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HEAT-RELATED ILLNESS – Deaths in St. Louis, Missouri, residents, by day,
June and July, 1978, 1979, and 1980
During the summer of 1980, record-breaking high temperatures occurred in much of the United States, especially in southern and midwestern states. Nationwide, estimates of the number of deaths due to the heat have ranged from 1,265 to as high as 1,800.
The cities of St. Louis and Kansas City, Missouri, were particularly severely affected. A total of 279 deaths attributed by physicians to the heat were counted in these 2 cities alone. Another 505 persons survived heat-related illness severe enough to require hospitalization.
Epidemiologic investigation undertaken in the 2 cities included a review of the demographic characteristics of 208 heatstroke cases and a case-control study of 156 of these cases. Heatstroke rates for persons 65 years or older were 12 to 13 times the rates for the remainder of the population. Low socioeconomic status and race other-than-white were characteristics also associated with increased rates of heatstroke. Biologic or medical conditions which were associated with heatstroke included inability to care for oneself, alcoholism, and the use of certain antipsychotic drugs (phenothiazines, butyrophenones, and thioxanthenes). Heatstroke tended to occur among residents of homes that lacked air conditioning or were surrounded by only a sparse growth of trees and shrubbery and among residents of the higher floors of multistory buildings. Reducing activity, spending more time in air-conditioned places (independent of whether or not there was a home air conditioner), and taking extra liquids appeared to be effective preventive measures.
LEAD POISONING – Number of children screened in childhood lead-based paint
poisoning prevention projects by quarter, 1977-1980
In 1980, 63 programs reported screening 512,504 children. Of those screened, 25,293 (4.9%) were identified as having lead toxicity. The definition of lead toxicity is a blood lead >30 mg/dl with an erythrocyte protoporphyrin (EP) >50 mg/dl. All children ages 1-5 should be screened at least annually. Although the screening rate for this age group has increased, this rate in 1980 was only 3,275/100,000 which was sig. nificantly below the desired level. The rate of lead toxicity among or in the screened population was 4,935/100,000. Using the estimated population of ages 1-5 in the United States, the prevalence of lead toxicity is 162/100,000. This clearly underestimates the extent of the problem, since screening data are only reported from 63 communities in the United States.
The seasonal fluctuation shown in screening and lead toxicity is probably due to the intensive screening efforts by all programs during warmer weather. The EP test also identifies children with iron deficiency. During 1980, 20,063 children (3.9% of children screened) were identified as iron deficient.
Although lead is a pervasive contaminant in the environment, epidemiologic investigations indicate that lead-based paint remains the most common high-dose lead source for children with lead toxicity.
LEAD POISONING - Number of children screened and found to have lead toxicity in childhood
lead-based paint poisoning prevention programs, United States, 1972-1980
Screening Class II and Classes 111 & IV defined in CDC Statement, "Preventing Lead Poisoning in Young children," April 1978. ? Reporting program not receiving lead poisoning prevention grant support as of end of fiscal year. Estimated.
PNEUMONIA-INFLUENZA – Observed and expected ratio of deaths attributed to pneumonia and influenza
in 121 U.S. cities, as determined by the time series method, September 1979-August 1981
*FORECASTS ARE MADE AT 4-WEEK INTERVALS EXCEPT DURING EPIDEMIC PERIODS
Every four weeks throughout the year the expected ratio of pneumonia and influenza (P&I) deaths to total deaths from all causes-in the absence of influenza epidemics-is forecast by the time series analysis of past nonepidemic mortality data to monitor mortality attributed to influenza activity. Large increases beyond the expected ratio of P&l deaths are usually associated with influenza A epidemics. This surveillance method is based on data from 121 urban centers, most of whose populations exceed 100,000 and whose total populations constitute approximately 26% of the U.S. population. These ratios represent not only an index of the national mortality attributable to P&I, but provide a readily available indicator of any increases associated with influenza. The following pages depict the total national mortality attributable to P&T based on final mortality data reported by the National Center for Health Statistics, with expected numbers being generated using time series analysis.
The predominant influenza viruses causing illness in the United States during 198081 were influenza A (H3N2) strains, generally closely related to A/Bangkok/1/79. Although influenza A (H1N1) and influenza B were isolated from several states, few outbreaks were reported to have been caused by influenza A (H1N1), and no outbreaks were reported for influenza B. Morbidity reports of influenza-like illness were received from schools, nursing homes, and industries. Reported deaths from 121 cities were elevated for a 13-week period beginning December 13, 1980.