We regularly disseminate our work in peer-reviewed journals and conferences.  We are also invited to speak at industry group meetings and university courses.

 

A sampling of recent publications and presentations
Window of Opportunity for New Disease Surveillance: Developing Keyword Lists for Monitoring Mental Health and Injury Through Syndromic Surveillance

Lauper, U., Chen, J., Lin, S. 2016 Disaster Medicine and Public Health Preparedness

Studies have documented the impact that hurricanes have on mental health and injury rates before, during, and after the event. Since timely tracking of these disease patterns is crucial to disaster planning, response, and recovery, syndromic surveillance keyword filters were developed by the New York State Department of Health to study the short- and long-term impacts of Hurricane Sandy. Emergency department syndromic surveillance is recognized as a valuable tool for informing public health activities during and immediately following a disaster. Data typically consist of daily visit reports from hospital emergency departments (EDs) of basic patient data and free-text chief complaints. To develop keyword lists, comparisons were made with existing CDC categories and then integrated with lists from the New York City and New Jersey health departments in a collaborative effort. Two comprehensive lists were developed, each containing multiple subcategories and over 100 keywords for both mental health and injury. The data classifiers using these keywords were used to assess impacts of Sandy on mental health and injuries in New York State. The lists will be validated by comparing the ED chief complaint keyword with the final ICD diagnosis code.

The effects of PM2.5 on Cardiovascular Disease in Karachi, Pakistan

Lauper, U., Lin, Z., Lin, S., Lu, Y., and Khwaja, H. 2016 Invited presentation at the Fourth International Conference on Environmental Horizon, Karachi, Pakistan

Air pollution is a critical health problem in many developing countries, yet most long-term studies have been conducted in developed Western countries. The purpose of this study was to assess the impact of daily particulates (PM2.5) on respiratory related emergency department visits and hospitalizations in Karachi, Pakistan. Levels of PM2.5 were monitored for a period of three years at six sites (two each year) in Karachi, Pakistan, a city with over 20 million residents. Monitoring was conducted daily for a period of six weeks during spring, summer, fall, and winter. Additionally, daily emergency room (ER) visits and hospital admissions for respiratory disease were obtained by review of medical records at three major tertiary and specialized hospitals during the same time periods. A time stratified case-crossover study design was used to examine the association between daily PM2.5 levels and respiratory related ED visits and hospitalizations, and to examine potential effect modifiers such as age, sex, and residential neighborhood. In the first year, 2008, particulate levels were extraordinarily high, with the mean PM2.5 levels exceeding WHO’s 24 hour air quality guideline almost every day and often by a factor of greater than 5-fold. Additional analyses are currently ongoing.

Flood of Data: Information Sources for Analyzing the Health Impacts of Disaster Events

Lauper, U. 2016 Invited lecture at the SUNY Albany School of Public Health, Albany, NY

This presentation described the relationship between the disaster cycle, data resources, and public health research needs.  It examined sources of quantitative and qualitative data for conducting disaster-related epidemiological studies, including:

  • Rapid needs assessment
  • Syndromic surveillance
  • Emergency department and hospital discharge records
  • Other health records and registries
  • Large-scale surveys
  • Social media analytics
  • Linked datasets
  • Weather, census, and other complimentary datasets
Using hospital emergency department chief complaint data to assess the impact of Hurricane Sandy on risk of injury subcategories by age, sex, and time period in three affected New York counties

Lauper, U., Pantea, C., Chen, J., Chang, H., and Lin, S. 2015 American Public Health Association Conference, Chicago, IL

While hurricanes cause drastic levels of destruction, little research has been done on how injury types differ by age and sex, or how the risk of injury type changes over time. The study aim was to evaluate the risk of injury type by demographics and the short- and long-term health effects in the aftermath of Hurricane Sandy in New York State. Using syndromic surveillance data, we compared the number of injury subcategory chief complaints in three affected counties with non-affected counties. We analyzed data for all injuries combined and by selected subcategories and time period (13-day, 3-month, and 1-year).  To control for seasonality, these periods were also compared to the average of the same date ranges for the previous five-year periods. During the initial 13-day period, greater risk for falls was associated with age over 60 (RR 1.90, 95%CI 1.69-2.13), and being female (RR 1.75, 95%CI 1.56-1.96), while greater risk for vehicular injury was associated with age under 20 (RR 1.55, 95%CI 1.20-2.00) and being male (RR 1.34, 95%CI 1.13-1.59).  Furthermore, while overall risk for falls (RR 1.30, 95%CI 1.27-1.33) and vehicular injury (RR 1.27, 95%CI 1.23-1.31) remained significantly elevated through the one-year period, the risk for environmental injury did not (RR 1.03, 95%CI 0.96-1.12).  Additional results will be reported. We found different patterns in risk of injury category across age, sex, and short- and long-term effects.  Understanding how the risk of injury type can vary by demographics and over time can help disaster preparedness efforts.

Exploring the use of syndromic surveillance data to identify short- and long-term trends of mental illness in the aftermath of Hurricane Sandy in New York State

Lauper, U., Pantea, C., Chen, J., Chang, H., and Lin, S. 2015  Online Journal of Public Health Informatics

Emergency department chief complaint data provides an opportunity for capturing the early mental health impact of disaster events at the community level, and to track their impact over time. However, while rapid mental health assessment can facilitate a better understanding of the acute post-disaster period and aid early identification of persons at long-term risk, determining how wide a net to effectively capture the critical range of mental health sub-categories has not yet been clearly defined. This project creates a comprehensive set of mental health sub-category keywords, and applies them to evaluate short- and long-term trends in post- Hurricane Sandy mental health outcomes in New York State.

Carbon Monoxide Poisoning during Hurricane Sandy in Affected New York State Counties

Chen, J., Lauper, U., Pantea, C., Chang, H., and Lin, S. 2015 Online Journal of Public Health Informatics

CO poisoning is a leading cause of mortality and morbidity in disaster and post-disaster situations, when widespread power outages most likely occur. The NYSDOH Syndromic Surveillance System receives daily ED visit chief complaint data from 140 NYS (excluding New York City) hospitals. Daily power outage data are available from the NYS Department of Public Service (NYSDPS). These data can be used to estimate the risk of CO-EDs and provide useful information for public health situational awareness and emergency response management during disaster events.