Last data update: Jun 17, 2024. (Total: 47034 publications since 2009)
Records 1-30 (of 36 Records) |
Query Trace: Storey E [original query] |
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Securing the supply of benzathine benzylpenicillin: a global perspective on risks and mitigation strategies to prevent future shortages
Seghers F , Taylor MM , Storey A , Dong J , Wi TC , Wyber R , Ralston K , Nguimfack BD . Int Health 2024 16 (3) 279-282 Benzathine benzylpenicillin is a globally indispensable medicine. As a long-lasting injectable penicillin, it serves as the primary treatment for syphilis, group A streptococcal infections, rheumatic fever and rheumatic heart disease. A competitive market and low profit margins, compounded by limited visibility of demand, have resulted in a decreased number of active pharmaceutical ingredient (API) manufacturers. By 2016, only three Chinese API manufacturers remained, continuing to supply to the global market today. Recurring global shortages, a consequence of supply and demand imbalances, indicate underlying market risks. Therefore, the need for mitigation strategies is imperative. |
Estimation of benzathine penicillin G demand for congenital syphilis elimination with adoption of dual HIV/syphilis rapid diagnostic tests in eleven high burden countries
Shah S , Garg S , Heath K , Ofili O , Bansal Y , Seghers F , Storey A , Taylor M . PLoS One 2021 16 (8) e0256400 BACKGROUND: WHO recommends use of rapid dual HIV/syphilis tests for screening pregnant women (PW) during antenatal care to prevent mother-to-child transmission. Scale-up of testing implies a need to accurately forecast and procure benzathine penicillin (BPG) to treat the additionally identified PW with syphilis. METHODS: Country-reported ANC coverage, PW syphilis screening and treatment coverage values in 2019 were scaled linearly to EMTCT targets by 2030 (constant increasing slope from 2019 figures to 95% in 2030) for 11 focus countries. Antenatal syphilis screening coverage was substituted with HIV screening coverage to estimate potential contribution of rapid dual HIV/syphilis tests in identifying additional PW with syphilis. BPG demand was calculated for 2019-2030 accordingly. RESULTS: The estimated demand for BPG (in 2.4 million unit vials) using current maternal syphilis prevalence and treatment coverage will increase from a baseline of 414,459 doses in 2019 to 683,067 doses (+65%) in 2021 assuming immediate replacement of single HIV test kits with rapid dual HIV/syphilis tests for these 11 countries. Continued scale up of syphilis screening and treatment coverage to reach elimination coverage of 95% will result in an estimated demand increase of 160%, (663,969 doses) from 2019 baseline for a total demand of 1,078,428 BPG doses by 2030. CONCLUSIONS: Demand for BPG will increase following adoption of rapid dual HIV/syphilis test kits due to increases in maternal diagnoses of syphilis. To eliminate congenital syphilis, MNCH clinical programs will need to synergize with disease surveillance programs to accurately forecast BPG demand with scale up of antenatal syphilis screening to ensure adequate treatment is available for pregnant women diagnosed with syphilis. |
Cost-effectiveness of dual maternal HIV and syphilis testing strategies in high and low HIV prevalence countries: a modelling study
Rodriguez PJ , Roberts DA , Meisner J , Sharma M , Owiredu MN , Gomez B , Mello MB , Bobrik A , Vodianyk A , Storey A , Githuka G , Chidarikire T , Barnabas R , Barr-Dichiara M , Jamil MS , Baggaley R , Johnson C , Taylor MM , Drake AL . Lancet Glob Health 2020 9 (1) e61-e71 BACKGROUND: Dual HIV and syphilis testing might help to prevent mother-to-child transmission (MTCT) of HIV and syphilis through increased case detection and treatment. We aimed to model and assess the cost-effectiveness of dual testing during antenatal care in four countries with varying HIV and syphilis prevalence. METHODS: In this modelling study, we developed Markov models of HIV and syphilis in pregnant women to estimate costs and infant health outcomes of maternal testing at the first antenatal care visit with individual HIV and syphilis tests (base case) and at the first antenatal care visit with a dual rapid diagnostic test (scenario one). We additionally evaluated retesting during late antenatal care and at delivery with either individual tests (scenario two) or a dual rapid diagnosis test (scenario three). We modelled four countries: South Africa, Kenya, Colombia, and Ukraine. Strategies with an incremental cost-effectiveness ratio (ICER) less than the country-specific cost-effectiveness threshold (US$500 in Kenya, $750 in South Africa, $3000 in Colombia, and $1000 in Ukraine) per disability-adjusted life-year averted were considered cost-effective. FINDINGS: Routinely offering testing at the first antenatal care visit with a dual rapid diagnosis test was cost-saving compared with the base case in all four countries (ICER: -$26 in Kenya,-$559 in South Africa, -$844 in Colombia, and -$454 in Ukraine). Retesting during late antenatal care with a dual rapid diagnostic test (scenario three) was cost-effective compared with scenario one in all four countries (ICER: $270 in Kenya, $260 in South Africa, $2207 in Colombia, and $205 in Ukraine). INTERPRETATION: Incorporating dual rapid diagnostic tests in antenatal care can be cost-saving across countries with varying HIV prevalence. Countries should consider incorporating dual HIV and syphilis rapid diagnostic tests as the first test in antenatal care to support efforts to eliminate MTCT of HIV and syphilis. FUNDING: WHO, US Agency for International Development, and the Bill & Melinda Gates Foundation. |
