UCLA public health professor hosts nationwide TV series.

In a four-part TV series airing on public broadcasting, UCLA Dr. Richard Jackson shows viewers the best and worst examples of urban planning and its effects on health.

The old adage says we are what we eat, but perhaps it should also say we are what we build.

One of America’s leading voices calling for smarter urban planning and architecture to create healthy environments is making that case to the public in a four-part series that’s airing nationwide on public broadcasting stations.

Dr. Richard Jackson, a UCLA professor of public health and urban planning as well as chair of environmental health sciences and a member of the Institute of the Environment and Sustainability, became convinced that the built environment deserved some of the blame for rising health risks after studying environmental health issues around pesticides, air pollution and cancer clusters.

The pediatrician and epidemiologist has already found a national audience for this concept among scientists, mayors, governors, urban planners, architects and public health specialists. Through his books, lectures and articles over the last three decades and as head of the National Center for Environmental Health at the Center for Disease Control and Prevention and as California’s chief state health officer, Jackson has long advocated designing, planning and building healthy communities. He has served on the Board of Directors of the American Institute of Architects, and last year, he was elected to the Institute of Medicine of the National Academy of Sciences, one of the highest honors awarded in the fields of health and medicine.

Once considered controversial, his premise that poorly thought-out design and planning of our cities, buildings and freeways have contributed to higher rates of asthma, cancer, obesity and diabetes has been borne out by studies of airborne particulates from cars and trucks, water contamination, lead poisoning, traffic congestion and the scarce access to fresh, healthy food in low-income urban communities.

“I’ve talked to a lot of ‘elites’ — science groups, mayors and groups of governors,” said Jackson from his fifth floor office in the School of Public Health. “But I became convinced four or five years ago that we are not going to change the way we have built America unless we change the fundamental American consciousness and our cultural awareness of the need for physical activity and designing good places.”

To do that, Jackson has been working on the television series, “Designing Healthy Communities,” over the last four years. The series, funded by the Kresge Foundation, California Endowment, Robert Wood Johnson Foundation and Kaiser Permanente, starts Tuesday, Jan. 31, on KLCS at 9 p.m. and will run Tuesdays, beginning Feb. 7, on KOCE at 10 p.m.

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UC Berkeley endocrinologist a pioneer in understanding how hormones affect development.

Howard Bern

Howard A. Bern, professor emeritus of integrative biology at the University of California, Berkeley, and a pioneer in understanding how hormones affect development, including that of the human fetus, died Jan. 3 at his home in Berkeley after a nine-month battle with cancer. He was 91.

Bern was an endocrinologist whose research in the 1960s on diethylstilbestrol (DES), a synthetic hormone given to women to prevent premature birth, helped scientists understand its role in causing cancer. He was co-author of the standard book on the developmental effects of DES during pregnancy.

Today, chemicals that affect hormones — so-called endocrine disruptors — are a major concern because of their prevalence in the environment.

“He was instrumental in recognizing that many synthetic chemicals can act as ‘endocrine disruptors,’” said developmental endocrinologist Tyrone Hayes, a UC Berkeley professor of integrative biology who has done groundbreaking research on the detrimental effects of the herbicide atrazine on amphibians. “By mimicking and/or affecting hormone synthesis or degradation, many chemicals can have drastic yet non-lethal effects on wildlife and humans … in processes ranging from reproductive failure to cancer. Howard’s groundbreaking work on DES, which affected millions of people exposed in utero, was critical in the development of studies in this area.”

According to Bern’s colleague and friend Stacia A. Sower, a professor of biochemistry and molecular biology at the University of New Hampshire, Bern was “one of the truly great scientists I have known. He was a giant and one of the founding fathers in our field of comparative endocrinology and the founding father of the field of endocrine disruptors.”

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UC Merced researchers show burning of sugarcane fields prior to harvest can create more pollution that previously thought.

