Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-6 (of 6 Records) |
Query Trace: Marcum L [original query] |
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The relative burden of occupational injuries and illnesses in firefighters: An analysis of Washington Workers' Compensation claims, 2006-2020
Anderson N , Marcum J , Bonauto D , Siegel M , LaSee C . Int J Environ Res Public Health 2023 20 (22) Firefighters face many hazards on the job and have a high rate of work-related injuries and illnesses (WRII). We analyzed Washington workers' compensation claims from 2006-2020 to characterize WRII in firefighters compared to law enforcement officers and "all other" workers. There were 9187 compensable claims for firefighters, 7801 for law enforcement officers, and 586,939 for "all other" workers. Nearly 40% of claims for firefighters were work-related musculoskeletal disorders (WMSDs). The claim rate per 10,000 full-time equivalent (FTE) firefighters was 716.4, which is significantly higher than that of law enforcement officers (510.0) and "all other" workers (163.2). The rate per 10,000 FTE of WMSD claims was also higher in firefighters (277.0) than in law enforcement officers (76.2) and "all other" workers (57.6). Additional WRII among firefighters commonly included being struck or caught in objects, slipping or tripping, and exposure to caustic or noxious substances; and amongst law enforcement, transportation accidents and violence. Medical costs and time-loss days per claim were lower for firefighters and law enforcement than for "all other" workers. Common tasks associated with WMSDs in firefighters included lifting and transporting patients, using specific tools and equipment, and physical training. WMSDs stand out as an area for prevention and intervention activities. |
A comparative analysis of selective serotonin reuptake inhibitors and fall risk in older adults
Haddad YK , Kakara R , Marcum ZA . J Am Geriatr Soc 2022 70 (5) 1450-1460 BACKGROUND: One in five older adults (age 65+) uses an antidepressant medication. However, little is known about how fall risk differs between commonly prescribed medications. We examine the comparative association between individual selective serotonin reuptake inhibitors (SSRI) and self-reported falls in older adults. METHODS: We used data from 2010-2017 Medicare Current Beneficiary Surveys, a nationally representative survey of Medicare beneficiaries. We included participants from three different panels surveyed over two successive years. Participants were limited to community-dwelling Medicare beneficiaries 65+, enrolled in Medicare Part D, and taking an SSRI (n=1023) during baseline years. Participants were asked about demographic and health characteristics, medication use (including dose, frequency, duration of use) and self-reported falls as any fall or recurrent falls in the past year. We compared individual SSRI (citalopram or escitalopram vs sertraline) use by the average monthly total standardized daily dose (TSDD) and self-reported falling, controlling for potential confounders. Descriptive analysis and multivariable logistic regressions were conducted using SAS-callable SUDAAN. RESULTS: Citalopram/escitalopram (n=460 users; 45.0% of all SSRI users) and sertraline (n=294 users; 28.7% of all SSRI users) were the most commonly prescribed SSRIs. Overall, 36.3% of citalopram/escitalopram users and 39.4% of sertraline users reported a fall in the year following medication use. There were no statistically significant differences between sertraline and citalopram/escitalopram users of either low or medium TSDD levels in the risk of self-reported any or recurrent falls. However, users of high TSDD of sertraline (>75mg) had a lower risk of recurrent falls compared to high TSDD citalopram (>30mg) or escitalopram (>15mg) daily for 30days. CONCLUSION: These findings suggest a potential comparative safety benefit of sertraline compared to citalopram/escitalopram at high doses related to recurrent falls. Additional comparative studies of individual antidepressants may better inform fall risk management and prescribing for older adults. |
Antibody titers reactive with Rickettsia rickettsii in blood donors and implications for surveillance of spotted fever rickettsiosis in the United States
Straily A , Stuck S , Singleton J , Brennan S , Marcum S , Condit M , Lee C , Kato C , Tonnetti L , Stramer SL , Paddock CD . J Infect Dis 2019 221 (8) 1371-1378 BACKGROUND: Since 2000, the reported prevalence of tick-borne spotted fever group rickettsioses (SFGR) has increased considerably. We compared the level of antibody reactivity among healthy blood donors from two widely separated regions of the United States, and evaluated the impact of antibody prevalence on public health surveillance in one of these regions. METHODS: Donor serum samples were evaluated by indirect immunofluorescence antibody assay to identify immunoglobulin G antibodies reactive with Rickettsiarickettsii. The Georgia Department of Public Health (GDPH) analyzed characteristics of cases from 2016 surveillance data to evaluate the utility of laboratory surveillance for case assessment. RESULTS: Of the Georgia donors (N = 1,493), 11.1% demonstrated antibody titers reactive with R. rickettsii at titers >/= 64, whereas 6.3% of donors from Oregon and Washington (N =1,511) were seropositive. Most seropositive donors had a titer of 64; only 3.1% (N = 93) of all donors had titers >/= 128. During 2016, GDPH interviewed 243 seropositive case-patients; only 28% (N = 69) met criteria defined in the national SFGR case definition. CONCLUSIONS: These findings suggest that a single IgG antibody titer is an unreliable measure of diagnosis and could inaccurately affect surveillance estimates that define magnitude and clinical characteristics of SFGR. |
