Akinbami L.J.,National Center for Health Statistics |
Moorman J.E.,National Center for Environmental Health |
Liu X.,National Center for Health Statistics
National Health Statistics Reports | Year: 2011
Objectives-This report presents recent data on asthma prevalence and health care use. Additional data on school and work absences and asthma management practices are also presented. Where possible, differences are examined by age, sex, race or ethnicity, geographic region, poverty status, and urbanicity. Methods-Data from the National Health Interview Survey, the National Ambulatory Medical Care Survey, the National Hospital Ambulatory Medical Care Survey, the National Hospital Discharge Survey, and the National Vital Statistics System were used to calculate national estimates. The most recent data available from each system are presented, and 3-year annual averages are used to increase the reliability of estimates for subgroups where necessary. Results-In 2009, current asthma prevalence was 8.2% of the U.S. population (24.6 million people); within population subgroups it was higher among females, children, persons of non-Hispanic black and Puerto Rican race or ethnicity, persons with family income below the poverty level, and those residing in the Northeast and Midwest regions. In 2008, persons with asthma missed 10.5 million school days and 14.2 million work days due to their asthma. In 2007, there were 1.75 million asthma-related emergency department visits and 456,000 asthma hospitalizations. Asthma emergency visit and hospitalization rates were higher among females than males, among children than adults, and among black than white persons. Despite the high burden from adverse impacts, use of some asthma management strategies based on clinical guidelines for the treatment of asthma remained below the targets set by the Healthy People 2010 initiative.
Ahluwalia N.,National Center for Health Statistics |
Herrick K.,National Center for Health Statistics |
Moshfegh A.,U.S. Department of Agriculture |
Rybak M.,National Center for Environmental Health
American Journal of Clinical Nutrition | Year: 2014
Background: Because of the increasing concern of the potential adverse effects of caffeine intake in children, recent estimates of caffeine consumption in a representative sample of children are needed.Objectives: We provide estimates of caffeine intake in children in absolute amounts (mg) and in relation to body weight (mg/kg) to examine the association of caffeine consumption with sociodemographic factors and describe trends in caffeine intake in children in the United States.Design: We analyzed caffeine intake in 3280 children aged 2-19 y who participated in a 24-h dietary recall as part of the NHANES, which is a nationally representative survey of the US population with a cross-sectional design, in 2009-2010. Trends over time between 2001 and 2010 were examined in 2-19-y-old children (n = 18,530). Analyses were conducted for all children and repeated for caffeine consumers.Results: In 2009-2010, 71% of US children consumed caffeine on a given day. Median caffeine intakes for 2-5-, 6-11-, and 12-19-y olds were 1.3, 4.5, and 13.6 mg, respectively, and 4.7, 9.1, and 40.6 mg, respectively, in caffeine consumers. Non-Hispanic black children had lower caffeine intake than that of non-Hispanic white counterparts. Caffeine intake correlated positively with age; this association was independent of body weight. On a given day, 10% of 12-19-y-olds exceeded the suggested maximum caffeine intake of 2.5 mg/kg by Health Canada. A significant linear trend of decline in caffeine intake (in mg or mg/kg) was noted overall for children aged 2-19 y during 2001-2010. Specifically, caffeine intake declined by 3.0 and 4.6 mg in 2-5- and 6-11-y-old caffeine consumers, respectively; no change was noted in 12-19-y-olds.Conclusion: A majority of US children including preschoolers consumed caffeine. Caffeine intake was highest in 12-19-y-olds and remained stable over the 10-y study period in this age group. © 2014 American Society for Nutrition.