The burning of sugarcane fields prior to harvest for ethanol production can create air pollution that detracts from the biofuel’s overall sustainability, according to research published recently by a team of researchers led by scientists at the University of California, Merced.

UC Merced graduate student Chi-Chung Tsao was the lead author on the paper and was aided in the study by UC Merced professors Elliott Campbell and Yihsu Chen. The study — published online this week in the Nature Climate Change journal — focused on Brazil, the world’s top producer of sugarcane ethanol and a possible source for U.S. imports of the alternative fuel.

“There is a big strategic decision our country and others are making, in whether to develop a domestic biofuels industry or import relatively inexpensive biofuels from developing countries,” Campbell said. “Our study shows that importing biofuels could result in human health and environmental problems in the regions where they are cultivated.”

[Download a PDF of the study.]

Ethanol is seen as an alternative to fossil fuels, which emit greenhouse gasses when used and are a major contributor to air pollution and climate change. But despite some governments encouraging farmers to reduce field burning — which is done in part to protect farmworkers by removing sharp leaves and harmful animals — more than half of sugarcane croplands in Brazil continue to be burned.

That leads to a reduction in air quality that can offset the benefits of ethanol over petroleum fuels that emit more greenhouse gases during their use, something Campbell said the U.S. should consider when determining whether to import inexpensive ethanol from Brazil or continuing to invest in domestic corn ethanol production.

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UC Davis professor chaired IOM committee that examined the evidence.

Irva Hertz-Picciotto, UC Davis

A national panel chaired by Irva Hertz-Picciotto of UC Davis has determined that there is consistent scientific evidence that breast cancer risk can be reduced if women avoid unnecessary medical radiation and use of hormone therapy and if they maintain healthy lifestyles.

The findings were delivered in a report Wednesday by the Institute of Medicine (IOM) at the 2011 San Antonio Breast Cancer Symposium. The research, begun in May 2010, was conducted with a grant from Susan G. Komen for the Cure. The independent committee of experts was charged with assessing what is known, as well as what is not conclusive, about environmental risk factors for breast cancer.

The evidence also indicates a possible, though currently less clear, link to increased risk for breast cancer from exposure to benzene, 1,3-butadiene and ethylene oxide, which are chemicals found in some workplace settings and in gasoline fumes, vehicle exhaust and tobacco smoke.

The committee found that avoiding personal use of hair dyes and non-ionizing radiation emitted by mobile devices and other technologies likely will not impact a woman’s risk for breast cancer, as multiple studies have found no connection between these factors and the disease.

Because of insufficient or contradictory evidence, the committee determined that the scientific jury is still out on whether many chemicals of concern, including bisphenol A (BPA), pesticides, ingredients in cosmetics and dietary supplements, and other substances, alter the risk for breast cancer. Women may choose to minimize their exposure to some chemicals, but the committee found the research inadequate to draw conclusions about the potential benefit of such actions. Chemical ingredients in cosmetics, dietary supplements and other products undergo only very limited testing before they are put on the market, and the committee noted the value of efforts to help consumers become more aware of this issue.

According to the IOM, the steps identified in the report have the potential to reduce the risk for breast cancer among women in general, but the committee cautioned that the evidence on how much risk reduction any of these steps offers is inconclusive. Whether it is small or significant, the impact on individuals will vary considerably because women are exposed to a range of substances throughout their lives; in addition, biological, physical and genetic factors influence their individual chances for developing the disease.

“Breast cancer develops over many years, so we need better ways to study exposures throughout women’s lives, including when they are very young,” said Hertz-Picciotto, professor and chief of the Division of Environmental and Occupational Health with the UC Davis Department of Public Health Sciences. “We also need improved methods to test for agents that may be contributing to breast cancer risk and to explore the effects of combined exposures.”

She said, for example, that research is needed on the effects of exposures at specific stages of breast development, and on the cumulative effects of exposures at different life stages or multiple exposures.

