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CBRA Bulletin - December 2008
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This new Community-Based Risk Assessment (CBRA) Listserv is sponsored by the Environmental Protection Agency (EPA) and managed through the EPA's National Center of Environmental Research (NCER). Please feel free to forward the listserv messages to interested colleagues or ask them to join!
News and Opportunities | Featured Resource | Featured Science Articles
- New NAS Book on Improving EPA Risk Studies - Science and Decisions: Advancing Risk Assessment
The National Academy of Sciences (NAS) has released a long-awaited book on improving and modernizing the Environmental Protection Agency's (EPA's) methods of performing risk assessments. Authors consider this book a complement to NAS' 1983 Risk Assessment in the Federal Government: Managing the Process, or the "Red Book," which established a framework for risk evaluations. This new book embeds the concepts of risk assessment within a broader framework for risk-based decision-making. It recommends rigorous up-front planning to ensure the relevancy of a risk assessment to the specific problem being addressed. In addition, the book suggests a unified approach to dose-response assessment for both cancer and noncancer endpoints. Copies of the book are available from the National Academies Press at: http://books.nap.edu/catalog.php?record_id=12209.
More information regarding NAS can be found at: http://www.nasonline.org.
- CDC's Promoting Environmental and Policy Change to Support Healthy Aging Research to Practice Symposium - Save the Date (Sept. 2009)
The Centers for Disease Control and Prevention's (CDC) Prevention Research Center-Healthy Aging Research Network announces their Research to Practice Symposium on healthy aging. The symposium will occur on September 15-16, 2009 in Chapel Hill, North Carolina. It will address challenges amenable to environmental and policy change, the evidence that supports specific approaches and their outcomes, and promising strategies for practice. The target audience includes: advocates for livable communities and professionals in public health, aging services, business, planning, engineering, recreation, healthcare, architecture, and design. Information and updates are available at: www.prc-han.org. - NIH Announces Funding for New Epigenomics Initiative
The National Institutes of Health (NIH) announces funding for the new NIH Roadmap Epigenomics Program. Epigenetic processes control normal growth and development, and epigenomics is the study of epigenetic processes at a genome-wide scale. The NIH will invest more than $190 million over the next five years to accelerate this emerging field of biomedical research. The Epigenomics Program is a trans-NIH effort led by several NIH institutes including the National Institute of Environmental Health Sciences, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and the National Center for Biotechnology Information of the National Library of Medicine. For more information, visit: http://www.nih.gov/news/health/sep2008/od-29.htm; or http://nihroadmap.nih.gov/epigenomics/. - Air Toxics: Transcending Boundaries Symposium - Save the Date (May 2009)
The Air Toxics Symposium will be held at the University of Michigan, Ann Arbor from May 6-7. It will focus on air pollution research and policy. Emerging air toxics challenges will be covered in sessions on the impact of new fuels, new engine and hybrid technology and the link between air toxics exposures and health effects, as well as trans-border exposure issues. This symposium provides the ideal venue for increasing communication across disciplines and geographic boundaries. The Symposium agenda and additional information can be found at: http://www.sph.umich.edu/riskcenter/09symposium/agenda.htm.
- New Director of NIEHS Named
Community-Campus Partnerships for Health (CCPH) Annual Award recognizes exemplary partnerships between communities and higher educational institutions that build on each other's strengths to improve higher education, civic engagement, and the overall health of communities. The award recognizes partnerships that are striving to achieve the systems and policy changes needed to overcome the root causes of health, social, and economic inequalities. Partnerships must nominate themselves before January 30, 2009 . Click here to find instructions for submitting a nomination. Read more about CCPH at: http://depts.washington.edu/ccph/index.html.
Community-Campus Partnerships for Health (CCPH) promotes health, broadly defined, through partnerships between communities and higher educational institutions. As interest in community-based participatory research(CBPR) grows, there is a need and demand for educational resources that help build the knowledge and skills needed to develop and sustain effective CBPR partnerships. Developing & Sustaining CBPR Partnerships: A Skill-Building Curriculum is an evidence-based curriculum in intended as a tool for partnerships that are using or planning to use a CBPR approach to improving health. Each of the units includes: learning objectives; in-depth content information; examples and interactive exercises; and citation and suggested resources. The units are:
- CBPR - Getting Grounded
- Developing a CBPR Partnership - Getting Started
- Developing a CBPR Partnership - Creating the "Glue"
- Trust and Communication in a CBPR Partnership - Spreading the "Glue" and Having it Stick
- Show Me the Money - Securing and Distributing Funds
- Disseminating the Results of CBPR
- Unpacking Sustainability in a CBPR Partnership
The full curriculum is available at: http://www.cbprcurriculum.info/.
