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Archive for the ‘respiratory diseases’ Category

Trends in Pediatric and Adult Hospital Stays for Asthma, 2000-2010

March 17, 2014 Comments off

Trends in Pediatric and Adult Hospital Stays for Asthma, 2000-2010
Source: Agency for Healthcare Research and Quality

Asthma is a chronic disease characterized by inflammation of the airways. It restricts the passage of air into the lungs and leads to episodes of wheezing, coughing, chest tightness, and shortness of breath. Severe asthmatic episodes can close off airways completely and, in some cases, may be life-threatening.1

In 2010, approximately 7.0 million children aged 0—17 years and 18.7 million adults aged 18 years and older had a diagnosis of asthma. The prevalence of asthma in the United States has increased from 7.3 percent of the population in 2001 to 8.4 percent in 2010.2

Asthma is largely controllable with proper primary care, and the need for hospitalization can usually be prevented. However, differences in rates of hospitalization for asthma suggest that there is significant room for improvement in caring for the condition.

This Statistical Brief presents data from the Healthcare Cost and Utilization Project (HCUP) on trends in pediatric and adult inpatient hospital stays for asthma at U.S. community hospitals from 2000 through 2010. In addition, we present patient characteristics of pediatric and adult hospital stays for asthma in 2010. Differences that are noted in the text exhibit at least a 10 percent difference between estimates and are statistically significant at 0.05 or better.

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Lung Cancer Incidence Trends Among Men and Women — United States, 2005–2009

January 14, 2014 Comments off

Lung Cancer Incidence Trends Among Men and Women — United States, 2005–2009
Source: Morbidity and Mortality Weekly Report (CDC)

Lung cancer is the leading cause of cancer death and the second most commonly diagnosed cancer (excluding skin cancer) among men and women in the United States (1,2). Although lung cancer can be caused by environmental exposures, most efforts to prevent lung cancer emphasize tobacco control because 80%–90% of lung cancers are attributed to cigarette smoking and secondhand smoke (1). One sentinel health consequence of tobacco use is lung cancer (1,2), and one way to measure the impact of tobacco control is by examining trends in lung cancer incidence rates, particularly among younger adults (3). Changes in lung cancer rates among younger adults likely reflect recent changes in risk exposure (3). To assess lung cancer incidence and trends among men and women by age group, CDC used data from the National Program of Cancer Registries (NPCR) and the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program for the period 2005–2009, the most recent data available. During the study period, lung cancer incidence decreased among men in all age groups except <35 years and decreased among women aged 35–44 years and 54–64 years. Lung cancer incidence decreased more rapidly among men than among women and more rapidly among adults aged 35–44 years than among other age groups. To further reduce lung cancer incidence in the United States, proven population-based tobacco prevention and control strategies should receive sustained attention and support (4).

Ibuprofen, paracetamol, and steam for patients with respiratory tract infections in primary care: pragmatic randomised factorial trial

November 5, 2013 Comments off

Ibuprofen, paracetamol, and steam for patients with respiratory tract infections in primary care: pragmatic randomised factorial trial
Source: British Medical Journal

Objective
To assess strategies for advice on analgesia and steam inhalation for respiratory tract infections.

Design
Open pragmatic parallel group factorial randomised controlled trial.

Setting
Primary care in United Kingdom.

Participants
Patients aged ≥3 with acute respiratory tract infections.

Intervention
889 patients were randomised with computer generated random numbers in pre-prepared sealed numbered envelopes to components of advice or comparator advice: advice on analgesia (take paracetamol, ibuprofen, or both), dosing of analgesia (take as required v regularly), and steam inhalation (no inhalation v steam inhalation).

Outcomes
Primary: mean symptom severity on days 2-4; symptoms rated 0 (no problem) to 7 (as bad as it can be). Secondary: temperature, antibiotic use, reconsultations.