An arm of the National Academies of Science, the IOM is an independent, nonprofit organization that works outside government to address pressing questions about health and health care and provide unbiased and authoritative advice to decision makers.

More information on the study is available at www.iom.edu/BreastCancerEnvironment.

New parenting book addresses full range of children’s respiratory issues.

Why do infants make snorting sounds during feedings? Is snoring normal in a toddler? Is it safe to give popcorn to a 2-year-old? How many colds a year are normal for a 5-year-old? Does air quality in the home affect a child’s respiratory system?

About 80 to 90 percent of children at one time or another experience breathing problems. In her new book, “Take a Deep Breath: Clear the Air for the Health of Your Child” (World Scientific Publishers), scheduled for publication in January 2012, Dr. Nina L. Shapiro, director of pediatric ear, nose and throat at Mattel Children’s Hospital UCLA and an associate professor of surgery at the David Geffen School of Medicine at UCLA, explains all the puzzling and oftentimes distressing breathing patterns children have throughout development.

“We all take for granted the silent ‘in and out’ breathing until a problem arises,” Shapiro said. “Based on my years of experience in treating tens of thousands children with breathing issues, I hope this guide will enlighten and empower parents on some of the most asked questions and concerns.”

“Take a Deep Breath” sheds new light on the latest research in pediatric breathing issues, sleep issues, airway safety and the truth behind “clean, green” home environments. Shapiro addresses what actually happens when a child breathes, and she guides readers through the uppermost part of the breathing apparatus (the nose), down to the lowermost part (the lungs).

Each of the book’s three age-based sections (newborn–3 months; 3 months–1 year; and 1 year–5 years) includes chapters that examine specific respiratory tract locations and potential problems for each age group and provides a “to-do” list offering successful preventions and treatments that can easily be done at home.

“‘Take A Deep Breath’ is a breath of fresh air for every parent and doctor who cares about children,” said Dr. Nancy L. Snyderman, chief medical editor for NBC News. ”Dr. Shapiro cuts through what we need to know and reassuringly tells us what we don’t need to worry about. A must-read for every parent and grandparent.”

For more information, visit www.drninashapiro.com. Advance copies of the book are available to the media; please contact Amy Albin at UCLA Health Sciences Media Relations at (310) 794-8672 or aalbin@mednet.ucla.edu.

UC Berkeley professor shines a light on human exposure to chemicals.

Brenda Eskenazi always had a thing for brains. By the age of 12, she was carving up cow and chicken brains to explore their anatomy. As a young woman at the 1969 Woodstock festival, surrounded by people on hallucinogens, she saw a man dive off a car headfirst into the concrete, thinking it was water. “Of course, at first, I was just horrified,” she recalls. “But then I remember walking back from Woodstock for miles in the rain, and wondering what happened to his brain? How had those chemicals distorted his brain?”

Eskenazi went on to study everything she could about the brain until she picked up the scent of a whole new field in the late 1970s – environmental health. At the time, many scientists thought “environmental factors” affecting human health involved things like social class and nutrition.

But Eskenazi put chemicals in the picture. In the 30 years of research that followed, she explored the impacts of everything from cigarette smoke, caffeine and chemotherapy to pesticides and flame retardants on brains, child development and reproductive health.

As a professor of public health at UC Berkeley, Eskenazi also spearheaded a study of 536 children born to farmworker families in the Salinas Valley between 2000 and 2001. Her research group began this long-term study during pregnancy and has been tracking development of the children ever since. In two recent papers, they found, for example, that children exposed to prenatal pesticides had lower IQs, and those exposed to flame retardants had lower birth weights.

Discussing her career trajectory, Eskenazi described some of the turning points and how she developed her passion for environmental health. Next year, this passion will take her to Africa to take part in one of the first studies of DDT exposure levels on the continent and its effects on human health.

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UC Riverside’s David Eastmond named fellow of the Collegium Ramazzini, a select group of health scholars.

