Emergency department visits by pediatric patients sustained as a passenger on a motorcycle

Objective: Currently only 5 out of the 50 states in the United States have laws restricting the age of passengers permitted to ride on a motorcycle. This study sought to characterize the visits by patients under the age of 16 to U.S. emergency departments (EDs) for injuries sustained as a passenger on a motorcycle.

Methods: In this retrospective cohort study, data were obtained from the Nationwide Emergency Department Sample (NEDS) for the years 2006 to 2011. Pediatric patients who were passengers on a motorcycle that was involved in a crash were identified using International Classification of Diseases, Ninth Revision (ICD-9) External Cause of Injury codes. We also examined gender, age, disposition, regional differences, common injuries, and charges.

Results: Between 2006 and 2011 there were an estimated 9,689 visits to U.S. EDs by patients under the age of 16 who were passengers on a motorcycle involved in a crash. The overall average patient age was 9.4 years, and they were predominately male (54.5%). The majority (85%) of these patients were treated and released. The average charges for discharged patients were $2,116.50 and amounted to roughly $17,500,000 during the 6 years. The average cost for admission was $51,446 per patient and totaled over $54 million. The most common primary injuries included superficial contusions; sprains and strains; upper limb fractures; open wounds of head, neck, and trunk; and intracranial injuries.

Conclusion: Although there were only about 9,700 visits to U.S. EDs for motorcycle crashes involving passengers less than 16 years old for 2006 to 2011, the total cost of visits that resulted in either ED discharge or hospital admission amounted to over $71 million.     

Fluoride removal and its impact on oral health in Sri Lanka's dry zone: Discussion and recommendation

Fifty percent of the dry zone areas in Sri Lanka have fluoride levels above 1 ppm. This paper discusses the ground conditions and recommends an appropriate range of fluoride in drinking water which can support preventive practices for improving the oral health of children 8-years old and younger. In efforts to address the Chronic Kidney Disease of Unknown etiology (CKDU), water treatment to reduce contaminant level in potable water has been implemented. Such treatment would also remove fluoride and has resulted in potable water with various fluoride levels, depending on concentrations in the raw water. While it is important to reduce fluoride levels, it is important to have appropriate residual levels for prevention of dental caries. It needs, however, to be noted fluoride in excess can cause dental fluorosis. In Sri Lanka's dry zone areas increasing prevalence of dental fluorosis with decreasing prevalence of dental caries has been noted. Consumption of tea and powdered milk could increase total intake of fluoride. Fluoridated toothpaste, when used properly, may, however, result in negligible intake of fluoride. Sri Lanka's hot tropical climate which results in substantial intake of fluids reinforces the need to consider reduction in water fluoride. Consideration of local studies and international standards indicate fluoride levels should be in the range of 0.225–0.500 ppm. In the range of 0.225–0.500 ppm, the prevalence of dental fluorosis and caries was only 14% and 8%, respectively, in an endemic district. When fluoride levels are above 0.500 ppm, the issue of dental fluorosis shall need to be addressed. When levels are below 0.225 ppm, oral health care services shall need to be directed at preventing dental caries.     

Spatial distribution of metals within the liver acinus and their perturbation by PCB126

Animal studies show that exposure to the environmental pollutant 3,3′,4,4′,5-pentachlorobiphenyl (PCB126) causes alterations in hepatic metals as measured in acid-digested volume-adjusted tissue. These studies lack the detail of the spatial distribution within the liver. Here we use X-ray fluorescence microscopy (XFM) to assess the spatial distribution of trace elements within liver tissue. Liver samples from male Sprague Dawley rats, treated either with vehicle or PCB126, were formalin fixed and paraffin embedded. Serial sections were prepared for traditional H&E staining or placed on silicon nitride windows for XFM. With XFM, metal gradients between the portal triad and the central vein were seen, especially with copper and iron. These gradients change with exposure to PCB126, even reverse. This is the first report of how micronutrients vary spatially within the liver and how they change in response to toxicant exposure. In addition, high concentrations of zinc clusters were discovered in the extracellular space. PCB126 treatment did not affect their presence, but did alter their elemental makeup suggesting a more general biological function. Further work is needed to properly evaluate the gradients and their alterations as well as classify the zinc clusters to determine their role in liver function and zinc homeostasis.     

Mangroves as nursery sites: comparisons of the abundance and species composition of fish and crustaceans in mangroves and other nearshore habitats in tropical Australia