Freeland A.L.,Centers for Disease Control and Prevention |
Banerjee S.N.,National Center for Environmental Health |
Dannenberg A.L.,Healthy Environmental |
Wendel A.M.,Healthy Environmental
American Journal of Public Health | Year: 2013
Objectives. We assessed changes in transit-associated walking in the United States from 2001 to 2009 and documented their importance to public health. Methods. We examined transit walk times using the National Household Travel Survey, a telephone survey administered by the US Department of Transportation to examine travel behavior in the United States. Results. People are more likely to transit walk if they are from lower income households, are non-White, and live in large urban areas with access to rail systems. Transit walkers in large urban areas with a rail system were 72% more likely to transit walk 30 minutes or more per day than were those without a rail system. From 2001 to 2009, the estimated number of transit walkers rose from 7.5 million to 9.6 million (a 28% increase); those whose transit-associated walking time was 30 minutes or more increased from approximately 2.6 million to 3.4 million (a 31% increase). Conclusions. Transit walking contributes to meeting physical activity recommendations. Study results may contribute to transportation-related health impact assessment studies evaluating the impact of proposed transit systems on physical activity, potentially influencing transportation planning decisions.
Zahran H.S.,National Center for Environmental Health |
Bailey C.,National Center for Environmental Health |
Garbe P.,National Center for Environmental Health
Morbidity and Mortality Weekly Report | Year: 2011
Background: Most persons with asthma can be symptom-free if they receive appropriate medical care, use inhaled corticosteroids when prescribed, and modify their environment to reduce or eliminate exposure to allergens and irritants. This report reviews recent progress in managing asthma and reducing its prevalence in the United States. Methods: CDC analyzed asthma data from the 2001--2009 National Health Interview Survey concerning children and adults, and from the 2001, 2005, and 2009 state-based Behavioral Risk Factor Surveillance System concerning adults. Results: Among persons of all ages, the prevalence of asthma increased from 7.3% (20.3 million persons) in 2001 to 8.2% (24.6 million persons) in 2009, a 12.3% increase. Prevalence among children (persons aged <18 years) was 9.6%, and was highest among poor children (13.5%) and among non-Hispanic black children (17.0%). Prevalence among adults was 7.7%, and was greatest in women (9.7%) and in adults who were poor (10.6%). More uninsured persons with asthma than insured could not afford to buy prescription medications (40.3% versus 11.5%), and fewer uninsured persons reported seeing or talking with a primary-care physician (58.8% versus 85.6%) or specialist (19.5% versus 36.9%). Among persons with asthma, 34.2% reported being given a written asthma action plan, and 68.1% had been taught the appropriate response to symptoms of an asthma attack. Only about one third of children or adults were using long-term control medicine such as inhaled corticosteroids at the time of the survey. Conclusions and Comment: Persons with asthma need to have access to health care and appropriate medications and use them. They also need to learn self-management skills and practice evidence-based interventions that reduce environmental risk factors.
Boothe V.L.,Scientific-Atlanta |
Boehmer T.K.,National Center for Environmental Health |
Wendel A.M.,Healthy Environmental |
Yip F.Y.,National Center for Environmental Health
American Journal of Preventive Medicine | Year: 2014
Context Exposure to elevated concentrations of traffic-related air pollutants in the near-road environment is associated with numerous adverse human health effects, including childhood cancer, which has been increasing since 1975. Results of individual epidemiologic studies have been inconsistent. Therefore, a meta-analysis was performed to examine the association between residential traffic exposure and childhood cancer. Evidence acquisition Studies published between January 1980 and July 2011 were retrieved from a systematic search of 18 bibliographic databases. Nine studies meeting the inclusion criteria were identified. Weighted summary ORs were calculated using a random effects model for outcomes with four or more studies. Subgroup and sensitivity analyses were performed. Evidence synthesis Childhood leukemia was positively associated (summary OR=1.53, 95% CI=1.12, 2.10) with residential traffic exposure among seven studies using a postnatal exposure window (e.g., childhood period or diagnosis address) and there was no association (summary OR=0.92, 95% CI=0.78, 1.09) among four studies using a prenatal exposure window (e.g., pregnancy period or birth address). There were too few studies to analyze other childhood cancer outcomes. Conclusions Current evidence suggests that childhood leukemia is associated with residential traffic exposure during the postnatal period, but not during the prenatal period. Additional well-designed epidemiologic studies that use complete residential history to estimate traffic exposure, examine leukemia subtypes, and control for potential confounding factors are needed to confirm these findings. As many people reside near busy roads, especially in urban areas, precautionary public health messages and interventions designed to reduce population exposure to traffic might be warranted. © 2014 American Journal of Preventive Medicine.
