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PubMed1997

An update of mortality from all causes among white uranium miners from the Colorado Plateau Study Group.

To place previously recognized mortality risks into the context of the total mortality from all causes, an updated retrospective cohort mortality study was conducted on 3,238 white males from the US Public Health Service cohort of Colorado Plateau uranium miners. Vital status was followed from 1960 through 1990. Life-table analyses used combined New Mexico, Arizona, Utah, and Colorado mortality rates for external comparison and mortality risks within the lowest radon-exposure or duration-employed category for internal comparison. Significantly elevated SMRs were found for pneumoconioses (SMR = 24.1, 95% CI 16.0-33.7), lung cancer (SMR = 5.8, 95% CI 5.2-6.4), tuberculosis (SMR = 3.7, 95% CI 1.9-6.2), chronic obstructive respiratory diseases (SMR = 2.8, 95% CI 2.2-3.5), emphysema (SMR = 2.5, 95% CI 1.9-3.2), benign and unspecified tumors (SMR = 2.4, 95% CI 1.0-4.6), and diseases of the blood and blood-forming organs (SMR = 2.4, 95% CI 1.0-5.0). No significantly lowered SMRs were found for any disease. For lung cancer and pneumoconioses standardized rate ratios increased with increasing exposure to radon progeny or duration of employment. Most findings from this update are consistent with previous studies. Not observed were previously elevated SMRs for chronic nephritis and for acute alcoholism. New findings observed were elevated SMRs for benign and unspecified tumors and for diseases of the blood and blood-forming organs. The most important long-term mortality risks for the white uranium-miners continue to be lung cancer and pneumoconioses, for which SMRs remain significantly elevated after a mean period of 22.4 years since last uranium mining.

Cause of Death↗
PubMed1999

Back pain and agricultural work among farmers: an analysis of the Colorado Farm Family Health and Hazard Surveillance Survey.

BACKGROUND: Back pain is the most prevalent occupational health problem experienced by much of the world's workforce. However, agricultural work-related back pain occurring among US farmers working on small operations or family farms is usually not included in surveillance. With data collected by Colorado Farm Family Health and Hazard Surveillance Survey, this study reports characteristics of and risk factors for back pain among adult farmers living in eight Colorado counties. METHODS: A stratified probability sample of 500 farms was selected in proportion to the number of farms in study areas. During the 4-year period from 1993 through 1996, 458 farms were enrolled in the study and 759 farmers were interviewed using a questionnaire. Information on self-reported back pain and potential risk factors among 742 white farmers was evaluated and reported here. RESULTS: A total of 194 farmers (26.2%) reported to have had at least one episode of back pain lasting for 1 week or more. Males had a slightly higher prevalence of back pain than females (28.6% vs. 22.5%) and the lower back was the predominantly affected part of body among both males and females. In 45.4% of males and 43.9% of females back pain was brought on by repeated activities. Males' activities at work were more likely to cause back pain while females' activities at home were more likely to cause back pain. Three factors were found to be significantly associated with back pain: being depressed (odds ratio (OR) = 3.68, 95% confidence interval (CI) = 2.23-6.09), farming/ranching as main activities (OR = 1.66, CI = 1.17-2.36), and worked in agriculture for 10 to 29 years (OR = 1.62, CI = 1.14-2.30). CONCLUSIONS: Our analyses indicate that back pain is an occupational health problem among farmers on small operations or family farms and that back pain affected males and females differently. The finding of significant positive associations between depression, farming activities, and back pain warrants further attention.

Adult↗
PubMed1984

Isolation of Eyach virus (Reoviridae, Colorado tick fever group) from Ixodes ricinus and I. ventalloi ticks in France.

During the spring of 1981, two strains of an identical virus were isolated in Mayenne, France, from Ixodes ricinus L. and Ixodes ventalloi Gil Collado, parasiting a wild rabbit (Oryctolagus cuniculus L.). Virological and serological results indicated that these strains belong to the Colorado tick fever serogroup and are indistinguishable from Eyach virus, a tick-borne virus previously described from West Germany. Study of dsRNA PAGE profiles confirmed these conclusions. The morphology and morphogenesis of French isolates were studied in infected suckling mouse brains showing some peculiar features previously described for Colorado tick fever virus. The importance of the isolation of Eyach virus in France is discussed.

