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BackgroundClimate change is increasing the frequency and intensity of heatwaves. Prior studies associate high temperature with preterm birth.ObjectivesWe tested the hypotheses that acute exposure to extreme heat was associated with higher risk of live spontaneous preterm birth (≥20 and historical [1971-2000] summertime 99th percentile) up to a week prior for each day of pregnancy. Survival analysis controlled for individual-level risk factors, secular and seasonal trends. We considered race/ethnicity, heat-trapping neighbourhood landcover and Index of Concentration at the Extremes as effect modifiers.ResultsThe frequency of preterm birth was 10.3%. A quarter (26.8%) of people were exposed to ATmax ≥40°C, and 22.8% were exposed to Tmax and Tmin >99th percentile while at risk. The preterm birth rate among the exposed was 8.9%. In multivariable models, the risk of preterm birth was 15% higher following extremely hot days (hazard ratio [HR] 1.15 (95% confidence interval [CI] 1.01, 1.30) for ATmax ≥40°C vs. 99th percentile). Censoring at earlier gestational ages suggested stronger associations earlier in pregnancy. The risk difference associated with extreme heat was higher in neighbourhoods of concentrated racialised economic disadvantage.ConclusionsAmbient heat was associated with spontaneous preterm birth, with stronger associations earlier in pregnancy and in racially and economically disadvantaged neighbourhoods, suggesting climate change may worsen existing social inequities in preterm birth rates.

The COVID-19 pandemic continues to exert immense societal impacts, with recent data showing inequitable distribution of consequences among racial and ethnic groups. The objective of this study was to assess associations between COVID-related work stressors and psychological distress, with special emphasis on differences by race and ethnicity. Data were from the population-based California Health Interview Survey (CHIS) 2020. Associations of individual and cumulative work stressors, including job loss, reduced work hours, and working from home, with psychological distress in 12,113 workers were examined via multivariable linear regression, and stratified analyses were conducted for racial and ethnic subgroups. After adjustment for covariates, compared to workers with no work stressors, those who experienced either one or two/more work stressors had higher psychological distress (βs and 95% CIs were 0.80 [0.51, 1.09] and 1.98 [1.41, 2.56], respectively). Notably, experiencing cumulative (two/more) work stressors had much stronger effects on psychological distress among participants who were Black (β and 95% CI were 3.51 [1.09, 5.93]) or racial minorities (β and 95% CI were 3.57 [1.10, 6.05]). Occupational consequences of the COVID-19 pandemic were associated with increased psychological distress in Californian workers and inequitably distributed, with racial and ethnic minorities suffering the greatest burden.

Methane superemitters emit non-methane copollutants that are harmful to human health. Yet, no prior studies have assessed disparities in exposure to methane superemitters with respect to race/ethnicity, socioeconomic status, and civic engagement. To do so, we obtained the location, category (e.g., landfill, refinery), and emission rate of California methane superemitters from Next Generation Airborne Visible/Infrared Imaging Spectrometer (AVIRIS-NG) flights conducted between 2016 and 2018. We identified block groups within 2 km of superemitters (exposed) and 5-10 km away (unexposed) using dasymetric mapping and assigned level of exposure among block groups within 2 km (measured via number of superemitter categories and total methane emissions). Analyses included 483 superemitters. The majority were dairy/manure (n = 213) and oil/gas production sites (n = 127). Results from fully adjusted logistic mixed models indicate environmental injustice in methane superemitter locations. For example, for every 10% increase in non-Hispanic Black residents, the odds of exposure increased by 10% (95% confidence interval (CI): 1.04, 1.17). We observed similar disparities for Hispanics and Native Americans but not with indicators of socioeconomic status. Among block groups located within 2 km, increasing proportions of non-White populations and lower voter turnout were associated with higher superemitter emission intensity. Previously unrecognized racial/ethnic disparities in exposure to California methane superemitters should be considered in policies to tackle methane emissions.

Background Per- and poly-fluoroalkyl substances (PFAS) are commonly detected in a variety of foods and food packaging materials. However, few studies have examined diet as a potential source of PFAS exposure during pregnancy. In the present cross-sectional study, we examined prenatal PFAS levels in relation to self-reported consumption of meats, dairy products, and processed foods during pregnancy. Methods Participants were enrolled in the Chemicals in Our Bodies study, a demographically diverse pregnancy cohort in San Francisco, CA (N = 509). Diet was assessed using a self-reported interview questionnaire administered during the second trimester. Participants were asked on average how many times a day, week, or month they ate 11 different foods since becoming pregnant. Responses were categorized as at least once a week or less than once a week and foods were grouped into three categories: processed foods, dairy products, and meats. Twelve PFAS (ng/mL) were measured in second trimester serum samples. We investigated relationships between consumption of individual dairy products, meats, and processed foods and natural log-transformed PFAS using separate linear regression models adjusted for maternal age, education, race/ethnicity, and nativity. Results Seven PFAS were detected in ≥65% of participants. Consumption of dairy milk and cheese at least once per week was moderately associated with elevated levels of perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDeA) relative to those who ate dairy products less than once week. The strongest associations observed were with PFDeA for dairy milk (β = 0.2, 95% confidence interval [CI] = 0.02, 0.39) and PFNA for cheese (β = 0.22, 95% CI = 0.02, 0.41). Eating fish, poultry, and red meat at least once per week was associated with higher levels of perfluoroundecanoic acid, PFDeA, PFNA, and perflucorooctane sulfonic acid. Conclusions Results indicate that consumption of animal products may contribute to elevated prenatal PFAS levels.