David Eastmond, UC Riverside

Toxicologist David Eastmond at the University of California, Riverside, has been elected a fellow of the Collegium Ramazzini, an organization of international scholars who work towards solutions of occupational and environmental health problems around the world.

Founded as an independent, international academy in 1982 and headquartered in Carpi, Italy, the Collegium Ramazzini is comprised of a select group of no more than 180 fellows from about 40 different countries, each fellow being distinguished by his or her contributions to occupation and environmental health.

“I am very pleased and honored to be selected as a fellow of the Collegium Ramazzini, and look forward to working with this esteemed group,” said Eastmond, the chair of the Department of Cell Biology and Neuroscience.

The Collegium Ramazzini assesses present and future risks of injury and disease attributable to the workplace and the environment, and focuses on the identification of preventable risk factors. It transmits its views on these hazards and their prevention to policy-making bodies, authorities, agencies and the public. The Collegium Ramazzini also translates the policy implications of scientific findings to legislators, regulators and other decision makers.

Eastmond is the second faculty member at UC Riverside to be honored by the Collegium Ramazzini. In 2004, Carl Cranor, a professor of philosophy, was named a fellow of the prestigious academy.

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UC Berkeley study raises questions about trade-offs between human health, environmental conservation.

The red-tinted hair and bloated abdomens of these three young girls in Madagascar are typical signs of malnutrition.

A new study by researchers at the University of California, Berkeley, finds that consuming bushmeat had a positive effect on children’s nutrition, raising complex questions about the trade-offs between human health and environmental conservation.

They further estimated that a loss of access to wildlife as a source of food – either through stricter enforcement of conservation laws or depletion of resources – would lead to a 29 percent jump in the number of children suffering from anemia. Among children in the poorest households, the researchers added, there would be a three-fold increase in the incidence of anemia. Left untreated, anemia in children can impair growth and cognitive development.

The findings are to be published the week of Nov. 21 in the journal Proceedings of the National Academy of Sciences.

“When thinking of creating protected areas for diversity, policymakers need to take into consideration how that will impact local people, both in livelihoods and from a health perspective,” said study lead author Christopher Golden, who did the research while a graduate student in UC Berkeley’s Department of Environmental Science, Policy and Management and at the School of Public Health. “We need to find ways to benefit the local population in our conservation policies, not hurt them.”

Hundreds of millions of people worldwide consume bushmeat a key source of bio-available iron, particularly for those living in rural communities. But when the menu includes endangered species, the researchers said, human nutritional needs must contend with efforts to manage wildlife resources.

Because bio-available iron is primarily sourced from meat, the researchers hypothesized that increased consumption of wildlife would result in a reduced incidence of clinical anemia. They tested their theory by monitoring the diet and hemoglobin levels of 77 children every month for a year.

The children, all under 12 years old, lived in the Makira Protected Area of Madagascar, one of the most critical biodiversity hotspots in the world.  The Makira region is located in a remote part of eastern Madagascar, and its inhabitants rely heavily upon local wildlife – such as lemurs and bats – for food.

Children there who ate more bushmeat had higher levels of hemoglobin, an iron-containing protein in red blood cells, even after factoring in such variables as consumption of domesticated meat, household income, sex, age and nutritional and disease status, the researchers found.

Eating domesticated meat is prohibitively expensive for many households, while wildlife is free, the authors noted. They found that, among impoverished people, bushmeat accounted for up to 20 percent of overall meat consumption. While many of the wildlife species are illegal to hunt, enforcement in the protected areas can often be lax.

“It is clearly not environmentally sustainable for children to eat endangered animals, but in the context of remote, rural Madagascar, households don’t always have a choice,” said Lia Fernald, UC Berkeley associate professor in the School of Public Health, who worked with Golden to design the study. “In places where a diverse range of nutritious food is unavailable, children rely upon animal-source foods – milk, eggs and meat – for critical nutrients like fats, protein, zinc and iron. What we need for these children are interventions that can provide high-quality food sources that are not endangered.”

