Factors associated with prehospital death among traffic accident patients in Osaka City,Japan: A population-based study

Objective: Although it is important to assess the factors associated with traffic accident fatalities to decrease them as a matter of public health, such factors have not been fully identified.

Methods: Using a large-scale data set of ambulance records in Osaka City, Japan, we retrospectively analyzed all traffic accident patients transported to hospitals by emergency medical service personnel from 2013 to 2014. In this study, prehospital death was defined as that occurring at the scene or in the emergency department immediately after hospital arrival. We assessed prehospital factors associated with prehospital death due to traffic accidents by logistic regression models.

Results: This study enrolled 28,903 emergency patients involved in traffic accidents, of whom 68 died prehospital. In a multivariate model, elderly patients aged ≥75 years (adjusted odds ratio [AOR] = 4.34; 95% confidence interval [CI], 2.29–8.23), nighttime (AOR = 2.75; 95% CI, 1.65–4.70), and type of injured person compared to bicyclists such as pedestrians (AOR = 9.58; 95% CI, 5.07–17.99), motorcyclists (AOR = 2.75; 95% CI, 1.21–6.24), and car occupants (AOR = 2.98; 95% CI, 1.39–6.40) were significantly associated with prehospital death due to traffic accidents. In addition, the AOR for automobile versus nonautomobile as the collision opponent was 4.76 (95% CI, 2.30–9.88).

Conclusions: In this population, the factors associated with prehospital death due to traffic accidents were elderly people, nighttime, and pedestrian as the type of patient. The proportion of prehospital deaths due to traffic accidents was also high when the collision component was an automobile.     

Mass spectrometric study of secondary organic aerosol formed from the photo-oxidation of aromatic hydrocarbons

From measurements by an Aerodyne Aerosol Mass Spectrometer (AMS), secondary organic aerosol (SOA) formed in laboratory chambers is believed to be less oxidized than well-oxidized ambient organic aerosol (OA). However, the mass spectrum of SOA formed from the photo-oxidation of aromatic hydrocarbons has not been sufficiently studied by using AMS though these reactions are potential sources of urban SOA. In this study, we studied SOA formed from the photo-oxidation of seven aromatic hydrocarbons by using Time-of-Flight AMS. Strong mass signals from SOA were found at m/z 43 (m43) and 44 (m44) in all the experiments. The m44 to total organic aerosol mass ratio (m44/OA) increased with irradiation time. For example, the m44/OA ratio increased from 10.6% to 13.3% during irradiation for 11 h in an experiment with toluene. The average m44/OA ratios were determined to be 5.8–17.1% for all the experiments. The m44/OA decreased and the m43/OA increased with increasing number of alkyl substituents of precursor aromatic hydrocarbons. This is because low-reactive ketones are preferentially produced rather than aldehydes with increasing number of alkyl substituents. The m44/OA ratios of the benzene and monoalkylbenzene oxidation were 12.2–17.1% and were close to those of well-oxidized ambient OA. These findings are consistent with the hypothesis that the photo-oxidation of aromatic hydrocarbons is a potential source of urban SOA. In addition to oxygenated organic compounds, organic nitrogen oxides were also shown to be present in SOA by high-resolution mass spectra.     

An ex post cost-benefit analysis of the nitrogen dioxide air pollution control program in Tokyo

The benefits and costs of past nitrogen dioxide (NO2) control policies were calculated for Tokyo, Japan, using environmental, economic, political, demographic, and medical data from 1973 to 1994. The benefits of NO2 control were estimated as medical expenses and lost work time due to hypothetical no-control air concentrations of NO2. Direct costs were calculated as annualized capital expenditures and 1 year's operating costs for regulated industries plus governmental agency expenses. The major findings were as follows: (1) Using Tokyo's average medical cost of pollution-related illness, the best net estimate of the avoided medical costs due to incidence of phlegm and sputum in adults was 730 billion yen ($6.08 billion; 1 U.S. dollar = 120 yen). (2) The best net estimate of the avoided medical costs due to incidence of lower respiratory illness in children was 93 billion yen ($775 million). (3) Using Tokyo's average duration of pollution-related illness and average wages, the best net estimate of the avoided costs of lost wages in workers was 760 billion yen ($6.33 billion). (4) The best net estimate of the avoided costs of lost wages in mothers caring for their sick children was 100 billion yen ($833 million). (5) Using Tokyo-specific data, the best net costs were estimated as 280 billion yen ($2.33 billion). (6) Using human health and productivity benefits, and annualized capital cost and operating cost estimates, the best net benefits-to-costs ratio was 6:1 (upper limit 44:1; lower limit 0.3:1). Benefit calculations were sensitive to assumptions of mobile source emissions and certain health impacts that were not included. Cost calculations were highly dependent on assumptions of flue gas volume and fuel use. For comparative purposes, we identified other studies for air pollution-related illness. Assumptions that formed the basis for most of the inputs in the present study, such as duration of illness, medical treatment costs, per person illness in children, and lost wages for working mothers, were similar to those recommended in the literature. Lost wages in sick workers and per capita illness incidence in adults were higher than numbers reported elsewhere. Further advances in cost-benefit analysis (CBA) procedures to evaluate the economic effectiveness of NO2 controls in Tokyo are recommended to estimate impacts and values for additional human health benefits, ecosystem health and productivity effects, and nonliving system effects, as well as benefits of ancillary reductions in other pollutants. The present study suggests that Tokyo's past NO2 control policies in total were economically quite effective.     

