Publications by authors named "Kristen Rappazzo"

Article Synopsis
  • The study investigates how exposure to wildfire smoke during pregnancy and early childhood impacts the long-term use of prescribed respiratory medications in children.
  • Using data from children born in western states between 2010 and 2014, researchers analyzed the correlation between smoke exposure and respiratory medication use.
  • Findings suggest increased risks for prolonged use of respiratory medications, especially linked to smoke exposure in the third trimester and the first 12 weeks after birth, with notable effects observed in male infants.
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Background: Coal-fired power plants are major contributors of ambient sulfur dioxide (SO) air pollution. Epidemiological literature suggests an adverse association between SO exposure during gestation and preterm birth (PTB; <37 weeks completed gestation). PTB is strongly associated with infant mortality and increased risk for later life morbidities.

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Background: Brownfields consist of abandoned and disused sites, spanning many former purposes. Brownfields represent a heterogenous yet ubiquitous exposure for many Americans, which may contain hazardous wastes and represent urban blight. Neonates and pregnant individuals are often sensitive to subtle environmental exposures.

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Background: Evidence from studies of air pollutants and birth outcomes suggests an association, but uncertainties around geographical variability and modifying factors still remain. As neighborhood-level social characteristics are associated with birth outcomes, we assess whether neighborhood deprivation level is an effect measure modifier on the association between air pollution and birth outcomes in a North Carolina birth cohort.

Methods: Using birth certificate data, all North Carolina residential singleton live births from 1 January 2011 to 31 December 2015 with gestational ages of 20-44 weeks ( = 566,799) were examined for birth defect diagnoses and preterm birth.

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Article Synopsis
  • Preterm birth (PTB) is linked to air pollution exposure, with varying effects depending on the type of pollutant and timing during pregnancy.
  • A study in North Carolina analyzed data from over 1.3 million births between 2003 and 2015 to assess the impact of fine particulate matter (PM), nitrogen dioxide (NO), and ozone (O) on PTB rates.
  • Findings indicated that higher PM and O exposure increased the risk of PTB, while NO exposure showed generally no significant association, suggesting PM might have the strongest influence on preterm births.
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Background: Sudden death accounts for approximately 10% of deaths among working-age adults and is associated with poor air quality. Objectives: To identify high-risk groups and potential modifiers and mediators of risk, we explored previously established associations between fine particulate matter (PM) and sudden death stratified by potential risk factors.

Methods: Sudden death victims in Wake County, NC, from 1 March 2013 to 28 February 2015 were identified by screening Emergency Medical Systems reports and adjudicated ( = 399).

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Introduction: In 2020, 13.8 million people in the United States struggled with food security. This means they were uncertain whether their food needs would be met.

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We examined the association between mean birth weight (BW) differences and perfluorohexane sulfonate (PFHxS) exposure biomarkers.We fit a random effects model to estimate the overall pooled effect and for different strata based on biomarker sample timing and overall study confidence. We also conducted an analysis to examine the impact of a continuous measure of gestational age sample timing on the overall pooled effect.

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Background: The Opportunity Atlas project is a pioneering effort to trace social mobility and adulthood socioeconomic outcomes back to childhood residence. Half of the variation in adulthood socioeconomic outcomes was explainable by neighborhood-level socioeconomic characteristics during childhood. Clustering census tracts by Opportunity Atlas characteristics would allow for further exploration of variance in social mobility.

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Background And Aim: Infant mortality is a widely reported indicator of population health and a leading public health concern. In this systematic review and meta-analysis, we review the available literature for epidemiologic evidence of the association between short-term air pollution exposure and infant mortality.

Methods: Relevant publications were identified through PubMed and Web of Science databases using comprehensive search terms and screened using predefined inclusion/exclusion criteria.

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Background: Approximately nine million adults in the United States are living with chronic obstructive pulmonary disease (COPD), and positive associations between short-term air pollution exposure and increased risk of COPD hospitalizations in older adults are consistently reported. We examined the association between short-term PM exposure and hospitalizations and assessed if there is modification by long-term exposure in a cohort of individuals with COPD.

Methods: In a time-referent case-crossover design, we used a cohort of randomly selected individuals with electronic health records from the University of North Carolina Healthcare System, restricted to patients with a medical encounter coded with a COPD diagnosis from 2004-2016 (n = 520), and estimated ambient PM concentrations from an ensemble model.

