Nontuberculous Mycobacterial Disease and Molybdenum in Colorado Watersheds

Ettie M. Lipner, Joshua French, Carleton R. Bern, Katherine Walton-Day, David Knox, Michael Strong, D. Rebecca Prevots and James L. Crooks
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Ettie M. Lipner: National Jewish Health, Denver, CO 80206, 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
James L. Crooks: National Jewish Health, Denver, CO 80206, USA

IJERPH, 2020, vol. 17, issue 11, 1-15

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.

Keywords: nontuberculous mycobacteria; watersheds; molybdenum; spatial; Poisson; source water (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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