Texas Department Of Health Research Articles

Illnesses Associated With Occupational Use of Flea-Control Products— California, Texas, and Washington, 1989-1997

Dips, shampoos, and other insecticide-containing flea-control products can produce systemic illnesses or localized symptoms in the persons applying them. Although these products may pose a risk to consumers, they are particularly hazardous to pet groomers and handlers who use them regularly. Illnesses associated with flea-control products were reported to the California Department of Pesticide Regulation, the Texas Department of Health, and the Washington State Department of Health, each of which maintains a surveillance system for identifying, investigating, and preventing pesticide-related illnesses and injuries. This report describes cases of occupational illnesses associated with flea-control products, summarizes surveillance data, and provides recommendations for handling these products safely.

Put prevention into practice: Evaluation of program initiation in nine Texas clinical sites

Introduction: Put Prevention Into Practice (PPIP) is a program designed to improve the delivery of clinical preventive services by primary care providers, through the use of specific office materials for providers and clinic staff, as well as an educational booklet for patients. The purpose of this study was to identify potential predictors of successful initiation of PPIP among 9 Texas public health clinics participating in a demonstration project funded by the Texas Department of Health (TDH). Methods: The PRECEDE model was utilized as a theoretical framework for the study. A qualitative, case study methodology was employed, with structured interviews and open-ended questions asked of each site’s PPIP personnel. Information from the sites’ report to the TDH on the number of charts containing PPIP forms was also used for purposes of data triangulation. Results: Sites that initiated PPIP successfully were characterized by a medium patient load, the ability to serve low-resource populations, prior attempts to implement categorical programs, existence of a philosophy of prevention, and pre-implementation planning. Barriers to successful initiation were identified as systems-related, patient-related, and staff-related. Conclusions: We identified factors that might predict the successful initiation of PPIP in public health primary care settings. Implications of present findings for implementation of similar health promotion programs in clinical settings are discussed.

Development of a surveillance program for occupational pesticide poisoning: lessons learned and future directions.

The authors describe the growth from 1987 through 1996 of the Occupational Pesticide Poisoning Surveillance Program at the Texas Department of Health. The program was initially based on a Sentinel Event Notification System for Occupational Risks (SENSOR) model, using sentinel providers to report cases, supplementing the passive reporting by physicians that was required by law. The model was evaluated after five years, and significant changes were implemented to improve case ascertainment. Current active surveillance methods emphasize collaboration with a number of agencies and organizations for identification of cases and follow-up. The number of confirmed occupational cases increased from 9 workers in 1987 to 99 workers in 1996. The evolution from a passive system to an active surveillance program expanded the number of reported cases and strengthened inter-agency collaborations.

Ciguatera Fish Poisoning—Texas, 1997

On October 21, 1997, the Southeast Texas Poison Center was contacted by a local physician requesting information about treatment for crew members of a cargo ship docked in Freeport, Texas, who were ill with nausea, vomiting, diarrhea, and muscle weakness. This report summarizes an investigation of this outbreak by the Texas Department of Health (TDH), which indicated that 17 crew members experienced ciguatera fish poisoning resulting from eating a contaminated barracuda.

Boat-Propeller–Related Injuries—Texas, 1997

Approximately 78 million persons engage in recreational boating annually in the United States. Several types of injury can occur during boating recreation, including drowning, falls, burns, and propeller-related injuries. Injuries from the propeller are typically multiple, deep, parallel lacerations that can result in permanent scarring, substantial blood loss, traumatic or surgical amputation, or death. Persons sustaining injuries from boat propellers can require long periods of hospitalization, recovery, and rehabilitation. In Texas, the extent of boat-propeller-related injuries is unknown; however, the existence of approximately 600,000 motorboats in the state exposes many Texans to the potential risk for propeller-related injury. To characterize the occurrence of boat-propeller-related injuries in Texas, the Texas Department of Health (TDH) and the Texas Parks and Wildlife Department (TPWD) investigated boat-propeller-related injuries that occurred in four lakes in Texas during May 24 -September 1, 1997, the time of year when boating activities are most common. This report summarizes the results of the investigation.

