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101.

Problem

Motorized recreational vehicle (MRV)-related injuries can result in severe medical and financial consequences. The objective of this study was to describe the epidemiology, and clinical and financial impact of MRV-related injuries in Ohio.

Method

Probabilistically linked statewide Emergency Medical Services (EMS) and hospital (inpatient and emergency department) data for 2003 and 2004 were examined. Record pairs with a MRV-related E-code (E821-E823, E825) were included in this study.

Results

There were 2,893 patients with MRV-related injuries, who had linked EMS and hospital records, resulting in more than $15 million in hospital charges and 1,921 inpatient days of hospitalization. The male-to-female ratio was nearly 4:1, and 19% were younger than 16. Almost 82% of cases were not wearing a helmet; there was a trend of decreasing helmet use with increasing age. Mean (SE) inpatient hospital charges and length of stay (LOS) were $22,218 ($1,290) and 3.8 (0.2) days, respectively. The mean (SE) Injury Severity Score (ISS) for inpatients was 9.2 (0.4). Individuals injured on a street/highway were 3.20 times more likely to sustain an ISS ≥ 16 (95% CI: 1.03, 9.88; p = 0.044) and 3.05 times more likely to sustain a traumatic brain injury (TBI) (95% CI: 1.17, 7.94; p = 0.024) than those who were injured at a place designated for sport or recreation. Children aged 12 to 15 and young adults aged 16 to 25 were 2.47 and 2.14 times more likely, respectively, to sustain a TBI than adults aged 36 or older (aged 12 to 15: 95% CI: 1.13, 5.38; p = 0.024; aged 16 to 25: 95% CI: 1.26, 3.64; p = 0.005). Higher ISS was associated with both higher total charges (p < 0.001) and longer LOS (p < 0.001).

Discussion

This study demonstrates that MRV-related injuries are an important public health problem in Ohio, with a substantial clinical and financial impact.