Living in a disadvantaged neighborhood has been associated with adverse birth outcomes. Most prior studies have conceptualized neighborhoods using census boundaries and few have examined the role of neighborhood perceptions, which may better capture the neighborhood environment. In the present study, we examined associations between extrinsic and perceived neighborhood quality measures and adverse birth outcomes.MethodsParticipants resided in the San Francisco Bay Area of California and were enrolled in Chemicals in Our Bodies, a prospective birth cohort (N = 817). The Index of Concentration at the Extremes (ICE) for income, Area Deprivation Index (ADI), and the Urban Displacement Project's measure of gentrification were included as census block group-level extrinsic neighborhood quality measures. Poor perceived neighborhood quality was assessed using an interview questionnaire. Linear regression models were utilized to examine associations between extrinsic and perceived neighborhood quality measures, and gestational age and birthweight for gestational age z-scores. Covariates in adjusted models were chosen via a directed acyclic graph (DAG) and included maternal age, education, and marital status.ResultsIn adjusted models, having poor perceived neighborhood quality was associated with higher birthweight z-scores, relative to those who did not perceive their neighborhood as poor quality (β = 0.21, 95% confidence intervals = 0.01, 0.42). Relative to the least disadvantaged tertile, the upper tertile of the ADI was associated with a modest reduction in gestational age (β = -0.35, 95% confidence intervals = -0.67, -0.02).ConclusionsIn the Chemicals in Our Bodies study population, extrinsic and perceived neighborhood quality measures were inconsistently associated with adverse birth outcomes.

Background Prenatal exposure to per- and poly-fluoroalkyl substances (PFAS) and psychosocial stressors has been associated with adverse pregnancy outcomes, including preterm birth. Previous studies have suggested that joint exposure to environmental chemical and social stressors may be contributing to disparities observed in preterm birth. Elevated corticotropin-releasing hormone (CRH) during mid-gestation may represent one biologic mechanism linking chemical and nonchemical stress exposures to preterm birth. Methods Using data from a prospective birth cohort (N = 497), we examined the cross-sectional associations between five individual PFAS (ng/mL; PFNA, PFOA, PFOS, PFHxS, and Me-PFOSA-AcOH) and CRH (pg/mL) using linear regression. PFAS and CRH were measured during the second trimester in serum and plasma, respectively. Coefficients were standardized to reflect change in CRH associated with an interquartile range (IQR) increase in natural log-transformed PFAS. We additionally examined if the relationship between PFAS and CRH was modified by psychosocial stress using stratified models. Self-reported depression, stressful life events, perceived stress, food insecurity, and financial strain were assessed using validated questionnaires during the second trimester and included as binary indicators of psychosocial stress. Results An IQR increase in PFNA was associated with elevated CRH (β = 5.17, 95% confidence interval [CI] = 1.79, 8.55). Increased concentrations of PFOA were also moderately associated with CRH (β = 3.62, 95% CI = −0.42, 7.66). The relationship between PFNA and CRH was stronger among women who experienced stressful life events, depression, food insecurity, and financial strain compared to women who did not experience these stressors. Conclusions This cross-sectional study is the first to examine the relationship between PFAS exposure and CRH levels in mid-gestation. We found that these associations were stronger among women who experienced stress, which aligns with previous findings that chemical and nonchemical stressor exposures can have joint effects on health outcomes.

Supplemental Digital Content is available in the text., Background: Prenatal exposure to hydraulic fracturing (HF), a chemically intensive oil and gas extraction method, may be associated with adverse birth outcomes, but no health studies have been conducted in California. Methods: We conducted a retrospective cohort study of 979,961 births to mothers in eight California counties with HF between 2006 and 2015. Exposed individuals had at least 1 well hydraulically fractured within 1 km of their residence during pregnancy; the reference population had no wells within 1 km, but at least one oil/gas well within 10 km. We examined associations between HF and low birth weight (LBW), preterm birth (PTB), small for gestational age birth (SGA), and term birth weight (tBW) using generalized estimating equations and assessing urban-rural effect modification in stratified models. Results: Fewer than 1% of mothers (N = 1,192) were exposed to HF during pregnancy. Among rural mothers, HF exposure was associated with increased odds of LBW (odds ratio [OR] = 1.74; 95% confidence interval [CI] = 1.10, 2.75), SGA (OR = 1.68; 95% CI = 1.42, 2.27) and PTB (OR = 1.17; 95% CI = 0.64, 2.12), and lower tBW (mean difference: –73 g; 95% CI = –131, –15). Among urban mothers, HF exposure was positively associated with SGA (OR = 1.23; 95% CI = 0.98, 1.55), inversely associated with LBW (OR = 0.83; 95% CI = 0.63, 1.07) and PTB (OR = 0.65; 95% CI = 0.48, 0.87), and not associated with tBW (mean difference: –2 g; 95% CI = –35, 31). Conclusion: HF proximity was associated with adverse birth outcomes, particularly among rural Californians.

