Background
The association between metals in water and soil and adverse child neurologic outcomes has focused on the singular effect of lead (Pb), mercury (Hg), and arsenic (As). This study describes the complex association between soil concentrations of As combined with Pb and the probability of intellectual disability (ID) in children.Methods
We used a retrospective cohort design with 3988 mother child pairs who were insured by Medicaid and lived during pregnancy and early childhood in South Carolina between 1/1/97 and 12/31/02. The children were followed until 6/1/08, using computerized service files, to identify the diagnosis of ID in medical records and verified by either school placement or disability service records. The soil was sampled using a uniform grid and analyzed for eight metals. The metal concentrations were interpolated using Bayesian Kriging to estimate concentration at individual residences.Results
The probability of ID increased for increasing concentrations of As and Pb in the soil. The Odds Ratio for ID, for one unit change in As was 1.130 (95% confidence interval 1.048-1.218) for Pb was 1.002 (95% confidence interval 1.000-1.004). We identified effect modification for the infants based on their birth weight for gestational age status and only infants who were normal size for their gestational age had increased probability of ID based on the As and Pb soil concentrations (OR for As at normal weight for gestational age = 1.151 (95% CI: 1.061-1.249) and OR for Pb at normal for gestational age = 1.002 (95% CI: 1.002-1.004)). For normal weight for gestational age children when As = 22 mg kg−1 and Pb = 200 mg kg−1 the risk for ID was 11% and when As = 22 mg kg−1and Pb = 400 mg kg−1 the probability of ID was 65%.Conclusion
The probability of ID is significantly associated with the interaction between Pb and As for normal weight for gestational age infants. 相似文献In this study, a multi-level-factorial risk-inference-based possibilistic-probabilistic programming (MRPP) method is proposed for supporting water quality management under multiple uncertainties. The MRPP method can handle uncertainties expressed as fuzzy-random-boundary intervals, probability distributions, and interval numbers, and analyze the effects of uncertainties as well as their interactions on modeling outputs. It is applied to plan water quality management in the Xiangxihe watershed. Results reveal that a lower probability of satisfying the objective function (θ) as well as a higher probability of violating environmental constraints (q i ) would correspond to a higher system benefit with an increased risk of violating system feasibility. Chemical plants are the major contributors to biological oxygen demand (BOD) and total phosphorus (TP) discharges; total nitrogen (TN) would be mainly discharged by crop farming. It is also discovered that optimistic decision makers should pay more attention to the interactions between chemical plant and water supply, while decision makers who possess a risk-averse attitude would focus on the interactive effect of q i and benefit of water supply. The findings can help enhance the model’s applicability and identify a suitable water quality management policy for environmental sustainability according to the practical situations.
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