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Purpose: To determine the risk of Hodgkin lymphoma (HL) associated with exposures to multiple pesticides grouped by various classes, including carcinogenic classifications. Methods: Data collected in the Cross-Canada Study of Pesticides and Health, a population-based incident case-control study in six provinces conducted between 1991 and 1994, were analyzed using unconditional logistic regression. Cases ( n = 316) were identified through provincial cancer registries and hospital records. Controls ( n = 1,506) were frequency-matched to cases by age (±2 years) within each province and were identified through provincial health records, telephone listings, or voter lists. The Cochran-Armitage test was used to check for trends within pesticide classes. Results: Overall, there was an increase in the risk of HL among all subjects who reported use of five or more insecticides (OR 1.88, 95 % CI 0.92-3.87) and among subjects younger than 40 who reported use of two acetylcholinesterase inhibitors (OR 3.16, 95 % CI 1.02-9.29). There was an elevated odds ratio associated with reported use of three or more probably carcinogenic pesticides (OR 2.47, 95 % CI 1.06-5.75), but no increase in risk for use of possibly carcinogenic pesticides. The risk of HL from reported use of fungicides or any pesticides was greater for cases diagnosed before age 40 than for cases diagnosed at or after age 40. When analyses excluded proxy respondents, OR estimates strengthened in some circumstances. Conclusions: This study found associations between HL and fungicides, insecticides, specifically acetylcholinesterase inhibitors, and pesticides previously identified as probable human carcinogens. These associations should be further evaluated, specifically in relation to age at diagnosis. [ABSTRACT FROM AUTHOR]

Setting: The Ontario government implemented a regulatory change to mandate the collection of socio-demographic (SD) data for individuals who tested positive for COVID-19. This change was informed by evidence of COVID-19's disproportionate impact on marginalized communities and calls for broader collection of SD data. Given the scarcity of similar efforts, there is a significant knowledge gap around implementing standardized SD data collection in public health settings., Intervention: Public Health Ontario provided collaborative support for the implementation of SD data collection, grounded in health equity principles, evidence, and best practices. We supported the addition of SD fields in Ontario's COVID-19 data collection systems, issued data entry guidance, hosted webinars for training and learning exchange, and published a resource to support the data collection process. The current focus is on building sustainability and quality improvement through continued engagement of public health units., Outcomes: By November 28, 2020, almost 80% of COVID-19 cases had information recorded for at least one SD question (individual questions, range 46.8-67.0%). We hosted three webinars for the field, and the data collection resource was viewed almost 650 times. Practitioners continue to express needs for support on applying equity principles to data analysis and interpretation, and community engagement on data collection and use., Implications: Sharing knowledge on responsive implementation supports in collaboration with the field and using current evidence and guidance will strengthen public health practice for SD data collection. Laying this groundwork will also improve the likelihood of success and sustainability of these equity-focused efforts., (© 2021. Crown 2021 as represented by Government of Ontario.)

Setting: Syndemics occur when two or more health conditions interact to increase morbidity and mortality and are exacerbated by social, economic, environmental, and political factors. Routine provincial surveillance in Ontario assesses and reports on the epidemiology of single infectious diseases separately. Therefore, we aimed to develop a method that allows disease overlaps to be examined routinely as a path to better understanding and addressing syndemics in Ontario., Intervention: We extracted data for individuals with a record of chlamydia, gonorrhea, infectious syphilis, hepatitis B and C, HIV/AIDS, invasive group A streptococcal disease (iGAS), or tuberculosis in Ontario's reportable disease database from 1990 to 2018. We transformed the data into a person-based integrated surveillance dataset retaining individuals (clients) with at least one record between 2006 and 2018., Outcomes: The resulting dataset had 659,136 unique disease records among 470,673 unique clients. Of those clients, 23.1% had multiple disease records with 50 being the most for one client. We described the frequency of disease overlaps; for example, 34.7% of clients with a syphilis record had a gonorrhea record. We quantified known overlaps, finding 1274 clients had gonorrhea, infectious syphilis, and HIV/AIDS records, and potentially emerging overlaps, finding 59 clients had HIV/AIDS, hepatitis C, and iGAS records., Implications: Our novel person-based integrated surveillance dataset represents a platform for ongoing in-depth assessment of disease overlaps such as the relative timing of disease records. It enables a more client-focused approach, is a step towards improved characterization of syndemics in Ontario, and could inform other jurisdictions interested in adopting similar approaches.

Objectives: The purpose of this study is to describe the impact of the 2016 Zika virus (ZIKV) outbreak on the health-seeking and information-seeking behaviours of Ontarians., Methods: A timeline that included events and announcements from health agencies was constructed to describe the unfolding of the ZIKV outbreak between January 1 and September 30, 2016. In order to gain an understanding of the information and health-seeking behaviours of Ontarians, data from the following sources were collected and analyzed descriptively over time in 1-week intervals: trends in web searches, calls to a provincial telemedicine advice line, test submissions to the provincial laboratory and Zika-related media coverage., Results: The World Health Organization's declaration that the ZIKV outbreak was a public health emergency of international concern (PHEIC) prompted a surge in media coverage peaking at 165 articles in a 1-week period. Concurrently, the frequency of Zika-related web searches was at its highest over the time period of the study, weekly telemedicine calls requesting Zika-related information were at their highest (177 calls/week) and requests for laboratory testing increased (162 patients submitting specimens/week)., Conclusions: Understanding the public response to novel and re-emerging infectious disease outbreaks as they unfold has the potential to facilitate timely public messaging for disease prevention, enable resource planning and inform effective public health action.