Opportunities at the intersection of work and health: Developing the occupational data for health information model
Marovich S , Luensman GB , Wallace B , Storey E . J Am Med Inform Assoc 2020 27 (7) 1072-1083 OBJECTIVE: The study sought to develop an information model of data describing a person's work for use by health information technology (IT) systems to support clinical care, population health, and public health. MATERIALS AND METHODS: Researchers from the National Institute for Occupational Safety and Health worked with stakeholders to define relationships and structure, vocabulary, and interoperability standards that would be useful and collectable in health IT systems. RESULTS: The Occupational Data for Health (ODH) information model illustrates relationships and attributes for a person's employment status, retirement dates, past and present jobs, usual work, and combat zone periods. Key data about the work of a household member that could be relevant to the health of a minor were also modeled. Existing occupation and industry classification systems were extended to create more detailed value sets that enable self-reporting and support patient care. An ODH code system, available in the Public Health Information Network Vocabulary Access and Distribution System, was established to identify the remaining value sets. ODH templates were prepared in all 3 Health Level 7 Internationalinteroperability standard formats. DISCUSSION: The ODH information model suggests data elements ready for use by health IT systems in the United States. As new data elements and values are better defined and refined by stakeholders and feedback is obtained through experience using ODH in clinical settings, the model will be updated. CONCLUSION: The ODH information model suggests standardized work information for trial use in health IT systems to support patient care, population health, and public health. |
Syphilis diagnosis and treatment during antenatal care: the potential catalytic impact of the dual HIV and syphilis rapid diagnostic test
Storey A , Seghers F , Pyne-Mercier L , Peeling RW , Owiredu MN , Taylor MM . Lancet Glob Health 2019 7 (8) e1006-e1008 An estimated 355 000 adverse pregnancy outcomes occur annually due to syphilis,1 two-thirds of which result in stillbirth or neonatal death.2 WHO launched the Elimination of Mother-to-Child Transmission of HIV and Syphilis initiative in 2014.3 However, antenatal syphilis screening and treatment rates remain low across sub-Saharan Africa and parts of Asia,4 particularly compared with progress made to reduce new HIV infections among infants, which have declined from 270 000 in 2010 to 180 000 in 2017.5 |
Work practices and respiratory health status of Appalachian coal miners with progressive massive fibrosis
Reynolds LE , Blackley DJ , Colinet JF , Potts JD , Storey E , Short C , Carson R , Clark KA , Laney AS , Halldin CN . J Occup Environ Med 2018 60 (11) e575-e581 OBJECTIVE: To characterize workplace practices and respiratory health among coal miners with large opacities consistent with progressive massive fibrosis (PMF) who received care at a federally-funded black lung clinic network in Virginia. METHODS: Participants were interviewed about their workplace practices and respiratory health. Medical records were reviewed. RESULTS: Nineteen former coal miners were included. Miners reported cutting rock, working downwind of dust-generating equipment, non-adherence to mine ventilation plans (including dust controls), improper sampling of respirable coal mine dust exposures, working after developing respiratory illness, and suffering from debilitating respiratory symptoms. CONCLUSIONS: Consistent themes of suboptimal workplace practices contributing to development of PMF emerged during the interviews. Some of the practices reported were unsafe and unacceptable. Further research is needed to determine the prevalence of these factors and how best to address them. |
Progressive massive fibrosis resurgence identified in U.S. coal miners filing for black lung benefits, 1970-2016
Almberg KS , Halldin CN , Blackley DJ , Laney AS , Storey E , Rose CS , Go LHT , Cohen RA . Ann Am Thorac Soc 2018 15 (12) 1420-1426 RATIONALE: There has been a resurgence of progressive massive fibrosis (PMF) in the United States, particularly among central Appalachian miners. OBJECTIVES: We characterized the proportion of PMF among former U.S. coal miners applying for Federal Black Lung Program benefits, 1970-2016. METHODS: Data from the U.S. Department of Labor were used to characterize trends in proportion of PMF cases, defined as an approved black lung claim with a determination of PMF, among all miners who filed for federal benefits between January 1, 1970 and December 31, 2016. Joinpoint, logistic, and linear regression models were used to identify changes in the proportion of claimants with PMF over time. MEASUREMENTS AND MAIN RESULTS: There were 4,679 unique PMF cases among claimants for federal black lung benefits between 1970 - 2016, with 2,474 miners determined to have PMF since 1996. The number of PMF cases among Federal Black Lung Program claimants fell from 404 (0.5% of claimants) in 1978 to a low of 18 cases (0.6%) in 1988, then increased to 353 cases (8.3%) in 2014. The proportion of federal black lung benefits claimants with PMF has been increasing since 1978 (0.06% APC; 95%CI 0.05%, 0.07%; p < .0001), and began increasing at a significantly increased rate after 1996 (0.26% APC; 95% CI 0.25%, 0.28%; p < .0001). Most miners with PMF (84%) last mined in West Virginia, Kentucky, Pennsylvania, or Virginia. Since 1970, the proportion of claimants with PMF has increased significantly among miners who last worked in Kentucky (16.6% APC; 95%CI 16.5%, 16.7%), Pennsylvania (4.7% APC; 95%CI 4.6%, 4.8%), Tennessee (16.1% APC; 95%CI 15.7%, 16.4%), West Virginia (16.8% APC; 95%CI 16.6%, 16.9%), and most sharply among miners last working in Virginia (31.5% APC; 95%CI 31.2%, 31.7%), where in 2009, over 17% of claimants received a PMF determination. The proportion of PMF determinations for the rest of the U.S. have not exceeded 4%. CONCLUSIONS: There has been a resurgence of PMF, particularly in central Appalachian miners. The resurgence of this preventable disease points to the need for improved primary and secondary prevention of dust-related lung disease in U.S. coal miners. |
