medRxiv : the preprint server for health sciences最新文献

{"title":"Preferences for Tongue Swab versus Sputum Collection for Tuberculosis Testing: A Multi-Country Survey.","authors":"Kingsley Manoj Kumar, April Borkman, Ashley Kim, Rebecca Crowder, Bukola Ajide, Karla Alí-Francia, Masuzyo Chirwa, Louis Kamulegeya, Hien Le, Vu Ngoc Trung, Rouxjeane Venter, John Bimba, Devasahayam J Christopher, Victoria Dalay, Nguyen Van Hung, Monde Muyoyeta, Lydia Nakiyingi, Nguyen Van Nhung, Grant Theron, Charles Yu, Carlos Zamudio-Fuertes, Julian Atim, Andrew D Kerkhoff, Maria Del Mar Castro Noriega, Payam Nahid, Claudia M Denkinger, Adithya Cattamanchi, Susan E Dorman, Nora West","doi":"10.1101/2025.07.04.25330895","DOIUrl":"10.1101/2025.07.04.25330895","url":null,"abstract":"<p><strong>Background: </strong>Sputum collection for tuberculosis (TB) diagnosis poses challenges for children, people living with HIV, and those who struggle with sputum production. Tongue swab-based molecular testing offers a promising non-invasive alternative, but person-centered research on acceptability is limited.</p><p><strong>Methods: </strong>We conducted a pragmatic survey across eight countries (Vietnam, Philippines, South Africa, Nigeria, Zambia, India, Uganda, Peru) among people with presumptive TB attending primary care facilities. Participants provided both tongue swab and sputum samples, then completed a 5-10 minute survey about their collection preferences.</p><p><strong>Results: </strong>From October 2023 to July 2024, 1,297 participants were enrolled (median age 43 years, 45% female, 13% HIV-positive). Overall, 61% (95% CI: 58-64%) preferred tongue swab collection compared to 22% (95% CI: 20-25%) who preferred sputum collection and 17% (95% CI: 15-19%) with no preference. Preference for tongue swab was consistent across demographic and clinical subgroups, with country-level variation ranging from 47% in South Africa to 74% in Zambia and Nigeria.</p><p><strong>Conclusion: </strong>Strong preference for tongue swab over sputum collection among individuals with presumptive TB supports this diagnostic innovation's potential to overcome barriers to timely TB testing, particularly for populations struggling with sputum production.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Troponin T Elevation Predicts Mortality in Hospitalized COVID-19 Patients.","authors":"Katelyn A Bruno, R Scott Wright, Joshua Culberson, Mikolaj A Wieczorek, David O Hodge, Patrick W Johnson, Yomary A Jimenez, Emily R Whelan, Jose M Malavet, Kathryn F Larson, Jonathon W Senefeld, Chad C Wiggins, Stephen A Klassen, Jacob Ricci, Taimur Sher, Rickey E Carter, Michael J Joyner, DeLisa Fairweather, Allan S Jaffe","doi":"10.1101/2025.07.03.25330855","DOIUrl":"10.1101/2025.07.03.25330855","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate if cardiac troponin values predict poor outcomes in COVID-19 patients across the range of patients of different sex and age.</p><p><strong>Methods: </strong>We examined high-sensitivity cardiac troponin T (hs-cTnT) levels in 1,050 severely ill hospitalized COVID-19 patients who had hs-cTnT data available and participated in the Expanded Access Program for convalescent plasma study during the first wave (April-August 2020) of the COVID-19 pandemic.</p><p><strong>Results: </strong>We observed a continuous relationship between hs-cTnT levels and mortality in hospitalized males and females with COVID-19. This finding was present regardless of sex or age.</p><p><strong>Conclusion: </strong>These data indicate the prognostic ability of hs-cTnT to predict mortality in hospitalized COVID-19 patients across all relevant patient groups.</p><p><strong>Clinical trials registration number: </strong>NCT04338360.