Research Areas

Aging
Cardiovascular & Respiratory Disease
Cancer
Environmental Exposures
Epidemiologic Methods
Infectious Disease
Minority Health
Pharmaceutical
Reproductive, Perinatal and Pediatric
Renal

Aging Research

The Normative Aging Study

The VA Normative Aging Study (NAS) is a multidisciplinary, longitudinal investigation of the aging process established as an intramural research program within the Department of Veterans Affairs in 1963 and conducted at the VA Outpatient Clinic in Boston. Longstanding objectives of the study have been the characterization of the biomedical and psychosocial parameters of aging as well as the development of disease conditions associated with advancing age. Epidemiology faculty: Avron Spiro III.

Stress, Health & Aging Research Program

The Stress, Health & Aging Research Program (SHARP) studies the effects of exposure to combat and other traumatic or stressful events on mental and physical health in aging veterans from a lifespan developmental perspective. Using this perspective, we seek to better understand the impact of military service on all veterans, with the ultimate goal of designing more effective programs for those affected by their service. SHARP activities involve a combination of analysis of existing data, collection of new data, and development and implementation of clinical research. Epidemiology faculty: Avron Spiro III.

Care Giving & Healthy Aging Research

Our research group is conducting epidemiologic studies on how psychosocial factors influence physical health and functioning in community-dwelling older adults, hip fracture patients, and adults at-risk of arthritis. Our work addresses two broad questions: How does care giving to an impaired friend or relative affect aging and health outcomes and how do positive affect and optimism influence functioning and physical health in elderly adults? Our caregiver research includes several NIH-funded prospective cohort studies on the health effects of caregiving, and the physiological pathways that may link caregiving stress to adverse health outcomes (i.e., higher mortality rates, poorer immune functioning) that have been observed in prior studies. Our findings from Caregiver SOF suggest that the relationship between caregiving, aging and health is more complex, and that older women may derive health benefits from caregiving. In the Health Pathways Study, we are utilizing biomarkers to uncover the physiological pathways that may link to metabolic syndrome and underlie the relationships between caregiving activities, caregiving-related stress, physiological functioning, and health outcomes. We are also conducting a randomized controlled trial of mindfulness-based stress reduction for caregivers, The Stress Reduction for Caregivers Study. Through the data we have collected from each of these studies, we are exploring the impact of positive affect and optimism on functional decline, stress, and other health outcomes in older adults.  We are interested in how physiological mechanisms may mediate these relationships. Epidemiology faculty: Lisa Fredman.

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Cardiovascular & Respiratory Research

Framingham Heart Study

In 1948, the Framingham Heart Study was formed to identify the common factors that contribute to cardiovascular disease (CVD) by following its development over a long period of time in a large group of participants who had not yet developed overt symptoms of CVD or suffered a heart attack or stroke. Under the direction and funding of by the National Heart, Lung, and Blood Institute (NHLBI), the study continues to enroll third-generation relatives of the original participants and has expanded its areas of research to also include the role of genetic factors in CVD, stroke and dementia, osteoporosis and arthritis, nutrition, diabetes, eye diseases, hearing disorders, lung diseases, and genetic patterns of common diseases. The Framingham Heart Study has been conducted in collaboration with Boston University since 1971. To read more about the study, please visit framinghamheartstudy.org. Epidemiology faculty: Emelia J. Benjamin, MD, ScM.

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Cancer Research

Long-term follow-up of individuals exposed to diethylstilbestrol (DES)

This multi-center prospective cohort study follows over 10,000 mothers, daughters, sons and third generation granddaughters who were exposed to the pregnancy drug, DES. DES was originally used to prevent miscarriage and preterm birth between the early 1940’s and 1971. Not only was it not effective in preventing pregnancy problems, but it was also found cause a rare vaginal cancer and other health problems in the daughters who were exposed in utero. Participants in this study are being followed for breast and other cancers, as well as reproductive problems such as infertility and early menopause. Epidemiology faculty: Julie Palmer, Elizabeth Hatch, and Lauren Wise.

