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Sample records for accurate health risk

  1. Pesticides and health risks.

    PubMed

    Gilden, Robyn C; Huffling, Katie; Sattler, Barbara

    2010-01-01

    Pesticides are a category of chemicals formulated to kill or repel a pest or halt its reproduction. In this article we review the toxicological and epidemiological literature; describe common potential pesticide exposures; and focus on the associated health risks to fetal development. Clinical implications are reviewed, and recommendations are made regarding the integration of this environmental health concern into nursing education, practice, research, and policy/advocacy work. Recommendations for pesticide elimination and reduction in health care settings are included. PMID:20409108

  2. Risk perceptions and health behavior

    PubMed Central

    Ferrer, Rebecca; Klein, William M

    2015-01-01

    Risk perceptions – or an individual’s perceived susceptibility to a threat – are a key component of many health behavior change theories. Risk perceptions are often targeted in health behavior change interventions, and recent meta-analytic evidence suggests that interventions that successfully engage and change risk perceptions produce subsequent increases in health behaviors. Here, we review recent literature on risk perceptions and health behavior, including research on the formation of risk perceptions, types of risk perceptions (including deliberative, affective, and experiential), accuracy of risk perceptions, and associations and interactions among types of risk perceptions. Taken together, existing research suggests that disease risk perceptions are a critical determinant of health behavior, although the nature of the association among risk perceptions and health behavior may depend on the profile of different types of risk perceptions and the accuracy of such perceptions. PMID:26258160

  3. New ventures require accurate risk analyses and adjustments.

    PubMed

    Eastaugh, S R

    2000-01-01

    For new business ventures to succeed, healthcare executives need to conduct robust risk analyses and develop new approaches to balance risk and return. Risk analysis involves examination of objective risks and harder-to-quantify subjective risks. Mathematical principles applied to investment portfolios also can be applied to a portfolio of departments or strategic business units within an organization. The ideal business investment would have a high expected return and a low standard deviation. Nonetheless, both conservative and speculative strategies should be considered in determining an organization's optimal service line and helping the organization manage risk.

  4. Plastics and health risks.

    PubMed

    Halden, Rolf U

    2010-01-01

    By 2010, the worldwide annual production of plastics will surpass 300 million tons. Plastics are indispensable materials in modern society, and many products manufactured from plastics are a boon to public health (e.g., disposable syringes, intravenous bags). However, plastics also pose health risks. Of principal concern are endocrine-disrupting properties, as triggered for example by bisphenol A and di-(2-ethylhexyl) phthalate (DEHP). Opinions on the safety of plastics vary widely, and despite more than five decades of research, scientific consensus on product safety is still elusive. This literature review summarizes information from more than 120 peer-reviewed publications on health effects of plastics and plasticizers in lab animals and humans. It examines problematic exposures of susceptible populations and also briefly summarizes adverse environmental impacts from plastic pollution. Ongoing efforts to steer human society toward resource conservation and sustainable consumption are discussed, including the concept of the 5 Rs--i.e., reduce, reuse, recycle, rethink, restrain--for minimizing pre- and postnatal exposures to potentially harmful components of plastics.

  5. New Cardiovascular Risk Factors and Their Use for an Accurate Cardiovascular Risk Assessment in Hypertensive Patients

    PubMed Central

    TAUTU, Oana-Florentina; DARABONT, Roxana; ONCIUL, Sebastian; DEACONU, Alexandru; COMANESCU, Ioana; ANDREI, Radu Dan; DRAGOESCU, Bogdan; CINTEZA, Mircea; DOROBANTU, Maria

    2014-01-01

    Objectives: To analyze the predictive value of new cardiovascular (CV) risk factors for CV risk assessment in the adult Romanian hypertensive (HT) population. Methods: Hypertensive adults aged between 40-65 years of age, identified in national representative SEPHAR II survey were evaluated by anthropometric, BP and arterial stiffness measurements: aortic pulse wave velocity (PWVao), aortic augmentation index (AIXao), revers time (RT) and central systolic blood pressure (SBPao), 12 lead ECGs and laboratory workup. Values above the 4th quartile of mean SBP' standard deviation (s.d.) defined increased BP variability. Log(TG/HDL-cholesterol) defined atherogenic index of plasma (AIP). Serum uric acid levels above 5.70 mg/dl for women and 7.0 mg/dl for males defined hyperuricemia (HUA). CV risk was assessed based on SCORE chart for high CV risk countries. Binary logistic regression using a stepwise likelihood ratio method (adjustments for major confounders and colliniarity analysis) was used in order to validate predictors of high and very high CV risk class. Results: The mean SBP value of the study group was 148.46±19.61 mmHg. Over forty percent of hypertensives had a high and very high CV risk. Predictors of high/very high CV risk category validated by regression analysis were: increased visit-to-visit BP variability (OR: 2.49; 95%CI: 1.67-3.73), PWVao (OR: 1.12; 95%CI: 1.02-1.22), RT (OR: 0.95; 95% CI: 0.93-0.98), SBPao (OR: 1.01; 95%CI: 1.01-1.03) and AIP (OR: 7.08; 95%CI: 3.91-12.82). Conclusion: The results of our study suggests that the new CV risk factors such as increased BP variability, arterial stiffness indices and AIP are useful tools for a more accurate identification of hypertensives patients at high and very high CV risk. PMID:25705267

  6. Real Time Radiation Exposure And Health Risks

    NASA Technical Reports Server (NTRS)

    Hu, Shaowen; Barzilla, Janet E.; Semones, Edward J.

    2015-01-01

    Radiation from solar particle events (SPEs) poses a serious threat to future manned missions outside of low Earth orbit (LEO). Accurate characterization of the radiation environment in the inner heliosphere and timely monitoring the health risks to crew are essential steps to ensure the safety of future Mars missions. In this project we plan to develop an approach that can use the particle data from multiple satellites and perform near real-time simulations of radiation exposure and health risks for various exposure scenarios. Time-course profiles of dose rates will be calculated with HZETRN and PDOSE from the energy spectrum and compositions of the particles archived from satellites, and will be validated from recent radiation exposure measurements in space. Real-time estimation of radiation risks will be investigated using ARRBOD. This cross discipline integrated approach can improve risk mitigation by providing critical information for risk assessment and medical guidance to crew during SPEs.

  7. Exploration Health Risks: Probabilistic Risk Assessment

    NASA Technical Reports Server (NTRS)

    Rhatigan, Jennifer; Charles, John; Hayes, Judith; Wren, Kiley

    2006-01-01

    Maintenance of human health on long-duration exploration missions is a primary challenge to mission designers. Indeed, human health risks are currently the largest risk contributors to the risks of evacuation or loss of the crew on long-duration International Space Station missions. We describe a quantitative assessment of the relative probabilities of occurrence of the individual risks to human safety and efficiency during space flight to augment qualitative assessments used in this field to date. Quantitative probabilistic risk assessments will allow program managers to focus resources on those human health risks most likely to occur with undesirable consequences. Truly quantitative assessments are common, even expected, in the engineering and actuarial spheres, but that capability is just emerging in some arenas of life sciences research, such as identifying and minimize the hazards to astronauts during future space exploration missions. Our expectation is that these results can be used to inform NASA mission design trade studies in the near future with the objective of preventing the higher among the human health risks. We identify and discuss statistical techniques to provide this risk quantification based on relevant sets of astronaut biomedical data from short and long duration space flights as well as relevant analog populations. We outline critical assumptions made in the calculations and discuss the rationale for these. Our efforts to date have focussed on quantifying the probabilities of medical risks that are qualitatively perceived as relatively high risks of radiation sickness, cardiac dysrhythmias, medically significant renal stone formation due to increased calcium mobilization, decompression sickness as a result of EVA (extravehicular activity), and bone fracture due to loss of bone mineral density. We present these quantitative probabilities in order-of-magnitude comparison format so that relative risk can be gauged. We address the effects of

  8. Health Risks of Nuclear Power.

    ERIC Educational Resources Information Center

    Cohen, Bernard L.

    1978-01-01

    Deals with the wastes generated in nuclear power plants and the health risks involved as compared to those of wastes generated by coal-fired plants. Concludes that the risks of nuclear power plants are many times smaller than the risks from alternative energy resources. (GA)

  9. Health risks in perspective: Judging health risks of energy technologies

    SciTech Connect

    Rowe, M.D.

    1992-09-18

    Almost daily, Americans receive reports from the mass news media about some new and frightening risk to health and welfare. Most such reports emphasize the newsworthiness of the risks -- the possibility of a crisis, disagreements among experts, how things happened, who is responsible for fixing them, how much will it cost, conflict among parties involved, etc. As a rule, the magnitudes of the risks, or the difficulty of estimating those magnitudes, have limited newsworthiness, and so they are not mentioned. Because of this emphasis in the news media, most people outside the risk assessment community must judge the relative significance of the various risks to which we all are exposed with only that information deemed newsworthy by reporters. This information is biased and shows risks in isolation. There is no basis for understanding and comparing the relative importance of risks among themselves, or for comparing one risk, perhaps a new or newly-discovered one, in the field of all risks. The purpose of this report is to provide perspective on the various risks to which we are routinely exposed. It serves as a basis for understanding the meaning of quantitative risk estimates and for comparing new or newly-discovered risks with other, better-understood risks. Specific emphasis is placed on health risks of energy technologies.

  10. Health Risk of Radon

    MedlinePlus

    ... menu Learn the Issues Air Chemicals and Toxics Climate Change Emergencies Greener Living Health and Safety Land and Cleanup Pesticides Waste Water Science & Technology Air Climate Change Ecosystems Health Land, Waste and Cleanup Pesticides Substances ...

  11. Does more accurate exposure prediction necessarily improve health effect estimates?

    PubMed

    Szpiro, Adam A; Paciorek, Christopher J; Sheppard, Lianne

    2011-09-01

    A unique challenge in air pollution cohort studies and similar applications in environmental epidemiology is that exposure is not measured directly at subjects' locations. Instead, pollution data from monitoring stations at some distance from the study subjects are used to predict exposures, and these predicted exposures are used to estimate the health effect parameter of interest. It is usually assumed that minimizing the error in predicting the true exposure will improve health effect estimation. We show in a simulation study that this is not always the case. We interpret our results in light of recently developed statistical theory for measurement error, and we discuss implications for the design and analysis of epidemiologic research.

  12. Health Security and Risk Aversion.

    PubMed

    Herington, Jonathan

    2016-09-01

    Health security has become a popular way of justifying efforts to control catastrophic threats to public health. Unfortunately, there has been little analysis of the concept of health security, nor the relationship between health security and other potential aims of public health policy. In this paper I develop an account of health security as an aversion to risky policy options. I explore three reasons for thinking risk avoidance is a distinctly worthwhile aim of public health policy: (i) that security is intrinsically valuable, (ii) that it is necessary for social planning and (iii) that it is an appropriate response to decision-making in contexts of very limited information. Striking the right balance between securing and maximizing population health thus requires a substantive, and hitherto unrecognized, value judgment. Finally, I critically evaluate the current health security agenda in light of this new account of the concept and its relationship to the other aims of public health policy. PMID:26990349

  13. Health Security and Risk Aversion.

    PubMed

    Herington, Jonathan

    2016-09-01

    Health security has become a popular way of justifying efforts to control catastrophic threats to public health. Unfortunately, there has been little analysis of the concept of health security, nor the relationship between health security and other potential aims of public health policy. In this paper I develop an account of health security as an aversion to risky policy options. I explore three reasons for thinking risk avoidance is a distinctly worthwhile aim of public health policy: (i) that security is intrinsically valuable, (ii) that it is necessary for social planning and (iii) that it is an appropriate response to decision-making in contexts of very limited information. Striking the right balance between securing and maximizing population health thus requires a substantive, and hitherto unrecognized, value judgment. Finally, I critically evaluate the current health security agenda in light of this new account of the concept and its relationship to the other aims of public health policy.

  14. Supermarket baker's asthma: how accurate is routine health surveillance?

    PubMed Central

    Brant, A; Nightingale, S; Berriman, J; Sharp, C; Welch, J; Newman, T; Cullinan, P

    2005-01-01

    Background: Regular health surveillance is commonly recommended for workers exposed to occupational antigens but little is known about how effective it is in identifying cases. Aims: To report one large company's surveillance and compare its findings with those of a standard cross-sectional survey in the same workforce. Methods: A supermarket company with 324 in-store bakeries producing bread from raw ingredients conducted a three-stage health surveillance programme in around 3000 bakery employees. The first stage involved the administration of a simple respiratory questionnaire. If chest symptoms were present a second questionnaire focusing on their work relationship was administered. If positive a blood sample was requested for the measurement of specific IgE to flour and fungal α-amylase. The results were compared to an independent cross-sectional survey of employees in 20 of the company's stores. Results: Two hundred and ninety nine (92%) of the company's bakeries took part in surveillance. The overall employee response for the first stage was 77%; a quarter of those with respiratory symptoms reported that they were work related. Seventy four (61%) of those with work related chest symptoms had a measurement of specific IgE to either flour or fungal α-amylase, of whom 30 (41%) had a positive result. Surveillance estimated that 1% of bakery employees (1% bakers, 2% managers, 0.6% confectioners) had work related symptoms with specific IgE. This compared with 4% (7.5% bakers, 3.3% managers, 0% confectioners) in the cross-sectional survey (n = 166, 93% response). Conclusion: Comparison with a standard cross-sectional survey suggests that routine surveillance can underestimate the workplace burden of disease. The reasons may include technical or resource issues and uncertainties over confidentiality or the perceived consequences of participation. More research needs to be done looking into the design and efficacy of surveillance in occupational asthma. PMID

  15. The challenge of accurately quantifying future megadrought risk in the American Southwest

    NASA Astrophysics Data System (ADS)

    Coats, Sloan; Mankin, Justin S.

    2016-09-01

    American Southwest (ASW) megadroughts represent decadal-scale periods of dry conditions the near-term risks of which arise from natural low-frequency hydroclimate variability and anthropogenic forcing. A large single-climate-model ensemble indicates that anthropogenic forcing increases near-term ASW megadrought risk by a factor of 100; however, accurate risk assessment remains a challenge. At the global-scale we find that anthropogenic forcing may alter the variability driving megadroughts over 55% of land areas, undermining accurate assessments of their risk. For the remaining areas, current ensembles are too small to characterize megadroughts' driving variability. For example, constraining uncertainty in near-term ASW megadrought risk to 5 percentage points with high confidence requires 287 simulations. Such ensemble sizes are beyond current computational and storage resources, and these limitations suggest that constraining errors in near-term megadrought risk projections with high confidence—even in places where underlying variability is stationary—is not currently possible.

  16. Biological risk and occupational health.

    PubMed

    Corrao, Carmela Romana Natalina; Mazzotta, Adele; La Torre, Giuseppe; De Giusti, Maria

    2012-01-01

    Many work activities include hazards to workers, and among these biological risk is particularly important, mostly because of different types of exposure, contact with highly dangerous agents, lack of limit values able to compare all exposures, presence of workers with defective immune systems and therefore more susceptible to the risk. Bioaerosols and dust are considered important vehicles of microganisms at workplaces and interaction with other occupational agents is assumed. Moreover, biological risk can be significant in countries with increasing economic development or particular habits and some biological agents are also classified as carcinogenic to human. Specific emerging biological risks have been recently pointed out by Risk Observatory of the European Agency for Safety and Health at work, and we must consider the worker's attitude and behaviour, influenced by his own perception of risk more than his real knowledge, that could over-underestimate the risk itself. Therefore, biological risk at work requires a complex approach in relation to risk assessment and risk management, made more difficult due to the wide variety of biological agents, working environments and working techniques that can determine the exposures. PMID:22785422

  17. Biological risk and occupational health.

    PubMed

    Corrao, Carmela Romana Natalina; Mazzotta, Adele; La Torre, Giuseppe; De Giusti, Maria

    2012-01-01

    Many work activities include hazards to workers, and among these biological risk is particularly important, mostly because of different types of exposure, contact with highly dangerous agents, lack of limit values able to compare all exposures, presence of workers with defective immune systems and therefore more susceptible to the risk. Bioaerosols and dust are considered important vehicles of microganisms at workplaces and interaction with other occupational agents is assumed. Moreover, biological risk can be significant in countries with increasing economic development or particular habits and some biological agents are also classified as carcinogenic to human. Specific emerging biological risks have been recently pointed out by Risk Observatory of the European Agency for Safety and Health at work, and we must consider the worker's attitude and behaviour, influenced by his own perception of risk more than his real knowledge, that could over-underestimate the risk itself. Therefore, biological risk at work requires a complex approach in relation to risk assessment and risk management, made more difficult due to the wide variety of biological agents, working environments and working techniques that can determine the exposures.

  18. Do We Know Whether Researchers and Reviewers are Estimating Risk and Benefit Accurately?

    PubMed

    Hey, Spencer Phillips; Kimmelman, Jonathan

    2016-10-01

    Accurate estimation of risk and benefit is integral to good clinical research planning, ethical review, and study implementation. Some commentators have argued that various actors in clinical research systems are prone to biased or arbitrary risk/benefit estimation. In this commentary, we suggest the evidence supporting such claims is very limited. Most prior work has imputed risk/benefit beliefs based on past behavior or goals, rather than directly measuring them. We describe an approach - forecast analysis - that would enable direct and effective measure of the quality of risk/benefit estimation. We then consider some objections and limitations to the forecasting approach. PMID:27197044

  19. Do We Know Whether Researchers and Reviewers are Estimating Risk and Benefit Accurately?

    PubMed

    Hey, Spencer Phillips; Kimmelman, Jonathan

    2016-10-01

    Accurate estimation of risk and benefit is integral to good clinical research planning, ethical review, and study implementation. Some commentators have argued that various actors in clinical research systems are prone to biased or arbitrary risk/benefit estimation. In this commentary, we suggest the evidence supporting such claims is very limited. Most prior work has imputed risk/benefit beliefs based on past behavior or goals, rather than directly measuring them. We describe an approach - forecast analysis - that would enable direct and effective measure of the quality of risk/benefit estimation. We then consider some objections and limitations to the forecasting approach.

  20. Health risks of energy systems.

    PubMed

    Krewitt, W; Hurley, F; Trukenmüller, A; Friedrich, R

    1998-08-01

    Health risks from fossil, renewable and nuclear reference energy systems are estimated following a detailed impact pathway approach. Using a set of appropriate air quality models and exposure-effect functions derived from the recent epidemiological literature, a methodological framework for risk assessment has been established and consistently applied across the different energy systems, including the analysis of consequences from a major nuclear accident. A wide range of health impacts resulting from increased air pollution and ionizing radiation is quantified, and the transferability of results derived from specific power plants to a more general context is discussed. PMID:9775447

  1. The health risk of radon

    SciTech Connect

    Conrath, S.M.; Kolb, L.

    1995-10-01

    Although radon is the second leading cause of lung cancer in the United States, second only to cigarette smoking, many members of the public are not aware that radon is one of the most serious environmental cancer risks in the US. Based on extensive data from epidemiological studies of underground miners, radon has been classified as a known human carcinogen. In contrast to most pollutants, the assessment of human risk from radon is based on human occupational exposure data rather than animal data. That radon causes lung cancer has been well established by the scientific community. More is known about radon than most other cancer causing environmental carcinogens. While there are some uncertainties involved when estimating radon risk to the public, it is important to recognize that the risk information is based on human data and that the uncertainties have been addressed in the risk assessment. The US Environmental Protection Agency (EPA) estimates that the number of annual US lung cancer deaths due to residential radon exposures is approximately 14,000 with an uncertainty range of 7,000 to 30,000. The abundant information on radon health risks that supports EPA`s risk assessment indicates that recommendations for public action by the federal government and other public health organizations constitute prudent public policy.

  2. Health risks at the Hajj.

    PubMed

    Ahmed, Qanta A; Arabi, Yaseen M; Memish, Ziad A

    2006-03-25

    Annually, millions of Muslims embark on a religious pilgrimage called the "Hajj" to Mecca in Saudi Arabia. The mass migration during the Hajj is unparalleled in scale, and pilgrims face numerous health hazards. The extreme congestion of people and vehicles during this time amplifies health risks, such as those from infectious diseases, that vary each year. Since the Hajj is dictated by the lunar calendar, which is shorter than the Gregorian calendar, it presents public-health policy planners with a moving target, demanding constant preparedness. We review the communicable and non-communicable hazards that pilgrims face. With the rise in global travel, preventing disease transmission has become paramount to avoid the spread of infectious diseases, including SARS (severe acute respiratory syndrome), avian influenza, and haemorrhagic fever. We examine the response of clinicians, the Saudi Ministry of Health, and Hajj authorities to these unique problems, and list health recommendations for prospective pilgrims. PMID:16564364

  3. Health risks at the Hajj.

    PubMed

    Ahmed, Qanta A; Arabi, Yaseen M; Memish, Ziad A

    2006-03-25

    Annually, millions of Muslims embark on a religious pilgrimage called the "Hajj" to Mecca in Saudi Arabia. The mass migration during the Hajj is unparalleled in scale, and pilgrims face numerous health hazards. The extreme congestion of people and vehicles during this time amplifies health risks, such as those from infectious diseases, that vary each year. Since the Hajj is dictated by the lunar calendar, which is shorter than the Gregorian calendar, it presents public-health policy planners with a moving target, demanding constant preparedness. We review the communicable and non-communicable hazards that pilgrims face. With the rise in global travel, preventing disease transmission has become paramount to avoid the spread of infectious diseases, including SARS (severe acute respiratory syndrome), avian influenza, and haemorrhagic fever. We examine the response of clinicians, the Saudi Ministry of Health, and Hajj authorities to these unique problems, and list health recommendations for prospective pilgrims.

  4. Perceived and calculated health risks: do the impacts differ

    SciTech Connect

    Payne, B.A.; Williams, R.G.

    1986-01-23

    In many cases of radioactive and hazardous waste management, some members of the general public perceive that human health risks associated with the wastes are higher than the calculated risks. Calculated risks are projections that have been derived from models, and it is these risks that are usually used as the basis for waste management. However, for various reasons, the calculated risks are often considered by the public as too low or inappropriate. The reasons that calculated risks are not perceived as accurate and the factors that affect these perceptions are explored in this paper. Also discussed are the impacts related to the perceived and calculated health risks: what they are, and if and how they differ. The kinds of potential impacts examined are health effects, land value changes, and social, transportation, and economic effects. The paper concludes with a discussion of the implications of incorporating these different risk perspectives in decisions on waste management.

  5. Health risks to fire fighters.

    PubMed

    Matticks, C A; Westwater, J J; Himel, H N; Morgan, R F; Edlich, R F

    1992-01-01

    Fire fighters work in varied and dangerous environments and face unique health hazards that increase their risk for line-of-duty injury and death. While working with sophisticated equipment within such environments, the fire fighter is exposed to high noise levels, changing thermal conditions, and hazardous breathing atmospheres. In addition, his or her protective equipment can impose limitations on efficiency and performance. These conditions have been related to specific physical performance requirements that will reduce line-of-duty injury, disability, and even death. Physical fitness and health maintenance programs that reduce the risk for cardiovascular disease and musculoskeletal injuries have been prescribed for fire fighters. These programs are essential components of any modern fire service. PMID:1587923

  6. Mental health disorders among individuals with mental retardation: challenges to accurate prevalence estimates.

    PubMed Central

    Kerker, Bonnie D.; Owens, Pamela L.; Zigler, Edward; Horwitz, Sarah M.

    2004-01-01

    OBJECTIVES: The objectives of this literature review were to assess current challenges to estimating the prevalence of mental health disorders among individuals with mental retardation (MR) and to develop recommendations to improve such estimates for this population. METHODS: The authors identified 200 peer-reviewed articles, book chapters, government documents, or reports from national and international organizations on the mental health status of people with MR. Based on the study's inclusion criteria, 52 articles were included in the review. RESULTS: Available data reveal inconsistent estimates of the prevalence of mental health disorders among those with MR, but suggest that some mental health conditions are more common among these individuals than in the general population. Two main challenges to identifying accurate prevalence estimates were found: (1) health care providers have difficulty diagnosing mental health conditions among individuals with MR; and (2) methodological limitations of previous research inhibit confidence in study results. CONCLUSIONS: Accurate prevalence estimates are necessary to ensure the availability of appropriate treatment services. To this end, health care providers should receive more training regarding the mental health treatment of individuals with MR. Further, government officials should discuss mechanisms of collecting nationally representative data, and the research community should utilize consistent methods with representative samples when studying mental health conditions in this population. PMID:15219798

  7. A 21st Century Roadmap for Human Health Risk Assessment

    EPA Science Inventory

    For decades human health risk assessment has depended primarily on animal testing to predict adverse effects in humans, but that paradigm has come under question because of calls for more accurate information, less use of animals, and more efficient use of resources. Moreover, t...

  8. Ultraviolet Radiation: Human Exposure and Health Risks.

    ERIC Educational Resources Information Center

    Tenkate, Thomas D.

    1998-01-01

    Provides an overview of human exposure to ultraviolet radiation and associated health effects as well as risk estimates for acute and chronic conditions resulting from such exposure. Demonstrates substantial reductions in health risk that can be achieved through preventive actions. Also includes a risk assessment model for skin cancer. Contains 36…

  9. Health risk of chrysotile revisited

    PubMed Central

    Dunnigan, Jacques; Hesterberg, Thomas; Brown, Robert; Velasco, Juan Antonio Legaspi; Barrera, Raúl; Hoskins, John; Gibbs, Allen

    2013-01-01

    This review provides a basis for substantiating both kinetically and pathologically the differences between chrysotile and amphibole asbestos. Chrysotile, which is rapidly attacked by the acid environment of the macrophage, falls apart in the lung into short fibers and particles, while the amphibole asbestos persist creating a response to the fibrous structure of this mineral. Inhalation toxicity studies of chrysotile at non-lung overload conditions demonstrate that the long (>20 µm) fibers are rapidly cleared from the lung, are not translocated to the pleural cavity and do not initiate fibrogenic response. In contrast, long amphibole asbestos fibers persist, are quickly (within 7 d) translocated to the pleural cavity and result in interstitial fibrosis and pleural inflammation. Quantitative reviews of epidemiological studies of mineral fibers have determined the potency of chrysotile and amphibole asbestos for causing lung cancer and mesothelioma in relation to fiber type and have also differentiated between these two minerals. These studies have been reviewed in light of the frequent use of amphibole asbestos. As with other respirable particulates, there is evidence that heavy and prolonged exposure to chrysotile can produce lung cancer. The importance of the present and other similar reviews is that the studies they report show that low exposures to chrysotile do not present a detectable risk to health. Since total dose over time decides the likelihood of disease occurrence and progression, they also suggest that the risk of an adverse outcome may be low with even high exposures experienced over a short duration. PMID:23346982

  10. [Psychosocial risks at work and occupational health].

    PubMed

    Gil-Monte, Pedro R

    2012-06-01

    The changes on work processes and job design in recent decades are focused in the demographic, economic, political, and technological aspects. These changes have created new psychosocial risks at work that affect the health and quality of workplace, increasing stress levels among workers. The aim of this study is to present such risks, their consequences, and some recommendations to promote health at the workplace as a strategy to improve public health of the population. The study is divided into five points in which: (1) introduces the concept of risk factors and psychosocial work, (2) describes the main emerging psychosocial risks labor, (3) provides some information on the prevalence of psychosocial risks at work in Europe and its consequences, (4) recommendations for health promotion in the workplace, and (5) describes the objective of Occupational Health Psychology and concludes with the recommendations to promote psychosocial health in the workplace as a strategy to improve public health of the population.

  11. Risk management frameworks for human health and environmental risks.

    PubMed

    Jardine, Cindy; Hrudey, Steve; Shortreed, John; Craig, Lorraine; Krewski, Daniel; Furgal, Chris; McColl, Stephen

    2003-01-01

    A comprehensive analytical review of the risk assessment, risk management, and risk communication approaches currently being undertaken by key national, provincial/state, territorial, and international agencies was conducted. The information acquired for review was used to identify the differences, commonalities, strengths, and weaknesses among the various approaches, and to identify elements that should be included in an effective, current, and comprehensive approach applicable to environmental, human health and occupational health risks. More than 80 agencies, organizations, and advisory councils, encompassing more than 100 risk documents, were examined during the period from February 2000 until November 2002. An overview was made of the most important general frameworks for risk assessment, risk management, and risk communication for human health and ecological risk, and for occupational health risk. In addition, frameworks for specific applications were reviewed and summarized, including those for (1)contaminated sites; (2) northern contaminants; (3) priority substances; (4) standards development; (5) food safety; (6) medical devices; (7) prescription drug use; (8) emergency response; (9) transportation; (10) risk communication. Twelve frameworks were selected for more extensive review on the basis of representation of the areas of human health, ecological, and occupational health risk; relevance to Canadian risk management needs; representation of comprehensive and well-defined approaches; generalizability with their risk areas; representation of "state of the art" in Canada, the United States, and/or internationally; and extent of usage of potential usage within Canada. These 12 frameworks were: 1. Framework for Environmental Health Risk Management (US Presidential/Congressional Commission on Risk Assessment and Risk Management, 1997). 2. Health Risk Determination: The Challenge of Health Protection (Health and Welfare Canada, 1990). 3. Health Canada Decision

  12. Health risks of alcohol use

    MedlinePlus

    Alcoholism - risks; Alcohol abuse - risks; Alcohol dependence - risks; Risky drinking ... Beer, wine, and liquor all contain alcohol. If you are drinking any of these, you are using alcohol. Your drinking patterns may vary, depending on who you are with ...

