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1.
Subst Abus ; 43(1): 1300-1307, 2022 12.
Article in English | MEDLINE | ID: mdl-35876783

ABSTRACT

BACKGROUND: Decreased physical fitness, loss of vision and hearing, and increased risk of chronic diseases are significant primary and secondary implications associated with the health of U.S. Military Service members who use tobacco, including electronic cigarettes. Despite the medical and non-medical costs to the U.S. Department of Defense and potential adverse health effects to Service members, electronic cigarette use is on the rise. METHODS: U.S. Military Service members who completed their Periodic Health Assessment, a standardized, electronic, logic-based tool, from July 2018 to July 2019 were eligible. This exploratory study examines the prevalence and significant risk factors associated with self-reported use of electronic cigarettes, as well as determines if tobacco use varies by sex and Service branch, through use of Chi-square analysis and logistic regression. RESULTS: U.S. Military Service members 17-70 years old were included in this study (N = 1.12 M), with 80% of study participants being male and 20% female. Exposure to secondhand smoke (OR: 2.12, 95% CI: 2.15-2.22) and screening positive for hazardous drinking (OR: 2.70, 95% CI: 2.64-2.76) were found to show the greatest increase in odds of using electronic cigarettes, with similar findings after stratification by sex and Service branch. Stratification by Service branch revealed further differences in the association between electronic cigarette use and various demographic, military, lifestyle, and health characteristics. CONCLUSION: Electronic cigarette use is increasing across the United States. U.S. Service members have unique risk factors and patterns of tobacco use. Despite tobacco use having potential adverse effects on military readiness, its use remains prevalent in this population. Our findings identify opportunities for the U.S. Department of Defense to review tobacco policy and availability and accessibility of cessation services to promote quitting tobacco, especially electronic cigarettes.


Subject(s)
Electronic Nicotine Delivery Systems , Military Personnel , Vaping , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Prevalence , Risk Factors , United States/epidemiology , Young Adult
2.
Ann Work Expo Health ; 65(7): 843-853, 2021 08 05.
Article in English | MEDLINE | ID: mdl-33787854

ABSTRACT

Overhaul is the phase of firefighting after flames have been extinguished but when products of combustion are still being released. While positive pressure self-contained breathing apparatus (SCBA) provide the highest level of respiratory protection during overhaul, use of air-purifying respirators (APRs) with suitable filters could potentially provide a lower weight, longer duration option for first responders. The objective of this study was to assess whether an APR with a chemical, biological, radiological, and nuclear (CBRN) canister could be recommended as substitution for SCBA during overhaul. A total of 15 simulated standard overhaul environments were created by burning household materials. Sampling was conducted using mannequin heads fitted with full facepiece respirators with either a CBRN canister or SCBA. In-mask and personal samples were collected for aldehydes, polynuclear aromatic hydrocarbons, inorganic acids, aromatic hydrocarbons, nitrogen dioxide, and particulate matter. An additional six simulated high-exposure overhaul environments were created in a flashover chamber by continuously adding household materials to a smoldering fire. The sampling train was the same for both the standard and high-exposure environments; however, the facepiece was sealed to the mannequin head in the high-exposure environments. In the standard overhaul environment, the CBRN canister effectively reduced the level of exposure for most contaminants, while in the high-exposure overhaul exposure setting in-mask acetaldehyde and formaldehyde were detected. In both exposure settings, the SCBA prevented almost all exposure, and therefore remains the recommended respiratory protection during overhaul.


Subject(s)
Air Pollutants, Occupational , Occupational Exposure , Respiratory Protective Devices , Air Pollutants, Occupational/analysis , Formaldehyde/analysis , Humans , Occupational Exposure/analysis , Ventilators, Mechanical
4.
J Occup Environ Med ; 60(3): 226-233, 2018 03.
Article in English | MEDLINE | ID: mdl-29227357

ABSTRACT

OBJECTIVE: Risk management (RM) is a cyclical process of identifying and ranking risks, implementing controls, and evaluating their effectiveness. This study aims to identify effective RM interventions in the U.S. mining industry. METHODS: RM interventions were identified in four companies representing metal, aggregate, and coal mining sectors. Injury rates were determined using Mine Safety and Health Administration (MSHA) data and changes in injury rates identified through change point analysis. Program implementation costs and associated changes in injury costs were evaluated for select interventions. RESULTS: Six of 20 RM interventions were associated with a decline in all injuries and one with a reduction in lost-time injuries, all with a positive return on investment. CONCLUSION: Reductions in injuries and associated costs were observed following implementation of a limited number of specific RM interventions.


