Environmental Public Health Commons^™

The Role Of Body Mass Index And Diabetes In The Development Of Acute Organ Failure And Subsequent Mortality In An Observational Cohort, Katarina Slynkova, David M. Mannino, Greg S. Martin, Richard S. Morehead, Dennis E. Doherty

David M. Mannino

Introduction

Several studies have shown a correlation between body mass index (BMI) and both the development of critical illness and adverse outcomes in critically ill patients. The goal of our study was to examine this relationship prospectively with particular attention to the influence of concomitant diabetes mellitus (DM).

Methods

We analyzed data from 15,408 participants in the Atherosclerosis Risk in Communities (ARIC) study for this analysis. BMI and the presence of DM were defined at baseline. We defined 'acute organ failure' as those subjects who met a standard definition with diagnostic codes abstracted from hospitalization records. Outcomes assessed included the …

Hospitalization For Patients With Sarcoidosis: 1979-2000, M. G. Foreman, David M. Mannino, L. Kamugisha, G. E. Westney

David M. Mannino

BACKGROUND AND AIM:

Sarcoidosis is a multi-system granulomatous disease of unknown etiology with significant racial and gender differences in disease severity, incidence, and prevalence. Primarily treated in outpatients, limited information is available on hospital outcomes in patients with sarcoidosis. The National Hospital Discharge Survey (NHDS) was analyzed over a 22-year period to determine trends in hospitalization and the impact of concurrent comorbidities.

METHODS:

Secondary analysis was done of the NHDS, a national survey of inpatient medical care for short stays in nonfederal facilities.

RESULTS:

There were a total of 750 million hospitalizations over this 22-year period, with 593,455 (0.08%) hospitalizations …

Cardiorespiratory Hospitalizations Associated With Smoke Exposure During The 1997, Southeast Asian Forest Fires, Joshua A. Mott, David M. Mannino, Clinton J. Alverson, Andrew Kiyu, Jamilah Hashim, Tzesan Lee, Kenneth Falter, Stephen C. Redd

David M. Mannino

We investigated the cardiorespiratory health effects of smoke exposure from the 1997 Southeast Asian Forest Fires among persons who were hospitalized in the region of Kuching, Malaysia. We selected admissions to seven hospitals in the Kuching region from a database of all hospital admissions in the state of Sarawak during January 1, 1995 and December 31, 1998. For several cardiorespiratory disease classifications we used Holt-Winters time-series analyses to determine whether the total number of monthly hospitalizations during the forest fire period (August 1 to October 31, 1997), or post-fire period (November 1, 1997 to December 31, 1997) exceeded forecasted estimates …

Active And Passive Smoking And Blood Lead Levels In U.S. Adults: Data From The Third National Health And Nutrition Examination Survey, David M. Mannino, David M. Homa, Thomas Matte, Mauricio Hernandez-Avila

David M. Mannino

Lead is a component of tobacco and tobacco smoke. We examined the relationship between current, former, and passive smoking and blood lead levels in a nationally representative sample of 16,458 U.S. adults, aged 17 years or older, who participated in the Third National Health and Nutrition Examination Survey (1988–1994). We used linear and logistic regression modeling, adjusting for known covariates, to determine the relationship between smoking and blood lead levels. Geometric mean blood lead levels were 1.8 μg/dl, 2.1 μg/dl, and 2.3 μg/dl in never-smokers with no, low, and high cotinine levels, respectively. Levels were 2.9 μg/dl in former smokers …

Sex Differences In Copd And Lung Cancer Mortality Trends—United States, 1968–1999, Neely Kazerouni, C. J. Alverson, Stephen C. Redd, Joshua A. Mott, David M. Mannino

David M. Mannino

Purpose: Cigarette smoking by U.S. women in the 1940s and 1950s caused large increases in smoking-related lung disease among women. To determine the magnitude of these increases, we compared the mortality trends for males and females in the United States for chronic obstructive pulmonary disease (COPD) and lung cancer for 1968-1999.

Methods: We used the national mortality data files compiled by the National Center for Health Statistics of the CDC and U.S. census data to calculate age-adjusted (2000) death rates for COPD, lung cancer, and all causes.

Results: COPD death rate for females increased by 382% from 1968 through 1999, …

Risk Factors For Asthma Incidence: A Review Of Recent Prospective Evidence, M. S. King, David M. Mannino, F. Holguin

David M. Mannino

AIM:

The aim of this study is to determine what factors have been shown, in prospective studies, to predict the incidence of asthma.

METHODS:

We performed a systematic review of peer-reviewed literature from 1994 to 2004 to determine what factors predict the development of asthma in both children and adults. This search strategy yielded 40 studies, with 36 providing some estimate of asthma incidence for the total sample and or a specific subgroup.

RESULTS:

Annual estimated incidence of physician-diagnosed asthma ranged from 0.6 to 29.5 per 1000 persons. Risk factors for incident asthma among children included: male sex, atopic sensitization, …

Copd In The Never-Smoker, David M. Mannino, Kathryn Marie Mcgonigle

David M. Mannino

Objectives 1. Identify never-smokers as an important subset of the COPD population. 2. Discuss the relationship between asthma and COPD. 3. Understand the genetic components of COPD. 4. Identify occupational risk factors for COPD. 5. Discuss prevention methods for COPD in the never-smoker.

