Abstract
Surveillance of Carbon Monoxide-Related Incidents and Associated Injuries and Illness, 2005-2014
Natalia Melnikova, MD, PhD1, Jennifer Wu, MS2, Maureen Orr, MS3, Sutapa Mukhopadhyay, PhD4, Kanta Sircar, PhD5, Suze Etienne, MPH, CPH, RT6 and Annie Hirsch, MPH, CPH7
(1)Atlanta, GA, (2)CDC/ATSDR, Chamblee, GA, (3)CDC/ATSDR/DTHHS, Atlanta, GA, (4)Tennessee Department of Health, Nashville, TN, (5)Centers for Disease Control and Prevention, Atlanta, GA, (6)TX Healthcare, Fort Worth, TX, (7)NC Dept of Public Health/Devision of Public Health, Releigh, NC
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Carbon monoxide (CO) is an insidious gas killing many people every year. We analyzed 10 years (2005─2014) of acute hazardous substance release surveillance data from the Agency for Toxic Substances and Disease Registry (ATSDR) for 17 states. Our analysis focused on CO incidents with injured people, including who was injured, the CO source, where it occurred, and contributing factors in an effort to guide public health outreach. Numerous (1,795) CO events occurred and 3,414 people were injured, many of whom (61%) were the general public. Consistent with previous studies, heating, ventilation, and air conditioning systems (HVAC), generators, and motor vehicle exhaust were the most common sources of CO., homes or apartments were the most frequent location. Participating states used their surveillance data for intervention. Hazardous substance incident surveillance data are valuable for states to evaluate trends in CO incidents and associated injuries and to develop targeted public health outreach, policies, and legislation.
Environmental health sciences Implementation of health education strategies, interventions and programs Occupational health and safety Planning of health education strategies, interventions, and programs Public health or related education Public health or related organizational policy, standards, or other guidelines
Abstract
Risk Factors for Injury during Occupational Physical Training for Low, Moderate, and High Mileage Road Marching
Anna Schuh-Renner, PhD1, Michelle Canham-Chervak, PhD, MPH2, Tyson Grier, MS2, Veronique Hauschild, MPH2, Tanja Roy, PhD, PT, SCS2, Jeremy Fletcher, PT, DPT, OCS, CSCS3 and Bruce H. Jones, MD, MPH2
(1)Army Public Health Center, Aberdeen Proving Ground, MD, (2)Army Public Health Center, Injury Prevention Division, Aberdeen Proving Ground, MD, (3)University of South Alabama, Mobile, AL
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
This is the first effort to investigate the differences in risk factors among Soldiers who perform low, moderate, and high mileage road marching. Purpose: To evaluate the association between modifiable characteristics of physical training and fitness and their association to road marching-related injuries. Methods: Demographic, physical fitness, tobacco use, physical job requirements, physical training, and injury data were collected by survey from 831 U.S Army infantry Soldiers. Frequencies, means, relative risk (RR) and unadjusted and adjusted odds ratios (OR) with 95% confidence intervals (CI) were calculated to assess associations with road marching-related injuries. Results: Road marching and running were the activities associated with half of the reported injuries. When miles of exposure were considered, injury risk during road marching was higher than during running (RR =1.8, 95%CI, 1.38-2.37). Road marching-related injuries among all road marching participants (regardless of distance) was associated with carrying a load that was ≥26% of one’s body weight (OR≥26%/1-20% = 2.09, 95% CI, 1.08-4.05), having high occupational lifting demands (OR50-100+lbs/25-50lbs = 3.43, 95% CI, 1.50-7.85), road marching ≥5 times per month (OR≥5 times/4 times = 2.11, 95% CI, 1.14-3.91), running <4 miles per week during personal physical training (OR0/≥10 miles/week = 3.56, 95% CI, 1.49-8.54, OR1-4/≥10 miles/week = 4.14, 95% CI, 1.85-9.25), and age ≥35 years (OR≥35/≤25 = 2.89, 95% CI, 1.17-7.16). Conclusion: Attempts should be made to decrease the percentage of body weight carried. Balancing physical training programs to reduce cumulative overloading may be a modifiable factor on which to focus interventions.
