The threat of and planning for pandemic flu

91 pages.Full text of the congressional hearing regarding planning for a possible outbreak of pandemic influenza

The public health benefits of insulation retrofits in existing housing in the United States

BACKGROUND: Methodological limitations make it difficult to quantify the public health benefits of energy efficiency programs. To address this issue, we developed a risk-based model to estimate the health benefits associated with marginal energy usage reductions and applied the model to a hypothetical case study of insulation retrofits in single-family homes in the United States. METHODS: We modeled energy savings with a regression model that extrapolated findings from an energy simulation program. Reductions of fine particulate matter (PM(2.5)) emissions and particle precursors (SO(2 )and NOx) were quantified using fuel-specific emission factors and marginal electricity analyses. Estimates of population exposure per unit emissions, varying by location and source type, were extrapolated from past dispersion model runs. Concentration-response functions for morbidity and mortality from PM(2.5 )were derived from the epidemiological literature, and economic values were assigned to health outcomes based on willingness to pay studies. RESULTS: In total, the insulation retrofits would save 800 TBTU (8 × 10(14 )British Thermal Units) per year across 46 million homes, resulting in 3,100 fewer tons of PM(2.5), 100,000 fewer tons of NOx, and 190,000 fewer tons of SO(2 )per year. These emission reductions are associated with outcomes including 240 fewer deaths, 6,500 fewer asthma attacks, and 110,000 fewer restricted activity days per year. At a state level, the health benefits per unit energy savings vary by an order of magnitude, illustrating that multiple factors (including population patterns and energy sources) influence health benefit estimates. The health benefits correspond to $1.3 billion per year in externalities averted, compared with$5.9 billion per year in economic savings. CONCLUSION: In spite of significant uncertainties related to the interpretation of PM(2.5 )health effects and other dimensions of the model, our analysis demonstrates that a risk-based methodology is viable for national-level energy efficiency programs

Baseline hospital performance and the impact of medical emergency teams: Modelling vs. conventional subgroup analysis

<p>Abstract</p> <p>Background</p> <p>To compare two approaches to the statistical analysis of the relationship between the baseline incidence of adverse events and the effect of medical emergency teams (METs).</p> <p>Methods</p> <p>Using data from a cluster randomized controlled trial (the MERIT study), we analysed the relationship between the baseline incidence of adverse events and its change from baseline to the MET activation phase using quadratic modelling techniques. We compared the findings with those obtained with conventional subgroup analysis.</p> <p>Results</p> <p>Using linear and quadratic modelling techniques, we found that each unit increase in the baseline incidence of adverse events in MET hospitals was associated with a 0.59 unit subsequent reduction in adverse events (95%CI: 0.33 to 0.86) after MET implementation and activation. This applied to cardiac arrests (0.74; 95%CI: 0.52 to 0.95), unplanned ICU admissions (0.56; 95%CI: 0.26 to 0.85) and unexpected deaths (0.68; 95%CI: 0.45 to 0.90). Control hospitals showed a similar reduction only for cardiac arrests (0.95; 95%CI: 0.56 to 1.32). Comparison using conventional subgroup analysis, on the other hand, detected no significant difference between MET and control hospitals.</p> <p>Conclusions</p> <p>Our study showed that, in the MERIT study, when there was dependence of treatment effect on baseline performance, an approach based on regression modelling helped illustrate the nature and magnitude of such dependence while sub-group analysis did not. The ability to assess the nature and magnitude of such dependence may have policy implications. Regression technique may thus prove useful in analysing data when there is a conditional treatment effect.</p

Regulation of tobacco products : hearings before the Subcommittee on Health and the Environment of the Committee on Energy and Commerce, House of Representatives, One Hundred Third Congress, second session.

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Radiation testing on humans : hearing before the Subcommittee on Energy and Power of the Committee on Energy and Commerce, House of Representatives, One Hundred Third Congress, second session, January 18, 1994.

"Serial no. 103-102."Shipping list no.: 94-0270-P.Distributed to some depository libraries in microfiche.Includes bibliographical references (p. 94).Mode of access: Internet

Legislative efforts to combat spam : joint hearing before the Subcommittee on Commerce, Trade, and Consumer Protection and the Subcommittee Telecommunications and the Internet of the Committee on Energy and Commerce, House of Representatives, One Hundred Eighth Congress, first session, July 9, 2003.

"Serial no. 108-35."Shipping list no.: 2004-0027-P.Distributed to some depository libraries in microfiche.Mode of access: Internet