Syni-An Hwang

Asthma hospitalization rates and socioeconomic status in New York State (1987-1993).

This study examined the geographic distribution of asthma hospitalizations in New York State (NYS) and its association with socioeconomic status. Statewide asthma hospitalization data (1987-1993) were merged with 1990 census data by residential zip code. The asthma hospitalization rate increased in NYS from 1987 (2.54 per 1000) through 1993 (2.87 per 1000) and the increase is largely attributable to increases for children 4 years old and younger. The risk factors for asthma admission varied in different areas. However, rates of hospitalization because of asthma were generally higher in the zip codes areas with higher proportions of poverty, unemployment, poorly educated residents, African-Americans, and Hispanics.

Fish consumption and other environmental exposures and their associations with serum PCB concentrations among Mohawk women at Akwesasne.

A study was conducted with the objective of assessing how dietary, occupational, and residential exposures to polychlorinated biphenyls (PCBs) contribute to body burden among pregnant Mohawk women residing near three hazardous waste sites. From 1992 to 1995, 111 pregnant women were interviewed about fish consumption and other environmental risk factors and donated a 20-mL venous blood sample for serum PCB analysis. To supplement previous fish sampling, samples of residential soil, ambient air, wild duck, and local meats and vegetables were also collected and analyzed for PCBs. The results indicated a significant decline in local fish consumption from an annual mean of 31.3 meals more than 1 year prior to pregnancy to an annualized mean of 11.7 meals during pregnancy. This change was reportedly a result of the advisories issued against consumption of local fish by pregnant and nursing women of childbearing age. The geometric mean concentration of total PCBs in the serum was 1.2 ppb, a level that is similar to that in other studies of women with no unusual exposures to PCBs. However, multiple regression analysis revealed that serum levels of total PCBs and three individual congeners were associated with local fish consumption. The PCB levels in soil, air, and local foodstuffs other than fish generally were not elevated, except for those obtained in close proximity to one of the hazardous waste sites, and no association was found between serum PCB levels and exposure through these media or through occupation.

Cancer incidence among a cohort of female farm residents in New York state

Abstract A retrospective cohort study of cancer incidence among 6,310 female farm residents who were New York Farm Bureau members, or members spouses or relatives, was conducted from 1980 through 1993. Similar to the previous findings for New York State male farmers, the female farm resident cohort experienced significantly lower cancer rates for all cancers combined, and for lung cancer, compared with rural nonfarm female residents. In addition, significantly low rates for colorectal cancer and ovarian cancer were found among the female cohort members. Nonsignificant excesses were found for thyroid and liver cancers. The findings suggest that female farm residents in this cohort might have experienced some of the same cancer-protective factors as male farmers.

Reported Respiratory Symptoms and Adverse Home Conditions after 9/11 among Residents Living near the World Trade Center

This study investigated whether self-reported damage, dust, and odors in homes near the World Trade Center (WTC) after September 11, 2001, were related to increased rates of respiratory symptoms among residents and if multiple sources of exposure were associated with greater health risk. We mailed questionnaires to homes within 1.5 km of the WTC site (affected area) and in upper Manhattan (control area). Surveys asked about respiratory symptoms, unplanned medical visits, physician diagnoses, medication use, and conditions in the home after 9/11. Adverse home conditions were associated with new-onset (i.e., began after 9/11) and persistent (i.e., remained 1 year after 9/11) upper and lower respiratory symptoms in the affected area (Cumulative Incidence Ratios [CIRs] 1.20–1.71). Residents reporting longer duration of dust/odors or multiple sources of exposure had greater risk for symptoms compared to those reporting shorter duration and fewer sources. These data suggest that WTC-related contamination in the home after 9/11 was associated with new and persistent respiratory symptoms among residents living near the site. While we cannot eliminate potential biases related to self-reported data, we took strategies to minimize their impact, and the observed effects are biologically plausible.

Safety awareness among New York farmers.

BACKGROUNDnThis study was conducted to assess the health status and safety practices among year-round adult farm workers and residents and included a telephone interview survey of 1,727 persons from 552 farms.nnnMETHODSnLogistic regression was used to analyze four safety questions.nnnRESULTSnAmong 541 farm owner/operators significant predictors of making substitutions in the use of chemicals and major changes to equipment include younger age, more persons assisting on the farm, and higher gross sales. Having training is associated with having more than a high school education. Among all participants the perception that personal protective equipment are useful is associated with being younger, male, an owner/operator or worker, and having at least a high school education.nnnCONCLUSIONSnThese findings suggest that older and less educated farmers should be targeted for health and safety programs.

