Acute health effects of a fire associated with asbestos-containing fallout.
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BACKGROUND: In September 1994 in a disused leather factory in Tranmere, Wirral, England, there was a fire associated with asbestos-containing fallout in an urban area. This study aimed to describe the acute health effects of this acute environmental incident. METHODS: Descriptive epidemiology of acute health effects of the fire was based on solicitors' letters from compensation claimants, hospital admissions for asthma and other respiratory diseases, accident and emergency records, occupational health records of fire-fighters and police, reports of cases by general practitioners (GPs), and geographical location of calls for help and claimants. RESULTS: Sixteen thousand people lived in the area worst affected by fallout. There were 344 claimants. Eighty-six per cent of claimants had a health complaint, with a total of 728 symptoms or diseases reported to be a consequence of the fire. Seventy per cent of complaints related to the respiratory tract, with 33 per cent of claimants noting sore throat, 31 per cent cough, 9 per cent exacerbated asthma, 8 per cent breathing problems and 13 per cent headaches. The number of hospital admissions for asthma and other lung diseases 1 day, 2 days, 7 days and 28 days after the date of the incident tended to be lower in the year of the fire than in other years. Within 72 h of the fire no cases connected with the fire were seen in the local accident and emergency unit. The geographical location of calls for help to the environmental health department was different from that for compensation claimants. CONCLUSIONS: Hundreds of people sought compensation for the acute health consequences of the fire. Many symptoms or diseases in 344 people were attributed to the fire, but there is no hard evidence to suggest that these were directly due to the fire, although some may have been indirectly attributable to it. (+info)
What is clinical smoke poisoning?
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In this 13-year study, 51 patients were admitted with the primary diagnosis of "smoke poisoning" "carbon monoxide (CO) poisoning" or "respiratory burns." Forty patients (78%) had diagnosis of smoke poisoning with minor or no skin burns. The study indicated that clinical diagnosis of CO poisoning cannot be made reliably without carboxyhemoglobin (COHg) determination and that smoke poisoning patients often had CO poisoning. Seventeen of 19 smoke poisoning patients (89%) had CO poisoning above COHb levels of 15% saturation. Carbon monoxide was successfully removed from the blood by improving alveolar ventilation and oxygen concentration. However, there were 2 smoke poisoning deaths as the result of gaseous chemical injury. There was a correlation coefficient of 0.87 between initial COHg levels and patients' hospital days primarily determined by patients' pulmonary complications. Since CO is non-irritating, COHb levels may be used as an additional indicator of suspected pulmonary injury by noxious combustion gases. (+info)
The Summerland Disaster.
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The reception, admission, and subsequent management of casualties from the Summerland fire are described. A senior member ofthe staff assessed priorities and direceted casualties to different prearranged teams, and a nurse was allocated to each patient to aid continuity of treatment and documentation. Though regular revision and discussion of major accident procedures with all members of the hospital staff and co-ordination with other rescue workers is helpful expensive rehearsals are of limited value in a civilian incident. (+info)
Urban residential fire and flame injuries: a population based study.
(20/612)
BACKGROUND: Fires are a leading cause of death, but non-fatal injuries from residential fires have not been well characterised. METHODS: To identify residential fire injuries that resulted in an emergency department visit, hospitalisation, or death, computerised databases from emergency departments, hospitals, ambulance and helicopter services, the fire department, and the health department, and paper records from the local coroner and fire stations were screened in a deprived urban area between June 1996 and May 1997. RESULT: There were 131 fire related injuries, primarily smoke inhalation (76%), an incidence of 36 (95% confidence interval (CI) 30 to 42)/100,000 person years. Forty one patients (32%) were hospitalised (11 (95% CI 8 to 15)/100,000 person years) and three people (2%) died (0.8 (95% CI 0.2 to 2.4)/100,000 person years). Injury rates were highest in those 0-4 (68 (95% CI 39 to 112)/100,000 person years) and > or = 85 years (90 (95% CI 29 to 213)/100,000 person years). Rates did not vary by sex. Leading causes of injury were unintentional house fires (63%), assault (8%), clothing and nightwear ignition (6%), and controlled fires (for example, gas burners) (4%). Cooking (31%) and smoker's materials (18%) were leading fire sources. CONCLUSIONS: Because of the varied causes of fire and flame injuries, it is likely that diverse interventions, targeted to those at highest risk, that is, the elderly, young children, and the poor, may be required to address this important public health problem. (+info)
A preschool program for safety and injury prevention delivered by home visitors.
