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Surveillance System (surveillance + system)
Kinds of Surveillance System Selected AbstractsTHE CORRELATION OF YOUTH PHYSICAL ACTIVITY WITH STATE POLICIESCONTEMPORARY ECONOMIC POLICY, Issue 4 2007JOHN CAWLEY Childhood overweight has risen dramatically in the United States during the past three decades. The search for policy solutions is limited by a lack of evidence regarding the effectiveness of state policies for increasing physical activity among youths. This paper estimates the correlation of student physical activity with a variety of state policies. We study nationwide data on high school students from the Youth Risk Behavior Surveillance System for 1999, 2001, and 2003 merged with data on state policies from several sources. We control for a variety of characteristics of states and students to mitigate bias due to the endogenous selection of policies, but we conservatively interpret our results as correlations, not causal impacts. Two policies are positively correlated with participation in physical education (PE) class for both boys and girls: a binding PE unit requirement and a state PE curriculum. We also find that state spending on parks and recreation is positively correlated with two measures of girls' overall physical activity. (JEL I18, I28) [source] Natural disasters and older US adults with disabilities: implications for evacuationDISASTERS, Issue 1 2007Lisa C. McGuire PhD We analysed 2003 and 2004 Behavioral Risk Factor Surveillance System (BRFSS) data from New Orleans-Metairie-Kenner, LA to produce estimates of the number of community dwelling people aged 65 years or older with a disability and requiring special equipment., Approximately, 47,840 (31.6 per cent) older adults with a disability and 24,938 (16.6 per cent) older adults requiring the use of special equipment were community dwelling and might require assistance to evacuate or a shelter that could accommodate special equipment. Older adults who need special equipment were likely to be female, unmarried and white, and to rate their health as fair or poor. Personnel who plan and prepare for evacuations and temporary shelter during disasters need baseline information on the number of older adults with a disability or who require special equipment. A surveillance system, such as the BRFSS, gathers information that planners can use to prepare for and to deliver services. [source] US state alcohol sales compared to survey data, 1993,2006ADDICTION, Issue 9 2010David E. Nelson ABSTRACT Aims Assess long-term trends of the correlation between alcohol sales data and survey data. Design Analyses of state alcohol consumption data from the US Alcohol Epidemiologic Data System based on sales, tax receipts or alcohol shipments. Cross-sectional, state annual estimates of alcohol-related measures for adults from the US Behavioral Risk Factor Surveillance System using telephone surveys. Setting United States. Participants State alcohol tax authorities, alcohol vendors, alcohol industry (sales data) and randomly selected adults aged , 18 years 1993,2006 (survey data). Measurements State-level per capita annual alcohol consumption estimates from sales data. Self-reported alcohol consumption, current drinking, heavy drinking, binge drinking and alcohol-impaired driving from surveys. Correlation coefficients were calculated using linear regression models. Findings State survey estimates of consumption accounted for a median of 22% to 32% of state sales data across years. Nevertheless, state consumption estimates from both sources were strongly correlated with annual r-values ranging from 0.55,0.71. State sales data had moderate-to-strong correlations with survey estimates of current drinking, heavy drinking and binge drinking (range of r-values across years: 0.57,0.65; 0.33,0.70 and 0.45,0.61, respectively), but a weaker correlation with alcohol-impaired driving (range of r-values: 0.24,0.56). There were no trends in the magnitude of correlation coefficients. Conclusions Although state surveys substantially underestimated alcohol consumption, the consistency of the strength of the association between sales consumption and survey data for most alcohol measures suggest both data sources continue to provide valuable information. These findings support and extend the distribution of consumption model and single distribution theory, suggesting that both sales and survey data are useful for monitoring population changes in alcohol use. [source] Injuries Related to Snow Blowers in the United States: 2002 Through 2008ACADEMIC EMERGENCY MEDICINE, Issue 5 2010Bart Hammig PhD Abstract Objectives:, The objective was to examine injuries related to the use of a snow blower among patients treated in an emergency department (ED). Methods:, Data were obtained from the National Electronic Injury Surveillance System (NEISS) for the years 2002,2008. National estimates of ED visits for injuries associated with the use of a snow blower were obtained, and descriptive epidemiologic characteristics assessed. Results:, From 2002 through 2008, there were an estimated 32,307 ED visits for injuries related to the use of a snow blower in the United States. Older adults had a higher proportion of ED visits for such injuries than younger age groups. The majority of injuries involved injuries to the hand, with 42% of cases diagnosed with fractures and 20% resulting in amputations. Conclusions:, Findings indicate that injuries from snow blowers remain a public health problem. Efforts to reduce injury incidence are discussed in accordance with inherent challenges of prevention of injuries associated with these products. ACADEMIC EMERGENCY MEDICINE 2010; 17:566,569 © 2010 by the Society for Academic Emergency Medicine [source] Curling Iron-related Injuries Presenting to U.S. Emergency DepartmentsACADEMIC EMERGENCY MEDICINE, Issue 4 2001Khajista Qazi MD Abstract. Objective: To describe curling iron-related injuries reported to the National Electronic Injury Surveillance System (NEISS) between January 1, 1992, and December 31, 1996. Methods: The authors retrospectively reviewed data from NEISS, a weighted probability sample of emergency departments (EDs) developed to monitor consumer product-related injuries. The information reported includes patient demographics, injury