Last data update: May 20, 2024. (Total: 46824 publications since 2009)
Records 1-6 (of 6 Records) |
Query Trace: Stearns D [original query] |
---|
Heat safety in the workplace: Modified Delphi consensus to establish strategies and resources to protect the US workers
Morrissey MC , Casa DJ , Brewer GJ , Adams WM , Hosokawa Y , Benjamin CL , Grundstein AJ , Hostler D , McDermott BP , McQuerry ML , Stearns RL , Filep EM , DeGroot DW , Fulcher J , Flouris AD , Huggins RA , Jacklitsch BL , Jardine JF , Lopez RM , McCarthy RB , Pitisladis Y , Pryor RR , Schlader ZJ , Smith CJ , Smith DL , Spector JT , Vanos JK , Williams WJ , Vargas NT , Yeargin SW . Geohealth 2021 5 (8) e2021GH000443 The purpose of this consensus document was to develop feasible, evidence-based occupational heat safety recommendations to protect the US workers that experience heat stress. Heat safety recommendations were created to protect worker health and to avoid productivity losses associated with occupational heat stress. Recommendations were tailored to be utilized by safety managers, industrial hygienists, and the employers who bear responsibility for implementing heat safety plans. An interdisciplinary roundtable comprised of 51 experts was assembled to create a narrative review summarizing current data and gaps in knowledge within eight heat safety topics: (a) heat hygiene, (b) hydration, (c) heat acclimatization, (d) environmental monitoring, (e) physiological monitoring, (f) body cooling, (g) textiles and personal protective gear, and (h) emergency action plan implementation. The consensus-based recommendations for each topic were created using the Delphi method and evaluated based on scientific evidence, feasibility, and clarity. The current document presents 40 occupational heat safety recommendations across all eight topics. Establishing these recommendations will help organizations and employers create effective heat safety plans for their workplaces, address factors that limit the implementation of heat safety best-practices and protect worker health and productivity. |
Characterizing environmental asthma triggers and healthcare use patterns in Puerto Rico
Lewis LM , Mirabelli MC , Beavers SF , Kennedy CM , Shriber J , Stearns D , Morales Gonzalez JJ , Santiago MS , Felix IM , Ruiz-Serrano K , Dirlikov E , Lozier MJ , Sircar K , Flanders WD , Rivera-Garcia B , Irizarry-Ramos J , Bolanos-Rosero B . J Asthma 2019 57 (8) 1-12 Objective: Asthma carries a high burden of disease for residents of Puerto Rico. We conducted this study to better understand asthma-related healthcare use and to examine potential asthma triggers. Methods: We characterized asthma-related healthcare use in 2013 by demographics, region, and date using outpatient, hospital, and emergency department (ED) insurance claims with a primary diagnostic ICD-9-CM code of 493.XX. We examined environmental asthma triggers, including outdoor allergens (i.e., mold and pollen), particulate pollution, and influenza-like illness. Analyses included descriptive statistics and Poisson time-series regression. Results: During 2013, there were 550,655 medical asthma claims reported to the Puerto Rico Healthcare Utilization database, representing 148 asthma claims/1,000 persons; 71% of asthma claims were outpatient visits, 19% were hospitalizations, and 10% were ED visits. Females (63%), children aged </=9 years (77% among children), and adults aged >/=45 years (80% among adults) had the majority of asthma claims. Among health regions, Caguas had the highest asthma claim-rate at 142/1,000 persons (overall health region claim-rate = 108). Environmental exposures varied across the year and demonstrated seasonal patterns. Metro health region regression models showed positive associations between increases in mold and particulate matter <10 microns in diameter (PM10) and outpatient asthma claims. Conclusions: This study provides information about patterns of asthma-related healthcare use across Puerto Rico. Increases in mold and PM10 were associated with increases in asthma claims. Targeting educational interventions on exposure awareness and reduction techniques, especially to persons with higher asthma-related healthcare use, can support asthma control activities in public health and clinical settings. |
Activity modification in heat: critical assessment of guidelines across athletic, occupational, and military settings in the USA
Hosokawa Y , Casa DJ , Trtanj JM , Belval LN , Deuster PA , Giltz SM , Grundstein AJ , Hawkins MD , Huggins RA , Jacklitsch B , Jardine JF , Jones H , Kazman JB , Reynolds ME , Stearns RL , Vanos JK , Williams AL , Williams WJ . Int J Biometeorol 2019 63 (3) 405-427 Exertional heat illness (EHI) risk is a serious concern among athletes, laborers, and warfighters. US Governing organizations have established various activity modification guidelines (AMGs) and other risk mitigation plans to help ensure the health and safety of their workers. The extent of metabolic heat production and heat gain that ensue from their work are the core reasons for EHI in the aforementioned population. Therefore, the major focus of AMGs in all settings is to modulate the work intensity and duration with additional modification in adjustable extrinsic risk factors (e.g., clothing, equipment) and intrinsic risk factors (e.g., heat acclimatization, fitness, hydration status). Future studies should continue to integrate more physiological (e.g., valid body fluid balance, internal body temperature) and biometeorological factors (e.g., cumulative heat stress) to the existing heat risk assessment models to reduce the assumptions and limitations in them. Future interagency collaboration to advance heat mitigation plans among physically active population is desired to maximize the existing resources and data to facilitate advancement in AMGs for environmental heat. |
