Residues of organochlorines in mallards and blue-winged teal collected in Colombia and Wisconsin, 1984–1989

We compared the seasonal concentrations of 12 organochlorine (OC) compounds in samples of breast muscle, associated skin, and subcutaneous fat of blue-winged teal (Anas discors) collected in Ciénaga Grande de Santa Marta, Colombia (1987–1988), and of mallards (Anas platyrhynchos) and blue-winged teal collected in Wisconsin (1984–1989). Although these species have similar feeding habits and overlapping breeding distributions, their winter ranges differ markedly. Most blue-winged teal winter in the Neotropics, whereas most mallards remain in the temperate regions of North America. A seasonal comparison of OC exposure in these species may help determine the geographic origins of contamination. All examined OCs were found to be below concentrations known to affect reproduction in waterfowl. DDE was most often detected in blue-winged teal and PCBs, in mallards. DDE exposure may have predominantly occurred outside of Wisconsin. The DDE concentration in blue-winged teal samples collected in Wisconsin in the spring (GM=0.406 g/g) were greater (P<0.001) than in the fall (GM=0.033 g/g) and greater than the concentrations in mallard samples from the spring (GM=0.058 g/g; P<0.001). Ciénaga Grande, however, was not a source of DDE contamination. The DDE concentrations in blue-winged teal samples from Ciénaga Grande did not differ between the spring (GM=0.037 g/g) and the fall (GM=0.039 g/g) and were lower (P<0.001) than the concentration in blue-winged teal samples from Wisconsin in the spring. In contrast, PCB contamination seemed to have occurred in Wisconsin and affected mostly mallards. PCBs were not detected in the samples from Colombia and were detected in only five (8.3%) of the blue-winged teal samples from Wisconsin (GM=0.025 g/g), however, those compounds were detected in 47% of the mallard samples collected in Wisconsin (GM=0.272 g/g). DDE and PCB concentrations were greater (P=0.0) in mallard samples collected from wetlands adjacent to Lake Michigan than in samples from inland wetlands.     

Estimating breast cancer incidence in Hispanic women in Connecticut, 1989–1991

Objectives. The objective of this study was to estimate incidence rates for breast cancer, the most commonly occurring cancer in women, in the growing Hispanic population of Connecticut.

Methods. The population‐based Connecticut Tumor Registry (CTR) routinely obtains only limited information on Hispanic origin and maiden name. In this study, surnames of CTR breast cancer patients diagnosed in 1989–1991 were matched with a list of Spanish surnames. To assess misclassification, both surnames and maiden names (from death certificates) of female Connecticut residents who had died in 1989–1991 from any cause of death at 20 years of age and older were matched with the Spanish‐surname list.

Results. Age‐specific incidence rates (1989–1991) for ‘Hispanic’ women (with Spanish surname) were lower than those for ‘non‐Hispanic’ white women (with non‐Spanish surname) for age 35–39 years and older. Errors in these estimated rates were probably small because among decedents the number with a Spanish surname differed by only 9% from the number with a Spanish maiden name; false positives were almost balanced by false negatives.

Conclusion. Matching of surnames in the cancer registry with a Spanish surname list provided reasonably accurate estimates of cancer incidence rates in Hispanic women, although individual women were misclassified as ‘Hispanic’ or ‘non‐Hispanic’.     

Contaminants in Ospreys from the Pacific Northwest: II. Organochlorine Pesticides, Polychlorinated Biphenyls, and Mercury, 1991–1997

Eggs of ospreys (Pandion haliaetus) were collected over the period 1991 to 1997 at 111 nests in the Fraser and Columbia River drainage systems of British Columbia, Washington, and Oregon. Contents were analyzed for organochlorine (OC) pesticides, polychlorinated biphenyls (PCBs), and total mercury. Blood samples were taken from nestling ospreys at two time points during the 1992 breeding season on the Thompson River and analyzed for non-ortho PCBs. Concentrations of DDE and related compounds showed high variability among individual eggs within study areas and no significant differences in mean concentrations among study areas. Some eggs contained high concentrations of DDE, up to 20 mg/kg (wet weight), for which there were no evident local sources, suggesting that exposure occurred outside of the breeding grounds. Most other OC pesticides measured in osprey eggs showed a similar distribution, although mean concentrations of chlordane-related compounds were generally, and in some cases significantly, higher in samples collected from the Columbia River sites compared to elsewhere. Significantly greater concentrations of PCBs were found in eggs from the Columbia River basin compared to the Fraser. This was attributed to extensive development of hydroelectric generation and related industries on the Columbia system. Significant differences among sites were also found in the pattern of PCB congeners, e.g., eggs from the lower Columbia River site had proportionally greater concentrations of less chlorinated, Aroclor 1242–type PCBs compared to other sites. In contrast, eggs from upper reaches of the Columbia River had relatively greater amounts of Aroclor 1254 and 1260 congeners. Mercury concentrations in osprey eggs tended to be uniform among sites and comparable to those reported in the literature for ospreys nesting on naturally formed lakes and rivers. There were no significant temporal changes in mean concentrations of any of the measured compounds at sites monitored from 1991 to 1997. Received: 24 August 1998/Accepted: 26 January 1999     