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Wildfire smoke is associated with short-term respiratory outcomes including asthma exacerbation in children. As investigations into developmental wildfire smoke exposure on children's longer-term respiratory health are sparse, we investigated associations between developmental wildfire smoke exposure and first use of respiratory medications. Prescription claims from IBM MarketScan Commercial Claims and Encounters database were linked with wildfire smoke plume data from NASA satellites based on Metropolitan Statistical Area (MSA).

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Background: Despite many efforts, preterm birth (PTB) is poorly understood and remains a major public health problem in the United States. Toxicological work suggests gestational parent (GP) diet may modify the effect of ambient pollutants on birth outcomes. We assessed risk of PTB in humans in relation to fine particulate matter (PM), ozone (O), and nitrogen dioxide (NO) and variation by diet.

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Air pollution exposure is associated with negative health consequences among children and adolescents. Physical activity is recommended for all children/adolescents due to benefits to health and development. However, it is unclear if physically active children have additional protective benefits when exposed to higher levels of air pollution, compared to less active children.

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In environmental programs and blue/green space development, improving aesthetics is a common goal. There is broad interest in understanding the relationship between ecologically sound environments that people find aesthetically pleasing and human health. However, to date, few studies have adequately assessed this relationship, and no summaries or reviews of this line of research exist.

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Multi-city epidemiologic studies examining short-term (daily) differences in fine particulate matter (PM) provide evidence of substantial spatial heterogeneity in city-specific mortality risk estimates across the United States. Because PM is a mixture of particles, both directly emitted from sources or formed through atmospheric reactions, some of this heterogeneity may be due to regional variations in PM toxicity. Using inverse variance weighted linear regression, we examined change in percent change in mortality in association with 24 "exposure" determinants representing three basic groupings based on potential explanations for differences in PM toxicity - size, source, and composition.

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Article Synopsis
  • Brownfields, which are abandoned sites that may contain hazardous waste, can pose environmental risks to vulnerable populations like neonates and pregnant individuals, potentially leading to birth defects.
  • A study of over 753,000 births in North Carolina from 2003 to 2015 found that living near brownfields is linked to an increased risk of certain birth defects, specifically cardiovascular and external defects, with some defects showing a stronger association than others.
  • The findings suggest a need for further research to explore the relationship between specific contaminants at brownfield sites and various types of birth defects, indicating that proximity to these sites may be a significant factor in birth outcomes.
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Background: Police-reported crime data (hereafter "crime") is routinely used as a psychosocial stressor in public health research, yet few studies have jointly examined (a) differences in crime exposure based on participant race and ethnicity, (b) differences in measures of crime exposure, and (c) considerations for how exposure to police is captured in police-recorded crime data. We estimate neighborhood exposure to crime and discuss the implications of structural differences in exposure to crime and police based on race and ethnicity.

Methods: Using GPS coordinates from 1188 participants in the Newborn Epigenetics Study, we estimated gestational exposure to crime provided by the Durham, North Carolina, Police Department within (a) 800 m and (b) the Census block group of residence.

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Exposure to ozone has been linked to reproductive outcomes, including preterm birth. In this systematic review, we summarize published epidemiologic cohort and case-control studies examining ozone exposures (estimated on a continuous scale) in early pregnancy (1st and 2nd trimesters (T1, T2)) and preterm birth using ratio measures, and perform a meta-analysis to evaluate the potential relationship between them. Studies were identified by searching PubMed and Web of Science, screened according to predefined inclusion/exclusion criteria, and evaluated for study quality.

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Background: Many studies neglect to account for variation in population served by community water systems (CWSs) when aggregating CWS-level contaminant concentrations to county level.

Objective: In an ecological epidemiologic analysis, we explored two methods-unweighted and weighted (proportion of CWS population served by county population)-to account for population served by CWS in association between arsenic and three cancers to determine the impact of population served on aggregated measures of exposure.

Methods: CWS arsenic concentration data for 19 states were obtained from Centers for Disease Control and Prevention (CDC) National Environmental Public Health Tracking Network for 2000-10, aggregated to county level, and linked to county-level cancer data for 2011-5 from National Cancer Institute and CDC State Cancer Profiles.

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The science behind the combined effect of (and possible interaction between) physical activity and air pollution exposure on health endpoints is not well established, despite the fact that independent effects of physical activity and air pollution on health are well known. The objective of this review is to systematically assess the available literature pertaining to exposure to air pollution while being physically active, in order to assess statistical interaction. Articles published during 2000-2020 were identified by searching PubMed, Science Direct, and ProQuest Agricultural & Environmental Science Database for terms encompassing air pollution and exercise/physical activity.

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