Environmental Public Health Commons^™

The Epidemic Of Extended-Spectrum-Β-Lactamase-Producing Escherichia Coli St131 Is Driven By A Single Highly Pathogenic Subclone, H30-Rx, Lance B. Price, James R. Johnson, Maliha Aziz, Connie Clabots, Brian Johnston, Veronika Tchesnokova, Lora Nordstrom, Maria Billig, Sujay Chattopadhyay, Marc Stegger, Paal S. Andersen, Talima Pearson, Kim Riddell, Peggy Rogers, Delia Scholes, Barbara Kahl, Paul Keim, Evgeni V. Sokurenko

Environmental and Occupational Health Faculty Publications

The Escherichia coli sequence type 131 (ST131) clone is notorious for extraintestinal infections, fluoroquinolone resistance, and extended-spectrum beta-lactamase (ESBL) production, attributable to a CTX-M-15-encoding mobile element. Here, we applied pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing to reconstruct the evolutionary history of the ST131 clone. PFGE-based cluster analyses suggested that both fluoroquinolone resistance and ESBL production had been acquired by multiple ST131 sublineages through independent genetic events. In contrast, the more robust whole-genome-sequence-based phylogenomic analysis revealed that fluoroquinolone resistance was confined almost entirely to a single, rapidly expanding ST131 subclone, designated H30-R. Strikingly, 91% of the CTX-M-15-producing isolates also …

Molecular Epidemiology Of Escherichia Coli Sequence Type 131 And Its H30 And H30-Rx Subclones Among Extended-Spectrum-Β-Lactamase-Positive And -Negative E. Coli Clinical Isolates From The Chicago Region, 2007 To 2010, Ritu Banerjee, Ari Robicsek, Michael A. Kusikowski, Stephen Porter, Brian D. Johnston, Evgeni Sokurenko, Veronika Tchesnokova, Lance B. Price, James R. Johnson

Environmental and Occupational Health Faculty Publications

We assessed Escherichia coli ST131 and its H30 and H30-Rx subclones for virulence genes, antimicrobial resistance, and extended-spectrum beta-lactamase (ESBL) type. Although both subclones were associated with ESBL production, H30-Rx isolates had higher resistance scores and were associated specifically with CTX-M-15. Three virulence genes (iha, sat, and iutA) were more prevalent among H30 than non-H30 ST131 isolates. Thus, the H30 and H30-Rx subclones are more antimicrobial resistant and have virulence profiles that are distinct from those of non-H30 ST131 isolates.

Early Chronic Low-Level Lead Exposure Produces Glomerular Hypertrophy In Young C57bl/6j Mice, Christina Sobin, John Basgen

Christina Sobin, Ph.D.

Early chronic lead exposure continues to pose serious health risks for children, particularly those living in lower socioeconomic environments. This study examined effects on developing glomeruli in young C57BL/6J mice exposed to low (30 ppm), higher (330 ppm) or no lead via dams’ drinking water from birth to sacrifice on post-natal day 28. Low-level lead exposed mice [BLL mean (SD); 3.19 (0.70) µg/dL] had an increase in glomerular volume but no change in podocyte number compared to control mice [0.03 (0.01) µg/dL]. Higher-level lead exposed mice [14.68 (2.74) µg/dL] had no change in either glomerular volume or podocyte number. The …

Association Between In Utero Arsenic Exposure, Placental Gene Expression, And Infant Birth Weight: A Us Birth Cohort Study, Dennis Liang Fei, Devin C. Koestler, Zhigang Li, Camilla Giambelli, Avencia Sanchez-Mejias, Julie Gosse, Carmen J. Marsit, Margaret R. Karagas, David J. Robbins

Dartmouth Scholarship

Epidemiologic studies and animal models suggest that in utero arsenic exposure affects fetal health, with a negative association between maternal arsenic ingestion and infant birth weight often observed. However, the molecular mechanisms for this association remain elusive. In the present study, we aimed to increase our understanding of the impact of low-dose arsenic exposure on fetal health by identifying possible arsenic-associated fetal tissue biomarkers in a cohort of pregnant women exposed to arsenic at low levels.

