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Gregory C Gray - One of the best experts on this subject based on the ideXlab platform.
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varicella susceptibility and vaccine use among young adults enlisting in the United States Navy
Journal of Medical Virology, 2003Co-Authors: Margaret A K Ryan, Tyler C Smith, William K Honner, Gregory C GrayAbstract:Primary varicella infection, or chicken pox, is a threat to all young adults who join the United States (U.S.) military if they fail to develop immunity prior to enlistment. Historically, outbreaks of chicken pox have caused marked morbidity and impaired military readiness. In December 1996, the U.S. Navy began performing serologic testing for varicella among all new recruits, and vaccinating those found to be sero-negative. We evaluated results of the screening program in its first 4 years, and used multivariable logistic regression modeling to describe factors associated with varicella susceptibility. Cases of chicken pox were tracked among all military services before and after program implementation. More than 190,000 young adults enlisted in the U.S. Navy between 1997 and 2000. Recruits originated from all 50 States and several foreign countries; 84% were male, and their average age was 19 years. Seven percent were found to be susceptible (sero-negative) to varicella. In multivariable modeling, race/ethnicity was associated with susceptibility, but age, gender, and home state were not. The overall incidence of chicken pox in the Navy was reduced by more than 80% after initiation of the screening-vaccination program. A successful varicella screening-vaccination program has been implemented in the U.S. Navy. Results of serologic screening undertaken on this large number of young adults may be useful in tracking the changing epidemiology of varicella in the general population in the post-vaccine era.
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tuberculosis infection among young adults enlisting in the United States Navy
International Journal of Epidemiology, 2000Co-Authors: Besa Smith, Gregory C Gray, Margaret A K Ryan, James M Polonsky, David H TrumpAbstract:Abstract : Tuberculosis (TB) is a re-emerging infectious disease threat worldwide. To protect the health and readiness of US military personnel, policies exist to screen for and treat latent TB infection at the time of service entrance. Results of this screening programme have not been recently described. Multivariate regression techniques were used to evaluate demographic and medical data associated with TB infection among all young adults entering US Navy enlisted service between 1 October 1997 and 30 September 1998. A total of 44 128 adults (ages 17-35, 81% male) were screened for TB during this 12-month period. The prevalence of latent TB infection was 3.5%. Place of birth was very strongly associated with TB infection, with foreign-born recruits eight times more likely to have a reactive tuberculin skin test or history of infection. Those who reported their race as Asian/Pacific Island' had 3.8 times the odds of having evidence of TB infection compared with Caucasian' recruits, even after adjusting for place of birth. The prevalence of TB infection among Navy recruits was last reported as 2.5% nearly 10 years ago. The apparent increase to 3.5% in this large cohort is likely due to a concurrent increase in the number of foreign-born recruits, and it serves to underscore the importance of comprehensive screening and treatment of latent TB infections in this population.
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risk factors for primary pulmonary coccidioidomycosis hospitalizations among United States Navy and marine corps personnel 1981 1994
American Journal of Tropical Medicine and Hygiene, 1998Co-Authors: Gregory C Gray, Evander F Fogle, Kristen L AlbrightAbstract:Recent coccidioidomycosis outbreaks among military personnel have alarmed public health officials. We used computerized hospitalization records to identify risk factors for coccidioidomycosis hospitalizations among active-duty United States Navy and Marine Corps personnel for the years 1981 to 1994. Primary pulmonary disease was the most common form of disease, accounting for 82 (73%) of the 113 first admissions. Crude annual rates of primary pulmonary disease increased markedly in 1992 and 1993 in concert with an epidemic in the United States. Demographic data from the pulmonary admissions were combined with that of a 2% random sample of the entire Navy and Marine Corps population for multivariate risk factor modeling. Persons from junior paygrades, older age groups, and those reporting a race/ethnicity other than Caucasian or Hispanic were most likely to be hospitalized with this disease. These risk factor data should be considered in designing coccidioidomycosis surveillance and prevention programs.