Berko J.,National Center for Health Statistics |
Ingram D.D.,National Center for Health Statistics |
Saha S.,National Center for Environmental Health |
Parker J.D.,National Center for Health Statistics
National Health Statistics Reports | Year: 2014
Objectives—This report examines heat-related mortality, cold-related mortality, and other weather-related mortality during 2006–2010 among subgroups of U.S. residents. Methods—Weather-related death rates for demographic and area-based subgroups were computed using death certificate information. Adjusted odds ratios for weather-related deaths among subgroups were estimated using logistic regression. Results and Conclusions—During 2006–2010, about 2,000 U.S. residents died each year from weather-related causes of death. About 31% of these deaths were attributed to exposure to excessive natural heat, heat stroke, sun stroke, or all; 63% were attributed to exposure to excessive natural cold, hypothermia, or both; and the remaining 6% were attributed to floods, storms, or lightning. Weather-related death rates varied by age, race and ethnicity, sex, and characteristics of decedent’s county of residence (median income, region, and urbanization level). Adjustment for region and urbanization decreased the risk of heat-related mortality among Hispanic persons and increased the risk of cold-related mortality among non-Hispanic black persons, compared with non-Hispanic white persons. Adjustment also increased the risk of heat-related mortality and attenuated the risk of cold-related mortality for counties in the lower three income quartiles. The differentials in weather-related mortality observed among demographic subgroups during 2006–2010 in the United States were consistent with those observed in previous national studies. This study demonstrated that a better understanding of subpopulations at risk from weather-related mortality can be obtained by considering area-based variables (county median household income, region, and urbanization level) when examining weather-related mortality patterns. © 2014, National Center for Health Statistics. All rights reserved.
News Article | January 30, 2017
The U.S. Centers for Disease Control and Prevention (CDC) has abruptly canceled the climate change summit it has been planning for months. But no need to fret, as former vice president Al Gore has stepped in to host his own conference in Atlanta next month. Last Thursday, Gore announced holding the Climate & Health Meeting in the state on Feb. 16 along with Howard Frumkin, former National Center for Environmental Health director, as well as health and climate groups such as the American Public Health Association, Harvard Global Health Institute, The Climate Reality Project, and the University of Washington Center for Health and the Global Environment. “[Al] called me and we talked about it and we said, ‘There’s still a void and still a need,’” recalled APHA’s executive director Georges Benjamin in a Washington Post report. “We said, Let’s make this thing happen.” The news came days after the CDC canceled its summit in the lead-up to the recent change in administrations in the White House. The decision was not explained in emails given to participants as well as invited speakers, the agency saying, when sought for comment, that the event might be held later this year. In a statement announcing the meeting, Gore said the conference will go forward anyway. “Today we face a challenging political climate, but climate shouldn’t be a political issue,” Gore asserted, citing the urgent need for health professionals for “the very best science” to protect the public. He also mentioned current warming and how it worsens the spread of public health threats such as the Zika virus. The one-day Feb. 16 meeting will not involve government circles, and will be conducted at the nonprofit Carter Center rather than at CDC. Organizers are eyeing as many as 200 participants from around the United States. It also remains unclear whether previously involved CDC employees will attend. Studies continue to warn the major public health risks of climate change around the world, with experts implicating warming in millions of deaths from heat, disease outbreak, longer allergy seasons, and more extreme weather events. Research published in the journal Lancet in 2016 argued that failing to address climate change could “undermine the last half century of gains” made in global health and development. But Frumkin is no longer surprised by how political climate change could get. He pointed out the external political pressure faced by the CDC, and sometimes its self-censorship and decision to shy away from specific issues. “Climate change has been that issue historically,” the expert told E&E News. The Huffington Post cited federal agency sources saying that the Trump administration’s efforts to limit access to climate change information from government have already begun. EPA sources, for instance, said they have been told to stop disseminating press releases and social media announcements, with the possibility of their climate change webpage coming down. The new summit vows to “preserve the focus of the CDC conference” and offer a platform for professionals and the community to discuss and provide solutions to climate change-related health problems. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.
