TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Advances in the Diagnosis and Evaluation of Disabling Physical Health Conditions SN - DO - 10.17226/26941 PY - 2023 UR - https://nap.nationalacademies.org/catalog/26941/advances-in-the-diagnosis-and-evaluation-of-disabling-physical-health-conditions PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The U.S. Social Security Administration (SSA) provides benefits to adults and children who meet the eligibility requirements for a disability as described in Title II and Title XVI of the Social Security Act. To determine whether more accurate or precise techniques exist for determining if a previously evaluated physical impairment is either more or less severe, SSA requested the National Academies assemble a committee to review new or improved diagnostic or evaluative techniques that have become generally available within the past 30 years for cardiovascular, neurological, respiratory, hematological, and digestive conditions. The resulting report presents a summary of the evidence and information around a selected subset of diagnostic and evaluative techniques. ER - TY - BOOK AU - Institute of Medicine A2 - Erin Balogh A2 - Margie Patlak A2 - Sharyl J. Nass TI - Reducing Tobacco-Related Cancer Incidence and Mortality: Workshop Summary SN - DO - 10.17226/13495 PY - 2013 UR - https://nap.nationalacademies.org/catalog/13495/reducing-tobacco-related-cancer-incidence-and-mortality-workshop-summary PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Tobacco use is the leading cause of preventable death in United States, causing more than 440,000 deaths annually and resulting in $193 billion in health-related economic losses each year—$96 billion in direct medical costs and $97 billion in lost productivity. Since the first U.S. Surgeon General's report on smoking in 1964, more than 29 Surgeon General's reports, drawing on data from thousands of studies, have documented the overwhelming and conclusive biologic, epidemiologic, behavioral, and pharmacologic evidence that tobacco use is deadly. This evidence base links tobacco use to the development of multiple types of cancer and other life-threatening conditions, including cardiovascular and respiratory diseases. Smoking accounts for at least 30 percent of all cancer deaths, and 80 percent of lung cancer deaths. Despite the widespread agreement on the dangers of tobacco use and considerable success in reducing tobacco use prevalence from over 40 percent at the time of the 1964 Surgeon General's report to less than 20 percent today, recent progress in reducing tobacco use has slowed. An estimated 18.9 percent of U.S. adults smoke cigarettes, nearly one in four high school seniors smoke, and 13 percent of high school males use smokeless tobacco products. In recognition that progress in combating cancer will not be fully achieved without addressing the tobacco problem, the National Cancer Policy Forum of the Institute of Medicine (IOM) convened a public workshop, Reducing Tobacco-Related Cancer Incidence and Mortality, June 11-12, 2012 in Washington, DC. In opening remarks to the workshop participants, planning committee chair Roy Herbst, professor of medicine and of pharmacology and chief of medical oncology at Yale Cancer Center and Smilow Cancer Hospital, described the goals of the workshop, which were to examine the current obstacles to tobacco control and to discuss potential policy, outreach, and treatment strategies that could overcome these obstacles and reduce tobacco-related cancer incidence and mortality. Experts explored a number of topics, including: the changing demographics of tobacco users and the changing patterns of tobacco product use; the influence of tobacco use on cancer incidence and cancer treatment outcomes; tobacco dependence and cessation programs; federal and state level laws and regulations to curtail tobacco use; tobacco control education, messaging, and advocacy; financial and legal challenges to tobacco control efforts; and research and infrastructure needs to support tobacco control strategies, reduce tobacco related cancer incidence, and improve cancer patient outcomes. Reducing Tobacco-Related Cancer Incidence and Mortality summarizes the workshop. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - David A. Savitz A2 - Anne N. Styka A2 - David A. Butler TI - Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry SN - DO - 10.17226/23677 PY - 2017 UR - https://nap.nationalacademies.org/catalog/23677/assessment-of-the-department-of-veterans-affairs-airborne-hazards-and-open-burn-pit-registry PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Environment and Environmental Studies AB - Military operations produce a great deal of trash in an environment where standard waste management practices may be subordinated to more pressing concerns. As a result, ground forces have long relied on incineration in open-air pits as a means of getting rid of refuse. Concerns over possible adverse effects of exposure to smoke from trash burning in the theater were first expressed in the wake of the 1990–1991 Gulf War and stimulated a series of studies that indicated that exposures to smoke from oil-well fires and from other combustion sources, including waste burning, were stressors for troops. In January 2013, Congress directed the Department of Veterans Affairs (VA) to establish and maintain a registry for service members who may have been exposed to toxic airborne chemicals and fumes generated by open burn pits. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry analyzes the initial months of data collected by the registry and offers recommendations on ways to improve the instrument and best use the information it collects. This report assesses the effectiveness of the VA's information gathering efforts and provides recommendations for addressing the future medical needs of the affected groups, and provides recommendations on collecting, maintaining, and monitoring information collected by the VA's Airborne Hazards and Open Burn Pit Registry. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Reassessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry SN - DO - 10.17226/26729 PY - 2022 UR - https://nap.nationalacademies.org/catalog/26729/reassessment-of-the-department-of-veterans-affairs-airborne-hazards-and-open-burn-pit-registry PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Beginning with the 1990–1991 Gulf War, more than 3.7 million U.S. service members have been deployed to Southwest Asia, where they have been exposed to a number of airborne hazards, including oil-well fire smoke, emissions from open burn pits, dust and sand, diesel exhaust, and poor-quality ambient air. Many service members, particularly those who served in Iraq and Afghanistan, have reported health problems they attribute to their exposure to emissions from open-air burn pits on military installations. In 2013, Congress directed the Department of Veterans Affairs (VA) to establish and maintain the Airborne Hazards and Open Burn Pit (AH&OBP) Registry to "ascertain and monitor" the health effects of such exposures. This report serves as a follow-up to an initial assessment of the AH&OBP Registry completed by an independent committee of the National Academies in 2017. This reassessment does not include any strength-of-the-evidence assessments of potential relationships between exposures to burn pits or airborne hazards and health effects. Rather, this report assesses the ability of the registry to fulfill the intended purposes that Congress and VA have specified for it. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Anne N. Styka A2 - Bruce N. Calonge TI - Review of the Department of Veterans Affairs Presumption Decision Process SN - DO - 10.17226/27166 PY - 2023 UR - https://nap.nationalacademies.org/catalog/27166/review-of-the-department-of-veterans-affairs-presumption-decision-process PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The Department of Veterans Affairs (VA) provides health care and other benefits to eligible veterans with physical and mental injuries or illnesses (conditions) related to their military service. When the scientific information needed to connect a veterans service or a particular military exposure with their diagnosed condition is nonexistent, impossible to obtain, or incomplete, VA may make a presumption of service connection using a formalized decision process. In 2022, VA instituted a series of changes intended to ensure the presumption decision process was more scientifically based, fair, consistent, transparent, timely, and veteran-centric. The PACT Act of 2022 called for a National Academies committee to review the VA revised process document used to identify medical conditions to evaluate for presumption status, the factors that such an evaluation entails, and the governance process for the review and approval of a presumption recommendation. This resulting report, Review of the Department of Veterans Affairs Presumption Decision Process, contains the committee findings, conclusions, and recommendations. ER - TY - BOOK AU - Transportation Research Board AU - National Academies of Sciences, Engineering, and Medicine A2 - Philip Mein A2 - Andrew Kirchhoff A2 - Patrick Fangen TI - Impacts of Aging Travelers on Airports DO - 10.17226/22417 PY - 2014 UR - https://nap.nationalacademies.org/catalog/22417/impacts-of-aging-travelers-on-airports PB - The National Academies Press CY - Washington, DC LA - English KW - Transportation and Infrastructure AB - TRB’s Airport Cooperative Research Program (ACRP) Synthesis 51: Impacts of Aging Travelers on Airports describes the challenges of