Native American patients were sicker and more likely to die during the COVID-19 pandemic, UNM researchers find

Peer-Reviewed Publication

UNIVERSITY OF NEW MEXICO HEALTH SCIENCES CENTER

When the COVID-19 pandemic swept into New Mexico in the spring of 2020, seriously ill patients from all over the state were brought to The University of New Mexico Hospital in Albuquerque, where many wound up in intensive care, breathing with the help of ventilators.

Early on, researchers from the UNM Center for Global Health launched a study of hospitalized patients to gauge the severity of symptoms from the infection, gathering data on 475 patients from April 2020 through December 2021.

In paper published this week in PNAS Nexus, they reported that patients who identified as American Indian/Alaska Native (AI/AN) were sicker and more likely to die in the hospital than Hispanic and non-Hispanic white patients, even though they had fewer pre-existing conditions.

The study was led by Center Director D.J. Perkins, PhD, Professor of Medicine, and Research Associate Professor Ivy Hurwitz, PhD, both of whom donned protective gear to visit the ICU and obtain consent from patients willing to participate in the study.

“There was never an original plan based on race and ethnicity,” Perkins said. “We literally didn’t know about whether there would be disproportionate levels of hospitalization or severe disease.”

Hurwitz added that as they began recruiting patients in the hospital, “We saw a lot of people who were really, really sick in the ICU, and a lot of those people unfortunately were American Indian. It was really sad. They were really suffering disproportionately.”

The researchers collected data on patient demographics, infection duration, blood test results, comorbidities (underlying health risks), treatments that the patients received, major clinical events and in-hospital deaths.

In the patient pool, 47% self-identified as Hispanic, 31% were AI/AN and 19% were non-Hispanic white (the remainder, including Black and Asian American, were excluded from analysis for statistical reasons).

The scientists also assessed comorbid conditions known to worsen outcomes for COVID-19. “COPD, sleep apnea, hyperlipidemia, hypothyroidism, and history of past smoking differed among the groups and was lowest in AI/AN patients,” they wrote. In fact, non-Hispanic whites scored highest overall in comorbidities.

The American Indian patients were also younger on average, but more likely to need ventilators and have blood results indicating more severe disease. They were also more prone to shock and brain injury from the infection and were hospitalized longer.

A similar pattern of relatively severe disease in Native Americans was seen during the 1918 influenza pandemic, historical tuberculosis outbreaks, and the 2009 H1N1 influenza pandemic, the authors noted.

The explanation for the disproportionate burden of severe disease and death in the AI/AN people likely involves multiple factors, the authors wrote, “and may include social determinants of health, as well as potential immunological responses to the virus, among many other non-medical and medical factors.”

An earlier phase of the research prior to emergence of the Delta variant showed that AI/AN patients had significantly higher and protracted SARS-CoV-2 viral loads in their blood.

“In a large group of people, be it pre-Delta or Delta, the strongest predictor of severe disease is virus in the blood and, what travels along with that, because they’re intertwined with their co-variants, is being self-identified American Indian,” Perkins said.

---

JOURNAL

PNAS Nexus

DOI

10.1093/pnasnexus/pgad259 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Disproportionate impact of COVID-19 severity and mortality on hospitalized American Indian/Alaska Native patients

 

Precarious employment conditions can increase risk of early death

Causal effect of shifting from precarious to standard employment on all-cause mortality in Sweden: an emulation of a target trial

Peer-Reviewed Publication

KAROLINSKA INSTITUTET

 

IMAGE: NURIA MATILLA-SANTANDER, ASSISTANT PROFESSOR AT KI view more 

CREDIT: N/A

People without a secure job contract can reduce their risk of premature death by 20 per cent if they gain permanent employment, a study from Karolinska Institutet published in The Journal of Epidemiology and Community reports. According to the researchers, the results indicate that job security on the Swedish labour market needs to improve.

Precarious employment is a term that is used to describe jobs with short contracts (e.g. temping), low wages and a lack of influence and rights, all of which lead to a working life without predictability and security.

In the present study, the researchers have examined how this affects the risk of death.