Daytime sampling of mangrove and seagrass (Halophila/Halodule community) habitats every 7 wk at Alligator Creek, Queensland, Australia, over a period of 13 mo (February 1985–February 1986) using two types of seine net, revealed distinct mangrove and seagrass fish and crustacean faunas. Total abundance of fish and relative abundance of small and large fish also varied between habitats and seasonally. Post-larval, juvenile and small adult fish captured with a small seine-net (3 mm mesh) were significantly more abundant (4 to 10 times) in the mangrove habitat throughout the 13 mo of sampling. Mangrove fish abundance showed significant seasonality, greatest catches being recorded in the warm, wet-season months of the year. Relative abundances of larger fish (captured in a seine net with 18 mm mesh) in the two habitats varied throughout the year, but did not show a seasonal pattern. At the same site, small crustaceans were significantly more abundant in the mangroves in all but one dryseason sample. Similar comparisons for three riverine sites, sampled less frequently, in the dry and wet seasons of 1985 and 1986, respectively, showed that in general mangrove habitats had significantly more fish per sample, although the relative abundance of fish in mangroves and other habitats changed with season. Crustacean catches showed a similar pattern, except that densities among sites changed with season. Fish and crustacean abundance in mangroves varied among sites, indicating that estuaries differ in their nursery-ground value. The juveniles of two commercially important penaeid prawn species (Penaeus merguiensis and Metapenaeus ensis) were amongst the top three species of crustaceans captured in the study, and both were significantly more abundant in the mangrove habitat. By contrast, mangroves could not be considered an important nursery for juveniles of commercially important fish species in northern Australia. However, based on comparisons of fish catches in other regions, the results of the present study indicate the importance of mangroves as nursery sites for commercially exploited fish stocks elsewhere in South-East Asia. Contribution No. 378 from the Australian Institute of Marine Science     

Upflow reactors for riparian zone denitrification

We used permeable reactive subsurface barriers consisting of a C source (wood particles), with very high hydraulic conductivities ( approximately 0.1-1 cm s(-1)), to provide high rates of riparian zone NO3-N removal at two field sites in an agricultural area of southwestern Ontario. At one site, a 0.73-m3 reactor containing fine wood particles was monitored for a 20-mo period and achieved a 33% reduction in mean influent NO3-N concentration of 11.5 mg L(-1) and a mean removal rate of 4.5 mg L(-1) d(-1) (0.7 g m(-2) d(-1)). At the second site, four smaller reactors (0.21 m3 each), two containing fine wood particles and two containing coarse wood particles, were monitored for a 4-mo period and were successful in attenuating mean influent NO3-N concentrations of 23.7 to 35.1 mg L(-1) by 41 to 63%. Mean reaction rates for the two coarse-particle reactors (3.2 and 7.8 mg L(-1) d(-1), or 1.5 and 3.4 g m(-2) d(-1)) were not significantly different (p > 0.2) than the rates observed in the two fine-particle reactors (5.0 and 9.9 mg L(-1) d(-1), or 1.8-3.5 g m(-2) d(-1)). A two-dimensional ground water flow model is used to illustrate how permeable reactive barriers such as these can be used to redirect ground water flow within riparian zones, potentially augmenting NO3- removal in this environment.     

Mangrove forest structure and productivity in the Fly River estuary,Papua New Guinea

In April, July and August 1989 and February 1990, the delta region of the Fly River was surveyed to establish the aerial extent of mangrove forests, their species composition, tree densities and basal areas, and potential net primary production. Mangrove forests cover 87 400 ha, mainly on islands within the delta. Twentynine mangrove plant species were recorded, but there were only three major forest types in the delta.Rhizophora apiculata-Bruguiera parviflora forests (hereafterRhizophora-Bruguiera forests) predominated in regions where river water salinities were >10. These forests covered 31 500 ha and had mean total tree densities and basal areas of 2027 stems ha^–1 and 21 m² ha^–1, respectively. Forests of the palmNypa fruticans (hereafterNypa forests) covered 38 400 ha, mainly in regions where river salinities were ~1 to 10, and had mean total densities and basal areas of 4431 stems ha^–1 and 38 m² ha^–1, respectively. Forests dominated byAvicennia marina and/orSonneratia lanceolata (hereafterAvicennia-Sonneratia forests) predominated on accreting banks of sediment and covered 17 500 ha. In very low-salinity (< 1) regions there are large monospecific stands ofS. lanceolata. Mean total densities and basal areas forAvicennia-Sonneratia forests were 7036 stems ha^–1 and 22 m² ha^–1, respectively. Mean net primary productivity (kg C ha^–1 d^–1) was estimated to be 26.7, 27.1 and 19.0 forRhizophora-Bruguiera, Nypa andAvicennia-Sonneratia forests, respectively. Total daily net primary production by all mangrove forests was estimated at 2214 t carbon. Using assumptions based on work in tropical Australia, it was estimated that ~678 t carbon (or 31% of primary production) were exported daily from mangrove forests to the waters of the delta.Contribution No. 550 from the Australian Institute of Marine Science     

Parameter values to model the soil ingestion pathway

Soil ingestion is an important exposure pathway for contaminants that are not otherwise very mobile in the environment. Health of both humans and animals can be affected. This paper summarizes the literature and recommends models and probabilistic parameter values for risk assessment applications. Models of the pathway require estimates of the amounts of soil ingested, the concentration of contaminants relative to the original soil, and the bioavailability in the gut of the contaminants ingested with soil. Using a lead-contaminated sandbox as an example, the modelling recommendations suggest that a child typically may consume 50 mg d^–1 of the sandbox soil, the soil ingested will have a tenfold higher lead concentration than the original soil, and the lead will be as bioavailable as if ingested as inorganic lead in water.The Canadian Government right to retain a non-exclusive, royalty free licence in and to any copyright is acknowledged.