Progressive massive fibrosis in coal miners from 3 clinics in Virginia
Blackley DJ , Reynolds LE , Short C , Carson R , Storey E , Halldin CN , Laney AS . JAMA 2018 319 (5) 500-501 This study describes the demographic and radiographic characteristics of 416 coal miners with progressive massive pulmonary fibrosis (PMF) identified by pneumoconiosis screening as part of the US Coal Workers' Health Surveillance Program. |
Longitudinal and cross-sectional analyses of lung function in toluene diisocyanate production workers
Wang ML , Storey E , Cassidy LD , Doney B , Conner PR , Collins JJ , Carson M , Molenaar D . J Occup Environ Med 2017 59 Suppl 12 S28-s35 OBJECTIVE: The aim of this study was to investigate lung function among toluene diisocyanate (TDI) production workers. METHODS: One hundred ninety-seven U.S workers performed spirometry from 2006 through 2012. Results were compared within the study cohort and with U.S. population measures. A mixed-effects model assessed factors affecting repeated forced expiratory volume in 1 second (FEV1) measurements. RESULTS: The cohort's mean FEV1 and forced vital capacity (FVC) percent reference values, although greater than 90%, were significantly lower and the prevalence of abnormal spirometry (predominantly restrictive pattern) was significantly higher than in the U.S. POPULATION: Differences in lung function among workers with higher cumulative TDI exposure were in the direction of an exposure effect, but not significant. CONCLUSION: We found little evidence of an adverse effect of TDI exposure on longitudinal spirometry in these workers. The association between TDI exposure and the increasing prevalence of a restrictive pattern needs further exploration. |
Medical monitoring for occupational asthma among toluene diisocyanate production workers in the United States
Cassidy LD , Doney B , Wang ML , Kurth L , Conner PR , Collins JJ , Carson M , Molenaar D , Redlich CA , Storey E . J Occup Environ Med 2017 59 Suppl 12 S13-s21 OBJECTIVE: The aim of this study was to describe a study of medical monitoring methods and lessons learned in detecting health outcomes in U.S. plants producing toluene diisocyanate (TDI). METHODS: A multidisciplinary team implemented a medical and environmental monitoring program in three TDI plants. RESULTS: Of 269 eligible workers, 197 (73%) participated and 42 (21%) met symptom and/or lung function criteria that would trigger evaluation for possible asthma over 5 years of data collection. Subsequent evaluation was delayed for most, and a web-based data collection system improved timeliness. CONCLUSION: Medical monitoring of TDI workers identified workers triggering further assessment per study protocol. Systems and/or personnel to ensure rapid follow-up are needed to highlight when triggering events represent potential cases of asthma needing further evaluation. Implementation of a research protocol requires resources and oversight beyond an occupational health program. |
Incidence of occupational asthma and exposure to toluene diisocyanate in the United States toluene diisocyanate production industry
Collins JJ , Anteau S , Conner PR , Cassidy LD , Doney B , Wang ML , Kurth L , Carson M , Molenaar D , Redlich CA , Storey E . J Occup Environ Med 2017 59 Suppl 12 S22-s27 OBJECTIVE: This study examines asthma risk in facilities producing toluene diisocyanate (TDI). METHODS: A total of 197 workers were monitored from 2007 to 2012. TDI air concentrations were used to estimate exposures. RESULTS: The incidence of cases consistent with TDI-induced asthma was 0.009 per person-years (seven cases) or consistent with TDI-induced asthma or asthma indeterminate regarding work-relatedness was 0.012 (nine cases). Increased risk of cases consistent with TDI asthma was observed for cumulative (odds ratio [OR] = 2.08, 95% confidence interval [CI] 1.07 to 4.05) per logarithm parts per billion-years and peak TDI exposures (OR = 1.18, 95% CI 1.06 to 1.32) (logarithm parts per billion). There was a weak association with cumulative and peak exposures for decline of short-term forced expiratory volume in one second (FEV1). Asthma symptoms were associated with workers noticing an odor of TDI (OR 6.02; 95% CI 1.36 to 26.68). CONCLUSIONS: There is evidence that cumulative and peak exposures are associated with TDI-induced asthma. |
Enhancing worker health through clinical decision support (CDS): An introduction to a compilation
Filios MS , Storey E , Baron S , Luensman GB , Shiffman RN . J Occup Environ Med 2017 59 (11) e227-e230 OBJECTIVE: This article outlines an approach to developing clinical decision support (CDS) for conditions related to work and health. When incorporated in electronic health records, such CDS will assist primary care providers (PCPs) care for working patients. METHODS: Three groups of Subject Matter Experts (SMEs) identified relevant clinical practice guidelines, best practices, and reviewed published literature concerning work-related asthma, return-to-work, and management of diabetes at work. RESULTS: SMEs developed one recommendation per topic that could be supported by electronic CDS. Reviews with PCPs, staff, and health information system implementers in five primary care settings confirmed that the approach was important and operationally sound. CONCLUSION: This compendium is intended to stimulate a dialogue between occupational health specialists and PCPs that will enhance the use of work information about patients in the primary care setting. |
