scholarly journals Estimating the infectious disease risks associated with drinking water in the United States

2006 ◽  
Vol 4 (S2) ◽  
pp. 1-2 ◽  
Author(s):  
Rebecca L. Calderon ◽  
Gunther Craun ◽  
Deborah A. Levy
Keyword(s):  
Infectious Disease ◽  
United States ◽  
Drinking Water ◽  
The United States ◽  
Disease Risks

The Empire of Disgust

2018 ◽  
Keyword(s):  
United States ◽  
Drinking Water ◽  
Sexual Orientation ◽  
Change Point ◽  
Minority Groups ◽  
The United States ◽  
Political Life ◽  
Swimming Pools ◽  
Economic Class ◽  
Group Resistance

All known societies exclude and stigmatize one or more minority groups. Frequently these exclusions are underwritten with a rhetoric of disgust: people of a certain group, it is alleged, are filthy, hyper-animal, or not fit to share such facilities as drinking water, food, and public swimming pools with the ‘clean’ and ‘fully human’ majority. But exclusions vary in their scope and also in the specific disgust-ideologies underlying them. In this volume, interdisciplinary scholars from the United States and India present a detailed comparative study of the varieties of prejudice and stigma that pervade contemporary social and political life: prejudice along the axes of caste, race, gender, age, sexual orientation, transgender, disability, religion, and economic class. In examining these forms of stigma and their intersections, the authors present theoretically pluralistic and empirically sensitive accounts that both explain group-based stigma and suggest ways forward. These forward-looking remedies, including group resistance to subordination as well as institutional and legal change, point the way towards a public culture that is informed by our diverse histories of discrimination and therefore equipped to eliminate stigma in all of its multifaceted forms.

Lithium in groundwater used for drinking-water supply in the United States

2020 ◽  
pp. 144691
Author(s):  
Bruce D. Lindsey ◽  
Kenneth Belitz ◽  
Charles A. Cravotta ◽  
Patricia L. Toccalino ◽  
Neil M. Dubrovsky
Keyword(s):  
United States ◽  
Drinking Water ◽  
Water Supply ◽  
The United States ◽  
Drinking Water Supply

Associations of Community Water Lead Concentrations with Hemoglobin Concentrations and Erythropoietin-Stimulating Agent Use among Patients with Advanced CKD

2021 ◽  
pp. ASN.2020091281
Author(s):  
John Danziger ◽  
Kenneth J. Mukamal ◽  
Eric Weinhandl
Keyword(s):  
United States ◽  
Drinking Water ◽  
Kidney Disease ◽  
The United States ◽  
Water Systems ◽  
Adverse Outcomes ◽  
Content Type ◽  
Community Water Systems ◽  
Community Water ◽  
Lead Levels

BackgroundAlthough patients with kidney disease may be particularly susceptible to the adverse health effects associated with lead exposure, whether levels of lead found commonly in drinking water are associated with adverse outcomes in patients with ESKD is not known.MethodsTo investigate associations of lead in community water systems with hemoglobin concentrations and erythropoietin stimulating agent (ESA) use among incident patients with ESKD, we merged data from the Environmental Protection Agency (EPA) Safe Drinking Water Information System (documenting average 90th percentile lead concentrations in community water systems during 5 years before dialysis initiation, according to city of residence) with patient-level data from the United States Renal Data System.ResultsAmong 597,968 patients initiating dialysis in the United States in 2005 through 2017, those in cities with detectable lead levels in community water had significantly lower pre-ESKD hemoglobin concentrations and more ESA use per 0.01 mg/L increase in 90th percentile water lead. Findings were similar for the 208,912 patients with data from the first month of ESKD therapy, with lower hemoglobin and higher ESA use per 0.01 mg/L higher lead concentration. These associations were observed at lead levels below the EPA threshold (0.015 mg/L) that mandates regulatory action. We also observed environmental inequities, finding significantly higher water lead levels and slower declines over time among Black versus White patients.ConclusionsThis first nationwide analysis linking EPA water supply records to patient data shows that even low levels of lead that are commonly encountered in community water systems throughout the United States are associated with lower hemoglobin levels and higher ESA use among patients with advanced kidney disease.

scholarly journals Automated Travel History Extraction From Clinical Notes for Informing the Detection of Emergent Infectious Disease Events: Algorithm Development and Validation

10.2196/26719 ◽  
2021 ◽  
Vol 7 (3) ◽  
pp. e26719
Author(s):  
Kelly S Peterson ◽  
Julia Lewis ◽  
Olga V Patterson ◽  
Alec B Chapman ◽  
Daniel W Denhalter ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
United States ◽  
Text Processing ◽  
The United States ◽  
Language Models ◽  
Travel History ◽  
Patient Travel ◽  
Electronic Health ◽  
Automated Text Processing

Background Patient travel history can be crucial in evaluating evolving infectious disease events. Such information can be challenging to acquire in electronic health records, as it is often available only in unstructured text. Objective This study aims to assess the feasibility of annotating and automatically extracting travel history mentions from unstructured clinical documents in the Department of Veterans Affairs across disparate health care facilities and among millions of patients. Information about travel exposure augments existing surveillance applications for increased preparedness in responding quickly to public health threats. Methods Clinical documents related to arboviral disease were annotated following selection using a semiautomated bootstrapping process. Using annotated instances as training data, models were developed to extract from unstructured clinical text any mention of affirmed travel locations outside of the continental United States. Automated text processing models were evaluated, involving machine learning and neural language models for extraction accuracy. Results Among 4584 annotated instances, 2659 (58%) contained an affirmed mention of travel history, while 347 (7.6%) were negated. Interannotator agreement resulted in a document-level Cohen kappa of 0.776. Automated text processing accuracy (F1 85.6, 95% CI 82.5-87.9) and computational burden were acceptable such that the system can provide a rapid screen for public health events. Conclusions Automated extraction of patient travel history from clinical documents is feasible for enhanced passive surveillance public health systems. Without such a system, it would usually be necessary to manually review charts to identify recent travel or lack of travel, use an electronic health record that enforces travel history documentation, or ignore this potential source of information altogether. The development of this tool was initially motivated by emergent arboviral diseases. More recently, this system was used in the early phases of response to COVID-19 in the United States, although its utility was limited to a relatively brief window due to the rapid domestic spread of the virus. Such systems may aid future efforts to prevent and contain the spread of infectious diseases.

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