Henry Falk

Centers for Disease Control and Prevention | CDC

Agenda and participant list for the May 2011 workshop, “Health Burden of Indoor Air Pollution on Women and Children in Developing Countries.” (DOC)

William Martin and colleagues report on their stakeholder meetings that reviewed the health risks of household air pollution and cookstoves, and identified research priorities in seven key areas. Please see later in the article for the Editors' Summary

After the May 18, 1980 volcanic eruption of Mount St. Helens, increases were observed in the number of patients who, because of asthma or bronchitis, sought medical care at emergency rooms of major hospitals in areas of ashfall. An interview study of 39 asthma and 44 bronchitis patients who became sick during the 4 wk following the eruption and who...

This commentary addresses the article by Berman, et al. on reproductive health trends in Israel potentially related to endocrine disrupting chemicals (EDCs) and on associated health policy decisions in Israel to prevent long-term effects from exposure to EDCs. There are intensive, ongoing research efforts in the US that will provide additional guid...

This paper summarizes environmental investigations (n = 458) conducted during the first 60 years of the epidemic-assistance investigation program at the Centers for Disease Control and Prevention. These investigations were grouped into 10 categories: toxic chemicals (n = 102), indoor air quality and outdoor air toxics (n = 21), new or rare epidemic...

Planning and Preparedness for Hazardous Substance Releases in India - Volume 25 Issue S1 - V. Kapil, H. Falk, P. Ruckart, A. Dewan, M. Orr, J. Madden

Preparing for the Predictable Surprise of a Terrorist Bombing Authors: Hunt R, Ashkenazi I, Deitchman S, Dorn B, Enders J, Falk H, Garbarino L, Kapil V, Madden J, Marcus L, Sarmiento K, Sasser S Affiliations: Centers for Disease Control and Prevention, and National Preparedness Leadership Initiative: A joint program of the Harvard School of Public...

Lead poisoning is an important environmental disease that can have life-long adverse health effects. Most susceptible are children, and most commonly exposed are those who are poor and live in developing countries. Studies of children's blood-lead levels (BLLs) are showing cognitive impairment at increasingly lower BLLs. Lead is dangerous at all le...

1 Division of Field Studies and Clinical Investigations National Institute for Occupational Safety and Health Cincinnati, Ohio 45202

Since 1995, the Agency for Toxic Substances and Disease Registry (ATSDR) has evaluated environmental contaminants and human health risks at nearly 3000 sites. Hazardous substances at these sites include newly emerging problems as well as historically identified threats. ATSDR classifies sites according to the degree of hazard they represent to the...

Extensive water damage after major hurricanes and floods increases the likelihood of mold contamination in buildings. This report provides information on how to limit exposure to mold and how to identify and prevent mold-related health effects. Where uncertainties in scientific knowledge exist, practical applications designed to be protective of a...

Achieving the goal of increasing quality and years of healthy life is fundamentally based on success in the practice of public health. As our life style changes with time and as public health issues become more global, the practice of public health is enhanced to meet new challenges. In addition to addressing infectious diseases, environmental conc...

The Agency for Toxic Substances and Disease Registry (ATSDR) identifies people near hazardous waste sites who are at potential health risk because of their exposure to environmental chemicals. Nearly, 2000 chemicals have been associated with such sites. Residents of U.S. communities are potentially exposed to hazardous substances through air, soil,...

Recent public recognition that children are different from adults in their exposures and susceptibilities to environmental contaminants has its roots in work that began >46 years ago, when the American Academy of Pediatrics (APA) established a standing committee to focus on children's radiation exposures. We summarize the history of that important...

Ultimately, the health and quality of life of all human beings depend upon the environment and ecosystems to which we are directly and indirectly connected. The papers in this special edition address a number of the critical environmental health issues on which U.S. government agencies and their collaborating partners are engaged internationally. T...

In developing countries, public health attention is focused on urgent health problems such as infectious diseases, malnutrition, and infant mortality. As a country develops and gains economic resources, more attention is directed to health concerns related to hazardous chemical wastes. Even if a country has little industry of its own that generates...

Studies have shown blood lead levels of some children in South Africa at levels of health concern. New studies show even relatively low lead levels to have detrimental effects on cognitive function in young children. Large numbers of South African inner-city and other children have been shown to have unacceptably high blood lead levels. Studies ind...

In spite of considerable economic progress in recent years, India continues to face challenges dealing with poverty, unemployment, malnutrition, disease and disability. The governments of India and the United States have formed a collaborative effort to address outstanding issues in the fields of environmental and occupational health. The Joint Sta...

Childhood lead poisoning is an important, preventable environmental disease affecting millions of children around the world. The effects of lead are well known and range from delayed and adversely affected neurodevelopment to severe health outcomes including seizures, coma, and death. This article reviews the childhood effects of lead poisoning, th...

