Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-9 (of 9 Records) |
Query Trace: Spivak H[original query] |
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The Effect of Pesticide Spray season and residential proximity to agriculture on glyphosate exposure among pregnant people in Southern Idaho, 2021
Curl CL , Hyland C , Spivak M , Sheppard L , Lanphear B , Antoniou MN , Ospina M , Calafat AM . Environ Health Perspect 2023 131 (12) 127001 BACKGROUND: Glyphosate is one of the most heavily used pesticides in the world, but little is known about sources of glyphosate exposure in pregnant people living in agricultural regions. OBJECTIVE: Our objective was to evaluate glyphosate exposure during pregnancy in relation to residential proximity to agriculture as well as agricultural spray season. METHODS: We quantified glyphosate concentrations in 453 urine samples collected biweekly from a cohort of 40 pregnant people in southern Idaho from February through December 2021. We estimated each participant's glyphosate exposure as the geometric mean (GM) of glyphosate concentrations measured in all samples (average n = 11 samples/participant), as well as the GM of samples collected during the pesticide "spray season" (defined as those collected 1 May-15 August; average n = 5 samples/participant) and the "nonspray season" (defined as those collected before 1 May or after 15 August; average n = 6 samples/participant). We defined participants who resided < 0.5 km from an actively cultivated agriculture field to live "near fields" and those residing ≥ 0.5 km from an agricultural field to live "far from fields" (n = 22 and 18, respectively). RESULTS: Among participants living near fields, urinary glyphosate was detected more frequently and at significantly increased GM concentrations during the spray season in comparison with the nonspray season (81% vs. 55%; 0.228 μg/L vs. 0.150 μg/L, p < 0.001). In contrast, among participants who lived far from fields, neither glyphosate detection frequency nor GMs differed in the spray vs nonspray season (66% vs. 64%; 0.154 μg/L vs. 0.165 μg/L, p = 0.45). Concentrations did not differ by residential proximity to fields during the nonspray season (0.154 μg/L vs. 0.165 μg/L, for near vs. far, p = 0.53). DISCUSSION: Pregnant people living near agriculture fields had significantly increased urinary glyphosate concentrations during the agricultural spray season than during the nonspray season. They also had significantly higher urinary glyphosate concentrations during the spray season than those who lived far from agricultural fields at any time of year, but concentrations did not differ during the nonspray season. These findings suggest that agricultural glyphosate spray is a source of exposure for people living near fields. https://doi.org/10.1289/EHP12768. |
Urinary glyphosate concentrations among pregnant participants in a randomized, crossover trial of organic and conventional diets
Hyland C , Spivak M , Sheppard L , Lanphear BP , Antoniou M , Ospina M , Calafat AM , Curl CL . Environ Health Perspect 2023 131 (7) 77005 BACKGROUND: Consumption of an organic diet reduces exposure to a range of agricultural pesticides. Only three studies have examined the effect of an organic diet intervention on exposure to the herbicide glyphosate, the most heavily used agricultural chemical in the world. Despite its widespread use, the primary sources of glyphosate exposure in humans are poorly understood. OBJECTIVE: Our objective was to examine the effect of an organic diet intervention on urinary glyphosate concentrations among pregnant individuals. METHODS: We conducted a 2-wk randomized crossover trial in which 39 pregnant participants living near ( ≤ 0.5 km) and far ( > 0.5 km) from agricultural fields received a 1-wk supply of conventional groceries and 1 wk of organic groceries, randomized to order. We collected daily first morning void urine samples and analyzed composite samples from each week for glyphosate. We examined differences in urinary glyphosate concentrations between the conventional week and the organic week among all participants and stratified by residential proximity to an agricultural field. RESULTS: Median specific gravity-adjusted glyphosate concentrations were 0.19 μg/L and 0.16 μg/L during the conventional and organic weeks, respectively. We observed modest decreases in urinary glyphosate concentrations from the conventional to organic week among far-field participants, but no difference among near-field participants. In secondary analyses excluding participants who did not meet a priori criteria of compliance with the intervention, we observed significant decreases in urinary glyphosate concentrations, particularly among far-field participants (p < 0.01 - 0.02, depending on exclusion criteria). DISCUSSION: This trial is the first to examine the effect of an organic diet intervention on glyphosate among people living near and far from agricultural fields. Our results suggest that diet is an important contributor to glyphosate exposure in people living > 0.5 km from agricultural fields; for people living near crops, agriculture may be a dominant exposure source during the pesticide spray season. https://doi.org/10.1289/EHP12155. |
Impact of implementation of the core elements of outpatient antibiotic stewardship within Veterans Health Administration Emergency Department and Primary Care Clinics on antibiotic prescribing and patient outcomes
