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September 2016 - Issue 8
Welcome to the Battelle Health & Analytics, a quarterly publication from Battelle. We put this together as a service to our public health clients, to keep you informed of the latest public health news from our researchers and the industry.
The Battelle Health & Analytics team works with agencies and healthcare institutions to advance public health research, practice and policy with the latest science and technology. Battelle Health and Analytics will keep you up-to-date on cutting edge research and public health innovations.
The Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Disease Control and Prevention (CDC) have released a new report that provides a comprehensive overview of trends in marijuana use and attitudes from 2002 to 2014. The surveillance summary is the first of its kind to analyze historical trends in data from SAMHSA’s annual survey of drug attitudes and behaviors.
Researchers examined historical patterns over the 12-year period, including trends in marijuana use across different age groups as well as related indicators (perceptions, access, penalties for use, etc.). Among the key findings was that the prevalence of marijuana use during the past month, past year, and daily or almost daily increased over the studied period among persons aged ≥18 years, but not among those aged 12–17 years. Other finding include:
Overall, the surveillance summary showed a decrease in the perception of great risk from smoking marijuana combined with increases in the perception of availability (i.e., fairly easy or very easy to obtain marijuana) and fewer punitive legal penalties (e.g., no penalty). While the survey data is not conclusive to link causes and effects, it seems likely that the movement towards greater legalization of medical and recreational marijuana use across the country, and the associated rise of legal distribution systems, has contributed to these overall trends.
With more states moving towards relaxing marijuana laws, and a national push for decimalization of marijuana, more research is needed to understand how public policy, criminal law and education impact marijuana behaviors and attitudes. The changing attitudes and beliefs of youth around the risks and availability of marijuana is of particular concern. While this survey did not show an increase in use or initiation behaviors among youth over the studied time period, lower perceptions of risk and higher availability of drugs are generally associated with higher levels of use. More frequent surveys may be needed to monitor marijuana use and initiation among youth ages 12-17 and determine whether changing attitudes will eventually lead to increased use behaviors. Better data will help federal, state and local public health officials develop targeted prevention activities to reduce youth initiation of marijuana use, prevent marijuana dependence and abuse and prevent adverse health effects.
“National Estimates of Marijuana Use and Related Indicators—National Survey on Drug Use and Health, United States, 2002-2014” was published by CDC in Morbidity and Mortality Weekly Report (MMWR) in September. Battelle’s Gillian Schauer was one of five co-authors on the report and contributed to the historical analysis. The full report can be downloaded from MMWR. State level data can be found at SAMHSA.
Researchers at Battelle are examining trends and exposure risks related to co-administration of tobacco and marijuana. Two papers based on recent studies have now been accepted for publication in peer-reviewed journals.
Marijuana use is on the rise, with 8.4% of the population older than 12 reporting use in the past month in the most recent Substance Abuse and Mental Health Service Administration (SAMHSA) survey. Nearly 70% of adults who smoke marijuana also smoke tobacco. However, much remains unknown about the specific behaviors and exposure risks related to co-administration of tobacco and marijuana. In particular, there are many research questions around the growing trend of smoking blunts (partially or entirely hollowed out cigar wrappers refilled with marijuana) or spliffs/mulled cigarettes (joints filled with both loose-leaf tobacco and marijuana). These administration methods, which combine marijuana and tobacco in the same product to be smoked at the same time, may lead to different patterns of addictive behavior and compounded health effects.
The two Battelle studies examine different aspects of tobacco and marijuana co-administration.
Battelle has a long history of work in tobacco and nicotine exposure and addiction. The Battelle Public Health Center for Tobacco Research is nationally and internationally known for cutting-edge work with a wide variety of tobacco and nicotine products, including cigars and cigarettes, smokeless tobacco products, e-cigarettes, waterpipes and other emerging tobacco and nicotine delivery products. Marijuana products and co-administered products are a logical extension of this work.
Battelle researchers plan to extend this work with additional studies around the use of blunts and spliffs, and in particular the role of flavorings in influencing use behaviors. They recently completed a pilot study survey to determine how flavored tobaccos are being used in co-administered products. The study determined that flavored tobaccos are widely used in co-administration, especially wine and fruit flavors. However, additional research is needed to determine why users prefer flavored tobaccos, how often they use flavored tobaccos, and whether the availability of flavored tobaccos (especially sweet varieties) encourages greater product use or influences initiation of smoking behaviors in youth.
