American journal of epidemiology最新文献

{"title":"The association between long-term exposure to PM2.5 constituents and diabetes incidence and blood glucose levels among World Trade Center Health Program General Responders.","authors":"Helena Krasnov, Pablo Knobel, Hsiao-Hsien Leon Hsu, Susan L Teitelbaum, Mary Ann McLaughlin, Allan C Just, Itai Kloog, Maayan Yitshak Sade","doi":"10.1093/aje/kwaf238","DOIUrl":"https://doi.org/10.1093/aje/kwaf238","url":null,"abstract":"<p><p>Exposure to fine particulate matter (PM2.5) is associated with cardiometabolic risk among World Trade Center Health Program general responders, but current studies focus mainly on PM2.5 mass. We studied the associations between annual source-apportioned PM2.5 exposures, and self-reported diabetes or repeated blood glucose measurements among general responders enrolled between 2003-2019 (n=34,764), residing in Tri-state area. We used non-negative matrix factorization to attribute PM2.5 component to sources (i.e., biomass burning, oil combustion, metal industry, other industries, and motor vehicles). We used multivariable mixed-effect models to estimate the simultaneous associations of the source-apportioned PM2.5 exposures with the outcomes. We found (% change [95% confidence intervals]) an interquartile range increase in PM2.5 attributed to metal industry sources (0.42 μg/m3) to be associated with an 8.35% (1.39%,15.79%) higher risk of diabetes and a 1.31% (0.80%,1.82%) increase in glucose levels. Source-specific associations with glucose were modified by sex, showing larger associations with biomass burning (1.08%[0.32%,1.85%] per 0.44 μg/m3) and motor vehicle (1.34%[0.76%,1.93%] per 0.92 μg/m3) pollution among women, and larger associations with oil-combustion (0.68%[0.03%,1.34%] per 1.74 μg/m3) pollution among men. These findings can inform policies and interventions targeting emissions from these specific sources, particularly for general responders with a history of extreme air pollution exposures.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneous Impact of Mask Mandates on U.S. Masking Behavior: An Interrupted Time Series Study.","authors":"Benjamin Rader, Christina M Astley, Laura F White, John S Brownstein, Matthew P Fox","doi":"10.1093/aje/kwaf236","DOIUrl":"https://doi.org/10.1093/aje/kwaf236","url":null,"abstract":"<p><p>Despite widespread implementation of mask mandates for COVID-19 transmission control, studies examining their effectiveness have yielded mixed results ranging from strong benefits to no effect. These inconsistencies may arise from a variety of methodological and measurement challenges, including the implicit assumption that mandates truly modify masking behavior-the essential mechanism for transmission interruption. Here we leverage self-reported mask adherence data from >34,000 individuals collected via a digital participatory surveillance platform between June 2, 2020 and January 1, 2021 to examine this assumption. Using an interrupted time series approach, we aggregate masking observations at the county-level to analyze the effect of mandates on masking uptake across 555 diverse U.S. counties. We evaluate masking during the 14 days pre- and post-mandate issuance, finding a modest 1-3 percentage point overall increases in masking. However, substantial heterogeneity was observed, with larger changes seen in counties initially exhibiting low mask adherence, the U.S. West, and on masking uptake in public compared to private settings. Our findings suggest that conflicting estimates of the effect of mandates on transmission reduction may reflect modification by heterogeneity in the mandates' alteration of masking behavior. Future interventions should tailor mandates to local context and baseline adherence for maximal behavioral change.