Nontuberculous Mycobacterial Disease and Molybdenum in Colorado Watersheds
by
Ettie M. Lipner 1,2,*
, Joshua French 3, Carleton R. Bern 4, Katherine Walton-Day 4, David Knox 5, Michael Strong 1, D. Rebecca Prevots 6,† and James L. Crooks 1,2,†
Ettie M. Lipner 1,2,*, Joshua French 3, Carleton R. Bern 4, Katherine Walton-Day 4, David Knox 5, Michael Strong 1, D. Rebecca Prevots 6,† and James L. Crooks 1,2,†
1
National Jewish Health, Denver, CO 80206, USA
2
Department of Epidemiology, Colorado School of Public Health, Aurora, CO 80045, USA
3
Department of Mathematical and Statistical Sciences, University of Colorado Denver, Denver, CO 80204, USA
4
U.S. Geological Survey, Colorado Water Science Center, Denver, CO 80225, USA
5
Department of Computer Science, University of Colorado-Boulder, Boulder, CO 80309, USA
6
National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20814, USA
*
Author to whom correspondence should be addressed.
†
D. Rebecca Prevots and James L. Crooks are co-senior authors.
Int. J. Environ. Res. Public Health 2020, 17(11), 3854; https://doi.org/10.3390/ijerph17113854
Received: 25 April 2020 / Revised: 16 May 2020 / Accepted: 22 May 2020 / Published: 29 May 2020
(This article belongs to the Section Environmental Science and Engineering)
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.
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Keywords:
nontuberculous mycobacteria; watersheds; molybdenum; spatial; Poisson; source water
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MDPI and ACS Style
Lipner, E.M.; French, J.; Bern, C.R.; Walton-Day, K.; Knox, D.; Strong, M.; Prevots, D.R.; Crooks, J.L. Nontuberculous Mycobacterial Disease and Molybdenum in Colorado Watersheds. Int. J. Environ. Res. Public Health 2020, 17, 3854.
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