Organizational policy and other factors associated with emergency medical technician seat belt use

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.     

Methodology for quantification of waste generated in Spanish railway construction works

In the last years, the European Union (EU) has been focused on the reduction of construction and demolition (C&D) waste. Specifically, in 2006, Spain generated roughly 47million tons of C&D waste, of which only 13.6% was recycled. This situation has lead to the drawing up of many regulations on C&D waste during the past years forcing EU countries to include new measures for waste prevention and recycling. Among these measures, the mandatory obligation to quantify the C&D waste expected to be originated during a construction project is mandated. However, limited data is available on civil engineering projects. Therefore, the aim of this research study is to improve C&D waste management in railway projects, by developing a model for C&D waste quantification. For this purpose, we develop two equations which estimate in advance the amount, both in weight and volume, of the C&D waste likely to be generated in railway construction projects, including the category of C&D waste generated for the entire project.     

Paper waste – Recycling,incineration or landfilling? A review of existing life cycle assessments

A review of existing life cycle assessments (LCAs) on paper and cardboard waste has been undertaken. The objectives of the review were threefold. Firstly, to see whether a consistent message comes out of published LCA literature on optimum disposal or recycling solutions for this waste type. Such message has implications for current policy formulation on material recycling and disposal in the EU. Secondly, to identify key methodological issues of paper waste management LCAs, and enlighten the influence of such issues on the conclusions of the LCA studies. Thirdly, in light of the analysis made, to discuss whether it is at all valid to use the LCA methodology in its current development state to guide policy decisions on paper waste. A total of nine LCA studies containing altogether 73 scenarios were selected from a thorough, international literature search. The selected studies are LCAs including comparisons of different management options for waste paper. Despite claims of inconsistency, the LCAs reviewed illustrate the environmental benefits in recycling over incineration or landfill options, for paper and cardboard waste. This broad consensus was found despite differences in geographic location and definitions of the paper recycling/disposal systems studied. A systematic exploration of the LCA studies showed, however, important methodological pitfalls and sources of error, mainly concerning differences in the definition of the system boundaries. Fifteen key assumptions were identified that cover the three paper cycle system areas: raw materials and forestry, paper production, and disposal/recovery. It was found that the outcome of the individual LCA studies largely depended on the choices made in some of these assumptions, most specifically the ones concerning energy use and generation, and forestry.     

Nitrite formation and nitrous oxide emissions as affected by reclaimed effluent application

The effect of irrigation with reclaimed effluent (RE) (after secondary treatment) on the mechanisms and rates of nitrite formation, N2O emissions, and N mineralization is not well known. Grumosol (Chromoxerert) soil was incubated for 10 to 14 d with fresh water (FW) and RE treated with 15NO3- and 15NH4+ to provide a better insight on N transformations in RE-irrigated soil. Nitrite levels in RE-irrigated soil were one order of magnitude higher than in FW- irrigated soil and ranged between 15 to 30 mg N kg(-1) soil. Higher levels of NO2- were observed at a moisture content of 60% than at 70% and 40% w/w. Nitrite levels were also higher when RE was applied to a relatively dry Grumosol (20% w/w) than at subsequent applications of RE to soil at 40% w/w. Isotopic labeling indicated that the majority of NO2 was formed via nitrification. The amount of N2O emitted from RE-treated Grumosol was double the amount emitted from FW treatments at 60% w/w. Nitrification was responsible for about 42% of the emissions. The N20 emission from the RE-treated bulk soil (passing a 9.5-mm sieve) was more than double the amount formed in large aggregates (4.76-9.5 mm in diameter). No dinitrogen was detected under the experimental conditions. Results indicate that irrigation with secondary RE stimulates nitrification, which may enhance NO3 leaching losses. This could possibly be a consequence of long-term exposure of the nitrifier population to RE irrigation. Average gross nitrification rate estimates were 11.3 and 15.8 mg N kg(-1) soil d(-1) for FW- and RE-irrigated bulk soils, respectively. Average gross mineralization rate estimates were about 3 mg N kg(-1) soil d(-1) for the two water types.     