  13. Can Public Health Risk Assessment Using Risk Matrices Be Misleading?

    PubMed Central

    Vatanpour, Shabnam; Hrudey, Steve E.; Dinu, Irina

    2015-01-01

    The risk assessment matrix is a widely accepted, semi-quantitative tool for assessing risks, and setting priorities in risk management. Although the method can be useful to promote discussion to distinguish high risks from low risks, a published critique described a problem when the frequency and severity of risks are negatively correlated. A theoretical analysis showed that risk predictions could be misleading. We evaluated a practical public health example because it provided experiential risk data that allowed us to assess the practical implications of the published concern that risk matrices would make predictions that are worse than random. We explored this predicted problem by constructing a risk assessment matrix using a public health risk scenario—Tainted blood transfusion infection risk—That provides negative correlation between harm frequency and severity. We estimated the risk from the experiential data and compared these estimates with those provided by the risk assessment matrix. Although we validated the theoretical concern, for these authentic experiential data, the practical scope of the problem was limited. The risk matrix has been widely used in risk assessment. This method should not be abandoned wholesale, but users must address the source of the problem, apply the risk matrix with a full understanding of this problem and use matrix predictions to inform, but not drive decision-making. PMID:26287224

  14. Profiles of Risk: Maternal Health, Socioeconomic Status, and Child Health

    PubMed Central

    Hardie, Jessica Halliday; Landale, Nancy S.

    2013-01-01

    Child health is fundamental to well-being and achievement throughout the life course. Prior research has demonstrated strong associations between familial socioeconomic resources and children’s health outcomes, with especially poor health outcomes among disadvantaged youth who experience a concentration of risks, yet little is known about the influence of maternal health as a dimension of risk for children. This research used nationally representative U.S. data from the National Health Interview Surveys in 2007 and 2008 (N = 7,361) to evaluate the joint implications of maternal health and socioeconomic disadvantage for youth. Analyses revealed that maternal health problems were present in a substantial minority of families, clustered meaningfully with other risk factors, and had serious implications for children’s health. These findings support the development of health policies and interventions aimed at families. PMID:23794751

  15. Addressing Risks to Advance Mental Health Research

    PubMed Central

    Iltis, Ana S.; Misra, Sahana; Dunn, Laura B.; Brown, Gregory K.; Campbell, Amy; Earll, Sarah A.; Glowinski, Anne; Hadley, Whitney B.; Pies, Ronald; DuBois, James M.

    2015-01-01

    Objective Risk communication and management are essential to the ethical conduct of research, yet addressing risks may be time consuming for investigators and institutional review boards (IRBs) may reject study designs that appear too risky. This can discourage needed research, particularly in higher risk protocols or those enrolling potentially vulnerable individuals, such as those with some level of suicidality. Improved mechanisms for addressing research risks may facilitate much needed psychiatric research. This article provides mental health researchers with practical approaches to: 1) identify and define various intrinsic research risks; 2) communicate these risks to others (e.g., potential participants, regulatory bodies, society); 3) manage these risks during the course of a study; and 4) justify the risks. Methods As part of a National Institute of Mental Health (NIMH)-funded scientific meeting series, a public conference and a closed-session expert panel meeting were held on managing and disclosing risks in mental health clinical trials. The expert panel reviewed the literature with a focus on empirical studies and developed recommendations for best practices and further research on managing and disclosing risks in mental health clinical trials. IRB review was not required because there were no human subjects. The NIMH played no role in developing or reviewing the manuscript. Results Challenges, current data, practical strategies, and topics for future research are addressed for each of four key areas pertaining to management and disclosure of risks in clinical trials: identifying and defining risks, communicating risks, managing risks during studies, and justifying research risks. Conclusions Empirical data on risk communication, managing risks, and the benefits of research can support the ethical conduct of mental health research and may help investigators better conceptualize and confront risks and to gain IRB approval. PMID:24173618

  16. New Mexico Adolescent Health Risks Survey.

    ERIC Educational Resources Information Center

    Antle, David

    To inform students of health risks (posed by behavior, environment, and genetics) and provide schools with collective risk appraisal information as a basis for planning/evaluating health and wellness initiatives, New Mexico administered the Teen Wellness Check in 1985 to 1,573 ninth-grade students from 7 New Mexico public schools. Subjects were…

  17. Air pollution ranks as largest health risk

    NASA Astrophysics Data System (ADS)

    Wendel, JoAnna

    2014-04-01

    The World Health Organization (WHO) reports that 7 million people died in 2012 from air-pollution-related sicknesses, marking air pollution as the single largest environmental health risk. This finding, a result of better knowledge and assessment of the diseases, is more than double previous estimates of the risk of death from air pollution.

  18. [Forest health ecological risk assessment in China].

    PubMed

    Xiao, Fengjin; Ouyang, Hua; Cheng, Shulan; Zhang, Qiang

    2004-02-01

    Forest health ecological risk assessment is an important factor in forest resources management. In this paper, we selected forest fire, forest disease-pest disasters and acid rain as main risk sources, described the risk resources by probability, intensity and distributing, and mapped each risk source. The endpoints were the damages that the risk acceptor might and these damages might cause ecosystems' organization and function changing under the uncertainty risk sources. Endpoints of forest might compose of productivity descent, reducing biodiversity, forest degrading, forest ecological function declining, furthermore, forest disappearing. We described exposure in terms of intensity, space, and time. In the exposure and hazard analysis, we used fragile index to show frangibility or resistibility (resistibility is reverse to frangibility), and analyzed the damages by different risk sources. Risk assessment and management was the integrated phase of the research. Because of the spatial heterogeneity of risk sources, all risk index were overlaid in the China map by GIS, which divided the region into 30 ecological risk sub-zones (provinces), according to risk index of each risk sub-zone, and the forest in China was divided into six levels of risk zones. In every level of risk zones, we also put forward the countermeasures for forest health ecological risk management. The result of assessment could provide scientific basis for forest management.

  19. Unilateral Prostate Cancer Cannot be Accurately Predicted in Low-Risk Patients

    SciTech Connect

    Isbarn, Hendrik; Karakiewicz, Pierre I.; Vogel, Susanne

    2010-07-01

    Purpose: Hemiablative therapy (HAT) is increasing in popularity for treatment of patients with low-risk prostate cancer (PCa). The validity of this therapeutic modality, which exclusively treats PCa within a single prostate lobe, rests on accurate staging. We tested the accuracy of unilaterally unremarkable biopsy findings in cases of low-risk PCa patients who are potential candidates for HAT. Methods and Materials: The study population consisted of 243 men with clinical stage {<=}T2a, a prostate-specific antigen (PSA) concentration of <10 ng/ml, a biopsy-proven Gleason sum of {<=}6, and a maximum of 2 ipsilateral positive biopsy results out of 10 or more cores. All men underwent a radical prostatectomy, and pathology stage was used as the gold standard. Univariable and multivariable logistic regression models were tested for significant predictors of unilateral, organ-confined PCa. These predictors consisted of PSA, %fPSA (defined as the quotient of free [uncomplexed] PSA divided by the total PSA), clinical stage (T2a vs. T1c), gland volume, and number of positive biopsy cores (2 vs. 1). Results: Despite unilateral stage at biopsy, bilateral or even non-organ-confined PCa was reported in 64% of all patients. In multivariable analyses, no variable could clearly and independently predict the presence of unilateral PCa. This was reflected in an overall accuracy of 58% (95% confidence interval, 50.6-65.8%). Conclusions: Two-thirds of patients with unilateral low-risk PCa, confirmed by clinical stage and biopsy findings, have bilateral or non-organ-confined PCa at radical prostatectomy. This alarming finding questions the safety and validity of HAT.

  20. Veterans Affairs databases are accurate for gout-related health care utilization: a validation study

    PubMed Central

    2013-01-01

    Introduction The aim of this study was to assess the accuracy of Veterans Affairs (VA) databases for gout-related health care utilization. Methods This retrospective study utilized VA administrative and clinical databases. A random sample of gout patients with visits (outpatient, inpatient or emergent/urgent care) with or without the diagnosis of gout (International Classification of Diseases, ninth revision, common modification ICD-9-CM code of 274.x or 274.xx) at the Birmingham VA hospital was selected. A blinded abstractor performed a review of VA electronic health records for the documentation of gout or gout-related terms (gouty arthritis, tophaceous gout, tophus/tophi, acute gout, chronic gout, podagra, urate stones, urate or uric acid crystals and so on) in the chief complaint, history of present illness or assessment and plan for the visit; this constituted the gold standard for gout-related utilization. The accuracy of database-derived gout-related claims was assessed by calculating sensitivity, specificity, and positive and negative predictive values (PPV and NPV). Results Of 108 potential visits, 85 outpatient, inpatient or urgent care/emergency room visits to a health care provider (85 patients: 84 men and 1 woman with a mean age of 63 years) and retrievable data from medical records constituted the analyzed dataset. Administrative claims for gout-related utilization with ICD-9 code for gout were accurate with a PPV of 86%, specificity of 95%, sensitivity of 86% and NPV of 95%. Conclusions VA databases are accurate for gout-related visits. These findings support their use for studies of health services and outcome studies. It remains to be seen if these findings are generalizable to other settings and databases. PMID:24377421

  1. Work stress and health risk behavior.

    PubMed

    Siegrist, Johannes; Rödel, Andreas

    2006-12-01

    This contribution discusses current knowledge of associations between psychosocial stress at work and health risk behavior, in particular cigarette smoking, alcohol consumption and overweight, by reviewing findings from major studies in the field published between 1989 and 2006. Psychosocial stress at work is measured by the demand-control model and the effort-reward imbalance model. Health risk behavior was analyzed in the broader context of a health-related Western lifestyle with socially and economically patterned practices of consumption. Overall, the review, based on 46 studies, only modestly supports the hypothesis of a consistent association between work stress and health risk behavior. The relatively strongest relationships have been found with regard to heavy alcohol consumption among men, overweight, and the co-manifestation of several risks. Suggestions for further research are given, and the need to reduce stressful experience in the framework of worksite health promotion programs is emphasized.

  2. Health effects of risk-assessment categories

    SciTech Connect

    Kramer, C.F.; Rybicka, K.; Knutson, A.; Morris, S.C.

    1983-10-01

    Environmental and occupational health effects associated with exposures to various chemicals are a subject of increasing concern. One recently developed methodology for assessing the health impacts of various chemical compounds involves the classification of similar chemicals into risk-assessment categories (RACs). This report reviews documented human health effects for a broad range of pollutants, classified by RACs. It complements other studies that have estimated human health effects by RAC based on analysis and extrapolation of data from animal research.

  3. The health risks of decommissioning nuclear facilities.

    PubMed

    Dodic-Fikfak, M; Clapp, R; Kriebel, D

    1999-01-01

    The health risks facing workers involved in decommissioning nuclear facilities are a critical concern as the nuclear weapons complex and nuclear power plants begin to be dismantled. In addition to risks from exposure to radioactive materials, there are risks from other common industrial materials like crystalline silica dust and asbestos. We discuss these issues in the context of recent research on the risk of low-level ionizing radiation, the classification of crystalline silica as a carcinogen, and early experience with decommissioning nuclear facilities in the United States. Health and safety advocates will need to be vigilant to prevent worker exposure. PMID:17208791

  4. The health risks of decommissioning nuclear facilities.

    PubMed

    Dodic-Fikfak, M; Clapp, R; Kriebel, D

    1999-01-01

    The health risks facing workers involved in decommissioning nuclear facilities are a critical concern as the nuclear weapons complex and nuclear power plants begin to be dismantled. In addition to risks from exposure to radioactive materials, there are risks from other common industrial materials like crystalline silica dust and asbestos. We discuss these issues in the context of recent research on the risk of low-level ionizing radiation, the classification of crystalline silica as a carcinogen, and early experience with decommissioning nuclear facilities in the United States. Health and safety advocates will need to be vigilant to prevent worker exposure.

  5. Health Risk Behaviors and Academic Achievement

    MedlinePlus

    ... 2009 † Health-Risk Behaviors Percentage of U.S. high school students who engaged in each risk behavior, by type of grades mostly earned A’s B’s C’s D’s/F’s Unintentional Injury and Violence-Related Behaviors Rarely or never wore a seat ...

  6. Environmental Risk to Health of the Population

    ERIC Educational Resources Information Center

    Anopchenko, Tatiana Y.; Murzin, Anton D.; Kandrashina, Elena A.; Kosyakova, Inessa V.; Surnina, Olga E.

    2016-01-01

    Researches of the last years in the field of ecological epidemiology and the analysis of risk for health allow to claim with confidence that the polluted environment is one of the important factors defining changes of a state of health of the population. Expert opinions on the scale of this influence differ considerably now. These estimations vary…

  7. The importance of accurate road data for spatial applications in public health: customizing a road network

    PubMed Central

    Frizzelle, Brian G; Evenson, Kelly R; Rodriguez, Daniel A; Laraia, Barbara A

    2009-01-01

    Background Health researchers have increasingly adopted the use of geographic information systems (GIS) for analyzing environments in which people live and how those environments affect health. One aspect of this research that is often overlooked is the quality and detail of the road data and whether or not it is appropriate for the scale of analysis. Many readily available road datasets, both public domain and commercial, contain positional errors or generalizations that may not be compatible with highly accurate geospatial locations. This study examined the accuracy, completeness, and currency of four readily available public and commercial sources for road data (North Carolina Department of Transportation, StreetMap Pro, TIGER/Line 2000, TIGER/Line 2007) relative to a custom road dataset which we developed and used for comparison. Methods and Results A custom road network dataset was developed to examine associations between health behaviors and the environment among pregnant and postpartum women living in central North Carolina in the United States. Three analytical measures were developed to assess the comparative accuracy and utility of four publicly and commercially available road datasets and the custom dataset in relation to participants' residential locations over three time periods. The exclusion of road segments and positional errors in the four comparison road datasets resulted in between 5.9% and 64.4% of respondents lying farther than 15.24 meters from their nearest road, the distance of the threshold set by the project to facilitate spatial analysis. Agreement, using a Pearson's correlation coefficient, between the customized road dataset and the four comparison road datasets ranged from 0.01 to 0.82. Conclusion This study demonstrates the importance of examining available road datasets and assessing their completeness, accuracy, and currency for their particular study area. This paper serves as an example for assessing the feasibility of readily

  8. Health and environmental risks of energy systems

    SciTech Connect

    Hamilton, L.D.

    1984-01-01

    This paper gives four examples of health risk assessments of energy systems: (1) Comparative risk assessment of the health effects of the coal and nuclear fuel cycles. Estimates differ from previous values chiefly by inclusion of ranges of uncertainty, but some coal-cycle numbers were re-estimated. Upper-boundary public disease risks of air pollution from coal-fired plants dominate. Reactors probably account for most of the potential effect of major nuclear accidents. Accidental death rates in electricity generation are low for reactors and higher for coal. (2) Upper boundary air pollution health risks of existing fossil-based energy technologies in the United States. Preliminary mortality estimates were obtained combining potential impacts of three index pollutants - SO/sub 4/, NO/sub 2/, and CO - as independent measures of risk. Four fuel cycle trajectories leading to three end-uses were analyzed. Example results: domestic wood burning has substantial potential impact, with an upper boundary exceeding that of coal; upper-boundary air pollution impacts of gas can exceed those of oil, because of NO/sub 2/. (3) Health risks of acid deposition and other transported air pollutants, carried out as part of an assessment of the US Congress Office of Technology Assessment (OTA) Acid Rain and Transported Air Pollutants - Implications for Public Policy. Three scenarios were examined, leading to estimates of 40,000 to 50,000 annual premature deaths, depending on year (1978 vs 2000) and scenario (holding total emissions constant vs 30% reduction). (4) health effects of uranium mill tailings piles. Mortality risk is estimated to be minuscule (8.7 x 10/sup -9/ average individual lifetime cancer risk from a model mill, compared with 9.5 x 10/sup -4/ for background radiation). Methods that sum risks over the indefinite future are shown to be to be unrealistic. 39 references, 7 figures, 15 tables.

  9. Migration, refugees, and health risks.

    PubMed Central

    Carballo, M.; Nerukar, A.

    2001-01-01

    Migration both voluntary and forced is increasing all over the world. People are moving in larger numbers faster and further than at any other time in history. This is happening at a time when many countries are ill-prepared to deal with a changing demography and when policies and attitudes to population movement and immigration are hardening. The health implications of this are many, and, in some cases, illness and death rates associated with migration are exacerbated by a lack of policies needed to make migration a healthy and socially productive process. From a public health point of view, this is having and will continue to have serious ramifications for the people that move, the family they leave behind, and the communities that host the newcomers. PMID:11485671

  10. Migration, refugees, and health risks.

    PubMed

    Carballo, M; Nerukar, A

    2001-01-01

    Migration both voluntary and forced is increasing all over the world. People are moving in larger numbers faster and further than at any other time in history. This is happening at a time when many countries are ill-prepared to deal with a changing demography and when policies and attitudes to population movement and immigration are hardening. The health implications of this are many, and, in some cases, illness and death rates associated with migration are exacerbated by a lack of policies needed to make migration a healthy and socially productive process. From a public health point of view, this is having and will continue to have serious ramifications for the people that move, the family they leave behind, and the communities that host the newcomers.

  11. Space Radiation and Risks to Human Health

    NASA Technical Reports Server (NTRS)

    Huff, Janice L.; Patel, Zarana S.; Simonsen, Lisa C.

    2014-01-01

    The radiation environment in space poses significant challenges to human health and is a major concern for long duration manned space missions. Outside the Earth's protective magnetosphere, astronauts are exposed to higher levels of galactic cosmic rays, whose physical characteristics are distinct from terrestrial sources of radiation such as x-rays and gamma-rays. Galactic cosmic rays consist of high energy and high mass nuclei as well as high energy protons; they impart unique biological damage as they traverse through tissue with impacts on human health that are largely unknown. The major health issues of concern are the risks of radiation carcinogenesis, acute and late decrements to the central nervous system, degenerative tissue effects such as cardiovascular disease, as well as possible acute radiation syndromes due to an unshielded exposure to a large solar particle event. The NASA Human Research Program's Space Radiation Program Element is focused on characterization and mitigation of these space radiation health risks along with understanding these risks in context of the other biological stressors found in the space environment. In this overview, we will provide a description of these health risks and the Element's research strategies to understand and mitigate these risks.

  12. Health risks and benefits of bottled water.

    PubMed

    Napier, Gena L; Kodner, Charles M

    2008-12-01

    Health and safety concerns have dramatically increased the consumption of bottled water in developed countries, including the United States. The economic and environmental impact of the many different bottled water products on the market is considerable, and the role and impact of bottled water for routine use is unclear, outside the setting of emergencies or natural disasters, when routine water sources may be unsafe. Evidence for routine health risks or benefits from using bottled water is limited. Patients who have specific health needs may wish to use bottled or filtered water. Physicians can use background information regarding the regulation, production, and possible health impact of bottled water to counsel patients.

  13. Can student health professionals accurately estimate alcohol content in commonly occurring drinks?

    PubMed Central

    Sinclair, Julia; Searle, Emma

    2016-01-01

    Objectives: Correct identification of alcohol as a contributor to, or comorbidity of, many psychiatric diseases requires health professionals to be competent and confident to take an accurate alcohol history. Being able to estimate (or calculate) the alcohol content in commonly consumed drinks is a prerequisite for quantifying levels of alcohol consumption. The aim of this study was to assess this ability in medical and nursing students. Methods: A cross-sectional survey of 891 medical and nursing students across different years of training was conducted. Students were asked the alcohol content of 10 different alcoholic drinks by seeing a slide of the drink (with picture, volume and percentage of alcohol by volume) for 30 s. Results: Overall, the mean number of correctly estimated drinks (out of the 10 tested) was 2.4, increasing to just over 3 if a 10% margin of error was used. Wine and premium strength beers were underestimated by over 50% of students. Those who drank alcohol themselves, or who were further on in their clinical training, did better on the task, but overall the levels remained low. Conclusions: Knowledge of, or the ability to work out, the alcohol content of commonly consumed drinks is poor, and further research is needed to understand the reasons for this and the impact this may have on the likelihood to undertake screening or initiate treatment. PMID:27536344

  14. The Risk Approach in Health Care: With Special Reference to Maternal and Child Health, Including Family Planning. Public Health Papers No. 76.

    ERIC Educational Resources Information Center

    Backett, E. Maurice; And Others

    Primary health care has a new tool with which to improve its effectiveness, its efficiency, and its decisions about national and local priorities: the accurate measurement of the chances of occurrence of a future event of health or illness. Human and other resources should go where the need is greatest, and assessment of the risk of future…

  15. Assessment of health risks of policies

    SciTech Connect

    Ádám, Balázs; Molnár, Ágnes; Ádány, Róza; Bianchi, Fabrizio; Bitenc, Katarina; Chereches, Razvan; Cori, Liliana; Fehr, Rainer; Kobza, Joanna; Kollarova, Jana; and others

    2014-09-15

    The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals.

  16. Physical Activity, Health Benefits, and Mortality Risk

    PubMed Central

    Kokkinos, Peter

    2012-01-01

    A plethora of epidemiologic evidence from large studies supports unequivocally an inverse, independent, and graded association between volume of physical activity, health, and cardiovascular and overall mortality. This association is evident in apparently healthy individuals, patients with hypertension, type 2 diabetes mellitus, and cardiovascular disease, regardless of body weight. Moreover, the degree of risk associated with physical inactivity is similar to, and in some cases even stronger than, the more traditional cardiovascular risk factors. The exercise-induced health benefits are in part related to favorable modulations of cardiovascular risk factors observed by increased physical activity or structured exercise programs. Although the independent contribution of the exercise components, intensity, duration, and frequency to the reduction of mortality risk is not clear, it is well accepted that an exercise volume threshold defined at caloric expenditure of approximately 1,000 Kcal per week appears to be necessary for significant reduction in mortality risk. Further reductions in risk are observed with higher volumes of energy expenditure. Physical exertion is also associated with a relatively low and transient increase in risk for cardiac events. This risk is significantly higher for older and sedentary individuals. Therefore, such individuals should consult their physician prior to engaging in exercise. “Walking is man’s best medicine”Hippocrates PMID:23198160

  17. The risks of innovation in health care.

    PubMed

    Enzmann, Dieter R

    2015-04-01

    Innovation in health care creates risks that are unevenly distributed. An evolutionary analogy using species to represent business models helps categorize innovation experiments and their risks. This classification reveals two qualitative categories: early and late diversification experiments. Early diversification has prolific innovations with high risk because they encounter a "decimation" stage, during which most experiments disappear. Participants face high risk. The few decimation survivors can be sustaining or disruptive according to Christensen's criteria. Survivors enter late diversification, during which they again expand, but within a design range limited to variations of the previous surviving designs. Late diversifications carry lower risk. The exception is when disruptive survivors "diversify," which amplifies their disruption. Health care and radiology will experience both early and late diversifications, often simultaneously. Although oversimplifying Christensen's concepts, early diversifications are likely to deliver disruptive innovation, whereas late diversifications tend to produce sustaining innovations. Current health care consolidation is a manifestation of late diversification. Early diversifications will appear outside traditional care models and physical health care sites, as well as with new science such as molecular diagnostics. They warrant attention because decimation survivors will present both disruptive and sustaining opportunities to radiology. Radiology must participate in late diversification by incorporating sustaining innovations to its value chain. Given the likelihood of disruptive survivors, radiology should seriously consider disrupting itself rather than waiting for others to do so. Disruption entails significant modifications of its value chain, hence, its business model, for which lessons may become available from the pharmaceutical industry's current simultaneous experience with early and late diversifications.

  18. Health risks in perspective: Judging health risks of energy technologies. Revision 5/94

    SciTech Connect

    Rowe, M.D.

    1992-09-01

    The purpose of this report is to provide perspective on the various risks to which man is routinely exposed. It serves as a basis for understanding the meaning of quantitative risk estimates and for comparing new or newly-discovered risks with other, better-understood risks. Specific emphasis is placed on health risks of energy technologies. This report is not a risk assessment; nor does it contain instructions on how to do a risk assessment. Rather, it provides background information on how most of us think about risks and why it is difficult to do it rationally, it provides a philosophy and data with which to do a better job of judging risks more rationally, and it provides an overview of where risks of energy technologies fit within the spectrum of all risks. Much of the quantitative information provided here is on relative risk of dying of various causes. This is not because risk of dying is seen as the most important kind of risk, but because the statistics on mortality rates by cause are the highest quality data available on health risks in the general population.

  19. Prioritizing environmental health risks in the UAE.

    PubMed

    Willis, Henry H; Gibson, Jacqueline MacDonald; Shih, Regina A; Geschwind, Sandra; Olmstead, Sarah; Hu, Jianhui; Curtright, Aimee E; Cecchine, Gary; Moore, Melinda

    2010-12-01

    This article presents the results of a comparative environmental risk-ranking exercise that was conducted in the United Arab Emirates (UAE) to inform a strategic planning process led by the Environment Agency-Abu Dhabi (EAD). It represents the first national-level application of a deliberative method for comparative risk ranking first published in this journal. The deliberative method involves a five-stage process that includes quantitative risk assessment by experts and deliberations by groups of stakeholders. The project reported in this article considered 14 categories of environmental risks to health identified through discussions with EAD staff: ambient and indoor air pollution; drinking water contamination; coastal water pollution; soil and groundwater contamination; contamination of fruits, vegetables, and seafood; ambient noise; stratospheric ozone depletion; electromagnetic fields from power lines; health impacts from climate change; and exposure to hazardous substances in industrial, construction, and agricultural work environments. Results from workshops involving 73 stakeholders who met in five separate groups to rank these risks individually and collaboratively indicated strong consensus that outdoor and indoor air pollution are the highest priorities in the UAE. Each of the five groups rated these as being among the highest risks. All groups rated soil and groundwater contamination as being among the lowest risks. In surveys administered after the ranking exercises, participants indicated that the results of the process represented their concerns and approved of using the ranking results to inform policy decisions. The results ultimately shaped a strategic plan that is now being implemented.

  20. Towards more accurate life cycle risk management through integration of DDP and PRA

    NASA Technical Reports Server (NTRS)

    Cornford, Steven L.; Paulos, Todd; Meshkat, Leila; Feather, Martin

    2003-01-01

    The focus of this paper is on the integration of PRA and DDP. The intent is twofold: to extend risk-based decision though more of the lifecycle, and to lead to improved risk modeling (hence better informed decision making) wherever it is applied, most especially in the early phases as designs begin to mature.

  1. Critical Thinking for Environmental Health Risk Education.

    ERIC Educational Resources Information Center

    Gregory, Robin

    1991-01-01

    Proposes an approach for helping school-age children to think critically about environmental health risks. Discusses elements of a school curriculum--defining a decision perspective, making choices under uncertainty, and thinking about consequences--and recommends classroom implementation procedures. (Author/JOW)

  2. Evaluating Potential Health Risks in Relocatable Classrooms.

    ERIC Educational Resources Information Center

    Katchen, Mark; LaPierre, Adrienne; Charlin, Cary; Brucker, Barry; Ferguson, Paul

    2001-01-01

    Only limited data exist describing potential exposures to chemical and biological agents when using portable classrooms or outlining how to assess and reduce associated health risks. Evaluating indoor air quality involves examining ventilating rates, volatile organic compounds, and microbiologicals. Open communication among key stakeholders is…

  3. [Environment and child health: from health transition to shared risk?].

    PubMed

    Revault, P; Monjour, L

    2003-01-01

    Children under the age of 18 account for almost half of the world's population, with most living in developing countries. Young people are especially sensitive to acute and chronic environmental conditions and 43% of environmental diseases occur in the 12% of the world's population under age 5. The main environmental threats to the health of children in developing countries are inadequate access to clean water for drinking and hygiene, exposure to air pollution: primarily indoors and secondarily outdoors, risk of accidents and wounds, and poisoning due to toxic products. Recent data suggest that the number and diversity of environmental risk factors affecting child health is increasing as a result of increasing malnutrition, pollution, and violence and consequently that the level of health and quality of life of future generations will decrease. Due to the complexity of the interactions between environmental factors and socio-economic determinants, the epidemiological transition model is poorly suited to analyzing and predicting the concurring risks of infectious disease and chronic disease (diabetes, cancer...). This article presents a number of recommendations for training health professional, developing environmental reference centers, implementing risk assessment, coordinating decentralized activities and policy, and involving parents and children in the decisional process with emphasis on divulgating study findings and developing interfaces between the various stakeholders.

  4. Health risks of photovoltaic energy technologies

    NASA Astrophysics Data System (ADS)

    Moskowitz, P. D.; Hamilton, L. D.; Morris, S. C.; Novak, K. M.; Robinson, C. V.; Rowe, M. D.

    1981-12-01

    Health risks of photovoltaic energy technologies arise from mining, processing and refining of raw materials, and fabrication, installation, operation, and disposal of devices used to convert sunlight into useful energy. Using an accounting approach, public and occupational health risks are examined for four different photovoltaic cell alternatives: silicon single-crystal cells produced by an ingot process; silicon metal/insulator/semiconductor cells produced by ribbon growing; cadmium sulfide backwall cells produced by spray deposition; and gallium arsenide cells produced by modified ingot-growing. These alternatives cover a range of manufacturing options (e.g., ingot versus spray deposition) and materials (silicon versus arsenic) which might be used in future commercialization efforts. Most occupational mortality and morbidity effects probably relate to industrial risks similar to those encountered in the day-to-day operation of any industrial operation. Material supply, installation, and operation appear to contribute substantial portions of the damage.