Modification of tamoxifen effectiveness by gene polymorphisms & other drugs

This research project investigates modification of tamoxifen’s effectiveness in reducing breast cancer recurrence risk. Tamoxifen is a hormonal therapy that reduces the risk of breast cancer recurrence by about half in women whose tumors carry the estrogen receptor. Tamoxifen must be metabolized by an enzyme called CYP2D6 to achieve its most active form. This study investigated whether breast cancer patients who carry a genetic mutation in CYP2D6, or who take other drugs that inhibit CYP2D6 activity, are at higher risk of recurrence. The study involves a collaboration with the Universities of Aarhus and Odense in Denmark. It uses a cohort of Danish breast cancer patients diagnosed 1985 to 2002 on the Jutland peninsula, and is jointly supported by the US National Cancer Institute and the Danish Cancer Society. Epidemiology faculty: Timothy Lash and Henrik Sorensen.

Health Advocates as a Vehicle to Improve Treatment for Smokers in Public Housing

Quitting smoking is the most important step that smokers can take to benefit their health. However, low-income smokers are less successful in quitting than higher-income smokers. If these socioeconomic disparities in smoking and smoking cessation rates persist, low-income smokers will bear an increasingly disparate burden of smoking-related morbidity and mortality. Therefore, interventions to improve the rate of smoking cessation among low-income smokers are urgently needed. Smoking cessation treatment programs such as telephone quitlines and clinic-based programs exist but are underutilized, particularly by low-income smokers. A group-randomized trial is being conducted among public housing residents to test whether the use of resident Community Health Advocates with special training in smoking cessation (Tobacco Treatment Advocates (TTAs) can improve (1) utilization of quitlines and clinic-based programs and (2) smoking cessation rates among smokers in public housing. Epidemiology faculty: Dan Brooks.

The project described above is supported by the National Cancer Institute. To read more about this research project and other NCI funded tobacco control research, please visit cancercontrol.cancer.gov/tcrb.

Risk Stratification & Shared-Making for Colorectal Cancer Screening

Eliciting patient preferences within the context of shared decision-making has been endorsed as an appropriate and potentially effective strategy for increasing colorectal cancer screening rates. Nevertheless, many providers are reluctant to comply with patient preferences in instances where those preferences differ from their own. Funded by the National Cancer Institute, the primary objective of this study is to determine whether risk stratification for advanced neoplasia, using a validated prediction model developed by our group, influences decision-making related to test selection and adherence to screening within a shared decision-making framework. Epidemiology Faculty: Paul Schroy.

Patient Navigation for Screening Colonoscopy

Funded by the Center for Disease Control and Prevention, the study is a randomized trial to test the cost-effectiveness of a patient navigator intervention for screening colonoscopy among a diverse, mostly medically underserved patient population. Epidemiology Faculty: Paul Schroy

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Environmental Exposure Research

Investigating Breast Cancer & the Environment on Cape Cod

Higher-than-statewide breast cancer incidence remains a persistent and unexplained public health problem in the Cape Cod region of Massachusetts. The goal of this case-control study was to investigate possible environmental and other risk factors for breast cancer in order to better understand the reasons for the increased incidence. In collaboration with Silent Spring Institute (Newton, Massachusetts), this study has evaluated the following exposures in relation to breast cancer risk: pesticides; pharmaceutical, personal care and household products (other than pesticides); residential exposure to drinking water infiltrated by wastewater; and residential exposure to industrial/commercial pollutants. The study includes 1,165 individuals residing in 15 Cape Cod towns who were diagnosed with breast cancer in 1998–1995 and 1,006 controls. Many findings from this study have been published (McKelvey et al., 2004; Brody et al., 2004; Brody et al., 2006: Zota et al., 2010). Epidemiology faculty: Ann Aschengrau.

PCE-Contaminated Water & the Risk of Breast Cancer

Part of the Superfund Basic Research Program at Boston University, this NIH-funded, population-based case-control study tested the hypothesis that PCE found in the public drinking water supplies in the Cape Cod region of Massachusetts is associated with the risk of breast cancer. The case group (n=672) was composed of residents of eight Cape Cod towns who had been diagnosed with breast cancer diagnosed in 1987-1993. Controls were demographically similar residents of the same towns (n=616). The study found a modest association between high levels of PCE exposure and breast cancer risk (Aschengrau et al., 2003; Gallagher et al., 2011). Epidemiology faculty: Ann Aschengrau.

