Objectives/Goals: To assess the effect on the immune response to COVID-19 in children exposed to pesticides. The hypothesis is that increased pesticide exposure results in different immunological response to COVID-19. The goal of the proposal is to improve scientific knowledge on factors affecting COVID-19 and identify a modifiable factor to reduce these disparities. Methods/Study Population: A cross-sectional analysis of children (aged 5–17 years) with asthma to assess pesticide exposure and immune markers of SARS-CoV-2. SARS-CoV-2 infection or vaccination was determined with blood exposome RNA analyses assessed from blood samples taken at baseline. Immunological response was measured using neutralizing, phagocytizing, and NK-activating antibody responses biomarkers using plasma antibody isotyping, effector functions, T-cell activation-induced marker (AIM), and recall cytokine secretion assays on lysed, whole blood. Pesticide exposure was assessed as concentration of four urinary metabolites in a spot urine sample adjusted for creatinine. Unadjusted regression models were created to assess the effect of 3-phenoxy benzoic acid, a common pyrethroid pesticide, on immune markers. Results/Anticipated Results: Children’s (N = 30) average age was 10 years (interquartile range: 8–11) A majority of children were male (63%) and Non-Hispanic Black (73%). The majority of children had markers of SARS-CoV-2 infection (77%). Of the 4 pesticide metabolites assessed, only 3-PBA was commonly found (77% of samples > LOQ). Higher urinary concentrations of 3-PBA are associated with a significant (p Discussion/Significance of Impact: Significant associations in cytokine and inflammatory marker may indicate a Th2-skewed response, and dysregulated cytokine responses can lead to severe disease. A suggested increase in T-cell activation markers (e.g., CD4, CD8) may indicate potential exhaustion if excessively activated.

OBJECTIVES/GOALS: The objective is to assess the effect of pesticide exposure (individually and pesticide mixtures) on the immune response to COVID-19 in children. The goal is to improve scientific knowledge on factors affecting COVID-19 and identify a potentially modifiable factor to reduce disparities in COVID-19 morbidity. METHODS/STUDY POPULATION: Blood samples will be obtained from 50 children with asthma two time points; baseline and 12 months later. SARS-CoV-2 infection or vaccination will be determined with blood exposome RNA analyses.. Immunological response will be measured using neutralizing, phagocytizing, and NK-activating anti-body responses biomarkers. Pesticide exposure will be measured via urinary pesticide metabolites (UPMs). For individual metabolites multivariable analyses for each pesticide will be conducted using generalized estimating equation (GEE) models with compound symmetry correlation to account for the repeated measures design. To assess the pesticide mixture, weighted quantile sum regression (WQS) will be used. RESULTS/ANTICIPATED RESULTS: The main hypothesis is that increased pesticide exposure results in a reduction in the immunological response to SARS-CoV-2 infection and the COVID-19 vaccine. Therefore, we anticipate that increasing concentrations of individual UPMs as well as the increasing index will result in reductions in markers of the immune response to SARS-CoV-2 infection and the COVID-19 vaccine. DISCUSSION/SIGNIFICANCE: Exposure to pesticides is a modifiable environmental factor. If pesticides are found to alter the immune response to COVID-19 infection and vaccination, these data will provide an evidence base for efforts to reduce pesticide exposure in children.

Abstract Introduction: The avoidance of asthma triggers, like tobacco smoke, facilitates asthma management. Reliance upon caregiver report of their child’s environmental tobacco smoke (ETS) exposure may result in information bias and impaired asthma management. This analysis aimed to characterize the chronicity of ETS exposure, assess the validity of caregiver report of ETS exposure, and investigate the relationship between ETS exposure and asthma attack. Methods: A secondary data analysis was performed on data from a longitudinal study of 162 children aged 7–12 years with asthma living in federally subsidized housing in three US cities (Boston, Cincinnati, and New Orleans). Data were collected at three time points over 1 year. Results: Over 90% of children were exposed to ETS (≥0.25 ng/ml of urine cotinine (UC)). Exposure was consistent over 1 year. Questionnaire data had a sensitivity of 28–34% using UC ≥0.25 ng/ml as the gold standard. High ETS exposure (UC ≥ 30 ng/ml) was significantly associated with asthma attack (aOR 2.97, 0.93–9.52, p = 0.07). Lower levels (UC 0.25–30 ng/ml) were not statistically significant (aOR 1.76, 0.71– 4.38, p = 0.22). No association was found using caregiver-reported ETS exposure. Conclusion: Relying on questionnaire data to assess children’s exposure to tobacco smoke may lead to substantial information bias. For children with asthma, incorrect characterization may substantially impact asthma morbidity.