  5. Emerging Radiation Health-Risk Mitigation Technologies

    NASA Astrophysics Data System (ADS)

    Wilson, J. W.; Cucinotta, F. A.; Schimmerling, W.

    2004-02-01

    Past space missions beyond the confines of the Earth's protective magnetic field have been of short duration and protection from the effects of solar particle events was of primary concern. The extension of operational infrastructure beyond low-Earth orbit to enable routine access to more interesting regions of space will require protection from the hazards of the accumulated exposures of Galactic Cosmic Rays (GCR). There are significant challenges in providing protection from the long-duration exposure to GCR: the human risks to the exposures are highly uncertain and safety requirements places unreasonable demands in supplying sufficient shielding materials in the design. A vigorous approach to future radiation health-risk mitigation requires a triage of techniques (using biological and technical factors) and reduction of the uncertainty in radiation risk models. The present paper discusses the triage of factors for risk mitigation with associated materials issues and engineering design methods.

  6. Emerging Radiation Health-Risk Mitigation Technologies

    SciTech Connect

    Wilson, J.W.; Cucinotta, F.A.; Schimmerling, W.

    2004-02-04

    Past space missions beyond the confines of the Earth's protective magnetic field have been of short duration and protection from the effects of solar particle events was of primary concern. The extension of operational infrastructure beyond low-Earth orbit to enable routine access to more interesting regions of space will require protection from the hazards of the accumulated exposures of Galactic Cosmic Rays (GCR). There are significant challenges in providing protection from the long-duration exposure to GCR: the human risks to the exposures are highly uncertain and safety requirements places unreasonable demands in supplying sufficient shielding materials in the design. A vigorous approach to future radiation health-risk mitigation requires a triage of techniques (using biological and technical factors) and reduction of the uncertainty in radiation risk models. The present paper discusses the triage of factors for risk mitigation with associated materials issues and engineering design methods.

  7. Risk Analysis for Environmental Health Triage

    SciTech Connect

    Bogen, K T

    2005-11-18

    The Homeland Security Act mandates development of a national, risk-based system to support planning for, response to and recovery from emergency situations involving large-scale toxic exposures. To prepare for and manage consequences effectively, planners and responders need not only to identify zones of potentially elevated individual risk, but also to predict expected casualties. Emergency response support systems now define ''consequences'' by mapping areas in which toxic chemical concentrations do or may exceed Acute Exposure Guideline Levels (AEGLs) or similar guidelines. However, because AEGLs do not estimate expected risks, current unqualified claims that such maps support consequence management are misleading. Intentionally protective, AEGLs incorporate various safety/uncertainty factors depending on scope and quality of chemical-specific toxicity data. Some of these factors are irrelevant, and others need to be modified, whenever resource constraints or exposure-scenario complexities require responders to make critical trade-off (triage) decisions in order to minimize expected casualties. AEGL-exceedance zones cannot consistently be aggregated, compared, or used to calculate expected casualties, and so may seriously misguide emergency response triage decisions. Methods and tools well established and readily available to support environmental health protection are not yet developed for chemically related environmental health triage. Effective triage decisions involving chemical risks require a new assessment approach that focuses on best estimates of likely casualties, rather than on upper plausible bounds of individual risk. If risk-based consequence management is to become a reality, federal agencies tasked with supporting emergency response must actively coordinate to foster new methods that can support effective environmental health triage.

  8. Accurately Predicting Future Reading Difficulty for Bilingual Latino Children at Risk for Language Impairment

    ERIC Educational Resources Information Center

    Petersen, Douglas B.; Gillam, Ronald B.

    2013-01-01

    Sixty-three bilingual Latino children who were at risk for language impairment were administered reading-related measures in English and Spanish (letter identification, phonological awareness, rapid automatized naming, and sentence repetition) and descriptive measures including English language proficiency (ELP), language ability (LA),…

  9. Women brothel workers and occupational health risks

    PubMed Central

    Cwikel, J; Ilan, K; Chudakov, B

    2003-01-01

    Study objectives: This study examined working conditions, reported morbidity, symptoms of post-traumatic stress disorder (PTSD) and depression and their relation to an index of occupational health risk among women working in brothels in Israel. Design: Personal structured interviews with a scale of occupational risk that included seven self report items reflecting past and present morbidity and symptoms. Participants and setting: A purposive sample of 55 women in three cities in Israel, between the ages of 18–38. Main results: Most (82%) women were trafficked into Israel to work illegally in prostitution, effectively deriving them of access to discretionary health care. A third of the sample (32%) had a high score (between 3 to 6) on the index of occupational risk factors. A high score was not related to recent physician or gynaecological visits and was more common among illegal workers than those with residence status. A set of regression analyses showed that the most significant predictors of reporting a high level of occupational risk symptoms were starting sex work at an early age, the number of hours worked in a day, a history of suicide attempts and PTSD symptoms. Conclusions: High occupational risk was found to be unrelated to recent physician or gynaecological visits, indicating that these visits were most probably controlled by the brothel owners and not by medical need as perceived by the women themselves. Furthermore, occupational risk factors were associated with some of the working and background conditions reported by women brothel workers. There is an urgent need for medical care for this high risk group. PMID:14573588

  10. Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Sex

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2011

    2011-01-01

    The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

  11. TIMP2•IGFBP7 biomarker panel accurately predicts acute kidney injury in high-risk surgical patients

    PubMed Central

    Gunnerson, Kyle J.; Shaw, Andrew D.; Chawla, Lakhmir S.; Bihorac, Azra; Al-Khafaji, Ali; Kashani, Kianoush; Lissauer, Matthew; Shi, Jing; Walker, Michael G.; Kellum, John A.

    2016-01-01

    BACKGROUND Acute kidney injury (AKI) is an important complication in surgical patients. Existing biomarkers and clinical prediction models underestimate the risk for developing AKI. We recently reported data from two trials of 728 and 408 critically ill adult patients in whom urinary TIMP2•IGFBP7 (NephroCheck, Astute Medical) was used to identify patients at risk of developing AKI. Here we report a preplanned analysis of surgical patients from both trials to assess whether urinary tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor–binding protein 7 (IGFBP7) accurately identify surgical patients at risk of developing AKI. STUDY DESIGN We enrolled adult surgical patients at risk for AKI who were admitted to one of 39 intensive care units across Europe and North America. The primary end point was moderate-severe AKI (equivalent to KDIGO [Kidney Disease Improving Global Outcomes] stages 2–3) within 12 hours of enrollment. Biomarker performance was assessed using the area under the receiver operating characteristic curve, integrated discrimination improvement, and category-free net reclassification improvement. RESULTS A total of 375 patients were included in the final analysis of whom 35 (9%) developed moderate-severe AKI within 12 hours. The area under the receiver operating characteristic curve for [TIMP-2]•[IGFBP7] alone was 0.84 (95% confidence interval, 0.76–0.90; p < 0.0001). Biomarker performance was robust in sensitivity analysis across predefined subgroups (urgency and type of surgery). CONCLUSION For postoperative surgical intensive care unit patients, a single urinary TIMP2•IGFBP7 test accurately identified patients at risk for developing AKI within the ensuing 12 hours and its inclusion in clinical risk prediction models significantly enhances their performance. LEVEL OF EVIDENCE Prognostic study, level I. PMID:26816218

  12. An assessment of health hazard/health risk appraisal.

    PubMed Central

    Wagner, E H; Beery, W L; Schoenbach, V J; Graham, R M

    1982-01-01

    A state-of-the-art review of a widely-used health promotion technique, the health hazard/health risk appraisal (HHA/HRA), was conducted. The review included preparing a 212-item annotated bibliography, compiling an inventory of 217 programs that have used HHA/HRA, holding discussions with HHA/HRA developers and users, conducting formal site visits to 15 HHA/HRA programs, and consultation with experts on epidemiology, biostatistics, and behavioral science as well as developers and users of HHA/HRA. Programs use HHA/HRA primarily as a promotional device, as a tool for structuring education about health-related behaviors, and as a motivational device for stimulating behavioral change. The scientific basis for HHA/HRA risk predictions is problematic, but their arithmetic imprecision is of less concern than insufficiency of the scientific evidence for certain behavioral recommendations, and inaccuracies in client-supplied data. Widely-held beliefs in HHA/HRA's efficacy for motivating behavioral change cannot be substantiated from available evidence, nor can the assumed absence of adverse effects. The importance of this particular health promotion technique appears to have been exaggerated. PMID:7065313

  13. Adolescent cigarette smoking and health risk behavior.

    PubMed

    Busen, N H; Modeland, V; Kouzekanani, K

    2001-06-01

    During the past 30 years, tobacco use among adolescents has substantially increased, resulting in major health problems associated with tobacco consumption. The purpose of this study was to identify adolescent smoking behaviors and to determine the relationship among smoking, specific demographic variables, and health risk behaviors. The sample consisted of 93 self-selecting adolescents. An ex post facto design was used for this study and data were analyzed by using nonparametric statistics. Findings included a statistically significant relationship between lifetime cigarette use and ethnicity. Statistically significant relationships were also found among current cigarette use and ethnicity, alcohol use, marijuana use, suicidal thoughts, and age at first sexual intercourse. Nurses and other providers must recognize that cigarette smoking may indicate other risk behaviors common among adolescents.

  14. Risk factors, health risks, and risk management for aircraft personnel and frequent flyers.

    PubMed

    Kim, Jeoum Nam; Lee, Byung Mu

    2007-01-01

    Health risks associated with long periods of time in flight are of concern to astronauts, crew members, and passengers. Many epidemiological studies showed that occupational and frequent flyers may be susceptible to ocular, cardiovascular, neurological, pulmonary, gastrointestinal, sensory, immunological, physiological, and even developmental disorders. In addition, the incidences of cancer and food poisoning are expected to be higher in such individuals. This article reviews health risks and risk factors associated with air travel, and discusses risk management strategies. To reduce adverse health risks, risk factors such as radiation, infection, stress, temperature, pressure, and circadian rhythm need to be avoided or reduced to levels that are as low as technologically achievable to protect flight personnel and passengers.

  15. Risk factors, health risks, and risk management for aircraft personnel and frequent flyers.

    PubMed

    Kim, Jeoum Nam; Lee, Byung Mu

    2007-01-01

    Health risks associated with long periods of time in flight are of concern to astronauts, crew members, and passengers. Many epidemiological studies showed that occupational and frequent flyers may be susceptible to ocular, cardiovascular, neurological, pulmonary, gastrointestinal, sensory, immunological, physiological, and even developmental disorders. In addition, the incidences of cancer and food poisoning are expected to be higher in such individuals. This article reviews health risks and risk factors associated with air travel, and discusses risk management strategies. To reduce adverse health risks, risk factors such as radiation, infection, stress, temperature, pressure, and circadian rhythm need to be avoided or reduced to levels that are as low as technologically achievable to protect flight personnel and passengers. PMID:17454553

  16. Environmental and health risk studies at HHWCFs

    SciTech Connect

    Kehoe, C.

    1995-09-01

    Sanitary Fill Company is proposing to expand San Francisco`s household hazardous waste facility. This paper describes our proposal and discusses the environmental review and public involvement processes that are now required. Planning this expansion has been long and expensive. To my knowledge we are among the first programs to conduct a detailed study of the potential health risks associated with household facilities. I will present a summary of our planning process and compare the process to the outcome.

  17. Predicting Stroke Risk Based on Health Behaviours: Development of the Stroke Population Risk Tool (SPoRT)

    PubMed Central

    Manuel, Douglas G.; Tuna, Meltem; Perez, Richard; Tanuseputro, Peter; Hennessy, Deirdre; Bennett, Carol; Rosella, Laura; Sanmartin, Claudia; van Walraven, Carl; Tu, Jack V.

    2015-01-01

    Background Health behaviours, important factors in cardiovascular disease, are increasingly a focus of prevention. We appraised whether stroke risk can be accurately assessed using self-reported information focused on health behaviours. Methods Behavioural, sociodemographic and other risk factors were assessed in a population-based survey of 82 259 Ontarians who were followed for a median of 8.6 years (688 000 person-years follow-up) starting in 2001. Predictive algorithms for 5-year incident stroke resulting in hospitalization were created and then validated in a similar 2007 survey of 28 605 respondents (median 4.2 years follow-up). Results We observed 3 236 incident stroke events (1 551 resulting in hospitalization; 1 685 in the community setting without hospital admission). The final algorithms were discriminating (C-stat: 0.85, men; 0.87, women) and well-calibrated (in 65 of 67 subgroups for men; 61 of 65 for women). An index was developed to summarize cumulative relative risk of incident stroke from health behaviours and stress. For men, each point on the index corresponded to a 12% relative risk increase (180% risk difference, lowest (0) to highest (9) scores). For women, each point corresponded to a 14% relative risk increase (340% difference, lowest (0) to highest (11) scores). Algorithms for secondary stroke outcomes (stroke resulting in death; classified as ischemic; excluding transient ischemic attack; and in the community setting) had similar health behaviour risk hazards. Conclusion Incident stroke can be accurately predicted using self-reported information focused on health behaviours. Risk assessment can be performed with population health surveys to support population health planning or outside of clinical settings to support patient-focused prevention. PMID:26637172

  18. Oil shale health and environmental risk analysis

    SciTech Connect

    Gratt, L.B.

    1983-04-01

    The potential human health and environmental risks of hypothetical one-million-barrels-per-day oil shale industry have been analyzed to serve as an aid in the formulation and management of a program of environmental research. The largest uncertainties for expected fatalities are in the public sector from air pollutants although the occupational sector is estimated to have 60% more expected fatalities than the public sector. Occupational safety and illness have been analyzed for the oil shale fuel cycle from extraction to delivery of products for end use. Pneumoconiosis from the dust environment is the worker disease resulting in the greatest number of fatalities, followed by chronic bronchitis, internal cancer, and skin cancers, respectively. Research recommendations are presented for reducing the uncertainties in the risks analyzed and to fill data gaps to estimate other risks.

  19. Accurate Risk Assessment of Patients with Asymptomatic Hematuria for the Presence of Bladder Cancer

    PubMed Central

    Cha, Eugene K.; Tirsar, Lenuta-Ancuta; Schwentner, Christian; Hennenlotter, Joerg; Christos, Paul J.; Stenzl, Arnulf; Mian, Christine; Martini, Thomas; Pycha, Armin; Shariat, Shahrokh F.; Schmitz-Dräger, Bernd J.

    2014-01-01

    Purpose Bladder cancer is frequently diagnosed during a workup for hematuria. However, most patients with microscopic hematuria and many with gross hematuria are not appropriately referred to urologists. We hypothesized that in patients presenting with asymptomatic hematuria, the risk of having bladder cancer can be predicted with high accuracy. Towards this end, we analyzed risk factors in patients with asymptomatic hematuria and developed a nomogram for the prediction of bladder cancer presence. Methods Data from 1,182 consecutive subjects without a history of bladder cancer undergoing initial evaluation for asymptomatic hematuria were collected at three centers. Clinical risk factors including age, gender, smoking status, and degree of hematuria were recorded. All subjects underwent standard workup including voided cytology, upper tract imaging, and cystourethroscopy. Factors associated with the presence of bladder cancer were evaluated by univariable and multivariable logistic regression analyses. The multivariable analysis was used to construct a nomogram. Internal validation was performed using 200 bootstrap samples. Results Of the 1,182 subjects who presented with asymptomatic hematuria, 245 (20.7%) had bladder cancer. Increasing age (OR=1.03, p<0.0001), smoking history (OR=3.72, p<0.0001), gross hematuria (OR=1.71, p=0.002), and positive cytology (OR=14.71, p<0.0001) were independent predictors of bladder cancer presence. The multivariable model achieved 83.1% accuracy for predicting the presence of bladder cancer. Conclusions Bladder cancer presence can be predicted with high accuracy in patients who present with asymptomatic hematuria. We developed a nomogram to help optimize referral patterns (i.e., timing and prioritization) of patients with asymptomatic hematuria. PMID:23124847

  20. A toolbox for health risk related decisions

    SciTech Connect

    Easterly, C.E.; Jones, T.D.

    1996-10-01

    Development efforts since the late 1970s have resulted in a generalized method for ranking health hazards. This method provides the basis for a wide range of applications where decisions are needed for allocating resources on the basis of health risk considerations. It has been used for more than a decade to solve real problems, and it is supported by 23 publications in the open literature. The diversity of this generalized methodology allows us to provide support in a great number of problem areas. we give four examples in this manuscript: the relative toxicities of petroleum mixtures; a method to derive Emergency Response Planning Guides; an estimate of the possible carcinogenic potency of tungsten, an alternative material to depleted uranium for heavy armor penetrators; and an approach to low dose extrapolation. Our experience suggests that many more applications of the original concept and variations on it can be of utility in military situations. Some potentially fruitful areas may be in the: development of a health-risk-ranking system for alternative solutions to manufacturing, waste management, and remediation; provision of a basis for identifying levels of hazardous agents which are below health concerns, or which should be of concern; development of a framework for evaluating chemicals and radioactive materials on the same basis, and in the development of a battery of in vitro bioassays which could take the place of long-term whole animal tests.

  1. Excessive Alcohol Use and Risks to Women's Health

    MedlinePlus

    ... Spectrum Disorders (FASDs) Impaired Driving Fact Sheets - Excessive Alcohol Use and Risks to Women's Health Recommend on Facebook Tweet Share Compartir Excessive Alcohol Use and Risks to Women’s Health Although men ...

  2. Excessive Alcohol Use and Risks to Men's Health

    MedlinePlus

    ... Spectrum Disorders (FASDs) Impaired Driving Fact Sheets - Excessive Alcohol Use and Risks to Men's Health Recommend on Facebook Tweet Share Compartir Excessive Alcohol Use and Risks to Men's Health Men are ...

  3. Implementing health information exchange for public health reporting: a comparison of decision and risk management of three regional health information organizations in New York state.

    PubMed

    Phillips, Andrew B; Wilson, Rosalind V; Kaushal, Rainu; Merrill, Jacqueline A

    2014-02-01

    Health information exchange (HIE) is a significant component of healthcare transformation strategies at both the state and national levels. HIE is expected to improve care coordination, and advance public health, but implementation is massively complex and involves significant risk. In New York, three regional health information organizations (RHIOs) implemented an HIE use case for public health reporting by demonstrating capability to deliver accurate responses to electronic queries via a set of services called the Universal Public Health Node. We investigated process and outcomes of the implementation with a comparative case study. Qualitative analysis was structured around a decision and risk matrix. Although each RHIO had a unique operational model, two common factors influenced risk management and implementation success: leadership capable of agile decision-making and commitment to a strong organizational vision. While all three RHIOs achieved certification for the public health reporting, only one has elected to deploy a production version.

  4. Global climate changes, natural disasters, and travel health risks.

    PubMed

    Diaz, James H

    2006-01-01

    Whether the result of cyclical atmospheric changes, anthropogenic activities, or combinations of both, authorities now agree that the earth is warming from a variety of climatic effects, including the cascading effects of greenhouse gas emissions to support human activities. To date, most reports of the public health outcomes of global warming have been anecdotal and retrospective in design and have focused on heat stroke deaths following heat waves, drowning deaths in floods and tsunamis, and mosquito-borne infectious disease outbreaks following tropical storms and cyclones. Accurate predictions of the true public health outcomes of global climate change are confounded by several effect modifiers including human acclimatization and adaptation, the contributions of natural climatic changes, and many conflicting atmospheric models of climate change. Nevertheless, temporal relationships between environmental factors and human health outcomes have been identified and may be used as criteria to judge the causality of associations between the human health outcomes of climate changes and climate-driven natural disasters. Travel medicine physicians are obligated to educate their patients about the known public health outcomes of climate changes, about the disease and injury risk factors their patients may face from climate-spawned natural disasters, and about the best preventive measures to reduce infectious diseases and injuries following natural disasters throughout the world. PMID:17107430

  5. Global climate changes, natural disasters, and travel health risks.

    PubMed

    Diaz, James H

    2006-01-01

    Whether the result of cyclical atmospheric changes, anthropogenic activities, or combinations of both, authorities now agree that the earth is warming from a variety of climatic effects, including the cascading effects of greenhouse gas emissions to support human activities. To date, most reports of the public health outcomes of global warming have been anecdotal and retrospective in design and have focused on heat stroke deaths following heat waves, drowning deaths in floods and tsunamis, and mosquito-borne infectious disease outbreaks following tropical storms and cyclones. Accurate predictions of the true public health outcomes of global climate change are confounded by several effect modifiers including human acclimatization and adaptation, the contributions of natural climatic changes, and many conflicting atmospheric models of climate change. Nevertheless, temporal relationships between environmental factors and human health outcomes have been identified and may be used as criteria to judge the causality of associations between the human health outcomes of climate changes and climate-driven natural disasters. Travel medicine physicians are obligated to educate their patients about the known public health outcomes of climate changes, about the disease and injury risk factors their patients may face from climate-spawned natural disasters, and about the best preventive measures to reduce infectious diseases and injuries following natural disasters throughout the world.

  6. A rapid, economical, and accurate method to determining the physical risk of storm marine inundations using sedimentary evidence

    NASA Astrophysics Data System (ADS)

    Nott, Jonathan F.

    2015-04-01

    The majority of physical risk assessments from storm surge inundations are derived from synthetic time series generated from short climate records, which can often result in inaccuracies and are time-consuming and expensive to develop. A new method is presented here for the wet tropics region of northeast Australia. It uses lidar-generated topographic cross sections of beach ridge plains, which have been demonstrated to be deposited by marine inundations generated by tropical cyclones. Extreme value theory statistics are applied to data derived from the cross sections to generate return period plots for a given location. The results suggest that previous methods to estimate return periods using synthetic data sets have underestimated the magnitude/frequency relationship by at least an order of magnitude. The new method promises to be a more rapid, economical, and accurate assessment of the physical risk of these events.

  7. Energy production and the risk to human health and life

    SciTech Connect

    Hamilton, L.D.

    1981-01-01

    Current issues in health-risk assessment of energy production and factors in developing countries affecting risk analysis are discussed. Information is presented on the relative risks of coal and nuclear fuel cycles. (JGB)

  8. Human Health Risks of Engineered Nanomaterials

    NASA Astrophysics Data System (ADS)

    Elder, A.; Lynch, I.; Grieger, K.; Chan-Remillard, S.; Gatti, A.; Gnewuch, H.; Kenawy, E.; Korenstein, R.; Kuhlbusch, T.; Linker, F.; Matias, S.; Monteiro-Riviere, N.; Pinto, V. R. S.; Rudnitsky, R.; Savolainen, K.; Shvedova, A.

    There are currently hundreds of available consumer products that contain nanoscale materials. Human exposure is, therefore, likely to occur in occupational and environmental settings. Mounting evidence suggests that some nanomaterials exert toxicity in cultured cells or following in vivo exposures, but this is dependent on the physicochemical characteristics of the materials and the dose. This Working Group report summarizes the discussions of an expert scientific panel regarding the gaps in knowledge that impede effective human health risk assessment for nanomaterials, particularly those that are suspended in a gas or liquid and, thus, deposit on skin or in the respiratory tract. In addition to extensive descriptions of material properties, the Group identified as critical research areas: external and internal dose characterization, mechanisms of response, identification of sensitive subpopulations, and the development of screening strategies and technology to support these investigations. Important concepts in defining health risk are reviewed, as are the specific kinds of studies that will quickly reduce the uncertainties in the risk assessment process.

  9. Health-risk behaviors in early adolescence.

    PubMed

    Rew, Lynn; Horner, Sharon D; Brown, Adama

    2011-01-01

    The major morbidities and mortalities of adolescents are related to preventable risky behaviors, but how, when, and in whom these behaviors develop in early adolescence is unknown. The purpose of this study was to determine which set of risk factors and protective resources of school-age children were best predictors of health-risk behaviors in early adolescence. A longitudinal, cohort sequential design was used with a diverse sample of 1,934 children in grades 4 through 8. Parents provided demographic and neighborhood data for children through a mailed survey. Children completed valid scales annually at schools, using audio-computer-assisted self-interviewing (A-CASI) technology. Significant gender and racial/ethnic differences were found in carrying a weapon and using alcohol. Higher perceived levels of stress increased the risk for alcohol use as did riding in a car with a driver who was drinking. Health behaviors exhibited while in 4th through 6th grades protected early adolescents from alcohol use and riding in a car with a driver who was drinking. A parent's education and perceived safety in neighborhood protected against carrying a weapon and smoking. Many findings are similar to those of national samples, but others show positive differences in this localized sample, over 50% of whom were Latino. Protective resources suggest numerous nursing interventions to promote healthy adolescent development.

  10. Secure e-Health: managing risks to patient health data.

    PubMed

    Kluge, Eike-Henner W

    2007-01-01

    e-Health, as an inter-jurisdictional enterprise, presents risks to patient health data that involve not only technology and professional protocols but also laws, regulations and professional security cultures. The USA Patriot Act is one example of how national laws can shape these concerns. Secure e-Health therefore requires not only national standardization of professional education and protocols but also global interoperability of regulations and laws. Some progress in this regard has been made in the European context; however, even here developments are incomplete, and nothing similar has been accomplished on a global scale. Professional health information organizations must take the lead in developing appropriate high-level principles for professional certification and security protocols and in harmonizing these on a global basis, so that they can provide a firm and consistent foundation for international treaties. Such developments should occur in concert with other health professions, so that coordinated requirements are integrated into revisions of the relevant codes of ethics. This presentation identifies and addresses some of the ethical and legal issues and proposes a series of recommendations.

  11. Foster Kids Face Higher Risk of Health Problems

    MedlinePlus

    ... foster care face increased risks of physical and mental health issues, from asthma to ADHD to depression, a new ... or federal policy. More Health News on: Child Mental Health Children's Health Family Issues Recent Health News Related MedlinePlus Health Topics Child ...

  12. The Minimization of Public Health Risks in Newspapers after Hurricane Katrina

    PubMed Central

    Cohen, Elisia L.; Vijaykumar, Santosh; Wray, Ricardo; Karamehic, Ajlina

    2009-01-01

    During natural disasters, mass media facilitate the timely provision of accurate information about health risks to the public. This study informs our understanding of such public health discourse utilizing content-analysis of 235 newspaper articles in four major metropolitan newspapers published in the five weeks after Hurricane Katrina hit the Gulf coast in August 2005. These data reveal a small and diminishing number of articles included public health information over time, detailed the hurricane impact on affected communities, and used reliable health sources. The implications for future research from a public health and media relations perspective are discussed. PMID:20011666

  13. [Health risks in the biotechnological industry].

    PubMed

    Colombi, A; Maroni, M; Foà, V

    1989-01-01

    Biotechnology has been defined as the application of biological organisms, systems or processes to manufacturing and service industries. In considering health aspects of biotechnological development it must be underlined that the use of microorganisms in traditional industries, such as the production of food, bread, beer and dairy products, has not added significantly to the more usual industrial hazards. The risk factors encountered in the biotechnology industry can be defined as general, i.e., common to other industrial activities, and specific, i.e., depending on the presence of microorganisms and/or their metabolic products. The specific health risks vary according to the type of process, but can be grouped into three main categories: immunological diseases, toxic effects; pathological effects of microorganisms. Allergic immunological diseases such as bronchial asthma, contact dermatitis, oculo-rhinitis and extrinsic allergic alveolitis are by far the most frequent and well known diseases occurring among workers employed on biotechnological production. Toxic effects were observed among workers employed on the production of antibiotics and hormones or single cell proteins, where absorption of endotoxins has been described. Infectious diseases may arise from uncontrolled dissemination of pathogenic microorganisms through aerosols, dusts, aqueous and semisolid sludge effluents from biotechnological plants. The greatest risks occur in the production of antiviral vaccines, in research laboratories and in waste-water treatment plants. Risk of pathogenic effects has also been speculated from exposure to engineered microorganisms in laboratory and environmental or agricultural applications. Safety precautions consisting of protective measures, and effective barriers of containment (both physical and biological) have to be advised according to the hazardous characteristics of the organisms.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. The Neural Correlates of Health Risk Perception in Individuals with Low and High Numeracy

    ERIC Educational Resources Information Center

    Vogel, Stephan E.; Keller, Carmen; Koschutnig, Karl; Reishofer, Gernot; Ebner, Franz; Dohle, Simone; Siegrist, Michael; Grabner, Roland H.