PCE-Contaminated Drinking Water & Disorders of Reproduction & Development

Part of the Superfund Basic Research Center at Boston University , this NIH-funded, population-based retrospective cohort study tested the hypothesis that PCE found in the distributions systems of public drinking water supplies in the Cape Cod region of Massachusetts is associated with reproductive abnormalities of adults and developmental outcomes of newborns. The study includes Cape Cod children and their families who were exposed to PCE-contaminated drinking water between 1969 and 1983, when PCE leached from the vinyl lining of asbestos-cement drinking water pipes and a comparable group of unexposed children and their families. To date, manuscripts describing the results for birth defects, low birth weight, prematurity, learning disabilities, and spontaneous abortion have been published (Aschengrau et al., 2008, 2009; Janulewicz et al., 2008). Epidemiology faculty: Ann Aschengrau.

Neurotoxic Effects of PCE Exposure During Gestation & Childhood

Part of the Superfund Basic Research Program at Boston University, this population-based retrospective cohort study tested the hypothesis that PCE found in the distribution systems of public drinking water supplies in the Cape Cod region of Massachusetts is associated with neurotoxic effects among individuals who were exposed during gestation and childhood. Hypothesized nervous system effects include an increased prevalence of developmental disabilities of learning and attention, vision disorders, impaired performance on neuropsychological and vision tests, and increased prevalence of cerebral pathology and dysfunction as seen in neuroimaging studies.To date, manuscripts have been published describing an increased affinity for risky behaviors (including drug use), increased risks of post-traumatic stress disorder and bipolar disorder, and impaired performance on neuropsychological and vision tests among subjects with early life exposure to PCE (Aschengrau et al., 2011, 2012; Janulewicz et al., 2011; and Getz et al., 2012) Epidemiology faculty: Ann Aschengrau

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Epidemiologic Methods Research

Boston University Sensitivity Analysis Tools

Matthew Fox, and others have developed tools for a Monte Carlo technique for bias analysis of epidemiologic data. These bias analysis methods allow for correction of systematic errors due to selection bias, misclassification, or unmeasured confounding, given assumptions about the factors that affect these biases. The information on this page complements several manuscripts that describe the methods. In addition, the National Library of Medicine has provided support to write a textbook that compiles, explains, and illustrates methods of bias analysis applied to epidemiologic data.  The text, which will be published by Springer in 2009, will be accompanied by Excel spreadsheets and SAS code that implement the bias analysis methods. You can find the sensitivity analysis tools and information about the book at this site sites.google.com/site/biasanalysis.

Internet-based study of time to pregnancy

This NIH-funded prospective cohort study is recruiting Danish women via the internet to study risk factors for delayed time to pregnancy and miscarriage. Over 3500 women have enrolled so far and are being followed for up to twelve months or until they become pregnant. The primary risk factors of interest are caffeine and alcohol consumption, smoking, medication use, and body mass index. The extensive system of medical registries in Denmark, including birth, medication, and medical registries will allow data linkage to assess the validity of the using the internet for epidemiologic research. Epidemiology faculty: Elizabeth Hatch, Lauren Wise, and Ken Rothman.

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Infectious Disease Research

Tuberculosis

Boston University School of Public Health participates in TB research through two Federally-funded research networks, the Tuberculosis Trials Consortium (TBTC), supported by the CDC, and the Tuberculosis Translational Science Group of the AIDS Clinical Trials Group (ACTG), supported by NIAID. These consortia design and conduct clinical trials of new drugs and regimens for the treatment and prevention of TB. Epidemiology faculty: C. Robert Horsburgh Jr.

Human Papillomavirus Vaccination & Abnormal Cervical Cytology in Young Women attending Boston University Medical Center Clinics

The overall objective of this case-control study is to provide preliminary data to help prevent cervical cancer in young women in the era of HPV vaccination. Specifically, we will examine the distribution of HPV types and frequency of vaccination in relation to abnormal cervical cytology to assess the overall effectiveness of the vaccine including whether there is residual oncogenicity of HPV types not included in the quadrivalent vaccine. This preliminary data will help to determine whether the current vaccine strategies to decrease HPV-related cervical disease are working or if additional efforts are needed. Epidemiology faculty: Susan Brogly.