Methods: Arsenic concentrations were determined from the urine samples of a cohort of 133 pregnant women from New Hampshire. Placental tissue samples collected from …

On Head Lice And Social Interaction In Archaic Andean Coastal Populations, Bernardo Arriaza, Vivien Standen, Karl Reinhard, Aduto Araújo, Jörg Heukelbach, Katharina Dittmar

Karl Reinhard Publications

Archaic mummies from northern Chile were examined for the presence of Pediculus humanus capitis. The excellent preservation of mummies and louse nits/eggs permitted a study of the degree of head lice infestation. We studied 63 Chinchorro mummies (ca. 5000–3000 years B.P.) from the Arica-Camarones coast. An area of 2 cm × 2 cm on each mummy’s head was systematically inspected for louse nits/eggs. Hairs with nits/eggs and lice were collected and analyzed using optic and scanning electronic microscopy. About 79% (50/63) of the mummies resulted positive for pediculosis, with an average of 2.1 nits/ eggs/cm2 per positive individual. Microscopic …

Glutathione Redox Dynamics And Expression Of Glutathione-Related Genes In The Developing Embryo, Alicia R. Timme-Laragy, Jared V. Goldstone, Barry R. Imhoff, John J. Stegemana, Mark E. Hahn, Jason M. Hansen

Alicia R. Timme-Laragy

Embryonic development involves dramatic changes in cell proliferation and differentiation that must be highly coordinated and tightly regulated. Cellular redox balance is critical for cell fate decisions, but it is susceptible to disruption by endogenous and exogenous sources of oxidative stress. The most abundant endogenous non-protein antioxidant defense molecule is the tri-peptide glutathione (γ-glutamyl-cysteinylglycine, GSH), but the ontogeny of GSH concentration and redox state during early life stages is poorly understood. Here, we describe the GSH redox dynamics during embryonic and early larval development (0–5 days post-fertilization) in the zebrafish (Danio rerio), a model vertebrate embryo. We measured reduced and …

Diet And Toenail Arsenic Concentrations In A New Hampshire Population With Arsenic-Containing Water, Kathryn L. Cottingham, Roxanne Karimi, Joann F. Gruber, M Scot Zens, Vicki Sayarath, Carol L. Folt, Tracy Punshon, J. Steven Morris, Margaret R. Karagas

Dartmouth Scholarship

Background: Limited data exist on the contribution of dietary sources of arsenic to an individual's total exposure, particularly in populations with exposure via drinking water. Here, the association between diet and toenail arsenic concentrations (a long-term biomarker of exposure) was evaluated for individuals with measured household tap water arsenic. Foods known to be high in arsenic, including rice and seafood, were of particular interest.

Methods: Associations between toenail arsenic and consumption of 120 individual diet items were quantified using general linear models that also accounted for household tap water arsenic and potentially confounding factors (e.g., age, caloric intake, sex, smoking) …

Rapid Differentiation Between Livestock-Associated And Livestock-Independent Staphylococcus Aureus Cc398 Clades, Marc Stegger, Cindy M. Liu, Jesper Larsen, Katerina Soldanova, Maliha Aziz, Tania Contente-Cuomo, Andreas Petersen, Stien Vandendriessche, Judy N. Jiménez, Caterina Mammina, Alex Van Belkum, Saara Salmenlinna, Frederic Laurent, Robert L. Skov, Anders R. Larsen, Paal S. Andersen, Lance B. Price

Environmental and Occupational Health Faculty Publications

Staphylococcus aureus clonal complex 398 (CC398) isolates cluster into two distinct phylogenetic clades based on single-nucleotide polymorphisms (SNPs) revealing a basal human clade and a more derived livestock clade. The scn and tet(M) genes are strongly associated with the human and the livestock clade, respectively, due to loss and acquisition of mobile genetic elements. We present canonical single-nucleotide polymorphism (canSNP) assays that differentiate the two major host-associated S. aureus CC398 clades and a duplex PCR assay for detection of scn and tet(M). The canSNP assays correctly placed 88 S. aureusCC398 isolates from a reference collection into …

Local Tobacco Control: Application Of The Essential Public Health Services Model In A County Health Department’S Efforts To Put It Out Rockland, Lisa D. Lieberman, Una Diffley, Sandy King, Shelley Chanler, Maryanne Ferrera, Oscar Alleyne, Joan Facelle

Department of Public Health Scholarship and Creative Works

In 2000, Rockland County, a small suburban county north of New York City, dedicated $1 million of its Master Settlement Agreement funds to a comprehensive tobacco control program, Put It Out Rockland. Developed and implemented by the county health department, this program used an essential public health services model and an ongoing financial investment, within the context of strong statewide tobacco control efforts, to lower adult smoking rates to 9.7% and to reduce both smoking among youths and exposure to secondhand smoke over the ensuing decade. By combining state funds and local dollars for a total of $6.75 cost per …

