Discordance between age- and size-based criteria of child passenger restraint appropriateness

Objectives: In this study, we sought to accomplish the following objectives: to (1) calculate the percentage of children considered appropriately restrained across 8 criteria of increasing restrictiveness; (2) examine agreement between age- and size-based appropriateness criteria; (3) assess for changes in the percentage of children considered appropriately restrained by the 8 criteria between 2011 (shortly after updates to U.S. guidelines) and 2015.

Methods: Data from 2 cross-sectional surveys of 928 parents of children younger than 12 years old (n = 591 in 2011, n = 337 in 2015) were analyzed in 2017. Child age, weight, and height were measured at an emergency department visit and used to determine whether the parent-reported child passenger restraint was considered appropriate according to 8 criteria. Age-based criteria were derived from Michigan law and U.S. guidelines. Weight, height, and size-based criteria were derived from typical restraints available in the United States in 2007 and 2011. The percentage appropriate restraint use was calculated for each criterion. The kappa statistic was used to measure agreement between criteria. Change in appropriateness from 2011 to 2015 was assessed with chi-square statistics.

Results: Percentage appropriate restraint use varied from a low of 19% for higher weight limits in 2011 to a high of 91% for Michigan law in 2015. Agreement between criteria was slight to moderate. The lowest kappa was for Michigan law and higher weight limits in 2011 (κ = 0.06) and highest for U.S. guidelines and lower weight limits in 2011 (κ = 0.60). Percentage appropriate restraint use was higher in 2015 than 2011 for the following criteria: U.S. guidelines (74 vs. 58%, P < .001), lower weight (57 vs. 47%, P = .005), higher weight (25 vs. 19%, P = .03), greater height (39 vs. 26%, P < .001), and greater size (42 vs. 30%, P = .001).

Conclusions: The percentage of children considered to be using an appropriate restraint varied substantially across criteria. Aligning the definition of appropriate restraint use with current U.S. guidelines would increase consistency in reporting results from studies of child passenger safety in the United States. Potential explanations for the increased percentage of children considered appropriately restrained between 2011 and 2015 include adoption of the updated U.S. guidelines and the use of child passenger restraints with higher weight and height limits.     

机动车尾气对人体健康的危害

随着城市机动车保有量的不断增加,机动车尾气已经成为影响我国城市大气环境的主要问题之一。本文以儿童和交通警察两类人群为例,分析了机动车尾气污染给人体呼吸系统、免疫系统、心脑血管系统等造成的危害。结果表明,由于儿童的呼吸带与机动车尾气排放带非常接近,交警在机动车尾气环境中暴露事件太长,导致这两类人群的呼吸系统极易遭到破坏,发生支气管炎等疾病的概率大大增加;而免疫球蛋白水平和血压发生改变导致了抵抗能力的下降。最后建议通过采取发展公共交通、加强城市交通管理、完善检查维修制度等有效措施加强机动车尾气治理,减少对人体健康产生的危害。     

武汉市儿童多途径铅暴露风险评估

在武汉市区设置70个采样点,采集土壤、灰尘、大气及食品样品.根据美国EPA推荐的儿童铅暴露参数,应用美国EPA人体暴露风险评估方法对武汉市儿童多途径铅暴露进行了风险评估,结果表明,武汉市区儿童每天的铅暴露量为1.20×10-3mg.（kg.d）-1.经消化道途径是儿童摄入铅的主要途径,其暴露量为1.04×10-3mg.（kg.d）-1,其次为经呼吸道途径及皮肤吸收途径,其暴露量分别为0.153×10-3mg.（kg.d）-1和8.56×10-7mg.（kg.d）-1.在消化道途径中,摄入土壤或灰尘铅暴露量占占总暴露量的52.0%,通过消化道途径摄入土壤或灰尘是最主要的暴露途径.用Monte Carlo法进行模拟,在消化道途径中,通过摄取土壤铅暴露量为2.48×10-2mg.d-1.超过JECFA指定的PTDI的概率为2.1%.风险水平R计算结果表明,从消化道、呼吸道、皮肤吸收这3个途径的铅暴露风险均小于最大可接受风险水平5.0×10-5,其中经过皮肤吸收途径的铅暴露风险值小于可忽略风险水平1×10-8.应用Kriging插值法获得武汉市中心城区儿童铅日暴露量的空间分布,运用指示Kriging方法获得了武汉市儿童铅暴露危险指数图,显示武汉市青山区及江岸区儿童铅暴露水平较高.     