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Minority Health Research

Black Women’s Health Study (BWHS)

The BWHS is the largest follow-up study of the health of African-American women yet conducted. The purpose is to identify and evaluate causes and preventives of cancers and other serious illnesses in African-American women. Among the diseases being studied are breast cancer, colon cancer, hypertension, type 2 diabetes, uterine fibroids, systemic lupus erythematosus, rheumatoid arthritis, and sarcoidosis. The study began in 1995, when 59,000 black women from all parts of the United States enrolled through postal questionnaires. The women provided demographic and health data on the 1995 baseline questionnaire, including information on weight, height, smoking, drinking, contraceptive use, use of other selected medications, illnesses, reproductive history, physical activity, diet, use of health care, and other factors. The participants are followed through biennial questionnaires to determine the occurrence of cancers and other illnesses and to update information on risk factors. Completion of follow-up questionnaires by members of the 1995 cohort has exceeded 80% in each cycle of follow-up. Information on outcomes is validated through medical record review. Validation studies of diet, anthropometric measures, and physical activity have been completed. In a genetic component, saliva samples have been obtained from participants; DNA from the samples will serve as a resource for testing hypotheses about gene-environment interactions. Epidemiology faculty: Lynn Rosenberg, Julie Palmer, Yvette Cozier, Lauren Wise, Patricia Coogan, and Edward Ruiz-Narvaez.

Sarcoidosis in US Black Women

This is a recently funded study (K01) of selected genetic and non-genetic potential risk factors for sarcoidosis, a chronic, granulomatous, systemic disorder, in black women. Black women bear the largest burden of sarcoidosis in the US in terms of incidence, and they are more likely than any other group to be younger at diagnosis, experience progressive disease, and die. Little has been established about causes of the disease. Potential risk factors, including psychosocial stressors, and markers of endogenous and exogenous hormone exposure will be assessed in relation to the risk of sarcoidosis. We will also assess alleles of genes involved in sex hormone metabolism, including those involved in the synthesis of sex steroids, and the metabolism and detoxification of estrogen, in relation to sarcoidosis risk. The study is being conducted within the Black Women’s Health Study at the Slone Epidemiology Center, and in collaboration with the Pulmonary Center at Boston Medical Center. Epidemiology faculty: Yvette Cozier.

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Pharmaceutical Research

Pharmacoepidemiology

Boston Collaborative Drug Surveillance Program (BCDSP) continues its work in the area of pharmacoepidemiology and drug safety. We are completing several studies on a diverse set of questions including a series of studies of various hormonal contraceptives in relation to risks of venous thromboembolism (VTE) where we found that risks vary according to the progestational agent in the contraceptive. We are also finishing studies on

  1. drugs and other risk factors in relation to myeloid neoplasms,
  2. drugs in relation to congenital anomalies,
  3. the safety of rosiglitazone use, and
  4. risk factors in people with chronic renal failure.

We are also conducting research on

  1. adverse effects in long term users of opioids to treat non-cancer pain,
  2. drug safety and changes in use of oral hypoglycemic drugs,
  3. the association of various drugs on the risk of cancer, and
  4. characteristics of people who receive knee replacements.

We are also conducting a long term study of risk factors for development of multiple sclerosis and a study of risk factors for autism spectrum disorders. Epidemiology faculty: Susan Jick.

The Slone Epidemiology Center (Slone)

Our staff of approximately 100 includes specialists in epidemiology, adult and pediatric medicine, nursing, pharmacy, biostatistics, and computer science. Slone researchers use a variety of epidemiological tools, including case-control and follow-up studies, clinical trials, surveillance studies, risk management studies, and population-based surveys. Over the years, Slone investigators have been supported by grants and contracts from the National Institutes of Health (NIH), other government agencies, the pharmaceutical industry, and private foundations. Slone works in partnership with hundreds of hospitals and thousands of health care providers, both nationally and internationally. Epidemiology faculty: Patricia Coogan, Michael Corwin, Yvette Cozier, David Kaufman, Carol Louik, Allen Mitchell, Julie Palmer, Lynn Rosenberg, Edward Ruiz-Narvaez, Martha Werler, and Lauren Wise.

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Reproductive, Perinatal & Pediatric Research

Best Treatment Practices in Opioid Dependent Pregnant Women & Their Infants

Opioid agonist therapy with methadone or buprenorphine improves pregnancy outcomes in opioid dependent women. However, preventing maternal opioid relapse and withdrawal requires exposing the fetus to potent therapies, which can cause neonatal opioid withdrawal (neonatal abstinence syndrome, NAS). Rising rates of opioid use in pregnant women and NAS in their neonates are major public health concerns. Investigators from the Departments of Epidemiology, Biostatistics, Internal Medicine, Obstetrics & Gynecology, and Pediatrics of Boston University Medical Campus are collaborating to establish a large prospective cohort of mother-neonate pairs. Epidemiology faculty: Susan Brogly.