With marijuana legalized for medical or recreational use in more than half of all U.S. states, increased access and changing perceptions of risk are altering use behaviors among all age groups. Additional studies are urgently needed to guide public policy and educational outreach efforts related to marijuana use by itself and in co-administered products. The Battelle Public Health Center for Tobacco Research continues to lead the way in asking—and answering—critical questions around exposure risks and use behaviors for tobacco and marijuana, used together or separately.
The year 1982 is known for the release of the Commodore 64 computer, the first CD player by Sony and the movie, ET. It was also the year that Battelle was awarded its first task order contract to provide statistical and technical support to the U.S. Environmental Protection Agency’s (EPA) Office of Toxic Substances. Since then, personal computers have become small enough to fit in your pocket, CD players have been replaced by music streaming services and the cast of ET are all grown up. One thing that hasn’t changed? Battelle continues to do work for the EPA, with several employees supporting the organization for over 25 years. In fact, the team recently won a contract worth $16.9 million over the next five years, the most recent rebid of the task order contract that Battelle has held, with no interruptions, since 1982.
The EPA’s Office of Toxic Substances is now the Office of Pollution Prevention and Toxics (OPPT). Battelle Health Analytics scientists and researchers from the Health & Consumer Solutions business unit continue to provide statistical and technical support to OPPT, primarily to fulfill a key mission of characterizing the risks of existing chemicals to human health and the environment as required by the Toxic Substances Control Act (TSCA).
Since the initial contract, Battelle has held approximately 60 task order contracts with EPA. “In the last three decades, Battelle has established a very strong relationship with the EPA,” said Bruce Buxton, Research Leader and Project Manager. “Over the years, we have consistently delivered high quality research, demonstrated the breadth and depth of our capabilities and built a reputation for success. All of which contributed to winning this contract and opportunity to work with the agency for another five years.”
Throughout the life of the contract with the OPPT, the Battelle team has conducted research across a number of different areas including lead poisoning protection, high priority chemicals and water contamination, among others.
After Congress enacted major amendments to the Lead-Based Paint Poisoning Prevention Act in 1987, Battelle began conducting research to assess the impact of exposure by young children to lead-based paint hazards, how lead moves around the environment, and the adverse health impacts of lead exposure to those under a certain age. Battelle’s findings provided the OPPT with the scientific basis needed to develop regulation on lead levels in paint, dust, and soil, as well as guidance on minimizing lead-based paint hazards when performing renovation, remodeling, and painting activities. Since then, the team has conducted community outreach and education for the general public, contractors and home buyers, and continued to conduct studies that inform updated policies and procedures.
In addition to the work done in the lead poisoning prevention space, the team has also focused on exposures and health effects associated with high priority chemicals, including formaldehyde that is released from some composite wood products. They have worked to reach the manufacturers and distributors of these wood products and to educate them on the dangers associated with exposure.
Currently, they are focused on conducting statistical trend analysis on water quality measures in the New York/New Jersey Harbor System to assess the environmental impact of Superstorm Sandy that hit the East Coast in 2012.
Keeping a contract with the same government agency for over three decades does not happen by accident. It is the direct result of the importance of nurturing relationships, providing outstanding service and quality work, time and time again.
“It has been extremely rewarding to work alongside this team on such a wide variety of projects for that have the potential to do so much good for society,” said Bruce. “We are all excited to see what we can accomplish with another five years.”
Stephanie Kute and Chad Konchak delivered an Express Workshop on data analytics for medical devices at the MD&M East Educational Conference in June. Their talk, titled Harnessing Data Analytics in the Design and Development of Medical Devices to Address Patient Care Gaps,” focused on emerging applications of “big data” analytics to build smart devices, predict and prevent adverse outcomes, and deliver personalized healthcare.
Stephanie Kute is a Manager for Consumer, Industrial and Medical Products for Battelle. Chad Konchak is the Director of Clinical Analytics for Northshore University Health System.
Battelle is an industry leader in healthcare data analytics. One of our applications is Battelle EluciData™, a healthcare data analytics program that uses advanced machine learning, pattern recognition and bioinformatics to bring new understanding to complex medical questions. Battelle also created the Battelle WayFinder™ QI Dashboard, a quality improvement analytics tool that allows hospitals to analyze trends and monitor performance. Stephanie and the Battelle Health and Analytics team are continuing to pioneer new applications for data analytics in healthcare.