News Article | August 24, 2016
Chemicals used in certain pesticides and as insulating material banned in the 1970s may still be haunting us, according to new research that suggests links between higher levels of exposure during pregnancy and significantly increased odds of autism spectrum disorder in children. According to the research, children born after being exposed to the highest levels of certain compounds of the chemicals, called organochlorine chemicals, during their mother's pregnancy were roughly 80 percent more likely to be diagnosed with autism when compared to individuals with the very lowest levels of these chemicals. That also includes those who were completely unexposed. Although production of organochlorine chemicals was banned in the United States in 1977, these compounds can remain in the environment and become absorbed in the fat of animals that humans eat, leading to exposure. With that in mind, Kristen Lyall, ScD, assistant professor in Drexel University's A.J. Drexel Autism Institute, and her collaborators, decided to look at organochlorine chemicals during pregnancy since they can cross through the placenta and affect the fetus' neurodevelopment. "There's a fair amount of research examining exposure to these chemicals during pregnancy in association with other outcomes, like birth weight -- but little research on autism, specifically," Lyall said. "To examine the role of environmental exposures in risk of autism, it is important that samples are collected during time frames with evidence for susceptibility for autism -- termed 'critical windows' in neurodevelopment. Fetal development is one of those critical windows." Their paper describing this study was titled, "Prenatal Organochlorine Chemicals and Autism," and published in Environmental Health Perspectives. Now a researcher in the A.J. Drexel Autism Institute's Modifiable Risk Factors Program, Lyall was with the California Department of Public Health when she began the work. She teamed with researchers from the department, including Gayle Windham, PhD, and Martin Kharrazi, PhD, members of the Kaiser Permanente Division of Research (which includes the study's principal investigator, Lisa Croen, PhD), as well as an expert on measuring organochlorine chemicals, Andreas Sjodin, PhD, of the Division of Laboratory Sciences of the National Center for Environmental Health. The team looked at a population sample of 1,144 children born in Southern California between 2000 and 2003. Data was accrued from mothers who had enrolled in California's Expanded Alphafetoprotein Prenatal Screening Program, which is dedicated to detecting birth defects during pregnancy. Participants' children were separated into three groups: 545 who were diagnosed with autism spectrum disorder, 181 with intellectual disabilities but no autism diagnosis, and 418 with a diagnosis of neither. Blood tests taken from the second trimester of the children's mothers were used to determine the level of exposure to two different classes of organochlorine chemicals: Polychlorinated biphenyls (PCBs, which were used as lubricants, coolants and insulators in consumer and electrical products) and organochlorine pesticides (OCPs, which include chemicals like DDT). "Exposure to PCBs and OCPs is ubiquitous," Lyall said. "Work from the National Health and Nutrition Examination Survey, which includes pregnant women, shows that people in the U.S. generally still have measurable levels of these chemicals in their bodies." However, Lyall emphasized that exposure levels were key in determining risk. "Adverse effects are related to levels of exposure, not just presence or absence of detectable levels," she said. "In our Southern California study population, we found evidence for modestly increased risk for individuals in the highest 25th percentile of exposure to some of these chemicals." It was determined that two compounds in particular -- PCB 138/158 and PCB 153 -- stood out as being significantly linked with autism risk. Children with the highest in utero levels (exposure during their mother's pregnancy) of these two forms of PCBs were between 79 and 82 percent more likely to have an autism diagnosis than those found to be exposed to the lowest levels. High levels of two other compounds, PCB 170 and PCB 180, were also associated with children being approximately 50 percent more likely to be diagnosed -- again, this is relative to children with the lowest prenatal exposure to these PCBs. None of the OCPs appeared to show an association with higher autism diagnosis risk. In children with intellectual disabilities but not autism, the highest exposure to PCBs appeared to double the risk of a diagnosis when compared to those with the lowest exposure. Mid-range (rather than high) OCP exposure was also associated with an increased level of intellectual disability diagnosis when measured against children with the lowest exposure levels. "The results suggest that prenatal exposure to these chemicals above a certain level may influence neurodevelopment in adverse ways," Lyall said. These results are a first step to suggest these compounds may increase risk of development of autism, and Lyall and her colleagues are eyeing up more work in the field. "We are definitely doing more research to build on this -- including work examining genetics, as well as mixtures of chemicals," Lyall said. "This investigation draws from a rich dataset and we need more studies like this in autism research."
