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OBJECTIVE This study was designed to examine the associations between regional weather data and agricultural worksite temperatures in Florida. METHODS Florida farmworkers (n = 105) were each monitored using iButton technology paired with simultaneous data from regional weather stations. Conditional inference tree models were developed for (1) regional environmental temperatures and iButton (worksite) temperatures, and (2) regional heat index (HI) and iButton HI. RESULTS Worksite temperatures were partitioned by regional temperature at the primary node of 29.1°C. Worksite HI was partitioned at nodes of 33.0°C, 36.0°C, 37.0°C, and 40.0°C. The nodes at 33.0°C and 40.0°C mirror the National Weather Service's category entry points for "extreme caution" and "danger" regarding the risk of developing heat-related illness. CONCLUSION Regional weather data have the potential to provide estimations of worksite environmental conditions allowing employers to quickly implement strategies to protect workers.

Background Laboring in hot and humid conditions is a risk factor for heat-related illnesses. Little is known about the amount of physical activity performed in the field setting by agricultural workers, a population that is among those at highest risk for heat-related mortality in the United States. Methods We measured accelerometer-based physical activity and work activities performed in 244 Florida agricultural workers, 18 to 54 years of age, employed in the fernery, nursery, and crop operations during the summer work seasons of 2015-2017. Environmental temperature data during the participant's workdays were collected from the Florida Automated Weather Network and used to calculate wet bulb globe temperature (WBGT). Generalized linear mixed model regression was used to examine the association between WBGT on physical activity, stratified by the agricultural sector. Results Fernery workers had the highest overall volume of physical activity, spending nearly 4 hours in moderate to vigorous activity per workday. Activity over the course of the workday also differed by the agricultural sector. A reduction on average physical activity with increasing environmental temperature was observed only among crop workers. Conclusions The quantity and patterns of physical activity varied by the agricultural sector, sex, and age, indicating that interventions that aim to reduce heat-related morbidity and mortality should be tailored to specific subpopulations. Some workers did not reduce overall physical activity under dangerously hot environmental conditions, which has implications for policies protecting worker health. Future research is needed to determine how physical activity and climatic conditions impact the development of heat-related disorders in this population.

Background: Girasoles is an academic–community partnership investigating heat-related illness (HRI) among farm-workers. An unexpected outcome is health screening and intervention for participants without access to health care. Objectives: We present a case of renal failure in a farmworker, detected during data collection, to illustrate how academic–community collaboration can result in clinical benefits for study participants. Methods: Girasoles is examining physiologic responses to heat stress, associated vulnerability factors, and HRI symptoms. Data include blood pressure, fasting and non-fasting blood glucose, blood creatinine, blood urea nitrogen, and urine dipsticks. Participants with out-of-range findings are referred to local health care providers. Results: During two summers, health screenings of 192 workers resulted in 71 referrals (37%) for conditions to be rechecked and treated. One of these referrals involved chronic renal failure requiring extensive follow-up by research team members. Conclusions: The case of renal failure illustrates the value of collaborative research as a health intervention with vulnerable populations.

It is well known that lead (Pb) produces reduced haemoglobin (Hb) levels and risk of anemia when blood lead levels (BPb) are greater than 20 µg dL-1. Two recent studies reported an increased risk of anemia in children with BPb between 10-20 µg dL-1, but few studies examined the association between Hb levels or risk of anemia and BPb under 10 µg dL-1. In the present study this association was examined using data of 140 preschool children from a larger prospective cohort study in China. Data showed that compared to children with BPb

There is no escaping the fact that the ability to skillfully influence change is a requirement for nurse leaders. This need is intensified as the national health care system reforms and as the morphology of health care systems continues to change, especially in academic health care systems. The purpose of this article was 2-fold. The first objective was to relay the experience of the integration of nursing practice, education, and research within an academic health care system. The second was to, through this story of integration, expose the uniqueness and importance of nurse leader roles influencing innovation across a multisystem enterprise to fulfill the organization's mission.

Repealing the Affordable Care Act (ACA) has significant implications for the future of occupational health nursing practice. As changes are proposed and implemented, occupational health nurses must continue to prioritize preventive care, chronic disease management, healthy communities, environmental health, and sustainability. In particular, immigrant workers are a vulnerable population needing attention by occupational health nurses.

