Mass SARS-CoV-2 Testing in a Dormitory-Style Correctional Facility in Arkansas.

Objectives. To assess SARS-CoV-2 transmission within a correctional facility and recommend mitigation strategies.Methods. From April 29 to May 15, 2020, we established the point prevalence of COVID-19 among incarcerated persons and staff within a correctional facility in Arkansas. Participants provided respiratory specimens for SARS-CoV-2 testing and completed questionnaires on symptoms and factors associated with transmission.Results. Of 1647 incarcerated persons and 128 staff tested, 30.5% of incarcerated persons (range by housing unit = 0.0%-58.2%) and 2.3% of staff tested positive for SARS-CoV-2. Among those who tested positive and responded to symptom questions (431 incarcerated persons, 3 staff), 81.2% and 33.3% were asymptomatic, respectively. Most incarcerated persons (58.0%) reported wearing cloth face coverings 8 hours or less per day, and 63.3% reported close contact with someone other than their bunkmate.Conclusions. If testing remained limited to symptomatic individuals, fewer cases would have been detected or detection would have been delayed, allowing transmission to continue. Rapid implementation of mass testing and strict enforcement of infection prevention and control measures may be needed to mitigate spread of SARS-CoV-2 in this setting.

Public Health Response to COVID-19 Cases in Correctional and Detention Facilities - Louisiana, March-April 2020.

Correctional and detention facilities face unique challenges in the control of infectious diseases, including coronavirus disease 2019 (COVID-19) (1-3). Among >10 million annual admissions to U.S. jails, approximately 55% of detainees are released back into their communities each week (4); in addition, staff members at correctional and detention facilities are members of their local communities. Thus, high rates of COVID-19 in correctional and detention facilities also have the potential to influence broader community transmission. In March 2020, the Louisiana Department of Health (LDH) began implementing surveillance for COVID-19 among correctional and detention facilities in Louisiana and identified cases and outbreaks in many facilities. In response, LDH and CDC developed and deployed the COVID-19 Management Assessment and Response (CMAR) tool to guide technical assistance focused on infection prevention and control policies and case management with correctional and detention facilities. This report describes COVID-19 prevalence in correctional and detention facilities detected through surveillance and findings of the CMAR assessment. During March 25-April 22, 489 laboratory-confirmed COVID-19 cases, including 37 (7.6%) hospitalizations and 10 (2.0%) deaths among incarcerated or detained persons, and 253 cases, including 19 (7.5%) hospitalizations and four (1.6%) deaths among staff members were reported. During April 8-22, CMAR telephone-based assessments were conducted with 13 of 31 (42%) facilities with laboratory-confirmed cases and 11 of 113 (10%) facilities without known cases. Administrators had awareness and overall understanding of CDC guidance for prevention of transmission in these facilities but reported challenges in implementation, related to limited space to quarantine close contacts of COVID-19 patients and inability of incarcerated and detained persons to engage in social distancing, particularly in dormitory-style housing. CMAR was a useful tool that helped state and federal public health officials assist multiple correctional and detention facilities to better manage COVID-19 patients and guide control activities to prevent or mitigate transmission.

Federal Research Action Plan on Recycled Tire Crumb Used on Playing Fields: Tire Crumb Rubber Characterization and Exposure Characterization Study Overview.

As part of our continued effort to highlight innovative approaches to improve the health and environment of communities, the Journal is pleased to publish a bimonthly column from the Agency for Toxic Substances and Disease Registry (ATSDR) at the Centers for Disease Control and Prevention (CDC). ATSDR serves the public by using the best science, taking responsive public health actions, and providing trusted health information to prevent harmful exposures and diseases related to toxic substances. The purpose of this column is to inform readers of ATSDR's activities and initiatives to better understand the relationship between exposure to hazardous substances in the environment, its impact on human health, and how to protect public health. The conclusions of this column are those of the author(s) and do not necessarily represent the official position of ATSDR or CDC. Kelsey Benson is an environmental epidemiologist at ATSDR. Elizabeth Irvin-Barnwell currently serves as the acting chief of the Environmental Epidemiology Branch at ATSDR. Angela Ragin-Wilson currently serves as the acting deputy director of the Division of Toxicology and Human Health Sciences at ATSDR. Pat Breysse is the director of CDC's National Center for Environmental Health/ATSDR.

Polychlorinated biphenyls, indicators of thyroid function and thyroid autoantibodies in the Anniston Community Health Survey I (ACHS-I).