Varicella-Related Deaths Among Children—United States, 1997

During the first quarter of 1998, the Texas Department of Health and the Iowa Department of Public Health notified CDC of three fatal cases of varicella (chickenpox) that occurred in children during 1997. All three children were unvaccinated. Two children contracted chickenpox from unvaccinated siblings, and the mode of exposure was unknown for the third. This report summarizes these cases and indicates that varicella-related deaths continue to occur among children in the United States despite the availability of vaccine and recommendations for its use in all susceptible children.

Letter. Prenatal detection of a deletion 22q11 by FISH

Prenatal DiagnosisVolume 18, Issue 4 p. 411-413 Correspondence Letter. Prenatal detection of a deletion 22q11 by FISH J. Garcia-Heras, Corresponding Author J. Garcia-Heras Genetic Testing Center, Bureau of Laboratories, Texas Department of Health, Denton, TX, U.S.A.Genetic Testing Center, Texas Department of Health, 3600 E. McKinney, Denton, TX 76201, U.S.A.Search for more papers by this authorP. N. Rao, P. N. Rao Section of Medical Genetics, Department of Pediatrics, Bowman Gray School of Medicine, Winston-Salem, NC, U.S.A.Search for more papers by this authorR. W. Stettler, R. W. Stettler Texas Maternal Fetal Medicine, P. A., Fort Worth, TX, U.S.A.Search for more papers by this authorM. Huslig, M. Huslig Texas Maternal Fetal Medicine, P. A., Fort Worth, TX, U.S.A.Search for more papers by this authorRuth Lanigan Smart, Ruth Lanigan Smart Genetic Testing Center, Bureau of Laboratories, Texas Department of Health, Denton, TX, U.S.A.Search for more papers by this authorM. J. Pettenati, M. J. Pettenati Section of Medical Genetics, Department of Pediatrics, Bowman Gray School of Medicine, Winston-Salem, NC, U.S.A.Search for more papers by this author J. Garcia-Heras, Corresponding Author J. Garcia-Heras Genetic Testing Center, Bureau of Laboratories, Texas Department of Health, Denton, TX, U.S.A.Genetic Testing Center, Texas Department of Health, 3600 E. McKinney, Denton, TX 76201, U.S.A.Search for more papers by this authorP. N. Rao, P. N. Rao Section of Medical Genetics, Department of Pediatrics, Bowman Gray School of Medicine, Winston-Salem, NC, U.S.A.Search for more papers by this authorR. W. Stettler, R. W. Stettler Texas Maternal Fetal Medicine, P. A., Fort Worth, TX, U.S.A.Search for more papers by this authorM. Huslig, M. Huslig Texas Maternal Fetal Medicine, P. A., Fort Worth, TX, U.S.A.Search for more papers by this authorRuth Lanigan Smart, Ruth Lanigan Smart Genetic Testing Center, Bureau of Laboratories, Texas Department of Health, Denton, TX, U.S.A.Search for more papers by this authorM. J. Pettenati, M. J. Pettenati Section of Medical Genetics, Department of Pediatrics, Bowman Gray School of Medicine, Winston-Salem, NC, U.S.A.Search for more papers by this author First published: 04 December 1998 https://doi.org/10.1002/(SICI)1097-0223(199804)18:4<411::AID-PD262>3.0.CO;2-UCitations: 4AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume18, Issue4April 1998Pages 411-413 RelatedInformation

Tyler asbestos workers: mortality experience in a cohort exposed to amosite.

OBJECTIVES: To examine the causes of death among 1130 former workers of a plant in Tyler, Texas dedicated to the manufacture of asbestos pipe insulation materials. This cohort is important...

TB or not TB? Increasing door-to-door response to screening.

Tuberculosis (TB) has made a disconcerting come-back in the United States in recent years. In 1994, Texas ranked third nationally in total number of TB cases and fifth in annual TB case rates. This is of great concern to the Texas Department of Health (TDH) and has led to the development of TB Innovative Demonstration Projects under the Tuberculosis Elimination Division of the TDH. One such project involves identifying high-risk communities by utilizing a computer-based geographic information system and then sending field-workers door-to-door offering free skin testing. Because this project was so successful in identifying positive skin test reactors, numerous requests have been made to duplicate its methods. One area of improvement is to increase individual and family participation. The purpose of this article is to present a survey of the literature on nonresponse in door-to-door soliciting, analyze the project's methods of soliciting and nonresponse, and propose ways nonresponse can be decreased in future projects of this nature.