Impact of increased collection rates and the use of commingled collection systems on the quality of recovered paper. Part 1: increased collection rates

The recovery and utilization of recovered paper have increased over past decades all over the world due to economic, environmental, and social issues. However, it is well known that an extended recovered paper collection is detrimental to its quality, either by the exploitation of lower quality sources such as households, or the spreading of commingled systems instead of selective collection systems. The influence of these two factors was assessed by analyzing the quality of different recovered paper grades used as raw material in a mill located in Madrid (Spain) producing newsprint and light weight coated paper from recovered paper. Part 1 of the paper deals with the impact of increased collection rates on the quality of recovered paper and Part 2 with the use of commingled collection systems. Results of Part 1 show that increased collection rates have a large impact on the quality of the recovered paper. The quality, measured as total unusable material and moisture contents, had deteriorated very rapidly in only 4 years (2005–2008) as a consequence of increased collection rates. Collection rates increased in Spain from 58.5% to 68.6% during this period, resulting in more than 50% increase of total unusable material and 25% of moisture content. The downgrading of the quality of recovered paper is one of the major threats for extending the current limits of paper recycling. Therefore, future challenge is to increase its availability but maintaining its quality.     

Protection of the vehicle cab environment against bacteria, fungi and endotoxins in composting facilities

Microbial quality of air inside vehicle cabs is a major occupational health risk management issue in composting facilities. Large differences and discrepancies in protection factors between vehicles and between biological agents have been reported. This study aimed at estimating the mean protection efficiency of the vehicle cab environment against bioaerosols with higher precision. In-cab measurement results were also analysed to ascertain whether or not these protection systems reduce workers' exposure to tolerable levels. Five front-end loaders, one mobile mixer and two agricultural tractors pulling windrow turners were investigated. Four vehicles were fitted with a pressurisation and high efficiency particulate air (HEPA) filtration system. The four others were only equipped with pleated paper filter without pressurisation. Bacteria, fungi and endotoxins were measured in 72 pairs of air samples, simultaneously collected inside the cab and on the outside of the cab with a CIP 10-M sampler. A front-end loader, purchased a few weeks previously, fitted with a pressurisation and high efficiency particulate air (HEPA) filtration system, and with a clean cab, exhibited a mean protection efficiency of between 99.47% CI 95% [98.58-99.97%] and 99.91% [99.78-99.98%] depending on the biological agent. It is likely that the lower protection efficiency demonstrated in other vehicles was caused by penetration through the only moderately efficient filters, by the absence of pressurisation, by leakage in the filter-sealing system, and by re-suspension of particles which accumulated in dirty cabs. Mean protection efficiency in regards to bacteria and endotoxins ranged between 92.64% [81.87-97.89%] and 98.61% [97.41-99.38%], and between 92.68% [88.11-96.08%] and 98.43% [97.44-99.22%], respectively. The mean protection efficiency was the lowest when confronted with fungal spores, from 59.76% [4.19-90.75%] to 94.71% [91.07-97.37%]. The probability that in-cab exposure to fungi exceeded the benchmark value for short-term respiratory effects suggests that front-end loaders and mobile mixers in composting facilities should be fitted with a pressurisation and HEPA filtration system, regardless of whether or not the facility is indoors or outdoors. Regarding the tractors, exposure inside the cabs was not significantly reduced. However, in this study, there was a less than 0.01% risk of exceeding the bench mark value associated with fungi related short-term respiratory effects during an 1-h per day windrow turning operation. Pressurisation and a HEPA filtration system can provide safe working conditions inside loaders and mobile mixer with regard to airborne bacteria, fungi and endotoxins in composting facilities. However, regular thorough cleaning of the vehicle cab, as well as overalls and shoes cleaning, and mitigation of leakage in the filter-sealing system are necessary to achieve high levels of protection efficiency.