Subject(s)
Mining/economics , Occupational Injuries/economics , Occupational Injuries/prevention & control , Risk Management/economics , Risk Management/methods , Coal Mining/economics , Humans , Metals , Occupational Health/economics , Program Evaluation
5.
J Occup Environ Hyg ; 14(7): D102-D109, 2017 07.
Article in English | MEDLINE | ID: mdl-28166462

ABSTRACT

This study aimed to compare personal exposures to diesel fuel and a biodiesel blend exhaust in an underground mine. Personal exposure monitoring was performed in a non-operational, hard rock underground mine during use of a load-haul-dump vehicle. Eight-hour time-weighted average (TWA8) exposure concentrations of ultra-low sulfur diesel and 75% biodiesel/25% diesel blend (B75) fuels were compared. Compared to diesel, use of B75 was associated with relative percent reductions of 22 and 28% in median respirable (r) diesel particulate matter (DPM) and nitrogen dioxide and 25 and 23% increases in median total DPM and nitric oxide TWA8 exposure concentrations, respectively. Diesel was associated with a slightly greater total geometric mean mass concentration and lower mean surface area concentration. Although further testing is needed, B75 has the potential to reduce rDPM exposures.


Subject(s)
Air Pollutants, Occupational/analysis , Biofuels , Gasoline , Mining , Occupational Exposure/analysis , Vehicle Emissions/analysis , Carbon Monoxide/analysis , Environmental Monitoring , Humans , Nitrogen Dioxide/analysis , Particulate Matter/analysis , Pilot Projects
6.
J Occup Environ Hyg ; 13(3): 177-84, 2016.
Article in English | MEDLINE | ID: mdl-26554925

ABSTRACT

According to the National Fire Protection Association there were 487,500 structural fires in the U.S. in 2013. After visible flames are extinguished firefighters begin the overhaul stage where remaining hot spots are identified and further extinguished. During overhaul, a significant amount of potentially hazardous chemicals can remain in the ambient environment. Previous research suggests that the use of air purifying respirators fitted with chemical, biological, radiological, and nuclear (CBRN) canisters may reduce occupational exposure. This study used large scale burns of representative structural materials to perform side-by-side, filtering, and service-life evaluations of commercially available CBRN filters using two head forms fitted with full-face respirators and a dynamic breathing machine. Three types of CBRN canisters and one non-CBRN cartridge were challenged in repetitive post-fire environments. Tests were conducted with two different breathing volumes and rates for two sampling durations (0-15 min and 0-60 min). Fifty-five different chemicals were selected for evaluation and results indicate that 10 of the 55 chemicals were present in the post-fire overhaul ambient environment. Acetaldehyde and formaldehyde were found to be the only two chemicals detected post filter but were effectively filtered to below ACGIH TLVs. Counter to our prior published work using continuous flow filter evaluation, this study indicates that, regardless of brand, CBRN filters were effective at reducing concentrations of post-fire ambient chemicals to below occupational exposure limits. However, caution should be applied when using CBRN filters as the ambient formaldehyde level in the current study was 8.9 times lower than during the previous work.


Subject(s)
Firefighters , Inhalation Exposure/prevention & control , Occupational Exposure/prevention & control , Respiratory Protective Devices , Acetaldehyde/analysis , Air Pollutants, Occupational/analysis , Fires , Formaldehyde/analysis , Hazardous Substances/analysis , Humans , Inhalation Exposure/analysis , Manikins , Occupational Exposure/analysis
7.
Inj Prev ; 22(3): 181-8, 2016 06.
Article in English | MEDLINE | ID: mdl-26559144