“This is the first study to show that changing from precarious employment to secure employment can reduce the risk of death,” says the paper’s last author Theo Bodin, assistant professor at the Institute of Environmental Medicine, Karolinska Institutet. “It’s the same as saying that the risk of early death is higher if one keeps working in jobs without a secure employment contract.”

The researchers used registry data from over 250,000 workers in Sweden between the ages of 20 and 55 gathered over a period from 2005 to 2017. The study included people who worked under insecure working conditions and who then shifted to secure working conditions.

Those who switched from precarious to secure employment had a 20 percent lower risk of death, regardless of what happened afterward, compared to those who remained in precarious employment. If they remained in secure employment for 12 years, the risk of death decreased by 30 percent.

“Using this large population database allowed us to take account of many factors that could influence mortality, such as age, other diseases that workers can suffer from or life changes like divorce,” explains Nuria Matilla-Santander, assistant professor at the same institute and the study’s first author. “Because of the methods we used, we can be relatively certain that the difference in mortality is due to the precariousness of employment rather than individual factors.”

She continues: “The results are important since they show that the elevated mortality rate observed in workers can be avoided. If we reduce precariousness in the labour market, we can avoid premature deaths in Sweden.”

Dr Matilla-Santander says that the next stage of the research is to examine the specific causes of mortality in this regard.

The study was mainly financed by the Swedish Research Council for Health, Working Life and Welfare (Forte). The researchers report no conflicts of interest.

Publication: “Causal effect of shifting from precarious to standard employment on all-cause mortality in Sweden: an emulation of a target trial”, Nuria Matilla-Santander, Anthony A Matthews, Virginia Gunn, Carles Muntaner, Bertina Kreshpaj, David H Wegman,  Néstor Sánchez-Martínez, Julio C Hernando-Rodriguez, Maria Albin, Rebeka Balogh, Letitia Davis, Theo Bodin, Journal of Epidemiology and Community Health, online 23 August 2023, doi: 10.1136/jech-2023-220734

---

JOURNAL

Journal of Epidemiology & Community Health

DOI

10.1136/jech-2023-220734 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Causal effect of shifting from precarious to standard employment on all-cause mortality in Sweden: an emulation of a target trial

 

Could insights from ants help people build better transportation networks?

UCLA study finds the insects’ nests reflect the way they work together – or don’t – to forage for food

Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - LOS ANGELES

Key takeaways

• Ants can either forage for food as individuals or recruit other members of their colonies to help search for or carry food back to their nests.
• UCLA biologists found that the strategies ants use to forage play a bigger role in how they build their nests than innate, evolutionary “blueprints” do.
• When building nests, ants strike a balance between transportation efficiency and architectural constraints. Researchers say that observation could help humans design more efficient transportation systems tailored to specific needs.

Could ants’ nests hold the secret to reducing traffic congestion on the 405 Freeway?

In a new study, UCLA biologists discovered insights about how ants build their nests that could be useful for designing more efficient human transportation systems.

The scientists were interested in learning whether the way ants build their nests is more influenced by the evolutionary history of each individual species or current ecological conditions. What they found was that evolution could not explain the variations they observed among different species’ nests. Rather, they found, the environments in which ants forage and the way they transport food are the main factors that dictate how each species builds its nests.

The lesson for humans? If roads were better tailored to the ways goods and people move through our cities, transportation networks could be more efficient. For example, congestion on Southern California’s freeways might be improved if there were dedicated lanes or roads for trucks traveling to and from major logistics hubs like ports, warehouses and distribution centers.

“Ants deal with the same issues we deal with when it comes to living in crowded spaces,” said Sean O’Fallon, a UCLA doctoral student in ecology and evolutionary biology, and the study’s first author. “We’re densely packed in cities, and ideally we should be densely connected, but there are constraints to how closely packed together we can be. There’s only so much space to construct buildings and roads.”

In the study, published in Philosophical Transactions of the Royal Society B, scientists analyzed information from two sources — details about 397 ant nests came from previously published data and images, and the authors conducted new studies of 42 other nests, all located at the Archbold Biological Reserve near Venus, Florida. In total, the 439 nests represented 31 different species of ants.