To examine changes in health beliefs, pesticide safety knowledge, and biomarkers of pesticide exposure in indigenous farmworkers who received enhanced pesticide safety training compared with those receiving the standard training.Farmworkers in Oregon were randomly assigned to either a promotors pesticide safety training program or a standard video-based training. Spot urine samples were analyzed for dialkyl phosphate urinary metabolites. Pre-/postintervention questionnaires were used to measure pesticide safety knowledge, health beliefs, and work practices.Baseline to follow-up improvements in total pesticide knowledge scores were higher in the promotor group than in the standard video group. Pairwise differences in mean concentrations of dialkyl phosphate metabolite levels showed declines from baseline to follow-up for both intervention groups.Results showed reductions in pesticide exposure in indigenous-language speaking farmworkers who received enhanced pesticide safety training.

Background Recent evidence suggests that antecedent packed red blood cell (PRBC) transfusions increase the risk for necrotizing enterocolitis (NEC), the most common gastrointestinal emergency encountered by very low birth weight (VLBW) infants. The underlying mechanism for this association is unknown. Altered oxygenation of the mesenteric vasculature during PRBC transfusion has been hypothesized to contribute to NEC development and was investigated in this study.

The Age of Data is upon us, promising sweeping changes in all areas of business, including healthcare. The Shaw quote reminds us that data (facts) are fundamental to change. The Fourth Paradigm: Data-Intensive Scientific Discovery (Hey et al. The fourth paradigm: data-intensive scientific discovery, 2009) builds on the importance of data. Our science is powered by advanced computing capabilities and team work. The age of data-intensive discovery encompasses the transition from hypothesis-driven to data-driven science. The convergence of statistics, computer science and physical and life sciences is a reality today. What does it mean for nursing to become more data intensive? What will it mean for the practice of nursing and how do academic institutions adjust to prepare the nurses of the future to function well in a data-rich world? The potential is great to harness the massive stores of data on biological systems as well as social determinants of health; patients could change the way that care is provided. However our history tells us it may not be an easy transition. Nursing will need a large number of data-savvy professionals who can lead the profession forward; academic nursing must change to meet this challenge. In this chapter, the critical need for workforce training will be examined and the role that schools of nursing and academia will play to prepare the workforce of the future will be described. Competencies across different types of nursing education programs will be reviewed and exemplars of innovative curricular change will be described.

While the impact of active maternal smoking during pregnancy on child health has been well investigated, the association between maternal passive smoking, or environmental tobacco smoke (ETS), or second-hand smoke, and behavioral development of offspring is less clear. This study examines the association between maternal ETS exposure during pregnancy and child behavior problems.Cross-sectional data of 646 mother-child pairs from the Jintan China Cohort Study were used in the analyses. Mother's exposure to tobacco smoking at home, the workplace, and other places during pregnancy (for the determination of maternal ETS exposure) and children's behaviors (via Child Behavior Checklist) were assessed when the children were 5-6 years old. Logistic regression models were constructed to examine associations between maternal exposure to ETS during pregnancy and internalizing and externalizing behavior problems, adjusting for potential cofounders including child sex and parental characteristics.37% of mothers reported ETS during pregnancy. Children of mothers exposed to ETS during pregnancy had higher scores for externalizing and total behavior problems, with 25% of children whose mothers were exposed to ETS compared to 16% of children of unexposed mothers. After adjusting for potential confounders, ETS exposure was associated with a higher risk of externalizing behavior problems in offspring of exposed mothers (OR=2.08, 95% confidence interval [CI] 1.27-3.43). Analysis after multiple imputations and sensitivity analysis further verified the association, but no dose-response relationship was found. ETS exposure, however, was not associated with internalizing or total behavior problems.This study suggests that maternal ETS exposure during pregnancy may impact child behavioral development, particularly externalizing behaviors.

Work is a major part of the human experience, and most individuals spend over one third of their waking hours doing a job. Considering this span of time, what we experience and encounter while working undoubtedly has significant bearing on our health. Moreover, the jobs we do typically define a larg

Occupational pesticide exposure may be hazardous to pregnant farmworkers, yet few studies have focused on the health of female farmworkers distinct from their male counterparts or on the impact of agricultural work tasks on pregnancy outcomes. In the current community-based participatory research study, researchers conducted five focus groups with female nursery and fernery workers in Central Florida to enhance knowledge of attitudes about occupational risks and pregnancy health and to gather qualitative data to help form a survey instrument. This article presents the results from questions focused on pesticide exposure and its impact on general, reproductive, pregnancy, and fetal health. Workers reported a belief that pesticide exposure could be hazardous to pregnancy health; descriptions of symptoms and health concerns believed to be related to farmwork and to pesticide exposure; and descriptions of barriers preventing them from practicing safer occupational behaviors.