Recommendations for a clinical decision support system for work-related asthma in primary care settings
Harber P , Redlich CA , Hines S , Filios M , Storey E . J Occup Environ Med 2017 59 (11) e231-e235 OBJECTIVE: Describe a recommended clinical decision support approach for work-related asthma for incorporation in electronic health records for primary care health care providers. METHODS: Subject matter experts convened by the American Thoracic Society reviewed available guidelines and published literature to develop specific recommendations. RESULTS: It is important to recognize possible work-related asthma among persons with new-onset or worsening asthma. The work group recommends incorporating three simple questions about temporal relations between asthma symptoms and work in EHR systems and identified specific clinical conditions to trigger this intervention. Patients with positive responses to the three questions should have the asthma diagnosis documented and have further evaluation, education, and possible referral. CONCLUSIONS: An effective CDS system for improving recognition of work-related asthma may help reduce morbidity and mortality of asthma in adults. |
Current asthma and asthma-like symptoms among workers at a Veterans Administration Medical Center
Kurth L , Virji MA , Storey E , Framberg S , Kallio C , Fink J , Laney AS . Int J Hyg Environ Health 2017 220 (8) 1325-1332 INTRODUCTION: Healthcare workers are at increased risk for respiratory disorders. The purpose of our respiratory health survey was to estimate the prevalence of current asthma and asthma-like symptoms and their association with workplace exposures and tasks among healthcare workers at a Veterans Administration (VA) Medical Center. MATERIAL AND METHODS: Information on respiratory health and work characteristics, including tasks performed, products used, and exposures, were collected by questionnaire from a convenience sample of workers employed at the VA Medical Center during 2012-2014. Associations of asthma and asthma-like symptoms with cleaning and disinfecting tasks and products as well as exposure to dampness and molds, and construction dust were evaluated using log-binomial regression. RESULTS: The prevalence of current asthma was 17.6% and almost half of all workers reported asthma-like symptoms. We observed elevated prevalence of current asthma among the VA healthcare workers compared to the U.S. general and working adult populations. Asthma and asthma-like symptoms were significantly associated with mold, dampness, and construction material exposures; cleaning and disinfecting products; and cleaning or disinfecting tasks. CONCLUSIONS: Workplace exposures and tasks associated with current asthma and asthma-like symptoms were identified but further research is needed to investigate the temporal association between workplace exposures and current asthma and asthma-like symptoms. |
Evolution and current understanding of physicochemical characterization of particulate matter from reactivity controlled compression ignition combustion on a multicylinder light-duty engine
Storey JME , Curran SJ , Lewis SA , Barone TL , Dempsey AB , Moses-Debusk M , Hanson RM , Prikhodko VY , Northrop WF . Int J Engine Res 2017 18 505-519 Low-temperature compression ignition combustion can result in nearly smokeless combustion, as indicated by a smoke meter or other forms of soot measurement that rely on absorbance due to elemental carbon content. Highly premixed low-temperature combustion modes do not form particulate matter in the traditional pathways seen with conventional diesel combustion. Previous research into reactivity controlled compression ignition particulate matter has shown, despite a near zero smoke number, significant mass can be collected on filter media used for particulate matter certification measurement. In addition, particulate matter size distributions reveal that a fraction of the particles survive heated double-dilution conditions. This study summarizes research completed at Oak Ridge National Laboratory to date on characterizing the nature, chemistry and aftertreatment considerations of reactivity controlled compression ignition particulate matter and presents new research highlighting the importance of injection strategy and fuel composition on reactivity controlled compression ignition particulate matter formation. Particle size measurements and the transmission electron microscopy results do show the presence of soot particles; however, the elemental carbon fraction was, in many cases, within the uncertainty of the thermal-optical measurement. Particulate matter emitted during reactivity controlled compression ignition operation was also collected with a novel sampling technique and analyzed by thermal desorption or pyrolysis gas chromatography mass spectroscopy. Particulate matter speciation results indicated that the high boiling range of diesel hydrocarbons was likely responsible for the particulate matter mass captured on the filter media. To investigate potential fuel chemistry effects, either ethanol or biodiesel were incorporated to assess whether oxygenated fuels may enhance particle emission reduction. © 2016 IMechE. |
Linking compensation and health surveillance data sets to improve knowledge of US coal miners' health
