Using data linkage to assess the impact of motorized recreational vehicle-related injuries in Ohio

Problem

Motorized recreational vehicle (MRV)-related injuries can result in severe medical and financial consequences. The objective of this study was to describe the epidemiology, and clinical and financial impact of MRV-related injuries in Ohio.

Method

Probabilistically linked statewide Emergency Medical Services (EMS) and hospital (inpatient and emergency department) data for 2003 and 2004 were examined. Record pairs with a MRV-related E-code (E821-E823, E825) were included in this study.

Results

There were 2,893 patients with MRV-related injuries, who had linked EMS and hospital records, resulting in more than $15 million in hospital charges and 1,921 inpatient days of hospitalization. The male-to-female ratio was nearly 4:1, and 19% were younger than 16. Almost 82% of cases were not wearing a helmet; there was a trend of decreasing helmet use with increasing age. Mean (SE) inpatient hospital charges and length of stay (LOS) were $22,218 ($1,290) and 3.8 (0.2) days, respectively. The mean (SE) Injury Severity Score (ISS) for inpatients was 9.2 (0.4). Individuals injured on a street/highway were 3.20 times more likely to sustain an ISS ≥ 16 (95% CI: 1.03, 9.88; p = 0.044) and 3.05 times more likely to sustain a traumatic brain injury (TBI) (95% CI: 1.17, 7.94; p = 0.024) than those who were injured at a place designated for sport or recreation. Children aged 12 to 15 and young adults aged 16 to 25 were 2.47 and 2.14 times more likely, respectively, to sustain a TBI than adults aged 36 or older (aged 12 to 15: 95% CI: 1.13, 5.38; p = 0.024; aged 16 to 25: 95% CI: 1.26, 3.64; p = 0.005). Higher ISS was associated with both higher total charges (p < 0.001) and longer LOS (p < 0.001).

Discussion

This study demonstrates that MRV-related injuries are an important public health problem in Ohio, with a substantial clinical and financial impact.

Impact on Industry

Enactment and enforcement of statewide MRV safety legislation and training of MRV users offer valuable opportunities to prevent these costly injuries.     

Trends in land use and land cover change in the protected and communal areas of the Zambezi Region,Namibia

Land management decisions have extensively modified land use and land cover in the Zambezi Region. These decisions are influenced by land tenure classifications, legislation, and livelihoods. Land use and land cover change is an important indicator for quantifying the effectiveness of different land management strategies. However, there has been no evidence on whether protected or communal land tenure is more affected by land use and land cover changes in southern Africa and particularly Namibia. Our study attempted to fill this gap by analyzing the relationship between land use and land cover change and land tenure regimes stratified according to protected and communal area in the Zambezi Region. Multi-temporal Landsat TM and ETM+ imagery were used to determine the temporal dynamics of land use and land cover change from 1984 to 2010. The landscape showed distinctive modifications over the study period; broad trends include the increase in forest land after 1991. However, changes were not uniform across the study areas. Two landscape development stages were deduced: (1) 1984–1991 represented high deforestation and gradual increase in shrub land; (2) 1991–2000 and 2000–2010 represented lower deforestation and slower agropastoral expansion. The results further show clear patterns of the dynamics, magnitude, and direction of land use and land cover change by tenure regime. The study concluded that land tenure has a direct impact on land use and land cover, since it may restrict some activities carried out on the land in the Zambezi Region.     

Silver near municipal wastewater discharges into western Lake Ontario,Canada

Because of the widespread use of silver nanoparticles in commercial products, discharges of municipal wastewater may be a point source of silver in the aquatic environment. We monitored two sites in western Lake Ontario impacted by discharges from wastewater treatment plants serving the City of Toronto. Concentrations of silver were elevated in bottom sediments and suspended sediments collected at the two sites. We also deployed two types of passive samplers in the water column at the two sites, the newly developed Carbon Nanotube Integrative Samplers for monitoring “CNIS-labile” silver and Diffusive Gradient in Thin Film samplers for monitoring “DGT-labile” silver. Results from these passive samplers indicated that the concentrations of silver at the two sites were either below detection limits or were in the ng/L range. In laboratory experiments where the sediments were re-suspended in Milli-Q water, a small proportion of the silver (i.e., <?25%) was labile and partitioned as colloidal or dissolved silver into the liquid phase after agitation. Nanoparticles tentatively identified as silver nanoparticles were detected by single-particle ICP-MS in suspension after agitation of both suspended and bottom sediments. Therefore, there is a need to assess whether silver species, including silver nanoparticles are transported from wastewater treatment plants into sediments in the aquatic environment. This study is unique in focusing on the in situ distribution of silver in natural waters and in sediments that are potentially impacted by urban sources of nanoparticles.     