Privatizing maternal and child health services in Texas: reinventing Title V programs.

In November 1994, the Texas Department of Health embarked upon a major initiative to "reinvent" maternal and child health services funded through the Title V Maternal and Child Health Block Grant and related state general revenue. This article describes the rationale, planning process, and implementation issues associated with the initiative to redefine the fundamental roles and priorities of the department and traditional public health entities in the delivery of maternal and child health services.

Adverse Events Associated With Ephedrine-Containing Products— Texas, December 1993-September 1995

During December 1993-September 1995, the Bureau of Food and Drug Safety, Texas Department of Health (TDH), received approximately 500 reports of adverse events in persons who consumed dietary supplement products containing ephedrine and associated alkaloids (pseudoephedrine, norephedrine, and N-methyl ephedrine). This total included reports by individuals and reports identified by the Bureau of Epidemiology, TDH, in a review of records from the six centers of the Texas Poison Center Network. Reported adverse events ranged in severity from tremor and headache to death in eight ephedrine users and included reports of stroke, myocardial infarction, chest pain, seizures, insomnia, nausea and vomiting, fatigue, and dizziness. Seven of the eight reported fatalities were attributed to myocardial infarction or cerebrovascular accident. This report describes three patients in which the recommended dosage for the dietary supplements reportedly was not exceeded, summarizes results from ongoing investigations, and underscores the potential health risks associated with the use of products containing ephedrine.

Mercury Poisoning Associated With Beauty Cream—Texas, New Mexico, and California, 1995-1996

The Texas Department of Health (TDH), New Mexico Department of Health (NMDH), and San Diego County Health Department (SDCHD) recently investigated three cases of mercury poisoning among persons who had used a beauty cream produced in Mexico. The investigations implicated the beauty cream as the source of the mercury. The cream, marketed as "Crema de Belleza--Manning," lists "calomel" (mercurous chloride) as an ingredient and was found to contain 6%-8% mercury by weight. This report summarizes the ongoing investigation of these and other possible cases.

Dengue Fever at the US-Mexico Border, 1995-1996

Dengue is a mosquito-transmitted acute disease caused by any of four virus serotypes (DEN-1, DEN-2, DEN-3 and DEN-4) and is characterized by acute manifestations that can include fever, headache, myalgia, arthralgia, rash, nausea, and vomiting. On August 25, 1995, public health authorities in Mexico notified the Texas Department of Health (TDH) of an ongoing outbreak of dengue fever in the state of Tamaulipas, which borders south Texas. Because of the year-round presence of the Aedes aegypti mosquito (a major vector for dengue) in southernmost Texas and the frequent movement of persons across the U.S.-Mexico border, the outbreak in adjacent Tamaulipas suggested an increased potential for imported and autochthonous cases in Texas, as had occurred during 1980 and 1986. In response to the notification from Mexico, TDH intensified surveillance efforts for dengue, resulting in identification of 29 laboratory-diagnosed cases in Texas residents, including seven persons with no history of travel outside the state. This report summarizes results of dengue surveillance in the U.S.-Mexico border area during 1995-1996.

Pharmacists in State Government The Regulatory Perspective

Responsibilities encountered as director of the Drugs and Medical Devices Division of the Texas Department of Health are discussed. The author explains how her twelve years of experience in the practice of pharmacy provided a limited background for the responsibilities of a career in state government. Specific challenges in the areas of drug scheduling, substance abuse programs and regulation of dietary supplements are described. Challenges to operating within the state system are detailed.

Performance-Based Public Health in Texas

Responding to a 1987 state audit report, the Texas Department of Health began a performance-based objectives project to tie contract funds to local health departments (LHDs) to performance measures. The overall goal of the project is to improve public health practice in Texas. A major focus has been on having regional and LHD program staff develop realistic and measurable outcome and process objectives. Training on the planning and monitoring phases of the health program management cycle has been conducted, with future training planned on the evaluation phase. There are increasing reports on the value of the performance-based objectives process.