    2016-01-01

    The ability to use numerical information in different contexts is a major goal of mathematics education. In health risk communication, outcomes of a medical condition are frequently expressed in probabilities. Difficulties to accurately represent probability information can result in unfavourable medical decisions. To support individuals with…

  15. Cyanobacterial toxins: risk management for health protection.

    PubMed

    Codd, Geoffrey A; Morrison, Louise F; Metcalf, James S

    2005-03-15

    This paper reviews the occurrence and properties of cyanobacterial toxins, with reference to the recognition and management of the human health risks which they may present. Mass populations of toxin-producing cyanobacteria in natural and controlled waterbodies include blooms and scums of planktonic species, and mats and biofilms of benthic species. Toxic cyanobacterial populations have been reported in freshwaters in over 45 countries, and in numerous brackish, coastal, and marine environments. The principal toxigenic genera are listed. Known sources of the families of cyanobacterial toxins (hepato-, neuro-, and cytotoxins, irritants, and gastrointestinal toxins) are briefly discussed. Key procedures in the risk management of cyanobacterial toxins and cells are reviewed, including derivations (where sufficient data are available) of tolerable daily intakes (TDIs) and guideline values (GVs) with reference to the toxins in drinking water, and guideline levels for toxigenic cyanobacteria in bathing waters. Uncertainties and some gaps in knowledge are also discussed, including the importance of exposure media (animal and plant foods), in addition to potable and recreational waters. Finally, we present an outline of steps to develop and implement risk management strategies for cyanobacterial cells and toxins in waterbodies, with recent applications and the integration of Hazard Assessment Critical Control Point (HACCP) principles. PMID:15737680

  16. Cyanobacterial toxins: risk management for health protection

    SciTech Connect

    Codd, Geoffrey A.; Morrison, Louise F.; Metcalf, James S

    2005-03-15

    This paper reviews the occurrence and properties of cyanobacterial toxins, with reference to the recognition and management of the human health risks which they may present. Mass populations of toxin-producing cyanobacteria in natural and controlled waterbodies include blooms and scums of planktonic species, and mats and biofilms of benthic species. Toxic cyanobacterial populations have been reported in freshwaters in over 45 countries, and in numerous brackish, coastal, and marine environments. The principal toxigenic genera are listed. Known sources of the families of cyanobacterial toxins (hepato-, neuro-, and cytotoxins, irritants, and gastrointestinal toxins) are briefly discussed. Key procedures in the risk management of cyanobacterial toxins and cells are reviewed, including derivations (where sufficient data are available) of tolerable daily intakes (TDIs) and guideline values (GVs) with reference to the toxins in drinking water, and guideline levels for toxigenic cyanobacteria in bathing waters. Uncertainties and some gaps in knowledge are also discussed, including the importance of exposure media (animal and plant foods), in addition to potable and recreational waters. Finally, we present an outline of steps to develop and implement risk management strategies for cyanobacterial cells and toxins in waterbodies, with recent applications and the integration of Hazard Assessment Critical Control Point (HACCP) principles.

  17. Brownfields and health risks--air dispersion modeling and health risk assessment at landfill redevelopment sites.

    PubMed

    Ofungwu, Joseph; Eget, Steven

    2006-07-01

    Redevelopment of landfill sites in the New Jersey-New York metropolitan area for recreational (golf courses), commercial, and even residential purposes seems to be gaining acceptance among municipal planners and developers. Landfill gas generation, which includes methane and potentially toxic nonmethane compounds usually continues long after closure of the landfill exercise phase. It is therefore prudent to evaluate potential health risks associated with exposure to gas emissions before redevelopment of the landfill sites as recreational, commercial, and, especially, residential properties. Unacceptably high health risks would call for risk management measures such as limiting the development to commercial/recreational rather than residential uses, stringent gas control mechanisms, interior air filtration, etc. A methodology is presented for applying existing models to estimate residual landfill hazardous compounds emissions and to quantify associated health risks. Besides the toxic gas constituents of landfill emissions, other risk-related issues concerning buried waste, landfill leachate, and explosive gases were qualitatively evaluated. Five contiguously located landfill sites in New Jersey intended for residential and recreational redevelopment were used to exemplify the approach.

  18. [Mass gatherings - health risks and preventive strategies].

    PubMed

    Steffen, Robert

    2013-06-01

    Experience from mass gatherings - usually attended by at least 25'000 persons - shows that approximately one in a thousand participants will consult with an on-site medical emergency service. Communicable diseases usually play a minor role. Historically outbreaks of meningococcal disease were recorded after the hajj, but this has been well controlled in the past few years subsequent to vaccinations and other measures required by the Kingdom of Saudi Arabia health authorities. Major stress of the regional public health system is associated with accidents and non-communicable diseases, the majority being trivial. Host and environmental risk factors can result in a dramatic increase in the rate of consultations: Age and pre-existing illness play a decisive role particularly in pilgrims, be that in Mecca or Lourdes. Emotional factors may influence behavior; aggressions can develop. Alcohol and drugs, also the duration of an event may play a decisive role. Extreme climatic conditions, both heat and cold, also exhaustion result in a dramatic increase of emergency consultations. Infrastructure must be adapted for the crowd size, particularly stampede associated disasters can be avoided. The World Health Organization and other interested expert groups have in the past few years formulated interdisciplinary programs for prevention.

  19. Occupational Health Promotion Programs to Reduce Cardiovascular Risk.

    ERIC Educational Resources Information Center

    Glasgow, Russell E.; Terborg, James R.

    1988-01-01

    Surveys literature on worksite health promotion programs targeting cardiovascular risk factors. Reviews findings on health-risk appraisal, hypertension control, smoking cessation, weight reduction, exercise, and programs addressing multiple risk factors. Discusses current knowledge, highlights exemplary studies, and identifies problems and…

  20. Brain health and shared risk factors for dementia and stroke.

    PubMed

    Gardener, Hannah; Wright, Clinton B; Rundek, Tatjana; Sacco, Ralph L

    2015-11-01

    Impaired brain health encompasses a range of clinical outcomes, including stroke, dementia, vascular cognitive impairment, cognitive ageing, and vascular functional impairment. Conditions associated with poor brain health represent leading causes of global morbidity and mortality, with projected increases in public health burden as the population ages. Many vascular risk factors are shared predictors for poor brain health. Moreover, subclinical brain MRI markers of vascular damage are risk factors shared between stroke and dementia, and can be used for risk stratification and early intervention. The broad concept of brain health has resulted in a conceptual shift from vascular risk factors to determinants of brain health. Global campaigns to reduce cardiovascular diseases by targeting modifiable risk factors are necessary and will have a broad impact on brain health. Research is needed on the distinct and overlapping aetiologies of brain health conditions, and to define MRI markers to help clinicians identify patients who will benefit from aggressive prevention measures.

  1. Biomarkers: Dynamic "Tools" for Health and Safety Risk Assessment

    EPA Science Inventory

    Today informational flow from biomarkers contributes importantly to various types of health effects research, risk assessment and risk management decisions that impact, or have the potential to impact, public health and safety. Therefore, dependent upon the nature of the health r...

  2. The role of health-risk appraisals in disease management.

    PubMed

    Hudson, Laurel R; Pope, James E

    2006-02-01

    Managed care organizations and disease management vendors often find themselves in the position of responding to employers who want to administer a health-risk appraisal (HRA) without committing to implementation of a comprehensive health promotion program. The assumption appears to be that information on health risks is sufficient to motivate employees to change their health behaviors in order to reduce estimated health risks. A review of the relevant literature does not substantiate the efficacy of a stand-alone HRA for motivating behavior change. The challenge is to engage employers in informed conversations on what works in health promotion and achieve cost-effective benefits.

  3. PoopMD, a Mobile Health Application, Accurately Identifies Infant Acholic Stools

    PubMed Central

    Franciscovich, Amy; Vaidya, Dhananjay; Doyle, Joe; Bolinger, Josh; Capdevila, Montserrat; Rice, Marcus; Hancock, Leslie; Mahr, Tanya; Mogul, Douglas B.

    2015-01-01

    Biliary atresia (BA) is the leading cause of pediatric end-stage liver disease in the United States. Education of parents in the perinatal period with stool cards depicting acholic and normal stools has been associated with improved time-to-diagnosis and survival in BA. PoopMD is a mobile application that utilizes a smartphone’s camera and color recognition software to analyze an infant’s stool and determine if additional follow-up is indicated. PoopMD was developed using custom HTML5/CSS3 and wrapped to work on iOS and Android platforms. In order to define the gold standard regarding stool color, seven pediatricians were asked to review 45 photographs of infant stool and rate them as acholic, normal, or indeterminate. Samples for which 6+ pediatricians demonstrated agreement defined the gold standard, and only these samples were included in the analysis. Accuracy of PoopMD was assessed using an iPhone 5s with incandescent lighting. Variability in analysis of stool photographs as acholic versus normal with intermediate rating weighted as 50% agreement (kappa) was compared between three laypeople and one expert user. Variability in output was also assessed between an iPhone 5s and a Samsung Galaxy S4, as well as between incandescent lighting and compact fluorescent lighting. Six-plus pediatricians agreed on 27 normal and 7 acholic photographs; no photographs were defined as indeterminate. The sensitivity was 7/7 (100%). The specificity was 24/27 (89%) with 3/27 labeled as indeterminate; no photos of normal stool were labeled as acholic. The Laplace-smoothed positive likelihood ratio was 6.44 (95% CI 2.52 to 16.48) and the negative likelihood ratio was 0.13 (95% CI 0.02 to 0.83). kappauser was 0.68, kappaphone was 0.88, and kappalight was 0.81. Therefore, in this pilot study, PoopMD accurately differentiates acholic from normal color with substantial agreement across users, and almost perfect agreement across two popular smartphones and ambient light settings

  4. PoopMD, a Mobile Health Application, Accurately Identifies Infant Acholic Stools.

    PubMed

    Franciscovich, Amy; Vaidya, Dhananjay; Doyle, Joe; Bolinger, Josh; Capdevila, Montserrat; Rice, Marcus; Hancock, Leslie; Mahr, Tanya; Mogul, Douglas B

    2015-01-01

    Biliary atresia (BA) is the leading cause of pediatric end-stage liver disease in the United States. Education of parents in the perinatal period with stool cards depicting acholic and normal stools has been associated with improved time-to-diagnosis and survival in BA. PoopMD is a mobile application that utilizes a smartphone's camera and color recognition software to analyze an infant's stool and determine if additional follow-up is indicated. PoopMD was developed using custom HTML5/CSS3 and wrapped to work on iOS and Android platforms. In order to define the gold standard regarding stool color, seven pediatricians were asked to review 45 photographs of infant stool and rate them as acholic, normal, or indeterminate. Samples for which 6+ pediatricians demonstrated agreement defined the gold standard, and only these samples were included in the analysis. Accuracy of PoopMD was assessed using an iPhone 5s with incandescent lighting. Variability in analysis of stool photographs as acholic versus normal with intermediate rating weighted as 50% agreement (kappa) was compared between three laypeople and one expert user. Variability in output was also assessed between an iPhone 5s and a Samsung Galaxy S4, as well as between incandescent lighting and compact fluorescent lighting. Six-plus pediatricians agreed on 27 normal and 7 acholic photographs; no photographs were defined as indeterminate. The sensitivity was 7/7 (100%). The specificity was 24/27 (89%) with 3/27 labeled as indeterminate; no photos of normal stool were labeled as acholic. The Laplace-smoothed positive likelihood ratio was 6.44 (95% CI 2.52 to 16.48) and the negative likelihood ratio was 0.13 (95% CI 0.02 to 0.83). kappauser was 0.68, kappaphone was 0.88, and kappalight was 0.81. Therefore, in this pilot study, PoopMD accurately differentiates acholic from normal color with substantial agreement across users, and almost perfect agreement across two popular smartphones and ambient light settings. Poop

  5. PoopMD, a Mobile Health Application, Accurately Identifies Infant Acholic Stools.

    PubMed

    Franciscovich, Amy; Vaidya, Dhananjay; Doyle, Joe; Bolinger, Josh; Capdevila, Montserrat; Rice, Marcus; Hancock, Leslie; Mahr, Tanya; Mogul, Douglas B

    2015-01-01

    Biliary atresia (BA) is the leading cause of pediatric end-stage liver disease in the United States. Education of parents in the perinatal period with stool cards depicting acholic and normal stools has been associated with improved time-to-diagnosis and survival in BA. PoopMD is a mobile application that utilizes a smartphone's camera and color recognition software to analyze an infant's stool and determine if additional follow-up is indicated. PoopMD was developed using custom HTML5/CSS3 and wrapped to work on iOS and Android platforms. In order to define the gold standard regarding stool color, seven pediatricians were asked to review 45 photographs of infant stool and rate them as acholic, normal, or indeterminate. Samples for which 6+ pediatricians demonstrated agreement defined the gold standard, and only these samples were included in the analysis. Accuracy of PoopMD was assessed using an iPhone 5s with incandescent lighting. Variability in analysis of stool photographs as acholic versus normal with intermediate rating weighted as 50% agreement (kappa) was compared between three laypeople and one expert user. Variability in output was also assessed between an iPhone 5s and a Samsung Galaxy S4, as well as between incandescent lighting and compact fluorescent lighting. Six-plus pediatricians agreed on 27 normal and 7 acholic photographs; no photographs were defined as indeterminate. The sensitivity was 7/7 (100%). The specificity was 24/27 (89%) with 3/27 labeled as indeterminate; no photos of normal stool were labeled as acholic. The Laplace-smoothed positive likelihood ratio was 6.44 (95% CI 2.52 to 16.48) and the negative likelihood ratio was 0.13 (95% CI 0.02 to 0.83). kappauser was 0.68, kappaphone was 0.88, and kappalight was 0.81. Therefore, in this pilot study, PoopMD accurately differentiates acholic from normal color with substantial agreement across users, and almost perfect agreement across two popular smartphones and ambient light settings. Poop

  6. Editorial: Lead Risk Assessment and Health Effects.

    PubMed

    Mielke, Howard W

    2016-01-01

    In 1980, Clair C. Patterson stated: "Sometime in the near future it probably will be shown that the older urban areas of the United States have been rendered more or less uninhabitable by the millions of tons of poisonous industrial lead residues that have accumulated in cities during the past century". We live in the near future about which this quote expressed concern. This special volume of 19 papers explores the status of scientific evidence regarding Dr. Patterson's statement on the habitability of the environments of communities. Authors from 10 countries describe a variety of lead issues in the context of large and small communities, smelter sites, lead industries, lead-based painted houses, and vehicle fuel treated with lead additives dispersed by traffic. These articles represent the microcosm of the larger health issues associated with lead. The challenges of lead risk require a concerted global action for primary prevention. PMID:27314364

  7. Poor periodontal health: A cancer risk?

    PubMed Central

    Rajesh, K. S.; Thomas, Deepak; Hegde, Shashikanth; Kumar, M. S. Arun

    2013-01-01

    Evidence indicates that chronic infections and inflammation are associated with increased risk of cancer development. There has also been considerable evidence that proves the interrelationship between bacterial and viral infections and carcinogenesis. Periodontitis is a chronic oral infection thought to be caused by gram-negative anaerobic bacteria in the dental biofilm. Periodontal bacteria and viruses may act synergistically to cause periodontitis. Many studies have shown that periodontal pockets may act as reservoirs for human papilloma virus, cytomegalovirus, Epstein Barr virus, and suspected agents associated with oral cancer. Periodontitis, characterized by epithelial proliferation and migration, results in a chronic release of inflammatory cytokines, chemokines, growth factors, prostaglandins, and enzymes, all of which are associated with cancer development. This review article intends to shed light on the association between periodontal health and carcinogenesis. PMID:24554877

  8. Editorial: Lead Risk Assessment and Health Effects

    PubMed Central

    Mielke, Howard W.

    2016-01-01

    In 1980, Clair C. Patterson stated: “Sometime in the near future it probably will be shown that the older urban areas of the United States have been rendered more or less uninhabitable by the millions of tons of poisonous industrial lead residues that have accumulated in cities during the past century”. We live in the near future about which this quote expressed concern. This special volume of 19 papers explores the status of scientific evidence regarding Dr. Patterson’s statement on the habitability of the environments of communities. Authors from 10 countries describe a variety of lead issues in the context of large and small communities, smelter sites, lead industries, lead-based painted houses, and vehicle fuel treated with lead additives dispersed by traffic. These articles represent the microcosm of the larger health issues associated with lead. The challenges of lead risk require a concerted global action for primary prevention. PMID:27314364

  9. Methodological challenges in health risk assessment. Final report

    SciTech Connect

    Not Available

    1987-10-12

    Risk assessment, a major activity of both health and regulatory agencies, is subject to large and unavoidable uncertainties. Thus, different teams of knowledgeable experts can come to different conclusions about risks to human health from various sorts of hazards. This report examines and compares analyses by two or more agencies of ten health hazards or potential hazards: ethylene dibromide, formaldehyde, Tris, dioxin (limited to cancer risks of contaminated soil), lead (reproductive effects), cotton dust, noise (long-term hearing impairment), passive smoking, dietary fat (cancer risks), and the radiation hazards of mammography. Each set of risk assessments is analyzed in depth. The report then turns to cross-cutting analyses of such matters as setting priorities for risk assessment, approaches and methods used to evaluate different kinds of risks, and the relationships between risk assessment and risk management. Overall, the report found large differences among risk assessments of the same hazard, but these differences are often quite appropriate.

  10. Firearms and health: the right to be armed with accurate information about the Second Amendment.

    PubMed

    Vernick, J S; Teret, S P

    1993-12-01

    An organized campaign by groups such as the National Rifle Association has sought to convince policymakers and others that the Second Amendment to the US Constitution grants an unfettered right to individuals to possess any firearm, free from federal or state regulation. Although advocates may debate the meaning that should be given to the Second Amendment, under the American legal system the meaning of any particular constitutional provision is determined by the controlling precedent of Supreme Court cases. Two cases, Presser v Illinois and United States v Miller, remain the Supreme Court's latest word on the meaning of the Second Amendment. In Presser, the Court held that the Second Amendment is applicable only to federal, not state, laws. In Miller and subsequent federal cases, any Second Amendment "right" to bear arms is closely linked to the preservation of state militias, upholding a variety of federal gun legislation. Unless the Supreme Court modifies or reverses its Presser and Miller decisions, health advocates should understand that the Second Amendment poses no obstacle to even broad gun control legislation. PMID:8259817

  11. Firearms and health: the right to be armed with accurate information about the Second Amendment.

    PubMed

    Vernick, J S; Teret, S P

    1993-12-01

    An organized campaign by groups such as the National Rifle Association has sought to convince policymakers and others that the Second Amendment to the US Constitution grants an unfettered right to individuals to possess any firearm, free from federal or state regulation. Although advocates may debate the meaning that should be given to the Second Amendment, under the American legal system the meaning of any particular constitutional provision is determined by the controlling precedent of Supreme Court cases. Two cases, Presser v Illinois and United States v Miller, remain the Supreme Court's latest word on the meaning of the Second Amendment. In Presser, the Court held that the Second Amendment is applicable only to federal, not state, laws. In Miller and subsequent federal cases, any Second Amendment "right" to bear arms is closely linked to the preservation of state militias, upholding a variety of federal gun legislation. Unless the Supreme Court modifies or reverses its Presser and Miller decisions, health advocates should understand that the Second Amendment poses no obstacle to even broad gun control legislation.

  12. Firearms and health: the right to be armed with accurate information about the Second Amendment.

    PubMed Central

    Vernick, J S; Teret, S P

    1993-01-01

    An organized campaign by groups such as the National Rifle Association has sought to convince policymakers and others that the Second Amendment to the US Constitution grants an unfettered right to individuals to possess any firearm, free from federal or state regulation. Although advocates may debate the meaning that should be given to the Second Amendment, under the American legal system the meaning of any particular constitutional provision is determined by the controlling precedent of Supreme Court cases. Two cases, Presser v Illinois and United States v Miller, remain the Supreme Court's latest word on the meaning of the Second Amendment. In Presser, the Court held that the Second Amendment is applicable only to federal, not state, laws. In Miller and subsequent federal cases, any Second Amendment "right" to bear arms is closely linked to the preservation of state militias, upholding a variety of federal gun legislation. Unless the Supreme Court modifies or reverses its Presser and Miller decisions, health advocates should understand that the Second Amendment poses no obstacle to even broad gun control legislation. PMID:8259817

  13. [Cell phones: health risks and prevention].

    PubMed

    Talamanca, I Figà; Giliberti, C; Salerno, S

    2012-01-01

    The paper describes first of all the electromagnetic radiation of cellular phones and presents the physical parameters used to measure and evaluate the absorption of emissions of radio stations and cellular phones. It then presents selected research results of the experimental studies in vivo and in vitro which examine the biological effects of the emissions of cellular phones. The review of the epidemiologic evidence focuses in particular the epidemiologic studies on the use of cell phones and brain tumours, identifying some of the reasons of the conflicting results obtained. Studies dealing with the health risks involved in the increasing use of cellular phones by adolescents and children, more sensitive to this exposure, are also presented showing the need for special caution. The problem of hypersensitivity observed in some individuals is also briefly discussed. Finally the paper presents a summary of the main prevention measures necessary in order to reduce the risks in the framework of the "precautionary principle" including prevention policies and exposure limits in various countries.

  14. [International adoption: children's health risk evolution].

    PubMed

    Dartiguenave, C

    2012-05-01

    The socioeconomic and sanitary conditions in many countries make it necessary to weigh as precisely as possible the uncertainties which might affect the health of internationally adopted children, which is one of the key drivers to adoption decision. Indeed, health troubles are more and more frequent among children proposed by countries, at a time when there are fewer children to be adopted. Hence the institutions and the actors in the field of international adoption are compelled to frequently update their professional practices, so as to cope both with the declining offer for adoptable children and with the increasing pressure from the birth countries of children to make host countries adopt children with high age or with special needs. It also requires from the administrations the will to provide better initial information and to implement the demand for an agreement. Meanwhile, in spite of those growing constraints, adopting families have been more and more risk adverse during the latest decades, this being a common trend in our developed countries.

  15. Assessing the health risks of aluminum.

    PubMed

    Orme, J; Ohanian, E V

    1990-03-01

    Aluminum is a ubiquitous substance with over 4,000 uses. Aluminum, as aluminum sulfate, is commonly used in the United States as a coagulant in the treatment of drinking water. For many years aluminum was not considered to be toxic to humans. However, reports associating aluminum with several skeletal and neurological disorders in humans suggest that exposure to aluminum may pose a health hazard. In 1983 the US Environmental Protection Agency (EPA) announced plans to regulate a number of substances, including aluminum, in drinking water. Aluminum was considered because of its occurrence and apparent toxicity. Upon further evaluation of the health effects data the EPA proposed not to regulate aluminum as a result of the uncertainty of the toxicity of ingested aluminum. Putative causal associations between aluminum exposure and neurological disorders such as Alzheimer's disease have yet to be substantiated. Although several issues regarding the toxicity of ingested aluminum are unresolved, aluminum has been specified in the 1986 Amendments to the Safe Drinking Water Act, as one of 83 substances in drinking water to be regulated by 1989. Additional data are needed before the potential risk of aluminum can be assessed; therefore the EPA has deferred possible regulation until 1991. PMID:24202565

  16. The Relation between Adolescent Self Assessment of Health and Risk Behaviours: Could a Global Measure of Health Provide Indications of Health Risk Exposures?

    ERIC Educational Resources Information Center

    Nkansah-Amankra, Stephen; Walker, Ashley Dawn

    2012-01-01

    Objective: Self-rated health (SRH) has become a key organizing construct for assessing multiple dimensions of populations' physical and psychosocial health functioning. However, it is unclear how adolescents' subjective self assessment of health reflects health risk exposures, co-occurring health risks (problem behaviours) and other pre-existing…

  17. [Managing health risks of workers in business trip].

    PubMed

    Gevorkian, E V

    2014-01-01

    The article presents data of prospective observation over the risk management system concerning health of international oil and gas company workers in business trips. The management system included training and screening of workers under risk, specific prophylaxis and other measures. The authors described problems of the risk management system implementation, suggested recommendations to control risks connected with business trips.

  18. Health literacy in HIV treatment: accurate understanding of key biological treatment principles is not required for good ART adherence.

    PubMed

    Laws, M Barton; Danielewicz, Michael; Rana, Aadia; Kogelman, Laura; Wilson, Ira B

    2015-04-01

    Findings on the relationship between health literacy and outcomes in HIV have been inconsistent. Health literacy has previously been operationalized as general functional literacy, but has not included content knowledge about HIV disease and treatment. Semi-structured interviews with people living with HIV in 2 U.S. cities, including questions about the etiology, pathophysiology and treatment of HIV. We compared responses to biomedical conceptions. The 32 respondents were demographically diverse. Although most understood that HIV degrades the immune system, none could explain the nature of a virus, or the mechanism of antiretroviral (ARV) drug action. Fewer than half accurately reported that it is desirable to have a high CD4+ cell count and low viral load. A minority understood the concept of drug resistance. While most believed that strict adherence to ARV regimens was important to maintain health, three believed that periodic treatment interruption was beneficial, and three believed they should not take ARVs when they used alcohol or illicit drugs. Respondents generally had very limited, and often inaccurate biomedical understanding of HIV disease. Most reported good regimen adherence but did not have any mechanistic rationale for it. The failure to find a consistent relationship between health literacy and ARV adherence may be largely because most people simply follow their doctors' instructions, without the need for deep understanding.

  19. Health Literacy in HIV Treatment: Accurate Understanding of Key Biological Treatment Principles is Not Required for Good ART Adherence

    PubMed Central

    Laws, M. Barton; Danielewicz, Michael; Rana, Aadia; Kogelman, Laura; Wilson, Ira B.

    2016-01-01

    Findings on the relationship between health literacy and outcomes in HIV have been inconsistent. Health literacy has previously been operationalized as general functional literacy, but has not included content knowledge about HIV disease and treatment. Semi-structured interviews with people living with HIV in 2 U.S. cities, including questions about the etiology, pathophysiology and treatment of HIV. We compared responses to biomedical conceptions. The 32 respondents were demographically diverse. Although most understood that HIV degrades the immune system, none could explain the nature of a virus, or the mechanism of antiretroviral (ARV) drug action. Fewer than half accurately reported that it is desirable to have a high CD4+ cell count and low viral load. A minority understood the concept of drug resistance. While most believed that strict adherence to ARV regimens was important to maintain health, three believed that periodic treatment interruption was beneficial, and three believed they should not take ARVs when they used alcohol or illicit drugs. Respondents generally had very limited, and often inaccurate biomedical understanding of HIV disease. Most reported good regimen adherence but did not have any mechanistic rationale for it. The failure to find a consistent relationship between health literacy and ARV adherence may be largely because most people simply follow their doctors’ instructions, without the need for deep understanding. PMID:25354736

  20. Accuracy of Parents' Perceptions of Their College Student Children's Health and Health Risk Behaviors

    ERIC Educational Resources Information Center

    Bylund, Carma L.; Imes, Rebecca S.; Baxter, Leslie A.

    2005-01-01

    The authors compared parents' perceptions of their college student children's health and health risk behaviors with the college students' own reports. One hundred sixty-four parent-college student child dyads completed questionnaires regarding the students' health, illness status, and health risk behaviors. Parents tended to be overoptimistic…

  1. Catalogue of Risks: Natural, Technical, Social and Health Risks

    NASA Astrophysics Data System (ADS)

    Ebi, Kristie L.

    2009-01-01

    Financial, geophysical, and terrorist-related disasters have been headline news in the past few months. As amply demonstrated on a regular basis, the recognition and evaluation of risks are skills that could be more widespread. As such, Proske's Catalogue of Risks is timely and of potential interest. The book is a revised and expanded version of an earlier German publication that aims to provide an encyclopedic discussion of issues related to risks and disasters, with a goal of facilitating an understanding of the components and assessment of risk. The book includes chapters that discuss the difficulty of coming to a consensus on a definition of risk, a comprehensive range of risks and disasters, objective risk measures, subjective risk judgment, quality of life measures, and legal aspects of risk. The book ends with an example of applying the concepts discussed to ship impacts against bridges.

  2. Exclusionary health policy: responding to the risk of poor health among sexual minority youth in Canada.

    PubMed

    Ylioja, Thomas; Craig, Shelley L

    2014-01-01

    Measuring indicators of health status and demographics are essential in the population health approach. In Canada, sexual minority youth face increased risk for poor health outcomes in behavioral and mental health indicators, yet the health policy response has been severely lacking. The current population health approach exacerbates the social exclusion of a vulnerable, at-risk population. The authors examine health status through the social determinants of health to highlight the need for including sexual identity, attraction, and behavior in youth population health surveys. Additional interventions that address the social determinants of health are needed.

  3. Estimation of health risks from radiation exposures

    SciTech Connect

    Randolph, M.L.

    1983-08-01

    An informal presentation is given of the cancer and genetic risks from exposures to ionizing radiations. The risks from plausible radiation exposures are shown to be comparable to other commonly encountered risks.