Background Children are potentially more susceptible to the adverse effects of pesticides due to more sensitive organ systems and lower capacity to metabolize and eliminate chemicals compared to adults. The health risks are particularly concerning children with asthma, living in low-income neighborhoods in multi-family housing because of their impaired respiratory health, and factors associated with low-income, multi-family environments. Objective To assess the association between pesticide exposure and asthma morbidity among children 7–12 years residing in low-income, multi-family housing. Methods The concentrations of seven urinary pesticide biomarkers: 3,5,6-trichloro-2-pyridinol (TCPy), 2-isopropyl-4-methyl-6-hydroxypyrimidine, para-nitrophenol (PNP), 3-phenoxybenzoic acid (3-PBA), 4-fluoro-3-phenoxybenzoic acid, trans-3-(2,2-dichlorovinyl)-2,2-dimethyl-cyclopropane-1-carboxylic acid, and 2,4-dichlorophenoxyacetic acid (2,4-D) were measured. Children ( n = 162) were followed for one year with three measures of pesticides biomarkers. Associations between individual biomarkers and asthma attack, asthma related health care utilization, and fraction of exhaled nitric oxide (FeNO), adjusting for demographic and household factors were examined with Generalized Estimating Equations (GEE). Weighted Quantile Sum (WQS) regression was used to examine the effect of pesticide mixture on asthma attacks and asthma-related health care utilization (HCU). Results In adjusted GEE models, positive non-significant associations were found between PNP and HCU (adjusted Odds Ratio(aOR):2.05 95% CI:0.76–5.52) and null associations for 3-PBA and HCU (aOR:1.07 95% CI: 0.88–1.29). Higher concentrations of PNP and 2,4-D were associated with significantly lower FeNO levels (PNP: −17.4%; 2,4-D:−19.74%). The mixture was positively associated with HCU in unadjusted (OR: 1.56 97.5% CI: 1.08–2.27) but not significant in adjusted models (aOR: 1.40 97.5% CI: .86–2.29). The non-specific pyrethroid biomarker 3-PBA at baseline contributed the greatest weight to the index (45%). Significance There were non-significant associations between pesticide biomarkers and respiratory outcomes in children with asthma. There was a suggestive association between urinary pesticide biomarkers and HCU. Further studies with larger sample sizes could help to confirm these findings. Impact statement Pesticide exposure among children in the urban environment is ubiquitous and there is a dearth of information on the impact of low-level chronic exposure in vulnerable populations. This study suggested that pesticide exposure at concentrations below the national average may not affect asthma morbidity in children. However, different biomarkers of pesticides showed different effects, but the mixture suggested increasing pesticide exposure results in asthma related HCU. The results may show that children with asthma may be at risk for negative health outcomes due to pesticides and the need to further examine this relationship.

OBJECTIVES:The condition of the home is a strong predictor of exposure to environmental contaminants, with low-income households being particularly vulnerable. Therefore, improving housing standards is a priority. Housing built to "green" standards, with improved building methods and materials, has been suggested to reduce contaminants. However, evidence is limited as to which contaminants are reduced. The Green Housing Study was conducted to address this issue. The study hypothesis was that housing built using green components has lower concentrations of environmental contaminants compared to conventional housing. METHODS:A repeated-measures, 12-month cohort study was performed in three U.S. cities. Data were collected in the home at three time points throughout a year. The level of contaminants were estimated using air samples for particulate matter and black carbon, dust samples for aeroallergens and pesticides, and resident or study staff reporting evidence of mold. To investigate source(s) of PM2.5 and black carbon, multivariable models using stepwise variable selection were developed. RESULTS:In adjusted generalized estimating equations (GEE) models, black carbon concentration (μg/m3) (β = -0.22, 95% CI = -0.38 to -0.06, p = 0.01), permethrin (OR = 0.28, 95% CI = 0.15-0.49, p < 0.0001), and reported mold (OR = 0.29, 95% CI = 0.13-0.68, p = 0.003) were significantly lower in green homes. Cockroach antigen was also lower in green homes (OR = 0.59, 95% CI = 0.33-1.08, p = 0.09), although not statistically significant. We found that 68% of PM2.5 was explained by dwelling type and smoking and 42% of black carbon was explained by venting while cooking and use of a gas stove. CONCLUSIONS:This study provides quantitative data suggesting benefits of incorporating green building practices on the level of numerous environmental contaminants known to be associated with health. Occupant behavior, particularly smoking, is an important contributor to indoor air pollution.

Background: Fractional exhaled nitric oxide (FeNO) is a marker of airway inflammation. Elevated FeNO has been associated with environmental exposures, however, studies from tropical countries are limited. Using data from the Infants' Environmental Health Study (ISA) birth cohort, we evaluated medical conditions and environmental exposures' association with elevated FeNO.Methods: We performed a cross-sectional analysis of 277 women and 293 8-year old children who participated in the 8-year post-partum visit in 2019. We measured FeNO and collected information on medical conditions and environmental exposures including smoke from waste burning, work in banana plantations, and home pesticide use. We defined elevated FeNO as >25 ppb for women and >20 ppb for children. To evaluate factors associated with elevated FeNO, we used logistic regression models adjusted for obesity in women and unadjusted in children.Results: Overall elevated FeNO was common (20% of women, 13% of children). Rhinitis diagnosis was signifi-cantly associated with elevated FeNO in both women (odds ratio (OR): 3.67 95% Confidence Interval (CI): 1.81,7.35) and children (OR: 8.18 95%CI: 3.15, 21.22); wheeze was associated with elevated FeNO in women (OR: 4.50 95% CI: 2.25, 8.99). Environmental exposures were associated with elevated FeNO, but not signifi-cantly. Waste burning was associated with elevated FeNO in both women (OR: 1.58 95%CI 0.68, 4.15) and children (OR: 2.49 95%CI:0.82, 10.79). Para-occupational pesticide exposures were associated with elevated FeNO in women and children. For women, having a partner working in agriculture was associated with elevated FeNO (OR: 1.61 95%CI:0.77, 3.58) and for children, maternal work in agriculture was associated with elevated FeNO. (OR 2.08 95%CI 0.86, 4.67)Conclusion: Rhinitis and wheeze were associated with elevated FeNO in this rural, agricultural population. Smoke from waste burning as well as para-occupational pesticide exposure may contribute to elevated FeNO in rural communities.

SARS CoV-2 in children or special populations post-infection has not been well studied. Asthma is a heterogenous disease marked by chronic airway inflammation; triggers include cockroaches (CRA), and other inhaled irritants. Asthma also has links to viral infections like respiratory syncytial virus (RSV). Additionally, some with moderate to severe asthma are more likely to be hospitalized with COVID. T cells play key roles in asthma and control of viruses such; however, there is limited information connecting T cell responses in people with asthma to viral infections. We aimed to evaluate T cells and antibodies in an asthma confirmed cohort. Thirty-five children aged 5–17 years were included. We measured SARS CoV-2 spike (S) and Nucleoprotein (N) plasma antibody responses or effector functions and CD4, CD8 T cells specific to CRA or peptide pools made from RSV, S and N antigen using an activation induced markers (AIM) assay. Surprisingly, in this population many CD4 and CD8 T-cell AIM responses to S, N, CRA, and RSV were significantly associated, particularly for CD8 T-cells (Spearmans r = 0.57–0.76) and the restimulation antigens CRA and RSV. N-specific CD4 AIM was the only immune measure to correlate to a recent asthma attack within a month of the blood collection visit, though anti-N antibodies, CD4 AIM to CRA, RSV or CD8 AIM to CRA, RSV, or N antigens also correlated with asthmatic outcomes (e.g., ER visits, night waking from symptoms, etc.) whereas allergen specific IgE or anti-S IgG did not. Taken together these results indicate an immunological association between viral infection and asthma, broadly allowing for the conjecture that viral infections, in particular RSV and SARS-CoV-2 could act together as possible triggers of asthma.

