Last data update: Sep 23, 2024. (Total: 47723 publications since 2009)
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Deaths and years of potential life lost from excessive alcohol use - United States, 2011-2015
Esser MB , Sherk A , Liu Y , Naimi TS , Stockwell T , Stahre M , Kanny D , Landen M , Saitz R , Brewer RD . MMWR Morb Mortal Wkly Rep 2020 69 (39) 1428-1433 Excessive alcohol use is a leading cause of preventable death in the United States (1) and costs associated with it, such as those from losses in workplace productivity, health care expenditures, and criminal justice, were $249 billion in 2010 (2). CDC used the Alcohol-Related Disease Impact (ARDI) application* to estimate national and state average annual alcohol-attributable deaths and years of potential life lost (YPLL) during 2011-2015, including deaths from one's own excessive drinking (e.g., liver disease) and from others' drinking (e.g., passengers killed in alcohol-related motor vehicle crashes). This study found an average of 95,158 alcohol-attributable deaths (261 deaths per day) and 2.8 million YPLL (29 years of life lost per death, on average) in the United States each year. Of all alcohol-attributable deaths, 51,078 (53.7%) were caused by chronic conditions, and 52,921 (55.6%) involved adults aged 35-64 years. Age-adjusted alcohol-attributable deaths per 100,000 population ranged from 20.8 in New York to 53.1 in New Mexico. YPLL per 100,000 population ranged from 631.9 in New York to 1,683.5 in New Mexico. Implementation of effective strategies for preventing excessive drinking, including those recommended by the Community Preventive Services Task Force (e.g., increasing alcohol taxes and regulating the number and concentration of alcohol outlets), could reduce alcohol-attributable deaths and YPLL.(†). |
Characteristics of a multistate outbreak of lung injury associated with e-cigarette use, or vaping - United States, 2019
Perrine CG , Pickens CM , Boehmer TK , King BA , Jones CM , DeSisto CL , Duca LM , Lekiachvili A , Kenemer B , Shamout M , Landen MG , Lynfield R , Ghinai I , Heinzerling A , Lewis N , Pray IW , Tanz LJ , Patel A , Briss PA . MMWR Morb Mortal Wkly Rep 2019 68 (39) 860-864 Electronic cigarettes (e-cigarettes), also called vapes, e-hookas, vape pens, tank systems, mods, and electronic nicotine delivery systems (ENDS), are electronic devices that produce an aerosol by heating a liquid typically containing nicotine, flavorings, and other additives; users inhale this aerosol into their lungs (1). E-cigarettes also can be used to deliver tetrahydrocannabinol (THC), the principal psychoactive component of cannabis (1). Use of e-cigarettes is commonly called vaping. Lung injury associated with e-cigarette use, or vaping, has recently been reported in most states (2-4). CDC, the Food and Drug Administration (FDA), state and local health departments, and others are investigating this outbreak. This report provides data on patterns of the outbreak and characteristics of patients, including sex, age, and selected substances used in e-cigarette, or vaping, products reported to CDC as part of this ongoing multistate investigation. As of September 24, 2019, 46 state health departments and one territorial health department had reported 805 patients with cases of lung injury associated with use of e-cigarette, or vaping, products to CDC. Sixty-nine percent of patients were males, and the median age was 23 years (range = 13-72 years). To date, 12 deaths have been confirmed in 10 states. Among 514 patients with information on substances used in e-cigarettes, or vaping products, in the 30 days preceding symptom onset, 76.9% reported using THC-containing products, and 56.8% reported using nicotine-containing products; 36.0% reported exclusive use of THC-containing products, and 16.0% reported exclusive use of nicotine-containing products. The specific chemical exposure(s) causing the outbreak is currently unknown. While this investigation is ongoing, CDC recommends that persons consider refraining from using e-cigarette, or vaping, products, particularly those containing THC. CDC will continue to work in collaboration with FDA and state and local partners to investigate cases and advise and alert the public on the investigation as additional information becomes available. |