diagnosis, body part injured, incident locale, patient disposition, and a brief narrative description. The authors reviewed the narrative in the hair care products category and abstracted records indicating the injury was caused by contact with a curling iron. Also analyzed were the design features of commonly available curling irons purchased from national discount department stores. Results: There were an estimated 105,081 hair care product-related injuries in the five-year period, of which 82,151 (78%) involved a curling iron. Seventy percent of injuries were to females. The patient's median age was 8 years (range 1 month to 96 years). The most commonly occurring injury was thermal burns (97%; 79,912/82,151). Ninety-eight percent of the injuries occurred in the home and 99% of the patients were discharged home from the ED. In patients <4 years old, 56% of burns occurred by grabbing or touching, while in those ,10 years the burns occurred by contact while in use. In the older group 69% of burns were of the cornea. Most curling irons use small amounts of power, yet there are no standards for temperature settings or control. The cylinder containing the heating element is mostly exposed, and many irons do not have a power switch. Conclusions: The most common injury resulting from curling irons is thermal burns. The mechanisms and patterns of injury in developmentally distinct age groups suggest that many of these injuries could be prevented by public education and the re-engineering of curling irons. [source] The impact of state physical education requirements on youth physical activity and overweightHEALTH ECONOMICS, Issue 12 2007John Cawley Abstract To combat childhood overweight in the US, which has risen dramatically in the past three decades, many medical and public health organizations have called for students to spend more time in physical education (PE) classes. This paper is the first to examine the impact of state PE requirements on student PE exercise time. It also exploits variation in state laws as quasi-natural experiments in order to estimate the causal impact of PE on overall student physical activity and weight. We study nationwide data from the Youth Risk Behavior Surveillance System for 1999, 2001, and 2003 merged with data on state minimum PE requirements from the 2001 Shape of the Nation Report. We find that high school students with a binding PE requirement report an average of 31 additional minutes per week spent physically active in PE class. Our results also indicate that additional PE time raises the number of days per week that girls report having exercised vigorously or having engaged in strength-building activity. We find no evidence that PE lowers BMI or the probability that a student is overweight. We conclude that raising PE credit requirements may make girls more physically active overall but there is not yet the scientific base to declare raising PE requirements an anti-obesity initiative for either boys or girls. Copyright © 2007 John Wiley & Sons, Ltd. [source] Assessment and Interpretation of Comorbidity Burden in Older Adults with CancerJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2009Siran M. Koroukian PhD OBJECTIVES: To evaluate the associations between comorbidities, functional limitations, geriatric syndromes, treatment patterns, and outcomes in a population-based cohort of older patients diagnosed with colorectal cancer and receiving home health care. DESIGN: Retrospective study. SETTING: Data from the Ohio Cancer Incidence Surveillance System, Medicare claims and enrollment files, and the home health care Outcome and Assessment Information Set. PARTICIPANTS: Ohio residents diagnosed with incident colorectal cancer in 1999 to 2001 and receiving home health care in the 30 days before or after cancer diagnosis (N=957). MEASUREMENTS: Outcome measures included receipt of cancer treatment and survival through 2005. RESULTS: Not having surgery was associated negatively with comorbidities but positively with functional limitations and geriatric syndromes. Receipt of chemotherapy was negatively associated with comorbidities and functional limitations. The presence of two or more geriatric syndromes was significantly associated with unfavorable survival outcomes when analyzing overall survival and disease-specific survival (DSS). Having limitations in two or more activities of daily living was associated with unfavorable overall survival but not with DSS. Comorbity was associated with favorable DSS at borderline level of statistical significance but not with overall survival. CONCLUSION: The findings highlight the importance of incorporating functional limitations and geriatric syndrome data in geriatric oncology outcomes studies. [source] Cardiometabolic Syndrome and Its Association With Education, Smoking, Diet, Physical Activity, and Social Support: Findings From the Pennsylvania 2007 BRFSS SurveyJOURNAL OF CLINICAL HYPERTENSION, Issue 7 2010Longjian Liu MD J Clin Hypertens (Greenwich).2010;12:556,564. © 2010 Wiley Periodicals, Inc. The authors aimed to examine the prevalence of cardiometabolic syndrome (CMS) and its association with education, smoking, diet, physical activity, and social support among white, black, and Hispanic adults using data from the 2007 Pennsylvania Behavior Risk Factor Surveillance System (BRFSS) survey, the largest population-based survey in the state. The authors examined associations between CMS and associated factors cross-sectionally using univariate and multivariate methods. The study included a representative sample of 12,629 noninstitutionalized Pennsylvanians aged ,18. Components of CMS included obesity, hypercholesterolemia, angina (as a surrogate for decreased high-density lipoprotein), prehypertension or hypertension, and prediabetes or diabetes. CMS was identified as the presence of ,3 CMS components. The results show that the prevalence of CMS was 20.48% in blacks, followed by Hispanics (19.14%) and whites (12.26%), (P<.01). Multivariate logistic regression analyses indicated that physical inactivity, lower educational levels, smoking, daily consumption of vegetables and/or fruits <3 servings, and lack of social support were significantly associated with the odds of having CMS. In conclusion, black and Hispanic adults have a significantly higher prevalence of CMS