There is growing concern about children’s chronic low-level pesticide exposure and its impact on health. Green building practices (e.g., reducing leakage of the thermal and pressure barrier that surrounds the structure, integrated pest management, improved ventilation) have the potential to reduce pesticide exposure. However, the potential impact of living in green housing on children’s pesticide exposure is unknown. To address this question, a longitudinal study of pyrethroid metabolites (3-phenoxybenzoic acid [3-PBA], 4-fluoro-3-phenoxybenzoic acid [4-F-3-PBA], trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid [trans-DCCA]) in first morning void urine, collected from 68 children from New Orleans, Louisiana residing in green and non-green housing was conducted. Children were followed for 1 year with three repeated measures of pesticide exposure. Generalized estimating equations examined associations between housing type (green vs. non-green) and urinary pyrethroid metabolite concentrations adjusting for demographic and household factors over the year. Ninety-five percent of samples had detectable concentrations of 3-PBA (limit of detection [LOD]: 0.1 μg/L); 8% of 4-F-3-PBA (LOD: 0.1 μg/L), and 12% of trans-DCCA (LOD: 0.6 μg/L). In adjusted models, green housing was not associated with statistically significant differences in children’s 3-PBA urinary concentrations compared to non-green housing.

Circulating micronutrient levels of both serum copper and zinc have been studied to varying degrees in both the general public and patients having undergone bariatric surgery. According to the 2019 ASMBS clinical guidelines, copper supplementation is recommended for patients undergoing metabolic surgery, especially after Roux-en-Y gastric bypass and duodenal switch. Copper excess has not been previously reported to any significant degree in any population. In this study, we investigate an elevated serum copper level in the pre-surgical intervention population of the Bariatric Center of the University Medical Center–New Orleans, a primary safety net hospital for the state of Louisiana. Five hundred five consecutive patients from the bariatric surgery undergoing a workup for surgical intervention were assessed. Patients were included regardless of whether they proceeded to surgery. The study was conducted as a retrospective review of deidentified data that was collected as part of our routine workup for bariatric surgery. The study population of the clinic consisted of a mean BMI of approximately 50 kg/m2, with 91% of the population reporting female and 69% recording an African American race. It was discovered in this population that 26% of the patients had an elevated copper level of > 155 mcg/dl. Additional analysis was performed attempting to elucidate an environmental role in the elevation by qualitative analysis of patient’s location of residence using reported home address. Additional variables were studied as well including serum zinc concentration, age, BMI, and race to address any correlative variables with our findings. This study identifies an elevated serum copper concentration in a pre-intervention underserved bariatric center population positively associated with BMI, female gender, and African American race. Additional studies will be necessary to see if these trends are also apparent in normal weight controls, or if weight loss influences copper levels. Pre-existing serum copper deficiencies may be more prevalent in the bariatric populations than previously believed. Increased serum copper in this population was positively associated with increased BMI, age, and female gender compared to that of the male group. Increased serum copper was also associated more closely with African American ethnicity compared to Caucasian patients.

Background Cockroach allergen is one of the most important asthma triggers for children. There is an extensive body of research on interventions to reduce exposure. However, adherence to these interventions is low. Insight into the knowledge, attitudes, and practices (KAP) associated with cockroach remediation is needed. We assessed KAP using the Health Beliefs Model (HBM) as a framework for predicting behavior. This study aimed to assess the socio-demographic and psycho-social characteristics associated with cockroach KAP and to quantify the relationship between KAP and number of cockroaches in the home. Methods To identify factors associated with cockroach KAP a cross-sectional study was conducted using a structured questionnaire administered to caregivers of children with asthma in New Orleans, Louisiana. Positive scores in each metric of the KAP signified better cockroach knowledge, increased concern about cockroaches’ impact on health (attitudes), and participation in recommended cockroach remediation practices (practices). To evaluate cockroach KAP scores as a predictor of cockroach exposure in the home, a cohort study was conducted among a sub-sample of participants. Results Fifty-six caregivers participated in the study. Participants had positive scores on all subscales of KAP with knowledge having a lower score compared to attitudes and practices. Cockroach knowledge was inversely correlated with age at asthma diagnosis ( ρ = − 0.36, p = 0.01). Caregivers identifying as black/African American had higher cockroach knowledge scores compared to other races (Median: 6.0 v 3.0; p = 0.05). Caregivers other than mothers had higher cockroach attitude scores (Median 6.5 v 4.0; p = 0.003) and total KAP scores (Median 18.0 v 14.0; p = 0.05). Twenty-six participants completed the cohort study. Cockroach exposure was not significantly associated with higher cockroach knowledge, cockroach practice, or total KAP score. For attitude scores, participants in the highest quartile had significantly lower exposure (β: -1.96, 95% CI: − 3.50 - 0.42) compared to those in the lowest quartile ( p = 0.01). Conclusions Different socio-demographic and psycho-social factors were associated with the components of cockroach KAP. Greater concern about cockroaches (attitude) was significantly associated with reduced cockroach exposure. This highlights the importance of identifying the key elements of caregiver KAP to improve cockroach remediation among caregivers of children with asthma.