Immigration,ethnicity, and avoidable mortality in Canada, 1991–2006

Objective. Avoidable mortality is a well-recognized, but less studied indicator of the performance of the health system. First, the study seeks to establish whether immigrants overall and selected foreign-born ethnic groups (Western Europeans, South Asians, Chinese, and Filipinos) have an advantage over nonimmigrants in avoidable mortality. Second, it assesses the effect of sociodemographic and socioeconomic factors on any observed differences by duration of residence.

Design. Deaths grouped by cause of death and by behavioral risk factors, namely smoking-related and alcohol-related, were derived from the 1991 Canadian Census Cohort: Mortality and Cancer Follow-up. The analysis estimated age-standardized mortality rates (ASMRs), rate ratios, and rate differences and also fitted hazard regression models for the overall Canadian-born population and for selected foreign-born ethnicities by sex. Predictors were assessed at baseline.

Results. Compared to the Canadian-born persons, foreign-born men and women had lower ASMRs for overall avoidable mortality and also for selected causes of avoidable mortality. The only exception to this overall trend was for ischemic heart disease among South Asian women. Except for the order of prominence, the three leading causes of death for nonimmigrant and immigrant men and women overall were ischemic heart diseases, smoking-related diseases, and neoplasms. A similar pattern was observed among the ethnic groups, except for circulatory heart diseases replacing ischemic heart diseases and smoking-related diseases among Chinese and Filipino women, respectively. In the hazard regression analysis, the risk of avoidable mortality was lower for immigrants overall and selected ethnicities irrespective of the duration in Canada compared to nonimmigrants. These differences persisted even with adjustment for sociodemographic and socioeconomic factors.

Conclusion. Immigrants overall and the selected ethnicities enjoy an advantage over nonimmigrants in avoidable mortality. However, for certain causes of death especially ischemic heart disease mortality among South Asian women, immigrants appeared worse-off than nonimmigrants. The results suggest differential access to and use of health services, differences in protective health-related behavior, and the healthy immigrant effect.     

Trends in Racial and Ethnic Disparities in Childhood Asthma in Miami,Florida: 2005–2013

Nationally, racial and ethnic disparities in childhood asthma plateaued from 2005 to 2013. We assessed trends in childhood asthma in Miami, Florida using Youth Risk Behavior Surveillance System (YRBSS) data and emergency department (ED) utilization and hospitalization rates by zip code population characteristics. Asthma prevalence in Miami did not vary significantly by race/ethnicity in YRBSS respondents in 2005 (16.2–17.2%, all groups), but rose in African–Americans and Hispanics and declined in Whites by 2013 to 27.9, 20.9 and 12.6%, respectively (P?=?0.02). Median asthma ED visit rates rose from 106.8 (2006–2008) to 138.2 (2011–2013; P?=?0.004) per 10,000 children. High-poverty and majority African–American zip codes were 6.3 and 7.3 times more likely to have asthma ED visit rates?>?200 than others (P?<?0.001). In high-poverty zip codes, majority African–American population was not associated with significantly higher ED utilization. In low-poverty zip codes, the association became stronger. Greater poverty explains much, but not all of Miami African–Americans’ higher asthma risk.     

Paternal Age and Congenital Malformations in Offspring in California, 1989–2002

This study examined the association between paternal age and a wide range of structural birth defects. Data were drawn from The California Birth Defects Monitoring Program, a population-based active surveillance system for collecting information on infants and fetuses with defects born between 1989 and 2002. The analysis included 46,114 cases with defects, plus a random sample of 36,838 non-malformed births. After adjustment for maternal age, risks of anomalies of the nervous system for 38 and 42 year-old fathers, as compared to 29 year-old fathers, were 1.05-fold [1.00, 1.11] and 1.10-fold [1.02, 1.18] higher, respectively. Similar results were observed for anomalies of the limbs, where 38 and 42 year-old fathers had a 1.06-fold [1.02, 1.11] and 1.11-fold [1.05, 1.18] higher risk, respectively. Risks of anomalies of the integument were 1.05-fold [1.00, 1.09] and 1.10-fold [1.03, 1.16] higher for 38 and 42 year olds, respectively. Young paternal age, i.e., less than 29 years, was associated with an increased risk of amniotic bands (OR: 0.87 [0.78, 0.97]), pyloric stenosis (OR: 0.93 [0.90, 0.96]) and anomalies of the great veins (OR: 0.93 [0.87, 1.00]). In sum, both advanced and young paternal age was associated with select birth defects in California between 1989 and 2002.     