than whites. The significant association between CMS and risk factors provides new insights in the direction of health promotion to prevent and control CMS in those who are at high risk. [source] Binge Drinking and Suboptimal Self-Rated Health Among Adult DrinkersALCOHOLISM, Issue 8 2010James Tsai Background:, Binge drinking accounts for more than half of the 79,000 annual deaths in the United States that are owing to excessive drinking. The overall objective of our study was to examine the prevalence of binge drinking and consumption levels associated with suboptimal self-rated health among the general population of adult drinkers in all 50 states and territories in the United States. Methods:, The study included a total of 200,587 current drinkers who participated in the 2008 Behavioral Risk Factor Surveillance System (BRFSS) survey. We estimated the prevalence of binge drinking (i.e., ,5 drinks on 1 occasion for men or ,4 drinks on 1 occasion for women) and heavy drinking (i.e., an average of >14 drinks per week for men or >7 drinks per week for women), as well as the average number of binge episodes per person during a 30-day period. Odds ratios were produced with multivariate logistic regression models using binge-drinking levels as a predictor; status of suboptimal self-rated health was used as an outcome variable while controlling for sociodemographic, health, and behavioral risk factors. Results:, We estimate that 34.7 million adult drinkers in the United States engaged in binge drinking in 2008, including an estimated 42.2% who reported either heavy drinking or at least 4 binge-drinking episodes in a 30-day period. Binge drinking with such levels was associated with a 13,23% increased likelihood of reporting suboptimal self-rated health, when compared to the nonbinge drinkers. Conclusions:, Binge drinking continues to be a serious public health concern. Frequent binge drinkers or binge drinkers who consume alcohol heavily are especially at risk of suboptimal self-rated health. Our findings underscore the importance of broad-based implementation in health care settings of screening for and brief interventions to address alcohol misuse, as well as the continuing need to implement effective population-based prevention strategies to reduce alcohol-related morbidity and mortality. [source] Characterizing and Reaching High-Risk Drinkers Using Audience SegmentationALCOHOLISM, Issue 8 2009Howard B. Moss Background:, Market or audience segmentation is widely used in social marketing efforts to help planners identify segments of a population to target for tailored program interventions. Market-based segments are typically defined by behaviors, attitudes, knowledge, opinions, or lifestyles. They are more helpful to health communication and marketing planning than epidemiologically defined groups because market-based segments are similar in respect to how they behave or might react to marketing and communication efforts. However, market segmentation has rarely been used in alcohol research. As an illustration of its utility, we employed commercial data that describes the sociodemographic characteristics of high-risk drinkers as an audience segment, including where they tend to live, lifestyles, interests, consumer behaviors, alcohol consumption behaviors, other health-related behaviors, and cultural values. Such information can be extremely valuable in targeting and planning public health campaigns, targeted mailings, prevention interventions, and research efforts. Methods:, We described the results of a segmentation analysis of those individuals who self-reported to consume 5 or more drinks per drinking episode at least twice in the last 30 days. The study used the proprietary PRIZMÔ (Claritas, Inc., San Diego, CA) audience segmentation database merged with the Center for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) database. The top 10 of the 66 PRIZMÔ audience segments for this risky drinking pattern are described. For five of these segments we provided additional in-depth details about consumer behavior and the estimates of the market areas where these risky drinkers resided. Results:, The top 10 audience segments (PRIZM clusters) most likely to engage in high-risk drinking are described. The cluster with the highest concentration of binge-drinking behavior is referred to as the "Cyber Millenials." This cluster is characterized as "the nation's tech-savvy singles and couples living in fashionable neighborhoods on the urban fringe." Almost 65% of Cyber Millenials households are found in the Pacific and Middle Atlantic regions of the United States. Additional consumer behaviors of the Cyber Millenials and other segments are also described. Conclusions:, Audience segmentation can assist in identifying and describing target audience segments, as well as identifying places where segments congregate on- or offline. This information can be helpful for recruiting subjects for alcohol prevention research as well as planning health promotion campaigns. Through commercial data about high-risk drinkers as "consumers," planners can develop interventions that have heightened salience in terms of opportunities, perceptions, and motivations, and have better media channel identification. [source] Exploring Pregnancy-Related Changes in Alcohol Consumption Between Black and White WomenALCOHOLISM, Issue 3 2008Daniel S. Morris Background:, Although epidemiological data indicate that White women are more likely to drink and binge drink before pregnancy, fetal alcohol syndrome (FAS) is more common in the Black population than among Whites in the United States. Differences in drinking cessation between Black and White women who become pregnant may help explain the disparity in FAS rates. Methods:, The study sample was comprised of 280,126 non-Hispanic Black and White women, ages 18 to 44, from the Behavioral Risk Factor Surveillance System (BRFSS) 2001 to 2005 data sets. Predictors of reduction in alcohol consumption (in drinks per month) and binge drinking (>4 drinks on one occasion) by pregnant and non-pregnant women were identified with logistic regression. The effect of interactions of pregnancy status with age, education, and Black or White race on drinks per month and binge occasions were explored using analysis of variance (ANOVA). Results:, Pregnant