Results
Neither advice on dosing nor on steam inhalation was significantly associated with changes in outcomes. Compared with paracetamol, symptom severity was little different with ibuprofen (adjusted difference 0.04, 95% confidence interval −0.11 to 0.19) or the combination of ibuprofen and paracetamol (0.11, −0.04 to 0.26). There was no evidence for selective benefit with ibuprofen among most subgroups defined before analysis (presence of otalgia; previous duration of symptoms; temperature >37.5°C; severe symptoms), but there was evidence of reduced symptoms severity benefit in the subgroup with chest infections (ibuprofen −0.40, −0.78 to −0.01; combination −0.47; −0.84 to −0.10), equivalent to almost one in two symptoms rated as a slight rather than a moderately bad problem. Children might also benefit from treatment with ibuprofen (ibuprofen: −0.47, −0.76 to −0.18; combination: −0.04, −0.31 to 0.23). Reconsultations with new/unresolved symptoms or complications were documented in 12% of those advised to take paracetamol, 20% of those advised to take ibuprofen (adjusted risk ratio 1.67, 1.12 to 2.38), and 17% of those advised to take the combination (1.49, 0.98 to 2.18). Mild thermal injury with steam was documented for four patients (2%) who returned full diaries, but no reconsultations with scalding were documented.

Conclusion
Overall advice to use steam inhalation, or ibuprofen rather than paracetamol, does not help control symptoms in patients with acute respiratory tract infections and must be balanced against the possible progression of symptoms during the next month for a minority of patients. Advice to use ibuprofen might help short term control of symptoms in those with chest infections and in children.

CRS — Clean Air Issues in the 113th Congress: An Overview

July 25, 2013 Comments off

Clean Air Issues in the 113th Congress: An Overview (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

As the 113th Congress continues consideration of air quality issues, oversight of Environmental Protection Agency (EPA) regulatory actions is expected to remain the main focus. Of particular interest are EPA’s Clean Air Act regulations on emissions of greenhouse gases and revision of the ambient air quality standards for ozone. President Obama’s June 25 announcement of initiatives to address climate change has sparked renewed interest in the former, and EPA’s expected proposal of new ozone standards by the end of the year is stimulating interest in the latter.

Air quality has improved substantially in the United States in the 40 years of EPA’s Clean Air Act (CAA) regulation. According to the agency’s science advisers and others, however, more needs to be done to protect public health and the environment from the effects of air pollution. Thus, the agency continues to promulgate regulations using authority given it by Congress in CAA amendments more than 20 years ago. Members of Congress from both parties have raised questions about the cost-effectiveness of some of these regulations and/or whether the agency has exceeded statutory authority in promulgating them. Others in Congress have supported EPA, noting that the Clean Air Act, often affirmed in court decisions, has authorized or required the agency’s actions. EPA’s regulatory actions on greenhouse gas (GHG) emissions have been one focus of congressional interest. Although the Obama Administration has consistently said that it would prefer that Congress pass new legislation to address climate change, such legislation now appears unlikely. Instead, over the last four years, EPA has developed GHG emission standards using its existing CAA authority. Relying on a finding that GHGs endanger public health and welfare, the agency promulgated GHG emission standards for cars and light trucks on May 7, 2010, and again on October 15, 2012, and for larger trucks on September 15, 2011. The implementation of these standards, in turn, triggered permitting and Best Available Control Technology requirements for new major stationary sources of GHGs (power plants, manufacturing facilities, etc.).

It is the triggering of standards for stationary sources that has raised the most concern in Congress. A proposal to limit carbon dioxide emissions from new power plants is the focus of attention currently, but other sources (refineries, cement plants, etc.) could be subject to GHG emission controls under the same statutory authority. Also, on June 25, the President directed EPA to develop standards for existing power plants by June 2015. Legislation has been considered in both the House and Senate aimed at preventing EPA from implementing such requirements. The House passed several of these bills in the 112th Congress, but none of them passed the Senate.