  4. Estimation of Hypertension Risk from Lifestyle Factors and Health Profile: A Case Study

    PubMed Central

    2014-01-01

    Hypertension is a highly prevalent risk factor for cardiovascular disease and it can also lead to other diseases which seriously harm the human health. Screening the risks and finding a clinical model for estimating the risk of onset, maintenance, or the prognosis of hypertension are of great importance to the prevention or treatment of the disease, especially if the indicator can be derived from simple health profile. In this study, we investigate a chronic disease questionnaire data set of 6563 rural citizens in East China and find out a clinical signature that can assess the risk of hypertension easily and accurately. The signature achieves an accuracy of about 83% on the external test dataset, with an AUC of 0.91. Our study demonstrates that a combination of simple lifestyle features can sufficiently reflect the risk of hypertension onset. This finding provides potential guidance for disease prevention and control as well as development of home care and home-care technologies. PMID:25019099

  5. Mental health-related risk factors for violence: using the evidence to guide mental health triage decision making.

    PubMed

    Sands, N; Elsom, S; Gerdtz, M; Khaw, D

    2012-10-01

    Mental health clinicians working in emergency crisis assessment teams or mental health triage roles are required to make rapid and accurate risk assessments. The assessment of violence risk at triage is particularly pertinent to the early identification and prevention of patient violence, and to enhancing the safety of clinical staff and the general public. To date, the evidence base for mental health triage violence risk assessment has been minimal. This study aimed to address this evidence gap by identifying best available evidence for mental health-related risk factors for patient-initiated violence. We conducted a systematic review based on the National Health and Medical Research Council of Australia's methodology for systematic reviews. A total of 6847 studies were retrieved, of which 326 studies met the study inclusion criteria. Of these studies, 277 met inclusion criteria but failed the quality appraisal process, thus a total of 49 studies were included in the final review. The risk factors that achieved the highest evidence grading were predominantly related to dynamic clinical factors immediately observable in the patient's general appearance, behaviour and speech. These factors included hostility/anger, agitation, thought disturbance, positive symptoms of schizophrenia, suspiciousness and irritability. PMID:23094288

  6. Mental health-related risk factors for violence: using the evidence to guide mental health triage decision making.

    PubMed

    Sands, N; Elsom, S; Gerdtz, M; Khaw, D

    2012-10-01

    Mental health clinicians working in emergency crisis assessment teams or mental health triage roles are required to make rapid and accurate risk assessments. The assessment of violence risk at triage is particularly pertinent to the early identification and prevention of patient violence, and to enhancing the safety of clinical staff and the general public. To date, the evidence base for mental health triage violence risk assessment has been minimal. This study aimed to address this evidence gap by identifying best available evidence for mental health-related risk factors for patient-initiated violence. We conducted a systematic review based on the National Health and Medical Research Council of Australia's methodology for systematic reviews. A total of 6847 studies were retrieved, of which 326 studies met the study inclusion criteria. Of these studies, 277 met inclusion criteria but failed the quality appraisal process, thus a total of 49 studies were included in the final review. The risk factors that achieved the highest evidence grading were predominantly related to dynamic clinical factors immediately observable in the patient's general appearance, behaviour and speech. These factors included hostility/anger, agitation, thought disturbance, positive symptoms of schizophrenia, suspiciousness and irritability.

  7. Perceptions of the risks and benefits of fish consumption: Individual choices to reduce risk and increase health benefits

    PubMed Central

    Burger, Joanna; Gochfeld, Michael

    2014-01-01

    Studies of fish consumption often focus on awareness of and adherence to advisories, how much fish people eat, and contaminant levels in those fish. This paper examines knowledge and accuracy of risks and benefits of fish consumption among fishers and other recreationists in the New York Bight, indicative of whether they could make sound dietary decisions. While most respondents knew about health risks (70%) and benefits (94%) of consuming fish, far fewer could name specific risks and benefits. Less than 25% of respondents mentioned mercury and less than 15% mentioned that pregnant women and children were at risk. Far fewer people mentioned polychlorinated biphenyls (PCBs). Nearly 70% said it was healthy to eat fish, and 45% were aware that fish were rich in healthful oils. Despite the lack of details about what specific risks and benefits of fish, well over a third did not feel they needed more information. Other respondents had basic questions, but did not pose specific questions about the fish they caught or ate that would have clarified their individual risk-balancing decisions. Knowledge of which fish were high in contaminants did not match the mercury or PCB levels in those fish. There was a disconnect between the information base about specific risks and benefits of fish consumption, levels of mercury and PCBs in fish, and the respondent’s desire for more information. These data indicate that respondents did not have enough accurate information about contaminants in fish to make informed risk-balancing decisions. PMID:19193369

  8. Forecasting disease risk for increased epidemic preparedness in public health

    NASA Technical Reports Server (NTRS)

    Myers, M. F.; Rogers, D. J.; Cox, J.; Flahault, A.; Hay, S. I.

    2000-01-01

    Emerging infectious diseases pose a growing threat to human populations. Many of the world's epidemic diseases (particularly those transmitted by intermediate hosts) are known to be highly sensitive to long-term changes in climate and short-term fluctuations in the weather. The application of environmental data to the study of disease offers the capability to demonstrate vector-environment relationships and potentially forecast the risk of disease outbreaks or epidemics. Accurate disease forecasting models would markedly improve epidemic prevention and control capabilities. This chapter examines the potential for epidemic forecasting and discusses the issues associated with the development of global networks for surveillance and prediction. Existing global systems for epidemic preparedness focus on disease surveillance using either expert knowledge or statistical modelling of disease activity and thresholds to identify times and areas of risk. Predictive health information systems would use monitored environmental variables, linked to a disease system, to be observed and provide prior information of outbreaks. The components and varieties of forecasting systems are discussed with selected examples, along with issues relating to further development.

  9. Forecasting Disease Risk for Increased Epidemic Preparedness in Public Health

    PubMed Central

    Myers, M.F.; Rogers, D.J.; Cox, J.; Flahault, A.; Hay, S.I.

    2011-01-01

    Emerging infectious diseases pose a growing threat to human populations. Many of the world’s epidemic diseases (particularly those transmitted by intermediate hosts) are known to be highly sensitive to long-term changes in climate and short-term fluctuations in the weather. The application of environmental data to the study of disease offers the capability to demonstrate vector–environment relationships and potentially forecast the risk of disease outbreaks or epidemics. Accurate disease forecasting models would markedly improve epidemic prevention and control capabilities. This chapter examines the potential for epidemic forecasting and discusses the issues associated with the development of global networks for surveillance and prediction. Existing global systems for epidemic preparedness focus on disease surveillance using either expert knowledge or statistical modelling of disease activity and thresholds to identify times and areas of risk. Predictive health information systems would use monitored environmental variables, linked to a disease system, to be observed and provide prior information of outbreaks. The components and varieties of forecasting systems are discussed with selected examples, along with issues relating to further development. PMID:10997211

  10. Environment, Safety, and Health Risk Assessment Program (ESHRAP)

    SciTech Connect

    Eide, Steven Arvid; Thomas Wierman

    2003-12-01

    The Environment, Safety and Health Risk Assessment Program (ESHRAP) models human safety and health risk resulting from waste management and environmental restoration activities. Human safety and health risks include those associated with storing, handling, processing, transporting, and disposing of radionuclides and chemicals. Exposures to these materials, resulting from both accidents and normal, incident-free operation, are modeled. In addition, standard industrial risks (falls, explosions, transportation accidents, etc.) are evaluated. Finally, human safety and health impacts from cleanup of accidental releases of radionuclides and chemicals to the environment are estimated. Unlike environmental impact statements and safety analysis reports, ESHRAP risk predictions are meant to be best estimate, rather than bounding or conservatively high. Typically, ESHRAP studies involve risk predictions covering the entire waste management or environmental restoration program, including such activities as initial storage, handling, processing, interim storage, transportation, and final disposal. ESHRAP can be used to support complex environmental decision-making processes and to track risk reduction as activities progress.

  11. The Effect of Genetic Risk Information and Health Risk Assessment on Compliance with Preventive Behaviors.

    ERIC Educational Resources Information Center

    Bamberg, Richard; And Others

    1990-01-01

    Results from a study of 82 males provide no statistical support and limited encouragement that genetic risk information may motivate persons to make positive changes in preventive health behaviors. Health risk assessments were used to identify subjects at risk for coronary heart disease or lung cancer because of genetic factors. (IAH)

  12. Implementation of health risk assessments with family health history: barriers and benefits.

    PubMed

    Wu, R Ryanne; Orlando, Lori A

    2015-09-01

    Health risk assessments provide an opportunity to emphasise health promotion and disease prevention for individuals and populations at large. A key component of health risk assessments is the detailed collection of family health history information. This information is helpful in determining risk both for common chronic conditions and more rare diseases as well. While the concept of health risk assessments has been around since the Framingham Heart Study was launched in the 1950s, and such assessments are commonly performed in the workplace today, the US healthcare system has been slow to embrace them and the emphasis on prevention that they represent. Before wider implementation of health risk assessments within healthcare can be seen, several concerns must be addressed: (1) provider impact, (2) patient impact, (3) validity of patient-entered data and (4) health outcomes effect. Here, we describe recent developments in health risk assessment design that are helping to address these issues.

  13. Can Pregnancy Problems Foretell Future Health Risks?

    MedlinePlus

    ... 21, 2016 HealthDay Copyright (c) 2016 HealthDay . All rights reserved. News stories are provided by HealthDay and do not reflect the views of MedlinePlus, the National Library of Medicine, the ...

  14. Clean Slate transportation and human health risk assessment

    SciTech Connect

    1997-02-01

    Public concern regarding activities involving radioactive material generally focuses on the human health risk associated with exposure to ionizing radiation. This report describes the results of a risk analysis conducted to evaluate risk for excavation, handling, and transport of soil contaminated with transuranics at the Clean Slate sites. Transportation risks were estimated for public transport routes from the Tonopah Test Range (TTR) to the Envirocore disposal facility or to the Area 3 Radioactive Waste Management Site (RWMS) at the Nevada Test Site (NTS) for both radiological risk and risk due to traffic accidents. Human health risks were evaluated for occupational and radiation-related health effects to workers. This report was generated to respond to this public concern, to provide an evaluation of the risk, and to assess feasibility of transport of the contaminated soil for disposal.

  15. A new approach to criteria for health risk assessment

    SciTech Connect

    Spickett, Jeffery; Katscherian, Dianne; Goh, Yang Miang

    2012-01-15

    Health Impact Assessment (HIA) is a developing component of the overall impact assessment process and as such needs access to procedures that can enable more consistent approaches to the stepwise process that is now generally accepted in both EIA and HIA. The guidelines developed during this project provide a structured process, based on risk assessment procedures which use consequences and likelihood, as a way of ranking risks to adverse health outcomes from activities subjected to HIA or HIA as part of EIA. The aim is to assess the potential for both acute and chronic health outcomes. The consequences component also identifies a series of consequences for the health care system, depicted as expressions of financial expenditure and the capacity of the health system. These more specific health risk assessment characteristics should provide for a broader consideration of health consequences and a more consistent estimation of the adverse health risks of a proposed development at both the scoping and risk assessment stages of the HIA process. - Highlights: Black-Right-Pointing-Pointer A more objective approach to health risk assessment is provided. Black-Right-Pointing-Pointer An objective set of criteria for the consequences for chronic and acute impacts. Black-Right-Pointing-Pointer An objective set of criteria for the consequences on the health care system. Black-Right-Pointing-Pointer An objective set of criteria for event frequency that could impact on health. Black-Right-Pointing-Pointer The approach presented is currently being trialled in Australia.

  16. The effect of graphics on environmental health risk beliefs, emotions, behavioral intentions, and recall.

    PubMed

    Severtson, Dolores J; Henriques, Jeffrey B

    2009-11-01

    Lay people have difficulty understanding the meaning of environmental health risk information. Visual images can use features that leverage visual perception capabilities and semiotic conventions to promote meaningful comprehension. Such evidence-based features were employed to develop two images of a color-coded visual scale to convey drinking water test results. The effect of these images and a typical alphanumeric (AN) lab report were explored in a repeated measures randomized trial among 261 undergraduates. Outcome measures included risk beliefs, emotions, personal safety threshold, mitigation intentions, the durability of beliefs and intentions over time, and test result recall. The plain image conveyed the strongest risk message overall, likely due to increased visual salience. The more detailed graded image conveyed a stronger message than the AN format only for females. Images only prompted meaningful risk reduction intentions among participants with optimistically biased safety threshold beliefs. Fuzzy trace theory supported some findings as follow. Images appeared to promote the consolidation of beliefs over time from an initial meaning of safety to an integrated meaning of safety and health risk; emotion potentially shaped this process. Although the AN report fostered more accurate recall, images were related to more appropriate beliefs and intentions at both time points. Findings hinted at the potential for images to prompt appropriate beliefs independent of accurate factual knowledge. Overall, results indicate that images facilitated meaningful comprehension of environmental health risk information and suggest foci for further research.

  17. The Effect of Graphics on Environmental Health Risk Beliefs, Emotions, Behavioral Intentions and Recall

    PubMed Central

    Severtson, Dolores J.; Henriques, Jeffrey B.

    2010-01-01

    Lay people have difficulty understanding the meaning of environmental health risk information. Visual images can use features that leverage visual perception capabilities and semiotic conventions to promote meaningful comprehension. Such evidence-based features were employed to develop two images of a color-coded visual scale to convey drinking water test results. The effect of these images and a typical alphanumeric (AN) lab report were explored in a repeated measures randomized trial among 261 undergraduates. Outcome measures included risk beliefs, emotions, personal safety threshold, mitigation intentions, the durability of beliefs and intentions over time, and test result recall. The plain image conveyed the strongest risk message overall, likely due to increased visual salience. The more detailed graded image conveyed a stronger message than the AN format only for females. Images only prompted meaningful risk reduction intentions among participants with optimistically biased safety threshold beliefs. Fuzzy trace theory supported some findings as follow. Images appeared to promote the consolidation of beliefs over time from an initial meaning of safety to an integrated meaning of safety and health risk; emotion potentially shaped this process. Although the AN report fostered more accurate recall, images were related to more appropriate beliefs and intentions at both time points. Findings hinted at the potential for images to prompt appropriate beliefs independent of accurate factual knowledge. Overall, results indicate that images facilitated meaningful comprehension of environmental health risk information and suggest foci for further research. PMID:19886946

  18. Weighing health benefit and health risk information when consuming sport-caught fish.

    PubMed

    Knuth, Barbara A; A Connelly, Nancy; Sheeshka, Judy; Patterson, Jacqueline

    2003-12-01

    Fish consumers may incur benefits and risks from eating fish. Health advisories issued by states, tribes, and other entities typically include advice about how to limit fish consumption or change other behaviors (e.g., fish cleaning or cooking) to reduce health risks from exposure to contaminants. Eating fish, however, may provide health benefits. Risk communicators and fish consumers have suggested the importance of including risk comparison information, as well as health risk-benefit comparisons in health advisory communications. To improve understanding about how anglers fishing in waters affected by health advisories may respond to such risk-risk or risk-benefit information, we surveyed Lake Ontario (NY, USA) anglers. We interviewed by telephone 4,750 anglers, 2,593 of which had fished Lake Ontario in the past 12 months and were sent a detailed mail questionnaire (1,245 responded). We posed questions varying the magnitude of health risks and health benefits to be gained by fish consumption, and varied the population affected by these risks and benefits (anglers, children, women of childbearing age, and unborn children). Respondents were influenced by health benefit and health risk information. When risks were high, most respondents would eat less fish regardless of the benefit level. When risks were low, the magnitude of change in fish consumption was related to level of benefit. Responses differed depending on the question wording order, that is, whether "risks" were posed before "benefits." For a given risk-benefit level, respondents would give different advice to women of childbearing age versus children, with more conservative advice (eat less fish) provided to women of childbearing age. Respondents appeared to be influenced more strongly by risk-risk comparisons (e.g., risks from other foods vs. risks from fish) than by risk-benefit comparisons (e.g., risks from fish vs. benefits from fish). Risk analysts and risk communicators should improve efforts to

  19. TOXICOPROTEOMICS AND ITS APPLICATION TO HUMAN HEALTH RISK ASSESSMENT

    EPA Science Inventory

    Humans are exposed to a variety of environmental toxicants, and this together with a large number of interacting factors can contribute to an individual's risk for health. To understand the toxic mechanisms and/or modes of action for human health risk assessment, molecular charac...

  20. Rural Adolescent Health Risk Behaviors: Age, Gender, and Ethnic Differences.

    ERIC Educational Resources Information Center

    Salzman, Stephanie A.; Girvan, James T.

    A survey of health risk behaviors was administered to a representative sample of 7,776 Idaho students in grades 8-12. Respondents were 86% White, 6% Hispanic, 4% American Indian, 3% Asian, and 2% Black. These rural adolescents reported that they had engaged in some health risk behaviors at rates comparable to those of other U.S. adolescents: 57%…

  1. Nuclear power — is the health risk too great?

    PubMed Central

    Wynne, B E

    1982-01-01

    Apparently objective and value-free `scientific' assessments of health risks are often highly value-laden and incorporate contentious social assumptions. Mr Wynne exposes some of the complexities underlying attempts to compare the health risks of nuclear and other sources of energy. PMID:7108912

  2. mHealth Apps and Their Risks - Taking Stock.

    PubMed

    Albrecht, Urs-Vito; von Jan, Ute

    2016-01-01

    Despite the popularity of health related apps and the great potential they hold for improving health care, the risks as well as potential hazards posed by such apps are often not adequately appreciated by users. Based on an analysis of scientific literature as well as anecdotal evidence, this contribution addresses the most common risks and pitfalls of health related apps (e.g. related to physical integrity as well as bodily and mental wellbeing) that users may encounter and sketches some remedies. While certainly not exhaustive, the mentioned aspects may serve as a starting point to raise awareness about potential risks of health related apps. PMID:27350511

  3. [Health risk assessment of coke oven PAHs emissions].

    PubMed

    Bo, Xin; Wang, Gang; Wen, Rou; Zhao, Chun-Li; Wu, Tie; Li, Shi-Bei

    2014-07-01

    Polycyclic aromatic hydrocarbons (PAHs) produced by coke oven are with strong toxicity and carcinogenicity. Taken typical coke oven of iron and steel enterprises as the case study, the dispersion and migration of 13 kinds of PAHs emitted from coke oven were analyzed using AERMOD dispersion model, the carcinogenic and non-carcinogenic risks at the receptors within the modeling domain were evaluated using BREEZE Risk Analyst and the Human Health Risk Assessment Protocol for Hazardous Waste Combustion (HHRAP) was followed, the health risks caused by PAHs emission from coke oven were quantitatively evaluated. The results indicated that attention should be paid to the non-carcinogenic risk of naphthalene emission (the maximum value was 0.97). The carcinogenic risks of each single pollutant were all below 1.0E-06, while the maximum value of total carcinogenic risk was 2.65E-06, which may have some influence on the health of local residents.

  4. A longitudinal perspective on health plan-provider risk contracting.

    PubMed

    Hurley, Robert; Grossman, Joy; Lake, Timothy; Casalino, Lawrence

    2002-01-01

    During the past decade many health plans adopted risk-contracting arrangements that transferred substantial financial risk and care management responsibility to physician groups and hospital-sponsored integrated delivery systems. Risk transfer arrangements are now believed to be in steep decline, but there is little empirical evidence on this topic, particularly at the local-market level. Data from the Community Tracking Study were used to examine changes in risk contracting from 1996 to 2000. A decline in reliance on risk contracting is evident in nearly all markets. However, retrenchment in risk contracting has followed different patterns ranging from refinements in the scope of risk transfer to reduced use of risk arrangements to total rejection of risk-sharing arrangements. Modified risk-transfer agreements remain viable in several markets, but continued refinement in the nature and scope of risk sharing will be necessary.

  5. The Impact of an Incentive-Based Worksite Health Promotion Program on Modifiable Health Risk Factors.

    ERIC Educational Resources Information Center

    Poole, Kathleen; Kumpfer, Karol; Pett, Marjorie

    2001-01-01

    Examined the impact of participating in an incentive-based employee health promotion program on modifiable health risk factors over 4 years. Data from physiological and self-report measures indicated that modifiable health risks improved over time (smoking, physical activity, systolic and diastolic blood pressure, and seat belt use). Cholesterol…

  6. Mental Health and Health Risk Behaviours of Homeless Adolescents and Youth: A Mixed Methods Study

    ERIC Educational Resources Information Center

    Oppong Asante, Kwaku; Meyer-Weitz, Anna; Petersen, Inge

    2016-01-01

    Background: Homeless youth, as a vulnerable population are susceptible to various mental and health risk behaviours. However, less is known of the mental health status of these homeless youth and its role in risky sexual behaviours; neither do we understand the reasons homeless youth give for their engagement in various health risk behaviour.…

  7. The Measurement of Health Behavior Change: The Health Behavior Risk Factor Prevalence Instrument.

    ERIC Educational Resources Information Center

    Sutherland, Mary; And Others

    This paper addresses some issues concerning the use of written instruments for measuring health behavior change. A description is given of the Health Behavior Risk Factor Prevalence Survey which was developed to identify group members' risk-taking behaviors. This instrument was used to measure the health behaviors of a group of employees in the…

  8. Reduction in health risks and disparities with participation in an employer-sponsored health promotion program.

    PubMed

    Burton, Wayne N; Chen, Chin-Yu; Li, Xingquan; Schultz, Alyssa B; Edington, Dee W

    2013-08-01

    There is an increasing awareness among employers and health care providers that health care needs to be tailored to address the diversity of the workforce. Population-based data have shown significant differences in health behaviors and health risks among different racial/ethnic groups in the United States. The purpose of this study was to examine health risks and changes in health risks over time in an employed population at a financial services corporation. This large financial services corporation is naturally concerned about any disparities in health among employees. The study population consists of employees who participated in the organization's medical plan and also the annual health risk appraisal questionnaire in both 2009 and 2010. Significant demographic differences exist among the four ethnic groups studied: whites, African Americans, Hispanics, and Asians. At baseline, African American employees had a significantly higher average number of health risks measured by the health risk appraisal, but they also experienced the greatest improvement in health risks by time 2. There were differences in the health risk profiles of the ethnic groups, with certain risk factors being more prevalent among some ethnicities than among others. The health care costs were not significantly different among the groups studied here. It is likely that other large employers may also find health risk differences among employees belonging to various ethnicities. Future research in this field should seek to understand the reasons behind differences in health among ethnic groups and how best to address them so that all employees can achieve a high level of health and wellness. PMID:23924828

  9. Reduction in health risks and disparities with participation in an employer-sponsored health promotion program.

    PubMed

    Burton, Wayne N; Chen, Chin-Yu; Li, Xingquan; Schultz, Alyssa B; Edington, Dee W

    2013-08-01

    There is an increasing awareness among employers and health care providers that health care needs to be tailored to address the diversity of the workforce. Population-based data have shown significant differences in health behaviors and health risks among different racial/ethnic groups in the United States. The purpose of this study was to examine health risks and changes in health risks over time in an employed population at a financial services corporation. This large financial services corporation is naturally concerned about any disparities in health among employees. The study population consists of employees who participated in the organization's medical plan and also the annual health risk appraisal questionnaire in both 2009 and 2010. Significant demographic differences exist among the four ethnic groups studied: whites, African Americans, Hispanics, and Asians. At baseline, African American employees had a significantly higher average number of health risks measured by the health risk appraisal, but they also experienced the greatest improvement in health risks by time 2. There were differences in the health risk profiles of the ethnic groups, with certain risk factors being more prevalent among some ethnicities than among others. The health care costs were not significantly different among the groups studied here. It is likely that other large employers may also find health risk differences among employees belonging to various ethnicities. Future research in this field should seek to understand the reasons behind differences in health among ethnic groups and how best to address them so that all employees can achieve a high level of health and wellness.

  10. Health Promotion and Risk Behaviors among Adolescents in Turkey

    ERIC Educational Resources Information Center

    Ortabag, Tulay; Ozdemir, Serpil; Bakir, Bilal; Tosun, Nuran

    2011-01-01

    Adolescents experience the onset and development of several health-related behaviors. The purpose of this study is to determine health risk and promotion behaviors of adolescents between the ages of 11 and 19 who were attending and to test the reliability and validity analysis of the Turkish version of Adolescent Health Promotion Scale (AHPS). The…

  11. 75 FR 70009 - Development of Health Risk Assessment Guidance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Development of Health Risk Assessment Guidance AGENCY: Centers for Disease Control and Prevention (CDC), Department of Health and Human Services...

  12. Is demography destiny? Application of machine learning techniques to accurately predict population health outcomes from a minimal demographic dataset.

    PubMed

    Luo, Wei; Nguyen, Thin; Nichols, Melanie; Tran, Truyen; Rana, Santu; Gupta, Sunil; Phung, Dinh; Venkatesh, Svetha; Allender, Steve

    2015-01-01

    For years, we have relied on population surveys to keep track of regional public health statistics, including the prevalence of non-communicable diseases. Because of the cost and limitations of such surveys, we often do not have the up-to-date data on health outcomes of a region. In this paper, we examined the feasibility of inferring regional health outcomes from socio-demographic data that are widely available and timely updated through national censuses and community surveys. Using data for 50 American states (excluding Washington DC) from 2007 to 2012, we constructed a machine-learning model to predict the prevalence of six non-communicable disease (NCD) outcomes (four NCDs and two major clinical risk factors), based on population socio-demographic characteristics from the American Community Survey. We found that regional prevalence estimates for non-communicable diseases can be reasonably predicted. The predictions were highly correlated with the observed data, in both the states included in the derivation model (median correlation 0.88) and those excluded from the development for use as a completely separated validation sample (median correlation 0.85), demonstrating that the model had sufficient external validity to make good predictions, based on demographics alone, for areas not included in the model development. This highlights both the utility of this sophisticated approach to model development, and the vital importance of simple socio-demographic characteristics as both indicators and determinants of chronic disease.

  13. Risk and uncertainty in health investment.

    PubMed

    Asano, Takao; Shibata, Akihisa

    2011-02-01

    Extending the Grossman (J Polit Econ 80:223-255, 1972) model of health capital into a stochastic one, we analyze how the presence of Knightian uncertainty about the efficacy of health care affects the optimal health investment behavior of individuals. Using Gilboa and Schmeidler's (J Math Econ 18:141-153, 1989) model of max/min expected utility (MMEU) with multiple priors, we show that an agent retains the initial level of health capital if the price of health care lies within a certain range. We also show that the no-investment range expands as the degree of Knightian uncertainty rises.

  14. Is accuracy of weight perception associated with health risk behaviors in a diverse sample of obese adolescents?

    PubMed

    Lenhart, Clare M; Daly, Brian P; Eichen, Dawn M

    2011-12-01

    Current evidence is equivocal as to whether adolescent's perception of weight status is linked to both healthy and risky behaviors. This study examined the association between accurate and inaccurate perception of weight and self-reported health and risk behaviors among a diverse sample of obese, urban adolescents. Data were analyzed from 1,180 participants in the 2009 Philadelphia Youth Risk Behavior Survey. Health behaviors of obese students self-identifying as very or slightly overweight were compared to obese students who underestimated their weight status. Accurate self-identifiers of weight status were significantly more likely to report trying to lose weight, bullying victimization, and suicide attempts as compared to obese students underestimating their weight status. Findings suggest that it is important for school nurses to understand that perceived weight status confers distinct risk profiles and differing needs for health-related services related to the physical, mental, and social health of adolescents. PMID:21976189

  15. Rural Latino adolescent health: preliminary examination of health risks and cultural correlates.

    PubMed

    Nelson, Timothy D; Kidwell, Katherine M; Armenta, Brian E; Crockett, Lisa J; Carlo, Gustavo; Whitbeck, Les B

    2014-06-01

    Latino adolescents living in rural settings may be at increased risk of health problems; however, data describing the health status of this population are limited. This study examined 60 rural Latino adolescents and found high rates of health risk, including at-risk/clinical results for hemoglobin A1C (23.3%), high-density lipoprotein cholesterol (55%), systolic blood pressure (21.7%), and overweight/obesity (55%). Time in sedentary behaviors was high and physical activity was limited. Adolescent language use was associated with health risk status, with greater use of English associated with lower risk. Health psychologists could promote improved health by providing health behavior interventions to this underserved population. PMID:23520352

  16. Creation of an Accurate Algorithm to Detect Snellen Best Documented Visual Acuity from Ophthalmology Electronic Health Record Notes

    PubMed Central

    French, Dustin D; Gill, Manjot; Mitchell, Christopher; Jackson, Kathryn; Kho, Abel; Bryar, Paul J

    2016-01-01

    Background Visual acuity is the primary measure used in ophthalmology to determine how well a patient can see. Visual acuity for a single eye may be recorded in multiple ways for a single patient visit (eg, Snellen vs. Jäger units vs. font print size), and be recorded for either distance or near vision. Capturing the best documented visual acuity (BDVA) of each eye in an individual patient visit is an important step for making electronic ophthalmology clinical notes useful in research. Objective Currently, there is limited methodology for capturing BDVA in an efficient and accurate manner from electronic health record (EHR) notes. We developed an algorithm to detect BDVA for right and left eyes from defined fields within electronic ophthalmology clinical notes. Methods We designed an algorithm to detect the BDVA from defined fields within 295,218 ophthalmology clinical notes with visual acuity data present. About 5668 unique responses were identified and an algorithm was developed to map all of the unique responses to a structured list of Snellen visual acuities. Results Visual acuity was captured from a total of 295,218 ophthalmology clinical notes during the study dates. The algorithm identified all visual acuities in the defined visual acuity section for each eye and returned a single BDVA for each eye. A clinician chart review of 100 random patient notes showed a 99% accuracy detecting BDVA from these records and 1% observed error. Conclusions Our algorithm successfully captures best documented Snellen distance visual acuity from ophthalmology clinical notes and transforms a variety of inputs into a structured Snellen equivalent list. Our work, to the best of our knowledge, represents the first attempt at capturing visual acuity accurately from large numbers of electronic ophthalmology notes. Use of this algorithm can benefit research groups interested in assessing visual acuity for patient centered outcome. All codes used for this study are currently

  17. Pathways to Health Risk Exposure in Adult Film Performers

    PubMed Central

    Ryan, Gery; Margold, William; Torres, Jacqueline; Gelberg, Lillian

    2008-01-01

    Despite being part of a large and legal industry in Los Angeles, little is known about adult film performers’ exposure to health risks and when and how these risks might occur. The objective was to identify exposure to physical, mental, and social health risks and the pathways to such risks among adult film performers and to determine how risks differ between different types of performers, such as men and women. Semi-structured in-depth interviews were conducted with 18 female and ten male performers as well as two key informants from the industry. Performers and key informants were recruited through Protecting Adult Welfare, adult film venues, and snowball sampling. Performers engaged in risky health behaviors that included high-risk sexual acts that are unprotected, substance abuse, and body enhancement. They are exposed to physical trauma on the film set. Many entered and left the industry with financial insecurity and suffered from mental health problems. Women were more likely than men to be exposed to health risks. Adult film performers, especially women, are exposed to health risks that accumulate over time and that are not limited to sexually transmitted diseases. PMID:18709554

  18. The impact of an integrated population health enhancement and disease management program on employee health risk, health conditions, and productivity.

