Running Coupling Constant from Position-Space Current-Current Correlation Functions in Three-Flavor Lattice QCD.

In this Letter, we provide a determination of the coupling constant in three-flavor quantum chromodynamics (QCD), α_{s}^{MS[over ¯]}(µ), for MS[over ¯] renormalization scales µ∈(1,2) GeV. The computation uses gauge field configuration ensembles with O(a)-improved Wilson-clover fermions generated by the Coordinated Lattice Simulations (CLS) consortium. Our approach is based on current-current correlation functions and has never been applied before in this context. We convert the results perturbatively to the QCD Λ parameter and obtain Λ_{MS[over ¯]}^{N_{f}=3}=342±17 MeV, which agrees with the world average published by the Particle Data Group and has competing precision. The latter was made possible by a unique combination of state-of-the-art CLS ensembles with very fine lattice spacings, further reduction of discretization effects from a dedicated numerical stochastic perturbation theory simulation, combining data from vector and axial-vector channels, and matching to high-order perturbation theory.

Assessment of the Overall and Multidrug-Resistant Organism Bioburden on Environmental Surfaces in Healthcare Facilities.

OBJECTIVE To determine the typical microbial bioburden (overall bacterial and multidrug-resistant organisms [MDROs]) on high-touch healthcare environmental surfaces after routine or terminal cleaning. DESIGN Prospective 2.5-year microbiological survey of large surface areas (>1,000 cm2). SETTING MDRO contact-precaution rooms from 9 acute-care hospitals and 2 long-term care facilities in 4 states. PARTICIPANTS Samples from 166 rooms (113 routine cleaned and 53 terminal cleaned rooms). METHODS Using a standard sponge-wipe sampling protocol, 2 composite samples were collected from each room; a third sample was collected from each Clostridium difficile room. Composite 1 included the TV remote, telephone, call button, and bed rails. Composite 2 included the room door handle, IV pole, and overbed table. Composite 3 included toileting surfaces. Total bacteria and MDROs (ie, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci [VRE], Acinetobacter baumannii, Klebsiella pneumoniae, and C. difficile) were quantified, confirmed, and tested for drug resistance. RESULTS The mean microbial bioburden and range from routine cleaned room composites were higher (2,700 colony-forming units [CFU]/100 cm2; ≤1-130,000 CFU/100 cm2) than from terminal cleaned room composites (353 CFU/100 cm2; ≤1-4,300 CFU/100 cm2). MDROs were recovered from 34% of routine cleaned room composites (range ≤1-13,000 CFU/100 cm2) and 17% of terminal cleaned room composites (≤1-524 CFU/100 cm2). MDROs were recovered from 40% of rooms; VRE was the most common (19%). CONCLUSIONS This multicenter bioburden summary provides a first step to determining microbial bioburden on healthcare surfaces, which may help provide a basis for developing standards to evaluate cleaning and disinfection as well as a framework for studies using an evidentiary hierarchy for environmental infection control. Infect Control Hosp Epidemiol 2016;1426-1432.

Replacing Windows Reduces Childhood Lead Exposure: Results From a State-Funded Program.

CONTEXT: Despite considerable evidence that window replacement reduces childhood lead exposure and improves energy conservation and market value, federal policies in childhood lead poisoning, home improvement, and weatherization programs all tend to discourage it. OBJECTIVE AND INTERVENTION: To evaluate a state bond-financed pilot program that replaced old lead-contaminated windows with new lead-free energy efficient ones. DESIGN AND SETTING: Pre-/post evaluation in 1 urban and 1 rural jurisdiction. PARTICIPANTS: Low-income households (n = 96). MAIN OUTCOME MEASURES: Dust wipe sampling, visual assessment, and physical and mental self-reported health at baseline and 1 year. RESULTS: Geometric mean lead dust (PbD) from baseline to 1 year for interior floors, interior sills, and exterior troughs declined by 44%, 88%, and 98%, respectively (P < .001); 1 year later, levels remained well below baseline but rose slightly compared with clearance sampling just after intervention. PbD declined significantly on both sills and troughs in both the urban and rural jurisdictions from baseline to 1 year. On interior floors, PbD significantly declined by 58% (P = .003) in the rural area and 25% (P = .38) in the urban area, where the decline did not reach statistical significance. Households reported improvements in uncomfortable indoor temperatures (P < .001) and certain health outcomes. Economic benefits were estimated at $5 912 219 compared with a cost of $3 451 841, resulting in a net monetary benefit of $2 460 378. Residents reported that they were "very satisfied" with the window replacement work (87%). CONCLUSION: Local and state governments should fund and operate window replacement programs to eliminate a major source of childhood lead exposure, improve energy bills, increase home market value, and create local construction and industrial jobs. Federal agencies should encourage (not discourage) replacement of old windows contaminated with lead. In budget climates such as Illinois with reduced public expenditures, making wise investments such as lead-safe window replacement is more important than ever.

