienists as the evaluation criteria; Evaluation of the efficiency of engineering controls.

An investigation of 24 buildings in the Greater Boston Area revealed that one-third (8 of 24) contained caulking materials with polychlorinated biphenyl (PCB) content exceeding 50 ppm by weight, which is the U.S. Environmental Protection Agency (U.S. EPA) specified limit above which this material is considered to be PCB bulk product waste. These buildings included schools and other public buildings. In a university building where similar levels of PCB were found in caulking material, PCB levels in indoor air ranged from 111 to 393 ng/m³; and in dust taken from the building ventilation system, < 1 ppm to 81 ppm. In this building, the U.S. EPA mandated requirements for the removal and disposal of the PCB bulk product waste as well as for confirmatory sampling to ensure that the interior and exterior of the building were decontaminated. Although U.S. EPA regulations under the Toxic Substances Control Act stipulate procedures by which PCB-contaminated materials must be handled and disposed, the regulations apparently do not require that materials such as caulking be tested to determine its PCB content. This limited investigation strongly suggests that were this testing done, many buildings would be found to contain high levels of PCBs in the building materials and potentially in the building environment. The presence of PCBs in schools is of particular concern given evidence suggesting that PCBs are developmental toxins. [ABSTRACT FROM AUTHOR]

Polychlorinated biphenyls (PCBs) are a class of lipophilic endocrine-disrupting chemicals with wide industrial use in the U.S. from the 1930s through 1977. Due to their environmental and biological persistence, low levels of PCBs remain detected in wildlife and humans. Although U.S. studies have shown higher serum PCB concentrations among Black women compared with White women, studies of correlates of PCB exposure among Black women are scarce. We examined predictors of plasma PCB concentrations in a cross-sectional analysis of baseline data from a prospective cohort study of 1693 premenopausal Black women aged 23-35 years from Detroit, Michigan (2010-2012). We collected demographic, behavioral, dietary, and medical data via self-administered questionnaires, telephone interviews, and in-person clinic visits, as well as non-fasting blood samples. We measured concentrations of 24 PCB congeners in baseline plasma from a subset of 762 participants. We used linear regression for log-transformed lipid-adjusted PCB concentrations to calculate percentage differences across levels of selected predictors. We did this separately for individual PCBs, sum of total PCBs, and sum of PCBs by degree of chlorination and hormonal activity. PCB concentrations were positively associated with age, duration of urban residence, cigarette smoking, heavy alcohol intake, and being breastfed in infancy, and inversely associated with body mass index (BMI) and lactation duration. The strength of some associations varied by degree of chlorination. For example, a 5-kg/m2 higher BMI corresponded to a 2.9% lower summed concentration of tri- and tetra-substituted PCBs (95% CI -4.6%, -1.2%), an 8.3% lower summed concentration of penta- and hexa-substituted PCBs (95% CI -10.0%, -6.5%), and a 12.1% lower summed concentration of hepta-, octa-, nona-, and deca-substituted PCBs (95% CI -13.7%, -10.4%). Likewise, associations for age and being breastfed in infancy were stronger for higher-chlorinated PCBs. Results agree with studies on predictors of PCB body burdens, few of which include large numbers of Black women. [ABSTRACT FROM AUTHOR]

Head and neck squamous cell carcinomas (HNSCCs) represent clinically and etiologically heterogeneous tumors affecting >40 000 patients per year in the USA. Previous research has identified individual epigenetic alterations and, in some cases, the relationship of these alterations with carcinogen exposure or patient outcomes, suggesting that specific exposures give rise to specific types of molecular alterations in HNSCCs. Here, we describe how different etiologic factors are reflected in the molecular character and clinical outcome of these tumors. In a case series of primary, incident HNSCC (n = 68), we examined the DNA methylation profile of 1413 autosomal CpG loci in 773 genes, in relation to exposures and etiologic factors. The overall pattern of epigenetic alteration could significantly distinguish tumor from normal head and neck epithelial tissues (P P < 0.01), we did not observe an association between these profiles and overall patient survival after adjustment for stage; although methylation of a number of specific loci falling in different cellular pathways was associated with overall patient survival. We found that the etiologic heterogeneity of HNSCC is reflected in specific patterns of molecular epigenetic alterations within the tumors and that the DNA methylation profiles may hold clinical promise worthy of further study. [ABSTRACT FROM AUTHOR]

