Citation

Prissel CM, Grossardt BR, Klinger GS, St Sauver JL, Rocca WA. Int. J. Environ. Res. Public Health 2023; 20(6).

Copyright

(Copyright © 2023, MDPI: Multidisciplinary Digital Publishing Institute)

DOI

10.3390/ijerph20065116

PMID

36982025

PMCID

PMC10049688

Abstract

BACKGROUND: The Rochester Epidemiology Project (REP) medical records-linkage system offers a unique opportunity to integrate medical and residency data with existing environmental data, to estimate individual-level exposures. Our primary aim was to provide an archetype of this integration. Our secondary aim was to explore the association between groundwater inorganic nitrogen concentration and adverse child and adolescent health outcomes.

METHODS: We conducted a nested case-control study in children, aged seven to eighteen, from six counties of southeastern Minnesota. Groundwater inorganic nitrogen concentration data were interpolated, to estimate exposure across our study region. Residency data were then overlaid, to estimate individual-level exposure for our entire study population (n = 29,270). Clinical classification software sets of diagnostic codes were used to determine the presence of 21 clinical conditions. Regression models were adjusted for age, sex, race, and rurality.

RESULTS: The analyses support further investigation of associations between nitrogen concentration and chronic obstructive pulmonary disease and bronchiectasis (OR: 2.38, CI: 1.64-3.46) among boys and girls, thyroid disorders (OR: 1.44, CI: 1.05-1.99) and suicide and intentional self-inflicted injury (OR: 1.37, CI: >1.00-1.87) among girls, and attention deficit conduct and disruptive behavior disorders (OR: 1.34, CI: 1.24-1.46) among boys.

CONCLUSIONS: Investigators with environmental health research questions should leverage the well-enumerated population and residency data in the REP.

Language: en

Keywords

*Self-Injurious Behavior; *Suicide; Adolescent; adolescent health; Case-Control Studies; Child; child health; epidemiology; Female; groundwater nitrogen; Humans; Male; Medical Record Linkage; Outcome Assessment, Health Care; records-linkage system; spatial methods