An intervention to reduce playground equipment hazards. (41/5122)

OBJECTIVES: A community intervention trial was carried out to evaluate the relative effectiveness of two methods of reducing playground hazards in schools. The study hypotheses were: (1) a health promotion programme addressing barriers to implementing the New Zealand Playground Safety Standard will reduce playground hazards and (2) the intervention programme will be more successful than providing information alone. METHODS: Twenty four schools in Wellington, New Zealand were randomly allocated into two groups of 12 and their playgrounds audited for hazards. After the audit, the intervention group received a health promotion programme consisting of information about the hazards, an engineer's report, regular contact and encouragement to act on the report, and assistance in obtaining funding. The control group only received information about hazards in their playground. RESULTS: After 19 months, there was a significant fall in hazards in the intervention schools compared with the control schools (Mann-Whitney U test, p = 0.027). No intervention schools had increased hazards and eight out of 12 had reduced them by at least three. In contrast, only two of the control schools had reduced their hazards by this amount, with three others increasing their hazards in that time. CONCLUSIONS: It is concluded that working intensively with schools to overcome barriers to upgrading playground equipment can lead to a reduction in hazards, and that this form of intensive intervention is more effective than providing information alone.  (+info)

Where do UK health services researchers publish their findings? (42/5122)

Health services research has emerged as the third vital requirement for understanding and improving health care, alongside basic science and clinical research. This has coincided with more stringent management of research, in particular by funding bodies. The latter are seeking to use bibliographic databases to aid the monitoring of the output of their investments. The principal source of data in the UK is the Research Outputs Database (ROD) set up by the Wellcome Trust primarily to monitor basic and clinical research. Health services researchers' output is difficult to monitor in view of the large number and wide variety of journals in which they publish. In addition, nearly half the journals (representing 35% of the articles) are not currently covered by the ROD. Funding bodies will underestimate the quantity of health services researchers' output unless they take these findings into account.  (+info)

Twice vaccinated recipients are better protected against epidemic measles than are single dose recipients of measles containing vaccine. (43/5122)

OBJECTIVE: To study measles risk after revaccination. DESIGN: A population-based case-control study during an epidemic season. MAIN OUTCOME MEASURE: Relative serologically confirmed measles risk. PARTICIPANTS AND METHODS: 153 vaccinated cases, mostly from rural areas, were serologically confirmed as measles at the central laboratory in 1988-89. A randomly selected group of 453 controls from either municipalities of vaccinated cases or from areas where measles attack rate was > 600/10(5), was identified via the population registry. Vaccination and measles histories of cases and controls were determined from official vaccination cards. RESULTS: Once and twice vaccinated had crude relative risk 15.6 and 2.3 compared with thrice vaccinated. When cases who had received their first vaccination at less than 14 months of age were omitted from analysis, once vaccinated had 4.0 (95% CI 1.2, 16.6) times higher age adjusted measles risk compared with twice vaccinated. When, omission was extended to cases from one particular municipality where even revaccinees had high measles risk during an explosive outbreak the corresponding risk ratio was 17.8 (2.8, 67.8). CONCLUSIONS: Twice vaccinated have better protection against epidemic measles compared with single dose recipients.  (+info)

Philippine plan to cut diarrhoea deaths.(44/5122)

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Comparative hazards of chrysotile asbestos and its substitutes: A European perspective. (45/5122)

Although the use of amphibole asbestos (crocidolite and amosite) has been banned in most European countries because of its known effects on the lung and pleura, chrysotile asbestos remains in use in a number of widely used products, notably asbestos cement and friction linings in vehicle brakes and clutches. A ban on chrysotile throughout the European Union for these remaining applications is currently under consideration, but this requires confidence in the safety of substitute materials. The main substitutes for the residual uses of chrysotile are p-aramid, polyvinyl alcohol (PVA), and cellulose fibers, and it is these materials that are evaluated here. Because it critically affects both exposure concentrations and deposition in the lung, diameter is a key determinant of the intrinsic hazard of a fiber; the propensity of a material to release fibers into the air is also important. It is generally accepted that to be pathogenic to the lung or pleura, fibers must be long, thin, and durable; fiber chemistry may also be significant. These basic principles are used in a pragmatic way to form a judgement on the relative safety of the substitute materials, taking into account what is known about their hazardous properties and also the potential for uncontrolled exposures during a lifetime of use (including disposal). We conclude that chrysotile asbestos is intrinsically more hazardous than p-aramid, PVA, or cellulose fibers and that its continued use in asbestos-cement products and friction materials is not justifiable in the face of available technically adequate substitutes.  (+info)

