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Papers by Alicia Fletcher

BACKGROUND: Homicide and assault are commonly thought of as a problem for the criminal justice sy... more BACKGROUND: Homicide and assault are commonly thought of as a problem for the criminal justice system, however, homicide and assault also are a significant public health. In fact, homicide is the second leading cause of death for New Yorkers ages 15-34 years old. Assaults affect the quality of the victim’s life and can result in long-term diminished health, job changes, loss of income and depression. METHODS: NYS vital statistics death files, inpatient and outpatient hospital discharge data and data from the Bureau of Labor Statistics’ Survey of Occupational Injuries and Illnesses and Census of Fatal Occupational Injuries were used to track the incidence of assault-related injuries and deaths for New York residents and workers during the period 2008-2010. RESULTS: Homicides among New Yorkers resulted in an annual average of 832 deaths and 14 work-related fatalities. In addition, there was an annual average of 94,610 residents treated at a hospital for assault-related injuries – 9,27...

MMWR. Morbidity and mortality weekly report

Over the past several decades there has been a remarkable reduction in environmental sources of l... more Over the past several decades there has been a remarkable reduction in environmental sources of lead, improved protection from occupational lead exposure, and an overall decreasing trend in the prevalence of elevated blood lead levels (BLLs) in U.S. adults. As a result, the U.S. national BLL geometric mean among adults was 1.2 µg/dL during 2009–2010 (1). Nonetheless, lead exposures continue to occur at unacceptable levels (2). Current research continues to find that BLLs previously considered harmless can have harmful effects in adults, such as decreased renal function and increased risk for hypertension and essential tremor at BLLs <10 µg/dL (3–5). CDC has designated 10 µg/dL as the reference BLL for adults; levels ≥10 µg/dL are considered elevated (2). CDC's Adult Blood Lead Epidemiology and Surveillance (ABLES) program tracks elevated BLLs among adults in the United States (2). In contrast to the CDC reference level, prevailing Occupational Safety and Health Administration...

Public health reports (Washington, D.C. : 1974)

Laboratories that test New York State (NYS) employees and adult residents for lead exposure are r... more Laboratories that test New York State (NYS) employees and adult residents for lead exposure are required to report blood lead test results to the NYS Department of Health's Heavy Metals Registry. This registry is used to monitor exposures and to identify new high-risk occupational and nonoccupational activities. We used interviews conducted with people having blood lead levels of > or = 25 micrograms/deciliter (microg/dL) reported to the Heavy Metals Registry to determine the primary source of lead exposure. We reviewed this information, together with demographic information, for the years 1994 through 2006. While overall there has been an increase in the number of tests being conducted on NYS residents since 1994, the vast majority of the increase is among those with the lowest blood lead levels (<10 microg/dL). Conversely, there has been a decline in the number of adults tested with blood lead levels of > or = 25 microg/dL in NYS due primarily to occupational exposure...

Journal of community health, 1999

The purpose of this study was to examine the circumstances under which women receive blood lead t... more The purpose of this study was to examine the circumstances under which women receive blood lead tests in New York State and to characterize the sources of lead exposure among women of childbearing age with moderate blood lead levels. Telephone interviews were conducted with 135 women between the ages of 18 and 45, with blood lead levels from 10 through 25 micrograms/dl, were used to collect information on the reason for their blood lead test and possible sources of lead exposure. It was found that the two most common reasons to be tested for blood lead were workplace screening (47%) and pregnancy (27%). Occupational exposure was the primary source of lead exposure in this population (46%). Another common source of lead exposure was home renovation (24%). A significant proportion (31%) of women with blood lead levels from 10 through 25 micrograms/dl had no known current source of lead exposure. Based on New York's sample, there are a significant number of women of reproductive ag...