White women averaged 79.5% fewer drinks per month than non-pregnant White women (F = 1250.1, p < 0.001), and 85.4% fewer binge drinking occasions (F = 376, p < 0.001). Pregnant Black women averaged 58.2% fewer drinks per month than non-pregnant Black women (F = 31.8, p < 0.001) and 64.0% fewer binge occasions (F = 13.8, p < 0.001). Compared to Black women, White women appear to make a 38% greater reduction in drinks per month, and a 33% greater reduction in binge occasions. Conclusions:, Non-Hispanic White women appear more likely to reduce drinks per month and binge drinking occasions than non-Hispanic Black women during pregnancy. These findings may help explain disparities in FAS in the United States, though this cross-sectional sample does not permit claims of causation. To better describe the impact of differential drinking reduction on FAS rates, future studies of longitudinal data should be done. [source] Travel-Associated Dengue Infections in the United States, 1996 to 2005JOURNAL OF TRAVEL MEDICINE, Issue 1 2010Hamish P. Mohammed PhD Background. As the incidence of dengue increases globally, US travelers to endemic areas may be at an increased risk of travel-associated dengue. Methods. Data from the US Centers for Disease Control and Prevention's laboratory-based Passive Dengue Surveillance System (PDSS) were used to describe trends in travel-associated dengue reported from January 1, 1996 to December 31, 2005. The PDSS relies on provider-initiated requests for diagnostic testing of serum samples via state health departments. A case of travel-associated dengue was defined as a laboratory-positive dengue infection in a resident of the 50 US states and the District of Columbia who had been in a dengue-endemic area within 14 days before symptom onset. Dengue infection was confirmed by serologic and virologic techniques. Results. One thousand one hundred and ninety-six suspected travel-associated dengue cases were reported,334 (28%) were laboratory-positive, 597 (50%) were laboratory-negative, and 265 (22%) were laboratory-indeterminate. The incidence of laboratory-positive cases varied from 1996 to 2005, but had an overall increase with no significant trend (53.5 to 121.3 per 108 US travelers, p = 0.36). The most commonly visited regions were the Caribbean, Mexico and Central America, and Asia. The median age of laboratory-positive cases was 37 years (range: <1 to 75 y) and 166 (50%) were male. Of the 334 laboratory-positive cases, 41 (12%) were hospitalized, and 2 (1%) died. Conclusions. Residents of the US traveling to dengue-endemic regions are at risk of dengue infection and need to be instructed on appropriate prevention measures prior to travel. Especially in light of the potential transmissibility of dengue virus via blood transfusion, consistent reporting of travel-associated dengue infections is essential. [source] Risk of hepatitis A infection following travelJOURNAL OF VIRAL HEPATITIS, Issue 6 2002M. Ciccozzi summary.,Travel to endemic areas is one of the most frequently reported risk factors for infection with the hepatitis A virus (HAV). We evaluated the association between HAV infection and travel, by area of destination. We conducted a case,control study on all cases of HAV infection reported to the Italian National Surveillance System for Acute Viral Hepatitis in the period 1996,2000. The study population consisted of 9695 persons with HAV infection (cases) and 2590 with HBV infection (controls). The risk of acquiring HAV was highest for travel to Asia, Africa and Latin America [Odds Ratio=9.30 (95%CI=6.71,12.9)]; a three-fold statistically significant excess of risk was found for travel to southern Italy (OR=3.03) and to the Mediterranean Area and Eastern Europe (OR=3.15). Travel was implicated in 28% of the cases of HAV infection. When stratifying the analysis by area of residence (northern and central Italy vs southern Italy and the Islands), the above-mentioned risks were confirmed only for those residing in northern and central Italy, with no significant risk for those residing in southern Italy and the Islands. Travel to areas endemic for HAV infection constitutes a considerable risk. Our results highlight the importance of developing health policies for improving environmental and hygienic conditions, as well as the prevention of certain eating habits. Vaccination before travelling to a medium or high endemic area could be a safe and effective means of preventing travel-related HAV infection. [source] Assessment of anthrax vaccination data in the Defense Medical Surveillance System, 1998,2004,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 6 2007Daniel C. Payne PhD MSPH Abstract Purpose Understanding the completeness and accuracy of U.S. military anthrax vaccination data is important to the design and interpretation of studies to assess the safety of anthrax vaccine. We estimated the agreement between electronically recorded anthrax vaccination data in the Defense Medical Surveillance System (DMSS) versus anthrax vaccination data abstracted from hardcopy medical charts in a representative sample of the U.S. military from 1998 to 2004. Methods Medical chart abstractions were conducted at 28 military treatment facilities for 4201 personnel. Abstracted anthrax vaccination data for 1817 personnel, representing 7400 anthrax vaccine doses, were compared with electronically captured data in the DMSS from 1998 to 2004. Sensitivity, positive predictive value (PPV), specificity and negative predictive value (NPV) were calculated using weighted analyses. Results Weighted person-level analysis revealed DMSS sensitivity,=,93.8% (95%CI,=,91.1, 95.8), specificity,=,87.0% (79.0, 92.3), PPV,=,85.6% (77.2, 91.3) and NPV,=,94.5% (91.7, 96.4). Report of anthrax vaccination within a ±7 days window in both medical chart and DMSS electronic data had a sensitivity of 88.3% (85.4, 90.7) and a PPV of 86.6% (84.9, 88.2) in the vaccine dose-level analysis. Conclusions These results support that anthrax vaccination data captured by the DMSS are adequate for post-marketing surveillance investigations in the U.S. military and are of comparable quality to data captured by other vaccine safety databases. Copyright © 2007 John Wiley & Sons, Ltd. [source] Nonfatal tool- or equipment-related injuries treated in US emergency departments among