BackgroundPrenatal exposure to individual per‑ and poly‑fluoroalkyl substances (PFAS) and psychosocial stressors have been associated with reductions in fetal growth. Studies suggest cumulative or joint effects of chemical and non-chemical stressors on fetal growth. However, few studies have examined PFAS and non-chemical stressors together as a mixture, which better reflects real life exposure patterns. We examined joint associations between PFAS, perceived stress, and depression, and fetal growth using two approaches developed for exposure mixtures.MethodsPregnant participants were enrolled in the Chemicals in Our Bodies cohort and Illinois Kids Development Study, which together make up the ECHO.CA.IL cohort. Seven PFAS were previously measured in 2nd trimester maternal serum samples and were natural log transformed for analyses. Perceived stress and depression were assessed using self-reported validated questionnaires, which were converted to t-scores using validated methods. Quantile g-computation and Bayesian kernel machine regression (BKMR) were used to assess joint associations between PFAS, perceived stress and depression t-scores and birthweight z-scores (N=876).ResultsIndividual PFAS, depression and perceived stress t-scores were negatively correlated with birthweight z-scores. Using quantile g-computation, a simultaneous one quartile increase in all PFAS, perceived stress and depression t-scores was associated with a slight reduction in birthweight z-scores (mean change per quartile increase=-0.09, 95% confidence interval=-0.21,0.03). BKMR similarly indicated that cumulative PFAS and stress t-scores were modestly associated with lower birthweight z-scores. Across both methods, the joint association appeared to be distributed across multiple exposures rather than due to a single exposure.ConclusionsOur study is one of the first to examine the joint effects of chemical and non-chemical stressors on fetal growth using mixture methods. We found that PFAS, perceived stress, and depression in combination were modestly associated were lower birthweight z-scores, which supports prior studies indicating that chemical and non-chemical stressors are jointly associated with adverse health outcomes.

BACKGROUND AND AIM: Hydraulic fracturing (HF) is a chemically intensive oil and gas extraction method. Although studies indicate exposure to HF during pregnancy may be associated with adverse birth...

BACKGROUND AND AIM: Issues of environmental justice exist with respect to toxic waste facilities, concentrated animal feeding operations, and air pollution exposure. For the first time, we aimed to...

PURPOSE OF REVIEW: Polluting industries are more likely to be located in low income communities of color who also experience greater social stressors that may make them more vulnerable than others to the health impacts of toxic chemical exposures. We describe recent developments in assessing pollutant exposures and health threats posed by industrial facilities using or releasing synthetic chemicals to nearby communities in the U.S. RECENT FINDINGS: More people are living near oil and gas development due to the expansion of unconventional extraction techniques as well as near industrial animal operations, both with suggestive evidence of increased exposure to hazardous pollutants and adverse health effects. Legacy contamination continues to adversely impact a new generation of residents in fenceline communities, with recent studies documenting exposures to toxic metals and poly- and perfluoroakyl substances (PFASs). Researchers are also giving consideration to acute exposures resulting from inadvertent industrial chemical releases, including those resulting from extreme weather events linked to climate change. Natural experiments of industrial closures or clean ups provide compelling evidence that exposures from industry harm the health of nearby residents. SUMMARY: New and legacy industries, coupled with climate change, present unique health risks to communities living near industry due to the release of toxic chemicals. Cumulative impacts from multiple stressors faced by environmental justice communities may amplify these adverse effects.

Author(s): Buchanan, MK; Kulp, S; Cushing, L; Morello-Frosch, R; Nedwick, T; Strauss, B | Abstract: The frequency of coastal floods around the United States has risen sharply over the last few decades, and rising seas point to further future acceleration. Residents of low-lying affordable housing, who tend to be low-income persons living in old and poor quality structures, are especially vulnerable. To elucidate the equity implications of sea level rise (SLR), we provide the first nationwide assessment of recent and future risks to affordable housing from SLR and coastal flooding in the United States. By using high-resolution building footprints and probability distributions for both local flood heights and SLR, we identify the coastal states and cities where affordable housing - both subsidized and market-driven - is most at risk of flooding. We provide estimates of both the expected number of affordable housing units exposed to extreme coastal water levels and of how often those units may be at risk of flooding. The number of affordable units exposed in the United States is projected to more than triple by 2050. New Jersey, New York, and Massachusetts have the largest number of units exposed to extreme water levels both in absolute terms and as a share of their affordable housing stock. Some top-ranked cities could experience numerous coastal floods reaching higher than affordable housing sites each year. As the top 20 cities account for 75% of overall exposure, limited, strategic and city-level efforts may be able to address most of the challenge of preserving coastal-area affordable housing stock.

Pregnant women who experience psychosocial stressors, such as stressful life events, poor neighborhood quality, and financial hardship, are at an increased risk for adverse pregnancy outcomes. Yet, few studies have examined associations between multiple stressors from different sources, which may be helpful to better inform causal pathways leading to adverse birth outcomes. Using path analysis, we examined associations between multiple self-reported stressor exposures during and before pregnancy in the Chemicals in Our Bodies-2 study (N = 510), a demographically diverse cohort of pregnant women in San Francisco. We examined associations between eight self-reported exposures to stressors and three responses to stress which were assessed via interview questionnaire at the 2nd trimester. Stressors included: neighborhood quality, stressful life events, caregiving, discrimination, financial strain, job strain, food insecurity, and unplanned pregnancy. Perceived stress, depression, and perceived community status were included as indicators of self-reported stress response. Our model indicated that women who experienced discrimination and food insecurity had a 3.76 (95% confidence interval [CI] = 1.60, 5.85) and 2.67 (95% CI = 1.31, 4.04) increase in depression scale scores compared to women who did not experience discrimination and food insecurity, respectively. We additionally identified job strain and caregiving for an ill family member as strong predictors of increased depressive symptoms (β = 1.63, 95% CI = 0.29, 3.07; β = 1.48, 95% CI = 0.19, 2.70, respectively). Discrimination, food insecurity, and job strain also influenced depression indirectly through the mediating pathway of increasing perceived stress, although indirect effects were less precise. In our study population, women who experienced discrimination, food insecurity, job strain and caregiving for an ill family member had an increased number of depressive symptoms compared to women who did not experience these stressors. Results from our study highlight the complex relationships between stressors and stress responses and may help to identify possible mediating pathways leading to adverse pregnancy outcomes.

