Vital Signs: Drug Overdose Deaths,by Selected Sociodemographic and Social Determinants of Health Characteristics — 25 States and the District of Columbia, 2019–2020

Introduction: Drug overdose deaths increased approximately 30% from 2019 to 2020 in the United States. Examining rates by demographic and social determinants of health characteristics can identify disproportionately affected populations and inform strategies to reduce drug overdose deaths.Methods: Data from the State Unintentional Drug Overdose Reporting System (SUDORS) were used to analyze overdose death rates from 2019 to 2020 in 25 states and the District of Columbia. Rates were examined by race and ethnicity and county-level social determinants of health (e.g., income inequality and treatment provider availability).Results: From 2019 to 2020, drug overdose death rates increased by 44% and 39% among non-Hispanic Black (Black) and non-Hispanic American Indian or Alaska Native (AI/AN) persons, respectively. Significant disparities were found across sex, age, and racial and ethnic subgroups. In particular, the rate in 2020 among Black males aged ≥65 years (52.6 per 100,000) was nearly seven times that of non-Hispanic White males aged ≥65 years (7.7). A history of substance use was frequently reported. Evidence of previous substance use treatment was lowest for Black persons (8.3%). Disparities in overdose deaths, particularly among Black persons, were larger in counties with greater income inequality. Opioid overdose rates in 2020 were higher in areas with more opioid treatment program availability compared with areas with lower opioid treatment availability, particularly among Black (34.3 versus 16.6) and AI/AN (33.4 versus 16.2) persons.Conclusions and Implications for Public Health Practice: Health disparities in overdose rates continue to worsen, particularly among Black and AI/AN persons; social determinants of health, such as income inequality, exacerbate these inequities. Implementation of available, evidence-based, culturally responsive overdose prevention and response efforts that address health disparities impacting disproportionately affected populations are urgently needed.     

Modelling effects of bromide ion concentration on the formation of brominated trihalomethanes

A series of statistically‐based models have been developed for predicting the formation of individual trihalomethane (THM) species, ranging from chloroform to bromoform, as a function of various reaction conditions. These equations allow a quantitative assessment of bromide effects on overall THM formation as well as THM speciation.     

Identifying Preschool Children with Asthma in Orange County

Airway changes related to childhood asthma occur early in the disease process. This pilot study focuses on the validation of the Breathmobile Case Identification Survey (BCIS) in preschool-age children in Orange County, CA. Fifty-two children from low-income Spanish-speaking families participated in the study. Thirteen children were identified as possibly having asthma from the survey results compared with 20 children diagnosed by an asthma specialist. We found that the complete seven-question survey had a sensitivity of 0.65 and a specificity of 0.94. An abbreviated three-question version had a sensitivity of 0.70 and a specificity of 0.84. Our data suggest that the abbreviated BCIS, which is simple and easily analyzed, may be a useful tool in identifying young children who are at risk for asthma and need further evaluation and appropriate therapy.     

Changes in sputum cytology,airway inflammation and oxidative stress due to chronic inhalation of biomass smoke during cooking in premenopausal rural Indian women

To perform sputum analysis for verification of pulmonary changes in premenopausal rural Indian women chronically exposed to biomass smoke during cooking.Three consecutive morning sputum samples were collected from 196 women (median age 34 years) cooking with biomass and 149 age-matched control women cooking with cleaner fuel liquefied petroleum gas. Smears made on slides were stained with Papanicolaou and Perl's Prussian blue. Airway oxidative stress was estimated as reactive oxygen species (ROS) generation (by flow cytometry) and superoxide dismutase (SOD) level (by spectrophotometry) in sputum cells. Airway inflammation was measured as sputum levels of interleukin (IL)-6, -8 and tumor necrosis factor- alpha (TNF-α). Particulate matter of diameter less than 10 (PM₁₀) was measured using laser photometer while benzene exposure was monitored by measuring trans, trans-muconic acid (t,t-MA) in urine by HPLC-UV. Compared with control, sputum of biomass users contained more neutrophils, lymphocytes, eosinophils, alveolar macrophages, and showed presence of ciliocytophthoria, Charcot-Leyden crystals, Curschmann's spiral. ROS generation was increased by 2-fold while SOD was depleted by 31% in biomass users. They also had higher sputum levels of IL-6, -8 and TNF-α. Levels of PM₁₀ and t,t-MA were 2.9- and 5.8-times higher in biomass-using women. PM₁₀ and t,t-MA levels were positively associated with cellular changes in the sputum, markers of airway inflammation, and oxidative stress. Cooking with biomass alters sputum cytology, and increases airway inflammation and oxidative stress that might result in further amplification of the tissue damaging cascade in women chronically exposed to biomass smoke.     

Epidemiology of childhood burn: yield of largest community based injury survey in Bangladesh

In terms of mortality, morbidity and disability, burns are emerging as a major child health problem in Bangladesh. This trend is similar to many other developing countries. To develop effective burn prevention programmes, information on its magnitude and determinants is necessary. The purpose of this study was to document the magnitude and determinant of childhood burns in Bangladesh, based on a population-based survey which was conducted between January and December 2003. Nationally representative data was collected from 171,366 rural and urban households, comprising of a total population of 819,429. To facilitate data collection, face-to-face interviews were conducted. The rate of non-fatal burn among children under 18 years of age was calculated as 288.1 per 100,000 children-year. The highest incidence (782.1/100,000 children-year) was found among the 1-4 years age group. About 46% of non-fatal burn injuries occurred between 9 a.m. and 3 p.m. The incidence of childhood burn was found to be more than four times higher in rural children than urban children. Ninety percent (90%) of the childhood burns occurred at homes and the kitchen was the most common place. The rate of disability due to burn was 5.7 per 100,000 children per year. The rate of fatal burn was 0.6 per 100,000 per year among all children. The study findings confirmed that childhood burn was a major childhood illness in Bangladesh. An urgent and appropriate prevention programme is required to prevent these unwanted morbidities, disabilities and deaths due to burn.