MMWR supplements最新文献

{"title":"Adaptation and National Dissemination of a Brief, Evidence-Based, HIV Prevention Intervention for High-Risk Men Who Have Sex with Men.","authors":"J. Herbst, J. Raiford, Monique Carry, A. Wilkes, R. Ellington, D. Whittier","doi":"10.15585/mmwr.su6501a7","DOIUrl":"https://doi.org/10.15585/mmwr.su6501a7","url":null,"abstract":"CDC's high-impact human immunodeficiency virus (HIV) prevention approach calls for targeting the most cost-effective and scalable interventions to populations of greatest need to reduce HIV incidence. CDC has funded research to adapt and demonstrate the efficacy of Personalized Cognitive Counseling (PCC) as an HIV prevention intervention. Project ECHO, based in San Francisco, California, during 2010-2012, involved an adaptation of PCC for HIV-negative episodic substance-using men who have sex with men (SUMSM) and a randomized trial to test its efficacy in reducing sexual and substance-use risk behaviors. Episodic substance use is the use of substances recreationally and less than weekly. PCC is a 30-minute to 50-minute counseling session that involves addressing self-justifications men use for engaging in risky sexual behavior despite knowing the potential for HIV infection. By exploring these justifications, participants become aware of the ways they make sexual decisions, become better prepared to realistically assess their risk for HIV during future risky situations, and make decisions to decrease their HIV risk. The findings of Project ECHO demonstrated the efficacy of PCC for reducing HIV-related substance-use risk behaviors. The study also demonstrated efficacy of PCC for reducing sexual risk behaviors among SUMSM screened as nondependent on targeted drug substances. CDC has identified PCC as a \"best evidence\" HIV behavioral intervention and supports its national dissemination. Several features of PCC enhance its feasibility of implementation: it is brief, delivered with HIV testing, relatively inexpensive, allows flexibility in counselor qualifications and delivery settings, and is individualized to each client. The original PCC and its adapted versions can contribute to reducing HIV-related health disparities among high-risk MSM, including substance users, by raising awareness of and promoting reductions in personal risk behaviors.","PeriodicalId":37858,"journal":{"name":"MMWR supplements","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76281843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The HoMBReS and HoMBReS Por un Cambio Interventions to Reduce HIV Disparities Among Immigrant Hispanic/Latino Men.","authors":"S. Rhodes, J. Leichliter, Christina J. Sun, F. R. Bloom","doi":"10.15585/mmwr.su6501a8","DOIUrl":"https://doi.org/10.15585/mmwr.su6501a8","url":null,"abstract":"Hispanics/Latinos in the United States are affected disproportionately by human immunodeficiency virus (HIV) infection, acquired immunodeficiency syndrome (AIDS), and other sexually transmitted diseases (STDs); however, few effective evidence-based prevention interventions for this population exist. This report describes the Hombres Manteniendo Bienestar y Relaciones Saludables (Men Maintaining Wellbeing and Healthy Relationships) (HoMBReS) intervention, which was developed by a community-based, participatory research partnership in North Carolina and initially implemented during 2005-2009. HoMBReS is an example of an effective intervention that uses lay health advisors (known as Navegantes [navigators]) in the context of existing social networks (i.e., recreational soccer teams) to promote consistent condom use and HIV and STD testing among Hispanic/Latino men. In 2012, HoMBReS was classified as a best-evidence community-level HIV prevention intervention (CDC. Compendium of evidence-based behavioral interventions and best practices for HIV prevention. Atlanta, GA: US Department of Health and Human Services, CDC; 2015). The intervention has been implemented elsewhere, enhanced, and further evaluated in longitudinal intervention and implementation studies. HoMBReS has been adapted for other populations, including men who have sex with men and transgender persons. Additional evaluation has found that Navegantes continue in their roles as health advisors, opinion leaders, and community advocates after study support ends. Hispanic/Latino men's social networks can be leveraged to promote sexual health within the community by decreasing HIV risk behaviors among Hispanics/Latinos in the United States.","PeriodicalId":37858,"journal":{"name":"MMWR supplements","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85316384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community