Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-30 (of 36 Records) |
Query Trace: Byrne M[original query] |
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Evidence for a role of Anopheles stephensi in the spread of drug and diagnosis-resistant malaria in Africa
Emiru T , Getachew D , Murphy M , Sedda L , Ejigu LA , Bulto MG , Byrne I , Demisse M , Abdo M , Chali W , Elliott A , Vickers EN , Aranda-Díaz A , Alemayehu L , Behaksera SW , Jebessa G , Dinka H , Tsegaye T , Teka H , Chibsa S , Mumba P , Girma S , Hwang J , Yoshimizu M , Sutcliffe A , Taffese HS , Bayissa GA , Zohdy S , Tongren JE , Drakeley C , Greenhouse B , Bousema T , Tadesse FG . Nat Med 2023 29 (12) 3203-3211 Anopheles stephensi, an Asian malaria vector, continues to expand across Africa. The vector is now firmly established in urban settings in the Horn of Africa. Its presence in areas where malaria resurged suggested a possible role in causing malaria outbreaks. Here, using a prospective case-control design, we investigated the role of An. stephensi in transmission following a malaria outbreak in Dire Dawa, Ethiopia in April-July 2022. Screening contacts of patients with malaria and febrile controls revealed spatial clustering of Plasmodium falciparum infections around patients with malaria in strong association with the presence of An. stephensi in the household vicinity. Plasmodium sporozoites were detected in these mosquitoes. This outbreak involved clonal propagation of parasites with molecular signatures of artemisinin and diagnostic resistance. To our knowledge, this study provides the strongest evidence so far for a role of An. stephensi in driving an urban malaria outbreak in Africa, highlighting the major public health threat posed by this fast-spreading mosquito. |
Folate-related gene variants in Irish families affected by neural tube defects.
Fisk Green R , Byrne J , Crider KS , Gallagher M , Koontz D , Berry RJ . Front Genet 2013 4 223 Periconceptional folic acid use can often prevent neural tube defects (NTDs). Variants of genes involved in folate metabolism in mothers and children have been associated with occurrence of NTDs. We identified Irish families with individuals affected by neural tube defects. In these families, we observed that neural tube defects and birth defects overall occurred at a higher rate in the maternal lineage compared with the paternal lineage. The goal of this study was to look for evidence for genetic effects that could explain the discrepancy in the occurrence of these birth defects in the maternal vs. paternal lineage. We genotyped blood samples from 322 individuals from NTD-affected Irish families, identified through their membership in spina bifida associations. We looked for differences in distribution in maternal vs. paternal lineages of five genetic polymorphisms: the DHFR 19 bp deletion, MTHFD1 1958G>A, MTHFR 1298A>C, MTHFR 677C>T, and SLC19A1 80A>G. In addition to looking at genotypes individually, we determined the number of genotypes associated with decreased folate metabolism in each relative ("risk genotypes") and compared the distribution of these genotypes in maternal vs. paternal relatives. Overall, maternal relatives had a higher number of genotypes associated with lower folate metabolism than paternal relatives (p = 0.017). We expected that relatives would share the same risk genotype as the individuals with NTDs and/or their mothers. However, we observed that maternal relatives had an over-abundance of any risk genotype, rather than one specific genotype. The observed genetic effects suggest an epigenetic mechanism in which decreased folate metabolism results in epigenetic alterations related to the increased rate of NTDs and other birth defects seen in the maternal lineage. Future studies on the etiology of NTDs and other birth defects could benefit from including multigenerational extended families, in order to explore potential epigenetic mechanisms. |
Identify contributing factors and root causes to help stop and prevent foodborne outbreaks
Wittry CDRB , Curtiss E , Byrne M . J Environ Health 2024 86 (6) 28-31 |
Design and Implementation of a Federal Program to Engage Community Partners to Reduce Disparities in Adult COVID-19 Immunization Uptake, United States, 2021-2022
Ashenafi SG , Martinez GM , Jatlaoui TC , Koppaka R , Byrne-Zaaloff M , Falcón AP , Frank A , Keitt SH , Matus K , Moss S , Ruddock C , Sun T , Waterman MB , Wu TY . Public Health Rep 2023 333549231208642 Vaccination disparities are part of a larger system of health inequities among racial and ethnic groups in the United States. To increase vaccine equity of racial and ethnic populations, the Centers for Disease Control and Prevention (CDC) designed the Partnering for Vaccine Equity program in January 2021, which funded and supported national, state, local, and community organizations in 50 states-which include Indian Health Service Tribal Areas; Washington, DC; and Puerto Rico-to implement culturally tailored activities to improve access to, availability of, and confidence in COVID-19 and influenza vaccines. To increase vaccine uptake at the local level, CDC partnered with national organizations such as the National Urban League and Asian & Pacific Islander American Health Forum to engage community-based organizations to take action. Lessons learned from the program include the importance of directly supporting and engaging with the community, providing tailored messages and access to vaccines to reach communities where they are, training messengers who are trusted by those in the community, and providing support to funded partners through trainings on program design and implementation that can be institutionalized and sustained beyond the COVID-19 pandemic. Building on these lessons will ensure CDC and other public health partners can continue to advance vaccine equity, increase vaccine uptake, improve health outcomes, and build trust with communities as part of a comprehensive adult immunization infrastructure. |
Co-circulating mumps lineages at multiple geographic scales (preprint)
