Road traffic mortality in the Slovak Republic in 1996–2014

Objective: Road traffic mortality takes an enormous toll in every society. Transport safety interventions play a crucial role in improving the situation. In the period 1996–2014 several road safety measures, including a complex new road traffic law in 2009, were implemented in the Slovak Republic, introducing stricter conditions for road users.

The aim of this study is to describe and analyze the trends in road user mortality in the Slovak Republic in individual age groups by sex during the study period 1996–2014.

Methods: Data on overall mortality in the Slovak Republic for the period 1996–2014 were obtained from the Statistical Office of the Slovak Republic. Mortality rates were age-adjusted to the European standard population. Joinpoint regression was used to assess the statistical significance of change in time trends of calculated standardized mortality rates.

Results: Mortality rates of all types of road users as well as all age groups and both sexes in the Slovak Republic in the period 1996–2014 are decreasing. The male : female ratio decreased from 4:1 in 1996 to 2:1 in 2014. Motor vehicle users (other than motorcyclists) and pedestrians have the highest mortality rates among road user groups. Both of these groups show a significant decline in mortality rates over the study period. Within the age groups, people age 65 years and over have the highest mortality rates, followed by the age groups 25–64 and 15–24 years old.

Joinpoint regression confirmed a steady, significant decline in all mortality rates over the study period. A statistically significant decrease in mortality rates in the last years of the study period was observed in the age group 25–64 and in male motorcycle users.

Assessing the impact of the 2009 road traffic law, a drop was observed in the average standardized mortality rate of all road traffic users from 14.56 per 100,000 person years in the period 1996–2008 to 7.69 per 100,000 person years in the period 2009–2014. A similar drop in the average standardized mortality rate was observed in all individual road user groups.

Conclusions: The implementation of the new traffic regulations may have contributed significantly to the observed decrease in mortality rates of road users in the Slovak Republic. A significant decrease in mortality was observed in all population groups and in all groups of road users. The introduction of a new comprehensive road traffic law may have expedited the decrease of road fatalities, especially in the age group 25–64 years old. This type of evidence-based epidemiology data can be used for improved targeting of future public health measures for road traffic injury prevention.     

伊犁地区维吾尔民族氟斑牙研究

应用环境流行病学原理和方法，就可能导致伊犁地区维吾尔民族中发现的氟斑牙的环境化学因子，存在于食物、大气、水、土壤的诸介质进行了调查，并进行了环境因子效应的研究，发现维吾尔民族尿氟较高，平均为２．１９ｍｇ／Ｌ，波动范围为：１．６５～６．１０ｍｇ／Ｌ氟斑牙在维吾尔民族中呈散在发生（２％），总氟摄入量为１０．７５ｍｇ，奶茶中过量氟摄入为主要贡献。     

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.     

Blood dioxin biomonitoring to assess local residents' exposure from a large urban remediation project

Background

A total of 265 000 m³ of dioxin contaminated soil and sediments from past industrial activity was treated on site in an urban setting in Sydney, Australia. To respond to local community concerns about potential dioxin exposure from fugitive emissions a human biomonitoring study was undertaken.

Objective

To determine whether local residents were exposed to significant amounts of dioxin from the remediation process.Methods: Blood samples were collected from local residents around the site and a representative metropolitan control group. They were pooled within age and sex strata and the change in dioxin concentrations over the remediation period and a summary of the mid point and post remediation dioxin concentrations were compared between groups. Information on dietary intake was collected to look for possible confounding.

Results

The mean dioxin Toxic Equivalent concentrations (TeQ) decreased among both the local resident and control groups over the remediation period by 1.9 and 2.1 pg gm⁻¹ lipid respectively. Modelled blood concentrations adjusting for age and sex did not detect a significant difference between groups for changes in either TeQ or 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8 TCDD). The summary measure approach did however demonstrate that the 2,3,7,8 TCDD concentrations among the local resident group was approximately 0.7 pg g⁻¹ lipid higher compared to the control group post remediation. There were no significant changes in dietary intake sources of dioxin.

Conclusion

Biomonitoring demonstrated that local residents were not exposed to significant quantities of dioxin. Large scale remediation of dioxin contaminated land can be safely undertaken in an urban setting.     

Epidemiology of tornado destruction in rural northern Bangladesh: risk factors for death and injury

The epidemiology of tornado-related disasters in the developing world is poorly understood. An August 2005 post-tornado cohort study in rural Bangladesh identified elevated levels of death and injury among the elderly (≥ 60 years of age) (adjusted odds ratio (AOR) = 8.9 (95 per cent confidence interval (CI): 3.9-20.2) and AOR = 1.6 (95 per cent CI: 1.4-1.8), respectively), as compared to 15-24 year-olds, and among those outdoors versus indoors during the tornado (AOR = 10.4 (95 per cent CI: 5.5-19.9) and AOR = 6.6 (95 per cent CI: 5.8-7.5), respectively). Females were 1.24 times (95 per cent CI: 1.15-1.33) more likely to be injured than males. Elevated risk of injury was significantly associated with structural damage to the house and tin construction materials. Seeking treatment was protective against death among the injured, odds ratio = 0.08 (95 per cent CI: 0.03-0.21). Further research is needed to develop injury prevention strategies and to address disparities in risk between age groups and between men and women.     

