Identifying 'non-medical' datasets to monitor community health and well-being.
(33/1018)
BACKGROUND: The aim of the study was to identify 'non-medical' datasets holding routinely collected information that might be used to measure and monitor the wider determinants of community health and well-being. METHODS: An expert panel discussion, involving public health and environmental health academics and professionals with expertise in a variety of backgrounds (including environmental health, housing, transport, community safety, public health, primary and secondary care), and interrogation of the Office for National Statistics database were carried out for the West Midlands region. The aim was to identify routinely collected 'non-medical' datasets containing information on the following factors: physical environment, crime, housing and homelessness, social services, socio-economic environment including employment, lifestyles, education, leisure and culture, transport and accidents. RESULTS: Fifty-six datasets were identified. Although 43 (77 per cent) were collected at least annually, few (17; 30 per cent) held data that were disaggregated and routinely available at the sub-local authority level. CONCLUSIONS: This study has identified a number of datasets that hold information relevant to health. However, no single dataset is likely to provide information on all dimensions of health and the determinants of health, and local agencies should consider carefully the strengths and weaknesses of each. Through the development of inter-sectoral working and multi-agency involvement at the local level there is now considerable scope to improve the quality of many of these datasets and to promote their use in the measurement and monitoring of community health. (+info)
Developing principles for health impact assessment.
(34/1018)
BACKGROUND: Policies and practice in many sectors affect health. Health impact assessment (HIA) is a way to predict these health impacts, in order to recommend improvements in policies to improve health. There has been debate about appropriate methods for this work. The Scottish Executive funded the Scottish Needs Assessment Programme to conduct two pilot HIAs and from these to develop guidance on HIA. METHODS: Case study 1 compared three possible future scenarios for developing transport in Edinburgh, based on funding levels. It used a literature review, analysis of local data and the knowledge and opinions of key informants. Impacts borne by different population groups.were compared using grids. Case study 2 assessed the health impacts of housing investment in a disadvantaged part of Edinburgh, using published literature, focus groups with community groups and interviews with professionals. RESULTS: Disadvantaged communities bore more detrimental effects from the low transport investment scenario, in the areas of: accidents; pollution; access to amenities, jobs and social contacts; physical activity; and impacts on community networks. The housing investment had greatest impact on residents' mental health, by reducing overcrowding, noise pollution, stigma and fear of crime. CONCLUSION: Although there is no single 'blueprint' for HIA that will be appropriate for all circumstances, key principles to inform future HIA were defined. HIA should be systematic; involve decision-makers and affected communities; take into account local factors; use evidence and methods appropriate to the impacts identified and the importance and scope of the policy; and make practical recommendations. (+info)
Lessons from tobacco control for advocates of healthy transport.
(35/1018)
Many parallels can be drawn between cigarettes and motor vehicles, smoking and car driving, and the tobacco and the auto/oil industries. Those promoting healthy and sustainable transport policies can learn lessons from tobacco control activities over the past 50 years. Evidence-based legislation is more effective than negotiated voluntary agreements between industry and government. Media advocacy is crucial to reframe the issues to allow changes in national policies that facilitate healthier choices. Worthwhile public health policies seen as a threat by multinational companies will be opposed by them but active national and international networks of healthcare professionals, voluntary organizations, charities and their supporters can match the political power of these industries. (+info)
Successful Day 5 embryo transfer and pregnancies resulting after transport of embryos by air for biopsy and genetic analysis.
(36/1018)
PURPOSE: Case studies of four in vitro fertilization (IVF) cycles where embryo transport by commercial airline followed by biopsy and genetic analysis with subsequent culture to Day 5 and resulting ongoing pregnancy. METHOD: Retrospective clinical case study of 4 patients requiring preimplantation genetic diagnosis (PGD) testing. Normally fertilized embryos were transported in a battery-powered portable incubator by commercial airline following evaluation for fertilization under controlled conditions from the Center for Assisted Reproduction, Bedford, Texas to the Reproductive Genetic Institute, Chicago, Illinois. Following Day 3 embryo biopsy and genetic analysis, embryos were transported back to the Center for Assisted Reproduction for Day 5 embryo transfer. RESULTS: Ongoing clinical pregnancy resulted for all patients receiving embryo transfer. CONCLUSION: These results demonstrate the feasibility of embryo transport by air for centers that do not have the in-house capabilities to perform genetic analysis. With successful pregnancies obtained through extended culture to Day 5, embryos requiring genetic analysis can be successfully transported by air, tested, and returned to the initial facility for embryo transfer without time restriction. (+info)
Procedures for transportation workplace drug and alcohol testing programs. Office of the Secretary, DOT. Final rule.
(37/1018)
The Department of Transportation is revising its drug and alcohol testing procedures regulation. The purposes of the revision are to make the organization and language of the regulation clearer, to incorporate guidance and interpretations of the rule into its text, and to update the rule to include new provisions responding to changes in technology, the testing industry, and the Department's program. (+info)
The prevalence of asthma and heart disease in transport workers: a practice-based study.