Wohl S , Metsky HC , Schaffner SF , Piantadosi A , Burns M , Lewnard JA , Chak B , Krasilnikova LA , Siddle KJ , Matranga CB , Bankamp B , Hennigan S , Sabina B , Byrne EH , McNall RJ , Park DJ , Gharib S , Fitzgerald S , Barreira P , Fleming S , Lett S , Rota PA , Madoff LC , Yozwiak NL , MacInnis BL , Smole S , Grad YH , Sabeti PC . bioRxiv 2018 343897 Despite widespread vaccination, eleven thousand mumps cases were reported in the United States (US) in 2016–17, including hundreds in Massachusetts, primarily in college settings. We generated 203 whole genome mumps virus (MuV) sequences from Massachusetts and 15 other states to understand the dynamics of mumps spread locally and nationally, as well as to search for variants potentially related to vaccination. We observed multiple MuV lineages circulating within Massachusetts during 2016–17, evidence for multiple introductions of the virus to the state, and extensive geographic movement of MuV within the US on short time scales. We found no evidence that variants arising during this outbreak contributed to vaccine escape. Combining epidemiological and genomic data, we observed multiple co-circulating clades within individual universities as well as spillover into the local community. Detailed data from one well-sampled university allowed us to estimate an effective reproductive number within that university significantly greater than one. We also used publicly available small hydrophobic (SH) gene sequences to estimate migration between world regions and to place this outbreak in a global context, but demonstrate that these short sequences, historically used for MuV genotyping, are inadequate for tracing detailed transmission. Our findings suggest continuous, often undetected, circulation of mumps both locally and nationally, and highlight the value of combining genomic and epidemiological data to track viral disease transmission at high resolution. |
Spatiotemporal Distribution of Vector Mosquito Species and Areas at Risk for Arbovirus Transmission in Maricopa County, Arizona (preprint)
Wilke ABB , Damian D , Litvinova M , Byrne T , Zardini A , Poletti P , Merler S , Mutebi JP , Townsend J , Ajelli M . bioRxiv 2022 28 Mosquito-borne diseases are a major global public health concern and mosquito surveillance systems are essential for the implementation of effective mosquito control strategies. The objective of our study is to determine the spatiotemporal distribution of vector mosquito species in Maricopa County, AZ from 2011 to 2021, and to identify the hotspot areas for West Nile virus (WNV) and St. Louis Encephalitis virus (SLEV) transmission in 2021. The Maricopa County Mosquito Control surveillance system utilizes BG-Sentinel and EVS-CDC traps throughout the entire urban and suburban areas of the county. We estimated specific mosquito species relative abundance per unit area using the Kernel density estimator in ArcGIS 10.2. We calculated the distance between all traps in the surveillance system and created a 4 km buffer radius around each trap to calculate the extent to which each trap deviated from the mean number of Cx. quinquefasciatus and Cx. tarsalis collected in 2021. Our results show that vector mosquito species are widely distributed and abundant in the urban areas of Maricopa County. A total of 691,170 Culex quinquefasciatus, 542,733 Culex tarsalis, and 292,305 Aedes aegypti were collected from 2011 to 2022. The relative abundance of Ae. aegypti was highly seasonal peaking in the third and fourth quarters of the year. Culex quinquefasciatus, on the other hand, was abundant throughout the year with several regions consistently yielding high numbers of mosquitoes. Culex tarsalis was abundant but it only reached high numbers in well-defined areas bordering natural and rural areas. We also detected high levels of heterogeneity in the risk of WNV and SLEV transmission to humans disregarding traps geographical proximity. The well-defined species-specific spatiotemporal and geographical patterns found in this study can be used to inform vector control operations. Copyright The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-ND 4.0 International license. |
A nested case-control study of serum per- and polyfluoroalkyl substances and testicular germ cell tumors among U.S. Air Force servicemen
Purdue MP , Rhee J , Denic-Roberts H , McGlynn KA , Byrne C , Sampson J , Botelho JC , Calafat AM , Rusiecki J . Environ Health Perspect 2023 131 (7) 77007 BACKGROUND: Per- and polyfluoroalkyl substances (PFAS) are a component of firefighting foams used at military installations. Although high PFAS exposures have been related to cancer risks among civilian populations, the effects for military personnel are unclear. OBJECTIVES: We investigated associations between serum PFAS concentrations and testicular germ cell tumors (TGCT) among U.S. Air Force servicemen. METHODS: This nested case-control study involved active-duty Air Force servicemen with sera from the Department of Defense Serum Repository. We selected 530 cases and 530 controls individually matched on birth date, race and ethnicity, year entered the service, and year of sample collection, with prediagnostic serum samples collected between 1988 and 2017. A second prediagnostic sample, collected a median of 4 y after the first, was selected for 187 case-control pairs. Seven PFAS were quantified using isotope-dilution tandem mass spectrometry. Odds ratios (ORs) and 95% confidence intervals (CIs) from conditional logistic regression adjusting for military grade, number of deployments, and, in some models, other PFAS, estimated associations between PFAS concentrations (categorized using quartiles among controls) and TGCT. RESULTS: Elevated concentrations of some PFAS were observed for military employment in firefighting [perfluorooctanesulfonic acid (PFOS), perfluorohexanesulfonic acid (PFHxS), perfluorooctanoic acid] and service at a base with high PFAS concentrations in drinking water (PFHxS). Elevated PFOS concentrations in the second sample were positively associated with TGCT [OR for fourth vs. first quartile (ORQ4) = 2.6, 95% CI: 1.1, 6.4; ptrend = 0.02], including after adjustment for other PFAS (ORQ4 = 4.6, 95% CI: 1.4, 15.1; ptrend = 0.009). Associations with PFOS in the first/only samples were weak and not statistically significant. Elevated concentrations of perfluorononanoic acid were inversely associated with TGCT, whereas results were null for other PFAS. DISCUSSION: We identified service-related predictors of PFAS concentrations and increased TGCT relative risks with elevated PFOS concentrations among Air Force servicemen. These findings warrant further investigation in other populations and military service branches. 10.1289/EHP12603. |
Spatiotemporal distribution of vector mosquito species and areas at risk for arbovirus transmission in Maricopa County, Arizona