Children are especially vulnerable to lead toxicity, and exposure to lead has been linked to poor school performance and delinquency in children and adolescents. Even low-level lead exposure (blood lead level [BLL] lower than 10 µg/dL) can cause intelligence deficit. In China, BLLs in children decreased slightly after the phase-out of lead in gasoline, but few studies have examined the socio-demographic factors associated with BLL above 10 µg/dL. In thus study, we sought to examine the hypothesis that socio-demographic factors predict BLLs. We measured BLLs of 1,344 preschool children (3–5 years old) from the China Jintan Child Cohort Study. Children’s socio-demographics and health statuses, as well as parental socio-demographics, were collected through questionnaire. Multiple regression models were used to explore the association between socio-demographic factors and log-transformed BLLs as well as the relationship between socio-demographic factors and the risk of BLL above 10 µg/dL. We found the median BLL to be 6.2 µg/dL (range: 1.8–32.0 µg/dL), and 8% of children had BLLs above 10 µg/dL. Boys had a higher median BLL (6.4 µg/dL) than girls and were more likely to have BLL above 10 µg/dL (OR=1.77, 95% CI 1.14 –2.74). BLLs increased as children aged, with a median BLL of 6.6 µg/dL among 5-year old children. Children with sibling(s) had higher average BLL and prevalence of BLL above 10 µg/dL than those without sibling(s). Living in a crowded neighborhood was also associated with increased BLLs. Mother’s lower education, father’s occupation (as professional worker), and parental smoking at home were associated with increased BLLs. This study shows that children in this area still have relatively high BLLs after the phase-out of leaded gasoline. Both children’s and parental factors and community condition are associated with increased BLLs. Future efforts are needed to identify other exposure sources and develop targeted prevention strategies.

High levels of exposure to phthalates have been associated with an increased risk for adverse male fetal reproductive development. Although animal studies have consistently demonstrated reproductive health effects, additional human epidemiological studies are needed to fully understand the potential harm to humans. Recent findings reported for humans have demonstrated endocrine-disrupting action similar to that associated with phthalate exposures in animals. As a result, phthalate exposure is an emerging public health concern that warrants further review. This article explores the state of the science on phthalate exposure, reviews the literature, and provides recommendations occupational health nurses can use to optimize the health of susceptible populations.

In 2004, the American Association of Colleges of Nursing (AACN) adopted a position statement concerning the future of advanced practice nursing education. A target date of 2015 was articulated as the point by which master's preparation for advanced practice nurses would be replaced by doctoral level education. Seismic shifts in the realities surrounding nursing education and practice have occurred since the proposal to require a Doctor of Nursing Practice (DNP) degree for entry into advanced practice nursing was proposed. Unprecedented economic challenges have resulted in significant budget downturns for all sectors, including higher education. The consequent cutbacks, furloughs, and restructuring in educational operations of all types have placed enormous demands on faculty, staff, and students across the country. In addition, the growing incidence and earlier onset of chronic disease, a rapidly aging population, health care reform agendas, a shortage of primary care practitioners, and projected severe shortages of nursing faculty have raised fundamental questions about the capacity of nursing education to produce the numbers of advanced practice nurses needed. This article addresses the changing realities and growing concerns associated with the future of advanced practice nursing. Recommendations to ensure continuing development of advanced nursing practice that serves the interests and needs of the public now and in the future are presented within the context of a national workforce perspective.

Since their discovery, the safety of artificial sweeteners has been controversial. Artificial sweeteners provide the sweetness of sugar without the calories. As public health attention has turned to reversing the obesity epidemic in the United States, more individuals of all ages are choosing to use these products. These choices may be beneficial for those who cannot tolerate sugar in their diets (e.g., diabetics). However, scientists disagree about the relationships between sweeteners and lymphomas, leukemias, cancers of the bladder and brain, chronic fatigue syndrome, Parkinson's disease, Alzheimer's disease, multiple sclerosis, autism, and systemic lupus. Recently these substances have received increased attention due to their effects on glucose regulation. Occupational health nurses need accurate and timely information to counsel individuals regarding the use of these substances. This article provides an overview of types of artificial sweeteners, sweetener history, chemical structure, biological fate, physiological effects, published animal and human studies, and current standards and regulations.