(38/1018)
BACKGROUND: There has been widespread concern that the increasing incidence of asthma observed during the late 1980s might have arisen because of environmental pollution, and in particular vehicle pollution. The General Practice Morbidity Survey in 1991/92 (MSGP4) collected data on occupation, employment status, and smoking habit linked individually to each patient record. OBJECTIVES: To examine whether people with occupations that have high exposure to vehicle exhaust fumes have an increased prevalence of asthma, acute respiratory infections, and ischaemic heart disease (IHD). METHOD: Men aged 16 to 64 years were grouped by Standard Occupational Classification codes; 93,692 employed and 20,858 not-employed men were studied separately. Those with likely high occupational exposure were grouped together ('all-exposed')--the remainder occupations in corresponding chapters of the code were used as controls. We compared 12-month age and smoking standardised disease prevalence ratios for asthma, chronic obstructive pulmonary disease (COPD), acute respiratory infections (IHD), and all circulatory disorders in the all exposed and individual exposed occupations with their matching controls. Also the mean frequency of consultations per person consulting was calculated for each occupational group and disease. RESULTS: For employed persons, the prevalence ratio (PR) for asthma in the all-exposed, (116, 95% confidence interval [95% CI] = 101-130) exceeded that for all employed persons (100); however, the difference compared with chapter-matched controls (PR = 97, 95% CI = 92-103), was not statistically significant. Results for COPD were similar. Prevalence ratios in motor mechanics, a high-exposure group, were 98 (95% CI = 70-127) 96 (95% CI = 70-123) for asthma and COPD respectively. Among the employed, prevalence ratios for IHD in all but one of the individual occupation groups examined did not differ from the average, however among those not employed the ratio in the all-exposed (PR = 152, 95% CI = 128-174) exceeded that in the controls (PR = 112, 95% CI = 104-120). CONCLUSION: Occupational groups exposed to motor vehicle pollution have a marginally increased prevalence of asthma compared with working males generally, though not compared with occupation matched controls. This study has demonstrated a methodology for using GP data to examine occupation-related disease. This could be used in future by augmenting GP data with occupation and smoking information. (+info)
Human immunodeficiency virus, hepatitis B, C and D in Bangladesh's trucking industry: prevalence and risk factors.
(39/1018)
BACKGROUND: Human immunodeficiency virus (HIV) and hepatitis B and C, viral infections with shared percutaneous, mucosal and perinatal routes of transmission, are responsible for serious morbidity and mortality globally. In Bangladesh there is a dearth of research on prevalence and risk factors for these diseases. This study examines the prevalence of HIV and hepatitis (B, C, D) and risk factors associated with infection in men in Bangladesh's trucking industry (drivers and helpers on trucks), a population at risk for sexually transmitted infections. METHODS: The study population comprised 388 men (245 drivers, 143 helpers) working out of Tejgaon truck stand in Dhaka, Bangladesh. Subjects were selected through a two-tiered sampling strategy. Of 185 trucking agencies 38 were randomly selected and a of 10 subjects was recruited from each agency. Subjects were interviewed, underwent a comprehensive physical examination and had blood samples taken. Gold standard laboratory tests were conducted to detect HIV, hepatitis B, C, and D infections. To assess risk factors associated with current hepatitis B infections or being a carrier (HBsAg) and lifetime exposure to hepatitis B infection (anti-HBc), simple and multiple logistic regression analyses were performed. RESULTS: The prevalence of diseases were: HIV 0%, hepatitis C <1%, hepatitis B surface antigen 5.9%, antibody to hepatitis B core antigen 48.1% (with 5 of the 23 HBsAg positive cases testing positive for HBeAg and 18 for anti-HBe), and hepatitis D 0%. Having ever received a therapeutic injection and having had relations with a commercial sex worker (CSW) in the past year were both significantly associated with lifetime exposure to hepatitis B (anti-HBc); having received a therapeutic injection in the past year was associated with being either currently infected with hepatitis B or a carrier (HBsAg). CONCLUSIONS: The results of the study illustrate the importance of educating health care practitioners about the dangers of unsterile injections, and of educating men in the trucking industry as well as their partners (CSW in particular) about the importance of condom use, especially in high-risk sexual contacts. (+info)
Land use and transportation issues in environmental control.
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Analyses have been made of the effects of environmental controls and planning at regional, subarea, and project levels. The results obtained at the regional level are reviewed for a proposed highway development around Baltimore, Md. The findings for both short-term and long-term effects of alternative transport policies are summarized in respect of population and employment, economic indicators, traffic and travel, air quality, water and solid waste, noise, and environmentally sensitive areas. Problems at subarea and project levels are briefly considered. (+info)