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.

The scale and extent of the effects of COVID-19 on our lives is unmatched by any other recent natural disaster. Effective management of the spread and consequences of this pandemic can reduce the burden on health and help in managing the different costs by relaxing restrictions. Understanding this need, our interdisciplinary team of geo and health scientists at the University of Nebraska Medical Center (UNMC) developed a multi-layered interactive dashboard in March 2020. The dashboard provides an automatically updating map of COVID case numbers and their time series in Nebraska counties. Also, Nebraska’s pandemic response leaders can see each hospital and its number of beds and contact information, the location of dialysis centers, long term care facilities, and pharmacies; the name of the emergency response coordinator; and the number of electricity-dependent Medicare beneficiaries in each county. The UNMC Dashboard, has helped the emergency response and health departments of Nebraska. It has received attention from local to international level. In addition to garnering public recognition, the Dashboard established connections between our team and stakeholders in our original climate tracking projects, as well as with other groups with whom we had not previously collaborated. We have established a close connection with Nebraska Medicine, one of the top medical facilities in the region, and their demand forecasting team. Also, we have developed new connections with out of state contacts in health department, resulting into an expanded version of the dashboard. Additionally, the dashboard demonstrated our capabilities and strengthened our relationships with local health departments in Nebraska. One of our primary projects relates to public health emergency preparedness for extreme weather and climate events in Nebraska. The success of that project depends on collaboration with different health officials in the state, who are now more aware of our team and our capability to provide practical solutions and tools. We suggest that this system can adapt to different frameworks, such as the Emergency Risk Framework (ERF) by World Health Organization (WHO). Our system provides the foundation for the information sharing required by such systems -therefore helping with communication and decision making.