Rebates incentivize clean vehicle adoption but may raise equity concerns because upfront capital is required for vehicle acquisition, limiting access for low-income households. Since poorer communities typically experience worse air quality than their wealthier counterparts, rebates also may not incentivize clean vehicle acquisitions in more polluted areas where air quality benefits would be greater. We analyzed whether equity-promoting policy design elements changed the associations between rebate allocation rates and census tract characteristics including community disadvantage, household income, education, race and ethnicity, and ambient air pollution in two California rebate programs. We found that the Clean Vehicle Rebate Project issued more rebates per household to advantaged, higher-income, better-educated communities with more White residents and intermediate levels of ambient nitrogen dioxide (NO2). An income cap and income-tiered rebate amount introduced part way through the program improved distributional equity, but fewer rebates were still issued to lower income, less-educated census tracts with higher percentages of Hispanic and non-Hispanic Black residents. Furthermore, these policy design elements reduced the overall number of rebates that were distributed. In the Enhanced Fleet Modernization Program, which incorporates additional equity-related design elements, rebate allocation rates were positively associated with community disadvantage, lower income and education, and a higher proportion of Hispanics, and were the highest in areas with slightly higher NO2 levels. These findings indicate that design elements such as an income cap, income-tiered rebate amounts, expanded vehicle eligibility, and increased benefit eligibility in disadvantaged communities, can facilitate distribution of rebates to more socioeconomically diverse populations with higher air pollution burdens.

Background Perfluoroalkyl substances (PFAS) and polybrominated diphenyl ethers (PBDEs) are used in consumer products for their water repellent and flame retardant properties, respectively. However, there is widespread prenatal exposure and concern about their potential harm to the developing fetus. Here, we utilized data from a demographically diverse cohort of women in San Francisco, CA to examine associations between prenatal exposure to PFAS and PBDEs with gestational age and birth weight for gestational age z-scores. Methods Women included in this analysis were enrolled in the Chemicals in our Bodies (CIOB) cohort study (N = 506). PFAS and PBDEs were measured in serum obtained during the second trimester of pregnancy. Linear regression models were used to calculate crude and adjusted β coefficients for the association between PFAS and PBDE concentrations in tertiles and gestational age and birth weight z-scores. Individual PFAS and PBDE concentrations, as well as their sums, were examined in separate models. Results The highest compared to lowest tertile of BDE-47 was associated with shorter gestational age (β = − 0.49, 95% confidence interval [CI] = − 0.95, − 0.02). Additionally, exposure to BDE-47 and BDE-99 in the middle tertile was also associated with a reduction in birth weight z-scores (β = − 0.26, 95% CI = -0.48, − 0.04; β = − 0.25, 95% CI = -0.47, − 0.04, respectively) compared to those in the lowest tertile of exposure. No consistent associations were observed between increasing PFAS concentrations and gestational age or birth weight z-scores. Discussion Among a diverse group of pregnant women in the San Francisco Bay Area, we found non-linear associations between prenatal exposure to PBDEs during the second trimester of pregnancy and birth weight z-scores. However, most PFAS congeners were not associated with adverse birth outcomes. PFAS and PBDE concentrations were lower in our cohort relative to other studies. Future research should assess the effects of emerging and persistent PFAS and PBDEs on birth outcomes, as some congeners are being phased out and replaced by chemically similar structures.

BackgroundPrior studies suggest exposure to oil and gas development (OGD) adversely affects birth outcomes, but no studies have examined flaring-the open combustion of natural gas-from OGD.ObjectivesWe investigated whether residential proximity to flaring from OGD was associated with shorter gestation and reduced fetal growth in the Eagle Ford Shale of south Texas.MethodsWe conducted a retrospective cohort study using administrative birth records from 2012 to 2015 (N=23,487) and satellite observations of flaring activity during pregnancy within 5km of maternal residence. Multivariate logistic and linear regression models were used to estimate associations between four outcomes (preterm birth, small-for-gestational age, continuous gestational age, and term birthweight) and exposure to a low (1-9) or high (≥10) number of nightly flare events, as compared with no exposure, while controlling for known maternal risk factors. We also examined associations with the number of oil and gas wells within 5km using data from DrillingInfo (now Enverus).ResultsExposure to a high number of nightly flare events was associated with a 50% higher odds of preterm birth [odds ratio (OR)=1.50 (95% CI: 1.23, 1.83)] and shorter gestation [mean difference=-1.9 (95% CI: -2.8, -0.9) d] compared with no exposure. Effect estimates were slightly reduced after adjustment for the number of wells within 5km. In stratified models these associations were present only among Hispanic women. Flaring and fetal growth outcomes were not significantly associated. Women exposed to a high number of wells (fourth quartile, ≥27) vs. no wells within 5km had a higher odds of preterm birth [OR=1.31 (95% CI: 1.14, 1.49)], shorter gestation [-1.3 (95% CI: -1.9, -0.8) d], and lower average birthweight [-19.4 (95% CI: -36.7, -2.0) g].DiscussionOur study suggests exposure to flaring from OGD is associated with an increased risk of preterm birth. Our findings need to be confirmed in other populations. https://doi.org/10.1289/EHP6394.

