PubMed Health⌕ Search

Biomedical subjects

J P Middaugh

Publications and source records attributed to J P Middaugh.

At least 55 records · Page 3Linked to original sources
PubMed1986

Injuries associated with three-wheeled, all-terrain vehicles, Alaska, 1983 and 1984.

From January 1983 through December 1984, twenty deaths and at least 534 injuries in Alaska were associated with three-wheeled, all-terrain vehicles. Age at death ranged from 12 to 53 years; 15 deaths (75%) were in the 15- to 34-year age group. Of the 20 fatalities, 12 (60%) might have been prevented had the riders been wearing a helmet. Alcohol use was detected or highly suspected as the major contributing cause of the fatal crash for 12 of 15 drivers and three of five female passengers. Potential risk factors for injuries associated with all-terrain vehicles include alcohol use, failure to use helmets, rider inexperience and inattention, and excessive speed.

Adolescent↗
PubMed1986

Linked outbreaks of hepatitis A in homosexual men and in food service patrons and employees.

Outbreaks of hepatitis A among patrons and employees of two food service establishments in Anchorage, Alaska, in November 1982 and April 1983 were linked to male food handlers infected with the virus. By case finding and contact tracing, we established that the food handlers in both outbreaks were associated with an epidemic of hepatitis A that was transmitted among Anchorage homosexual men for more than six months. Lacking specific serologic findings, physicians treating several of these homosexual men had incorrectly diagnosed the illness as hepatitis B, delaying recognition of the epidemic.

Adolescent↗
PubMed1979

Arctic trichinosis: two Alaskan outbreaks from walrus meat.

The arctic form of Trichinella spiralis that infects terrestrial and marine mammals is of importance in public health because persons living in arctic regions still depend on wild animals for economic subsistence. In 1975, an extended common-source epidemic of trichinosis attributed to consumption of walrus meat involved 29 persons in Barrow, Alaska. Of those persons eating this meat, 64% became ill, and the rate of infection of persons eating meat prepared with little or no cooking was four times as great as that of persons eating cooked meat. One year later a second outbreak occurred when a family ate partially cooked meat from an infected walrus. Clinical illness differed little from the disease acquired in temperature climates; however, only 70% had a positive bentonite flocculation titer, whereas 96% had eosinophilia. These epidemics of trichinosis are the first reported in Alaska to be associated with the consumption of walrus meat.

Alaska↗
PubMed1979

Side effects of diphtheria-tetanus toxoid in adults.

During a mass diphtheria-tetanus immunization campaign in November 1975, more than 220,000 doses of diphtheria-tetanus toxoid, adult type were administered to adults throughout Alaska. In Anchorage, where more than 87,000 doses were given, a survey was conducted to determine the frequency of side effects. Postcard questionnaires were mailed to 2,000 randomly selected Anchorage residents; 467 questionnaires were returned by the post office as undeliverable, and 697 questionnaires were completed and returned. A follow-up survey was done of a random sample of the 836 non-responders. Of those responding, 57.8 per cent reported at least one reaction to the toxoids. The most frequent side effects were sore arm (42.7 per cent), swelling at the site of injection (34.8 per cent), and itching (24.2 per cent). Serious side effects occurred less frequently-swelling of the arm below the elbow (1.1 per cent) and abscess or infection (0.7 per cent). Of those vaccinated, 0.5 per cent saw a physician. There were no statistically significant differences in reaction rates by age group, except for sore arms. The jet injector produced more arm swelling at the site of injection, hives, and itching. More women than men reported adverse reactions, especially sore arm, swelling at the site of injection, and itching. Fear of adverse side effects should not preclude mass vaccination of adults. (Am. J. Public Health (69:246-249,1979.)

Adult↗
PubMed1978

Enforcement of school immunization law in Alaska.