Journal of Occupational and Environmental Medicine, 2006

The objective of this study was to characterize the work-related asthma population seen by the Ne... more The objective of this study was to characterize the work-related asthma population seen by the New York State Occupational Health Clinic Network (OHCN) to determine which industries, occupations, and causal agents are associated with work-related asthma in New York State (NYS). The OHCN patient database was analyzed to identify those patients with a diagnosis of work-related asthma and medical charts were then abstracted for data on demographics, clinical history, disease severity, industry, occupation, and putative agent. The OHCN patients with work-related asthma were most commonly employed in the service and manufacturing industries. Common occupations included teachers, farm operators/managers, and construction trades. The most frequently reported putative agents associated with work-related asthma were dust, indoor air, mold, and solvents. Our findings suggest the potential importance of prevention of workplace exposure in reducing adult asthma in NYS.

Journal of Community Health, 2013

The extent of methylmercury exposures among adults in New York State (NYS) has not been well char... more The extent of methylmercury exposures among adults in New York State (NYS) has not been well characterized. Over the past few years, the NYS Heavy Metals Registry (HMR) has seen an increase in both blood mercury tests being reported, and nonoccupational exposures to mercury, which appear primarily due to fish consumption. This study will, (1) Characterize the adults who are tested for blood mercury in NYS; (2) Examine the circumstances for blood mercury testing; and (3) Characterize this population in terms of exposure history, specifically those individuals who are non-occupationally exposed through a diet of seafood consumption in reference to blood mercury levels. Data available from HMR laboratory results, including basic demographics and test results, were combined with data from telephone interviews. The interview contains information on the reasons for testing, possible sources of exposure, and the individual's work and home environment. Approximately 99 % of adults reported to the HMR, with identifiable exposures to mercury, had non-occupational exposures resulting from seafood consumption. Common types of fish consumed include salmon, tuna, and swordfish, with 90 % of adults eating seafood a few times or more per week. Information will be provided on the reasons for being tested and the range of blood mercury levels in relation to their seafood consumption. NYS residents who frequently eat fish should be aware of what types of fish contain mercury and avoid or reduce consumption of fish with high mercury levels.

The Moving Image: The Journal of the Association of Moving Image Archivists, 2013

BACKGROUND: Homicide and assault are commonly thought of as a problem for the criminal justice sy... more BACKGROUND: Homicide and assault are commonly thought of as a problem for the criminal justice system, however, homicide and assault also are a significant public health. In fact, homicide is the second leading cause of death for New Yorkers ages 15-34 years old. Assaults affect the quality of the victim’s life and can result in long-term diminished health, job changes, loss of income and depression. METHODS: NYS vital statistics death files, inpatient and outpatient hospital discharge data and data from the Bureau of Labor Statistics’ Survey of Occupational Injuries and Illnesses and Census of Fatal Occupational Injuries were used to track the incidence of assault-related injuries and deaths for New York residents and workers during the period 2008-2010. RESULTS: Homicides among New Yorkers resulted in an annual average of 832 deaths and 14 work-related fatalities. In addition, there was an annual average of 94,610 residents treated at a hospital for assault-related injuries – 9,27...

MMWR. Morbidity and mortality weekly report

Over the past several decades there has been a remarkable reduction in environmental sources of l... more Over the past several decades there has been a remarkable reduction in environmental sources of lead, improved protection from occupational lead exposure, and an overall decreasing trend in the prevalence of elevated blood lead levels (BLLs) in U.S. adults. As a result, the U.S. national BLL geometric mean among adults was 1.2 µg/dL during 2009–2010 (1). Nonetheless, lead exposures continue to occur at unacceptable levels (2). Current research continues to find that BLLs previously considered harmless can have harmful effects in adults, such as decreased renal function and increased risk for hypertension and essential tremor at BLLs <10 µg/dL (3–5). CDC has designated 10 µg/dL as the reference BLL for adults; levels ≥10 µg/dL are considered elevated (2). CDC's Adult Blood Lead Epidemiology and Surveillance (ABLES) program tracks elevated BLLs among adults in the United States (2). In contrast to the CDC reference level, prevailing Occupational Safety and Health Administration...

