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At least 19 recordsLinked to original sources

PubMedDate not supplied

Establishment of an exposure level to tetrachloroethylene in ambient air in Vermont.

Where environmental contaminants pose potential health hazards, health departments are involved in complex and often controversial situations. Often the rapid formation of a threshold exposure level is required to protect public health. A decision making process was implemented in Vermont when it became necessary to have an interim ambient air exposure level to test for tetrachloroethylene contamination in the water, air, and soil of a community. Contamination of public and private drinking water and ambient air in schools and homes was discovered as a result of uncontrolled waste disposal from an industrial uniform laundry and drycleaning plant. A telephone survey was conducted to determine action taken by the other 49 States regarding emission standards for tetrachloroethylene into ambient air. There were no guidelines in 25 States, and there were guidelines in the remaining 25. Vermont's Commissioner of Health convened a multidisciplinary group of public health professionals to review various approaches to the establishment of an ambient air standard. A decision making action using modified Delphi and nominal group consensus methods set the interim standard at 67 micrograms per cubic meter in ambient air. The drycleaning plant had been closed voluntarily before the standard was established, and the interim standard was used to prevent reopening of the plant through a health order issued by the Vermont Health Department. The standard was also useful for guidance during environmental remediation.

Air Pollutants↗

PubMed1975

Undiagnosed bacterial meningitis in Vermont children.

Community-acquired bacterial meningitis in Vermont children under 5 years of age was recognized less frequently in 1967-1970 in those towns with low total hospitalization rates than in towns with hospitalization rates above 15 admissions per 100 population. Using the towns with high hospitalization rates as a norm, it was found that towns with fewer recognized meningitis cases than expected had significantly greater rates of death from obscure causes in children 1-59 months of age in 1967-1970. It is suggested that about 17 deaths in 1967-1970 in Vermont children 1-59 months of age were associated with the failure to recognize bacterial meningitis in children from towns with low rates of medical care utilization.

Bacterial Infections↗

PubMed1989

Epidemiologic surveillance for endemic Giardia lamblia infection in Vermont. The roles of waterborne and person-to-person transmission.

The authors studied 1,211 laboratory-confirmed, non-outbreak-related cases of giardiasis in Vermont residents reported through Vermont's laboratory-based active surveillance system between 1983 and 1986. Giardiasis was the most common reportable disease in the state, with an average annual incidence rate of 45.9 cases per 100,000 population per year. This rate is higher than that in other states reporting giardiasis incidence. Morbidity from giardiasis was also significant in that 30% of cases reported symptoms lasting four or more weeks. Waterborne transmission was suggested to be an important cause of non-outbreak-related cases because rates of infection were highest in persons receiving nonfiltered municipal or nonmunicipal residential drinking water. Rates were also higher at higher elevations, where water supplies may be difficult to protect from contamination. In addition, the pattern of age-specific incidence rates and the high estimated incidence of infection in children attending day care suggested that person-to-person transmission also played a role in causing non-outbreak-related cases. Routine surveillance data can serve to indicate likely important routes of transmission of giardiasis in the community.

Adolescent↗

PubMed1979

Farmer's lung disease in Vermont.

Several Vermont population groups were surveyed for the occurrence of antibodies to thermophilic actinomycetes. Antibodies to M. faeni and T. vulgaris were measured by the precipitin method in all subjects and, in 124 subjects, M. faeni antibodies were also measured by the indirect fluorescent antibody (IFA) technique. There was relatively good correlation between the two techniques (r 0.48, p less than 0.01). Hospital employees, blood donors and patients with chronic bronchitis were generally negative for precipitins to thermophilic actinomycetes. Of the 258 Vermont dairy farmers surveyed, 14 (5.4%) had precipitins to M. faeni, 3 (1.2%) had precipitins to T. vulgaris but only 1 farmer with antibodies to M. faeni had symptoms of possible farmer's lung disease (FLD). On the other hand, 10 (4.1%) precipitin-negative farmers had symptoms possibly consistent with FLD. The IFA test did not correlate any better with symptoms. 7 (5.6%) patients with pulmonary fibrosis had precipitins to M. faeni 5 of these were diagnosed as having FLD. 18 (14.4%) had precipitins to T. vulgaris and only 3 of these patients were felt to have hypersensitivity pneumonitis. Patients with pulmonary fibrosis and FLD hat IFA titers of greater than or equal to 1/128, but so did asymptomatic farmers.