Panagiotis Matsangas - One of the best experts on this subject based on the ideXlab platform.
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eating behaviors in sailors of the United States Navy meal to sleep intervals
Nutrition and Health, 2021Co-Authors: Nita Lewis Shattuck, Panagiotis MatsangasAbstract:BACKGROUND Due to their long workdays and erratic watch schedules, sailors on United States Navy (USN) ships often eat meals close to their bedtime, which may contribute to sleep disruption. AIM To assess the duration of meal-to-sleep (M-S) intervals in relation to timing of sailor workdays and watch schedules. METHODS Longitudinal field assessment of USN sailors performing their underway duties (N = 234). Participants completed questionnaires, wore actigraphs, and completed activity logs. RESULTS Approximately 35% of M-S intervals were <3 h in duration. M-S interval duration was associated with watchstanding status (p < 0.001) and the number of sections in the watchstanding schedule (p < 0.001). Sailors on the two-section watch schedule had, on average, the shortest M-S intervals (55 min) compared to sailors on three- or four-section watchbills (∼4 h) and to non-watchstanders (4.85 h). CONCLUSION Sailors on two-section watchbills often eat quite close to bedtime. To provide appropriate recommendations regarding healthy dietary patterns, we will continue assessing dietary behaviors and food choices of sailors while underway, especially as they relate to sailor work hours, circadian rhythms, and sleep practices.
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preliminary assessment of a novel watchstanding schedule for a crew on a small surface combatant of the United States Navy
Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2019Co-Authors: Panagiotis Matsangas, Nita Lewis ShattuckAbstract:We assessed the utility of a fixed, 3-section, watchstanding schedule in a small surface combatant of the United States Navy. Sailors on the “5 hrs-daytime/3 hrs-nighttime” or “D5/N3” schedule stoo...
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caffeinated beverage consumption rates and reported sleep in a United States Navy ship
Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2015Co-Authors: Nita Lewis Shattuck, Panagiotis MatsangasAbstract:Ship crews live and work in an environment characterized by extreme sleep deprivation. In an attempt to maintain alertness, crewmembers frequently consume caffeinated beverages and energy drinks. A...
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psychomotor vigilance performance predicted by epworth sleepiness scale scores in an operational setting with the United States Navy
Journal of Sleep Research, 2015Co-Authors: Nita Lewis Shattuck, Panagiotis MatsangasAbstract:SUMMARY It is critical in operational environments to identify individuals who are at higher risk of psychomotor performance impairments. This study assesses the utility of the Epworth Sleepiness Scale for predicting degraded psychomotor vigilance performance in an operational environment. Active duty crewmembers of a USA Navy destroyer (N = 69, age 21–54 years) completed the Epworth Sleepiness Scale at the beginning of the data collection period. Participants wore actigraphs and completed sleep diaries for 11 days. Psychomotor vigilance tests were administered throughout the data collection period using a 3-min version of the psychomotor vigilance test on the actigraphs. Crewmembers with elevated scores on the Epworth Sleepiness Scale (i.e. Epworth Sleepiness Scale >10) had 60% slower reaction times on average, and experienced at least 60% more lapses and false starts compared with individuals with normal Epworth Sleepiness Scale scores (i.e. Epworth Sleepiness Scale ≤10). Epworth Sleepiness Scale scores were correlated with daily time in bed (P < 0.01), sleep (P < 0.05), mean reaction time (P < 0.001), response speed 1/reaction time (P < 0.05), slowest 10% of response speed (P < 0.001), lapses (P < 0.01), and the sum of lapses and false starts (P < 0.001). In this chronically sleep-deprived population, elevated Epworth Sleepiness Scale scores identified that subset of the population who experienced degraded psychomotor vigilance performance. We theorize that Epworth Sleepiness Scale scores are an indication of personal sleep debt that varies depending on one’s individual sleep requirement. In the absence of direct performance metrics, we also advocate that the Epworth Sleepiness Scale can be used to determine the prevalence of excessive sleepiness (and thereby assess the risk of performance decrements).
