March 9, 2022
Jacob Simmering, Ph.D., University of Iowa
Abstract: Despite being a common cause of abdominal pain and surgery, the risk factors for acute appendicitis are poorly understood. Notably, there are more causes of acute appendicitis in the summer months. One possible cause of this observed seasonality may be changes in recent temperature with higher risk during warmer periods. Using health insurance claims data for a national-scale cohort using the Truven Health Analytics Marketscan database, Simmering and fellow researchers estimated daily incidence of acute appendicitis in roughly 400 cities across the United States. After adjustment for age, sex, day-of-week, year, and city, they found warmer weather was associated with an increased incidence of appendicitis with the incidence increasing by 1.2 to 3.0 percent per 10 degree increase in prior week temperature. As a sensitivity analysis, they repeated their analysis using expected temperature and whether the observed temperature was warmer or cooler than typical for that city at that time of year. Compared to times following normal temperatures, a week that was 5 degrees warmer than expected had a nearly 5% increase in incidence of acute appendicitis. The strong relationship with the deviations of temperature strongly suggests a causal relationship between temperature and appendicitis risk exists. Such a relationship is biologically plausible: lower fluid intake is a known risk factor for acute appendicitis. This work suggests a broader category of diseases that may have increased incidence and geographic range with expected changes in average temperature over the next century.
EHS Core Center Affiliation: University of Iowa, EHSR Center
Melissa Furlong, Ph.D., University of Arizona
Abstract: Integrating big data tools such as -OMICs approaches, electronic health records, and statewide exposure databases, into epidemiological pesticide research can transform the discovery pipeline for pesticide-associated health outcomes. Pesticides are engineered to interfere with basic biological mechanisms with major downstream health effects, and the known or suspected health effects likely represent only the tip of an iceberg. Several challenges have contributed to limiting advances in this area. Examples of such challenges include:
- Traditional epidemiologic approaches tend to rely on single exposure/single outcome approaches.
- Cohort studies are generally underpowered to assess the relationship of pesticides with rare diseases.
- Pesticide exposure assessment relies mainly on biomarkers, which are prohibitively expensive for massive cohort studies.
Furlong aims to address these challenges by developing novel paradigms that can rapidly expand targeted avenues for pesticide research, using a confluence of databases and health research initiatives at University of Arizona and University of California, Los Angeles. Furlong will present results from her studies on differential methylation of emerging pesticide classes (pyrethroids and neonicotinoids) and discuss their exploratory potential to highlight novel pesticide-associated biological pathways (e.g., WNT signaling, metabolism, & autophagy and lysosomal pathways) and health outcomes (e.g., Alzheimer’s, Schizophrenia, diabetes, several cancers) for targeted focus in future studies. These future studies require sufficiently-powered health outcomes databases, and concomitant advances in inexpensive pesticide exposure assessment. Thus, at University of Arizona, Furlong is linking 25 years of a statewide geospatial agricultural pesticide use registry with health outcomes from birth certificates and Medicaid records. To enhance exposure assessment, Furlong is developing a statewide pesticide dispersion model in CALPUFF, using daily pesticide applications as area sources of pollution. Furlong will present initial results and implications from this research and conclude with a discussion of how the use of emerging technologies can rapidly advance health outcomes research in environmental health sciences.
EHS Core Center Affiliation: University of Arizona, SWEHS Center