Wilke ABB , Damian D , Litvinova M , Byrne T , Zardini A , Poletti P , Merler S , Mutebi JP , Townsend J , Ajelli M . Acta Trop 2023 240 106833 Mosquito-borne diseases are a major global public health concern and mosquito surveillance systems are essential for the implementation of effective mosquito control strategies. The objective of our study is to determine the spatiotemporal distribution of vector mosquito species in Maricopa County, AZ from 2011 to 2021, and to identify the hotspot areas for West Nile virus (WNV) and St. Louis Encephalitis virus (SLEV) transmission in 2021. The Maricopa County Mosquito Control surveillance system utilizes BG-Sentinel and EVS-CDC traps throughout the entire urban and suburban areas of the county. We estimated specific mosquito species relative abundance per unit area using the Kernel density estimator in ArcGIS 10.2. We calculated the distance between all traps in the surveillance system and created a 4 km buffer radius around each trap to calculate the extent to which each trap deviated from the mean number of Cx. quinquefasciatus and Cx. tarsalis collected in 2021. Our results show that vector mosquito species are widely distributed and abundant in the urban areas of Maricopa County. A total of 691,170 Culex quinquefasciatus, 542,733 Culex tarsalis, and 292,305 Aedes aegypti were collected from 2011 to 2022. The relative abundance of Ae. aegypti was highly seasonal peaking in the third and fourth quarters of the year. Culex quinquefasciatus, on the other hand, was abundant throughout the year with several regions consistently yielding high numbers of mosquitoes. Culex tarsalis was abundant but it only reached high numbers in well-defined areas near irrigated landscapes. We also detected high levels of heterogeneity in the risk of WNV and SLEV transmission to humans disregarding traps geographical proximity. The well-defined species-specific spatiotemporal and geographical patterns found in this study can be used to inform vector control operations. |
Outbreaks of acute gastrointestinal illness associated with a splash pad in a Wildlife Park - Kansas, June 2021
Aluko SK , Ishrati SS , Walker DC , Mattioli MC , Kahler AM , Vanden Esschert KL , Hervey K , Rokisky JJr , Wikswo ME , Laco JP , Kurlekar S , Byrne A , Molinari NA , Gleason ME , Steward C , Hlavsa MC , Neises D . MMWR Morb Mortal Wkly Rep 2022 71 (31) 981-987 In June 2021, Kansas state and county public health officials identified and investigated three cases of shigellosis (a bacterial diarrheal illness caused by Shigella spp.) associated with visiting a wildlife park. The park has animal exhibits and a splash pad. Two affected persons visited animal exhibits, and all three entered the splash pad. Nonhuman primates are the only known animal reservoir of Shigella. The splash pad, which sprays water on users and is designed so that water does not collect in the user area, was closed on June 19. The state and county public health codes do not include regulations for splash pads. Thus, these venues are not typically inspected, and environmental health expertise is limited. A case-control study identified two distinct outbreaks associated with the park (a shigellosis outbreak involving 21 cases and a subsequent norovirus infection outbreak involving six cases). Shigella and norovirus can be transmitted by contaminated water; in both outbreaks, illness was associated with getting splash pad water in the mouth (multiply imputed adjusted odds ratio [aOR(MI)] = 6.4, p = 0.036; and 28.6, p = 0.006, respectively). Maintaining adequate water disinfection and environmental health expertise and targeting prevention efforts to caregivers of splash pad users help prevent splash pad-associated outbreaks. Outbreak incidence might be further reduced when U.S. jurisdicitons voluntarily adopt CDC's Model Aquatic Health Code (MAHC) recommendations and through the prevention messages: "Don't get in the water if sick with diarrhea," "Don't stand or sit above the jets," and "Don't swallow the water."(†). |
The Wildland Firefighter Exposure and Health Effect (WFFEHE) Study: Rationale, design, and methods of a repeated-measures study
Navarro KM , Butler CR , Fent K , Toennis C , Sammons D , Ramirez-Cardenas A , Clark KA , Byrne DC , Graydon PS , Hale CR , Wilkinson AF , Smith DL , Alexander-Scott MC , Pinkerton LE , Eisenberg J , Domitrovich JW . Ann Work Expo Health 2021 66 (6) 714-727 The wildland firefighter exposure and health effect (WFFEHE) study was a 2-year repeated-measures study to investigate occupational exposures and acute and subacute health effects among wildland firefighters. This manuscript describes the study rationale, design, methods, limitations, challenges, and lessons learned. The WFFEHE cohort included fire personnel ages 18-57 from six federal wildland firefighting crews in Colorado and Idaho during the 2018 and 2019 fire seasons. All wildland firefighters employed by the recruited crews were invited to participate in the study at preseason and postseason study intervals. In 2019, one of the crews also participated in a 3-day midseason study interval where workplace exposures and pre/postshift measurements were collected while at a wildland fire incident. Study components assessed cardiovascular health, pulmonary function and inflammation, kidney function, workplace exposures, and noise-induced hearing loss. Measurements included self-reported risk factors and symptoms collected through questionnaires; serum and urine biomarkers of exposure, effect, and inflammation; pulmonary function; platelet function and arterial stiffness; and audiometric testing. Throughout the study, 154 wildland firefighters participated in at least one study interval, while 144 participated in two or more study interval. This study was completed by the Centers for Disease Control and Prevention's National Institute for Occupational Safety and Health through a collaborative effort with the U.S. Department of Agriculture Forest Service, Department of the Interior National Park Service, and Skidmore College. Conducting research in the wildfire environment came with many challenges including collecting study data with study participants with changing work schedules and conducting study protocols safely and operating laboratory equipment in remote field locations. Forthcoming WFFEHE study results will contribute to the scientific evidence regarding occupational risk factors and exposures that can impact wildland firefighter health over a season and across two wildland fire seasons. This research is anticipated to lead to the development of preventive measures and policies aimed at reducing risk for wildland firefighters and aid in identifying future research needs for the wildland fire community. |
Examining Individual and Synergistic Contributions of PTSD and Genetics to Blood Pressure: A Trans-Ethnic Meta-Analysis.