Douglas K Owens - One of the best experts on this subject based on the ideXlab platform.
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cost effectiveness of the pneumococcal vaccine in the United States Navy and marine corps
Clinical Infectious Diseases, 2000Co-Authors: Patricia Vold Pepper, Douglas K OwensAbstract:Vaccination for Streptococcus pneumoniae has been recommended for its efficacy and cost-effectiveness in elderly and immunocompromised populations. However, its use in active-duty military personnel has not been analyzed. We developed a Markov model to evaluate health and economic outcomes of vaccinating or not vaccinating all members of the active-duty cohort, measuring quality-adjusted life years (QALYs) gained, costs, and marginal cost-effectiveness. Pneumococcal pneumonia vaccination increased each person's life expectancy by 0. 03 days and decreased costs by $9.88 per person. The magnitude of the benefit of immunization is moderately sensitive to the rate of serious side effects caused by the vaccine, the incidence of pneumonia, the length of protection, and the efficacy of the vaccine. Vaccinating all 575,000 active-duty US Navy and Marine Corps members could save $5.7 million during the time the members are alive and on active duty and could provide a total gain of 54 QALYs. On the basis of these results, the military should consider expanding current guidelines to include pneumococcal vaccine immunization for all active-duty members of the military.
Margaret A K Ryan - One of the best experts on this subject based on the ideXlab platform.
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varicella susceptibility and vaccine use among young adults enlisting in the United States Navy
Journal of Medical Virology, 2003Co-Authors: Margaret A K Ryan, Tyler C Smith, William K Honner, Gregory C GrayAbstract:Primary varicella infection, or chicken pox, is a threat to all young adults who join the United States (U.S.) military if they fail to develop immunity prior to enlistment. Historically, outbreaks of chicken pox have caused marked morbidity and impaired military readiness. In December 1996, the U.S. Navy began performing serologic testing for varicella among all new recruits, and vaccinating those found to be sero-negative. We evaluated results of the screening program in its first 4 years, and used multivariable logistic regression modeling to describe factors associated with varicella susceptibility. Cases of chicken pox were tracked among all military services before and after program implementation. More than 190,000 young adults enlisted in the U.S. Navy between 1997 and 2000. Recruits originated from all 50 States and several foreign countries; 84% were male, and their average age was 19 years. Seven percent were found to be susceptible (sero-negative) to varicella. In multivariable modeling, race/ethnicity was associated with susceptibility, but age, gender, and home state were not. The overall incidence of chicken pox in the Navy was reduced by more than 80% after initiation of the screening-vaccination program. A successful varicella screening-vaccination program has been implemented in the U.S. Navy. Results of serologic screening undertaken on this large number of young adults may be useful in tracking the changing epidemiology of varicella in the general population in the post-vaccine era.
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tuberculosis infection among young adults enlisting in the United States Navy
International Journal of Epidemiology, 2000Co-Authors: Besa Smith, Gregory C Gray, Margaret A K Ryan, James M Polonsky, David H TrumpAbstract:Abstract : Tuberculosis (TB) is a re-emerging infectious disease threat worldwide. To protect the health and readiness of US military personnel, policies exist to screen for and treat latent TB infection at the time of service entrance. Results of this screening programme have not been recently described. Multivariate regression techniques were used to evaluate demographic and medical data associated with TB infection among all young adults entering US Navy enlisted service between 1 October 1997 and 30 September 1998. A total of 44 128 adults (ages 17-35, 81% male) were screened for TB during this 12-month period. The prevalence of latent TB infection was 3.5%. Place of birth was very strongly associated with TB infection, with foreign-born recruits eight times more likely to have a reactive tuberculin skin test or history of infection. Those who reported their race as Asian/Pacific Island' had 3.8 times the odds of having evidence of TB infection compared with Caucasian' recruits, even after adjusting for place of birth. The prevalence of TB infection among Navy recruits was last reported as 2.5% nearly 10 years ago. The apparent increase to 3.5% in this large cohort is likely due to a concurrent increase in the number of foreign-born recruits, and it serves to underscore the importance of comprehensive screening and treatment of latent TB infections in this population.
