Global, regional, and national mortality due to unintentional carbon monoxide poisoning, 2000-2021: results from the Global Burden of Disease Study 2021

BACKGROUND: Unintentional carbon monoxide poisoning is a largely preventable cause of death that has received insufficient attention. We aimed to conduct a comprehensive global analysis of the demographic, temporal, and geographical patterns of fatal unintentional carbon monoxide poisoning from 2000 to 2021. METHODS: As part of the latest Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), unintentional carbon monoxide poisoning mortality was quantified using the GBD cause of death ensemble modelling strategy. Vital registration data and covariates with an epidemiological link to unintentional carbon monoxide poisoning informed the estimates of death counts and mortality rates for all locations, sexes, ages, and years included in the GBD. Years of life lost (YLLs) were estimated by multiplying deaths by remaining standard life expectancy at age of death. Population attributable fractions (PAFs) for unintentional carbon monoxide poisoning deaths due to occupational injuries and high alcohol use were estimated. FINDINGS: In 2021, the global mortality rate due to unintentional carbon monoxide poisoning was 0·366 per 100 000 (95% uncertainty interval 0·276-0·415), with 28 900 deaths (21 700-32 800) and 1·18 million YLLs (0·886-1·35) across all ages. Nearly 70% of deaths occurred in males (20 100 [15 800-24 000]), and the 50-54-year age group had the largest number of deaths (2210 [1660-2590]). The highest mortality rate was in those aged 85 years or older with 1·96 deaths (1·38-2·32) per 100 000. Eastern Europe had the highest age-standardised mortality rate at 2·12 deaths (1·98-2·30) per 100 000. Globally, there was a 53·5% (46·2-63·7) decrease in the age-standardised mortality rate from 2000 to 2021, although this decline was not uniform across regions. The overall PAFs for occupational injuries and high alcohol use were 13·6% (11·9-16·0) and 3·5% (1·4-6·2), respectively. INTERPRETATION: Improvements in unintentional carbon monoxide poisoning mortality rates have been inconsistent across regions and over time since 2000. Given that unintentional carbon monoxide poisoning is almost entirely preventable, policy-level interventions that lower the risk of carbon monoxide poisoning events should be prioritised, such as those that increase access to improved heating and cooking devices, reduce carbon monoxide emissions from generators, and mandate use of carbon monoxide alarms. FUNDING: Bill & Melinda Gates Foundation

Recommendations for blood lead screening of young children enrolled in Medicaid: targeting a group at high risk

Children aged 1-5 years enrolled in Medicaid are at increased risk for having elevated blood lead levels (BLLs). According to estimates from the National Health and Nutrition Examination Survey (NHANES) (1991-1994), Medicaid enrollees accounted for 83% of U.S. children aged 1-5 years who had BLLs > or = 20 microg/dL. Despite longstanding requirements for blood lead screening in the Medicaid program, an estimated 81% of young children enrolled in Medicaid had not been screened with a blood lead test. As a result, most children with elevated BLLs are not identified and, therefore, do not receive appropriate treatment or environmental intervention. To ensure delivery of blood lead screening and follow-up services for young children enrolled in Medicaid, the Advisory Committee on Childhood Lead Poisoning Prevention (ACCLPP) recommends specific steps for health-care providers and states. Health-care providers and health plans should provide blood lead screening and diagnostic and treatment services for children enrolled in Medicaid, consistent with federal law, and refer children with elevated BLLs for environmental and public health follow-up services. States should change policies and programs to ensure that young children enrolled in Medicaid receive the screening and follow-up services to which they are legally entitled. Toward this end, states should a) ensure that their own Medicaid policies comply with federal requirements, b) support health-care providers and health plans in delivering screening and follow-up services, and c) ensure that children identified with elevated BLLs receive essential, yet often overlooked, environmental follow-up care. States should also monitor screening performance and BLLs among young children enrolled in Medicaid. Finally, states should implement innovative blood lead screening strategies in areas where conventional screening services have been insufficient. This report provides recommendations for improved screening strategies and relevant background information for health-care providers, state health officials, and other persons interested in improving the delivery of lead-related services to young children served by MedicaidAdvisory Committee on Childhood Lead Poisoning Prevention (ACCLPP).December 8, 2000.The following CDC staff members prepared this report: Alan B. Bloch, _Lisa R. Rosenblum, Division of Environmental Hazards and Health Effects, National Center for Environmental Health; in collaboration with Anne M. Guthrie, Alliance to End Childhood Lead PoisoningIncludes bibliographical references

Recommendations for preventing lead poisoning among the internally displaced Roma population in Kosovo from the Centers for Disease Control and Prevention