Sumner JA , Maihofer AX , Michopoulos V , Rothbaum AO , Almli LM , Andreassen OA , Ashley-Koch AE , Baker DG , Beckham JC , Bradley B , Breen G , Coleman JRI , Dale AM , Dennis MF , Feeny NC , Franz CE , Garrett ME , Gillespie CF , Guffanti G , Hauser MA , Hemmings SMJ , Jovanovic T , Kimbrel NA , Kremen WS , Lawford BR , Logue MW , Lori A , Lyons MJ , Maples-Keller J , Mavissakalian MR , McGlinchey RE , Mehta D , Mellor R , Milberg W , Miller MW , Morris CP , Panizzon MS , Ressler KJ , Risbrough VB , Rothbaum BO , Roy-Byrne P , Seedat S , Smith AK , Stevens JS , van den Heuvel LL , Voisey J , Young RM , Zoellner LA , Nievergelt CM , Wolf EJ . Front Neurosci 2021 15 678503 Growing research suggests that posttraumatic stress disorder (PTSD) may be a risk factor for poor cardiovascular health, and yet our understanding of who might be at greatest risk of adverse cardiovascular outcomes after trauma is limited. In this study, we conducted the first examination of the individual and synergistic contributions of PTSD symptoms and blood pressure genetics to continuous blood pressure levels. We harnessed the power of the Psychiatric Genomics Consortium-PTSD Physical Health Working Group and investigated these associations across 11 studies of 72,224 trauma-exposed individuals of European (n = 70,870) and African (n = 1,354) ancestry. Genetic contributions to blood pressure were modeled via polygenic scores (PGS) for systolic blood pressure (SBP) and diastolic blood pressure (DBP) that were derived from a prior trans-ethnic blood pressure genome-wide association study (GWAS). Results of trans-ethnic meta-analyses revealed significant main effects of the PGS on blood pressure levels [SBP: β = 2.83, standard error (SE) = 0.06, p < 1E-20; DBP: β = 1.32, SE = 0.04, p < 1E-20]. Significant main effects of PTSD symptoms were also detected for SBP and DBP in trans-ethnic meta-analyses, though there was significant heterogeneity in these results. When including data from the largest contributing study - United Kingdom Biobank - PTSD symptoms were negatively associated with SBP levels (β = -1.46, SE = 0.44, p = 9.8E-4) and positively associated with DBP levels (β = 0.70, SE = 0.26, p = 8.1E-3). However, when excluding the United Kingdom Biobank cohort in trans-ethnic meta-analyses, there was a nominally significant positive association between PTSD symptoms and SBP levels (β = 2.81, SE = 1.13, p = 0.01); no significant association was observed for DBP (β = 0.43, SE = 0.78, p = 0.58). Blood pressure PGS did not significantly moderate the associations between PTSD symptoms and blood pressure levels in meta-analyses. Additional research is needed to better understand the extent to which PTSD is associated with high blood pressure and how genetic as well as contextual factors may play a role in influencing cardiovascular risk. |
Uncovering environmental health needs and opportunities
Byrne MK , Kayleigh Hall S , Dejarnett N , Tariq R , Gustafson M . J Environ Health 2020 83 (1) 34-37 Health departments represent the frontline of public health but how much do we really know about the professionals working there? Profiles of state and local health departments provide helpful information about health department services and programs. Detailed information about the environmental health profession, however, is beyond the scope of those assessments. | | To better understand environmental health professionals and the programs they lead, the Centers for Disease Control and Prevention's (CDC) National Center for Environmental Health, the National Environmental Health Association (NEHA), and Baylor University partnered to conduct a first of its kind assessment of this critical group within governmental health departments. The initiative became known as Understanding the Needs, Challenges, Opportunities, Vision, and Emerging Roles in Environmental Health (UNCOVER EH). Overall, the final results included responses from 1,700 environmental health professionals from governmental public health programs at state, tribal, local, and territorial levels. | | This month's column provides key takeaways from the UNCOVER EH initiative and recommendations to strengthen environmental health programs and address challenges facing the profession. |
Combining genomics and epidemiology to track mumps virus transmission in the United States.
Wohl S , Metsky HC , Schaffner SF , Piantadosi A , Burns M , Lewnard JA , Chak B , Krasilnikova LA , Siddle KJ , Matranga CB , Bankamp B , Hennigan S , Sabina B , Byrne EH , McNall RJ , Shah RR , Qu J , Park DJ , Gharib S , Fitzgerald S , Barreira P , Fleming S , Lett S , Rota PA , Madoff LC , Yozwiak NL , MacInnis BL , Smole S , Grad YH , Sabeti PC . PLoS Biol 2020 18 (2) e3000611 Unusually large outbreaks of mumps across the United States in 2016 and 2017 raised questions about the extent of mumps circulation and the relationship between these and prior outbreaks. We paired epidemiological data from public health investigations with analysis of mumps virus whole genome sequences from 201 infected individuals, focusing on Massachusetts university communities. Our analysis suggests continuous, undetected circulation of mumps locally and nationally, including multiple independent introductions into Massachusetts and into individual communities. Despite the presence of these multiple mumps virus lineages, the genomic data show that one lineage has dominated in the US since at least 2006. Widespread transmission was surprising given high vaccination rates, but we found no genetic evidence that variants arising during this outbreak contributed to vaccine escape. Viral genomic data allowed us to reconstruct mumps transmission links not evident from epidemiological data or standard single-gene surveillance efforts and also revealed connections between apparently unrelated mumps outbreaks. |
Population-based age adjustment tables for use in occupational hearing conservation programs
