The impact of charging for insecticide on the Gambian National Impregnated Bednet Programme. (1/452)

During the second year of the Gambian National Impregnated Bednet Programme (NIBP) charges for insecticide ($0.50 per net) were introduced into the half of the primary health care villages in the country where insecticide have been provided free of charge the previous year. Free insecticide was provided in the remaining villages that had acted as controls during the previous year. In villages where insecticide was provided free, 77% of nets were treated with insecticide. In contrast, in villages where charges were made coverage was only 14%. During the first year of the NIBP, mortality in children was significantly lower in villages where insecticide was provided free than in the control villages. Introduction of a charge for insecticide into the first group of villages and the provision of free insecticide in the latter abolished this difference. The cash income of rural Gambians is very limited and payment of even $2-3 for insecticide treatment for all the bednets in a household represents a substantial outlay. Further education on the benefits of treatment of nets and/or the provision of cheaper insecticide will be required before the full benefits of this powerful new malaria control measure can be fully realised in the Gambia.  (+info)

Exposure of farmers to phosmet, a swine insecticide. (2/452)

OBJECTIVES: The goal of this study was to measure dermal and inhalation exposures to phosmet during application to animals and to identify what determinants of exposure influence the exposure levels. METHODS: Ten farmers were monitored using dermal patches, gloves, and air sampling media during normal activities of applying phosmet to pigs for insect control. Exposures were measured on the clothing (outer), under the clothing (inner), on the hands, and in the air. Possible exposure determinants were identified, and a questionnaire on work practices was administered. RESULTS: The geometric mean of the outer exposure measurements was 79 microg/h, whereas the geometric mean of the inner exposure measurements was 6 microg/h. The geometric mean for hand exposure was 534 microg/h, and the mean air concentration was 0.2 microg/m3. Glove use was associated with the hand and total dermal exposure levels, but no other determinant was associated with any of the exposure measures. The average penetration through the clothing was 54%, which dropped to 8% when the farmers wearing short sleeves were excluded. The farmers reported an average of 40 hours a year performing insecticide-related tasks. CONCLUSIONS: Farmers who applied phosmet to animals had measurable exposures, but the levels were lower than what has been seen in other pesticide applications. Inhalation exposures were insignificant when compared with dermal exposures, which came primarily from the hands. Clothing, particularly gloves, provided substantial protection from exposures. No other exposure determinant was identified.  (+info)

Malaria prevention in travelers. (3/452)

The prevention of malaria in travelers is becoming a more challenging clinical and public health problem because of the global development of drug-resistant Plasmodium strains of malaria and the increasing popularity of travel to exotic locales. Travelers can reduce their risk of acquiring malaria by using bed netting, wearing proper clothing and applying an insect repellent that contains N,N-diethyl-meta-toluamide. Chloroquine, once the standard agent for weekly malaria prophylaxis, is no longer reliably effective outside the Middle East and Central America because of the emergence of resistant Plasmodium falciparum strains. Mefloquine is now the most effective and most recommended antimalarial agent on the U.S. market; however, the side effects of this agent have begun to limit its acceptance. Doxycycline is effective for malaria prophylaxis in travelers who are unable to take mefloquine. Daily proguanil taken in conjunction with weekly chloroquine is an option for pregnant patients traveling to sub-Saharan Africa. Terminal prophylaxis with two weeks of primaquine phosphate can eliminate an asymptomatic carrier state and the later development of malaria in newly returned long-term travelers with probable exposure to Plasmodium vivax or Plasmodium ovale. Travelers who elect not to take an antimalarial agent or who are at high risk for malaria and are more than 24 hours from medical care can use self-treatment regimens such as those featuring pyrimethamine-sulfadoxine. Conventional agents may be contraindicated in certain travelers, especially pregnant women and small children, and several prophylactic agents are not available in the United States. Azithromycin and a number of malaria vaccines are currently under investigation.  (+info)

Heat balance when wearing protective clothing. (4/452)

This issue of the Annals of Occupational Hygiene is dedicated to the topic of heat stress evaluation. For this evaluation, several evaluation programs and international standards are available. In order to understand the reasoning and underlying theory behind these programs and standards, a basic knowledge of heat exchange processes between workers and their environment is needed. This paper provides an overview of the relevant heat exchange processes, and defines the relevant parameters (air and radiant temperature, humidity, wind speed, metabolic heat production and clothing insulation). Further it presents in more detail the relation between clothing material properties and properties of clothing ensembles made from those materials. The effects of clothing design, clothing fit, and clothing air permeability are discussed, and finally an overview of methods for the determination of clothing heat and vapour resistance is given.  (+info)

International standards for the assessment of the risk of thermal strain on clothed workers in hot environments. (5/452)

