Application and demonstration of meso-activity exposure factors to advance estimates of incidental soil ingestion among agricultural workers.

Background: Soil is an understudied and underregulated pathway of chemical exposure, particularly for agricultural workers who cultivate food in soils. Little is known about how agricultural workers spend their time and how they may contact soil while growing food. Exposure factors are behavioral and environmental variables used in exposure estimation.

A qualitative characterization of meso-activity factors to estimate soil exposure for agricultural workers.

Background: Agricultural workers' exposure to soil contaminants is not well characterized. Activity pattern data are a useful exposure assessment tool to estimate extent of soil contact, though existing data do not sufficiently capture the range and magnitude of soil contact in the agricultural context.

Objective: We introduce meso-activity, or specific tasks, to improve traditional activity pattern methodology.

Urban Soil Safety Policies: The Next Frontier for Mitigating Lead Exposures and Promoting Sustainable Food Production.

Urban soils bear the persistent legacy of leaded gasoline and past industrial practices. Soil safety policies (SSPs) are an important public health tool with the potential to inform, identify, and mitigate potential health risks faced by urban growers, but little is known about how these policies may protect growers from exposures to lead and other soil contaminants. We reviewed and evaluated 43 urban agriculture (UA) policies in 40 US cities pertaining to soil safety.

Charting a Path Forward: Assessing the Science of Chemical Risk Evaluations under the Toxic Substances Control Act in the Context of Recent National Academies Recommendations.

Background: In 2016, Congress enacted the Frank R. Lautenberg Chemical Safety for the 21st Century Act ("the Lautenberg Act"), which made major revisions to the main U.S.

Key considerations for assessing soil ingestion exposures among agricultural workers.

Background: Soil ingestion is a critical, yet poorly characterized route of exposure to contaminants, particularly for agricultural workers who have frequent, direct contact with soil.

Objective: This qualitative investigation aims to identify and characterize key considerations for translating agricultural workers' soil ingestion experiences into recommendations to improve traditional exposure science tools for estimating soil ingestion.

Methods: We conducted qualitative in-depth interviews with 16 fruit and vegetable growers in Maryland to characterize their behaviors and concerns regarding soil contact in order to characterize the nature of soil ingestion in the agricultural context.

Reimagining Public Health in the Aftermath of a Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented challenge for society, affecting those already subject to unacceptable health inequalities and resulting in vast economic impacts. The pandemic reminds everyone of the value and necessity of public health.In the context of an era that will be shaped by COVID-19, we outline the coming series of challenges and transitions in public health and the needed actions over the next 5 years to reinvent our public health systems.

Deregulation and the Assault on Science and the Environment.

The quality of the environment is a major determinant of the health and well-being of a population. The role of scientific evidence is central in the network of laws addressing environmental pollution in the United States and has been critical in addressing the myriad sources of environmental pollution and the burden of disease attributable to environmental factors. We address the shift away from reasoned action and science to a reliance on belief and document the efforts to separate regulation from science and to remove science-based regulations and policies intended to protect public health.

Pembrolizumab plus chemotherapy for first-line treatment of metastatic nonsquamous non-small-cell lung cancer: a network meta-analysis.

Aim: A systematic review and network meta-analysis were conducted to evaluate the efficacy of pembrolizumab + pemetrexed + platinum relative to other regimens in metastatic nonsquamous non-small-cell lung cancer (NSq-NSCLC).

Patients & Methods: Eligible studies evaluated first-line regimens in NSq-NSCLC patients without known targetable mutations. Relative treatment effects were synthesized with random effects proportional hazards Bayesian network meta-analyses.

Building Healthy Community Environments: A Public Health Approach.

Environmental quality has a profound effect on health and the burden of disease. In the United States, the environment-related burden of disease is increasingly dominated by chronic diseases. At the local level, public health practitioners realize that many policy decisions affecting environmental quality and health transcend the authorities of traditional health department programs.

Opportunities and Challenges for Dietary Arsenic Intervention.

The diet is emerging as the dominant source of arsenic exposure for most of the U.S. population.

Epidemiology: a foundation of environmental decision making.