BackgroundNonpharmacologic interventions for asthma management rely on identification and mitigation of important asthma triggers. Cockroach exposure is strongly associated with asthma morbidity. It is also associated with stress, another risk factor for asthma. Despite high prevalence of both in vulnerable populations, the impact of joint exposure has not been examined.MethodsParticipants included 173 children with asthma in New Orleans, Louisiana. Cockroach exposure was based on visual inspection using standard protocols. Caregiver stress was measured using Cohen's 4-item Perceived Stress Scale. Outcomes included unscheduled clinic or emergency department (ED) visits, hospitalization, and pulmonary function. Multivariable logistic regression was performed to assess independent effects of the exposure on the outcome and effect modification was examined in stratified analysis based on stress. Path analysis to explore the mediation effect by stress was performed using a probit link with parameters based on Bayes' method with non-informative priors.ResultsAdjusting for stress and other covariates, cockroach exposure was associated with unscheduled clinic/ED visits (aOR=6.2; 95% CI 1.8, 21.7). Positive associations were also found for hospitalization and FEV1<80%. High stress modified the relationship with unscheduled clinic/ED visits (high aOR=7.7 95% CI 1.0, 60.2, versus normal aOR=4.1 95% CI 0.8, 21.9). Path models identified direct and indirect effects (p=0.05) indicating that a majority of the total effect on unscheduled clinic/ED visits is attributed directly to cockroach exposure.ConclusionThe strong association between cockroach exposure and asthma morbidity is not due to uncontrolled confounding by stress. The combination of cockroach exposure and high stress, common in urban homes, are modifiable factors associated with poor asthma outcomes.

Abstract Background Nonpharmacologic interventions for asthma management rely on identification and mitigation of important asthma triggers. Cockroach exposure is strongly associated with asthma morbidity. It is also associated with stress, another risk factor for asthma. Despite high prevalence of both in vulnerable populations, the impact of joint exposure has not been examined. Methods Participants included 173 children with asthma in New Orleans, Louisiana. Cockroach exposure was based on visual inspection using standard protocols. Caregiver stress was measured using Cohen’s 4-item Perceived Stress Scale. Outcomes included unscheduled clinic or emergency department (ED) visits, hospitalization, and pulmonary function. Multivariable logistic regression was performed to assess independent effects of the exposure on the outcome and effect modification was examined in stratified analysis based on stress. Path analysis to explore the mediation effect by stress was performed using a probit link with parameters based on Bayes’ method with non-informative priors. Results Adjusting for stress and other covariates, cockroach exposure was associated with unscheduled clinic/ED visits (aOR = 6.2; 95% CI 1.8, 21.7). Positive associations were also found for hospitalization and FEV1 < 80%. High stress modified the relationship with unscheduled clinic/ED visits (high aOR = 7.7 95% CI 1.0, 60.2, versus normal aOR = 4.1 95% CI 0.8, 21.9). Path models identified direct and indirect effects (p = 0.05) indicating that a majority of the total effect on unscheduled clinic/ED visits is attributed directly to cockroach exposure. Conclusion The strong association between cockroach exposure and asthma morbidity is not due to uncontrolled confounding by stress. The combination of cockroach exposure and high stress, common in urban homes, are modifiable factors associated with poor asthma outcomes.