Source characterization and risk of exposure to atmospheric polychlorinated biphenyls (PCBs) in Ghana

With recent evidence that persistent organic pollutants (POPs) such as polychlorinated biphenyls (PCBs) are emerging in environmental media in some developing countries that otherwise have sparing production and usage history, it has become important to identify such contemporary source factors of PCBs and the risks this may pose, in line with the global consensus on POP management and elimination. The present study investigated contaminations from atmospheric PCBs in Ghana, deciphered source factors, and accessed risk of exposure to dioxin-like PCBs (DL-PCBs). Atmospheric PCBs were monitored by deployment of PUF-disk passive air samplers (PAS) at several sites across Ghana for 56 days. Atmospheric ∑₁₉₀PCB concentration in Ghana ranged from 0.28 ng/m³ in Kumasi to 4.64 ng/m³ at Agbogbloshie, a suburb in Accra noted for informal electronic waste (e-waste) recycling activities. As high as 11.10 ng/m³ of PCB concentration was measured in plumes from uncontrolled open burning of e-wastes at Agbogbloshie. Applying statistical source characterization tools, it emerged that e-wastes were a major contributor to the environmental burden of atmospheric PCBs in Ghana. The risk of DL-PCB toxicity via inhalation in the Agbogbloshie area was 4.2 pg TEQ/day, within similar order of magnitude of an estimated risk of 3.85 pg TEQ/day faced by e-waste workers working averagely for 8 h per day. It is suggested that elimination of e-waste sites would help to significantly reduce PCB-related toxicity issues in Ghana.

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Research priorities for managing the impacts and dependencies of business upon food,energy, water and the environment

Delivering access to sufficient food, energy and water resources to ensure human wellbeing is a major concern for governments worldwide. However, it is crucial to account for the ‘nexus’ of interactions between these natural resources and the consequent implications for human wellbeing. The private sector has a critical role in driving positive change towards more sustainable nexus management and could reap considerable benefits from collaboration with researchers to devise solutions to some of the foremost sustainability challenges of today. Yet opportunities are missed because the private sector is rarely involved in the formulation of deliverable research priorities. We convened senior research scientists and influential business leaders to collaboratively identify the top forty questions that, if answered, would best help companies understand and manage their food-energy-water-environment nexus dependencies and impacts. Codification of the top order nexus themes highlighted research priorities around development of pragmatic yet credible tools that allow businesses to incorporate nexus interactions into their decision-making; demonstration of the business case for more sustainable nexus management; identification of the most effective levers for behaviour change; and understanding incentives or circumstances that allow individuals and businesses to take a leadership stance. Greater investment in the complex but productive relations between the private sector and research community will create deeper and more meaningful collaboration and cooperation.     

Towards an international standard: The ISO/DIS 18504 standard on sustainable remediation

Sustainable remediation is the elimination and/or control of unacceptable risks in a safe and timely manner while optimizing the environmental, social, and economic value of the work. Forthcoming International Organization for Standardization (ISO) Standard on Sustainable Remediation will allow countries without the capacity to develop their own guidance to benefit from work done over the past decade by various groups around the world. The ISO standard has progressed through the committee draft (ISO/CD 18504) and draft international standard (ISO/DIS 18504) stages. The risk‐based approach to managing the legacy of historically contaminated soil and groundwater has been incorporated into policy, legislation, and practice around the world. It helps determine the need for remediation and the end point of such remediation. Remediation begins with an options appraisal that short lists strategies that could deliver the required reduction in risk. A remediation strategy comprises one or more remediation technologies that will deliver the safe and timely elimination and/or control of unacceptable risks. The ISO standard will help assessors identify the most sustainable among the shortlisted, valid alternative remediation strategies. Practitioners presenting case studies claiming to constitute sustainable remediation should now report how they have aligned their work with the new standard. Indicators are used to compare alternative remediation strategies. The simplest metric that allows a characteristic to act as an indicator should be chosen. Weightings indicators can become a contested exercise and should only be undertaken where there is a clear desire for it by stakeholders and a clear need for it in identifying a preferred strategy. The simplest means of ranking alternative remediation strategies should be adopted.     

The macroeconomic determinants of volatility in precious metals markets

This paper models the monthly price volatilities of four precious metals (gold, silver, platinum and palladium prices) and investigates the macroeconomic determinants (business cycle, monetary environment and financial market sentiment) of these volatilities. Gold volatility is shown to be explained by monetary variables, but this is not true for silver. Overall, there is limited evidence that the same macroeconomic factors jointly influence the volatility processes of the four precious metal price series, although there is evidence of volatility feedback between the precious metals. These results are consistent with the view that precious metals are too distinct to be considered a single asset class, or represented by a single index. This finding is of importance for portfolio managers and investors.     

Effects of particle size on chemical speciation and bioavailability of copper to earthworms (Eisenia fetida) exposed to copper nanoparticles

To investigate the role of particle size on the oxidation, bioavailability, and adverse effects of manufactured Cu nanoparticles (NPs) in soils, we exposed the earthworm Eisenia ferida to a series of concentrations of commercially produced NPs labeled as 20- to 40-nm or < 100-nm Cu in artificial soil media. Effects on growth, mortality, reproduction, and expression of a variety of genes associated with metal homeostasis, general stress, and oxidative stress were measured. We also used X-ray absorption spectroscopy and scanning X-ray fluorescence microscopy to characterize changes in chemical speciation and spatial distribution of the NPs in soil media and earthworm tissues. Exposure concentrations of Cu NPs up to 65 mg kg(-1) caused no adverse effects on ecologically relevant endpoints. Increases in metallothionein expression occurred at concentrations exceeding 20 mg kg(-1) of Cu NPs and concentrations exceeding 10 mg kg(-1) of CuSO4. Based on the relationship of Cu tissue concentration to metallothionein expression level and the spatial distribution and chemical speciation of Cu in the tissues, we conclude that Cu ions and oxidized Cu NPs were taken up by the earthworms. This study suggests that oxidized Cu NPs may enter food chains from soil but that adverse effects in earthworms are likely to occur only at relatively high concentrations (> 65 mg Cu kg(-1) soil).     

Trace metals, anions and polybromodiphenyl ethers in settled indoor dust and their association

Contaminants in settled indoor dust are potentially health hazardous to human. Thus, identification and quantification of toxic chemicals in settled indoor dust is of great concern. In this study, the levels of major anions ( $ \mathrm{C}{{\mathrm{l}}^{-}},\mathrm{N}{{\mathrm{O}}_2}^{-},\mathrm{B}{{\mathrm{r}}^{-}},\mathrm{N}{{\mathrm{O}}_3}^{-},\mathrm{P}{{\mathrm{O}}_4}^{3-}\,\mathrm{and}\,\mathrm{S}{{\mathrm{O}}_4}^{2- } $ ), trace metals (Cr, Mn, Fe, Co, Ni, Cu, Zn, Cd, As and Pb) and polybromodiphenyl ethers (PBDEs) in settled office and home dust were determined and correlations between the contaminants investigated. Depending on the available materials in both microenvironments, the most possible sources were identified. The results showed that the settled office dusts (n?=?6 pooled samples from 85 offices) were more contaminated than home dusts (n?=?8 homes). For anions, $ \mathrm{S}{{\mathrm{O}}_4}^{2- } $ and Cl^– accounted for 87 and 97 % of the total office and home dust contaminants, respectively. For trace metals, Fe, Cu, Zn and Mn, accounted for 98 % of the contaminants in both office and home dust samples. Fe exhibited the highest percentage of 76.7 and 87.3 % in office and home dust samples, respectively. For PBDEs, the mean concentrations detected in office and home dust ranged between 5.8–86.3 and 1.5–20.6 ng?g^?1, respectively. The log-transformed correlation between the total concentrations of trace metals and major anions detected in offices and homes was positive for offices and negative for homes with a statistically significant values (r?=?0.73, p?<?0.01; r?= ?0.22, p?<?0.01, respectively). The daily exposure rates determined for the most hazardous such as As, Cd, Pb and PBDEs congeners, relative to the individual concentrations reported in the literature in settled indoor dust, were found very lower. Therefore, maybe it is possible to expect less potential health risk. Investigation of formation of coordination compounds between trace metals and PBDEs congeners is possible; however, this requires further study.