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PubMed2005

Costs and savings associated with community water fluoridation programs in Colorado.

INTRODUCTION: Local, state, and national health policy makers require information on the economic burden of oral disease and the cost-effectiveness of oral health programs to set policies and allocate resources. In this study, we estimate the cost savings associated with community water fluoridation programs (CWFPs) in Colorado and potential cost savings if Colorado communities without fluoridation programs or naturally high fluoride levels were to implement CWFPs. METHODS: We developed an economic model to compare the costs associated with CWFPs with treatment savings achieved through averted tooth decay. Treatment savings included those associated with direct medical costs and indirect nonmedical costs (i.e., patient time spent on dental visit). We estimated program costs and treatment savings for each water system in Colorado in 2003 dollars. We obtained parameter estimates from published studies, national surveys, and other sources. We calculated net costs for Colorado water systems with existing CWFPs and potential net costs for systems without CWFPs. The analysis includes data for 172 public water systems in Colorado that serve populations of 1000 individuals or more. We used second-order Monte Carlo simulations to evaluate the inherent uncertainty of the model assumptions on the results and report the 95% credible range from the simulation model. RESULTS: We estimated that Colorado CWFPs were associated with annual savings of 148.9 million dollars (credible range, 115.1 million dollars to 187.2 million dollars) in 2003, or an average of 60.78 dollars per person (credible range, 46.97 dollars dollars to 76.41 dollars). We estimated that Colorado would save an additional 46.6 million dollars (credible range, 36.0 dollars to 58.6 dollars million) annually if CWFPs were implemented in the 52 water systems without such programs and for which fluoridation is recommended. CONCLUSION: Colorado realizes significant annual savings from CWFPs; additional savings and reductions in morbidity could be achieved if fluoridation programs were implemented in other areas.

Colorado↗
PubMed2005

Chronic toxicity of un-ionized ammonia to early life-stages of endangered Colorado pikeminnow (Ptychocheilus lucius) and razorback sucker (Xyrauchen texanus) compared to the surrogate fathead minnow (Pimephales promelas).

Ammonia-contaminated groundwater enters the Upper Colorado River from beneath the abandoned Moab Uranium Mill Tailings Pile near Moab, Utah. This reach of the Upper Colorado River was designated as critical habitat for four endangered fish species because it is one of the few existing areas with known spawning and rearing habitats. Un-ionized ammonia (NH3) concentrations frequently exceed 1.00 mg/L in backwaters adjacent to the tailings pile, which exceeds the Utah 30-d average chronic water quality criterion for un-ionized ammonia (0.07 mg/L NH3; temperature 20 degrees C; pH 8.2) by a factor of more than 10. However, there is little published information regarding the sensitivity of endangered fishes to ammonia. We conducted 28-d static renewal studies with post-swim-up larvae to determine the relative sensitivity of Colorado pikeminnow (Ptychocheilus lucius), razorback sucker (Xyrauchen texanus), and the standard surrogate fathead minnow (Pimephales promelas) to NH3. Chronic values (ChVs) for mortality and growth were determined as the geometric mean of the no observed effect concentration and the lowest observed effect concentration based on analysis of variance. The ChVs for growth of fathead minnow, Colorado pikeminnow, and razorback sucker were 0.43, 0.40, and 0.67 mg/L NH3, respectively. The ChVs for mortality of fathead minnow, Colorado pikeminnow, and razorback sucker were 0.43, 0.70, and 0.67 mg/L NH3, respectively. Therefore, the ChVs for mortality and growth were similar for fathead minnow and razorback sucker; however, the ChV for growth was lower than the ChV for mortality for Colorado pikeminnow. Maximum likelihood regression was used to calculate 28-d lethal concentrations (LCx) for each species. The 28-d LC50, LC20, and LC1 values for fathead minnow were 0.69, 0.42, and 0.13 mg/L NH3, respectively. The 28-d LC50, LC20, and LC1 values for Colorado pikeminnow were 0.76, 0.61, and 0.38 mg/L NH3, respectively. The 28-d LC50, LC20, and LC1 values for razorback sucker were 0.54, 0.38, and 0.25 mg/L NH3, respectively. The fathead minnow, Colorado pikeminnow, and razorback sucker are relatively similar in sensitivity and rank at the 35th, 49th, and 31st percentiles, respectively, of the theoretical chronic fish sensitivity distributions for NH3. The existing water quality criteria for NH3, if met by remediation activities at the Moab site, would be protective of these endangered fishes even if fish sensitivity is based on the conservative LC1 value.

