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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.

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.

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.

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.

Introduction Long-term endocrine and metabolic health risks associated with oil spill cleanup exposures are largely unknown, despite the endocrine-disrupting potential of crude oil and oil dispersant constituents. We aimed to investigate risks of longer-term endocrine and metabolic conditions among U.S. Coast Guard (USCG) responders to the Deepwater Horizon (DWH) oil spill. Methods Our study population included all active duty DWH Oil Spill Coast Guard Cohort members ( N  = 45,224). Self-reported spill exposures were ascertained from post-deployment surveys. Incident endocrine and metabolic outcomes were defined using International Classification of Diseases (9th Revision) diagnostic codes from military health encounter records up to 5.5 years post-DWH. Using Cox proportional hazards regression, we estimated adjusted hazard ratios (aHR) and 95% confidence intervals (CIs) for various incident endocrine and metabolic diagnoses (2010–2015, and separately during 2010–2012 and 2013–2015). Results The mean baseline age was 30 years (~ 77% white, ~ 86% male). Compared to non-responders ( n  = 39,260), spill responders ( n  = 5,964) had elevated risks for simple and unspecified goiter (aHR = 2.09, 95% CI: 1.29–3.38) and disorders of lipid metabolism (aHR = 1.09, 95% CI: 1.00–1.18), including its subcategory other and unspecified hyperlipidemia (aHR = 1.10, 95% CI: 1.01–1.21). The dysmetabolic syndrome X risk was elevated only during 2010–2012 (aHR = 2.07, 95% CI: 1.22–3.51). Responders reporting ever ( n  = 1,068) vs. never ( n  = 2,424) crude oil inhalation exposure had elevated risks for disorders of lipid metabolism (aHR = 1.24, 95% CI: 1.00–1.53), including its subcategory pure hypercholesterolemia (aHR = 1.71, 95% CI: 1.08–2.72), the overweight, obesity and other hyperalimentation subcategory of unspecified obesity (aHR = 1.52, 95% CI: 1.09–2.13), and abnormal weight gain (aHR = 2.60, 95% CI: 1.04–6.55). Risk estimates for endocrine/metabolic conditions were generally stronger among responders reporting exposure to both crude oil and dispersants (vs. neither) than among responders reporting only oil exposure (vs. neither). Conclusion In this large cohort of active duty USCG responders to the DWH disaster, oil spill cleanup exposures were associated with elevated risks for longer-term endocrine and metabolic conditions.

Wastewater-based epidemiology has expanded as a tool for collecting COVID-19 surveillance data, but there is limited information on the feasibility of this form of surveillance within decentralized wastewater systems (e.g., septic systems). This study assessed SARS-CoV-2 RNA concentrations in wastewater samples from a septic system servicing a mobile home park (66 households) and from two pumping stations serving a similarly sized (71 households) and a larger (1,000 households) neighborhood within a nearby sewershed over 35 weeks in 2020. Also, raw wastewater from a hospital in the same sewershed was sampled. The mobile home park samples had the highest detection frequency (39/39 days) and mean concentration of SARS-CoV-2 RNA (2.7 × 107 gene copies/person/day for the N1) among the four sampling sites. N1 gene and N2 gene copies were highly correlated across mobile home park samples (Pearson's r = 0.93, p < 0.0001). In the larger neighborhood, new COVID-19 cases were reported every week during the sampling period; however, we detected SARS-CoV-2 RNA in 12% of the corresponding wastewater samples. The results of this study suggest that sampling from decentralized wastewater infrastructure can be used for continuous monitoring of SARS-CoV-2 infections.

Background Workers involved in the response and clean-up of the 2010 Deepwater Horizon oil spill faced possible exposures to crude oil, burning oil, dispersants and other pollutants in addition to physical and emotional stress. These exposures may have increased risk of myocardial infarction (MI) among oil spill workers. Methods Gulf Long-term Follow-up (GuLF) STUDY participants comprise individuals who either participated in the Deepwater Horizon response efforts or registered for safety training but were not hired. Oil spill-related exposures were assessed during enrollment interviews conducted in 2011–2013. We estimated risk ratios (RR) and 95% confidence intervals for the associations of clean-up work characteristics with self-reported nonfatal MI up to three years post-spill. Results Among 31,109 participants without history of MI prior to the spill, 77% worked on the oil spill. There were 192 self-reported MI during the study period; 151 among workers. Among the full cohort, working on the oil spill clean-up (vs not working on the clean-up) and living in proximity to the oil spill (vs further away) were suggestively associated with a possible increased risk of nonfatal MI [RR: 1.22 (0.86, 1.73) and 1.15 (0.82, 1.60), respectively]. Among oil spill workers, working for > 180 days was associated with MI [RR for > 180 days (vs 1–30 days): 2.05 (1.05, 4.01)], as was stopping working due to heat [RR: 1.99 (1.43, 2.78)]. There were suggestive associations of maximum total hydrocarbon exposure ≥3.00 ppm (vs < 0.30 ppm) [RR: 1.69 (0.90, 3.19)] and working on decontaminating oiled equipment (vs administrative support) [1.72 (0.96, 3.09)] with nonfatal MI. Conclusion This is the first study to assess the associations between oil spill exposures and MI. Results suggest that working on the spill for > 180 days and stopping work due to heat increased risk of nonfatal MI. Future research should evaluate whether the observed associations are related to specific chemical exposures or other stressors associated with the spill.