Animals↗
PubMed2003

Fitting the two-stage model of carcinogenesis to nested case-control data on the Colorado Plateau uranium miners: dependence on data assumptions.

This paper investigates some problems with the Colorado Plateau uranium miners cohort when fitting the mechanistic model of carcinogenesis of Moolgavkar et al. (MVK model) to nested case-control data for lung cancers. The influence of data for hard rock mining and work histories on the model fitting is examined and found to be highly influential. The question of selecting the most appropriate number of controls per case is also considered. Analyses were carried out assuming that the hard rock mining exposure occurred prior to all other work histories and that miners received no exposure between work histories. The use of less than 15 controls per case was found to seriously restrict the quality of fit of the models. The best fitting, most reliable model contained linear effects of radon exposure on the first mutation rate, the rate of differentiation, and the rate of death of the intermediate cells. An effect of smoking on the growth of the intermediate cells was also included in the model. It is concluded that owing to the complexity of the MVK model and the limited amount of information in this dataset, the reliability of the Colorado Plateau dataset for fitting this type of model, particularly in a case-control format, is questionable.

Case-Control Studies↗
PubMed2006

Realigning clinical and economic incentives to support depression management within a medicaid population: the Colorado access experience.

The authors describe their experiences in developing an economically sustainable depression care management program within Colorado Access, a non-profit Medicaid health plan. They describe high rates of mental health issues, medical comorbidities, and psychosocial barriers to care within the plan's Medicaid population. They discuss how the company redirected resources to incorporate depression care management into an intensive care management program focused on high-cost members with multiple chronic medical conditions. This strategy allowed Colorado Access to cost effectively care manage a targeted group of high-cost Medicaid recipients across multiple primary care physician (PCP) practices without requiring changes in provider workflow.

Colorado↗
PubMed2005

The effects of urban areas on benthic macroinvertebrates in two Colorado Plains rivers.

Water demands in arid and semi-arid areas, coupled with increased human populations and concomitant changes in land use, can greatly alter aquatic ecosystems. A good example of this type of system occurs along the eastern slope of the Colorado Rocky Mountains, U.S.A. Long-term macroinvertebrate metric data from the Big Thompson and Cache la Poudre Rivers, Colorado, were collected at one site above, and three sites in and downstream from urban areas. These data were compared both with regional reference and single reference sites in the respective rivers. Using the surrogate variables of potential urban impact (population and housing units), and the environmental gradient represented primarily by chemical factors, it was determined that there was an effect of urban land use that was reflected in the macroinvertebrate assemblages in both rivers. The most robust results were usually seen when regional reference data were used. However, even using only the upstream reference site in either river indicated some negative impacts from the urban areas. The long-term data, particularly in the Cache la Poudre River, showed that water quality has not been getting worse and there is some evidence of a slight improvement in downstream reaches, even with increased urban development.

Animals↗
PubMed1995

Universal newborn hearing screening--the Colorado story.

The Colorado State Public Health Department inaugurated a state-wide program of universal newborn hearing screening in 1992. A preliminary report covers the screening of 14,494 infants. 95% passed the screening tests, 5% failed. Of the failures, 6% were found with confirmed hearing losses. The average cost per test was $25.00. Research from the University of Colorado confirms that children receiving intervention by 3 months perform significantly higher at 40 months than those identified later.

Awards and Prizes↗
PubMed1985

Pharmacological aspects of selected herbs employed in Hispanic folk medicine in the San Luis Valley of Colorado, USA: I. Ligusticum porteri (osha) and Matricaria chamomilla (manzanilla).

Interviews with Hispanic families in the San Luis Valley of Colorado delineated several medicinal herbs that are popular in Hispanic folk medicine, including Ligusticum porteri (osha) and Matricaria chamomilla (manzanilla). A search of the scientific literature reveals that related species of Ligusticum and Matricaria chamomilla contain compounds that possess significant pharmacologic activity. This combined information is now being used as a basis for further investigation at the University of Colorado School of Pharmacy in an effort to detect pharmacologic activity in osha and manzanilla preparations.

