Behaviour of viruses in activated sludge treatment.

The behaviour of f2 coliphage and poliovirus I in activated sludge treatment was studied under different operating conditions of flow through time, mixed liquor suspended solids, temperature and virus loading in a bench scale model plant whose performance was similar to that of a full scale treatment plant. The liquid and solids fractions of mixed liquor samples containing virus were assayed separately, with the solids fraction receiving ultrasonic treatment. The recovery of poliovirus from mixed liquor by this method was about 83%, while that of f2 coliphage was in the range of about 54-85%. The average removal of f2 coliphage across the model plant was about 84 %, and was not significantly altered by altering the flow through time, mixed liquor suspended solids and temperature in the plant. The removal was, however, decreased from about 96 % to about 70% with higher virus loads. The association of f2 with the mixed liquor solids showed an inverse relation with increased flow, a direct relation with increased mixed liquor solids, and apparently direct relation (with an optimum) with increased temperature and a clear direct relation with increased virus load. The removal of poliovirus across the plant over the range of conditions studied was generally high and reached up to about 99.7 %. The behaviour and removal of both viruses in the model plant correlated with the association of these viruses with the suspended solids. The degree of association, which appeared to depend upon the nature of each virus and was achieved by physical adsorption, was strikingly contrasting with about 18 and 85 % of f2 and poliovirus respectively detected on the solids. The striking differences between the behaviour of f2 coliphage and poliovirus I imposed interesting implications on the concept of indicator virus from the public health viewpoint

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. Disaster-associated hazardous material releases are of concern, given increases in population density and accelerating industrial development in areas subject to natural disasters. These trends increase the probability of catastrophic future disasters and the potential for mass human exposure to hazardous materials released during disasters. This systematic review summarizes direct and indirect disaster-associated releases, as well as environmental contamination and adverse human health effects that have resulted from natural disaster-related hazmat incidents. Thorough examination of historic disaster-related hazmat releases can be used to identify future threats and improve mitigation and prevention efforts

Visual impairment and age-related eye diseases in Florida: Findings from 2006 Behavioral Risk Factors Surveillance System (BRFSS) in Nine states

Yan Li, Amy Z Fan, Lina S BalluzBehavioral Surveillance Branch, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USAPurpose: To compare the prevalence of age-related eye disease, visual impairment, and eye care service utilization among adults aged 65 and older in Florida with eight other states. Methods: In 2006, nine states conducted the visual impairment and access to eye care module using the Behavioral Risk Factors Surveillance System (BRFSS) survey (N = 62,750). Visual impairment was based on self-reported ability to see distant and near objects. Age-related eye diseases including cataract, glaucoma, macular degeneration, and diabetic retinopathy were self-reported with diagnosis confirmed by a health care professional. Eye care visit or examination was assessed by whether a respondent reported an eye visit or dilated eye examination within the past year.Results: The estimated prevalence of distant and near visual impairment was lower in Florida than in the eight other states (distant: 11.5% vs 15.2%, P < 0.001; near: 22.3% vs 28.7%, P < 0.001). There was no significant difference with the prevalence of age-related macular degeneration and diabetic retinopathy between these two groups. The prevalence of glaucoma and cataract was higher in Florida. The rates of eye care visits (80.5% vs 74.8%, P < 0.01) and dilated eye examinations (74.7% vs 64.0%, P < 0.01) were higher in Florida. After controlling for demographic variables, chronic conditions, insurance, and eye examination, results for elderly in Florida continued to demonstrate less visually impaired.Conclusion: Fewer elderly in Florida reported visual impairment in spite of comparable or higher prevalence of age-related eye diseases with other states. Health care utilization and health insurance for eye care coverage were also higher in Florida, which may account for the phenomena. More research is needed to investigate the association.Keywords: visual impairment, age-related eye disease, eye care service utilization, health insurance, BRFS

Influenza-like Illness, the Time to Seek Healthcare, and Influenza Antiviral Receipt During the 2010–2011 Influenza Season— United States

