Reproductive health in Afghanistan: results of a knowledge, attitudes and practices survey among Afghan women in Kabul

A reproductive-health knowledge, attitudes and practices (KAP) survey was carried out among 468 Afghan women of reproductive age. A convenience sample of women was selected from attendees in the outpatient departments of four health facilities in Kabul. Seventy-nine per cent of respondents had attended at least one antenatal consultation during their last pregnancy. Two-thirds (67 per cent) delivered their first child between 13 and 19 years. The Caesarean-section rate was low (1.6 per cent). Two-thirds (67 per cent) of deliveries occurred in the home. The contraceptive prevalence rate was 23 per cent (16 per cent modern and 7 per cent natural methods). Twenty-four per cent had knowledge of any STIs, although most of these women did not know correctly how to prevent them. Most of the women (93 per cent) needed authorization from their husband or a male relative before seeking professional health-care. In multivariate analysis, women's schooling was significantly associated with antenatal-care attendance (AOR 4.78), institutional delivery (AOR 2.29), skilled attendance at birth (AOR 2.07) and use of family planning (AOR 4.59). Reproductive-health indicators were noted to be poor even among these women living in Kabul, a group often considered to be the most privileged. To meet the reproductive-health needs of Afghan women, the socio-cultural aspects of their situation--especially their decision-making abilities -- will need to be addressed. A long-standing commitment from agencies and donors is required, in which the education of women should be placed as a cornerstone of the reconstruction process of Afghanistan.     

The Truth about Public Health Protection and Community Sewerage and Water Supply Sanitation in Developing Countries

Since the establishment, following World War II, of the World System, by which the affluent industrialized countries established various international assistance agencies (including the multilateral development banks, UN affiliates, and Bilaterals), these assistance agencies have invested very large sums in helping finance planning and construction of community sewerage and water supply facilities in the developing countries. However, much of this large investment has been ineffective and wasted, primarily because of the lack of understanding by the staff of the assistance agencies that the design criteria for the facilities must be modified to suit the socio-economic status of the developing country. The developing countries are relatively very poor in terms of available finances, hence cannot afford to emulate Western environmental standards and design practices, especially as related to operation and maintenance, hence much simpler approaches must be used. Experiences in several Asian countries are discussed, and a recommendation is made on how to go about resolving this problem.     

Safety teams. Government and business organizations want them and use them, but are they legal?

BACKGROUND: Safety teams have become a popular means to recognize and prevent injuries in the workplace. In fact, organizations, such as OSHA, NIOSH, NIEHS, DOE, and the Ohio BWC, not only encourage safety teams, but have implemented them in their organizations. However, safety teams may not be legal as defined by NLRB Act Sections 2(5) and 8(a)(2). OBJECTIVE: To determine whether safety teams are illegal labor organizations. METHODS: A review of government regulations, safety programs, and safety teams was performed to create a framework of what types of safety programs/regulations are requested and/or required by a variety of government agencies. Next, these requirements were compared to existing case law on illegal labor organizations as defined by the NLRB. RESULTS: Most safety teams and programs, even those implemented by the Federal Government, are illegal labor organizations as defined by NLRB Act Sections 2(5) and 8(a)(2). CONCLUSIONS: The Federal Government needs to amend existing legislation and develop a revision of the NLRB Act that would allow safety teams to function legally in organizations without having to meet intrusive, constricting guidelines that may inhibit the value of safety teams. IMPACT ON INDUSTRY: Organizations must be aware that safety teams may be valuable in reducing job-related accidents and injuries but they may be illegal labor organizations.     

Environmental Health Policy: Analytic “Framing” of the Great Lakes Picture

/ The International Joint Commission (IJC) has overseen the implementation of the Great Lakes Water Quality Agreement between Canada and the United States for 25 years. Part of its mandate has been to facilitate international cooperation among a diversity of stakeholders focusing on the "waters" and the "ecosystem." In the 1970s policy focused on phosphorus reduction and individual contaminants, with some efforts (after 1978) to take an ecosystem (ecological perspectives) approach. In the last 15 years human health effects from (real and perceived) environmental causes have received considerable recognition. By contrast, less concern has been expressed for what is traditionally considered "environment" issues (such as protecting fish species). This shift at the policy level is well illustrated in the manner in which human health is increasingly used as a way for mobilizing environmental agendas. This paper analyzes nine IJC biennial reports to track how the framing of Great Lakes issues has shifted from concern for its waters to concern for human neurobehavior and reproductive systems. Frame analysis is used to conceptualize the controversies that are expressed through the Great Lakes policy documents. The analysis of the reports also reveals a shift in operational frames, used by the IJC to mobilize decision-makers into action.     

新民市柳河水源地水环境健康风险评价

为了评价新民柳河水源地的供水安全,简要介绍水环境健康风险评价基本方法的基础上,建立了水环境健康风险评价模式.研究结果表明:①柳河水源地地面水基因毒物质为优先控制污染物;而地下水应着力控制躯体毒物质.②对于基因毒物质,监测断面优先控制污染物为As和Cr;而对于躯体毒物质,所有监测断面的优先控制污染物均为氨.③在所有监测断面中,柳河上断面等6处有毒污染物所致健康危害的个人年总风险数量级为10-5-10-4.在日后的管理过程中,应对这6处加大治理力度.④目前环境健康风险评价还没有包括在常规环境评价工作中,建议在今后的评价工作中应该逐步开展这方面的工作,以提高供水安全.     