Spatially mixed crops to control the stratified dispersal of airborne fungal diseases

Intraspecific crop diversification is thought to be a possible solution to the disease susceptibility of monocultured crops. We modelled the stratified dispersal of an airborne pathogen population in order to identify the spatial patterns of cultivar mixtures that could slow epidemic spread driven by dual dispersal mechanisms acting over both short and long distances. We developed a model to simulate the propagation of a fungal disease in a 2D field, including a reaction-diffusion model for short-distance disease dispersal, and a stochastic model for long-distance dispersal. The model was fitted to data for the spatio-temporal spread of faba bean rust (caused by Uromyces viciae-fabae) through a discontinuous field. The model was used to compare the effectiveness of eight different planting patterns of cultivar mixtures against a disease spread by short-distance and stratified dispersal. Our combined modelling approach provides a reasonably good fit with the observed data for the spread of faba bean rust. Similar predictive power could be expected for the management of resource-mediated invasions by other airborne fungi. If a disease spreads by short-distance dispersal, random mixtures can be used to slow the epidemic spread, since their spatial irregularity creates a natural barrier to the progression of a smooth epidemic wave. In the context of stratified dispersal, heterogeneous patterns should be used that include a minimum distance between susceptible units, which decreases the probability of infection by long-distance spore dispersal. We provide a simple framework for modelling the stratified dispersal of disease in a diversified crop. The model suggests that the spatial arrangement of components in cultivar mixtures has to accord with the dispersal characteristics of the pathogen in order to increase the efficiency of diversification strategies in agro-ecosystems and forestry. It can be applied in low input agriculture to manage pathogen invasion by intercropping and cultivar mixtures, and to design sustainable systems of land use.     

西藏的环境氟水平与砖茶型氟中毒

为探讨西藏儿童与砖茶型氟中毒的关系,以拉萨为中点,藏北那曲为北部点,定日县为南部点,对这3个地区的土壤、燃料、水源和主要食物进行了氟含量测定.采用世界卫生组织(WHO)和世界粮农组织(FAO)提出的<化学污染物的膳食摄入量研究指南>,进行了食物结构、饮茶习惯、儿童食物摄入量以及儿童每日总摄氟量的调查按美国国家牙科研究所Horowitz提出的标准进行了儿童氟斑牙检查.结果表明,3个调查点均属传统的低氟区,而儿童每日摄氟量高,那曲8.03mg,拉萨6.93mg,定日7.68mg.其原因来自含砖茶的食品酥油茶和糌粑(青稞粉拌砖茶水的食物).这2种食物占日总摄氟量的99.74%(那曲),98.70%(拉萨),99.60%(定日),砖茶氟摄入导致西藏儿童砖茶型氟中毒的流行.氟斑牙患病率分别达到82.66%(那曲),52.89%(拉萨),75.93%(定日),氟斑牙指数表明,那曲、定日属氟中毒重度流行区,拉萨属中度流行区.砖茶型氟中毒是我国近年来发现的氟病新类型,与饮水型、燃煤污染型比较,它具有覆盖面大、隐蔽性强、难以防治的特点,降低砖茶氟含量可能是防治砖茶型氟中毒的最好方式.     

DETERMINING THE RELATIONSHIP BETWEEN WATER QUALITY AND INFECTIOUS DISEASE IN FISHERY POPULATIONS1

ABSTRACT: Diseases in wild fish populations may have multiple economic and social impacts. Epidemics of infectious diseases, which are associated with the presence of some microbe or parasite, have recently been observed in several major estuarine systems in the eastern United States. The most prevalent of these problems is ulcerative mycosis (UM), a fungal infection. The agents responsible for UM and many of these other diseases are opportunistic pathogens that are not believed to infect normal, immunocompetent individuals. While inroads have been made into determining the infectious agents associated with these diseases, we know very little of how pollution may influence their prevalence. Understanding the importance of pollution requires an awareness of all the environmental conditions that can affect the health of wild populations. In this paper, a multistep examination of the interactions between the host, pathogen(s), and environment is outlined.     

Arsenic in Drinking Water and Bladder Cancer: Comparison between Studies Based on Cancer Registry and Death Certificates

Associations between arsenic in drinking water and bladder cancer in an area along the southwest coast of Taiwan have been documented for decades. Several ecologic studies were conducted to assess the dose-response relationships. Some of them used the National Cancer Registry Program to identify cancer cases, and some used death certificates. Whereas the cancer registry collects information on all patients no matter if they died of bladder cancer or not, the case ascertainment might be incomplete due to the fact that reporting of cases is not mandatory. Reporting of death, on the other hand, is strictly enforced by law, but patients who did not die of bladder cancer might not be identified. In order to assess the problems with both approaches, we conducted a study using both case identification mechanisms. A total of 243 townships with measurements of arsenic in drinking water were included in the analysis of cancer registry data, and death certificates were collected from 10 of those townships. In both analyses, the same measurements of arsenic made by the mercuric bromide stain method were adopted. Due to limitation of the method, all levels below 0.04mg L^–1 were combined as a single exposure category. The results were very much alike; both approaches detected statistically significant associations between high arsenic levels in drinking water (above 0.64mg L^–1) and occurrence of bladder cancer but did not find such associations for arsenic exposures at lower levels.