The attacks on the World Trade Center in 2001 resulted in hazardous environmental exposures of enormous magnitude, bringing about persistent respiratory and psychological problems among survivors. Approximately 40,000 men and women worked at Ground Zero, the former site of the World Trade Center in New York City, and at the Staten Island landfill, the main wreckage depository, in the days, weeks, and months following 9/11. First responders such as firefighters and police, construction workers, and utility and public sector workers were involved. These individuals were at high risk for injury, respiratory complications, and psychological distress from the traumatic event. This article highlights the controversy surrounding 9/11 research and reports, identifies populations at high risk for exposure, and examines the health effects. Occupational health nurses should not only be empowered to provide the best care for workers affiliated with 9/11, but also contribute to research to protect worker health in future disaster responses.

Personal care items including lotions, perfumes, deodorants, shampoos, and cosmetics are sources of phthalate exposure. Women of childbearing age, children, and beauty salon workers are at greater risk for exposure. Occupational health nurses are in an ideal position to rally support for improved regulatory laws and for funding of evidence-based research that will reduce phthalate exposures and improve client health. Occupational health nurses must support the establishment and implementation of procedures for workplace safety inspections among susceptible populations. Information regarding reduction of overall phthalate exposure must be available for clients. Resources like phthalate-free product lists can be valuable tools in helping clients make informed decisions about alternatives to phthalates.

The China Jintan Child Cohort study began in 2004 with 1656 pre-school participants and a research focus on studying the impact of environmental exposures, such as lead, on children’s neurobehavioural outcomes. This population cohort now includes around 1000 of the original participants, who have been assessed three times over a period of 10 years. Since the original IJE cohort profile publication in 2010, participants have experienced a critical developmental transition from pre-school to school age and then adolescence. The study has also witnessed an increase in breadth and depth of data collection from the original aim of risk assessment. This cohort has added new directions to investigate the mechanisms and protective factors for the relationship between early health factors and child physical and mental health outcomes, with an emphasis on neurobehavioural consequences. The study now encompasses 11 domains, composed of repeated measures of the original variables and new domains of biomarkers, sleep, psychophysiology, neurocognition, personality, peer relationship, mindfulness and family dynamics. Depth of evaluation has increased from parent/teacher report to self/peer report and intergenerational family report. Consequently, the cohort has additional directions to include: (i) classmates of the original cohort participants for peer relationship assessment; and (ii) parental and grandparental measures to assess personality and dynamics within families. We welcome interest in our study and ask investigators to contact the corresponding author for additional information on data acquisition.

The exposure of migrant and seasonal farmworkers and their families to agricultural and residential pesticides is a continuing public health concern. Pesticide exposure research has been spurred on by the development of sensitive and reliable laboratory techniques that allow the detection of minute amounts of pesticides or pesticide metabolites. The power of research on farmworker pesticide exposure has been limited because of variability in the collection of exposure data, the predictors of exposure considered, the laboratory procedures used in analyzing the exposure, and the measurement of exposure. The Farmworker Pesticide Exposure Comparable Data Conference assembled 25 scientists from diverse disciplinary and organizational backgrounds to develop methodologic consensus in four areas of farmworker pesticide exposure research: environmental exposure assessment, biomarkers, personal and occupational predictors of exposure, and health outcomes of exposure. In this introduction to this mini-monograph, first, we present the rationale for the conference and its organization. Second, we discuss some of the important challenges in conducting farmworker pesticide research, including the definition and size of the farmworker population, problems in communication and access, and the organization of agricultural work. Third, we summarize major findings from each of the conference's four foci-environmental exposure assessment, biomonitoring, predictors of exposure, and health outcomes of exposure-as well as important laboratory and statistical analysis issues that cross-cut the four foci.

While chemical warfare agents have been used for decades in military conflict, it is only in the last two decades that increased attention has been paid to the acute and chronic health effects associated with exposure to these agents. This chapter describes the leading epidemiological investigations of populations exposed to chemical warfare agents from before World War II through the Japanese terrorist attacks in the mid-1990s. Limitations of these studies are described, including the lack of accurate exposure assessment and clinical data.

The authors conducted factor analysis on survey data from 1,779 Persian Gulf War veterans. Their purposes were to: 1) determine whether factor analysis identified a unique "Gulf War syndrome" among veterans potentially exposed to chemical warfare agents; 2) compare the findings of factor analysis with those from an epidemiologic analysis of symptom prevalence; and 3) observe the behavior of factor analysis when performed on dichotomous data. The factor analysis identified three factors, but they were not unique to any particular deployment group. A unique pattern of illness was not found for the larger group of veterans potentially exposed to chemical warfare agents; however, veterans who had witnessed the demolition of chemical warfare agents at the Khamisiyah site in Iraq had a greater prevalence of dysesthesia. An analysis of the performance of dichotomous variables in factor analysis showed that the standard criteria used to determine the number of relevant factors and the dominant variables within them may be inappropriate. While Gulf War veterans appear to suffer an increased burden of illness, there is insufficient evidence to identify a unique syndrome in this population of deployed servicemen and women. Furthermore, the results provide evidence that factor analysis may make a limited contribution in this area of research.

