Objective: Associations between magnitude and timing of maternal pregnancy blood lead (Pb) levels (BLLs), birth weight, and total days of gestation were examined, as well as associations with related clinical diagnoses of low birth weight (LBW), preterm, and small-for-gestational-age (SGA) birth.Study Design: Among a sample of 262 mother-infant pairs studied retrospectively, one-way analysis of variance and regression statistics were used to measure the relationship between level of maternal pregnancy BLLs and birth outcomes while controlling for key maternal and newborn factors. Results: Women with maximum pregnancy BLLs (max-PBLLs)X10 mg/dl tended to give birth earlier and their babies were at substantially increased risk for preterm and SGA birth. By holding other explanatory factors constant, each unit increase in max-PBLL above 10 mg/dl was found to be associated with a decrease of À0.3 in total days of gestation. Compared to women with lower levels, women with maxPBLLs X10 mg/dl were at a threefold increased risk for preterm birth (adjusted OR ¼ 3.2, 95% CI 1.2-7.4) and more than a fourfold increased risk for having an SGA infant (adjusted OR ¼ 4.2, 1.3-13.9). Second trimester maximum BLLs X10 mg/dl were associated with a steep decrease in total days of gestation (a decrease of À1.0 days per each unit increase above 10 mg/dl).Conclusions: These data provide evidence of the adverse effects of maternal pregnancy BLLs, particularly when levels are X10 mg/dl. Prenatal Pb exposure at these levels was associated with significant decreases in total days of gestation and an increased risk of preterm and SGA birth.

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safety-and-availability/fda-cautions-againstuse-hydroxychloroquine-or-chloroquine-covid-19-outside-hospital-setting-or. §

Background: Lead can adversely affect child health across a wide range of exposure levels. We describe the distribution of blood lead levels (BLLs) in U.S. children ages 1–11 y by selected sociodemographic and housing characteristics over a 40-y period. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) II (1976–1980), NHANES III (Phase 1: 1988–1991 and Phase II: 1991–1994), and Continuous NHANES (1999–2016) were used to describe the distribution of BLLs (in micrograms per deciliter; ) in U.S. children ages 1–11 y from 1976 to 2016. For all children with valid BLLs ( ), geometric mean (GM) BLLs [95% confidence intervals (CI)] and estimated prevalence (95% CI) were calculated overall and by selected characteristics, stratified by age group (1–5 y and 6–11 y). Results: The GM BLL in U.S. children ages 1–5 y declined from (95% CI: 14.3, 16.1) in 1976–1980 to (95% CI: 0.78, 0.88) in 2011–2016, representing a 94.5% decrease over time. For children ages 6–11 y, GM BLL declined from (95% CI: 11.9, 13.4) in 1976–1980 to (95% CI: 0.58, 0.63) in 2011–2016, representing a 95.3% decrease over time. Even so, for the most recent period (2011–2016), estimates indicate that approximately 385,775 children ages 1–11 y had BLLs greater than or equal to the CDC blood lead reference value of . Higher GM BLLs were associated with non-Hispanic Black race/ethnicity, lower family income-to-poverty-ratio, and older housing age. Discussion: Overall, BLLs in U.S. children ages 1–11 y have decreased substantially over the past 40 y. Despite these notable declines in population exposures to lead over time, higher GM BLLs are consistently associated with risk factors such as race/ethnicity, poverty, and housing age that can be used to target blood lead screening efforts. https://doi.org/10.1289/EHP7932

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Background Older adults and people from certain racial and ethnic groups are disproportionately represented in coronavirus disease 2019 (COVID-19) hospitalizations and deaths. Methods Using data from the Premier Healthcare Database on 181 813 hospitalized adults diagnosed with COVID-19 during March–September 2020, we applied multivariable log-binomial regression to assess the associations between age and race/ethnicity and COVID-19 clinical severity (intensive care unit [ICU] admission, invasive mechanical ventilation [IMV], and death) and to determine whether the impact of age on clinical severity differs by race/ethnicity. Results Overall, 84 497 (47%) patients were admitted to the ICU, 29 078 (16%) received IMV, and 27 864 (15%) died in the hospital. Increased age was strongly associated with clinical severity when controlling for underlying medical conditions and other covariates; the strength of this association differed by race/ethnicity. Compared with non-Hispanic White patients, risk of death was lower among non-Hispanic Black patients (adjusted risk ratio, 0.96; 95% CI, 0.92–0.99) and higher among Hispanic/Latino patients (risk ratio [RR], 1.15; 95% CI, 1.09–1.20), non-Hispanic Asian patients (RR, 1.16; 95% CI, 1.09–1.23), and patients of other racial and ethnic groups (RR, 1.13; 95% CI, 1.06–1.21). Risk of ICU admission and risk of IMV were elevated among some racial and ethnic groups. Conclusions These results indicate that age is a driver of poor outcomes among hospitalized persons with COVID-19. Additionally, clinical severity may be elevated among patients of some racial and ethnic minority groups. Public health strategies to reduce severe acute respiratory syndrome coronavirus 2 infection rates among older adults and racial and ethnic minorities are essential to reduce poor outcomes.

For this state-of-science overview of geospatial approaches for identifying US communities with high lead-exposure risk, we compiled and summarized public data and national maps of lead indices and models, environmental lead indicators, and children’s blood lead surveillance data. Currently available indices and models are primarily constructed from housing-age and sociodemographic data; differing methods, variables, data, weighting schemes, and geographic scales yield maps with different exposure risk profiles. Environmental lead indicators are available (e.g., air, drinking water, dust, soil) at different spatial scales, but key gaps remain. Blood lead level data have limitations as testing, reporting, and completeness vary across states. Mapping tools and approaches developed by federal agencies and other groups for different purposes present an opportunity for greater collaboration. Maps, data visualization tools, and analyses that synthesize available geospatial efforts can be evaluated and improved with local knowledge and blood lead data to refine identification of high-risk locations for prioritizing prevention efforts and targeting risk-reduction strategies. Remaining challenges are discussed along with a work-in-progress systematic approach for cross-agency data integration, toward advancing “whole-of-government” public health protection from lead exposures. (Am J Public Health. 2022;112(S7):S658–S669. https://doi.org/10.2105/AJPH.2022.307051 )

Because experimental and epidemiologic evidence indicates that the colon is particularly sensitive to stress, and because work conditions contribute to an individual's stress experience, we examined the relation of both job stress (defined in terms of perceived job demand and job control) and job social support to the risk of colon cancer in a large population-based case-control study (744 pairs) in Los Angeles. Controls were individually matched to cases on age, sex, and neighborhood. For jobs held 5 years before, participants in the lowest tertile of job control had a slightly increased risk when compared with those in the highest tertile (multivariate adjusted odds ratio = 1.3; 95% confidence interval = 1.0-1.6), but there was no evidence of a trend. Lower levels of job social support were associated with a decreased risk of colon cancer (odds ratio = 0.6 for lowest vs highest tertile; 95% confidence interval = 0.4-1.0). We saw no effect for job demand. The effect of job control appeared to be independent of the level of job demand. We found no consistent pattern of effects associated with jobs held 30 years before. These findings indicate that if job stress, as reflected by perceived job demand or control, is a determinant of colon cancer, it is probably not a strong one.