    PubMed

    Loeppke, Ron; Nicholson, Sean; Taitel, Michael; Sweeney, Matthew; Haufle, Vince; Kessler, Ronald C

    2008-12-01

    This study evaluated the impact of an integrated population health enhancement program on employee health risks, health conditions, and productivity. Specifically, we analyzed changes in these measures among a cohort of 543 employees who completed a health risk assessment in both 2003 and 2005. We compared these findings with 2 different sets of employees who were not offered health enhancement programming. We found that the DIRECTV cohort showed a significant reduction in health risks after exposure to the program. Relative to a matched comparison group, the proportion of low-risk employees at DIRECTV in 2005 was 8.2 percentage points higher; the proportion of medium-risk employees was 7.1 percentage points lower; and the proportion of high-risk employees was 1.1 percentage points lower (p < 0.001). The most noticeable changes in health risk were a reduction in the proportion of employees with high cholesterol; an improvement in diet; a reduction of heavy drinking; management of high blood pressure; improved stress management; increased exercise; fewer smokers; and a drop in obesity rates. We also found that a majority of employees who improved their risk levels from 2003 to 2005 maintained their gains in 2006. Employees who improved their risks levels also demonstrated relative improvement in absenteeism. Overall, this study provides additional evidence that integrated population health enhancement positively impacts employees' health risk and productivity; it also reinforces the view that "good health is good business."

  19. Occupational health and safety: Designing and building with MACBETH a value risk-matrix for evaluating health and safety risks

    NASA Astrophysics Data System (ADS)

    Lopes, D. F.; Oliveira, M. D.; Costa, C. A. Bana e.

    2015-05-01

    Risk matrices (RMs) are commonly used to evaluate health and safety risks. Nonetheless, they violate some theoretical principles that compromise their feasibility and use. This study describes how multiple criteria decision analysis methods have been used to improve the design and the deployment of RMs to evaluate health and safety risks at the Occupational Health and Safety Unit (OHSU) of the Regional Health Administration of Lisbon and Tagus Valley. ‘Value risk-matrices’ (VRMs) are built with the MACBETH approach in four modelling steps: a) structuring risk impacts, involving the construction of descriptors of impact that link risk events with health impacts and are informed by scientific evidence; b) generating a value measurement scale of risk impacts, by applying the MACBETH-Choquet procedure; c) building a system for eliciting subjective probabilities that makes use of a numerical probability scale that was constructed with MACBETH qualitative judgments on likelihood; d) and defining a classification colouring scheme for the VRM. A VRM built with OHSU members was implemented in a decision support system which will be used by OHSU members to evaluate health and safety risks and to identify risk mitigation actions.

  20. Trends in the Health Status of Medicare Risk Contract Enrollees

    PubMed Central

    Riley, Gerald; Zarabozo, Carlos

    2006-01-01

    Previous research has found Medicare risk contract enrollees to be healthier than beneficiaries in fee-for-service (FFS). Medicare Current Beneficiary Survey (MCBS) data were used to examine trends in health and functional status measures among risk contract and FFS enrollees from 1991 to 2004. Risk contract enrollees reported better health and functioning, but the differences tended to narrow over time. Most of the differences in trends were observed for functional status measures and institutionalization; differences in trends for perceived health status and prevalence rates of chronic conditions tended to be small or non-existent. The narrowing of functional and health status differences between the risk contract and FFS populations may have implications for payment policy, as well as implications for the role of private health plans in Medicare. PMID:17427847

  1. Community Health Risk Assessment of Primary Aluminum Smelter Emissions

    PubMed Central

    Larivière, Claude

    2014-01-01

    Objective: Primary aluminum production is an industrial process with high potential health risk for workers. We consider in this article how to assess community health risks associated with primary aluminum smelter emissions. Methods: We reviewed the literature on health effects, community exposure data, and dose–response relationships of the principal hazardous agents emitted. Results: On the basis of representative measured community exposure levels, we were able to make rough estimates on health risks associated with specific agents and categorize these as none, low, medium, or high. Conclusions: It is possible to undertake a rough-estimate community Health Risk Assessment for individual smelters on the basis of information available in the epidemiological literature and local community exposure data. PMID:24806724

  2. “Any Condomless Anal Intercourse” is No Longer an Accurate Measure of HIV Sexual risk Behavior in Gay and Other Men Who have Sex with Men

    PubMed Central

    Jin, Fengyi; Prestage, Garrett P.; Mao, Limin; Poynten, I. Mary; Templeton, David J.; Grulich, Andrew E.; Zablotska, Iryna

    2015-01-01

    Background: Condomless anal intercourse (CLAI) has long been recognized as the primary mode of sexual transmission of HIV in gay and other men who have sex with men (MSM). A variety of measures of CLAI have been commonly used in behavioral surveillance for HIV risk and to forecast trends in HIV infection. However, gay and other MSM’s sexual practices changed as the understanding of disease and treatment options advance. In the present paper, we argue that summary measures such as “any CLAI” do not accurately measure HIV sexual risk behavior. Methods: Participants were 1,427 HIV-negative men from the Health in Men cohort study run from 2001 to 2007 in Sydney, Australia, with six-monthly interviews. At each interview, detailed quantitative data on the number of episodes of insertive and receptive CLAI in the last 6 months were collected, separated by partner type (regular vs. casual) and partners’ HIV status (negative, positive, and HIV status unknown). Results: A total of 228,064 episodes of CLAI were reported during the study period with a mean of 44 episodes per year per participant (median: 14). The great majority of CLAI episodes were with a regular partner (92.6%), most of them with HIV-negative regular partners (84.8%). Participants were more likely to engage in insertive CLAI with casual than with regular partners (66.7 vs. 55.3% of all acts of CLAI with each partner type, p < 0.001). Men were more likely to report CLAI in the receptive position with HIV-negative and HIV status unknown partners than with HIV-positive partners (p < 0.001 for both regular and casual partners). Conclusion: Gay and other MSM engaging in CLAI demonstrate clear patterns of HIV risk reduction behavior. As HIV prevention enters the era of antiretroviral-based biomedical approach, using all forms of CLAI indiscriminately as a measure of HIV behavioral risk is not helpful in understanding the current drivers of HIV transmission in the community. PMID:25774158

  3. The Relationship of Depression to Health Risk Behaviors and Health Perceptions in Korean College Students.

    ERIC Educational Resources Information Center

    Kim, Oksoo

    2002-01-01

    Investigates the relationship of depression to health risk behaviors and health perceptions in Korean college students. The level of students' depression predicted alcohol consumption, symptom pattern, and physical health. Students who were more depressed reported more symptoms and perceived their health as worse than those who were less…

  4. SU-E-J-208: Fast and Accurate Auto-Segmentation of Abdominal Organs at Risk for Online Adaptive Radiotherapy

    SciTech Connect

    Gupta, V; Wang, Y; Romero, A; Heijmen, B; Hoogeman, M; Myronenko, A; Jordan, P

    2014-06-01

    Purpose: Various studies have demonstrated that online adaptive radiotherapy by real-time re-optimization of the treatment plan can improve organs-at-risk (OARs) sparing in the abdominal region. Its clinical implementation, however, requires fast and accurate auto-segmentation of OARs in CT scans acquired just before each treatment fraction. Autosegmentation is particularly challenging in the abdominal region due to the frequently observed large deformations. We present a clinical validation of a new auto-segmentation method that uses fully automated non-rigid registration for propagating abdominal OAR contours from planning to daily treatment CT scans. Methods: OARs were manually contoured by an expert panel to obtain ground truth contours for repeat CT scans (3 per patient) of 10 patients. For the non-rigid alignment, we used a new non-rigid registration method that estimates the deformation field by optimizing local normalized correlation coefficient with smoothness regularization. This field was used to propagate planning contours to repeat CTs. To quantify the performance of the auto-segmentation, we compared the propagated and ground truth contours using two widely used metrics- Dice coefficient (Dc) and Hausdorff distance (Hd). The proposed method was benchmarked against translation and rigid alignment based auto-segmentation. Results: For all organs, the auto-segmentation performed better than the baseline (translation) with an average processing time of 15 s per fraction CT. The overall improvements ranged from 2% (heart) to 32% (pancreas) in Dc, and 27% (heart) to 62% (spinal cord) in Hd. For liver, kidneys, gall bladder, stomach, spinal cord and heart, Dc above 0.85 was achieved. Duodenum and pancreas were the most challenging organs with both showing relatively larger spreads and medians of 0.79 and 2.1 mm for Dc and Hd, respectively. Conclusion: Based on the achieved accuracy and computational time we conclude that the investigated auto

  5. Health Risks Information Reaches Secondary School Smokers

    ERIC Educational Resources Information Center

    Ridout, Fran; Charlton, Anne; Hutchison, Iain

    2008-01-01

    This cross-sectional study aimed to assess smoking prevention and cessation education delivered as part of the UK National Curriculum and to evaluate the relative effectiveness of health, social influence and other/non-health components. In all, 1789 students aged 11-15 from 12 secondary schools completed online surveys assessing smoking status,…

  6. [Smoking: what are the health risks?].

    PubMed

    Perriot, Jean; Underner, Michel; Doly-Kuchcik, Ludivine

    2012-03-01

    Smoking is the primary cause of avoidable deaths in developing countries; it is the principal cause of many illnesses and is risk factor or aggravated cause. Cigarettes or smokeless tobacco have a direct or indirect toxicity effect on practically every organ. The induced diseases are cardiovascular, cancers, respiratory complaints and many consequences less well known but often serious. There is no smoking without risk; however, stopping smoking at any age is beneficial.

  7. Applying risk perception theory to public health workforce preparedness training.

    PubMed

    Barnett, Daniel J; Balicer, Ran D; Blodgett, David W; Everly, George S; Omer, Saad B; Parker, Cindy L; Links, Jonathan M

    2005-11-01

    Since 9/11, public health has seen a progressive culture change toward a 24/7 emergency response organizational model. This transition entails new expectations for public health workers, including (1) a readiness and willingness to report to duty in emergencies and (2) an ability to effectively communicate risk to an anxious public about terrorism or naturally occurring disasters. To date, however, research on readiness education for health department workers has focused little attention upon the risk perceptions that may influence their willingness to report to duty during disasters, as well as their ability to provide effective emergency risk communication to the public. Here, we apply risk perception factors to explore the potential barriers and remedies to effective public health workforce emergency response.

  8. Educated guesses: health risk assessment in environmental impact statements.

    PubMed

    Harvey, P D

    1990-01-01

    Environmental pollution threatens public health. The search for solutions has advanced the frontiers of science and law. Efforts to protect the environment and public health begin with describing potential adverse consequences of human activities and characterizing the predicted risk. The National Environmental Policy Act requires the preparation of environmental impact statements to describe the effects of proposed federal projects and provide information for agency decisionmakers and the public. Risks to public health are particularly difficult to quantify because of uncertainty about the relation between exposure to environmental contamination and disease. Risk assessment is the current scientific tool to present estimates of risk. The methodology has created controversy, however, when underlying assumptions and uncertainties are not clearly presented. Critics caution that the methodology is vulnerable to bias. This Note evaluates the use of risk assessment in the environmental impact statement process and offers recommendations to ensure informed decisions.

  9. Educated guesses: health risk assessment in environmental impact statements.

    PubMed

    Harvey, P D

    1990-01-01

    Environmental pollution threatens public health. The search for solutions has advanced the frontiers of science and law. Efforts to protect the environment and public health begin with describing potential adverse consequences of human activities and characterizing the predicted risk. The National Environmental Policy Act requires the preparation of environmental impact statements to describe the effects of proposed federal projects and provide information for agency decisionmakers and the public. Risks to public health are particularly difficult to quantify because of uncertainty about the relation between exposure to environmental contamination and disease. Risk assessment is the current scientific tool to present estimates of risk. The methodology has created controversy, however, when underlying assumptions and uncertainties are not clearly presented. Critics caution that the methodology is vulnerable to bias. This Note evaluates the use of risk assessment in the environmental impact statement process and offers recommendations to ensure informed decisions. PMID:2278245

  10. Uncertainties associated with assessing the public health risk from Legionella

    PubMed Central

    Whiley, Harriet; Keegan, Alexandra; Fallowfield, Howard; Ross, Kirstin

    2014-01-01

    Legionella is an opportunistic pathogen of public health concern. Current regulatory and management guidelines for the control of this organism are informed by risk assessments. However, there are many unanswered questions and uncertainties regarding Legionella epidemiology, strain infectivity, infectious dose, and detection methods. This review follows the EnHealth Risk Assessment Framework, to examine the current information available regarding Legionella risk and discuss the uncertainties and assumptions. This review can be used as a tool for understanding the uncertainties associated with Legionella risk assessment. It also serves to highlight the areas of Legionella research that require future focus. Improvement of these uncertainties will provide information to enhance risk management practices for Legionella, potentially improving public health protection and reducing the economic costs by streamlining current management practices. PMID:25309526

  11. Glutaraldehyde: a potential health risk to nurses

    SciTech Connect

    Newman, M.A.; Kachuba, J.B.

    1992-06-01

    This article discusses the potential toxicity of glutaraldehyde, a chemical commonly used in endoscopy units. The literature review cites adverse health effects experienced by workers exposed to glutaraldehyde. The sampling methodology for glutaraldehyde relative to the Occupational Safety and Health standard for glutaraldehyde is presented. Air monitoring should be performed to assess employee exposure to airborne glutaraldehyde in endoscopy departments. Recommendations for reducing exposure to glutaraldehyde in endoscopy units are included.

  12. Human health risk assessment of heavy metals in urban stormwater.

    PubMed

    Ma, Yukun; Egodawatta, Prasanna; McGree, James; Liu, An; Goonetilleke, Ashantha

    2016-07-01

    Toxic chemical pollutants such as heavy metals (HMs) are commonly present in urban stormwater. These pollutants can pose a significant risk to human health and hence a significant barrier for urban stormwater reuse. The primary aim of this study was to develop an approach for quantitatively assessing the risk to human health due to the presence of HMs in stormwater. This approach will lead to informed decision making in relation to risk management of urban stormwater reuse, enabling efficient implementation of appropriate treatment strategies. In this study, risks to human health from heavy metals were assessed as hazard index (HI) and quantified as a function of traffic and land use related parameters. Traffic and land use are the primary factors influencing heavy metal loads in the urban environment. The risks posed by heavy metals associated with total solids and fine solids (<150μm) were considered to represent the maximum and minimum risk levels, respectively. The study outcomes confirmed that Cr, Mn and Pb pose the highest risks, although these elements are generally present in low concentrations. The study also found that even though the presence of a single heavy metal does not pose a significant risk, the presence of multiple heavy metals could be detrimental to human health. These findings suggest that stormwater guidelines should consider the combined risk from multiple heavy metals rather than the threshold concentration of an individual species. Furthermore, it was found that risk to human health from heavy metals in stormwater is significantly influenced by traffic volume and the risk associated with stormwater from industrial areas is generally higher than that from commercial and residential areas.

  13. Human health risk assessment of heavy metals in urban stormwater.

    PubMed

    Ma, Yukun; Egodawatta, Prasanna; McGree, James; Liu, An; Goonetilleke, Ashantha

    2016-07-01

    Toxic chemical pollutants such as heavy metals (HMs) are commonly present in urban stormwater. These pollutants can pose a significant risk to human health and hence a significant barrier for urban stormwater reuse. The primary aim of this study was to develop an approach for quantitatively assessing the risk to human health due to the presence of HMs in stormwater. This approach will lead to informed decision making in relation to risk management of urban stormwater reuse, enabling efficient implementation of appropriate treatment strategies. In this study, risks to human health from heavy metals were assessed as hazard index (HI) and quantified as a function of traffic and land use related parameters. Traffic and land use are the primary factors influencing heavy metal loads in the urban environment. The risks posed by heavy metals associated with total solids and fine solids (<150μm) were considered to represent the maximum and minimum risk levels, respectively. The study outcomes confirmed that Cr, Mn and Pb pose the highest risks, although these elements are generally present in low concentrations. The study also found that even though the presence of a single heavy metal does not pose a significant risk, the presence of multiple heavy metals could be detrimental to human health. These findings suggest that stormwater guidelines should consider the combined risk from multiple heavy metals rather than the threshold concentration of an individual species. Furthermore, it was found that risk to human health from heavy metals in stormwater is significantly influenced by traffic volume and the risk associated with stormwater from industrial areas is generally higher than that from commercial and residential areas. PMID:27046140

  14. [Health alert management and emerging risk].

    PubMed

    Pillonel, J

    2010-12-01

    Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens. PMID:21051258

  15. [Health alert management and emerging risk].

    PubMed

    Pillonel, J

    2010-12-01

    Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens.

  16. Who comes to a workplace health risk assessment?

    PubMed

    Dobbins, T A; Simpson, J M; Oldenburg, B; Owen, N; Harris, D

    1998-01-01

    Workplace health promotion initiatives have proliferated, but there are difficulties in recruiting employees of lower socioeconomic status and at higher risk of disease. A survey of health behaviors and attitudes was administered in 20 worksites and the opportunity to attend a health risk assessment promoted. Those more likely to attend were women, those of higher occupational prestige, and those from a non-English-speaking background. After adjustment for these variables, the only health behavior associated with attendance was smoking status. Perceived risk of lung cancer was significant, even after adjustment for smoking status. Stage of readiness to change health behaviors was associated with attendance, with those in the preparation stage being more likely to attend than those in the precontemplation stage. However, this association was statistically significant only for fruit and vegetable consumption. There was no relation between attendance and support for health promotion, perceived general health, or other perceived risk of disease. These findings suggest that additional risk communication strategies and environmental support are required to involve those with less prestigious occupations.

  17. Environmental risks and children's health: what can PRAMS tell us?

    PubMed

    Korfmacher, Katrina Smith; Suter, Barbara J; Cai, Xueya; Brownson, Susan A; Dozier, Ann M

    2014-07-01

    Environmental exposures during pregnancy have a lasting impact on children's health. We combined environmental and maternal risk factor survey data to inform efforts to protect children's health. We made recommendations for future use of such data. A modified version of the Pregnancy Risk Assessment Monitoring System (PRAMS) mail survey was conducted based on weighted sampling design with low-income and non-low income women in Monroe County, NY (1,022 respondents). A series of environmental questions were included in the questionnaire. Data were analyzed using Chi square tests and Poisson loglinear regression model to identify patterns in environmental health risk and sociodemographic characteristics. We identified women who rented their homes, had lower incomes, and lived in inner city zip codes as "high environmental health risk" (HEHR). HEHR respondents were more likely to report that a health care provider talked with them about lead and on average reported more behaviors to protect their children from lead poisoning. Combining environmental and perinatal risk factor data could yield important recommendations for medical practice, health education, and policy development. However, at present PRAMS gathers only limited and inconsistent environmental data. We found that existing PRAMS environmental questions are insufficient. Further work is needed to develop updated and more comprehensive environmental health survey questions and implement them consistently across the country. PMID:23955384

  18. Health Risk Behavior and Sexual Assault among Ethnically Diverse Women

    ERIC Educational Resources Information Center

    Littleton, Heather L.; Grills-Taquechel, Amie E.; Buck, Katherine S.; Rosman, Lindsey; Dodd, Julia C.

    2013-01-01

    Sexual assault is associated with a number of health risk behaviors in women. It has been hypothesized that these risk behaviors, such as hazardous drinking, may represent women's attempts to cope with psychological distress, such as symptoms of depression and anxiety. However, extant research has failed to evaluate these relationships among…

  19. INCORPORATING HUMAN INTERINDIVIDUAL BIOTRANSFORMATION VARIANCE IN HEALTH RISK ASSESSMENT

    EPA Science Inventory

    The protection of sensitive individuals within a population dictates that measures other than central tendencies be employed to estimate risk. The refinement of human health risk assessments for chemicals metabolized by the liver to reflect data on human variability can be accom...

  20. Weight Misperception and Health Risk Behaviors among Early Adolescents

    ERIC Educational Resources Information Center

    Pasch, Keryn E.; Klein, Elizabeth G.; Laska, Melissa N.; Velazquez, Cayley E.; Moe, Stacey G.; Lytle, Leslie A.

    2011-01-01

    Objectives: To examine associations between weight misperception and youth health risk and protective factors. Methods: Three thousand ten US seventh-graders (72.1% white, mean age: 12.7 years) self-reported height, weight, risk, and protective factors. Analyses were conducted to determine cross-sectional and longitudinal associations between…

  1. Victimization and Health Risk Factors among Weapon-Carrying Youth

    ERIC Educational Resources Information Center

    Stayton, Catherine; McVeigh, Katharine H.; Olson, E. Carolyn; Perkins, Krystal; Kerker, Bonnie D.

    2011-01-01

    Objective: To compare health risks of 2 subgroups of weapon carriers: victimized and nonvictimized youth. Methods: 2003-2007 NYC Youth Risk Behavior Surveys were analyzed using bivariate analyses and multinomial logistic regression. Results: Among NYC teens, 7.5% reported weapon carrying without victimization; 6.9% reported it with victimization.…

  2. Is Accuracy of Weight Perception Associated with Health Risk Behaviors in a Diverse Sample of Obese Adolescents?

    ERIC Educational Resources Information Center

    Lenhart, Clare M.; Daly, Brian P.; Eichen, Dawn M.

    2011-01-01

    Current evidence is equivocal as to whether adolescent's perception of weight status is linked to both healthy and risky behaviors. This study examined the association between accurate and inaccurate perception of weight and self-reported health and risk behaviors among a diverse sample of obese, urban adolescents. Data were analyzed from 1,180…

  3. Risk distribution across multiple health insurance funds in rural Tanzania

    PubMed Central

    Chomi, Eunice Nahyuha; Mujinja, Phares Gamba; Enemark, Ulrika; Hansen, Kristian; Kiwara, Angwara Dennis

    2014-01-01

    Introduction Multiple insurance funds serving different population groups may compromise equity due to differential revenue raising capacity and an unequal distribution of high risk members among the funds. This occurs when the funds exist without mechanisms in place to promote income and risk cross-subsidisation across the funds. This paper analyses whether the risk distribution varies across the Community Health Fund (CHF) and National Health Insurance Fund (NHIF) in two districts in Tanzania. Specifically we aim to 1) identify risk factors associated with increased utilisation of health services and 2) compare the distribution of identified risk factors among the CHF, NHIF and non-member households. Methods Data was collected from a survey of 695 households. A multivariate logisitic regression model was used to identify risk factors for increased health care utilisation. Chi-square tests were performed to test whether the distribution of identified risk factors varied across the CHF, NHIF and non-member households. Results There was a higher concentration of identified risk factors among CHF households compared to those of the NHIF. Non-member households have a similar wealth status to CHF households, but a lower concentration of identified risk factors. Conclusion Mechanisms for broader risk spreading and cross-subsidisation across the funds are necessary for the promotion of equity. These include risk equalisation to adjust for differential risk distribution and revenue raising capacity of the funds. Expansion of CHF coverage is equally important, by addressing non-financial barriers to CHF enrolment to encourage wealthy non-members to join, as well as subsidised membership for the poorest. PMID:25574326

  4. Assessing human health risk in the USDA forest service

    SciTech Connect

    Hamel, D.R.

    1990-12-31

    This paper identifies the kinds of risk assessments being done by or for the US Department of Agriculture (USDA) Forest Service. Summaries of data sources currently in use and the pesticide risk assessments completed by the agency or its contractors are discussed. An overview is provided of the agency`s standard operating procedures for the conduct of toxicological, ecological, environmental fate, and human health risk assessments.

  5. Prognostic models and risk scores: can we accurately predict postoperative nausea and vomiting in children after craniotomy?

    PubMed

    Neufeld, Susan M; Newburn-Cook, Christine V; Drummond, Jane E

    2008-10-01

    Postoperative nausea and vomiting (PONV) is a problem for many children after craniotomy. Prognostic models and risk scores help identify who is at risk for an adverse event such as PONV to help guide clinical care. The purpose of this article is to assess whether an existing prognostic model or risk score can predict PONV in children after craniotomy. The concepts of transportability, calibration, and discrimination are presented to identify what is required to have a valid tool for clinical use. Although previous work may inform clinical practice and guide future research, existing prognostic models and risk scores do not appear to be options for predicting PONV in children undergoing craniotomy. However, until risk factors are further delineated, followed by the development and validation of prognostic models and risk scores that include children after craniotomy, clinical judgment in the context of current research may serve as a guide for clinical care in this population. PMID:18939320

  6. Health-risk assessment of trichlorofluoromethane in California drinking water

    SciTech Connect

    Reed, N.R.; Reed, W.; Weir, K.; Beltran, K.; Babapour, R.

    1988-12-22

    Existing literature is reviewed that is pertinent to the health risk posed by the use of Freon-11 contaminated drinking water, an estimation of the Freon-11 exposure for California residents based on the most recent data on Freon-11 concentrations in California drinking-water supplies, and a delineation of the level of Freon-11 that may cause a noncarcinogenic health effect.

  7. Physical Activity Protects against the Health Risks of Obesity.

    ERIC Educational Resources Information Center

    Welk, Gregory J.; Blair, Steven N.

    2000-01-01

    This paper reviews the relationships between physical fitness and body composition and their combined effect on health. After discussing the epidemiologic evidence for a protective effect of physical fitness on the health risks associated with obesity, it describes the Aerobics Center Longitudinal Study, an ongoing observational study that…

  8. Can Community Health Workers Report Accurately on Births and Deaths? Results of Field Assessments in Ethiopia, Malawi and Mali

    PubMed Central

    Silva, Romesh; Amouzou, Agbessi; Munos, Melinda; Marsh, Andrew; Hazel, Elizabeth; Victora, Cesar; Black, Robert; Bryce, Jennifer

    2016-01-01

    Introduction Most low-income countries lack complete and accurate vital registration systems. As a result, measures of under-five mortality rates rely mostly on household surveys. In collaboration with partners in Ethiopia, Ghana, Malawi, and Mali, we assessed the completeness and accuracy of reporting of births and deaths by community-based health workers, and the accuracy of annualized under-five mortality rate estimates derived from these data. Here we report on results from Ethiopia, Malawi and Mali. Method In all three countries, community health workers (CHWs) were trained, equipped and supported to report pregnancies, births and deaths within defined geographic areas over a period of at least fifteen months. In-country institutions collected these data every month. At each study site, we administered a full birth history (FBH) or full pregnancy history (FPH), to women of reproductive age via a census of households in Mali and via household surveys in Ethiopia and Malawi. Using these FBHs/FPHs as a validation data source, we assessed the completeness of the counts of births and deaths and the accuracy of under-five, infant, and neonatal mortality rates from the community-based method against the retrospective FBH/FPH for rolling twelve-month periods. For each method we calculated total cost, average annual cost per 1,000 population, and average cost per vital event reported. Results On average, CHWs submitted monthly vital event reports for over 95 percent of catchment areas in Ethiopia and Malawi, and for 100 percent of catchment areas in Mali. The completeness of vital events reporting by CHWs varied: we estimated that 30%-90% of annualized expected births (i.e. the number of births estimated using a FPH) were documented by CHWs and 22%-91% of annualized expected under-five deaths were documented by CHWs. Resulting annualized under-five mortality rates based on the CHW vital events reporting were, on average, under-estimated by 28% in Ethiopia, 32% in

  9. Evaluation of health risks for contaminated aquifers.

    PubMed Central

    Piver, W T; Jacobs, T L; Medina, M A

    1997-01-01

    This review focuses on progress in the development of transport models for heterogeneous contaminated aquifers, the use of predicted contaminant concentrations in groundwater for risk assessment for heterogeneous human populations, and the evaluation of aquifer remediation technologies. Major limitations and areas for continuing research for all methods presented in this review are identified. Images Figure 2. PMID:9114282

  10. Evaluation of health risks for contaminated aquifers.

    PubMed

    Piver, W T; Jacobs, T L; Medina, M A

    1997-02-01

    This review focuses on progress in the development of transport models for heterogeneous contaminated aquifers, the use of predicted contaminant concentrations in groundwater for risk assessment for heterogeneous human populations, and the evaluation of aquifer remediation technologies. Major limitations and areas for continuing research for all methods presented in this review are identified.

  11. Comparison of health risk behavior, awareness, and health benefit beliefs of health science and non-health science students: An international study.