More information on CCPH and information on becoming a CCPH member are available at: http://www.ccph.info.
- Epigenetics and the Embodiment of Race: Developmental Origins of US Racial Disparities in Cardiovascular Health
American Journal of Human Biology (Epublication, ahead of print) by CW Kuzawa and E Sweet
Abstract: The relative contribution of genetic and environmental influences to the US black-white disparity in cardiovascular disease (CVD) is hotly debated within the public health, anthropology, and medical communities.
In this article, we review evidence for developmental and epigenetic pathways linking early life environments with CVD, and critically evaluate their possible role in the origins of these racial health disparities. African Americans not only suffer from a disproportionate burden of CVD relative to whites, but also have higher rates of the perinatal health disparities now known to be the antecedents of these conditions. There is extensive evidence for a social origin to prematurity and low birth weight in African Americans, reflecting pathways such as the effects of discrimination on maternal stress physiology. In light of the inverse relationship between birth weight and adult CVD, there is now a strong rationa le to consider developmental and epigenetic mechanisms as links between early life environmental factors like maternal stress during pregnancy and adult race-based health disparities in diseases like hypertension, diabetes, stroke, and coronary heart disease. The model outlined here builds upon social constructivist perspectives to highlight an important set of mechanisms by which social influences can become embodied, having durable and even transgenerational influences on the most pressing US health disparities. We conclude that environmentally responsive phenotypic plasticity, in combination with the better-studied acute and chronic effects of social-environmental exposures, provides a more parsimonious explanation than genetics for the persistence of CVD disparities between members of socially imposed racial categories.
- State-of-the-Science Workshop Report: Issues and Approaches in Low Dose-Response Extrapolation for Environmental Health Risk Assessment
Environmental Health Perspectives (Epublication ahead of print) by Ronald H. White, Ila Cote, Lauren Zeise, Mary Fox, Francesca Dominici, Thomas A. Burke, Paul D. White, Dale B. Hattis, and Jonathan M. Samet
Abstract: Low-dose extrapolation model selection for evaluating the health effects of environmental pollutants is a key component of the risk assessment process. At a workshop held in Baltimore, MD, on April 23-24, 2007, and sponsored by U.S. Environmental Protection Agency and Johns Hopkins Risk Sciences and Public Policy Institute, a multidisciplinary group of experts reviewed the state of the science regarding low-dose extrapolation modeling and its application in environmental health risk assessments. Discussion topics were identified based on a literature review, which included examples for which human responses to ambient exposures have been extensively characterized for cancer and/or noncancer outcomes. Topics included: the need for formalized approaches and criteria to assess the evidence for mode of action; the use of human vs. animal data; the use of mode of action information in biologically-based models; and the impl ications of interindividual variability, background disease processes and background exposures in threshold vs. nonthreshold model choice. Approaches that differ from current practice were recommended for extrapolating high-dose animal data to low-dose human exposures, including categorical approaches for integrating information on mode of action, statistical approaches such as model averaging, and inference-based models that explicitly consider uncertainty and interindividual variability.
Free access available at: http://www.ehponline.org/docs/2008/11502/abstract.html.
- Reflections on the Use of Bayesian Belief Networks for Adaptive Management.
Journal of Environmental Management (Volume 88, Issue 4: 1025-1036) by HJ Henriksen and HC Barlebo)
Abstract: A broad range of tools are available for integrated water resource management (IWRM). In the EU research project NeWater, a hypothesis exists that IWRM cannot be realised unless current management regimes undergo a transition toward adaptive management (AM). This includes a structured process of learning, dealing with complexity, uncertainty etc. We assume that it is no longer enough for managers and tool researchers to understand the complexity and uncertainty of the outer natural system-the environment. It is just as important, to understand what goes on in the complex and uncertain participatory processes between the water managers, different stakeholders, authorities and researchers when a specific tool and process is used for environmental management. The paper revisits a case study carried out 2001-2004 where the tool Bayesian networks (BNs) was tested for groundwater management with full stakeholder involvement. With the participation of two researchers (the authors) and two water managers previously involved in the case study, a qualitative interview was prepared and carried out in June 2006. The aim of this ex-post evaluation was to capture and explore the water managers' experience with Bayesian belief networks when used for integrated and adaptive water management and provide a narrative approach for tool enhancement.