Trends in smoking prevalence and attributable mortality in China, 1991–2011

ObjectiveChina is the largest producer of tobacco worldwide. We assessed secular trends in prevalence of smoking, average cigarettes per day, mean age of initiation, and mortality attributable to smoking among the Chinese population between 1991 and 2011.DesignData came from the China Health and Nutrition Survey, conducted eight times between 1991 and 2011. A total of 83,447 participants aged 15 years or older were included in this study. Trends in smoking were stratified by sex, age, and region (urban vs. rural).ResultsIn 2011, 311 millions individuals were current smokers in China, with 295 million men and 16 million women, respectively. Between 1991 and 2011, the prevalence of current smoking decreased from 60.6% to 51.6% in men, and from 4.0% to 2.9% in women. However, during this period, the average number of cigarettes smoked per day per smoker increased from 15.0 to 16.5 in males, and from 8.5 to 12.4 in females. Further, age of smoking initiation decreased from 21.9 to 21.4 years in men and from 31.4 to 28.4 years in women. In 2011, 16.5% of all deaths in men and 1.7% in women were due to smoking. Between 1991 and 2011, the total number of deaths caused by smoking increased from 800,000 to 900,000.ConclusionsDuring the past 20 years, a slight decrease in smoking prevalence was observed in the Chinese population. However, cigarette smoking remains a major cause of death in China, especially in men.     

Levels of polychlorinated biphenyls,DDE, and mirex in waterfowl collected in New York State, 1979–1980

Levels of polychlorobiphenyls (PCBs), DDE, and mirex were measured in the subcutaneous fat, breast muscle, liver, and brain of sixty-three waterfowl collected in New York State during 1979 and 1980. Mean PCB levels were 7.5 g/g in fat and 1.3 g/g in breast muscle on a wet weight basis. The FDA tolerance level is 3.0 g/g in fat on a wet weight basis. Mean DDE and mirex levels were 0.34 g/g and 0.10 g/g in fat and 0.16 g/g and 0.07 g/g in breast muscle on a wet weight basis, respectively. Comparisons and correlations were made of contaminant levels in the various tissues by different concentration bases, and PCB concentrations were compared to the Aroclor^® (PCB) type. Potential health hazards are discussed. Comparisons to earlier studies show declined levels. Mergansers are the most contaminated species.     

Multiresidue Analysis of Organochlorine Pesticides in Milk,Egg and Meat by GC–ECD and Confirmation by GC–MS

A multiresidue method was developed and optimized for the quantification of organochlorine pesticides (OCPs) in milk, egg and meat samples. Sample extraction was performed by adopting QuEChERS principle and the extracts were cleaned-up dispersive solid-phase extraction with primary secondary amine after salting out with NaCl and MgSO₄. Analysis was carried out by gas chromatography coupled with electron capture detector and confirmation by gas chromatography-mass spectrometry. The performance of the method was investigated in terms of linearity, accuracy, precision, detection limit and quantification limit (LOQ). Good linearity was obtained, with correlation coefficients (r²) higher than 0.992. Mean recoveries were found in the ranges 72 %–108 %, 74 %–101 % and 75.27 %–104.56 % for the milk, egg and meat, respectively, RSD % turned out to range from 0.28 % to 10.05 %. The method developed was successfully tested on commercial milk, egg, and meat samples from the markets of Tamil Nadu (India), proving to be a useful tool in routine analysis of OCPs for monitoring purposes. None of the compounds of interest were observed above their respective LOQ.     

Continuing Organochlorine Insecticide Mortality in Wild Birds in New York, 2000–2004

No abstract available.     