They discovered that nest structures were largely determined by factors like whether ants foraged alone or in groups, as well as the methods they used to recruit other ants to help find and carry food. In a nutshell, the animals’ activity and behavior play bigger roles in nest construction than any innate evolutionary template.

“You can think of the nest itself as a transportation network — it’s where ants live, but it’s also a kind of highway network they move things in and out of,” said Noa Pinter-Wollman, a UCLA professor of ecology and evolutionary biology and the paper’s corresponding author.

The researchers examined four common foraging strategies used by ants. In some species, individual ants hunt for food. In others, an ant brings food to the nest as a means of recruiting other ants to accompany it to the food source. Ants can also form a continuous trail between the food source and the nest that can persist for months. Or they can leave a pheromone trail that members of the colony can follow in large numbers — a phenomenon the researchers called “mass recruitment.”

Ants’ nests consist of a tunnel leading down to an entrance chamber, where ants enlist other members of their colony to help them find or transport food. From the entrance chamber, tunnels lead down to other chambers, which are connected by tunnels to still deeper chambers. Chambers serve different purposes, such as food and waste storage and rearing young.

The researchers expected that in ant species that use the mass recruitment style of foraging, the nests’ entrance chambers would be larger than they are in other species’ nests, because those spaces would need to allow larger numbers of ants to interact. And indeed, they found that to be the case.

However, the scientists also expected that nests for the mass recruitment foragers would have greater “network density” — meaning larger numbers of connections among the chambers — than nests built by other species. Greater network density, the scientists reasoned, would help facilitate more movement of ants and resources throughout the nest.

But the research revealed that for ants representing all four foraging strategies, network density was relatively low — even for large nests with hundreds of chambers. In fact, the study revealed, across all foraging strategies, nests with the most chambers tended to have the lowest network density.

In the paper, the researchers write that finding could be simply a function of architecture: Too many tunnels between chambers could weaken the structural integrity of the nest, which could cause the entire system to collapse.

“Ants have to balance the efficiency of highly connected nests with architectural stability,” Pinter-Wollman said. “On one hand, they want transportation to be faster, but if they start making too many connections, the nest will crumble.

---

JOURNAL

Philosophical Transactions of the Royal Society B Biological Sciences

‘Broadband Prairie’ rural wireless project moves to public phase of researching, testing

Meeting Announcement

IOWA STATE UNIVERSITY

 

IMAGE: DOCTORAL STUDENT MD NADIM DEPLOYS HARDWARE AT AN IOWA STATE RESEARCH FARM FOR THE ARA RURAL BROADBAND PROJECT. view more 

CREDIT: PHOTOS COURTESY OF THE ARA PROJECT.

AMES, Iowa – A wireless tower at Iowa State University’s Ag Engineering/Agronomy Farm west of Ames is loaded with hardware sending radio waves across the countryside, creating wireless internet connections for rural users.

 

There are more poles, antennas and cabinets full of electronics on the roof of the Economic Development Core Facility at the Iowa State University Research Park. And bolted to the top of Wilson Hall, a 10-story residence hall. And hanging from the top of a wooden utility pole at Iowa State’s Curtiss Farm south of town.

 

There are also electronics and lower-to-the ground antennas next to research fields and in a sheep barn. There’s equipment going through the roof of a dairy barn. There are even hardware cabinets on the roof of a CyRide bus.

 

The deployment of all this infrastructure in and around Ames means the $16 million ARA Wireless Living Lab for Smart and Connected Rural Communities is moving to a public testing phase. The project’s progress will be celebrated during a launch event Sept. 6-8 on the Iowa State campus, including field trips to ARA deployment sites.

 

The event will feature technical presentations, including:

 

• “ARA-Enabled Teleoperation of Automated PhenoBots,” by Lie Tang, an Iowa State professor of agricultural and biosystems engineering and a Plant Sciences Institute faculty scholar

 

• “ARA-Enabled Livestock Health Monitoring” by Joshua Peschel, an Iowa State associate professor of agricultural and biosystems engineering

 

• and, “ARA-Enabled Agriculture Automation” by Matthew Darr, the John Deere Endowed Chair in Agricultural Innovation and leader of Iowa State’s Digital Ag Innovation Lab.