Asthma Initiative to Improve Health Outcomes and Reduce Disparities Among Children with Asthma.","authors":"E. Woods, Urmi Bhaumik, Susan J. Sommer, E. Chan, Lindsay Tsopelas, E. Fleegler, M. Lorenzi, E. M. Klements, Deborah U. Dickerson, Shari Nethersole, Rick Dulin","doi":"10.15585/mmwr.su6501a4","DOIUrl":"https://doi.org/10.15585/mmwr.su6501a4","url":null,"abstract":"Black and Hispanic children are hospitalized with complications of asthma at much higher rates than white children. The Boston Children's Hospital Community Asthma Initiative (CAI) provides asthma case management and home visits for children from low-income neighborhoods in Boston, Massachusetts, to address racial/ethnic health disparities in pediatric asthma outcomes. CAI objectives were to evaluate 1) case management data by parent/guardian report for health outcomes and 2) hospital administrative data for comparison between intervention and comparison groups. Data from parent/guardian reports indicate that CAI decreased the number of children with any (one or more) asthma-related hospitalizations (decrease of 79% at 12 months) and any asthma-related emergency department visits (decrease of 56% at 12 months) among children served, most of whom were non-Hispanic black or Hispanic. Hospital administrative data also indicate that the number of asthma-related hospitalizations per child significantly decreased among CAI participants compared with a comparison group. The CAI model has been replicated in other cities and states with adaptations to local cultural and systems variations. Health outcome and cost data have been used to contribute to a business case to educate legislators and insurers about outcomes and costs for this enhanced approach to care. Strong partnerships with public health, community, and housing agencies have allowed CAI to leverage its outcomes to expand systemic changes locally and statewide to reduce asthma morbidity.","PeriodicalId":37858,"journal":{"name":"MMWR supplements","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74428453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Competency Guidelines for Public Health Laboratory Professionals: CDC and the Association of Public Health Laboratories.","authors":"Renée Ned-Sykes,&nbsp;Catherine Johnson,&nbsp;John C Ridderhof,&nbsp;Eva Perlman,&nbsp;Anne Pollock,&nbsp;John M DeBoy","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>These competency guidelines outline the knowledge, skills, and abilities necessary for public health laboratory (PHL) professionals to deliver the core services of PHLs efficiently and effectively. As part of a 2-year workforce project sponsored in 2012 by CDC and the Association of Public Health Laboratories (APHL), competencies for 15 domain areas were developed by experts representing state and local PHLs, clinical laboratories, academic institutions, laboratory professional organizations, CDC, and APHL. The competencies were developed and reviewed by approximately 170 subject matter experts with diverse backgrounds and experiences in laboratory science and public health. The guidelines comprise general, cross-cutting, and specialized domain areas and are divided into four levels of proficiency: beginner, competent, proficient, and expert. The 15 domain areas are 1) Quality Management System, 2) Ethics, 3) Management and Leadership, 4) Communication, 5) Security, 6) Emergency Management and Response, 7) Workforce Training, 8) General Laboratory Practice, 9) Safety, 10) Surveillance, 11) Informatics, 12) Microbiology, 13) Chemistry, 14) Bioinformatics, and 15) Research. These competency guidelines are targeted to scientists working in PHLs, defined as governmental public health, environmental, and agricultural laboratories that provide analytic biological and/or chemical testing and testing-related services that protect human populations against infectious diseases, foodborne and waterborne diseases, environmental hazards, treatable hereditary disorders, and natural and human-made public health emergencies. The competencies support certain PHL workforce needs such as identifying job responsibilities, assessing individual performance, and providing a guiding framework for producing education and training programs. Although these competencies were developed specifically for the PHL community, this does not preclude their broader application to other professionals in a variety of different work settings. </p>","PeriodicalId":37858,"journal":{"name":"MMWR supplements","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33304214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryptosporidiosis surveillance -- United States, 2011-2012.","authors":"Julia E Painter,&nbsp;Michele C Hlavsa,&nbsp;Sarah A Collier,&nbsp;Lihua Xiao,&nbsp;Jonathan S Yoder","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Problem/condition: </strong>Cryptosporidiosis is a nationally notifiable gastrointestinal illness caused by extremely chlorine-tolerant protozoa of the genus Cryptosporidium.