Besides addressing climate change, EPA has taken action on a number of other air pollution regulations, generally in response to court actions remanding previous rules. Remanded rules included the Clean Air Interstate Rule (CAIR) and the Clean Air Mercury Rule—rules designed to control the long-range transport of sulfur dioxide, nitrogen oxides, and mercury from power plants through cap-and-trade programs. Other remanded rules included hazardous air pollutant standards for boilers and cement kilns. EPA also recently proposed a controversial rule to lower the sulfur content of gasoline, in conjunction with tighter (“Tier3”) standards for motor vehicle emissions.

In addition to these rules, EPA is reviewing ambient air quality standards (NAAQS) for ozone and other widespread air pollutants. An ozone NAAQS proposal is expected by the end of 2013. NAAQS serve as EPA’s definition of clean air, and drive a range of regulatory controls. EPA’s review process for the NAAQS, mandated at five-year intervals by the Clean Air Act, has also faced opposition in Congress. As passed by the House in the 112th Congress, H.R. 2401 and H.R. 3409 would have amended the act to require EPA to consider feasibility and cost in setting NAAQS, reversing a unanimous 2001 Supreme Court decision that the law requires standards based on health considerations alone.

Global premature mortality due to anthropogenic outdoor air pollution and the contribution of past climate change

July 16, 2013 Comments off

Global premature mortality due to anthropogenic outdoor air pollution and the contribution of past climate change
Source: Environmental Research Letters

Increased concentrations of ozone and fine particulate matter (PM2.5) since preindustrial times reflect increased emissions, but also contributions of past climate change. Here we use modeled concentrations from an ensemble of chemistry–climate models to estimate the global burden of anthropogenic outdoor air pollution on present-day premature human mortality, and the component of that burden attributable to past climate change. Using simulated concentrations for 2000 and 1850 and concentration–response functions (CRFs), we estimate that, at present, 470 000 (95% confidence interval, 140 000 to 900 000) premature respiratory deaths are associated globally and annually with anthropogenic ozone, and 2.1 (1.3 to 3.0) million deaths with anthropogenic PM2.5-related cardiopulmonary diseases (93%) and lung cancer (7%). These estimates are smaller than ones from previous studies because we use modeled 1850 air pollution rather than a counterfactual low concentration, and because of different emissions. Uncertainty in CRFs contributes more to overall uncertainty than the spread of model results. Mortality attributed to the effects of past climate change on air quality is considerably smaller than the global burden: 1500 (−20 000 to 27 000) deaths yr−1 due to ozone and 2200 (−350 000 to 140 000) due to PM2.5. The small multi-model means are coincidental, as there are larger ranges of results for individual models, reflected in the large uncertainties, with some models suggesting that past climate change has reduced air pollution mortality.

Update: Recommendations for Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

July 11, 2013 Comments off

Update: Recommendations for Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
Source: Morbidity and Mortality Weekly Report (CDC)

On June 11, 2013, CDC issued interim infection prevention and control recommendations for hospitalized patients with known or suspected Middle East respiratory syndrome coronavirus (MERS-CoV) infection in U.S. hospitals (1). To date, no MERS-CoV cases have been reported in the United States; however, cases have been reported in eight other countries (2). Recent published reports (3,4) have described limited health-care transmission of MERS-CoV, including cases among health-care personnel in international settings. These published reports highlight the need for rapid detection of infectious patients and adherence to correct infection prevention measures to prevent transmission of the virus among patients, health-care personnel, and visitors.

In coming months, the U.S. health-care system might be called upon to provide care to patients infected with MERS-CoV. Front-line providers and health-care organizations should be prepared to care for MERS-CoV patients as part of routine operations. To aid providers and facilities, CDC has developed checklists that identify key actions that can be taken now to enhance preparedness for treating persons with MERS-CoV infection and compiled a list of preparedness resources (available at http://www.cdc.gov/coronavirus/mers/preparedness).

Additional information, including guidance on case definitions, infection control, case investigation, and specimen collection and testing, is available at the CDC MERS website (2). The MERS website contains the most current information and guidance, which is subject to change. State and local health departments with questions should contact the CDC Emergency Operations Center at telephone, 770-488-7100.