Roy E Shore - One of the best experts on this subject based on the ideXlab platform.
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mortality of enlisted men who served on nuclear powered submarines in the United States Navy
Journal of Occupational and Environmental Medicine, 2021Co-Authors: George Friedmanjimenez, Ikuko Kato, Pam Factorlitvak, Roy E ShoreAbstract:Objective To describe the long-term mortality experience of a cohort of enlisted men who served on nuclear-powered submarines in the United States Navy and breathed recirculated filtered air for extended periods of time. Methods In this historical cohort study we estimated Standardized Mortality Ratios (SMRs) and used within-cohort Poisson regression analyses to address healthy worker biases. Results 3,263 deaths occurred among 85,498 men during 1,926,875 person-years of follow-up from 1969 to 1995. SMRs were reduced for most cause-of-death categories, prostate cancer had a twofold elevation. In within-cohort comparisons, prostate cancer mortality did not increase with duration of submarine service, but ischemic heart disease mortality increased 26% per 5 years of submarine service. Conclusions Long periods of submarine service do not increase mortality in most cause-of-death categories. Increased mortality from ischemic heart disease likely reflects the effects of tobacco smoke.
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low dose ionizing radiation and cancer mortality among enlisted men stationed on nuclear powered submarines in the United States Navy
Annals of Epidemiology, 2014Co-Authors: George Friedmanjimenez, Ikuko Kato, Yelena Afanasyeva, Roy E ShoreAbstract:s / Annals of Epidemiology 24 (2014) 682e702 687 Conclusions: Men who serve on nuclear-powered submarines are selected to be healthier than the general public and have lower mortality rates for nearly all causes of death. The excess suicide among menwith short duration of service on nuclear-powered submarines is notable. The increasing trend of mortality from ischemic heart disease with duration of submarine duty may reflect, in part, an effect of environmental tobacco smoke, although confounding by individual tobacco smoking cannot be excluded. P19. Low Dose Ionizing Radiation and Cancer Mortality Among Enlisted Men Stationed on Nuclear-Powered Submarines in the United States Navy George Friedman-Jimenez MD, DrPH, Ikuko Kato MD, PhD, Yelena Afanasyeva MS, Roy E. Shore PhD, DrPH. NYU School of Medicine Purpose: Men stationed on nuclear-powered submarines are occupationally exposed to external ionizing radiation at very low levels. Radiation dose for each individual is closely monitored. Little is known about the cancer mortality experience of this group. Methods: This historical cohort study followed 85,033 enlisted men who served on nuclear-powered submarines in the U.S. Navy between 1969 and 1982 to determine patterns of cancer mortality. Occupational radiation doses were measured by badge dosimeters for each individual for all periods of Navy service potentially involving radiation exposure. Deaths were ascertained through searches of multiple national mortality databases. Within-cohort dose-response relationships were estimated using linear and loglinear Poisson regression models to adjust for multiple confounders. Results: A total of 584 cancer deaths occurred in 1,805,581 person years (up to 27 years) of follow-up. The mean occupational radiation dose received while in the Navy was 5.7 millisieverts (mSv). Excess Relative Risks per 10 mSv and 95% Confidence Intervals are 0.052(-0.03,0.18) for all solid cancers, 0.003(-0.29,0.30) for leukemias excluding chronic lymphocytic leukemia, 0.052(-0.07,0.17) for cancers previously associated with smoking, and 0.012 (-0.10,0.12) for cancers not previously associated with smoking. The 95 percent Confidence Intervals include the null value for all cause-of-death categories analyzed. Conclusions: The Excess Relative Risk and Relative Risk point estimates for most cancers are similar to those reported in previous published studies, however, the 95% Confidence Intervals are wide. Confounding of these estimates by tobacco smoking cannot be excluded for cancers that are associated