Investigation of measles outbreaks during the fall of 1976 led to the discovery that Alkaska's school immunization law was not being enforced. In an effort to control a large outbreak of measles in Fairbanks, children were required to show proof of measles vaccination or be excluded from school. Of the Fairbanks schoolchildren, 25% were vaccinated against measles; 1,251 (11%) of 11,727 unvaccinated schoolchildren were excluded in January, and no further cases of measles occurred. Subsequently, the school law was enforced statewide, and on March 1, 1977, all children not immunized against diphtheria, tetanus, pertussis, polio, measles, and rubella were excluded from school (7,418 [8.3%] of 89,108). One month later, fewer than 51 children still did not meet immunization requirements. More than 35,000 children were vaccinated in the immunization campaign; no adverse side effects to any vaccine were reported.

Age Factors↗
PubMedDate not supplied

Methyl tertiary butyl ether in human blood after exposure to oxygenated fuel in Fairbanks, Alaska.

Residents of Fairbanks, Alaska reported health complaints when 15%, by volume, methyl tertiary butyl ether (MTBE) was added to gasoline during an oxygenated fuel program. We conducted an exposure survey to investigate the effect of the program on human exposure to MTBE. We studied 18 workers in December 1992 during the program and 28 workers in February 1993 after the program was suspended. All workers were heavily exposed to motor vehicle exhaust or gasoline fumes. In December, the median post-shift blood concentration of MTBE in the workers was 1.8 micrograms/l (range, 0.2-37.0 micrograms/l), and in February the median post-shift blood concentration of MTBE in the 28 workers was 0.24 micrograms/l (range, 0.05-1.44 micrograms/l; p = .0001). Blood MTBE levels were measurably higher during the oxygenated fuel program in Fairbanks than after the program was suspended.

Adult↗
PubMedDate not supplied

An assessment of potential injury surveillance data sources in Alaska using an emerging problem: all-terrain vehicle-associated injuries.

Using injuries associated with three-wheeled all-terrain vehicles in Alaska as an example, the existing injury data bases were assessed for usefulness, cost, simplicity, acceptability, flexibility, sensitivity, specificity, representativeness, and timeliness. In this study strengths and weaknesses of existing data for all-terrain vehicles were identified and ways to improve data collection and linkages across data systems are suggested. Based on this evaluation, linked death certificates and medical examiner data provide an excellent mechanism for monitoring vehicle-related fatalities. Information sources for nonfatal and nonvehicle-related injuries require further development. Police records provide supplemental information, but they are limited to the events reported to police. Although other sources were explored, they added no advantage to the primary sources. Data processing, analysis, and dissemination--traditional responsibilities for public health and other governmental agencies--can transform these data sources into meaningful mechanisms to define injury trends and monitor injury-specific intervention strategies.

Alaska↗
PubMedDate not supplied

Results of an indoor air pollution investigation.

After the opening of a new elementary school in fall 1986, several members of the school's staff noticed symptoms they attributed to the workplace. An investigation by the Occupational Safety and Health Branch (OSHA) of the Alaska Department of Labor found no major health problems and concluded that fireproofing at the school may have caused a petroleum-like odor. In fall 1987, parents reported illness in their children that they attributed to school attendance. Subsequent epidemiologic investigation found that student and staff absentee rates were not increased and were similar to other schools in the district. Testing conducted by the National Institute for Occupational Safety and Health (NIOSH) confirmed that the petroleum-like odor was due to the fireproofing. Toxicologic information and the results of air sampling confirmed that no adverse health effects would be expected from the product. By working together with NIOSH, OSHA, the school district, and a consulting mechanical engineer, deficiencies in the school's ventilation system were discovered and immediately corrected with interim engineering changes. Only by bringing multiple agencies together and openly sharing findings with concerned parents and staff were the problems at the school resolved.

Absenteeism↗
PubMedDate not supplied

Surveillance for tuberculosis in Alaska, 1986.