Family planning clinic

Several randomized control trials are ongoing in the Family Planning Clinic of the Department of Obstetrics & Gynecology to identify optimal treatment approaches in

  1. Effective contraception
  2. The discontinuation of pregnancy

Epidemiology faculty: Susan Brogly.

Internet-based study of time to pregnancy

This NIH-funded prospective cohort study is recruiting Danish women via the internet to study risk factors for delayed time to pregnancy and miscarriage. Over 3500 women have enrolled so far and are being followed for up to twelve months or until they become pregnant. The primary risk factors of interest are caffeine and alcohol consumption, smoking, medication use, and body mass index. The extensive system of medical registries in Denmark, including birth, medication, and medical registries will allow data linkage to assess the validity of the using the internet for epidemiologic research. Epidemiology faculty: Elizabeth Hatch, Lauren Wise, and Ken Rothman.

Long-term follow-up of individuals exposed to diethylstilbestrol (DES)

This multi-center prospective cohort study follows over 10,000 mothers, daughters, sons and third generation granddaughters who were exposed to the pregnancy drug, DES. DES was originally used to prevent miscarriage and preterm birth between the early 1940s and 1971. Not only was it not effective in preventing pregnancy problems, but it was also found cause a rare vaginal cancer and other health problems in the daughters who were exposed in utero. Participants in this study are being followed for breast and other cancers, as well as reproductive problems such as infertility and early menopause. Epidemiology faculty: Julie Palmer, Elizabeth Hatch, and Lauren Wise.

Birth Defects Study

The Slone Epidemiology Center Birth Defects Study (also known as the Pregnancy Health Interview Study), is an ongoing study of factors in pregnancy that may be related to the health of newborns. It focuses on the safety and risks of a wide range of environmental exposures (primarily medications, including vaccines) in pregnancy. The outcomes of primary interest include birth defects and complications of pregnancy such as prematurity and pregnancy-induced hypertension. This multi-center case-control study is currently conducted in Massachusetts, the metropolitan areas surrounding Philadelphia, and San Diego and in portions of New York State. Infants with birth defects and a sample of healthy infants without birth defects are identified through special arrangements with either state birth defect registries or through regular contact with approximately 35 participating institutions. Mothers of these infants are invited to take part in a telephone interview conducted by trained nurse-interviewers. The interview includes questions on medical history, previous pregnancies, nutrition, occupation, health behaviors, and smoking, as well as detailed questions on medication use and vaccines received in the period prior to conception through the entire pregnancy. To date, over 40,000 women have been interviewed, making this one of the largest studies of its kind. Epidemiology faculty: Carol Louik, Allen Mitchell, Martha Werler.

Hemifacial Microsomia Studies, Slone Epidemiology Center.

Hemifacial microsomia is a craniofacial malformation characterized by asymmetric development of the cheek, chin, mouth, ear, and/or eye. A multi-center, case-control study of children affected with this malformation was conducted to identify maternal risk factors. Cases were identified at 26 craniofacial centers across the US and Canada, and controls were identified from the case’s pediatrician. Interviews of case and control mothers elicited information on demographic factors; reproductive, medical and pregnancy illness histories; medication use; behaviors (smoking, alcohol, coffee); and nutrition. Cases and controls were assessed in a first follow-up study for psycho-social and cognitive outcomes. Mothers and teachers completed standardized questionnaires and tests when the children were between the ages of 5 and 12 years. At present, a second follow-up study is being conducted which includes face-to-face psychometric testing when study subjects are between 11 and 17 years of age. Epidemiology faculty: Martha Werler.

Thalidomide Survey, Slone Epidemiology Center

Thalidomide is a drug known to cause serious birth defects if taken during pregnancy. In 1998, FDA approved thalidomide under restricted distribution regulations. To minimize the risk of fetal exposure to the drug, the manufacturer, with FDA’s support and guidance, instituted the System for Thalidomide Education and Prescribing Safety (STEPS), a comprehensive risk management program directed at both physicians and patients. From 1998 through 2004, the Slone Epidemiology Center conducted a survey of all patients who received the drug to assess the effectiveness of the STEPS program. Epidemiology faculty: Allen Mitchell.