Short- And Long-Term Associations Between Widowhood And Mortality In The United States: Longitudinal Analyses, J. Robin Moon, M. Maria Glamour, Anusha M. Vable, Sze Yan Liu, S.V. Subramanian

Department of Public Health Scholarship and Creative Works

Background

Past research shows that spousal death results in elevated mortality risk for the surviving spouse. However, most prior studies have inadequately controlled for socioeconomic status (SES), and it is unclear whether this ‘widowhood effect’ persists over time.

Methods

Health and Retirement Study participants aged 50+ years and married in 1998 (n = 12 316) were followed through 2008 for widowhood status and mortality (2912 deaths). Discrete-time survival analysis was used to compare mortality for the widowed versus the married.

Results

Odds of mortality during the first 3 months post-widowhood were significantly higher than in the continuously married (odds ratio …

Tobacco Policies At Colleges And Universities Housing Prek – 12 Laboratory Schools: An Exploratory Study, Sarah Prudhomme, Tara L. Gallien

NALS Journal

Objective. This study examined the current status of tobacco-/smoke-free campus policies at PreK - 12 laboratory schools and their affiliated colleges/universities. Perceived barriers to passage of tobacco-/smoke-free policies and aspects of the school environment perceived to aid in passage of such polices were also examined. Methods. Data were collected through electronic surveys to administrators of 61 U.S. International Association of Laboratory School members and their affiliated colleges/universities. Information on state tobacco policies was obtained from the National Association of State Board of Education’s State School Healthy Policy Database on tobacco use. Results. Inconsistencies between college/university tobacco-/smoke-free policies and state …

Wash Education: Need For More Than Water Treatment For Floating Villages In Cambodia, Kevin Curry

2013 New England Association for Asian Studies Conference

Point of use (POU) water treatment systems are widely used around the world to provide microbiologically safe drinking water in developing countries. Work done in Cambodia by Brown et al. (2007) and Liang et al. (2010) have documented ceramic and biosand filters as cost effective point of use treatment systems capable of removing over 95% E. coli bacteria when properly used and maintained. Bridgewater State University and Water for Cambodia (WfC) explored using BioSand filters (BSF) to provide microbiologically safe drinking water for people in the Moat Khla floating village on the Tonle Sap Lake in Siem Reap Province. All …

Structural Approaches To Health Promotion: What Do We Need To Know About Policy And Environmental Change?, Lisa D. Lieberman, Shelley D. Golden, Jo Anne L. Earp

Department of Public Health Scholarship and Creative Works

Although the public health literature has increasingly called on practitioners to implement changes to social, environmental, and political structures as a means of improving population health, recent research suggests that articles evaluating organization, community, or policy changes are more limited than those focused on programs with individuals or their social networks. Even when these approaches appear promising, we do not fully understand whether they will benefit all population groups or can be successful in the absence of accompanying individually oriented programs. The role of this broad category of approaches, including both policy and environmental changes, in decreasing health disparities is …

Environmental, Human, And Socioeconomic Characteristics Of Pedestrian Injury And Death In Las Vegas, Nv, Courtney Coughenour, Jennifer Pharr, Tim Bungum

Courtney Coughenour

No abstract provided.

Schistosomiasis (Bilharzia) In Madagascar: A Case Study Of A Neglected Tropical Disease, Sarah Grace Sawyer

Independent Study Project (ISP) Collection

Over 50% of Madagascar’s population is infected with intestinal or urinary schistosomiasis (Rollinson et al., 2012). The disease slowly debilitates infected persons, who are frequently children, resulting in lower productivity and reduced learning in school-age children. The disease involves a vicious cycle perpetuated by a number of environmental, psychological, and social factors. A multifaceted approach, involving mass treatment, biological control, environmental control, education, and disease surveillance, can lead to schistosomiasis control and elimination in Madagascar. This would yield many socio-economic benefits such as increased productivity, increased school attendance rates, and generally better welfare. Schistosomiasis is the most burdensome and deadly …

Developmental Expression Of The Nfe2-Related Factor (Nrf) Transcription Factor Family In The Zebrafish, Danio Rerio, Larissa M. Williams, Alicia R. Timme-Laragy, Jared V. Goldstone, Andrew G. Mcarthur, John J. Stegeman, Roxanna M. Smolowitz, Mark E. Hahn