Environmental HealthPrevention and ControlCurrent"Lead exposure is a continuing urgent health problem for Roma in Kosovo. The Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and the United Nations International Children's Emergency Fund (UNICEF) have collaborated in blood lead surveillance of the Roma children living in displacement camps in Kosovo. In the last 3 rounds of blood lead testing, conducted between 2005 and 2007, on average, 30% of children tested had capillary blood lead levels > 45 \u3bcg/dL, the level at which CDC recommends chelation therapy. Few if any children in the camps have maintained a blood lead level < 10 \u3bcg/dL for their entire childhood. These children are at tremendous risk for a lifetime of developmental and behavioral disabilities and other adverse health conditions. The Cesmin Lug camp is the most highly contaminated camp and should be closed immediately. The situation in Cesmin Lug is made more critical because Roma living in Serbia and Montenegro are now moving into vacant dwellings in the camp. Dwellings that are currently vacant should be demolished immediately. These dwellings are not only contaminated by lead but a clear and present fire hazard. In addition, uncontrolled informal smelting at the now closed Kablar camp must be stopped. These activities result in lead exposure to children in both Cesmin Lug and Osterode Camps. Lack of data has hampered decision making and resulted in confusion on the part of Roma and others as to the seriousness of the problem and the extent of the environmental contamination. A periodic, systematic review of the data would provide important information about the quality of the children's clinical care. Reportedly 39 children have been chelated. Perhaps as many as 90 children are candidates for therapy. The actual number cannot be determined at this time. Lead exposure should be a priority for repatriation to the Roma Mahala. Plans should be developed for continued medical surveillance of these children when they are repatriated to Roma Mahala." - p. 3Mary Jean Brown and Barry Brooks, Lead Poisoning Prevention Branch, U. S. Centers for Disease Control and Prevention."October 27, 2007"Available on the internet as an Acrobat .pdf file (629.5 KB, 12 p.)

Safety and health in manufactured structures

This report identifies and summarizes safety and health issues in manufactured structures based on a wide expanse of research. The end result is a thorough characterization of health and safety hazards in manufactured structures, along with mitigation strategies and discussions of opportunities for health/ safety enhancements and at-risk populations.Millions of people in America live in manufactured structures--a range of units that includes manufactured homes, travel trailers, camping trailers, and park trailers. Manufactured structures are used for long- term residence; for temporary housing following disasters; for recreational and travel purposes; and also for classrooms, day care centers, and workplaces. Housing is a primary purpose of these structures, with manufactured homes accounting for 6.3% of the housing units in the U.S. and housing 17.2 million persons. Manufactured homes offer flexibility and affordability, and comprise an important part of the U.S. housing stock. Whether used for long-term housing or for short-term shelter following a disaster, for classrooms or for offices, manufactured structures should be safe and healthy for the people who live, work, study, and play in them. With Americans spending the vast majority of their time indoors, it is vital that buildings protect occupants from the elements and provide privacy, comfort, and peace of mind. At the same time, these structures should not present risks to occupant's health and safety due to design, construction, or maintenance problems. This report identifies and summarizes safety and health issues in manufactured structures based on a wide expanse of research. The end result is a thorough characterization of health and safety hazards in manufactured structures, along with mitigation strategies and discussions of opportunities for health/ safety enhancements and at-risk populations. Many of the hazards discussed in this report are not unique to manufactured structures, while other issues have been identified as particular problems for this form of housing. Further, when manufactured structures are used as interim housing following a disaster, additional health/safety issues can arise. The specific topics covered in this report are an introduction to manufactured structures, fire safety, moisture and mold, indoor air quality (IAQ), pests and pesticides, siting and installation, utilities, postdisaster housing, and potential opportunities for future enhancements. The health and safety hazards related to fire safety, moisture and mold, IAQ, pests and pesticides, and other issues generally fall into the categories of design, construction, and maintenance. Thus, for an issue like effective moisture management to prevent mold and related problems, strategies range from good product selection in the design phase to proper grading of the site during construction all the way to regular maintenance of the building envelope after many years of service. Most other health and safety hazards are similar in nature, with multiple parties playing an important role in managing risks from the design of the manufactured home through its use as a home for years to come. Fortunately, the challenges of managing health and safety risks in manufactured structures are well documented, along with appropriate strategies and solutions. This report documents and summarizes this information, with the intent of serving as a comprehensive resource to inform discussions and future decisions regarding the design, construction, maintenance, and deployment of manufactured structures in the United States.Glossary -- 1. Introduction -- 2. Fire safety -- 3. Moisture and mold -- 4. Indoor air quality -- 5. Pests and pesticides -- 6. Siting and installation -- 7. Utilities -- 8. Postdisaster housing: keeping safe and healthy -- 9. Potential opportunities -- Referencesedited by Don Ryan, Liza Bowles."218685-A."The manual was developed as a follow-up to the Safe and Healthy Manufactured Structures working meeting held on October 17, 2008. Meeting participants representing federal, state, and local government; community and environmental groups; industry; professional associations; and academic institutions reviewed and commented on formative materials for this document.On cover: U.S. Department of Health and Human Services, U.S. Department of Housing and Urban Development.Available via the World Wide Web as an Acrobat .pdf file (2.92 MB, 108 p.).Centers for Disease Control and Prevention and U.S. Department of Housing and Urban Development. Safety and health in manufactured structures. Atlanta: U.S. Department of Health and Human Services; 2011.Malasky8/27/14Environmental HealthPrevention and ControlCurren