National unintentional carbon monoxide poisoning estimates using hospitalization and emergency department data
Stearns D , Sircar K . Am J Emerg Med 2018 37 (3) 421-426 Unintentional non-fire-related (UNFR) carbon monoxide (CO) poisoning is a leading cause of poisoning in the US and a preventable cause of death. We generated national estimates of accidental CO poisoning and characterized the populations most at risk. UNFR CO poisoning cases were assessed using hospitalization and emergency department (ED) data from the Healthcare Costs and Utilization Project National Inpatient Sample and Nationwide Emergency Department Sample databases. We used hospitalization data from 2003 to 2013 and ED data from 2007 to 2013. We calculated trends using a linear regression of UNFR CO poisonings over the study period and age-adjusted rates using direct standardization and U.S. Census Bureau estimates. During 2003-2013, approximately 14,365 persons (4.1 cases/million annually) with confirmed or probable UNFR CO poisoning were admitted to hospitals and the annual rate of poisonings showed a weak downward trend (p=0.12). During 2007-2013, approximately 101,847 persons (48.3 visits/million annually) visited the ED and the annual rate of poisonings showed a significant downward trend (p</=0.01). Most UNFR CO hospital cases involved patients who were older (aged 45-64years), white, male, or living in the South or Midwest. Overall, the rate of hospitalizations did not change over the study period. Unintentional CO poisoning is preventable and these cases represent the most recent national estimates. ED visits declined over the study period, but the hospitalization rates did not change. This emphasizes the need for prevention efforts, such as education in the ED setting, increased use of CO alarms, and proper use and maintenance of fuel-powered household appliances. |
Identification of heart failure events in CMS-Medicare claims. The Atherosclerosis Risk in communities (ARIC) Study
Kucharska-Newton AM , Heiss G , Ni H , Stearns SC , Puccinelli-Ortega N , Wruck LM , Chambless L . J Card Fail 2015 22 (1) 48-55 BACKGROUND: We examined the accuracy of CMS Medicare HF diagnostic codes in the identification of acute decompensated and chronic stable HF (ADHF and CSHF). METHODS AND RESULTS: Hospitalizations were identified from medical discharge records for ARIC study participants with linked CMS Medicare Provider Analysis and Review (MedPAR) files for the years 2005-2009. The ARIC Study classification of ADHF and CSHF, based on adjudicated review of medical records, was considered the "gold standard". A total 8,239 ARIC medical records and MedPAR records meeting fee-for-service (FFS) criteria matched on unique participant ID and date of discharge (68.5% match). Agreement between HF diagnostic codes from the two data sources found in the matched records for codes in any position (kappa coefficient (kappa) >0.9) was attenuated for primary diagnostic codes (kappa<0.8). Sensitivity of HF diagnostic codes found in CMS Medicare claims in the identification of ADHF and CSHF was low, especially for the primary diagnostic codes. CONCLUSION: Matching of hospitalizations from CMS Medicare claims with those obtained from abstracted medical records is incomplete, even for hospitalizations meeting FFS criteria. Within matched records, HF diagnostic codes from CMS Medicare show excellent agreement with HF diagnostic codes obtained from medical record abstraction. CMS Medicare data may, however, over-estimate the occurrence of hospitalized acute decompensated or chronic stable HF. |
Cost-effectiveness of a behavioral weight loss intervention for low-income women: the Weight-Wise Program
Gustafson A , Khavjou O , Stearns SC , Keyserling TC , Gizlice Z , Lindsley S , Bramble K , Garcia B , Johnston L , Will J , Poindexter P , Ammerman AS , Samuel-Hodge CD . Prev Med 2009 49 (5) 390-5 OBJECTIVE: Assess the cost-effectiveness of a 16-week weight loss intervention (Weight-Wise) for low-income midlife women. METHOD: A randomized controlled trial conducted in North Carolina in 2007 tested a weight loss intervention among 143 women (40-64 years old, mean BMI=35.1 kg/m(2)). Women were randomized to one of two arms-special intervention (n=72) and a wait-listed control group (n=71). Effectiveness measures included changes in weight, systolic and diastolic blood pressure, total cholesterol, and HDL cholesterol. Cost-effectiveness measures calculated life years gained (LYG) from changes in weight, based on excess years life lost (YLL) algorithm. RESULTS: Intervention participants had statistically significant decreases in weight (kg) (-4.4 95% CI=-5.6, -3.2) and in systolic blood pressure (-6.2 mm Hg, 95% CI=-10.6, -1.7) compared to controls. Total cost of conducting Weight-Wise was $17,403, and the cost per participant in intervention group was $242. The incremental cost per life year gained (discounted) from a decrease in obesity was $1862. CONCLUSION: Our results suggest the Weight-Wise intervention may be a cost-effective approach to improving the health of low-income women. |
- Page last reviewed:Feb 1, 2024
- Page last updated:May 20, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure