Risk of limb birth defects and mother's home proximity to cornfields

Background

Although previous studies have linked proximity to crops and birth defects, they lacked individual-level exposure data and none was based on using planted area instead of linear proximity to crops as the exposure metric. We studied birth defects in relation to the area of corn or soybeans within 500 m of the mother's residence.

Methods

We selected all singleton births from rural areas conceived during the 2000-2004 spring-summer months (n = 48,216). We determined whether the area with corn or soybeans around the home was associated with birth defects using multiple unconditional logistic regression.

Results

We found that limb birth defects (ICD-9-CM 754.5, 755) increased in relation to cornfields (Adjusted OR = 1.22; 95 % CI = 1.01, 1.47 per additional 10 ha planted with corn within 500 m). None of the birth defect types studied was associated with soybeans.

Conclusions

In the Midwest, a significant and expanding proportion of the population is now living in close proximity to cornfields. Our results suggest that additional studies should be conducted to identify which factor(s) associated with cornfields are behind the observed increase in limb birth defects.     

Estimating the primary etiologic agents in recreational freshwaters impacted by human sources of faecal contamination

Epidemiology studies of recreational waters have demonstrated that swimmers exposed to faecally-contaminated recreational waters are at risk of excess gastrointestinal illness. Epidemiology studies provide valuable information on the nature and extent of health effects, the magnitude of risks, and how these risks are modified or associated with levels of faecal contamination and other measures of pollution. However, such studies have not provided information about the specific microbial agents that are responsible for the observed illnesses in swimmers. The objective of this work was to understand more fully the reported epidemiologic results from studies conducted on the Great Lakes in the US during 2003 and 2004 by identifying pathogens that could have caused the observed illnesses in those studies. We used a Quantitative Microbial Risk Assessment (QMRA) approach to estimate the likelihood of pathogen-induced adverse health effects. The reference pathogens used for this analysis were Norovirus, rotavirus, adenovirus, Cryptosporidium spp., Giardia lamblia, Campylobacter jejuni, Salmonella enterica, and Escherichia coli O157:H7. Two QMRA-based approaches were used to estimate the pathogen combinations that would be consistent with observed illness rates: in the first, swimming-associated gastrointestinal (GI) illnesses were assumed to occur in the same proportion as known illnesses in the US due to all non-foodborne sources, and in the second, pathogens were assumed to occur in the recreational waters in the same proportion as they occur in disinfected secondary effluent. The results indicate that human enteric viruses and in particular, Norovirus could have caused the vast majority of the observed swimming-associated GI illnesses during the 2003/2004 water epidemiology studies. Evaluation of the time-to-onset of illness strongly supports the principal finding and sensitivity analyses support the overall trends of the analyses even given their substantial uncertainties.     

Estimation of prevalence and incidence of subclinical mastitis in a large population of Brazilian dairy herds

The objectives of this study were to estimate the prevalence and incidence of subclinical mastitis (SM) in a large population of Brazilian dairy herds and to describe how these indices changed over time. A data set comprising individual cow somatic cell counts (SCC) from 18,316 test days (TD) of 1,809 herds that participated in a Dairy Herd Improvement Association (DHIA) program between January 2011 and May 2015 was available for analysis. Only tests that had ≥10 lactating cows and that were performed at 30 ± 10-d intervals were used for analysis. The final data set included 8,285 TD from 517 herds located in 5 regions of the country. Prevalence (%) of SM was defined as the number of cows with SCC ≥200,000 cells/mL divided by the total number of tested cows on a given TD. The incidence of SM was defined as the number of cows whose SCC increased from <200,000 to ≥200,000 cells/mL over 2 consecutive TD divided by the sum of each cow's days at risk during this interval, expressed as new cases per cow month at risk. Prevalence and incidence of SM were compared among years, regions, herd size categories, and frequency of DHIA testing during the study period. The overall mean prevalence and incidence of SM including all tests performed during the study period was 46.4% and 0.17 new cases per cow month at risk, respectively. The prevalence of SM varied little from 2011 to 2015, and an increasing trend was observed over the years. Prevalence was lower in herds that performed ≥60 DHIA tests during the study period than in those that performed fewer tests and was not different among regions or herd size categories. Incidence of SM varied little over the years and was not different among the regions studied. Prevalence and incidence of SM in the 517 herds studied were high and did not improve over the years. These trends were observed across all herd size categories and regions studied. Producers who had more DHIA tests performed per herd during the study period had lower prevalence of SM. Results of this study highlight the need to establish large-scale milk quality programs in Brazil.     

Relation between Breast Cancer and High Glycemic Index or Glycemic Load: A Meta-analysis of Prospective Cohort Studies

Breast cancer is the commonest form of cancer in women worldwide. It has been suggested that chronic hyperinsulinemia associated with insulin resistance plays a role in breast cancer etiology. To test the hyperinsulinemia hypothesis, a dietary pattern associated with a high glycemic index and glycemic load, both proxies for chronic hyperinsulinemia, should be associated with an increased risk of breast cancer. A meta-analysis restricted to prospective cohort studies was undertaken using a random effects model with tests for statistical significance, publication bias and heterogeneity. The metric for analysis was the risk of breast cancer in the highest relative to the lowest glycemic index and glycemic load dietary pattern. A dietary pattern with a high glycemic index was associated with a summary relative risk (SRR) of 1.05 (95% CI: 1.00, 1.11), and a high glycemic load with a SRR of 1.06 (95% CI: 1.00, 1.13). Adjustments for body mass index [BMI], physical activity and other lifestyle factors did not influence the SRR, nor did menopausal status and estrogen receptor status of the tumor. In conclusion, the current evidence supports a modest association between a dietary pattern with high glycemic index or glycemic load and the risk of breast cancer.     

Illicit drug consumption estimations derived from wastewater analysis: A critical review

The consumption of illicit drugs causes indisputable societal and economic damage. Therefore it is necessary to know their usage levels and trends for undertaking targeted actions to reduce their use. Recently, a new approach (namely sewage epidemiology) was developed for the estimation of illicit drug use based on measurements of urinary excreted illicit drugs and their metabolites in untreated wastewater. This review aims at critically evaluating the published literature and identifying research gaps of sewage epidemiology. Firstly, the existing analytical procedures for the determination of the four most used classes of illicit drugs worldwide (cannabis, cocaine, opiates and amphetamine-like stimulants) and their metabolites in wastewater are summarized and discussed. The focus lies on the sample preparation and on the analysis with chromatographic techniques coupled to mass spectrometry. Secondly, back-calculations used to transform measured concentrations in wastewater (in ng/L) into an amount of used illicit drug (in g/day per 1000 inhabitants or doses/day per 1000 inhabitants) are discussed in detail for the four groups of illicit drugs. Sewage epidemiology data from Spain, Belgium, UK, Italy, Switzerland and USA are summarized and compared with data from international organisations, such as the European Monitoring Centre for Drug and Drug Addiction (EMCDDA) and the United Nations Office on Drugs and Crime (UNODC). The results derived from wastewater analysis show in general good agreement with existing prevalence data (percentage of a population that uses illicit drugs at a given time) and demonstrate the potential of sewage epidemiology. However, this review confirms that future work should focus on further optimisation and standardisation of various important parameters (e.g. sample collection and back-calculations). In the future, sewage epidemiology could be used in routine drug monitoring campaigns as a valuable tool in addition to the classical socio-epidemiological studies for the determination of local, national and international illicit drug use.