After a chemical fire, an investigation assessed health effects by using syndromic surveillance to monitor emergency department (ED) visits, a general health survey to assess the general public, and a first responders health survey to assess first responders. A total of four separate multivariable logistic regression models were developed to examine associations between reported exposure to smoke, dust, debris, or odor with any reported symptom in the general public. Syndromic surveillance identified areas with increased ED visits. Among general health survey respondents, 45.1% (911 out of 2,020) reported at least one symptom. Respondents reporting exposure to smoke, dust, debris, or odor had 4.5 (95% confidence interval (CI) [3.7, 5.5]), 4.6 (95% CI [3.6, 5.8]), 2.0 (95% CI [1.7, 2.5]), or 5.8 (95% CI [4.7, 7.3]) times the odds of reporting any symptom compared with respondents not reporting exposure to smoke, dust, debris, or odor, respectively. First responders commonly reported contact with material and being within 1 mi of the fire ≥5 hr; 10 out of 31 of first responders reported at least one symptom. There was high symptom burden reported after the fire. Results from our investigation might assist the directing of public health resources to effectively address immediate community needs and prepare for future incidents. © 2023, National Environmental Health Association. All rights reserved.

On June 14, 2021, an industrial manufacturing facility in Winnebago County, Illinois caught fire and released smoke, dust, and debris, requiring evacuation of the area in the vicinity of the facility for 4 days. Following the emergency response, the Illinois Department of Public Health (IDPH) and Winnebago County Health Department (WCHD) requested assistance from the Agency for Toxic Substances and Disease Registry (ATSDR) to conduct a community Assessment of Chemical Exposure (ACE). That assessment found that almost one half of respondents reported symptoms during the 2 weeks after the fire (1). | | One year after the fire, IDPH and WCHD invited ATSDR to conduct a follow-up ACE investigation to assess ongoing health impacts. WCHD and ATSDR emailed a modified survey to all 2,030 previous 2021 survey respondents, through the existing electronic system, to collect information related to ongoing exposure and mental and physical health symptoms. This investigation team also conducted a total of 22 semistructured interviews to collect open-ended responses to questions regarding mental health symptoms and community needs. Nine residents of a neighborhood adjacent to the fire site were interviewed in-person and 13 survey respondents who expressed interest in participating were interviewed by phone.

On June 14, 2021, an industrial fluid and grease manufacturing facility in Winnebago County, Illinois, (population = 285,350) (1) caught fire, releasing smoke, dust, and debris for 4 days and prompting local authorities to issue a precautionary 1-mile (1.5-km) evacuation order and 3-mile (5-km) masking advisory around the location of the facility during this time. Review of Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) data during this time demonstrated increased emergency department visits in five zip codes downwind of the fire. In response, the Winnebago County Health Department (WCHD), Illinois Department of Public Health, and Agency for Toxic Substances and Disease Registry (ATSDR) collaborated to investigate the fire’s effect on human health.

It is critical for the safety of miners to be able to escape, unaided, during a mine emergency. Self-escape is challenging in the presence of smoke that can occur during a mine emergency. To assist self-escape, coloured markers in underground mines designate the primary/secondary escapeways, but no universal colour code exists. Ten participants were tested to recognize the colour and designation (primary/secondary) of fluorescent yellow–green (FYG), yellow (Y), white (W) and green (G) escapeway markers in both a clear and smoked-filled environment. The overall misidentification rate for all colours was 1.9% and 18.1%, respectively, in clear and smoke conditions. FYG had the highest misidentification percentage for both conditions. For the marker designation tests, participants were most accurate in clear conditions (100.0%) for the FYG + W, Y + G, G + W and W + FYG combinations, and least accurate (89.6%) for the Y + FYG combination, while for smoke conditions participants were most accurate for the G + Y combination (95.8%). The overall effect of colour combination was significant, indicating that the colour combination for primary/secondary recognition is a significant factor where the G + Y combination was best. It can be inferred from these data that the colour combination is an important factor in participants’ ability to recognize primary/secondary escapeway markers in smoke conditions.

Lighting regulations for luminance in U. S. coal mines are verified in the field by using a luminance photometer calibrated to the Standard Illuminant A light source. Significant measurement errors can exist when measuring light sources that are dissimilar to light sources used to calibrate the photometer. This paper quantifies the measurement errors when measuring these dissimilar light sources commonly used in U.S. underground coal mines-an LED, a CFL with a clear cover, a CFL with an amber cover, and a tungsten halogen. The impact of photometer quality was also evaluated. Three different luminance measuring instruments of high, medium, and low quality were compared-a PR-650, LS-100, and PMEX, respectively. The PMEX was under evaluation for measuring luminance compliance in U.S. underground coal mines. The PR-650 was used as the referent to which the other photometers were compared. The PMEX error ranged from -17.0% to -26.5% with the highest error for the amber CFL. The LS-100 closely matched the luminance measurement for the LED and halogen; however, it had a percent error of -10.4% for the amber CFL. After the initial experiment, MSHA made improvements to the PMEX resulting in the PMEX-MSHA. The experiment was replicated using the new photometer and the newer PR-670. After repeating the experiment, the measurement errors ranged from -16% to -19% for the PMEX-MSHA, thus indicating an improvement over the PMEX. These results show that the spectral content of a light source and the photometer quality can greatly impact the accuracy of luminance measurement.