Asthma and Complementary Health Approaches

July 8, 2013 Comments off

Asthma and Complementary Health Approaches
Source: National Center for Complementary and Alternative Medicine (NCCAM)

Asthma is a chronic lung disease that affects people of all ages. It causes episodes of wheezing, coughing, shortness of breath, and chest tightness. Although there is no cure, most people with asthma are able to manage the disease with medications and behavioral changes.

Researchers also are studying various complementary health approaches for asthma relief. This fact sheet provides basic information about asthma, summarizes scientific research on the effectiveness and safety of complementary health approaches for asthma, and suggests sources for additional information.

Potentially Improper Frequency of Pneumococcal Vaccinations for Medicare Beneficiaries

June 25, 2013 Comments off

Potentially Improper Frequency of Pneumococcal Vaccinations for Medicare Beneficiaries
Source: U.S. Department of Health and Human Services, Office of Inspector General

WHY WE DID THIS STUDY
Current vaccination recommendations state that individuals without immunocompromising medical conditions should receive a single pneumococcal vaccination at the age of 65 years or older and that individuals with immunocompromising conditions should receive a second vaccination 5 years after their first. Medicare instructs providers to administer a pneumococcal vaccination if a beneficiary is uncertain of his or her vaccination history in the past 5 years. Vaccination is intended to reduce the risk of contracting serious disease, but vaccination is not without risk. In 2012, the Vaccine Adverse Event Reporting System, a national vaccine surveillance program, reported more than 1,000 adverse events associated with the 4.6 million pneumococcal vaccinations for Medicare beneficiaries between 2007 and 2011.

HOW WE DID THIS STUDY
We obtained all Medicare Part B claims from the National Claims History File for the period 2007-2011 for the three different types of pneumococcal vaccine-PCV7, PCV13, and PPSV23-and the administration of the vaccine. Using this claims data, we reviewed the frequency of pneumococcal vaccinations for beneficiaries age 65 and older without immunocompromising medical conditions to detect beneficiaries receiving vaccinations more frequently than recommended. We then limited our review to claims for beneficiaries who were eligible for Medicare by age alone and whose diagnosis codes indicated vaccination against Streptococcus pneumoniae. We limited the period of review to 5 years and allowed for one vaccination of each type per beneficiary. Our calculations as to whether a given vaccination constituted a second (or greater) vaccination of the same type were based on the order of occurrence for each vaccination.

WHAT WE FOUND
Of the 4.6 million beneficiaries receiving a pneumococcal vaccination from 2007-2011, we identified 122,498 beneficiaries who received multiple pneumococcal vaccinations of the same type. Medicare allowed a total of $234 million for pneumococcal vaccinations in outpatient settings, of which nearly $7 million was for two or more pneumococcal vaccinations, and their administration, of the same type for the same beneficiary within the 5-year period. For beneficiaries who received repeat vaccinations of the same type, 43 percent received repeat vaccinations from their same providers.

WHAT WE CONCLUDE
We support CMS and CDC/ACIP in their vaccination goals and efforts, but the data suggest a need to educate certain providers about repeat vaccinations more often than recommended. The data also suggest that 43 percent of the unnecessary vaccination could be reduced through providers’ reviewing the medical history of established patients. Tools, such as electronic medical records, may assist in this effort.

CDC and NIH survey provides first report of state-level COPD prevalence

November 22, 2012 Comments off

CDC and NIH survey provides first report of state-level COPD prevalence
Source: Centers for Disease Control and Prevention

he age-adjusted prevalence of chronic obstructive pulmonary disease (COPD) varies considerably within the United States, from less than 4 percent of the population in Washington and Minnesota to more than 9 percent in Alabama and Kentucky. These state-level rates are among the COPD data available for the first time as part of the newly released 2011 Behavioral Risk Factor Surveillance System (BRFSS) survey.

“COPD is a tremendous public health burden and a leading cause of death. It is a health condition that needs to be urgently addressed, particularly on a local level,” said Nicole Kosacz, M.P.H., an epidemiologist with the Centers for Disease Control and Prevention and one of the lead analysts of the data. “This first-ever state-level analysis and breakdown is a critical source of information that will allow states to focus their resources where they will have maximum impact.”