INTERNATIONAL DECADE ON DRINKING WATER AND SANITATION1

ABSTRACT: The UN conference on Human Settlements (HABITAT) held in June 1976 at Vancouver, Canada, concluded that nearly two-thirds of the population of the developing world lacked access to safe drinking water and that a larger proportion lacked the means for hygienic human waste disposal. The conference urged governments to give priority to these two areas in their developement process. In March 1977, the UN Water Conference, held at Mar del Plata, Argentina, called for establishing the 1980's as the Decade for Drinking Water and Sanitation. The goal would be to bring clean water and sanitation to all peoples in the world by 1990. Since March 1979, four separate UN bodies have passed resolutions supporting the Decade and calling on all governments to support the Decade's goals. The U.S. Government, other OECD member states, and the private sector must combine to make this Decade a success.     

Public policy for the use of reclaimed water

This article documents the general need to reuse water reclaimed from sewage effluents for beneficial purposes and then considers in detail which specific uses will be most beneficial. The analysis begins by describing five levels of wastewater treatment: primary, secondary, tertiary, advanced, and advanced plus complete treatment. Next, five major uses for reclaimed water are identified: groundwater recharge, industrial use, irrigation, recreational lakes, and direct municipal reuse. Subcategories of reuse falling under each of the five major reuse categories are also identified and discussed. The analysis then proceeds to review significant literature available on health and environmental effects, treatment and distribution costs, and public opinion concerns in relation to each of the five major uses and their related subcategories. The paper concludes with a cumulative numerical analysis of the disbenefits associated with each specific type of reuse summed over the health effects, environmental effects, treatment costs, distribution costs, and public opinion concerns. Uses of reclaimed water for industrial purposes and for irrigation of fodder and fiber crops are found to be most beneficial by the analysis here employed, and use for aquifer recharge and direct municipal reuse are found to be least beneficial.     

Health and safety implications of alternative energy technologies. I. Geothermal and biomass

An evaluation of potential occupational and public health aspects of geopressure, hydrothermal, hot dry rock, silviculture, crop and animal residues, fermentable plant products, municipal waste, and plantation energy technologies has been performed. Future development of these energy options in the United States will contain hazards that could easily be eliminated by safer equipment design and common-sense attention to operation and maintenance. Occupational exposure to hydrogen sulfide gas occurs near all geothermal sites and wherever organic matter decomposes anaerobically. Respiratory damage has occurred to laborers in geothermal fields, while farm workers have been fatally overcome when employed near agitating liquid manure systems. However, the most frequent and severe of reported injuries to geothermal workers is dermal exposure to caustic sludges produced by H₂S abatement systems.Principal health and safety considerations of biomass pathways are directly related to the diffuse nature of solar energy fixation by photosynthesis and subsequent transfer to animal food chains. Since the potential fuel is in an unconcentrated form, cultivation, harvest, and transport are necessarily laborintensive. Thus, a significant potential for occupational injuries and fatalities exists. Of all biomass systems evaluated, direct burning of solid fuels presents the greatest public health risk. Data are presented to characterize the population at risk and the frequency and severity of injuries.Operated by Union Carbide Corporation under contract W-7405-eng-26 with the U.S. Department of Energy.     

The Effect of Shoreline Recreational Angling Activities on Aquatic and Riparian Habitat Within an Urban Environment: Implications for Conservation and Management

There is growing concern that recreational shoreline angling activity may negatively impact littoral and riparian habitats independent of any direct or indirect influences of fish harvest or fishing mortality through mechanisms such as disturbance (e.g., trampling, erosion) and pollution (e.g., littering). We sampled a suite of aquatic and terrestrial variables (i.e., water quality, aquatic and terrestrial macrophytes, soil compaction, anthropogenic refuse) at 14 high shoreline angling-activity sites (identified by way of interviews with conservation officers and angling clubs) within an urban area (Ottawa, Canada). For each high angling-activity site, a nearby corresponding low angling-activity site was sampled for comparison. We found that the percentage of barren area and soil compaction were greater in areas of high angling activity compared with areas that experienced relatively low angling activity. In addition, terrestrial and aquatic macrophyte density, height, and diversity were lower at high angling-activity sites. Angling- and non-angling-related litter was present in large quantities at each of the high angling-activity sites, and comparatively little litter was found at low angling-activity sites. Collectively, these findings indicate that shoreline angling does alter the riparian environment, contributing to pollution and environmental degradation in areas of high angling intensity. With growing interest in providing urban angling opportunities and in response to increasing interest in developing protected areas and parks, a better understanding of the ecologic impacts of shoreline angling is necessary to address multiuser conflicts, to develop angler outreach and educational materials, and to optimize management of angling effort to maintain ecologic integrity of riparian and aquatic ecosystems.