Our study looked at how different factors affect the quality of life related to health among adults in Puerto Rico in 2019. Puerto Rico, a territory of the United States, faces many problems like poverty, a weak healthcare system, poor infrastructure, financial crisis, and the risk of natural disasters exacerbated by climate change. These issues impact the health and well-being of its people, but there hasn't been much research on this.

We used data from a large survey (4,944 adults) to understand how factors like age, income, and health conditions are linked to health-related quality of life, a standardized metric used by the Centers for Disease Control and Prevention. Not surprisingly, the data showed that having chronic health conditions, being older, and having a lower income were all linked to worse health-related quality of life. Specifically, as people had more chronic health conditions, they reported worse overall health, more physical and mental health problems, and more limitations in their daily activities. Interestingly, while older age was generally linked to poorer health-related quality of life, younger people reported more mental health issues.

The study's findings are concerning because they show that the health-related quality of life in Puerto Rico hasn't improved since the last time it was measured. The situation might be getting worse due to the decline in healthcare services following natural disasters and the national economic crisis. The research suggests that there should be specific programs and continuous monitoring to help those who are most at risk, like people with chronic and mental health conditions, the elderly, and those with low income, to improve health equality in Puerto Rico.

Citation: Frontera-Escudero, I., Bartolomei, J.A., Rodríguez-Putnam, A. Claudio, L.  Sociodemographic and health risk factors associated with health-related quality of life among adults living in Puerto Rico in 2019: a cross-sectional study. BMC Public Health 23, 2150 (2023). https://doi.org/10.1186/s12889-023-17115-3

Residents have long blamed the smoke stacks for high asthma rates, but fresh air may be coming.
Gov. Kathy Hochul unveiled three offshore wind and 22 land-based renewable energy projects to power 2.6 million New York homes. Clean energy conversion at Ravenswood Generating Station is one of them. The Queens area is called “asthma alley.” Queensbridge has been home to Noel Merritt since the 1970s. He blames plant particles for his asthma.
“There was a thick acrid smell that was constantly bombarding us,” Merritt told News 12 New York. “The teacher opened the windows in school. He recalled that she closed the windows when she heard three long horns, so we couldn't go to recess, but when she heard three small horns, she opened them.
According to Public Health Solutions, Ravenswood and Queensbridge have 235.4 asthma-related hospitalizations per 10,000 children ages 5 to 17, compared to 115.4 in Astoria and 76.8 in Hunter's Point, Sunnyside, and Maspeth.
Mount Sinai environmental medicine expert Dr. Luz Claudio calls this environmental injustice.
This is what many NYC communities with higher asthma prevalence have in common.  Environmental injustice stems from low-income neighborhoods, marginalized populations being burdened with  facilities that generate pollutants, especially air pollution. This applies to several electricity plants, Claudio added.  But there is currently an opportunity to reduce this burden, she said.
One company greening this fossil fuel facility is Rise Light and Power. In a statement to News 12, it said: "Attentive Energy One appreciates Governor Hochul and NYSERDA President and CEO Doreen Harris for their work in implementing New York's nation-leading Climate Act.
The 1.4 GW project will alter the City and State, incorporating environmental justice community input and ensuring a just transition for union workers. Attentive Energy One will retire and replace fossil fuel generation at Ravenswood Generating Station, New York City's largest power plant, with offshore wind, reducing emissions and retraining vital workers for the green economy.
Attentive Energy One builds support, incorporates feedback, and meets statewide community requirements throughout project development.
We appreciate the faith and support of so many partners and look forward to delivering this project for New Yorkers."
This state award will only eliminate one of Ravenswood's three smokestacks; future contracts will remove the rest. Everyone, even Merritt, agrees it's a good start.
He remarked, “As far as the Queensbridge community is concerned, I honestly feel my contribution standing out against these smokestacks will benefit future residents years, years after I'm gone.”
Gov. Hochul claims this clean energy initiative will create jobs. Local organizations are fighting to give Ravenswood jobs to NYCHA members who have been affected by the facility.