 

Details and a program are here: https://arawireless.org/2023-public-launch/#overview.

 

A major goal for the ARA project is to address the broadband gap between rural and urban regions and to advance the frontiers of 5G and 6G technologies, said Hongwei Zhang, an Iowa State professor of electrical and computer engineering and the project leader.  

 

Researchers have installed ARA infrastructure for rural broadband testing on the roof of Iowa State's Wilson Hall.

CREDIT

Photos courtesy of the ARA Project

Toward a ‘Broadband Prairie’

The ARA project launched in June 2021, when the Platforms for Advanced Wireless Research (PAWR) program, which is supported by the National Science Foundation (NSF) and a consortium of 30 wireless companies and associations, announced $16 million in support for ARA (which stands for Agriculture and Rural Communities and has a logo featuring the Ara constellation of stars).

 

Over five years, the NSF is providing $7 million, the U.S. Department of Agriculture’s National Institute of Food and Agriculture is providing $1 million and PAWR industry partners are providing $8 million of cash and in-kind support.

 

In addition to Zhang, there are major contributors from Iowa State faculty, staff and students. The project is part of Iowa State’s Center for Wireless, Communities and Innovation.

 

Other project leaders are affiliated with the University of California, Irvine, Ohio State University and the International Computer Science Institute at the University of California, Berkeley.

 

“This two-year effort is coming to fruition,” Zhang said. “ARA phase one has been deployed for research, education and innovation in advanced wireless and its rural applications.”

 

While a project goal is to eventually improve wireless service to rural residents and communities, project researchers are now building a wireless platform using the latest technology and testing its performance in variety of applications, including precision agriculture and rural education.

 

As a wireless testbed, researchers write and talk of ARA’s technical details: AraHaul for multi-modal, long-distance and high-throughput wireless; AraRAN wireless access infrastructure for connecting to equipment such as tractors; many-antenna, multiple-input and multiple-output systems, x-haul radios operating in the 11 gigahertz and 80 gigahertz bands; the TV White Space spectrum and Open Radio Access Networks (O-RAN).

 

Successfully tie all that together and Zhang envisions ARA one day enabling a “Broadband Prairie” that connects rural residents, farms, schools and communities.

 

“We are on track,” Zhang said. “We are overcoming challenges. And I can’t wait for this to go public.”

– 30 –

Air pollution has decreased across the US, but new Yale research finds health burdens remain unequal among racial groups

Peer-Reviewed Publication

YALE UNIVERSITY

New Haven, Conn. — Health benefits that have resulted from reductions in fine particulate air pollution aren’t distributed equally among populations in the U.S., a new Yale-led study finds. Racial and ethnic minorities — and Black people in particular — still experience disproportionately high rates of cardiovascular disease-related deaths caused by exposure to fine particulate matter, according to the research.

The findings were published Aug. 31 in Nature Human Behavior.

Fine particulate matter, also known as PM2.5, consists of particles or droplets smaller than 2.5 micrometers in diameter, or 30 times smaller than the width of a human hair. While some PM2.5 in the environment comes from natural sources, such as wildfires, the majority of particulate matter pollution in the U.S. is the result of human activities, including emissions from vehicles, power plants, and factories.

The small size makes PM2.5 harmful for human health, said Kai Chen, assistant professor of epidemiology at Yale School of Public Health and senior author of the study.

“When you inhale such small particles, they can get into your lungs and some smaller particles can even get into the blood stream and circulate around the body,” said Chen. “That can impact your heart, which leads to a lot of the cardiovascular disease we see today.”

Environmental efforts including the 1963 Clean Air Act and the Environmental Protection Agency’s (EPA) National Ambient Air Quality Standards for PM2.5, established in 1997, have helped bring down PM2.5 levels throughout the United States. This, in turn, has yielded benefits to human health. But it has remained unclear whether these health benefits are distributed equitably across racial and ethnic groups.

“We know that some minorities, especially Black and Hispanic people, are exposed to higher levels of PM2.5 than white people,” said Chen. “In our study, we wanted to go further and assess vulnerability to PM2.5 across different groups and see how that relates to mortality.”