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Strategies to Introduce Two New Antibiotics for Gonorrhea: A Modeling Study.","authors":"Madeleine C Kline, Kirstin Oliveira Roster, David Helekal, Eva Rumpler, Yonatan H Grad","doi":"10.1101/2025.07.01.25330638","DOIUrl":"10.1101/2025.07.01.25330638","url":null,"abstract":"<p><strong>Introduction: </strong>Drug resistance in <i>Neisseria gonorrhoeae</i> is an urgent public health threat. The anticipated approval of two new antimicrobials for gonorrhea prompts the need for evidence-based rollout strategies that minimize drug resistance.</p><p><strong>Methods: </strong>We used a stochastic compartmental model of men who have sex with men (MSM) in the United States (U.S.) to compare two main strategies-equal allocation and sequential drug deployment-for two new and one existing drug and measured the time for each drug to reach a resistance prevalence threshold of 5%. We conducted broad analyses assessing the sensitivity of our results to wide variation in parameters governing the baseline behavior of the model and drug resistance evolution and fitness.</p><p><strong>Results: </strong>Compared to the equal allocation strategy, the sequential strategy had reached the resistance prevalence threshold i) for each drug individually in at least as many simulations; ii) for all three drugs in at least as many simulations; and iii) for at least as many drugs on average. After 10 years, no equal allocation strategy simulations had met the 5% resistance prevalence threshold for any of the drugs, whereas 99.6% of sequential simulations had for the first drug, of which 3.5% had also met the threshold for the second drug. The sequential strategy was worse for nearly every reasonable combination of model parameters.</p><p><strong>Conclusion: </strong>In a model of U.S. MSM, the equal allocation strategy for introducing new drugs for gonorrhea matched or outperformed the strategy of sequential introduction in terms of resistance prevalence.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantification of Optical Coherence Tomography Features in >3500 Patients with Inherited Retinal Disease Reveals Novel Genotype-Phenotype Associations.","authors":"William Woof, Thales A C de Guimarães, Saoud Al-Khuzaei, Malena Daich Varela, Mital Shah, Gunjan Naik, Sagnik Sen, Pallavi Bagga, Bernardo Mendes, Yiu Wai Chan, Siying Lin, Biraja Ghoshal, Bart Liefers, Dun Jack Fu, Michalis Georgiou, Alan Sousa da Silva, Quang Nguyen, Yichen Liu, Dayyanah Sumodhee, Yu Fujinami-Yokokawa, Praveen J Patel, Jennifer Furman, Ismail Moghul, Mariya Moosajee, Juliana Sallum, Samantha R De Silva, Birgit Lorenz, Philipp Herrmann, Frank G Holz, Kaoru Fujinami, Andrew R Webster, Omar A Mahroo, Susan M Downes, Savita Madhusuhan, Konstantinos Balaskas, Michel Michaelides, Nikolas Pontikos","doi":"10.1101/2025.07.03.25330767","DOIUrl":"10.1101/2025.07.03.25330767","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To quantify spectral-domain optical coherence tomography (SD-OCT) images cross-sectionally and longitudinally in a large cohort of molecularly characterized patients with inherited retinal disease (IRDs) from the UK.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Retrospective study of imaging data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Patients with a clinical and molecularly confirmed diagnosis of IRD who have undergone macular SD-OCT imaging at Moorfields Eye Hospital (MEH) between 2011 and 2019. We retrospectively identified 4,240 IRD patients from the MEH database (198 distinct IRD genes), including 69,664 SD-OCT macular volumes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Eight features of interest were defined: retina, fovea, intraretinal cystic spaces (ICS), subretinal fluid (SRF), subretinal hyper-reflective material (SHRM), pigment epithelium detachment (PED), ellipsoid zone loss (EZ-loss) and retinal pigment epithelium loss (RPE-loss). Manual annotations of five b-scans per SD-OCT volume was performed for the retinal features by four graders based on a defined grading protocol. A total of 1,749 b-scans from 360 SD-OCT volumes across 275 patients were annotated for the eight retinal features for training and testing of a neural-network-based segmentation model, AIRDetect-OCT, which was then applied to the entire imaging dataset.