workers in the construction industry, 1998,2005AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 6 2010Hester J. Lipscomb PhD Abstract Background Individuals in the construction industry are exposed to a variety of tools and pieces of equipment as they work. Methods Data from the National Institute for Occupational Safety and Health (NIOSH) occupational supplement to the National Electronic Injury Surveillance System (NEISS-Work) were used to characterize tool- and equipment,related injuries among workers in the construction industry that were treated in US emergency departments between 1998 and 2005. Based on a national stratified probability sample of US hospitals with 24,hr emergency services, NEISS-Work allows calculation of national injury estimates. Results Over the 8-year period between 1998 and 2005, we estimated 786,900 (95% CI 546,600,1,027,200) ED-treated tool- or equipment-related injuries identified by the primary or secondary source of injury code. These injuries accounted for a quarter of all ED-treated construction industry injuries. Although over 100 different tools or pieces of equipment were responsible for these injuries, seven were responsible for over 65% of the injury burden: ladders, nail guns, power saws, hammers, knives, power drills, and welding tools in decreasing order. Conclusions Current injury estimates and their severity, marked by the proportion of cases that were not released after ED treatment, indicate interventions are particularly needed to prevent injuries associated with use of ladders as well as nail guns and power saws. Attention should focus on design and guarding to more efficiently prevent these injuries rather than simply calling for the training of workers in how to safely use a dangerous tool or piece of equipment. Am. J. Ind. Med. 53: 581,587, 2010. © 2010 Wiley-Liss, Inc. [source] Occupational injuries among emergency responders,,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 1 2010Audrey A. Reichard MPH Abstract Background Emergency responders frequently incur injuries while providing medical, fire, and law enforcement services. National surveillance systems provide fragmented perspectives on responder injuries because they omit specific classes of workers (e.g., government or volunteers); they report only selected injuries; and employment information is incomplete. Methods We characterized injuries among emergency medical services (EMS), firefighting, and police occupations by using data from the National Electronic Injury Surveillance System,Occupational Supplement (NEISS-Work) for injuries treated in U.S. hospital emergency departments in 2000,2001. Results Sprains and strains were the leading injury (33,41%) among EMS, firefighter, and police occupations. Police officers and career firefighters had the highest injury rates (8.5 and 7.4 injuries per 100 full-time equivalent workers, respectively). Conclusions The physical demands of emergency response are a leading cause of injuries that may benefit from similar interventions across the occupations. To assess risk, improved exposure data need to be acquired, particularly for volunteers. Am. J. Ind. Med. 53:1,11, 2010. Published 2009 Wiley-Liss, Inc. [source] Potential work-related bloodborne pathogen exposures by industry and occupation in the United States Part I: An emergency department-based surveillance study,,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2007Guang X. Chen Abstract Background Since the early 1990s, researchers have attempted to assess the magnitude of potential work-related bloodborne pathogen (BBP) exposures in the U.S. The only data-derived estimate of 385,000 needlestick and other sharps injuries per year was reported in 2004. The estimate was derived from a convenience sample and did not include exposures outside of hospitals. This study seeks to understand the magnitude and distribution of the exposures across all industries and occupations. Methods Data were from the 1998 to 2000 National Electronic Injury Surveillance System (NEISS), a stratified probability-based sample of U.S. hospital emergency departments (EDs). NEISS covers all industries and occupations. National estimates of exposures and exposure rates (the number of exposures/1,000 full-time equivalents (FTE)) were computed. Results An estimated 78,100 potential work-related exposures to BBP were treated in hospital EDs annually in the U.S. While hospitals accounted for 75% of all these exposures, 11 other industries had a substantial number of exposures. While registered nurses accounted for 36% of all exposures, 13 other occupations had a substantial number of exposures. Hospitals had the highest exposure rate of 11.3/1,000 FTE, followed by nursing homes (2.8), and residential care facilities without nursing (1.9). Registered nurses had the highest exposure rate of 15.3/1,000 FTE, followed by clinical laboratory technologists and technicians (13.9), and physicians (7.1). Conclusions While this study begins to more completely describe the problem of potential BBP exposure in the workplace, it is but a first step in further understanding the complex issues surrounding workplace BBP exposures. Am. J. Ind. Med. 50: 183,190, 2007. Published 2007 Wiley-Liss, Inc. [source] Parental exposure to lead and small for gestational age birthsAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 6 2006Pau-Chung Chen MD Abstract Background Previous studies about the effect of lead exposure on adverse birth outcomes are still inconsistent and few studies estimate the relationship between parental lead exposure and small for gestational age (SGA) infants. An occupational cohort study to assess whether parental lead exposure would be related to decreased birth weight and shortened gestational ages of their offspring was conducted. Whether higher lead exposure doses would increase risks of low birth weight (LBW), preterm delivery, and SGA births was also investigated. Methods A Program to Reduce Exposure by Surveillance System,Blood Lead Levels (Press-BLLS) was established in Taiwan in July 1993. The names of workers exposed to lead was collected from this occupational blood-lead notification database. The birth outcomes of their offspring were determined by linking to the Taiwan birth registration database from 1993 to 1997. Only singleton births whose