Background Exposure to black carbon indoors may be associated with blood pressure; however, evidence is limited to vulnerable subpopulations and highly exposed individuals. Our objective was to explore the relationship between indoor black carbon at various exposure windows on resting blood pressure in a general population sample. Methods Black carbon was measured in the home of 76 individuals aged 10-71 in New Orleans, Louisiana. Exposure was measured every 1 minute for up to 120 hours using an AE51 microaethalometer. Systolic blood pressure and diastolic blood pressure were measured at the conclusion of exposure monitoring. Results In adjusted models, at all exposure windows, increasing black carbon was associated with increased systolic blood pressure. The period 0-72 hours prior to blood pressure measurement showed the strongest effect; a 1 mu g/m(3) increase in black carbon was associated with a 7.55 mm Hg (P = .02) increase in systolic blood pressure. The relationship was stronger in participants reporting doctor-diagnosed hypertension (beta = 6.47 vs beta = 3.27). Black carbon was not associated with diastolic blood pressure. Conclusion Increasing black carbon concentration indoors is positively associated with increasing systolic blood pressure with the most relevant exposure window being 0-72 hours prior to blood pressure measurement. Individuals with hypertension may be a more susceptible population.

Background: Little is known about urinary pesticide (UP) concentration in socially disadvantaged children. These children may be at greater exposure risk because low income is associated with more household pest exposure. Urinary pesticide concentration and its association with asthma morbidity was measured in 161 children with asthma (7-12 years) residing in subsidized housing in three U.S. cities (Boston, Cincinnati, New Orleans).Methods: Morning void and convenience spot samples were collected at three time points over one year. Urine samples were analyzed for seven pesticide metabolites; 3 organophosphates (OPs): TCPY, IMPY, PNP; 3 pyrethroids (PYR): 4-F-3-PBA, 3-PBA, trans-DCCA; and 1 herbicide: 2,4-D. Total PYR was calculated as the sum of 4-F-3PBA, 3-PBA, and trans-DCCA and total OP as the sum of TCPY, IMPY, and PNP. Outcomes were forced expiratory volume in one second (FEV1), and respiratory inflammation measured as fractional exhaled nitric oxide (FeNO).Results: A total of eight hundred and ten urine samples were collected. The proportion with detectable metabolites ranged from 35% (trans-DCCA) to 97% (TCPY and PNP). Geomeans of each pesticide were higher in this cohort compared to a national sample (NHANES 2009-2010) of children 6-11 years. In models adjusting for socio-demographic factors, a 1 µg/mL increase in TCPy, IMPY, trans-DCCA, 2,4-D, total OPs and PNP was associated with a reduction in FEV1 (-0.004 to -0.158) although no model reached statistical significance (p<0.05). An increase in TCPY, total OPs, and 4-F-3-PBA, resulted in a non-statistically significant increase in FeNO (0.0004 to 0.0675) .Conclusion: Results demonstrate these low-income children with asthma residing in subsidized housing are exposed to higher concentrations of pesticides compared to a general population sample. Additionally, the evidence suggests negative respiratory outcomes with increasing levels of UPs. Reducing exposure to pesticides is important to mitigate the potential negative health effects for vulnerable populations.

OPS 57: Black carbon exposure and health effects, Room 110, Floor 1, August 26, 2019, 10:30 AM - 12:00 PM Background: Particulate matter less than 2.5 μm in diameter (PM2.5) is a multi-component air pollutant and a major environmental contributor to cardiovascular disease (CVD). The specific components of PM2.5 responsible for CVD are under investigated. Black carbon (BC) comprises a significant portion of PM2.5 and is thought to be an important contributor to CVD through its impact on blood pressure. The effect of indoor BC exposure on blood pressure (BP) is less clear with few studies conducted in U.S. general population cohorts. Our objective was to explore the relationship between various lag times of BC exposure in the home on BP. Methods: Acute exposure (1 hour – 5 days) to BC was measured in 76 homes of individuals aged 10-71 in New Orleans, Louisiana. Continuous 5-day samples were obtained in the home using a microaethalometer (AethLabs MicroAeth AE51). Blood pressure was measured on day 5 using the Omron HEM 907XL sphygmomanometer (Omron Healthcare Inc).The average of three BP measurements taken 1 minute apart was used in all analyses. Results: Black carbon exposure averaged 0.60 (± 0.81) μg/m3 over the 5-day sampling period and daily averages ranged from 0.48 - 0.78 μg/m3. At all lag times, increasing BC was associated with increased systolic blood pressure. The BC level 0-72 hours prior to the measured BP showed the strongest effect. In adjusted models, a 1-μg/m3 increase in BC was associated with a 7.09 mmHg (p=0.03) increase in systolic blood pressure. The relationship was stronger in those reporting doctor diagnosed hypertension (β = 6.7 vs β = 1.7). Black carbon level was not associated with diastolic blood pressure. Conclusion: Indoor exposure to BC is positively associated with increasing systolic blood pressure with the most relevant exposure window being 0-72 hours prior to BP measurement. Those with hypertension may be a more susceptible subpopulation.

