Young Gay Men Bullied to Death - more data just in..

As if we need more data to convey the impact of homophobia, stigmatisation and outright bullying on suicide among young gay males, adding to the prior post on this subject, this article in the latest issue of the American Journal of Public Health: Intersecting Identities and the Association Between Bullying and Suicide Attempt Among New York City Youths: Results From the 2009 New York City Youth Risk Behavior Survey found that the effect of bullying on suicide attempt was strongest among non-Hispanic sexual minority male youths (odds ratio = 21.39 vs 1.65–3.38 for other groups).  A public health tragedy that needs greater intervention.

Duelling Rail Corridor Coal Dust Studies Confuses Community

THE latest of three local (Newcastle, Australia) rail-corridor studies on coal dust was released last week. I published an opinion piece on the confusion these duelling dust studies are causing in the community.
The first study was released by the Australian Rail Track Corporation (ARTC) in October 2012. It had multiple limitations and was dismissed by community activists. Under the auspices of the Coal Terminal Action Group (CTAG), they responded by designing and conducting their own community-funded study of coal dust in Newcastle and the Lower Hunter coal train corridor.
The community study also had multiple limitations including - according to Professor Howard Bridgman, the consultant to the study - an inability to reliably calibrate the particle monitors.
Now the ARTC has released the third study of coal dust in the rail corridor. CTAG has dismissed this and says it will begin fund-raising to conduct a fourth study.
Many members of the community are confused by the duelling claims of health impacts and the uncertainty surrounding each of the studies. Uncertainty about health impacts is itself a source of psychological stress and a cause of poor health. More here

Same Love - Rapper Leads Public Health Campaign for Marriage Equality

When I  think of needless public health tragedies, uppermost in my mind are smoking and the suicide of young gay men who feel there is no place for them in a homophobic world.  Lutwaks short piece and accompanying references in The Impact of Not Legalizing Same-Sex Marriage on the Lesbian, Gay, Bisexual, and Transgender Community in the American Journal of Public Health again identifies more evidence that the stigmatisation of gays, lesbians and transgender people leads to suicidal ideation and suicide.  Equal right to marriage is an important public health initiative that can help redress this stigmatisation.  I am grateful to my teenage sons for introducing me to Mackelmore, the rapper from Seattle and Same Love  - the words and images in the music video are raw and honest and there is a touching story played out in a "short film" format.  Send this Youtube clip to everyone you know, the more young (and old) people that see this the better the world will be. Here is a taste of the lyrics..

International Online Influenza-like Illness Surveillance Systems Unite

On April 15 in Amsterdam, the three largest online ILI surveillance systems in the world signed an agreement to share data and harmonise analysis and data display to help build a global picture of influenza transmission.  The collaborators at the official signing were the lead researchers (from L to R) from Flutracking.net Australia (Craig Dalton),Influenzanet Europe (Ronald Smallenburg and Daniella Paolotti) and Flu Near You USA (John Brownstein - Health Map and Mark Smolinkski - Skoll Global Threats)
More on the share learnings from this meeting soon.

Submission to the Air Pollution and Health Senate Inquiry

I made a submission to the Senate Inquiry into the Impacts on Health of Air Quality in Australia as a private citizen entitled How to investigate the impact of coal mining on community health - a  Hunter Valley Perspective.
It focused on 3 suggested solutions:
1. Integrate toxicological and epidemiological research to identify the major sources of
environmental health risk and quantify the risk.
2. Develop an independent Environmental Health Investigation and Conflict Resolution
Centre in the Hunter to:
a. Respond to the environmental health concerns of the community.
b. Initiate participatory research on the environmental health impacts of mining
and related industries collaboratively between community, academia and
government.
3. Develop better methods for assessment and approval of major projects that are
strategic, based on explicit values, participatory and deliberative with stakeholders.
It received some local coverage in Singleton Argus and ABC 1233 and the EPA have started discussing the conceptual model for balancing psychological and physical risk on page 8 of the submission.

H7N9 - Betting its not a pandemic in the making.

So the world is watching the emergence of H7N9 avian influenza - the H7 strain not usually infecting humans - causing severe illness and death in China. But I think it is this paper: Using Routine Surveillance Data to Estimate the Epidemic Potential of Emerging Zoonoses: Application to the Emergence of US Swine Origin Influenza A H3N2v Virus,  and reflecting on the emergence of the 2009 pandemic that causes me to doubt the pandemic potential of an influenza virus that, when we first hear about it, is apparently directly associated with zoonotic spill over - not in all cases but in significant numbers of cases. 

