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1. Network Analysis of U.S. Non-Fatal Opioid-Involved Overdose Journeys, 2018-2023

Author

McCabe, Lucas H., Masuda, Naoki, Casillas, Shannon, Danneman, Nathan, Alic, Alen, and Law, Royal

Subjects
Computer Science - Social and Information Networks, Physics - Physics and Society
Abstract

We present a nation-wide network analysis of non-fatal opioid-involved overdose journeys in the United States. Leveraging a unique proprietary dataset of Emergency Medical Services incidents, we construct a journey-to-overdose geospatial network capturing nearly half a million opioid-involved overdose events spanning 2018-2023. We analyze the structure and sociological profiles of the nodes, which are counties or their equivalents, characterize the distribution of overdose journey lengths, and investigate changes in the journey network between 2018 and 2023. Our findings include that authority and hub nodes identified by the HITS algorithm tend to be located in urban areas and involved in overdose journeys with particularly long geographical distances.

Published
2024

15. Harmful Algal Bloom Exposures Self-reported to Poison Centers in the United States, May–October 2019.

Author

Lavery, Amy M., Kieszak, Stephanie M., Law, Royal, Bronstein, Alvin C., Funk, Alexandra R., Banerji, Shireen, Brown, Kaitlyn, Sollee, Dawn R., and Backer, Lorraine C.

Subjects
POISONING, SELF-evaluation, PUBLIC health, POISON control centers, DESCRIPTIVE statistics, RESEARCH funding, ALGAE, ENVIRONMENTAL exposure
Abstract

The National Poison Data System (NPDS) comprises self-reported information from people who call US poison center hotlines. NPDS data have proven to be important in identifying emerging public health threats. We used NPDS to examine records of people who had self-reported exposure to harmful algal blooms (HABs). Participating poison centers then contacted people who had called their centers from May through October 2019 about their HAB exposure to ask about exposure route, symptoms, health care follow-up, and awareness of possible risks of exposure. Of 55 callers who agreed to participate, 47 (85%) reported exposure to HABs while swimming or bathing in HAB-contaminated water. Nine callers reported health symptoms from being near waters contaminated with HABs, suggesting potential exposure via aerosolized toxins. Symptoms varied by the reported routes of exposure; the most commonly reported symptoms were gastrointestinal and respiratory. More public and health care provider education and outreach are needed to improve the understanding of HAB-related risks, to address ways to prevent HAB-related illnesses, and to describe appropriate support when exposures occur. [ABSTRACT FROM AUTHOR]

Published
2023
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25. Emergency Department Visits for Suspected Suicide Attempts Among Persons Aged 12-25 Years Before and During the COVID-19 Pandemic--United States, January 2019-May 2021

Author

Yard, Ellen, Radhakrishnan, Lakshmi, Ballesteros, Michael F., Sheppard, Michael, Gates, Abigail, Stein, Zachary, Hartnett, Kathleen, Kite-Powell, Aaron, Rodgers, Loren, Adjemian, Jennifer, Idaikkadar, Nimi, Ivey-Stephenson, Asha, Martinez, Pedro, Law, Royal, and Stone, Deborah M.

Subjects
Suicidal behavior -- Reports, Hospitals -- Emergency service, Mental health -- Reports, Teenagers -- Reports, Youth -- Reports, Health
Abstract

On June, 11, 2021, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). Beginning in March 2020, the COVID-19 pandemic and response, which included physical [...]

Published
2021

30. Trends in US Emergency Department Visits for Mental Health, Overdose, and Violence Outcomes Before and During the COVID-19 Pandemic

Author

Holland, Kristin M., primary, Jones, Christopher, additional, Vivolo-Kantor, Alana M., additional, Idaikkadar, Nimi, additional, Zwald, Marissa, additional, Hoots, Brooke, additional, Yard, Ellen, additional, D’Inverno, Ashley, additional, Swedo, Elizabeth, additional, Chen, May S., additional, Petrosky, Emiko, additional, Board, Amy, additional, Martinez, Pedro, additional, Stone, Deborah M., additional, Law, Royal, additional, Coletta, Michael A., additional, Adjemian, Jennifer, additional, Thomas, Craig, additional, Puddy, Richard W., additional, Peacock, Georgina, additional, Dowling, Nicole F., additional, and Houry, Debra, additional

Published
2021
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31. Development of a Machine Learning Model Using Multiple, Heterogeneous Data Sources to Estimate Weekly US Suicide Fatalities

Author

Choi, Daejin, primary, Sumner, Steven A., additional, Holland, Kristin M., additional, Draper, John, additional, Murphy, Sean, additional, Bowen, Daniel A., additional, Zwald, Marissa, additional, Wang, Jing, additional, Law, Royal, additional, Taylor, Jordan, additional, Konjeti, Chaitanya, additional, and De Choudhury, Munmun, additional

Published
2020
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45. Surveillance for Radiation-Related Exposures Reported to the National Poison Data System

Author

Law, Royal K., Martin, Colleen, Bronstein, Alvin, Chang, Arthur, and Schier, Joshua

