Environmental Health

Wildland firefighter exposure to smoke and COVID-19: A new risk on the fire line

Kathleen M Navarro
Kathleen A Clark
Daniel J Hardt
Colleen E Reid
Peter W Lahm
Joseph W Domitrovich
Corey R Butler
John R Balmes
2020

Throughout the United States, wildland firefighters respond to wildfires, performing arduous work in remote locations. Wildfire incidents can be an ideal environment for the transmission of infectious diseases, particularly for wildland firefighters who congregate in work and living settings. In this review, we examine how exposure to wildfire smoke can contribute to an increased likelihood of SARS-CoV-2 infection and severity of coronavirus disease (COVID-19). Human exposure to particulate matter (PM), a component of wildfire smoke, has been associated with oxidative stress and...

Health effects of wildfire smoke in children and public health tools: a narrative review

Stephanie M Holm
Mark D Miller
John R Balmes
2020

Wildfire smoke is an increasing environmental health threat to which children are particularly vulnerable, for both physiologic and behavioral reasons. To address the need for improved public health messaging this review summarizes current knowledge and knowledge gaps in the health effects of wildfire smoke in children, as well as tools for public health response aimed at children, including consideration of low-cost sensor data, respirators, and exposures in school environments. There is an established literature of health effects in children from components of ambient air pollution,...

Cycle Threshold to Test Positivity in COVID-19 for Return to Work Clearance in Health Care Workers

Sandra Domeracki, RN, MSN, FNP-BC, COHN-S, FAAOHN
Robert N Clapp
Kristopher Taylor
Chuanyi M Lu
Harry Lampiris
Paul D Blanc
2020

Objective: To ascertain whether reverse transcriptase polymerase chain reaction (RT-PCR) cycle amplifications until detection, the cycle threshold (Ct), could help inform return to work (RTW) strategies for health care workers (HCWs) recovering from COVID-19 infection.

Methods: Sequential Ct data from COVID-19 nasal pharyngeal (NP) RT-PCR testing in all COVID-19 positive HCWs at a single institution. Analysis of Ct in relation to time until negative testing for RTW clearance.

Results: Data for 12 employees showed that time...

The Changing Nature of Wildfires: Impacts on the Health of the Public

John R Balmes
2020

Catastrophic wildfires are increasing around the globe as climate change continues to progress. Another risk factor for large wildfires in the western United States is a legacy of fire suppression that has allowed overgrowth of underbrush and small trees in forests where periodic lightning-sparked wildfires are part of the natural ecosystem. Wildfire smoke contains CO2, CO, NOx, particulate matter, complex hydrocarbons (including polycyclic aromatic hydrocarbons), and irritant gases, including many of the same toxic and carcinogenic substances as cigarette smoke. The public...

Prevention of Occupational Heat-Related Illnesses

Aaron Tustin
Yusef Sayeed
Manijeh Berenji
Kathleen Fagan
Ronda B McCarthy
Judith Green-McKenzie
James McNicholas
Charles Babajide Onigbogi
William Brett Perkison
James W Butler
ACOEM Work Group on Occupational Heat-Related Illness
2021

High ambient temperatures and strenuous physical activity put workers at risk for a variety of heat-related illnesses and injuries. Through primary prevention, secondary prevention, and treatment, OEM health providers can protect workers from the adverse effects of heat. This statement by the American College of Occupational and Environmental Medicine provides guidance for OEM providers who serve workers and employers in industries where heat exposure occurs.

Cumulative occupational exposure to inorganic dust and fumes and invasive pneumococcal disease with pneumonia

Kjell Torén
Paul D Blanc
Rajen Naidoo
Nicola Murgia
Leo Stockfelt
Linus Schiöler
2022

Purpose
Occupational exposure to inorganic dust and fumes in the year preceding disease has been associated with increased pneumococcal pneumonia risk, but the impact of prior cumulative exposure has not been characterized.

Methods
We studied 3184 cases of invasive pneumococcal disease with pneumonia. The case index date was the day the infection was diagnosed. We selected six controls for each case from the Swedish population registry; each control was assigned the index date of their corresponding case. We linked job histories to a job-exposure matrix to calculate a...

The SARS-CoV-2 Pandemic: Real-Time Training and Service for Preventive Medicine Residents

Lisa A Miller
HRSA-Funded Preventive Medicine Residency Program Directors Workgroup*
2021

The 2020 SARS-CoV-2 pandemic created a unique opportunity for Public Health/General Preventive Medicine (PH/GPM) and Occupational and Environmental Medicine (OM) residents to contribute to pandemic public health response activities. We surveyed all 18 Health Resources and Services Administration (HRSA)-funded PH/GPM and OM residency program directors to evaluate program and resident involvement in pandemic response activities from January 1 through June 30, 2020. Of 116 residents, 110 (95%) participated at some level in the response activities including screening/testing, contact tracing,...

Testing for SARS-CoV-2 in Symptomatic Vaccinated and Unvaccinated Health Care Workers During the Delta Variant Surge

Anthony Lopez
Robert Kosnik
Paul D Blanc
Brian R Taylor
Sandeep Guntur
2021
Background:

Infection with SARS- CoV- 2 in health care workers (HCWs) challenges employee health services.

Methods:

We analyzed telephone Coronavirus Disease 2019 (COVID-19) hotline data over 8 weeks in 2021 during SARS- CoV- 2 Delta variant surge. We calculated COVID-19 case rates among persons-under-investigation (PUIs) for illness at two health care centers (HCs).

Results:

There were 41 COVID-19 cases among the 285 PUIs (14.4%) at the study HC and 549 (16.9%) of 3244 at the comparison HC. At the study HC, 11.7% of vaccinated PUIs versus 36.6% of unvaccinated...

Systematic Review of Ozone Effects on Human Lung Function, 2013 Through 2020

Stephanie M Holm
John R Balmes
2021
Background

Ozone effects on lung function are particularly important to understand in the context of the air pollution-health outcomes epidemiologic literature, given the complex relationships between ozone and other air pollutants with known lung function effects.

Research Question

What has been learned about the association between ozone exposures and lung function from epidemiology studies published from 2013 through 2020?

Study Design and Methods

On March 18, 2018, and September 8, 2020, PubMed was searched using the terms health AND ozone,...

No fire without smoke (particles)

Stephanie M Holm
John Balmes
2021

Pollution from landscape fires, which are increasing with climate change, leads to babies being born with lower birthweights in low- and middle-income countries.