Background: Studies suggest associations between oil and gas development (OGD) and adverse birth outcomes, but few epidemiological studies of oil wells or inactive wells exist, and none in California. Objective: Our study aimed to investigate the relationship between residential proximity to OGD and birth outcomes in California. Methods: We conducted a retrospective cohort study of 2,918,089 births to mothers living within 10 km of at least one production well between January 1, 2006 and December 31, 2015. We estimated exposure during pregnancy to inactive wells count (no inactive wells, 1 well, 2–5 wells, 6+ wells) and production volume from active wells in barrels of oil equivalent (BOE) (no BOE, 1–100 BOE/day, >100 BOE/day). We used generalized estimating equations to examine associations between overall and trimester-specific OGD exposures and term birth weight (tBW), low birth weight (LBW), preterm birth (PTB), and small for gestational age birth (SGA). We assessed effect modification by urban/rural community type. Results: Adjusted models showed exposure to active OGD was associated with adverse birth outcomes in rural areas; effect estimates in urban areas were close to null. In rural areas, increasing production volume was associated with stronger adverse effect estimates. High (>100 BOE/day) vs. no production throughout pregnancy was associated with increased odds of LBW [odds ratio (OR)=1.40, 95% confidence interval (CI): 1.14, 1.71] and SGA (OR=1.22, 95% CI: 1.02, 1.45), and decreased tBW (mean difference = −36 grams, 95% CI: −54, −17), but not with PTB (OR=1.03, 95% CI: 0.91, 1.18). Conclusion: Proximity to higher production OGD in California was associated with adverse birth outcomes among mothers residing in rural areas. Future studies are needed to confirm our findings in other populations and improve exposure assessment measures. https://doi.org/10.1289/EHP5842

Unconventional extraction techniques including hydraulic fracturing or "fracking" have led to a boom in oil and gas production in the Eagle Ford shale play, Texas, one of the most productive regions in the United States. Nearly 400000 people live within 5 km of an unconventional oil or gas well in this largely rural area. Flaring is associated primarily with unconventional oil wells and is an increasingly common practice in the Eagle Ford to dispose of excess gas through combustion. Flares can operate continuously for months and release hazardous air pollutants such as particulate matter and volatile organic compounds in addition to causing light and noise pollution and noxious odors. We estimated ethnic disparities in exposure to flaring using satellite observations from the Visible Infrared Imaging Spectroradiometer between March 2012-December 2016. Census blocks with majority Hispanic (>60%) populations were exposed to twice as many nightly flare events within 5 km as those with

Over the past decade, increases in high-volume hydraulic fracturing for oil and gas extraction in the United States have raised concerns with residents living near wells. Flaring, or the combustion of petroleum products into the open atmosphere, is a common practice associated with oil and gas exploration and production, and has been under-examined as a potential source of exposure. We leveraged data from the Visible Infrared Imaging Spectroradiometer (VIIRS) Nightfire satellite product to characterize the extent of flaring in the Eagle Ford Shale region of south Texas, one of the most productive in the nation. Spatiotemporal hierarchical clustering identified flaring sources, and a regression-based approach combining VIIRS information with reported estimates of vented and flared gas from the Railroad Commission of Texas enabled estimation of flared gas volume at each flare. We identified 43887 distinct oil and gas flares in the study region from 2012 to 2016, with a peak in activity in 2014 and an estimated 4.5 billion cubic meters of total gas volume flared over the study period. A comparison with well permit data indicated the majority of flares were associated with oil-producing (82%) and horizontally drilled (92%) wells. Of the 49 counties in the region, 5 accounted for 71% of the total flaring. Our results suggest flaring may be a significant environmental exposure in parts of this region.

Background Telomere length in early life predicts later length, and shortened telomere length among adults and children has been linked to increased risk of chronic disease and mortality. Maternal stress during pregnancy may impact telomere length of the newborn. Methods In a diverse cohort of 355 pregnant women receiving prenatal and delivery care services at two hospitals in San Francisco, California, we investigated the relationship between self-reported maternal psychosocial stressors during the 2nd trimester of pregnancy and telomere length (T/S ratio) in newborn umbilical cord blood leukocytes. We examined financial strain, food insecurity, high job strain, poor neighborhood quality, low standing in one’s community, experience of stressful/traumatic life events, caregiving for a dependent family member, perceived stress, and unplanned pregnancy. We used linear regression and Targeted Minimum Loss-Based Estimation (TMLE) to evaluate the change in the T/S ratio associated with exposure to each stressor controlling for maternal age, education, parity, race/ethnicity, and delivery hospital. Results In TMLE analyses, low community standing (-0.09; 95% confidence interval [CI]-0.19 to 0.00) and perceived stress (-0.07; 95% CI -0.15 to 0.021 was marginally associated with shorter newborn telomere length, but the associations were not significant after adjusting for multiple comparisons. All linear regression estimates were not statistically significant. Our results also suggest that the association between some maternal stressors and newborn telomere length varies by race/ethnicity and infant sex. Conclusions This study is the first to examine the joint effect of multiple stressors during pregnancy on newborn TL using a flexible modeling approach.

Supplemental Digital Content is available in the text., Background: Restricting to live births can induce bias in studies of pregnancy and developmental outcomes, but whether this live-birth bias results in underestimating disparities is unknown. Bias may arise from collider stratification due to an unmeasured common cause of fetal loss and the outcome of interest, or depletion of susceptibles, where exposure differentially causes fetal loss among those with underlying susceptibility. Methods: We conducted a simulation study to examine the magnitude of live-birth bias in a population parameterized to resemble one year of conceptions in California (N = 625,000). We simulated exposure to a non–time-varying environmental hazard, risk of spontaneous abortion, and time to live birth using 1000 Monte Carlo simulations. Our outcome of interest was preterm birth. We included a social vulnerability factor to represent social disadvantage, and estimated overall risk differences for exposure and preterm birth using linear probability models and stratified by the social vulnerability factor. We calculated how often confidence intervals included the true point estimate (CI coverage probabilities) to illustrate whether effect estimates differed qualitatively from the truth. Results: Depletion of susceptibles resulted in a larger magnitude of bias compared with collider stratification, with larger bias among the socially vulnerable group. Coverage probabilities were not adversely affected by bias due to collider stratification. Depletion of susceptibles reduced coverage, especially among the socially vulnerable (coverage among socially vulnerable = 46%, coverage among nonsocially vulnerable = 91% in the most extreme scenario). Conclusions: In simulations, hazardous environmental exposures induced live-birth bias and the bias was larger for socially vulnerable women.