Almberg KS , Cohen RA , Blackley DJ , Laney AS , Storey E , Halldin CN . J Occup Environ Med 2017 59 (10) 930-934 OBJECTIVE: Increase knowledge of US coal miners' respiratory health by linking data from the black lung benefits program (BLBP) and the coal workers' health surveillance program (CWHSP). METHODS: BLBP claims data from 2000 through 2013 was linked to CWHSP data from 1970 through 2016. RESULTS: Overall, 273,644 miners participated in CWHSP, 37,548 in BLBP, and 22,903 in both programs. Median age of miners at their time of first/only participation in CWHSP was 28 and 32 years, respectively. BLBP claimants were older (median age 59). Thirty-nine percent of BLBP claimants had not participated in CWHSP. The relative contributions of states to participation differed between CWHSP and BLBP. For example, Kentucky miners accounted for 18% of CWHSP participants, but 36% of BLPB participants. CONCLUSIONS: Many BLBP claimants never appeared in CWHSP, indicating missed opportunities for secondary prevention. |
Strengthening the Coal Workers' Health Surveillance Program
Reynolds LE , Wolfe AL , Clark KA , Blackley DJ , Halldin CN , Laney AS , Storey E . J Occup Environ Med 2017 59 (4) e71 In 2014, the Mine Safety and Health Administration (MSHA) issued a final rule1 requiring the National Institute for Occupational Safety and Health (NIOSH) to expand the coal workers’ health surveillance program (CWHSP). Since 1970, when it was established by the Coal Mine Health and Safety Act of 1969, the CWHSP has offered chest radiographs to US coal miners—primarily those working underground—to detect coal workers’ pneumoconiosis (CWP) early and prevent it from progressing to disabling disease. The expansion of the CWHSP adds periodic lung function testing (spirometry) and respiratory health assessment questionnaires, and extends its coverage to include surface coal miners. This will permit the early detection of lung function impairment secondary to chronic obstructive pulmonary disease, an important manifestation of coal mine dust lung disease that is not detected by chest radiography. | On October 24, 2016, in accordance with the MSHA rule, NIOSH published a final rule2 updating medical surveillance for coal miners. NIOSH collaborated with MSHA, mine operators, clinics, medical device manufacturers, and other stakeholders to develop a framework to meet its new mandate. All clinics participating in the CWHSP, including new spirometry clinics, must be approved by NIOSH to ensure clinic personnel are trained, equipment and procedures are standardized, and miners’ health information can be securely collected and transmitted to NIOSH. |
Misclassification of occupational disease in lung transplant recipients
Blackley DJ , Halldin CN , Cohen RA , Cummings KJ , Storey E , Laney AS . J Heart Lung Transplant 2017 36 (5) 588-590 Data from the United States Organ Procurement and Transplantation Network (OPTN) registry have been analyzed in recent years to assess post–lung transplant (LT) survival in occupational lung disease patients.1–3 Registry data include diagnosis codes with limited specificity; each patient is assigned a diagnosis code at waitlist candidacy, at listing, and at LT, and these codes can differ. The use of both numeric and free-text data can produce incompatible or unlikely diagnosis code pairings (such as a numeric code for idiopathic pulmonary fibrosis with a paired free-text entry of “silicosis”). The resulting misclassification could bias findings related to patient characteristics, post-LT survival comparisons and other measures used to summarize outcomes. | Diagnosis codes from OPTN data could be inadequate for case finding and may result in missed occupational lung disease cases. Our objective was to identify and describe adult LT recipients documented as having conditions known to be entirely attributable to occupational exposure, and to calculate the proportion of those patients who were assigned an occupational lung disease diagnosis code at LT. |
Resurgence of progressive massive fibrosis in coal miners - Eastern Kentucky, 2016
Blackley DJ , Crum JB , Halldin CN , Storey E , Laney AS . MMWR Morb Mortal Wkly Rep 2016 65 (49) 1385-1389 Coal workers' pneumoconiosis, also known as "black lung disease," is an occupational lung disease caused by overexposure to respirable coal mine dust. Inhaled dust leads to inflammation and fibrosis in the lungs, and coal workers' pneumoconiosis can be a debilitating disease. The Federal Coal Mine Health and Safety Act of 1969 (Coal Act),* amended in 1977, established dust limits for U.S. coal mines and created the National Institute for Occupational Safety and Health (NIOSH)-administered Coal Workers' Health Surveillance Program with the goal of reducing the incidence of coal workers' pneumoconiosis and eliminating its most severe form, progressive massive fibrosis (PMF),dagger which can be lethal. The prevalence of PMF fell sharply after implementation of the Coal Act and reached historic lows in the 1990s, with 31 unique cases identified by the Coal Workers' Health Surveillance Program during 1990-1999. Since then, a resurgence of the disease has occurred, notably in central Appalachia (Figure 1) (1,2). This report describes a cluster of 60 cases of PMF identified in current and former coal miners at a single eastern Kentucky radiology practice during January 2015-August 2016. This cluster was not discovered through the national surveillance program. This ongoing outbreak highlights an urgent need for effective dust control in coal mines to prevent coal workers' pneumoconiosis, and for improved surveillance to promptly identify the early stages of the disease and stop its progression to PMF. |
