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Surveillance for waterborne disease outbreaks--United States, 1991-1992 ; Silicosis surveillance--Michigan, New Jersey, Ohio, and Wisconsin, 1987-1990 ; Sensitivity of multiple-cause mortality data for surveillance of deaths associated with head or neck injuries
  • Published Date:
    November 19, 1993
Filetype[PDF-416.97 KB]

  • Corporate Authors:
    Centers for Disease Control and Prevention (U.S.) ; National Center for Environmental Health (U.S), Division of Environmental Hazards and Health Effects. ; National Center for Infectious Diseases (U.S.), Division of Parasitic Diseases. ; ... More ▼
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  • Description:
    Most recent reports published in CDC surveillance summaries -- Surveillance for waterborne disease outbreaks--United States, 1991-1992 / Anne C. Moore, Barbara L. Herwaldt, Anita K. Highsmith, Dennis D. Juranek, [et al.] -- Silicosis surveillance--Michigan, New Jersey, Ohio and Wisconsin, 1987-1990 / Ruth A. Jajosky, Karl J. Musgrave, Robert M. Castellan, Diana L. Ordin, [et al.] --Sensitivity of multiple-cause mortality data for surveillance of deaths associated with head or neck injuries / David E. Nelson, Jeffrey J. Sacks, R. Gibson Parrish, Daniel M. Sosin, [et al.] -- State and Territorial Epidemiologists and Laboratory Directors

    Sensitivity of multiple-cause mortality data for surveillance of deaths associated with head or neck injuries: "Problem/Condition: Multiple-cause mortality data was assessed as a source of information for surveillance of deaths associated with head or neck injuries. Reporting Period Covered: 1985-1986 Description of System: Data on causes of death were abstracted from death certificates in New Mexico and coded according to criteria of the International Classification of Diseases, Ninth Revision (ICD-9). Deaths with an external cause-of-death (E) code as the underlying cause of death and one or more head or neck injury nature-of-condition (N) codes as contributing causes of death were considered head or neck injury deaths. These data were compared with data for head or neck injury deaths obtained from computerized records from the New Mexico Office of the Medical Investigator (OMI). Data for alcohol or drug use were abstracted from both systems. Results: Of the 699 head or neck injury deaths coded by the New Mexico OMI system in 1985-1986, 536 were identified as head or neck injury deaths in multiple-cause mortality data (sensitivity = 76.7%). Firearms were the leading cause of head or neck injury deaths, followed by motor vehicles. Multiple-cause mortality data contained alcohol codes for only 3.7% of OMI records with blood alcohol concentrations 0.10 mg/dL and contained drug codes for none of the OMI records with positive toxicology tests for drugs. Interpretation: The sensitivity of multiple-cause mortality data was relatively high for surveillance of head and neck injury deaths. This information source may be useful for conducting statewide surveillance for mortality from head injuries; however, the sensitivity and positive predictive value of these data require further assessment. Multiple-cause data substantially underestimate the extent of alcohol and drug involvement for head or neck injury deaths. Actions Taken: The findings in this investigation have prompted further assessment of the usefulness of death certificate data for head injury surveillance." p. 29-30

    Silicosis surveillance--Michigan, New Jersey, Ohio and Wisconsin, 1987-1990: "Problem/Condition: Improved surveillance for silicosis is needed to target interventions to prevent this occupational lung disease caused by the inhalation of crystalline silica dust. Reporting Period Covered: 1987-1990. Description of Systems: State-based silicosis surveillance and intervention programs have been developed in Michigan, New Jersey, Ohio, and Wisconsin as part of the Sentinel Event Notification System for Occupational Risks (SENSOR) Program, initiated in 1987 by the National Institute for Occupational Safety and Health (NIOSH). Results: From 1987 through 1990, the SENSOR program confirmed a total of 430 cases of silicosis reported from these four states. Overall, approximately 60% of these cases were in workers employed in primary metal industries, although the types of industries in which cases occurred varied by state. Some cases were attributable to relatively recent exposure, including new cases in seven persons first exposed since 1980 in New Jersey. Silicosis case reports have prompted measurement of respirable silica concentrations at 25 Michigan work sites, and 14 (56%) of these sites were found to have levels that exceeded the legally permissible exposure level. Interpretation: The silicosis surveillance and intervention strategies piloted by state health departments in the NIOSH-funded SENSOR Program have demonstrated the feasibility and effectiveness of identifying specific silica-using work sites that need preventive intervention. Actions Taken: On the basis of initial experience in these four states, NIOSH developed guidelines for state-based silicosis surveillance and awarded SENSOR cooperative agreements to three additional states where the applicability of these surveillance methods will be further evaluated." - p. 23

    Surveillance for waterborne disease outbreaks--United States, 1991-1992 : "Problem/Condition: Since 1971, CDC and the U.S. Environmental Protection Agency have maintained a collaborative surveillance program for collection and periodic reporting of data on the occurrence and causes of waterborne disease outbreaks. Reporting Period Covered: January 1991 through December 1992. Description of System: The surveillance system includes data about outbreaks associated with water intended for drinking and also about those associated with recreational water. State and local public health departments are the agencies with primary responsibility for the detection and investigation of outbreaks. State and territorial health departments report these outbreaks to CDC on a standard form. Results: For the 2-year period 1991-1992, 17 states and territories reported 34 outbreaks associated with water intended for drinking. The outbreaks caused an estimated 17,464 persons to become ill. A protozoal parasite (Giardia lamblia or Cryptosporidium ) was identified as the etiologic agent for seven of the 11 outbreaks for which an agent was determined. Five (71%) of the outbreaks caused by protozoa were associated with a surface-influenced groundwater source. One outbreak of cryptosporidiosis was associated with filtered and chlorinated surface water. Shigella sonnei and hepatitis A virus were implicated in one outbreak each; both were linked to consumption of contaminated well water. Two outbreaks due to acute chemical poisoning were reported; one had an associated fatality. No etiology was established for 23 (68%) of the 34 outbreaks, including the largest one reported during this period, in which an estimated 9,847 persons using a filtered surface water supply developed gastroenteritis. Most (76%) of the 34 outbreaks were associated with a well water source. Twenty-one states reported 39 outbreaks associated with recreational water, in which an estimated 1,825 persons became ill. The most frequently reported illness was hot tub- or whirlpool-associated Pseudomonas dermatitis (12 outbreaks). Of 11 outbreaks of swimming-associated gastroenteritis, six were caused by Giardia or Cryptosporidium, including three outbreaks associated with chlorinated, filtered pool water. The first reported outbreak of Escherichia coli O157:H7 infection associated with recreational exposure occurred during this period. Primary amebic meningoencephalitis, caused by Naegleria fowleri infection, resulted in six deaths. Interpretation: The number of waterborne disease outbreaks reported per year has not changed substantially in the past 5 years. However, etiologic agents only recently associated with waterborne disease, such as E. coli O157:H7 and Cryptosporidium, are being reported more frequently and from new settings. Water quality data for outbreaks during the period 1991-1992 indicate that available water disinfection technology is not always in place or used reliably. However, the high percentage of outbreaks attributed to relatively chlorine-resistant protozoa suggests that improvements in monitoring and treatment of potable water may be needed. Actions Taken: Surveillance data, which identify the types of water systems and their deficiencies and the etiologic agents associated with outbreaks, are used to evaluate the adequacy of current technologies for providing safe drinking and recreational water, establish research priorities, and assist in improving water quality regulations. " p. 1-2

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