Estimating resource utilization demands in implementing statewide screening,brief intervention,and referral to treatment for alcohol-impaired drivers

Objectives: The Alcohol Use Disorders Identification Test (AUDIT) is used to assess the level of alcohol use/misuse and to inform the intensity of intervention delivered within screening, brief intervention, and referral to treatment (SBIRT) programs. Policy initiatives are recommending delivery of SBIRT within health care settings to reduce alcohol misuse and prevent alcohol-impaired driving. Recent reports are considering extending delivery of SBIRT to criminal justice settings. One consideration in implementing SBIRT delivery is the question of resource utilization; the amount of effort required in delivering the 4 different intensities of intervention in SBIRT: Alcohol education, simple advice, brief counseling and continued monitoring, and brief counseling and referral to specialist (from least to most intense in terms of delivery time, the skill level of the provider, and personnel resources).

Methods: In order to inform expectations about intervention intensity, this article describes the AUDIT scores from 982 adults recently arrested for alcohol-impaired driving. The distribution of scores is extrapolated to state rates for individuals arrested for alcohol-impaired driving by intervention level.

Results: Though alcohol education was the most common intervention category, about one quarter of the sample scored in a range corresponding with the more intensive interventions using the brief counseling, continued monitoring for ongoing alcohol use, and/or referral to specialist for diagnostic evaluation and treatment.

Conclusions: This article provides local distribution of AUDIT scores and state estimates for the number of individuals scoring in each level of risk (AUDIT risk zone) and corresponding intervention type. Routine criminal justice practice is well positioned to deliver alcohol screening, education, simple advice, and continued alcohol monitoring, making delivery of SBIRT feasible for the majority of alcohol-impaired drivers. Challenges to implementing the full range of SBIRT services include resource demands of brief counseling, identifying the appropriate providers within a criminal justice context, and availability of community providers for referral to diagnostic and specialty care. Solutions may vary by state due to differences in population density and incidence rates of alcohol-impaired driving.     

Blood lead levels of residents living around 350 abandoned metal mines in Korea

In 2007, as part of the control and prevention of environmental contamination threatening public health, the Korean Ministry of Environment planned to implement a national biomonitoring survey of three metals: lead, cadmium, and mercury in the blood of residents living near 350 abandoned metal mines known to be contaminated and as possible threats to the health of inhabitants. Thus, we investigated demographic and lifestyle variables and blood lead levels in residents living around the mines and compared them against those of control subjects. We measured the blood lead concentrations in 14,849 subjects (14,132 from nearby the 350 abandoned metal mines and 717 subjects from eight control areas). A questionnaire was provided to all subjects to determine gender, age, mining experience, period of time living in the vicinity of mines, smoking status, and personal perception of abandoned mines as a health risk. The geometric means (95% confidence intervals) of the blood lead levels of residents living around the abandoned metal mines and control areas were 3.017 (2.996-3.037 μg/dL) [female, 2.797 μg/dL (2.771-2.822 μg/dL); male, 3.330 μg/dL (3.298-3.363 μg/dL)] and 2.757 (2.677-2.837 μg/dL) [female, 2.604 μg/dL (2.506-2.700 μg/dL); male, 2.993 μg/dL (2.859-3.126 μg/dL)], respectively. Among residents of the mining areas, nonsmokers and residents who had no mining experience showed significantly lower mean blood lead levels than did smokers, past smokers, and those with mining experience. The mean blood lead concentrations of residents who expressed some concern about the abandoned mines were significantly higher than those of residents without concerns. The mean blood lead concentration of residents living around the abandoned mines was significantly higher than that of residents living in control areas as well as that of the general adult Korean population. We also confirmed that smoking is an important variable to consider, as it increases blood lead concentration.     

Visibility Trends in Korea during the Past Two Decades

Abstract

Temporal trends and spatial distributions of visibility measured by the human eye over 60 stations in Korea between 1980 and 2000 are analyzed and discussed. Generally, visibility is lowest on winter mornings and highest on summer afternoons throughout Korea. Visibility in Seoul is now in an increasing trend while it has decreased nationwide, especially in clean coastal areas. Spatial distribution of visibility in the 1990s was related negatively to that of relative humidity (RH). However, visibility generally decreased despite an overall decrease in RH throughout the country. Air pollutants should have played a role in this dissonant variation, particularly in relatively clean areas and on summer afternoons. It was interpreted that the visibility increase in major metropolitan areas, including the greater Seoul area, in the 1990s was caused mainly by the reduction in pollutant emissions by rigorous government policy. But the effect of the emission reduction was manifested with decreasing RH.     

Arsenic concentration in porewater of an alkaline coal ash disposal site: Roles of siderite precipitation/dissolution and soil cover

The geochemical behavior of As in porewaters of an alkaline coal ash disposal site was investigated using multilevel samplers. The disposal site was in operation from 1983 until 1994 and was covered with 0.3–0.5 m thick soils in 2001 when this study was initiated. Sequential extraction analyses and batch leaching experiments were also performed using the coal ash samples collected from the disposal site. The results suggest the important roles of siderite (FeCO₃) precipitation/dissolution and soil cover, which have been ignored previously. Arsenic levels in the porewater were very low (average of 10 μg L⁻¹) when the site was covered with soil due to coprecipitation with siderite. The soil cover enabled the creation of anoxic conditions, which raised the Fe concentration by the reductive dissolution of Fe-(hydr)oxides. Because of the high alkalinity generated from the alkaline coal ash, even a small increase in the Fe concentration (0.66 mg L⁻¹ on average) could cause siderite precipitation. When the soil cover was removed, however, an oxidizing condition was created and triggered the precipitation of dissolved Fe as (hydr)oxides. As a result, the dissolution of previously precipitated As-rich siderite caused higher As concentration in the porewater (average of 345 μg L⁻¹).     