The incidence of tuberculosis in the Native population in Alaska (92.2/100,000) continues to be higher than the U.S. tuberculosis incidence (9.3/100,000). This paper describes tuberculosis surveillance in Alaska and estimates the "predictive value positive" for cases recorded by the surveillance system during 1986. (Predictive value positive refers to the proportion of all people identified who actually have the disease.) Active surveillance components included an itinerant chest clinic and survey chest roentgenography program, epidemiologic case investigations, and skin testing. Passive components included cases reported by health-care providers and the U.S. Immigration and Naturalization Service. Half of all new cases were reported by health-care providers. Only 42% of cases were bacteriologically confirmed (vs 87% nationwide) suggesting that some cases may have been false positives. many cases did not have a contact investigation completed. Recommendations to improve the surveillance system include: 1) following the Centers for Disease Control/American Thoracic Society diagnostic criteria more closely, 2) increasing the number of cases which have contact investigations completed, and 3) targeting surveillance activities towards high risk subgroups such as Southeast Asian immigrants.

Alaska↗
PubMedDate not supplied

The epidemiology of tuberculosis in Alaska, 1987.

Alaska's tuberculosis morbidity and mortality rates have declined dramatically since the 1950's. At the same time, the epidemiologic characteristics of the disease in Alaska have changed. The tuberculosis incidence rate is now highest among persons of Asian ancestry, particularly the foreign-born. The high rate of disease in Alaskan children indicates that active transmission of Mycobacterium tuberculosis to previously uninfected persons is still occurring. The large proportion of cases among persons under the age of 35 implies a failure in the detection of tuberculosis infection and/or in the use of isoniazid chemoprophylaxis. Alaska's tuberculosis control efforts must focus on ensuring that persons with tuberculosis disease are appropriately and fully treated, on detecting tuberculosis infection in persons eligible for isoniazid preventive therapy, and on applying aggressively the preventive therapy recommendations of the American Thoracic Society and the Centers for Disease Control.

Age Factors↗
PubMedDate not supplied

Pedestrian fatalities in Alaska, 1980-1984.

During 1980-1984, 94 pedestrians (15.6% of 601 total traffic-related fatalities) were killed and 1,293 were injured in Alaska. The pedestrian fatality rate for Alaskan Natives (10.95 per 100,000 population per year) was four times the rate for non-Natives (2.84 per 100,000 population per year), and in Anchorage was 13 times higher (37.98 per 100,000 per year compared to 2.89 per 100,000 per year, respectively). Alcohol use by adult pedestrians and drivers was strongly associated with pedestrian fatal events and was especially associated with Alaskan Native pedestrian fatalities (O.R. 8, 95% CI 1.95-32.78). This previously unrecognized epidemic needs to be controlled by attacking associated risk-factors and by modifying the environment to separate pedestrians from motor vehicles.

Accidents, Traffic↗
PubMedDate not supplied

Pneumococcal vaccination in a remote population of high-risk Alaska Natives.

In response to an increasing prevalence of serious pneumococcal disease among adult Alaska Natives of northwest Alaska, a 3-year program was begun in 1987 to identify residents of that remote region who were at high risk for developing invasive pneumococcal disease, to determine their pneumococcal vaccination status, and to deliver vaccine to at least 80 percent of those at risk. After reviewing public health nursing and Indian Health Service data bases, the authors identified 1,337 persons, 20 percent of the 6,692 residents of the region, at high risk for invasive pneumococcal infection, defined either by having a specific chronic disease or by age criteria. Cardiovascular disease and alcoholism were the two most common chronic diseases. Only 30 percent of those determined to be at high risk had received one or more doses of pneumococcal vaccine previously. Half of those persons had received their most recent vaccination 6 or more years earlier. The program used both customary and innovative methods to deliver 23-valent polysaccharide vaccine to 1,046 of those at high risk (78 percent), including 388 persons who were revaccinated. At the completion of the project, 1,123 persons, 84 percent of those at high risk, had received at least 1 dose. They included 1,088 persons, 81 percent of those at high risk, with vaccination within the previous 5 years as a result of the project, compared with a 15-percent rate prior to the vaccination phase of the project. The program demonstrated that high levels of vaccination against pneumococcal disease, exceeding Year 2000 objectives of 60 percent, are attainable in a remote rural Alaskan population.

Adolescent↗