wayfinding, fatigue, technology and equipment, and needed amenities, as well as the practices that airports are enacting to accommodate and improve the airport experience of aging travelers. The report is designed to help users better understand the aging demographic, and define issues and implement effective practices to accommodate aging travelers at airports.View the ACRP Impacts on Practice related to this report. ER - TY - BOOK AU - Institute of Medicine AU - National Academies of Sciences, Engineering, and Medicine A2 - Deborah Cory-Slechta A2 - Roberta Wedge TI - Gulf War and Health: Volume 10: Update of Health Effects of Serving in the Gulf War, 2016 SN - DO - 10.17226/21840 PY - 2016 UR - https://nap.nationalacademies.org/catalog/21840/gulf-war-and-health-volume-10-update-of-health-effects PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - For the United States, the 1991 Persian Gulf War was a brief and successful military operation with few injuries and deaths. However, soon after returning from duty, a large number of veterans began reporting health problems they believed were associated with their service in the Gulf. At the request of Congress, the Institute of Medicine (IOM) has been conducting an ongoing review of the evidence to determine veterans' long-term health problems and potential causes. The fourth volume in the series, released in 2006, summarizes the long-term health problems seen in Gulf War veterans. In 2010, the IOM released an update that focuses on existing health problems and identifies possible new ones, considering evidence collected since the initial summary. Gulf War and Health: Volume 10 is an update of the scientific and medical literature on the health effects associated with deployment to the Gulf War that were identified in Volumes 4 and 8. This report reviews and evaluates the associations between illness and exposure to toxic agents, environmental or wartime hazards, or preventive measures and vaccines associated with Gulf War service, and provides recommendations for future research efforts on Gulf War veterans. ER - TY - BOOK AU - Institute of Medicine A2 - David Blumenthal A2 - Elizabeth Malphrus A2 - J. Michael McGinnis TI - Vital Signs: Core Metrics for Health and Health Care Progress SN - DO - 10.17226/19402 PY - 2015 UR - https://nap.nationalacademies.org/catalog/19402/vital-signs-core-metrics-for-health-and-health-care-progress PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Thousands of measures are in use today to assess health and health care in the United States. Although many of these measures provide useful information, their usefulness in either gauging or guiding performance improvement in health and health care is seriously limited by their sheer number, as well as their lack of consistency, compatibility, reliability, focus, and organization. To achieve better health at lower cost, all stakeholders - including health professionals, payers, policy makers, and members of the public - must be alert to what matters most. What are the core measures that will yield the clearest understanding and focus on better health and well-being for Americans? Vital Signs explores the most important issues - healthier people, better quality care, affordable care, and engaged individuals and communities - and specifies a streamlined set of 15 core measures. These measures, if standardized and applied at national, state, local, and institutional levels across the country, will transform the effectiveness, efficiency, and burden of health measurement and help accelerate focus and progress on our highest health priorities. Vital Signs also describes the leadership and activities necessary to refine, apply, maintain, and revise the measures over time, as well as how they can improve the focus and utility of measures outside the core set. If health care is to become more effective and more efficient, sharper attention is required on the elements most important to health and health care. Vital Signs lays the groundwork for the adoption of core measures that, if systematically applied, will yield better health at a lower cost for all Americans. ER - TY - BOOK TI - Review of a Screening Level Risk Assessment for the Navy Air Facility at Atsugi, Japan DO - 10.17226/9501 PY - 1998 UR - https://nap.nationalacademies.org/catalog/9501/review-of-a-screening-level-risk-assessment-for-the-navy-air-facility-at-atsugi-japan PB - The National Academies Press CY - Washington, DC LA - English KW - Conflict and Security Issues KW - Environment and Environmental Studies ER - TY - BOOK AU - National Research Council TI - Research Priorities for Airborne Particulate Matter: I. Immediate Priorities and a Long-Range Research Portfolio SN - DO - 10.17226/6131 PY - 1998 UR - https://nap.nationalacademies.org/catalog/6131/research-priorities-for-airborne-particulate-matter-i-immediate-priorities-and