Alicia R. Timme-Laragy

Transcription factors in the CNC-bZIP family (NFE2, NRF1, NRF2 and NRF3) regulate genes with a wide range of functions in response to both physiological and exogenous signals, including those indicating changes in cellular redox status. Given their role in helping to maintain cellular homeostasis, it is imperative to understand the expression, regulation, and function of CNC-bZIP genes during embryonic development. We explored the expression and function of six nrf genes (nfe2, nrf1a, nrf1b, nrf2a, nrf2b, and nrf3) using zebrafish embryos as a model system. Analysis by microarray and quantitative RT-PCR showed that genes in the nrf family were expressed throughout …

Daviess County Hazardous Materials Commodity Flow Study, Dr. Vijay Golla, Dr. Ritchie Taylor, Jacob Eagleson, Ethan Givan, Richard Payne

Public Health Faculty Publications

This report presents the results of a Hazardous Materials Commodity Flow Study for Daviess County, KY. Study components were conducted by Western Kentucky University in partnership with Daviess County Emergency Management Agency. The study area was focused in Daviess County and included a railway-monitoring site near Henderson, KY. A map of the Daviess County is shown in Figure 1.1. As part of this study, hazardous materials (hazmats) transported through the study area were monitored via placard surveys at the following sites: U.S. Highway 60 (Hwy 60), east and westbound lanes at East Fourth Street & the Hwy 60 Bypass (U.S. …

Structural Approaches To Health Promotion: What Do We Need To Know About Policy And Environmental Change?, Lisa D. Lieberman, Shelley D. Golden, Jo Anne L. Earp

Department of Public Health Scholarship and Creative Works

Although the public health literature has increasingly called on practitioners to implement changes to social, environmental, and political structures as a means of improving population health, recent research suggests that articles evaluating organization, community, or policy changes are more limited than those focused on programs with individuals or their social networks. Even when these approaches appear promising, we do not fully understand whether they will benefit all population groups or can be successful in the absence of accompanying individually oriented programs. The role of this broad category of approaches, including both policy and environmental changes, in decreasing health disparities is …

Henderson County Hazardous Materials Commodity Flow Study, Dr. Ritchie D. Taylor, Dr. Vijay Golla, Jacob Eagleson, Ethan Givan, Larry Koerber

Public Health Faculty Publications

This report presents the results of a Hazardous Materials (Hazmat) commodity flow study for Henderson County, Kentucky. Study components were conducted by Western Kentucky University in partnership with Henderson County Emergency Management (HCEM) and Henderson County Local Planning Committee (LEPC). Location of Henderson County and the City of Henderson in Kentucky are shown in Figure 1.1. In addition, data from an Audubon Parkway placard survey, conducted in July of 2013 for Daviess County, were used in the analysis for this report. Hazardous materials transported through Henderson County were monitored at the following sites during the study period: U.S. Highway 41 …

Epidemiology Of Esophageal Cancer, Yuwei Zhang

Environmental and Occupational Health Faculty Publications

Esophageal cancer (EsC) is one of the least studied and deadliest cancers worldwide because of its extremely aggressive nature and poor survival rate. It ranks sixth among all cancers in mortality. In retrospective studies of EsC, smoking, hot tea drinking, red meat consumption, poor oral health, low intake of fresh fruit and vegetables, and low socioeconomic status have been associated with a higher risk of esophageal squamous cell carcinoma. Barrett’s esophagus is clearly recognized as a risk factor for EsC, and dysplasia remains the only factor useful for identifying patients at increased risk, for the development of esophageal adenocarcinoma in …

Never Smokers -- Are They More Sensitive To The Respiratory Health Effects Of Ambient Air Pollution?, Zuhair Saleh Natto

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Several studies show an association between ambient particulate matter (PM) and all-cause mortality. The Adventist Health and Smog 1 (AHSMOG-1) study (N=6,338) has previously found associations between ambient air pollution and incident chronic obstructive pulmonary disease (COPD) using the spatial interpolation method from the three nearest fixed monitoring stations to residence and workplace. However, few studies have assessed the risk of death among disease specific subgroups such as those with COPD.