ABSTRACT

BACKGROUND: Firefighting is a hazardous profession and firefighters suffer workplace injury at a higher rate than most US workers. Decreased physical fitness is associated with injury in firefighters. A physical fitness intervention was implemented among Tucson Fire Department recruit firefighters with the goals of decreasing injury and compensation claims frequency and costs during the recruit academy, and over the subsequent probationary year. METHODS: Department injury records were analysed and described by body part, injury type and mechanism of injury. Injury and workers' compensation claims outcomes from the recruit academy initiation through the 12-month probationary period for the intervention recruit class were compared with controls from three historical classes. RESULTS: The majority of injuries were sprains and strains (65.4%), the most common mechanism of injury was acute overexertion (67.9%) and the lower extremity was the most commonly affected body region (61.7%). The intervention class experienced significantly fewer injuries overall and during the probationary year (p=0.009), filed fewer claims (p=0.028) and experienced claims cost savings of approximately US$33 000 (2013) from avoided injury and reduced claims costs. The estimated costs for programme implementation were $32 192 leading to a 1-year return on investment of 2.4%. CONCLUSIONS: We observed reductions in injury occurrence and compensation costs among Probationary Firefighter Fitness (PFF-Fit) programme participants compared with historical controls. The initiation of the PFF-Fit programme has demonstrated promise in reducing injury and claims costs; however, continued research is needed to better understand the programme's potential effectiveness with additional recruit classes and carryover effects into the recruit's career injury potential.


Subject(s)
Firefighters , Health Promotion , Occupational Health Services/economics , Occupational Health Services/organization & administration , Occupational Injuries/prevention & control , Physical Conditioning, Human , Workers' Compensation/statistics & numerical data , Adult , Arizona , Cost-Benefit Analysis , Female , Humans , Male , Occupational Health Services/standards , Occupational Injuries/economics , Physical Conditioning, Human/economics , Physical Conditioning, Human/methods , Physical Exertion , Program Evaluation , Sprains and Strains/prevention & control , Workers' Compensation/economics
8.
J Occup Environ Med ; 57(7): 705-12, 2015 Jul.
Article in English | MEDLINE | ID: mdl-26147538

ABSTRACT

OBJECTIVE: To investigate the comparative acute health effects associated with exposures to diesel and 75% biodiesel/25% diesel (B75) blend fuel emissions. METHODS: We analyzed multiple health endpoints in 48 healthy adults before and after exposures to diesel and B75 emissions in an underground mine setting-lung function, lung and systemic inflammation, novel biomarkers of exposure, and oxidative stress were assessed. RESULTS: B75 reduced respirable diesel particulate matter by 20%. Lung function declined significantly more after exposure to diesel emissions. Lung inflammatory cells along with sputum and plasma inflammatory mediators increased significantly to similar levels with both exposures. Urinary 8-hydroxydeoxyguanosine, a marker of oxidative stress, was not significantly changed after either exposure. CONCLUSIONS: Use of B75 lowered respirable diesel particulate matter exposure and some associated acute health effects, although lung and systemic inflammation were not reduced compared with diesel use.


Subject(s)
Air Pollutants, Occupational/analysis , Biofuels , Gasoline , Inhalation Exposure/analysis , Mining , Occupational Exposure/analysis , Particulate Matter/analysis , Vehicle Emissions/analysis , Adult , Air Pollution, Indoor/analysis , Biomarkers/analysis , Endpoint Determination , Environmental Monitoring , Female , Healthy Volunteers , Humans , Male , Oxidative Stress , Respiratory Function Tests
9.
Am J Infect Control ; 43(6): 606-11, 2015 Jun.
Article in English | MEDLINE | ID: mdl-26042849

ABSTRACT

BACKGROUND: To our knowledge, no studies to date demonstrate potential spread of microbes during actual emergency medical service (EMS) activities. Our study introduces a novel approach to identification of contributors to EMS environment contamination and development of infection control strategies, using a bacteriophage surrogate for pathogenic organisms. METHODS: Bacteriophage ΦX174 was used to trace cross-contamination and evaluate current disinfection practices and a hydrogen peroxide (H2O2) wipe intervention within emergency response vehicles. Prior to EMS calls, 2 surfaces were seeded with ΦX174. On call completion, EMS vehicle and equipment surfaces were sampled before decontamination, after decontamination per current practices, and after implementation of the intervention. RESULTS: Current decontamination practices did not significantly reduce viral loads on surfaces (P = .3113), but H2O2 wipe intervention did (P = .0065). Bacteriophage spread to 56% (27/48) of sites and was reduced to 54% (26/48) and 40% (19/48) with current decontamination practices and intervention practices, respectively. CONCLUSION: Results suggest firefighters' hands were the main vehicles of microbial transfer. Current practices were not consistently applied or standardized and minimally reduced prevalence and quantity of microbial contamination on EMS surfaces. Although use of a consistent protocol of H2O2 wipes significantly reduced percent prevalence and concentration of viruses, training and promotion of surface disinfection should be provided.