Multiple species in the toxic marine diatom genus Pseudo-nitzschia have been identified in the Northwestern Atlantic region encompassing the Gulf of Maine (GOM), including the Bay of Fundy (BOF). To gain further knowledge of the taxonomic composition and toxicity of species in this region, Pseudo-nitzschia isolates (n=146) were isolated from samples collected during research cruises that provided broad spatial coverage across the GOM and the southern New England shelf, herein referred to as the GOM region, during 2007-2008. Isolates, and cells in field material collected at 38 stations, were identified using electron microscopy (EM). Eight species (P. americana, P. fraudulenta, P. subpacifica, P. heimii, P. pungens, P. seriata, P. delicatissima and P. turgidula), and a novel form, Pseudo-nitzschia sp. GOM, were identified. Species identity was confirmed by sequencing the large subunit of the ribosomal rDNA (28S) and the internal transcribed spacer 2 (ITS2) for six species (36 isolates). Phylogenetic analyses (including neighbor joining, maximum parsimony, and maximum likelihood estimates and ITS2 secondary structure analysis) and morphometric data supported the placement of P. sp. GOM in a novel clade that includes morphologically and genetically similar isolates from Australia and Spain and is genetically most similar to P. pseudodelicatissima and P. cuspidata. Seven species (46 isolates) were grown in nutrient-replete batch culture and aliquots consisting of cells and growth medium were screened by Biosense ASP ELISA to measure total domoic acid (DA) produced (intracellular + extracellular); P. americana and P. heimii were excluded from all toxin analyses as they did not persist in culture long enough for testing. All 46 isolates screened produced DA in culture and total DA varied among species (e.g., 0.04 to 320 ng ml-1 for P. pungens and P. sp. GOM isolates, respectively) and among isolates of the same species (e.g., 0.24 – 320 ng ml-1 for P. sp. GOM). The 15 most toxic isolates corresponded to P. seriata, P. sp. GOM and P. pungens, and fg DA cell-1 was determined for whole cultures (cells and medium) using ELISA and liquid chromatography (LC) with fluorescence detection (FLD); for seven isolates, toxin levels were also estimated using LC - with mass spectrometry and ultraviolet absorbance detection. Pseudo-nitzschia seriata was the most toxic species (up to 3,500 fg cell-1) and was observed in the GOM region during all cruises (i.e., during the months of April, May, June and October). Pseudo-nitzschia sp. GOM, observed only during September and October 2007, was less toxic (19 – 380 fg cell-1) than P. seriata but more toxic than P. pungens var. pungens (0. 4 fg cell-1). Quantitation of DA indicated that concentrations measured by LC and ELISA were positively and significantly correlated; the lower detection limit of the ELISA permitted quantification of toxicity in isolates that were found to be nontoxic with LC methods. The confirmation of at least seven toxic species and the broad spatial and temporal distribution of toxic Pseudo-nitzschia spp. have significant implications for the regional management of nearshore and offshore shellfisheries resources.

Few epidemiological studies have been conducted that have incorporated clinical evaluations of Gulf War veterans with unexplained health symptoms and healthy controls. We conducted a mail survey of 2022 Gulf War veterans residing in the northwest United States and clinical examinations on a subset of 443 responders who seemed to have unexplained health symptoms or were healthy. Few clinical differences were found between cases and controls. The most frequent unexplained symptoms were cognitive/psychological, but significant overlap existed with musculoskeletal and fatigue symptoms. Over half of the veterans with unexplained musculoskeletal pain met the criteria for fibromyalgia, and a significant portion of the veterans with unexplained fatigue met the criteria for chronic fatigue syndrome. Similarities were found in the clinical interpretation of unexplained illness in this population and statistical factor analysis performed by this study group and others.

