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(1) Background: American Indians are disproportionately affected by air pollution, an important risk factor for dementia. However, few studies have investigated the effects of air pollution on the risk of dementia among American Indians. (2) Methods: This retrospective cohort study included a total of 26,871 American Indians who were 55+ years old in 2007, with an average follow-up of 3.67 years. County-level average air pollution data were downloaded from land-use regression models. All-cause dementia was identified using ICD-9 diagnostic codes from the Indian Health Service’s (IHS) National Data Warehouse and related administrative databases. Cox models were employed to examine the association of air pollution with dementia incidence, adjusting for co-exposures and potential confounders. (3) Results: The average PM2.5 levels in the IHS counties were lower than those in all US counties, while the mean O3 levels in the IHS counties were higher than the US counties. Multivariable Cox regressions revealed a positive association between dementia and county-level O3 with a hazard ratio of 1.24 (95% CI: 1.02–1.50) per 1 ppb standardized O3. PM2.5 and NO2 were not associated with dementia risk after adjusting for all covariates. (4) Conclusions: O3 is associated with a higher risk of dementia among American Indians.

BackgroundPer- and polyfluoroalkyl substances (PFAS) widely exist in the environment and human bodies. Contaminated drinking water is one of the major exposure pathways for humans. Previous studies found weak or moderate associations between PFAS and hypertensive disorders of pregnancy (HDP).MethodsWe obtained the number of births and counts of HDP cases for singleton births multiply stratified by county, maternal age, race, education, smoking status, and parity from CDC WONDER, and PFAS water concentrations from EPA UCMR3 data in the United States during 2013-2015. We used binomial regression on the multiply stratified HDP data to produce equal effect estimates and standard errors to those that would be derived from using individual-level data on binary HDP status and demographic covariates in logistic regression.ResultsAfter adjusting for demographic covariates, we found small but statistically significant positive associations between HDP and population-weighted average water concentrations (ng/L) of all four PFAS: Odds ratio (OR) = 1.009, 95% CI = (1.001, 1.016) per IQR increase in perfluorooctanoic acid (PFOA); 1.030, 95% CI = (1.021, 1.040) per IQR increase in perfluorooctane sulfonate (PFOS); 1.008, 95% CI = (1.005, 1.011) per IQR increase in perfluoroheptanoic acid (PFHpA); 1.007, 95% CI = (1.004, 1.010) per IQR increase in perfluorohexane sulfonic acid (PFHxS), and 1.032, 95% CI = (1.022, 1.042) per IQR increase in the sum of four PFAS. Further adjustment for coexposures reversed the effect of PFOA from positive to inverse, and attenuated the effects of PFOS and PFHxS toward the null. After drinking water to serum concentration conversions, our effect estimates for PFOA, PFOS, and PFHxS are similar to previous studies.ConclusionsWe found a weak positive association between the PFAS mixture and HDP, although the generalizability is subject to inherent limitations of the public-available datasets.

BackgroundPer- and polyfluoroalkyl substances (PFAS) are ubiquitous in the serum of the general US population. Food, drinking water, consumer products, dust, and air have been assessed as PFAS exposure sources for humans. The effects of various types of carpeting on serum PFAS concentrations have been less studied, despite the known use of PFAS in stain-resistant carpet treatments.ObjectiveThis study aimed to examine the associations between serum PFAS concentrations and type of residential flooring among the general US population aged 12 years and older using the 2005-2006 National Health and Nutrition Examination Survey (NHANES).MethodsWe used multiple linear regressions adjusted for complex survey design and relevant covariates to analyze the relations between serum PFAS concentrations and type of floor covering (smooth surface, low pile carpet, medium to high pile carpet, and combination of carpet and smooth surface), as well as other potential exposure factors. We used multiple imputation to address missing values.ResultsWe found significantly higher serum concentrations of perfluorohexane sulfonic acid (PFHxS) and 2-(N-methyl-perfluorooctane sulfonamido) acetic acid (MeFOSAA) in US residents residing in homes with low pile carpeting compared with those residing in homes with smooth surface. We concluded that among US residents aged 12 years and older residing in homes with low pile carpeting in the home in 2005-2006, on average 24% and 19% of the PFHxS and MeFOSAA body burdens, respectively, could be attributed to carpeting. We found associations between other types of floor covering (medium to high pile carpet, combination of carpet and smooth surface) and some PFAS concentrations compared with the smooth surface, but these results were less consistent and generally not statistically significant. Additionally, a group Wald Chi-squared test showed a significant result for PFOS, indicating different contributions of various types of flooring to PFOS serum concentration.SignificanceOur results are representative of the general US population at the time of the survey, and potentially informative regarding ongoing PFAS exposure from a variety of sources including carpeting.

BackgroundPer- and polyfluoroalkyl substances (PFAS) are ubiquitous in the serum of the general US population, and were detected in public water systems serving approximately 16.5 million US residents during 2013-2015. Low birthweight was associated with PFAS exposures in previous studies.MethodsBirthweights for singleton births during 2013-2015 were obtained from CDC WONDER, multiply stratified by county, maternal age, race, education, smoking status, and parity. PFAS water concentrations were obtained from EPA UCMR3 database and aggregated by county. Multiple regression weighted by inverse variance was used to produce effect estimates equivalent to those that would be obtained from individual-level data on birthweight and confounders.ResultsAdjusting for stratification demographic confounders (maternal age, race, education, smoking status, and parity), we found an average change in birthweight of 0.9 g (95% confidence interval [CI] = -0.5, 2.2), -1.3 g (-1.6, -0.9), -3.8 g (-4.9, -2.7), and -3.8 g (-4.3, -3.3) per ng/L increase in the population-weighted average perfluorooctanoic acid, perfluorooctane sulfonate, perfluoroheptanoic acid, and perfluorohexane sulfonic acid in public water supplies by county, respectively. We found an average change in birthweight of -1.0 g (95% CI = -1.2, -0.8) per ng/L increase in the sum of perfluorooctanoic acid, perfluorooctane sulfonate, perfluoroheptanoic acid, and perfluorohexane sulfonic acid concentrations in public water supplies.ConclusionsThe direction and magnitude of association between PFAS and birthweight varied by PFAS chemical in this study. Conclusions are tempered by inherent limitations of the 2 public-use datasets, and by the sensitivity of our results to alternative methods such as mutual adjustment for co-exposures.