Association between Mycobacterium tuberculosis lineage and site of disease in Florida, 2009–2015

BackgroundMycobacterium tuberculosis is characterized into four global lineages with strong geographical restriction. To date one study in the United States has investigated M. tuberculosis lineage association with tuberculosis (TB) disease presentation (extra-pulmonary versus pulmonary). We update this analysis using recent (2009–2015) data from the State of Florida to measure lineage association with pulmonary TB, the infectious form of the disease.MethodsM. tuberculosis lineage was assigned based on the spacer oligonucleotide typing (spoligotyping) patterns. TB disease site was defined as exclusively pulmonary or extra-pulmonary. We used ORs to measure the association between M. tuberculosis lineages and pulmonary compared to extra-pulmonary TB. The final multivariable model was adjusted for patient socio-demographics, HIV and diabetes status.ResultsWe analyzed 3061 cases, 83.4% were infected with a Euro-American lineage, 8.4% Indo-Oceanic and 8.2% East-Asian lineage. The majority of the cases (86.0%) were exclusively pulmonary. Compared to the Indo-Oceanic lineage, infection with a Euro-American (AOR = 1.87, 95% CI: 1.21, 2.91) or an East-Asian (AOR = 2.11, 95% CI: 1.27, 3.50) lineage favored pulmonary disease compared to extra-pulmonary. In a sub-analysis among pulmonary cases, strain lineage was not associated with sputum smear positive status, indicating that the observed association with pulmonary disease is independent of host contagiousness.ConclusionAs an obligate pathogen, M. tuberculosis' fitness is directly correlated to its transmission potential. In this analysis, we show that M. tuberculosis lineage is associated with pulmonary disease presentation. This association may explain the predominance in a region of certain lineages compared to others.     

The Black and White of Infant Back Sleeping and Infant Bed Sharing in Florida, 2004–2005

Not using the infant back sleep position is an established risk factor for sudden unexpected infant death (SUID). Infant bed sharing may also increase SUID risk, particularly under certain circumstances. Both of these infant sleeping behaviors are disproportionately higher among Black mothers. We explored the relationship between not using the infant back sleeping and infant bed sharing, developed separate risk factor profiles for these behaviors, and identified maternal characteristics contributing to racial differences in their practice. Merged 2004–2005 birth certificate and Pregnancy Risk Assessment Monitoring System data for 2,791 non-Hispanic Black and White Florida women were evaluated using univariable and multivariable analyses to develop risk factor profiles for infrequent back sleeping and frequent bed sharing. Cross-product interaction terms were introduced to identify factors contributing to racial differences. Infrequent back sleeping and frequent bed sharing were reported by two-thirds of Black women and one-third of White women. There was no association between the infant sleeping behaviors when adjusted for race (adjusted odds ratio [aOR], 1.04; 95% CI, 0.83–1.31). The infant sleeping behaviors shared no common independent maternal characteristics. Father acknowledgement on the birth certificate was a strong contributor to racial differences in infrequent back sleeping while breastfeeding, trimester of entry to prenatal care, and maternal depression revealed notable racial differences for bed sharing. Behavior-specific and race-specific public health messages may be an important public health strategy for reducing risky infant sleeping behaviors and decreasing SUIDs.     

The Growth of Managed Care and Changes in Physicians' Incomes, Autonomy, and Satisfaction, 1991–1997

Using survey data collected in 1991 and 1997 from a panel of almost 1,500 physicians, we analyzed the relationship between changes in physicians' incomes, practice autonomy, and satisfaction, and the growth of HMOs and physicians' perceived financial incentives. Both the growth of HMOs and financial incentives to reduce services were significantly related to lower income growth, reductions in practice autonomy, and decreases in satisfaction. Changes in income and autonomy were both positively and significantly related to changes in satisfaction. Controlling for changes in income and autonomy, HMO growth was no longer significantly related to changes in satisfaction. Having a perceived financial incentive to reduce services remained a negative and significant determinant of the change in career satisfaction.     

Organochlorine pesticide,polychlorobiphenyl, and mercury residues in bald eagle eggs—1969–79—and their relationships to shell thinning and reproduction

Bald eagle (Haliaeetus leucocephalus) eggs were collected in 14 States in 1969–79 and analyzed for organochlorine pesticides, polychlorobiphenyls, and mercury. Moderate shell thinning occurred in eggs from several areas. Eggs from the Chesapeake Bay area contained the highest residue levels of most organochlorines. DDE was detected in all eggs; other organochlorines were detected less frequently. Mercury levels were highest in eggs from Maine. Eight contaminants were significantly negatively correlated with shell thickness or reproduction at sampled breeding areas; DDE was most closely related to these factors. Production of young was near normal at breeding areas when DDE was 3 ppm (wet weight); reproductive failure approached 100% for those breeding areas where DDE in eggs was >15 ppm. Five ppm DDE was associated with 10% shell thinning. The other contaminants that were associated with these factors were also highly correlated with DDE; their impact appeared minor in relation to those of DDE.     