Background. Few data exist describing healthcare-seeking behaviors among persons with influenza-like illness (ILI) or adherence to influenza antiviral treatment recommendations. Methods. We analyzed adult responses to the Behavioral Risk Factor Surveillance System in 31 states and the District of Columbia (DC) and pediatric responses in 25 states and DC for January–April 2011 by demographics and underlying health conditions. Results. Among 75 088 adult and 15 649 child respondents, 8.9% and 33.9%, respectively, reported ILI. ILI was more frequent among adults with asthma (16%), chronic obstruction pulmonary disease (COPD; 26%), diabetes (12%), heart disease (19%), kidney disease (16%), or obesity (11%). Forty-five percent of adults and 57% of children sought healthcare for ILI. Thirty-five percent of adults sought care ≤2 days after ILI onset. Seeking care ≤2 days was more frequent among adults with COPD (48%) or heart disease (55%). Among adults with a self-reported physician diagnosis of influenza, 34% received treatment with antiviral medications. The only underlying health condition with a higher rate of treatment was diabetes (46%). Conclusions. Adults with underlying health conditions were more likely to report ILI, but the majority did not seek care promptly, missing opportunities for early influenza antiviral treatment

Serum Non-high-density lipoprotein cholesterol concentration and risk of death from cardiovascular diseases among U.S. adults with diagnosed diabetes: the Third National Health and Nutrition Examination Survey linked mortality study

<p>Abstract</p> <p>Background</p> <p>Non-high-density lipoprotein cholesterol (non-HDL-C) measures all atherogenic apolipoprotein B-containing lipoproteins and predicts risk of cardiovascular diseases (CVD). The association of non-HDL-C with risk of death from CVD in diabetes is not well understood. This study assessed the hypothesis that, among adults with diabetes, non-HDL-C may be related to the risk of death from CVD.</p> <p>Methods</p> <p>We analyzed data from 1,122 adults aged 20 years and older with diagnosed diabetes who participated in the Third National Health and Nutrition Examination Survey linked mortality study (299 deaths from CVD according to underlying cause of death; median follow-up length, 12.4 years).</p> <p>Results</p> <p>Compared to participants with serum non-HDL-C concentrations of 35 to 129 mg/dL, those with higher serum levels had a higher risk of death from total CVD: the RRs were 1.34 (95% CI: 0.75-2.39) and 2.25 (95% CI: 1.30-3.91) for non-HDL-C concentrations of 130-189 mg/dL and 190-403 mg/dL, respectively (<it>P </it>= 0.003 for linear trend) after adjustment for demographic characteristics and selected risk factors. In subgroup analyses, significant linear trends were identified for the risk of death from ischemic heart disease: the RRs were 1.59 (95% CI: 0.76-3.32) and 2.50 (95% CI: 1.28-4.89) (<it>P </it>= 0.006 for linear trend), and stroke: the RRs were 3.37 (95% CI: 0.95-11.90) and 5.81 (95% CI: 1.96-17.25) (<it>P </it>= 0.001 for linear trend).</p> <p>Conclusions</p> <p>In diabetics, higher serum non-HDL-C concentrations were significantly associated with increased risk of death from CVD. Our prospective data support the notion that reducing serum non-HDL-C concentrations may be beneficial in the prevention of excess death from CVD among affected adults.</p

Use of folic acid and vitamin supplementation among adults with depression and anxiety: a cross-sectional, population-based survey

