Worker illness related to ground application of pesticide--Kern County, California, 2005

In California, suspected pesticide and work-related illnesses and injuries are reportable conditions. The Occupational Health Branch (OHB) of the California Department of Health Services (CDHS) conducts surveillance of work-related pesticide illness with support from the National Institute for Occupational Safety and Health (NIOSH) and the U.S. Environmental Protection Agency (EPA). On May 12, 2005, CDHS received a report from the California Department of Pesticide Regulation (CDPR) of a suspected pesticide incident in Kern County involving 27 farmworkers (age range: 21-61 years; median: 32.5 years) and six emergency responders (age range: 28-51 years; median: 33.5 years). CDHS investigated this incident by conducting a site visit; reviewing medical and meteorologic records; and interviewing affected workers, pesticide applicators, and the farmworker employer. Findings indicated that workers became ill from drift of a pyrethroid pesticide (cyfluthrin) that was being applied in a neighboring field. Pyrethroid pesticide applicators should always operate in a manner that ensures workers are not exposed.     

Illnesses and injuries related to total release foggers--eight states, 2001-2006

Total release foggers (TRFs), sometimes called "bug bombs," are pesticide products designed to fill an area with insecticide and often are used in homes and workplaces to kill cockroaches, fleas, and flying insects. Most TRFs contain pyrethroid, pyrethrin, or both as active ingredients. TRFs also contain flammable aerosol propellants that can cause fires or explosions. The magnitude and range of acute health problems associated with TRF usage has not been described previously. This report summarizes illnesses and injuries that were associated with exposures to TRFs during 2001--2006 in eight states (California, Florida, Louisiana, Michigan, New York, Oregon, Texas, and Washington) and were investigated by the California Department of Pesticide Regulation (CDPR) and state health departments participating in the SENSOR-Pesticides program. During 2001-2006, a total of 466 TRF-related illnesses or injuries were identified. These illnesses or injuries often resulted from inability or failure to vacate before the TRF discharged, reentry into the treated space too soon after the TRF was discharged, excessive use of TRFs for the space being treated, and failure to notify others nearby. The findings indicate that TRFs pose a risk for acute, usually temporary health effects among users and bystanders. To reduce the risk for TRF-related health effects, integrated pest management control strategies that prevent pests' access to food, water, and shelter need to be promoted and adopted. In addition, awareness of the hazards and proper use of TRFs need to be better communicated on TRF labels and in public media campaigns.     

Patterns of Mortality in California Hmong, 1988–2002

Background From mid-1980s to early 1990s, there were several studies evaluating a condition known as “nocturnal sudden death syndrome” among the healthy, young Hmong (immigrants from Laos) individuals who mysteriously died from unknown causes during the night. To date, very little has been reported on the mortality patterns in the Hmong. The purpose of the present study is to examine causes of death (COD) and compare age-adjusted mortality rates (AAMR) in the Hmong with those of non-Hispanic white (NHW) population in California, which may yield useful data for health prevention and planning purposes. Methods This study was based on 2,744 Hmong deaths occurred in California from 1988 to 2002. To calculate AAMR, Hmong population at risk of dying was derived by interpolating Hmong population counts from the 1990 and 2000 decennial censuses. For comparison, AAMR were calculated for both Hmong and NHW, and the statistical test, incidence rate ratio, was used to examine differences in relative mortality risk of each major COD between Hmong and NHW. Results AAMR are highest in neoplasm (184.0/100,000), circulatory (277.9/100,000) and respiratory (100.0/100,000) diseases for both Hmong and NHW. The AAMR for all COD during the entire study time period was 879.5/100,000 in males and 736.0/100,000 in females. AAMR for all other COD range from 4.9/100,000 to 67.2/100,000. Hmong experienced 1.3–1.9 times higher mortality rates for certain COD, compared to NHW. Conclusion The interesting findings of this study are the differences in AAMR observed for lower ranking COD between Hmong and NHW. Hmong were found to be experiencing 1.3–1.9 times higher mortality rates for injuries and poisonings, digestive diseases, prenatal conditions, ENMID (endocrine, nutritional, metabolic, immunity disorders), infections and parasitic illnesses, and congenital anomalies when compared to NHW. However, while Hmong women were found to have statistically significantly higher mortality risk for injuries and poisonings (P-value < 0.05), ENMID (P-value < 0.05), and infections and parasitic ailments (P-value < 0.05) when compare to NHW women, Hmong men were observed to be at statistically significantly higher mortality risk for just infections and parasitic diseases (P-value < 0.05) when compared to NHW men     

