Children's exposure to environmental tobacco smoke: using diverse exposure metrics to document ethnic/racial differences.

Sexton, Ken; Adgate, John L.; Church, Timothy R.; Hecht, Stephen S.; Ramachandran, Gurumurthy; Greaves, Ian A.; Fredrickson, Ann L.; Ryan, Andrew D.; Carmella, Steven G.; Geisser, Mindy S.

doi:10.1289/ehp.6473

Cited by 45 publications

(45 citation statements)

References 23 publications

(23 reference statements)

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“…The SHIELD study was conducted between 1999 and 2001, and focused on measuring children's exposure to multiple chemicals and documenting changes over time (Sexton et al, , 2004. Among the environmental agents measured as part of the study were allergens, bioaerosols, cotinine (biomarker for environmental tobacco smoke), metals, polychlorinated biphenyls (PCBs), persistent and nonpersistent pesticides, phthalates, and volatile organic compounds (VOCs).…”

Section: Study Designs and Methodsmentioning

confidence: 99%

Comparison of recruitment, retention, and compliance results for three children's exposure monitoring studies

Sexton

2004

J Expo Sci Environ Epidemiol

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The School Health Initiative: Environment, Learning, Disease (SHIELD) study, the Minnesota Children's Pesticide Exposure Study (MNCPES), and the National Cooperative Inner-City Asthma Study (NCICAS) are three of the most intensive and invasive exposure-monitoring projects ever undertaken in children. An intrinsic facet of each study was the need to recruit children and their families, retain them for the duration of the project, and ensure that they completed monitoring protocols successfully. All of the studies used fiscal incentives to encourage participation, retention, and compliance. Recruitment rates varied from 40% in MNCPES, to 57% in SHIELD, to 64% in NCICAS, while retention rates varied from 85% in SHIELD, to 94% in MNCPES, to 95% in NCICAS. Rates of compliance with exposure sampling procedures were typically 480% for each study. For example, Z85% of the enrolled children provided all requested urine samples (1 for NCICAS, 2 for SHIELD, 3 for MNCPES), and 82% of the children in SHIELD provided two out of two blood samples (optional in MNCPES and NCICAS). However, compliance rates were substantially lower (34% SHIELD, 40% NCICAS, not applicable to MNCPES) for the more complex and time-consuming protocol used to collect peak flow data. Overall, results demonstrate that it is practical and affordable to conduct demanding exposure-monitoring studies in children, including children from poor minority communities.

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Section: Study Designs and Methodsmentioning

confidence: 99%

Comparison of recruitment, retention, and compliance results for three children's exposure monitoring studies

Sexton

2004

J Expo Sci Environ Epidemiol

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“…74 Positive emotion has also been shown to lead to the use of more inclusive social categories, so that people are more likely to view themselves as being part of a larger group, 28,75 which can facilitate empathy and increase the capacity to see others as members of a common "ingroup," as opposed to "outgroup." 43 More generally, positive emotional states have been shown to broaden the scope of attention and the tendency to attend to new information, 76 a mental state that is consistent with greater levels of individuation and lower levels of categorization.…”

Section: Enhance Emotional Regulation Skills Specific To Promoting Pomentioning

confidence: 99%

Reducing Racial Bias Among Health Care Providers: Lessons from Social-Cognitive Psychology

et al. 2007

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The paper sets forth a set of evidence-based recommendations for interventions to combat unintentional bias among health care providers, drawing upon theory and research in social cognitive psychology. Our primary aim is to provide a framework that outlines strategies and skills, which can be taught to medical trainees and practicing physicians, to prevent unconscious racial attitudes and stereotypes from negatively influencing the course and outcomes of clinical encounters. These strategies and skills are designed to: 1) enhance internal motivation to reduce bias, while avoiding external pressure; 2) increase understanding about the psychological basis of bias; 3) enhance providers' confidence in their ability to successfully interact with socially dissimilar patients; 4) enhance emotional regulation skills; and 5) improve the ability to build partnerships with patients. We emphasize the need for programs to provide a nonthreatening environment in which to practice new skills and the need to avoid making providers ashamed of having racial, ethnic, or cultural stereotypes. These recommendations are also intended to provide a springboard for research on interventions to reduce unintentional racial bias in health care.

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“…Current laboratory methods allow for measurement of picogram per gram levels or lower for hundreds of exposure biomarkers in relatively small amounts of blood and urine (Needham and Sexton, 2000;Sexton et al, 2004a;Needham et al, 2005). Biomarker data have been collected in children to evaluate environmental exposures to specific chemicals or chemical classes, including lead (Brody et al, 1994), pesticides (Payne-Sturges et al, 2009), environmental tobacco smoke (ETS; Sexton et al, 2004b), volatile organic chemicals (VOCs; Sexton et al, 2005), polychlorinated biphenyls (PCBs; Soechitram et al, 2004;Fukata et al, 2005), and phthalates (Silva et al, 2004;Wolff et al, 2007). But relatively few studies have been conducted that make longitudinal (over time) measurements of multiple biomarkers in the same children (Cohen Hubal et al, 2000;Needham and Sexton, 2000;Clayton et al, 2003;Sexton et al, 2006Sexton et al, , 2011.…”

Section: Introductionmentioning

confidence: 99%

Using exposure biomarkers in children to compare between-child and within-child variance and calculate correlations among siblings for multiple environmental chemicals

Sexton¹,

Ryan

2011

J Expo Sci Environ Epidemiol

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Longitudinal measurements of biomarkers for metals, phthalates, environmental tobacco smoke, organochlorine and organophosphate pesticides, polychlorinated biphenyls, and volatile organic compounds were made in blood and/or urine from a stratified, random sample of more than 100 elementary school-aged children living in an inner-city section of Minneapolis. Repeated measures of 31 exposure biomarkers indicate that between-child variance (B-CV) was greater than within-child variance (W-CV) for 8 compounds, B-CV was a significant proportion of total variance for 9 compounds, and variances were homogeneous for 14 compounds. Among siblings living in the same household, positive correlations were observed for biomarker concentrations of polychlorinated biphenyls, organochlorine pesticides, metals, and volatile organic chemicals in blood, and total cotinine in urine. Biologic markers confirm that children from a low-income, ethnically diverse neighborhood experienced concurrent exposure to a variety of hazardous environmental chemicals during their everyday activities. Future monitoring studies should examine the nature and magnitude of children's cumulative exposure to both chemical and non-chemical stressors, especially in disadvantaged populations.

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Children's exposure to environmental tobacco smoke: using diverse exposure metrics to document ethnic/racial differences.

Abstract: a Number (weighted percentage) of respondents either answering "yes" to a particular question or reporting a value > 0. b Percentages are weighted to adjust for selection and response probabilities.

Cited by 45 publications

References 23 publications

Comparison of recruitment, retention, and compliance results for three children's exposure monitoring studies

Comparison of recruitment, retention, and compliance results for three children's exposure monitoring studies

Reducing Racial Bias Among Health Care Providers: Lessons from Social-Cognitive Psychology

Using exposure biomarkers in children to compare between-child and within-child variance and calculate correlations among siblings for multiple environmental chemicals

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