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the association between upstream perceived individual and neighborhood determinants of health and intensity of breast cancer screening.","authors":"Faith Morley, Anjile An, Vivian Bea, Rulla M Tamimi, Kevin H Kensler","doi":"10.1093/aje/kwaf234","DOIUrl":"https://doi.org/10.1093/aje/kwaf234","url":null,"abstract":"<p><p>Exposure to negative perceived individual and neighborhood determinants disproportionately impacts marginalized groups and can profoundly shape health behavior. We assessed the hypothesized relationship between exposure to adverse perceived individual and neighborhood determinants and rates of mammography. In this cohort study, we identified 31,568 female participants aged 40-74 without history of breast cancer in the All of Us Research Program. Participant-reported levels of perceived stress, everyday discrimination, perceived neighborhood physical disorder, perceived neighborhood social cohesion, and receipt of mammography were ascertained in the linked participant survey and electronic health record data. 52% of participants had at least one mammogram during follow-up. Women reporting high stress were screened at lower rates compared to low stress individuals. Higher discrimination (IRR=0.92, 95% CI=0.88, 0.95) and higher perceived stress (IRR=0.84, 95% CI=0.79, 0.90) were both respectively associated with lower breast cancer screening rates, while perceived neighborhood physical disorder and social cohesion were not. Women reporting high stress and discrimination were also less likely to be compliant with screening guidelines. The associations between the determinants and breast cancer screening rates did not differ by race and ethnicity. Women who report highest levels of discrimination and stress may face additional barriers obtaining breast cancer screening.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying mixtures methodology to analyze how exposure to structural racism and economic disadvantage affect perinatal health outcomes: an ECHO study.","authors":"Dana E Goin, Ronel Ghidey, Holly Schuh, Lori Dean, Emily Barrett, Tracy M Bastain, Jessie P Buckley, Nicole R Bush, Marie Camerota, Kecia N Carroll, Nicholas Cragoe, Lara J Cushing, Dana Dabelea, Anne L Dunlop, Stephanie Eick, Amy J Elliott, Tali Felson, Sarah Geiger, Frank D Gilliland, Tamarra James-Todd, Linda G Kahn, Matt Kasman, Jordan R Kuiper, Bennett Leventhal, Maristella Lucchini, Morgan Nelson, Gwendolyn Norman, Chaela Nutor, T Michael O'Shea, Amy M Padula, Susan L Schantz, Shilpi S Mehta-Lee, Benjamin Steiger, Tracey J Woodruff, Rosalind J Wright, Rachel A Morello-Frosch, For The Echo Cohort Consortium","doi":"10.1093/aje/kwaf224","DOIUrl":"https://doi.org/10.1093/aje/kwaf224","url":null,"abstract":"<p><p>Our objective was to examine the role of structural racism and economic disadvantage in perinatal health inequities using the Environmental influences on Child Health Outcomes Cohort. Participants' addresses were linked to area-level measures of life expectancy, education, unemployment, health insurance, jail rate, segregation, and housing cost burden. We created absolute measures to represent economic disadvantage and relative measures comparing values for Black or Latinx people to White people in the same area to represent structural racism. We used quantile G-computation to estimate the effects of a one-quartile increase in all exposures simultaneously on fetal growth and gestational age measures. A one-quartile increase in economic disadvantage was associated with a reduction in birthweight [(-25.65 grams, 95% CI (-45.83, -5.48)], but not gestational age [-0.02 weeks, 95% CI (-0.13, 0.09)]. With a one-quartile increase in Latinx-White structural racism, we observed reductions in birthweight [-80.83, 95% CI (-143.42, -18.23)) among Latinx participants. A one-quartile increase in Black-White structural racism was weakly associated with lower birthweight among Black participants [-15.70, 95% CI (-82.89, 51.48)] but was associated with higher birthweight among White participants [57.47, 95% CI (13.26, 101.67)]. Our findings suggest co-occurring forms of structural inequity likely influence racialized disparities in fetal growth outcomes.