Recognition and response to opioid overdose deaths-New Mexico, 2012
Levy B , Spelke B , Paulozzi LJ , Bell JM , Nolte KB , Lathrop S , Sugerman DE , Landen M . Drug Alcohol Depend 2016 167 29-35 PURPOSE: Drug overdose deaths are epidemic in the U.S. Prescription opioid pain relievers (OPR) and heroin account for the majority of drug overdoses. Preventing death after an opioid overdose by naloxone administration requires the rapid identification of the overdose by witnesses. This study used a state medical examiner database to characterize fatal overdoses, evaluate witness-reported signs of overdose, and identify opportunities for intervention. METHODS: We reviewed all unintentional drug overdose deaths that occurred in New Mexico during 2012. Data were abstracted from medical examiner records at the New Mexico Office of the Medical Investigator. We compared mutually exclusive groups of OPR and heroin-related deaths. RESULTS: Of the 489 overdose deaths reviewed, 49.3% involved OPR, 21.7% involved heroin, 4.7% involved a mixture of OPR and heroin, and 24.3% involved only non-opioid substances. The majority of OPR-related deaths occurred in non-Hispanic whites (57.3%), men (58.5%), persons aged 40-59 years (55.2%), and those with chronic medical conditions (89.2%). Most overdose deaths occurred in the home (68.7%) and in the presence of bystanders (67.7%). OPR and heroin deaths did not differ with respect to paramedic dispatch and CPR delivery, however, heroin overdoses received naloxone twice as often (20.8% heroin vs. 10.0% OPR; p<0.01). CONCLUSION: OPR overdose deaths differed by age, health status, and the presence of bystanders, yet received naloxone less often when compared to heroin overdose deaths. These findings suggest that naloxone education and distribution should be targeted in future prevention efforts. |
Using hospital inpatient discharge data to supplement active surveillance for invasive pneumococcal disease: is the extract worth the exertion?
Nichols MC , Bareta J , Coyle A , Landen M . Public Health Rep 2016 131 (3) 404-410 Objective. Invasive pneumococcal disease (IPD) surveillance systems monitor morbidity, mortality, and vaccine impact; accurate surveillance is important to detect changes in epidemiology. We evaluated completeness of IPD reporting in New Mexico by comparing data from the Hospital Inpatient Discharge Database (HIDD) and the New Mexico Active Bacterial Core Surveillance (ABCs) program. Methods. We linked data from the HIDD and the ABCs program. We defined cases of IPD in the HIDD among New Mexico residents with hospitalizations during 2007–2009 as specific (320.1 or 038.2) or nonspecific (481, 320.2, or 041.2) using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. To validate if HIDD records that could not be matched to ABCs data were true IPD cases, we reviewed laboratory data and determined if Streptococcus pneumoniae (S. pneumoniae) had been isolated from a sterile body site. Results. We examined 732 HIDD records for cases that were not matched in the ABCs database; of such records, S. pneumoniae was isolated from a sterile body site in 10 HIDD records. Conclusion. ABCs data detected the majority of IPD cases in New Mexico. Laboratory and medical record review is essential when using HIDD data because ICD-9-CM coding alone does not ensure data accuracy. The addition of IPD cases to the ABCs program from the HIDD was minimally beneficial to active surveillance and reporting completeness in New Mexico. States that rely exclusively on passive reporting and that have access to HIDD data might use linkages of pneumococcal and IPD-specific ICD-9-CM–coded HIDD data to improve IPD surveillance and case ascertainment. © 2016, Association of Schools of Public Health. All rights reserved. |
A case-control study of risk factors for death from 2009 pandemic influenza A(H1N1): is American Indian racial status an independent risk factor?
