Background: The adverse health effects from acute extreme weather events are well-established. However, the COVID-19 pandemic incited behaviors that may impact those seeking medical care for non-COVID illnesses. Our study investigates the interaction between extreme heat and chronic illness during the pandemic.

Methods: We used daily electronic medical records (EMR) for patients enrolled in 11 different health systems in Minnesota (2017-2023). Diagnostic testing confirmed urgent care or emergency room visits for acute health outcomes and extreme temperature events were identified as census tract days with a heat index of >95 or >100℉. Applying a case crossover design, we estimated the association between respiratory and electrolyte disorders with extreme heat, stratifying by non-COVID years (2017-2019, 2023), and COVID years (2020-2021).

Results: Our findings reveal that 100 degree heat days were associated with significantly higher admission for electrolyte conditions during non-COVID years (RR: 1.28, 95% CI: 1.07, 1.52) compared to COVID years (RR: 0.87, 95% CI: 0.68, 1.09) in the Twin Cities with similar trends observed in the metro-area and statewide. However, admissions for asthma and COPD were slightly reduced during extreme heat and did not differ during COVID (RR: 0.77, 95% CI: 0.62, 0.96) and non-COVID years (RR: 0.81, 95% CI: 0.68, 0.97).

Conclusion: It is unknown whether heat related illnesses saw a true decline, or if these effects are behavior related. Policies or fear of contracting COVID-19 may have encouraged individuals to avoid exposure during hot days or discouraged those with heat-related illness from seeking medical care.

BACKGROUND: Due to the perception of poor quality and infrequent availability of municipal water, people in the Kathmandu Valley store two types of water: drinking water (DW) and non-drinking water (NDW). This study aimed to determine if the deliberate separation of water into DW and NDW by households results in households having DW with lower microbial and chemical contamination than NDW.

METHODS: DW and NDW samples were collected from 50 households across the Kathmandu Valley, selected by stratified random sampling. The samples were compared to Nepal’s National Drinking Water Quality Standards (NDWQS).

RESULTS: Overall, 17 of the 100 water samples met the standard for all essential parameters of NDWQS. DW samples failed fewer parameters than NDW samples (mean 1.08 vs. 1.96, difference 0.88, 95% C.I. 0.53-1.23, p-value <0.001). DW samples had significantly higher odds of meeting microbiological quality criteria compared to NDW samples (OR 7.11, 95% C.I. 2.89-17.53, p-value <0.001), but a similar association was not found for non-microbiological parameters (OR 1.65, 95% C.I. 0.74-3.71, p-value 0.22). Among DW samples, proportions safe for different categories were filtered (95%), boiled (75%), purchased jar water (<50%), and raw water (0%).

CONCLUSIONS: DW samples were microbiologically safer than NDW samples, thereby validating the practice of keeping separate DW and NDW samples. Boiling and filtering appeared to be effective methods of obtaining microbiologically safe water while purchasing jar water and consuming raw water did not.

Background: Climate change is an ongoing problem that must be addressed by current and future generations. Thus, it is important to know specifically how college students, who will be entering the workforce, understand climate change as a problem and how their choices are impacted by this knowledge. Existing literature has investigated college student perceptions of climate change as an issue, yet it remains unknown whether college students' knowledge of climate impacts their current and future actions and decisions.

Purpose: To address this gap, the study explores the intersections of climate change knowledge, perceptions, and actions among college students. The purpose of study is to examine if and how undergraduate students' knowledge of climate change is changing their participation in campus events and activities and decision about career goals.

Methods: A 25-question IRB-approved online survey was launched between February and March 2024. A total of 249 part- or full-time undergraduate college students participated. The survey collected data on demographic information, the student’s perceived knowledge of climate change and their actions taken to address climate change. Data was analyzed with descriptive statistics and regression analyses to examine associations between participant demographics, knowledge and action.

Results: Preliminary survey results indicate that most participants acknowledge climate change as a real phenomenon and trust the findings from climate scientists that agree climate change is happening. The data revealed a notable cohort of students who have adopted daily sustainable practices, though they have not tailored their career trajectories in response to climate change concerns.

