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Suarthana E.,Centers for Disease Control and Prevention | McFadden J.D.,Centers for Disease Control and Prevention | Laney A.S.,Centers for Disease Control and Prevention | Kreiss K.,Centers for Disease Control and Prevention | And 4 more authors.
Journal of Occupational and Environmental Medicine | Year: 2010

Objective: To assess the distribution of illness by industry sector and occupation reflected in early 2009 H1N1 influenza surveillance. Methods: We analyzed data reported for April to July 2009, for 1361 laboratory-confirmed 2009 H1N1 influenza-infected persons 16 years or older, with work status information from four states. A North American Industry Classification System 2007 code was assigned to each employed person. For a subset, an occupation code was assigned. Results: Of 898 employed individuals, 611 (68.0%) worked in the non-health care sector. The largest proportions worked in public administration, educational services, and accommodation and food services. In Wisconsin health care personnel, 53.6% were paraprofessionals, 33.6% professionals, and 12.7% other workers; 26.9% worked in ambulatory settings, 46.2% in hospitals, and 26.9% in nursing or residential care facilities. Conclusions: Our findings suggest that industry sectors and occupations should be explored systematically in future influenza surveillance. Copyright © 2010 by American College of Occupational and Environmental Medicine. Source

Lorber M.,U.S. Environmental Protection Agency | Schecter A.,University of Louisville | Paepke O.,Eurofins | Shropshire W.,University of Texas at Dallas | And 2 more authors.
Environment International | Year: 2015

Bisphenol A (BPA) is a high-volume, synthetic compound found in epoxy resins and plastics used in food packaging. Food is believed to be a major source of BPA intake. In this study, we measured the concentration of BPA in convenience samplings of foodstuffs purchased in Dallas, Texas. Sampling entailed collection of 204 samples of fresh, frozen, and canned foods in two rounds in 2010. BPA was positive in 73% of the canned food samples, while it was found in only 7% of non-canned foods at low concentrations. The results of this food sampling program were used to calculate adult dietary intakes of BPA. A pathway approach combined food intakes, a "canned fraction" parameter which described what portion of total intake of that food came from canned products, and measured food concentrations. Dietary intakes were calculated as 12.6. ng/kg-day, of which 12.4. ng/kg-day was from canned foods. Canned vegetable intakes alone were 11.9. ng/kg-day. This dietary intake was compared to total intakes of BPA estimated from urine measurements of the National Health and Nutrition Examination Survey (NHANES). Total adult central tendency intakes ranged from 30 to 70. ng/kg-day for NHANES cycles between 2005 and 2010. Three possibilities were explored to explain the difference between these two approaches for intake estimation. Not all foods which may have been canned, particularly canned beverages such as soft drinks, were sampled in our food sampling program. Second, non-food pathways of exposure may be important for adults, including thermal paper exposures, and dust and air exposures. Finally, our canned food concentrations may not be adequately representative of canned foods in the United States; they were found to be generally lower compared to canned food concentrations measured in six other worldwide food surveys including three in North America. Our finding that canned food concentrations greatly exceeded non-canned concentrations was consistent with other studies, and underscores the importance of canned foods in the overall exposure of adults of BPA. © 2015 Published by Elsevier Ltd. Source

Roy M.,Epidemic Intelligence Service | Roy M.,Centers for Disease Control and Prevention | Benedict K.,Centers for Disease Control and Prevention | Deak E.,Centers for Disease Control and Prevention | And 7 more authors.
Clinical Infectious Diseases | Year: 2013