Objectives: The aims of this study were 1) to assess the effect of chronic exposure to ambient air pollutants on risk of all-cause mortality among persons with COPD …

Science And Policy On Endocrine Disrupters Must Not Be Mixed: A Reply To A “Common Sense” Intervention By Toxicology Journal Editors, Åke Bergman, Anna-Maria Andersson, Georg Becher, Martin Van Den Berg, Bruce Blumberg, Poul Bjerregaard, Carl-Gustaf Bornehag, Riana Bornman, Ingvar Brandt, Jayne V. Brian, Stephanie C. Casey, Paul A. Fowler, Heloise Frouin, Linda C. Giudice, Taisen Iguchi, Ulla Hass, Susan Jobling, Anders Juul, Karen A. Kidd, Andreas Kortenkamp, Monica Lind, Olwenn V. Martin, Derek Muir, Roseline Ochieng, Nicolas Olea, Leif Norrgren, Erik Ropstad, Peter S. Ross, Christina Rudén, Martin Scheringer, Niels Erik Skakkebaek, Olle Söder, Carlos Sonnenschein, Ana Soto, Shanna Swan, Jorma Toppari, Charles R. Tyler, Laura Vandenberg, Anne Marie Vinggaard, Karin Wiberg, R Thomas Zoeller

Laura Vandenberg

The “common sense” intervention by toxicology journal editors regarding proposed European Union endocrine disrupter regulations ignores scientific evidence and well-established principles of chemical risk assessment. In this commentary, endocrine disrupter experts express their concerns about a recently published, and is in our considered opinion inaccurate and factually incorrect, editorial that has appeared in several journals in toxicology. Some of the shortcomings of the editorial are discussed in detail. We call for a better founded scientific debate which may help to overcome a polarisation of views detrimental to reaching a consensus about scientific foundations for endocrine disrupter regulation in the EU.

Allostatic Load Amplifies The Effect Of Blood Lead Levels On Elevated Blood Pressure Among Middle-Aged U.S. Adults: A Cross-Sectional Study, Ami R. Zota, Edmond R. Shenassa, Rachel Morello-Frosch

Environmental and Occupational Health Faculty Publications

Background

Scientists and regulators have sought to understand whether and how physiologic dysregulation due to chronic stress exposure may enhance vulnerability to the adverse health effects of toxicant exposures. We conducted a cross-sectional study to determine whether allostatic load (AL), a composite measure of physiologic response to chronic exposure to stress, amplifies the effect of lead exposure on blood pressure among middle-aged adults.

Methods

We analyzed associations between blood lead levels and blood pressure in a nationally representative sample of 8,194 U.S. adults (aged 40-65 years) participating in the National Health and Nutritional Examination Survey, 1999--2008. Outcomes were elevated systolic …

Environmental Health News, Georgia Southern University

Environmental Health News (2012-2018)

• JPHCOPH Faculty Accepted as National Scholars

Juxtaposing Nasa’S Aeronet Aod With Carb Pm Data Over The San Joaquin Valley To Facilitate Multi-Angle Imaging Spectroradiometer (Misr) Pm Pollution Research, John Kanemoto

STAR Program Research Presentations

Airborne particulate matter (PM) has been shown to increase the risk for asthma, chronic bronchitis, cardiopulmonary complications, and respiratory cell membrane damage/infection/leakage. PM levels are currently analyzed from two perspectives: stationary land-based monitoring (LBM) sites and total Aerosol Optical Depth (AOD) atmospheric column measurements. Both perspectives often leave miles of space between measuring locations and will have a continually increasing cost from introducing/maintaining sites. The Multi-angle Imaging SpectroRadiometer (MISR) satellite team hopes to begin investigating/archiving PM levels comprehensively via inputting MISR AOD measurements into a function/model which predicts the amount of ground level PM.

In the future, multivariable spatial correlations …

Prevalensi Dan Faktor Risiko Tuli Akibat Bising Pada Operator Mesin Kapal Feri, Jumali Jumali, Sumadi Sumadi, Sylvia Andriani, Misbahul Subhi, Damianus Suprijanto, Wuri Diah Handayani, Abdul Chodir, Fadilatus Sukma Ika Noviarmi, Leli Indahwati