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;Performance of AIRDetect-OCT, comparing to inter-grader agreement was evaluated using Dice score on a held-out dataset. Feature prevalence, volume and area were analysed cross-sectionally and longitudinally.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The inter-grader Dice score for manual segmentation was ≥90% for retina, ICS, SRF, SHRM and PED, &gt;77% for both EZ-loss and RPE-loss. Model-grader agreement was &gt;80% for segmentation of retina, ICS, SRF, SHRM, and PED, and &gt;68% for both EZ-loss and RPE-loss. Automatic segmentation was applied to 272,168 b-scans across 7,405 SD-OCT volumes from 3,534 patients encompassing 176 unique genes. Accounting for age, male patients exhibited significantly more EZ-loss (19.6mm&lt;sup&gt;2&lt;/sup&gt; vs 17.9mm&lt;sup&gt;2&lt;/sup&gt;, p&lt;2.8×10&lt;sup&gt;-4&lt;/sup&gt;) and RPE-loss (7.79mm&lt;sup&gt;2&lt;/sup&gt; vs 6.15mm&lt;sup&gt;2&lt;/sup&gt;, p&lt;3.2×10&lt;sup&gt;-6&lt;/sup&gt;) than females. RPE-loss was significantly higher in Asian patients than other ethnicities (9.37mm&lt;sup&gt;2&lt;/sup&gt; vs 7.29mm&lt;sup&gt;2&lt;/sup&gt;, p&lt;0.03). ICS average total volume was largest in &lt;i&gt;RS1&lt;/i&gt; (0.47mm&lt;sup&gt;3&lt;/sup&gt;) and &lt;i&gt;NR2E3&lt;/i&gt; (0.25mm&lt;sup&gt;3&lt;/sup&gt;), SRF in &lt;i&gt;BEST1&lt;/i&gt; (0.21mm&lt;sup&gt;3&lt;/sup&gt;) and PED in &lt;i&gt;EFEMP1&lt;/i&gt; (0.34mm&lt;sup&gt;3&lt;/sup&gt;). &lt;i&gt;BEST1&lt;/i&gt; and &lt;i&gt;PROM1&lt;/i&gt; showed significantly different patterns of EZ-loss (p&lt;10&lt;sup&gt;-4&lt;/sup&gt;) and RPE-loss (p&lt;0.02) comparing the dominant to the recessive forms. Sectoral analysis revealed significantly increased EZ-loss in the inferior quadrant compared to superior quadrant for &lt;i&gt;RHO&lt;/i&gt; (Δ=-0.414 mm&lt;sup&gt;2&lt;/sup&gt;, p=0.036) and EYS (Δ=-0.908 mm&lt;sup&gt;2&lt;/sup&gt;, p=1.5×10&lt;sup&gt;-4&lt;/sup&gt;). In &lt;i&gt;ABCA4&lt;/i","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptive mobility responses during Hurricanes Helene and Milton in 2024.","authors":"Qing Yao, Victoria D Lynch, Molei Liu, Xiao Wu, Robbie M Parks, Sen Pei","doi":"10.1101/2025.07.02.25330752","DOIUrl":"10.1101/2025.07.02.25330752","url":null,"abstract":"<p><p>Adaptation is crucial for minimizing the societal impacts of tropical cyclones amid climate change. Using 355.5 million high-resolution foot-traffic records from mobile devices, we analyzed human mobility patterns during Hurricanes Helene and Milton, which struck the southeastern United States in 2024. We observed marked differences in adaptive mobility responses across geographic regions with varying levels of historical hurricane exposure. Milton primarily impacted coastal areas with frequent hurricane exposure and prompted sharp increases in out-region travel prior to landfall and sustained elevated mobility in the post-disaster period. In contrast, Helene affected mostly inland areas, where mobility changes were modest and largely within natural variation. Within Helene-affected regions, coastal counties showed stronger mobility responses than inland counties. Our findings underscore the need for tailoring disaster preparedness and response strategies to the specific characteristics of affected populations.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Hospital to Home: Continuity between Skin-to-Skin Care and Later Verbal Engagement in Infants Born Preterm.","authors":"Pamela M Rios, Virginia A Marchman, Molly F Lazarus, Nuria L Ontiveros Perez, Melissa Scala, Katherine E Travis, Heidi M Feldman","doi":"10.1101/2025.07.02.25330762","DOIUrl":"10.1101/2025.07.02.25330762","url":null,"abstract":"<p><p>This descriptive cohort study documented continuity between family-delivered skin-to-skin care rates for preterm infants in the NICU and amount of child-directed speech at child age 9 months. Involvement in skin-to-skin care may be an early marker of caregiver engagement and a target for early interventions that support positive caregiver-infant interactions.