We examined variations in cigarette smoking by socioeconomic status (education and poverty status) in relation to population sociodemographic characteristics (age, race/ethnicity, region and sex). We analyzed data from a nationally representative sample of US adults by using combined data from the National Survey on Drug Use and Health (2011-2014). Low socioeconomic status was generally associated with increased cigarette smoking prevalence by age, race/ethnicity, and region, irrespective of sex. The only exceptions were for Asian and Hispanic women, where low educational attainment was not associated with a high prevalence of cigarette smoking, and among Hispanic men and Asian women, where there was no association between poverty status and smoking. Efforts to reach smokers of low socioeconomic status by using proven tobacco control strategies could reduce disparities in cigarette smoking and smoking-related disease and death.

Lifelines are used to aid self-escape of underground miners, but they are difficult to find in low-visibility conditions of smoke, therefore a self-illuminating lifeline could facilitate miners in locating the lifeline. The detection distance, colour recognition, and miss rate for 10 subjects were determined for red-, green- and blue-lighted diffuse fibre-optic cables, used to create a lighted lifeline, and a traditional rope lifeline in a smoked-filled environment. The testing was conducted with and without a cap lamp. The use of a cap lamp resulted in all cases being undetected in 98.3% of trials. With the cap lamp off, there was no significant difference in the detection distance for blue- and green-lighted fibres; however, the miss rate for the green-lighted fibre was slightly higher. The red-lighted fibre was not detected in 93.3% of trials. The green- and blue-lighted fibres enabled the best visual performance, but subjects had difficulty correctly identifying the colour of the fibre. The lighted fibre-optic cable appears to have merit for improving self-escape from underground mines, and may have other mining and non-mining applications that include improving self-escape visibility.

Proper lighting plays a critical role in enabling miners to detect hazards when operating a roof bolter, one of the most dangerous mining machines to operate; however, there has not been any lighting research to address the walk-thru type of roof bolter commonly used today. To address this, the Saturn light was designed to directly address walk-thru roof bolter safety by improving trip hazard illumination. The visual performances of 30 participants that comprised three age groups were quantified by measuring each participant's visual performance in detecting trip objects positioned on the two floor locations within the machine's interior working space. The lighting conditions were the existing compact fluorescent lights (CFLs) and the Saturn LED area light developed by NIOSH researchers. Three intensities of the Saturn lights were used, 100%, 75%, and 50%, all of which resulted in better visual performance, and up to a 48% reduction in average trip detection time compared to the CFL. For the Saturn trip object miss rates were <0.5% for all age groups in contrast to the CFL, which ranged between 32.5% for the youngest group and 50.4% for the oldest group.

The mining industry often uses shift work schedules with the intention to have a productive working mine around the clock. However, one potential side effect of operating on a 24/7 basis can be the disruption of circadian rhythms, which results in worker fatigue — the mental state between wake and sleep. | | Fatigue from shift work has the potential to decrease productivity and increase accidents in organizations where workers are overly fatigued (Dawson et al., 2000). In open-pit mines fatigue-related accidents account for up to 65% of truck driving accidents alone (Schmidt, 2015).

Although cigarette smoking has substantially declined since the release of the 1964 Surgeon General's report on smoking and health,* disparities in tobacco use exist among racial/ethnic populations (1). Moreover, because estimates of U.S. adult cigarette smoking and tobacco use are usually limited to aggregate racial or ethnic population categories (i.e., non-Hispanic whites [whites]; non-Hispanic blacks or African Americans [blacks]; American Indians and Alaska Natives [American Indians/Alaska Natives]; Asians; Native Hawaiians or Pacific Islanders [Native Hawaiians/Pacific Islanders]; and Hispanics/Latinos [Hispanics]), these estimates can mask differences in cigarette smoking prevalence among subgroups of these populations. To assess the prevalence of and changes in cigarette smoking among persons aged ≥18 years in six racial/ethnic populations and 10 select subgroups in the United States,(dagger) CDC analyzed self-reported data collected during 2002-2005 and 2010-2013 from the National Survey on Drug Use and Health (NSDUH) (2) and compared differences between the two periods. During 2010-2013, the overall prevalence of cigarette smoking among the racial/ethnic populations and subgroups ranged from 38.9% for American Indians/Alaska Natives to 7.6% for both Chinese and Asian Indians. During 2010-2013, although cigarette smoking prevalence was relatively low among Asians overall (10.9%) compared with whites (24.9%), wide within-group differences in smoking prevalence existed among Asian subgroups, from 7.6% among both Chinese and Asian Indians to 20.0% among Koreans. Similarly, among Hispanics, the overall prevalence of current cigarette smoking was 19.9%; however, within Hispanic subgroups, prevalences ranged from 15.6% among Central/South Americans to 28.5% among Puerto Ricans. The overall prevalence of cigarette smoking was higher among men than among women during both 2002-2005 (30.0% men versus 23.9% women) and 2010-2013 (26.4% versus 21.1%) (p<0.05). These findings highlight the importance of disaggregating tobacco use estimates within broad racial/ethnic population categories to better understand and address disparities in tobacco use among U.S. adults.