Hennessy TW , Bruden D , Castrodale L , Komatsu K , Erhart LM , Thompson D , Bradley K , O'Leary DR , Mc Laughlin J , Landen M . Epidemiol Infect 2015 144 (2) 1-10 Historically, American Indian/Alaska Native (AI/AN) populations have suffered excess morbidity and mortality from influenza. We investigated the risk factors for death from 2009 pandemic influenza A(H1N1) in persons residing in five states with substantial AI/AN populations. We conducted a case-control investigation using pandemic influenza fatalities from 2009 in Alaska, Arizona, New Mexico, Oklahoma and Wyoming. Controls were outpatients with influenza. We reviewed medical records and interviewed case proxies and controls. We used multiple imputation to predict missing data and multivariable conditional logistic regression to determine risk factors. We included 145 fatal cases and 236 controls; 22% of cases were AI/AN. Risk factors (P 45 years vs. <18 years], pre-existing medical conditions (mOR 7.1), smoking (mOR 3.0), delayed receipt of antivirals (mOR 6.5), and barriers to healthcare access (mOR 5.3). AI/AN race was not significantly associated with death. The increased influenza mortality in AI/AN individuals was due to factors other than racial status. Prevention of influenza deaths should focus on modifiable factors (smoking, early antiviral use, access to care) and identifying high-risk persons for immunization and prompt medical attention. |
Incidence of notifiable diseases among American Indians/Alaska Natives - United States, 2007-2011
Adekoya N , Truman B , Landen M . MMWR Morb Mortal Wkly Rep 2015 64 (1) 16-19 American Indian/Alaska Native (AI/AN) populations experience substantial disparities in the incidence of multiple diseases compared with other racial/ethnic groups in the United States. A major goal of Healthy People 2020 is to eliminate health disparities, monitor disease trends, and identify population groups and diseases for targeted interventions. High rates of certain infectious diseases continue to be a major problem facing AI/AN populations. During 1990-2011, incidence rates for some infectious diseases declined among AI/AN populations, but disparities remain and AI/AN populations are still disproportionately affected. To describe disparities in selected notifiable diseases among AI/ANs, CDC analyzed data from the National Notifiable Diseases Surveillance System (NNDSS) for 2007-2011, the most recent 5 years for which data are available. The results of this analysis of 26 infectious diseases indicate that incidence rates of 14 diseases were higher for AI/ANs than for whites. Interventions are needed to address and reduce disparities in chlamydia, gonorrhea, West Nile virus, spotted fever rickettsiosis, and other infections among AI/ANs. |
Coal workers’ pneumoconiosis prevalence disparity between Australia and the United States
Joy GL , Colinet JF , Landen DD . Min Eng 2012 64 (7) 65-71 Although rates of pneumoconiosis in coal miners have declined substantially in the United States since the passage of the Federal Coal Mine Health and Safety Act of 1969, new cases continue to occur, including cases of rapidly progressive disease. In contrast, Australia’s underground coal mining industry has reported few new cases of pneumoconiosis for more than 20 years. Mortality from coal workers’ pneumoconiosis in official health statistics and the prevalence of pneumoconiosis among miners screened in X-ray surveillance programs are also lower in Australia. The U.S. National Institute for Occupational Safety and Health (NIOSH) was requested by both industry and labor stakeholders to examine this issue, with the ultimate aim of reducing the rate of pneumoconiosis among U.S. coal miners. A number of factors, including coal dust exposure, silica exposure and coal rank were examined as potential contributors to the above noted differences. Comparison of coal rank data from each country did not illuminate the issue. Air sample data from the coal mining industries in both countries show that coal dust levels in Australian mines are somewhat higher than those reported in similar U.S. mines; however, quartz exposure for Australian miners is lower than for many U.S. miners. If quartz is contributing to the greater number of cases of pneumoconiosis in the United States, more effective dust control measures, as well as an independent exposure standard for respirable quartz in coal mining, should be implemented to reduce this potentially disabling condition. |
Group medical claims as a source of information on worker health and potentially work-related diseases
Bushnell PT , Li J , Landen D . J Occup Environ Med 2011 53 (12) 1430-41 OBJECTIVE: To help address underrecognition of occupational illnesses and support planning of workplace health initiatives. METHODS: Data from Highmark Inc., a health care insurer headquartered in Pittsburgh and Camp Hill, Pennsylvania, was used to calculate age and gender-adjusted rates of 15 diseases by industry and broad industry sector. RESULTS: Significant industry differences in disease rates were observed, some corresponding to known differences in workplace risk factors. CONCLUSION: Group medical claims offer timely, relatively low cost, longitudinal data on rates of physician-diagnosed cases and costs of many diseases for large populations. Limitations of medical claims data include inaccuracies in industry coding, lack of occupation codes, and lack of key variables that affect health. Yet, some elevated industry rates suggest potential new targets for wellness programs and evaluation of possible workplace health risks. |