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Meta-research on Evolving Evidence Behind Genetic Variant (Re)Classification.","authors":"Haotian Ma, Zihan Xu, Wendy Chung, Chunhua Weng, Yifan Peng","doi":"10.1101/2025.04.07.25325116","DOIUrl":"10.1101/2025.04.07.25325116","url":null,"abstract":"<p><p>Variant classification and reclassification are fundamental to advancing precision medicine. This study focuses on the reclassifications of variants of uncertain significance (VUS) in <i>BRCA1</i> and <i>BRCA2</i> genes. By analyzing 162 unique cited publications supporting VUS reclassifications, we examined the accuracy, completeness, and currency of citations to these publications. Our findings reveal missing or inadequate evidence for reclassifications, as well as temporally misaligned citations and ClinVar submissions. Furthermore, we observed patterns in the cited studies, including the use of classification recommendations, genetic mechanisms, computational tools, and diverse population studies. This study underscores the need for stronger evidence supporting reclassifications and greater inclusion of diverse populations to optimize genomic variant reclassification and clinical decision-making.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Antiprotozoal Treatments and Reduced Mortality Across Populations Suggest That Protozoal Colonization May Contribute Significantly to Human Mortality and Age-Related Morbidity.","authors":"Ariel Israel, Abraham Weizman, Sarah Israel, Shai Ashkenazi, Eytan Ruppin, Shlomo Vinker, Eli Magen, Eugene Merzon","doi":"10.1101/2025.07.01.25330644","DOIUrl":"https://doi.org/10.1101/2025.07.01.25330644","url":null,"abstract":"<p><p>To identify medications with the potential to increase human lifespan, we conducted a systematic screening of electronic health records from a national health organization, comparing medications consumed over the preceding decade by individuals over 60 who outlived the average life expectancy with those consumed by matched individuals who died before reaching it. This screen identified two antiprotozoal agents, atovaquone-proguanil and mefloquine, as strongly associated with increased longevity (odds ratios for 10-year mortality: 0.43 and 0.32; FDR = 0.0002 and 0.0001, respectively). We validated these associations in the U.S.-based TriNetX federated network, confirming that these two antiprotozoals, along with nirmatrelvir-ritonavir-a medication used to prevent severe COVID-19 outcomes and possessing antiprotozoal properties-were associated with significantly reduced mortality and a lower incidence of major age-related conditions, including diabetes mellitus, cardiovascular and cerebrovascular diseases, renal insufficiency, dementia, pulmonary disease, liver disease, and malignancies. Across both populations, antiprotozoal exposure was also associated with increased risks of specific adverse outcomes, notably hearing loss, Sjögren's syndrome, and lichen planus. The consistent observation of both benefits and risks across independent populations supports the biological plausibility of these effects and argues against confounding by indication or underdiagnosis. Taken together, these findings suggest that elimination of protozoal parasites-notably <i>Toxoplasma gondii</i> - may significantly reduce human age-related morbidity and mortality while increasing the risk of specific auditory, ophthalmic, and dermatologic complications. These results offer promising new avenues to extend human lifespan and promote healthy aging through targeted antimicrobial interventions.