Two sessions Wednesday will address pulmonary health among migrant populations and rapid-response teams.

On Wednesday, two sessions—”Global Migration and Respiratory Disease” and “Rapid Response Teams: Actually Effective or Just Highly Contagious?”—will focus on two important issues facing pulmonologists today.

“The ATS is making an important step in bringing together and disseminating research on the pulmonary health problems frequently found in migrant populations, which are affected by unique respiratory disease hazards,” said Marc B. Schenker, M.D., co-chair of the session on global migration. Many respiratory health outcomes are worse among migrants. This is important information for clinicians and for public health professionals working to improve the health of this underserved population.”

Dr. Schenker, a professor of medicine and public health at the University of California, Davis, said the recent H1N1 epidemic highlighted the critical need to understand the impact of migration on respiratory disease transmission and effective public health interventions. The symposium will focus on educating clinicians, public health practitioners and researchers about the differences in diseases associated with migration, effective public health policies to prevent migration-associated disease and research needs to increase the understanding of the phenomena that have been observed, but not yet fully understood.

“For many of these issues, there is very little research or understanding of underlying causes,” he said. “Over 200 million people live outside their country of origin, and several times this number regularly move between countries, primarily for work.”

“There are 400 million border crossings between the U.S. and Mexico annually,” he continued. “For acute epidemics such as H1N1, SARS and avian flu, migration plays a critical role in global transmission of these diseases.” Migration also affects other respiratory diseases, such as asthma and occupational lung diseases, and is strongly associated with cigarette smoking.

David A. Kaufman, M.D., co-chair of the session on rapid response teams, said that his program would focus on a genuine problem facing practitioners of critical care medicine.

“Rapid response teams have grown over the past 10 years in order to better treat patients who, for example, deteriorate in the hospital to the point that they have cardiac arrest,” he said. “There is a good chance that these patients have shown signs of deterioration many hours before the problem is recognized.”

The rapid response team is a group of people who focus on treating these patients before the get to the ICU, while they are being transferred.

“That transfer can take a while, and that is valuable time to a patient,” said Dr. Kaufman, who is the section chief of pulmonary, critical care and sleep medicine at Bridgeport Hospital in Connecticut. “The idea of rapid response teams makes logical sense, but that data supporting their efficacy is scarce.”

“Many, many studies have been published, but only a couple have shown a real benefit, while quite a few have failed to show any benefit at all,” he continued. “So we have a real quandary. This is a great idea that appears to meet a need, but in fact, rapid response teams may not work as well as we had hoped.”

Conservative estimates indicate that an average rapid response team costs a hospital $400,000 per year, which is $400,000 too much for a program that fails to show a positive effect on the health of patients.

“The goal of this session is to bring physicians, scientists and allied healthcare professionals together to have an open discussion about the level of evidence that either supports or fails to support the use of these teams across the country,” he said. “I think attendees ought to be able to answer the question regarding whether a rapid response team is the right thing to do for their own institution. Do the benefits justify the costs, and if so, how can they role out a team most effectively for their own institution?”