BackgroundBlastomycosis is a potentially life-threatening infection caused by the soil-based dimorphic fungus Blastomyces dermatitidis, which is endemic throughout much of the Midwestern United States. We investigated an increase in reported cases of blastomycosis that occurred during 2009-2010 in Marathon County, Wisconsin.MethodsCase detection was conducted using the Wisconsin Electronic Disease Surveillance System (WEDSS). WEDSS data were used to compare demographic, clinical, and exposure characteristics between outbreak-related and historical case patients, and to calculate blastomycosis incidence rates. Because initial mapping of outbreak case patients' homes and recreational sites demonstrated unusual neighborhood and household case clustering, we conducted a 1:3 matched case-control study to identify factors associated with being in a geographic cluster.ResultsAmong the 55 patients with outbreak-related cases, 33 (70%) were hospitalized, 2 (5%) died, 30 (55%) had cluster-related cases, and 20 (45%) were Hmong. The overall incidence increased significantly since 2005 (average 11% increase per year, P <. 001), and incidence during 2005-2010 was significantly higher among Asians than non-Asians (2010 incidence: 168 vs 13 per 100 000 population). Thirty of the outbreak cases grouped into 5 residential clusters. Outdoor activities were not risk factors for blastomycosis among cluster case patients or when comparing outbreak cases to historical cases.ConclusionsThis outbreak of blastomycosis, the largest ever reported, was characterized by unique household and neighborhood clustering likely related to multifocal environmental sources. The reasons for the large number of Hmong affected are unclear, but may involve genetic predisposition. © 2013 Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2013. This work is written by (a) US Government employee(s) and is in the public domain in the US. Source

Magzamen S.,Colorado State University | Amato M.S.,University of Wisconsin - Madison | Imm P.,Bureau of Environmental and Occupational Health | Havlena J.A.,University of Wisconsin - Madison | And 5 more authors.
Environmental Research | Year: 2015

Conditional means regression, including ordinary least squares (OLS), provides an incomplete picture of exposure-response relationships particularly if the primary interest resides in the tail ends of the distribution of the outcome. Quantile regression (QR) offers an alternative methodological approach in which the influence of independent covariates on the outcome can be specified at any location along the distribution of the outcome. We implemented QR to examine heterogeneity in the influence of early childhood lead exposure on reading and math standardized fourth grade tests. In children from two urban school districts (n=1,076), lead exposure was associated with an 18.00 point decrease (95% CI: -48.72, -3.32) at the 10th quantile of reading scores, and a 7.50 point decrease (95% CI: -15.58, 2.07) at the 90th quantile. Wald tests indicated significant heterogeneity of the coefficients across the distribution of quantiles. Math scores did not show heterogeneity of coefficients, but there was a significant difference in the lead effect at the 10th (β=-17.00, 95% CI: -32.13, -3.27) versus 90th (β=-4.50, 95% CI: -10.55, 4.50) quantiles. Our results indicate that lead exposure has a greater effect for children in the lower tail of exam scores, a result that is masked by conditional means approaches. © 2014 Elsevier Inc. Source

Christensen K.,Bureau of Environmental and Occupational Health | Werner M.,Bureau of Environmental and Occupational Health | Malecki K.,University of Wisconsin - Madison
Environmental Research | Year: 2015

Selenium is an essential micronutrient, and due to its antioxidant activity, is hypothesized to be beneficial to cardiovascular health. However, the evidence for an association between selenium and health markers such as lipid levels has been mixed. This may be due to substantial variability in the level of selenium intake between populations and potential non-linearity of selenium-health outcome associations. We used the 2011-2012 National Health and Nutrition Examination Survey (NHANES) to examine the relationship between serum selenium and lipid levels among participants aged 12 years and older. Associations were evaluated using both linear regression models, as well as ordinal logistic regression and quantile regression models to allow for potential non-linear relationships. In all models, potential confounders of sex, age group, race/ethnicity, educational attainment and cotinine were included. Overall, 40% of participants had total cholesterol levels classified as borderline or elevated, and total cholesterol increased with increasing selenium (p=0.01). A similar pattern was seen for triglycerides (p=0.02). LDL cholesterol was also associated with selenium but not in a linear fashion; HDL cholesterol did not vary with selenium. Multivariate quantile regression showed significant associations between selenium and total cholesterol, LDL cholesterol, and triglycerides. The effect of selenium was stronger with increasing quantile for total cholesterol and for triglycerides. In contrast, for LDL cholesterol the association was positive in the 10th and 50th percentiles, but (non-significant and) negative in the 90th percentile. These results show that while selenium may impact cardiovascular health via effects on lipid levels, the associations may not be linear. © 2015 Elsevier Inc. Source

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