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Nontuberculous Mycobacterial Disease and Molybdenum in Colorado Watersheds

Author

Listed:
  • Ettie M. Lipner

    (National Jewish Health, Denver, CO 80206, USA
    Department of Epidemiology, Colorado School of Public Health, Aurora, CO 80045, USA)

  • Joshua French

    (Department of Mathematical and Statistical Sciences, University of Colorado Denver, Denver, CO 80204, USA)

  • Carleton R. Bern

    (U.S. Geological Survey, Colorado Water Science Center, Denver, CO 80225, USA)

  • Katherine Walton-Day

    (U.S. Geological Survey, Colorado Water Science Center, Denver, CO 80225, USA)

  • David Knox

    (Department of Computer Science, University of Colorado-Boulder, Boulder, CO 80309, USA)

  • Michael Strong

    (National Jewish Health, Denver, CO 80206, USA)

  • D. Rebecca Prevots

    (National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20814, USA
    D. Rebecca Prevots and James L. Crooks are co-senior authors.)

  • James L. Crooks

    (National Jewish Health, Denver, CO 80206, USA
    Department of Epidemiology, Colorado School of Public Health, Aurora, CO 80045, USA
    D. Rebecca Prevots and James L. Crooks are co-senior authors.)

Abstract

Nontuberculous mycobacteria (NTM) are environmental bacteria that may cause chronic lung disease. Environmental factors that favor NTM growth likely increase the risk of NTM exposure within specific environments. We aimed to identify water-quality constituents (Al, As, Cd, Ca, Cu, Fe, Pb, Mg, Mn, Mo, Ni, K, Se, Na, Zn, and pH) associated with NTM disease across Colorado watersheds. We conducted a geospatial, ecological study, associating data from patients with NTM disease treated at National Jewish Health and water-quality data from the Water Quality Portal. Water-quality constituents associated with disease risk were identified using generalized linear models with Poisson-distributed discrete responses. We observed a highly robust association between molybdenum (Mo) in the source water and disease risk. For every 1- unit increase in the log concentration of molybdenum in the source water, disease risk increased by 17.0%. We also observed a statistically significant association between calcium (Ca) in the source water and disease risk. The risk of NTM varied by watershed and was associated with watershed-specific water-quality constituents. These findings may inform mitigation strategies to decrease the overall risk of exposure.

Suggested Citation

  • Ettie M. Lipner & Joshua French & Carleton R. Bern & Katherine Walton-Day & David Knox & Michael Strong & D. Rebecca Prevots & James L. Crooks, 2020. "Nontuberculous Mycobacterial Disease and Molybdenum in Colorado Watersheds," IJERPH, MDPI, vol. 17(11), pages 1-15, May.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:11:p:3854-:d:364481
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    References listed on IDEAS

    as
    1. Lê, Sébastien & Josse, Julie & Husson, François, 2008. "FactoMineR: An R Package for Multivariate Analysis," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 25(i01).
    2. Josse, Julie & Husson, François, 2016. "missMDA: A Package for Handling Missing Values in Multivariate Data Analysis," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 70(i01).
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