Adolescent↗

PubMed1991

Radiographic abnormalities in Vermont granite workers exposed to low levels of granite dust.

The issue of whether low levels of granite dust exposure lead to radiographic abnormalities after a lifetime of exposure has not been settled. In 1983, we carried out a radiographic survey of the Vermont granite industry, consisting of quarry and stone shed workers who had been exposed to the low dust levels prevailing in the industry since 1938 to 1940. Films were read by three "B" readers, using the ILO classification system, which requires the identification of both rounded and irregular opacities, as well as combinations of both. X-ray films were taken of 972 workers, out of a total work force of approximately 1,400. Of these films, 28 (3 percent) were interpreted by either two or three of the three readers as showing abnormalities consistent with pneumoconiosis. Only seven films (or 0.7 percent of the entire cohort) showed nodular or rounded opacities of the type typically seen in uncomplicated silicosis. The remainder of the abnormal x-ray films showed irregular opacities, largely in the lower lung zones, which are of uncertain significance, but may be related to heavy cigarette smoking and aging, and possibly dust inhalation. In addition, total gravimetric dust concentrations in the workplace were measured; 417 respirable-size mass samples showed concentrations of 601 micrograms/cu m +/- 368 micrograms/cu m. Using previously published estimates of 10 percent quartz in granite dust, the average quartz concentration was 60 micrograms/cu m. Twelve percent of the samples exceeded 100 micrograms/cu m, the current OSHA standard for quartz. We conclude that control of quartz exposure in the Vermont granite industry to levels which are on average less than the current OSHA standard has essentially eliminated definite radiographic changes of silicosis. The significance of the irregular opacities in the lower lung zones seen on a majority of the 28 x-ray films judged to be abnormal is not clear.

Adult↗

PubMed1992

The modeling of breast cancer deaths in Vermont.

Methodologic issues in modeling breast cancer deaths were investigated through modeling the number of breast cancer deaths in Vermont for the period 1975 to 1988. Age-specific incidence rates, case fatality rates, and secular trends of these rates were necessary to represent the observed trend in breast cancer deaths over this time period. Additional information, such as mortality from other causes, stage distribution, or screening history, was not necessary. Incidence and survival information were obtained from a statewide population-based breast cancer registry in Vermont and the Surveillance, Epidemiology and End Results (SEER) program. SEER incidence rates overestimated the actual number of deaths for long-term survival rates. Case fatality rates and secular trends in incidence and survival reported by SEER were appropriate. These results can be applied to the planning of community intervention studies by providing the essential expected numbers of deaths in control communities.

Adult↗

PubMed1992

Tetanus--Rutland County, Vermont, 1992.

In July 1992, the Vermont Department of Health received a report of a case of tetanus. The last reported case of tetanus in Vermont was in 1987. This report summarizes the case investigation.

Adult↗

PubMedDate not supplied

Educational program evaluation: the University of Vermont family nurse practitioner program.

Graduates of the Family Nurse Practitioner (FNP) Program at the University of Vermont, Burlington, were surveyed to determine if the FNPs had enlarged their nursing roles following completion of the program. A sample of Vermont nurses served as a control group. Results of a questionnaire, used to obtain information about the nurses' training, functions, and attitudes, indicated that FNPs performed activities associated with an expanded nursing role more frequently than did their nonpractiioner counterparts. There was evidence that the two groups differed in their attitudes toward various aspects of their nursing roles. The evaluation is an ongoing study; as the number of program graduates increases, further characterization of their roles will be possible.

Attitude of Health Personnel↗

PubMedDate not supplied

AIDS knowledge and attitudes among adults in Vermont.

To design a statewide educational campaign, the Vermont Department of Health attempted to measure knowledge about AIDS among residents of the State. During the period November 1986 through January 1987, the authors conducted a telephone survey of noninstitutionalized residents ages 18 and over. The results were examined in relation to age and education. The most accurate answers were given by respondents less than 45 years. In terms of educational attainment, respondents with less than a high school education had an average score of 61.4 and those with a college degree averaged 85.0. When the authors examined responses to individual questions, it became apparent that respondents were more knowledgeable about ways the virus could be transmitted than about ways it could not. A more comprehensive education program must reduce fear. One component of the current AIDS campaign in Vermont is an advertisement that addresses unfounded concern about casual transmission of AIDS.