Fatal Occupational Injuries in the Forestry and Logging Industry in North Carolina, 1977–1991

Abstract

Fatal occupational injuries in the forestry and logging industry and occupation in the state of North Carolina from January 1, 1977, to December 31,1991, were analyzed. Data were obtained through the North Carolina medical examiners system. The analysis was performed for the whole state as well as for the four forestry regions into which the state is divided. A total of 125 deaths happened over the study period. All were men, and the majority (60%) were white, with a mean age of 43 years. The crude fatality rate for the overall study period was 2.2 deaths per 1,000 person-years, with age-specific rates increasing with age. The Piedmont region had the highest proportion of cases (31.2%), while the Mountain region accounted for the highest overall rate (22.7 per 1,000 personyears). For all the forestry regions, the leading means of injury was found to be falling objects.     

Age at first birth,parity, and post-reproductive mortality among white and black women in the US, 1982–2002

We investigate the relationship between the timing of first birth, parity, and women's risk of post-reproductive mortality over twenty-one years (1982–2002), among representative samples of black and white women in the United States. Data are taken from the National Longitudinal Survey of Mature Women. We find early childbearing to be associated with higher mortality among whites, while later childbearing is associated with higher mortality among blacks. The effect of age at first birth on white women's mortality is explained by background and mediating social, economic, and health related factors, but this effect remains robust for black women. In addition, childless white women have a higher risk of post-reproductive mortality than those with 2–3 children. High parity (6+ children) has a significant protective effect for blacks, though the effect is reduced with age. A similar protective effect of high parity becomes apparent among whites only after controlling for background and mediating characteristics. Findings are interpreted in light of the weathering hypothesis and from a life course framework that views women's fertility as adaptive to particular social and historical contexts.     

Drug injection rates and needle-exchange use in New York City, 1991–1996

Objectives included (1) to develop methods for identifying injection drug users with accelerating injection habits so they might be referred to counseling and treatment and (2) to investigate behavioral correlates of accelerating injection habits, including syringe-exchange program utilization. Data on drug use, enrollment in methadone maintenance, and demographic variables were obtained from 328 subjects who were seronegative for human immunodeficiency virus (HIV) who attended anywhere from 4 to 11 quarterly study visits for interview, HIV pretest counseling and risk reduction couseling, and blood donation for HIV antibody testing. Subjects were recalled 2 weeks after each study visit to receive their results and post-test counseling. We characterized subjects according to their patterns of drug injection as accelerating, decelerating, or stable, using intraindividual regression analyses and categorization rules, and by syringe-exchange use as consistent users, sporadic users, or nonusers. The present subjects included 52% with decelerating, 29% with stable, and 19% with accelerating rates of drug injection. There were 128 subjects (39%) who were categorized as consistent users of syringe-exchange programs, 84 (25%) were categorized as sporadic users, and 116 (35%) were categorized as nonusers. All syringe-exchange groups showed significantly decelerating drug injection. Rates of decline were significantly less, however, among consistent syringe-exchange users than sporadic or nonusers of syringe exchanges. Categorical analysis also showed significant differences among groups, with 30% of consistent syringe-exchange program users having accelerating rates of drug injection compared to 9% of nonusers and 17% of sporadic users. That consistent syringe-exchange users included a larger proportion of individuals whose drug habits were accelerating than did sporadic users or nonusers of syringe exchanges suggests a need for improved identification and counseling of such subjects by syringe-exchange program staff. The present statistical approaches may be of value in targeting such efforts. The ability of a syringe-exchange program to attract a disproportionate share of drug users with accelerating rates of drug injection underscores the importance of these programs to HIV prevention efforts.     

Ciprofloxacin Resistance and Gonorrhea Incidence Rates in 17 Cities,United States, 1991–2006

Antimicrobial drug resistance can hinder gonorrhea prevention and control efforts. In this study, we analyzed historical ciprofloxacin resistance data and gonorrhea incidence data to examine the possible effect of antimicrobial drug resistance on gonorrhea incidence at the population level. We analyzed data from the Gonococcal Isolate Surveillance Project and city-level gonorrhea incidence rates from surveillance data for 17 cities during 1991–2006. We found a strong positive association between ciprofloxacin resistance and gonorrhea incidence rates at the city level during this period. Their association was consistent with predictions of mathematical models in which resistance to treatment can increase gonorrhea incidence rates through factors such as increased duration of infection. These findings highlight the possibility of future increases in gonorrhea incidence caused by emerging cephalosporin resistance.