Online-only: Public health extras: News roundup on respiratory fungal infections, falls from windows, asthma and more
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* Donya Currie

## Respiratory fungal infection risk higher for some older adults

Being active and living in the Midwestern and Western parts of the United States can increase older adults’ risk for developing fungal disease.

A study in the September issue of Emerging Infectious Diseases found three types of fungal infections among patients ages 65 and older occurred mostly in the nation’s Western and Midwestern regions. The examination of Medicare claims found incidence of histoplasmosis and blastomycosis was highest in the Midwest, at 6.1 cases and one case per 100,000 person years, respectively, and coccidioidomycosis incidence rate was highest in the West at 15.2 cases per 100,000 person years.

The study’s authors said prevention efforts should focus on the Midwest and West, and doctors in those areas should consider fungal infections a possible cause in older patients with respiratory disease.

## Falls from windows injured nearly 100,000 children

Falls from windows injured nearly 100,000 U.S. children from 1990 to 208, according to a recent study.

Published in the Aug. 22 issue of Pediatrics, the study found window falls occur more frequently during spring and summer months and that the rate of injury is higher for children younger than 5. Those younger children also were more likely than older children to sustain serious injuries after falling out of a window. The study was reportedly the first to use a nationally representative sample to identify risk factors.

The study’s authors stressed the need for fall prevention measures such as the use of window guards or window locks and moving furniture away from windows to decrease a young child’s access. And injury reduction measures include planting bushes or installing plant beds under windows to soften the landing surface and potentially reduce impact and resulting injuries.

## Poorly controlled asthma ups school absences, health costs

Poorly controlled asthma more than doubles health care costs associated with the disease and leads to a dramatic increase in school absences, according to a study in the August issue of the Archives of Allergy, Asthma & Immunology.

The study found children with “very poorly controlled” asthma, as defined by National Institutes of Health guidelines, missed an average of 18 days of school each year, compared to two or less missed days for other asthma patients. And very poorly controlled asthma patients incurred an average of about $7,800 in health care costs associated with asthma, compared to about $3,800 among patients with well-controlled asthma.

“There are effective strategies to improve asthma control among children,” said study lead author Stanley Szefler, MD, professor of pediatrics at National Jewish Health. “By addressing medication adherence, inhaler technique, proper medication and other asthma management strategies, we could improve asthma and reduce costs significantly.”

## Risky behaviors higher among American Indian and Alaska Native youth

Some risky health behaviors are significantly higher among American Indian and Alaska Native high school students, according to a study in the July issue of Preventing Chronic Disease.

Based on data collected every other year from 2001–2009, the study found higher rates for seven of 16 health behaviors among American Indian and Alaska Native youth and lower rates of consuming fruits and vegetables five or more times per day. The American Indian and Alaska Native youth who were surveyed reported higher rates of cigarette smoking, obesity, insufficient vigorous physical activity, and television viewing than white students.

The study’s authors said their findings suggest public health action is needed to “reduce the prevalence of risk behaviors” among American Indian and Alaska Native youth. Because the population of the country’s federally recognized tribes ranges from fewer than 100 to more than 750,000 people, “a one-size-fits-all approach would not be appropriate.”

## Not enough HIV testing in emergency departments

Not enough emergency departments are testing for HIV, despite recommendations that they do so, a recent study found. 78 percent of emergency departments did not have systematic HIV testing in 2009.

The study, published in a July special supplement to the Annals of Emergency Medicine, found that 78 percent of emergency departments did not have systematic HIV testing in 2009.

The study also found that 60 percent of non-academic emergency departments were not aware of the Centers for Disease Control and Prevention’s recommendation that all adults, adolescents and pregnant women be offered an HIV test as part of routine medical care. That routine care includes emergency department visits.

“Ensuring that all Americans know their HIV status is vital to ending the U.S. HIV epidemic,” said Jonathan Mermin, MD, director of CDC’s Division of HIV/AIDS Prevention.

On the positive side, the study found that the number of emergency departments offering HIV testing is increasing.

The supplement, “HIV Testing in Emergency Departments,” is online at [www.annemergmed.com](http://www.annemergmed.com).

*   Copyright The Nation’s Health, American Public Health Association