</p><p><strong>Reporting period: </strong>2011-2012.</p><p><strong>Description of system: </strong>Fifty state and two metropolitan public health agencies voluntarily report cases of cryptosporidiosis through CDC's National Notifiable Diseases Surveillance System.</p><p><strong>Results: </strong>For 2011, a total of 9,313 cryptosporidiosis cases (confirmed and nonconfirmed) were reported; for 2012, a total of 8,008 cases were reported; 5.8% and 5.3%, respectively, were associated with a detected outbreak. The rates of reported nonconfirmed cases were 1.0 and 0.9 per 100,000 population in 2011 and 2012, respectively, compared with an average of 0.0 during 1995-2004, and 0.3 during 2005-2010. The highest overall reporting rates were observed in the Midwest; 10 states reported >3.5 cases per 100,000 population in 2011 and in 2012. During 2011-2012, reported cases were highest among children aged 1-4 years (6.6 per 100,000 population), followed for the first time by elderly adults aged ≥80 years (3.4), and 75-79 years (3.3). Overall, cryptosporidiosis rates were higher among females than males during both years. For specific age groups, rates were higher among males than females aged <15 years and higher among females than males aged ≥15 years. Cryptosporidiosis symptom onset increased 4.4 fold during late summer.</p><p><strong>Interpretation: </strong>Cryptosporidiosis incidence rates remain elevated nationally, and rates of nonconfirmed cases have increased. Rates remain highest in young children, although rates among elderly adults are increasing. Transmission of Cryptosporidium occurs throughout the United States, with increased reporting occurring in Midwestern states. Seasonal onset peaks coincide with the summer recreational water season and might reflect increased use of communal swimming venues.</p><p><strong>Public health action: </strong>Future research is needed to address the evolving epidemiology of cryptosporidiosis cases, with a specific focus on the increase in nonconfirmed cases and increasing incidence rates among elderly adults. National systematic genotyping and subtyping of Cryptosporidium isolates could also help elucidate Cryptosporidium transmission and thus cryptosporidiosis epidemiology in the United States.</p>","PeriodicalId":37858,"journal":{"name":"MMWR supplements","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33265238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giardiasis surveillance -- United States, 2011-2012.","authors":"Julia E Painter,&nbsp;Julia W Gargano,&nbsp;Sarah A Collier,&nbsp;Jonathan S Yoder","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Problem/condition: </strong>Giardiasis is a nationally notifiable gastrointestinal illness caused by the protozoan parasite Giardia intestinalis.</p><p><strong>Reporting period: </strong>2011-2012.</p><p><strong>Description of system: </strong>Forty-four states, the District of Columbia, New York City, the Commonwealth of Puerto Rico, and Guam voluntarily reported cases of giardiasis to CDC through the National Notifiable Diseases Surveillance System (NNDSS).</p><p><strong>Results: </strong>For 2011, a total of 16,868 giardiasis cases (98.8% confirmed and 1.2% nonconfirmed) were reported; for 2012, a total of 15,223 cases (98.8% confirmed and 1.3% nonconfirmed) were reported. In 2011 and 2012, 1.5% and 1.3% of cases, respectively, were associated with a detected outbreak. The incidence rates of all reported cases were 6.4 per 100,000 population in 2011 and 5.8 per 100,000 population in 2012. This represents a slight decline from the relatively steady rates observed during 2005-2010 (range: 7.1-7.9 cases per 100,000 population). In both 2011 and 2012, cases were most frequently reported in children aged 1-4 years, followed by those aged 5-9 years and adults aged 45-49 years. Incidence of giardiasis was highest in Northwest states. Peak onset of illness occurred annually during early summer through early fall.