Search

The COVID-19 pandemic—and its associated restrictions—have changed many behaviors that can influence environmental exposures including chemicals found in commercial products, packaging and those resulting from pollution. The pandemic also constitutes a stressful life event, leading to symptoms of acute traumatic stress. Data indicate that the combination of environmental exposure and psychological stress jointly contribute to adverse child health outcomes. Within the Environmental influences on Child Health Outcomes (ECHO)-wide Cohort, a national consortium initiated to understand the effects of environmental exposures on child health and development, our objective was to assess whether there were pandemic-related changes in behavior that may be associated with environmental exposures. A total of 1535 participants from nine cohorts completed a survey via RedCap from December 2020 through May 2021. The questionnaire identified behavioral changes associated with the COVID-19 pandemic in expected directions, providing evidence of construct validity. Behavior changes reported by at least a quarter of the respondents include eating less fast food and using fewer ultra-processed foods, hair products, and cosmetics. At least a quarter of respondents reported eating more home cooked meals and using more antibacterial soaps, liquid soaps, hand sanitizers, antibacterial and bleach cleaners. Most frequent predictors of behavior change included Hispanic ethnicity and older age (35 years and older). Respondents experiencing greater COVID-related stress altered their behaviors more than those not reporting stress. These findings highlight that behavior change associated with the pandemic, and pandemic-related psychological stress often co-occur. Thus, prevention strategies and campaigns that limit environmental exposures, support stress reduction, and facilitate behavioral change may lead to the largest health benefits in the context of a pandemic. Analyzing biomarker data in these participants will be helpful to determine if behavior changes reported associate with measured changes in exposure.

Lyme disease, the leading vector-borne disease in the United States, may present with psychiatric features. Consider the following cases. ABOUT THE AUTHORS Dr. Fallon is associate professor of clinical psychiatry, Columbia University, and director, Lyme and Tick-borne Disease Research, New York State Psychiatric Institute, New York, NY. Mr. Vaccaro is summer intern, Columbia University Charles Ray Jones Fellowship, and student, Georgetown University, Washington, DC. Ms. Romano is research assistant, Columbia University. Ms. Clemente is neuropsychology evaluator, Columbia University. Address reprint requests to: Brian A. Fallon, MD, Columbia University, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 69, New York, NY 10032; or e-mail baf1@columbia.edu.