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Study raises concern that current clean-air standards may be inadequate to protect early childhood health.

Irva Hertz-Picciotto, UC Davis

A new international study conducted by researchers at UC Davis Health System and in the Czech Republic has found that exposure to ambient nitrogen oxides in air pollution may increase acute bronchitis episodes in children from birth to 4½ years.

The association between nitrogen oxides exposure and acute bronchitis was found to increase with age in the first two years. In other words, those between 1 and 2 years showed a stronger association compared to those younger than 1 year of age.

A similar trend was not observed in children between 2 and 4½ years of age, said study lead author Rakesh Ghosh, a postdoctoral researcher with the UC Davis Department of Public Health Sciences.

“Ambient nitrogen oxides exposure and early childhood respiratory illnesses” is published online this week in the journal Environmental International.

“Acute bronchitis is relatively common in preschool children,” said Irva Hertz-Picciotto, professor and chief, Division of Environmental and Occupational Health in the UC Davis Department of Public Health Sciences and the study’s principal investigator.

“We found an exposure of approximately 35 micrograms per cubic meter of nitrogen oxides increased incidence of acute bronchitis by about 30 percent,” Hertz-Picciotto said.

Acute bronchitis involves inflammation of the main airways to the lungs and often occurs after a viral infection. It causes cough, fatigue and low-grade fever, and may be followed by several weeks of a dry, nagging cough. About 20 percent of deaths in children under 5 years are due to acute lower-respiratory illness.

Nitrogen dioxide is known to be a deep lung irritant and is regulated by the U.S. Environmental Protection Agency (EPA). The standard is no more than 188 micrograms per cubic meter for any one-hour average and no more than 100 micrograms per cubic meter as an annual average.

The study was conducted in two districts in the Czech Republic, Teplice and Prachatice, where ambient levels of nitrogen oxides were regularly monitored. The mixture of gases, consisting mainly of nitrogen dioxide and nitric oxide, are pollutants that result from burning fossil fuels in industrial installations such as power plants and automobiles.

For the study, the researchers obtained monitored daily ambient nitrogen-oxide levels starting in May 1994 through June 2003. A total of 1,133 children were followed from birth up to 4½ years of age. The children’s respiratory health information was obtained from medical records and additional information was collected using maternal questionnaires.

The researchers also examined what fuels were used in the children’s homes for heating and cooking, i.e. gas, electricity or coal, and other potential exposures, such as second-hand cigarette smoke. The increased association found solely from air pollution persisted even after accounting for these other factors.

“Although our results are not directly comparable, because the current regulatory standards are for nitrogen dioxide and we investigated a mix of nitrogen oxides, the standards are much higher than the levels associated with increased incidence of respiratory illnesses in this study. This means that levels considered safe actually may pose a risk of elevated rates of respiratory disease in young children,” Hertz-Picciotto said.

Other study authors include Jesse Joad, associate dean of Diversity and Faculty Life at the UC Davis School of Medicine; Ivan Benes with the Institute of Hygiene in Teplice, Czech Republic; and Miroslav Dostal and Radim J. Sram, both with the Institute of Experimental Medicine, Academy of Sciences, the Czech Republic in Prague.

The study was funded by the Czech Ministry of the Environment.

The UC Davis School of Medicine is among the nation’s leading medical schools, recognized for its research and primary care programs. The school offers fully accredited master’s degree programs in public health and in informatics, and its combined M.D.-Ph.D. program is training the next generation of physician-scientists to conduct high-impact research and translate discoveries into better clinical care. Along with being a recognized leader in medical research, the school is committed to serving underserved communities and advancing rural health. For more information, visit UC Davis School of Medicine at medschool.ucdavis.edu.

Studies spotlight human health effects of exposure to smoke from open fires, dirty cookstoves.

An estimated 3 billion people in the world still cook with open fires and dirty cookstoves, including this mother in Guatemala.