For the study, the researchers collected data on cardiovascular disease deaths and monthly PM2.5 concentrations across 3,103 counties in the contiguous U.S. between 2001 and 2016. They then evaluated whether there was a link between increases in PM2.5 levels and changes in cardiovascular disease-related deaths.

Overall, an increase of one microgram per square meter in average PM2.5 levels was associated with 2.01 additional cardiovascular disease-related deaths per 1 million people. But when the researchers took a closer look at the data, they found that the human costs vary in different populations: the same increase in the average PM2.5 levels was associated with 1.76 additional deaths per 1 million white people, 2.66 additional deaths per 1 million Hispanic people, and 7.16 additional deaths per 1 million Black people.

The researchers also assessed mortality burden across race and ethnicity, evaluating the number of cardiovascular disease-related deaths that were attributable to long-term PM2.5exposure between 20o1 and 2016. On average, there were 202.70 deaths per 1 million white people, 279.24 deaths per 1 million Hispanic people, and 905.68 deaths per 1 million Black people each year.

“Black people experience the highest burden when it comes to mortality rate,” said Chen.

To determine whether mortality burden changed over time, the researchers then compared mortality rates between 2001 and 2016. In total, cardiovascular disease-related deaths attributable to long-term PM2.5 exposure decreased by more than 34% over that time period. And rates decreased within white, Hispanic, and Black populations. 

However, the ratio of mortality rates between white and Hispanic people and between white and Black people hardly changed between 2001 and 2016. Mortality rates for Hispanic people were 1.37 times higher than white people in 2001, increasing to 1.45 times higher by 2016. Mortality rates for Black people were 4.59 times higher than white people in 2001 and 4.47 times higher in 2016. 

“Air pollution reduced and that reduced exposure for everyone, which is very good news,” said Chen. “But Black people still experience a higher burden because they are more vulnerable and at higher risk of mortality.”

The findings, he says, underscore that the public health burden of air pollution differs across racial groups and that should help inform policy design going forward. The EPA, U.S. lawmakers, and local governments should consider not just the overall population as they develop policies to improve air quality, but also high-vulnerability groups in particular.

“Poor air quality imposes a substantial burden on Black Americans, with greater exposures and greater vulnerability,” said coauthor Harlan Krumholz, the Harold H. Hines, Jr. Professor of Medicine at Yale School of Medicine. “We have identified another way that the structure of our society contributes to cardiovascular health disparities. The study demonstrates that the excess mortality among Black people is not just derived from traditional risk factors, but likely also to the increased exposure to poor air quality based on where they live.”

Chen will continue to investigate this health burden disparity in a new project funded by a Yale Planetary Solutions Project seed grant. He and his colleagues will assess PM2.5 exposure, cardiovascular disease risk, and morbidity burden at the neighborhood level and design location-specific strategies to address inequalities.

---

JOURNAL

Nature Human Behaviour

DOI

10.1038/s41562-023-01694-7 

ARTICLE TITLE

Racial/ethnic disparities in PM2.5-attributable cardiovascular mortality burden in the United States

ARTICLE PUBLICATION DATE

31-Aug-2023

Disclaimer: AAAS and EurekAlert! are not r

 

Toxic molds, fossil fuels, antibiotics linked to chemical intolerance: Survey

In Idalia’s wake, harmful mold poses major health risk

Peer-Reviewed Publication

UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO

SAN ANTONIO (Sept. 1, 2023) — What initiates chemical intolerance (CI)? In a newly released survey of thousands of U.S. adults, respondents most frequently cited exposures to biological sources, such as mold and algae “blooms,” and/or fossil fuels, their combustion products and synthetic chemical derivatives such as pesticides, plastics and persistent organic pollutants. 

It's an issue in the news, as toxic mold spawned by the moisture left behind by flood waters from Hurricane Idalia could lead to severe health problems for people who suffer from chemical intolerance. This mold also could initiate the condition in some individuals.

“Everyone should avoid prolonged exposure to mold whenever possible,” said physician-researcher Claudia Miller, MD, MS, from The University of Texas Health Science Center at San Antonio, also called UT Health San Antonio. “Research has increasingly shown that toxic mold is much more dangerous than was previously recognized.”