Organizational Learning in the Implementation of Maternal and Infant Health Policy

Health care policy and practice are frequently driven by government mandate. What role does organizational learning have in government‐directed organizational change and what kind of organizational learning might we expect from legislated procedure? In 1983, a task force on indigent health care recommended that maternal and child health become a top service priority in the USA in Texas. The Maternal and Infant Health Improvement Act in Texas eventually grew out of the realization of such need. The Texas Department of Health was assigned responsibility for implementation. Focuses this investigation on the implementation of the state′s resulting maternal and infant health policy from an organizational learning perspective.

Interagency implementation of government policy: Strategic management of maternal and child health care in texas

Focusing on a joint effort of the Texas Department of Health and the Texas Department of Human Services, this study examined the interagency implementation of maternal and infant health policy in the state. Thompson's typology of implementation(1) was integrated with the Montjoy and O’Toole(2) model of overhead influence on intraorganizational factors in public policy implementation for analysis. The findings provide some support to the Montjoy and O’Toole model.(3) The data suggested Type A Mandate Effects and Expected Activity for both departmental programs. Reciprocal Operating Interdependence existed between the two state departments.

Field studies using the oyster Crassostrea virginica to determine mercury accumulation and depuration rates

Mercury as an environmental hazard, especially with regard to human health, has been of concern since the Minamata disaster. From 1966 to 1970 a chlor-alkali plant in Point Comfort, Texas released mercury-enriched wastewater (up to 29.9 kgHg/day) into Lavaca Bay (TWQB 1977). Since 1970 the Texas Department of Health (TDH) has periodically closed and then re-opened portions of Lavaca Bay to the harvesting of crabs and finfish based on their levels ( 0.5 ppm Hg wet weight) of mercury. A 1988 closure remains in effect as of this writing. Mercury contamination in Lavaca Bay organisms thus continues to be a problem 22 years after the chlor-alkali plant ceased releasing mercury into the bay. The goal of the following research was to better understand the behavior of mercury in Lavaca Bay. Oysters have been widely used as indicator species in metal pollution studies. Most such programs have focused on the concentrations of metals in oysters from different geographic areas. This study, however, investigated the rate and amount of mercury a [open quotes]clean[close quotes] oyster would accumulate when transplanted to a contaminated estuary and the rate of mercury depuration by contaminated oysters placed in a clean environment. The oysters were additionally analyzed formore » Ba, Cu, Fe, P, and Zn to test for the possible involvement of these metals in mercury accumulation and depuration. 17 refs., 3 figs., 2 tabs.« less

Radiation safety aspects of production of commercial levels of medical radioisotopes

The first step toward efficient radiation safety in a facility that intends to produce commercial levels of radionuclides is to nticipate the scope of the facility during the design stages of the physical plant and during formulation of operating procedures. The design and operation must include flexibility to accommodate changing needs of production and research and development while providing radiation safety. A recently proposed licensing guide from the Bureau of Radiation Control, Texas Department of Health, while providing for safe operation, would severely limit flexibility and development. For example, engineering controls and procedures should be specified for generic systems as opposed to each specific radionuclide and by-products. Operator training is critical for reduced exposure and should be addressed, but requiring prior training for all operators is not reasonably achievable and would result in loss of proprietary information. Procedures to reduce exposure should include experimentally determined “cooldown” times, “problem indexes” for specific jobs related to particular cyclotrons, and proper management and administrative structures.

Firearm-Related Deaths— Louisiana and Texas, 1970-1990

In 1990, firearm-related injuries surpassed motor-vehicle crashes as the leading cause of death from injuries in both Louisiana and Texas, and from 1979 through 1987, these states ranked third and fifth, respectively, for age-adjusted firearm-related death rates. Because firearm-related injuries are a major cause of death in Louisiana and Texas, the Louisiana Disability Prevention Program, Louisiana Office of Public Health, and the Injury Control Program, Epidemiology Division, Texas Department of Health, used death certificates to examine patterns in firearm-related mortality. This report summarizes the analysis of death certificate data for firearm-related mortality in these two states.