Last data update: Nov 04, 2024. (Total: 48056 publications since 2009)
Records 1-9 (of 9 Records) |
Query Trace: Laco JP[original query] |
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Assessing state partner use of the Model Aquatic Health Code (MAHC): A cross comparison of five states with varying degrees of self-reported adoption status
Kelen PV , Laco JP , McClenahan S , Fletcher C , Hubbard B . PLOS Water 2024 3 Despite the development of the Model Aquatic Health Code (MAHC), U.S. public health departments and aquatics agencies face obstacles in incorporating this guidance into their pool codes. A cross comparison of five state pool codes with the MAHC was conducted to quantify MAHC incorporation into these state codes. The proportion of MAHC code agreement with state codes in this study had a range of 14%–86%. Only 2% of all the MAHC codes available were present in all five state codes, conversely, 12% of the MAHC codes were not found in any state. These differences in code agreement highlight the challenge of measuring MAHC effectiveness at the national level. To improve aquatic safety at a national level, a potential solution is development and use of common core elements in state and local pool codes. Once there is a basis for code comparisons across states, public health programs can investigate whether core MAHC codes result in reduced waterborne illness outbreaks, drowning incidents, injuries from pool chemicals, health outcomes from exposure to disinfection by-products, and swimming-related emergency department visits. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. |
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."(†). |
Tools from the Centers for Disease Control and Prevention to help prevent pathogen transmission in increased risk aquatic venues
Laco JP , Aluko S , Hlavsa MC . J Environ Health 2022 84 (9) 32-33 The article discusses the launch of the Model Aquatic Health Code (MAHC) by the U.S. Centers for Disease Control and Prevention to enhance the safety and health of aquatic venues. Topics mentioned include the inclusion of guidelines and best practices about the prevention of pathogen transmission, illness and injury in the code, the MACH definition of splash pad and wading pool, and other web sites that can help prevent transmission of pathogens in public pools and water playgrounds. |
Strengthening Aquatic Health and Safety: How a Pilot Program Supported Local Health Departments in Updating Pool Codes
D'Angelo EK , Galan DI , Laco JP , Fink T , Skaggs JM , Kunsman C , Warren E . J Public Health Manag Pract 2021 27 (4) 428-431 Aquatic activities play an important role for many when it comes to living a healthy lifestyle. Not only is swimming great exercise, it can help to maintain health among people living with chronic conditions such as arthritis, diabetes, and heart disease.1 However, despite the health benefits, there are many risks associated with aquatic activities. The Centers for Disease Control and Prevention (CDC) estimates that approximately 3,500 unintentional drownings occur annually in the United States, with children aged one to four having the highest drowning rates.2 Pool chemical injuries in the United States lead to over 4,500 emergency department visits annually, despite being preventable with proper education and safety equipment.3 |
Outbreaks Associated with Treated Recreational Water - United States, 2015-2019
Hlavsa MC , Aluko SK , Miller AD , Person J , Gerdes ME , Lee S , Laco JP , Hannapel EJ , Hill VR . MMWR Morb Mortal Wkly Rep 2021 70 (20) 733-738 Outbreaks associated with treated recreational water can be caused by pathogens or chemicals in aquatic venues such as pools, hot tubs, water playgrounds, or other artificially constructed structures that are intended for recreational or therapeutic purposes. For the pseriod 2015-2019, public health officials from 36 states and the District of Columbia (DC) voluntarily reported 208 outbreaks associated with treated recreational water. Almost all (199; 96%) of the outbreaks were associated with public (nonbackyard) pools, hot tubs, or water playgrounds. These outbreaks resulted in at least 3,646 cases of illness, 286 hospitalizations, and 13 deaths. Among the 155 (75%) outbreaks with a confirmed infectious etiology, 76 (49%) were caused by Cryptosporidium (which causes cryptosporidiosis, a gastrointestinal illness) and 65 (42%) by Legionella (which causes Legionnaires' disease, a severe pneumonia, and Pontiac fever, a milder illness with flu-like symptoms). Cryptosporidium accounted for 2,492 (84%) of 2,953 cases resulting from the 155 outbreaks with a confirmed etiology. All 13 deaths occurred in persons affected by a Legionnaires' disease outbreak. Among the 208 outbreaks, 71 (34%) were associated with a hotel (i.e., hotel, motel, lodge, or inn) or a resort, and 107 (51%) started during June-August. Implementing recommendations in CDC's Model Aquatic Health Code (MAHC) (1) can help prevent outbreaks associated with treated recreational water in public aquatic venues. |
Outbreaks associated with untreated recreational water - California, Maine, and Minnesota, 2018-2019
Vanden Esschert KL , Mattioli MC , Hilborn ED , Roberts VA , Yu AT , Lamba K , Arzaga G , Zahn M , Marsh Z , Combes SM , Smith ES , Robinson TJ , Gretsch SR , Laco JP , Wikswo ME , Miller AD , Tack DM , Wade TJ , Hlavsa MC . MMWR Morb Mortal Wkly Rep 2020 69 (25) 781-783 Outbreaks associated with fresh or marine (i.e., untreated) recreational water can be caused by pathogens or chemicals, including toxins. Voluntary reporting of these outbreaks to CDC's National Outbreak Reporting System (NORS) began in 2009. NORS data for 2009-2017 are finalized, and data for 2018-2019 are provisional. During 2009-2019 (as of May 13, 2020), public health officials from 31 states voluntarily reported 119 untreated recreational water-associated outbreaks, resulting at least 5,240 cases; 103 of the outbreaks (87%) started during June-August. Among the 119 outbreaks, 88 (74%) had confirmed etiologies. The leading etiologies were enteric pathogens: norovirus (19 [22%] outbreaks; 1,858 cases); Shiga toxin-producing Escherichia coli (STEC) (19 [22%]; 240), Cryptosporidium (17 [19%]; 237), and Shigella (14 [16%]; 713). This report highlights three examples of outbreaks that occurred during 2018-2019, were caused by leading etiologies (Shigella, norovirus, or STEC), and demonstrate the wide geographic distribution of such outbreaks across the United States. Detection and investigation of untreated recreational water-associated outbreaks are challenging, and the sources of these outbreaks often are not identified. Tools for controlling and preventing transmission of enteric pathogens through untreated recreational water include epidemiologic investigations, regular monitoring of water quality (i.e., testing for fecal indicator bacteria), microbial source tracking, and health policy and communications (e.g., observing beach closure signs and not swimming while ill with diarrhea). |