Subject(s)
Bacteriophage phi X 174 , Disinfection/methods , Emergency Medical Services/standards , Infection Control/methods , Anti-Infective Agents, Local , Disinfection/standards , Equipment Contamination/prevention & control , Humans , Hydrogen Peroxide , Infection Control/standards , Microbial Viability
10.
J Occup Environ Hyg ; 12(5): 287-93, 2015.
Article in English | MEDLINE | ID: mdl-25830445

ABSTRACT

Noise exposures and hearing loss in the mining industry continue to be a major problem, despite advances in noise control technologies. This study evaluated the effectiveness of engineering, administrative, and personal noise controls using both traditional and in-ear dosimetry by job task, work shift, and five types of earplug. The noise exposures of 22 miners performing deep shaft-sinking tasks were evaluated during 56 rotating shifts in an underground mine. Miners were earplug-insertion trained, earplug fit-tested, and monitored utilizing traditional and in-ear dosimetry. The mean TWA8 noise exposure via traditional dosimetry was 90.1 ± 8.2 dBA, while the mean in-ear TWA8 was 79.6 ± 13.8 dBA. The latter was significantly lower (p < 0.05) than the Mine Safety and Health Administration (MSHA) personal exposure limit (PEL) of 90 dBA. Dosimetry mean TWA8 noise exposures for bench blowing (103.5 ± 0.9 dBA), jumbo drill operation (103.0 ± 0.8 dBA), and mucking tasks (99.6 ± 4.7 dBA) were significantly higher (p < 0.05) than other tasks. For bench blowing, cable pulling, grinding, and jumbo drill operation tasks, the mean in-ear TWA8 was greater than 85 dBA. Those working swing shift had a significantly higher (p < 0.001) mean TWA8 noise exposure (95.4 ± 7.3 dBA) than those working day shift. For percent difference between traditional vs. in-ear dosimetry, there was no significant difference among types of earplug used. Reflective of occupational hearing loss rate trends across the mining industry, this study found that, despite existing engineering and administrative controls, noise exposure levels exceeded regulatory limits, while the addition of personal hearing protection limited excessive exposures.


Subject(s)
Mining , Noise, Occupational/prevention & control , Occupational Exposure/analysis , Ear Protective Devices , Hearing Loss, Noise-Induced/etiology , Hearing Loss, Noise-Induced/prevention & control , Humans , Noise, Occupational/adverse effects , Occupational Diseases/etiology , Occupational Diseases/prevention & control , Occupational Exposure/prevention & control
11.
J Occup Environ Hyg ; 12(5): 314-22, 2015.
Article in English | MEDLINE | ID: mdl-25738516

ABSTRACT

In the United States, there are approximately 366,600 structural fires each year. After visible flames are extinguished, firefighters begin the overhaul stage of firefighting to smother remaining hot spots and initiate investigations. Typically during overhaul significant ambient concentrations of chemical contaminants remain. However, previous research suggests that the use of air purifying respirators (APR) fitted with chemical, biological, radiological, and nuclear (CBRN) canisters may reduce occupational respiratory exposures. This pilot study used large-scale prescribed burns of representative structural materials to perform simultaneous, side-by-side, filtering and service-life evaluations of commercially available CBRN filters. Three types of CBRN canisters and one cartridge were challenged in repetitive post live-fire overhaul exposure tests using a sampling manifold apparatus. At a flow rate of 80 L/min, nine tests were conducted in the breathing zone for three different exposure durations (0-15 min, 0-30 min, and 0-60 min). Fifty different chemicals were identified for evaluation and results indicate that 21 of the 50 chemicals tested were in the air of the overhaul environment. Respirable particles and formaldehyde were consistently present above the American Conference of Governmental Industrial Hygienists (ACGIH®) recommended exposure level (REL) and threshold limit ceiling value (TLVc), respectively. Each filter effectively reduced concentrations for respirable particulates below the maximum recommended level. Formaldehyde was reduced, but not consistently filtered below the TLVc. These results were consistent across all exposure durations. This study indicates that, regardless of brand, CBRN filters provide protection from the vast majority of particle and gas-phase contaminants. However, due to formaldehyde breakthrough, CBRN filters do not provide complete protection during firefighter overhaul.