Due to advances in unconventional extraction techniques, the rate of fossil fuel production in the United States (US) is higher than ever before. The disposal of waste gas via intentional combustion (flaring) from unconventional oil and gas (UOG) development has also been on the rise, and may expose nearby residents to toxic air pollutants, light pollution and noise. However, little data exists on the extent of flaring in the US or the number of people living near UOG flaring activity. Utilizing nightly sattelite observations of flaring from the Visible Infrared Imaging Radiometer Suite Nightfire product, 2010 Census data and a dataset of remotely sensed building footprints, we applied a dasymetric mapping approach to estimate the number of nightly flare events across all oil shale plays in the contiguous US between March 2012 and February 2020 and characterize the populations residing within 3 km, 5 km and 10 km of UOG flares in terms of age, race and ethnicity. We found that three basins accounted for over 83% of all UOG flaring activity in the contiguous US over the 8 year study period. We estimated that over half a million people in these basins reside within 5 km of a flare, and 39% of them lived near more than 100 nightly flares. Black, indigenous, and people of color were disproportionately exposed to flaring.

In a demographically diverse cohort of 500 pregnant women recruited from two San Francisco hospitals, we used linear regression to evaluate the association between eight PFAS with detection frequen...

In a cohort of 500 pregnant women recruited from two San Francisco hospitals serving economically and ethnically diverse populations, we used Targeted Minimum Loss-Based Estimation (TMLE) to evalua...

In recent years there has been a rapid rise in unconventional oil and gas (UOG) extraction, commonly known as fracking. Excess natural gas resulting from UOG extraction is disposed of through flari...

Background Policies to mitigate climate change by reducing greenhouse gas (GHG) emissions can yield public health benefits by also reducing emissions of hazardous co-pollutants, such as air toxics and particulate matter. Socioeconomically disadvantaged communities are typically disproportionately exposed to air pollutants, and therefore climate policy could also potentially reduce these environmental inequities. We sought to explore potential social disparities in GHG and co-pollutant emissions under an existing carbon trading program—the dominant approach to GHG regulation in the US and globally. Methods and findings We examined the relationship between multiple measures of neighborhood disadvantage and the location of GHG and co-pollutant emissions from facilities regulated under California’s cap-and-trade program—the world’s fourth largest operational carbon trading program. We examined temporal patterns in annual average emissions of GHGs, particulate matter (PM2.5), nitrogen oxides, sulfur oxides, volatile organic compounds, and air toxics before (January 1, 2011–December 31, 2012) and after (January 1, 2013–December 31, 2015) the initiation of carbon trading. We found that facilities regulated under California’s cap-and-trade program are disproportionately located in economically disadvantaged neighborhoods with higher proportions of residents of color, and that the quantities of co-pollutant emissions from these facilities were correlated with GHG emissions through time. Moreover, the majority (52%) of regulated facilities reported higher annual average local (in-state) GHG emissions since the initiation of trading. Neighborhoods that experienced increases in annual average GHG and co-pollutant emissions from regulated facilities nearby after trading began had higher proportions of people of color and poor, less educated, and linguistically isolated residents, compared to neighborhoods that experienced decreases in GHGs. These study results reflect preliminary emissions and social equity patterns of the first 3 years of California’s cap-and-trade program for which data are available. Due to data limitations, this analysis did not assess the emissions and equity implications of GHG reductions from transportation-related emission sources. Future emission patterns may shift, due to changes in industrial production decisions and policy initiatives that further incentivize local GHG and co-pollutant reductions in disadvantaged communities. Conclusions To our knowledge, this is the first study to examine social disparities in GHG and co-pollutant emissions under an existing carbon trading program. Our results indicate that, thus far, California’s cap-and-trade program has not yielded improvements in environmental equity with respect to health-damaging co-pollutant emissions. This could change, however, as the cap on GHG emissions is gradually lowered in the future. The incorporation of additional policy and regulatory elements that incentivize more local emission reductions in disadvantaged communities could enhance the local air quality and environmental equity benefits of California’s climate change mitigation efforts., Rachel Morello-Frosch and colleagues reveal the health inequities in California’s carbon trading program with a disproportionate number of greenhouse gas-regulated facilities in economically disadvantaged neighbourhoods reported., Author summary Why was this study done? Climate change policies to reduce greenhouse gas (GHG) emissions can also reduce emissions of hazardous co-pollutants, such as air toxics and particulate matter. Decreases in GHG emissions are therefore also likely to provide health benefits by improving local air quality to communities near regulated facilities. Globally, socioeconomically disadvantaged communities are often disproportionately exposed to hazardous air pollutants due to emissions from facilities nearby. We examined temporal patterns in GHG and co-pollutant emissions with respect to neighborhood demographics under California’s cap-and-trade program—the world’s fourth largest carbon trading market. What did the researchers do and find? We assessed GHG and co-pollutant (particulate matter, nitrogen oxides, sulfur oxides, volatile organic compounds, and air toxics) emission patterns and the social equity implications of California’s cap-and-trade program before (2011–2012) and after (2013–2015) the initiation of carbon trading. Facilities regulated under California’s cap-and-trade program are disproportionately located in disadvantaged neighborhoods. Statistical analysis found that co-pollutant emissions from regulated facilities were temporally correlated with GHG emissions, and most regulated facilities (52%) reported higher annual average local (in-state) GHG emissions after the initiation of trading, even though total emissions remained well under the cap established by the program. Since California’s cap-and-trade program began, neighborhoods that experienced increases in annual average GHG and co-pollutant emissions from regulated facilities nearby had higher proportions of people of color and poor, less educated, and linguistically isolated residents, compared to neighborhoods that experienced decreases in GHGs. What do these findings mean? To our knowledge, this is the first study to assess social disparities in GHG and co-pollutant emissions under an existing carbon trading program. Although GHG emission reductions could bring about significant air quality and health benefits for California’s disadvantaged residents, thus far the state’s cap-and-trade program has yet to yield such localized improvements in environmental equity. Policy and regulatory incentives to enhance local GHG emission reductions in disadvantaged communities could yield greater local air quality and environmental equity benefits from California’s climate change mitigation strategies. Future regulatory efforts should systematically track trends in hazardous co-pollutant emissions associated with GHG emissions from stationary and transportation-related sources and assess how they impact socioeconomically disadvantaged populations.