Epidemiology
Abstract
What do we need? Describing the needs of Victims of a Wildfire based on their requests
Paula B. Repetto, PhD
Pontificia Universidad Catolica de Chile, Santiago, Chile
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
The delivery of humanitarian aid to victims of disaster is a difficult task for many agencies, that face coordination problems and the arrival of non-priority aid. Some researchers suggest that this can be explained by the fact that is not clear what victims need and in what amount. In the present study, we try to fill this gap through an empirical estimation of aid-demand using the requests from victims of the big fire in Valparaíso, Chile, that occurred in 2104. We used the requests made by victims to a local NGO that was used shelter and distribution center. All requests were written in a record card that also included information about family composition. We entered 954 report cards that had a date on it and examine the requests, coded in categories (food, liquids, cleaning supplies, hygiene, etc) and described how these changed over time. We found that during the first two weeks, water, prepared meals and hygiene supplies were most needed. After the first week, close to a 50% of the demand of water was fulfilled. Overtime, other requests appear, such as cleaning supplies, building material and school supplies. Our findings shed about the needs of victims and can help to define priorities to help respond to the needs of victims of disasters.
Advocacy for health and health education Other professions or practice related to public health Public health or related education Public health or related public policy Public health or related research Social and behavioral sciences
Abstract
Spatial analysis of fatalities and injuries by urban residential fire incidents
Soojin Min
University of Texas at Dallas, Boston, MA
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Residential fires, the most common type of structure fires, tend to result in the great number of injuries and casualties as well as an enormous amount of property loss. Most of the fire injury or death burdens are concentrated in densely populated urban areas where a substantial size of vulnerable population is present. Risk factors in residential fire injuries at the demand side of fire fighting services, such as racial, socioeconomic, behavioral and housing factors have been relatively well acknowledged. On the other hand, risk factors that are associated with the supply side, such as response time, have not been highlighted enough. In this study, fire injury risk factors are examined at the both demand and supply sides of fire fighting services by integrate information on fire incidents in Dallas City in Texas (2012-2014) with the census block group indicators in the geographic information system (GIS) framework. The preliminary findings suggest a statistically significant difference between the underlying distributions of the median incomes of census block groups that have experienced residential fires and those that have not. As neighborhoods with vulnerable population are may be associated with a higher likelihood of having injuries and fatalities by residential fire incidents, this study employs spatial analysis, including pattern analysis, to explore the links between neighborhood characteristics and risk factors for residential fire fatalities and injuries. The research findings that allow identification of the areas at greater risk can ultimately be used as a guide to targeted intervention for fire injury prevention.
Public health or related public policy Public health or related research
Abstract
Comparison of Suicide Deaths with Legal Intervention and Undetermined Intent Deaths Reporting Suicide Characteristics, Los Angeles County, 2010-2013
Isabelle Sternfeld, MSPH1, Nicolle Perras, MA, MPH2, Kelly Fischer, MA3 and Andrea Welsing, MPH3
(1)Los Angeles County Department of Public Health, Alhambra, CA, (2)LA County Dept. of Public Health, Los Angeles, CA, (3)Los Angeles County Department of Public Health, Los Angeles, CA
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Background
Previous research has indicated that many suicides may be misclassified as deaths of undetermined intent and that many victims killed by law enforcement officers may, in fact, be trying to die. We examine Los Angeles County data to compare suicides with undetermined intent and legal intervention deaths that exhibited suicide characteristics.
Method
We use 2010-2013 data from the California Electronic Violent Death Reporting System, which is modelled after the National Violent Death Reporting System. We examine differences in demographics, incident characteristics, and precipitating circumstances for suicides compared to deaths undetermined intent or legal intervention deaths where at least one suicide-related precipitating circumstance was reported.
Results
There were 3,128 suicides, 194 legal intervention deaths, and 191 undetermined intent deaths. 68 of the legal intervention and 88 of the undetermined intent deaths had at least one reported suicide-related precipitating circumstance. We found differences by manner of death for age, race/ethnicity, and weapon involved, but not for gender. A mental health problem and leaving a suicide note were the most commonly reported circumstances for suicide victims, mental health problem and substance use problem were the most common for undetermined intent, and criminal legal problem and a recent crisis were the most common for legal intervention victims.