In addition to the nationwide prevalence data, surveys in 21 states as well as Washington, D.C., and Puerto Rico asked additional questions related to diagnosis and quality of life of those reporting COPD. Results from the more detailed surveys included:

  • 71.4 percent of those reporting COPD were diagnosed via spirometry – a simple test to assess breathing
  • 62.5 percent felt that symptoms adversely affected their quality of life
  • 50.9 percent were taking at least one daily medication to manage their COPD, with rates of medication usage increasing with age

See: First Report of State-Level COPD Prevalence in U.S.(Science Daily)

The Air That We Breathe: Addressing the Risks of Global Urbanization on Health

September 11, 2012 Comments off

The Air That We Breathe: Addressing the Risks of Global Urbanization on Health

Source: PLoS Medicine

More than half of the world’s population now live in cities [1], and while urbanization has the potential to allow greater access to health care for all, huge discrepancies in how resources are allocated within cities result in major inequities in health [2]. Addressing these discrepancies and improving health require accurate assessment. To that point, earlier this month PLOS Medicine published a Policy Forum article by Jason Corburn and Alison Cohen that focused on the urbanizing planet and the need for health equity indicators to guide public health policy in cities and urban areas [2].

The major theme of Corburn and Cohen’s argument is that if societies are to ensure those living in the poorest urban slums have the same right to health as people living on the richest boulevards, health indicators must allow for the identification of where health inequities exist. For example, while indicators in Nairobi measure population access to communal toilet blocks, they give no information as to whether the toilet blocks are hygienic or safe to use and therefore mask inequity within the city. Such indicators, however, would have little value in cities like London or New York, which illustrates the need for context-specific measures.

Effect of Inhaled Glucocorticoids in Childhood on Adult Height

September 5, 2012 Comments off

Effect of Inhaled Glucocorticoids in Childhood on Adult Height
Source: New England Journal of Medicine

The initial decrease in attained height associated with the use of inhaled glucocorticoids in prepubertal children persisted as a reduction in adult height, although the decrease was not progressive or cumulative.

See: Children Taking Steroids for Asthma Are Slightly Shorter Than Peers, Study Finds (Science Daily)

Health Benefits From Large Scale Ozone Reduction in the United States

July 26, 2012 Comments off

Health Benefits From Large Scale Ozone Reduction in the United States

Source: Environmental Health Perspectives

Background:

Exposure to ozone has been associated with adverse health effects, including premature mortality, cardiopulmonary and respiratory morbidity. In 2008, the U.S. Environmental Protection Agency (EPA) lowered the primary (health-based) National Ambient Air Quality Standard (NAAQS) for ozone to 75ppb, expressed as the fourth-highest daily maximum 8-hr average over a 24-hr period. Based on recent monitoring data, U.S. ozone levels still exceed this standard in numerous locations resulting in avoidable adverse health consequences.

Objectives:

To quantify the potential human health benefits from achieving the current primary NAAQS standard of 75ppb and two alternative standard levels, 70 and 60ppb, representing the range recommended by the EPA Clean Air Scientific Advisory Committee (CASAC).

Methods:

We apply health impact assessment methodology to estimate numbers of deaths and other adverse health outcomes that would have been avoided during 2005, 2006 and 2007 if the current NAAQS ozone standards (or lower standards) had been met. Estimated reductions in ozone concentrations were interpolated according to geographic area and year, and concentration-response functions were obtained or derived from the epidemiological literature.

Results:

We estimated that annual numbers of avoided ozone-related premature deaths would have ranged from 1,410-2,480 at 75ppb to 2,450-4,130 at 70ppb and 5,210-7,990 at 60ppb. Acute respiratory symptoms would have been reduced by 3 million cases and school-loss days by one million cases annually if the current 75ppb standard had been attained. Substantially greater health benefits would have resulted if the CASAC recommended range of standards (70 to 60ppb) had been met.