Environmental health practice challenges and research needs for U.S. health departments
Brooks BW , Gerding JA , Landeen E , Bradley E , Callahan T , Cushing S , Hailu F , Hall N , Hatch T , Jurries S , Kalis MA , Kelly KR , Laco JP , Lemin N , McInnes C , Olsen G , Stratman R , White C , Wille S , Sarisky J . Environ Health Perspect 2019 127 (12) 125001 BACKGROUND: Environmental health (EH) professionals, one of the largest segments of the public health workforce, are responsible for delivery of essential environmental public health services. The challenges facing these professionals and research needs to improve EH practice are not fully understood, but 26% of EH professionals working in health departments of the United States plan to retire in 5 y, while only 6% of public health students are currently pursuing EH concentrations. OBJECTIVES: A groundbreaking initiative was recently launched to understand EH practice in health departments of the United States. This commentary article aims to identify priority EH practice challenges and related research needs for health departments. METHODS: A horizon scanning approach was conducted in which challenges facing EH professionals were provided by 1,736 respondents working at health departments who responded to a web-based survey fielded in November 2017. Thematic analyses of the responses and determining the frequency at which respondents reported specific issues and opportunities identified primary EH topic areas. These topic areas and related issues informed focus group discussions at an in-person workshop held in Anaheim, California. The purpose of the in-person workshop was to engage each of the topic areas and issues, through facilitated focus groups, leading to the formation of four to five related problem statements for each EH topic. DISCUSSION: EH professionals are strategically positioned to diagnose, intervene, and prevent public health threats. Focus group engagement resulted in 29 priority problem statements partitioned among 6 EH topic areas: a) drinking water quality, b) wastewater management, c) healthy homes, d) food safety, e) vectors and public health pests, and f) emerging issues. This commentary article identifies priority challenges and related research needs to catalyze effective delivery of essential environmental public health services for common EH program areas in health departments. An unprecedented initiative to revitalize EH practice with timely and strategic recommendations for student and professional training, nontraditional partnerships, and basic and translational research activities is recommended. https://doi.org/10.1289/EHP5161. |
Pool chemical injuries in public and residential settings - United States, 2008-2017, and New York, 2018
Vanden Esschert KL , Haileyesus T , Tarrier AL , Donovan MA , Garofalo GT , Laco JP , Hill VR , Hlavsa MC . MMWR Morb Mortal Wkly Rep 2019 68 (19) 433-438 Pool chemicals are added to water in treated recreational water venues (e.g., pools, hot tubs/spas, and water playgrounds) primarily to protect public health. Pool chemicals inactivate pathogens (e.g., chlorine or bromine), optimize pH (e.g., muriatic acid), and increase water clarity, which helps prevent drowning by enabling detection of distressed swimmers underwater. However, pool chemicals can cause injuries if mishandled. To estimate the annual number of U.S. emergency department (ED) visits for pool chemical injuries, CDC analyzed 2008-2017 data from the National Electronic Injury Surveillance System (NEISS), operated by the U.S. Consumer Product Safety Commission (CPSC). During 2015-2017, pool chemical injuries led to an estimated 13,508 (95% confidence interval [CI] = 9,087-17,929) U.S. ED visits; 36.4% (estimated 4,917 [95% CI = 3,022-6,811]) of patients were aged <18 years. At least 56.3% (estimated 7,601 [95% CI = 4,587-10,615]) of injuries occurred at a residence. Two thirds of the injuries occurred during the period from Memorial Day weekend through Labor Day. This report also describes a toxic chlorine gas incident that occurred at a public pool in New York in 2018. Pool chemical injuries are preventable. CDC's Model Aquatic Health Code (MAHC) is an important resource that operators of public treated recreational water venues (e.g., at hotels, apartment complexes, and waterparks) can use to prevent pool chemical injuries. |
Good pool chemistry keeps swimming healthy and safe
Hlavsa MC , Laco JP , Hill VR . J Environ Health 2019 81 (9) 32-34 Many pool chemicals are used to protect the health and safety of swimmers and aquatics staff. For example, to help prevent outbreaks of infectious diseases, chlorine or bromine is added as a barrier to pathogen transmission. Muriatic (hydrochloric) acid is added to maintain pH at 7.2–7.8. Clarifiers are added to maximize water clarity, which enable lifeguards and others to identify distressed swimmers underwater and help prevent drownings. | | Maximizing the positive public health impact of pool chemicals calls for minimizing the risk of pool chemical injuries. State and local environmental health practitioners are on the frontline of prevention through educating pool operators about pool chemical safety, inspecting on pool code elements that minimize the risk of pool chemical injuries, investigating pool chemical injuries to identify their root cause(s), and informing the development of optimized measures to prevent future events. This month's column looks at pool chemical injuries and how they can be prevented. |
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- Page last updated:Nov 04, 2024
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