In the survey, published in the journal Environmental Sciences Europe, 17.5% of participants who attributed their illness to an initiating event cited mold exposure as the perceived cause of their chemical intolerance. CI is estimated to afflict up to 20% to 30% of Americans, Miller, senior author of the study, said.

Participants were queried about antibiotic use, as well. According to the results, prolonged courses of antibiotics were associated with an increased risk of CI.

The survey data also indicate that with each additional initiating exposure respondents can recall, the odds of their reporting CI nearly triple. 

“With climate change contributing to more severe storms and more intense flooding worldwide, the danger posed by toxic mold is likely to increase dramatically in the near future,” Miller said. “As mold exposure is known to be a major initiator, the likelihood of more and more people with chemical intolerance is also unfortunately on the rise."

TILT

The study furthers understanding about how a two-stage disease process called TILT (toxicant-induced loss of tolerance) begins. The survey asked 10,981 people to state their self-perceptions about the events that began the downward spiral through TILT and into chemical intolerance.

“TILT can develop rapidly, for instance after a pesticide exposure, or gradually if someone is working or living in a setting such as a moldy building,” Miller said. She first proposed TILT in 1996 and is professor emerita of family and community medicine at UT Health San Antonio. 

Unknown origins

“Initiating events commonly go unrecognized and therefore unreported, leaving triggers and symptoms as the only documented components,” Miller said. “This has thwarted our understanding of the actual causes of TILT.”

Participants completed an 80-question online survey called the Personal Exposure Inventory. It included items concerning individuals’ medical diagnoses and personal exposures including antibiotic use.

Chemical intolerance was assessed using the Quick Environmental Exposure and Sensitivity Inventory (QEESI©) developed by Miller 25 years ago. It is a validated, self-administered questionnaire now used worldwide to differentiate individuals with CI from the general population. One-fifth of survey respondents met the QEESI criteria for chemical intolerance. 

Toxic mold

Exposure to mold was the most frequently mentioned initiating event on the Personal Exposure Inventory. “In recent years, global warming has led to more rainfall, floods, hurricanes, roof leaks and water intrusion, resulting in increased mold growth indoors,” said paper co-author Raymond F. Palmer, PhD, a biostatistician and professor of family and community medicine at UT Health San Antonio.

Mold was followed in rank order by exposures to pesticides (cited by 13.8% of respondents), medical/surgical procedures (12.6%), remodeling/new construction (12.0%), fires/combustion products (7.2%) and breast implants (1.8%).

Antibiotics

Respondents answered questions pertaining to how many courses of antibiotics they had completed for specific types of infections. Antibiotics prescribed for infections categorized as skin, tonsil, gastrointestinal, prostate, sinus, wound and pneumonia were most strongly associated with chemical intolerance.

“Our search for the underlying causes of CI represents a much-needed addition to the CI/TILT literature, whose principal focus has been on triggers that elicit CI symptoms from day to day with no attempt to determine what initiated TILT,” Miller said.

'A cohesive narrative'

“Taken together, our data support the idea that the person who reports multiple symptoms, multiple intolerances and recurrent infections as well as a history of exposure events is sharing a cohesive narrative, one that points to physiological (as opposed to psychosomatic) explanations of their oft-confusing complaints,” she said.

Although certain exposures such as medical/surgical procedures may be difficult to avoid, reducing exposures to contaminants related to pesticide use, new construction/remodeling and mold is possible and should be the focus of efforts to prevent future CI/TILT, the authors wrote.

Digging in

Finally, they encourage practitioners who see patients with medically unexplained symptoms — currently one in four primary care patients — to consider administering the QEESI. “‘TILTed’ individuals who report brain fog, memory, mood and concentration difficulties often receive referrals to psychiatrists, psychologists or social workers who explore their psychosocial environments but do not ask about changes in their actual — physical and chemical — environments,” Miller said. “If initiating exposures such as pesticides, toxic mold, implants and combustion products are not stopped, sensitivities can spiral out of control.”  

Teaching in schools of medicine, public health, architecture and engineering has not kept pace with these toxicants, many of which are new to the planet since World War ll, Miller noted. This is exacerbated by energy conservation efforts that have increased exposures to indoor air toxicants, she said.  