Conclusions: These findings underscore the profound impact of perceived knowledge of climate change on shaping students' behaviors and aspirations, emphasizing the significance of educational efforts in fostering environmental consciousness and sustainable action among future generations. Findings will provide insight into the behavioral and environmental nexus that students navigate on campus and post-graduation.

Objective: We investigated the association between environmental pollution burden and atopic dermatitis (AD) clinic visits in San Francisco, California, during and after a wildfire event.

Design and Participants: Patient visit data from University of California, San Francisco Dermatology clinics were collected before, during, and after the 2018 Camp Fire, which burned for 2 weeks and occurred 175 mi away. Smoke density data for San Francisco was collected from NOAA satellites and pollution data, specifically particulate matter less than or equal to 2.5 microns, was collected from ground monitors. Patients diagnosed with AD were categorized into control (pre-fire) and exposed (during and post-fire) groups. Demographic information including age, sex, self-reported race/ethnicity, and insurance type was collected. Pollution burden scores were obtained from CalEnviroScreen 4.0, which merges pollution burden and population characteristics at the census tract level. Lastly, historical redlining data were obtained from the Home Owners' Loan Corporation (HOLC) maps.

Results: A total of 2,123 AD visits occurred pre-fire, and 1,560 visits occurred during and post-fire. Patients in the exposed group were more likely to come from environmentally vulnerable neighborhoods (p < 0.0001). Spatial analysis revealed increased AD visits during the exposure period from specific zip codes with higher CalEnviroScreen scores, notably historically redlined and industrially zoned areas, compared to other neighborhoods.

Conclusion: Environmental injustice, characterized by disparities in neighborhood pollution burdens, are found in previously redlined and industrially zoned areas. Vulnerable communities, with higher pollution burdens, exhibit heightened susceptibility to AD flares during environmental challenges. Conversely, areas with lower pollution burdens, associated with higher socioeconomic status, demonstrated better resilience, resulting in fewer AD visits. This study highlights the critical role of social and environmental determinants in AD health disparities. Targeted interventions to mitigate these inequities could improve health outcomes in vulnerable communities.

Background: Nitrogen dioxide (NO₂) and particulate matter (PM) impact multiple health outcomes, especially for vulnerable populations with respiratory diseases. These pollutants can lead to acute exacerbations with an increased risk of hospitalization and death in older adults with asthma.

Objective: Evaluate the impact of High-Efficiency Particulate Air (HEPA)/Charcoal air purifier use on indoor NO₂ and PM emitted from gas stoves in low-income homes of older adults with asthma.

Method: We conducted a longitudinal intervention study with HEPA/charcoal filter air purifiers in homes of older adults with asthma in Lowell, Massachusetts. We conducted a home visit every 4 months for a 12-month period, we conducted environmental sampling, collected environmental exposure data using questionnaires and participants heath data using St. George’s respiratory questionnaire (SGRQ) and asthma control test (ACT) questionnaire. Environmental sampling included measuring indoor NO₂, PM, stove use, temperature, and humidity between 5 -7 days. HEPA/charcoal air purifiers were introduced in the 4th month of the study. Mixed models were used to predict continuous outcomes and generalized mixed models were used for binary outcomes to control for repeated measurement.

Results: 71 participants completed the study; the average age of the participants was 67, 31% were male. HEPA/Charcoal air purifiers were introduced in 69 homes. The pre-intervention geometric mean (GM) for NO₂ reduced by 57% from 19.9ppb to 12.6ppb (p< 0.0001) post-intervention. Pre-intervention GM for PM_2.5 reduced by 81% from 16.8µg/m³ to 9.3µg/m³ (p < 0.0001) post-intervention. Indoor NO₂ concentrations were influenced by air purifier usage, stove usage, and season. While indoor PM_2.5 concentrations were influenced by air purifier usage. SGRQ-Symptom, SGRQ-Impact score, and ACT score improved significantly from pre- to post-intervention. Doctor visits for asthma reduced post-intervention.

Conclusion: Findings show a significant decrease in indoor NO₂ and PM_2.5 and improvement of asthma control with use of HEPA/Charcoal air purifiers.

