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- Title
Estimating missing concentrations of p,p′-DDT in the 1999-2004 National Health and Nutrition Examination Survey using multiple imputation.
- Authors
Everett, Charles J.; Gebregziabher, Mulugeta
- Abstract
We investigated the association between diabetes and p,p′-DDT (dichlorodiphenyltrichloroethane) in blood of Mexican Americans who participated in the 1999-2004 National Health and Nutrition Examination Survey (NHANES). In this sample, p,p′-DDT were missing in 50% of subjects and we used multiple imputation (MI) to address the problem. Compared to ignoring the missing data, MI led to a more robust threshold for the p,p′-DDT reference category. Whereas previously p,p′-DDT ≤ 0.0860 ng/g was used as the reference category, using MI, we were able to use p,p′-DDT < 0.0574 ng/g as the reference category to study the association between p,p′-DDT and diabetes via logistic regression. In this analysis, p,p′-DDT ≥ 0.0750 ng/g was associated with an odds ratio of 1.99 (95% CI 1.09-3.61) for diabetes and 4.20 (95% CI 1.93-9.12) for diabetic nephropathy. The reference category for diabetes without nephropathy outcome stayed consistent after MI but our analysis confirmed that p,p′-DDT > 0.0860 ng/g was associated with diabetes without nephropathy with an odds ratio of 1.89 (95% CI 1.09-3.27). Our study showed that MI can be effectively used to deal with missing at random data in persistent organic pollutants measured in the 1999-2004 NHANES.
- Subjects
DDT (Insecticide); DIABETIC nephropathies; X-ray diffraction; MULTIPLE imputation (Statistics); KIDNEY disease diagnosis; KIDNEY disease treatments
- Publication
Environmental Science & Pollution Research, 2019, Vol 26, Issue 6, p5885
- ISSN
0944-1344
- Publication type
Article
- DOI
10.1007/s11356-018-04078-x