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America in the world : a history in documents from the War with Spain to the War on Terror
\"How should America wield its enormous power beyond its borders? Should it adhere to grand principles or act on narrow self-interest? Should it partner with other nations or avoid entangling alliances? Americans have been grappling with questions like these throughout the nation's history, and especially since the emergence of the United States as a major world power in the late nineteenth century. America in the World illuminates this history by capturing the diverse voices and viewpoints of some of the most colorful and eloquent people who participated in these momentous debates.Spanning the era from the Gilded Age to the Obama years, this unique reader collects more than two hundred documents--everything from presidential addresses and diplomatic cables to political cartoons and song lyrics. It encompasses various phases of American diplomatic history that are typically treated separately, such as the First World War, the Cold War, and 9/11. The book presents the perspectives of elite policymakers--presidents, secretaries of state, generals, and diplomats--alongside those of other kinds of Americans, such as newspaper columnists, clergymen, songwriters, poets, and novelists. It also features numerous documents from other countries, illustrating how foreigners viewed America's role in the world.Ideal for classroom use, America in the World sheds light on the complex interplay of political, economic, ideological, and cultural factors underlying the exercise of American power on the global stage\"-- Provided by publisher.
Book
Blood acetylcholinesterase and butyrylcholinesterase as biomarkers of cholinesterase depression among pesticide handlers
Objective Agricultural pesticide handlers are at an elevated risk for overexposure to organophosphate (OP) pesticides, but symptoms can be difficult to recognise, making biomarkers invaluable for diagnosis. Occupational monitoring programmes for cholinesterase depression generally rely on measuring activity of either of the two common blood cholinesterases which serve as proxy measurements for nervous-system acetylcholinesterase activity: red blood cell acetylcholinesterase (AChE) and plasma butyrylcholinesterase (BChE). These biomarkers, however, may be affected differentially by some OPs and the relationship between them has not been well characterised. We aim to determine the association between blood AChE and BChE activity levels and assess whether they produce comparable classifications of clinical cholinesterase depression among OP pesticide handlers. Methods Using blood samples from 215 participants of the Washington State Cholinesterase Monitoring Program, we quantified changes in AChE and BChE activity from before and after exposure to OP pesticides and calculated Pearson correlation statistics for correlation of AChE and BChE changes in activity, as well as weighted κ statistics for agreement of classification of clinical cholinesterase depression based on AChE versus BChE measurements. Results AChE and BChE activity measurements are weakly negatively correlated in our study population. Reaching a clinical threshold for diagnosis of cholinesterase depression based on the AChE marker did not correlate with reaching clinical depression based on the BChE marker. Conclusions Both AChE and BChE should be measured in monitoring programmes because they may both give potentially important but disparate classifications of clinical cholinesterase depression.
Journal Article
Pesticide use and risk of end-stage renal disease among licensed pesticide applicators in the Agricultural Health Study
ObjectivesExperimental studies suggest a relationship between pesticide exposure and renal impairment, but epidemiological evidence is limited. We evaluated the association between exposure to 39 specific pesticides and end-stage renal disease (ESRD) incidence in the Agricultural Health Study, a prospective cohort study of licensed pesticide applicators in Iowa and North Carolina.MethodsVia linkage to the US Renal Data System, we identified 320 ESRD cases diagnosed between enrolment (1993–1997) and December 2011 among 55 580 male licensed pesticide applicators. Participants provided information on use of pesticides via self-administered questionnaires. Lifetime pesticide use was defined as the product of duration and frequency of use and then modified by an intensity factor to account for differences in pesticide application practices. Cox proportional hazards models, adjusted for age and state, were used to estimate associations between ESRD and: (1) ordinal categories of intensity-weighted lifetime use of 39 pesticides, (2) poisoning and high-level pesticide exposures and (3) pesticide exposure resulting in a medical visit or hospitalisation.ResultsPositive exposure-response trends were observed for the herbicides alachlor, atrazine, metolachlor, paraquat, and pendimethalin, and the insecticide permethrin. More than one medical visit due to pesticide use (HR=2.13; 95% CI 1.17 to 3.89) and hospitalisation due to pesticide use (HR=3.05; 95% CI 1.67 to 5.58) were significantly associated with ESRD.ConclusionsOur findings support an association between ESRD and chronic exposure to specific pesticides, and suggest pesticide exposures resulting in medical visits may increase the risk of ESRD.Clinical trial registrationClinicaltrials.gov NCT00352924.