Slone Center Office-based Research Network (SCOR Network)

The Slone Center Office-based Research (SCOR) Network is a national pediatric research network run by investigators at the Slone Epidemiology Center (Slone) at Boston University. The network evolved from Slone’s experience performing a large, double-blind, randomized controlled trial of the safety of ibuprofen for children, known as the Boston University Fever Study. For that study, Slone researchers recruited more than 1,700 physicians from the 48 continental United States who in turn enrolled over 83,000 febrile children who were broadly representative of the US population. Since the successful completion of the fever study, the SEC has formalized this approach to pediatric clinical research as the SCOR Network, which currently has approximately 500 physician-members who participate in studies in their office practices. The goal of the network is to conduct studies of practical importance to the health of children, particularly in areas most relevant to primary-care physicians. Completed and current SCOR Network studies include a case-control study of group A streptococcal disease complicating varicella infections, a cohort study of pediatric diarrheal disease, a clinical trial of xylitol to prevent acute otitis media, a study evaluating the possible improvement of asthma outcomes through spirometry distance learning, a survey of practices relating to the diagnosis and management of acute otitis media, and a survey assessing primary-care physicians’ practices and opinions regarding screening for type 2 diabetes. Epidemiology faculty: Allen Mitchell, Michael Corwin.

Slone Epidemiology Center Infant Care Practices Study

Investigators at Slone Epidemiology Center conducted a follow-up study of newborn infants to determine the prevalence of sleep position, predictors of infant sleep position, and the relation between infant sleep position and the risk of SIDS. Over 15,000 infant-mother pairs were enrolled in the study from hospitals in Boston, Lowell, and Lawrence, Massachusetts, and Toledo, Ohio. Data in the Infant Care Practices Study were collected at birth, and at one, three, and six months of age on demographic factors, sleep patterns, feeding behaviors, and other infant care practices. Epidemiology faculty: Allen Mitchell, Theodore Colton, Michael Corwin.

Prospective Study of Uterine Fibroids in Black Women

Uterine fibroids are the primary indication for hysterectomy in the US. Black women are 2–3 times more likely to be diagnosed with uterine fibroids than white women, and they tend to have earlier onset and greater symptoms at the time of diagnosis. Established risk factors for fibroids do not fully explain this black-white discrepancy in rates. GENETICS STUDY: We will compare genes of Black Women’s Health Study (BWHS) participants with and without fibroids in an attempt to identify genes potentially involved in the etiology of fibroids. A total of 2500 cases (fibroids) and 2500 controls (without fibroids) will be studied. Differences will also be examined according to age at onset and disease severity. The DNA for these analyses will be obtained from saliva samples that have been provided by BWHS participants. PSYCHOSOCIAL FACTORS: Recent evidence in white populations suggests that psychosocial stress can increase the risk of fibroids, possibly by causing chronic dysregulation of the hypothalamic-pituitary-adrenal axis and alterations in ovarian hormones that could affect fibroid risk. We have planned analyses of BWHS data to identify whether various psychosocial stressors—including adverse socioeconomic conditions across the lifespan, abuse victimization across the lifespan, depressive symptoms, and caregiver responsibilities—influence the risk of fibroids. SPH Faculty: Lauren Wise, Julie Palmer, Lynn Rosenberg.

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Renal Research

Chronic Kidney Disease of Unknown Etiology in Nicaragua

This project is attempting to determine the causes of an unexplained epidemic of chronic kidney disease (CKD) in western Nicaragua that has led to significant health, economic, and social strains. SPH has been working as part of a World Bank-organized mediation process that has brought together a Nicaraguan sugar company and a group of ex-workers and widows who have been affected by CKD to address these problems. A team of epidemiologists, environmental health faculty, and nephrologists is carrying out a number of activities intended to evaluate the potential causes of the excess of CKD in the area and whether work practices or chemicals used at the company is at least partly responsible for the occurrence of the disease. To date, two reports have been issued: (1) a review of the evidence available, proposed hypotheses, and recommendations for research activities; and (2) an evaluation of the current work practices at the company and a review of the literature on the renal effects of the agrichemicals that have been used. Potential causes being investigated include occupational, environmental, medical, and behavioral factors.  Some of the activities planned or in process include a record-based retrospective cohort study, environmental sampling, blood and urine testing of 1200 current workers, a urinalysis study among adolescents, and kidney biopsies. Epidemiology Faculty: Daniel Brooks, Kate Applebaum, Ann Aschengrau.

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