</p><p><strong>Interpretation: </strong>For the first time since 2002, giardiasis rates appear to be decreasing. Possible reasons for the decrease in rates during 2011-2012 could include changes in transmission patterns, a recent change in surveillance case definition, increased uptake of strategies to reduce waterborne transmission, or a combination of these factors. Transmission of giardiasis occurs throughout the United States, with more frequent diagnosis or reporting occurring in northern states. Geographical differences might suggest actual regional differences in giardiasis transmission or variation in surveillance capacity across states. Six states did not report giardiasis cases in 2011-2012, representing the largest number of nonreporting states since giardiasis became nationally notifiable in 2002. Giardiasis is reported more frequently in young children, which might reflect increased contact with contaminated water or ill persons, or a lack of immunity.</p><p><strong>Public health action: </strong>Educational efforts to decrease exposure to unsafe drinking and recreational water and prevent person-to-person transmission have the potential to reduce giardiasis transmission. The continual decrease in jurisdictions opting to report giardiasis cases could negatively impact the ability to interpret national surveillance data; thus, further investigation is needed to identify barriers to and facilitators of giardiasis case reporting. Existing state and local public health infrastructure supported through CDC (e.g., Epidemiology and Laboratory Capacity grants and CDC-sponsored Council of State and Territorial Epidemiologists Ap","PeriodicalId":37858,"journal":{"name":"MMWR supplements","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33265239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal trends of acute chemical incidents and injuries—Hazardous Substances Emergency Events Surveillance, nine states, 1999-2008.","authors":"Perri Zeitz Ruckart,&nbsp;Maureen F Orr","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Problem/condition: </strong>Widespread use of hazardous chemicals in the United States is associated with unintentional acute chemical incidents (i.e., uncontrolled or illegal release or threatened release of hazardous substances lasting <72 hours). Efforts by industries, government agencies, academics, and others aim to reduce chemical incidents and the public health consequences, environmental damage, and economic losses; however, incidents are still prevalent.</p><p><strong>Reporting period: </strong>1999-2008.</p><p><strong>Description of system: </strong>The Hazardous Substances Emergency Events Surveillance (HSEES) system was operated by the Agency for Toxic Substances and Disease Registry (ATSDR) during January 1991-September 2009 to describe the public health consequences of chemical releases and to develop activities aimed at reducing the harm. This report summarizes temporal trends in the numbers of incidents, injured persons, deaths, and evacuations from the nine states (Colorado, Iowa, Minnesota, New York, North Carolina, Oregon, Texas, Washington, and Wisconsin) that participated in HSEES during its last 10 full years of data collection (1999-2008).</p><p><strong>Results: </strong>A total of 57,975 incidents and 15,506 injured persons, including 354 deaths, were reported. During the surveillance period, several trends were observed: a slight overall decrease occurred in incidents for fixed facilities (R² = 0.6) and an increasing trend in deaths (R² = 0.7) occurred, particularly for the general public (R² = 0.9). The number of incidents increased in the spring during March-June, and a decrease occurred in the remainder of the year (R² = 0.5). A decreasing trend in incidents occurred during Monday-Sunday (R² = 0.7) that was similar to that for the number of injured persons (R² = 0.6). The highest number of incidents occurred earlier in the day (6:00 a.m.-11:59 a.m.) and then decreased as the day went on (R² = 0.9); this trend was similar for the number of injured persons (R² = 1.0).</p><p><strong>Interpretation: </strong>Chemical incidents continue to affect public health and appear to be a growing problem for the general public. The number of incidents and injuries varied by month, day of week, and time of day and likely was influenced by other factors such as weather and the economy. PUBLIC HEALTH IMPLICATIONS: Public and environmental health and safety practitioners, worker representatives, emergency planners, preparedness coordinators, industries, emergency responders, and others can use the findings in this report to prepare for and prevent chemical incidents and injuries. Specifically, knowing when to expect the most incidents and injuries can guide preparedness and prevention efforts. In addition, new or expanded efforts and outreach to educate consumers who could be exposed to chemicals are needed (e.g., education about the dangers of carbon monoxide poisoning for consumers in areas likely to experience weather-relat","PeriodicalId":37858,"journal":{"name":"MMWR