Madaras-Kelly K , Hostler C , Townsend M , Potter EM , Spivak ES , Hall SK , Goetz MB , Nevers M , Ying J , Haaland B , Rovelsky SA , Pontefract B , Fleming-Dutra K , Hicks LA , Samore MH . Clin Infect Dis 2020 73 (5) e1126-e1134 BACKGROUND: The Core Elements of Outpatient Antibiotic Stewardship provide a framework to improve antibiotic use, but evidence supporting safety are limited. We report the impact of Core Elements implementation within Veterans Health Administration sites. METHODS: A quasi-experimental controlled study assessed the effects of an intervention targeting antibiotic prescription for uncomplicated acute respiratory tract infections (ARI). Outcomes included per-visit antibiotic prescribing, treatment appropriateness, potential benefits and complications of reduced antibiotic treatment, and change in ARI diagnoses over a 3-year pre-implementation and 1-year post implementation period. Logistic regression adjusted for covariates [OR (95% CI)] and a difference-in-differences analysis compared outcomes between intervention and control sites. RESULTS: From 2014-2019, there were 16,712 and 51,275 patient-visits in 10 intervention and 40 control sites, respectively. Antibiotic prescribing rates pre-post implementation in intervention sites were 59.7% and 41.5%, respectively; in control sites they were 73.5% and 67.2%, respectively [difference-in-differences p<0.001]. The intervention site pre-post implementation odds ratio to receive appropriate therapy increased [1.67 (1.31, 2.14)] which remained unchanged within control sites [1.04 (0.91, 1.19)]. There was no difference in ARI-related return visits post-implementation [(-1.3% vs. -2.0%; difference-in-differences p=0.76] but all-cause hospitalization was lower within intervention sites [(-0.5% vs. -0.2%); difference-in-differences p=0.02]. The odds ratio to diagnose upper respiratory tract infection not otherwise specified compared to other non-ARI diagnosis increased post-implementation for intervention [1.27(1.21,1.34)] but not control [0.97(0.94,1.01)] sites. CONCLUSIONS: Implementation of the Core Elements was associated with reduced antibiotic prescribing for uncomplicated ARIs and a reduction in hospitalizations. ARI diagnostic coding changes were observed. |
Introduction to the special issue: The role of public policies in preventing IPV, TDV, and SV
D'Inverno AS , Kearns MC , Reidy DE . J Interpers Violence 2018 33 (21) 3259-3266 Intimate partner violence (IPV), teen dating violence (TDV), and sexual violence (SV) constitute a major public health problem within the United States. More than 37 million men and 43 million women have experienced contact SV, physical violence, and/or stalking by an intimate partner in their life-time; 25.5 million women and 2.8 million men have been the victims of completed or attempted rape at some point in their lives (Smith et al., 2018). Furthermore, in 2017, 8.0% of high school students reported experiencing physical dating violence and 6.9% reported sexual dating violence in the last year (Kann et al., 2018). Both IPV and SV are associated with multiple negative health impacts and related costs to society, with recent studies suggesting an estimated lifetime economic burden of US $3.6 trillion for IPV and US $3.1 trillion for rape (Peterson, DeGue, Florence, & Lokey, 2017; Peterson et al., 2018). There are numerous efforts and strategies implemented to prevent and reduce these acts of violence; however, the few that have been evaluated and shown to be effective focus on individual- or relationship-level factors and have limited population impact due to difficulty in scaling up these strategies (Spivak et al., 2014; Whitaker, Hall, & Coker, 2009; Whitaker, Murphy, Eckhardt, Hodges, & Cowart, 2013). To this end, the Centers for Disease Control and Prevention (CDC) has prioritized the development and evaluation of innovative prevention strategies for IPV, TDV, and SV to have a population-level impact (CDC, National Center for Injury Prevention and Control, 2015). |
Measuring appropriate antimicrobial use: Attempts at opening the black box
Spivak ES , Cosgrove SE , Srinivasan A . Clin Infect Dis 2016 63 (12) 1639-1644 Indiscriminate antimicrobial use has plagued medicine since antibiotics were first introduced into clinical practice more than seventy years ago. Infectious diseases physicians and public health officials have advocated for preservation of these life-saving drugs for many years. With rising burden of antimicrobial resistant organisms and Clostridium difficile infections, halting unnecessary antimicrobial use has become one of the largest public health concerns of our time. Inappropriate antimicrobial use has been quantified in various settings using numerous definitions; however, no established reference standard exists. With mounting national efforts to improve antimicrobial use, a consensus definition and standard method of measuring appropriate antimicrobial use is imperative. We review existing literature on systematic approaches to define and measure appropriate antimicrobial use, and describe a collaborative effort at developing standardized audit tools for assessing the quality of antimicrobial prescribing. |
CDC Grand Rounds: preventing youth violence