PB - The National Academies Press CY - Washington, DC LA - English KW - Environment and Environmental Studies AB - New National Ambient Air Quality Standards for airborne particles smaller than 2.5 micrometers, called PM2.5, were issued by the U.S. Environmental Protection Agency (EPA) amidst scientific uncertainty and controversy. In response to a request from Congress, Research Priorities for Airborne Particulate Matter, the first of four books in a series, offers a conceptual framework for an integrated national program of particulate-matter research, identifies the 10 most critical research needs linked to key policy-related scientific uncertainties, and describes the recommended timing and estimated costs of such research. The committee concludes that EPA should devote more resources to investigating the relationships between fixed-site outdoor monitoring data and actual human breathing-zone exposures to ambient particulate matter and to identifying the most biologically important constituents and characteristics of particulate matter through toxicological studies. The recommended research activities are critical to determining actual exposures of human subpopulations most susceptible to harm from the most hazardous constituents of particulate matter. Future research will be an investment in public health and a means to ensure that resources spent on control technology and regulatory compliance will have a reasonable probability of success. ER - TY - BOOK AU - National Research Council A2 - Thomas J. Plewes A2 - Kevin Kinsella TI - The Continuing Epidemiological Transition in Sub-Saharan Africa: A Workshop Summary SN - DO - 10.17226/13533 PY - 2012 UR - https://nap.nationalacademies.org/catalog/13533/the-continuing-epidemiological-transition-in-sub-saharan-africa-a-workshop PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences KW - Health and Medicine AB - Among the poorest and least developed regions in the world, sub-Saharan Africa has long faced a heavy burden of disease, with malaria, tuberculosis, and, more recently, HIV being among the most prominent contributors to that burden. Yet in most parts of Africa-and especially in those areas with the greatest health care needs-the data available to health planners to better understand and address these problems are extremely limited. The vast majority of Africans are born and will die without being recorded in any document or spearing in official statistics. With few exceptions, African countries have no civil registration systems in place and hence are unable to continuously generate vital statistics or to provide systematic information on patterns of cause of death, relying instead on periodic household-level surveys or intense and continuous monitoring of small demographic surveillance sites to provide a partial epidemiological and demographic profile of the population. In 1991 the Committee on Population of the National Academy of Sciences organized a workshop on the epidemiological transition in developing countries. The workshop brought together medical experts, epidemiologists, demographers, and other social scientists involved in research on the epidemiological transition in developing countries to discuss the nature of the ongoing transition, identify the most important contributors to the overall burden of disease, and discuss how such information could be used to assist policy makers in those countries to establish priorities with respect to the prevention and management of the main causes of ill health. This report summarizes the presentations and discussions from a workshop convened in October 2011 that featured invited speakers on the topic of epidemiological transition in sub-Saharan Africa. The workshop was organized by a National Research Council panel of experts in various aspects of the study of epidemiological transition and of sub-Saharan data sources. The Continuing Epidemiological Transition in Sub-Saharan Africa serves as a factual summary of what occurred at the workshop in October 2011. ER - TY - BOOK AU - Institute of Medicine A2 - Wilhelmine Miller A2 - Lisa A. Robinson A2 - Robert S. Lawrence TI - Valuing Health for Regulatory Cost-Effectiveness Analysis SN - DO - 10.17226/11534 PY - 2006 UR - https://nap.nationalacademies.org/catalog/11534/valuing-health-for-regulatory-cost-effectiveness-analysis PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Behavioral and Social Sciences AB - Promoting human health and safety by reducing exposures to risks and harms through regulatory interventions is among the most important responsibilities of the government. Such efforts encompass a wide array of activities in many different contexts: improving air and water quality; safeguarding the food supply; reducing the risk of injury on the job, in