Conclusions
Many deaths that are not classified as suicides do involve suicide-related circumstances. Including these deaths in studies of suicides will provide a more complete understanding of the full range of fatal suicidal behaviors. This information can be helpful in appropriately targeting prevention efforts.
Public health or related research
Abstract
Balcony falls while intoxicated : A new injury trend among young adults?
Kathryn B Schaffer, MPH, CSTR, CCRP1, Gary Schwendig, MD2, Fady Nasrallah, MD1 and Jiayan Wang, BSPH1
(1)Scripps Memorial Hospital, La Jolla, CA, (2)Scripps Memorial Hospital La Jolla, La Jolla, CA
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Purpose: Unintentional falls from heights are events associated with life threatening traumatic injury. Alcohol is a known risk factor and, when combined with environmental risks and poor judgment, creates a potentially fatal combination. One Level II trauma center’s surveillance identified a growing cohort at risk for injury.
Methods: Admissions from 2010-2016 were reviewed for unintentional falls. All suicide and falls through roofs were excluded. Medical chart and prehospital data were reviewed and collected.
Results: Falls from heights comprised 4.2% of injuries, and 11% balcony-related. Majority of the cohort were male, 18-29 years (64%). Alcohol was involved in all cases with 64% having average Blood Alcohol Concentration of 0.21. No gender differences evident among alcohol use or underage drinking. Increased risk for falls with the underage drinkers was evident (p=0.0370). 98% of falls occurred at a residence during a social event. Falling backwards off railings and attempts to jump to adjoining balconies were common. Injuries involved chest and head trauma. There were two deaths.
Conclusion: Falls from balconies are rare yet growing among young adults in our community, with increased risk among underage drinkers. 47% of these events occurred from 2014-2016. Generalizability is difficult with small samples yet common risky behaviors and environmental factors should not be ignored. Similar events are occurring across the nation, especially on or near college campuses. It is imperative that programs identify and educate this population at risk with the development of collaborative prevention efforts with local universities and residential areas where multiple events have occurred.
Epidemiology Occupational health and safety Other professions or practice related to public health Public health or related education Public health or related research Social and behavioral sciences
Abstract
Effect of Exposure to Community Violence and Positive Screens for Posttraumatic Stress Symptoms
Carol Reese, MDiv, LCSW1, Kimberly Joseph, MD, FACS, FCCM1, Bradley C Stolbach, PhD2 and Madison Hammett, MPH, MSW3
(1)John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, (2)University of Chicago, Chicago, IL, (3)John H Stroger Hospital of Cook County, Chicago, IL
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
A cohort of urban African-American teenaged (age 13-18) victims of violent injury was studied and found to have a 48% incidence of positive screens for Posttraumatic Stress (PTSD) symptoms, eight times the national average of 6%. Eighty-six percent of those with a positive screen report being “on the lookout” for danger.
This elevated rate of PTSD screens is consistent with that found in a prior study performed by the same investigators. Aside from their age-related vulnerability, these teenagers were also found to be at increased risk due to their concomitant exposure to multiple forms of community violence (e.g. death of a loved one, hearing gunshots, witnessing violent acts/homicide, etc.), in addition to their physical violent injuries. The teens in this pilot study were exposed on average to 7.7 types of community violence. Among those with positive PTSD screens the average exposure was 8.6 types of violence. The combination of violent injury and prior exposure to community violence increased the risk of a positive PTSD screen (87% with the murder of a friend; 68% with the murder of a family member; 83% with seeing someone jumped; and 100% witnessing a homicide).
Public health, mental health, and trauma professionals must consider prior community violence exposure when treating patients with violent injuries. Additional investigation is needed to discover interventions that take community violence exposure into account in order to promote effective recovery in these patients.