Subjects
radiation, Surveillance, ISDS 2012 Conference Abstracts, Poison center
Abstract

Objective To describe radiation-related exposures of potential public health significance reported to the National Poison Data System (NPDS). Introduction For radiological incidents, collecting surveillance data can identify radiation-related public health significant incidents quickly and enable public health officials to describe the characteristics of the affected population and the magnitude of the health impact which in turn can inform public health decision-making. A survey administered by the Council of State and Territorial Epidemiologists (CSTE) to state health departments in 2010 assessed the extent of state-level planning for surveillance of radiation-related exposures and incidents: 70%–84% of states reported minimal or no planning completed. One data source for surveillance of radiological exposures and illnesses is regional poison centers (PCs), who receive information requests and reported exposures from healthcare providers and the public. Since 2010, the Centers for Disease Control and Prevention (CDC) and the American Association of Poison Control Centers (AAPCC) have conducted ongoing surveillance for exposures to radiation and radioactive materials reported from all 57 United States (US) PCs to NPDS, a web-based, national PC reporting database and surveillance system. Methods We collaborated with the American Association of Poison Control Centers (AAPCC), Poisindex® and Thomson Reuters Healthcare to develop an improved coding system for tracking radiation-related exposures reported to US PCs during 2011 and trained PC staff on its usage. We reviewed NPDS data from 1 September 2010 – 30 June 2012 for reported exposures to pharmaceutical or nonpharmaceutical radionuclides; ionizing radiation; radiological or nuclear weapons; or X-ray, alpha, beta, gamma, or neutron radiation. CDC medical toxicology and epidemiology staff reviewed each reported exposure to determine whether it was of potential public health concern (e.g. exposures associated with an ongoing public health emergency, several reported exposures clustered in space and time). When further information was needed to classify the potential public health importance of a call, CDC and AAPCC staff contacted the regional PC where each call originated. When exposures were spatially and temporally clustered, we reviewed news stories in the public media for evidence of an associated radiation incident. Results Of 419 exposures reported during the study period, 25 were associated with a radiation-related incident. Of these, 4 were related to an exposure to x-ray radiation from an industrial radiography incident, 11 were related to a transportation accident involving potential contamination with radioactive material, and 10 were related to the Fukushima Daiichi Japan nuclear reactor disaster. Public health, hazardous materials, or hospital radiation safety staff were involved in responding to each of these events. We also identified 26 reported exposures associated with a regional radiation anti-terrorism exercise. The reported exposures were followed-up and removed from analysis once we determined they were part of the exercise. The remaining (n=368; 88%) were either requests for information, confirmed non-exposures, or exposures deemed unrelated or non-significant. Conclusions The capability to monitor self- or clinician-reported exposures to radiation and radioactive materials is available in NPDS for state and local public health use in collaboration with their regional PC and may improve public health capacity to identify and respond to radiological emergencies. Next steps include testing the system’s capability to accurately classify and rapidly respond to a cluster of calls to PCs reporting radiation exposures associated with a “dirty bomb” exercise during July, 2012.

Published
2013

46. Assessing the public health impact of using poison center data for public health surveillance.

Author

Wang, Alice, Law, Royal, Lyons, Rebecca, Choudhary, Ekta, Wolkin, Amy, and Schier, Joshua

Subjects
*POISON control centers, *POISONING, *PUBLIC health, *PATIENTS, *THERAPEUTICS
Abstract

Context: The National Poison Data System (NPDS) is a database and surveillance system for US poison centers (PCs) call data. The Centers for Disease Control and Prevention (CDC) and American Association of Poison Control Centers (AAPCC) use NPDS to identify incidents of potential public health significance. State health departments are notified by CDC of incidents identified by NPDS to be of potential public health significance. Our objective was to describe the public health impact of CDC’s notifications and the use of NPDS data for surveillance. Methods: We described how NPDS data informed three public health responses: the Deepwater Horizon incident, national exposures to laundry detergent pods, and national exposures to e-cigarettes. Additionally, we extracted survey results of state epidemiologists regarding NPDS incident notification follow-up from 1 January 2015 to 31 December 2016 to assess current public health application of NPDS data using Epi Info 7.2 and analyzed data using SAS 9.3. We assessed whether state health departments were aware of incidents before notification, what actions were taken, and whether CDC notifications contributed to actions. Discussion: NPDS data provided evidence for industry changes to improve laundry detergent pod containers safety and highlighted the need to regulate e-cigarette sale and manufacturing. NPDS data were used to improve situational awareness during the 2010 Deepwater Horizon oil spill. Of 59 health departments and PCs who responded to CDC notifications about anomalies (response rate = 49.2%), 27 (46%) reported no previous awareness of the incident, and 20 (34%) said that notifications contributed to public health action. Conclusions: Monitoring NPDS data for anomalies can identify emerging public health threats and provide evidence-based science to support public health action and policy changes. [ABSTRACT FROM AUTHOR]

Published
2018
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