Marilyn Brachman Hoffman

In their acknowledgments, the authors “thank the Marilyn Brachman Hoffman Foundation for generously funding this study and Marilyn Hoffman for her prescient bequest prioritizing research on toxicant-induced loss of tolerance. We are deeply grateful to the patients who participated in this groundbreaking study.”

Hoffman’s bequest specified research on TILT. “She suffered terribly from chemical, food and drug intolerances herself, but especially from not being believed by family members and her doctors,” Miller said. “She was a citizen-scientist who read all my papers and book, “Chemical Exposures: Low Levels and High Stakes,” co-authored with Nicholas Ashford, PhD, JD, of the Massachusetts Institute of Technology. 

“More than anything, Mrs. Hoffman wanted to discover the biomechanism for TILT,” Miller said. “She knew that it was essential for helping patients like herself. Her bequest has led to publication of the biomechanism for TILT in a series of papers over the past two years in Environmental Sciences Europe, a journal read by regulatory toxicologists around the world.” 

---

If you suspect that you or a loved one has developed chemical intolerance or TILT, answer this brief, three yes-or-no question screening test, called BREESI. A positive response to any of the questions should lead to taking the more extensive, validated diagnostic questionnaire, the QEESI, or Quick Environmental Exposure and Sensitivity Inventory. People who have high scores on the QEESI are seen as likely to be chemically intolerant and are encouraged to share the information with their health care providers.

---

What Initiates Chemical Intolerance? Findings from a Large Population-Based Survey of U.S. Adults

Claudia S. Miller, Raymond F. Palmer, David Kattari, Shahir Masri, Nicholas A. Ashford, Rodolfo Rincon, Roger B. Perales, Carl Grimes, Dana R. Sundblad

First published: Aug. 14, 2023, Environmental Sciences Europe

https://enveurope.springeropen.com/articles/10.1186/s12302-023-00772-x

---

The University of Texas Health Science Center at San Antonio (UT Health San Antonio) is one of the country’s leading health science universities and is designated as a Hispanic-Serving Institution by the U.S. Department of Education. With missions of teaching, research, patient care and community engagement, its schools of medicine, nursing, dentistry, health professions, graduate biomedical sciences and public health have graduated more than 42,300 alumni who are leading change, advancing their fields and renewing hope for patients and their families throughout South Texas and the world. To learn about the many ways “We make lives better®,” visit UTHealthSA.org.

Stay connected with The University of Texas Health Science Center at San Antonio on Facebook, Twitter, LinkedIn, Instagram and YouTube.

---

JOURNAL

Environmental Sciences Europe

DOI

10.1186/s12302-023-00772-x 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

What initiates chemical intolerance? Findings from a large population-based survey of U.S. adults

$26M NIH grant addresses environmental influences on child health

MSU, Henry Ford Health, University of Michigan, Wayne State University, and Michigan Department of Health and Human Services collaborate on statewide initiative

Grant and Award Announcement

MICHIGAN STATE UNIVERSITY

 

IMAGE: JEAN KERVER, ASSOCIATE PROFESSOR OF EPIDEMIOLOGY & BIOSTATISTICS AT MICHIGAN STATE UNIVERSITY’S COLLEGE OF HUMAN MEDICINE. view more 

CREDIT: COURTESY PHOTO MICHIGAN STATE UNIVERSITY.

EAST LANSING, Mich. – Backed by a $26 million federal grant, researchers at three Michigan universities, a leading health care system, and a state agency will continue a long-term study of how exposure to environmental factors during pregnancy and early childhood can impact health for a lifetime. 

The funding from the National Institutes of Health, or NIH, is for the second phase of a national research program called ECHO, which stands for the Environmental Influences on Child Health Outcomes, and includes a sample of mothers, infants and children from across the United States. The first phase began in 2016. 

“This award shows the research potential we have across the state,” said Jean Kerver, an associate professor of epidemiology and biostatistics at the Michigan State University College of Human Medicine and the lead principal investigator for the Michigan-based part of ECHO. “The partnership brings together some of the greatest research minds of our state. It’s definitely greater than the sum of its parts.” 