Obstructive And Restrictive Lung Disease And Markers Of Inflammation: Data From The Third National Health And Nutrition Examination, David M. Mannino, Earl S. Ford, Stephen C. Redd

David M. Mannino

Although chronic obstructive pulmonary disease (COPD) and restrictive lung diseases are important causes of morbidity and mortality in the United States 1, 2 and 3, a large proportion of the morbidity and mortality is not pulmonary (4). This raises the possibility that lung disease may be an indicator of susceptibility to the development of other diseases or may be associated with systemic inflammation that leads to other diseases 5 and 6. Previous analyses of the relation between lung function and markers of inflammation 7 and 8 have not looked at restrictive lung disease separately.

We applied spirometric criteria to define …

Tobacco Smoke Exposure And Decreased Serum And Red Blood Cell Folate Levels: Data From The Third National Health And Nutrition Examination Survey, David M. Mannino, Joseph Mulinare, Earl S. Ford, Joel Schwartz

David M. Mannino

The aim of this cross-sectional study was to determine the effects of smoke exposure on serum and red blood cell folate levels. Data collected as part of the Third National Health and Nutrition Examination Survey were analyzed. Serum and red blood cell folate levels were measured in active smokers and nonsmokers with high, moderate, and low exposure to environmental tobacco smoke. After adjusting for dietary intake of folate and other covariates, we found that both smokers and nonsmokers with high smoke exposure had lower red blood cell folate levels than did nonsmokers with low smoke exposure (−86 nmol/l [95% confidence …

The Epidemiology Of Sepsis In The United States From 1979 Through 2000, Greg S. Martin, David M. Mannino, Stephanie Eaton, Marc Moss

David M. Mannino

BACKGROUND

Sepsis represents a substantial health care burden, and there is limited epidemiologic information about the demography of sepsis or about the temporal changes in its incidence and outcome. We investigated the epidemiology of sepsis in the United States, with specific examination of race and sex, causative organisms, the disposition of patients, and the incidence and outcome.

METHODS

We analyzed the occurrence of sepsis from 1979 through 2000 using a nationally representative sample of all nonfederal acute care hospitals in the United States. Data on new cases were obtained from hospital discharge records coded according to the International Classification of …

Chronic Obstructive Pulmonary Disease Surveillance --- United States, 1971--2000, David M. Mannino, David M. Homa, Lara J. Akinbami, Earl S. Ford, Stephen C. Redd

David M. Mannino

PROBLEM/CONDITION:

Chronic obstructive pulmonary disease (COPD) includes chronic bronchitis and emphysema but has been defined recently as the physiologic finding of nonreversible pulmonary function impairment. This surveillance summary reports trends in different measures of COPD during 1971-2000.

REPORTING PERIOD COVERED:

This report presents national data regarding objectively determined COPD (1971-1994); COPD-associated activity and functional limitations (1980-1996); self-reported COPD prevalence, COPD physician office and hospital outpatient department visits, COPD hospitalizations, and COPD deaths (1980-2000); and COPD emergency department visits (1992-2000).

DESCRIPTION OF SYSTEMS:

The Centers for Disease Control's National Center for Health Statistics conducts the National Health Interview Survey annually, which …

Surveillance For Asthma - United States, 1980-1999, David M. Mannino, David M. Homa, Lara J. Akinbami, Jeanne E. Moorman, Charon Gwynn, Stephen C. Redd

David M. Mannino

Problem/Condition: Asthma, a chronic disease occurring among both children and adults, has been the focus of clinical and public health interventions during recent years. In addition, CDC has outlined a strategy to improve the timeliness and geographic specificity of asthma surveillance as part of a comprehensive public health approach to asthma surveillance.

Reporting Period Covered: This report presents national data regarding self-reported asthma prevalence, school and work days lost because of asthma, and asthma-associated activity limitations (1980--1996); asthma-associated outpatient visits, asthma-associated hospitalizations, and asthma-associated deaths (1980--1999); asthma-associated emergency department visits (1992--1999); and self-reported asthma episodes or attacks (1997--1999).

Description of …

Chronic Arsenic Exposure And Risk Of Infant Mortality In Two Areas Of Chile, Claudia Hopenhayn-Rich, Steven R. Browning, Irva Hertz-Picciotto, Catterina Ferreccio, Cecilia Peralta, Herman Gibb

Preventive Medicine and Environmental Health Faculty Publications

Chronic arsenic exposure has been associated with a range of neurologic, vascular, dermatologic, and carcinogenic effects. However, limited research has been directed at the association of arsenic exposure and human reproductive health outcomes. The principal aim of this study was to investigate the trends in infant mortality between two geographic locations in Chile: Antofagasta, which has a well-documented history of arsenic exposure from naturally contaminated water, and Valparaíso, a comparable low-exposure city. The arsenic concentration in Antofagasta's public drinking water supply rose substantially in 1958 with the introduction of a new water source, and remained elevated until 1970. We used …