Lead and other heavy metals in dust fall from single-family housing demolition.

OBJECTIVE: We measured lead and other heavy metals in dust during older housing demolition and effectiveness of dust suppression. METHODS: We used American Public Housing Association Method 502 and U.S. Environmental Protection Agency Methods SW3050B and SW6020 at 97 single-family housing demolition events with intermittent (or no) use of water to suppress dust at perimeter, non-perimeter, and locations without demolition, with nested mixed modeling and tobit modeling with left censoring. RESULTS: The geometric mean (GM) lead dust fall during demolition was 6.01 micrograms of lead per square foot per hour (µg Pb/ft(2)/hour). GM lead dust fall was 14.18 µg Pb/ft(2)/hour without dust suppression, but declined to 5.48 µg Pb/ft(2)/hour (p=0.057) when buildings and debris were wetted. Significant predictors included distance, wind direction, and main street location. At 400 feet, lead dust fall was not significantly different from background. GM lead concentration at demolition (2,406 parts per million [ppm]) was significantly greater than background (GM=579 ppm, p=0.05). Arsenic, chromium, copper, iron, and manganese demolition dust fall was significantly higher than background (p<0.001). Demolition of approximately 400 old housing units elsewhere with more dust suppression was only 0.25 µg Pb/ft(2)/hour. CONCLUSIONS: Lead dust suppression is feasible and important in single-family housing demolition where distances between houses are smaller and community exposures are higher. Neighbor notification should be expanded to at least 400 feet away from single-family housing demolition, not just adjacent properties. Further research is needed on effects of distance, potential water contamination, occupational exposures, and water application.

Contaminated product water as the source of Phialemonium curvatum bloodstream infection among patients undergoing hemodialysis.

OBJECTIVE: We investigated a cluster of cases of bloodstream infection (BSI) due to the mold Phialemonium at a hemodialysis center in Illinois and conducted a cohort study to identify risk factors. DESIGN: Environmental assessment and cohort study. SETTING: A hemodialysis center in a tertiary care hospital. METHODS: A case patient was defined as a person who underwent dialysis at the center and had a blood sample that tested positive for Phialemonium curvatum on culture. We reviewed microbiology and medical records and tested water, surface, and dialysate samples by culture. Molds isolated from environmental and clinical specimens were identified by their morphological features and confirmed by sequencing DNA. RESULTS: We identified 2 case patients with BSI due to P. curvatum. Both became febrile and hypotensive while undergoing dialysis on the same machine at the same treatment station, although on different days. Dialysis machines were equipped with waste handling option ports that are used to discard dialyzer priming fluid. We isolated P. curvatum from the product water (ie, water used for dialysis purposes) at 2 of 19 treatment stations, one of which was the implicated station. CONCLUSION: The source of P. curvatum was likely the water distribution system. To our knowledge, this is the first report of patients acquiring a mold BSI from contaminated product water. The route of exposure in these cases of BSI due to P. curvatum may be related to the malfunction and improper maintenance of the waste handling option ports. Waste handling option ports have been previously implicated as the source of bacterial BSI due to the backflow of waste fluid into a patient's blood line. No additional cases of infection were noted after remediation of the water distribution system and after discontinuing use of waste handling option ports at the facility.

Particle size fractionation and human exposure of polybrominated diphenyl ethers in indoor dust from Chicago.

The objective of this study was to investigate the concentration level, the mass distribution based on dust particle size, and the associated human exposure of polybrominated diphenyl ethers (PBDEs) in indoor dust. The total concentration of 13 PBDEs Sigma(13)(BDEs) was found to be 500-6,944 ng/g in indoor dusts, 4,000 ng/g in car interior dust, 260-300 ng/g in outdoor ambient air particles, 30 ng/g in carpet fibers, and as high as 0.5% in carpet padding. Selected dust samples were fractionated based on particle size, and over 80% of the Sigma(13)BDEs were associated with particles < 150 mum in diameter. Mass ratios of BDE206/BDE209 are higher in both indoor and outdoor samples than in commercial deca products; and mass ratio BDE47/BDEs(85+99+100) was much higher in outdoor than in indoor samples. Using EPA software ProUCL, the exposure of Americans to PBDEs via hand-to-mouth transfer of house dust was estimated under the central tendency exposure and reasonable maximum exposure scenarios. The results suggest that ingestion of PBDE-laden house dust via hand-to-mouth contact is likely a significant exposure pathway, especially for children.

The Great Lakes Center's health hazard evaluation program: promoting community environmental health through partnerships between academic and public health departments.

