The shifting prevalence of asthma and allergic disease in US children.

Background: Asthma is a chronic lung disease that affected 5 million children. Allergy is a common comorbidity of asthma. Having both conditions is associated with unfavorable health outcomes and impaired quality of life.

Trends in Asthma-Related School Health Policies and Practices in the US States.

Background: Asthma is one of the leading causes of school absenteeism. Schools can play an important role in coordinating asthma care. The purpose of this study was to assess the implementation of asthma-related school health policies and practices across states and how they have changed over time.

Asthma Among Adults and Children by Urban-Rural Classification Scheme, United States, 2016-2018.

Objectives: Although data on the prevalence of current asthma among adults and children are available at national, regional, and state levels, such data are limited at the substate level (eg, urban-rural classification and county). We examined the prevalence of current asthma in adults and children across 6 levels of urban-rural classification in each state.

Methods: We estimated current asthma prevalence among adults for urban-rural categories in the 50 states and the District of Columbia and among children for urban-rural categories in 27 states by analyzing 2016-2018 Behavioral Risk Factor Surveillance System survey data.

Asthma Surveillance - United States, 2006-2018.

Problem: Asthma is a chronic disease of the airways that requires ongoing medical management. Socioeconomic and demographic factors as well as health care use might influence health patterns in urban and rural areas. Persons living in rural areas tend to have less access to health care and health resources and worse health outcomes.

Heat-Related Deaths - United States, 2004-2018.

Deaths attributable to natural heat exposure, although generally considered preventable (1), represent a continuing public health concern in the United States. During 2004-2018, an average of 702 heat-related deaths occurred in the United States annually. To study patterns in heat-related deaths by age group, sex, race/ethnicity, and level of urbanization, and to explore comorbid conditions associated with deaths resulting from heat exposure, CDC analyzed nationally comprehensive mortality data from the National Vital Statistics System (NVSS).

Asthma-related emergency department (ED) visits and post-ED visit hospital and critical care admissions, National Hospital Ambulatory Medical Care Survey, 2010-2015.

Exacerbation of asthma symptoms increases the likelihood of emergency department (ED) visits and hospitalizations. Because the ED is an important healthcare resource for immediate asthma care with acute exacerbations, we identify those populations most likely to seek ED treatment for asthma and describe the asthma burden for post-ED visit hospitalizations and critical care units. We examined the characteristics of asthma-related ED visits and hospital admissions and assessed the association between them using multivariable logistic regression models by analyzing data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) during 2010-2015.

Evaluating Disaster Damages and Operational Status of Health-Care Facilities During the Emergency Response Phase of Hurricane Maria in Puerto Rico.

On September 20, 2017, Hurricane Maria made landfall on Puerto Rico as a category 4 storm, resulting in serious widespread impact across the island, including communication and power outages, water systems impairment, and damage to life-saving infrastructure. In collaboration with the Puerto Rico Department of Health, the Public Health Branch (PHB), operating under the Department of Health and Human Services Incident Response Coordination Team, was tasked with completing assessments of health-care facilities in Puerto Rico to determine infrastructure capabilities and post-hurricane capacity. Additionally, in response to significant data entry and presentation needs, the PHB leadership worked with the Puerto Rico Planning Board to develop and test a new app-based infrastructure capacity assessment tool.

Assessing the Congregate Disaster Shelter: Using Shelter Facility Assessment Data for Evaluating Potential Hazards to Occupants During Disasters.

Disaster shelter assessments are environmental health assessments conducted during disaster situations to evaluate the living environment of shelters for hygiene, sanitation, and safety conditions. We conducted a secondary data analysis of shelter assessment records available (n = 108) on ice storms, floods, and tornado events from 1 state jurisdiction. Descriptive statistics were used to analyze results of environmental health deficiencies found in the facilities.

Knowledge of and Preparedness for Use of Environmental Assessments in Shelters During Disasters: Results of the 2013 State and Territorial Use of Shelter Assessments Survey.

Objective: Environmental health assessments of disaster shelters are critical for monitoring the living conditions of the occupants. However, knowledge and levels of utilization of these assessments have never been estimated in the United States or its territories. We aimed to conduct a cross-sectional survey to ascertain knowledge and Utilization of environmental health disaster shelter assessments.

Urolithiasis, Urinary Cancer, and Home Drinking Water Source in the United States Territory of Guam, 2006-2010.

We reviewed patient records with a first-listed diagnosis of urolithiasis-also known as urinary tract or kidney stone disease, nephrolithiasis-upon discharge from Guam's sole civilian hospital during 2006 to 2010 and urinary cancer mortality records from the Guam Cancer Registry for 1970 to 2009 to determine the source of municipal water supplied to the patients' residence. The objective was to investigate a possible relationship between the sources of municipal water supplied to Guam villages and the incidence of urolithiasis and urinary cancer. We analyzed hospital discharge diagnoses of urolithiasis or renal calculi by calculating the incidence of first-mentioned discharge for urolithiasis or renal calculi and comparing rates across demographic or geographic categories while adjusting by age, sex, and ethnicity/race.

Formaldehyde Levels in Traditional and Portable Classrooms: A Pilot Investigation.

