Search

Background: Although firefighters have increased risk for colon and prostate cancer, limited information exists on screening practices for these cancers in volunteer firefighters who compose two-thirds of the US fire service. We estimated the prevalence of colon and prostate cancer screening among volunteer firefighters using eligibility criteria from 4 evidence-based screening recommendations and evaluated factors influencing screening., Methods: We evaluated colon (n = 569) and prostate (n = 498) cancer screening prevalence in a sample of US volunteer firefighters using eligibility criteria from the US Preventive Services Taskforce (USPSTF), National Fire Protection Association, American Cancer Society, and National Comprehensive Cancer Network. We assessed associations with fire service experience, demographics, and cancer risk perception based on USPSTF guidelines., Results: For those eligible based on USPSTF guidelines, colon and prostate cancer screening prevalence was 51.7% (95% CI: 45.7, 57.8) and 48.8% (95% CI: 40.0, 57.6), respectively. Higher odds of colon and prostate cancer screening were observed with older age and with some college education compared to those with less education. Fire service experience and cancer risk perception were not associated with screening practices., Conclusion: This is the first large study to assess colon and prostate cancer screening among US volunteer firefighters based on different screening guidelines. Our findings suggest gaps in cancer prevention efforts in the US volunteer fire service. Promoting cancer screening education and opportunities for volunteer firefighters by their fire departments, healthcare professionals, and public health practitioners, may help to address the gaps., (© 2024 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals LLC.)

Background: Firefighters have a higher risk of melanoma incidence and mortality compared to the general population. In the United States (US), the National Fire Protection Association recommends all firefighters receive annual skin cancer screening through visual skin examination by a clinician. However, there is limited information on skin cancer screening practices among volunteer firefighters who comprise two-thirds of the US fire service., Methods: This cross-sectional study of 552 US volunteer firefighters estimated the prevalence of skin cancer screening and evaluated associations with their fire service experience, demographics, sun protection practices, and cancer risk perception., Results: The prevalence of receiving skin cancer screening among volunteer firefighters was 26.1% (95% confidence interval [CI]: 22.4, 29.8). The odds of being screened for skin cancer, compared to not being screened, were twice as high for firefighters who used sunscreen (odds ratio [OR]: 2.35, 95% CI: 1.48, 3.73) and who perceived their skin likely to burn with prolonged sun exposure (OR: 1.81, 95% CI: 1.10, 3.00). Older age, some college education, and family history of skin cancer were also positively associated with skin cancer screening. A positive exposure-response relationship was observed between more monthly firefighting calls and receiving screening. Cancer risk perception was not associated with screening., Conclusion: To our knowledge, this is the first large study to assess skin cancer screening among US volunteer firefighters. Our findings suggest gaps in skin cancer prevention efforts in the volunteer fire service. Additional assessment of skin cancer prevention practices within volunteer fire departments could help address these gaps., (© 2023 The Authors. American Journal of Industrial Medicine published by Wiley Periodicals LLC.)

Heart disease is the leading cause of death in the United States. African Americans and people of low socioeconomic status suffer disproportionately from heart disease-related morbidity and mortality. In Detroit, Michigan, a primarily African American and low-income urban area, heart disease mortality is at twice the national rate. Despite evidence for the effectiveness of self-management support interventions in reducing chronic disease burden for older adults, few are adapted for communities most in need. This article describes the process of adapting Take PRIDE, an evidence-based heart disease self-management intervention, for older adults in Detroit via the Replicating Effective Programs (REP) framework. Working within a community-academic partnership, we found REP useful in facilitating the identification of diverse stakeholders, core versus adaptable elements of the intervention and barriers to implementation. We also made several modifications to the REP framework in order to better fit our project needs. Overall, we found REP to be an effective, flexible tool that allowed us to successfully adapt a disease-management intervention for this setting. Processes, lessons learned, and recommendations offered in this article may help researchers and practitioners working to expand access to self-management support for populations most affected by chronic disease.

