July 1, 2005
Epi Update Managing Staff:
"The reason for collecting, analyzing and disseminating information on a disease is to control that disease. Collection and analysis should not be allowed to consume resources if action does not follow."
Foege WH., International
Journal of Epidemiology 1976; 5:29-37
The Florida Department of Health, Bureau of Epidemiology is pleased to announce the latest four reports from the Florida Pregnancy Risk Assessment Monitoring System (PRAMS). The titles of these reports are “Florida PRAMS 2003 Surveillance Data Book,” “Florida PRAMS 2002 Surveillance Data Book,” “Florida PRAMS 2001 Surveillance Data Book” and “Florida PRAMS 2000 Surveillance Data Book.”
These data books contain detailed statistics for all maternal and child health variables available in the Florida PRAMS datasets. These publications are presented in three sections: Maternal Health and Behaviors, Prenatal and Postpartum Care, and Infant Health. To make navigation through the material as user-friendly as possible, the layout of the bookmarks follows that of the table of contents. The release of these four data books marks the completed publication of the four most current years of Florida PRAMS data. Access these and other Florida PRAMS publications online at the following Florida Department of Health website http://www.doh.state.fl.us/disease_ctrl/epi/prams/prams.htm
These reports have been of particular interest to Secretary of Health Dr. John O. Agwunobi who forwarded copies of the 2003 report to the executive heads of other state departments including the Agency for Health Care Administration, the Office of Children and Families, and the Executive Office of the Governor. Copies of all these reports will also be made available on CD-ROM.
A similar analysis has also been completed for each Florida PRAMS data set from 1993 through 1999. Each report will be posted online upon completion. This series of historic information is being produced retrospectively beginning with 2003, Florida’s most current PRAMS data.
Anyone with questions about these special reports can contact either Helen Marshall, PRAMS coordinator, at 850.245.4444, extension 2415, or Curt Miller, data analyst at 850.245.4444, extension 2407.
Curt Miller is a data analyst in the
Chronic Disease Section at the Bureau of Epidemiology in Tallahassee.
Contact him by calling 850.245.4444, ext. 2407.
Incidence in a Population
Combustion of municipal solid waste generates fly ash of various compositions. Fly ash is the fine-grained ash that is carried to the smoke stack or emission control facility. Fly ash consists of 70 to 95% inorganic matter, primarily silicon, iron, aluminum, calcium, magnesium, and sodium. The remaining 5 to 30% of fly ash contains dioxins, furans, polynuclear aromatic hydrocarbons and metals, such as arsenic, cadmium, chromium, nickel and lead.
Considering fly ash released by the incinerator as a possible route of inhalation exposure, arsenic and dioxin were selected as chemicals of concern. According to the ATSDR’s toxicological profiles, cancers of lung, liver, bladder, kidneys and skin may be associated with long-term exposure to arsenic, whereas soft tissue sarcoma, non-Hodgkin’s lymphoma and cancers of the respiratory system may be associated with long-term exposure to dioxins.
Population information for Broward County and the state of Florida were collected from the Office of the Governor. For the census tracts that form the study area, the populations for inter-census years were estimated from the values for the 1980, 1990 and 2000 census using linear interpolation.
The incidence of cancers associated with dioxin and arsenic were considered for analysis individually. As dioxin is identified as a promoter for all types of cancers, the incidence of all cancers combined was analyzed as a category by itself.
For the period 1986 to 2000, Standardized Incidence Ratios (SIR) were calculated by dividing observed number of cases by the expected number of cases for a particular cancer type and race group for the area of concern. To assess the statistical significance, 95% confidence intervals (CI) were calculated for each SIR of each cancer type selected, and for the SIR of all cancers combined category.
For the trend analysis, SIRs with the CIs were calculated for each of the three five-year period aggregates. The three periods were compared for each race and type of cancer.
Review for the trend analysis, SIRs calculated for each of the three five-year period aggregates for each race and type of cancer showed no statistically significant increases in the SIRs of cancers.