Many epidemiologic studies are designed so they can be drawn upon to provide scientific evidence for evaluating hazards of environmental exposures, conducting quantitative assessments of risk, and informing decisions designed to reduce or eliminate harmful exposures. However, experimental animal studies are often relied upon for environmental and public health policy making despite the expanding body of observational epidemiologic studies that could inform the relationship between actual, as opposed to controlled, exposures and health effects. This paper provides historical examples of how epidemiology has informed decisions at the U.

Chemical Risk Assessment: Traditional vs Public Health Perspectives.

Preventing adverse health effects of environmental chemical exposure is fundamental to protecting individual and public health. When done efficiently and properly, chemical risk assessment enables risk management actions that minimize the incidence and effects of environmentally induced diseases related to chemical exposure. However, traditional chemical risk assessment is faced with multiple challenges with respect to predicting and preventing disease in human populations, and epidemiological studies increasingly report observations of adverse health effects at exposure levels predicted from animal studies to be safe for humans.

The bacterial virulence factors VopL and VopF nucleate actin from the pointed end.

VopL and VopF (VopL/F) are tandem WH2-domain actin assembly factors used by infectious species to induce actin assembly in host cells. There is disagreement about the filament assembly mechanism of VopL/F, including whether they associate with the filament barbed or pointed end. Here, we used multicolor total internal reflection fluorescence microscopy to directly observe actin assembly with fluorescently labeled VopL/F.

Rethinking Environmental Protection: Meeting the Challenges of a Changing World.

From climate change to hydraulic fracturing, and from drinking water safety to wildfires, environmental challenges are changing. The United States has made substantial environmental protection progress based on media-specific and single pollutant risk-based frameworks. However, today’s environmental problems are increasingly complex and new scientific approaches and tools are needed to achieve sustainable solutions to protect the environment and public health.

Media Messages and Perception of Risk for Ebola Virus Infection, United States.

News media have been blamed for sensationalizing Ebola in the United States, causing unnecessary alarm. To investigate this issue, we analyzed US-focused news stories about Ebola virus disease during July 1-November 30, 2014. We found frequent use of risk-elevating messages, which may have contributed to increased public concern.

News media coverage of U.S. Ebola policies: Implications for communication during future infectious disease threats.

The Ebola outbreak of 2014-2015 raised concerns about the disease's potential spread in the U.S. and received significant news media coverage.

Hospital Evacuation and Shelter-in-Place: Who Is Responsible for Decision-Making?

Objective: During natural disasters, hospital evacuation may be necessary to ensure patient safety and care. We aimed to examine perceptions of stakeholders involved in these decisions throughout the Mid-Atlantic region of the United States during Hurricane Sandy in October 2012.

Methods: Semistructured interviews were conducted from March 2014 to February 2015 to characterize stakeholders' perceptions about authority and responsibility for acute care hospital evacuation/shelter-in-place decision-making in Delaware, Maryland, New Jersey, and New York during Hurricane Sandy.

Legal Preparedness for Hurricane Sandy: Authority to Order Hospital Evacuation or Shelter-in-Place in the Mid-Atlantic Region.

Hospitals were once thought to be places of refuge during catastrophic hurricanes, but recent disasters such as Hurricanes Katrina and Sandy have demonstrated that some hospitals are unable to ensure the safety of patients and staff and the continuity of medical care at key times. The government has a duty to safeguard public health and a responsibility to ensure that appropriate protective action is taken when disasters threaten or impair the ability of hospitals to sustain essential services. The law can enable the government to fulfill this duty by providing necessary authority to order preventive or reactive responses--such as ordering evacuation of or sheltering-in-place in hospitals--when safety is imperiled.

Informing 21st-Century Risk Assessments with 21st-Century Science.

Understanding and preventing adverse impacts from chemicals in the environment is fundamental to protecting public health, and chemical risk assessments are used to inform public health decisions in the United States and around the world. Traditional chemical risk assessments focus on health effects of environmental contaminants on a chemical-by-chemical basis, largely based on data from animal models using exposures that are typically higher than those experienced by humans. Results from environmental epidemiology studies sometimes show effects that are not observed in animal studies at human exposure levels that are lower than those used in animal studies.