The agricultural industry has some of the highest incidence rates and numbers of occupational injuries and illnesses in the United States. Injuries and illnesses in agriculture result from accidents, falls, excessive heat, repetitive motion and adverse pesticide exposure. Women working in agriculture are exposed to the same hazards and risks as their male counterparts, but can face additional adverse impacts on their reproductive health. Yet, few occupational risk assessment studies have considered the reproductive health of female farmworkers. The objective of this community-based participatory research study was to conduct a retrospective, cross-sectional survey to collect information on workplace conditions and behaviors and maternal, pregnancy and infant health outcomes among a sample of female nursery and fernery farmworkers in Central Florida. Survey results showed that nursery workers were more likely to report health symptoms during their pregnancy than fernery workers. We also observed a self-reported increased risk of respiratory illness in the first year of life for infants whose mothers worked in ferneries. Our findings confirm that agricultural work presents potential reproductive hazards for women of childbearing age.

OBJECTIVE:: To compare workplace characteristics, workplace behaviors, and the health beliefs of female farmworkers of childbearing age with actual biomarkers of exposure to organophosphate pesticides and to the fungicide mancozeb. METHODS:: Hispanic and Haitian farmworkers between the ages of 18 and 40 years working in nursery or fernery operations were recruited to participate in a cross-sectional survey, examining demographics, work practices, work-related hygiene, and pesticide exposure beliefs. Single-void (spot) urine samples were analyzed for organophosphate and ethylenethiourea metabolites. RESULTS:: Women in nurseries worried less frequently about the effects of pesticides on their health than those in fernery operations. In summary, organophosphate and ethylenethiourea levels in nursery workers were significantly higher than levels in fernery workers and the control group. CONCLUSIONS:: Results showed that perceived pesticide exposure did not correspond to actual metabolite levels within differing agricultural subpopulations. Language: en

Although agricultural workers have elevated risks of heat-related illnesses (HRI), pregnant farmworkers exposed to extreme heat face additional health risk, including poor pregnancy health and birth outcomes. Qualitative data from five focus groups with 35 female Hispanic and Haitian nursery and fernery workers provide details about the women's perceptions of HRI and pregnancy. Participants believe that heat exposure can adversely affect general, pregnancy, and fetal health, yet feel they lack control over workplace conditions and that they lack training about these specific risks. These data are being used to develop culturally appropriate educational materials emphasizing health promoting and protective behaviors during pregnancy.

Recent evidence suggests that antecedent red blood cell (RBC) transfusions increase the risk for necrotizing enterocolitis (NEC), the most common gastrointestinal emergency encountered by very-low-birthweight (VLBW) infants. The underlying mechanism for this association is unknown. Altered oxygenation of the mesenteric vasculature during RBC transfusion has been hypothesized to contribute to NEC development and was investigated in this study.Oxygenation patterns among four VLBW infants who developed transfusion-related NEC (TR-NEC) were compared to four VLBW infants with similar gestational age who were transfused but did not develop NEC (non-NEC). Cerebral and mesenteric patterns were recorded before, during, and 48 hours after RBC transfusion using near-infrared spectroscopy (NIRS) technology. Percentage change from mean baseline regional oxygen saturation values and cerebrosplanchnic oxygenation ratios were analyzed.All TR-NEC infants (24-29 weeks' gestation; 705-1080 g) demonstrated greater variation in mesenteric oxygenation patterns surrounding transfusions than non-NEC infants (27.6-30 weeks' gestation; 980-1210 g). TR-NEC infants received larger mean volumes of total blood (27.75 ± 8.77 mL/kg) than non-NEC infants (15.25 ± 0.5 mL/kg).Wide fluctuation and decreases in mesenteric oxygenation patterns are more pronounced in TR-NEC infants, especially before TR-NEC onset, compared to non-NEC infants. Greater total volume of infused blood was associated with TR-NEC in preterm infants. Using NIRS, larger prospective studies are needed to further evaluate potential risk factors for NEC in this high-risk population.

Pregnant farmworkers and their fetuses are at increased risk of negative health outcomes due to environmental and occupational factors at their workplaces. Health care providers who serve farm communities can positively affect workers' health through the informed care they deliver. Yet, interviews with rural health care providers reveal limited knowledge about agricultural work or occupational and environmental health risks during pregnancy. Professional associations, government organizations, academic institutions, and practice settings must renew their efforts to ensure that environmental and occupational health education, especially as it relates to women and their children, is incorporated into academic and practice environments.

Objective: The potential health consequences of exposure to nanomaterials have yet to be elucidated though increasing evidence points to the potential for nanomaterials to cause adverse human health effects. This workshop addressed the feasibility of developing studies to measure health risks among nanomaterial workers. Methods: Breakout groups discussed different epidemiologic designs and methods to encourage companies to collect and retain exposure and health data. Results: Major challenges include defining and recruitment of appropriate study populations and obtaining adequate exposure data. Both prospective cohort studies and small cross-sectional panel studies utilizing biomarkers of exposure and effect offer approaches to study occupational groups. Conclusions: Potential exists to assemble cohorts to study the human health effects associated with nanomaterial exposure. Stakeholder partnerships are critical to the success of these studies and international partnerships hold great potential.

