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Objectives. Methamphetamine (meth) is a highly addictive drug of abuse that can easily be made in small illegal laboratories from household chemicals that are highly toxic and dangerous. Meth labs have been found in locations such as homes, outbuildings, motels, and cars. Its production endangers the "cook," neighbors, responders, and the environment. This article describes surveillance data used to examine the emergence and public health impacts of illicit clandestine meth labs, as well as two states' efforts to thwart lab operations and prevent responder injuries.Methods. We analyzed data collected from 2001 to 2008 by 18 states participating in the Agency for Toxic Substances and Disease Registry's Hazardous Substances Emergency Events Surveillance (HSEES) Program to examine the occurrence and public health impacts of clandestine meth production.Results. HSEES data indicate that the majority of clandestine meth lab events occurred in residential areas. About 15% of meth lab events required evacuation. Nearly one-fourth of these events resulted in injuries, with 902 reported victims. Most victims (61%) were official responders, and one-third were members of the general public. Since 2004, with the implementation of local and federal laws and prevention activities, the number of meth lab events has declined. Increased education and training of first responders has led to decreased injuries among police officers, firefighters, and emergency medical personnel.Conclusions. HSEES data provided a good data source for monitoring the emergence of domestic clandestine meth production, the associated public health effects, and the results of state and federal efforts to promote actions to address the problem.

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Objective: To quantify and describe the activities of social workers dedicated to a large urban emergency department (ED).Methods: A retrospective case series of all patients seen by social workers in an urban university hospital ED over a period of six weeks.Results: Social-work service was provided to 5% of ED patients. Three distinct groups of patients were usually seen by social workers: the elderly, young adults, and children less than 5 years of age. The median age of the group referred for social work services was greater than that of the ED population as a whole; triage acuity also was greater in the referred group. The types of services provided varied with age. Among those patients with social-work consultations, the average time spent with each patient was over one hour and did not vary according to the age, sex, race, or insurance status of the patient. More than 60% of the social worker's time was spent with patients or their significant others. Conclusion:Social workers provide valuable services to ED patients. The availability of social workers in the ED reduces the demands for emergency physicians and nurses to arrange home health care, nursing home placement, and other social-service functions. Cost savings through diversion of nonacute social admissions are possible. The types of services provided vary and depend to a large extent on patient age. The availability of dedicated social-work personnel in the ED and the education of emergency personnel regarding the services that they can provide should be beneficial for patients, staff, and the hospital served.Acad. Etnerg. Med. 1994; 1~247-253.