<p>Abstract</p> <p>Background</p> <p>Evidence suggests that folate deficiency may be causatively linked to depressive symptoms. However, little is known on the status of use of folic acid and vitamin supplements among people with mental disorders. This study examined the prevalence and the likelihood of use of folic acid or vitamin supplements among adults with depression and anxiety in comparison to those without these conditions.</p> <p>Methods</p> <p>Using data from 46, 119 participants (aged ≥ 18 years) in the 2006 Behavioral Risk Factor Surveillance System survey, we estimated the adjusted prevalence and odds ratios with 95% confidence intervals for taking folic acid and vitamin supplements among those with ever diagnosed depression (n = 8, 019), ever diagnosed anxiety (n = 5, 546) or elevated depressive symptoms (n = 3, 978, defined as having a depression severity score of ≥ 10 on the Patient Health Questionnaire-8 diagnostic algorithm).</p> <p>Results</p> <p>Overall, women were more likely than men to take folic acid supplements 1-4 times/day (50.2% versus 38.7%, P < 0.001) and vitamin supplements (62.5% versus 49.8%, P < 0.001). After multivariate adjustment, men with ever diagnosed depression or anxiety were 42% and 83%, respectively, more likely to take folic acid supplements < 1 time/day; 44% and 39%, respectively, more likely to take folic acid supplements 1-4 times/day; and 40% and 46%, respectively, more likely to take vitamin supplements compared to men without these conditions (P < 0.05 for all comparisons). Women with ever diagnosed depression were 13% more likely to take folic acid supplements 1-4 times/day and 15% more likely to take vitamin supplements than women without this condition (P < 0.05 for both comparisons). Use of folic acid and vitamin supplements did not differ significantly by elevated depressive symptoms in either sex.</p> <p>Conclusion</p> <p>The prevalence and the likelihood of taking folic acid and vitamin supplements varied substantially by a history of diagnosed depression among both men and women and by a history of diagnosed anxiety among men, but not by presence of elevated depressive symptoms in either sex.</p

When data are not missing at random: implications for measuring health conditions in the Behavioral Risk Factor Surveillance System

Objectives To examine the effect on estimated levels of health conditions produced from large-scale surveys, when either list-wise respondent deletion or standard demographic item-level imputation is employed. To assess the degree to which further bias reduction results from the inclusion of correlated ancillary variables in the item imputation process. Design Large cross-sectional (US level) household survey. Participants 218 726 US adults (18 years and older) in the 2006 Behavioral Risk Factor Surveillance System Survey. This survey is the largest US telephone survey conducted by the Centers for Disease Control and Prevention. Primary and secondary outcome measures Estimated rates of severe depression among US adults. Results The use of list-wise respondent deletion and/or demographic imputation results in the underestimation of severe depression among adults in the USA. List-wise deletion produces underestimates of 9% (8.7% vs 9.5%). Demographic imputation produces underestimates of 7% (8.9% vs 9.5%). Both of these differences are significant at the 0.05 level. Conclusion The use of list-wise deletion and/or demographic-only imputation may produce significant distortion in estimating national levels of certain health conditions

Associations between Overall and Abdominal Obesity and Suicidal Ideation among US Adult Women

Obesity is associated with increased risks for mental disorders. This study examined associations of obesity indicators including body mass index (BMI), waist circumference, and waist-height ratio with suicidal ideation among U.S. women. We analyzed data from 3,732 nonpregnant women aged ≥20 years who participated in the 2005–2008 National Health and Nutrition Examination Survey. We used anthropometric measures of weight, height, and waist circumference to calculate BMI and waist-height ratio. Suicidal ideation was assessed using the Item 9 of the Patient Health Questionnaire-9. Odds ratios with 95% conference intervals were estimated using logistic regression analyses after controlling for potential confounders. The age-adjusted prevalence of suicidal ideation was 3.0%; the prevalence increased linearly across quartiles of BMI, waist circumference, and waist-height ratio (P for linear trend <0.01 for all). The positive associations of waist circumference and waist-height ratio with suicidal ideation remained significant (P < 0.05) after adjustment for sociodemographics, lifestyle-related behavioral factors, and having either chronic conditions or current depression. However, these associations were attenuated after both chronic conditions and depression were entered into the models. Thus, the previously reported association between obesity and suicidal ideation appears to be confounded by coexistence of chronic conditions and current depression among women of the United States