典型河谷城市儿童土壤与灰尘铅暴露风险

为定量评价河谷型城市土壤与灰尘铅对城市儿童健康的影响与风险,结合野外调查的基础上,以陕西渭河谷地典型工业城市宝鸡、西安、渭南和铜川为研究区域,以定量分析河谷型城市儿童环境铅暴露为核心,收集4个城市土壤与灰尘分析样品总计243个。利用X射线荧光光谱法测定了4个城市土壤与灰尘铅的含量;采用BCR连续形态分级法探究了城市土壤与灰尘重金属铅地球化学形态分布与迁移特征;根据US EPA污染物暴露与健康风险评价模型对城市儿童铅暴露进行了评价。研究结果表明渭河谷地典型城市宝鸡、铜川、西安和渭南城市土壤与灰尘铅浓度(X±SD)分别为(409.2±52.54)和(624.70±66.15)mg·kg-1、(357.47±41.37)和(592.60±36.78)mg·kg-1、(61.4±13.31)和(78.42±14.89)mg·kg-1、(46.71±12.11)和(64.7±13.76)mg·kg-1,均高出陕西省土壤铅背景值;污染水平依次为宝鸡铜川西安渭南。4个河谷型城市土壤与灰尘重金属铅发生整体迁移的趋势为:宝鸡城市灰尘(90.71%)西安城市灰尘(84.74%)≥宝鸡城市土壤(83.12%)渭南城市灰尘(74.89%)≥西安城市土壤(74.50%)铜川城市灰尘(72.49%)铜川城市土壤(57.50%)渭南城市土壤(53.79%)。可见,铅在均在城市灰尘中的迁移趋势远大于相应的城市土壤。4个城市土壤与灰尘均表现出较大的儿童暴露致癌风险,宝鸡和铜川城市儿童土壤与灰尘铅暴露也分别存在非致癌风险,风险程度依次为宝鸡铜川西安渭南。儿童铅暴露致癌与非致癌风险程度与其城市土壤和灰尘中铅可氧化态分布呈相似的规律,表明碱性的城市土壤与城市灰尘(p H7)中可氧化态铅可能是导致河谷型城市儿童铅暴露风险和儿童血铅污染的主要形态和因素。由此,城市燃煤排放与含铅制品的加工等活动可能是渭河谷地河谷型城市儿童血铅与铅暴露最主要的贡献源,必须采取长期有效的监测与控制措施。     

The effect of different educational interventions on schoolchildren's knowledge of earthquake protective behaviour in Israel

Knowledge of appropriate behaviour during an earthquake is crucial for prevention of injury and loss of life. The Israeli Home Front Command conducts a yearly earthquake education programme in all Israeli schools, using three types of educational interventions: lectures, drills and a combination of the two. The aim of this study was to evaluate the effectiveness of these interventions in providing students with knowledge. We distributed a questionnaire to 2,648 children from the 5th and 6th grades in 120 schools nationwide. Knowledge scores for both 5th and 6th grades were increased, regardless of type of intervention, compared to the non-exposure group. A combined intervention of lectures and drills resulted in the highest knowledge scores. Our findings suggest that for the age group studied a combination of lectures and drills will likely prepare students best for how to behave in the event of an earthquake.     