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OBJECTIVE: To evaluate the feasibility, acceptability, and effectiveness of an injury prevention program delivered by school based home visitors to the families of low income children attending preschool enrichment programs in Washington State. STUDY SAMPLE: The families of children attending preschool Head Start programs in two regions were eligible. A total of 213 families (77.8% of those eligible) from intervention sites, and 149 families (71.9% of those eligible) from concurrent comparison sites, agreed to participate and completed the trial. INTERVENTION: Trained school personnel conducted home safety inspections as part of a planned home visit. Intervention families were offered educational materials as well as smoke detectors, batteries, ipecac, and age appropriate car safety restraints based on results of the home inspection. EVALUATION METHODS: At a repeat home visit three months later, the proportion of families with a positive change in injury prevention knowledge or behavior among those in the intervention group was compared with the proportion in the comparison group. Smoke detector presence and function were observed. RESULTS: Among families without a working smoke detector at baseline, the intervention was associated with an increased probability of having a working detector at follow up (relative risk (RR) 3.3, 95% confidence interval (CI) 1.3 to 8.6). Intervention families were also more likely to report the presence of ipecac in the home (RR 4.7, 95% CI 3.0 to 7.3) at follow up and to have obtained an age appropriate booster seat (RR 4.1, 95% CI 1.9 to 8.8). The program was acceptable to client families and to the home visitors who conducted the intervention. CONCLUSIONS: Among the families of low income children enrolled in preschool enrichment programs, home safety inspections and the distribution of safety supplies by school based home visitors appears to improve knowledge and behavior related to poisoning, smoke detector installation, and car safety seat use over three months of follow up. (+info)
Prospective study of hepatic, renal, and haematological surveillance in hazardous materials firefighters.
(22/612)
OBJECTIVES: To evaluate possible health effects related to work with hazardous materials as measured by end organ effect markers in a large cohort over about 2 years, and in a subcohort over 5 years. METHODS: Hepatic, renal, and haematological variables were analysed from 1996-98 in hazardous materials firefighters including 288 hazardous materials technicians (81%) and 68 support workers (19%). The same end organ effect markers in a subcohort of the technicians were also analysed (n=35) from 1993-98. Support workers were considered as controls because they are also firefighters, but had a low potential exposure to hazardous materials. RESULTS: During the study period, no serious injuries or exposures were reported. For the end organ effect markers studied, no significant differences were found between technicians and support workers at either year 1 or year 3. After adjustment for a change in laboratory, no significant longitudinal changes were found within groups for any of the markers except for creatinine which decreased for both technicians (p<0.001) and controls (p<0.01). CONCLUSIONS: Health effects related to work are infrequent among hazardous materials technicians. Haematological, hepatic, and renal testing is not required on an annual basis and has limited use in detecting health effects in hazardous materials technicians. (+info)
Tropical tropospheric ozone and biomass burning.
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New methods for retrieving tropospheric ozone column depth and absorbing aerosol (smoke and dust) from the Earth Probe-Total Ozone Mapping Spectrometer (EP/TOMS) are used to follow pollution and to determine interannual variability and trends. During intense fires over Indonesia (August to November 1997), ozone plumes, decoupled from the smoke below, extended as far as India. This ozone overlay a regional ozone increase triggered by atmospheric responses to the El Nino and Indian Ocean Dipole. Tropospheric ozone and smoke aerosol measurements from the Nimbus 7 TOMS instrument show El Nino signals but no tropospheric ozone trend in the 1980s. Offsets between smoke and ozone seasonal maxima point to multiple factors determining tropical tropospheric ozone variability. (+info)
An evaluation of the flammability of five dental gloves.
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OBJECTIVE: To assess the flammability of five brands of dental procedure glove. DESIGN: A total of ten gloves of each brand (Biogel-D, Premier Protectors, Roeko-D, Safeskin Satin Plus and Schottlander Low Allergy) underwent flammability testing. Five of these were tested as supplied (unwashed) and five following the application of the hand disinfectant Hydrex (washed). Each glove was stretched over a metal frame and the time to ignition, when exposed to a standardised butane flame, recorded. In addition, the thickness of each glove was also assessed by micrometer measurement. RESULTS: All the gloves tested ignited in less than 2.5 seconds. Two way analysis of variance revealed significant effects of glove type (P< 0.001) and treatment (P< 0.05), together with a significant interaction of these factors (P < 0.05), upon the ignition time. Washing Roeko-D gloves with Hydrex significantly (P< 0.01) retarded the ignition time compared with those in the unwashed state. Both the glove thickness and material type appeared to be related to ignition time. CONCLUSION: The work presented here demonstrates the acute and varying flammability of a range of dental procedure gloves. It should serve as a reminder to those who routinely use open flames whilst gloved of the dangers of this practice. (+info)