Subject(s)
Air Pollutants, Occupational/analysis , Firefighters , Occupational Exposure/prevention & control , Particulate Matter/analysis , Respiratory Protective Devices , Air Pollutants, Occupational/toxicity , Formaldehyde/analysis , Formaldehyde/toxicity , Humans , Inhalation Exposure , Occupational Exposure/adverse effects , Occupational Exposure/analysis , Particle Size , Particulate Matter/toxicity , Pilot Projects , Smoke/analysis
12.
J Occup Environ Hyg ; 12(3): D18-25, 2015.
Article in English | MEDLINE | ID: mdl-25412337

ABSTRACT

Diesel fuel is commonly used for underground mining equipment, yet diesel engine exhaust is a known human carcinogen. Alternative fuels, including biodiesel, and a natural gas/diesel blend, offer the potential to reduce engine emissions and associated health effects. For this pilot study, exposure monitoring was performed in an underground mine during operation of a load-haul-dump vehicle. Use of low-sulfur diesel, 75% biodiesel/25% diesel blend (B75), and natural gas/diesel blend (GD) fuels were compared. Personal samples were collected for total and respirable diesel particulate matter (tDPM and rDPM, respectively) and total and respirable elemental and organic carbon (tEC, rEC, tOC, rOC, respectively), as well as carbon monoxide (CO), formaldehyde, acetaldehyde, naphthalene, nitric oxide (NO), and nitrogen dioxide (NO2). Compared to diesel, B75 use was associated with a 33% reduction in rDPM, reductions in rEC, tEC, and naphthalene, increased tDPM, tOC, and NO, and no change in rOC, CO, and NO2. Compared to diesel, GD was associated with a 66% reduction in rDPM and a reduction in all other exposures except CO. The alternative fuels tested both resulted in reduced rDPM, which is the basis for the current Mine Safety and Health Administration (MSHA) occupational exposure standard. Although additional study is needed with a wider variety of equipment, use of alternative fuels have the promise of reducing exposures from vehicular exhaust in underground mining settings.


Subject(s)
Air Pollutants, Occupational/analysis , Mining , Occupational Exposure/statistics & numerical data , Vehicle Emissions/analysis , Air Pollution, Indoor/analysis , Biofuels , Carbon/analysis , Carbon Monoxide/analysis , Environmental Monitoring , Gasoline , Humans , Natural Gas , Nitrogen Oxides/analysis , Occupational Exposure/analysis , Organic Chemicals/analysis , Particulate Matter/analysis , Pilot Projects
13.
J Environ Health ; 76(9): 16-20, 2014 May.
Article in English | MEDLINE | ID: mdl-24909008

ABSTRACT

The study described in this article evaluated surface survivability of culturable Pseudomonas aeruginosa by time and type (glass, stainless steel, and laminate) using two sampling techniques: contact plates and surface swabs. Recovery of P. aeruginosa decreased logarithmically over time and varied by surface type. P. aeruginosa survival averaged 3.75, 5.75, and 6.75 hours on laminate, glass, and stainless steel, respectively. Culturable P. aeruginosa loss on stainless steel and glass were not different (p > .05); however, laminate had significantly greater loss at each time point than either glass or stainless (p < .05). A comparison of surface swab and contact plate collection efficiencies found no significant difference for laminate surfaces. Swabs, however, had a higher collection efficiency than contact plates (p < .05). For the first time, the authors report P. aeruginosa mean survival time of 3.75-6.75 hours on clinically relevant surfaces, with P. aeruginosa on stainless steel surviving the longest. Their data also indicate that culturable surface sampling appears to most accurately represent actual P. aeruginosa surface loading when swab sampling is used.


Subject(s)
Fomites/microbiology , Pseudomonas aeruginosa/isolation & purification , Specimen Handling/methods , Glass , Pseudomonas aeruginosa/physiology , Stainless Steel
14.
Int J Environ Res Public Health ; 11(2): 2299-313, 2014 Feb 21.
Article in English | MEDLINE | ID: mdl-24566055