I think the chance of us “being there” in the early days or weeks of the next pandemic and actually seeing it spill from animals to humans is extremely remote and so when we see significant numbers of cases associated with chicken or pig exposure, as in the current H7N9 issue and the recent pig associated H3N2 clusters in the USA,  then I suspect it will more often then not stay that way.    I suspect most of the initial spill overs will escape our surveillance and arise in humans without any immediately recognised links to animals – as did the 2009 H1N1 pandemic.  But this is just a probabilistic argument which will fail sometimes - hence the need to remain watchful.

CDC Conference 2013, Canberra, Australia - Day 2

 Day 2 of CDC 2013, the main themes were foodborne disease, vaccine preventable diseases and anti-microbial resistance.

Blogging CDC 2013 Canberra, Australia, Day 1

Blogging some highlights from the Australian CDC 2013 Conference - the peak biannual communicable disease surveillance conference in Australia. The presentations should be available on the website soon. Some highlights from the morning panel session was John Kaldor's (from Kirby Institute) comment that the decreased rate of viral warts in young men prior to the roll out of the male HPV vaccine suggests "that we probably don't need to vaccinate guys as the women have it covered".   Rosemary Lester, CHO of Victoria - but speaking as chair of the Communicable Disease Network of Australia described a vision of national surveillance out to 2020. Allan Cheng from University of Melbourne asked what were the barriers to a CDC i.e. a federal centre for disease control akin to the US CDC or European ECDC in Australia.  It was obvious that this was an uncomfortable question for some of the panelists.More highlights..

Randomness is lumpy

Randomness is lumpy. Can you imagine anything less random than a bunch of trees all growing in a matrix each 2 metre apart, perfectly 2 metres apart. Or, if you dropped a handful of jelly beans and each one fell, perfectly 3 cm apart from each other.  Unlikely, and not "random". So why are we so surprised in public health (and life in general) when we see a "cluster"  (a time space aggregation) - isn't this what we should expect to see?   But then if we believe there is a cause behind everything is anything truly random or do we just not the reason determining the outcome.   See this nice article at 3quarks daily for more.

Obesity, low vitamin D and bi-directional mendelian randomisation

Just when you think you cant sort out cause and effect in cross sectional data correlating low vitamin D levels with obesity  – along comes bi-directional mendelian randomisation in PLOS Medicine. Interesting, from a previous post,  that a big chunk of the Environmental Health 2013 conference is devoted to the mediation of  environmental exposures via genetic and epigenetic pathways.

Health Risk Assessment - the leading edge from NTP

The National Toxicology Program, part of the National Institute for Environmental Science of NIH is a great resource for human toxicological information. You can subscribe to the NIEHS newsletter Environmental Factor for updates.

The NTP Office of Health Assessment and Translation has just released a Draft OHAT Approach for Systematic Review and EvidenceIntegration for Literature-based Health Assessments – February 2013 – it provides a seven-step framework for conducting evaluations using principles of systematic review. I particularly like the way step 5 (Rate confidence in the body of evidence)  and Step 6 (Translate confidence ratings into evidence of health effects) are described in Figure 1. 

Reviewing my Journal Table of Contents Alerts

Its 2013 and time to review my journal table of contents alerts.  I have decided to reduce the number of journals I will follow and focus on higher quality journals.  I sed the journal impact factor to review top ranked journals in public health/enviromental health. I know there is controversy as to whether the impact factor is the best guide to the importance of  journal so I used the Thomson Reuters Journal Citation Reports which includes other metrics to fine tune my selection. Basically, impact factor was not so different to "Article Influence Score" for most of the public health/environmental health journals of interest - except for Annual Reviews in Public Health which is only ranked 5 in impact factor but number 2 in "Article Influence Score".   Here follows the journals dropped from the reading list in 2013, those added and those continued..

Willingness to Share Research Data Is Related to the Strength of the Evidence and the Quality of Reporting of Statistical Results

We all know we should - but now we have evidence to support open sharing of data. In the summer of 2005, Wicherts and colleagues contacted the corresponding authors of 141 papers that were published in American Psychological Association journals which contract authors to openly share their data after publication (as do PLOS One).  Although all corresponding authors had signed a statement that they would share their data for verification purposes, most authors failed to do so and the authors of papers with more statistical errors were less likely to share their data.

What's hot in Environmental Health - check the program

Although I won't make Environmental Health 2013 in Boston - just reading the program provides great insight into what's hot in environmental health at this important conference - climate change and health, low dose exposure to industrial chemicals, and genetic and epigenetic mediators of environmental diseases.