The high cost of bath salts: a study of the health care burden of illicit synthetic drug use in Duluth, Minnesota.

The Minnesota Department of Health conducted an exploratory epidemiologic investigation into the health care burden of illicit synthetic drug (ISD) use in Duluth, Minnesota. Staff reviewed medical records of 78 patients with suspected ISD use who were treated in emergency departments at two Duluth-area hospitals from January through September 2013. Most (67%) were unemployed, 75% arrived at the hospital by ambulance or police escort and 57% were admitted to the hospital. Use of ISDs has the potential to create a significant burden on the health care system and public services. Therefore, effective prevention and response strategies need to be developed.

Exposure efficiency: an idea whose time has come?

Exposure efficiency, the fraction of material released from a source that is eventually inhaled or ingested, is arguably the simplest of all possible descriptions of the link between pollutant emissions and population exposures. This paper, prepared in late 1999 for the SGOMSEC Workshop, notes that several groups of researchers independently developed the concept of exposure efficiency in the late 1980s and early 1990s but argues that the potential importance of exposure efficiency in risk analysis and life cycle assessment has only recently been appreciated. The paper reviews the history of the concept; discusses and summarizes previous estimates of exposure efficiency for particulate matter and other air pollutants; presents new values for fine particulate matter emitted from power plants and mobile sources in the United States; and illustrates how preliminary estimates of exposure efficiency might be developed. The authors assert that in order for the concept of exposure efficiency to achieve its full potential exposure efficiency estimates for a wide variety of pollutants and sources must be developed and that both the results and methods must be made widely available and accessible to the community of risk assessors and life cycle analysts.

A regression-based approach for estimating primary and secondary particulate matter intake fractions.

One of the common challenges for life cycle impact assessment and risk assessment is the need to estimate the population exposures associated with emissions. The concept of intake fraction (a unitless term representing the fraction of material or its precursor released from a source that is eventually inhaled or ingested) can be used when limited site data are available or the number of sources to model is large. Although studies have estimated intake fractions for some pollutant-source combinations, there is a need to quickly and accurately estimate intake fractions for sources and settings not previously evaluated. It would be expected that limited source or site information could be used to yield intake fraction estimates with reasonable accuracy. To test this theory, we developed regression models to predict intake fractions previously estimated for primary fine particles (PM2.5) and secondary sulfate and nitrate particles from power plants and mobile sources in the United States. Our regression models were able to predict pollutant-specific intake fractions with R2 between 0.53 and 0.86 and equations that reflected expected relationships (e.g., intake fraction increased with population density, stack height influenced the intake fraction of primary but not secondary particles). Further analysis would be needed to generalize beyond this case study and construct models applicable across source categories and settings, but our analysis demonstrates that inclusion of a limited number of parameters can significantly reduce the uncertainty in population-average exposure estimates.