Abstract Background Mobile (MHCs), Community (CHCs), and School-based health clinics (SBHCs) are understudied alternative sources of health care delivery used to provide more accessible primary care to disenfranchised populations. However, providing access does not guarantee utilization. This study explored the utilization of these alternative sources of health care and assessed factors associated with residential segregation that may influence their utilization. Methods A cross-sectional study design assessed the associations between travel distance, perceived quality of care, satisfaction-adjusted distance (SAD) and patient utilization of alternative health care clinics. Adults (n = 165), child caregivers (n = 124), and adult caregivers (n = 7) residing in New Orleans, Louisiana between 2014 and 2015 were conveniently sampled. Data were obtained via face-to face interviews using standardized questionnaires and geospatial data geocoded using GIS mapping tools. Multivariate regression models were used to predict alternative care utilization. Results Overall 49.4% of respondents reported ever using a MCH, CHC, or SBHC. Travel distance was not significantly associated with using either MCH, CHC, or SBHC (OR = 0.91, 0.74–1.11 p > .05). Controlling for covariates, higher perceived quality of care (OR = 1.02, 1.01–1.04 p < .01) and lower SAD (OR = 0.81, 0.73–0.91 p < .01) were significantly associated with utilization. Conclusions Provision of primary care via alternative health clinics may overcome some barriers to care but have yet to be fully integrated as regular sources of care. Perceived quality and mixed-methods measures are useful indicators of access to care. Future health delivery research is needed to understand the multiple mechanisms by which residential segregation influences health-seeking behavior.

We examined urinary pesticide (UP) metabolite levels in asthmatic children residing in subsidized housing in New Orleans, Louisiana and compared these levels between children residing in green and non-green housing.Morning void samples were collected from 68 children (aged 7-12 years) at three time points between 2014 and 2016. Ninety-seven percent of children provided three urine samples. Urine samples were analyzed for seven pesticide metabolites (3 organophosphates: TCPY, IMPY, PNP; 3 pyrethroids: 4-F-3-PBA, 3-PBA, trans-DCCA; and 1 herbicide: 2,4-D). Metabolites were creatinine-adjusted and natural log transformed. Children were classified as residing in green housing if the home was constructed with low VOC materials and utilized integrated pest management. Differences in metabolite levels were analyzed using generalized estimating equations.Four metabolites (2,4-D, TCPY, 3-PBA, PNP) were detected in >90% of samples. IMPY was detected in 52% of samples, and 4-F-3-PBA and trans-DCCA were not frequently detected (<9%, <13%, respectively). There were no statistically significant differences in UP level at any time point. There were lower levels of 4-F-3-PBA (β=-1.23, p=0.11), TCPY (β=-0.05, p=0.63), and PNP (β=-0.01, p=0.93) for children living in green housing. 2,4-D (β=0.09, p=0.43), 3-PBA (β=0.08, p=0.63), IMPY (β=0.02, p=0.90), and trans-DCCA (β=0.37, p=0.07) levels were higher for those in green housing. None of the differences in housing type reached statistical significance. In models examining the interaction between housing type and time, there were no statistically significant differences between green and non-green housing at any time point.These results suggest that asthmatic children residing in subsidized housing in New Orleans are chronically exposed to low levels of pesticides resulting in limited variability of UP metabolite. We found no significant differences in UP levels between children residing in green housing compared to non-green housing.

American cockroaches are an important source of household allergens in tropical and semitropical climates. To determine which outdoor niches produce American cockroaches, traps were placed at 40 homes in New Orleans to collect nymphs. Nymphs were collected from the sewers, yards, and within the homes themselves. To compare sewers and yards as sources of cockroaches entering homes, adult cockroaches were collected, marked, and released into yards and sewers. No sewer-released cockroaches were collected in homes. Cockroaches released into yards were collected in the homes, suggesting that yards, rather than sewers, are a more important source niche. A field trial applying boric acid granules to the yard was performed in an effort to reduce entry of cockroaches. There was a significant reduction in the cockroach antigen collected in intervention homes compared with controls.