Physician's knowledge, attitudes, and practices regarding seasonal influenza, pandemic influenza, and highly pathogenic avian influenza A (H5N1) virus infections of humans in Indonesia
Amalya M , Iuliano AD , Wahyuningrum Y , Praptiningsih CY , Lafond KE , Storms AD , Samaan G , Ariawan I , Soeharno N , Kreslake J , Storey D , Uyeki TM . Influenza Other Respir Viruses 2016 11 (1) 93-99 Indonesia has reported highest number of fatal human cases of highly pathogenic avian influenza (HPAI) A (H5N1) virus infection worldwide since 2005. There are limited data available on seasonal and pandemic influenza in Indonesia. During 2012, we conducted a survey of clinicians in two districts in western Java, Indonesia to assess knowledge, attitudes and practices (KAP) of clinical diagnosis, testing, and treatment of patients with seasonal influenza, pandemic influenza, or HPAI H5N1 virus infections. Overall, a very low percentage of physician participants reported ever diagnosing hospitalized patients with seasonal, pandemic, or HPAI H5N1 influenza. Use of influenza testing was low in outpatients and hospitalized patients, and use of antiviral treatment was very low for clinically-diagnosed influenza patients. Further research is needed to explore health system barriers for influenza diagnostic testing and availability of antivirals for treatment of influenza in Indonesia. |
Effects of oil formulation, oil separator, and engine speed and load on the particle size, chemistry, and morphology of diesel crankcase aerosols
Uy Dairene , Storey John , Sluder CScott , Barone Teresa , Lewis Sam , Jagner Mark . SAE Int J Fuels Lubr 2016 9 (1) 224-238 The recirculation of gases from the crankcase and valvetrain can potentially lead to the entrainment of lubricant in the form of aerosols or mists. As boost pressures increase, the blow-by flow through both the crankcase and the valve cover increases. The resulting lubricant can then become part of the intake charge, potentially leading to fouling of intake components such as the intercooler and the turbocharger. The entrained aerosol which can contain the lubricant and soot may or may not have the same composition as the bulk lubricant. The complex aerodynamic processes that lead to entrainment can strip out heavy components or volatilize light components. Similarly, the physical size and numbers of aerosol particles can be dependent upon the lubricant formulation and engine speed and load. For instance, high rpm and load may increase not only the flow of gases but the amount of lubricant aerosol. In this study, the number, size distribution, composition, and morphology of entrained lubricant aerosol is examined on a medium-duty diesel engine operating at different speeds and loads. A unique sampling apparatus is described for sampling the aerosol in the same manner that it enters the intake. In addition, the performance of oil separators is examined. Results demonstrate that the size distribution changes with load, and contains both a sub-micron and super-micron component. The chemical composition of the aerosol varies depending on engine speed and load and oil separator used, while TEM results show that aerosol morphology changes with lubricant viscosity and also engine conditions. |
The intersection of care seeking and clinical capacity for patients with highly pathogenic avian influenza A (H5N1) virus in Indonesia: knowledge and treatment practices of the public and physicians
Kreslake JM , Wahyuningrum Y , Iuliano AD , Storms AD , Lafond KE , Mangiri A , Praptiningsih CY , Safi B , Uyeki TM , Storey JD . Disaster Med Public Health Prep 2016 10 (6) 1-10 BACKGROUND: Indonesia has the highest human mortality from highly pathogenic avian influenza (HPAI) A (H5N1) virus infection in the world. METHODS: A survey of households (N=2520) measured treatment sources and beliefs among symptomatic household members. A survey of physicians (N=554) in various types of health care facilities measured knowledge, assessment and testing behaviors, and perceived clinical capacity. RESULTS: Households reported confidence in health care system capacity but infrequently sought treatment for potential HPAI H5N1 signs/symptoms. More clinicians were confident in their knowledge of diagnosis and treatment than in the adequacy of related equipment and resources at their facilities. Physicians expressed awareness of the HPAI H5N1 suspect case definition, yet expressed only moderate knowledge in questioning symptomatic patients about exposures. Self-reported likelihood of testing for HPAI H5N1 virus was high after learning of certain exposures. Knowledge of antiviral treatment was moderate, but it was higher among clinicians in puskesmas. Physicians in private outpatient clinics, the most heavily used facilities, reported the lowest confidence in their diagnostic and treatment capabilities. CONCLUSIONS: Educational campaigns can encourage recall of possible poultry exposure when patients are experiencing signs/symptoms and can raise awareness of the effectiveness of antivirals to drive people to seek health care. Clinicians may benefit from training regarding exposure assessment and referral procedures, particularly in private clinics. (Disaster Med Public Health Preparedness. 2016;page 1 of 10). |
Healthcare-seeking behaviors for acute respiratory illness in two communities of Java, Indonesia