Impact on Industry

Enactment and enforcement of statewide MRV safety legislation and training of MRV users offer valuable opportunities to prevent these costly injuries.  相似文献   
102.
PROBLEM: Federal policy recommends environmental strategies as part of a comprehensive workplace violence program in healthcare and social services. The purpose of this project was to contribute specific, evidence-based guidance to the healthcare and social services employer communities regarding the use of environmental design to prevent violence. METHOD: A retrospective record review was conducted of environmental evaluations that were performed by an architect in two Participatory Action Research (PAR) projects for workplace violence prevention in 2000 and, in the second project in 2005. Ten facility environmental evaluation reports along with staff focus group reports from these facilities were analyzed to categorize environmental risk factors for Type II workplace violence. RESULTS: Findings were grouped according to their impact on access control, the ability to observe patients (natural surveillance), patient and worker safety (territoriality), and activity support. DISCUSSION: The environmental assessment findings reveal design and security issues that, if corrected, would improve safety and security of staff, patients, and visitors and reduce fear and unpredictability. IMPACT ON INDUSTRY: Healthcare and social assistance employers can improve the effectiveness of violence prevention efforts by including an environmental assessment with complementary hazard controls.  相似文献   
103.
INTRODUCTION: The purpose of this study was to determine factors associated with seat belt usage among Emergency Medical Technicians (EMTs). METHODS: As part of biennial re-registration paperwork, nationally registered EMTs completed a survey on the safety and health risks facing Emergency Medical Services (EMS) providers. Respondents were asked to describe their seat belt use while in the front seats of an ambulance. They were categorized as "high" in seat belt use if it had been more than a year since they had not worn their seat belt or "low" in seat belt use if they had not worn their seat belt at least once within the past 12 months. A logistic regression model was fit to estimate the association between seat belt use, organizational seat belt policy, type of EMS organization worked for, EMT certification level, and the size of community where EMS work is performed. RESULTS: Of the 41,823 EMTs that re-registered in 2003, surveys were received from 29,575 (70.7%). A significant interaction between organizational seat belt policy and type of EMS organization was found to exist. Participants reporting no organizational seat belt policy had lower odds of seat belt usage when compared to individuals that do have a seat belt policy. Odds Ratios ranged from 0.20 (95% CI 0.10-0.40) for military organizations to 0.59 (95% CI 0.38-0.93) for private EMS organizations. Paramedics and those working in rural areas also had lower odds of seat belt use. CONCLUSION: Several factors were found to be associated with seat belt usage among EMTs while in the front compartment of an ambulance. However, it appears that only one, organizational policy, is a modifiable characteristic.  相似文献   
104.
Environmental Information Services, Inc. (EIS) publishes detailed reports and offers custom research related to the full spectrum of environmental issues facing corporations. This article highlights several key sections from EIS's new 1998 Aerospace Industry Report. It details the environmental performance, policies, and expenditures of the largest companies in the aerospace industry. EIS industry reports contain data on five key performance criteria—toxic waste management, hazardous waste generation, penalties and enforcement actions, spills, and Superfund sites. Here we examine one of those—penalties and enforcement actions—and the policies of the three largest companies. © 1998 John Wiley & Sons, Inc.  相似文献   
105.
ABSTRACT: The primary objective of this study was to perform a cost‐benefit analysis of maintaining the current level of water quality in the Catawba River basin. Economic benefits were estimated using a stated preference survey method designed to value respondents' willingness to pay for a management plan to protect water quality in the Catawba basin over time. From the surveys conducted with 1,085 area residents, we calculated an annual mean willingness to pay of $139 for the management plan, or more than $75.4 million for all taxpayers in the area. Over the five‐year time horizon in which respondents were asked to pay for the management plan, this resulted in a total economic benefit of $340.1 million. The Watershed Analysis Risk Management Framework model was used to estimate the amount of management activities needed to protect the current level of water quality in the basin over time. Based on the model results, the total cost of the management plan was calculated to be $244.8 million over a ten‐year period. The resulting cost‐benefit analysis indicated that the potential benefits of this management plan would outweigh the costs by more than $95 million.  相似文献   
106.
Environmental Information Services, Inc. (EIS) publishes detailed reports and offers custom research related to the full spectrum of environmental issues facing corporations. In this new article, EIS reports on the compliance performance of the largest companies in the chemical industry focusing on five key environmental concerns: toxic waste management, air pollution, water pollution, spills, and Superfund. It is important to note that the following article does not contain normalized data and graphs which would adjust findings to various size features (e.g., domestic revenues per company). This as well as detailed environmental policy and programs data on each company can be obtained from EIS. In future issues of EQM, EIS compliance reports will be presented for other major industries to help companies of all sizes benchmark their environmental performance and improvement efforts.  相似文献   
107.
Polycyclic aromatic hydrocarbons (PAHs) have earned considerable attention due to their widespread environmental distribution and toxicity. In the environment, PAHs decompose by a variety of biotic and abiotic pathways. In both polar and nonpolar environments, phenanthrene (Phe, a common, three-ring PAH) is converted by sunlight to more polar products such as 9,10-phenanthrenequinone (PheQ) and subsequent oxidation products such as the corresponding open-ring dicarboxylic acid product. Biodegradation of phenanthrene also usually leads to oxidative metabolites, and eventually ends in mineralization. Our experimental objective was to investigate the photodegradation of phenanthrene and determine the effect of reaction products such as PheQ on microbial biodegradation of two- and three-ring PAHs. Abiotic experiments were performed to examine the photolytic breakdown of Phe; Phe was converted to PheQ, which catalyzed its own formation. In biodegradation experiments PheQ (0.04-4 mg/L) caused marked inhibition of naphthalene (Nap) biodegradation by a Burkholderia species; Phe did not. Only 20% of the naphthalene was degraded in the presence of PheQ compared with 75% in the control culture with no PheQ added. No PAH-degrading cultures were able to use PheQ as sole carbon source; however, the Phe-degrading enrichment culture dominated by a Sphingomonas species was able to degrade PheQ cometabolically in the presence of Phe. These results may explain why photooxidized phenanthrene-containing mixtures can resist biodegradation.  相似文献   
108.
轰燃后火焰的辐射热通量计算   总被引:4,自引:3,他引:4  
轰燃后火焰的热辐射危害,是目前确定建筑物间安全距离的主要依据之一。该文提出了轰燃后火焰在室外一定距离处辐射热通量的计算方法;并在喷出火焰不受室外风影响的情况下,利用小规模试验的结果对这一方法进行了验证。  相似文献   
109.
110.
Scale-up of a hollow-fiber-membrane (HFM) bioreactor treating trichloroethylene- (TCE-) contaminated water via co-metabolism with the methanotroph Methylosinus trichosporium OB3b PP358 was investigated through cost comparisons, bioreactor experiments, and mathematical modeling. Cost comparisons, based on a hypothetical treatment scenario of 568-L/min (150-gpm) flowrate with an influent TCE concentration of 100 microg/L, resulted in a configuration of treatment trains with two HFM modules in series and an overall annual cost of US dollar 0.36/m3 treated. Biological experiments were conducted with short lumen and shell residence times, 0.16 and 0.40 min, respectively, as a result of the cost comparisons. A new variable, specific transformation, was defined for characterizing the cometabolic transformation in continuous-flow systems, and values as large as 38.5 microg TCE/mg total suspended solids were sustainable for TCE treatment. Using mathematical modeling, HFM bioreactor system design was investigated, resulting in a five-step system design strategy to facilitate sizing of the unit processes.  相似文献   
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