Flamme GA , Deiters KK , Stephenson MR , Themann CL , Murphy WJ , Byrne DC , Goldfarb DG , Zeig-Owens R , Hall C , Prezant DJ , Cone JE . Int J Audiol 2019 59 1-11 Objective: In occupational hearing conservation programmes, age adjustments may be used to subtract expected age effects. Adjustments used in the U.S. came from a small dataset and overlooked important demographic factors, ages, and stimulus frequencies. The present study derived a set of population-based age adjustment tables and validated them using a database of exposed workers.Design: Cross-sectional population-based study and retrospective longitudinal cohort study for validation.Study sample: Data from the U.S. National Health and Nutrition Examination Survey (unweighted n = 9937) were used to produce these tables. Male firefighters and emergency medical service workers (76,195 audiograms) were used for validation.Results: Cross-sectional trends implied less change with age than assumed in current U.S. regulations. Different trends were observed among people identifying with non-Hispanic Black race/ethnicity. Four age adjustment tables (age range: 18-85) were developed (women or men; non-Hispanic Black or other race/ethnicity). Validation outcomes showed that the population-based tables matched median longitudinal changes in hearing sensitivity well.Conclusions: These population-based tables provide a suitable replacement for those implemented in current U.S. regulations. These tables address a broader range of worker ages, account for differences in hearing sensitivity across race/ethnicity categories, and have been validated for men using longitudinal data. |
Public health emergency response lessons learned by Rapid Deployment Force 3, 2006-2016
Iskander J , McLanahan E , Thomas JD , Henry JB , Byrne D , Williams H . Am J Public Health 2018 108 S179-s182 Following Hurricane Katrina, the uniformed US Public Health Service created an updated system through which its officers participated in emergency responses. The Rapid Deployment Force (RDF) concept, begun in 2006, involved five teams of officers with diverse clinical and public health skill sets organized into an incident command system led by a team commander. Each team can deploy within 12 hours, according to a defined but flexible schedule. The core RDF mission is to set up and provide care for up to 250 patients, primarily persons with chronic diseases or disabilities, in a temporary federal medical station. Between 2006 and 2016, the RDF 3 team deployed multiple times in response to natural disasters and public health emergencies. Notable responses included Hurricane Sandy in 2012, the unaccompanied children mission in 2014, and the Louisiana floods in 2016. Lessons learned from the RDF 3 experience include the need for both clinical and public health capacity, the value of having special mental health resources, the benefits of collaboration with other federal medical responders, and recognition of the large burden of chronic disease management issues following natural disasters. |
Segmental variations in facet joint translations during in vivo lumbar extension
Byrne RM , Zhou Y , Zheng L , Chowdhury SK , Aiyangar A , Zhang X . J Biomech 2017 70 88-95 The lumbar facet joint (FJ) is often associated with pathogenesis in the spine, but quantification of normal FJ motion remains limited to in vitro studies or static imaging of non-functional poses. The purpose of this study was to quantify lumbar FJ kinematics in healthy individuals during functional activity with dynamic stereo radiography (DSX) imaging. Ten asymptomatic participants lifted three known weights starting from a trunk-flexed ( approximately 75 degrees ) position to an upright position while being imaged within the DSX system. High resolution computed tomography (CT) scan-derived 3D models of their lumbar vertebrae (L2-S1) were registered to the biplane 2D radiographs using a markerless model-based tracking technique providing instantaneous 3D vertebral kinematics throughout the lifting tasks. Effects of segment level and weight lifted were assessed using mixed-effect repeated measures ANOVA. Superior-inferior (SI) translation dominated FJ translation, with L5S1 showing significantly less translation magnitudes (Median (Md) = 3.5 mm, p < 0.0001) than L2L3, L3L4, and L4L5 segments (Md = 5.9 mm, 6.3 mm and 6.6 mm respectively). Linear regression-based slopes of continuous facet translations revealed strong linearity for SI translation (r2>0.94), reasonably high linearity for sideways sliding (Z-) (r2>0.8), but much less linearity for facet gap change (X-) (r2 approximately 0.5). Caudal segments (L4-S1), particularly L5S1, displayed greater coupling compared to cranial (L2-L4) segments, revealing distinct differences overall in FJ translation trends at L5S1. No significant effect of weight lifted on FJ translations was detected. The study presents a hitherto unavailable and highly precise baseline dataset of facet translations measured during a functional, dynamic lifting task. |
Inter-laboratory comparison of three earplug fit-test systems
Byrne DC , Murphy WJ , Krieg EF , Ghent RM , Michael KL , Stefanson EW , Ahroon WA . J Occup Environ Hyg 2016 14 (4) 294-305 The National Institute for Occupational Safety and Health (NIOSH) sponsored tests of three earplug fit-test systems (NIOSH HPD Well-Fit, Michael & Associates FitCheck, and Honeywell Safety Products VeriPRO(R)). Each system was compared to laboratory-based real-ear attenuation at threshold (REAT) measurements in a sound field according to ANSI/ASA S12.6-2008 at the NIOSH, Honeywell Safety Products, and Michael & Associates testing laboratories. An identical study was conducted independently at the U.S. Army Aeromedical Research Laboratory (USAARL), which provided their data for inclusion in this report. The Howard Leight Airsoft premolded earplug was tested with twenty subjects at each of the four participating laboratories. The occluded fit of the earplug was maintained during testing with a soundfield-based laboratory REAT system as well as all three headphone-based fit-test systems. The Michael & Associates lab had highest average A-weighted attenuations and smallest standard deviations. The NIOSH lab had the lowest average attenuations and the largest standard deviations. Differences in octave-band attenuations between each fit-test system and the American National Standards Institute (ANSI) sound field method were calculated (Attenfit-test - AttenANSI). A-weighted attenuations measured with FitCheck and HPD Well-Fit systems demonstrated approximately +/-2 dB agreement with the ANSI sound field method, but A-weighted attenuations measured with the VeriPRO system underestimated the ANSI laboratory attenuations. For each of the fit-test systems, the average A-weighted attenuation across the four laboratories was not significantly greater than the average of the ANSI sound field method. Standard deviations for residual attenuation differences were about +/-2 dB for FitCheck and HPD Well-Fit compared to +/-4 dB for VeriPRO. Individual labs exhibited a range of agreement from less than a dB to as much as 9.4 dB difference with ANSI and REAT estimates. Factors such as the experience of study participants and test administrators, and the fit-test psychometric tasks are suggested as possible contributors to the observed results. |