Praptiningsih CY , Lafond KE , Wahyuningrum Y , Storms AD , Mangiri A , Iuliano AD , Samaan G , Titaley CR , Yelda F , Kreslake J , Storey D , Uyeki TM . J Epidemiol Glob Health 2016 6 (2) 77-86 Understanding healthcare-seeking patterns for respiratory illness can help improve estimations of disease burden and inform public health interventions to control acute respiratory disease in Indonesia. The objectives of this study were to describe healthcare-seeking behaviors for respiratory illnesses in one rural and one urban community in Western Java, and to explore the factors that affect care seeking. From February 8, 2012 to March 1, 2012, a survey was conducted in 2520 households in the East Jakarta and Bogor districts to identify reported recent respiratory illnesses, as well as all hospitalizations from the previous 12-month period. We found that 4% (10% of those older than 5years) of people had respiratory disease resulting in a visit to a healthcare provider in the past 2weeks; these episodes were most commonly treated at government (33%) or private (44%) clinics. Forty-five people (0.4% of those surveyed) had respiratory hospitalizations in the past year, and just over half of these (24/45, 53%) occurred at a public hospital. Public health programs targeting respiratory disease in this region should account for care at private hospitals and clinics, as well as illnesses that are treated at home, in order to capture the true burden of illness in these communities. |
Cigarette smoking prevalence among adults working in the health care and social assistance sector, 2008 to 2012
Syamlal G , Mazurek JM , Storey E , Dube SR . J Occup Environ Med 2015 57 (10) 1107-12 OBJECTIVE: The primary objective of this study was to estimate current smoking among workers in the health care and social assistance sector. METHODS: We analyzed the 2008 to 2012 National Health Interview Survey data for adults (age 18 years or more) working in health care and social assistance sector who reported current cigarette smoking. RESULTS: Of the approximately 18.9 million health care and social assistance workers, 16.0% were current cigarette smokers. Smoking prevalence was highest in women (16.9%) and among workers: age 25 to 44 years (17.7%); with a high school education or less (24.4%); with income less than $35,000 (19.5%); with no health insurance (28.5%); in the nursing and residential care facilities (26.9%) industry; and in the material recording, scheduling, dispatching, and distributing (34.7%) occupations. CONCLUSIONS: These findings suggest that specific group of workers in the health care and social assistance sector might particularly benefit from cessation programs and incentives to quit smoking. |
Current knowledge of U.S. metal and nonmetal miner health: current and potential data sources for analysis of miner health status
Yeoman KM , Halldin CN , Wood J , Storey E , Johns D , Laney AS . Arch Environ Occup Health 2015 71 (2) 119-26 Little is known about the current health status of U.S. metal and nonmetal (MNM) miners in part because no health surveillance systems exist for this population. The National Institute for Occupational Safety and Health (NIOSH) is developing a program to characterize burden of disease among MNM miners. This report discusses current knowledge and potential data sources of MNM miner health. Recent national surveys were analyzed, and literature specific to MNM miner health status was reviewed. No robust estimates of disease prevalence were identified, and national surveys did not provide information specific to MNM miners. Because substantial gaps exist in the understanding of MNM miners' current health status, NIOSH plans to develop a health surveillance program for this population to guide intervention efforts to reduce occupational and personal risks for chronic illness. |
Debilitating lung disease among surface coal miners with no underground mining tenure
Halldin CN , Reed WR , Joy GJ , Colinet JF , Rider JP , Petsonk EL , Abraham JL , Wolfe AL , Storey E , Laney AS . J Occup Environ Med 2015 57 (1) 62-7 OBJECTIVE: To characterize exposure histories and respiratory disease among surface coal miners identified with progressive massive fibrosis from a 2010 to 2011 pneumoconiosis survey. METHODS: Job history, tenure, and radiograph interpretations were verified. Previous radiographs were reviewed when available. Telephone follow-up sought additional work and medical history information. RESULTS: Among eight miners who worked as drill operators or blasters for most of their tenure (median, 35.5 years), two reported poor dust control practices, working in visible dust clouds as recently as 2012. Chest radiographs progressed to progressive massive fibrosis in as few as 11 years. One miner's lung biopsy demonstrated fibrosis and interstitial accumulation of macrophages containing abundant silica, aluminum silicate, and titanium dust particles. CONCLUSIONS: Overexposure to respirable silica resulted in progressive massive fibrosis among current surface coal miners with no underground mining tenure. Inadequate dust control during drilling/blasting is likely an important etiologic factor. |
Patient-physician communication about work-related asthma: what we do and do not know
Mazurek JM , White GE , Moorman JE , Storey E . Ann Allergy Asthma Immunol 2014 114 (2) 97-102 BACKGROUND: Effective patient-physician communication is the key component of the patient-physician relationship. OBJECTIVE: To assess the proportion of ever-employed adults with current asthma who talked about asthma associated with work with their physician or other health professional and to identify factors associated with this communication. METHODS: The 2006 to 2010 Behavioral Risk Factor Surveillance System Asthma Call-Back Survey data from 40 states and the District of Columbia for ever-employed adults (≥18 years old) with current asthma (N = 50,433) were examined. Multivariable logistic regression analyses were conducted to identify factors associated with communication with a health professional about asthma and work. RESULTS: Among ever-employed adults with