Advocacy for health and health education Assessment of individual and community needs for health education Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Public health or related organizational policy, standards, or other guidelines Social and behavioral sciences
Abstract
Community Health Centers as well positioned entities to provide forensic nursing services in rural communities
Jennifer Runge, BS, Michelle Kearney, RN, BS and Amanda Guay, MPH
North Country HealthCare, Flagstaff, AZ
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Northern Arizona Care and Services after Assault (NACASA), a program of North Country HealthCare (a community health center serving 14 communities in northern Arizona), applies an innovative health care delivery system for the provision of forensic nursing services in three rural counties. NACASA leverages community health center clinics to bring domestic violence strangulation and sexual assault exams for victims aged 13 and older to communities that may not otherwise have capacity to provide this timely critical care. This presentation will provide details on the elements of a successful forensic nursing program and essential partnerships required to implement the model elsewhere. Community health centers are well positioned to play a key role in the sexual assault response team and this model can be replicated elsewhere to increase capacity for rural communities to meaningfully respond to sexual violence.
Clinical medicine applied in public health Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Provision of health care to the public Public health or related nursing Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Personal narratives of African-American mothers and male offenders on violence: A case study in Omaha, Nebraska
Eric Meyer, MA, MLA, Dejun Su, PhD, Melissa Tibbits, PhD, MS, Nizar K. Wehbi, MD, MPH, MBA and Kandy Do, BS
University of Nebraska Medical Center, Omaha, NE
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Background: Homicide is the leading cause of death in the US for African-American young people, with most victims being male. Prior exposure to violence is the top risk factor for future violence. Despite the importance in the identification of risk factors, there is a need for more research as to how these factors increase the risk for violence and what protection do people employ to avoid violence. The objective of this project is to explain the complexities of violence among African-American youth who reside in Omaha, Nebraska through interviews with male offenders and mothers of males who are at-risk for gang involvement. Method: We recruited and interviewed 16 African-American adults (8 mothers and 8 male offenders) to learn about their perceptions and personal experiences with violence. Results: Based on our qualitative analysis of the interview transcripts using grounded theory, five themes surfaced including (1) personal experiences and perceptions of violence; (2) individual level consequences from exposures to violence; (3) personal challenges; (4) whom to rely on for protection; and (5) perceptions of how to stop the violence. Conclusion: The personal narratives of African-American mothers and male offenders offer valuable sources of insight for the research of violence. Mothers and male offenders are able to provide additional explanations as to why certain risks exist and what strategies they use to shield themselves and their families from violence in their community.
Diversity and culture Public health or related research Social and behavioral sciences
Abstract
Shared risk and protective factors for the top 10 fatal injury mechanisms in US counties
Bernadette D'Alonzo, MPH1, Douglas J. Wiebe, PhD1, Christopher Morrison, PhD1, Beidi Dong, Ph.D.2, David Karp, MUSA1, Therese S. Richmond, PhD, CRNP, FAAN1 and Vicky Tam1
(1)University of Pennsylvania, Philadelphia, PA, (2)Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Background. Identifying meaningful shared risk and protective factors for injury is a priority public health issue to enable efficient prevention efforts.
Methods. We used data on all deaths that occurred in the US in 2014 from the 10 most frequent injury mechanisms. Deaths from each mechanism were aggregated to the county level and calculated as rates per 100,000 population. We also accessed data on the prevalence of 14 features of the built and social environment in each county that were hypothesized to potentially pose a risk for or protect against injuries. Bivariate negative binomial regression models were used to estimate how rates of each injury outcome corresponded to rates of each exposure.
Results. The highest rates of injury among US counties were 13.4/100,000 poisoning-related deaths, 11.3/100,000 motor traffic-related deaths, and 10.2/100,000 falls-related deaths. Percent unemployed, percent living below poverty level, and percent with only high school education or lower served as the most important shared risk factors for the most frequent mechanisms of injury. Non English speaking population and Hispanic population served as the most important shared protective factor for the most frequent mechanisms of injury.
Conclusions. We found preliminary evidence that shared risk and protective factors exist for the most frequent mechanisms of injury. Efforts should continue to explore opportunities to address factors that are modifiable and, for those that are not modifiable, identify correlates of those in those areas that may be adopted to aid prevention elsewhere, or modified to achieve prevention.
Epidemiology