Journal Article
Associations between Personal Care Product Use Patterns and Breast Cancer Risk among White and Black Women in the Sister Study
Many personal care products include chemicals that might act as endocrine disruptors and thus increase the risk of breast cancer.
We examined the association between usage patterns of beauty, hair, and skin-related personal care products and breast cancer incidence in the Sister Study, a national prospective cohort study (enrollment 2003-2009).
Non-Hispanic black (4,452) and white women (n=42,453) were examined separately using latent class analysis (LCA) to identify groups of individuals with similar patterns of self-reported product use in three categories (beauty, skin, hair). Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between product use and breast cancer incidence.
A total of 2,326 women developed breast cancer during follow-up (average follow-up=5.4y). Among black women, none of the latent class hazard ratios was elevated, but there were <100 cases in any category, limiting power. Among white women, those classified as \"moderate\" and \"frequent\" users of beauty products had increased risk of breast cancer relative to \"infrequent\" users [HR=1.13 (95% CI: 1.00, 1.27) and HR=1.15 (95% CI: 1.02, 1.30), respectively]. Frequent users of skincare products also had increased risk of breast cancer relative to infrequent users [HR=1.13 (95% CI: 1.00, 1.29)]. None of the hair product classes was associated with increased breast cancer risk. The associations with beauty and skin products were stronger in postmenopausal women than in premenopausal women, but not significantly so.
This work generates novel hypotheses about personal care product use and breast cancer risk. Whether these results are due to specific chemicals or to other correlated behaviors needs to be evaluated. https://doi.org/10.1289/EHP1480.
Journal Article
Predictors and Variability of Repeat Measurements of Urinary Phenols and Parabens in a Cohort of Shanghai Women and Men
Exposure to certain phenols is ubiquitous because of their use in many consumer and personal care products. However, predictors of exposure have not been well characterized in most populations.
We sought to identify predictors of exposure and to assess the reproducibility of phenol concentrations across serial spot urine samples among Chinese adults.
We measured 2,4-dichlorophenol, 2,5-dichlorophenol, butyl paraben, methyl paraben, propyl paraben, benzophenone-3, bisphenol A, and triclosan in urine collected during 1997-2006 from 50 participants of the Shanghai Women's Health Study cohort and during 2002-2006 from 50 participants of the Shanghai Men's Health Study cohort. We investigated predictors of concentrations using the Satterthwaite t-test, and assessed reproducibility among serial samples using intraclass correlation coefficients (ICCs) and Spearman correlation coefficients (SCCs).
Creatinine-corrected phenol concentrations were generally higher among women than men. Participants who had taken medicine within the previous 24 hr had higher concentrations of propyl paraben. Cigarette smoking was associated with lower concentrations of propyl and methyl parabens among men. Bottled water consumption was associated with higher bisphenol A, 2,4-dichlorophenol, and 2,5-dichlorophenol concentrations among women. Among men, reproducibility across serial samples was moderate for 2,4-dichlorophenol and 2,5-dichlorophenol (ICC = 0.54-0.60, SCC = 0.43-0.56), but lower for other analytes (ICC = 0.20-0.29). Reproducibility among women was low (ICC = 0.13-0.39), but increased when restricted to morning-only urine samples.
Among these 100 Shanghai residents, urinary phenol concentrations varied by sex, smoking, and consumption of bottled water. Our results suggest that a single urine sample may be adequate for ranking exposure to the precursors of 2,4-dichlorophenol and 2,5-dichlorophenol among men and, under certain circumstances, among women.
Journal Article
The GuLF STUDY: A Prospective Study of Persons Involved in the Deepwater Horizon Oil Spill Response and Clean-Up
The 2010
disaster led to the largest ever marine oil spill. Individuals who worked on the spill were exposed to toxicants and stressors that could lead to adverse effects.
The GuLF STUDY was designed to investigate relationships between oil spill exposures and multiple potential physical and mental health effects.
Participants were recruited by telephone from lists of individuals who worked on the oil spill response and clean-up or received safety training. Enrollment interviews between 2011 and 2013 collected information about spill-related activities, demographics, lifestyle, and health. Exposure measurements taken during the oil spill were used with questionnaire responses to characterize oil exposures of participants. Participants from Gulf states completed a home visit in which biological and environmental samples, anthropometric and clinical measurements, and additional health and lifestyle information were collected. Participants are being followed for changes in health status.