Childhood lead poisoning is a preventable illness. In the past 3 decades, removal of key lead sources and prevention of exposure in the United States have led to dramatic decreases in population blood lead concentrations and also in instances of severe lead poisoning requiring treatment. From an international perspective, childhood lead poisoning s...

People with asthma who live near or downwind from a source of toxic emissions commonly express concerns about the possible impact of hazardous air pollution on their health, especially when these emissions are visible or odorous. Citizens frequently turn to their local and state health departments for answers, but health departments face many chall...

This special issue of the International Journal of Hygiene and Environmental Health provides extensive background on the Superfund programs, findings of specific research studies and future directions. Three federal agencies are leading the effort in this program. They are the National Institute of Environmental Health Sciences, U.S. Environmental...

Additional research on human exposures to hazardous substances in community settings and resultant adverse health effects is needed to fill an extensive number of information gaps. For example, information is needed to answer specific public health questions about the toxic effects of specific chemicals, who has been exposed, what the health risks...

Although recent data continue to demonstrate a decline in the prevalence of elevated blood lead levels (BLLs) in children, lead remains a common, preventable, environmental health threat. Because recent epidemiologic data have shown that lead exposure is still common in certain communities in the United States, the Centers for Disease Control and P...

This statement describes molds, their toxic properties, and their potential for causing toxic respiratory problems in infants. Guidelines for pediatricians are given to help reduce exposures to mold in homes of infants. This is a rapidly evolving area and more research is ongoing.

Results of epidemiologic studies provide strong evidence that exposure of children to environmental tobacco smoke is associated with increased rates of lower respiratory illness and increased rates of middle ear effusion, asthma, and sudden infant death syndrome. Exposure during childhood may also be associated with development of cancer during adu...

Evidence from an array of scientific studies strongly supports the conclusion that ingestion of products containing L-tryptophan (LT) produced by Showa Denko KK caused the 1989 epidemic of eosinophilia-myalgia syndrome (EMS) in the United State. In case-control studies of EMS, LT exposure was essentially universal among cases but rare among control...

In a previous study, we did follow-up on 418 patients who were exposed to tryptophan in 1989, of whom 47 (11%) had definite and 63 (9%) possible eosinophilia-myalgia syndrome (EMS). We assessed mortality and clinical spectrum of illness since 1989 for 242 (58%) of the 418 tryptophan-exposed patients from the original study. To assess outcomes, we u...

To evaluate subclinical health effects of excess vitamin D, a cross-sectional study was conducted of persons consuming milk from a dairy that had overfortified milk for at least 4 years. Milk consumption, sunlight exposure, medical symptoms, serum 25-hydroxyvitamin D (25[OH]D), serum and urinary calcium, and indicators of renal function were measur...

The purpose of the study was to identify cases of hypervitaminosis D caused by the inadvertent overfortification of milk from a home-delivery dairy and to identify risk factors for this illness. Hospital discharge, laboratory, and state health department data were used to define, identify, and describe cases of hypervitaminosis D diagnosed in the e...

The authors conducted a mailed questionnaire survey of a 5% sample of the cohort of 20643 people officially recognized by the Spanish government as having had toxic oil syndrome, a previously undescribed illness that was epidemic in Spain in 1981. After three mailings of a letter and questionnaire, responses for only 66% of the sample had been rece...

To describe some of the most severe features of eosinophilia-myalgia syndrome (EMS) and identify potential prognostic indicators. Systematic review of data from initial case reports and from followup supplemental death report forms forwarded to the national surveillance system administered by the US Centers for Disease Control (CDC). As of August 1...

Eosinophilia-myalgia syndrome (EMS) has been linked to ingestion of tryptophan contaminated with 1,1'-ethylidene-bis[L-tryptophan] (EBT), but other contaminants have received little study. The authors identified 101 lots of L-tryptophan that had been consumed either by persons with EMS or by asymptomatic tryptophan users and quantified the amounts...

Eosinophilia-myalgia syndrome (EMS) has been linked to ingestion of tryptophan contaminated with 1,1′-ethylidenebis[L-tryptophan] (EBT), but other contaminants have received little study. The authors identified 101 lots of L-tryptophan that had been consumed either by persons with EMS or by asymptomatic tryptophan users and quantified the amounts o...

The use of food supplements by the general public is poorly quantified, and little information on this subject is available in the medical literature. We surveyed 12 recent issues of popular health and bodybuilding magazines (1) to quantify the number of advertisements for food supplements, the number of products advertised, and the number and type...

To study the incidence of eosinophilia-myalgia syndrome, the risk factors associated with the syndrome, and the clinical spectrum of illness associated with L-tryptophan use in an exposed population. Retrospective cohort and nested case-control studies of risk factors for eosinophilia-myalgia syndrome using inpatient and outpatient chart reviews, t...