Two new studies led by University of California, Berkeley, researchers spotlight the human health effects of exposure to smoke from open fires and dirty cookstoves, the primary source of cooking and heating for 43 percent, or some 3 billion members, of the world’s population. Women and young children in poverty are particularly vulnerable.

In the first study, the researchers found a dramatic one-third reduction in severe pneumonia diagnoses among children in homes with smoke-reducing chimneys on their cookstoves. The second study uncovered a surprising link between prenatal maternal exposure to woodsmoke and poorer performance in markers for IQ among school-aged children.

The findings on pneumonia, the chief cause of death for children five and under, will be published in the journal The Lancet on Thursday, Nov. 10, two days before World Pneumonia Day. While previous research has linked exposure to household cooking smoke to respiratory infections, the latest results come from the first-ever randomized controlled trial – the gold standard of scientific experiments – on air pollution.

“This study is critically important because it provides compelling evidence that reducing household woodsmoke exposure is a public health intervention that is likely on a par with vaccinations and nutrition supplements for reducing severe pneumonia, and is worth investing in,” said Kirk Smith, professor of global environmental health at UC Berkeley’s School of Public Health and principal investigator of the RESPIRE (Randomized Exposure Study of Pollution Indoors and Respiratory Effects) study.

“There is a huge burden of disease and death due to child pneumonia, and there aren’t a lot of good interventions out there,” added Dr. Arthur Reingold, a UC Berkeley professor of epidemiology and an internationally recognized expert on infectious diseases, who was not part of the RESPIRE trial. “Randomized controlled trials are frequently demanded by funding agencies and decision makers before they are willing to make substantial investments in new technologies or strategies, and this study provides the needed evidence of an intervention that works.”

In the RESPIRE study – which includes partners from Guatemala’s Universidad Del Valle, the U.S. Centers for Disease Control and Prevention, University of Liverpool, Norway’s University of Bergen and the World Health Organization – researchers worked with rural communities in the Western Highlands of Guatemala. Households with a pregnant woman or young infant were randomly assigned to either receive a woodstove with a chimney or to continue cooking with traditional open woodfires.

The researchers found that using chimneys to vent cooking smoke outside homes led to a more striking decrease in cases of severe pneumonia compared with total pneumonia cases, possibly because the reduction in smoke with the chimney stoves was insufficient to significantly reduce all risk.

“The amount of smoke exposure babies were getting from the open woodfire stoves is comparable to having them smoke three to five cigarettes a day,” said Smith, whose research in this field began 30 years ago. “The chimney stoves reduced that smoke exposure by half, on average.”

In all there were 265 children in the chimney-stove homes and 253 children in the control homes. During the study, the researchers reported 149 children in the chimney-stove homes and 180 in the open-fire homes with physician-diagnosed pneumonia. For severe pneumonia, characterized by low blood oxygenation, there were 72 cases in the chimney-stove group and 101 in the control group.

In the second study, published online Sept. 24 in the journal NeuroToxicology, Smith led the research team that followed up with some of the families in the RESPIRE trial, which officially ended in 2005 when the infants were 18 months old. In 2010, when the children were 6-7 years old, the researchers recruited 39 mother-child pairs for the study.

The results found, for the first time, a link between exposure to woodsmoke – as determined by carbon monoxide levels measured individually – during the third trimester of pregnancy and lower performance on neurodevelopmental tests when the children were ages 6 and 7. Specifically, the researchers found impairments in visuo-spatial perception and integration, visual-motor memory, and fine motor skills.

“I was surprised because woodsmoke was always considered a risk for respiratory health, but not IQ,” said study lead author Linda Dix-Cooper, who conducted the study for her master’s thesis in UC Berkeley’s Global Health and Environment graduate program. “The implications of our findings are highly worrisome. Neurodevelopmental impacts have societal costs, such as impacts on an individual’s future lifetime earnings and educational attainment.”