Thirty-two thousand six hundred eight individuals enrolled in the cohort, and 11,193 completed a home visit. Most were young (56.2% ≤ 45 years of age), male (80.8%), lived in a Gulf state (82.3%), and worked at least 1 day on the oil spill (76.5%). Workers were involved in response (18.0%), support operations (17.5%), clean-up on water (17.4%) or land (14.6%), decontamination (14.3%), and administrative support (18.3%). Using an ordinal job exposure matrix, 45% had maximum daily total hydrocarbon exposure levels ≥ 1.0 ppm.
The GuLF STUDY provides a unique opportunity to study potential adverse health effects from the
oil spill.
Journal Article
Insecticide Use and Breast Cancer Risk among Farmers’ Wives in the Agricultural Health Study
Some epidemiologic and laboratory studies suggest that insecticides are related to increased breast cancer risk, but the evidence is inconsistent. Women engaged in agricultural work or who reside in agricultural areas may experience appreciable exposures to a wide range of insecticides.
We examined associations between insecticide use and breast cancer incidence among wives of pesticide applicators (farmers) in the prospective Agricultural Health Study.
Farmers and their wives provided information on insecticide use, demographics, and reproductive history at enrollment in 1993-1997 and in 5-y follow-up interviews. Cancer incidence was determined via cancer registries. Among 30,594 wives with no history of breast cancer before enrollment, we examined breast cancer risk in relation to the women's and their husbands' insecticide use using Cox proportional hazards regression to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).
During an average 14.7-y follow-up, 39% of the women reported ever using insecticides, and 1,081 were diagnosed with breast cancer. Although ever use of insecticides overall was not associated with breast cancer risk, risk was elevated among women who had ever used the organophosphates chlorpyrifos [HR=1.4 (95% CI: 1.0, 2.0)] or terbufos [HR=1.5 (95% CI: 1.0, 2.1)], with nonsignificantly increased risks for coumaphos [HR=1.5 (95% CI: 0.9, 2.5)] and heptachlor [HR=1.5 (95% CI: 0.7, 2.9)]. Risk in relation to the wives' use was associated primarily with premenopausal breast cancer. We found little evidence of differential risk by tumor estrogen receptor status. Among women who did not apply pesticides, the husband's use of fonofos was associated with elevated risk, although no exposure-response trend was observed.
Use of several organophosphate insecticides was associated with elevated breast cancer risk. However, associations for the women's and husbands' use of these insecticides showed limited concordance. Ongoing cohort follow-up may help clarify the relationship, if any, between individual insecticide exposures and breast cancer risk. https://doi.org/10.1289/EHP1295.
Journal Article
Volatile Hydrocarbon Exposures and Incident Coronary Heart Disease Events: Up to Ten Years of Follow-up among Deepwater Horizon Oil Spill Workers
During the 2010
(
) disaster, response and cleanup workers were potentially exposed to toxic volatile components of crude oil. However, to our knowledge, no study has examined exposure to individual oil spill-related chemicals in relation to cardiovascular outcomes among oil spill workers.
Our aim was to investigate the association of several spill-related chemicals [benzene, toluene, ethylbenzene, xylene,
-hexane (BTEX-H)] and total hydrocarbons (THC) with incident coronary heart disease (CHD) events among workers enrolled in a prospective cohort.
Cumulative exposures to THC and BTEX-H across the cleanup period were estimated via a job-exposure matrix that linked air measurement data with self-reported
spill work histories. We ascertained CHD events following each worker's last day of cleanup work as the first self-reported physician-diagnosed myocardial infarction (MI) or a fatal CHD event. We estimated hazard ratios (HR) and 95% confidence intervals for the associations of exposure quintiles (Q) with risk of CHD. We applied inverse probability weights to account for bias due to confounding and loss to follow-up. We used quantile g-computation to assess the joint effect of the BTEX-H mixture.
Among 22,655 workers with no previous MI diagnoses, 509 experienced an incident CHD event through December 2019. Workers in higher quintiles of each exposure agent had increased CHD risks in comparison with the referent group (Q1) of that agent, with the strongest associations observed in Q5 (range of
). However, most associations were nonsignificant, and there was no evidence of exposure-response trends. We observed stronger associations among ever smokers, workers with
education, and workers with body mass index
. No apparent positive association was observed for the BTEX-H mixture.
