TY - JOUR
T1 - Health impacts of perchlorate and pesticide exposure
T2 - Protocol for community-engaged research to evaluate environmental toxicants in a US border community
AU - Trotter, Robert
AU - Baldwin, Julie
AU - Buck, Charles Loren
AU - Remiker, Mark
AU - Aguirre, Amanda
AU - Milner, Trudie
AU - Torres, Emma
AU - von Hippel, Frank Arthur
N1 - Funding Information:
We would like to acknowledge the collaboration and continuing participation of the Regional Center for Border Health, Inc., Campesinos sin Fronteras, and the Yuma Regional Medical Center. Their counsel, assistance in data collection, and advocacy have been invaluable for the project. The authors would also like to thank Dr. Francisco Villa, Professor of Biological Sciences at Northern Arizona University, Yuma, and his students Ashley Menard, Kevin Hurtado, and Melissa Cabrera Bernal for their assistance with study coordination; Joseph Espinoza for his help with medical record audits; and Danielle Dillion, Jonathan Credo, and Amy Chandos for laboratory analyses. This study was funded by The Flinn Foundation (grant numbers 2102 and 2187), 1802 N. Central Avenue, Phoenix AZ 85004-1506; Center for Health Equity Research, Northern Arizona University; and Southwest Health Equity Research Collaborative (National Institutes of Health grant U54MD012388).
Publisher Copyright:
©Robert Trotter II, Julie Baldwin, Charles Loren Buck, Mark Remiker, Amanda Aguirre, Trudie Milner, Emma Torres, Frank Arthur von Hippel.
PY - 2021/8
Y1 - 2021/8
N2 - Background: The Northern Arizona University (NAU) Center for Health Equity Research (CHER) is conducting community-engaged health research involving “environmental scans” in Yuma County in collaboration with community health stakeholders, including the Yuma Regional Medical Center (YRMC), Regional Center for Border Health, Inc. (RCBH), Campesinos Sin Fronteras (CSF), Yuma County Public Health District, and government agencies and nongovernmental organizations (NGOs) working on border health issues. The purpose of these efforts is to address community-generated environmental health hazards identified through ongoing coalitions among NAU, and local health care and research institutions. Objective: We are undertaking joint community/university efforts to examine human exposures to perchlorate and agricultural pesticides. This project also includes the parallel development of a new animal model for investigating the mechanisms of toxicity following a “one health” approach. The ultimate goal of this community-engaged effort is to develop interventions to reduce exposures and health impacts of contaminants in Yuma populations. Methods: All participants completed the informed consent process, which included information on the purpose of the study, a request for access to health histories and medical records, and interviews. The interview included questions related to (1) demographics, (2) social determinants of health, (3) health screening, (4) occupational and environmental exposures to perchlorate and pesticides, and (5) access to health services. Each participant provided a hair sample for quantifying the metals used in pesticides, urine sample for perchlorate quantification, and blood sample for endocrine assays. Modeling will examine the relationships between the concentrations of contaminants and hormones, demographics and social determinants of health, and health status of the study population, including health markers known to be impacted by perchlorate and pesticides. Results: We recruited 323 adults residing in Yuma County during a 1-year pilot/feasibility study. Among these, 147 residents were patients from either YRMC or RCBH with a primary diagnosis of thyroid disease, including hyperthyroidism, hypothyroidism, thyroid cancer, or goiter. The remaining 176 participants were from the general population but with no history of thyroid disorder. The pilot study confirmed the feasibility of using the identified community-engaged protocol to recruit, consent, and collect data from a difficult-to-access, vulnerable population. The demographics of the pilot study population and positive feedback on the success of the community-engaged approach indicate that the project can be scaled up to a broader study with replicable population health findings. Conclusions: Using a community-engaged approach, the research protocol provided substantial evidence regarding the effectiveness of designing and implementing culturally relevant recruitment and dissemination processes that combine laboratory findings and public health information. Future findings will elucidate the mechanisms of toxicity and the population health effects of the contaminants of concern, as well as provide a new animal model to develop precision medicine capabilities for the population. International Registered Report Identifier (IRRID): DERR1-10.2196/15864.
AB - Background: The Northern Arizona University (NAU) Center for Health Equity Research (CHER) is conducting community-engaged health research involving “environmental scans” in Yuma County in collaboration with community health stakeholders, including the Yuma Regional Medical Center (YRMC), Regional Center for Border Health, Inc. (RCBH), Campesinos Sin Fronteras (CSF), Yuma County Public Health District, and government agencies and nongovernmental organizations (NGOs) working on border health issues. The purpose of these efforts is to address community-generated environmental health hazards identified through ongoing coalitions among NAU, and local health care and research institutions. Objective: We are undertaking joint community/university efforts to examine human exposures to perchlorate and agricultural pesticides. This project also includes the parallel development of a new animal model for investigating the mechanisms of toxicity following a “one health” approach. The ultimate goal of this community-engaged effort is to develop interventions to reduce exposures and health impacts of contaminants in Yuma populations. Methods: All participants completed the informed consent process, which included information on the purpose of the study, a request for access to health histories and medical records, and interviews. The interview included questions related to (1) demographics, (2) social determinants of health, (3) health screening, (4) occupational and environmental exposures to perchlorate and pesticides, and (5) access to health services. Each participant provided a hair sample for quantifying the metals used in pesticides, urine sample for perchlorate quantification, and blood sample for endocrine assays. Modeling will examine the relationships between the concentrations of contaminants and hormones, demographics and social determinants of health, and health status of the study population, including health markers known to be impacted by perchlorate and pesticides. Results: We recruited 323 adults residing in Yuma County during a 1-year pilot/feasibility study. Among these, 147 residents were patients from either YRMC or RCBH with a primary diagnosis of thyroid disease, including hyperthyroidism, hypothyroidism, thyroid cancer, or goiter. The remaining 176 participants were from the general population but with no history of thyroid disorder. The pilot study confirmed the feasibility of using the identified community-engaged protocol to recruit, consent, and collect data from a difficult-to-access, vulnerable population. The demographics of the pilot study population and positive feedback on the success of the community-engaged approach indicate that the project can be scaled up to a broader study with replicable population health findings. Conclusions: Using a community-engaged approach, the research protocol provided substantial evidence regarding the effectiveness of designing and implementing culturally relevant recruitment and dissemination processes that combine laboratory findings and public health information. Future findings will elucidate the mechanisms of toxicity and the population health effects of the contaminants of concern, as well as provide a new animal model to develop precision medicine capabilities for the population. International Registered Report Identifier (IRRID): DERR1-10.2196/15864.
KW - Community-engaged research
KW - Endocrine disruption
KW - Environmental contaminants
KW - Health disparities
KW - Perchlorates
KW - Pesticides
KW - Population health
KW - Thyroid disease
KW - Toxic metal contamination
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U2 - 10.2196/15864
DO - 10.2196/15864
M3 - Article
AN - SCOPUS:85112691384
SN - 1929-0748
VL - 10
JO - JMIR Research Protocols
JF - JMIR Research Protocols
IS - 8
M1 - e15864
ER -