In the spring and summer of 1981, an epidemic of a new illness now referred to as the toxic oil syndrome occurred in central and northwestern Spain, resulting in some 20,000 cases, 12,000 hospital admissions and >300 deaths in the 1st year of the epidemic. The initial onset of illness was usuallv acute, and patients presented primarily with a respi...

On June 12 and 13, 1990 the Los Alamos National Laboratory in cooperation with the New Mexico Department of Health and Environment, the Centers for Disease Control (CDC), the Food and Drug Administration (FDA), and the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health (NIH) hosted a conferenc...

This document describes an agenda for the first 5 years of a comprehensive effort to eliminate childhood lead poisoning. In 1984, between 3 and 4 million children were estimated to have blood lead levels high enough to adversely affect intelligence and behavior. Lead in the home environment, especially lead-based paint, is the major source of lead...

Eosinophilia-myalgia syndrome, a newly recognized disorder that occurred in epidemic proportions during 1989, is associated with ingestion of manufactured tryptophan. A case is defined by debilitating myalgias and absolute eosinophilia greater than or equal to 1.0 × 109 cells/L. As of July 10,1990, a total of 1531 cases had been reported nationwide...

Radon gas, a relatively common natural indoor air pollutant is a radioactive decay product of uranium. Radon and its decay product of uranium. Radon and its decay products have been shown to increase the risk of lung cancer in underground miners. More recently, radon has been recognized to be widespread in homes in the United States. An estimated 1...

Paired human serum and adipose tissue samples were analyzed from 50 persons for 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD) by high-resolution gas chromatography/high-resolution mass spectrometry (HRGC/HRMS). On a lipid weight basis, the range of values in adipose tissue spanned approximately 2.5 orders of magnitude, from 3.3 to 969 parts pe...

The compound 2,3,7,8-tetrachlorodibenzo-p-dioxin, commonly known as dioxin, was measured in the adipose tissue of 39 persons with a history of residential, recreational, or occupational exposure in Missouri and in 57 persons in a control group. All participants had detectable levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin in their adipose tissue, bu...

The Centers for Disease Control in collaboration with affected state and local health departments, clinicians, and private institutions carried out a compulsive epidemiologic evaluation of mortality and morbidity associated with volcanic activity following the 1980 eruption of Mount St. Helens. Excession morbidity were limited to transient increase...

We noted with interest this publication's recent editorial which emphasizes the importance of injuries as causes of death, disability, and economic costs in the United States today and proposes the establishment of a 'National Institute of Injury Prevention' to develop and coordinate research and control efforts directed at the problem of injuries....

Increasing production and use of formaldehyde in consumer products have resulted in widespread recognition of its acute irritant effects at exposure levels below the current occupational health standard [3 parts per million parts of air (ppm)]. Formaldehyde is an allergic (immunologically mediated) skin sensitizer which may also cause or exacerbate...

The Drake Superfund site in Clinton County, Pennsylvania, has been contaminated with the carcinogens beta-naphthylamine, benzidene, and benzene. The authors reviewed county-wide, age-adjusted, sex-, race-, and site-specific cancer mortality rates for the years 1950-1959, 1960-1969, and 1970-1979, and type-specific birth defects incidence rates for...

A national survey of health department activities in 1982 revealed that 32 states (63 per cent) had a program or person(s) responsible for evaluating exposures to one or more nonoccupational indoor air pollutants (NIAPs). Only four states (8 per cent) had existing or proposed NIAP exposure standards. Twenty-nine (57 per cent) of the states had a pr...

In Reply.— We agree with Dr Gross that experimental evidence in animals and data from human populations exposed to 150 to 200 rad of ionizing radiation suggest that they experienced an increased incidence of leukemia and solid tumors, but we have no data indicating that the nuclear test participants at Smoky were exposed to that level of radiation...

To establish whether the syndrome of unexplained generalized lymphadenopathy in homosexual men was new and related epidemiologically to the acquired immune deficiency syndrome (AIDS), we reviewed 3,139 pathology reports of lymph node biopsies performed at seven hospitals in New York City during the years 1977 through 1981. Three hundred twenty-nine...

An epidemic of a new illness involving multiple organ systems began in Spain in May 1981, with 19,828 cases and 315 deaths reported by June 1, 1982. An epidemiologic investigation has linked the occurrence of illness with ingestion of an unlabeled, illegally marketed cooking oil. To elucidate the natural history of this illness, we reviewed the med...

Follow-up of health status has been completed through 1979 for 3,072 (95.5%) of 3,217 nuclear test participants on military maneuvers during the 1957 nuclear test "Smoky." In these participants, 112 cases of cancer were diagnosed, compared with 117.5 cases expected. During the same follow-up period (1957 through 1979), 64 persons died of cancer, co...