current asthma, 9.1% were ever told by a physician that their asthma was related to any job they ever had and 11.7% ever told a physician or other health professional that this was the case. When responses to the 2 questions were combined, the proportion of those who communicated with a health professional about asthma and work was 14.7%. Communication with a health professional about asthma and work was associated with age, race or ethnicity, employment, education, income, insurance, and urgent treatment for worsening asthma. CONCLUSION: A small proportion of patients with asthma might communicate with a health professional about asthma associated with work. Future studies should examine whether patients with asthma ever discussed with a health professional the possibility that their asthma might be related to work to provide information on the frequency of patient-clinician communication about asthma related to work. |
Employed adults with asthma who have frequent workplace exposures
White GE , Mazurek JM , Storey E . J Asthma 2014 52 (1) 1-17 BACKGROUND: The recent increase in asthma prevalence is thought to be partially due to environmental changes such as changes in air pollution and occupational exposures. Nationally representative information on workplace exposures among U.S. adults with asthma is limited. METHODS: We examined 2010 National Health Interview Survey data to determine the proportion of employed adults with asthma who had frequent workplace exposures. RESULTS: Among adults with current asthma, 19.6% frequently worked outdoors, 17.5% were frequently exposed to workplace secondhand smoke, and 28.1% were frequently exposed to workplace vapors, gas, dust, or fumes. Adults ever told by a health professional that asthma is probably work-related, when compared to adults who were not, had increased odds of frequent work outdoors (prevalence odds ratio [POR]=2.76), frequent workplace exposure to secondhand smoke (POR=3.08), and frequent workplace exposure to vapors, gas, dust, or fumes (POR=3.56). CONCLUSIONS: To our knowledge, this is the first population-based study in the United States that estimates the proportion of working adults with asthma that have frequent workplace exposures. Increasing the understanding of workplace exposures among adults with asthma will help enable prevention of asthma through workplace exposure reduction or avoidance. Future studies should further examine industries and occupations of individuals with asthma and frequent workplace exposures. |
Influenza vaccination among persons with work-related asthma
Mazurek JM , White GE , Moorman JE , Storey E . Am J Prev Med 2014 47 (2) 203-11 BACKGROUND: Seasonal influenza vaccination is recommended for all asthma patients. Persons with work-related asthma may have more severe disease than those with non-work-related asthma and may particularly benefit from receiving influenza vaccination. PURPOSE: To determine if influenza vaccination coverage differs among individuals aged 18-64 years with work-related and non-work-related asthma. METHODS: Data from the 2006-2009 Behavioral Risk Factor Surveillance System Asthma Call-Back Survey collected in 38 states and the District of Columbia were analyzed in 2013. Multivariable logistic regression and predictive marginal analyses were conducted to identify factors independently associated with influenza vaccination among respondents aged 18-64 years with work-related asthma. RESULTS: Among adults aged 18-64 years with current asthma, an estimated 42.7% received influenza vaccination in the past 12 months. Although influenza vaccination coverage was significantly higher among adults with work-related asthma than those with non-work-related asthma (48.5% vs 42.8%), this association became non-significant after adjustment for demographic and clinical characteristics (prevalence ratio=1.08, 95% CI=0.99, 1.20). Among individuals with work-related asthma, receiving the influenza vaccine was associated with being 50-64 years old, being unemployed in the prior year, and seeking urgent treatment for worsening asthma symptoms. CONCLUSIONS: Among persons with work-related and non-work-related asthma, less than half received influenza vaccination in the prior year, both below the Healthy People 2010 target of 60%. These results suggest the need for strengthening current vaccination interventions to meet the updated Healthy People 2020 objective of achieving at least 70% influenza vaccination coverage. |
Occupation held at the time of asthma symptom development
Knoeller GE , Mazurek JM , Storey E . Am J Ind Med 2013 56 (10) 1165-73 BACKGROUND: Examining occupations other than those held when asthma symptoms first developed may not correctly identify occupations with higher risk of asthma onset. METHODS: To determine the occupation held when individuals first developed asthma symptoms, we examined 2010 National Health Interview Survey data for working adults with current asthma. RESULTS: Overall 37.1% of working adults with current asthma developed asthma while employed. Of these, the highest proportions of individuals identified office and administrative support (13.3%), sales and related (9.4%), and management (8.5%) as the occupation held when asthma first developed; 37.8% had a different current occupation than at asthma onset, and estimates of a change in occupation were highest for those who developed asthma while working in business and financial operations (49.3%), sales and related (48.6%), and healthcare support (43.8%) occupations. CONCLUSION: Future population-based studies should further examine associations between asthma and occupation held at time of asthma onset. |
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