parental blood-lead concentrations were tested during pregnancy or prior to conception, or within a 1-year span before these two periods were included. Results Among 1,611 eligible births, 72 births were LBW, 74 were preterm deliveries, and 135 were SGA. Maternal blood-lead concentrations (PbBs) equal to or more than 20 µg/dl had a higher risk of mothering a SGA child (risk ratio (RR),=,2.15; 95% confidence interval (CI), 1.15,3.83). Conclusions Additional evidence of the effects of lead on adverse birth outcomes, especially for SGA births is reported. Maternal exposure to lead plays a more important role in the adverse effect on birth outcome than does paternal exposure. Am. J. Ind. Med. 2006. © 2006 Wiley-Liss, Inc. [source] Labour migration and change in older people's living arrangements: the case of Kanchanaburi Demographic Surveillance System (KDSS), ThailandPOPULATION, SPACE AND PLACE (PREVIOUSLY:-INT JOURNAL OF POPULATION GEOGRAPHY), Issue 5 2008Min Qin Abstract This study involves an investigation of changes in older people's living arrangements in the context of a 4-round panel design from the Kanchanaburi Demographic Surveillance System (KDSS), Thailand. The respondents were 2320 persons aged 60 and above, who were co-residing with family members in addition to, or other than, their spouse at the time of the first round of the census. Survival analysis is used to interpret the data. Results indicate that labour migration plays an important role in changes in the living arrangements of older people. Migration increases the risk of living alone. Other demographic and socio-economic factors of importance include the marital status of older people, economic security, household assets, household size, and household members living nearby. The paper concludes by discussing policy implications of the findings. Copyright © 2008 John Wiley & Sons, Ltd. [source] A National Study of Obesity Prevalence and Trends by Type of Rural CountyTHE JOURNAL OF RURAL HEALTH, Issue 2 2005J. Elizabeth Jackson MA ABSTRACT: Context: Obesity is epidemic in the United States, but information on this trend by type of rural locale is limited. Purpose: To estimate the prevalence of and recent trends in obesity among US adults residing in rural locations. Methods: Analysis of data from the Behavioral Risk Factor Surveillance System (BRFSS) for the years 1994,1996 (n = 342,055) and 2000,2001 (n = 385,384). The main outcome measure was obesity (body mass index [BMI] ,30), as determined by calculating BMI from respondents' self-reported height and weight. Results: In 2000,2001, the prevalence of obesity was 23.0% (95% confidence interval [CI] 22.6%-23.4%) for rural adults and 20.5% (95% CI 20.2%-20.7%) for their urban counterparts, representing increases of 4.8% (95% CI 4.2%-5.3%) and 5.5% (95% CI 5.1%-5.9%), respectively, since 1994,1996. The highest obesity prevalence occurred in rural counties in Louisiana, Mississippi, and Texas; obesity prevalence increased for rural residents in all states but Florida over the study period. African Americans had the highest obesity prevalence of any group, up to 31.4% (95% CI 29.1%-33.6) in rural counties adjacent to urban counties. The largest difference in obesity prevalence between those with a college education compared with those without a high school diploma occurred in urban areas (18.4% [95% CI 17.9%-18.9%] vs 23.5% [95% CI 22.5%-24.5%], respectively); the smallest difference occurred in small, remote rural counties (20.3% [95% CI 18.7%-21.9%] versus 22.3% [95% CI 20.7%-24.0%], respectively). Conclusions: The prevalence of obesity is higher in rural counties than in urban counties; obesity affects some residents of rural counties disproportionately. [source] Pediatric Tree House,Related Injuries Treated in Emergency Departments in the United States: 1990,2006ACADEMIC EMERGENCY MEDICINE, Issue 3 2009Charles Randazzo Abstract Objectives:, The objective was to describe the epidemiology of tree house,related injuries in the United States among children and adolescents. Methods:, The authors conducted a retrospective analysis using data from the National Electronic Injury Surveillance System for patients ,19 years who were treated in an emergency department (ED) for a tree house,related injury from 1990 through 2006. Results:, An estimated 47,351 patients ,19 years of age were treated in EDs for tree house,related injuries over the 17-year study period. Fractures were the most common diagnosis (36.6%), and the upper extremities were the most commonly injured body part (38.8%). The odds of sustaining a head injury were increased for children aged <5 years. Falls were the most common injury mechanism (78.6%) and increased the odds of sustaining a fracture. Falls or jumps from a height ,10 feet occurred in 29.3% of cases for which height of the fall/jump was recorded. Boys had significantly higher odds of falling or jumping from a height of ,10 ft than girls, and children 10 to 19 years old also had significantly higher odds of falling or jumping from a height of ,10 feet, compared to those 9 years old and younger. The odds of hospitalization were tripled if the patient fell or jumped from ,10 feet and nearly tripled if the patient sustained a fracture. Conclusions:, This study examined tree house,related injuries on a national level. Tree house safety deserves special attention because of the potential for serious injury or death due to falls from great heights, as well as the absence of national or regional safety standards. The authors provide safety and prevention recommendations based on the successful standards developed for playground equipment. [source] Injuries in Youth Football: National Emergency Department Visits during 2001,2005 for Young and Adolescent PlayersACADEMIC EMERGENCY MEDICINE, Issue 3 2009Michael J. Mello MD Abstract Objectives:, Limited research exists describing youth football injuries, and many of these are confined to specific regions or communities. The authors describe U.S. pediatric football injury patterns receiving emergency department (ED) evaluation and compare injury patterns between the younger and older youth football participants. Methods:, A retrospective analysis of ED data on football injuries was performed using the National Electronic Injury Surveillance System,All Injury Program. Injury risk estimates were calculated over a 5-year period (2001,2005) using participation data from the National Sporting Goods Association. Injury types are described for young (7,11 years) and adolescent (12,17 years) male football participants. Results:, There were an estimated total of 1,060,823 visits to U.S. EDs for males with football-related injuries. The most common diagnoses in the younger group (7,11 years) were fracture/dislocation (29%), sprain/strain (27%), and contusion (27%). In the older group (ages 12,17 years), diagnoses included sprain/strain (31%), fracture/dislocation (29%), and contusion (23%). Older participants had a significantly higher injury risk of injury over the 5-year study period: 11.0 (95% confidence interval [CI] = 9.2 to 12.8) versus 6.1 (95% CI = 4.8 to 7.3) per 1,000 participants/year. Older participants had a higher injury risk across all categories, with the greatest disparity being with traumatic brain injury (TBI), 0.8 (95% CI = 0.6 to 1.0) versus 0.3 (95% CI = 0.2 to 0.4) per 1,000 participants/year. Conclusions:, National youth football injury patterns are similar to those previously reported in community and cohort studies. Older participants have a significantly higher injury risk, especially with TBI. [source] The 2005 Wellington influenza outbreak: syndromic surveillance of Wellington Hospital Emergency Department activity may have provided early warningAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2009Melissa McLeod Abstract Objectives: To assess whether the Wellington Emergency Department (ED) Respiratory Syndromic Surveillance System may have provided early warning of the influenza outbreak in Wellington schools during 2005, and as a result might have provided the opportunity for an earlier or more effective public health response. Methods: All events of respiratory syndrome, as defined by selected ICD 10 codes, were extracted from Wellington Hospital ED for the dates 1 January 2004 to 31 December 2006, and analysed using the Centers for Disease Control and Prevention (CDC) surveillance program, Early Aberration Reporting System (EARS). Daily events were analysed for total counts and by lifecycle age group. Seven day moving averages of the numbers of events were also calculated. Results: This study indicated that the surveillance system may have provided early warning of a potential respiratory outbreak. Regular exceedance flags were generated nine days prior to the initial notification received by Regional Public Health (RPH). The surveillance system also provided information on the type of illness (respiratory), the groups affected (5-14 year olds), and the progression of the outbreak (peak, end). Conclusions: The surveillance system might have worked by providing early notification of the outbreak. This may have prompted RPH to earlier investigate the potential outbreak and may have led to an earlier response. Implications: Surveillance of Emergency Department activity may be useful for early public health response. [source] Tuberculosis in pregnancy in the UKBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 4 2009M Knight Tuberculosis (TB) is a globally important cause of morbidity and mortality with an increasing incidence in women of reproductive ages. This descriptive study using the UK Obstetric Surveillance System demonstrates key differences in the presentation of TB during pregnancy compared with the nonpregnant population. The disease is limited to ethnic minority women, most commonly recent immigrants. Presentation may be atypical, with extrapulmonary disease as common as pulmonary. Clinicians should be aware of the potential for nonspecific presentation of the disease in pregnancy and consider the diagnosis in women, especially recently arrived immigrants, presenting with nonspecific symptoms. [source] Antenatal pulmonary embolism: risk factors, management and outcomesBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 4 2008M Knight Objectives, To estimate the incidence of antenatal pulmonary embolism and describe the risk factors, management and outcomes. Design, A national matched case,control study using the UK Obstetric Surveillance System (UKOSS). Setting, All hospitals with consultant-led maternity units in the UK. Participants, A total of 143 women who had an antenatal pulmonary embolism between February 2005 and August 2006. Two hundred and fifty nine matched control women. Methods, Prospective case and control identification through the UKOSS monthly mailing. Main outcome measures, Incidence and case fatality rates with 95% CIs. Adjusted odds ratio estimates. Results, One hundred per cent of UK consultant-led obstetric units contributed data to UKOSS. A total of 143 antenatal pulmonary embolisms were reported, representing an estimated incidence of 1.3 per 10 000 maternities (95% CI 1.1,1.5). Seventy per cent of women had identifiable classical risk factors for thromboembolic disease. The main risk factors for pulmonary embolism were multiparity (adjusted odds ratio [aOR] 4.03, 95% CI 1.60,9.84) and body mass index , 30 kg/m2 (aOR 2.65, 95% CI 1.09,6.45). Nine women who had a pulmonary embolism should have received antenatal thromboprophylaxis with low-molecular-weight heparin (LMWH) according to national guidelines; only three (33%) of them did. Six women (4%) had a pulmonary embolism following antenatal prophylaxis with LMWH; three of these women (50%) were receiving lower than recommended doses. Two women had recurrent pulmonary emboli (1.4%, 95% CI 0.2,5.1%). Five women died (case fatality 3.5%, 95% CI 1.1,8.0%). Conclusions, Significant severe morbidity from thromboembolic disease underlies the maternal deaths from pulmonary embolism in the UK. This study has shown some cases where thromboprophylaxis was not provided according to national guidelines, and there may be scope for further work on guideline implementation. [source] Complications from treatment for prostate carcinoma among men in the Detroit areaCANCER, Issue 1 2002Kendra Schwartz M.D., M.S.P.H. Abstract BACKGROUND Aggressive treatment of early stage prostate carcinoma (PC) is limited primarily to two modalities: radical prostatectomy (RP) and external beam radiation therapy (RT). The authors conducted a population-based study of Detroit area men with localized PC to determine the outcome of