Conclusions:

Attaining a more stringent primary ozone standard would significantly reduce ozone-related premature mortality and morbidity.

Racial/Ethnic Disparities in the Prevalence of Selected Chronic Diseases Among US Air Force Members, 2008

June 27, 2012 Comments off

Racial/Ethnic Disparities in the Prevalence of Selected Chronic Diseases Among US Air Force Members, 2008
Source: Preventing Chronic Disease (CDC)

Introduction
Few studies have evaluated possible racial/ethnic disparities in chronic disease prevalence among US Air Force active-duty members. Because members have equal access to free health care and preventive screening, the presence of health disparities in this population could offer new insight into the source of these disparities. Our objective was to identify whether the prevalence of 4 common chronic diseases differed by race/ethnicity in this population.

Methods
We compiled de-identified clinical and administrative data for Air Force members aged 21 or older who had been on active duty for at least 12 months as of October 2008 (N = 284,850). Multivariate logistic regression models were used to determine the prevalence of hypertension, dyslipidemia, type 2 diabetes, and asthma by race/ethnicity, controlling for rank and sex.

Results
Hypertension was the most prevalent chronic condition (5.3%), followed by dyslipidemia (4.6%), asthma (0.9%), and diabetes (0.3%). Significant differences were noted by race/ethnicity for all conditions. Compared with non-Hispanic whites, the prevalence of all chronic diseases was higher for non-Hispanic blacks; disparities for adults of other minority race/ethnicity categories were evident but less consistent.

Conclusion
The existence of racial/ethnic disparities among active-duty Air Force members, despite equal access to free health care, indicates that premilitary health risks continue after enlistment. Racial and ethnic disparities in the prevalence of these chronic diseases suggest the need to ensure preventive health care practices and community outreach efforts are effective for racial/ethnic minorities, particularly non-Hispanic blacks.

Youth Risk Behavior Surveillance — United States, 2011

June 25, 2012 Comments off

Youth Risk Behavior Surveillance — United States, 2011
Source: Morbidity and Mortality Weekly Report (CDC)

Problem: Priority health-risk behaviors, which are behaviors that contribute to the leading causes of morbidity and mortality among youth and adults, often are established during childhood and adolescence, extend into adulthood, and are interrelated and preventable.

Reporting Period Covered: September 2010–December 2011.

Description of the System: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults: 1) behaviors that contribute to unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection; 5) unhealthy dietary behaviors; and 6) physical inactivity. In addition, YRBSS monitors the prevalence of obesity and asthma. YRBSS includes a national school-based Youth Risk Behavior Survey (YRBS) conducted by CDC and state and large urban school district school-based YRBSs conducted by state and local education and health agencies. This report summarizes results from the 2011 national survey, 43 state surveys, and 21 large urban school district surveys conducted among students in grades 9–12.

Results: Results from the 2011 national YRBS indicated that many high school students are engaged in priority health-risk behaviors associated with the leading causes of death among persons aged 10–24 years in the United States. During the 30 days before the survey, 32.8% of high school students nationwide had texted or e-mailed while driving, 38.7% had drunk alcohol, and 23.1% had used marijuana. During the 12 months before the survey, 32.8% of students had been in a physical fight, 20.1% had ever been bullied on school property, and 7.8% had attempted suicide. Many high school students nationwide are engaged in sexual risk behaviors associated with unintended pregnancies and STDs, including HIV infection. Nearly half (47.4%) of students had ever had sexual intercourse, 33.7% had had sexual intercourse during the 3 months before the survey (i.e., currently sexually active), and 15.3% had had sexual intercourse with four or more people during their life. Among currently sexually active students, 60.2% had used a condom during their last sexual intercourse. Results from the 2011 national YRBS also indicate many high school students are engaged in behaviors associated with the leading causes of death among adults aged ≥25 years in the United States. During the 30 days before the survey, 18.1% of high school students had smoked cigarettes and 7.7% had used smokeless tobacco. During the 7 days before the survey, 4.8% of high school students had not eaten fruit or drunk 100% fruit juices and 5.7% had not eaten vegetables. Nearly one-third (31.1%) had played video or computer games for 3 or more hours on an average school day.