Ammonia↗
PubMed1999

Physician Health Research Conference (Estes Park, Colorado--September 15-17, 1996): progress report one year later.

The 1996 Physician Health Research Conference was the first conference to focus exclusively on research issues and methods for impaired physicians. The conference was initiated by James Shore, M.D., professor and chairman of the Department of Psychiatry in the School of Medicine at the University of Colorado Health Sciences Center and superintendent of the Colorado Psychiatric Hospital, and Stephen Dilts, M.D., Ph.D., medical director of the Colorado Physician Health Program and clinical professor of psychiatry at the University of Colorado Health Sciences Center. Forty participants represented a wide range of national organizations. The conference was supported by contributions from the American Medical Association, American Psychiatric Association, Colorado Physician Health Program, Colorado Physician Insurance Program, and the Department of Psychiatry and Colorado Psychiatric Hospital at the Health Sciences Center. In addition, the conference was cosponsored by the American Academy of Addiction Psychiatry, the American Society of Addiction Medicine, and the Federation of State Physician Health Programs. This paper summarizes the formal presentations of the conference.

Adult↗
PubMed1999

Population genetics and phylogenetic analysis of Colorado Borrelia burgdorferi.

Borrelia burgdorferi is transmitted in an enzootic cycle in Colorado between the tick Ixodes spinipalpis and the woodrat Neotoma mexicana. The genetic relationship of Colorado isolates to other B. burgdorferi isolates is unknown nor have relationships among various Colorado isolates been determined. Portions of the flagellin (fla), 66-kD protein, and outer surface protein A (ospA) genes were amplified from 71 Colorado isolates, screened for genetic variability using single strand conformation polymorphism analysis, and unique alleles were sequenced. Colorado isolates were most similar to tick isolates from California and New York isolate 25015. Genetic distances among Colorado ospA sequences were the same or higher than distances among other isolates whereas distances among fla sequences tended to be the same or lower. The index of association (I(A)) was calculated among all loci as a measure of clonality. The I(A) among Colorado isolates was similar to I(A) previously estimated among other United States isolates.

Amino Acid Sequence↗
PubMed2002

Comparisons of lung tumour mortality risk in the Japanese A-bomb survivors and in the Colorado Plateau uranium miners: support for the ICRP lung model.

PURPOSES: To estimate the ratio of risks for exposure to radon progeny relative to low-LET radiation based on human lung cancer data, taking account of possible time and age variations in radiation-induced lung cancer risk. MATERIALS AND METHODS: Fitting two sorts of time- and age-adjusted relative risk models to a case-control dataset nested within the Colorado Plateau uranium miner cohort and to the Japanese atomic (A)-bomb survivor mortality data. RESULTS: If all A-bomb survivors are compared with the Colorado data, there are statistically significant (two-sided p < 0.05) differences between the two datasets in the pattern of the variation of relative risk with time after exposure, age at exposure and attained age. The excess relative risk decreases much faster with time, age at exposure and attained age in the Colorado uranium miners than in the Japanese A-bomb survivors. If only male A-bomb survivors are compared with the Colorado data, there are no longer statistically significant differences between the two datasets in the pattern of variation of relative risk with time after exposure, age at exposure or attained age. There are no statistically significant differences between the male and female A-bomb survivors in the speed of reduction of relative risk with time after exposure, age at exposure or attained age, although there are indications of rather faster reduction of relative risk with time and age among male survivors than among female survivors. The implicit risk conversion factor for exposure to radon progeny relative to the A-bomb radiation in the male survivors is 1.8 x 10(-2) Sv WLM(-1) (95% CI 6.1 x10(-3), 1.1 x 10(-1)) using a model with exponential adjustments for the effects of radiation for time since exposure and age at exposure, and 1.9 x 10(-2) Sv WLM(-1) (95% CI 6.2 x 10(-3), 1.6 x 10(-1)) using a model with adjustments for the effects of radiation proportional to powers of time since exposure and attained age. Estimates of the risk conversion factor calculated using variant assumptions as to the definition of lung cancer in the Colorado data, or by excluding miners for whom exposure estimates may be less reliable, are very similar. The absence of information on cigarette smoking in the Japanese A-bomb survivors, and the possibility that this may confound the time trends in radiation-induced lung cancer risk in that cohort, imply that these findings should be interpreted with caution. CONCLUSIONS: There are no statistically significant differences between the male A-bomb survivors data and the Colorado miner data in the pattern of variation of relative risk with time after exposure and age at exposure. The risk conversion factor is very close to the value suggested by the latest ICRP lung model, albeit with substantial uncertainties.

Adult↗