supplements","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33201256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Top five chemicals resulting in injuries from acute chemical incidents—Hazardous Substances Emergency Events Surveillance, nine states, 1999-2008.","authors":"Ayana R Anderson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Problem/condition: </strong>The Toxic Substances Control Act Chemical Substance Inventory lists >84,000 chemicals used in commerce (http://www.epa.gov/oppt/existingchemicals/pubs/tscainventory/basic.html). With chemicals having a multitude of uses, persons are potentially at risk daily for exposure to chemicals as a result of an acute chemical incident (lasting <72 hours). Depending on the level of exposure and the type of chemical, exposure can result in morbidity and, in some cases, mortality.</p><p><strong>Reporting period: </strong>1999-2008.</p><p><strong>Description of system: </strong>The Hazardous Substances Emergency Events Surveillance (HSEES) system was operated by the Agency for Toxic Substances and Disease Registry during January 1991-September 2009 to collect data that would enable researchers to describe the public health consequences of chemical incidents and to develop activities aimed at reducing the harm from such incidents. This report identifies the top five chemicals that caused injuries in the nine states (Colorado, Iowa, Minnesota, New York, North Carolina, Oregon, Texas, Washington, and Wisconsin) that participated in HSEES during its last 10 full years of data collection (1999-2008).</p><p><strong>Results: </strong>Of the 57,975 incidents that were reported, 54,989 (95%) involved the release of only one chemical. The top five chemicals associated with injury were carbon monoxide (2,364), ammonia (1,153), chlorine (763), hydrochloric acid (326), and sulfuric acid (318). Carbon monoxide and ammonia by far caused the most injuries, deaths, and evacuations. Chlorine, while not in the top 10 chemicals released, was in the top five chemicals associated with injury because of its hazardous properties.</p><p><strong>Interpretation: </strong>Multiple measures can be taken to prevent injuries associated with the top five chemicals. Because many carbon monoxide releases occur in residential settings, use of carbon monoxide detectors can prevent injuries. Substituting chemicals with less lethal alternatives can result in mitigating injuries associated with ammonia. Routine maintenance of equipment and engineering controls can reduce injuries associated with chlorine and sulfuric acid, and proper chemical handling training can reduce injuries associated with hydrochloric acid. PUBLIC HEALTH IMPLICATIONS: Understanding the most frequently reported locations where carbon monoxide, ammonia, chlorine, hydrochloric acid, and sulfuric acid are released along with the most frequently reported contributing factors can help mitigate injuries associated with these releases. Prevention initiatives should focus on educating the public and workers about the dangers of these chemicals and about proper handling of these chemicals along with routine maintenance of equipment.</p>","PeriodicalId":37858,"journal":{"name":"MMWR supplements","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33201260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persons injured during acute chemical incidents—Hazardous Substances Emergency Events Surveillance, nine states, 1999-2008.","authors":"Mary Anne Duncan,&nbsp;Jennifer Wu,&nbsp;M Caitlin Neu,&nbsp;Maureen F Orr","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Problem/condition: </strong>Persons exposed to chemicals during acute chemical incidents (i.e., uncontrolled or illegal release or threatened release of hazardous substances lasting <72 hours) can experience both acute and chronic health effects. Surveillance of toxic substance incidents provides data that can be used to prevent future incidents and improve the emergency response to those that occur, leading to a decrease in morbidity and mortality from chemical releases.</p><p><strong>Reporting period: </strong>1999-2008 DESCRIPTION OF SYSTEM: The Hazardous Substances Emergency Events Surveillance (HSEES) system was operated by the Agency for Toxic Substances and Disease Registry (ATSDR) during January 1991-September 2009 to describe the public health consequences of chemical releases and to develop activities aimed at reducing the harm. This report summarizes the data collected on injured persons from the nine states (Colorado, Iowa, Minnesota, New York, North Carolina, Oregon, Texas, Washington, and Wisconsin) that participated in HSEES during its last 10 full years of data collection (1999-2008).