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Risk of Nonvertebral Fractures Associated with Oral Anticoagulants in Patients with Venous Thromboembolism.","authors":"Zhifei Zeng, Sungho Bea, Sushama K Sreedhara, Katsiaryna Bykov","doi":"10.1093/aje/kwaf235","DOIUrl":"https://doi.org/10.1093/aje/kwaf235","url":null,"abstract":"<p><p>Oral anticoagulants are widely used to prevent recurrence in patients with venous thromboembolism (VTE), but studies of these drugs in patients with atrial fibrillation have raised concerns that warfarin may be associated with higher risk of fractures than direct oral anticoagulants. Using the United States administrative claims data from Medicare and Optum Clinformatics® (January 2016 - June 2024), we conducted a cohort study that emulated a 3-arm target trial of VTE patients who initiated apixaban (N = 73,668), rivaroxaban (N = 30,849), or warfarin (N = 20,872). The primary outcome was nonvertebral fractures. Propensity score matching weights were used to balance baseline covariates. Patients were followed while on treatment; intention-to-treat (ITT) analyses were also conducted. Weighted HRs while on treatment were 1.12 (95% CI 0.89 to 1.41) for apixaban vs. warfarin, 1.13 (95% CI 0.87 to 1.46) for rivaroxaban vs. warfarin, and 0.92 (95% CI 0.69 to 1.22) for apixaban vs. rivaroxaban. Results were consistent for ITT and other sensitivity analyses and across subgroups of age, sex, osteoporosis, and chronic kidney disease. Our findings suggest that apixaban, rivaroxaban, and warfarin are comparable with regards to nonvertebral fracture risk when used for VTE secondary prevention.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating sex-specific population-level effects of limiting sugar-sweetened beverages or 100% fruit juices during childhood on insulin resistance, central adiposity, and glycemic outcomes in late adolescence.","authors":"Soren Harnois-Leblanc, Sheryl L Rifas-Shiman, Karen M Switkowski, Wei Perng, Izzuddin M Aris, Emily Oken, Jessica G Young, Marie-France Hivert","doi":"10.1093/aje/kwaf225","DOIUrl":"https://doi.org/10.1093/aje/kwaf225","url":null,"abstract":"<p><p>We estimated sex-specific population effects of hypothetical interventions to limit SSBs and 100% fruit juice throughout childhood on central adiposity, insulin resistance and glycemic outcomes in adolescence in Project Viva pre-birth cohort. Among 481 females and 491 males, mothers reported beverage intake from 3 to 10 years from food frequency questionnaire. Primary outcome was the homeostasis model assessment for insulin resistance (HOMA-IR), and secondary outcomes were waist circumference, truncal fat mass, fasting glucose and glycated hemoglobin in late adolescence. We applied inverse probability weighting of longitudinal marginal structural models to account for baseline and time-varying confounding, and censoring. We estimated that limiting SSBs to one serving weekly across childhood would reduce HOMA-IR by 0.28 units (95%CI: -0.61; 0.02), waist circumference by 1.91 cm (95%CI: -3.79; -0.05), truncal fat mass by 0.64 kg (95%CI: -1.33; 0.05) and fasting glucose by 1.02 mg/dL (95%CI: -2.40; 0.35) in males compared to no intervention. In females, effect estimates were near zero and less precise than males. Effect estimates for 100% fruit juice were small with imprecise CI in both sexes. Overall, limiting SSBs in childhood may have small effects on insulin resistance, central adiposity and glycemia in males in this population of low consumers. Study registry number: NCT02820402.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145311979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tree Canopy Cover and Injurious Pedestrian Falls: A Location-Based Case-Control Study.","authors":"Kathryn G Burford, Alexander X Lo, James W Quinn, Remle P Crowe, Allan C Just, Michelle C Kondo, John R Beard, Andrew G Rundle","doi":"10.1093/aje/kwaf231","DOIUrl":"https://doi.org/10.1093/aje/kwaf231","url":null,"abstract":"<p><p>Despite about half a million injurious pedestrian falls occurring annually in the US, prevention of pedestrian falls is under studied. Sidewalk damage from street trees is a known risk for falls, however tree canopy cover might reduce falls in summer months by lowering ambient temperatures. We conducted pilot research to assess whether Emergency Medical Services (EMS) data could be used to implement a multi-city, location-based case-control study investigating the association between tree canopy cover and locations of injurious pedestrian falls. Case locations (n=497) were places where EMS responded to a pedestrian fall occurrence between April and September of 2019. Matched control locations (n=994) were selected from intersections, street segments, and ramp segments that existed in 2019. Percent tree canopy cover was measured within a 100-m radial buffer of each location. Median tree canopy coverage at fall locations was 8%, compared to 14% for control locations. In adjusted analyses, higher tree canopy cover was inversely associated with fall locations (adjusted OR across the inter-quartile range of canopy cover = 0.57, 95% CI:0.45-0.74), suggesting higher tree canopy cover is associated with lower pedestrian falls risk. Methodological challenges and solutions to implementing and interpreting the location-based, case-control design with EMS data are discussed.