Ambient nitrogen oxides exposure and early childhood respiratory illnesses

Acute respiratory infections are common in children below 5 years and recent studies suggest a possible link with air pollution. In this study, we investigated the association between ambient nitrogen oxides (NO_x) and bronchitis or upper airway inflammation.This longitudinal study was conducted in Teplice and Prachatice districts, Czech Republic. Children were followed from birth to 4.5 years of age. Data were compiled from medical records at delivery and at follow up, and from self-administered questionnaires from the same two time points. Air pollution monitoring data were used to estimate exposure over five different averaging periods ranging from three to 45 days prior to an episode. To quantify the association between exposure and outcome, while accounting for repeated measure correlation we conducted logistic regression analysis using generalized estimating equations.During the first 2 years of life, the adjusted rate ratio for bronchitis associated with interquartile increase in the 30-day average NO_x was 1.31 [95% confidence interval (CI): 1.07, 1.61] and for two to 4.5 year olds, it was 1.23 (95% CI: 1.01, 1.49). The 14-day exposure also had stable association across both age groups: below 2 years it was 1.25 (95% CI: 1.06, 1.47) and for two to 4.5 years it was 1.21 (95% CI: 1.06, 1.39). The association between bronchitis and NO_x increased with child's age in the under 2 years group, which is a relatively novel finding.The results demonstrate an association between NO_x and respiratory infections that are sufficiently severe to come to medical attention. The evidence, if causal, can be of public health concern because acute respiratory illnesses are common in preschool children.     

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.     

Does Decentralization Matter in Environmental Management?

/ Questionnaires from 39 state National Pollutant Discharge Elimination System (NPDES) agencies were analyzed using principal component analysis and multiple regression. Decentralized programs scored better in a fundamental indicator of efficiency (lower percentage of expired permits) and in the key effectiveness measure of unit-cost compliance achieved. In no case did centralized states score significantly better than decentralized ones. These results indicated support for the theory that superior local knowledge is the key mechanism. Case studies of five states suggested internal program adjustments may cause outcomes to converge towards efficiency and effectiveness, perhaps explaining the large number of variables showing no difference between centralized programs and decentralized ones.KEY WORDS: NPDES; Compliance; Decentralization; Outcome; Efficiency; Unit-cost analysis     

The impact of a standard enforcement safety belt law on fatalities and hospital charges in Ohio

Introduction

The purpose of this study was to analyze linked crash and hospital data to determine the effect that enactment of a standard enforcement safety belt law in Ohio would have on hospital charges and direct medical costs due to motor-vehicle crashes, focusing on the impact to the state's Medicaid system.

Method

The linkage and analysis was conducted as part of the Ohio Crash Outcome Data Evaluation System (CODES) program. Current safety belt usage in Ohio stands at 82% with its secondary enforcement safety belt law.

Results

Assuming an increase in usage to 92% through standard enforcement, over $15.3 million in medical costs to Medicaid for injuries that occur in a single year could be prevented over a 10-year period. Cumulative savings could reach more than $91.2 million during the 10-year period. In addition, 161 fatalities could have been prevented in one year had all unbelted occupants who sustained a fatal injury instead chosen to wear their safety belt.

Summary and Impact on Industry

Clearly, substantial progress can be made in reducing the number of deaths and injuries, as well as medical costs associated with motor-vehicle crashes, by strengthening safety belt laws and increasing safety belt usage in Ohio.     

基于生物导向的水生态健康监测及评估概述

环境监测是水生态健康监测与评估的重要环节,基于物理、化学监测的传统水质监测通常仅能提供独立的数据信息,不能全面、直观地反映水环境状况。基于生物等生命体导向的水生态监测通过生物对环境的响应,能够直接反应复杂水体状况,在水环境健康监测与评估中占据重要地位。基于病原微生物、指示生物介绍了生物监测中的常规生物指标,总结了包括藻类、无脊椎动物和鱼类在内的常见指示生物在不同类型污染水体中的环境指示作用。从生物毒性效应出发介绍了常用的毒性效应测试方法、分析了污染物在不同生物学水平的响应,从而指明生物毒性效应在水环境健康评估中的发展优势。再从生态完整性角度阐述了生态完整性评价的一般方法和新兴分子生物学技术在水生态健康评估中的应用。重点指出环境毒理学和分子生物学在水环境监测的优势,以期为更加科学精确地进行水生态健康监测预警提供支撑。     