Background/aim Unconventional oil and gas (UOG) operations may increase exposure to hazardous air pollutants and several studies suggest they can harm the health of nearby residents. However, research is hampered by a lack of data on pollutant emissions from drilling sites and few studies have examined the potential health impacts of flaring, the common practice of combusting petroleum waste products on site. Methods We utilise a novel remote sensing data source to estimate exposure to flaring among residents of the Eagle Ford Shale region of Texas, U.S. This rural region has experienced a roughly tenfold increase in oil and gas production since 2010 and is the highest oil-producing and fourth highest gas-producing region in the U.S. We investigate the potential of the VIIRS Nightfire product – which includes satellite observations of infrared radiation at night from combustion sources – to characterise exposure to flaring and compare estimates of exposure to UOG operations derived from VIIRS and those derived from more traditional data sources (permit and self-reported production data) that have been used in previous epidemiological studies. Results Nearly 8 00 000 people live less than 5 km from one or more of the 22 000 active, permitted UOG wells in the study region. Nighttime infrared observations from VIIRS confirm reports of extensive flaring in close proximity to homes. We construct VIIRS-derived indices to characterise exposure to flaring based on residential proximity to flaring locations, flaring frequency and duration, temperature of combustion, and areal extent. We discuss the strengths and limitations of these measures for estimating air pollutant emissions, and the implications of this exposure assessment method for future epidemiological research on the health impacts of UOG operations. Conclusion While previous studies have relied on self-reported information on the location, timing, and productivity of oil and gas extraction activities, careful processing of VIIRS observations can provide novel, objective estimates of exposure to flaring that are likely better capture exposure to air pollutants resulting from UOG operations.

Background/Aim: Cross-sectional studies suggest unequal distribution of urban greenspace. The extent to which neighborhood demographics are related to changes in greenspace over time remains unknow...

A growing body of literature suggests that more unequal societies have more polluted and degraded environments, perhaps helping explain why more unequal societies are often less healthy. We summarize the mechanisms by which inequality can lead to environmental degradation and their relevance for public health. We review the evidence of a relationship between environmental quality and social inequality along the axes of income, wealth, political power, and race and ethnicity. Our review suggests that the evidence is strongest for air- and water-quality measures that have more immediate health implications; evidence is less strong for more dispersed pollutants that have longer-term health impacts. More attention should be paid in research and in practice to links among inequality, the environment, and health, including more within-country studies that may elucidate causal pathways and points of intervention. We synthesize common metrics of inequality and methodological considerations in an effort to bring cohesion to such efforts.

The purpose of this chapter is to examine how science shops, institutional intermediaries that coordinate and execute community-engaged research, can foster a culture of critical civic engagement and disrupt the power dynamics of “expertise” inherent in traditional models of university-based scientific research. The authors argue that a science shop model that fully incorporates principled engagement with communities in equitable research partnerships could make important strides towards disrupting traditional hierarchical modes of knowledge production and reshaping academic scientific culture. The establishment of an environmentally focused science shop at the University of California, Berkeley in 2013 is described as a case study. The authors describe a project conducted by this science shop and highlight how it helped a small community organization working towards habitat conservation and enabled an undergraduate student to understand how to connect research with social change.

Objective: We examined the distribution of heat risk–related land cover (HRRLC) characteristics across racial/ethnic groups and degrees of residential segregation. Methods: Block group–level tree canopy and impervious surface estimates were derived from the 2001 National Land Cover Dataset for densely populated urban areas of the United States and Puerto Rico, and linked to demographic characteristics from the 2000 Census. Racial/ethnic groups in a given block group were considered to live in HRRLC if at least half their population experienced the absence of tree canopy and at least half of the ground was covered by impervious surface (roofs, driveways, sidewalks, roads). Residential segregation was characterized for metropolitan areas in the United States and Puerto Rico using the multigroup dissimilarity index. Results: After adjustment for ecoregion and precipitation, holding segregation level constant, non-Hispanic blacks were 52% more likely (95% CI: 37%, 69%), non-Hispanic Asians 32% more likely (95% CI: 18%, 47%), and Hispanics 21% more likely (95% CI: 8%, 35%) to live in HRRLC conditions compared with non-Hispanic whites. Within each racial/ethnic group, HRRLC conditions increased with increasing degrees of metropolitan area-level segregation. Further adjustment for home ownership and poverty did not substantially alter these results, but adjustment for population density and metropolitan area population attenuated the segregation effects, suggesting a mediating or confounding role. Conclusions: Land cover was associated with segregation within each racial/ethnic group, which may be explained partly by the concentration of racial/ethnic minorities into densely populated neighborhoods within larger, more segregated cities. In anticipation of greater frequency and duration of extreme heat events, climate change adaptation strategies, such as planting trees in urban areas, should explicitly incorporate an environmental justice framework that addresses racial/ethnic disparities in HRRLC.