Comment on "Concerns with amplitude variation in calibrated audiometer systems in clinical simulations"
Byrne DC , Themann CL , Stephenson MR . Noise Health 2015 17 (76) 172 Barlow and colleagues addressed the important question of variation in pure-tone audiometric thresholds within and across audiometers in their article entitled “Concerns with Amplitude Variation in Calibrated Audiometer Systems in Clinical Simulations.”[1] We agree that the reliability of thresholds obtained across test systems and individuals is a vital concern when monitoring hearing health. However, we believe that a few important details are missing, which limits the validity of this study. | The authors reported, “Each of the audiometers had recently undergone certified traceable calibration by its recommended laboratory, meaning that the tone presentation from each should theoretically be identical” [page 300]. Ideally, this would be the case; however, it is not necessarily true. An audiometer is considered “in calibration” when its output is within a certain tolerance range. The International Electrotechnical Commission (IEC) 60645-1 standard allows a deviation of ± 3.7 dB from the indicated value at test frequencies from 125 Hz through 4000 Hz, and ±6.2 dB up to and including 8000 Hz. This means, for example, that an audiometer set to generate a 50-dB HL tone at 6000 Hz could produce anywhere from 43.8 dB HL to 56.2 dB HL and be considered “in calibration.” In some cases, the ±3.7 dB calibration tolerance (i.e., 7.4 dB range) at frequencies below 6000 Hz is close to the range of variation reported for the audiometers in this study. Without verifying that all four audiometers actually produced identical outputs, the measured differences cannot be assumed to be solely due to earphone placement. (Note: The allowable deviation according to American National Standards Institute (ANSI) standard S3.6 is ±3 dB at test frequencies from 125 Hz through 5000 Hz, and ± 5 dB at 6000 Hz and higher.) |
Scientific rigor required for a re-examination of exchange rate for occupational noise measurements Re: Dobie, R.A., & Clark, W.W. (2014) Exchange rates for intermittent and fluctuating occupational noise: a systematic review of studies of human permanent threshold shift, Ear Hear, 35, 86-96
Morata TC , Themann CL , Byrne DC , Davis RR , Murphy WJ , Stephenson MR . Ear Hear 2015 36 (4) 488-91 Dobie and Clark’s recent article “Exchange rates for intermittent and fluctuating occupational noise: A systematic review of studies of human permanent threshold shift” aimed to compare the suitability of a 3-dB versus 5-dB exchange rate (ER) in predicting hearing loss from non-impulsive intermittent or fluctuating noise exposures by reviewing studies of human noise-induced permanent threshold shift. The authors concluded that 3-dB ER systematically overestimates the risk of noise-induced hearing loss for intermittent or fluctuating noise. We contend that the authors did not arrive at their conclusions through an appropriate investigation. The article used flawed methodologies in the treatment and analysis of the data/studies and drew conclusions that were not substantiated by the cited data. | The authors indicated that their review did not aim to make recommendations for regulation of occupational noise, but suggested that their review provided evidence for a re-examination of recommendations in their concluding remarks. The National Institute for Occupational Safety and Health (NIOSH) maintains its recommendation of the 3-dB ER to provide sufficient protection for the many variations of continuous, intermittent and fluctuating noise exposure scenarios encountered in the workplace. In view of the advances in noise measurement and the studies’ other weaknesses, we question the suitability of revisiting a narrow segment of the human evidence (excluding robust animal studies and temporary threshold shift studies) based on outdated methodologies to address such an important issue. |
Early prognosis of noise-induced hearing loss: prioritising prevention over prediction
Themann CL , Byrne DC , Davis RR , Morata TC , Murphy WJ , Stephenson MR . Occup Environ Med 2014 72 (2) 83-4 Moshammer and colleagues (1) have recommended routine implementation of a temporary threshold shift (TTS) screening test to identify workers particularly at risk of developing noise-induced hearing loss (NIHL) from occupational exposure to hazardous noise. Their work addresses an important occupational health problem. NIHL ranks among the most common work-related injuries in many countries, with an estimated global annual incidence of 1.6 million cases and accounting for approximately 16% of disabling adult hearing losses worldwide (2,3). Individuals vary in their susceptibility to the damaging effects of noise and no suitable method currently exists to predict the susceptibility of a particular worker. | In their study, Moshammer et al. measured TTS in newly-hired employees following exposure to a 20-minute, high intensity, low frequency experimental noise. They then followed the workers over time to see who ultimately developed a permanent threshold shift (PTS). The authors report that a TTS of 14 dB or more measured 2.5 minutes after the experimental exposure identifies workers at greater risk for PTS. They recommend routinely using this procedure to screen for susceptibility to noise in workplace hearing loss prevention programs. | However, this recommendation is premature in view of the study results. The TTS measure had a sensitivity of 82%, meaning that 18% of those who developed PTS were not identified by the TTS screening – a high false negative rate, particularly as we already know how to prevent PTS through reduction of noise exposures and consistent use of properly-fit hearing protection. Specificity was 70% at best, corresponding to a false positive rate 30%. If this procedure were implemented, approximately a third of the workers would be told that they are particularly at risk for NIHL when they aren’t, raising unnecessary alarm and opening the door to potential discrimination in work assignments, promotions, etc. |
Burkholderia pseudomallei isolates in 2 pet iguanas, California, USA
