Date of Award




Document Type


Degree Name

Doctor of Philosophy (PhD)


Department of Environmental Health Sciences

Content Description

1 online resource (viii, 167 pages) : illustrations (some color)

Dissertation/Thesis Chair

David O Carpenter

Committee Members

Beth J Feingold, Ramune Reliene, Samuel C Byrne, Xiaobo X Romeiko


disability, functioning, low chlorinated PCBs, Native American, polychlorinated biphenyls, World Health Organization Disability Assessment Schedule 2.0, Polychlorinated biphenyls, Environmental health, Mohawk Indians, People with disabilities

Subject Categories

Environmental Health | Epidemiology | Public Health


The Akwesasne reservation along the St. Lawrence River has experienced significant exposure to several persistent organic pollutants due to rapid industrialization. The Aluminum Company of America, General Motors, and Reynolds Metals operated aluminum foundries that used polychlorinated biphenyls (PCBs) as hydraulic fluids, which contaminated the community environment, the soil, air and water, and community food sources with PCBs. We administered the World Health Organization Disability Assessment Schedule II (WHODAS II) to 119 Akwesasne Mohawk adults residing along the St. Lawrence River in New York. We used exploratory factor analysis to summarize the 36- items comprising the WHODAS II. The 7 factors retained by the analyses correspond to the 6 summary domains of disability, suggesting that the data are sound and measure the intended constructs. Our assessment concludes that WHODAS II is a valid tool for assessing disability within this American Indian population. We explored the potentially moderating effects of social support and cultural identity on disability, taking into account age, gender, and health comorbidities among 119 Akwesasne Mohawk adults. We used the WHO-DAS II to measure disability, the Duke University Social Support Scale with Likert-type responses to quantify social support, and the Orthogonal Ethnic Identification Scale to calculate cultural affiliation. We found that overall social support was significantly negatively associated with disability related to self-care. Both family support and non-family support were negatively associated with disabilities that prevent full participation in society. Cultural affiliation to either the white culture or the Mohawk culture was not significantly associated with disability. Although preliminary, our findings may help inform clinicians advising American Indians and Alaska Natives with disabilities on helpful interventions to provide greater social support. To understand the long-term health effects of PCB exposure, we conducted a hypothesis-generating, exploratory investigation of associations between serum PCB concentrations and disability among Mohawk adults (n=109). We found that each log-unit increase in exposure to low chlorinated PCBs was significantly positively associated with a 1.12 unit increase in disability associated with performing life activities (β = 1.12, 95% confidence interval (CI): 0.07, 2.18). This suggests exposure to low chlorinated PCBs may be linked to increased difficulty performing life activities at both home and work among this population. A larger and more comprehensive investigation is necessary to more definitively assess the risks. Historically, it was thought that individuals were mostly exposed to high chlorinated PCBs via diet, specifically through fish consumption. However, recent exposure assessments have shown that inhalation is another major route of exposure for low chlorinated PCBs. Our study findings support the notion that additional epidemiological studies are necessary to assess the health risks associated with exposure to low chlorinated PCBs. Low chlorinated PBCs are toxic as their metabolites can have harmful effects on health, future studies are needed to assess the health effects associated with exposure.