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential for Extreme Bias Due to Outcome Misclassification in Relative Measures of Effect for Rare Time-to-Event Outcomes.","authors":"Guy Cafri, Peter C Austin, Joshua J Gagne","doi":"10.1093/aje/kwaf228","DOIUrl":"https://doi.org/10.1093/aje/kwaf228","url":null,"abstract":"<p><p>Time-to-event outcomes are widely used in clinical and epidemiological research. For instance, studies of medical product safety often involve comparative analyses of rare time-to-event outcomes. The effects of misclassified outcomes and error in survival times for time-to-event data have not been widely investigated. In this Monte Carlo simulation study we compared the relative bias of absolute and relative measures of effect under varying degrees of outcome misclassification, outcome incidences, direction of error in survival times and the time point of inference. Relative measures of effect were susceptible to considerable downward bias, which was larger when: the outcome incidence and specificity were lower, error in survival times led to earlier times, time point of inference was earlier and the estimation excluded samples for which an estimate could not be obtained. For absolute measures of effect, the pattern of bias was much simpler, greater downward bias was primarily a function of the degree of sensitivity. The results suggest when the outcome incidence is rare, specificity and sensitivity are high, absolute measures of effect may be preferable to relative measures of effect.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intimate Partner Violence Google Searches Before and After the Dobbs Decision.","authors":"Krista Neumann, Kriszta Farkas, Maryam Tanveer, Stephen J Mooney, Molly Altman, N Jeanie Santaularia","doi":"10.1093/aje/kwaf230","DOIUrl":"https://doi.org/10.1093/aje/kwaf230","url":null,"abstract":"","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invited Commentary: Building rigorous clinical evidence for drug-drug interactions.","authors":"Paraskevi Tassopoulou, Antonios Douros","doi":"10.1093/aje/kwaf222","DOIUrl":"https://doi.org/10.1093/aje/kwaf222","url":null,"abstract":"<p><p>Drug-drug interactions (DDIs) are a major cause of preventable adverse drug events. However, the clinical relevance of specific DDIs is often uncertain due to limited evidence beyond preclinical findings and pharmacokinetic studies. In this editorial, we discuss the recent study by Bea et al. (Am J Epidemiol. 0000;000(00):0000-0000), which assessed whether the pharmacologic interaction between hydrocodone and non-dihydropyridine calcium-channel blockers is associated with the risk of opioid overdose, finding no increased risk. We highlight the methodological strengths of the study, including the use of a control precipitant, the consideration of the order of drug initiation in concomitant use, and the application of multiple exposure definitions. At the same time, we outline remaining challenges -both in this study and more broadly in the DDI field- such as the appropriate selection of control precipitants and selection bias due to depletion of susceptibles. Finally, we briefly discuss potential applications of novel pharmacoepidemiologic methods for DDI studies and also ways to strengthen the rationale for DDI studies and prioritize study questions. Given the rising rates of polypharmacy that lead to increased concomitant use of medications potentially interacting with each other, pharmacoepidemiology is well-positioned to generate clinically actionable evidence to guide medication safety.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}