transportation, and from consumer products; and minimizing exposure to toxic chemicals. Estimating the magnitude of the expected health and longevity benefits and reductions in mortality, morbidity, and injury risks helps policy makers decide whether particular interventions merit the expected costs associated with achieving these benefits and inform their choices among alternative strategies. Valuing Health for Regulatory Cost-Effectiveness Analysis provides useful recommendations for how to measure health-related quality of- life impacts for diverse public health, safety, and environmental regulations. Public decision makers, regulatory analysts, scholars, and students in the field will find this an essential review text. It will become a standard reference for all government agencies and those consultants and contractors who support the work of regulatory programs. ER - TY - BOOK AU - Institute of Medicine A2 - William F. Page A2 - Heather A. Young A2 - Harriet M. Crawford TI - Long-Term Health Effects of Participation in Project SHAD (Shipboard Hazard and Defense) SN - DO - 10.17226/11900 PY - 2007 UR - https://nap.nationalacademies.org/catalog/11900/long-term-health-effects-of-participation-in-project-shad-shipboard-hazard-and-defense PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Environment and Environmental Studies AB - More than 5,800 military personnel, mostly Navy personnel and Marines, participated in a series of tests of U.S. warship vulnerability to biological and chemical warfare agents, Project SHAD (Shipboard Hazard and Defense), in the period 1962-1973. Only some of the involved military personnel were aware of these tests at the time. Many of these tests used simulants, substances with the physical properties of a chemical or biological warfare agent, thought at the time to have been harmless. The existence of these tests did not come to light until many decades later. In September 2002, the Institute of Medicine (IOM) agreed to undertake a scientific study, funded by the Veterans' Affairs, of potential long-term health effects of participation in Project SHAD. In general, there was no difference in all-cause mortality between Project SHAD participants and nonparticipant controls, although participants statistically had a significantly higher risk of death due to heart disease, had higher levels of neurodegenerative medical conditions and higher rates of symptoms with no medical basis. Long-Term Health Effects of Participation in Project SHAD focuses on the potential health effects of participation in Project SHAD. It is a useful resource for government defense agencies, scientists and health professionals. ER - TY - BOOK AU - Institute of Medicine A2 - Lynn Goldman A2 - Christine M. Coussens TI - Environmental Health Indicators: Bridging the Chasm of Public Health and the Environment: Workshop Summary SN - DO - 10.17226/11136 PY - 2004 UR - https://nap.nationalacademies.org/catalog/11136/environmental-health-indicators-bridging-the-chasm-of-public-health-and PB - The National Academies Press CY - Washington, DC LA - English KW - Environment and Environmental Studies KW - Health and Medicine AB - This report is the summary of the fourth workshop of The Roundtable on Environmental Health Sciences, Research, and Medicine. Environmental Indicators: Bridging the Chasm Between Public Health and the Environment, continues the overarching themes of previous workshops on rebuilding the unity of health and the environment. The purpose of the workshop was to bring people together from many fields, including federal, state, local, and private partners in environmental health, to examine potential leading indicators of environmental health, to discuss the proposed national health tracking effort, to look into monitoring systems of other nations, and to foster a dialogue on the steps for establishing a nationwide environmental health monitoring system. This workshop brought together a number of experts who presented, discussed, and debated the issues surrounding the implementation of a monitoring system. ER - TY - BOOK AU - Institute of Medicine TI - Preventing Low Birthweight: Summary SN - DO - 10.17226/512 PY - 1985 UR - https://nap.nationalacademies.org/catalog/512/preventing-low-birthweight-summary PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Written for a broad audience, including program administrators, policymakers, teachers, students, and health care professionals and their patients—anyone with an interest in preventing low birthweight—this summary is a condensation of the full report, Preventing Low Birthweight. It clearly and concisely covers most of the topics discussed in the comprehensive volume. 