Diabetes among Hispanics--Los Angeles County, California, 2002-2003

Diabetes is associated with severe morbidity and premature death and affects U.S. Hispanics disproportionately. Although regional variation in diabetes prevalence has been observed among Hispanics, limited information is available on how sociodemographic factors affect the risk for diabetes among Hispanics in urban settings. Los Angeles County (LAC), California, has the largest urban Hispanic population in the United States. To assess the prevalence of diabetes among Hispanic adults in LAC and to examine variations in diabetes prevalence across sociodemographic groups in this population, the LAC Department of Health Services analyzed data from the 2002-2003 LAC Health Survey (LACHS). This report summarizes the results of that analysis, which indicate that the prevalence of diabetes is approximately two times higher among Hispanics than among non-Hispanic whites and is strongly associated with living below poverty level. These findings underscore the need to provide additional diabetes prevention and treatment interventions for Hispanics in LAC, particularly those living in poverty.     

Sentinel Chicken Surveillance Programme in Australia, 1 July 2001 to 30 June 2002.

Detection of flavivirus seroconversions in sentinel chicken flocks located throughout Australia is used to provide an early warning of increased levels of Murray Valley encephalitis (MVE) and Kunjin virus activity in the region. During the 2001/2002 season low levels of flavivirus activity were detected in northern Australia compared to previous years. MVE and Kunjin virus activity was detected in the Kimberley and Pilbara regions of Western Australia and the Northern Territory but not in north Queensland, New South Wales or Victoria. This is in contrast to the previous season when MVE activity was detected both in northern Australia and, for the first time in over 20 years, in New South Wales. Two cases of Murray Valley encephalitis were reported from the north of Western Australia during the 2001/2002 wet season.     

West Nile virus activity--United States,August 8-14, 2002, and Mississippi,July 1-August 14, 2002

This report summarizes West Nile virus (WNV) surveillance data reported to CDC through ArboNET and by states and other jurisdictions as of August 14, 2002.     

West Nile virus activity--United States,July 31-August 7, 2002, and Louisiana,January 1-August 7, 2002

This report summarizes West Nile virus (WNV) surveillance data reported to CDC through ArboNET and by states and other jurisdictions as of August 7, 2002.     

Modeling of methyl isothiocyanate air concentrations associated with community illnesses following a metam-sodium sprinkler application

BACKGROUND: A series of illnesses occurred in Earlimart, CA on November 13, 1999 following a metam-sodium sprinkler application to a potato field on the southern edge of the town. METHODS: Case information was obtained from direct interviews, from illness complaints filed with state or county agencies, or from illness reports filed by community physicians for 173 subjects. Air concentrations of the by-product methyl isothiocyanate (MITC) during the episode were estimated based upon the Industrial Source Complex Short-Term (ISC3) air dispersion model, estimates from prior metam-sodium monitoring studies, and data from weather stations in two adjoining communities. RESULTS: Weather station data indicated that the November 13th incident corresponded with a temperature inversion at approximately 5:00 p.m. and a shift in the direction of prevailing wind from northwest to southeast. On the edge of Earlimart, 1-hr time weighted average (TWA) MITC concentration estimates ranged from 0.5 to 1 ppm. Of the 173 subjects, 170 had MITC-compatible symptoms, including eye or upper respiratory irritation (77.6%), non-specific systemic symptoms (64.7%), and lower respiratory symptoms (20.0%). 78.2% were exposed within 0.5 miles of the northern edge of the treated field where average 1 hr MITC concentrations exceeded the 800 ppb ocular irritation threshold. CONCLUSIONS: ISC3 modeling is a useful means of evaluating MITC concentrations for illness episodes when industrial hygiene assessment is not possible.     