Introduction: San Diego County is the site of the BioNet Project, which seeks to improve the ability of the Navy Region Southwest and San Diego County to respond to a biologic attack on its population and its critical infrastructure by improving, integrating, and enhancing disparate military and civilian detection and characterization capabilities. BioNet is funded by the Department of Homeland Security. One component of this project is the comparison of data sources available in San Diego County to understand their relative strengths and weaknesses for syndromic surveillance purposes. Objectives: This study quantitatively compared the different syndromic data sources (both military and civilian) available in San Diego County both in terms of signal strength and timeliness. Methods: Multiple types of data were compared, including emergency medical services (EMS), school nurse, school absentee, physician outpatient encounters, over-the-counter (OTCs) pharmaceuticals, and prescription pharmaceuticals. Three major historical disease outbreaks are used as points of comparison. The specific outbreaks are respiratory disease caused by a major wildfire event in October 2003, influenza-like illness in December 2003, and a surge of gastrointestinal illness in February 2004. Each data source is separately filtered to bring out the types of symptoms associated with each of the outbreaks. The sources are compared both before and after smoothing with a moving 7-day average, designed to eliminate certain idiosyncratic effects and to reduce noise. Finally, the data sources were compared on the basis of timing and signal-to-noise ratio for their ability to capture these outbreaks. Additional time-series comparisons were also used to determine whether the data sources trend together during nonoutbreak periods. Results: The disease outbreaks are each observable in multiple data sources, but the most useful data source varies with the event. EMS, military ambulatory encounters, OTCs, and school nurse reports were especially useful for different illness events. For example, EMS data indicate the strongest signal-to-noise ratio for disease caused by wildfires; the school nurse data give an early indication of influenza; and the military ambulatory encounter data provide the strongest indication of an outbreak of gastrointestinal illness. Conclusion: These results indicate that a system that integrates multiple syndromic data streams into a single prospective surveillance tool might enhance the ability of military and civilian authorities in San Diego County to detect biologic terrorist or other disease outbreaks in a timely fashion. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate blood volatile organic compound (VOC) levels as biomarkers of occupational jet propulsion fuel 8 (JP-8) exposure while controlling for smoking. Methods: Among 69 Air Force personnel, post-shift blood samples were analyzed for components of JP-8, including ethylbenzene, toluene, o-xylene, and m/p-xy\ene, and for the smoking biomarker, 2,5-dimethylfuran. JP-8 exposure was characterized based on self-report and measured work shift levels of total hydrocarbons in personal air. Multivariate regression was used to evaluate the relationship between JP-8 exposure and post-shift blood VOCs while controlling for potential confounding from smoking. Results: Blood VOC concentrations were higher among US Air Force personnel who reported JP-8 exposure and work shift smoking. Breathing zone total hydrocarbons was a significant predictor of VOC blood levels, after controlling for smoking. Conclusions: These findings support the use of blood VOCs as a biomarker of occupational JP-8 exposure. [ABSTRACT FROM AUTHOR]

The article discusses as study to evaluate whether exposure to short-term jet propulsion fuel 8 (JP-8) is associated with balance problems among U.S. Air Force (USAF) personnel. The study found that the balance control among USAF personnel decreased as the task became more challenging, and workday exposure to JP-8 was not related to postural sway. The factors actually responsible for postural sway include demographic variables like younger age, being a smoker, and higher body mass index (BMI).

Abstract: One of the most prevalent workplace chemical exposures historically and currently confronting the global military and civilian workforce is jet propellant (JP) fuel (e.g., JP4, JP5, JP8, jet A1), a complex mixture of numerous hydrocarbon compounds and additives. To date, numerous protective and preventive strategies (e.g., federal exposure limits, workplace procedure protocols, protective gear such as goggles, respirator use, gloves, and coveralls) have been put in place to minimize acutely toxic exposure levels. However, questions remain regarding the effect of repeated exposures at lower (than regulated) levels of JP fuel. The Occupational JP8 Exposure Neuroepidemiology Study (OJENES) was designed to examine the relationships between occupational JP8 exposure over multiple, repeated workdays and specific aspects of central nervous system (CNS) functioning among Air Force (AF) personnel. In this report, we present the OJENES methodology, descriptive findings related to participant characteristics, JP8 exposure levels observed over a work week among higher and lower exposure groups, and neuropsychological task performances at the first study assessment. Results indicated minimal differences between participants in the high and lower exposure groups in terms of descriptive characteristics, other than daily JP8 exposure levels (p <0.001). In addition, neuropsychological task performances for most task measures were not found to be significantly different from reported reference ranges. These findings demonstrated that confounding and misclassification of exposure and outcome status are not major concerns for the study. Therefore, future OJENES analyses targeting the more focused research questions regarding associations between JP8 exposure and CNS functioning are likely to provide valid conclusions, as they will be less influenced by these research biases. [Copyright &y& Elsevier]

This study was designed to determine the body burden of polybrominated diphenyl ethers (PBDEs) among first-time mothers in the Greater Boston, Massachusetts area and to explore key routes of exposure. We collected breast milk samples from 46 first-time mothers, 2-8 weeks after birth. We also sampled house dust from the homes of a subset of participants by vacuuming commonly used areas. Data on personal characteristics, diet, home furniture, and electrical devices were gathered from each participant using a questionnaire. Breast milk and dust samples were analyzed for PBDEs using gas chromatography! mass spectrometry. PBDE concentrations were log- normally distributed in breast milk and dust. We found statistically significant, positive associations between PBDE concentrations in breast milk and house dust (r = 0.76, p = 0.003, not including BDE-209), as well as with reported dietary habits, particularly the consumption of dairy products (r = 0.41, p = 0.005) and meat (r = 0.37, p = 0.01). Due to low detection rates, it was not possible to draw conclusions about the association between BDE-209 in milk and dust. Our results support the hypothesis that the indoor environment and diet both play prominent roles in adult human exposure to PBDEs. [ABSTRACT FROM AUTHOR]