Developing shared qualitative models for complex systems

Understanding complex systems is essential to ensure their conservation and effective management. Models commonly support understanding of complex ecological systems and, by extension, their conservation. Modeling, however, is largely a social process constrained by individuals’ mental models (i.e., a small-scale internal model of how a part of the world works based on knowledge, experience, values, beliefs, and assumptions) and system complexity. To account for both system complexity and the diversity of knowledge of complex systems, we devised a novel way to develop a shared qualitative complex system model. We disaggregated a system (carbonate coral reefs) into smaller subsystem modules that each represented a functioning unit, about which an individual is likely to have more comprehensive knowledge. This modular approach allowed us to elicit an individual mental model of a defined subsystem for which the individuals had a higher level of confidence in their knowledge of the relationships between variables. The challenge then was to bring these subsystem models together to form a complete, shared model of the entire system, which we attempted through 4 phases: develop the system framework and subsystem modules; develop the individual mental model elicitation methods; elicit the mental models; and identify and isolate differences for exploration and identify similarities to cocreate a shared qualitative model. The shared qualitative model provides opportunities to develop a quantitative model to understand and predict complex system change.     

Enrichment of potentially toxic elements in areas underlain by black shales and slates in Korea

The Okchon black shale in Korea provides an important example of natural geological materials containing toxic elements; the Chung-Joo, Duk-Pyung, Geum-Kwan, I-Won and Chu-Bu areas are underlain by these black shales and slates of the Guryongsan Formation. This formation is part of the Okchon Group which is found in the central part of Korea. Geochemical surveys were undertaken in these five study areas in the Okchon Zone in order to examine the level of enrichment and dispersion patterns of potentially toxic elements in rocks and soils. After appropriate preparation, samples were analysed by instrumental neutron activation analysis and inductively coupled plasma atomic emission spectrometry for a range of elements. Arsenic, Cu, Mo, V, U and Zn are highly enriched in the Okchon black shales and their mean concentrations are significantly higher than those in black slates. These elements are closely associated with one another from a geochemical viewpoint and may be enriched simultaneously. Mean concentrations of As, Mo and U in soils derived from black shales occurring in the Duk-Pyung and Chu-Bu areas are higher than the permissible level suggested by Kloke (1979), and the enrichment index decreases in the order of Duk- Pyung > Chu-Bu > Chung-Joo > Geum-Kwan = I-Won areas. Uranium-bearing minerals such as uraninite and brannerite have been identified in black shales from the Chung-Joo area by electron probe micro-analysis. Uraninite grains are closely associated with monazite and pyrite with a grain size ranging from 2m to 10m whereas brannerite grains occur as a euhedral form 50m in diameter.     

Concentrations and accumulation profiles of PCDDs, PCDFs and dioxin-like PCBs in adipose fat tissues of Korean women

Reports on residue levels and accumulation profiles of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (DL-PCBs) in human adipose tissue are scarce in Korea. In this study, concentrations and accumulation features of PCDD/Fs and DL-PCBs were determined in the samples of adipose tissue collected from Korean women in 2007-2008. The total dioxin-like toxic equivalent (TEQ) concentrations (3.4-42 pg g(-1) lipid wt) in Korean adipose tissues were similar to those reported in European and other Asian countries. The relative contributions of individual compounds to total TEQs were as follows: non-ortho PCBs (mean: 45%) > PCDFs (28%) > PCDDs (24%) > mono-ortho PCBs (3%), a pattern similar to those reported for seafoods in Korea. The dominant PCDD/F congeners found in adipose tissues were OCDD and 2,3,4,7,8-PeCDF and dominant PCBs were 118, 156 and 105. No correlation was found between subject's age and concentrations of dioxin-like contaminants. Body mass index was not correlated with concentrations of PCDD/Fs and was negatively (p < 0.001) correlated with concentrations of DL-PCBs. The results of this study provide baseline information on PCDD/Fs and DL-PCBs in adipose tissues of the general population in Korea.     

Effectiveness of compacted soil liner as a gas barrier layer in the landfill final cover system

A compacted soil liner (CSL) has been widely used as a single barrier layer or a part of composite barrier layer in the landfill final cover system to prevent water infiltration into solid wastes for its acceptable hydraulic permeability. This study was conducted to test whether the CSL was also effective in prohibiting landfill gas emissions. For this purpose, three different compaction methods (i.e., reduced, standard, and modified Proctor methods) were used to prepare the soil specimens, with nitrogen as gas, and with water and heptane as liquid permeants. Measured gas permeability ranged from 2.03x10(-10) to 4.96x10(-9)cm(2), which was a magnitude of two or three orders greater than hydraulic permeability (9.60x10(-13) to 1.05x10(-11)cm(2)). The difference between gas and hydraulic permeabilities can be explained by gas slippage, which makes gas more permeable, and by soil-water interaction, which impedes water flow and then makes water less permeable. This explanation was also supported by the result that a liquid permeability measured with heptane as a non-polar liquid was similar to the intrinsic gas permeability. The data demonstrate that hydraulic requirement for the CSL is not enough to control the gas emissions from a landfill.