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This article presents information on pregnant women with incident blood lead levels (BLLs) of 20 µg per deciliter or greater as reported to the New York City Department of Health between September 1996 and June 1999 (n = 33)

Findings suggest the merits of multipronged efforts to prevent crashes and to improve bicyclist safety in NYC and in other dense, urban environments. Motorists and bicyclists should be made aware of the risks of alcohol use and the benefits of helmet-wearing. Road users should pay attention to traffic control measures and travel at safe speeds. Interventions that control traffic at intersections and on multilane streets, that dedicate and demarcate routes for motorists and cyclists, and that improve visibility, especially for large vehicles, warrant consideration.

The NYC Health Department successfully adapted its EDRS for near real-time disaster-related mortality surveillance. Retrospective assessment of deaths, advanced methods for case identification and analysis, standardized reports, and system enhancements will further improve surveillance. Local, state, and federal partners would benefit from partnering with vital records to develop EDRSs for surveillance and to promote ongoing evaluation.

Introduction:The 11 September 2001 terrorist attacks on the World Trade Center (WTC) resulted in thousands of deaths and injuries. Research on previous bombings and explosions has shown that head injuries, including traumatic brain injuries (TBIs), are among the most common injuries.Objective:The objective of this study was to identify diagnosed and undiagnosed (undetected) TBIs among persons hospitalized in New York City following the 11 September 2001 WTC attacks.Methods:The medical records of persons admitted to 36 hospitals in New York City with injuries or illnesses related to the WTC attacks were abstracted for signs and symptoms of TBIs. Diagnosed TBIs were identified using the International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes. Undiagnosed TBIs were identified by an adjudication team of TBI experts that reviewed the abstracted medical record information. Persons with an undiagnosed TBI were contacted and informed of the diagnosis of potential undetected injury.Results:A total of 282 records were abstracted. Fourteen cases of diagnosed TBIs and 21 cases of undiagnosed TBIs were identified for a total of 35 TBI cases (12% of all of the abstracted records). The leading cause of TBI was being hit by falling debris (22 cases). One-third of the TBIs (13 cases) occurred among rescue workers.More than three years after the event, four out of six persons (66.67%) with an undiagnosed TBI who were contacted reported they currently were experiencing symptoms consistent with a TBI.Conclusions:Not all of the TBIs among hospitalized survivors of the WTC attacks were diagnosed at the time of acute injury care. Some persons with undiagnosed TBIs reported problems that may have resulted from these TBIs three years after the event. For hospitalized survivors of mass-casualty incidents, additional in-hospital, clinical surveys could help improve pre-discharge TBI diagnosis and provide the opportunity to link patients to appropriate outpatient services. The use and adequacy of head protection for rescue workers deserves re-evaluation.

Objective: To describe the epidemiology of pedestrian deaths due to motor vehicle crashes (MVCs) between age groups in New York City (NYC), with a comparison to national data. Methods: Review of MVC pedestrian deaths in NYC and the US from 1998 to 2002. Data on deaths were obtained from the National Highway Traffic Safety Administration. Results: Almost half (48%) of all MVC deaths in NYC were among pedestrians, compared with 12% nationally. Pedestrian death rates were highest among older age groups (>65 years). NYC's older pedestrians were more likely than US older pedestrians to be killed at an intersection, during daytime and on weekdays. Conclusion: Older people constitute a major proportion of MVC pedestrian deaths in NYC. Conditions (such as traffic exposure) surrounding pedestrian MVCs may differ by age group. The high burden of MVCs among older pedestrians in NYC highlights the importance of local-level analysis to guide public health planning. P edestrian deaths from motor vehicle crashes (MVCs) are a major public health problem. In the developing world, more people die from MVCs while outside of the motor vehicle (walking or bicycling) than inside the motor vehicle.

Objective We briefly describe 2 systems that provided disaster-related mortality surveillance during and after Hurricane Sandy in New York City, namely, the New York City Health Department Electronic Death Registration System (EDRS) and the American Red Cross paper-based tracking system. Methods Red Cross fatality data were linked with New York City EDRS records by using decedent name and date of birth. We analyzed cases identified by both systems for completeness and agreement across selected variables and the time interval between death and reporting in the system. Results Red Cross captured 93% (41/44) of all Sandy-related deaths; the completeness and quality varied by item, and timeliness was difficult to determine. The circumstances leading to death captured by Red Cross were particularly useful for identifying reasons individuals stayed in evacuation zones. EDRS variables were nearly 100% complete, and the median interval between date of death and reporting was 6 days (range: 0–43 days). Conclusions Our findings indicate that a number of steps have the potential to improve disaster-related mortality surveillance, including updating Red Cross surveillance forms and electronic databases to enhance timeliness assessments, greater collaboration across agencies to share and use data for public health preparedness, and continued expansion of electronic death registration systems.

In the summer of 2005, responding to an apparent increase in the number of bicyclist fatalities in New York City (NYC), a coalition of bicycling advocacy groups, clubs, racing organizations, and working cyclists presented a six-point Bike Safety Action Plan to NYC's Department of Transportation (DOT) and Police Department (NYPD). Leading the list of desired action steps was the coalition's request for a comprehensive study of bicyclist fatalities. The requested report was to be modeled on a bicycling casualty study completed by the city of Toronto in the late 1990s, 1 considered by many advocates to be the most comprehensive municipal study to improve bicycling conditions to date. Advocates asked that the city's health department play a role in the study. One year later, in September 2006, four NYC agencies with a shared interest in promoting safe bicycling-the Department of Health and Mental Hygiene (DOHMH), Department of Parks and Recreation, DOT, and NYPD-released a joint report to the public entitled Bicyclist Fatalities and Serious Injuries in New York City: 1996-2005. 2 The report provided a comprehensive examination of bicyclist fatalities and serious injuries, drawing on multiple data sources including police accident reports, accident scene investigations, and medical examiner files. As part of the report, the city announced an aggressive package of action steps to increase bicycling and promote safety. Details of the investigation, proposed action steps, and subsequent efforts are described in this article.