You can view the newscast here:

In the News: Air Pollution Linked to Increased Risk of Autoimmune DiseasesAir contaminated by traffic fumes, dust, soot, and smoke may make you more likely to develop rheumatoid arthritis and other autoimmune conditions, a new study suggests.
 
By Lisa Rapaport
March 17, 2022

Car exhaust and other airborne contaminants have long been connected to heart and lung ailments, as well as rheumatoid arthritis, an immune system disorder that causes chronic swelling and joint pain.  Our own studies have shown the relationship with indicators of cognitive deficiencies in children.
In a study I reviewed, researchers from the University of Verona, Italy, reviewed medical records of over 81,000 elderly Italians treated by over 3,500 clinicians. They looked at the association between particulate of less than 2.5 micrometers in diameter that can come from burning gasoline, oil, and wood. Particulate matter (PM) is also a term used to describe dust from construction, agriculture, landfills and wildfires.
They found that 12% of the patients had an autoimmune illness during the research and that pollution exposure enhanced the likelihood of this diagnosis. Each extra 10 mcg/m3 of average PM10 was related with a 7% increased risk of autoimmune illness.
The study revealed that in the study area the average yearly PM2.5 and PM10 exposure levels were 16 and 25 mcg/m3, respectively. The WHO recommends 25 mcg/m3 for PM2.5 and 20 mcg/m3 for PM10.
The study found that those with autoimmune illnesses had a 12-13% increased chance of being diagnosed with these diseases if they were exposed to levels higher than the WHO's guidelines.
The study shows that air pollution can contribute to autoimmune illnesses, says Luz Claudio, PhD, preventive medicine and public health professor at Mount Sinai's Icahn School of Medicine.  In addition to the lungs, Dr. Claudio adds air pollution affects numerous other organs as well.
People can't escape filthy air, but they can lobby for stronger environmental standards, Claudio adds. They can also urge for greater monitoring of local air quality.
“Having a strong surveillance system in high pollution locations is quite important, especially for vulnerable individuals,” Claudio explains. “On polluted days, individuals should avoid outdoor activities.”

 In a new study we published this week in The Journal of Clinical Investigation, our multidisciplinary team of computer scientists, physicians, and epidemiologists at the Icahn School of Medicine at Mount Sinai developed a novel machine-learning algorithm. We used this new machine learning method to identify previously unknown mixtures of toxic air pollutants that appear to be linked to poor asthma outcomes in children.  
     The issue we addressed with this investigation was that most studies assess the toxicity of pollutants one at a time. But in the real world, people are exposed to mixtures of pollutants that cause different health effects. Gaurav Pandey, PhD, Assistant Professor of Genetics and Genomic Sciences and a senior author of the study, said: "Traditionally, for technical reasons, it has been difficult to study the health effects of more than one toxic at a time. We overcame this by tapping into the power of machine learning algorithms."    
     To do this, we examined early exposure to dozens of pollutants to which 151 children with mild to severe asthma were potentially exposed early in their lives, as measured by the Environmental Protection Agency's National Air Toxics Assessment resource. We developed and applied a novel algorithm, named "Data-driven ExposurE Profile (DEEP) Extraction, to determine the possible ways that each pollutant, alone or in combination with others, could explain asthma outcomes in the children. The algorithm development was led by Yan-Chak Li, MPhil, a bioinformatician, and Hsiao-Hsien Leon Hsu, ScD, Assistant Professor of Environmental Medicine and Public Health. 
     We found that some disease cases could be linked to an individual chemical. One example of an individual chemical showing an effect was the ammonia-scented waterproofing agent trimethylamine, which raised the chances that a child with asthma would spend a night in the hospital.
     Other pollutants could act alone or in mixtures. One example was acrylic acid, a chemical used in plastics, coatings, medical products, and detergents. Exposure to acrylic acid raised the chances that a child would need daily medication. Exposure to acrylic acid combined with other chemicals further increased this possibility, and in addition, it boosted the chances of emergency room visits and overnight hospitalizations among the asthmatic children who participated in the study. (See illustration)  
     In all, 34 individual chemicals were found to be linked to poor asthma outcomes. Importantly, some asthma cases appeared to be linked to mixtures of pollutants that had never been associated with asthma.   
      "As a physician who treats children with asthma, I was struck by how many potential air toxics are not on our radar," said Supinda Bunyavanich, MD, MPH, MPhil, Professor of Pediatrics, and Genetics and Genomic Sciences, and a senior author of the study. "These results changed my view of the heightened risk some children face."  
     "Our study is an example of how machine learning has the potential to alter medical research," said Dr. Pandey. "It is allowing us to understand how a wide variety of environmental factors—or the exposome—influences our health. In the future, we plan to use DEEP and other computer science techniques to tackle environmental factors associated with other complex disorders."  
     This work was supported by the Department of Genetics and Genomic Sciences at Mount Sinai, Scientific Computing at Icahn Mount Sinai, and the National Institutes of Health (AI118833, HG011407, HL147328, OD023337, and ES023515).
Article
Citation: Li, Y.C., Hsu, H.H.L., Chun Y, Chiu PH, Arditi Z, Claudio L, Pandey G, Bunyavanich S. Machine learning-driven identification of early-life air toxic combinations associated with childhood asthma outcomes. Journal of Clinical Investigation, October 5, 2021, DOI: 10.1172/JCI152088