Background Previous studies have shown that fasting increases lead absorption in the gastrointestinal tract of adults. Regular meals/snacks are recommended as a nutritional intervention for lead poisoning in children, but epidemiological evidence of links between fasting and blood lead levels (B-Pb) is rare. The purpose of this study was to examine the association between eating a regular breakfast and B-Pb among children using data from the China Jintan Child Cohort Study. Methods Parents completed a questionnaire regarding children's breakfast-eating habit (regular or not), demographics, and food frequency. Whole blood samples were collected from 1,344 children for the measurements of B-Pb and micronutrients (iron, copper, zinc, calcium, and magnesium). B-Pb and other measures were compared between children with and without regular breakfast. Linear regression modeling was used to evaluate the association between regular breakfast and log-transformed B-Pb. The association between regular breakfast and risk of lead poisoning (B-Pb≥10 μg/dL) was examined using logistic regression modeling. Results Median B-Pb among children who ate breakfast regularly and those who did not eat breakfast regularly were 6.1 μg/dL and 7.2 μg/dL, respectively. Eating breakfast was also associated with greater zinc blood levels. Adjusting for other relevant factors, the linear regression model revealed that eating breakfast regularly was significantly associated with lower B-Pb (beta = -0.10 units of log-transformed B-Pb compared with children who did not eat breakfast regularly, p = 0.02). Conclusion The present study provides some initial human data supporting the notion that eating a regular breakfast might reduce B-Pb in young children. To our knowledge, this is the first human study exploring the association between breakfast frequency and B-Pb in young children.

Buccal cells are becoming a widely used tissue source for monitoring human exposure to occupational and environmental genotoxicants. A variety of methods exist for collecting buccal cells from the oral cavity, including rinsing with saline, mouthwash, or scraping the oral cavity. Buccal cells are also routinely cryopreserved with dimethyl sulfoxide (DMSO), then examined later for DNA damage by the comet assay. The effects of these different sampling procedures on the integrity of buccal cells for measuring DNA damage are unknown. This study examined the influence of the collection and cryopreservation of buccal cells on cell survival and DNA integrity. In individuals who rinsed with Hank's balanced salt solution (HBSS), the viability of leukocytes (90%) was significantly (p

Laboratory animal allergy is a relatively common work-related condition occurring in an estimated one-third of laboratory animal workers. More than 10% of these workers develop occupational asthma. Sensitization often occurs in the first 3 years of employment. Risk factors include a personal or family history of atopy, other preexisting non-work-related allergies, and a significant exposure to laboratory animals. Inhalation is the most common route of exposure, followed by skin and eye exposures. Preplacement testing and regular health surveillance screening may be used by institutions employing laboratory animal workers to identify, monitor, and prevent allergies and disease in these workers. Intervention and prevention techniques (i.e., engineering, administrative, and work practice controls and personal protective equipment) are key to controlling and preventing allergy symptoms and occupational asthma. Occupational health professionals play an important role in the early identification of at-risk and affected employees, and can render the necessary treatment, referrals, education, and recommendations to prevent debilitating illness.

IN THEIR EFFORTS TO IMPROVE THE health outcomes of neonates and infants in the Neonatal Intensive Care Unit (NICU), neonatal nurses should understand the potential for harm that plastic medical devices pose to infants. Di(2-ethylhexyl) phthalate (DEHP) is a plasticizer used to soften polyvinylchloride (PVC) that can leach from the plastic into the fluid or gas being delivered to the neonate. DEHP can harm the developing reproductive system. The U.S. Food and Drug Administration (FDA) has issued a public health notification recommendation that DEHP- free devices be considered for use in NICU patients.1 There are alternatives available. The purpose of this column is to inform neonatal nurses of the risk of DEHP exposure among infants and to make it simpler for them to implement change in reducing DEHP in their institution.