East Trenton, a neighborhood in the Trenton North Ward, is an environmental justice (EJ) community burdened by lead (Pb). East Trenton is home to 4,000 residents (>85% African-American or Hispanic) in approximately 900 households. According to the U.S. EPA EJ Screen tool, it is in the 95^th percentile nationally for Pb paint, low income, and demographic index, a combination of low income and people of color population.

East Trenton Collaborative (ETC), a local community organization was created to revitalize their neighborhood and empower their community. ETC partnered with Rutgers Environmental and Occupational Health Sciences Institute (EOHSI) to reduce Pb exposure to their residents. ETC was specifically interested in capacitating and educating residents to develop mitigation strategies for Pb exposure. Using a community-based participatory research approach, EOHSI trained 6 residents living in the East Trenton neighborhood as community scientists to conduct soil sampling throughout the neighborhood.

In August of 2023, the 6 community scientists collected 242 soil samples from 121 homes in East Trenton. The mean Pb soil level was 620.8 ppm with a median Pb soil level of 478.8 ppm. 95% of homes had at least one sample above the EPA’s Residential Lead Hazard Pb for Soil (200 ppm). Additionally, 55 blood samples were collected and analyzed with an averaged blood Pb of 13.1 ppb (range: 1.6-86.5ppb).

This research is initiated by East Trenton community members concerned with the potential health impact from Pb exposure. We strengthened our partnership by directly partnering researchers with the community members and supporting open and flexible communication. Future work includes follow-up in homes to assess potential exposure in water, paint, soil, and house dust. Finally, a targeted intervention using these results will be designed to decrease possible Pb exposure in East Trenton.

PFAS constitute a diverse group of environmentally persistent anthropogenic chemicals widely used in consumer and industrial products. Evidence has linked PFAS exposure to harmful health effects; yet, their broad use and complexity of their toxicokinetics pose challenges in assessing PFAS exposure and bioaccumulation. We conducted a comprehensive analysis of pre-selected NHANES demographic variables: education level, household income, race, pregnancy status, gender, interpreter use, military status, US-born status, and US-citizenship status. Through comparisons of the distributions of PFAS concentrations per demographic variable, we aimed to identify populations with elevated body burdens. Our analysis of PFAS serum concentrations from the 2013-4, 2015-6, and 2017-8 NHANES cohorts revealed significant gender disparities for different PFAS. Women consistently had lower PFHxS (C6), PFHpS (C7), PFOS (C8) and PFOA (C8) serum concentrations than men, potentially attributable to menstruation or breast-feeding, known pathways for PFAS removal from the body. However, PFDA (C10) and PFUdA (C11) concentrations showed no significant difference between genders, suggesting a possible association between PFAS chain length and post-puberty gender-specific removal mechanisms. Among children ages 3-11 (i.e., predominantly pre-menarche aged) males exhibited higher serum concentrations of PFOS and PFHxS than females. This disparity may be influenced by behavioral factors, such as increased hand-to-mouth contact among boys leading to heightened ingestion of PFAS-containing dust particles. Additionally, differences in physical size between pre-pubescent boys and girls may contribute to variations in body burden. Interestingly, male and female children exhibited similar PFDA and PFUdA measurements, supporting the hypothesis of gender-specific removal pathways for shorter PFAS chain lengths. Our findings highlight the potential for targeted interventions to reduce childhood exposure risks to PFAS. The correlation between PFAS chain length and gender suggests the need for better understanding of gender-based removal mechanisms to from the body.