News Article | February 17, 2017
Climate change will not wait for us; it is already affecting our health. The Climate & Health Meeting fills an important void and will strengthen the public health response to this growing threat. Some issues should rise above the clatter of Capitol Hill discord. Like the air we breathe and the water we drink, they are too fundamental to ignore – and too important to get lost amid partisan squabbling. They are concerns at the heart of the universal human rights we all enjoy. Public health ranks high among them, and it’s threatened in a critical way by the climate crisis. Climate change will continue to exacerbate existing threats to health and give rise to new ones. And while the movement for solutions may seem in the throes of an especially challenging moment, addressing the crisis’ impacts on our current and future well-being is not a political issue but an ethical and practical one. According to the World Health Organization, “Climate change is among the greatest health risks of the twenty first century. Rising temperatures and more extreme weather events cost lives directly, increase transmission and spread of infectious diseases, and undermine the environmental determinants of health, including clean air and water, and sufficient food.” The impact of the climate crisis on human health is far-reaching, but solutions exist that can help us improve quality of life around the world right now and work toward a healthier, more sustainable future for all. Indeed, this very subject will be front and center on February 16 when the public health and climate communities come together to share knowledge and advocate for action at the Climate & Health Meeting in Atlanta, Georgia. Hosted by former US Vice President Al Gore, the American Public Health Association (APHA), The Climate Reality Project, Harvard Global Health Institute, the University of Washington Center for Health and the Global Environment, and Dr. Howard Frumkin, former director of the CDC’s National Center for Environmental Health, the meeting will provide a crucial forum for collaboration. But to solve a problem, first you’ve got to understand what’s at stake. Here’s a quick look: Burning fossil fuels not only pollutes our air directly with irritants like particulate matter and soot, but as greenhouse gases accumulate in the atmosphere and average temperatures rise, they also contribute to higher levels of ground-level ozone that can cause acute and long-term respiratory problems. Moreover, rising global average temperatures lead to longer pollen seasons in many places and – when combined with stronger rainfall events, flooding, and higher humidity – create the perfect environment for mold to flourish. The result? More allergies, asthma attacks, and other respiratory health problems. Periods of extreme heat are directly related to higher rates of death from cardiovascular disease and heat stroke, particularly among the elderly and low-income communities who tend to be disproportionately affected by the impacts of all types of extreme weather. It’s important to remember here that 2016 was the Earth’s hottest year on record – and the third year in a row to take that dubious honor. Vector-borne diseases are illnesses spread by insects and other organisms (the vectors) like mosquitoes, fleas, mites, or ticks. As our climate changes, the geographic areas hospitable to many vectors may shift or simply grow, changing the scope of disease outbreaks and introducing new illness to places they never previously existed. Most recently, climate change is suspected to have played a role in the spread of the Zika virus into new areas. What’s the connection between extreme weather and public health? Beyond the tragic fatalities that can result directly, extreme weather events can damage infrastructure, jeopardizing access to lifesaving care for extended periods of time, and can compromise water quality and food supplies. Drought and heavy rainfall events can make drinking water vulnerable to contamination and can ruin agriculture, leading to increases in incidents of water-borne infections and diseases like cholera, as well as malnutrition and hunger when damaged farms fail to provide enough crops for the people who rely on them. The good news is Americans aren’t the sort to sit on the sidelines when a pressing-but-solvable