Emergency planning and the acute toxic potency of inhaled ammonia. (46/5122)

Ammonia is present in agriculture and commerce in many if not most communities. This report evaluates the toxic potency of ammonia, based on three types of data: anecdotal data, in some cases predating World War 1, reconstructions of contemporary industrial accidents, and animal bioassays. Standards and guidelines for human exposure have been driven largely by the anecdotal data, suggesting that ammonia at 5,000-10,000 parts per million, volume/volume (ppm-v), might be lethal within 5-10 min. However, contemporary accident reconstructions suggest that ammonia lethality requires higher concentrations. For example, 33,737 ppm-v was a 5-min zero-mortality value in a major ammonia release in 1973 in South Africa. Comparisons of secondary reports of ammonia lethality with original sources revealed discrepancies in contemporary sources, apparently resulting from failure to examine old documents or accurately translate foreign documents. The present investigation revealed that contemporary accident reconstructions yield ammonia lethality levels comparable to those in dozens of reports of animal bioassays, after adjustment of concentrations to human equivalent concentrations via U.S. Environmental Protection Agency (EPA) procedures. Ammonia levels potentially causing irreversible injury or impairing the ability of exposed people to escape from further exposure or from coincident perils similarly have been biased downwardly in contemporary sources. The EPA has identified ammonia as one of 366 extremely hazardous substances subject to community right-to-know provisions of the Superfund Act and emergency planning provisions of the Clean Air Act. The Clean Air Act defines emergency planning zones (EPZs) around industrial facilities exceeding a threshold quantity of ammonia on-site. This study suggests that EPZ areas around ammonia facilities can be reduced, thereby also reducing emergency planning costs, which will vary roughly with the EPZ radius squared.  (+info)

Daily mortality and air pollution in Santa Clara County, California: 1989-1996. (47/5122)

Since the last revision of the national particulate standards, there has been a profusion of epidemiologic research showing associations between particulates and health effects--mortality in particular. Supported by this research, the U.S. Environmental Protection Agency promulgated a national standard for particulate matter [less than/equal to] 2.5 microm in aerodynamic diameter (PM(2.5)). Nevertheless, the San Francisco Bay Area of California may meet this new standard. This study investigates the relationship between daily mortality and air pollution in Santa Clara County (a Bay Area county) using techniques similar to those utilized in earlier epidemiologic studies. Statistically significant associations persist in the early 1990s, when the Bay Area met national air pollution standards for every criteria pollutant. Of the various pollutants, the strongest associations occur with particulates, especially ammonium nitrate and PM(2.5). The continuing presence of associations between mortality and air pollutants calls into question the adequacy of national standards for protecting public health.  (+info)

Talking trash: the economic and environmental issues of landfills. (48/5122)

The U.S. per-capita figure for garbage production has topped four pounds per person per day, and that amount is rising at roughly 5% per year. In the past, municipal solid waste was sent to the nearest local landfill or incinerator. But in 1988, the U.S. Environmental Protection Agency instituted the first federal standards for landfills, designed to make them safer. Over 10,000 small municipal landfills have since been consolidated into an estimated 3,500 newer, safer landfills, some of which are "megafills" that can handle up to 10,000 tons of waste a day. The new landfills are outfitted to prevent air and water pollution and limit the spread of disease by scavengers. Although the new landfills provide better controls against air and water pollution as well as an alternate source of municipal income, they are not entirely problem-free. Some experts believe the new landfill technology has not been properly tested and will therefore not provide protection in the long run. Others feel that poorer, less well-informed communities are targeted as sites for new landfills. In addition, many people that live near megafills, which may draw garbarge from several states, are unhappy about the noise, truck traffic, odors, and pests caused by the facilities.  (+info)