The living environment and children's fears following the Indonesian tsunami

The tsunami that struck South-east Asia on 26 December 2004 left more than 500,000 people in Aceh, Indonesia, homeless and displaced to temporary barracks and other communities. This study examines the associations between prolonged habitation in barracks and the nature of fears reported by school-age children and adolescents. In mid-2007, 30 months after the tsunami, the authors interviewed 155 child and parent dyads. Logistic regression analysis was used to compare the fears reported by children and adolescents living in barracks with those reported by their peers who were living in villages. After adjusting for demographic factors and tsunami exposure, the data reveals that children and adolescents living in barracks were three times more likely than those living in villages to report tsunami-related fears. The study demonstrates that continued residence in barracks 30 months after the tsunami is associated with higher rates of reporting tsunami-related fears, suggesting that barracks habitation has had a significant impact on the psychological experience of children and adolescents since the tsunami.     

An evaluation of lead concentrations in imported hot sauces

In the last decade, the U.S. Food and Drug Administration (FDA) has issued several warnings and recalls for food products that exceed FDA standards for lead. Products containing chili peppers and salt were often suspected as sources of lead contamination, and included items such as candy that are routinely investigated. However, products such as hot sauces that contain similar ingredients have not been the focus of evaluations. This study quantified lead concentrations in imported hot sauces, evaluated product compliance to existing United States standards, and calculated potential dietary lead exposure for children using the Integrated Exposure Uptake Biokinetic Model. Finally, recommendations for reducing the risk of lead exposure from hot sauces are provided. Twenty-five (25) bottles of imported hot sauces manufactured in Mexico and South America were purchased in Clark County, Nevada. All hot sauces were analyzed for lead concentrations, pH, and leaded packaging. Hot sauces were analyzed by inductively coupled plasma mass spectrometry and packaging was analyzed using x-ray fluorescence technology. Four brands of hot sauces (16%) exceeded 0.1 ppm lead, the current FDA action level for lead in candy. Hot sauces with lead concentrations >0.1 ppm lead contained salt and were manufactured in Mexico. Subsequent analysis of additional lots of hot sauces exceeding 0.1 ppm lead revealed inconsistent lead concentrations between and within manufacturer lots. The lead concentrations of the plastic hot sauce lids ranged from below the limit of detection to 2,028 ppm lead. There was no association between lead concentrations in hot sauces and pepper type. These results indicate the need for more rigorous screening protocols for products imported from Mexico, the establishment of an applicable standard for hot sauce, and resources to allow for the enforcement of existing food safety policies. The data reported herein represent the first known investigation of lead concentrations in hot sauces.     

Correlation between lead and iron in children's blood in Jordan

A total of 200 Jordanian children were classified into two groups: 100 Fe replete and 100 Fe deficient with ages ranging between 3.0 and 12.0 years (6.9 ± 2.7 years). All participants were chosen according to proper selection criteria followed by the sample collection: the samples were analyzed for hemoglobin and red blood cells; ferritin, an immunoassays-based instrument; and levels of Pb, Cu, and Zn. There were no significant differences between genders regarding Fe-deficiency (p = 0.57 and χ2 = 0.33), with a significant association of younger individuals (3.0–9.1 years) with Fe-deficiency (p < 0.05 and χ2 = 22.7).

In addition, there is a significant positive correlation between Fe-deficiency with blood levels of Pb, Cu, and Zn (p < 0.05), (r = 0.43, 0.35, and 0.42, respectively) as compared to control group, this findings supported, by comparing the levels of the examined metals in both groups, in individuals whom close to heavy metals source (highway traffic or oil gas station), and found that the mean of the heavy metals level in close Fe-deficient group higher than in close Fe-replete group.     

儿童腹股沟斜疝嵌顿急诊术后阴囊积液的预防及处理

总结儿童腹股沟斜疝嵌顿急诊术后阴囊积液出现的原因以及处理方式.回顾性分析2008年1月至2012年1月儿童腹股沟斜疝嵌顿急诊术后阴囊积液42例的临床资料.42例阴囊积液患者分为轻、中、重度均痊愈,其中轻度3 d左右恢复,中度5~7 d左右恢复,重度未合并感染7~10 d左右恢复,重度合并感染14 d内恢复.儿童腹股沟斜疝嵌顿急诊术后阴囊积液应注意围手术期的积极预防以及术后及时恰当的处理,即可避免严重并发症.参8.