Fatal motorcycle crashes in wide urban area of Zagreb,Croatia—A 10-year review

Objective: The objective of our study was to determine the prevalence of alcohol and drug intoxication among fatally injured motorcyclists in a wide urban area of Zagreb, Croatia.

Methods: We conducted a single-center observational retrospective study over a 10-year period (2007–2016) in 3 counties covering an area including 1.2 million residents. We reviewed the records on fatally injured motorcyclists, collecting information relating to sex, age, cause of death, time of death in relation to the time of the crash, and the circumstances of the crash (time of day, day of the week, season). Blood alcohol concentration (BAC) and toxicology analysis results were collected and analyzed.

Results: We identified 163 deaths (95.7% males, 4.3% females). Overall, 64.2% of the victims were 20 to 39 years old. The majority (50.9%) of those fatally injured were responsible for causing the traffic crash; the rest were determined not to be responsible or the responsibility could not be determined. The most frequent causes of death were multiple injuries (55.8%) and isolated head trauma (23.3%). The rider’s BAC was above the legal limit for driving (>0.50?g/kg) in 53.8% of cases, with a mean BAC of 1.91?g/kg. There was no difference in riding a motorcycle with a BAC above the legal limit between groups defined as younger (≤39 years of age) and older (≥40 years of age). The number of people with an illegal BAC was significantly higher during weekends than during the work week. The BAC of riders who were responsible for the crash was significantly higher than that of those who were not responsible or whose responsibility could not be determined. Use of illegal drugs or nontherapeutic use of legal drugs was not common and was detected in 10.4% of fatally injured riders.

Conclusions: Alcohol intoxication has a major role in motorcycle crash–related mortality. A significant difference in BAC between fatally injured riders responsible for the accident and those who were not responsible implies that measures directed toward prevention of drinking and driving behavior could lower the number of fatal motorcycle crashes. Weekend measures, especially during spring and summer, could have particularly significant effects.     

Flooding: what is the impact on pregnancy and child health?

Floods are the most common type of natural disaster in both developed and developing countries and have led to extensive morbidity and mortality throughout the world. Worldwide, over the past 30 years, flooding has claimed the lives of more than 200,000 people and affected more than 2.8 billion others. The impact of flooding on health varies among populations and depends primarily on vulnerability and the kind of event experienced. It severely disrupts livelihoods and has a significant impact on the health of pregnant women and children. In addition, it may exacerbate a range of negative psychological and physiological child and reproductive health outcomes. Awareness‐raising, education, and the issuing of warnings appear to be key initiatives to mitigate or prevent flood morbidity and mortality, especially among people living in low‐ and middle‐income countries. Agencies responding to emergencies also need to be more cognisant of the dangers, specifically those engaged in healthcare, nutrition, and water safety programmes.     

Increased maternal serum alpha-fetoprotein and human chorionic gonadotropin in compromised pregnancies other than for neural tube defects or Down syndrome

Intrauterine fetal death occurred in four women who were ‘screen-positive’ in a screening programme for neural tube defects (NTDs) and Down syndrome (DS). These women had very high levels of maternal serum alpha-fetoprotein (MSAFP) and maternal serum human chorionic gonadotropin (MShCG). Therefore, we evaluated all ‘screen-positive’ women in whom both of these markers were ⩾ 2.0 multiples of the median. The cases fulfilling these criteria totalled 11, and only one of them had no complications. High concentrations of both MSAFP and MShCG in a number of these cases might have been caused by an increased placental volume, which, in turn, might have been induced by decreased perfusion of the placenta. We conclude that screening programmes wrongly determine a high risk of fetal NTD or DS if the concentrations of both these parameters are very high. Invasive diagnostic procedures should be avoided in these cases, particularly in view of the increased risk of an adverse pregnancy outcome.     

Maternal transfer of mercury to the developing embryo/fetus: is there a safe level?

Mercury (Hg) exposure is ubiquitous in modern society via vaccines, fish/crustacea, dental amalgam, food, water, and the atmosphere. This article examines Hg exposure in the context of primary exposure to pregnant women and secondary exposure experienced by their unborn babies. Babies in utero are particularly at risk of higher Hg exposure than adults (on a dose/weight basis through maternal Hg transfer via the placenta), and are more susceptible to adverse effects from mercury and its biologically active compounds. It is, therefore, critical that regulatory advisories around maximum safe Hg exposures account for pregnant women and secondary exposure that children in utero experience. This study focused on standardized embryonic and fetal Hg exposures via primary exposure to the pregnant mother of two common Hg sources (dietary fish and parenteral vaccines). Data demonstrated that Hg exposures, particularly during the first trimester of pregnancy, at well-established dose/weight ratios produced severe damage to humans including death. In light of research suggestive of a mercuric risk factor for childhood conditions such as tic disorders, cerebral palsy, and autism, it is essential that Hg advisories account for secondary prenatal human exposures.     

Update on selective reduction

Over the past 25 years fetal reduction has been utilized to reduce the risks of higher-order multiple pregnancies that have resulted from overly successful infertility therapies. The demographics of multiple pregnancy patients have evolved over the past decade, with increasing proportions coming from IVF as opposed to ovulation induction, being older and a higher proportion with donor eggs. Genetic diagnosis prior to reduction is becoming more common and is very safe in experienced hands. For all starting numbers, including twins, reduction to a lower number of fetuses reduces fetal losses, prematurity, and infant mortality and morbidity. Copyright © 2005 John Wiley & Sons, Ltd.     

林丹淡水生物水质基准、生态风险及有害结局路径研究

为多角度评估我国淡水水体中林丹生态风险,按照HJ 831—2022《淡水生物水质基准推导技术指南》方法推导,获得林丹短期和长期淡水水质基准值分别为6.15和0.12 μg/L,再依据林丹基准值对我国主要淡水水体中林丹生态风险进行评价。结果显示,我国长江流域的太湖以及岷江、黄河、海河和大辽河河口等水体林丹生态风险处于高风险水平。目前生态风险评价的毒性效应终点仍为一般毒性效应终点（MATC、EC₁₀、EC₂₀、NOEC、LOEC、EC₅₀和LC₅₀等）,而有害结局路径（AOP）从基因、细胞、组织及器官水平对污染物毒性效应的因果关系进行定性和定量,可为未来精细化生态风险评价提供科学依据。因此,基于林丹淡水生物毒性研究的文献计量学分析结果,按照经济合作与发展组织（OECD）指导原则,从生物毒性机制的角度构建了肝损伤、生殖损伤和神经损伤3条有害结局路径。