Familial congenital diaphragmatic hernia: Prenatal diagnosis,management, and outcome

Congenital diaphragmatic hernia (CDH) is a developmental defect of as yet unknown aetiology which accounts for 8 per cent of all major congenital anomalies and is associated with up to 80 per cent mortality despite optimal postnatal treatment. The risk of recurrence of CDH for future sibs after one affected infant is about 2 per cent. A multifactorial/threshold inheritance pattern with an observed high male:female sex ratio is currently favoured for the rare occurrence of familial CDH, although other modes of inheritance have also been described. We report three cases of familial CDH, two of whom were brother and sister sibs and the third was a first cousin, born within 18 months of each other. The diagnosis was by ultrasound and there were several factors predicting a poor outcome. The mortality in this group was 100 per cent. The prenatal diagnosis, treatment options, the unusual genetic aspects, outcome, and the pathology involved are discussed.     

灾害信息的采集及其成果积累

首先叙述信息、灾害信息及其相互关系,提出关于灾害信息的个人观点．在此基础上,按照作者长期灾害信息的研究实践,用大量事例阐明灾害信息的采集、及成果积累的有关技术问题,最后归纳出几点认识。     

What shapes municipalities’ perceptions of fairness in windpower developments?

ABSTRACT

Siting controversies have become familiar in windpower development. Process and outcome fairness in the form of economic benefits to local communities and inclusion in decision-making processes are recognised as important elements in local acceptance of windpower installations. To these, we add the concept of “relative fairness” influencing perceptions of overall fairness. In this article, we examine why Norwegian municipalities agree to host windpower, and the role of process, outcome and relative fairness in this decision. Municipalities are central in providing welfare services, and in ensuring a viable local economy and local workplaces. Process fairness is important, as is evident when municipalities have little influence in the detailed planning of the plants. Also, outcome fairness, in the form of economic compensation – particularly through property tax – is decisive for positive attitudes towards windfarms, as municipalities can strengthen their role as welfare providers and boost local economic activities. Less emphasised are the effects on global climate and national climate goals. However, effects on local landscape and nature are also important for municipalities, as became clear when the national government proposed withdrawing the municipalities’ possibilities of levying property taxes. The municipalities argue that it is only fair to receive something in return for hosting windmills, and relative fairness is important to their argument for equal treatment regarding hydro- and wind-power electricity production in the form of a natural resource tax.     

Work–family conflict and neck and back pain in surgical nurses

Objective. Surgical nurses’ work is physically and mentally demanding, possibly leading to work–family conflict (WFC). The current study tests WFC to be a risk factor for neck and lower back pain (LBP). Job influence and social support are tested as resources that could buffer the detrimental impact of WFC. Methods. Forty-eight surgical nurses from two university hospitals in Germany and Switzerland were recruited. WFC was assessed with the Work–Family Conflict Scale. Job influence and social support were assessed with the Copenhagen Psychosocial Questionnaire, and back pain was assessed with the North American Spine Society Instrument. Results. Multiple linear regression analyses confirmed WFC as a significant predictor of cervical pain (β?=?0.45, p?β?=?0.33, p?=?0.012). Job influence and social support did not turn out to be significant predictors and were not found to buffer the impact of WFC in moderator analyses. Conclusion. WFC is likely to affect neck and back pain in surgery nurses. Work–life interventions may have the potential to reduce WFC in surgery nurses.     

Critical infrastructures and responsibility: A conceptual exploration

In this article some considerations are presented as a starting point for judging responsibility for infrastructural systems from a moral point of view. Infrastructural systems are essential for present day high-tech society. Without good working infrastructural systems people would hardly be able to survive. The importance and relevance of good working critical infrastructures for states and other public authorities are illustrated with some examples. Next, the meaning of the concept of responsibility in relation to infrastructural systems is developed. Outcome responsibility and remedial responsibility – developed in philosophy of law and political philosophy – are elaborated as useful concepts for dealing with responsibilities in infrastructural systems. This analysis is applied to the players on the infrastructural field: governments and other public authorities, non-state institutional actors and last but not least individual agents. In a last paragraph some conclusions are drawn, which can be applied for apportioning responsibility for infrastructures in practice.