Characterizing lake water quality, cyanotoxins, and Amyotrophic Lateral Sclerosis (ALS).

Concern over toxins and public health threats resulting from Cyanobacterial Harmful Algal Blooms (CHABs) have gained attention as reoccurring and seasonal blooms persist in many waters. Concordantly, climate change has been suggested to increase the intensity, duration, and frequency of CHAB events. Humans may be exposed to the cyanotoxins produced by cyanobacteria via the food chain, drinking water, recreational use of waterbodies and by aerosolization. Exposure to the cyanobacterial neurotoxin, β-N-methylamino-L-alanine (BMAA) that has been found in the brains of ALS patients is a hypothesized mechanism. The goals of this research initiative are to investigate spatiotemporal relationships between inland lake water quality and ALS across northern New England (NNE). Multiscale satellite remote sensing was integrated with in situ lake and toxin sampling to provide robust spatiotemporal exposure risk metrics characterizing CHAB. Semi-analytical, shape, and empirical algorithms were bldned together tp generate spatiotemporal measures of chl-a and PC with R2 ranging from 0.65-0.92 using withheld samples. Postmortem aerosolization analysis found 85% of high risk patients to express phycobillin in lung tissue using fluroesence microscopy. To scal eup to the region we employed complementing spatial statistics and a Bayesian hierarchical framework to model relationships between lake risk metrics and ALS case location across NNE. The eco-epidemiolgical modeling results show that on average poorer water quality conditions and higher measures of cyanobacteria are associated with increased odds of belonging to a normalized ALS hot spots and risk of ALS. This has broad societal impacts as the frequency, duration, and magnitude of cyanobacterial harmful algal blooms are expanding and this work helps characterize lake ecosystem services and human health.