    PubMed

    Peltzer, Karl; Pengpid, Supa; Yung, Tony K C; Aounallah-Skhiri, Hajer; Rehman, Rehana

    2016-06-01

    This study determines the differences in health risk behavior, knowledge, and health benefit beliefs between health science and non-health science university students in 17 low and middle income countries. Anonymous questionnaire data were collected in a cross-sectional survey of 13,042 undergraduate university students (4,981 health science and 8,061 non-health science students) from 17 universities in 17 countries across Asia, Africa, and the Americas. Results indicate that overall, health science students had the same mean number of health risk behaviors as non-health science university students. Regarding addictive risk behavior, fewer health science students used tobacco, were binge drinkers, or gambled once a week or more. Health science students also had a greater awareness of health behavior risks (5.5) than non-health science students (4.6). Linear regression analysis found a strong association with poor or weak health benefit beliefs and the health risk behavior index. There was no association between risk awareness and health risk behavior among health science students and an inverse association among non-health science students.

  12. Modelling microbial health risk of wastewater reuse: A systems perspective.

    PubMed

    Beaudequin, Denise; Harden, Fiona; Roiko, Anne; Stratton, Helen; Lemckert, Charles; Mengersen, Kerrie

    2015-11-01

    There is a widespread need for the use of quantitative microbial risk assessment (QMRA) to determine reclaimed water quality for specific uses, however neither faecal indicator levels nor pathogen concentrations alone are adequate for assessing exposure health risk. The aim of this study was to build a conceptual model representing factors contributing to the microbiological health risks of reusing water treated in maturation ponds. This paper describes the development of an unparameterised model that provides a visual representation of theoretical constructs and variables of interest. Information was collected from the peer-reviewed literature and through consultation with experts from regulatory authorities and academic disciplines. In this paper we explore how, considering microbial risk as a modular system, following the QMRA framework enables incorporation of the many factors influencing human exposure and dose response, to better characterise likely human health impacts. By using and expanding upon the QMRA framework we deliver new insights into this important field of environmental exposures. We present a conceptual model of health risk of microbial exposure which can be used for maturation ponds and, more importantly, as a generic tool to assess health risk in diverse wastewater reuse scenarios. PMID:26277638

  13. Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Race/Ethnicity

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2011

    2011-01-01

    The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

  14. Risk equalisation and voluntary health insurance: The South Africa experience.

    PubMed

    McLeod, Heather; Grobler, Pieter

    2010-11-01

    South Africa intends implementing major reforms in the financing of healthcare. Free market reforms in private health insurance in the late 1980s have been reversed by the new democratic government since 1994 with the re-introduction of open enrolment, community rating and minimum benefits. A system of national health insurance with income cross-subsidies, risk-adjusted payments and mandatory membership has been envisaged in policy papers since 1994. Subsequent work has seen the design of a Risk Equalisation Fund intended to operate between competing private health insurance funds. The paper outlines the South African health system and describes the risk equalisation formula that has been developed. The risk factors are age, gender, maternity events, numbers with certain chronic diseases and numbers with multiple chronic diseases. The Risk Equalisation Fund has been operating in shadow mode since 2005 with data being collected but no money changing hands. The South African experience of risk equalisation is of wider interest as it demonstrates an attempt to introduce more solidarity into a small but highly competitive private insurance market. The measures taken to combat over-reporting of chronic disease should be useful for countries or funders considering adding chronic disease to their risk equalisation formulae. PMID:20619476

  15. [Risk communication in analysis of occupational health risk for industrial workers].

    PubMed

    Barg, A O; Lebedeva-Nesevrya, N A

    2015-01-01

    The article covers problems of risk communication system function on industrial enterprise. Sociologic study in machinery construction enterprise of Perm area helped to consider main procedures of informing on occupational risk for health of workers exposed to occupational hazards, to describe features and mechanisms of risk communication, to specify its model. The authors proved that main obstacles for efficient system of occupational risks communication are insufficiently thorough legal basis, low corporative social responsibility of the enterprise and low social value of health for workers. This article was prepared with the support of the Russian Humanitarian Science Foundation (Project No. 14-16-59011). PMID:26596113

  16. Health Warnings on Alcoholic Beverages: Perceptions of the Health Risks and Intentions towards Alcohol Consumption

    PubMed Central

    Wigg, Sophie; Stafford, Lorenzo D.

    2016-01-01

    Objectives Research has demonstrated that packaging which includes pictorial health warnings are more effective in altering smokers’ perceptions and intentions as well as changing smoking behaviours compared to text-only health warnings. However, very few studies have investigated the effectiveness of health warnings on alcoholic beverages Methods Participants (N = 60) viewed alcoholic beverages presenting one of three health warnings (No health warning, Text-only, Pictorial) and then responded to questions relating to level of fear arousal and their perceptions toward alcohol use. Results We found that pictorial health warnings were associated with significantly higher fear arousal, increased perceptions of the health risks of consuming alcohol as well as greater intentions to reduce and quit alcohol consumption compared to the control. Conclusions These novel findings suggest pictorial health warnings on alcoholic beverages may be an important way of making the public aware of the health risks of alcohol consumption. PMID:27105210

  17. Integrating Risk Adjustment and Enrollee Premiums in Health Plan Payment

    PubMed Central

    McGuire, Thomas G.; Glazer, Jacob; Newhouse, Joseph P.; Normand, Sharon-Lise; Shi, Julie; Sinaiko, Anna D.; Zuvekas, Samuel

    2013-01-01

    In two important health policy contexts – private plans in Medicare and the new state-run “Exchanges” created as part of the Affordable Care Act (ACA) – plan payments come from two sources: risk-adjusted payments from a Regulator and premiums charged to individual enrollees. This paper derives principles for integrating risk-adjusted payments and premium policy in individual health insurance markets based on fitting total plan payments to health plan costs per person as closely as possible. A least squares regression including both health status and variables used in premiums reveals the weights a Regulator should put on risk adjusters when markets determine premiums. We apply the methods to an Exchange-eligible population drawn from the Medical Expenditure Panel Survey (MEPS). PMID:24308878

  18. Draugen HSE-case - occupational health risk management

    SciTech Connect

    Glas, J.J.P.; Kjaer, E.

    1996-12-31

    The Draugen HSE-Case serves as a risk management tool. Originally, risk management included only major safety hazards to personnel, environment and assets. Work Environment risks such as ergonomics, psycho-social factors and exposure to chemicals and noise, was not given the same attention. The Draugen HSE-Case addresses this weakness and extends all work environment risks. In order to promote line responsibility and commitment, relevant personnel is involved in the Case development. {open_quotes}THESIS{degrees}, a software application, is used to systematize input and to generate reports. The Draugen HSE-case encompasses: HSE risk analyses related to specific activities; Control of risk related to work environment; Established tolerability criteria; Risk reducing measures; Emergency contingency measures; and Requirements for Competence and Follow-up. The development of Draugen HSE-Case is a continuous process. It will serve to minimize the potential of occupational illnesses, raise general awareness, and make occupational health management more cost-effective.

  19. Health risk assessment of irradiated topaz

    SciTech Connect

    Nelson, J.W.; Baum, J.W.

    1993-01-01

    Irradiated topaz gemstones are currently processed for color improvement by subjecting clear stones to neutron or high-energy electron irradiations, which leads to activation of trace elements in the stones. Assessment of the risk to consumers required the identification and quantification of the resultant radionuclides and the attendant exposure. Representative stones from Brazil, India, Nigeria, Sri Lanka were irradiated and analyzed for gamma ray and beta particle emissions, using sodium iodide and germanium spectrometers; and Geiger-Muller, plastic and liquid scintillation, autoradiography, and thermoluminescent-dosimetry measurement techniques. Based on these studies and other information derived from published literature, dose and related risk estimates were made for typical user conditions. New criteria and methods for routine assays for acceptable release, based on gross beta and gross photon emissions from the stones, were also developed.

  20. Health risk appraisal: review of evidence for effectiveness.

    PubMed Central

    Schoenbach, V J; Wagner, E H; Beery, W L

    1987-01-01

    Since its introduction some two decades ago, health risk appraisal (HRA) has become a standard offering in the health promotion repertoire. The technique's distinctive feature is its use of epidemiologic data to generate quantitative risk messages for the client. Yet despite the dedication and considerable investments that have gone into HRA's development, dissemination, and use, there is only limited empirical evidence that these quantitative risk messages have any effect on clients. There do not appear to be any formal studies of HRA's effect on participation in health promotion programs, although increasing recruitment is regarded as a major benefit of using HRA. There are few indications of HRA effects on health beliefs. Most positive reports of effects on behavior change come from uncontrolled studies; several randomized controlled trials have yielded ambiguous findings. Virtually no data exist concerning the impact of the quantitative risk messages that distinguish HRA from other assessment techniques and that have motivated the substantial efforts toward developing and refining HRA. HRA has evident appeal and is probably a useful health education device for middle-class, middle-aged, nonminority clients. It may well have desirable effects on health-related beliefs, attitudes, and behaviors when accompanied by counseling or education, but available evidence has not established its effectiveness. Given the difficulty of obtaining definitive evidence of the effectiveness of HRA and specifically of its use of quantitative risk projections, the need for such evidence is debatable. An adequately funded and reviewed research program to examine whether projections of absolute risk affect knowledge, beliefs, attitudes, and intention to change is recommended as the most fruitful next step. Epidemiologically based HRA procedures that provide feedback in terms of qualitative statements or relative risk may be a promising approach to prospective health assessment. PMID

  1. Health risks for marine mammal workers.

    PubMed

    Hunt, Tania D; Ziccardi, Michael H; Gulland, Frances M D; Yochem, Pamela K; Hird, David W; Rowles, Teresa; Mazet, Jonna A K

    2008-08-19

    Marine mammals can be infected with zoonotic pathogens and show clinical signs of disease, or be asymptomatic carriers of such disease agents. While isolated cases of human disease from contact with marine mammals have been reported, no evaluation of the risks associated with marine mammal work has been attempted. Therefore, we designed a survey to estimate the risk of work-related injuries and illnesses in marine mammal workers and volunteers. The 17-question survey asked respondents to describe their contact with marine mammals, injuries sustained, and/or illnesses acquired during their period of marine mammal exposure. Most respondents, 88% (423/483), were researchers and rehabilitators. Of all respondents, 50% (243/483) reported suffering an injury caused by a marine mammal, and 23% (110/483) reported having a skin rash or reaction. Marine mammal work-related illnesses commonly reported included: 'seal finger' (Mycoplasma spp. or Erysipelothrix rhusiopathiae), conjunctivitis, viral dermatitis, bacterial dermatitis, and non-specific contact dermatitis. Although specific diagnoses could not be confirmed by a physician through this study, severe illnesses were reported and included tuberculosis, leptospirosis, brucellosis, and serious sequelae to seal finger. Risk factors associated with increased odds of injury and illness included prolonged and frequent exposure to marine mammals; direct contact with live marine mammals; and contact with tissue, blood, and excretions. Diagnosis of zoonotic disease was often aided by veterinarians; therefore, workers at risk should be encouraged to consult with a marine mammal veterinarian as well as a physician, especially if obtaining a definitive diagnosis for an illness becomes problematic.

  2. Biomarkers of bone health and osteoporosis risk.

    PubMed

    Eastell, Richard; Hannon, Rosemary A

    2008-05-01

    The assay features of biochemical markers of bone turnover have markedly improved in the past few years. The most sensitive and specific markers of bone formation include serum bone alkaline phosphatase, total osteocalcin (including the intact molecule and the large N-mid fragment) and the procollagen type I N-terminal propeptide assay. Among the various markers of bone resorption, measurements of the urinary excretion of N- and C-terminal cross-linked telopeptides) and of serum C-terminal cross-linked telopeptides are the most sensitive and specific. Markers of bone turnover can be used to predict the rate of bone loss in post-menopausal women and can also be used to assess the risk of fractures. In osteoporosis-treatment studies (with alendronate, risedronate, raloxifene) markers of bone turnover appear even more strongly associated with fracture risk reduction than bone mineral density (BMD). These observations support the use of markers of bone turnover as surrogates for fracture risk reduction, perhaps even more so than BMD. Bone markers can also be used to monitor the efficacy of antiresorptive therapy such as hormone-replacement therapy, raloxifene and bisphosphonates in individual patients. Furthermore, they have also proved to be helpful in monitoring the response to nutritional interventions and have the advantage over BMD in that they provide information about mechanism of effect and changes are often observed much more rapidly.

  3. Biologically Based Dose-Response Modeling. What is the potential for accurate description of the biological linkages in the applied dose - tissue dose-health effect continuum?

    EPA Science Inventory

    Given knowledge of exposure, the shape of the dose response curve is the key to predicting health risk, which in turn determines allowable levels of exposure and the associated economic costs of compliance.

  4. Human Health Risk Assessment of Trichloroethylene from Industrial Complex A

    PubMed Central

    Sin, Saemi

    2012-01-01

    This study investigated the human health risks of trichloroethylene from Industrial Complex A. The excessive carcinogenic risks for central tendency exposure were 1.40 × 10?5 for male and female residents in the vicinity of Industrial Complex A. The excessive cancers risk for reasonable maximum exposure were 2.88 × 10?5 and 1.97 × 10?5 for males and females, respectively. These values indicate that there are potential cancer risks for exposure to these concentrations. The hazard index for central tendency exposure to trichloroethylene was 1.71 for male and female residents. The hazard indexes for reasonable maximum exposure were 3.27 and 2.41 for males and females, respectively. These values were over one, which is equivalent to the threshold value. This result showed that adverse cancer and non-cancer health effects may occur and that some risk management of trichloroethylene from Industrial Complex A was needed. PMID:24278607

  5. In vitro assessment of equivalence of occupational health risk: welders.

    PubMed Central

    Stern, R M

    1983-01-01

    The possibility of using in vitro testing to determine the equivalence of risk for various occupational groups is discussed. In the absence of epidemiological evidence or relevant animal in vivo bioassays on which to determine the health effects of specific occupational exposures, it is proposed to use similarities in the in vitro response to substances with known (or strongly suspected) and unknown risk to demonstrate their risk equivalence. Identification and evaluation of a high risk "hot spot" due to exposure to Cr(VI) for stainless steel welders is discussed in terms of recent developments in collection, analysis and bioassay of welding fumes. PMID:6641655

  6. [Economic evaluation and rationale for human health risk management decisions].

    PubMed

    Fokin, S G; Bobkova, T E

    2011-01-01

    The priority task of human health maintenance and improvement is risk management using the new economic concepts based on the assessment of potential and real human risks from exposure to poor environmental factors and on the estimation of cost-benefit and cost-effectiveness ratios. The application of economic tools to manage a human risk makes it possible to assess various measures both as a whole and their individual priority areas, to rank different scenarios in terms of their effectiveness, to estimate costs per unit of risk reduction and benefit increase (damage decrease).

  7. Compounding conservatisms: EPA's health risk assessment methods

    SciTech Connect

    Stackelberg, K. von; Burmaster, D.E. )

    1993-03-01

    Superfund conjures up images of hazardous waste sites, which EPA is spending billions of dollars to remediate. One of the law's most worrisome effects is that it drains enormous economic resources without returning commensurate benefits. In a Sept. 1, 1991, front page article in The New York Times, experts argued that most health dangers at Superfund sites could be eliminated for a fraction of the billions that will be spent cleaning up the 1,200 high-priority sites across the country. Even EPA has suggested that the Superfund program may receive disproportionate resources, compared with other public health programs, such as radon in houses, the diminishing ozone layer and occupational diseases. Public opinion polls over the last decade consistently have mirrored the public's vast fear of hazardous waste sites, a fear as great as that held for nuclear power plants. Fear notwithstanding, the high cost of chosen remedies at given sites may have less to do with public health goals than with the method EPA uses to translate them into acceptable contaminant concentrations in soil, groundwater and other environmental media.

  8. Health Risk Assessment of Irradiated Topaz

    NASA Astrophysics Data System (ADS)

    Nelson, Kevin Lyle

    1991-06-01

    Radiation-produced blue topaz, indistinguishable from natural blue topaz, is produced by several different techniques. Published information on radionuclides present, activity levels, equipment necessary to detect activated nuclides and dosimetric assessment is lacking. Using a 60 megawatt nuclear reactor, fifty-one samples of colorless topaz from Nigeria, Sri Lanka, India and Brazil were irradiated with thermal and fast neutron fluences ranging from 1.8 times 10 13 to 9.2 times 1018 neutrons cm^{-2}. Seventeen MeV electrons produced by a linear accelerator were also used to irradiate 36 colorless topaz from the same countries. Gamma ray or positron-emitting nuclides were identified using calibrated well-type NaI or germanium detectors. For germanium detectors having relative efficiencies of approximately 20 percent, an analysis time of one hour or more was needed. Geiger Mueller (G-M) detectors, scintillators (plastic and liquid), gas flow proportional counters, a ZnS detector and autoradiography techniques were used to measure charged particle activity. Isotopes produced from neutron activation included 182Ta, ^ {59}Fe, 46Sc, 51Cr, 54Mn, 124Sb, ^{32 }P, 77As, ^ {183}Ta, 77Ge, 72Ga, and ^{24 }Na. Possible nuclides produced from 17 MeV electron treatment include ^{68 }Ga, 64Cu, ^ {49}Cr, and 18F. Positive identification of the electron activated nuclides was not possible because of the short half-lives involved (<1 day). Of the possible pure beta emitters activated during neutron bombardment, 32P and 35S are the most likely to be produced. The identification of 32P was made using a three point beta absorption analysis with a G-M detector. Skin and breast cancer risk estimates were calculated for various sized topaz containing NRC exempt concentration levels. When compared to a negligible individual risk level (NIRL) of 10^{-7}, the risk of an irradiated topaz in contact with the skin or three inches from breast tissue was a small fraction of the NIRL. At a risk

  9. Risk adjustment for high utilizers of public mental health care.

    PubMed

    Kapur, Kanika; Young, Alexander S.; Murata, Dennis

    2000-09-01

    BACKGROUND: Publicly funded mental health systems are increasingly implementing managed care systems, such as capitation, to control costs. Capitated contracts may increase the risk for disenrollment or adverse outcomes among high cost clients with severe mental illness. Risk-adjusted payments to providers are likely to reduce providers' incentives to avoid or under-treat these people. However, most research has focused on Medicare and private populations, and risk adjustment for individuals who are publicly funded and severely mentally ill has received far less attention. AIMS OF THE STUDY: Risk adjustment models for this population can be used to improve contracting for mental health care. Our objective is to develop risk adjustment models for individuals with severe mental illness and assess their performance in predicting future costs. We apply the risk adjustment model to predict costs for the first year of a pilot capitation program for the severely mentally ill that was not risk adjusted. We assess whether risk adjustment could have reduced disenrollment from this program. METHODS: This analysis uses longitudinal administrative data from the County of Los Angeles Department of Mental Health for the fiscal years 1991 to 1994. The sample consists of 1956 clients who have high costs and are severely mentally ill. We estimate several modified two part models of 1993 cost that use 1992 client-based variables such as demographics, living conditions, diagnoses and mental health costs (for 1992 and 1991) to explain the variation in mental health and substance abuse costs. RESULTS: We find that the model that incorporates demographic characteristics, diagnostic information and cost data from two previous years explains about 16 percent of the in-sample variation and 10 percent of the out-of-sample variation in costs. A model that excludes prior cost covariates explains only 5 percent of the variation in costs. Despite the relatively low predictive power, we find some

  10. Health risk assessment for inhalation exposure to arsenic.

    PubMed

    Fabiánová, E; Hettychová, L; Koppová, K; Hrubá, F; Marko, M; Maroni, M; Grech, G; Bencko, V

    2000-02-01

    Health risk assessment was used as the formal process to estimate the likelihood and magnitude of the health effects occurring in humans as a result of environmental and occupational exposure to polluting agents. This study was focused at estimating the human health risk of the general and working population living in the region polluted by arsenic for more than 40 years, from combustion of coal with high arsenic content in the power plant. The exposure to arsenic from inhalation was under investigation. A study period of 40 years (1973-1993) was chosen. The study period was defined taking into account, besides the availability of data, the temporal patterns of the technological processes and the trends over time of environmental concentrations. The results from the arsenic risk assessment study were used for the evaluation of the health risk for different population groups in the polluted areas and for different professions of workers exposed to As in a power plant. The results are applicable for the evaluation of risk in real conditions, for health surveillance and for remedial changes and a potential suggestion on technological improvement.

  11. Public Health Risk Conditioned by Chemical Composition of Ground Water

    NASA Astrophysics Data System (ADS)

    Yankovich, E.; Osipova, N.; Yankovich, K.; Matveenko, I.

    2016-03-01

    The article studies the public health potential risk originated from water consumption and estimated on the basis of the groundwater chemical composition. We have processed the results of chemical groundwater analysis in different aquifers of Tomsk district (Tomsk Oblast, Russia). More than 8400 samples of chemical groundwater analyses were taken during long-term observation period. Human health risk assessment of exposure to contaminants in drinking water was performed in accordance with the risk assessment guidance for public health concerning chemical pollution of the environment (Russian reference number: 2.1.10.1920-04-M, 2004). Identified potential risks were estimated for consuming water of each aquifer. The comparative analysis of water quality of different aquifers was performed on the basis of the risk coefficient of the total non-carcinogenic effects. The non-carcinogenic risk for the health of the Tomsk district population due to groundwater consumption without prior sanitary treatment was admitted acceptable. A rather similar picture is observed for all aquifers, although deeper aquifers show lower hazard coefficients.

  12. A continuum of risk? The management of health, physical and emotional risks by female sex workers.

    PubMed

    Sanders, Teela

    2004-07-01

    This paper describes the findings from a 10-month ethnographic study of the female sex industry in a large British city. I argue that sex workers construct a continuum of risk which prioritizes certain types of dangers depending on the perceived consequences and the degree of control individuals consider they have over minimising the likelihood of a risk occurring. Although health-related matters are a real concern to many women, because they generally have comprehensive strategies to manage health risks at work, this risk category is given a low priority compared with other risks. The risk of violence is considered a greater anxiety because of the prevalence of incidents in the sex work community. However, because of comprehensive screening and protection strategies to minimise violence, this type of harm is not given the same level of attention that emotional risks receive. By using a continuum of risk to understand how sex workers perceive occupational hazards in prostitution, further understanding can be gained about the nature of risk in prostitution, sex workers' routines and the organisational features of the sex industry. In addition, the implications for health policy are discussed, suggesting that the emotional consequences of selling sex should be considered as much as the tangible, physical risks of prostitution.

  13. A public health context for residual risk assessment and risk management under the clean air act.

    PubMed

    Charnley, G; Goldstein, B D

    1998-09-01

    The 1990 amendments to the Clean Air Act required the EPA to institute new pollution control technology requirements for industrial sources of air pollution. In part because agreement could not be reached on the best way for the EPA to determine whether any significant risks to human health will remain after the technology controls are in place, the amendments also created a Commission on Risk Assessment and Risk Management and gave the commission a broad mandate to review and make recommendations concerning risk assessment and risk management in federal regulatory programs. In its March 1997 final report to Congress and the administration, the commission recommended a tiered approach to assessing such residual risks. That approach included the idea that when decisions about managing residual risks are made, emissions should be evaluated in the context of other sources of air pollution. Evaluating risks in their larger contexts is consistent with what the commission called a public health approach to environmental risk management. This paper describes the public health approach and how it applies to evaluating residual risks under the Clean Air Act. PMID:9721251

  14. Food safety risks and consumer health.

    PubMed

    Chassy, Bruce M

    2010-11-30

    The major food safety risks are not eating a healthy diet, and failure to avoid foodborne illness. Over one billion people in the world suffer from food insecurity and malnutrition. Nutritionally enhanced transgenic crops such as Golden Rice are one potential strategy for reducing malnutrition in the world. Transgenic crops are subjected to a rigorous pre-market safety assessment. The safety of novel proteins and other products is established, and through compositional analysis and animal studies, the safety of any observed changes is evaluated. These studies provide evidence that the new product is as safe as, or safer than, comparable varieties. It must be asked, however, if this rigorous analysis is necessary, because unregulated crops produced by other breeding methods also undergo genetic changes and contain unintended effects. Golden Rice poses infinitesimally small, if any, risk to consumers whilst it has the potential to spare millions of lives each year. However, because it is a transgenic crop, it cannot be deployed without years of expensive pre-market safety review. Paradoxically, if Golden Rice had been produced by less precise conventional methods of breeding, it would already be in the hands of poor farmers. It is concluded that the hyper-precautionary regulatory process applied to transgenic crops works to the extreme disadvantage of the hungry and the poor.

  15. Review of health risks of low testosterone and testosterone administration

    PubMed Central

    Jia, Huanguang; Sullivan, Charles T; McCoy, Sean C; Yarrow, Joshua F; Morrow, Matthew; Borst, Stephen E

    2015-01-01

    Hypogonadism is prevalent in older men and testosterone replacement therapy (TRT) for older hypogonadal men is a promising therapy. However, a number of important clinical concerns over TRT safety remain unsolved due to a lack of large-scale randomized clinical trials directly comparing the health risks of untreated hypogonadism vs long-term use of TRT. Meta-analyses of clinical trials of TRT as of 2010 have identified three major adverse events resulting from TRT: polycythemia, an increase in prostate-related events, and a slight reduction in serum high-density lipoprotein cholesterol. There are other purported health risks but their incidence can be neither confirmed nor denied based on the small number of subjects that have been studied to date. Furthermore, subsequent literature is equivocal with regard to the safety and utility of TRT and this topic has been subject to contentious debate. Since January 2014, the United States Food and Drug Administration has released two official announcements regarding the safety of TRT and clinical monitoring the risks in TRT users. Additionally, the health risks related to the clinical presentation of low or declining testosterone levels not been resolved in the current literature. Because TRT is prescribed in the context of putative risks resulting from reduced testosterone levels, we reviewed the epidemiology and reported risks of low testosterone levels. We also highlight the current information about TRT utilization, the risks most often claimed to be associated with TRT, and current or emerging alternatives to TRT. PMID:25879005

  16. Health, safety and environmental risk management in laboratory fields

    PubMed Central

    Yarahmadi, Rasoul; Moridi, Parvin; Roumiani, YarAllah

    2016-01-01

    Background: Research project risks are uncertain contingent events or situations that, if transpire, will have positive or negative effects on objectives of a project. The Management of Health and Safety at Work (MHSW) Regulations 1999 require all employers and the self-employed persons to assess the risks from their work on anyone who may be affected by their activities. Risk assessment is the first step in risk-management procedure, and due to its importance, it has been deemed to be a vital process while having a unique place in the researchbased management systems. Methods: In this research, a two-pronged study was carried out. Firstly, health and safety issues were studied and analyzed by means of ISO 14121. Secondly, environmental issues were examined with the aid of Failure Mode and Effect Analysis. Both processes were utilized to determine the risk level independently for each research laboratory and corrective measure priorities in each field (laboratory). Results: Data analysis showed that the total main and inherent risks in laboratory sites reduced by 38% to 86%. Upon comparing the average risk levels before and after implementing the control and protective actions utilizing risk management approaches which were separate from health, safety and environmental aspects, a highly effective significance (p<0.001) was obtained for inherent risk reduction. Analysis of health, safety and environmental control priorities with the purpose of comparing the ratio of the number of engineering measures to the amount of management ones showed a relatively significant increase. Conclusion: The large number of engineering measures was attributed to the employment of a variety of timeworn machinery (old technologies) along with using devices without basic protection components. PMID:27284544

  17. Fukushima Nuclear Power Plant Accident and Comprehensive Health Risk Management—Global Radiocontamination and Information Disaster

    PubMed Central

    2014-01-01

    The Great East Japan Earthquake on March 11, 2011, besides further studying the appropriateness of the initial response and post-countermeasures against the severe Fukushima nuclear accident, has now increased the importance of the epidemiological study in comprehensive health risk management and radiation protection; lessons learnt from the Chernobyl accident should be also implemented. Therefore, since May 2011, Fukushima Prefecture has started the “Fukushima Health Management Survey Project” for the purpose of long-term health care administration and early diagnosis/treatment for the prefectural residents. Basic survey is under investigation on a retrospective estimation of external exposure of the first four months. As one of the four detailed surveys, the thyroid ultrasound examination has clarified the increased detection rate of childhood thyroid cancers as a screening effect in the past three years and so thyroid cancer occurrence by Fukushima nuclear power plant accident, especially due to radioactive iodine will be discussed despite of difficult challenge of accurate estimation of low dose and low-dose rate radiation exposures. Through the on-site valuable experience and a difficult challenge for recovery, we should learn the lessons from this severe and large-scale nuclear accident, especially how to countermeasure against public health emergency at the standpoint of health risk and also social risk management. PMID:25425958

  18. Child Social Exclusion Risk and Child Health Outcomes in Australia

    PubMed Central

    Mohanty, Itismita; Edvardsson, Martin; Abello, Annie; Eldridge, Deanna

    2016-01-01

    Introduction This paper studies the relationship between the risk of child social exclusion, as measured by the Child Social Exclusion (CSE) index and its individual domains, and child health outcomes at the small area level in Australia. The CSE index is Australia’s only national small-area index of the risk of child social exclusion. It includes five domains that capture different components of social exclusion: socio-economic background, education, connectedness, housing and health services. Methods The paper used data from the National Centre for Social and Economic Modelling (NATSEM), University of Canberra for the CSE Index and its domains and two key Australian Institute of Health and Welfare (AIHW) data sources for the health outcome measures: the National Hospital Morbidity Database and the National Mortality Database. Results The results show positive associations between rates of both of the negative health outcomes: potentially preventable hospitalisations (PPH) and avoidable deaths, and the overall risk of child social exclusion as well as with the index domains. This analysis at the small-area level can be used to identify and study areas with unexpectedly good or bad health outcomes relative to their estimated risk of child social exclusion. We show that children’s health outcomes are worse in remote parts of Australia than what would be expected solely based on the CSE index. Conclusions The results of this study suggest that developing composite indices of the risk of child social exclusion can provide valuable guidance for local interventions and programs aimed at improving children’s health outcomes. They also indicate the importance of taking a small-area approach when conducting geographic modelling of disadvantage. PMID:27152596

  19. Associations between multiple health risk behaviors and mental health among Chinese college students.

    PubMed

    Ye, Yong-ling; Wang, Pei-gang; Qu, Geng-cong; Yuan, Shuai; Phongsavan, Philayrath; He, Qi-qiang

    2016-01-01

    Although there is substantial evidence that health risk behaviors increase risks of premature morbidity and mortality, little is known about the multiple health risk behaviors in Chinese college students. Here, we investigated the prevalence of multiple health risk behaviors and its relation to mental health among Chinese college students. A cross-sectional study was conducted in Wuhan, China from May to June 2012. The students reported their health risk behaviors using self-administered questionnaires. Depression and anxiety were assessed using the self-rating depression scale and self-rating anxiety scale, respectively. A total of 2422 college students (1433 males) aged 19.7 ± 1.2 years were participated in the study. The prevalence of physical inactivity, sleep disturbance, poor dietary behavior, Internet addiction disorder (IAD), frequent alcohol use and current smoking was 62.0, 42.6, 29.8, 22.3, 11.6 and 9.3%, respectively. Significantly increased risks for depression and anxiety were found among students with frequent alcohol use, sleep disturbance, poor dietary behavior and IAD. Two-step cluster analysis identified two different clusters. Participants in the cluster with more unhealthy behaviors showed significantly increased risk for depression (odds ratio (OR): 2.21; 95% confidence interval (CI): 1.83, 2.67) and anxiety (OR: 2.32; 95% CI: 1.85, 2.92). This study indicates that a relatively high prevalence of multiple health risk behaviors was found among Chinese college students. Furthermore, the clustering of health risk behaviors was significantly associated with increased risks for depression and anxiety.