2-9 copies, $4.00 each; 10 or more copies, $2.50 each (no other discounts apply). ER - TY - BOOK AU - Institute of Medicine A2 - Karen M. Anderson TI - State and Local Policy Initiatives to Reduce Health Disparities: Workshop Summary SN - DO - 10.17226/13103 PY - 2011 UR - https://nap.nationalacademies.org/catalog/13103/state-and-local-policy-initiatives-to-reduce-health-disparities-workshop PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Although efforts to reduce health disparities receive attention at the national level, information on the successes of state and local efforts are often not heard. On May 11, 2009, the Institute of Medicine held a public workshop to discuss the role of state and local policy initiatives to reduce health disparities. The workshop brought together stakeholders to learn more about what works in reducing health disparities and ways to focus on localized efforts when working to reduce health disparities. ER - TY - BOOK AU - National Research Council TI - Eighteenth Interim Report of the Committee on Acute Exposure Guideline Levels DO - 10.17226/13002 PY - 2010 UR - https://nap.nationalacademies.org/catalog/13002/eighteenth-interim-report-of-the-committee-on-acute-exposure-guideline-levels PB - The National Academies Press CY - Washington, DC LA - English KW - Environment and Environmental Studies AB - The present report is the committee's 18th interim report. It summarizes the committee's conclusions and recommendations for improving NAC's AEGL documents for 25 chemicals: allyl alcohol, bis-chloromethyl ether, chloromethyl methyl ether, bromine pentafluoride, bromine trifluoride, chlorine pentafluoride, carbon tetrachloride, chloroform, chlorosilanes (26 selected compounds), epichlorohydrin, formaldehyde, hydrogen bromide, hydrogen iodide, methyl bromide, methyl chloride, nitric acid, nitric oxide, nitrogen dioxide, nitrogen tetroxide, piperidine, titanium tetrachloride, toluene, trimethylbenzenes (1,2,4-; 1,2,5-;and 1,3,5-TMB), vinyl acetate monomer, and vinyl chloride. ER - TY - BOOK AU - National Research Council A2 - Burton H. Singer A2 - Carol D. Ryff TI - New Horizons in Health: An Integrative Approach SN - DO - 10.17226/10002 PY - 2001 UR - https://nap.nationalacademies.org/catalog/10002/new-horizons-in-health-an-integrative-approach PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences KW - Health and Medicine AB - New Horizons in Health discusses how the National Institutes of Health (NIH) can integrate research in the social, behavioral, and biomedical sciences to better understand the causes of disease as well as interventions that promote health. It outlines a set of research priorities for consideration by the Office of Behavioral and Social Sciences Research (OBSSR), with particular attention to research that can support and complement the work of the National Institutes of Health. By addressing the range of interactions among social settings, behavioral patterns, and important health concerns, it highlights areas of scientific opportunity where significant investment is most likely to improve national—and global—health outcomes. These opportunities will apply the knowledge and methods of the behavioral and social sciences to contemporary health needs, and give attention to the chief health concerns of the general public. ER - TY - BOOK AU - Institute of Medicine TI - Evaluation of the U.S. Department of Defense Persian Gulf Comprehensive Clinical Evaluation Program DO - 10.17226/9057 PY - 1996 UR - https://nap.nationalacademies.org/catalog/9057/evaluation-of-the-us-department-of-defense-persian-gulf-comprehensive-clinical-evaluation-program PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine ER - TY - BOOK AU - National Research Council TI - Environmental Epidemiology, Volume 1: Public Health and Hazardous Wastes SN - DO - 10.17226/1802 PY - 1991 UR - https://nap.nationalacademies.org/catalog/1802/environmental-epidemiology-volume-1-public-health-and-hazardous-wastes PB - The National Academies Press CY - Washington, DC LA - English KW - Environment and Environmental Studies AB - The amount of hazardous waste in the United States has been estimated at 275 million metric tons in licensed sites alone. Is the health of Americans at risk from exposure to this toxic material? This volume, the first of several on environmental epidemiology, reviews the available evidence and makes recommendations for filling gaps in data and improving health assessments. The book explores: Whether researchers can infer health hazards from available data. The results of substantial state and federal programs on hazardous waste dangers. The book presents the results of studies of hazardous wastes in the air, water, soil, and food and examines the potential of biological markers in health risk assessment. The data and recommendations in this volume will be of immediate use to toxicologists, environmental health professionals, epidemiologists, and other biologists. ER -