ABSTRACT

Arsenic exposure from drinking water is associated with adverse respiratory outcomes, but it is unknown whether arsenic affects pulmonary microbiota. This exploratory study assessed the effect of exposure to arsenic in drinking water on bacterial diversity in the respiratory tract of non-smokers. Induced sputum was collected from 10 subjects with moderate mean household water arsenic concentration (21.1 ± 6.4 ppb) and 10 subjects with low household water arsenic (2.4 ± 0.8 ppb). To assess microbiota in sputum, the V6 hypervariable region amplicons of bacterial 16s rRNA genes were sequenced using the Ion Torrent Personal Genome Machine. Microbial community differences between arsenic exposure groups were evaluated using QIIME and Metastats. A total of 3,920,441 sequence reads, ranging from 37,935 to 508,787 per sample for 316 chips after QIIME quality filtering, were taxonomically classified into 142 individual genera and five phyla. Firmicutes (22%), Proteobacteria (17%) and Bacteriodetes (12%) were the main phyla in all samples, with Neisseriaceae (15%), Prevotellaceae (12%) and Veillonellacea (7%) being most common at the genus level. Some genera, including Gemella, Lactobacillales, Streptococcus, Neisseria and Pasteurellaceae were elevated in the moderate arsenic exposure group, while Rothia, Prevotella, Prevotellaceae Fusobacterium and Neisseriaceae were decreased, although none of these differences was statistically significant. Future studies with more participants and a greater range of arsenic exposure are needed to further elucidate the effects of drinking water arsenic consumption on respiratory microbiota.


Subject(s)
Arsenic/toxicity , Environmental Exposure/adverse effects , Lung/microbiology , Microbiota/drug effects , Sputum/microbiology , Adult , Aged , Case-Control Studies , Drinking Water , Female , Humans , Lung/drug effects , Male , Middle Aged , Young Adult
15.
J Occup Environ Med ; 56(4): 388-96, 2014 Apr.
Article in English | MEDLINE | ID: mdl-24495958

ABSTRACT

OBJECTIVE: In a hot underground metal mine, this study evaluated the relationship between job task, physical body type, work shift, and heat strain. METHODS: Thirty-one miners were evaluated during 98 shifts while performing deep shaft-sinking tasks. Continuous core body temperature, heart rate, pre- and postshift urine specific gravity (USG), and body mass index were measured. RESULTS: Cutting and welding tasks were associated with significantly (P < 0.05) increased core body temperature, maximum heart rate, and increased postshift urine specific gravity. Miners in the obese level II and III body mass index categories, as well as those working night shift, had lower core body temperatures (P < 0.05). CONCLUSIONS: This study confirms that job task, body type, and shift are risk factors for heat strain.


Subject(s)
Heat Stress Disorders/etiology , Hot Temperature , Mining , Occupational Diseases/etiology , Occupational Exposure/adverse effects , Adult , Body Mass Index , Body Temperature , Heart Rate , Humans , Male , Metals , Middle Aged , Risk Factors , Specific Gravity , Task Performance and Analysis
16.
Int J Environ Res Public Health ; 10(12): 6409-21, 2013 Nov 28.
Article in English | MEDLINE | ID: mdl-24287861

ABSTRACT

Schistosomiasis japonica remains a significant public-health problem in China. This study evaluated cost-effectiveness of a comprehensive schistosomiasis control program (2003-2006). The comprehensive control program was implemented in Zhangjia and Jianwu (cases); while standard interventions continued in Koutou and Xiajia (controls). Incurred costs were documented and the schistosomiasis comprehensive impact index (SCI) and cost-effectiveness ratio (Comprehensive Control Program Cost/SCI) were applied. In 2003, prevalence of Schistosoma japonicum infection was 11.3% (Zhangjia), 6.7% (Jianwu), 6.5% (Koutou), and 8.0% (Xiajia). In 2006, the comprehensive control program in Zhangjia and Jianwu reduced infection to 1.6% and 0.6%, respectively; while Koutou and Xiajia had a schistosomiasis prevalence of 3.2% and 13.0%, respectively. The year-by-year SCIs in Zhangjia were 0.28, 105.25, and 47.58, with an overall increase in cost-effectiveness ratio of 374.9%-544.8%. The SCIs in Jianwu were 16.21, 52.95, and 149.58, with increase in cost-effectiveness of 226.7%-1,149.4%. Investment in Koutou and Xiajia remained static (US$10,000 unit cost). The comprehensive control program implemented in the two case villages reduced median prevalence of schistosomiasis 8.5-fold. Further, the cost effectiveness ratio demonstrated that the comprehensive control program was 170% (Zhangjia) and 922.7% (Jianwu) more cost-effective. This work clearly shows the improvements in both cost and disease prevention effectiveness that a comprehensive control program-approach has on schistosomiasis infection prevalence.