Smoking trends among Filipino adults in California, 1990-2002

OBJECTIVES: Filipinos comprise about 18% of the Asian/Pacific Islander American (APIA) population and are increasing. Few studies have examined Filipino current smoking prevalence rates (CSPR) and none have described trends over time. METHODS: Trends in CSPR were estimated for Filipinos and non-Hispanic whites (NHW) from 1990-2002 from the California Tobacco Surveys (N>42,000/year). RESULTS: CSPR for Filipino males declined: 23.7% (95% CI: 18.7, 28.7) in 1990 to 18.7% (15.3, 22.1) in 2002 (p<0.05). The decline in CSPR for Filipino women was non-significant (p=0.24), 9.8% (5.5, 14.1) in 1990 and 7.7% (5.3, 10.1) in 2002. During the same period, CSPR among NHW males declined: 24.4% (23.8, 25.0) in 1990 to 18.8% (18.1, 19.4) in 2002 (p<0.01). For female NHW, CSPR were 21.3% (20.5, 22.0) in 1990 and 15.0% (14.4, 15.6) in 2002 (p<0.01). Adjusted logistic regression for Filipinos suggest that English language use is associated with current smoking among females (p<0.01) and that, overall, 18-29 year-olds were more likely to be current smokers than those 45+ years old (p<0.01). CONCLUSION: Trends for male Filipino current smokers declined similarly to male NHW from 1990-2002; female rates were lower but did not decline. Future smoking prevention and cessation programs would benefit by taking into account important differences in smoking rates between genders and age groups.     

Incidence rates of hospitalization related to traumatic brain injury--12 states, 2002

Traumatic brain injury (TBI) is a major cause of death and disability in the United States. Each year, among the estimated 1.4 million persons who sustain a TBI, an estimated 80,000-90,000 experience the onset of long-term disability. Since the early 1990s, CDC has supported state-level, population-based surveillance of TBI associated with hospitalization or death. For 2002, 12 states conducted TBI surveillance according to established CDC guidelines; the 2002 multistate data were finalized in December 2005 and are the most recent available. This report presents the results of TBI surveillance for 2002, which indicated that an estimated 74,517 persons (79.0 per 100,000 population) were hospitalized with TBI-related diagnoses in the 12 reporting states; unintentional falls, motor vehicle traffic (MVT) incidents, and assaults were the leading contributors to TBI-related hospitalizations. The findings underscore the need for states to continue to monitor TBI incidence and to implement effective injury-prevention programs.     

Environmental barriers to health care among persons with disabilities--Los Angeles County, California, 2002-2003

In 2002, an estimated 51.2 million persons in the United States (approximately 18.1% of the population) had a disability. Recent data suggest that substantial disparities in health behaviors and overall health status exist between persons with and without disabilities. Nonetheless, when they have access to adequate health care, persons with disabilities can lead healthy lives. The World Health Organization's International Classification of Functioning, Disability, and Health stresses the importance of environment (e.g., physical environment, attitudes of others, or policies) as either a barrier or facilitator in the daily activities of persons with disabilities. In addition, increasing access to health and wellness treatment programs for persons with disabilities and reducing the proportion of persons with disabilities who report environmental barriers to participation in daily activities are goals of Healthy People 2010 (objectives 6-10 and 6-12). However, few population-based studies have explored how environment affects the lives of those with disabilities. To determine the prevalence of disability among persons in Los Angeles County, California, and assess the effects of environmental barriers on these persons, residents were surveyed during 2002-2003. The results of that survey suggested that persons with physical or sensory disabilities experienced several environmental barriers and that the prevalence of barriers varied by demographic characteristics, household income, and severity of disability. To improve quality of life among persons with disabilities, public and private health agencies should implement measures to remove environmental barriers to health care and other services.     