The International Standards Organisation (ISO) has produced an integrated series of international standards for the assessment of human responses to thermal environments. They include standards for the assessment of thermal comfort, heat stress and cold stress and many have been adopted as European and British standards. This paper describes the series of standards and in particular those concerned with the assessment of risk in hot environments. A three tier approach is taken which involves a simple thermal index that can be used for monitoring and control of hot environments (ISO 7243), a rational approach which involves an analysis of the heat exchange between a worker and his or her environment (ISO 7933) and a standard that describes the principles of physiological measurement which can be used in the establishment of personal monitoring systems of workers exposed to hot environments (ISO 9886). The standards are self-contained and can be used independently. In any comprehensive assessment however they would be used in conjunction. The simple index provides a first stage analysis and can confirm whether or not there is likely to be unacceptable thermal strain. Where a more detailed analysis is required then ISO 7933 provides an analytical method that can provide a more extensive assessment and interpretation leading to recommendations for improvement to the working environment. Where a method needs to be confirmed, or conditions are beyond the scope of ISO 7243 and ISO 7933, then ISO 9886 provides guidance on physiological measurement and interpretation. This would be used in extreme environments where individual responses are required to ensure health and safety or, in the case where personal protective equipment (PPE) is worn, which is beyond the scope of ISO 7243 and ISO 7933. The ISO system therefore covers almost all exposures to hot environments. It would be useful however to extend the scope of the standards that provide a simple index or analytical approach. This paper describes the current standards and their scope and forms the basis and background for descriptions of proposed extensions to the scope of the standards described in other papers in this special issue.  (+info)

Development of a draft British standard: the assessment of heat strain for workers wearing personal protective equipment. (6/452)

Existing methods for estimating heat stress, enshrined in British/International Standards (the Wet Bulb Globe Temperature (WBGT) index [BS EN 27243] and the Required Sweat Rate equation [BS EN 12515; ISO 7933 modified]), assume that the clothing worn by the individual is water vapour permeable; the WBGT index also assumes that the clothing is relatively light. Because most forms of personal protective equipment (PPE) either have a higher insulative value than that assumed or are water vapour impermeable, the Standards cannot be accurately applied to workers wearing PPE. There was, therefore, a need to develop a British Standard which would allow interpretation of these existing Standards for workers wearing PPE. Relevant information was obtained through reviewing the literature and consulting experts. Two questionnaire surveys of potential users of the Standards were conducted, and physiological data collected both experimentally and in work situations were considered. The information collected was used to develop the draft British Standard. It provides information and data on: The general effect of PPE on heat balance of the body (the ability of the body to maintain its 'core' temperature within an acceptable range). The effect of specific forms of PPE on metabolic heat production rate. The thermal insulation and evaporative resistance of types of PPE. The effect of the closure of the garments to the body on heat transfer. The effect of the PPE on the proportion of the body covered. The effect of an air supply (for example, Breathing Apparatus [BA]) to the wearer. Guidance is given on conducting an analysis of the work situation, taking account of the impact of PPE. Detailed methods of interpreting both BS EN 27243 and BS EN 12515 for workers wearing PPE are given, taking account of the factors listed above. Three worked examples using BS EN 27243 and BS EN 12515 are given in the Annex of the draft Standard.  (+info)

Heat stress and protective clothing: an emerging approach from the United States. (7/452)

There is little doubt that heat stress affects many workers adversely and that protective clothing generally adds to the burden. The ACGIH threshold limit value for heat stress is the guiding document for evaluation of heat stress in the United States. Adjustment factors have been used to reflect the change in heat stress imposed by different clothing ensembles. While the first proposed factors started with limited experimental data and professional judgment, heat balance methods in the laboratory have yielded better estimates of adjustment factors and for a wider selection of ensembles. These same experiments have provided the starting point to accounting for nonporous clothing in heat balance evaluation schemes such as required sweat rate. Proposed changes to the ACGIH TLV have been mentioned and a framework for thinking about controls presented.  (+info)

Clothing convective heat exchange--proposal for improved prediction in standards and models. (8/452)

Convection is an important determinant for both sensible and evaporative heat exchange. Heat transfer by convection for normal boundary conditions is readily described by simple power functions. Clothing affects convection in various ways and existing characterisation of clothing by its static insulation values produces inaccurate prediction of sensible heat exchange, eventually leading to erroneous risk assessment. The present paper reviews various methods for evaluation of clothing convective (sensible) heat exchange. Based on available data, two equations are proposed for determination of the reduction of the total insulation values obtained under static, still wind conditions as a consequence of wind and walking effects. The equations apply from 0 to 1.84 clo, from 0.2 to 3 m/s and for walking speeds up to 1.2 m/s. The equations are incorporated in ISO 7933 to provide a more realistic and accurate prediction of sensible heat transfer through clothing.  (+info)