The Great Lakes Center of Excellence in Environmental Health (GLCEEH), an innovative capacity-building component of the University of Illinois, performs health hazard evaluations in collaboration with the Illinois Department of Public Health and local health departments. GLCEEH has provided state and local health departments with faculty, industrial-hygiene expertise, and research expertise to help them investigate a variety of environmental health issues. This article describes health hazard evaluations performed with support from the National Center for Environmental Health, lessons learned, and recommendations for successful collaboration between academic and public health departments. From the academic perspective, health hazard evaluations are beneficial because they provide faculty and students with the opportunity to engage in public health practice and encounter new issues that advance the science of environmental health through research. From the perspective of a public health department, health hazard evaluations are beneficial because they address priority environmental health concerns and build the capacity of department personnel to conduct health hazard evaluations with internal resources. A collaborative health hazard evaluation program increases public health capacity by developing new approaches to environmental health problems and by sharing limited resources.

Outbreak of bloodstream infection with the mold Phialemonium among patients receiving dialysis at a hemodialysis unit.

BACKGROUND: Molds are a rare cause of disseminated infection among dialysis patients. OBJECTIVE: We evaluated a cluster of intravascular infections with the mold Phialemonium among patients receiving hemodialysis at the same facility in order to identify possible environmental sources and prevent further infection. DESIGN: Environmental assessment and case-control study. SETTING: A hemodialysis center affiliated with a tertiary care hospital. METHODS: We reviewed surveillance and clinical microbiology records and performed a blood culture survey for all patients. The following data for case patients were compared with those for control patients: underlying illness, dialysis characteristics, medications, and other possible exposure for 120 days prior to infection. Environmental assessment of water treatment, dialysis facilities, and heating, ventilation, and air-conditioning (HVAC) systems of the current and previous locations of the dialysis center was performed. Samples were cultured for fungus; Phialemonium isolates were confirmed by sequencing of DNA. Investigators observed dialysis access site disinfection technique. RESULTS: Four patients were confirmed as case patients, defined as a patient having intravascular infection with Phialemonium species; 3 presented with fungemia, and 1 presented with an intravascular graft infection. All case patients used a fistula or graft for dialysis access, as did 12 (75%) of 16 of control patients (P=.54). Case and control patients did not differ in other dialysis characteristics, medications received, physiologic findings, or demographic factors. Phialemonium species were not recovered from samples of water or dialysis machines, but were recovered from the condensation drip pans under the blowers of the HVAC system that supplied air to the dialysis center. Observational study of 21 patients detected suboptimal contact time with antiseptic agents used to prepare dialysis access sites. CONCLUSION: The report of this outbreak adds to previous published reports of Phialemonium infection occurring in immunocompromised patients who likely acquired infection in the healthcare setting. Recovery of this mold from blood culture should be considered indicative of infection until proven otherwise. Furthermore, an investigation into possible healthcare-related environmental reservoirs should be considered.

Two outbreaks of occupationally acquired histoplasmosis: more than workers at risk.

OBJECTIVE: The objective of this study was to determine the etiology and risk factors for acute histoplasmosis in two outbreaks in Illinois among laborers at a landfill in 2001 and at a bridge reconstruction site in 2003. DESIGN: We performed environmental investigations during both outbreaks and also performed an analytic cohort study among bridge workers. PARTICIPANTS: Workers at the landfill during May 2001 and those at the bridge site during August 2003 participated in the study. At the landfill, workers moved topsoil from an area that previously housed a barn; at the bridge, workers observed bat guano on bridge beams. EVALUATIONS/MEASUREMENTS: We defined a case by positive immunodiffusion serology, a > or = 4-fold titer rise in complement fixation between acute and convalescent sera, or positive urinary Histoplasma capsulatum (HC) antigen. Relative risks (RR) for disease among bridge workers were calculated using bivariate analysis. RESULTS: Eight of 11 landfill workers (73%) and 6 of 12 bridge workers (50%) were laboratory-confirmed histoplasmosis cases. Three bridge workers had positive urinary HC antigen. At the bridge, seeing or having contact with bats [RR = 7.0; 95% confidence interval (CI), 1.1-43.0], jack-hammering (RR = 4.0; 95% CI, 1.2-13.3), and waste disposal (RR = 4.0; 95% CI, 1.2-13.3) were the most significant job-related risk factors for acquiring histoplasmosis. CONCLUSIONS: Workers performing activities that aerosolized topsoil and dust were at increased risk for acquiring histoplasmosis. Relevance to professional and clinical practice: Employees should wear personal protective equipment and use dust-suppression techniques when working in areas potentially contaminated with bird or bat droppings. Urinary HC antigen testing was important in rapidly identifying disease in the 2003 outbreak.