Azithromycin treatment failures in syphilis infections--San Francisco, California, 2002-2003

The San Francisco Department of Public Health (SFDPH) is investigating several clinical failures in syphilis patients treated with the macrolide antibiotic azithromycin. This report describes the use of azithromycin for syphilis treatment, recent treatment failures in San Francisco, and CDC recommendations for syphilis treatment. Clinicians should exercise caution in using azithromycin for treating incubating syphilis or syphilis infection until the risk and mechanism of failure are better understood.     

Weekly update: West Nile virus activity--United States,July 17-23, 2002

This report summarizes West Nile virus (WNV) surveillance data reported to CDC through ArboNET and verified by states and other jurisdictions as of July 23, 2002. During the reporting week of July 17-23, nine human cases of WNV were reported from two states (Louisiana and Mississippi). During the same period, WNV infections were reported in 202 dead crows, 48 other dead birds, 13 horses, and 69 mosquito pools.     

Estimating the mortality effect of the July 2006 California heat wave

Objective

As a result of the California heat wave in July 2006, county coroners reported that the high temperatures during that period caused approximately 147 deaths. However, heat wave-related deaths are likely to be underreported due to a lack of a clear case definition and the multi-factorial nature of heat-related mortality. Public health policy suggests a need for a careful assessment of mortality following a heat wave. In addition, it is useful to provide a comparison of the mortality impact per degree change during heat waves versus high temperatures observed during non-heat wave periods.

Design

Daily data were collected for mortality, weather and ozone in seven California counties impacted by the July 2006 heat wave. The association between apparent temperature and daily mortality was assessed using a Poisson regression model and combined across counties in a meta-analysis. These results were then used to estimate the increases in the number of deaths during the heat wave.

Results

Our analysis indicated that during the July heat wave, there was a 9% (95% CI=1.6, 16.3) increase in daily mortality per 10° Fahrenheit (F) change in apparent temperature for all counties combined. This estimate is almost 3 times larger than the effect estimated for the full warm season of May-September, during the non-heat wave years. Our estimates also determined that actual mortality during the July 2006 heat wave was 2-3 times greater than the coroner estimates.

Conclusion

This multi-county analysis provides additional evidence that the attributable risk of mortality following a heat wave may be underestimated by examining only direct heat-related deaths. In addition, we have found that the mortality effect per °F is several times higher than that reported during non-heat wave periods.     

Outbreak of botulism type E associated with eating a beached whale--Western Alaska,July 2002

Botulism is a neuroparalytic illness caused by toxins produced by the bacterium Clostridium botulinum, an obligate anaerobe found commonly in the environment. Intoxication with toxin type E is associated exclusively with eating animal foods of marine (salt or fresh water) origin. Persons who eat raw or fermented marine fish and mammals are at high risk for botulism from type E toxin. On July 17, 2002, the Alaska Division of Public Health investigated a cluster of suspected botulism cases among residents of a fishing village in Alaska. This report summarizes the findings of the outbreak investigation, which linked disease to eating raw muktuk (skin and a pink blubber layer) from a beached whale (Figure). To avoid delays in treatment, health-care providers evaluating patients suspected of having botulism should base treatment decisions on clinical findings. Public health authorities should be notified immediately about any suspected botulism case.     

Perspectives from the world's largest Alzheimer's disease research conference: Stockholm,Sweden, July 2002

The 8th International Conference on Alzheimer's Disease and Related Disorders, held in Stockholm, Sweden from July 20 to 25, 2002, provided an exciting forum for nearly 3700 researchers from 78 countries to present and discuss advances in dementia research on a worldwide stage. Hosted by the Alzheimer's Association (Chicago, IL), this largest dementia research conference ever held united experienced researchers and relative newcomers to the field to learn from one another, challenge one another's thinking, and explore new possibilities for collaboration. The 12-fold growth in attendance, up from 300 scientists at the 1st International Research Conference in 1988, signals the increasing global importance of Alzheimer's disease in the research community as well as among policy makers and the general public. In fact, a recent survey of older Americans by the National Council on the Aging revealed that future memory loss was the number one health worry of the American elderly population.