Acephate is a commonly used organophosphate insecticide applied on agricultural crops and in residential communities. Because very little acephate is metabolized prior to excretion, the parent pesticide compound can be measured in human urine. The residue method must be sensitive enough to determine human exposure and potential health risk for both agricultural workers and their families who may be exposed by pesticide drift or by inadvertent carry-home residues. A reliable and sensitive method was developed to measure acephate concentrations in human urine. Urine was diluted with water and acetone, adjusted to a neutral pH, and partitioned twice in acetone-methylene chloride (1 + 1, v/v), with NaCl added to aid separation. The solvent-reduced organic phase extracts were clarified by activated charcoal solid-phase extraction and then adjusted to a final volume with the addition of a D-xylose analyte protectant solution to reduce matrix enhancement effects. Acephate concentrations in urine were determined by gas chromatography using pulsed flame photometric detection. The method limit of detection was established at 2 microg/L, with a method limit of quantitation of 10 microg/L. The average recovery from urine fortified with 10-500 microg/L was 102 +/- 12% (n = 32).

Objective: A probabilistic model was used to analyze the cumulative risk of occupational hepatitis C virus (HCV) infection among U.S. public safety workers. Methods: A model for the career risk of HCV was developed using the frequency of parenteral exposures to blood, the population seroprevalence of HCV, and the risk of seroconversion after exposure. Estimates of key input variables were obtained from published studies. Results: Calculated estimates of the 30-year risk of infection ranged from < 0.1 % for police, firefighters, and corrections officers to 1.9% among paramedics and emergency department personnel in high-risk communities. Infrequent exposure to high-risk blood seems to present a greater risk of infection than more frequent contact to low-risk populations. Conclusions: Use of a probabilistic risk assessment model using published data can assist in policy decisions designed to protect the health and safety of workers. Further efforts to document the frequency of occupationally acquired HCV are needed.

Focus groups with culturally diverse populations, and Latino farmworkers in particular, have been used as an effective research method. However, the specifics of planning and implementing focus groups with diverse populations have not been elaborated in the literature. Focus groups were used as part of The Reducing Pesticide Exposure in Minority Families Project to successfully elicit migrant farmworkers' views on pesticide exposure and preferences for educational method. Although attention was paid to cultural and lifestyle considerations in the planning and implementation of our focus groups, recruitment, environmental context, convener, focus group questions, and within-population differences were identified as areas that required ongoing assessment and operational change. Vigilance to the dynamics of the process resulted in more effective focus groups.

Many factors have been considered as possible causes of the unexplained illness reported by veterans of the Gulf War (GW). In this study, we report an analysis of risk factors and unexplained illness in a population-based sample of GW veterans who underwent clinical evaluation. Multiple risk factors were compared in 241 veterans who met criteria for unexplained illness and 113 healthy controls. Results suggest that GW unexplained illness is most highly associated with combat conditions, heat stress, and having sought medical attention during the GW. When controlling for multiple simultaneous exposures during the GW, interactions around pyridostigmine bromide, insecticides and repellents, and stress were not significant. These results indicate that most unexplained illness in GW veterans cannot be explained by neurotoxic effects of exposures to chemicals that inhibit cholinesterase activity.

Importance The association between lead exposure and children’s IQ has been well studied, but few studies have examined the effects of blood lead concentrations on children’s behavior. Objective To evaluate the association between blood lead concentrations and behavioral problems in a community sample of Chinese preschool children with a mean blood lead concentration of less than 10 µg/dL. Design, Setting, and Participants A prospective cohort study was conducted at 4 preschools in Jintan, Jiangsu province of China. Participants included 1341 children aged 3 to 5 years. Exposures Lead. Main Outcomes and Measures Blood lead concentrations were measured in children aged 3 to 5 years. Behavioral problems were assessed using Chinese versions of the Child Behavior Checklist and Caregiver-Teacher Report Form when children were aged 6 years. Results The mean (SD) blood lead concentration was 6.4 (2.6) µg/dL, with the 75th and 90th percentiles being 7.5 and 9.4 µg/dL, respectively. General linear modeling showed significant associations between blood lead concentrations and increased scores for teacher-reported behavioral problems. A 1-µg/dL increase in the blood lead concentration resulted in a 0.322 (95% CI, 0.058 to 0.587), 0.253 (95% CI, 0.016 to 0.500), and 0.303 (95% CI, 0.046 to 0.560) increase of teacher-reported behavior scores on emotional reactivity, anxiety problems, and pervasive developmental problems, respectively ( P Conclusions and Relevance Blood lead concentrations, even at a mean concentration of 6.4 µg/dL, were associated with increased risk of behavioral problems in Chinese preschool children, including internalizing and pervasive developmental problems. This association showed different patterns depending on age and sex. As such, continued monitoring of blood lead concentrations, as well as clinical assessments of mental behavior during regular pediatric visits, may be warranted.