- Genome-Wide Transcriptional Profiling Linked to Social Class in Asthma
Thorax (Epublication, ahead of print) by Edith Chen, Gregory Miller, Hope Walker, Jesusa Arevalo, Caroline Sung, and Steve Cole
OBJECTIVES: Low socioeconomic status (SES) is one of the most robust social factors associated with disease morbidity, including more severe asthma in childhood. However, our understanding of the biological processes that explain this link is limited. In this study, we tested whether the social environment could get "under the skin" to alter genomic activity in children with asthma.
DESIGN AND PARTICIPANTS: Two group design of children physician diagnosed with asthma who came from either low or high SES families.
OUTCOMES: Genome-wide transcriptional profiles from T lymphocytes of children with asthma.
RESULTS: Children with asthma from a low SES background showed overexpression of genes regulating inflammatory processes, including those involved in chemokine activity, stress responses, and wound responses compared to high SES children with asthma. Bioinformatic analysis suggested that decreased activity of CREB and NF-Y, and increased NF-kB, transcriptional signaling mediated these effects. These pathways are known to regulate catecholamine and inflammatory signaling in immune cells.
CONCLUSIONS: This study provides the first evidence in a sample of pediatric patients diagnosed with asthma that the larger social environment can affect processes at the genomic level. Specifically, gene transcription control pathways that regulate inflammation and catecholamine signaling were found to vary by SES in children with asthma. Because these pathways are the primary targets of many asthma medications, these findings suggest that the larger social environment may alter molecular mechanisms that have implications for the efficacy of asthma therapeutics.
- Minority health and Small Numbers Epidemiology: A Case Study of Living Conditions and the Health of Children in 5 Foreign Roma Camps in Italy.
American Journal of Public Health (Volume 98, No 11: 2035-2041) by L Monasta, N Andersson, RJ Ledogar, and A Cockcroft
OBJECTIVE: We sought to test methods for generating epidemiological evidence on health conditions of small, dispersed minority communities.
METHODS: We used community-based mixed methods including a cross-sectional survey in 5 purposely selected settlements of Khorakane Roma (Gypsies of Muslim culture) in Italy to study the living conditions and health status of children aged from birth to 5 years.
RESULTS: In the 15 days prior to the survey, 32% of the children had suffered diarrhea and 55% had had a cough. Some 17% had experienced respiratory difficulties during the past year. Risk factors associated with these outcomes included years spent living at the camp, overcrowding, housing conditions, use of wood-burning stoves, presence of rats, and issues related to quality of sanitation and drains. Qualitative information helped define the approach and the design, and in the interpretation and consolidation of quantitative results.
CONCLUSIONS: Guided by the priorities expressed by dispersed minority communities, small studies with little resources can provide a solid base to advocate for evidence-based participatory planning. Exact intervals appeared to be robust and conservative enough compared with other intervals, conferring solidity to the results.
- Cumulative Cancer Risk from Air Pollution in Houston: Disparities in Risk Burden and Social Disadvantage
Environmental Science and Technology (Volume 42, No 12: 4312-4322) by Stephen H. Linder, Dritana Marko, and Ken Sexton
Abstract: Air toxics are of particular concern in Greater Houston, home to one of the world's largest petrochemical complexes and a quarter of the nation's refining capacity. Much of this complex lies along a navigable ship channel that flows 50 miles from east of the central business district through Galveston Bay and into the Gulf of Mexico. Numerous communities, including both poor and affluent neighborhoods, are located in close proximity to the 200 facilities along this channel. Our aim is to examine the spatial distribution of cumulative, air-pollution-related cancer risks in Houston and Harris County, with particular emphasis on identifying ethnic, economic, and social disparities. We employ exposure estimates from NATA-1999 and census data to assess whether the cumulative cancer risks from air toxics in Houston (and Harris County) fall disproportionately on certain ethnicities and on the socially and economically disadva ntaged. The cancer risk burden across Harris County census tracts increases with the proportion of residents who are Hispanic and with key indicators of relative social disadvantage. Aggregate disadvantage grows at each higher level of cancer risk. The highest cancer risk in Harris County is concentrated along a corridor flanking the ship channel. These high-risk neighborhoods, however, vary markedly in relative disadvantage, as well as in emission source mix. Much of the risk they face appears to be driven by only a few hazardous air pollutants. Results provide evidence of risk disparities from hazardous air pollution based on ethnicity and social disadvantage. At the highest levels of risk the pattern is more complex, arguing for a neighborhood level of analysis, especially when proximity to high-emissions industries is a substantial contributor to cumulative cancer risk.