The Pacific Northwest National Laboratory inspected and cleaned two radionuclide air-sampling systems that continuously monitor radioactive air emissions from research and development facilities. The inspection and cleaning was performed to evaluate effective methods and potential cost impacts of maintenance requirements in the revised American National Standard Institute standard Sampling and Monitoring Releases of Airborne Radioactive Substances from the Stacks and Ducts of Nuclear Facilities. The standard requires at least annual inspections of sampling systems followed by cleaning if deposits are visible. During 2001 and 2002, inspections were performed leaving the sampling systems in place and inserting videoscope cables into different access points to allow viewing of the inside and outside of sampling manifolds and transport lines. Cleaning was performed on one of the systems by disconnecting and extracting the sampling manifold, then washing it with de-ionized water and scrub brushes. The wash water was analyzed for radioactivity and solids. Results of the inspection showed greater deposition in one of the systems than would be expected by a High Efficiency Particulate Air (HEPA) filtered exhaust stream, possibly due to accumulation of dust from a short period when unfiltered air was exhausted from construction areas. The second system was also downstream of HEPA filters and appeared much cleaner. The videoscope was a useful and cost-effective tool and provided a better view than could be obtained with the naked eye. However, because even small amounts of deposition were made visible with the videoscope, clarification is needed in defining when probe washing is merited, particularly in existing sampling systems whose design is not conducive to easy removal and cleaning.

The Pacific Northwest National Laboratory characterized the performance of sampling locations for two radionuclide air-sampling systems that continuously monitor radioactive air emissions from research and development facilities. The testing was conducted to determine whether sampling system locations would meet the criteria for uniform air velocity and contaminant concentration in the American National Standard Institute standard, Sampling and Monitoring Releases of Airborne Radioactive Substances from the Stacks and Ducts of Nuclear Facilities (ANSI/HPS N13.1-1999). The standard is a revision of the 1969 version that the facilities have been required to meet. Whereas the 1969 standard provided prescriptive criteria for the selection of sampling locations, the 1999 standard is performance-based and requires well-mixed sampling locations that must be demonstrated through performance tests that are specified in the standard. Testing at the Life Sciences Laboratory I was performed on the existing stack at the current sampling location; a scale model was built and used in place of the Radiochemical Processing Laboratory. Although both facilities' sampling sites were compliant with the 1969 standard, only the Radiochemical Processing Laboratory met the criteria of the revised standard. In the future, the use of a computational fluid dynamics computer model may be useful in determining whether a sampling location is likely to test successfully.

The pathogenesis of Haemophilus influenzae type b (Hib) disease and methods for limiting spread of outbreaks of Hib disease are reviewed. Many strains of H. influenzae are surrounded by an outer polysaccharide capsule; of the six antigenically distinct capsular types, Hib is the predominant cause of such serious infections as meningitis, especially among children younger than five years of age. The age-specific incidence of Hib disease appears to be related to the relatively small concentrations of anti-Hib antibody present in young children. Children younger than 48 months of age who reside in the same house or attend the same day-care center as a child who develops Hib disease appear to be at increased risk for contracting systemic Hib infections. Prophylactic administration of rifampin 20 mg/kg once daily for four days can substantially decrease asymptomatic carriage of Hib in household contacts of the index patient and reduce the incidence of secondary Hib disease. The index patient should also receive prophylactic rifampin therapy before discharge from the hospital; i.v. antibiotics may cure the systemic infection but allow nasopharyngeal colonization to persist. A vaccine formulated from purified Hib capsular polysaccharide confers protection to more than 90% of children vaccinated at a minimum age of 24 months. Other candidates for vaccination include children between the ages of two and five years who attend day-care centers and children with anatomic or functional asplenia or malignancies. The vaccine is not effective in children younger than 18 months of age (who account for 60% of Hib disease in the U.S.); methods to increase vaccine immunogenicity in young infants are being evaluated. Reduction of Hib disease in the U.S. may be possible through widespread use of the new vaccine.