Graduate Academic Programs

Coccidioidomycosis and COVID-19 Co-Infection, United States, 2020

Alexandra K Heaney
Jennifer R Head
Kelly Broen
Karen Click
John Taylor
John R Balmes
Jon Zelner
Justin V Remais
2021

We review the interaction between coronavirus disease (COVID-19) and coccidioidomycosis, a respiratory infection caused by inhalation of Coccidioides fungal spores in dust. We examine risk for co-infection among construction and agricultural workers, incarcerated persons, Black and Latino populations, and persons living in high dust areas. We further identify common risk factors for co-infection, including older age, diabetes, immunosuppression, racial or ethnic minority status, and smoking. Because these diseases cause similar symptoms, the COVID-19 pandemic...

Letter from California, USA

Sheiphali A. Gandhi MD, MPH
2020

On the morning of 9 September 2020, residents of the San Francisco Bay Area awoke to an eerie orange light filtering through the windows (Fig. 1). Over the next day, post-apocalyptic images of the glowing, ash-filled sky flooded social media and became a global news focus. Air quality sharply decreased to unhealthy levels as ash particles fell to the ground. This alarming event was the result of a dry lightning storm that occurred 3 weeks before. During this storm, more than 12 000...

Biomass Smoke Exposure and Atopy among Young Children in the Western Highlands of Guatemala: A Prospective Cohort Study

Wenxin Lu
Laura Ann Wang
Jennifer Mann
Alisa Jenny
Carolina Romero
Andrea Kuster
Eduardo Canuz
Ajay Pillarisetti
Kirk R Smith
John Balmes, MD
Lisa Thompson
2022

Women and children in rural regions of low-income countries are exposed to high levels of household air pollution (HAP) as they traditionally tend to household chores such as cooking with biomass fuels. Early life exposure to air pollution is associated with aeroallergen sensitization and developing allergic diseases at older ages. This prospective cohort study assigned HAP-reducing chimney stoves to 557 households in rural Guatemala at different ages of the study children. The children's air pollution exposure was measured using personal CO diffusion tubes. Allergic outcomes at 4-5...

The Association between Ambient PM2.5 and Low Birth Weight in California

Jasmine Lee
Sadie Costello
John R Balmes
Stephanie M Holm
2022

Previous studies have shown associations between air pollutants and low birth weight. However, few studies assess whether poverty and race/ethnicity are effect modifiers for this relationship. We used publicly available data on 7785 California census tracts from the California Communities Environmental Health Screening Tool (CalEnviroScreen). Multivariable linear regression was used to examine the association between outdoor PM2.5 and low birth weight (LBW), including stratification by poverty and race/ethnicity (as a proxy for experienced racism). A 1 µg m...

Increased Bloodborne Pathogen Exposure Hotline Utilization During the COVID-19 Pandemic: An Unexpected Phenomenon

Matthew Kiok
Sandeep Guntur, MD, MPH
Paul Blanc, MD, MSPH
Olga Lozato
Grace Domingo
Robert Kosnik
Chika E Ugbaja
Noreen Chan
Alan Ramos
Sandra Domeracki, RN, MSN, FNP-BC, COHN-S, FAAOHN
2022

Background: Mitigating bloodborne pathogen exposure (BBPE) risk among healthcare workers is a major focus of hospital-based occupational health programs. The COVID-19 pandemic has placed added demands on occupational health services for healthcare workers. Its impact on BBPE incidence is unreported. Methods: As part of quality improvement efforts, we examined BBPE case incidence at two affiliated health centers during a 24-month period, 12 months preceding and following the COVID-19 pandemic onset. We used Year 1 to Year 2 change in incidence at the larger health center...

Rare case of occupational pulmonary hemorrhage in a firefighter

Sheiphali A Gandhi
TJ Welch
Kirk D Jones
Kristin J Cummings
Laura Styles
Paul D Blanc
Robert J Harrison
2022

Alveolar hemorrhage associated with physical exertion, known as exercise-induced pulmonary hemorrhage (EIPH), is a rare condition linked to strenuous exertion. This can be an unusual form of respiratory and occupational illness. We present the case of a healthy firefighter who developed fatal pulmonary hemorrhage after participating in a strenuous physical training exercise regimen. This case represents a severe presentation of EIPH, which results from the disruption of the pulmonary blood-gas barrier as a result of strenuous exertion. Clinicians caring for those in vocations and...

Assessment of cardiovascular load among hotel room cleaners

Duyen Dinh-Dang
Abdullah Khafagy
Niklas Krause
Carisa Harris-Adamson
2023

Hotel room cleaners are a vulnerable population at risk for cardiovascular disease. To evaluate their workload heart rate (HR), % heart rate reserve (%HRR), blood pressure (BP), metabolic equivalent (MET), and energy expenditure (EE) were measured over two workdays and two off-workdays. The mean age was 45.5 (SD 8.2) years with a mean 10.4 (SD 7.8) years of work experience. Mean average and peak HR, %HRR, MET, and EE were significantly higher during a workday than an off-workday for the entire work shift, first and last hour of work. Mean average HR and %HRR saw the largest increase...

Environmental Causes of Idiopathic Pulmonary Fibrosis

Sheiphali Gandhi
Roberto Tonelli
Margaret Murray
Anna Valeria Samarelli
Paolo Spagnolo
2023

Idiopathic pulmonary fibrosis (IPF), the most common and severe of the idiopathic interstitial pneumonias, is a chronic and relentlessly progressive disease, which occurs mostly in middle-aged and elderly males. Although IPF is by definition "idiopathic", multiple factors have been reported to increase disease risk, aging being the most prominent one. Several occupational and environmental exposures, including metal dust, wood dust and air pollution, as well as various lifestyle variables, including smoking and diet, have also been associated with an increased risk of IPF, probably...

Notes from the Field: Surveillance of Silicosis Using Electronic Case Reporting — California, December 2022–July 2023

Jennifer Flattery
Chelsea Woolsey
Melanie Epstein-Corbin
David J. Blackley
Robert J. Harrison
Kristin J. Cummings
2023

Electronic case reporting (eCR) (1) is a promising rapid reporting mechanism, whereby electronic health records (EHRs) automatically generate and transmit a disease report to jurisdictional public health agencies in real time using previously established criteria. All 50 U.S. states and other jurisdictions are connected to the eCR infrastructure. The Reportable Conditions Knowledge Management System (RCKMS),* a component of the eCR infrastructure, is a real-time decision support service that processes reports according to jurisdictional reporting requirements with criteria defined by...