Acquired Immunodeficiency Syndrome↗

PubMed1985

Presenting conditions of 1539 population-based lung cancer patients by cell type and stage in New Hampshire and Vermont.

The authors identified all newly diagnosed lung cancer cases in New Hampshire and Vermont for the period 1973 through 1976 and abstracted clinical data on presenting symptoms and findings from their hospital records. Microscopy slides were also reviewed, when possible, to confirm cell type. The most frequent presenting symptoms were weight loss (46%) and cough (45%). Other common symptoms were dyspnea (37%), weakness (34%), chest pain (27%), and hemoptysis (27%). The presence of symptoms and findings was in general related to disease stage but bore little relationship to cell type. These results differ from those of previously reported case series that were based on surgical, radiation therapy, or Veterans Hospital groups, but the current data agree closely with those from another population-based series in Finland.

Adenocarcinoma↗

PubMed1988

Vermont granite workers' mortality study.

A cohort mortality study was carried out in Vermont granite workers who had been employed between the years 1950 and 1982. The cohort included men who had been exposed to high levels of granite dust prior to 1938-1940 (average cutters to 40 million parts/cubic foot), and those employed at dust levels after 1940, which on average were less than 10 million parts/cubic foot. Deaths were coded by a qualified nosologist and standardized mortality ratios were calculated. The results confirm previous studies that show that death rates from silicosis and tuberculosis, the major health threats in the years before 1940, were essentially eliminated after dust controls. However, we found excessive mortality rates from lung cancer in stone shed workers who had been employed prior to 1930, and hence had been exposed to high levels of granite dust. When information was available, 100% of those dying from lung cancer had been smokers.

Adult↗

PubMed1985

The Vermont health risk survey and the design of community wide preventive health programs.

A Vermont health risk survey was performed to gain information on health knowledge and behaviors of the population. Telephone interviews with 1,594 individuals ascertained respondents' demographic characteristics, preventive health behaviors, and health knowledge. Risk prevalence was obtained on five health risks: alcohol (12%), smoking (33%), lack of exercise (70%), overweight (39%), and non-use of seatbelts (86%). Low income, less education, and blue collar occupation status were associated with increased risks of smoking, lack of exercise, and non-use of seatbelts. Increased prevalence of certain risks are associated with the 18-24 year old age group; 32% of those males reported an alcohol risk and 94% reported non-use of seatbelts. Combined risk scores were increased in groups with low income, less education, and blue collar occupations. These variations in health behaviors by social group were not explained by differences in health knowledge. Design of primary prevention activities needs to be community wide, utilize information on the epidemiology of health behaviors, influence diverse community groups and intervene before risk behaviors are established.

Adolescent↗

PubMed1975

Dust counting. Critical review and presentation of Vermont practice.

Counting respirable dust particles using bright field microscopy has been the classic approach for rapid practical evaluation of the dustiness of workplace atmospheres. The technique has been beset with difficulties arising out of variations in the optical systems and the counting cells used by various laboratories. This papar reviews the history of the technique and some of the problems which have been encountered. It also details the method used by the Vermont Division of Occupational Health for the past 20 years to count dust, describing the easily reproducible optical system and the use of a "thin" hemocytometer cell employed.

Air Pollution↗

PubMed1991

Incidence of nonmelanoma skin cancer in New Hampshire and Vermont.

A survey of skin cancer occurrence between June 1979 and May 1980 among residents of New Hampshire and Vermont identified 277 cases of squamous cell carcinoma and 1761 cases of basal cell carcinoma. The age-adjusted incidence rates for squamous cell carcinoma (32 per 100,000 in men, 8 per 100,000 in women) and for basal cell carcinoma (159 per 100,000 in men, 87 per 100,000 in women) were similar to those reported in other populations in the northern United States. Skin cancer incidence was particularly high among men more than 70 years of age and a large proportion (greater than 30%) of patients 55 years or older had a history of at least one previous skin cancer.

Adolescent↗

PubMed1988

Downhill ski fatalities: the Vermont experience.