Interpretation: Since 1991, the prevalence of many priority health-risk behaviors among high school students nationwide has decreased. However, many high school students continue to engage in behaviors that place them at risk for the leading causes of morbidity and mortality. Variations were observed in many health-risk behaviors by sex, race/ethnicity, and grade. The prevalence of some health-risk behaviors varied substantially among states and large urban school districts.

Public Health Action: YRBS data are used to measure progress toward achieving 20 national health objectives for Healthy People 2020 and one of the 26 leading health indicators; to assess trends in priority health-risk behaviors among high school students; and to evaluate the impact of broad school and community interventions at the national, state, and local levels. More effective school health programs and other policy and programmatic interventions are needed to reduce risk and improve health outcomes among youth.

Lung Cancer and Elemental Carbon Exposure in Trucking Industry Workers

June 4, 2012 Comments off

Lung Cancer and Elemental Carbon Exposure in Trucking Industry Workers
Source: Environmental Health Perspectives

Background: Diesel exhaust has been considered to be a probable lung carcinogen based on studies of occupationally exposed workers. Efforts to define lung cancer risk in these studies have been limited in part by lack of quantitative exposure estimates.

Objectives: We conducted a retrospective cohort study to assess lung cancer mortality risk in US trucking industry workers. Elemental carbon (EC) was used as a surrogate of exposure to engine exhaust from diesel vehicles, traffic, and loading dock operations.

Methods: Work records were available for 31,135 male workers employed in the unionized US trucking industry in 1985. A statistical model based on a national exposure assessment was used to estimate historical work-related exposures to EC. Lung cancer mortality was ascertained through 2000 and associations with cumulative and average EC were estimated using proportional hazards models.

Results: Duration of employment was inversely associated with lung cancer risk consistent with a healthy worker survivor effect and a cohort comprised of prevalent hires. Adjusting for employment duration, there was suggestion of a linear exposure-response relationship. For each 1000 µg/m3-months of cumulative EC, based on a 5-year exposure lag, the Hazard Ratio (HR) = 1.07 (95%CI: 0.99, 1.15) with a similar association for a 10-year exposure lag, HR=1.09 (95%CI: 0.99, 1.20). Average exposure was not associated with relative risk.

Conclusions: Lung cancer mortality in trucking industry workers increased in association with cumulative exposure to EC after adjustment for negative confounding by employment duration.

Trends in Asthma Prevalence, Health Care Use, and Mortality in the United States, 2001–2010

May 5, 2012 Comments off

Trends in Asthma Prevalence, Health Care Use, and Mortality in the United States, 2001–2010
Source: National Center for Health Statistics

Key findings

  • Asthma prevalence increased from 7.3% in 2001 to 8.4% in 2010, when 25.7 million persons had asthma.
  • For the period 2008–2010, asthma prevalence was higher among children than adults, and among multiple-race, black, and American Indian or Alaska Native persons than white persons.
  • From 2001 to 2009, health care visits for asthma per 100 persons with asthma declined in primary care settings, while asthma emergency department (ED) visit and hospitalization rates were stable.
  • For the period 2007–2009, black persons had higher rates for asthma ED visits and hospitalizations per 100 persons with asthma than white persons, and a higher asthma death rate per 1,000 persons with asthma. Compared with adults, children had higher rates for asthma primary care and ED visits, similar hospitalization rates, and lower death rates.