Colorado↗
PubMed1988

Pharmacological aspects of selected herbs employed in hispanic folk medicine in the San Luis Valley of Colorado, USA: II. Asclepias asperula (inmortal) and Achillea lanulosa (plumajillo).

Interviews with Hispanic families in the San Luis Valley of Colorado revealed that several herbs, including Asclepias asperula (inmortal) and Achillea lanulosa (plumajillo), are popular ingredients in Hispanic folk medicine preparations. A review of the scientific literature indicates that related species of Asclepias asperula and Achillea lanulosa contain pharmacologically active compounds; these data serve as the focal point for continuing ethnopharmacologic investigation at the University of Colorado School of Pharmacy.

Alkaloids↗
PubMed2006

Compassion fatigue, burnout, and compassion satisfaction among Colorado child protection workers.

OBJECTIVE: The goal of this study was to understand better the risk of compassion fatigue (the trauma suffered by the helping professional) and burnout (emotional exhaustion, depersonalization, and reduced sense of personal accomplishment), and the potential for compassion satisfaction (the fulfillment from helping others and positive collegial relationships) among Colorado county child protection staff using the Compassion Satisfaction/Fatigue Self-Test [Figley, C. R., & Stamm, B. H. (1996). Psychometric review of Compassion Fatigue Self-Test. In B. H. Stamm (Ed.), Measurement of stress, trauma, and adaptation (pp. 127-130). Lutherville, MD: Sidran Press]. An additional goal was to test the relationship of these three constructs to each other. METHOD: A self-report instrument developed by Stamm and Figley was used to measure the risk of compassion fatigue and burnout and the potential for compassion satisfaction among 363 child protection staff participating in a secondary trauma training seminar. RESULTS: Participants were significantly more likely to have high risk of compassion fatigue, extremely low risk of burnout, and good potential for compassion satisfaction. Participants with high compassion satisfaction had lower levels of compassion fatigue (p=.000; mean=35.73 high compassion satisfaction group, mean=43.56 low group) and lower levels of burnout (p=.000; mean=32.99 high compassion satisfaction group, mean=41.69 low group). CONCLUSION: Approximately 50% of Colorado county child protection staff suffered from "high" or "very high" levels of compassion fatigue. The risk of burnout was considerably lower. More than 70% of staff expressed a "high" or "good" potential for compassion satisfaction. We believe compassion satisfaction may help mitigate the effects of burnout.

Adult↗
PubMed2005

A review of horse-related injuries in a rural Colorado hospital: implications for outreach education.

INTRODUCTION: The literature contains many studies on the types of injuries sustained in horseback riding incidents. Most advocate the use of equestrian helmets to prevent head trauma. However, information is limited on other specific prevention strategies. METHODS: A 4-year, retrospective, and prospective review of medical records pertaining to horse-related injuries in a southwestern Colorado hospital yielded a sample of 85 patients who had been injured while riding or tending to horses. In addition to the record review, patients were interviewed during ED discharge, inpatient treatment, or in a follow-up telephone call to determine the types, causes, and mechanisms of injuries, and the circumstances surrounding the incidents. Operators of 7 guest ranches and outfitters within a 30-mile radius of the hospital plus 3 ranches in Oklahoma and an additional ranch in Colorado were contacted with the study results and suggestions for injury prevention. RESULTS: Patients ranged in age from 2 to 77 years. Fifty-five percent were inexperienced or beginner riders, 10% were novice riders, and 35% were experienced riders. Seventy percent were injured during recreational pursuits. The average Injury Severity Score for all patients was 8.5, with an average length of stay of 72 hours. Injuries were related to rider inexperience, equipment problems, or unpredictable horse behavior. CONCLUSION: Thirty-eight percent of the horse-related injuries were preventable. All operators of the guest ranches and outfitters were receptive to hearing or reading the study information. It is hoped that raising awareness and providing suggestions related to the screening of riders, prevention of injuries, and safety measures may decrease the numbers of horse-related injuries.