WILLINGNESS TO PAY FOR FLOOD RISK REDUCTION AND ITS DETERMINANTS IN JAPAN1

ABSTRACT: This study aimed to clarify public preferences for flood control measures in Japan, willingness to pay (WTP), and the main factors involved in WTP by applying the contingent valuation method. Findings showed that most residents surveyed expected some flood control measures, and revealed a diversity of interest in river management. WTP levels for different measures ranged from a mean of ¥2,887 to ¥4,861 and from a median of ¥1,000 to ¥2,000. However, WTP for additional flood risk reduction beyond initial levels was found to be zero. This was considered to be because WTP for flood risk reduction must be determined within a multi‐risk context. WTP for flood control measures may increase with per capita income, individual preparedness, and/or experience with flooding, but may decrease with distance from a river, acceptability of flood risk, and provision of environmental information. Furthermore, perception of flood risk may increase WTP, while perception of other risks may decrease it. Methods of dealing with environmental risk that were proposed in the survey may have affected WTP levels.     

A review of source tracking techniques for fine sediment within a catchment

Excessive transport of fine sediment, and its associated pollutants, can cause detrimental impacts in aquatic environments. It is therefore important to perform accurate sediment source apportionment to identify hot spots of soil erosion. Various tracers have been adopted, often in combination, to identify sediment source type and its spatial origin; these include fallout radionuclides, geochemical tracers, mineral magnetic properties and bulk and compound-specific stable isotopes. In this review, the applicability of these techniques to particular settings and their advantages and limitations are reviewed. By synthesizing existing approaches, that make use of multiple tracers in combination with measured changes of channel geomorphological attributes, an integrated analysis of tracer profiles in deposited sediments in lakes and reservoirs can be made. Through a multi-scale approach for fine sediment tracking, temporal changes in soil erosion and sediment load can be reconstructed and the consequences of changing catchment practices evaluated. We recommend that long-term, as well as short-term, monitoring of riverine fine sediment and corresponding surface and subsurface sources at nested sites within a catchment are essential. Such monitoring will inform the development and validation of models for predicting dynamics of fine sediment transport as a function of hydro-climatic and geomorphological controls. We highlight that the need for monitoring is particularly important for hilly catchments with complex and changing land use. We recommend that research should be prioritized for sloping farmland-dominated catchments.     

Value of information analysis for adequate monitoring of carbon dioxide storage in geological reservoirs under uncertainty

As monitoring is essential for the proper management of geological storage of carbon dioxide (CO₂), the ability to value information from monitoring is indispensable to adequately design a monitoring program. It is necessary to judge whether the expected improvement in management is worth the cost of monitoring. The value of information (VOI) is closely related to the possible increase in expected utility gained by gathering the information, the concept of which can be applied to such judgement. Although VOI analysis has been extensively studied in the context of decision analysis, its application to the management of carbon dioxide capture and storage (CCS) operations is rare. This paper introduces and discusses the methodology of VOI analyses in the context of monitoring CO₂ storage. A motivating problem with discrete probabilities is used to illustrate the concept of VOI. It is demonstrated that information is not always of value; for information to be worthwhile, monitoring under uncertainty must satisfy certain conditions. This concept is then extended to continuous probability distributions. The effects of prior uncertainty and information reliability on the VOI are examined. It is shown that an excessive improvement in information accuracy yields little value and that the optimal level of reliability can be inferred. VOI analyses provide quantitative insights into the value of information-gathering activities and therefore can be an objective means to adequately design and impartially justify a monitoring program.     

Prenatal diagnosis of triple X using fetal cells obtained by endocervical lavage

Prenatal diagnosis of aneuploidies currently relies on invasive procedures such as chorionic villous sampling and amniocentesis. These methods can provide an accurate diagnosis of the fetal karyotype but are relatively invasive. Here, we report a case of the prenatal detection of triple X using fetal cells obtained by lavage of the endocervical canal prior to amniocentesis, following ultrasound diagnosis of hydrops fetalis. Copyright © 2003 John Wiley & Sons, Ltd.