David-Ferdon C , Simon TR , Spivak H , Gorman-Smith D , Savannah SB , Listenbee RL , Iskander J . MMWR Morb Mortal Wkly Rep 2015 64 (7) 171-174 Youth violence occurs when persons aged 10-24 years, as victims, offenders, or witnesses, are involved in the intentional use of physical force or power to threaten or harm others. Youth violence typically involves young persons hurting other young persons and can take different forms. Examples include fights, bullying, threats with weapons, and gang-related violence. Different forms of youth violence can also vary in the harm that results and can include physical harm, such as injuries or death, as well as psychological harm. Youth violence is a significant public health problem with serious and lasting effects on the physical, mental, and social health of youth. In 2013, 4,481 youths aged 10-24 years (6.9 per 100,000) were homicide victims. Homicide is the third leading cause of death among persons aged 10-24 years (after unintentional injuries and suicide) and is responsible for more deaths in this age group than the next seven leading causes of death combined. Males and racial/ethnic minorities experience the greatest burden of youth violence. Rates of homicide deaths are approximately six times higher among males aged 10-24 years (11.7 per 100,000) than among females (2.0). Rates among non-Hispanic black youths (27.6 per 100,000) and Hispanic youths (6.3) are 13 and three times higher, respectively, than among non-Hispanic white youths (2.1). The number of young persons who are physically harmed by violence is more than 100 times higher than the number killed. In 2013, an estimated 547,260 youths aged 10-24 years (847 per 100,000) were treated in U.S. emergency departments for nonfatal physical assault-related injuries. |
CDC Grand Rounds: a public health approach to prevention of intimate partner violence
Spivak HR , Jenkins L , Vanaudenhove K , Lee D , Kelly M , Iskander J . MMWR Morb Mortal Wkly Rep 2014 63 (2) 38-41 Intimate partner violence (IPV) is a serious, and preventable, public health problem in the United States. IPV can involve physical and sexual violence, threats of physical or sexual violence, and psychological abuse, including stalking. It can occur within opposite-sex or same-sex couples and can range from one incident to an ongoing pattern of violence. On average, 24 persons per minute are victims of rape, physical violence, or stalking by an intimate partner in the United States. These numbers underestimate the problem because many victims do not report IPV to police, friends, or families. In 2010, IPV contributed to 1,295 deaths, accounting for 10% of all homicides for that year. The combined medical, mental health, and lost productivity costs of IPV against women are estimated to exceed $8.3 billion per year. In addition to the economic burden of IPV, victims are more likely to experience adverse health outcomes, such as depression, anxiety, posttraumatic stress disorder symptoms, suicidal behavior, sexually transmitted infections, and unintended pregnancy. |
Moving forward by looking back: reflecting on a decade of CDC's work in sexual violence prevention, 2000-2010
Degue S , Simon TR , Basile KC , Yee SL , Lang K , Spivak H . J Womens Health (Larchmt) 2012 21 (12) 1211-8 In 2011, the Division of Violence Prevention (DVP) within CDC's Injury Center engaged an external panel of experts to review and evaluate its research and programmatic portfolio for sexual violence (SV) prevention from 2000 to 2010. This article summarizes findings from the review by highlighting DVP's key activities and accomplishments during this period and identifying remaining gaps in the field and future directions for SV prevention. DVP's SV prevention work in the 2000s included (1) raising the profile of SV as a public health problem, (2) shifting the field toward a focus on the primary prevention of SV perpetration, and (3) applying the public health model to SV research and programmatic activities. The panel recommended that DVP continue to draw attention to the importance of sexual violence prevention as a public health issue, build on prior investments in the Rape Prevention and Education Program, support high-quality surveillance and research activities, and enhance communication to improve the link between research and practice. Current DVP projects and priorities provide a foundation to actively address these recommendations. In addition, DVP continues to provide leadership and guidance to the research and practice fields, with the goal of achieving significant reductions in SV perpetration and allowing individuals to live to their full potential. |
A history of injury and violence prevention in public health and evolution of the National Center for Injury Prevention and Control at CDC
Sleet DA , Baldwin G , Marr A , Spivak H , Patterson S , Morrison C , Holmes W , Peeples AB , Degutis LC . J Safety Res 2012 43 (4) 233-47 Injuries and violence are among the oldest health problems facing humans. And yet, only within the past 50 years has the problem being addressed with scientific rigor using public health methods. The field of injury and violence prevention began as early as 1913, but wasn't approached systematically or epidemiologically until the 1940s and 1950s. It accelerated rapidly between 1960 and 1985. Coupled with active federal and state interest in reducing injuries and violence, this period was marked by important medical, scientific, and public health advances. The National Center for Injury Prevention and Control (NCIPC) was an outgrowth of this progress and in 2012 celebrated its 20th anniversary. NCIPC was created in 1992 after a series of government reports identified injury as one of the most important public health problems facing the nation. Congressional action provided the impetus for the creation of NCIPC as the lead federal agency for non-occupational injury and violence prevention. In subsequent years, NCIPC and its partners fostered many advances and built even greater capacity. Because of the tragically high burden and cost of injuries and violence in the United States and across the globe, researchers, practitioners, and decision makers can improve progress by redoubling prevention efforts in the next 20 years. This article traces the history of injury and violence prevention as a public health priority – including the evolution and current structure of the CDC's National Center for Injury Prevention and Control. |
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