A history of being prescribed controlled substances and risk of drug overdose death
Paulozzi LJ , Kilbourne EM , Shah NG , Nolte KB , Desai HA , Landen MG , Harvey W , Loring LD . Pain Med 2011 13 (1) 87-95 OBJECTIVE: The abuse of prescription drugs has increased dramatically since 1990. Persons who overdose on such drugs frequently consume large doses and visit multiple providers. The risk of fatal overdose for different patterns of use of opioid analgesics and sedative/hypnotics has not been fully quantified. DESIGN: Matched case-control study. Cases were 300 persons who died of unintentional drug overdoses in New Mexico during 2006-2008, and controls were 5,993 patients identified through the state prescription monitoring program with matching 6-month exposure periods. OUTCOME MEASURES: Death from drug overdose or death from opioid overdose. Exposures were demographic variables and characteristics of prescription history. Crude and adjusted odds ratios (AOR) were calculated. RESULTS: Increased risk was associated with male sex (AOR 2.4, 95% confidence interval [CI] 1.8-3.1), one or more sedative/hypnotic prescriptions (AOR 3.0, CI 2.2-4.2), greater age (AOR 1.3, CI 1.2-1.4 for each 10-year increment), number of prescriptions (AOR 1.1, CI 1.1-1.1 for each additional prescription), and a prescription for buprenorphine (AOR 9.5, CI 3.0-30.0), fentanyl (AOR 3.5, CI 1.7-7.0), hydromorphone (AOR 3.3, CI 1.4-7.5), methadone (AOR 4.9, CI 2.5-9.6), or oxycodone (AOR 1.9, CI 1.4-2.6). Patients receiving a daily average of >40 morphine milligram equivalents had an OR of 12.2 (CI 9.2-16.0). CONCLUSIONS: Patients being prescribed opioid analgesics frequently or at high dosage face a substantial overdose risk. Prescription monitoring programs might be the best way for prescribers to know their patients' prescription histories and accurately assess overdose risk. |
Importance of employee vaccination against influenza in preventing cases in long-term care facilities
Wendelboe AM , Avery C , Andrade B , Baumbach J , Landen MG . Infect Control Hosp Epidemiol 2011 32 (10) 990-7 OBJECTIVE: Employees of long-term care facilities (LTCFs) who have contact with residents should be vaccinated against influenza annually to reduce influenza incidence among residents. This investigation estimated the magnitude of the benefit of this recommendation. METHODS: The New Mexico Department of Health implemented active surveillance in all of its 75 LTCFs during influenza seasons 2006-2007 and 2007-2008. Information about the number of laboratory-confirmed cases of influenza and the proportion vaccinated of both residents and direct-care employees in each facility was collected monthly. LTCFs reporting at least 1 case of influenza (defined alternately by laboratory confirmation or symptoms of influenza-like illness [ILI]) among residents were compared with LTCFs reporting no cases of influenza. Regression modeling was used to obtain adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association between employee vaccination coverage and the occurrence of influenza outbreaks. Covariates included vaccination coverage among residents, the staff-to-resident ratio, and the proportion of filled beds. RESULTS: Seventeen influenza outbreaks were reported during this 2-year period of surveillance. Eleven of these were laboratory confirmed ([Formula: see text] residents) and 6 were defined by ILI ([Formula: see text] residents). Mean influenza vaccination coverage among direct-care employees was 51% in facilities reporting outbreaks and 60% in facilities not reporting outbreaks ([Formula: see text]). Increased vaccination coverage among direct-care employees was associated with fewer reported outbreaks of laboratory-confirmed influenza (aOR, 0.97 [95% CI, 0.95-0.99]) and ILI (aOR, 0.98 [95% CI, 0.96-1.00]). CONCLUSIONS: High vaccination coverage among direct-care employees helps to prevent influenza in LTCFs. |
Coal dust exposure and mortality from ischemic heart disease among a cohort of U.S. coal miners
