In cooperation with the UMDNJ-New
Jersey Medical School, the Division has continued to participate
in the analysis of data from the $30 million Treatment of Lead-exposed
Children (TLC) study. The principal results of this multicenter, randomized
trial of succimer chelation therapy in young, lead-exposed children
were published in the New England Journal of Medicine (New Engl J Med.
1421-1426. 2001). Unfortunately, chelation provided no benefit on cognitive
and behavioral test results three years later when the children were
4-5 years old. Blood lead levels fell immediately in the chelated group
and more slowly in the control group, but the levels in the two groups
were indistinguishable within six months of the cessation of therapy.
Two hundred and seven children have been enrolled in New Jersey, contributing
to a total of 780 children from all the clinical centers combined. Dr.
Rhoads serves as Chair of the National Steering Committee for the
project. Further follow-up of these carefully studied children (to age
seven years) is under way with funding from the National
Institute of Environmental Health Sciences.
Dr. Rhoads is collaborating
with Jim
Zhang, Ph.D. and Paul
Lioy, Ph.D. of the Exposure
Measurement and Assessment Division, on a randomized field trial
of various methods of cleaning up lead-contaminated dust in urban homes
as well as different methods of assessing dust levels. The hypothesis
being tested is to determine whether simpler methods of household cleaning
will work as well as the combination of the special vacuum cleaners
and more chemically active cleaning agents that are currently recommended.
The study team completed enrollment of 127 houses in the year 2000.
There was no systematic advantage of the special vacuum cleaners and
cleaning agents on hard surfaces. Results for carpets are currently
being analyzed. A related project, funded by the U.S. Environmental
Protection Agency to determine whether simple methods will also work
well for cleaning up contaminated dust generated by removal of lead-based
paint is in the field.
Increases in mortality from
prostate cancer over the past two decades have suggested that environmental
influences may be contributing to this disease. For unknown reasons
these increases have recently leveled off and decreased slightly. This
could reflect a diminished exposure to an unidentified carcinogen or
tumor promoter or it could be due to more effective control through
screening. In order to test the latter hypothesis, Division members
have mounted a large case-control study of prostate specific antigens
(PSA) screening among prostate cancer decedents and healthy, age-matched
male controls. The hypothesis is that if PSA screening is effective
and accounts for the mortality reduction, it should be possible to show
that men dying of this disease were less likely to have been screened
than other men. The study is being funded by the National Cancer Institute.
So far approximately, 400 cases and 250 controls have been recruited.
Joanna
Burger, Ph.D. has been examining fish consumption and advisory information
issued by governmental authorities at two sites: Newark-Bay Complex
and in the Savannah River, in South Carolina. This has involved understanding
attitudes and perceptions about fish consumption and advisories, and
determining fish consumption rates and contaminants in the fish consumed.
In both cases it is an equity issue in that in South Carolina African
Americans consume far more fish than whites, and in Newark Bay, Hispanics
and other minorities are consuming large quantities of fish. In addition,
in Newark Bay, Dr. Burger has been interviewing anglers to determine
the reasons they fish. The initiatve is aimed at generating potential
intervention - in the quantities, parts of fish, and types of different
species of fish consumed.
This past year, Daniel
Wartenberg, Ph.D. has been examining risk assessment methodology
and its impact on policy and risk management. Most recently, he has
been studying limitations of Monte Carlo simulations in risk assessment
and the implications it has on policy. His work in more traditional
epidemiology includes field studies, reanalysis of data from studies
conducted by other researchers, development of new methods and reviews
of the literature. Recently, he completed an original analysis of data
from the American Cancer Society looking at passive smoking and breast
cancer mortality, and a cohort mortality study of workers at the Savannah
River Site nuclear fuels production facility. Currently, he is initiating
new work in the area of spatial epidemiology, and the geographic distribution
of risk factors and disease. This includes emphasis on disease clusters,
disease mapping, the use of spatial interpolation algorithms for exposure
assessment, and innovative applications of geographic information systems
(GIS) to epidemiology.
Joe
Shih, Ph.D. has made considerable progress this year in augmenting
the availability of statistical consultation in the Institute. He has
recruited two new statisticians to the campus and has developed a biostatistical
consulting service. In addition, he has personally consulted with a
number of Institute investigators on the statistical analyses of their
work.
Ronald
Cody, Ph.D. has continued to provide statistical consultation to
a number of Institute members during the year. In collaboration with
Clifford
Weisel, Ph.D., from the Exposure Measurement and Assessment Division
he has been investigating the association of ozone and other irritants,
along with environmental factors such as temperature, on the incidence
of asthma. A new study is underway, using both visits to hospital emergency
rooms and hospital admissions for asthma as outcome variables.