# Marietta Community Actively Researching Exposure Study (CARES)

Erin N. Haynes, DrPH , MS Assistant Professor Division of Epidemiology and Biostatistics College of Medicine University of Cincinnati 513

- 558

- 5327 Erin.Haynes@uc.edu www.eh.uc.edu/cares

# Acknowledgements University of Cincinnati

Kim Dietrich, PhD Amit Bhattacharya, PhD Paul Succop, PhD Tina Reponen, PhD Pat Ryan, PhD, CCHMC

Staff Cyndy Cox Jody Alden Pierce Kuhnell Megan Parin

Students Pam Heckel, PhD Fedoria Rugless Funding: 

### Marietta CARES funding is provided by the National Institute of Environmental Health Science ( 1R01 ES016531

- 01). Marietta College Mary Barnas, PhD David Brown, PhD

Clinic Team: Ashley Schaad Philip LeMaster Mark Jackson Andy Guimond Kristin Lutes Home Sampling Team: John St. Marie Velvet Tranchina Russelita Young Derek Hennen Callie Lyons Diana Hackenberg Anthony Derotto Ryan Ellis Corin Bonnett 

### Marietta, & Cambridge, Communities Caroline Beidler, Marietta Arthur Wittberg, PhD Marietta Dawn Wittberg, Marietta Rusty Roberts, Cambridge



### Community Advisory BoardMarietta, OH/Parkersburg, WV N = 300 Cambridge, OH N = 100

Home Environmental Sampling

- Interior Dust

- Exterior Dust

- Water Ambient Air Sampling

- PM 2.5 6 days/week

- 4 weeks/season

Personal Air Sampling N = 40

Neuropsychological Assessment

- Child IQ (WISC

- IV)

- BASC

- 2

- CVLT

- C

- Standardized Achievement Test

Neuromotor Assessment

- Grooved Pegboard

- Fingertapping

- Postural Balance Home Environmental Sampling

- Interior Dust

- Exterior Dust

- Water
Ambient Air Sampling

- PM 2.5 6 days/week

- 1 week/season

Neuropsychological Assessment

- Child IQ

- BASC

- 2

- CVLT

- C

- Standardized Achievement Test

Neuromotor Assessment

- Grooved Pegboard

- Fingertapping

- Postural Balance Biological Measures Whole Blood: Pb, Mn, Cd, Hg Serum : Fe, transferrin and whole blood CBC; Hair : Mn; Toot h: Mn (prenatal and postnatal) Toe NailsExposure AssessmentBiomarkers Study Cohort 7

- 9 year old children

N = 400Health Assessment

## Harvard

- type PM2.5 impactor

– Marietta :

• 6 days/week every week

• 2 years

• 271 total samples



### – Cambridge :

• 6 days/week 1 week/season

• 2 years

• 25 total samples 

# Stationary Air SamplingCambridge Air SamplingCambridge Air Sampling Marietta Air SamplingCambridge Air Sampling Marietta Air Sampling 

## Mn Air Concentration ( ng /m 3 

## )

Mean (SD) Range

Marietta 

# 18.13 (18.73) <DL

- 102.99

Cambridge 

# 4.26 ( 3.56) <DL

- 15.01Cambridge Air Sampling Marietta Air Sampling 

## Mn Air Concentration ( ng /m 3 

## ) Mean

(SD) Range

Marietta 

# 18.13 (18.73) <DL

- 102.99

Cambridge 

# 4.26 ( 3.56) <DL

- 15.01

0 100,000 200,000 300,000 400,000 500,000 600,000 700,0001999200020012002200320042005200620072008200920102011

# Personal Air Sampling

• Recruited from CARES participants from non

- smoking households

• Personal Modular Impactor , PM 2.5 

### sampler worn/nearby for 48hr.

• 38 children have complete data

• Conducted over two Spring seasonsHaynes et al., Sci of Total Environ 2010 • 90% of the child’s time was spent either at Home (70%) or School (20%)

TWD= ( Time@Home *Distance) + (Time @School*Distance) Total Sampling Time

## Stationary Air Mn , TWD , and Wind Speed were Significantly Associated with Personal Air Mn Concentration

Variable Parameter Estimate t
- value 95% C.I. p - value Intercept 2.84 2.07 0.04

– 5.64 0.05 Log Stationary Mn ( ng /m3) 0.51 0.24 0.3

– 0.99 0.04* Time Weighted Distance (km)

- 0.075

- 2.45 - 0.13

- - 0.01 0.02* Wind Index

- 0.32

- 0.85 - 1.07

– 0.44 0.40 Wind Speed (km/hr)

- 0.44

- 2.21 - 0.18

- - 0.01 0.03* Average Precipitation (cm)

- 0.44

- 1.73 - 0.96

– 0.08 0.09 Age

- 0.004

- 0.02 - 0.35

– 0.34 0.98 Gender

- 0.03

- 0.11 - 0.58

– 0.52 0.91

# Personal Air Mn Concentration was slightly related to Blood Mn Concentration, but this relationship was not statistically significant

0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 Log personal air Mn (ng/cubic meter) 5 7 9 11 13 15Blood Mn (microg/L)

### Quantifying Postural Balance/Sway

Model ACS

- 110, Advanced Mechanical Technology Inc. (AMTI), Watertown, MA Mean Sway Length (SL)



### Center of Pressure Total distance traveled by Center of Pressure

Area enclosed inside the perimeter outlined by the C of P movement pattern

Total distance traveled by Center of Pressure

Mean Sway Area (SA)Control Eyes Open Firm Surface

-3.5 -2.5 -1.5 -0.5 0.5 1.5 2.5 3.5

-3.5 -2.5 -1.5 -0.5 0.5 1.5 2.5 3.5 

# Stabilogram

## Postural Balance is Sensitive Measure for Motor Function

• Exclusion Criteria :

• Consumption of alcohol in last 24 hours

• History of....

– Meniere’s disease

– Multiple sclerosis

– Parkinson’s disease

– Legal Blindness

– Stroke

– Seizures

– Ear Infection within 2 weeks of testing



## • Difficulty standing unaided for at least 1 minute

• Pain and discomfort from standing 3 minutes

## Stabilograms of Study Participants Control Eyes Open Firm Surface

-3.5 -2.5 -1.5 -0.5 0.5 1.5 2.5 3.5

-3.5 -2.5 -1.5 -0.5 0.5 1.5 2.5 3.5

Marietta Subject Eye Open Firm Surface

-3.5 -2.5 -1.5 -0.5 0.5 1.5 2.5 3.5

-3.5 -2.5 -1.5 -0.5 0.5 1.5 2.5 3.5 

## Eyes Open on Firm Surface

# Residential Location of Pilot Study Balance Participants with 2006 Mn AERMOD Concentrations

# TRI Mn Emissions from EMI

0 100,000 200,000 300,000 400,000 500,000 600,000 700,000

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

# CARES Preliminary Results, Unpublished

# Standardized Achievement Test Scores Decrease 10

- 16 points for ever log Mn Hair Increase

# Postural Balance Assessment in CARES

Bhattacharya, A. et al. Neurotoxicology and Teratology. (2006). Bhattacharya, A. et al. Environmental Health Perspectives. (1990).

# Hair Mn is Significantly Associated with Nearly Every Balance Testing Condition

# CARES Marietta Balance Participants Residential Locations With Respect to AERMOD 2006

0 100,000 200,000 300,000 400,000 500,000 600,000 700,0001999200020012002200320042005200620072008200920102011