BACKGROUND: Suicides among men aged 35-64 years increased by 27% between 1999 and 2013, yet little research exists to examine the nature of the suicide risk within this population. Many men do not seek help if they have mental health problems and suicides may occur in reaction to stressful circumstances. AIMS: We examined the precipitating circumstances of 600 suicides without known mental health or substance abuse (MH/SA) problems and with a recent crisis. Whether these suicides occurred within the context of an acute crisis only or in the context of chronic circumstances was observed. METHOD: Using data from the National Violent Death Reporting System and employing mixed-methods analysis, we examined the circumstances and context of a census of middle-aged male suicides (n = 600) in seven states between 2005 and 2010. RESULTS: Precipitating circumstances among this group involved intimate partner problems (IPP; 58.3%), criminal/legal problems (50.7%), job/financial problems (22.5%), and health problems (13.5%). Men with IPP and criminal/legal issues were more likely than men with health and/or job/financial issues to experience suicide in the context of an acute crisis only. CONCLUSION: Suicides occurring in reaction to an acute crisis only or in the context of acute and chronic circumstances lend themselves to opportunities for intervention. Further implications are discussed.

Bullying has emerged as a behavior with deleterious effects on youth; however, prevalence estimates vary based on measurement strategies employed. We conducted a systematic review and content analysis of bullying measurement strategies to gain a better understanding of each strategy including behavioral content. Multiple online databases (i.e., PsychInfo, MedLine, ERIC) were searched to identify measurement strategies published between 1985 and 2012. Included measurement strategies assessed bullying behaviors, were administered to respondents with ages of 12 to 20, were administered in English, and included psychometric data. Each publication was coded independently by two study team members with a pre-set data extraction form, who subsequently met to discuss discrepancies. Forty-one measures were included in the review. A majority used differing terminology; student self-report as primary reporting method; and included verbal forms of bullying in item content. Eleven measures included a definition of bullying, and 13 used the term "bullying" in the measure. Very few definitions or measures captured components of bullying such as repetition, power imbalance, aggression, and intent to harm. Findings demonstrate general inconsistency in measurement strategies on a range of issues, thus, making comparing prevalence rates between measures difficult.

Since mid-March 2014, the frequency with which cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection have been reported has increased, with the majority of recent cases reported from Saudi Arabia and United Arab Emirates (UAE). In addition, the frequency with which travel-associated MERS cases have been reported and the number of countries that have reported them to the World Health Organization (WHO) have also increased. The first case of MERS in the United States, identified in a traveler recently returned from Saudi Arabia, was reported to CDC by the Indiana State Department of Health on May 1, 2014, and confirmed by CDC on May 2. A second imported case of MERS in the United States, identified in a traveler from Saudi Arabia having no connection with the first case, was reported to CDC by the Florida Department of Health on May 11, 2014. The purpose of this report is to alert clinicians, health officials, and others to increase awareness of the need to consider MERS-CoV infection in persons who have recently traveled from countries in or near the Arabian Peninsula. This report summarizes recent epidemiologic information, provides preliminary descriptions of the cases reported from Indiana and Florida, and updates CDC guidance about patient evaluation, home care and isolation, specimen collection, and travel as of May 13, 2014.

BACKGROUND: Sepsis in the first 3 days of life is a leading cause of morbidity and mortality among infants. Group B Streptococcus (GBS), historically the primary cause of early-onset sepsis (EOS), has declined through widespread use of intrapartum chemoprophylaxis. We estimated the national burden of invasive EOS cases and deaths in the era of GBS prevention. METHODS: Population-based surveillance for invasive EOS was conducted in 4 of the Centers for Disease Control and Prevention's Active Bacterial Core surveillance sites from 2005 to 2008. We calculated incidence using state and national live birth files. Estimates of the national number of cases and deaths were calculated, standardizing by race and gestational age. RESULTS: Active Bacterial Core surveillance identified 658 cases of EOS; 72 (10.9%) were fatal. Overall incidence remained stable during the 3 years (2005: 0.77 cases/1000 live births; 2008: 0.76 cases/1000 live births). GBS ( approximately 38%) was the most commonly reported pathogen followed by Escherichia coli ( approximately 24%). Black preterm infants had the highest incidence (5.14 cases/1000 live births) and case fatality (24.4%). Nonblack term infants had the lowest incidence (0.40 cases/1000 live births) and case fatality (1.6%). The estimated national annual burden of EOS was approximately 3320 cases (95% confidence interval [CI]: 3060-3580), including 390 deaths (95% CI: 300-490). Among preterm infants, 1570 cases (95% CI: 1400-1770; 47.3% of the overall) and 360 deaths (95% CI: 280-460; 92.3% of the overall) occurred annually. CONCLUSIONS: The burden of invasive EOS remains substantial in the era of GBS prevention and disproportionately affects preterm and black infants. Identification of strategies to prevent preterm births is needed to reduce the neonatal sepsis burden.