threat looms large. And luckily, even as climate change remains a fraught political issue, Americans continue to trust their nurses, pharmacists, and medical doctors above most other sources, making the medical community uniquely well-positioned to convey a message about the importance of climate solutions. So while alternative facts won’t cure life-threatening diseases or stop them from spreading faster than ever as the crisis continues, together, real climate scientists and medical professionals will. We have a responsibility to the people we love to solve the climate crisis and protect public health and wellness for generations to come. We can be the generation that took on the greatest challenge humanity’s ever faced – and won. Buy a cool T-shirt or mug in the CleanTechnica store! Keep up to date with all the hottest cleantech news by subscribing to our (free) cleantech daily newsletter or weekly newsletter, or keep an eye on sector-specific news by getting our (also free) solar energy newsletter, electric vehicle newsletter, or wind energy newsletter.
News Article | February 15, 2017
When a long-planned 2017 climate change summit, slated to be held at the U.S. Centers for Disease Control and Prevention, was abruptly canceled without explanation about a week before Pres. Donald Trump’s inauguration, it was not because of a specific directive from his administration. But individuals involved with the conference say political worries influenced the decision. The CDC had not responded to an e-mailed request for comment by the time of publication on Friday, and it was impossible to confirm any official reason for the altered plans. Some scheduled participants and a former CDC official, however, linked the agency’s move to concerns about attitudes within the Trump administration. Comments from Trump and some of his cabinet nominees about human-caused climate change (Trump has called it a hoax) had underscored their skepticism, and conference planners preemptively nixed the conference to prevent political backlash, says physician Georges Benjamin, executive director of the American Public Health Association and a scheduled opening speaker at the event. The decision “was informed by the political environment,” Benjamin says. “Obviously it was informed by the fact that there were a lot of mixed messages about support for climate change [science], and during the campaign there was a lot said on that,” he adds. “It was canceled because of political nervousness about the new administration's attitudes toward climate change work," says Howard Frumkin, former director of the CDC’s National Center for Environmental Health and currently an environmental health professor at the University of Washington's School of Public Health. In an e-mail to speakers, the CDC summit planners simply wrote, “Unfortunately, we are unable to hold the Summit in February 2017 as scheduled. We are currently exploring options so that the summit may take place later in the year. We will provide additional details in early 2017,” according to a copy of the e-mail seen by Scientific American. The conference is now back on—but not at the CDC. Former Vice Pres. Al Gore will instead host the event on February 16 at the nonprofit Carter Center in Atlanta. It remains unclear, however, whether any governmental scientists will attend or speak, Benjamin says. The new conference will be abridged to a one-day summit instead of the original three-day program, and will be sponsored by nongovernmental groups including the Harvard Global Health Institute and the Turner Foundation, along with Gore’s education and advocacy group, the Climate Reality Project. “I think it’s deeply problematic that the meeting was canceled in the first place,” says Ed Maibach, director of the Center for Climate Change Communication at George Mason University, who had also been scheduled to speak at the CDC conference. “I hope that our nation’s public health agencies—and by that I mean CDC, National Institutes of Health and the Environmental Protection Agency—will be allowed to participate in the replacement meeting, but I don’t know if that’s the case. I’m glad that there is an alternative to the original meeting, but I’m a little concerned that it will be perceived as a political event—not a public health and science event—based on the change in sponsorship.”