Background and aims: Increasing levels of alcohol use are associated with a risk of developing an alcohol use disorder (AUD), which, in turn, is associated with considerable burden. Our aim was to estimate the risk relationships between alcohol consumption and AUD incidence and mortality. Method: A systematic literature search was conducted, using Medline, Embase, PsycINFO and Web of Science for case–control or cohort studies published between 1 January 2000 and 8 July 2022. These were required to report alcohol consumption, AUD incidence and/or AUD mortality (including 100% alcohol‐attributable deaths). The protocol was registered with PROSPERO (CRD42022343201). Dose–response and random‐effects meta‐analyses were used to determine the risk relationships between alcohol consumption and AUD incidence and mortality and mortality rates in AUD patients, respectively. Results: Of the 5904 reports identified, seven and three studies from high‐income countries and Brazil met the inclusion criteria for quantitative and qualitative syntheses, respectively. In addition, two primary US data sources were analyzed. Higher levels of alcohol consumption increased the risk of developing or dying from an AUD exponentially. At an average consumption of four standard drinks (assuming 10 g of pure alcohol/standard drink) per day, the risk of developing an AUD was increased sevenfold [relative risk (RR) = 7.14, 95% confidence interval (CI) = 5.13–9.93] and the risk of dying fourfold (RR = 3.94, 95% CI = 3.53–4.40) compared with current non‐drinkers. The mortality rate in AUD patients was 3.13 (95% CI = 1.07–9.13) per 1000 person‐years. Conclusions: There are exponential positive risk relationships between alcohol use and both alcohol use disorder incidence and mortality. Even at an average consumption of 20 g/day (about one large beer), the risk of developing an alcohol use disorder (AUD) is nearly threefold that of current non‐drinkers and the risk of dying from an AUD is approximately double that of current non‐drinkers. [ABSTRACT FROM AUTHOR]

Background: Moderate alcohol use may be associated with lower risk of type 2 diabetes mellitus (T2DM). Previous reviews have reached mixed conclusions. Purpose: To quantify the dose-response relationship between alcohol consumption and T2DM, accounting for differential effects by sex and BMI. Data Sources: Medline, Embase, Web of Science, and one secondary data source. Study Selection: Cohort studies on the relationship between alcohol use and T2DM. Data Extraction: Fifty-five studies, and one secondary data source, were included with a combined sample size of 1,363,355 men and 1,290,628 women, with 89,983 and 57,974 individuals, respectively, diagnosed with T2DM. Data Synthesis: Multivariate dose-response meta-analytic random-effect models were used. For women, a J-shaped relationship was found with a maximum risk reduction of 31% (relative risk [RR] 0.69, 95% CI 0.64–0.74) at an intake of 16 g of pure alcohol per day compared with lifetime abstainers. The protective association ceased above 49 g per day (RR 0.82, 95% CI 0.68–0.99). For men, no statistically significant relationship was identified. When results were stratified by BMI, the protective association was only found in overweight and obese women. Limitations: Our analysis relied on aggregate data. We included some articles that determined exposure and cases via self-report, and the studies did not account for temporal variations in alcohol use. Conclusions: The observed reduced risk seems to be specific to women in general and women with a BMI ≥25 kg/m2. Our findings allow for a more precise prediction of the sex-specific relationship between T2DM and alcohol use, as our results differ from those of previous studies. [ABSTRACT FROM AUTHOR]

Objective: Alcohol use disorder is an established risk factor for suicide; however, it is largely unknown whether subclinical levels of drinking may also contribute to the risk of suicide. The objective was to evaluate the relationship between average alcohol volume consumed per day and suicide., Methods: Data from the annual, cross-sectional National Health Interview Survey, 1997-2018 in the USA, was obtained and linked to the 2019 National Death Index. The association between average alcohol volume consumed in grams per day (g/day) and suicide was quantified using Cox proportional hazards model (multiplicative) and Aalen's additive hazard model. All analyses were stratified by sex, and adjusted for education, marital status, psychological distress, race and ethnicity, and survey year., Results: On the multiplicative scale, for males, former drinkers and those who consumed on average >40-60 g/day had about 43% (HR=1.43, 95% CI 1.03, 2.01) and 72% (HR=1.72, 95% CI 1.14, 2.60) greater risk of dying by suicide, compared with lifetime abstainers, respectively. There was no significant association found for former or current drinkers among females, on the multiplicative scale. On the additive scale, for males, drinking >40-60 g/day on average was associated with 22.7 (95% CI 6.0, 39.4) additional deaths per 100 000 person-years, while for females, being a former drinker and drinking >0-20 g/day on average was associated with 5.5 (95% CI 0.7, 10.4) and 1.9 (95% CI 0.2, 3.5) additional deaths per 100 000 person-years, compared with lifetime abstainers. The level of education was not found to modify the focal relationship for males or females., Conclusions: The findings suggest that the relationship between average alcohol volume consumed per day and suicide is nuanced. Additional research on the respective relationship is needed, including repeated measures of average alcohol consumption over time., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)