Subject(s)
Communicable Disease Control/methods , Schistosomiasis japonica/economics , Schistosomiasis japonica/prevention & control , Snails/parasitology , Animals , Case-Control Studies , China/epidemiology , Communicable Disease Control/economics , Cost-Benefit Analysis , Humans , Livestock/parasitology , Models, Economic , Models, Theoretical , Prevalence , Retrospective Studies , Schistosomiasis japonica/epidemiology , Seasons
17.
Sci Total Environ ; 463-464: 35-41, 2013 Oct 01.
Article in English | MEDLINE | ID: mdl-23783270

ABSTRACT

With thousands of pesticides registered by the United States Environmental Protection Agency, it not feasible to sample for all pesticides applied in agricultural communities. Hazard-ranking pesticides based on use, toxicity, and exposure potential can help prioritize community-specific pesticide hazards. This study applied hazard-ranking schemes for cancer, endocrine disruption, and reproductive/developmental toxicity in Yuma County, Arizona. An existing cancer hazard-ranking scheme was modified, and novel schemes for endocrine disruption and reproductive/developmental toxicity were developed to rank pesticide hazards. The hazard-ranking schemes accounted for pesticide use, toxicity, and exposure potential based on chemical properties of each pesticide. Pesticides were ranked as hazards with respect to each health effect, as well as overall chronic health effects. The highest hazard-ranked pesticides for overall chronic health effects were maneb, metam-sodium, trifluralin, pronamide, and bifenthrin. The relative pesticide rankings were unique for each health effect. The highest hazard-ranked pesticides differed from those most heavily applied, as well as from those previously detected in Yuma homes over a decade ago. The most hazardous pesticides for cancer in Yuma County, Arizona were also different from a previous hazard-ranking applied in California. Hazard-ranking schemes that take into account pesticide use, toxicity, and exposure potential can help prioritize pesticides of greatest health risk in agricultural communities. This study is the first to provide pesticide hazard-rankings for endocrine disruption and reproductive/developmental toxicity based on use, toxicity, and exposure potential. These hazard-ranking schemes can be applied to other agricultural communities for prioritizing community-specific pesticide hazards to target decreasing health risk.


Subject(s)
Pesticides/toxicity , Arizona , Benzamides/toxicity , Endocrine System Diseases/chemically induced , Environmental Exposure/adverse effects , Humans , Maneb/toxicity , Neoplasms/chemically induced , Pyrethrins/toxicity , Thiocarbamates/toxicity , Trifluralin/toxicity
18.
Int J Parasitol ; 43(10): 837-42, 2013 Sep.
Article in English | MEDLINE | ID: mdl-23770037

ABSTRACT

Although the lifecycle of Schistosoma spp. and pathophysiology of schistosomiasis have been established, the mechanism by which cercariae find their host is not well understood. Speculatively, host infection by random and accidental host contact is not as biologically plausible as a biochemical mechanism of mammalian attraction. A few studies have indicated that biochemical cues and temperature gradients may play a role in host identification, attraction and attachment triggers. This study aimed to elucidate these mechanisms more specifically through evaluation of biochemical, age and temperature influences leading to Schistosoma mansoni cercariae attraction and attachment behaviors. Oleic acid, a common unsaturated free fatty acid in the outer layer of human skin, was tested for cercariae attraction across biologically relevant concentrations. Influence of media type (beeswax, nail varnish and agar), age-dependent behavior variability and environmentally appropriate temperatures (22 and 30 °C) were also evaluated. Results indicated that oleic acid at concentrations of 0.3, 0.9 and 1.8 g/mL in beeswax significantly increased median attachment to media (median attachment of 7.50%, 4.20% and 3.71%, respectively, P<0.001), compared with plain beeswax, with maximal attachment of 30.30% at 0.3g/mL of oleic acid. In media containing 0.3 g/mL of oleic acid, cercarial attachment was highest for freshly emerged cercariae to 5h post-emergence, with a significant decrease in attachment behavior at 10h post-emergence (P<0.01). Aquatic temperature at which cercariae were exposed to media did not yield significant results (P value >0.05). Biochemical, age and environmental factors influencing cercarial host attraction and attachment behavior have been elucidated by this study. This information will inform further development of devices for environmental surveillance and potentially improve cercarial exposure prevention strategies.