Higher exposures to volatile components of crude oil were associated with modest increases in risk of CHD among oil spill workers, although we did not observe exposure-response trends. https://doi.org/10.1289/EHP11859.
Journal Article
Risk of longer-term neurological conditions in the Deepwater Horizon Oil Spill Coast Guard Cohort Study – Five years of follow-up
Background
Long-term neurological health risks associated with oil spill cleanup exposures are largely unknown. We aimed to investigate risks of longer-term neurological conditions among U.S. Coast Guard (USCG) responders to the 2010
Deepwater Horizon
(DWH) oil spill.
Methods
We used data from active duty members of the DWH Oil Spill Coast Guard Cohort Study (
N
=45224). Self-reported oil spill exposures were ascertained from post-deployment surveys. Incident neurological outcomes were classified using International Classification of Diseases, 9th Revision, codes from military health encounter records up to 5.5 years post-DWH. We used Cox Proportional Hazards regression to calculate adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for various incident neurological diagnoses (2010–2015). Oil spill responder (
n
=5964) vs. non-responder (
n
= 39260) comparisons were adjusted for age, sex, and race, while within-responder comparisons were additionally adjusted for smoking.
Results
Compared to those not responding to the spill, spill responders had reduced risks for
headache
(aHR=0.84, 95% CI: 0.74-0.96),
syncope and collapse
(aHR=0.74, 95% CI: 0.56-0.97), and
disturbance of skin sensation
(aHR=0.81, 95% CI: 0.68-0.96). Responders reporting ever (
n
=1068) vs. never (
n
=2424) crude oil inhalation exposure were at increased risk for several individual and grouped outcomes related to headaches and migraines (aHR range: 1.39-1.83). Crude oil inhalation exposure was also associated with elevated risks for an inflammatory nerve condition,
mononeuritis of upper limb and mononeuritis multiplex
(aHR=1.71, 95% CI: 1.04-2.83), and
tinnitus
(aHR=1.91, 95% CI: 1.23-2.96), a condition defined by ringing in one or both ears. Risk estimates for those neurological conditions were higher in magnitude among responders reporting exposure to both crude oil and oil dispersants than among those reporting crude oil only.
Conclusion
In this large study of active duty USCG responders to the DWH disaster, self-reported spill cleanup exposures were associated with elevated risks for longer-term neurological conditions.
Journal Article
Prospective study of oil spill cleanup-related exposure to volatile organic compounds and glycemic dysregulation
Background
Exposures to volatile organic compounds could influence glycemic regulation. This study examines hemoglobin A1c (HbA1c) in a cohort of oil spill cleanup workers up to 6 years post-exposure in relation to benzene, toluene, ethylbenzene, and xylenes (BTEX) exposures, individually and as a mixture, as well as a separate estimation of the aggregate sum of BTEX (total BTEX).
Methods
Data for this analysis are from the Gulf Long-term Follow-up (GuLF) Study– a prospective cohort of workers involved in the 2010
Deepwater Horizon
oil spill cleanup. HbA1c and medication information were obtained at Home Visit and Clinical Exam phases 1–3 years and up to 6 years post-exposure, respectively. Cumulative inhalation exposure to the individual BTEX chemicals and to total BTEX were estimated using a job-exposure matrix linking air measurements to detailed individual worker cleanup work histories. We used Tobit regression models to examine associations between exposure to the chemicals and latent, untreated HbA1c, accounting for medication-reduced HbA1c. We used quantile g-computation to examine exposure to the mixture of BTEX chemicals and HbA1c.
Results
In results examining Home Visit HbA1c we observed no discernable patterns but found suggestive evidence of an association with total BTEX. In results for Clinical Exam HbA1c, we did not observe monotonic patterns, but rather an inverted-U pattern with elevations in Q2 or Q3 or no clear pattern. Similarly, in results for final HbA1c adjusting for initial HbA1c, total BTEX difference estimates showed an inverted-U pattern in point estimates across Q2 (0.24 95%CI (0.14, 0.34)), Q3 (0.13 95%CI (0.03, 0.24)), and Q4 (0.00 95% CI (-0.11, 0.10)), compared to Q1.
Conclusion
Exposures to the moderate levels of the BTEX chemicals observed in this study population, individually and as an aggregate, may be associated with elevated HbA1c up to 6 years after exposure, with an inverted-U pattern.
Journal Article