All ski-related accidental deaths in Vermont during the 1979-1980 through 1985-1986 ski seasons are reported. Sixteen deaths occurred in downhill skiers at major ski areas. During the same period 24.17 million skier-days were logged for an estimated rate of one death per 1.5 million skier-days. Of the skiers 81% were male, and 62% were between the ages of 15 and 26 years. Fourteen of 16 cases resulted from collisions with objects, most commonly trees. The predominance of head and upper body injuries was striking, and fractures of the lower extremities were uncommon. Lethal head/neck injuries accounted for all but two of the deaths. Only one skier was wearing a helmet. Speed and loss of control were the two major contributing factors identified in these accidents. The need for research and development in the prevention of this class of ski accidents is emphasized.

Adolescent↗

PubMedDate not supplied

Evidence for school transmission of Neisseria meningitidis during a Vermont outbreak.

A meningitis outbreak due to Neisseria meningitidis, serogroup C, serotype 2b, occurred in central Vermont in February, 1984. The highest incidence was in Northfield, where 7 cases occurred (129 per 100,000 population). Of these 7 cases 2 were students at Northfield High School and 5 were younger children; all had had close contact with Northfield High School students or staff in the week before illness. A case-control study demonstrated that these cases had significantly more exposure to Northfield High School students or staff in the 2 weeks before illness (112 hours) than did controls (8 hours) (P = 0.006). This finding was confirmed by a second case-control study designed to determine risk factors for the entire outbreak. School children in Northfield and their household contacts were given meningococcal A-C vaccine and sulfisoxazole prophylaxis. No further cases of meningococcal disease occurred in Northfield after the week that these control methods were initiated. Transmission of the outbreak strain of N. meningitidis appears to have occurred in a school setting with subsequent illness in household and close contacts of carriers of the outbreak strain.

Adolescent↗

PubMed1991

Effects of work exposure, retirement, and smoking on bronchoalveolar lavage measurements of lung dust in Vermont granite workers.

Estimation of the exposure to respirable dust in the workplace is an important aspect of industrial hygiene. We performed bronchoalveolar lavage (BAL) on 42 healthy nonindustrial control subjects and 44 workers in the Barre, Vermont granite industry to determine whether BAL materials reflected occupational exposure. The granite workers held jobs with a range of dust exposure intensities and had employment histories from 1 to 43 yr; 12 workers were retired. None of the workers had radiologic evidence of silicosis. The granite dust content of BAL materials was measured by enumerating the percentage of cells positive for particulates by polarized light microscopy, by analysis for silicon by scanning electron microscopy with energy-dispersive X-ray spectrometry, and by chemical analysis. Minerals were present in greater quantity in the BAL cells from granite workers than from nonindustrial control subjects. Polarized light microscopy was comparable in sensitivity, specificity, and overall accuracy to electron microscopy; chemical analysis was less accurate than either microscopic technique. Tobacco smoking did not interfere with the detection of the occupationally related minerals or influence the quantity of dust present. The mineral in BAL cells was partially related to the intensity of exposure within the granite industry and to the duration of employment, but there was great individual variation among subjects. Retirement led to a decrease in BAL mineral content, but substantial dust remained for many years.

Bronchoalveolar Lavage Fluid↗

PubMed1985

Mineral dust and cell recovery from the bronchoalveolar lavage of healthy Vermont granite workers.

We characterized the bronchoalveolar lavage (BAL) from healthy Vermont granite workers to investigate the pulmonary response to a chronic exposure to an injurious agent. Nine granite workers with 4 to 36 yr of employment in the industry and 27 unexposed volunteers were normal by history, physical examination, electrocardiogram, blood count, spirometry, and chest radiograph. Lavage cell recovery and percent neutrophils were not different. Lymphocyte recovery in BAL was increased in the granite-exposed population. Granite dust was present within the majority of alveolar macrophages from granite workers compared with those from control subjects, as determined by polarizing light microscopy and confirmed by scanning electron microscopy with X-ray energy spectrometry. There were no differences in phagocytic function or viability of macrophages from granite workers compared with those from unexposed volunteers. We conclude that in exposed populations, granite dust can be detected and semiquantitated in lavage specimens within the alveolar macrophages, macrophage function is preserved, and the response to this exposure involves an influx of lymphocytes.

Adult↗