広島県内介護保険施設・病院等における給食施設の食中毒発生時の食事提供マニュアルの整備状況

介護保険施設・病院等の給食施設では、食中毒が発生した場合においても入所者、入院患者への食事提供を継続しなければならず、被害拡大防止対策や再発防止対策を講じなければならない中で、この責務を果たすことは施設にとって大きな課題である。そこで、広島県内A保健所管内における介護保険施設・病院等の53給食施設を対象として、食中毒発生時における食事提供マニュアルの整備状況を調査し、危機管理対策が適正に講じられているかどうかを把握することを目的とした。食中毒対応体制を確立するための施設からの課題としては、組織・人材管理項目では「代行従事者の確保」が、食事管理項目では「一般食以外の提供先」が、施設・設備管理項目では「盛り付け場所の確保」「洗浄場所の確保」が挙げられた。食中毒発生時の食事提供マニュアルを作成していた施設は介護老人福祉施設・介護老人保健施設の39.3%、病院の64.0%であった。食中毒発生時の食事提供に関する保健衛生行政に対する要望は「食事提供マニュアルの作成指針(チェックリスト)の提示」、「模擬訓練の実施」、「食事提供を支援する組織づくり(地域協議会など)」の順に多かった。これらのことから、食中毒発生時において入所者・入院患者の食事提供が円滑に行えるよう平時より介護保険施設・病院等の給食施設と保健所、地域が連携して食事提供マニュアルを作成し、模擬訓練を定期的に実施することが必要であると考えられた。"In case food poisoning breaks out at welfare facilities for the elderly or hospitals, a major priority is to limit the damage by ensuring that the outbreak spreads no further and to secure substitute food for residents. In 2003 and 2004, we conducted investigations as to whether manuals were available for coping with food poisoning. This was done using questionnaires and personal interviews at 28 welfare facilities and 25 hospitals within a specific area of Hiroshima Prefecture. The figures are as follows: 39.3% of the facilities and 64.0% of the hospitals had manuals for coping with food poisoning. Problems in making out manuals in the facilities are as follows: ""to secure agent staff"", ""to secure a place to serve food"", and ""to secure substitute special food"". Problems in making out manuals in the hospitals are as follows: ""to secure agent staff"" and ""to secure substitute special food"". We formed ""check lists"" of those who had manuals readily available for coping with food poisoning and distributed the result all those involved. Check lists are comprised of 13 units such as ""how to establish a system for dealing with the outbreak of food poisoning"", ""distribution of substitute food"", ""to secure a place to serve food"", and ""to secure agent staff"". It is important that the manual defines exactly what is involved in case of an outbreak of food poisoning. We make a point of conducting a practical verification for the purpose of improving the ability of staff members to cope with the outbreak of food poisoning, and revising the manuals more effectively."原著Original国立情報学研究所で電子

Global, regional, and national mortality due to unintentional carbon monoxide poisoning, 2000–2021: results from the Global Burden of Disease Study 2021

Background Unintentional carbon monoxide poisoning is a largely preventable cause of death that has received insufficient attention. We aimed to conduct a comprehensive global analysis of the demographic, temporal, and geographical patterns of fatal unintentional carbon monoxide poisoning from 2000 to 2021. Methods As part of the latest Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), unintentional carbon monoxide poisoning mortality was quantified using the GBD cause of death ensemble modelling strategy. Vital registration data and covariates with an epidemiological link to unintentional carbon monoxide poisoning informed the estimates of death counts and mortality rates for all locations, sexes, ages, and years included in the GBD. Years of life lost (YLLs) were estimated by multiplying deaths by remaining standard life expectancy at age of death. Population attributable fractions (PAFs) for unintentional carbon monoxide poisoning deaths due to occupational injuries and high alcohol use were estimated. Findings In 2021, the global mortality rate due to unintentional carbon monoxide poisoning was 0·366 per 100 000 (95% uncertainty interval 0·276–0·415), with 28 900 deaths (21 700–32 800) and 1·18 million YLLs (0·886–1·35) across all ages. Nearly 70% of deaths occurred in males (20 100 [15 800–24 000]), and the 50–54-year age group had the largest number of deaths (2210 [1660–2590]). The highest mortality rate was in those aged 85 years or older with 1·96 deaths (1·38–2·32) per 100 000. Eastern Europe had the highest age-standardised mortality rate at 2·12 deaths (1·98–2·30) per 100 000. Globally, there was a 53·5% (46·2–63·7) decrease in the age-standardised mortality rate from 2000 to 2021, although this decline was not uniform across regions. The overall PAFs for occupational injuries and high alcohol use were 13·6% (11·9–16·0) and 3·5% (1·4–6·2), respectively. Interpretation Improvements in unintentional carbon monoxide poisoning mortality rates have been inconsistent across regions and over time since 2000. Given that unintentional carbon monoxide poisoning is almost entirely preventable, policy-level interventions that lower the risk of carbon monoxide poisoning events should be prioritised, such as those that increase access to improved heating and cooking devices, reduce carbon monoxide emissions from generators, and mandate use of carbon monoxide alarms.publishedVersio