Subject(s)
Chemotactic Factors/metabolism , Host-Pathogen Interactions , Oleic Acid/metabolism , Schistosoma mansoni/physiology , Animals , Schistosoma mansoni/drug effects , Schistosoma mansoni/radiation effects , Temperature
19.
Am J Infect Control ; 41(7): 648-51, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23321559

ABSTRACT

BACKGROUND: Methicillin-resistant Staphylococcus spp (MRS), such as methicillin-resistant Staphylococcus aureus (MRSA), is a nosocomial pathogen of significant concern. This study evaluates the prevalence and determinants of airborne MRS and methicillin-susceptible Staphylococcus spp (MSS) in a veterinary teaching hospital during periods of no known active clinical cases of Staphylococci infections. METHODS: Airborne MRS and MRSA were sampled from 10 areas on 3 days each over 3 consecutive months in a veterinary teaching hospital. Each location was sampled twice each day (daytime and evening). Hospital clinical personnel were surveyed for activity levels across the areas sampled. RESULTS: Airborne MSS was detected in 52% (25/48) of samples and mecA-confirmed airborne MRS in 12.5% (6/48) of samples. Among daytime air samples, Staphylococcus spp varied by functional area (P < .001), and airborne MRS varied by human activity level (P = .011) with the hallway posing the greatest risk for both. CONCLUSION: Our results indicate that (1) Staphylococcus spp is present in air in clinical environments during periods of no known clinical Staphylococci cases and (2) levels of airborne Staphylococcus spp are associated with functional space and human activity level. Applying these findings to MRSA surveillance creates opportunities for improving the accuracy and precision of exposure classification and risk mitigation.


Subject(s)
Air Microbiology , Environmental Monitoring , Hospitals, Animal , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Staphylococcus/isolation & purification , Animals , Human Activities , Humans , Seasons , Time Factors
20.
Foodborne Pathog Dis ; 8(11): 1229-34, 2011 Nov.
Article in English | MEDLINE | ID: mdl-21819210

ABSTRACT

The objective of this study was to investigate the association between ceftiofur use policy in finishing swine barns and recovery of fecal Escherichia coli or Salmonella spp. resistant to ceftriaxone. The study population included 54 finishing swine barns from three companies located in North Carolina. The barns were each classified according to their reported therapeutic ceftiofur use rates of "Rare," "Moderate," and "Common." Fecal samples from the barns were cultured for the presence of E. coli and Salmonella spp. resistant to ceftriaxone using selective media designed to recover rare organisms expressing the AmpC ß-lactamase phenotype. A total of 1899 swine fecal samples yielded 1193 E. coli (63%) resistant to ceftriaxone. Recovery rates by ceftiofur use classification were 45% for Rare, 73% for Moderate, and 68% Common ceftiofur use groups. Barns reporting Rare ceftiofur use had a lower odds of recovery of E. coli (OR=0.32; p<0.001) resistant to ceftriaxone compared to Common use barns. The overall Salmonella spp. prevalence was 63.8% (n=714). Of these, 65 Salmonella were resistant to ceftriaxone with the highest rate (6%) found in the Common ceftiofur use group, followed by Rare (4.1%) and Moderate (0.15%). The odds of recovery of Salmonella resistant to ceftriaxone were similar for barns with ceftiofur use classified as Rare and Common. Samples from barns with ceftiofur use classified as Moderate had a lower odds (OR=0.02; p<0.01) of recovery of Salmonella resistant to ceftriaxone than barns classified as Common. Our result is consistent with the hypothesis that the use of ceftiofur in finishing swine barns, beyond its rare application, may influence the recovery of enteric E. coli with resistance to cephalosporin drugs, although other unmeasured factors appear to be important in the recovery of cephalosporin-resistant Salmonella. The dissemination of enteric bacteria with resistance to cephalosporins has the potential to impact both veterinary and human therapeutic treatment options.


Subject(s)
Anti-Bacterial Agents/pharmacology , Ceftriaxone/pharmacology , Cephalosporins/pharmacology , Escherichia coli/drug effects , Feces/microbiology , Salmonella/drug effects , Animals , Cephalosporin Resistance , Cross-Sectional Studies , Drug Resistance, Bacterial , Escherichia coli/isolation & purification , Escherichia coli Infections/microbiology , Escherichia coli Infections/veterinary , Humans , Logistic Models , Microbial Sensitivity Tests , North Carolina , Salmonella/isolation & purification , Salmonella Infections, Animal/microbiology , Swine , Swine Diseases/microbiology
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