In addition to MSU, the partners include the University of Michigan, Wayne State University, Henry Ford Health and the Michigan Department of Health and Human Services.  

ECHO is not a single study but encompasses many research projects all over the country with the goal of improving the health of children as they grow into adults and for generations to come. The collaborative alliance of scientists in Michigan is called Child Health Advances from Research with Mothers, or CHARM. The goal of CHARM is to improve the health of mothers and children in Michigan. 

The investigators study the health effects of a broad range of environmental exposures that occur during pregnancy and early childhood. That includes air pollution, chemical exposures and inadequate nutrition, as well as societal factors, such as stress and poverty. 

Some of the child health outcomes studied include preterm birth, brain development and neurodevelopmental disorders, asthma and obesity.  

Nationally, ECHO has collected data from 105,000 participants, including more than 64,000 children. In Michigan, the cohorts include more than1,500 pairs of mothers and their children enrolled through 11 hospitals and 21 prenatal clinics around the state. In this second phase, researchers plan to enroll 500 more pairs of mothers and children from the Detroit, Flint and Traverse City areas, Kerver said. 

Kerver credited her predecessor as the lead principal investigator, Nigel Paneth, with forming the statewide partnerships. Although retired from a full-time faculty position, Paneth, an emeritus University Distinguished Professor of epidemiology and biostatistics and pediatrics and human development at the MSU College of Human Medicine, remains active in the ECHO program and other research. 

Charles Barone, a pediatrician at Henry Ford Health, has been key in maintaining clinical and stakeholder relationships.  

“It's both important and gratifying to receive such a strong commitment from the NIH in support of our affiliated Michigan institutions continuing to build upon the success of the ECHO program for an additional seven years,” said Barone. “This research helps us to better understand how environmental factors affect child health from birth through adolescence, and what can be done to mitigate and improve their health outcomes for generations to come.” 

Michael Elliott, professor of biostatistics at U-M, developed the hospital and prenatal clinic sampling plan that ensures results are representative of all births in the Lower Peninsula of Michigan.  

"This new grant will allow us to continue following our representative sample of Michigan births through infancy and childhood to assess how prenatal factors affect child health, pointing to ways to improve child health from birth on," Elliott said. "We will also leverage the relationships we developed at sampled hospitals in Detroit, Flint and Traverse City to continue recruiting mothers and babies in minority, low-income and rural communities, all areas at greater risk of poor child health. My work and the work of other researchers at the University of Michigan will be integral to these efforts." 

Douglas Ruden, a professor and director of epigenomics at Wayne State University’s Institute of Environmental Health Sciences, is joined by experts in immunology and toxicologists who study environmental exposures to both the mother and father. 

“The second Michigan ECHO grant is a tremendous opportunity to understand how a mother’s exposure to environmental chemicals and stressors affects the health of her children,” said Ruden. “This important alliance will impact the health of many around the U.S., now and into the future.”  

Kerver said she was excited when she learned that the NIH approved funding for the Michigan partners in the ECHO program. Some of the findings, she said, could immediately lead to better health for Michigan residents. 

“It absolutely should,” she said. “What we hope to do is solve health problems people in Michigan and across the U.S. have right now. That is the main thing. That’s what we’re all working for.” 

MEDIA CONTACTS

Geri Kelley, Michigan State University, 616-350-7976,  kelleyg3@msu.edu

Jeffrey Adkins, Henry Ford Health, 586-307-2027, jadkins6@hfhs.org

Kim North Shine, University of Michigan, 313-549-4995, kshine@umich.edu

Julie O’Connor, Wayne State University, 313-577-8845, julie.oconnor@wayne.edu

Lynn Sutfin, MDHHS, 517-284-4772, SutfinL1@michigan.gov

By Pat Shellenbarger.

Read on MSUToday.

###

Michigan State University has been advancing the common good with uncommon will for more than 165 years. One of the world's leading research universities, MSU pushes the boundaries of discovery to make a better, safer, healthier world for all while providing life-changing opportunities to a diverse and inclusive academic community through more than 400 programs of study in 17 degree-granting colleges.

For MSU news on the Web, go to MSUToday. Follow MSU News on Twitter at twitter.com/MSUnews.