Public health reports (Washington, D.C. : 1974)

Laboratories that test New York State (NYS) employees and adult residents for lead exposure are r... more Laboratories that test New York State (NYS) employees and adult residents for lead exposure are required to report blood lead test results to the NYS Department of Health's Heavy Metals Registry. This registry is used to monitor exposures and to identify new high-risk occupational and nonoccupational activities. We used interviews conducted with people having blood lead levels of > or = 25 micrograms/deciliter (microg/dL) reported to the Heavy Metals Registry to determine the primary source of lead exposure. We reviewed this information, together with demographic information, for the years 1994 through 2006. While overall there has been an increase in the number of tests being conducted on NYS residents since 1994, the vast majority of the increase is among those with the lowest blood lead levels (<10 microg/dL). Conversely, there has been a decline in the number of adults tested with blood lead levels of > or = 25 microg/dL in NYS due primarily to occupational exposure...

Journal of community health, 1999

The purpose of this study was to examine the circumstances under which women receive blood lead t... more The purpose of this study was to examine the circumstances under which women receive blood lead tests in New York State and to characterize the sources of lead exposure among women of childbearing age with moderate blood lead levels. Telephone interviews were conducted with 135 women between the ages of 18 and 45, with blood lead levels from 10 through 25 micrograms/dl, were used to collect information on the reason for their blood lead test and possible sources of lead exposure. It was found that the two most common reasons to be tested for blood lead were workplace screening (47%) and pregnancy (27%). Occupational exposure was the primary source of lead exposure in this population (46%). Another common source of lead exposure was home renovation (24%). A significant proportion (31%) of women with blood lead levels from 10 through 25 micrograms/dl had no known current source of lead exposure. Based on New York's sample, there are a significant number of women of reproductive ag...

Journal of Occupational and Environmental Medicine, 2006

The objective of this study was to characterize the work-related asthma population seen by the Ne... more The objective of this study was to characterize the work-related asthma population seen by the New York State Occupational Health Clinic Network (OHCN) to determine which industries, occupations, and causal agents are associated with work-related asthma in New York State (NYS). The OHCN patient database was analyzed to identify those patients with a diagnosis of work-related asthma and medical charts were then abstracted for data on demographics, clinical history, disease severity, industry, occupation, and putative agent. The OHCN patients with work-related asthma were most commonly employed in the service and manufacturing industries. Common occupations included teachers, farm operators/managers, and construction trades. The most frequently reported putative agents associated with work-related asthma were dust, indoor air, mold, and solvents. Our findings suggest the potential importance of prevention of workplace exposure in reducing adult asthma in NYS.

Journal of Community Health, 2013

The extent of methylmercury exposures among adults in New York State (NYS) has not been well char... more The extent of methylmercury exposures among adults in New York State (NYS) has not been well characterized. Over the past few years, the NYS Heavy Metals Registry (HMR) has seen an increase in both blood mercury tests being reported, and nonoccupational exposures to mercury, which appear primarily due to fish consumption. This study will, (1) Characterize the adults who are tested for blood mercury in NYS; (2) Examine the circumstances for blood mercury testing; and (3) Characterize this population in terms of exposure history, specifically those individuals who are non-occupationally exposed through a diet of seafood consumption in reference to blood mercury levels. Data available from HMR laboratory results, including basic demographics and test results, were combined with data from telephone interviews. The interview contains information on the reasons for testing, possible sources of exposure, and the individual's work and home environment. Approximately 99 % of adults reported to the HMR, with identifiable exposures to mercury, had non-occupational exposures resulting from seafood consumption. Common types of fish consumed include salmon, tuna, and swordfish, with 90 % of adults eating seafood a few times or more per week. Information will be provided on the reasons for being tested and the range of blood mercury levels in relation to their seafood consumption. NYS residents who frequently eat fish should be aware of what types of fish contain mercury and avoid or reduce consumption of fish with high mercury levels.

The Moving Image: The Journal of the Association of Moving Image Archivists, 2013