Spices are commonly used on a daily basis by most people, especially in minority and immigrant communities. Using spices can be a way to connect to their culture or family. When purchasing turmeric, cumin, cinnamon, and a variety of other spices, individuals may prefer to buy imported products from independent, loosely regulated local markets. However, unbeknownst to the consumer, spices could be a pathway for negative health effects, compounding the myriad health disparities faced by minority and immigrant communities. Occasional consumer group testing, governmental monitoring, and scientific analyses have observed spices contaminated with toxic trace elements such as lead, a potent neurotoxin. New York State recognized this public health threat and lowered the recall action levels for spices in 2021. However, only a fraction of products are tested overall. In collaboration with two local environmental education organizations, we will purchase 300 samples of spices from 15 small Asian, African, Caribbean, and Latin American import markets in the Capital District. The samples will be analyzed in triplicate for toxic trace element contaminants using an XOS Rocksand X-Ray Fluorescence Spectrometer. Triplicate results in ppm for lead, arsenic, cadmium, mercury, and chromium will be averaged and compared to New York State action levels. Results will be reported back to the public and shared with the local markets and the proper regulatory agencies, if warranted. The findings from this study will provide a framework for the food safety of spices purchased and consumed from local markets in the Capital District.

Introduction: Effective communication is imperative to reach time-urgent goals in reducing the magnitude and effects of climate change. Climate change policy advocacy is critical to achieve system-level change. Climate activism behaviors can include writing letters, e-mailing, or phoning government officials; voting for climate change activist candidates; signing petitions; volunteering and donating to organizations; attending protests. We identified communication strategies that facilitate individuals initiating and sustaining climate activism behaviors to support environmental policy.

Methods: Adult participants who were engaged in climate activism were recruited from Climate Changemakers, a national non-partisan organization that trains individuals to advocate for pro-climate actions in their communities. We conducted in-depth interviews with 24 participants. All interviews were recorded, transcribed, and by three coders using thematic analysis. A codebook was iteratively developed to identify emergent codes and analyzed through discussion with team members to ensure reliability.

Results: Participants were highly educated with relatively equal gender distributions. Multiple information sources were identified as motivating climate activism. Sources of effective messaging include narrative communication, including films, novels, and popular news media outlets. Highly engaged climate activists also received messaging from specific climate communication accounts on social media platforms, including Instagram, Twitter, LinkedIn, YouTube, and TikTok. Salient messaging strategies included entertaining, audio-visual, and action-oriented content. Participants emphasized the effectiveness of messaging that was relevant to an individual’s present local context. Highlighting the success of collective action on pro-climate efforts was reported as promoting initiation of climate activism behaviors. Relevant and present timing of climate change messaging also initiated activism. We additionally found that highly engaged climate activists created their own messaging to advocate for activism behaviors in their social networks through creative methods, including newsletters, videos, and games.

Conclusion: Our study emphasizes the sources and characteristics of effective messaging that motivate uptake of climate activism behaviors to promote environmental policy.

Introduction: According to the American Lung Association&#39;s annual air quality report, approximately 36%
of individuals living in the United States reside in places with high ozone levels and could be
simultaneously exposed to natural biopollutants, such as pollen. Airborne pollen has been found to be
associated with an increased risk for respiratory illnesses such as allergic rhinitis, hay fever symptoms,
asthma, and some cardiovascular diseases. Coastal areas such as Charleston, South Carolina, are
significantly influenced by anthropogenic activities that may contribute to the levels of gaseous
pollutants in the environment. This study aims to investigate the association between gaseous
pollutants and airborne pollen load in Charleston, South Carolina.
Methods: Environmental data from 2017 to 2021 were collected from federal databases between the
months of March to September and were used for this analysis. Pollen data were obtained through an
agreement between the National Allergy Bureau of AAAAI and Georgia Southern University. The
associations between gaseous pollutants and environmental factors such as NO₂ , SO_2, ozone, airborne
pollen, ambient temperature, and relative humidity were analyzed using Spearman correlations by the
SAS system.
Results: The results show a statistically significant positive association between pollen levels and the
ozone levels (0.650, p=0.0001) and a statistically significant negative correlation between pollen levels,
and ambient temperature (-0.721, p<0.0001), and relative humidity (-0.575, p=0.0003).
Conclusions: The findings show that the ozone level in the coastal areas may have a significant impact on
pollen load in the air. Further studies using a statistical model-based clustering approach are required to
detect significant clusters among locations and taxa based on airborne pollen loads and ozone levels.
The findings highlight the importance of implementing efforts to mitigate the adverse effects of gaseous
air pollutants on pollen-related asthma, rhinitis, and other respiratory health issues.