Adolescent↗
PubMed2007

Prevalence of Coxiella burnetii DNA in vaginal and uterine samples from healthy cats of north-central Colorado.

Q fever is a worldwide zoonotic disease caused by Coxiella burnetii. Although traditionally associated with livestock exposure, human infection has also been documented from contact with parturient cats. The goal of this study was to determine the prevalence of C burnetii DNA in uterine and vaginal tissues from healthy client-owned and shelter cats of north-central Colorado using polymerase chain reaction assay. Coxiella burnetii was not amplified from vaginal samples of any cat or uterine biopsies of shelter cats. However, a nucleotide sequence with 99% homology to C burnetii DNA was amplified from four of 47 (8.5%) uterine biopsies of client-owned cats. This study demonstrates that clinically normal cats in north-central Colorado can harbor C burnetii. Care should be taken when attending to parturient cats and contact with parturient secretions should be avoided. Additional studies are indicated to further characterize the role of cats in zoonotic Q fever.

Animals↗
PubMed2006

Influenza vaccine effectiveness among 50-64-year-old persons during a season of poor antigenic match between vaccine and circulating influenza virus strains: Colorado, United States, 2003-2004.

During the 2003-2004 influenza season, we conducted a case-control study of influenza vaccine effectiveness (VE) among Colorado residents aged 50-64 years. Cases (n=330) were identified from laboratory-confirmed influenza reports to the Colorado Department of Public Health and Environment (CDPHE). Controls (n=1055) were recruited by random-digit dial telephone survey. VE was 60% (43-72%) and 48% (21-66%) among those without and with high-risk medical conditions, respectively. VE was 90% (68-97%) and 36% (0-63%) against influenza-related hospitalization for persons without and with high-risk conditions, respectively.

Antigenic Variation↗
PubMed2003

Deaths associated with snow skiing in Colorado 1980-1981 to 2000-2001 ski seasons.

OBJECTIVES: To investigate the trend and injury patterns of deaths associated with snow skiing in Colorado between 1980 and 2001. METHODS: Death certificates were searched electronically and reviewed manually. Total skier ticket sales were used to calculate death rates. Types of injuries and characteristics of those who died were investigated. RESULTS: A total of 274 skier deaths occurred between 1980 and 2001 in Colorado. Death rates ranged from 0.53 to 1.88 per million skier visits. The majority of deaths were among males (>81%). Ages ranged from 7 to 77 years with an average of 32 years. The greatest number of deaths associated with downhill skiing (76 deaths) occurred between 10:00 a.m. and 2:00 p.m. while the greatest number of deaths associated with cross-country skiing happened between 2:00 and 6:00 p.m. About 65% of deaths associated with downhill skiing (133 cases) died of traumatic injuries resulting from collisions. CONCLUSIONS: A slight increase in the rate of ski-related deaths was observed. The role of collisions in ski-related deaths warrants further investigation to reduce the risk of this activity for all skiers. Further work is needed to determine the efficacy of helmet use to reduce the risk of head injuries in the skiing population.

Accidental Falls↗
PubMed1980

An epidemic of Reye syndrome associated with influenza A (H1N1) in Colorado.

An unusual cluster of Reye syndrome was associated with an outbreak of influenza A (H1N1) infections in the state of Colorado. Two of the 16 affected children had had prior episodes of Reye syndrome following respiratory infections, and one had had transverse myelitis following varicella. A serologic study of patients treated at a children's hospital and serum specimens submitted to the state health department revealed that approximately 59% of children in Colorado had been infected with the H1N1 strain of influenza A over a two-year period. Based upon this serologic survey, the minimum and maximum rates of Reye syndrome associated with H1N1 infections were calculated to be 2.5 and 4.3 cases per 100,000 H1N1 infections, respectively. A retrospective analysis of admissions to four referral hospitals in Denver failed to reveal any unusual clustering of Reye syndrome with outbreaks of influenza A H3N2 infections during 1975-1978. The reason for an association between Reye syndrome and the H1N1 strain but not the H3N2 strains of influenza A remains unclear.

Adolescent↗
PubMed1995

A cluster analysis of detected and substantiated child maltreatment incidents in rural Colorado.

