MPH, University of Cincinnati, 2023, Medicine: Biostatistics

Introduction: The Fernald Medical Monitoring Program (FMMP) was established to monitor the health of residents living in the area surrounding the Fernald Feed Materials Production Center (FMPC). Beginning in 1991, this program involved comprehensive physical examinations as well as multiple biospecimen collections. After the program ceased operations in 2008, the medical monitoring program became the Fernald Community Cohort (FCC), and as a result, a variety of laboratory data, medical histories, and lifetime uranium exposure estimates have been made available for research. Kidney diseases have been studied in this cohort, but specific analysis has not been conducted using lifetime exposure estimates and laboratory measures of renal health. Uranium has been associated with damage to the kidneys, but studies have struggled to establish a conclusive link between level of airborne exposure and renal function. The primary objective of this project is to investigate whether level of uranium exposure is associated with laboratory indicators of kidney function, namely serum glucose, serum creatinine, urine creatinine, and microalbumin. Methods: This study featured a cross-sectional quantitative approach using a sample of 8,235 eligible adult participants in the FCC. Upon enrollment, urine and blood samples were collected from participants in the program. An approximation of airborne uranium exposure was available for each participant using an algorithm provided by the Center for Disease Control and Prevention (CDC). Participants were also separated into three distinct groups by this exposure estimate. Descriptive statistics were generated for the full sample, as well as distributions of serum glucose, serum creatinine, urine creatinine, and microalbumin by age, sex, and exposure group. Linear regression and logistic regression models were created to investigate potential relationships between laboratory data and exposure, controlling for covariates of age and sex. Results (open full item for complete abstract)

Committee: Wei-Wen Hsu Ph.D. (Committee Member); Susan Pinney Ph.D. (Committee Chair) Subjects: Public Health

MPH, University of Cincinnati, 2022, Medicine: Environmental Public Health

Background: Ecological grief is a psychological response to environmental loss caused by natural and man-made events. The prevalence of ecological grief has been found to be especially pronounced in people who hold close relationships with the environment. The Fernald site, near Cincinnati, Ohio, is a former US Department of Energy nuclear fuel processing plant. During its operation from 1951-1989, releases from the site resulted in environmental contamination of radon, uranium, and various other organic and inorganic chemicals. The air, water, and soil were all found to be contaminated which consequently impacted the health and safety of people living on or in close proximity to the site and also challenged the long-term emotional wellbeing of nearby residents. The Fernald Community Cohort (FCC) was a cohort of 9,782 people who participated in the Fernald Medical Surveillance Program from 1990-2008. The purpose of this study was to examine the degree of ecological grief reported by the participants of the FCC and to discern the degree of ecological grief among this community by residential proximity to the plant, level of uranium exposure, and cancer diagnosis. Methods: As part of the ongoing FCC surveying, in 2020, participants were invited to complete a brief questionnaire of four questions to assess the impact of ecological grief among FCC participants. Data that was collected from the FCC was utilized in this study for variables such as demographics, cancer diagnosis, uranium exposure, and proximity to the Feed Material Production Center (FMPC). Descriptive statistics were calculated for demographic and main study variables using IMB SPSS (v. 28). Results: In the sample, 55.3% of respondents reported moderate to severe ecological grief. The model (n=3,737) was tested with one degree of freedom, with the program variable of uranium concentration accounting for most (2.8%) of the variance, followed by ecological grief (2.1%), and ever having a cancer diagnosi (open full item for complete abstract)

Committee: Rachael Nolan Ph.D. M.P.H. (Committee Member); Tiina Reponen Ph.D. (Committee Member) Subjects: Public Health

MS, University of Cincinnati, 2013, Medicine: Clinical and Translational Research

Objective: Effects of environmental exposures on the development of systemic lupus erythematosus (SLE) are relatively unexplored in SLE pathogenesis. Our objective was to explore the hypothesis that SLE patients will be found more frequently in community members exposed to high prior uranium exposure in the Fernald Community Cohort (FCC). Methods: A nested case control study was performed using data from the Fernald Community Cohort (FCC). The FCC is a volunteer population that lived within 5 miles of a uranium ore processing plant in Fernald, OH during plant operation (1951-1989) and followed from 1990-2008 in a medical monitoring program. Uranium plant workers were excluded. Potential SLE cases were identified with searches for lupus-associated ICD-9 codes and medication code for hydroxychloroquine. Cases were confirmed using American College of Rheumatology classification criteria and medical records. Each case was matched to four age-, race-, and sex-matched controls. Sera from potential cases and controls were screened for autoantibodies. Cumulative uranium particulate exposure was calculated using a dosimetry model developed by the US Centers for Disease Control and Prevention. Logistic regression with covariates (smoking, alcohol, and family history of SLE) was used to calculate odds ratios (OR) with 95% confidence intervals (CI). Results: The FCC includes 4,187 individuals with background uranium exposure, 1,273 with moderate exposure, and 2,756 with higher exposure. SLE was confirmed in 23 of 26 individuals with a lupus ICD9 code, and in 2 of 43 other individuals prescribed hydroxychloroquine. The female:male ratio was 5.25:1. Of the 25 SLE cases, 12 were in the higher exposure group. SLE was associated with higher exposure (OR 3.92, 95% CI 1.131-13.588, p = 0.031). Conclusion: High uranium exposure is associated with SLE relative to matched controls in this sample of uranium exposed individuals. Potential explanations for this relationship inclu (open full item for complete abstract)

Committee: Erin Nicole Haynes Ph.D. (Committee Chair); John Harley M.D., Ph.D. (Committee Member); Susan Pinney Ph.D. (Committee Member); Changchun Xie Ph.D. (Committee Member) Subjects: Health Sciences