Landen DD , Wassell JT , McWilliams L , Patel A . Am J Ind Med 2011 54 (10) 727-33 BACKGROUND: Particulate exposure from air pollution increases the risk of ischemic heart disease (IHD) mortality. Although coal miners are highly exposed to coal dust particulate, studies of IHD mortality risk among coal miners have had inconsistent results. Previous studies may have been biased by the healthy worker effect. METHODS: We examined the dose-response relationship between cumulative coal dust exposure, coal rank, and IHD mortality among a cohort of underground coal miners who participated in the National Study of Coal Workers' Pneumoconiosis. RESULTS: After adjusting for age, smoking, and body mass index, risk of IHD mortality increased at higher levels of coal dust exposure. Mortality risk was also associated with coal rank region. CONCLUSION: There was an increased risk of mortality from IHD associated with cumulative exposure to coal dust, and with coal rank. The effect of coal rank may be due differences in the composition of coal mine dust particulate. The association of risk of IHD mortality with cumulative particulate exposure is consistent with air pollution studies. Am. J. Ind. Med. (c) 2011 Wiley-Liss, Inc. |
Deaths related to 2009 pandemic influenza A (H1N1) among American Indian/Alaska Natives - 12 states, 2009
Castrodale L , McLaughlin J , Komatsu K , Wells E , Landen M , Selvage D , Sewell M , Smelser C , Thompson D , Bradley K , McDonald C , Leman R , Powell M , Miller T , VanderBusch L , Kightlinger L , Boulton R , Lofy K , Marfin AA , McClinton R , Hoopes M , Kim T , Hayes JM , Mahal Z , Chao E , Weiser T , Cheek JE , Redd JT , Bryan R , Jhung M , Morrison M , O'Leary D , Nichols M . MMWR Morb Mortal Wkly Rep 2009 58 (48) 1341-4 Indigenous populations from Australia, Canada, and New Zealand have been found to have a three to eight times higher rate of hospitalization and death associated with infection with the 2009 pandemic influenza A (H1N1) virus. In October, two U.S. states (Arizona and New Mexico) observed a disproportionate number of deaths related to H1N1 among American Indian/Alaska Natives (AI/ANs). These observations, plus incomplete reporting of race/ethnicity at the national level, led to formation of a multidisciplinary workgroup comprised of representatives from 12 state health departments, the Council of State and Territorial Epidemiologists, tribal epidemiology centers, the Indian Health Service, and CDC. The workgroup assessed the burden of H1N1 influenza deaths in the AI/AN population by compiling surveillance data from the states and comparing death rates. The results indicated that, during April 15-November 13, AI/ANs in the 12 participating states had an H1N1 mortality rate four times higher than persons in all other racial/ethnic populations combined. Reasons for this disparity in death rates are unknown and need further investigation; however, they might include a high prevalence of chronic health conditions (e.g., diabetes and asthma) among AI/ANs that predisposes them to influenza complications, poverty (e.g., poor living conditions), and delayed access to care. Efforts are needed to increase awareness among AI/ANs and their health-care providers of the potential severity of influenza and current recommendations regarding the timely use of antiviral medications. Efforts to promote the use of 2009 H1N1 influenza monovalent vaccine in AI/AN populations should be expanded. |
Noise exposure and hearing loss among sand and gravel miners
Landen D , Wilkins S , Stephenson M , McWilliams L . J Occup Environ Hyg 2004 1 (8) 532-41 The objectives of this study were to describe workplace noise exposures, risk factors for hearing loss, and hearing levels among sand and gravel miners, and to determine whether full shift noise exposures resulted in changes in hearing thresholds from baseline values. Sand and gravel miners (n = 317) were interviewed regarding medical history, leisure-time and occupational noise exposure, other occupational exposures, and use of hearing protection. Audiometric tests were performed both before the work shift (following a 12-hour noise-free interval) and immediately following the work shift. Full shift noise dosimetry was conducted. Miners' noise exposures exceeded the Recommended Exposure Limit (REL) of the National Institute for Occupational Safety and Health (NIOSH) for 69% of workers, and exceeded the Mine Safety and Health Administration's action level for enrollment in a hearing conservation program for 41% of workers. Significantly higher noise exposures occurred among employees of small companies, among workers with a job classification of truck driver, among males, and among black workers. Hearing protection usage was low, with 48% of subjects reporting that they never used hearing protection. Hearing impairment, as defined by NIOSH, was present among 37% of 275 subjects with valid audiograms. Black male workers and white male workers had higher hearing thresholds than males from a comparison North Carolina population unexposed to industrial noise. Small but statistically significant changes in hearing thresholds occurred following full shift noise exposure among subjects who had good hearing sensitivity at baseline. In a logistic regression model, age and history of a past noisy job were significant predictors of hearing impairment. Overall, sand and gravel workers have excessive noise exposures and significant hearing loss, and demonstrate inadequate use of hearing protection. Well-designed hearing conservation programs, with reduction of noise exposure, are clearly needed. |
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