This paper reports the results of a cluster analysis of the incidents of detected and substantiated child maltreatment in 31 rural Colorado counties during the 5-year period (1986-1990). Mapping and statistical techniques employed revealed time-space clustering in the occurrence of child abuse and neglect in sparsely settled rural areas of the state. The study examined temporal-geographic patterns among all 830 confirmed incidents in the Colorado Child Abuse and Neglect Registry for counties of less than 10,000 population. These findings suggest that a first incident of abuse or neglect serves as a sentinel event, predicting a period of more frequent receipt and substantiation of maltreatment cases by child protection professionals in the county or community of occurrence. Clustering was apparent using 3-, 7-, 14-, 30-, and 60-day intervals of time; a scheme endorsed by the Centers for Disease Control for national study of the epidemicity of adolescent suicide. An agenda is proposed to review the appropriateness and adequacy of child protection policies and protocols in view of this phenomenon, and to pursue additional related research objectives.

Child↗
PubMed2004

The effects of atmospheric nitrogen deposition in the Rocky Mountains of Colorado and southern Wyoming, USA-a critical review.

The Rocky Mountains of Colorado and southern Wyoming receive atmospheric nitrogen (N) deposition that ranges from 2 to 7 kg ha(-1) yr(-1), and some previous research indicates pronounced ecosystem effects at the highest rates of deposition. This paper provides a critical review of previously published studies on the effects of atmospheric N deposition in the region. Plant community changes have been demonstrated through N fertilization studies, however, N limitation is still widely reported in alpine tundra and subalpine forests of the Front Range, and sensitivity to changes in snow cover alone indicate the importance of climate sensitivity in these ecosystems. Retention of N in atmospheric wet deposition is <50% in some watersheds east of the Continental Divide, which reflects low biomass and a short growing season relative to the timing and N load in deposition. Regional upward temporal trends in surface water NO(3)(-) concentrations have not been demonstrated, and future trend analyses must consider the role of climate as well as N deposition. Relatively high rates of atmospheric N deposition east of the Divide may have altered nutrient limitation of phytoplankton, species composition of diatoms, and amphibian populations, but most of these effects have been inconclusive to date, and additional studies are needed to confirm hypothesized cause and effect relations. Projected future population growth and energy use in Colorado and the west increase the likelihood that the subtle effects of atmospheric N deposition now evident in the Front Range will become more pronounced and widespread in the future.

Air Pollutants↗
PubMed2003

Alcohol consumption patterns and work-related injuries among Colorado farm residents.

BACKGROUND: Few studies have assessed the relationship between alcohol consumption patterns among farm populations and work-related injuries. The purpose of this study was to assess the role of alcohol consumption patterns on farmwork-related injuries. METHODS: Prospective cohort study of Colorado farm residents, 1993 to 1995. Self-reported injuries, alcohol consumption, and demographics were assessed over 3 years. A stratified probability sample of farms was selected to include approximately 2.6% of Colorado farm residences with a farm operator living on the property. A total of 485 farms, including 872 individuals, were recruited in the initial cohort. In the second year, 746 individuals were re-interviewed, and in the third year, 653 of the original group participated. RESULTS: Injuries during the study period were assessed in relationship to alcohol consumption. During the 3 years, 150 farm residents reported a total of 215 farmwork-related injuries. An increased risk of injury was associated with increased alcohol consumption. Compared to abstainers, farm residents who drank more frequently had higher farmwork injury incidence rates (3.09 and 3.35 injuries per 10,000 person-days of observation versus 1.94 injuries per 10,000). Farm residents who typically drank three or more drinks per day had a farmwork injury rate of 3.62 per 10,000 person-days (95% confidence interval [CI]=2.38-4.85). Farm residents who typically drank one to two drinks per day had a farmwork-related injury rate of 3.02 per 10,000 person-days (95% CI=2.44-3.60). In multivariate models, alcohol consumption frequency and quantity were significantly associated with farmwork-related injuries. CONCLUSIONS: Alcohol consumption should be considered in studies of agricultural injuries.

Accidents, Occupational↗