How Much Asthma Is Occupationally Related?, David M. Mannino

David M. Mannino

Asthma is a chronic respiratory disease that is increasing in both prevalence and mortality in developed countries around the world. Occupational exposures to sensitizers and irritants are causes of both asthma cases and asthma exacerbations in adults. The determination of how many cases of asthma may be caused or worsened by occupational exposures is highly dependent on how asthma is defined, what constitutes work-relatedness, and what specific methodology is employed. Surveillance-based methods generally have found the lowest proportion of work-related asthma, ranging from 1-8% of cases. Other types of studies, using exposed-unexposed methodology or interviews of incident asthma cases, have …

A Case Study And National Database Report Of Progressive Systemic Sclerosis And Associated Conditions, David Phillips, Barbara Phillips, David M. Mannino

David M. Mannino

We report the case of a 34-year-old white woman with a history of progressive systemic scleroderma (PSS) and diffuse alveolar hemorrhage (DAH) that may be either a rare complication of PSS or induced by D-penicillamine. The DAH progressed to hemoptysis and led to intubation for airway protection. The patient progressed to acute renal failure. Her chest x-ray revealed diffuse bilateral infiltrates. She developed pulmonary fibrosis with secondary pulmonary hypertension. She experienced a brief period of improvement of her respiratory status after steroid treatment. We also report a database of 21,442 decedents with PSS over a 15-year period from 1979 to …

Emergency Department Visits And Hospitalizations For Respiratory Disease On The Island Of Hawaii, 1981-1991: Annual Trends On The Island Of Hawaii And Weekly Variability In Hilo, David M. Mannino, Samuel M. Ruben, Fred C. Holschuh, Timothy C. Holschuh, Michael D. Wilson, Tami Holschuh

David M. Mannino

This study examined trends in and patterns of emergency department visits and hospitalizations for respiratory disease on the island of Hawaii from 1981 to 1991. We found that emergency department visit rates and hospitalization rates for both asthma and COPD for 1987 to 1991 increased in all regions of the island in comparison with such rates for 1981 to 1986. Rates of emergency department visits and hospitalizations for chronic obstructive pulmonary disease or COPD, but not asthma, were significantly higher in the high-exposure Kona side of the island than in the intermittent-exposure Hilo side of the island during 1983 and …

Cigarette Smoking: An Independent Risk Factor For Impotence?, David M. Mannino, R. Monina Klevens, W. Dana Flanders

David M. Mannino

The authors sought to determine whether current cigarette smoking was associated with impotence among middle-aged men. This is a secondary analysis of a cross-sectional survey of 4,462 US Army Vietnam-era veterans aged 31–49 years who took part in the Vietnam Experience Study in 1985–1986. The main outcome measurement was the odds ratio for reported impotence, which was calculated by comparing current smokers with nonsmokers while controlling for multiple confounders. The study sample consisted of 1,162 never smokers, 1,292 former smokers, and 2,008 current smokers. The prevalence of impotence was 2.2% among never smokers, 2.0% among former smokers, and 3.7% among …

Do The Medical History Or Physical Examination Predict Low Lung Function?, David M. Mannino, Ruth A. Etzel, W. Dana Flanders

David M. Mannino

Background: We sought to determine whether an abnormal respiratory history or chest physical examination could be used to identify men with low lung function.Methods: We analyzed pulmonary function, physical examination, and questionnaire data from 4461 middle-aged male Vietnam-era army veterans.Main Results: The study sample consisted of 1161 never smokers, 1292 former smokers, and 2008 current smokers. Clinical indicators of respiratory disease (respiratory symptoms, respiratory signs, or a history of respiratory disease), were present in 26.1% of the never smokers, 31.7% of the former smokers, and 47.2% of the current smokers. We defined low forced expiratory volume in 1 second as …

Classification Of Radiographs For Pneumoconiosis: A Comparison Of Digitized Images And Conventional Radiographs, David M. Mannino, Rd Kennedy, Tk Hodous

David M. Mannino

To purchase full article: http://radiology.rsna.org/content/187/3/791.abstract

The classification of pneumoconiosis on 108 paired radiographs obtained in coal miners was compared by using conventional radiograph film images and digitized images of those conventional film images. Conventional film images and digitized images were each independently read in a random order in two separate sessions by three radiologists certified as "B" readers. Overall, the digitized images were perceived as being of better quality than the conventional film images (radiograph quality grade 1, 48% [617 of 1,292 classifications] vs 37% [482 of 1,296], respectively; P < .001). The mean International Labour Office (ILO) scores for small-opacity profusion were similar between the digitized images and conventional film images (3.14 vs 3.24, respectively; P = .19). The mean absolute differences in small-opacity profusion score between radiograph pairs were also similar (0.74 vs 0.77, respectively; P = .50). No difference in the ILO type of opacity was noted between the display modes. Interpretation of digitized images for pneumoconiotic small opacities was shown to be an acceptable alternative to interpretation of conventional film images; the important problem of reader variability affects both display modes.