with smoking. P20. Association Between Work-Related Discrimination and Low Back Pain Among Korean Employees: Role of Labor Union Status as an Effect Modifier Hyoju Sung, Seung-Sup Kim ScD. Korea University Purpose: To investigate the association between work-related discrimination (WRD) and low back pain (LBP) and to explore the role of labor union as an effect modifier. Methods: We analyzed 29,608 employees from the 3rd wave of Korean Working Condition Survey (2011). WRDs from five different reasons were assessed using questions: “Have you ever experienced work-related discrimination during the past 12 months based on your: (1) age, (2) education, (3) birth region, (4) sex, and (5) employment status?” Labor union status was assessed in three categories: (1) employees in a workplace without labor union, (2) employees did not have a union membership in a workplace with labor union, and (3) employees had union membership. Results: In a workplace without labor union, LBP was significantly associated with WRD based on age (OR: 2.08, 95% CI: 1.69, 2.55), education (OR: 1.31, 95% CI: 1.04, 1.64), birth region (OR: 1.44, 95% CI: 1.02, 2.05), sex (OR: 2.89, 95% CI: 2.18, 3.84), and employment status (OR: 2.03, 95% CI: 1.64, 2.51) among female employees after controlling covariates including self-reported ergonomic strains. Similar significant associations were observed among male employees except WRD based on birth region (OR: 1.37, 95% CI: 0.95, 1.97). However, no significant association was observed for both male and female employee in a workplace with labor union regardless of whether or not employee had union membership except sex discrimination among female employees with union membership (OR: 3.77, 95% CI: 1.45, 9.83). Conclusions: WRD was associated with LBP only in workplaces without labor union. P21. Police Stress and Posttraumatic Stress Disorder: The Role of Coping Claudia C. Ma MS, MPH, Michael E. Andrew PhD, Anna Mnatsakanova MS, Tara A. Hartley PhD, Desta Fekedulegn PhD, Erin McCanlies PhD, Ja K. Gu MSPH, John M. Violanti PhD, Cecil M. Burchfiel PhD. NIOSH Purpose: We investigated the cross-sectional associations between police stress and posttraumatic stress disorder (PTSD) symptoms, and the role of coping. Methods: A total score from PTSD Checklist-Civilian Version (PCL-C), a 17item self-report questionnaire, was used for PTSD assessment in 342 officers. Job stress was assessed using the 60-item Spielberger Police Stress Survey. Mean stress indices were computed by averaging the products of the stress rating (0-100) and frequency (events occurring in the previous year to the date of examination) for total and stress subscales including administrative pressure, physical/psychological threats, and lack of support. Active and passive coping scores were derived from the Brief COPE. Simple and multiple linear regression models were used in the analyses. Results: PTSD symptoms were positively associated with total stress (B1⁄40.016, p 75th percentiles). Relative risk (RR) and 95% confidence limits (CI) were calculated using generalized linear models adjusting for site, age, race, and diabetes. Interactions between pollutants and maternal asthma were explored. Results: Preeclampsia was not associated with air pollutants in nulliparas except for a protective effect of ozone observed for themid-range of exposure (25th -75th percentile) compared to the lowest quartile (reference), RR1⁄40.9907, 95% CI: 0.9858, 0.9956. Asthma was associated with a small increased risk (w1%) in all models. Significant interactions with maternal asthmawere observed for PM10 andNOx. Pollutant effect sizes for asthmatics were often greater but not significantly different from non-asthmatics. Conclusion: Air pollutants did not appear to increase preeclampsia beyond the risk associated with nulliparity. Asthma independently increased risk but without substantive interaction with exposure. P23. Disaster-Related Exposures and Health Effects Among U.S. Coast Guard Responders to Hurricanes Katrina and Rita: A Cross-Sectional Study Jennifer Rusiecki PhD, Dana L. Thomas MD, MPH, Ligong Chen MD, MS, Renee Funk DVM, MPH&TM, Jodi McKibben PhD, Melburn R. Dayton MPH. Uniformed Services University