Adults experiencing mental illness have higher rates of certain chronic physical illnesses

April 16, 2012 Comments off
Source:  Substance Abuse and Mental Health Services Administration
A new report shows that adults (aged 18 and older) who had a mental illness in the past year have higher rates of certain physical illnesses than those not experiencing mental illness. According to the report by the Substance Abuse and Mental Health Services Administration (SAMHSA), adults aged 18 and older who had any mental illness, serious mental illness, or major depressive episodes in the past year had increased rates of high blood pressure, asthma, diabetes, heart disease, and stroke.
For example, 21.9 percent of adults experiencing any mental illness (based on the diagnostic criteria specified in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)) in the past year had high blood pressure. In contrast, 18.3 percent of those not experiencing any mental illness had high blood pressure. Similarly, 15.7 percent of adults who had any mental illness in the past year also had asthma, while only 10.6 percent of those without mental illness had this condition.
Adults who had a serious mental illness (i.e., a mental illness causing serious functional impairment substantially interfering with one or more major life activities) in the past year also evidenced higher rates of high blood pressure, asthma, diabetes, heart disease and stroke than people who did not experience serious mental illnesses.
Adults experiencing major depressive episodes (periods of depression lasting two weeks or more in which there were significant problems with everyday aspects of life such as sleep, eating, feelings of self-worth, etc.) had higher rates of the following physical illnesses than those without past-year major depressive episodes: high blood pressure (24.1 percent vs. 19.8 percent), asthma (17.0 percent vs. 11.4 percent), diabetes (8.9 percent vs. 7.1 percent), heart disease (6.5 percent vs. 4.6 percent), and stroke (2.5 percent vs. 1.1 percent).

Full Report (PDF)

More Than 70 Medicines in Development for Asthma

March 9, 2012 Comments off

More Than 70 Medicines in Development for Asthma
Source: Pharmaceutical Research and Manufacturers of America (PhRMA)

America’s biopharmaceutical research companies are developing 74 medicines to treat or prevent asthma, according to a report released today by the Pharmaceutical Research and Manufacturers of America (PhRMA). All of the medicines are either in clinical trials or awaiting review by the Food and Drug Administration.

Asthma is a narrowing of the airways to the lungs caused by inflammation in the air passages, resulting from both genetic and environmental influences. Today, more than 24 million American adults and children suffer from asthma, with the prevalence increasing 12 percent in the last decade, according to the Centers for Disease Control and Prevention. Each day, 40,000 Americans miss school or work due to asthma, costing the U.S. economy an estimated $56 billion each year in direct and indirect costs.

+ Full Document (PDF)

Consumers Rely on OTC Cough Medicines to Stay Productive at Work, School

February 29, 2012 Comments off
Source:  Consumer Healthcare Products Association
The Consumer Healthcare Products Association (CHPA) today released the following statement regarding a new survey from the Center for Medicine in the Public Interest (CMPI) finding that the majority of adult consumers and parents in the United States rely on accessible, affordable over-the-counter (OTC) cough medicines to treat themselves and their families’ cough symptoms. CMPI’s Cough Medicine Consumer Insights national survey found that 68 percent of adult consumers agreed that OTC cough medicines allow them to stay productive at work and school, and 60 percent of parents reported that these medicines allowed their children to stay productive at school.

Cough Medicine Consumer Insights National Survey

Non-communicable Diseases will Cost Global Economy $47 Trillion by 2030

February 6, 2012 Comments off

Non-communicable Diseases will Cost Global Economy $47 Trillion by 2030
Source: Chatham House

Non-communicable diseases (NCDs) are the greatest cause of deaths and disability for humans and have a serious economic impact, says a new Chatham House paper, Silent Killer, Economic Opportunity: Rethinking Non-Communicable Disease. The cumulative losses in global economic output due to NCDs will total $47 trillion, or 5% of GDP, by 2030. The author, Sudeep Chand, says modest investments to prevent and treat NCDs could bring major economic returns and save tens of millions of lives.

NCDs, such as heart disease, cancer, asthma and depression, have their place alongside economic risks such as infectious diseases, illicit trade, migration, terrorism and food security. They have global scope, cross-industry relevance and a high economic and social impact. Economic policy-makers and businesses concerned with capital and labour costs have good reasons to consider the burdens from NCDs. Sustainable, balanced economic policy can consider low rates of NCDs as a measure of success. Where the economic benefits outweigh the costs, civil society has a major role to play in harnessing an effective response to NCDs.

+ Full Report

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