bowel, urinary, and sexual function after aggressive treatment. METHODS Men with PC were identified through the Metropolitan Detroit Cancer Surveillance System, a member of the National Cancer Institute Surveillance, Epidemiology, and End Results Program. Patients participated in interviews about their pretreatment bowel, urinary, and sexual function approximately 9 months after treatment. The same men were asked identical questions about their function an average of 2 years after treatment. Treatment outcomes were compared for men who underwent RP and men who received RT. RESULTS Of 501 men, 398 (79.4%) participated in both interviews, 304 of whom (76.4%) had localized PC and had been treated at least 1 year previously (median, 688 days). One hundred thirty men underwent RP, and 115 men received RT. The proportion of men in the RP group who reported an increase in incontinence symptoms was significant (53.8% compared with 19.2% in the RT group; P < 0.001). Men in the RT group reported increased loose stools between the pretreatment and post-treatment interviews (5.2% vs. 29.6%; P < 0.001). Men in both the RT group and the RP group reported increases in impotence from 40% to > 75% (P < 0.001 for both). Men in the RT group were 3.6 times more likely to have bowel incontinence compared with men in the RP group (odds ratio [OR], 3.61; 95% confidence interval [95% CI], 1.54,8.47). Urinary incontinence (OR, 2.87; 95% CI, 1.52,5.44) and erection difficulty (OR, 3.98; 95% CI, 1.35,11.70) were more likely among men in the RP group. CONCLUSIONS Although patients may have recalled their baseline function as better than it was, the current results are consistent with other population-based studies of treatment outcomes among men with localized PC. They indicate that the side effects associated with treatment are greater than those based on case series. Physicians and patients should be aware of these population-based outcomes and should use them as part of the decision-making process regarding the treatment options for men with PC. Cancer 2002;95:82,9. © 2002 American Cancer Society. DOI 10.1002/cncr.10650 [source] Emergency Department Visits for Pediatric Trampoline-related Injuries: An UpdateACADEMIC EMERGENCY MEDICINE, Issue 6 2007James G. Linakis PhD Objectives:To describe the epidemiology of emergency department (ED) visits for trampoline-related injuries among U.S. children from January 1, 2000, to December 31, 2005, using the National Electronic Injury Surveillance System (NEISS) and to compare recent trampoline injury demographics and injury characteristics with those previously published for 1990,1995 using the same data source. Methods:A stratified probability sample of U.S. hospitals providing emergency services in NEISS was utilized for 2000,2005. Nonfatal trampoline-related injury visits to the ED were analyzed for patients from 0 to 18 years of age. Results:In 2000,2005, there was a mean of 88,563 ED visits per year for trampoline-related injuries among 0,18-year-olds, 95% of which occurred at home. This represents a significantly increased number of visits compared with 1990,1995, when there was an average of 41,600 visits per year. Primary diagnosis and principal body part affected remained similar between the two study periods. Conclusions:ED visits for trampoline-related injuries in 2000,2005 increased in frequency by 113% over the number of visits for 1990,1995. Trampoline use at home continues to be a significant source of childhood injury morbidity. [source] Standardization and quality assurance for antimicrobial resistance surveillance of Streptococcus pneumoniae and Staphylococcus aureus within the European Antimicrobial Resistance Surveillance System (EARSS) ,CLINICAL MICROBIOLOGY AND INFECTION, Issue 2 2000W. Goettsch First page of article [source] Parsimonious prediction model for the prevalence of dental visitsCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 5 2008Hazem Seirawan Abstract,,, Objectives:, To analyze the prevalence of dental visits within the last year in the Behavioral Risk Factor Surveillance System or BRFSS (2003) national database by simple sociodemographic factors, and to predict prevalence in States that have not participated in BRFSS 2003. Methods:, Behavioral Risk Factor Surveillance System is a cross-sectional telephone survey conducted by the state-level authorities in the United States and based on a standardized questionnaire to determine the distribution of risk behaviors and health practices among noninstitutionalized adults. A multivariable logistic regression model considers the complex sample design of the BRFSS was used to predict the prevalence of dental visits based on four nonclinic parsimonious variables. Results:, White race, high income (,$35 000), education above high school, and marital status were associated with an annual dental visit with odds ratios of 1.38, 2.09, 1.61, and 1.18, respectively. Utah had the highest percentage (78%) of estimated annual users, while ,Virgin Islands' had the lowest percentage (59%). The model's correct classification rate was 61.5%. Conclusions:, State and local governments, health promotion organizations, insurance companies, and organizations that administer public health programs (such as Medicare and Medicaid in the U.S.) will benefit by applying this model to the available nonclinical databases, and will be able to improve planning of dental health services and required dental workforce. [source] The Rationale for Developing Public Health Surveillance Systems Based on Emergency Department DataACADEMIC EMERGENCY MEDICINE, Issue 12 2000Jon Mark Hirshon MD Abstract. Emergency departments (EDs) are well positioned to provide national data on several aspects of public health. The large volume of patients seen annually, improving medical record technology, and emergency uniform data sets make the development of public health surveillance systems a realistic opportunity for emergency medicine. Such data could identify public health concerns and suggest interventions to improve the health of the nation. This article describes current concepts and status of ED surveillance systems, their advantages and disadvantages, the rationale for their existence, and recommendations to allow their continued consideration and development. [source] | ||||||||||||||||