Zehnder AM , Hawkins MG , Koski MA , Lifland B , Byrne BA , Swanson AA , Rood MP , Gee JE , Elrod MG , Beesley CA , Blaney DD , Ventura J , Hoffmaster AR , Beeler ES . Emerg Infect Dis 2014 20 (2) 304-6 Burkholderia pseudomallei, the causative agent of melioidosis, was isolated from abscesses of 2 pet green iguanas in California, USA. The international trade in iguanas may contribute to importation of this pathogen into countries where it is not endemic and put persons exposed to these animals at risk for infection. |
Population-based surveillance for cervical cancer precursors in three central cancer registries, United States 2009
Flagg EW , Datta SD , Saraiya M , Unger ER , Peters E , Cole L , Chen VW , Tucker T , Byrne MJ , Copeland G , Silva W , Watson M , Weinstock H . Cancer Causes Control 2014 25 (5) 571-81 PURPOSE: The USA has a well-established network of central cancer registries (CCRs) that collect data using standardized definitions and protocols to provide population-based estimates of cancer incidence. The addition of cervical cancer precursors in select CCR operations would facilitate future studies measuring the population-level impact of human papillomavirus (HPV) vaccine. To assess the feasibility of collecting data on cervical cancer precursors, we conducted a multi-site surveillance study in three state-wide CCRs, to obtain annual case counts and compare rates of precursor lesions to those for invasive cervical cancer. METHODS: We developed standardized methods for case identification, data collection and transmission, training and quality assurance, while allowing for registry-specific strategies to accomplish surveillance objectives. We then conducted population-based surveillance for precancerous cervical lesions in three states using the protocols. RESULTS: We identified 5,718 cases of cervical cancer precursors during 2009. Age-adjusted incidence of cervical cancer precursors was 77 (Kentucky), 60 (Michigan), and 54 (Louisiana) per 100,000 women. Highest rates were observed in those aged 20-29 years: 274 (Kentucky), 202 (Michigan), and 196 (Louisiana) per 100,000. The variable with the most missing data was race/ethnicity, which was missing for 13 % of cases in Kentucky, 18 % in Michigan, and 1 % in Louisiana. Overall rates of cervical cancer precursors were over sixfold higher than invasive cervical cancer rates [rate ratios: 8.6 (Kentucky), 8.3 (Michigan), and 6.2 (Louisiana)]. CONCLUSIONS: Incorporating surveillance of cervical cancer precursors using existing CCR infrastructure is feasible and results in collection of population-based incidence data. Standardized collection of these data in high-quality registry systems will be useful in future activities monitoring the impact of HPV vaccination across states. As a result of this study, ongoing surveillance of these lesions has now been conducted in four CCRs since 2010. |
Culture shift: strengthening the role of environmental health in public health performance improvement efforts
Price JR , Grigg CM , Byrne MK . J Environ Health 2013 76 (3) 48-51 NEHA strives to provide up-to-date and relevant information on environmental health and to build partnerships in the profession. In pursuit of these goals, we feature a column from the Environmental Health Services Branch (EHSB) of the Centers for Disease Control and Prevention (CDC) in every issue of theJournal. In this column, EHSB and guest authors from across CDC will highlight a variety of concerns, opportunities, challenges, and successes that we all share in environmental public health. EHSB's objective is to strengthen the role of state, local, tribal, and national environmental health programs and professionals to anticipate, identify, and respond to adverse environmental exposures and the consequences of these exposures for human health. |
Noise impacts from professional dog grooming forced-air dryers
Scheifele PM , Johnson MT , Byrne DC , Clark JG , Vandlik A , Kretschmer LW , Sonstrom KE . Noise Health 2012 14 (60) 224-6 This study was designed to measure the sound output of four commonly used brands of forced-air dryers used by dog groomers in the United States. Many dog groomers have questions about the effect of this exposure on their hearing, as well as on the hearing of the dogs that are being groomed. Readings taken from each dryer at 1 meter (the likely distance of the dryer from the groomer and the dog) showed average levels ranging from 105.5 to 108.3 dB SPL or 94.8 to 108.0 dBA. Using the 90 dBA criterion required by the US Occupational Safety and Health Administration, dog groomers/bathers are at risk if exposure to the lowest intensity dryer (94.8 dBA) exceeds 4 hours per day. If the more stringent 85 dBA criterion and 3 dB tradeoff is applied, less than one hour of exposure is permissible in an 8 hour day. Cautions are recommended for any persons exposed to noise from forced-air dryers. |
Promoting hearing loss prevention in audiology practice
Byrne DC , Themann CL , Meinke DK , Morata TC , Stephenson MR . Perspect Pub Health Iss Rel Hear Bal 2012 13 (1) 3-19 An audiologist should be the principal provider and advocate for all hearing loss prevention activities. Many audiologists equate hearing loss prevention with industrial audiology and occupational hearing conservation programs. However, an audiologist's involvement in hearing loss prevention should not be confined to that one particular practice setting. In addition to supervising occupational programs, audiologists are uniquely qualified to raise awareness of hearing risks, organize public health campaigns, promote healthy hearing, implement intervention programs, and monitor outcomes. For example, clinical audiologists can show clients how to use inexpensive sound level meters, noise dosimeters, or phone apps to measure noise levels, and recommend appropriate hearing protection. Audiologists should identify community events that may involve hazardous exposures and propose strategies to minimize risks to hearing. Audiologists can help shape the knowledge, beliefs, motivations, attitudes, and behaviors of individuals toward self-protection. An audiologist has the education, tools, opportunity, and strategic position to facilitate or promote hearing loss surveillance and prevention services and activities. This article highlights real-world examples of the various roles and substantial contributions audiologists can make toward hearing loss prevention goals. |
Genotypic characterization of Streptococcus infantarius subsp. coli isolates from sea otters with infective endocarditis and/or septicemia and from environmental mussel samples.