Kesmas

Kebisingan ruang mesin dapat menyebabkan gangguan pendengaran. Tujuan penelitian ini adalah menganalisis prevalensi tuli akibat bising Noise Induced Hearing Loss (NIHL) dan faktor yang memengaruhi pada operator mesin kapal feri penyeberangan Ketapang-Gilimanuk. Penelitian observasional dengan pendekatan cross sectional ini menggunakan metode pengumpulan data dengan wawancara, pengukuran intensitas kebisingan ruang mesin dan pemeriksaan audiometri terhadap operator. Besar sampel adalah 66 operator dari 36 kapal feri yang memenuhi kriteria inklusi dipilih secara acak. Hasil studi menunjukkan 36% kapal memiliki intensitas kebisingan ² 85 dBA dan 64% > 85 dBA. Pemeriksaan audiometri dengan nada murni pada 66 operator didapatkan 34,85% responden mengalami NIHL. Hasil …

Pengetahuan Dan Perilaku Ibu Rumah Tangga Dalam Pengelolaan Sampah Plastik, Ririn Setyowati, Surahma Asti Mulasari

Kesmas

Pencemaran lingkungan akibat sampah plastik semakin mengkhawatirkan apabila tidak ada usaha untuk mengatasinya. Masyarakat yang kurang pengetahuan dan berperilaku buruk dalam pengelolaan sampah plastik dapat menimbulkan gangguan kesehatan dan lingkungan. Penelitian ini bertujuan mengetahui hubungan antara tingkat pengetahuan ibu rumah tangga dengan perilaku mengelola sampah plastik. Penelitian dilakukan di Dusun Kedesen, Desa Kradenan, Kecamatan Kaliwungu, Kabupaten Semarang Tahun 2012. Penelitian ini menggunakan rancangan studi cross sectional, dengan sampel berjumlah 74 orang yang diambil secara secara acak sederhana. Pengumpulan data dilakukan dengan wawancara terstruktur menggunakan kuesioner. Data dianalisis menggunakan analisis univariat dan analisis bivariat dengan uji statistik Kai Kuadrat (X2). Penelitian …

Livestock-Associated Methicillin And Multidrug Resistant Staphylococcus Aureus Is Present Among Industrial, Not Antibiotic-Free Livestock Operation Workers In North Carolina, Jessica L. Rinsky, Maya Nadimpalli, Steve Wing, Devon Hall, Dothula Baron, Lance B. Price, Jesper Larsen, Marc Stegger, Jill Stewart, Christopher D. Heaney

Environmental and Occupational Health Faculty Publications

Objectives

Administration of antibiotics to food animals may select for drug-resistant pathogens of clinical significance, such as methicillin-resistant Staphylococcus aureus (MRSA). In the United States, studies have examined prevalence of MRSA carriage among individuals exposed to livestock, but prevalence of multidrug-resistant S. aureus (MDRSA) carriage and the association with livestock raised with versus without antibiotic selective pressure remains unclear. We aimed to examine prevalence, antibiotic susceptibility, and molecular characteristics of S. aureus among industrial livestock operation (ILO) and antibiotic-free livestock operation (AFLO) workers and household members in North Carolina.

Methods

Participants in this cross-sectional study were interviewed and provided a …

Violence Among Young Adults Receiving Housing Assistance: Vouchers, Race, And Transitions Into Adulthood, Tamara Leech

Department of Public Health Scholarship and Creative Works

Scholarly literature has been very attentive to violence among adolescents whose families receive vouchers. Yet, it provides little information about violence among the more than 400,000 very young adults who head households that receive vouchers. This article explores this relationship, paying particular attention to life course considerations and racial context. Data on 18–22-year-olds, numbering 208, who received housing assistance and participated in the National Longitudinal Survey of Youth 1997 in 2002 indicate that normative theoretical models may not accurately capture the relationship between the transition to adulthood and violence within this group. Results also suggest that among those who experience …

Copd Surveillance-United States, 1999-2011, Earl S. Ford, Janet B. Croft, David M. Mannino, Anne G. Wheaton, Xingyou Zhang, Wayne H. Giles

David M. Mannino

This report updates surveillance results for COPD in the United States. For 1999 to 2011, data from national data systems for adults aged ≥ 25 years were analyzed. In 2011, 6.5% of adults (approximately 13.7 million) reported having been diagnosed with COPD. From 1999 to 2011, the overall age-adjusted prevalence of having been diagnosed with COPD declined (P = .019). In 2010, there were 10.3 million (494.8 per 10,000) physician office visits, 1.5 million (72.0 per 10,000) ED visits, and 699,000 (32.2 per 10,000) hospital discharges for COPD. From 1999 to 2010, no significant overall trends were noted for physician …