</p><p><strong>Results: </strong>A total of 57,975 chemical incidents were reported by these states during the 10-year surveillance period. In 4,621 (8%) of these incidents, 15,506 persons were injured. Among them, 354 deaths occurred. The most commonly reported category of injured persons included employees of the responsible party (7,616 [49%]), members of the general public (4,737 [31%]), students exposed at school (1,730 [11%]), and responders to the incident (1,398 [9%]). Deaths occurred among members of the general public (190 [54%]), employees (154 [44%]), and responders (10 [3%]). The most frequent health effects experienced as a result of these incidents included respiratory irritation (7,443), dizziness or central nervous system problems (3,186), and headache (3,167). The three chemicals associated with the largest number of persons injured were carbon monoxide (2,364), ammonia (1,153), and chlorine (763).</p><p><strong>Interpretation: </strong>Company employees, followed by members of the general public, are frequently injured in acute chemical incidents. The chemicals most often associated with these injuries are carbon monoxide, ammonia, and chlorine, all of which are hazardous gases that can be found in various locations including schools and homes. Respiratory irritation is the most common health effect. PUBLIC HEALTH IMPLICATIONS: By understanding the types of persons injured in chemical release incidents, as well as how they are injured and the injuries sustained, prevention outreach activities can be focused to protect the health of these groups in the future. Improved awareness among and training for not just employees but also the public is needed, particularly regarding carbon monoxide, ammonia, and chlorine. Appropriate measures to provide protection from respiratory effects of chemical incidents could prevent injuries","PeriodicalId":37858,"journal":{"name":"MMWR supplements","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33201257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Top five industries resulting in injuries from acute chemical incidents—Hazardous Substance Emergency Events Surveillance, nine states, 1999-2008.","authors":"Ayana R Anderson,&nbsp;Jennifer Wu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Problem/condition: </strong>Because industries using and/or producing chemicals are located in close proximity to populated areas, U.S. residents are at risk for unintentional chemical exposures.</p><p><strong>Reporting period: </strong>1999-2008.</p><p><strong>Description of system: </strong>The Hazardous Substances Emergency Events Surveillance (HSEES) system was operated by the Agency for Toxic Substances and Disease Registry during January 1991-September 2009 to collect data that would enable researchers to describe the public health consequences of chemical releases and to develop activities aimed at reducing the harm from such releases. This report summarizes data for the top five industries resulting in injuries from an acute chemical incident (lasting <72 hours) occurring in the nine states (Colorado, Iowa, Minnesota, New York, North Carolina, Oregon, Texas, Washington, and Wisconsin) that participated in HSEES during its last 10 full years of data collection (1999-2008).</p><p><strong>Results: </strong>Five industries (truck transportation, educational services, chemical manufacturing, utilities, and food manufacturing) accounted for approximately one third of all incidents in which persons were injured as a result of unintentional release of chemicals; the same five industries were responsible for approximately one third of all persons injured as a result of such releases.</p><p><strong>Interpretation: </strong>Acute chemical incidents in these five industries resulted in serious public health implications including the need for evacuations, morbidity, and mortality. PUBLIC HEALTH IMPLICATIONS: Targeting chemical incident prevention and preparedness activities towards these five industries provides an efficient use of resources for reducing chemical exposures. A variety of methods can be used to minimize chemical releases in industries. One example is the Occupational Safety and Health Administration's hierarchy of controls model, which focuses on controlling exposures to occupational hazards. The hierarchy includes elimination, substitution, engineering controls, administrative controls, and use of personal protective equipment.</p>","PeriodicalId":37858,"journal":{"name":"MMWR supplements","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33201261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}