Counihan-Edgar KL , Gill VA , Doroff AM , Burek KA , Miller WA , Shewmaker PL , Jang S , Goertz CE , Tuomi PA , Miller MA , Jessup DA , Byrne BA . J Clin Microbiol 2012 50 (12) 4131-3 Pulsed-field gel electrophoresis (PFGE) was used to type 128 Streptococcus infantarius subsp. coli isolates from sea otters and mussels. Six SmaI PFGE groups were detected, with one predominant group representing 57% of the isolates collected over a wide geographic region. Several sea otter and mussel isolates were highly related, suggesting that an environmental infection source is possible. |
Comparison of speech intelligibility measures for an electronic amplifying earmuff and an identical passive attenuation device
Byrne DC , Palmer CV . Audiol Res 2012 2 (1) 17-24 The purpose of this study was to identify any differences between speech intelligibility measures obtained with MineEars electronic earmuffs (ProEars, Westcliffe, CO, USA) and the Bilsom model 847 (Sperian Hearing Protection, San Diego, CA, USA), which is a conventional passive-attenuation earmuff. These two devices are closely related, since the MineEars device consisted of a Bilsom 847 earmuff with the addition of electronic amplification circuits. Intelligibility scores were obtained by conducting listening tests with 15 normalhearing human subject volunteers wearing the earmuffs. The primary research objective was to determine whether speech understanding differs between the passive earmuffs and the electronic earmuffs (with the volume control set at three different positions) in a background of 90 dB(A) continuous noise. As expected, results showed that speech intelligibility increased with higher speech-to-noise ratios; however, the electronic earmuff with the volume control set at full-on performed worse than when it was set to off or the lowest on setting. This finding suggests that the maximum volume control setting for these electronic earmuffs may not provide any benefits in terms of increased speech intelligibility in the background noise condition that was tested. Other volume control settings would need to be evaluated for their ability to produce higher speech intelligibility scores. Additionally, since an extensive electro-acoustic evaluation of the electronic earmuff was not performed as a part of this study, the exact cause of the reduced intelligibility scores at full volume remains unknown. | |
Acceptance of a semi-custom hearing protector by manufacturing workers
Davis RR , Murphy WJ , Byrne DC , Shaw PB . J Occup Environ Hyg 2011 8 (12) D125-30 Workers complain about wearing hearing protection for two primary reasons: comfort and communication.(1) Employers are concerned about hearing protection costs. Recent advances in hearing protector technology seemed to address those issues through a semi-custom earplug. This new device was designed to prevent overprotection by incorporating only enough attenuation to bring the worker down into the safe exposure zone. Although initially more expensive than disposable hearing protection devices (HPDs), the semi-custom hearing protector would be expected to last several years. | The Hearing Loss Prevention Team of the National Institute for Occupational Safety and Health (NIOSH) was invited by a major auto manufacturing company and the union (UAW) to supervise a longitudinal trial of a semi-custom hearing protector (SonoCustom by Sonomax Technologies, Inc.,Montreal, Canada). This protectorwas advertised as (1) being more comfortable since each plug was custom molded for each worker, and (2) more effective because each plug’s noise reduction rating was tuned to that worker’s particular job. The company’s hearing conservation contractor partnered with NIOSH by recruiting volunteers for the study and providing follow-up usage reports. The study was conducted over the course of 1 year with NIOSH site visits at the start, at 1 month, at 4 months, and at 1-year time intervals. The goal of this trial was to determine worker acceptance of the semi-custom earplug. | Compared with the non-custom earplugs used in this study, the SonoCustom ear plugs were relatively new to the market and have not been extensively investigated in the literature. Initial studies have focused on a new way to measure and model the acoustical performance.(2–4) Wagoner et al.(5) studied speech intelligibility and attenuation while subjects wore the SonoCustom earplugs or two other non-custom, commercially available hearing protectors in laboratory tests and in the field. In the laboratory they were not able to find any statistically significant difference, between the three earplugs, for speech intelligibility or attenuation. Regarding comfort issues, they briefly mentioned that the two non-custom HPDs were judged by the workers to be more comfortable and easier to use than the SonoCustom earplug. |
Comparison of the HPDLab and REATMaster software/hardware systems for ANSI S12.6 testing
Byrne DC , Perry CC , Murphy WJ . J Acoust Soc Am 2011 130 (4) 2434 The American National Standard Methods for Measuring the Real-Ear Attenuation of Hearing Protectors (ANSI S12.6-2008) requires a Bekesy procedure for testing occluded and unoccluded thresholds. Since 2002, the National Institute for Occupational Safety and Health (NIOSH) has used the custom-designed HPDLab software operating Tucker-Davis Technologies System 3 hardware. ViAcoustics, Nelson Acoustics, NASA, and NIOSH researchers recently developed REATMaster which runs on National Instruments hardware in the LabVIEW environment. Ten subjects were trained by the experimenter on how to fit a passive earmuff and were qualified according to the requirements of ANSI S12.6-2008. The laboratory was configured such that diffuse sound field thresholds were tested with either the HPDLab or REATmaster hardware by flipping a toggle switch. The earmuff was not touched or re-positioned between test trials with the two different hardware/software systems. The test sequence for the order of open and occluded measurements was counterbalanced across occluded conditions and hardware system. Results from this testing were used to validate the REATMaster system for its ability to produce accurate threshold data. Preliminary results indicate no significant differences between the two systems. |
Measuring, rating, and comparing the real ear attenuation at threshold of four earplugs
Murphy WJ , Stephenson MR , Byrne DC . J Acoust Soc Am 2011 130 (4) 2435 The effect of training instruction, whether presented as the manufacturer's printed instructions, a short video training session, specific to the product, or as a one-on-one training session, was evaluated using four hearing protection devices with eight groups of subjects. The Howard Leight Fusion and Airsoft premolded earplugs and the Moldex PuraFit and EAR Classic foam earplugs were tested. Naive subjects were recruited and tested using three different forms of training: written, video, and individual training. The differences between group averages for A-weighted attenuation were not statistically significant when compared between the video or the written instruction conditions, regardless of presentation order. The experimenter- trained A-weighted attenuations were significantly greater than the written and video instruction for most of the protectors and groups. For each earplug, the noise reduction statistic for A-weighting (NRSA) and the associated confidence intervals were calculated for the 90th and 10th percentiles of protection. Across subject groups for each protector, the differences between NRSA ratings were found to be not statistically significant. Several comparisons evaluating the order of testing, the type of testing, and statistical tests of the performance across the groups are presented. [Portions of this work were supported by the U.S. EPA Interagency Agreement DW75921973-01-0.]. |
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