In this study, we examined associations between serum concentrations of 35 polychlorinated biphenyl (PCB) congeners, pesticides, and indicators of thyroid function in participants of the Anniston Community Health Survey (ACHS). Study subjects lived in the vicinity of a former PCB production facility and had PCB concentrations 2 to 3 times higher than similar age and race groups from the general population. We investigated associations among serum levels of thyroid hormones (thyroxin [T4], free thyroxin [fT4], triiodothyronine [T3], thyroid stimulation hormone [TSH]) and auto-antibodies (thyroglobulin antibody [TgAb] or thyroperoxidase antibody [TPOAb]) and combined indicators of thyroid function with the sum of PCBs, varying PCB groups, individual PCB congeners, and 8 pesticides. Logistic and linear regression models were adjusted for log10 transformed total lipids, age, sex, ethnicity, BMI, smoking, and family history of thyroid disease. We also performed analyses stratified by ethnicity and sex. Linear regression showed inverse associations between TT3 and thyroid-like PCBs (sum of PCBs 28, 52, 74, 101, 105, and 118; p = .0004), two pesticides (hexachlorobenzene, and pp'-DDE), and individual congeners (PCBs 74, 105). Null associations were observed between PCBs, pesticides, TSH, TT4, and fT4. Logistic regression analyses did not provide support for TT3 findings and found no association with other thyroid hormones, antibodies, or combined indicator of thyroid function. These results suggest there is little evidence that these chemicals have any major clinical effect on thyroid function in this highly PCB exposed population.

Can the Social Vulnerability Index Be Used for More Than Emergency Preparedness? An Examination Using Youth Physical Fitness Data.

BACKGROUND: The Social Vulnerability Index (SVI), a publicly available dataset, is used in emergency preparedness to identify communities in greatest need of resources. The SVI includes multiple socioeconomic, demographic, and geographic indicators that also are associated with physical fitness and physical activity. This study examined the utility of using the SVI to explain variation in youth fitness, including aerobic capacity and body mass index. METHODS: FITNESSGRAM data from 2,126 Georgia schools were matched at the census tract level with SVI themes of socioeconomic, household composition, minority status and language, and housing and transportation. Multivariate multiple regression models were used to test whether SVI factors explained fitness outcomes, controlling for grade level (ie, elementary, middle, high school) and stratified by gender. RESULTS: SVI themes explained the most variation in aerobic fitness and body mass index for both boys and girls (R2 values 11.5% to 26.6%). Socioeconomic, Minority Status and Language, and Housing and Transportation themes were salient predictors of fitness outcomes. CONCLUSIONS: Youth fitness in Georgia was related to socioeconomic, demographic, and geographic themes. The SVI may be a useful needs assessment tool for health officials and researchers examining multilevel influences on health behaviors or identifying communities for prevention efforts.

Mindfulness-based stress reduction teachers, practice characteristics, cancer incidence, and health: a nationwide ecological description.

BACKGROUND: Studies have demonstrated the potential of the Mindfulness-Based Stress Reduction (MBSR) program to improve the condition of individuals with health outcomes such as hypertension, diabetes, and chronic pain; improve psychological well-being; reduce stress levels; and increase survival among cancer patients. To date, only one study has focused on the effect of long-term meditation on stress, showing a positive protective relationship. However, the relationship between meditation and cancer incidence remains unexplored. The objective of this study was to describe the state-level relationship between MBSR instructors and their practices and county-level health outcomes, including cancer incidence, in the United States. METHODS: This ecologic study was performed using geospatial mapping and descriptive epidemiology of statewide MBSR characteristics and overall health, mental health state rankings, and age-adjusted cancer incidence rates. RESULTS: Weak to moderate state-level correlations between meditation characteristics and colorectal and cervical cancer incidence were detected, with states with more meditation (e.g., more MBSR teachers per population) correlated with a decreased cancer incidence. A negative correlation was detected between lung & bronchus cancer and years teaching MBSR only. Moderate positive correlations were detected between Hodgkin's Lymphoma and female breast cancer in relation to all meditation characteristics. Statistically significant correlations with moderate coefficients were detected for overall health ranks and all meditation characteristics, most strongly for total number of years teaching MBSR and total number of years of general meditation practice. CONCLUSIONS: Our analyses might suggest that a relationship exists between the total number of MBSR teachers per state and the total number of years of general meditation practice per state, and colorectal and cervical cancer incidence. Positive correlations were observed with overall health rankings. Despite this study's limitations, its findings could serve to generate hypotheses and to inform and motivate a new focus on meditation and stress reduction in relation to cancer incidence, with specific relevance to colorectal and cervical cancer.