Juan A. Ortega-Garcia, Manuel Ruiz-Marin, Alberto Carceles-Alvarez, Ferran Campillo i Lopez, Luz Claudio. Environmental Research 189 (2020) 109957.
At one point during the global novel coronavirus pandemic, Spain was the epicenter of infection.  Yet, not all regions of the country had the same rates of hospital emergency visits during this time.  The region of Murcia flattened the curve quickly while other regions of the country had overwhelmed hospital capacity. This was attributed to a robust, community-based, social media campaign promoting tele-medicine and social distancing within health care centers. 
In this rapid communication, we describe the actions taken in Murcia that may have contributed to a more favorable outcome as compared to other regions.  One important action was the coalition of activists, community leaders, physicians and researchers working as amplifiers of an educational campaign using a variety of social media and outreach strategies. 

In these infographics and accompanying article, we gathered information from primary and secondary sources to summarize the effects of the COVID-19 pandemic and quarantine on different aspects of the environment.  We found that mother nature earned some points, but lost on others.  For example, here in New York, Columbia University measured a 50% reduction in carbon monoxide emissions.  But, medical waste quadrupled due to the increased use of disposable PPE and other contaminated biomedical solid waste. 

In the article, I was cited as follows:
"One of the things that we can learn from the pandemic’s effects on the environment is that we CAN actually have an impact if there were a global effort to do so.  It is inspiring how in cities that had extreme levels of air pollution, from Los Angeles to New Delhi, people are seeing the difference that cleaner air can make to quality of life if we could reduce the number of cars and emissions from polluting industries.  Another lesson will be the realization of how productive many workers can be while working from home when they are given the proper tools. Many companies will see the value of having at least some workers work from home, reducing the need for commuting and also reducing the office space needed to conduct business." 

See the full article with the beautiful interactive infographics and the list of sources including other scientists and business leaders who contributed Here. 

ABSTRACT
Aims
In current clinical practice, prenatal alcohol exposure is usually assessed by interviewing the pregnant woman. An alternative method for detecting alcohol use is to measure the biomarker carbohydrate-deficient transferrin (CDT). However, few studies measure CDT during pregnancy. This study examines the utility of CDT biomarker in the screening of alcohol exposure during early pregnancy.
Methods
A cohort of 91, first-trimester pregnant women assigned to a public reference maternity hospital, was screened using the Green Page (GP) questionnaire, an environmental exposure tool. CDT levels and other biomarkers of alcohol use were measured and compared with questionnaire data.
Results
About 70% of the mothers in the study consumed alcohol during early pregnancy and 22% met high-risk criteria for prenatal exposure to alcohol. CDT measurement showed a statistically significant area under the receiver operating characteristic curve with a value of 0.70. For a value of 0.95% of CDT, a specificity of 93% was observed. The most significant predictors of CDT were the number of binge drinking episodes, women’s body mass index and European white race.

Conclusion
Pregnant women with a CDT value >0.95% would be good candidates for the performance of the GP questionnaire during early pregnancy in order to detect potential high-risk pregnancy due to alcohol exposure.