The pilot study discussed in this article assessed formaldehyde levels in portable classrooms (PCs) and traditional classrooms the authors evaluated formaldehyde levels in day and overnight indoor air (TCs) and explored factors influencing indoor air quality (e.g., carbon dioxide, temperature, and relative humidity).

The role of applied epidemiology methods in the disaster management cycle.

Disaster epidemiology (i.e., applied epidemiology in disaster settings) presents a source of reliable and actionable information for decision-makers and stakeholders in the disaster management cycle.

Nonfatal natural and environmental injuries treated in emergency departments, United States, 2001-2004.

Exposure to adverse natural and environmental events (eg, extreme temperatures and disasters) poses a public health burden when resulting in injuries requiring emergency care. We examined the incidence and characteristics of persons with environmental exposure-related injuries treated in US-based hospital emergency departments during 2001 to 2004 by using the National Electronic Injury Surveillance System-All Injury Program. An estimated 26 527 (95% CI = 18 664-34 390) injuries were treated annually-78% were heat-related.

Risk factors for mortality during the 2002 landslides in Chuuk, Federated States of Micronesia.

This study examines health effects resulting from landslides in Chuuk during Tropical Storm Chata'an in July 2002, and suggests strategies to prevent future mortality. In August 2002, we conducted a cross-sectional survey to identify risk factors for mortality during landslides, which included 52 survivors and 40 surrogates for 43 decedents to identify risk factors for death. Findings suggest that 1) females had a higher mortality rate from this event than males, and 2) children aged 5-14 years had a 10-fold increase in mortality when compared with annual mortality rates from all causes.

Climate change: the importance of place.

Climate change-related risks are place-specific and path-dependent. Accordingly, location is an important determinant of hazardous exposure, and certain places will bear more risk than others. This article reviews the major environmental exposures associated with risky places in the U.

Climate change: the public health response.

There is scientific consensus that the global climate is changing, with rising surface temperatures, melting ice and snow, rising sea levels, and increasing climate variability. These changes are expected to have substantial impacts on human health. There are known, effective public health responses for many of these impacts, but the scope, timeline, and complexity of climate change are unprecedented.

Natural and technologic hazardous material releases during and after natural disasters: a review.

Natural disasters may be powerful and prominent mechanisms of direct and indirect hazardous material (hazmat) releases. Hazardous materials that are released as the result of a technologic malfunction precipitated by a natural event are referred to as natural-technologic or na-tech events. Na-tech events pose unique environmental and human hazards.

The public health response to the Chi-Chi earthquake in Taiwan, 1999.

Objective: On September 21, 1999, at 1:47 a.m., an earthquake measuring 7.

Emergency health surveillance after severe flooding in Louisiana, 1995.

Introduction: In disaster situations, timely surveillance systems that provide illness, injury, and mortality information to public health officials and hospitals are essential for planning and evaluating interventions.

Objectives: To describe flood surveillance methodology, the impact of the event on hospitals, and the number of daily patient visits due to selected illnesses and injuries before, during, and after severe flooding in southeastern Louisiana in May 1995.

Methods: Survey of disaster-area hospitals regarding flood impact.

Environmental pesticide exposure in Honduras following hurricane Mitch.

Objective: To investigate whether environmental contamination occurred in the wake of hurricane Mitch (30-31 October 1998), we conducted a population-based cross-sectional household survey in the barrio of Istoca, Department of Choluteca, Honduras. The goals were to evaluate chemical contamination of potable water and the extent of human exposure to chemicals as a result of extensive flooding.

Methods: The survey consisted of an environmental exposure assessment, which included assaying water and soil samples for contaminants, and taking blood and urine samples from 45 adolescents aged 15-18 years.

Public health assessments in disaster settings: recommendations for a multidisciplinary approach.

Introduction: Rapid assessments of needs and health status have been conducted by the U.S. Centers for Disease Control and Prevention (CDC) in natural disaster settings for gathering information about the status of affected populations during emergencies.

Predictors for people's response to a tornado warning: Arkansas, 1 March 1997.

On 1 March 1997, powerful tornadoes touched down in Arkansas (USA) on a Saturday afternoon. Twenty-six fatalities and 400 non-fatal injuries were reported. We performed a population-based cross-sectional study to determine factors associated with appropriate responses to tornado warnings.

An outbreak of carbon monoxide poisoning after a major ice storm in Maine.

Unintentional carbon monoxide (CO) exposure kills over 500 people in the U.S. annually.

Effects of temperature and snowfall on mortality in Pennsylvania.

The relation between exposure to severe cold weather and mortality is examined in a retrospective study of deaths occurring during the month of January from 1991 to 1996 in Pennsylvania. Using division-days as units of observation (n = 1,560) aggregated from death certificates and geographic divisions, the authors estimated mortality rates for total deaths and deaths due to ischemic heart disease, cerebrovascular diseases, and respiratory diseases by analyses based on generalized estimating equations. Total mortality increased on days of "extreme" climatic conditions, that is, when snowfall was greater than 3 cm and when temperatures were below -7 degrees C (rate ratio (RR) = 1.