Stephanie Domas of Battelle moderated a panel on medical device cybersecurity at the Medical Device Cybersecurity Risk Mitigation Conference in July.
The panel, titled “Effectively Addressing Cybersecurity in Medical Devices: The Inherent Risks, Impacts of Security Decisions, and Practical Approaches,” explored the vulnerabilities and risks inherent with embedded and connected devices and the range of impacts these have on medical devices. Panelists shared practical approaches companies may employ to more effectively address cybersecurity risks, including engineering, policy, expertise/team makeup, and others. Areas discussed included: recognizing vulnerabilities and risks in embedded medical devices, understanding the impacts of cybersecurity decisions in a medical device, integrating cybersecurity into corporate DNA and building an effective cybersecurity team.
Panelists were Steve Abrahamson of GE Healthcare, Bob Banta of Eli Lilly & Company and Tara Larson of Medtronic.
Modern and connected medical devices include an increasing array of features that can be intentionally or unintentionally misused. To help medical manufacturers mitigate their cybersecurity risks, Battelle has put together a suite of services called DeviceSecure™ Services, which incorporates secure design, threat and vulnerability assessment, anti-tampering and anti-counterfeiting measures.
Stephanie Domas is Lead Security Engineer for Battelle’s DeviceSecure® Services. In this role, she is responsible for the design, architecture, verification and execution of security best practices in the development of new medical devices as well as the testing and cybersecurity risk mitigation of legacy systems. Stephanie is a registered Professional Engineer (PE) in the state of Ohio and a Certified Ethical Hacker (CEH). She sits on several standards committees involved in furthering cybersecurity for medical products. She also serves as an adjunct faculty member at the Ohio State University College of Computer Engineering.
Please join us in welcoming our latest additions to the Battelle Health and Analytics team. Their research and clinical experience will help us to continue to expand our public health research programs and services.
Carl Blaesing Jr. is joining the Medical Readiness and Response (MRR) team as a Research Scientist. Carl will serve as an Occupational and Environmental Health (OEH) expert, assisting military medical and public health clients to achieve effective medical, public health and senior leader preparedness for identification and mitigation of environmental hazards, toxic industrial chemicals, emerging diseases and other hazards impacting environmental health mission requirements. Carl has over more than 20 years of experience in the management, execution and evaluation of occupational and environmental health, safety and emergency management programs as an Environmental Health Officer in the U.S. Navy, most recently serving as Force Health Protection Officer for Commander, U.S. Naval Forces Central Command, 5th Fleet. Carl is a Registered Environmental Health Specialist (REHS)/Registered Sanitarian with expertise in Public Health Law, Emergency Management, Outbreak Investigation, Disease Surveillance, Biosurveillance, Microbiology, Parasitology and Curriculum Development. Carl received his Master of Public Health (MPH) in Environmental Health from the Ohio State University. He also holds an MS in Emergency and Disaster Management and a Graduate Certificate in Health Law.
Alice Chapman is joining the Medical Readiness and Response (MRR) Team as a Senior Occupations & Environmental Health Professional. In this role, she will assist military medical and public health clients to achieve effective medical, public health and senior leader preparedness for identification and mitigation of health hazards, emerging diseases and other hazards impacting mission requirements. Alice is a board-certified public health professional with 24 years of experience in public health practice, research, epidemiology, clinical medicine and project management. Her most recent assignment was as Air Combat Command Public Health Officer at Joint Base Langley-Eustis, Virginia, where she directed communicable disease, occupational health, food safety and injury prevention programs. Alice also currently serves as Adjunct Faculty for Science at St. Leo University, and as an Adjunct Professor of Community Health at the Center for Global Health, Boonshoft School of Medicine at Wright State University in Dayton, Ohio. Alice is a Licensed Doctor of Veterinary Medicine, and a Diplomate with the American College of Veterinary Preventive Medicine. Other areas of expertise include occupational health, data collection tools, data analysis, technical writing and project management. Alice received her Doctor of Veterinary Medicine from the North Carolina State University. She also holds a BA in Biology from the University of North Carolina, Greensboro, and a Master of Public Health (MPH) from the Uniformed Services University of Health Sciences.
The Battelle Health and Analytics team frequently publishes peer-reviewed research as well as trade articles highlighting their work. Here are some notable recent publications.