Review of all cancers combined among whites, the SIR was increased only during the 1996 to 2000 period, but was not statistically significant. Among non-whites, the SIRs did not increase during any of the three five-year periods.
This was one of many abstracts submitted for the
poster session at the Bureau of Epidemiology 2005 annual seminar this
spring. Look for more abstracts from the seminar in upcoming issues of Epi
The University of Florida at Gainesville is offering two days of specialized training this August on keeping unhealthy levels of E. coli and Salmonella out of your ecology. The Soil and Water Science Department is teaching the course.
The program will include lectures and laboratory demonstrations to illuminate microbiological testing techniques for quality, basic biology and survival strategies of E. coli and Salmonella, management programs for control and elimination of E. coli and Salmonella outbreaks, and research presentations. Lessons learned from recent outbreaks in petting zoos, E. coli drinking water contaminations, multi-state gastro-intestinal illnesses, bioterrorism attacks, and programs to control water-borne bacterial pathogens will also be discussed.
Disease control professionals and environmental epidemiologists, journalists, first responders and veterinarians, environmental engineers and scientists, government officials and others will learn from this program. The course is scheduled for August 17 and 18th in Gainesville, with a short web course available at http://conference.ifas.ufl.edu/soils/pathogens/index.html
Fee for the course is $300 prior to July 15 and includes a printed course manual, instruction, training materials and daily refreshments. To register, contact call Dr. Max Teplitski at 352.392.1951, ext. 254 or Beth Miller Tipton at 352.392. 5930.
Jaime Forth is managing editor of Epi Update and can be reached at 850.245.4444, ext. 2440.
West Nile (WN) virus activity: None this week. To date, eight counties have reported confirmed WN activity compared to 21 at this time last year.
Eastern Equine Encephalomyelitis (EEE) virus activity: Thirteen seroconversions to EEE virus were confirmed in sentinel chickens from Alachua (3), Bay, Flagler, Nassau, Orange (2), Osceola, St. Johns (2), and Volusia (2) counties. Fifteen horses from Alachua, Duval, Escambia, (2), Gilchrist, Highlands, Lake (2), Levy (2), Osceola and Polk (4) counties were confirmed with EEE virus infection this week. Three out of four live wild birds captured in Okaloosa, six out of 14 captured in Santa Rosa, one out of eight captured in N. Walton, and three out of 15 captured in Washington County (altogether 13 of 41 birds) tested positive for EEE virus this week. One mosquito pool (Cx. nigripalpus) from Volusia County tested positive for EEE this week. One dead bird from Alachua County tested positive for EEE virus this week. To date, 31 counties have reported confirmed EEE activity, compared to 19 at this time last year.
Highlands J (HJ) Virus activity: Seven seroconversions to HJ virus were confirmed in sentinel chickens from Alachua, Bay (2), Duval and Putnam (3) counties.
Other arbovirus activity: One mosquito pool (An. crucians) from Sarasota County tested positive for California Group Virus this week. There has been no St. Louise Encephalitis (SLE) virus activity yet this year.
There are no counties currently under medical alert for mosquito-borne disease. Where mosquitoes are present, people are urged to take precautions against getting bitten.
Dead birds should be reported to www.wildflorida.org/bird. See the web page for more information at www.MyFloridaEH.com. The Disease Outbreak Information Hotline offers recorded updates on medical alerts status and surveillance at 888.880.5782.
The Bureau of Epidemiology encourages
Epi Update readers to not only register on the EpiCom system at
https://www.epicomfl.net but to sign up for features such as automatic
notification of certain events
contribute appropriate public health observations related
any suspicious or unusual occurrences or circumstances. EpiCom is the primary method of communication
between the Bureau of Epidemiology and other state medical agencies during emergency situations.
Christie Luce is an EpiCom
consultant in the Surveillance Systems Section of the Bureau of
Epidemiology. She can be reached at 850.245.4444, ext. 2450.
D'Juan Harris is a GIS
specialist in the Surveillance Systems Section of the Bureau of