Dix-Cooper added that similar cognitive impacts among children have been noted in previous case reports of childhood acute carbon monoxide poisonings and in epidemiological investigations of other prenatal air pollutant exposures in developed countries’ urban centers. However, larger studies are needed to confirm the link with pollution from woodsmoke, she said.

The new studies come amid growing worldwide attention to the need for cleaner, more fuel-efficient cookstoves. Just last year, the United Nations Foundation launched the Global Alliance for Clean Cookstoves, an international public-private initiative championed by Secretary of State Hillary Clinton.

In addition to the health consequences of burning wood, charcoal, dung or crop residue for cooking and heating, the alliance noted that use of traditional cookstoves increases pressures on local natural resources, contributes to climate change and puts women in danger when they forage for fuel in conflict zones.

Finding cleaner alternatives to traditional cookstoves has been an area of active research at UC Berkeley and the Lawrence Berkeley National Laboratory (LBNL) for decades. Some current projects are part of the UC Berkeley-based Blum Center for Developing Economies. They include one led by Smith to replace unhealthy coal stoves in rural China through carbon offsets, and another led by Daniel Kammen, Class of 1935 Distinguished Professor of Energy at UC Berkeley, to develop cost-effective methods to disseminate improved cook stoves throughout Tanzania.

“The biggest collection of people working in the area of cookstoves in the world is at UC Berkeley and LBNL,” said Kammen, who co-authored a 2001 study linking smoke from cookstoves and health in Kenya that also appeared in The Lancet. “We are the center of this field in the academic community.” Kammen just returned to campus from a one-year stint as the first clean-energy czar at the World Bank, one of the biggest sources of funding for cookstove projects and technology

Funding for The Lancet study was provided by the U.S. National Institute of Environmental Health Sciences (NIEHS) and the World Health Organization. The NeuroToxicology study was supported by the Northern California Center for Occupational and Environmental Health, NIEHS and the Center for Environmental Research and Children’s Health at UC Berkeley.

Related information:

• Household Energy, Climate, and Health Project (School of Public Health project)
• Cutting greenhouse pollutants could directly save millions of lives worldwide (UC Berkeley press release)
• UC Berkeley, Princeton team demonstrates cheap way to reduce toll of respiratory illness from indoor cooking fires in Third World (UC Berkeley press release)
• Cookstoves, Climate Change & Health (Blum Center project)
• Fuel Efficient Stoves for Darfur Refugees (Blum Center project)
• Establishing Effective Cookstove Dissemination Strategies in Tanzania (Blum Center project)
• Ghana Cookstoves Feasibility Study (Blum Center project)

First evidence that long-range wind transport of an infectious agent might result in human disease.

Jane Burns, UC San Diego

Kawasaki disease (KD) is a severe childhood disease that many parents, even some doctors, mistake for an inconsequential viral infection. In fact, if not diagnosed or treated in time, it can lead to irreversible heart damage. After 50 years of research, including genetic studies, scientists have been unable to pinpoint the cause of the disease.

Now, surprising findings of an international team of scientists organized by Jane C. Burns, M.D., professor and chief, Division of Allergy, Immunology, and Rheumatology at the University of California, San Diego, School of Medicine’s Department of Pediatrics and Rady Children’s Hospital-San Diego, suggest that KD cases are linked to large-scale wind currents that track from Asia to Japan and also traverse the North Pacific.

“Our findings suggest an environmental trigger for Kawasaki disease that could be wind-borne,” Burns said. The paper will appear in Nature Scientific Reports on Nov. 10.

Signs of KD include prolonged fever associated with rash, red eyes, mouth, lips and tongue, and swollen hands and feet with peeling skin. The disease causes damage to the coronary arteries in a quarter of untreated children and may lead to serious heart problems in early adulthood. There is no diagnostic test for Kawasaki disease, and current treatment fails to prevent coronary artery damage in at least one in 10 to 20 children and death in one in 1,000 children.

