Family and Community Medicine publications (MU)
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Items in this collection are the scholarly output of the Department of Family and Community Medicine faculty, staff, and students, either alone or as co-authors, and which may or may not have been published in an alternate format. Items may contain more than one file type.
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Item Chlorination By-Products in Drinking Water and Menstrual Cycle Function(National Institute of Environmental Health Sciences, 2003-06) Windham, Gayle C.; Waller, Kirsten; Anderson, Meredith; Fenster, Laura; Mendola, Pauline; Swan, Shanna H.We analyzed data from a prospective study of menstrual cycle function and early pregnancy loss to explore further the effects of trihalomethanes (THM) on reproductive end points. Premenopausal women collected urine samples daily during an average of 5.6 cycles for measurement of steroid metabolites that were used to define menstrual parameters such as cycle and phase length. Women were asked about consumption of various types of water as well as other habits and demographics. We found a monotonic decrease in mean cycle length with increasing total THM (TTHM) level. This finding was also reflected as a reduced follicular phase length. A decrement in cycle and follicular phase length of per 10 µg/L unit increase in TTHM concentration was found. There was little association with luteal phase length, menses length, or cycle variability. Examining the individual THMs by quartile, we found the greatest association with chlorodibromomethane or the sum of the brominated compounds. Incorporating tap water consumption showed a similar pattern of reduced cycle length with increasing TTHM exposure. These findings suggest that THM exposure may affect ovarian function and should be confirmed in other studies.Item The Question of Declining Sperm Density Revisited: An Analysis of 101 Studies Published 1934-1996(National Institute of Environmental Health Sciences, 2000-10) Swan, Shanna H.; Elkin, Eric P.; Fenster, LauraIn 1992 Carlsen et al. reported a significant global decline in sperm density between 1938 and 1990. We subsequently published a reanalysis of the studies included by Carlsen et al. In that analysis we found significant declines in sperm density in the United States and Europe/Australia after controlling for abstinence time, age, percent of men with proven fertility, and specimen collection method. However, we found no decline in sperm density in non-Western countries, for which data were very limited. In the current study, we used similar methods to analyze an expanded set of studies. We added 47 English language studies published in 1934-1996 to those we had analyzed previously. The average decline in sperm count was virtually unchanged from that reported previously by Carlsen et al. The slopes in the three geographic groupings were also similar to those we reported earlier. As before, studies from other countries showed no trend. These results are consistent with those of Carlsen et al. and our previous results, suggesting that the reported trends are not dependent on the particular studies included by Carlsen et al. and that the observed trends previously reported for 1938-1990 are also seen in data from 1934-1996.Item New Approaches for Estimating Risk from Exposure to Diethylstilbestrol(The National Institute of Environmental Health Sciences, 1999) Cunha, Gerald R.; Forsberg, John-Gunnar, 1935-; Golden, Robert; Haney, Arthur; Iguchi, Taisen, 1951-; Newbold, Retha R.; Swan, Shanna H.; Welshons, Wade V.A subgroup from a National Institute of Environmental Health Sciences, workshop concerned with characterizing the effects of endocrine disruptors on human health at environmental exposure levels considered the question, If diethylstilbestrol (DES) were introduced into the market for human use today and likely to result in low-dose exposure of the human fetus, what would be required to assess risk? On the basis of an analysis of the quality of data on human DES exposure, the critical times and doses for inducing genital tract malformations and cancer must be determined. This would be facilitated through analysis of the ontogeny of estrogen receptor expression in the developing human genital tract. Models of low-dose estrogenic effects will have to be developed for human and rodent genital tract development. Through multidisciplinary approaches, it should be possible to elucidate the cellular and molecular mechanisms of endocrine disruption elicited by estrogens during development and facilitate an assessment of risk to humans.Item TigerPlace: An Innovative Educational and Research Environment(AAAI, 2008) Rantz, Marilyn J.; Aud, Myra A., 1947-; Alexander, Gregory Lynn, 1961-; Oliver, Debra; Minner, De; Skubic, Marge; Keller, James M.; He, Zhihai, 1973-; Popescu, Mihail, 1962-; Demiris, George; Miller, SteveA one of a kind project based on the concept of aging in place is in progress at the University of Missouri (MU). This project required legislation in 1999 and 2001 to be fully realized. A specialized home health agency was developed by the MU Sinclair School of Nursing specifically to help older adults age in place. In 2004, TigerPlace, a specially designed independent living environment, was built by Americare Corporation of Sikeston, Missouri, a leading long-term care company. TigerPlace was developed as a true partnership between the University of Missouri and Americare Corporation. This partnership allows for unique student and research projects.Item Geographic Differences in Semen Quality of Fertile U.S. Males(Environmental Health Perspectives, 2003-04) Swan, Shanna H.; Brazil, Charlene; Drobnis, Erma Z.; Liu, Fan; Kruse, Robin L.; Hatch, Maureen; Redmon, J. Bruce; Wang, Christina; Overstreet, James W.; Study for Future Families Research Team; Study for Future Families Research TeamAlthough geographic variation in semen quality has been reported, this is the first study in the United States to compare semen quality among study centers using standardized methods and strict quality control. We evaluated semen specimens from partners of 512 pregnant women recruited through prenatal clinics in four U.S. cities during 1999-2001; 91% of men provided two specimens. Sperm concentration, semen volume, and motility were determined at the centers, and morphology was assessed at a central laboratory. Study protocols were identical across centers, and quality control was rigorously maintained. Sperm concentration was significantly lower in Columbia, Missouri, than in New York, New York; Minneapolis, Minnesota; and Los Angeles, California. Mean counts were 58.7, 102.9, 98.6, and 80.8 × 106/mL (medians 53.5, 88.5, 81.8, and 64.8 × 106/mL) in Missouri, New York, Minnesota, and California, respectively. The total number of motile sperm was also lower in Missouri than in other centers: 113, 196, 201, and 162 × 106 in Missouri, New York, Minnesota, and California, respectively. Semen volume and the percent morphologically normal sperm did not differ appreciably among centers. These between-center differences remained significant in multivariate models that controlled for abstinence time, semen analysis time, age, race, smoking, history of sexually transmitted disease, and recent fever (all p-values < 0.01). Confounding factors and differences in study methods are unlikely to account for the lower semen quality seen in this mid-Missouri population. These data suggest that sperm concentration and motility may be reduced in semirural and agricultural areas relative to more urban and less agriculturally exposed areas.