EPIC Proportions: Violence Against Women in California 1992-99

EPIC Proportions is a series of reports on injury control produced by the Epidemiology and Prevention for Injury Control (EPIC) Branch. This report, prepared by Laura E. Lund, M.A., updates a previous EPIC Proportions: Violent Injuries to Women in California

EPIC Proportions: Violence Against Women in California 1992-99

EPIC Proportions is a series of reports on injury control produced by the Epidemiology and Prevention for Injury Control (EPIC) Branch. This report, prepared by Laura E. Lund, M.A., updates a previous EPIC Proportions: Violent Injuries to Women in California

EPIC Proportions: Violent Injuries to California Youth

EPIC Proportions is a series of reports on injury control produced by the Emergency Preparedness and Injury Control (EPIC) Branch. Arthur A. Ellis, MA, Research Scientist in the Injury Surveillance and Epidemiology Section, prepared this report

EPIC Proportions: Violent Injuries to California Youth

EPIC Proportions is a series of reports on injury control produced by the Emergency Preparedness and Injury Control (EPIC) Branch. Arthur A. Ellis, MA, Research Scientist in the Injury Surveillance and Epidemiology Section, prepared this report

Public health management of antiviral drugs during the 2009 H1N1 influenza pandemic: a survey of local health departments in California

<p>Abstract</p> <p>Background</p> <p>The large-scale deployment of antiviral drugs from the Strategic National Stockpile during the 2009 H1N1 influenza response provides a unique opportunity to study local public health implementation of the medical countermeasure dispensing capability in a prolonged event of national significance. This study aims to describe the range of methods used by local health departments (LHDs) in California to manage antiviral activities and to gain a better understanding of the related challenges experienced by health departments and their community partners.</p> <p>Methods</p> <p>This research employed a mixed-methods approach. First, a multi-disciplinary focus group of pandemic influenza planners from key stakeholder groups in California was convened in order to generate ideas and identify critical themes related to the local implementation of antiviral activities during the H1N1 influenza response. These qualitative data informed the development of a web-based survey, which was distributed to all 61 LHDs in California for the purpose of assessing the experiences of a representative sample of local health agencies in a large region.</p> <p>Results</p> <p>Forty-four LHDs participated in this study, representing 72% of the local public health agencies in California. While most communities dispensed a modest number of publicly purchased antivirals, LHDs nevertheless drew on their previous work and engaged in a number of antiviral activities, including: acquiring, allocating, distributing, dispensing, tracking, developing guidance, and communicating to the public and clinical community. LHDs also identified specific antiviral challenges presented by the H1N1 pandemic, including: reconciling multiple sources and versions of antiviral guidance, determining appropriate uses and recipients of publicly purchased antivirals, and staffing shortages.</p> <p>Conclusions</p> <p>The 2009 H1N1 influenza pandemic presented an unusual opportunity to learn about the role of local public health in the management of antiviral response activities during a real public health emergency. Results of this study offer an important descriptive account of LHD management of publicly purchased antivirals, and provide practitioners, policy makers, and academics with a practice-based assessment of these events. The issues raised and the challenges faced by LHDs should be leveraged to inform public health planning for future pandemics and other emergency events that require medical countermeasure dispensing activities.</p

Impact of intercensal population projections and error of closure on breast cancer surveillance: examples from 10 California counties

INTRODUCTION: In 2001, data from the California Cancer Registry suggested that breast cancer incidence rates among non-Hispanic white (nHW) women in Marin County, California, had increased almost 60% between 1991 and 1999. This analysis examines the extent to which these and other breast cancer incidence trends could have been impacted by bias in intercensal population projections. METHOD: We obtained population projections for the year 2000 projected from the 1990 census from the California Department of Finance (DOF) and population counts from the 2000 US Census for nHW women living in 10 California counties and quantified age-specific differences in counts. We also computed age-adjusted incidence rates of invasive breast cancer in order to examine and quantify the impact of differences between the population data sources. RESULTS: Differences between year 2000 DOF projections and year 2000 census counts varied by county and age and ranged from underestimates of 60% to overestimates of 64%. For Marin County, the DOF underestimated the number of nHW women aged 45 to 64 years by 32% compared to the 2000 US census. This difference produced a significant 22% discrepancy between breast cancer incidence rates calculated using the two population data sources. In Los Angeles and Santa Clara counties, DOF-based incidence rates were significantly lower than rates based on census data. Rates did not differ significantly by population data source in the remaining seven counties examined. CONCLUSION: Although year 2000 population estimates from the DOF did not differ markedly from census counts at the state or county levels, greater discrepancies were observed for race-stratified, age-specific groups within counties. Because breast cancer incidence rates must be calculated with age-specific data, differences between population data sources at the age-race level may lead to mis-estimation of breast cancer incidence rates in county populations affected by these differences, as was observed in Marin County. Although intercensal rates based on population projections are important for timely breast cancer surveillance, these rates are prone to bias due to the error of closure between population projections and decennial census population counts. Intercensal rates should be interpreted with this potential bias in mind

Use of Pulsed-UV Processes to Destroy NDMA

About five years ago, N-nitrosodimethylamine (NDMA) began to be detected in drinking water sources. Typically an oxidative degradation product of unsymmetrical dimethylhydrazine, NDMA is a component of rocket fuel and is also formed during numerous industrial manufacturing processes as a byproduct of reactions involving chemicals called alkylamines. The US Environmental Protection Agency has identified NDMA as a probable human carcinogen. However, because NDMA had not historically been considered a common drinking water contaminant, no federal or state drinking water standards were established for it until 1998 in California. In addition to its presence in drinking water, it has recently been suggested that NDMA may be present in sewage and reclaimed water after chlorination, as well as surface water processed by conventional drinking water treatment methods. The mechanisms of NDMA formation appear to be associated with the chlorination process. Therefore, an urgent need has developed for technologies that can remediate drinking water sources contaminated by this compound. This need sparked a growing interest in the potential of pulsed-ultraviolet (UV) and pulsed-UV/hydrogen peroxide treatment processes for removing NDMA from drinking water. The authors of this article evaluated the effectiveness of these treatments for NDMA removal. The results showed that NDMA can be reduced with UV light treatment. This finding will help drinking water utilities to better comply with state and federal standards and to more effectively protect public health