Mothers who use beauty products containing chemicals known as parabens during pregnancy may be more likely to have overweight daughters, a small study suggests.
Babies tended to be heavier at birth, and more likely to become overweight by age 8, when mothers used makeup, lotions and other common beauty products containing parabens while pregnant, the study found. One of these chemicals, butylparaben, was associated with excess weight only in girls.

Even so, it makes sense for pregnant women to check product labels and steer clear of beauty items containing parabens, said Luz Claudio, an environmental health researcher at the Icahn School of Medicine in New York City who wasn’t involved in the study.

“The significance of this finding cannot be underestimated because girls and women typically used more personal care products and cosmetics containing parabens than do boys and men,” Claudio said. “Thus, this effect of early exposure to parabens in females could potentially continue to increase as they grow and use even more of these products, potentially affecting the next generation of girls.”

Read the full article at: Reuters, WebMD, Medscape 
Read the original research paper from Nature

Along with greening up our living rooms and workspaces, houseplants have been shown to elevate mood, sharpen mental focus, and even boost productivity. Plants are also hyped as being all-natural indoor air purifiers, cleaning the air and sucking up airborne toxins that make us sneeze, wheeze, and develop cancer — well, that’s what an infamous 1989 NASA study led us to believe, anyway.
The reality: Potted plants don’t work like living HVAC devices, neutralizing nasty chemicals to help us breathe easy. It would be awesome if that were true, but experts today say it’s simply a myth. Despite what old research implied, houseplants have very little if any impact on indoor air quality.
According to Luz Claudio, Ph.D., an environmental medicine and public health scientist at the Icahn School of Medicine at Mount Sinai, common houseplants can indeed draw certain VOCs out of the air — but the degree to which they do so is negligible. “The amount that houseplants may reduce chemicals in a real-world environment is likely not enough to have a noticeable impact on human health,” she says.

​It seems like nowadays, whenever we hear the word "environment" in the media, it refers to the latest disaster caused by the climate crisis or the latest commonplace chemical found to cause cancer.  Children, of course, are exposed to this barrage of information and feel helpless and hopeless.  The environment is bad, and there's nothing they can do about it.
Yes.  The situation is dire.  But unless we give some sense of empowerment to children, how can we expect them to care?  Some children have turned to activism, but it is not every day that students can walk out of class in protest.  For the most part, all that children hear is the predictions of environmental doom.  And they are going to tune it off.  
With that in mind, I agreed to participate in this great new TV program called Mission Unstoppable.  With support from the Lyda Hill Philanthropies, it aims to show how STEM can be part of our everyday lives, and for at least some of us, STEM can also be at the center of our careers.  The show focuses on women doing all kinds of STEM things, because well, why not? It doesn't beat you over the head to say that "girls can do anything."  Instead, it shows you diverse girls doing everything and anything that has to do with STEM skills.  
The producers filmed 8 hours of me talking for a 4-minute feature!  That in itself was eyeopening for me.  I didn't know how much work it takes to produce TV content.  
In the interview, I tried to show that:

• The "environment" is not some amorphous faraway thing that we only interact with when we go camping.  The environment is all around us, even in the city, and it can affect our health in positive and negative ways,
• That the pollution we produce as a society doesn't disappear.  It can always come back in different forms to affect our health,
• That people, cities and even children can make a difference with the choices that they  make every day to improve the environment,
• And, of course, that a girl with an accent can be an environmental health scientist.

With the help of my student Chrystal Galan, we created an environmental scavenger hunt that children can do in their neighborhoods, homes, and schools.  It is intended to show children that the environment is everything that surrounds us and to give them some things that they can do to improve it.
As my daughter said when she saw the show: "That was really cool."  For me, to go from dork to cool, even if only for four minutes, is a step forward.

Thanks to Adina Pliskin and Robyn Ramirez from Litton TV and to interviewer Erica Hernandez. Thanks also to Mount Sinai staff and students Marlene Naanes, Lisa Cole, Chrystal Galan Rivera, and Frances Morales Ramos, for their assistance during the long hours of filming.