Organochlorine (OC) insecticides and polychlorinated biphenyls (PCBs) have been shown to have estrogenic, antiestrogenic, or antiandrogenic properties; as a result, the impact of exposure to these compounds and risk of hormonal cancers, such as prostate cancer, is a concern. We conducted a nested case-control study, using prospectively collected serum, to estimate associations between OC exposures and metastatic prostate cancer in a population-based cohort from Norway. Sera from 150 cases and 314 controls matched on date of blood draw, age at blood draw, and region was used to determine concentrations of 11 OC pesticide metabolites and 34 PCB congeners. Odds ratios (ORs) and 95% confidence intervals (95% CIs) for quartiles of lipid-corrected metabolite levels were calculated using conditional logistic regression. Metastatic prostate cancer was two times as likely among men with serum concentrations of oxychlordane in the highest quartile compared with those in the lowest quartile (OR = 2.03; 95% CI: 1.03, 4.03; p-trend 0.05). Elevated but nonsignificant ORs were estimated for the highest versus lowest quartile of heptachlor epoxide, HCB, and mirex, although these exposures were correlated with oxychlordane. Findings for specific PCB congeners showed a significant inverse association between natural log-transformed lipid-adjusted PCB 44 and metastatic prostate cancer (OR = 0.74; 95% CI: 0.56, 0.97; p-trend = 0.02). Our study highlights the importance of estimating associations with specific OC chemicals and suggests a possible role of OC insecticides and PCBs in the etiology of metastatic prostate cancer. Koutros S, Langseth H, Grimsrud TK, Barr DB, Vermeulen R, Portengen L, Wacholder S, Beane Freeman LE, Blair A, Hayes RB, Rothman N, Engel LS. 2015. Prediagnostic serum organochlorine concentrations and metastatic prostate cancer: a nested case-control study in the Norwegian Janus Serum Bank cohort. Environ Health Perspect 123:867-872; http://dx.doi.org/10.1289/ehp.1408245.

Military veterans may have higher rates of amyotrophic lateral sclerosis (ALS) mortality than non-veterans. Few studies, with sparse exposure information and mixed results, have studied relationships between military-related factors and ALS survival. We evaluated associations between military-related factors and ALS survival among U.S. military veteran cases. We followed 616 medical record-confirmed cases from enrollment (2005-2010) in the Genes and Environmental Exposures in Veterans with Amyotrophic Lateral Sclerosis study until death or July 25, 2013, whichever came first. We ascertained vital status information from several sources within the Department of Veterans Affairs. We obtained information regarding military service, deployments, and 39 related exposures via standardized telephone interviews. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals. We adjusted for potential confounding and missing covariate data biases via inverse probability weights. We also used inverse probability weights to adjust for potential selection bias among a case group that included a disproportionate number of long-term survivors at enrollment. We observed 446 deaths during 24,267 person-months of follow-up (median follow-up: 28 months). Survival was shorter for cases who served before 1950, were deployed to World War II, or mixed and applied burning agents, with HRs between 1.58 and 2.57. Longer survival was associated with exposure to: paint, solvents, or petrochemical substances; local food not provided by the Armed Forces; or burning agents or Agent Orange in the field with HRs between 0.56 and 0.73. Although most military-related factors were not associated with survival, associations we observed with shorter survival are potentially important because of the large number of military veterans.

•The inclusion of the larger dataset is explicitly detailed to the reviewers.•The analyses were dichotomized on the medians of cumulative exposure among the statins-exposed individuals.•The use of exact test and their p-values has been added to the Material and Methods section.•The results of the sensitivity analysis which persons on statins for <6 months are reported.•The results remain consistent with a significant inverse association between statin use and HCC. Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) are medications widely prescribed to reduce cholesterol levels. Observational studies in high-risk populations, mostly in Asia, have suggested that statins are associated with a reduced risk of hepatocellular carcinoma (HCC). The current study sought to evaluate the association of statin use and HCC in a U.S.-based, low-risk, general population. A nested case–control study was conducted among members of the Health Alliance Plan HMO of the Henry Ford Health System enrolled between 1999 and 2010. Electronic pharmacy records of statin use were compared among tumor registry-confirmed cases of HCC (n=94) and controls (n=468) matched on age, sex, diagnosis date, and length of HMO enrolment. In multivariate analyses, ever-use of statins was significantly inversely associated with development of HCC (Odds ratio (OR): 0.32, 95%CI: 0.15–0.67). No clear dose–response relationship was evident as statin use for <2 years (OR=0.32, 95%CI=0.13–0.83) and >2 years (OR=0.31, 95CI%=0.12–9.81) resulted in very similar ORs. The use of statins among populations in low-risk HCC areas may be associated with decreased risk of HCC.