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative Social Ties as Emerging Risk Factors for Accelerated Aging, Inflammation, and Multimorbidity.","authors":"Byungkyu Lee, Gabriele Ciciurkaite, Siyun Peng, Colter Mitchell, Brea L Perry","doi":"10.1101/2025.05.23.25328261","DOIUrl":"10.1101/2025.05.23.25328261","url":null,"abstract":"<p><p>Negative social ties, or \"hasslers,\" are pervasive yet understudied components of social networks that may accelerate biological aging and morbidity. Using ego-centric network data and DNA methylation-based biological aging clocks from a representative Indiana sample, we demonstrate that negative social ties are surprisingly common: on average, one in four network members is described as a hassler, and nearly 60% of individuals report having at least one. Results show that having more hasslers is associated with accelerated biological aging, with the most pronounced associations observed among individuals whose networks comprise more than 50% hasslers. Crucially, not all negative ties show the same influence: ambivalent ties providing both support and stress show stronger aging acceleration than exclusively negative relationships. Beyond epigenetic aging, hassling exposure is associated with poorer self-rated health, higher levels of depression and anxiety, elevated inflammation, greater multimorbidity, and adverse anthropometric indicators. These findings together highlight the critical role of negative social ties in biological aging as chronic stressors and the need for interventions that reduce the impact of negative social stressors embedded within close social networks to promote healthier aging trajectories.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health damages and disparities from municipal and medical waste incineration in Baltimore, USA.","authors":"Kevin J Tu, Christopher D Heaney, Greg Sawtell, Carlos Sanchez, Bonita Salmerón, Matthew A Aubourg, Shiladitya DasSarma","doi":"10.1101/2025.06.27.25330313","DOIUrl":"10.1101/2025.06.27.25330313","url":null,"abstract":"<p><strong>Background: </strong>Waste incineration in Baltimore, USA, involves two major facilities: a municipal solid waste incinerator (WIN Waste) and the nation's largest medical waste incinerator (Curtis Bay Medical Waste Incinerator). Both operate in socio-economically disadvantaged communities, raising concerns about cumulative environmental exposures and health disparities from hazardous air pollutants.</p><p><strong>Methods: </strong>We estimated health impacts from available criteria incinerator emissions data (PM, NOx, SO₂, CO). We used AERMOD to model ground-level pollutant concentrations, linked these to U.S. Census tracts, and monetized health damages using established relative risk and cost of illness data. Health disparities were evaluated by modeling incinerator-attributable mortality against the Social Vulnerability Index (SVI).</p><p><strong>Findings: </strong>In 2024, the WIN Waste incinerator caused an estimated $53.8 million in health damages in Maryland and Washington DC. On average, the Curtis Bay Medical Waste Incinerator releases black smoke emissions for 52.5 minutes/day, a regulatory violation. The facility causes $36.9 million/year in health damages and is permitted to burn enough waste to cause up to $107.1 million/year; enforcing pollution controls at this site could prevent $13.8 million in annual harm in Baltimore. Combined, the two incinerators cause $97.0 million in damages annually. All-cause mortality from incinerator pollution was more common in communities with higher socioeconomic vulnerability.</p><p><strong>Interpretation: </strong>Despite being required to install new pollution control equipment following community and regulatory pressure, the WIN Waste incinerator still causes significant health damages to Maryland and Washington DC. Meanwhile, repeated black smoke emissions from the Curtis Bay incinerator indicate that ongoing, uncontrolled pollution is also a major threat to public health in the region. Health damages from these incinerators disproportionately affect communities least able to bear the economic burden. Our conservative estimates highlight the need for urgent policy reforms, including stricter emissions monitoring, phasing out non-essential incineration, and ongoing cumulative impact assessments.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}