Psychoactive medication use among older community-dwelling Americans
Haddad YK , Luo F , Karani MV , Marcum ZA , Lee R . J Am Pharm Assoc (2003) 2019 59 (5) 686-690 BACKGROUND: Falls are a common and serious health issue among older Americans. A common fall risk factor is the use of psychoactive medications. There is limited recent information on the national prevalence of psychoactive medication use among older Americans. OBJECTIVES: To estimate the prevalence of psychoactive medication use among community-dwelling older Americans and compare it with previous estimates from 1996. METHODS: The data source was the 2013 Cost and Use Data files combining Medicare claims data and survey data from the Medicare Current Beneficiary Survey, an in-person nationally representative survey of Medicare beneficiaries. Participants were included if they were 65 years of age and older, lived in the community, and had a complete year of prescription use data. Medication use was examined for 7 classes of psychoactive medications categorized by the 2015 American Geriatric Society Beers criteria as increasing fall risk. These include opioids, benzodiazepines, selective serotonin reuptake inhibitors, anticonvulsants, nonbenzodiazepine sedative hypnotics, antipsychotics, and tricyclic antidepressants. Data on participant demographic factors were also collected. RESULTS: Among the 6959 community-dwelling older adults studied, representing 33,268,104 community-dwelling Medicare beneficiaries, 53.3% used at least 1 psychoactive medication linked to falls in 2013. The most frequently used medication classes were opioids (34.9%), benzodiazepines (15.4%), selective serotonin reuptake inhibitors (14.3%), and anticonvulsants (13.3%). These estimates are considerably higher for all classes except tricyclic antidepressants than previous reports from 1996 that used the same data source. Among most psychoactive medication classes observed, women had higher usage than men. CONCLUSION: More than half of all older Americans used at least 1 psychoactive medication in 2013. Health care providers, including pharmacists, play a vital role in managing older adults' exposure to psychoactive medications. Medication management can optimize health and reduce older adult falls. |
Willingness to change medications linked to increased fall risk: A comparison between age groups
Haddad YK , Karani MV , Bergen G , Marcum ZA . J Am Geriatr Soc 2018 67 (3) 527-533 OBJECTIVE: To describe and compare two age groups' knowledge of medications linked to falls and willingness to change these medications to reduce their fall risk. METHOD: We analyzed data from community-dwelling adults age 55 and older (n = 1812): 855 adults aged 55 to 64 years and 957 older adults (65 and older) who participated in the 2016 summer wave of the ConsumerStyles survey, an annual Web-based survey. The data are weighted to match the US Current Population Survey proportions on nine US Census Bureau demographic characteristics. MEASUREMENTS: Survey respondents were asked about medication use, knowledge of side effects, their willingness to change their medications to reduce fall risk, communication in the previous year about fall risk with their healthcare provider, and their comfort in discussing fall risk with their healthcare provider. All data were weighted to match the 2016 population estimates. Descriptive statistics and chi(2) (p </= .05) were used to identify differences between the two age groups. RESULTS: About one-fifth of all respondents reported using at least one class of medication that increases fall risk. Older adults were less likely to report using medications for mood or sadness, less likely to report knowing the side effects of pain medications, and more willing to change their sleep medications compared with their younger counterparts. Among all respondents using these medication classes, less than one-third knew the potential fall-related side effects. However, most of them expressed willingness to change their medication if advised by their healthcare provider. CONCLUSION: Most older adults were unaware of potential fall risks associated with medications prescribed to address pain, difficulty sleeping, mood or sadness, and anxiety- or nervousness-related health issues. However, most were willing to change their medication if recommended by a healthcare provider. |
Enumerating the environmental public health workforce - challenges and opportunities
Massoudi M , Blake R , Marcum L . J Environ Health 2012 75 (4) 34-36 Workforce enumeration is the foundation for identifying workforce | needs. In 2000, the Health Resources and Services Administration (HRSA) | sponsored an enumeration of the public | health workforce (HRSA, 2000), but since | then, no comprehensive enumeration has occurred. The Centers for Disease Control and | Prevention (CDC) and HRSA are now collaborating on an effort to determine the number and composition of the U.S. workforce at the | federal, state, and local levels. |
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