The devastating 18 May 1980 eruption of Mount St. Helens presented an opportunity to evaluate the acute and potential chronic health effects associated with a major volcanic event. Investigations included assessment of immediate deaths around the volcano, surveillance of hospital visits and admissions in two ash exposure areas in the State of Washi...

The health and safety hazards posed by volcanic eruptions are outlined with special reference to experience gained from the eruptions of Mount St. Helens in 1980. The ability of volcanologists to predict the timing and the impact on local communities of an impending eruption are limited, some recent devastating eruptions having occurred without app...

Thirty-five known deaths were caused by the landslide and lateral blast of the May 18 eruption of Mount St Helens and at least 23 persons are missing. In 18 of 23 cases that reached autopsy, asphyxiation from ash inhalation was the cause of death. A rapidly established hospital surveillance system detected increases in the number of emergency room...

Several environmental emergencies are described which demonstrate how the Centers for Disease Control works with state and local health departments to assess the human health implications from exposures to chemical and radioactive materials. Events described include Three Mile Island, the Titan II missile explosion, and the Mount St. Helens eruptio...

A nationwide survey of hepatic angiosarcoma (HAS) in the United States during the years 1964 through 1974 identified 168 cases. Of these, 42 cases (25%) were associated with known etiologic factors, such as vinyl chloride monomer exposure during preparation of poly(vinyl chloride), use of Thorotrast in angiography, exposure to inorganic arsenic, an...

Four cases of childhood hepatic angiosarcoma (HAS), representing the malignant form of infantile hemangioendothelioma, are described. The morphologic appearance of childhood HAS differs from the adult form in the following features: the associated presence of benign infantile hemangioendothelioma; the presence of dysontogenetic features; and an alt...

Data from several small autopsy series in German vintners in the 1940s and 1950s and a number of case reports have previously suggested that arsenic is a cause of hepatic angiosarcoma (HAS). In a nationwide review of deaths from HAS in the United States, we identified seven cases with a history of prolonged use of Fowler's solution (inorganic potas...

A retrospective epidemiological study of deaths from hepatic angiosarcoma (HAS) in the U.S. showed that during 1964--74 there were 168 such cases, of which 37 (22%) were associated with previously known causes (vinyl chloride, 'Thorotrast', and inorganic arsenic) and 4 (3.1%) of the remaining 131 cases with the use of androgenic-anabolic steroids....

An epidemiologic investigation of hepatic angiosarcoma (HAS) in the United States, directed primarily at the years 1964–1974, has identified 26 cases of Thorotrast-induced HAS. This study indicates that the occurrence of Thorotrast-induced HAS was still increasing in the early 1970s and that a larger proportion of the more recent cases had relative...

A histological review of 25 cases of thorotrast-induced angiosarcoma revealed characteristic antecedent or precursor changes which are similar to previously described changes present in hepatic angiosarcoma secondary to vinyl chloride, arsenicals, or of unknown etiology. The antecedent or precursor change consists of areas with simultaneous activat...

Examples of human angiosarcoma following exposure to vinyl chloride, Thorotrast, or arsenic (medicinal and industrial) and cases, including children, of unknown etiology were studied to establish diagnostic criteria and to study their evolution. The uniform evolution suggests an environmental factor also in the cases of unknown etiology, which may...

Although polyvinyl chloride has been produced from vinyl chlride monomer for more than 40 years, recognition of toxicity among vinyl chloride polymerization workers is more recent. In the mid 1960s, workers involved in cleaning polymerization tanks were found to have acro-osteolysis. In 1974, the same population of workers was found to be at risk f...

A study of pregnancy outcome among wives of workers exposed to vinyl-chloride monomer (V.C.M.) indicated that, in comparison with controls, there was a significant excess fetal loss in the group whose husbands had a primary exposure to V.C.M., whereas no differences between the groups were observed before the husbands' exposures. The difference in...

A questionnaire survey was done in 152 Houston supermarkets to assess the prevalence of respiratory tract symptoms in meat wrappers exposed to the thermal decomposition fumes of polyvinyl chloride (PVC) film wrap and in two supermarket control groups (checkers and meat cutters). Meat wrappers had increased respiratory tract symptoms; 12% of meat wr...

Histologic examination of liver tissue (eight autopsy and 18 biopsy specimens) and five spleens from 20 workers with vinyl chloride polymerization showed hepatic angiosarcomas in 15. In addition, a peculiar pattern of progressive portal-tract, inconspicuous intralobular and conspicuous capsular fibrosis was observed in the five workers without angi...

A total of 13 cases of ASL have been documented to date among VC workers in four different plants in the United States. In this particular industrial population, this number of cases represents at least a 400-fold increase over expected incidence for this extremely rare tumor. The first case occurred in 1961. Average age at diagnosis is 48.2 years....