This study was conducted to examine, at the county level, the relationship between pediatric cancers incidence rate and atrazine and nitrate mean concentrations in surface and groundwater. A negative binomial regression analysis was performed to investigate the association between central nervous system (CNS) tumors, leukemia, lymphoma, and atrazine and nitrate mean concentrations in surface and groundwater. The age-adjusted brain and other CNS cancers incidence was higher than the national average in 63% of the Nebraska counties. After controlling for nitrate concentrations in surface and groundwater, counties with atrazine concentrations between 0.95 - 2.82 µg/L in both surface and groundwater had a higher incidence rate for pediatric cancers (brain and other CNS, leukemia, and lymphoma) compared to counties with surface and groundwater atrazine concentrations in the reference group (0.00 - 0.13 µg/L). Additionally, compared to counties with groundwater nitrate concentrations between 0 and 2 mg/L (reference group), counties with groundwater nitrate concentrations between 2.1 and 5 mg/L (group 2) had a higher incidence rate for pediatric brain and other CNS cancers (IRR=13.25; 95% CI: 13.00-13.50), leukemia (IRR=6.13; 95% CI: 6.02-6.26), and lymphoma (IRR=11.53; 95% CI: 11.32-11.75) after adjusting for all covariates in the model. While these findings do not indicate a causal relationship, they suggest that atrazine and nitrate may pose a significant risk relative to the genesis of pediatric brain and CNS cancers, leukemia, and lymphoma.

Climate change is known to increase the frequency and intensity of hot days (daily maximum temperature ≥ 30°C), both globally and locally. Exposure to extreme heat is associated with numerous adverse human health outcomes. This study estimated the burden of heat-related illness (HRI) attributable to anthropogenic climate change in North Carolina physiographic divisions (Coastal and Piedmont) during the summer months from 2011-2016. Additionally, assuming intermediate and high greenhouse gas emission scenarios, future HRI morbidity burden attributable to climate change was estimated. The association between daily maximum temperature and the rate of HRI was evaluated using the Generalized Additive Model. The rate of HRI assuming natural simulations (i.e., absence of greenhouse gas emissions) and future greenhouse gas emission scenarios were predicted to estimate the HRI attributable to climate change. During 2011-2016, we observed a significant decrease in the rate of HRI assuming natural simulations compared to the observed. About 15% of HRI is attributable to anthropogenic climate change in Coastal (13.40% (IQR: -34.90,95.52)) and Piedmont (16.39% (IQR: -35.18,148.26)) regions. During the future periods, the median rate of HRI was significantly higher (78.65%:Coastal and 65.85%:Piedmont), assuming a higher emission scenario than the intermediate emission scenario. We observed significant associations between anthropogenic climate change and adverse human health outcomes. Our findings indicate the need for evidence-based public health interventions to protect human health from climate-related exposures, like extreme heat, while minimizing greenhouse gas emissions.

Drought is probably the most complex among natural hazards to assess its effects. While most drought indicators and risk assessments are developed around agricultural or water shortages effects of drought, its effect on human health is highly understudied because of its unclear and complicated path towards physical and mental health effects. This study assesses the health risk of the latest decadal drought over the US counties by spatially superimposing several proxy variables of counties’ health vulnerabilities over their drought levels. We have used different variations of Local Moran’s I statistics to assess the spatial distribution of drought-vulnerability in two five-year study periods (2010-2014 and 2015-2019) and their differences. Our results show large clusters of significant risk increase in the west due to increases in both vulnerability and hazard indicators in the second study period. Since the used vulnerability variables include indicators of agriculture, drinking water, and socioeconomic prosperities, the results of this study can help researchers and policymakers in these areas to distinguish areas in need of higher attention for interdisciplinary study and planning in national or regional scales.