Perchlorate, thiocyanate, and low iodine intake can all decrease iodide intake into the thyroid gland. This can reduce thyroid hormone production since iodide is a key component of thyroid hormone. Previous research has suggested that each of these factors alone may decrease thyroid hormone levels, but effect sizes are small. We hypothesized that people who have all three factors at the same time have substantially lower thyroid hormone levels than people who do not, and the effect of this combined exposure is substantially larger than the effects seen in analyses focused on only one factor at a time. Using data from the 2007-2008 National Health and Nutrition Examination Survey, subjects were categorized into exposure groups based on their urinary perchlorate, iodine, and thiocyanate concentrations, and mean serum thyroxine concentrations were compared between groups. Subjects with high perchlorate (n=1939) had thyroxine concentrations that were 5.0% lower (mean difference=0.40 μg/dl, 95% confidence interval=0.14-0.65) than subjects with low perchlorate (n=2084). The individual effects of iodine and thiocyanate were even smaller. Subjects with high perchlorate, high thiocyanate, and low iodine combined (n=62) had thyroxine concentrations 12.9% lower (mean difference=1.07 μg/dl, 95% confidence interval=0.55-1.59) than subjects with low perchlorate, low thiocyanate, and adequate iodine (n=376). Potential confounders had little impact on results. Overall, these results suggest that concomitant exposure to perchlorate, thiocyanate, and low iodine markedly reduces thyroxine production. This highlights the potential importance of examining the combined effects of multiple agents when evaluating the toxicity of thyroid-disrupting agents.

© 2016 American Chemical Society. Exposures to environmental pollutants in utero may increase the risk of adverse health effects. We measured the concentrations of 59 potentially harmful chemicals in 77 maternal and 65 paired umbilical cord blood samples collected in San Francisco during 2010-2011, including polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), polybrominated diphenyl ethers (PBDEs), hydroxylated PBDEs (OH-PBDEs), and perfluorinated compounds (PFCs) in serum and metals in whole blood. Consistent with previous studies, we found evidence that concentrations of mercury (Hg) and lower-brominated PBDEs were often higher in umbilical cord blood or serum than in maternal samples (median cord:maternal ratio > 1), while for most PFCs and lead (Pb), concentrations in cord blood or serum were generally equal to or lower than their maternal pair (median cord:maternal ratio ≤ 1). In contrast to the conclusions of a recent review, we found evidence that several PCBs and OCPs were also often higher in cord than maternal serum (median cord:maternal ratio > 1) when concentrations are assessed on a lipid-adjusted basis. Our findings suggest that for many chemicals, fetuses may experience higher exposures than their mothers and highlight the need to characterize potential health risks and inform policies aimed at reducing sources of exposure.

Objectives. We used an environmental justice screening tool (CalEnviroScreen 1.1) to compare the distribution of environmental hazards and vulnerable populations across California communities. Methods. CalEnviroScreen 1.1 combines 17 indicators created from 2004 to 2013 publicly available data into a relative cumulative impact score. We compared cumulative impact scores across California zip codes on the basis of their location, urban or rural character, and racial/ethnic makeup. We used a concentration index to evaluate which indicators were most unequally distributed with respect to race/ethnicity and poverty. Results. The unadjusted odds of living in one of the 10% most affected zip codes were 6.2, 5.8, 1.9, 1.8, and 1.6 times greater for Hispanics, African Americans, Native Americans, Asian/Pacific Islanders, and other or multiracial individuals, respectively, than for non-Hispanic Whites. Environmental hazards were more regressively distributed with respect to race/ethnicity than poverty, with pesticide use and toxic chemical releases being the most unequal. Conclusions. Environmental health hazards disproportionately burden communities of color in California. Efforts to reduce disparities in pollution burden can use simple screening tools to prioritize areas for action.

© 2017 by the authors. Licensee MDPI, Basel, Switzerland. Background: Cross-sectional studies suggest urban greenness is unequally distributed by neighborhood demographics. However, the extent to which inequalities in greenness have changed over time remains unknown. Methods: We estimated 2001 and 2011 greenness using Moderate-resolution Imaging Spectroradiometer (MODIS) satellite-derived normalized difference vegetative index (NDVI) in 59,483 urban census tracts in the contiguous U.S. We fit spatial error models to estimate the association between baseline census tract demographic composition in 2000 and (1) 2001 greenness and (2) change in greenness between 2001 and 2011. Results: In models adjusted for population density, climatic factors, housing tenure, and Index of Concentration at the Extremes for income (ICE), an SD increase in percent White residents (a 30% increase) in 2000 was associated with 0.021 (95% CI: 0.018, 0.023) higher 2001 NDVI. We observed a stepwise reduction in 2001 NDVI with increased concentration of poverty. Tracts with a higher proportion of Hispanic residents in 2000 lost a small, statistically significant amount of greenness between 2001 and 2011 while tracts with higher proportions of Whites experienced a small, statistically significant increase in greenness over the same period. Conclusions: Census tracts with a higher proportion of racial/ethnic minorities, compared to a higher proportion of White residents, had less greenness in 2001 and lost more greenness between 2001 and 2011. Policies are needed to increase greenness, a health-promoting neighborhood asset, in disadvantaged communities.