While seasonality of the disease has been noted in many regions — particularly in Japan, the country of highest incidence for KD — the search for factors that might contribute to epidemics and fluctuations in KD occurrence has been elusive. A study of KD cases in Japan since 1970 showed three dramatic nationwide epidemics, each lasting several months and peaking in April 1979 (6,700 cases), May 1982 (16,100 cases) and March 1986 (14,700 cases). These three peaks represent the largest KD epidemic events ever recorded in the world.

To investigate a possible influence from large-scale environmental factors, researchers including Daniel R. Cayan, Climate Atmospheric Science and Physical Oceanography (CASPO) at Scripps Institution of Oceanography in La Jolla, and Xavier Rodo and Joan Ballester of the Institut Català de Ciències del Clima and the Institució Catalana de Recerca (IC3) in Barcelona, Spain, investigated a set of atmospheric and oceanographic measures, which revealed a link to pressure patterns and associated wind flow from the surface to mid-tropospheric atmospheric levels during the summer months prior to onset of the epidemics.

“The Japanese dataset revealed that a low number of KD cases were reported prior to the epidemics, a period coinciding with southerly winds which blew across Japan from the Pacific Ocean during the summer months,” said Rodo, the study’s first author. “However, the numbers rapidly mounted all over Japan when winds turned and blew in a southwesterly direction. After the peaks, the winds again shifted, blowing from the south when the number of cases again decreased.”

“Importantly, subsequent to the three epidemics, years with increased numbers of Kawasaki disease cases in Japan were significantly associated with enhanced local northwesterly winds, as a result of low pressure centered to the north,” said Cayan.

To assess whether such variations in wind patterns were associated with KD case fluctuations on the other side of the North Pacific, similar analyses were conducted for San Diego. According to the scientists, the atmospheric connection from continental Asia to Japan and San Diego is intermittent and can take different routes. However, it was possible from their analysis to identify the major anomalous yearly peaks of KD cases occurring in San Diego from 1994 to 2008 as belonging to two main atmospheric configurations.

In fact, the major fluctuations in KD case numbers in Japan, Hawaii and San Diego were linked to a seasonal shift in winds that exposed Japan to air masses from Central Asia. One key pattern simultaneously exposed Hawaii and California to air masses from the western North Pacific.

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Mathematical models can be used to characterize, quantify these effects.

Food supply and environmental conditions affect the growth rates of organisms, which in turn influence future survival and reproduction. A new study by researchers at the University of California, Santa Cruz, and the University of Glasgow shows how mathematical models can be used to characterize and quantify these effects.

“Over the last fifteen years, we have recognized that events early in the life of organisms, including people, can have great consequences for health in later life,” said Marc Mangel, distinguished professor of applied mathematics and statistics in the Baskin School of Engineering at UCSC and senior author of the study, published in the journal American Naturalist.

The paper describes complex patterns of feeding, growth rates, and reproductive success in fish. First author Who-Seung Lee worked on the study as an associate specialist at UC Santa Cruz and a graduate student at the University of Glasgow. He is currently a postdoctoral researcher at the University of Quebec in Montreal.

The researchers investigated the optimal rates of growth under different environmental conditions for fish and other “cold-blooded” animals (known as ectotherms). In these animals, growth is sensitive to ambient temperature even when food is not limiting. Compensatory growth can make up for a period of slow growth early in life, resulting in normal adult size, but the costs of an accelerated growth rate can reduce fitness. Costs may include increased exposure to predators due to more active foraging behavior, as well as increased accumulation of biomolecular damage during periods of higher metabolic rates.

“One expected consequence of climate change is that fish will experience growth conditions quite different from the ones in which they evolved. Our work suggests that even if it appears that a fish has ‘caught up’ when a period of poor growth is followed by one of good growth, there may be unforeseen consequences for its survival and reproduction, and our work provides a framework for assessing these consequences,” said Mangel, who directs the Center for Stock Assessment Research (CSTAR), a collaboration between UCSC and NOAA Fisheries Service labs.

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