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Morbidity and Mortality Weekly Report

Populations Receiving Optimally Fluoridated Public Drinking Water – United States, 1992-2006

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The second half of the 20th century saw a major decline in the prevalence and severity of dental caries, which is attributed in part to an increase use of fluoridation. Community water fluoridation is a safe, equitable, and cost effective method of delivering fluoride to communities. However, this public health measure remains underutilized. More collaboration among drinking water and oral health programs at the state and federal levels are essential to increase access to fluoridated water and to improve oral health in the United States. Approximately 184 million persons (69.2 percent) served by public water systems received optimally fluoridated water. The study, “Populations Receiving Optimally Fluoridated Public Drinking Water — United States, 1992-2006,” found the percentage of states with optimal fluoridated water ranged from 8.4 percent in Hawaii to 100 percent in District of Columbia. During 1992-2006, the proportion of states with optimal fluoridated water increased by 0.3 percent in Alabama to a high of 69.9 percent in Nevada. The study also found the proportion of optimal fluoridated water decreased in 10 states, with 0.2 percent decreases occurring in Kentucky and North Dakota to a 17 percent decrease occurring in Idaho. The national objective is for 75 percent of the United States population to have access to community water systems with optimally fluoridated water by 2010.

Monitoring Health Effects of Wildfires Using the BioSense System – San Diego County, California, October 2007

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Automated surveillance systems such as CDC′s BioSense are potentially valuable for monitoring and coping with large-scale emergencies. During October 21–26, 2007, wildfires consumed hundreds of thousands of acres and forced the evacuation of more than 300,000 persons in San Diego County, California. This report describes some of the health effects of the wildfires based on data from the CDC BioSense system. BioSense, CDC′s automated surveillance system, receives data from emergency departments at six hospitals in San Diego County. Major health problems due to the wildfires were largely avoided by timely evacuation orders, school closures, and other emergency measures implemented by local officials. However, automated analyses from the BioSense system showed sharp increases in emergency room visits for respiratory disease, primarily shortness of breath and asthma. This report shows the potential value of automated surveillance systems in monitoring and coping with large-scale incidents such as the San Diego wildfires.

Disparities in Secondhand Smoke Exposure – United States, 1988-1994 and 1999-2004

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Secondhand smoke exposure has declined markedly in the US population since the late 1980s. Nevertheless in 1999-2004, almost 50 percent of nonsmokers still had detectable levels of serum cotinine, a biochemical measurement of secondhand smoke exposure. This underscores that efforts are still needed to further reduce or eliminate all exposures to secondhand smoke. Exposure to secondhand smoke declined markedly in the U.S. population between 1988-1994 and 1999-2004. Reported secondhand smoke exposure inside the home declined from 21 percent to 10 percent. Serum cotinine levels, a biochemical indicator of any detectable secondhand smoke exposure, declined from 84 percent to 46 percent. These declines reflect the implementation of laws and policies that prohibit smoking outside the home environment. Despite an overall improvement, disparities in exposure among subpopulations widened. From 1999-2004, children were four times more likely to be exposed at home than were adults (23.8 percent vs 5.9 percent). A higher percentage of non-Hispanic blacks and persons from low income families were exposed to secondhand smoke than their counterparts. Strategies to reduce these gaps will help protect the harmful health effects of secondhand smoke exposure.



  • Historical Document: July 10, 2008
  • Content source: Office of Enterprise Communication
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