Respiratory and Cardiovascular Hospitalizations After the World Trade Center Disaster

ABSTRACT The objective of this study was to determine whether there were increases in respiratory and cardiovascular hospital admissions among residents of lower Manhattan after the destruction of the World Trade Center. The authors used hospital admission records from 1991 to 2001 with a diagnosis of respiratory, cardiovascular, or cerebrovascular illness and a residential address in lower Manhattan or Queens. The authors assessed the change in admissions by comparing lower Manhattan to Queens (the control area) and before and after 9/11 admissions in lower Manhattan. They found the following significant increases in hospital admissions: for respiratory illnesses during the weeks of 9/11/01 and 10/16/01; asthma during the week of 9/11/01; cardiovascular during the weeks of 9/18/01 and 10/9/01; cerebrovascular during the weeks of 9/11/01, 9/18/01, 10/2/01, and 10/9/01. There was an immediate increase in respiratory admissions after the disaster and a delayed increase in cardiovascular and cerebrovascular admissions.

Asthma Prevalence, Management, and Education in New York State Elementary Schools: A Survey of School Nurses:

A survey of school nurses was conducted in New York State elementary schools to assess asthma and asthma management in students. The survey contained questions about asthma morbidity, management and education, obstacles to management, and school indoor air quality. The reported prevalence of asthma among students was 8.5%. Of the students with asthma, 64% visited the health office, 26% were absent from school, 20% had physical limitations, and 7% needed urgent care. Only 28% had a written management plan at school, less than 25% of schools used asthma self-management programs, and obstacles to management included lack of time and funding. More than 25% rated school indoor air quality as “fair” or “poor.” Schools need to adopt key components of asthma management, and school nurses should be encouraged to work with others in the school setting to address indoor air quality problems that might be affecting health.

Self-Reported Home Environmental Risk Factors for Childhood Asthma : A Cross-Sectional Study of Children in Buffalo, New York

We present prevalence estimates of indoor and outdoor environmental risk factors for asthma from a cross-sectional study of children 1to 17 years of age living in Buffalo, New York. A childs primary caretaker completed a questionnaire about the households demographics, lifestyle habits, housing, indoor and outdoor environment, and the childs activity patterns, family history of asthma, asthma symptoms and treatment, and medical care access. Significant environmental risk factors were presence of smokers in the household, humidifier or vaporizer use, chemical odors indoors, frequent truck traffic, and chemical odors outdoors. Most of these risk factors can be mitigated or controlled.

An Evaluation of the Asthma Intervention of the New York State Healthy Neighborhoods Program

Background. The Healthy Neighborhoods Programs (HNP) are funded by the Federal Preventive Health and Health Services block grants and administered by the New State Department of Health (NYSDOH). Eight county and local health departments are funded for 3 years for a total of

Concentrations of selected organochlorines and chlorobenzenes in the serum of former Love Canal residents, Niagara Falls, New York.

1.25 million per year to target households at risk for environmental health and safety hazards. The HNP asthma intervention uses home visits to identify asthmatics, assess asthma morbidity and management, and identify environmental asthma triggers. Outreach workers provide education about asthma, referrals, and controls for asthma triggers. The purpose of this evaluation was to assess the impact of the HNP asthma intervention for the 1997–1999 funding cycle and for the first year of the 2000–2002 funding cycle. Because of changes in reporting requirements across the funding cycles, the findings for 1997–1999 and 2000 were analyzed separately. Methods. We analyzed one final outcome measure, the rate of self‐reported hospitalizations (admissions and emergency room visits), and three intermediate outcome measures (the percent of homes with cockroaches, the percent of asthmatics with a written management plan, and the percent of asthmatics using a peak flow meter). We also estimated the net savings resulting from a reduction in hospital admissions due to asthma. Results. For the 1997–1999 funding cycle, the average hospitalization rate was 86 hospitalizations per 100 asthmatics per year at the intervention visit (i.e., the baseline rate) and 44.5 at the 1‐year follow‐up, a decrease of 48%. This was a larger decrease than the 24% average annual decrease in the baseline rates during the 3 years. In 2000, there were 96 hospitalizations per 100 asthmatics per year at the intervention visit and 25 at the 1‐year follow‐up, a decrease of 74%. In 2000 there were about 110 fewer hospital admissions thought to be due to the net effects of the HNP intervention, resulting in an estimated gross savings of