  20. Antibiotics exposure and health risks: chloramphenicol.

    PubMed

    Hanekamp, Jaap C; Bast, Aalt

    2015-01-01

    The antibiotic chloramphenicol (CAP) is banned from food production. Besides being a medicinal product, CAP is also a natural product, produced by Streptomyces Venezuelae. The lack of scientific data hampers setting of an Acceptable Daily Intake (ADI). Consequently, a maximum residue limit (MRL) in food could not be established. This was then translated into a zero tolerance using the so-called Minimum Required Performance Limit (MRPL) level, viz. the achievable detection limit in food, to guide the zero tolerance policy. The MRPL is clearly not relevant to food safety and human health but is solely related to analytical technological capabilities. The increase in the latter enables detection at ever-lower levels and ignores toxicological relevance. We here provide arguments to use a Threshold of Toxicological Concern (TTC) for CAP that can accommodate developing toxicological insights. PMID:25528412

  1. A 21st century roadmap for human health risk assessment.

    PubMed

    Pastoor, Timothy P; Bachman, Ammie N; Bell, David R; Cohen, Samuel M; Dellarco, Michael; Dewhurst, Ian C; Doe, John E; Doerrer, Nancy G; Embry, Michelle R; Hines, Ronald N; Moretto, Angelo; Phillips, Richard D; Rowlands, J Craig; Tanir, Jennifer Y; Wolf, Douglas C; Boobis, Alan R

    2014-08-01

    The Health and Environmental Sciences Institute (HESI)-coordinated Risk Assessment in the 21st Century (RISK21) project was initiated to develop a scientific, transparent, and efficient approach to the evolving world of human health risk assessment, and involved over 120 participants from 12 countries, 15 government institutions, 20 universities, 2 non-governmental organizations, and 12 corporations. This paper provides a brief overview of the tiered RISK21 framework called the roadmap and risk visualization matrix, and articulates the core principles derived by RISK21 participants that guided its development. Subsequent papers describe the roadmap and matrix in greater detail. RISK21 principles include focusing on problem formulation, utilizing existing information, starting with exposure assessment (rather than toxicity), and using a tiered process for data development. Bringing estimates of exposure and toxicity together on a two-dimensional matrix provides a clear rendition of human safety and risk. The value of the roadmap is its capacity to chronicle the stepwise acquisition of scientific information and display it in a clear and concise fashion. Furthermore, the tiered approach and transparent display of information will contribute to greater efficiencies by calling for data only as needed (enough precision to make a decision), thus conserving animals and other resources.

  2. The health risks of saccharin revisited.

    PubMed

    Ellwein, L B; Cohen, S M

    1990-01-01

    Almost from its discovery in 1879, the use of saccharin as an artificial, non-nutritive sweetener has been the center of several controversies regarding potential toxic effects, most recently focusing on the urinary bladder carcinogenicity of sodium saccharin in rats when fed at high doses in two-generation studies. No carcinogenic effect has been observed in mice, hamsters, or monkeys, and numerous epidemiological studies provide no clear or consistent evidence to support the assertion that sodium saccharin increases the risk of bladder cancer in the human population. Mechanism of action studies in the one susceptible species, the rat, continue to provide information useful in assessing potential risk to the human from saccharin consumption. Unlike typical carcinogens which interact with DNA, sodium saccharin is not genotoxic, but leads to an increase in cell proliferation of the urothelium, the only target tissue. It also appears that the effect of saccharin is modified by the salt form in which it is administered, despite equivalent concentrations of saccharin in the urine. The chemical form of saccharin in the urine is unaffected, and there is no evidence for a specific cell receptor for the saccharin molecule. Changes in several urinary parameters, such as pH, sodium, protein, silicates, volume, and others, appear to influence the reaction of the urothelium to sodium saccharin administration. Silicon-containing precipitate and/or crystals appear to be generated in the urine under specific circumstances, acting as microabrasive, cytotoxic material. Using a mathematical model of carcinogenesis, which encompasses the temporal dynamics and complexity of the process at a cellular level, including spontaneous genetic transitions, it has been shown that the effects of sodium saccharin can be explained entirely in terms of its non-genotoxic influence on cell proliferation. In interpreting these analytical studies in the human context, particularly as they pertain to

  3. A Model for Risk Assessment in Health Care.

    PubMed

    Prijatelj, Vesna; Rajkovič, Vladislav; Šušteršič, Olga

    2016-01-01

    The purpose of our research is to reduce risks and hence prevent errors in the health care process. The aim is to design an organizational information model using error prevention methods for risk assessment in a clinical setting. The model is based on selected indicators of quality nursing care, resulting from the world-known theoretical and practical models combined with experience in the Slovenian health care. The proposed organizational information model and software solution has a significant impact on the professional attention, communication and information, critical thinking, experience and knowledge. PMID:27332383

  4. Rural Community Leaders’ Perceptions of Environmental Health Risks

    PubMed Central

    Larsson, Laura S.; Butterfield, Patricia; Christopher, Suzanne; Hill, Wade

    2015-01-01

    Qualitative description was used to explore how rural community leaders frame, interpret, and give meaning to environmental health issues affecting their constituents and communities. Six rural community leaders discussed growth, vulnerable families, and the action avoidance strategies they use or see used in lieu of adopting health-promoting behaviors. Findings suggest intervention strategies should be economical, use common sense, be sensitive to regional identity, and use local case studies and “inside leadership.” Occupational health nurses addressing the disparate environmental health risks in rural communities are encouraged to use agenda-neutral, scientifically based risk communication efforts and foster collaborative relationships among nurses, planners, industry, and other community leaders. PMID:16562621

  5. Health of North American forests: Stress and risk assessment

    SciTech Connect

    Smith, W.H. )

    1990-01-01

    The 1980s will be remembered by forest professionals as a decade of intense and widespread societal concern for the vitality and integrity of forest systems. Daily reports of tropical deforestation and temperate forest decline have heightened social consciousness of forest health. It is therefore appropriate, as we enter the 1990s, to assess the health of our forests and propose new initiatives in this critically important area. Making generalizations about the health of North American forests is difficult because of the extraordinary diversity of forests, management regimes, and stress factors. This overview article summarizes forest health fundamentals, significant health risks, and priorities in future forest health management for temperate forests of the United States.

  6. Methylcyclopentadienyl manganese tricarbonyl: health risk uncertainties and research directions.

    PubMed Central

    Davis, J M

    1998-01-01

    With the way cleared for increased use of the fuel additive methylcyclopentadienyl manganese tricarbonyl (MMT) in the United States, the issue of possible public health impacts associated with this additive has gained greater attention. In assessing potential health risks of particulate Mn emitted from the combustion of MMT in gasoline, the U.S. Environmental Protection Agency not only considered the qualitative types of toxic effects associated with inhaled Mn, but conducted extensive exposure-response analyses using various statistical approaches and also estimated population exposure distributions of particulate Mn based on data from an exposure study conducted in California when MMT was used in leaded gasoline. Because of limitations in available data and the need to make several assumptions and extrapolations, the resulting risk characterization had inherent uncertainties that made it impossible to estimate health risks in a definitive or quantitative manner. To support an improved health risk characterization, further investigation is needed in the areas of health effects, emission characterization, and exposure analysis. PMID:9539013

  7. Cardiovascular Health Informatics: Risk Screening and Intervention

    PubMed Central

    Hartley, Craig J.; Naghavi, Morteza; Parodi, Oberdan; Pattichis, Constantinos S.; Poon, Carmen C. Y.; Zhang, Yuan-Ting

    2014-01-01

    Despite enormous efforts to prevent cardiovascular disease (CVD) in the past, it remains the leading cause of death in most countries worldwide. Around two-thirds of these deaths are due to acute events, which frequently occur suddenly and are often fatal before medical care can be given. New strategies for screening and early intervening CVD, in addition to the conventional methods, are therefore needed in order to provide personalized and pervasive healthcare. In this special issue, selected emerging technologies in health informatics for screening and intervening CVDs are reported. These papers include reviews or original contributions on 1) new potential genetic biomarkers for screening CVD outcomes and high-throughput techniques for mining genomic data; 2) new imaging techniques for obtaining faster and higher resolution images of cardiovascular imaging biomarkers such as the cardiac chambers and atherosclerotic plaques in coronary arteries, as well as possible automatic segmentation, identification, or fusion algorithms; 3) new physiological biomarkers and novel wearable and home healthcare technologies for monitoring them in daily lives; 4) new personalized prediction models of plaque formation and progression or CVD outcomes; and 5) quantifiable indices and wearable systems to measure them for early intervention of CVD through lifestyle changes. It is hoped that the proposed technologies and systems covered in this special issue can result in improved CVD management and treatment at the point of need, offering a better quality of life to the patient. PMID:22997187

  8. Health risks of genetically modified foods.

    PubMed

    Dona, Artemis; Arvanitoyannis, Ioannis S

    2009-02-01

    As genetically modified (GM) foods are starting to intrude in our diet concerns have been expressed regarding GM food safety. These concerns as well as the limitations of the procedures followed in the evaluation of their safety are presented. Animal toxicity studies with certain GM foods have shown that they may toxically affect several organs and systems. The review of these studies should not be conducted separately for each GM food, but according to the effects exerted on certain organs it may help us create a better picture of the possible health effects on human beings. The results of most studies with GM foods indicate that they may cause some common toxic effects such as hepatic, pancreatic, renal, or reproductive effects and may alter the hematological, biochemical, and immunologic parameters. However, many years of research with animals and clinical trials are required for this assessment. The use of recombinant GH or its expression in animals should be re-examined since it has been shown that it increases IGF-1 which may promote cancer.

  9. Air pollution and health risks due to vehicle traffic.

    PubMed

    Zhang, Kai; Batterman, Stuart

    2013-04-15

    Traffic congestion increases vehicle emissions and degrades ambient air quality, and recent studies have shown excess morbidity and mortality for drivers, commuters and individuals living near major roadways. Presently, our understanding of the air pollution impacts from congestion on roads is very limited. This study demonstrates an approach to characterize risks of traffic for on- and near-road populations. Simulation modeling was used to estimate on- and near-road NO2 concentrations and health risks for freeway and arterial scenarios attributable to traffic for different traffic volumes during rush hour periods. The modeling used emission factors from two different models (Comprehensive Modal Emissions Model and Motor Vehicle Emissions Factor Model version 6.2), an empirical traffic speed-volume relationship, the California Line Source Dispersion Model, an empirical NO2-NOx relationship, estimated travel time changes during congestion, and concentration-response relationships from the literature, which give emergency doctor visits, hospital admissions and mortality attributed to NO2 exposure. An incremental analysis, which expresses the change in health risks for small increases in traffic volume, showed non-linear effects. For a freeway, "U" shaped trends of incremental risks were predicted for on-road populations, and incremental risks are flat at low traffic volumes for near-road populations. For an arterial road, incremental risks increased sharply for both on- and near-road populations as traffic increased. These patterns result from changes in emission factors, the NO2-NOx relationship, the travel delay for the on-road population, and the extended duration of rush hour for the near-road population. This study suggests that health risks from congestion are potentially significant, and that additional traffic can significantly increase risks, depending on the type of road and other factors. Further, evaluations of risk associated with congestion must

  10. Human Health Risk Assessment Calculator. In: SMARTe20ll, EPA/600/C-10/007

    EPA Science Inventory

    This calculator is aimed at supporting a human health risk assessment. Risk scenarios can be built by combining various health effects, exposure pathways, exposure parameters, and analytes. Scenario risk are calculated for each exposure pathway and analyte combination. The out...

  11. Exploring Mexican adolescents' perceptions of environmental health risks: a photographic approach to risk analysis.

    PubMed

    Börner, Susanne; Albino, Juan Carlos Torrico; Caraveo, Luz María Nieto; Tejeda, Ana Cristina Cubillas

    2015-05-01

    The objective of this study was to explore Mexican adolescents' perceptions of environmental health risks in contaminated urban areas, and to test the environmental photography technique as a research tool for engaging adolescents in community-based health research. The study was conducted with 74 adolescents from two communities in the city of San Luis Potosi, Mexico. Participants were provided with disposable cameras and asked to take photographs of elements and situations which they believed affected their personal health both at home and outside their homes. They were also asked to describe each photograph in writing. Photographs and written explanations were analyzed by using quantitative and qualitative content analysis. Risk perception plays a crucial role in the development of Risk Communication Programs (RCPs) aimed at the improvement of community health. The photography technique opens up a promising field for environmental health research since it affords a realistic and concise impression of the perceived risks. Adolescents in both communities perceived different environmental health risks as detrimental to their well-being, e.g. waste, air pollution, and lack of hygiene. Yet, some knowledge gaps remain which need to be addressed. PMID:26017963

  12. Exploring Mexican adolescents' perceptions of environmental health risks: a photographic approach to risk analysis.

    PubMed

    Börner, Susanne; Albino, Juan Carlos Torrico; Caraveo, Luz María Nieto; Tejeda, Ana Cristina Cubillas

    2015-05-01

    The objective of this study was to explore Mexican adolescents' perceptions of environmental health risks in contaminated urban areas, and to test the environmental photography technique as a research tool for engaging adolescents in community-based health research. The study was conducted with 74 adolescents from two communities in the city of San Luis Potosi, Mexico. Participants were provided with disposable cameras and asked to take photographs of elements and situations which they believed affected their personal health both at home and outside their homes. They were also asked to describe each photograph in writing. Photographs and written explanations were analyzed by using quantitative and qualitative content analysis. Risk perception plays a crucial role in the development of Risk Communication Programs (RCPs) aimed at the improvement of community health. The photography technique opens up a promising field for environmental health research since it affords a realistic and concise impression of the perceived risks. Adolescents in both communities perceived different environmental health risks as detrimental to their well-being, e.g. waste, air pollution, and lack of hygiene. Yet, some knowledge gaps remain which need to be addressed.

  13. Motivators and barriers to incorporating climate change-related health risks in environmental health impact assessment.

    PubMed

    Turner, Lyle R; Alderman, Katarzyna; Connell, Des; Tong, Shilu

    2013-03-22

    Climate change presents risks to health that must be addressed by both decision-makers and public health researchers. Within the application of Environmental Health Impact Assessment (EHIA), there have been few attempts to incorporate climate change-related health risks as an input to the framework. This study used a focus group design to examine the perceptions of government, industry and academic specialists about the suitability of assessing the health consequences of climate change within an EHIA framework. Practitioners expressed concern over a number of factors relating to the current EHIA methodology and the inclusion of climate change-related health risks. These concerns related to the broad scope of issues that would need to be considered, problems with identifying appropriate health indicators, the lack of relevant qualitative information that is currently incorporated in assessment and persistent issues surrounding stakeholder participation. It was suggested that improvements are needed in data collection processes, particularly in terms of adequate communication between environmental and health practitioners. Concerns were raised surrounding data privacy and usage, and how these could impact on the assessment process. These findings may provide guidance for government and industry bodies to improve the assessment of climate change-related health risks.

  14. Health risks from increases in methylmercury exposure.

    PubMed Central

    Mottet, N K; Shaw, C M; Burbacher, T M

    1985-01-01

    Our present knowledge of the human health effects of methylmercury exposure is derived from study of major outbreaks of human poisonings in Japan and Iraq and experimental studies on primates. Methylmercury readily passes through such physiological barriers as the blood-brain barrier, blood-testes barrier, and the placenta. Its major pathological effects are on the nervous and reproductive systems and the developing embryo/fetus. The neurotoxicity of methylmercury is well established in both humans and non-human primates. Lesions in the cerebral and cerebellar gray matter consist of necrosis and lysis of neurons, phagocytosis and gliosis. The changes are most prominent in the deep sulci and may have a vascular component. A late effect is cerebral atrophy. At high dose levels the liver, kidneys, and other organs may also have degenerative changes. Although not yet described in humans, a major effect of exposure of female primates is an adverse effect on pregnancy. Maternal female M. fascicularis blood mercury levels above 1 ppm are associated with a decreased pregnancy rate and increased abortion rate. To date our experimental data lack sufficient numbers to detect infrequent pregnancy effects below 1 ppm. Preliminary studies also reveal that methylmercury may also decrease the number and function (swim speed) of sperm. Both human and primate studies demonstrate deleterious effects of methylmercury on the developing embryo/fetus. Autopsies on human and primate infants reveal retarded brain development and the occurrence of a cerebral palsy-like behavior in the newborns, whereas the mother may be free of signs and symptoms of methylmercury toxicity. The fetal blood level of mercury is higher than the maternal level.(ABSTRACT TRUNCATED AT 250 WORDS) Images FIGURE 1. FIGURE 2. FIGURE 3. FIGURE 5. PMID:3908085

  15. Environmental health risk assessment and management for global climate change

    NASA Astrophysics Data System (ADS)

    Carter, P.

    2014-12-01

    This environmental health risk assessment and management approach for atmospheric greenhouse gas (GHG) pollution is based almost entirely on IPCC AR5 (2014) content, but the IPCC does not make recommendations. Large climate model uncertainties may be large environmental health risks. In accordance with environmental health risk management, we use the standard (IPCC-endorsed) formula of risk as the product of magnitude times probability, with an extremely high standard of precaution. Atmospheric GHG pollution, causing global warming, climate change and ocean acidification, is increasing as fast as ever. Time is of the essence to inform and make recommendations to governments and the public. While the 2ºC target is the only formally agreed-upon policy limit, for the most vulnerable nations, a 1.5ºC limit is being considered by the UNFCCC Secretariat. The Climate Action Network International (2014), representing civil society, recommends that the 1.5ºC limit be kept open and that emissions decline from 2015. James Hansen et al (2013) have argued that 1ºC is the danger limit. Taking into account committed global warming, its millennial duration, multiple large sources of amplifying climate feedbacks and multiple adverse impacts of global warming and climate change on crops, and population health impacts, all the IPCC AR5 scenarios carry extreme environmental health risks to large human populations and to the future of humanity as a whole. Our risk consideration finds that 2ºC carries high risks of many catastrophic impacts, that 1.5ºC carries high risks of many disastrous impacts, and that 1ºC is the danger limit. IPCC AR4 (2007) showed that emissions must be reversed by 2015 for a 2ºC warming limit. For the IPCC AR5 only the best-case scenario RCP2.6, is projected to stay under 2ºC by 2100 but the upper range is just above 2ºC. It calls for emissions to decline by 2020. We recommend that for catastrophic environmental health risk aversion, emissions decline

  16. Occupational HIV risk for health care workers: risk factor and the risk of infection in the course of professional activities

    PubMed Central

    Wyżgowski, Przemysław; Rosiek, Anna; Grzela, Tomasz; Leksowski, Krzysztof

    2016-01-01

    Virtually created panic among health care workers about pandemic acquired immune deficiency syndrome prompted us to review the scientific literature to investigate the risk of human immunodeficiency virus (HIV) transmission in the daily works of health care workers, especially surgeons and anesthesiologists. In this review, we report worldwide valuations of the number of HIV infections that may occur from unsafe daily work in health care. We also present how to minimize the risk of infection by taking precautions and how to utilize postexposure prophylaxis in accordance with the latest reports of the Centers for Disease Control and Prevention. HIV-infected patients will be aging, and most of them will become the candidates for procedures such as major vascular reconstruction and artery bypass grafting, where the risks of blood contact and staff injury are high. For these reasons, all health care workers need to know how to prevent, and fight following the accidental exposure to HIV. PMID:27366077

  17. Smoking and HIV: prevalence, health risks, and cessation strategies.

    PubMed

    Lifson, Alan R; Lando, Harry A

    2012-09-01

    Health hazards due to smoking may undermine benefits of HIV treatment on morbidity and mortality. Over 40% of persons with HIV are current smokers. Health risks of smoking include increases in some HIV-associated infections, cardiovascular disease, some cancers, bacterial pneumonia and other lung disease, and overall mortality. Proven strategies for smoking cessation include various counseling approaches, nicotine replacement therapy and other pharmacotherapy; approaches may need to be individualized to address specific client needs and comorbidities. HIV clinicians and other service providers can have an influential role in screening their patients for smoking and promoting cessation programs to improve health.

  18. [Urbanization--a factor that increases the risk for health].

    PubMed

    Fridman, K B; Kriukova, T V

    2015-01-01

    The negative impact of urbanization on public health is obvious. However; due to the comprehensiveness and polymorphicity of its manifestations there are not established criteria for them. Health risk methodology allows, in principle, to obtain quantitative indices of the separate results of the impact on the health status of the citizens of metropolis that can be extremely effective in this area. The total cross-media riskfrom traffic pollution, drinking water quality, open ponds, noise, etc. permits to use of hygiene criteria in urban planning, insurance, taxation, etc. PMID:26031033

  19. [The operational role of the occupational health physician in the assessment and management of health risks related to night risks].

    PubMed

    Mucci, Nicola; Giorgi, Gabriele; Gonnelli, Irene Margherita; Garbarino, Sergio; Cupelli, Vincenzo; Arcangelil, Giulio

    2016-01-01

    The operational role of the occupational health physician in the assessment and management of health risks related to night work. Night work, in the last 30-40 years, has been extended to almost all areas of employment. The potential effects on workers' health--related to the disruption of circadian rhythms--are now well defined and studied in the Literature. All issues about the protection of safety and health for night workers are governed by the Italian Legislative Decree no. 66/2003 and subsequent amendments. The management of night work hasn't been included into the main Law on Occupational Safety and Health (Italian Legislative Decree no. 81/2008 and subsequent amendments) and a coordination between the two disciplines is desirable. The occupational health physician, as a global consultant for the protection of all health issues into a company, has to evaluate the potential effects of night work on health, both individually and as a group of workers. In this way, the physician may use either traditional tools (history, physical examination, blood tests) or innovative tools (questionnaires, health promotion programs, interventions on shift schedules). In the management of night work is useful to employ schedules that respect both psychophysical integrity and social welfare of workers and the needs of the production. The occupational health physician plays a significant role in information and training of workers, both individually and as a group of workers, and in the organization of health promotion programs (whit a voluntary participation by the workers). PMID:27311142

  20. Communicating Health Risks under Pressure: Homeland Security Applications

    SciTech Connect

    Garrahan, K.G.; Collie, S.L.

    2006-07-01

    The U.S. Environmental Protection Agency's (EPA) Office of Research and Development (ORD) Threat and Consequence Assessment Division (TCAD) within the National Homeland Security Research Center (NHSRC) has developed a tool for rapid communication of health risks and likelihood of exposure in preparation for terrorist incidents. The Emergency Consequence Assessment Tool (ECAT) is a secure web-based tool designed to make risk assessment and consequence management faster and easier for high priority terrorist threat scenarios. ECAT has been designed to function as 'defensive play-book' for health advisors, first responders, and decision-makers by presenting a series of evaluation templates for priority scenarios that can be modified for site-specific applications. Perhaps most importantly, the risk communication aspect is considered prior to an actual release event, so that management or legal advisors can concur on general risk communication content in preparation for press releases that can be anticipated in case of an actual emergency. ECAT serves as a one-stop source of information for retrieving toxicological properties for agents of concern, estimating exposure to these agents, characterizing health risks, and determining what actions need to be undertaken to mitigate the risks. ECAT has the capability to be used at a command post where inputs can be checked and communicated while the response continues in real time. This front-end planning is intended to fill the gap most commonly identified during tabletop exercises: a need for concise, timely, and informative risk communication to all parties. Training and customization of existing chemical and biological release scenarios with modeling of exposure to air and water, along with custom risk communication 'messages' intended for public, press, shareholders, and other partners enable more effective communication during times of crisis. For DOE, the ECAT could serve as a prototype that would be amenable to

  1. Health Status and Health Risks of the "Hidden Majority" of Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Emerson, Eric

    2011-01-01

    Little is known about the health status of and health risks faced by adults with intellectual disability who do not use intellectual disability services. Self-report data collected from 1,022 people with mild intellectual disability in England indicated that people who do not use intellectual disability services are more likely to smoke tobacco…

  2. Environmental Health and Aging: Activity, Exposure and Biological Models to Improve Risk Assessment and Health Promotion

    EPA Science Inventory

    The US Environmental Protection Agency (EPA) and other public health agencies are concerned that the environmental health of America’s growing population of older adults has not been taken into consideration in current approaches to risk assessment. The reduced capacity to respo...

  3. Important recent advances in the practice of health risk assessment: Implications for the 1990s

    SciTech Connect

    Paustenbach, D.J. )

    1989-12-01

    Health risk assessments have been so widely adopted in the United States that their conclusions are a major factor in many environmental decisions. The procedure by which these assessments are conducted is one which has evolved over the past 10-15 years and a number of short-comings have been widely recognized. Recent significant advances for more accurately estimating the risks posed by environmental chemicals are likely to have a dramatic effect on the regulation of many substances. Each of the four portions of risk assessment (hazard identification, dose-response assessment, exposure assessment, and risk characterization) has undergone significant refinement since 1985. This paper reviews some of the specific changes and explains the likely benefits as well as the implications. Emphasis is placed on the improved techniques for (a) identifying those chemicals which may pose a human cancer or developmental hazard, (b) using statistical approaches which account for the distribution of interindividual biological differences, (c) using lognormal statistics when interpreting environmental data, (d) using physiologically based pharmacokinetic models for estimating delivered dose and for scaling up rodent data, (e) using biologically based cancer models to account for the seven or more apparently different mechanisms of chemical carcinogenesis, (f) describing the severity of the public health risks by considering those portions of the population exposed to various concentrations of a contaminant, and (g) reviewing how criteria for acceptable risk have been influenced by the number of exposed persons. The net benefit of these improvements should be a reduction in the uncertainty inherent in current estimates of the health risks posed by low level exposure to carcinogens and developmental toxicants.233 references.

  4. Important recent advances in the practice of health risk assessment: implications for the 1990s.

    PubMed

    Paustenbach, D J

    1989-12-01

    Health risk assessments have been so widely adopted in the United States that their conclusions are a major factor in many environmental decisions. The procedure by which these assessments are conducted is one which has evolved over the past 10-15 years and a number of short-comings have been widely recognized. Unfortunately, improvements in the process have often occurred more slowly than advancements in technology or scientific knowledge. Recent significant advances for more accurately estimating the risks posed by environmental chemicals are likely to have a dramatic effect on the regulation of many substances. Each of the four portions of risk assessment (hazard identification, dose-response assessment, exposure assessment, and risk characterization) has undergone significant refinement since 1985. This paper reviews some of the specific changes and explains the likely benefits as well as the implications. Emphasis is placed on the improved techniques for (a) identifying those chemicals which may pose a human cancer or developmental hazard, (b) using statistical approaches which account for the distribution of interindividual biological differences, (c) using lognormal statistics when interpreting environmental data, (d) using physiologically based pharmacokinetic models for estimating delivered dose and for scaling up rodent data, (e) using biologically based cancer models to account for the seven or more apparently different mechanisms of chemical carcinogenesis, (f) describing the severity of the public health risks by considering those portions of the population exposed to various concentrations of a contaminant, and (g) reviewing how criteria for acceptable risk have been influenced by the number of exposed persons. The net benefit of these improvements should be a reduction in the uncertainty inherent in current estimates of the health risks posed by low level exposure to carcinogens and developmental toxicants.

  5. Older Women: A Population at Risk for Mental Health Problems.

    ERIC Educational Resources Information Center

    Wisniewski, Wendy; Cohen, Donna

    The expanding population of older women relative to older men or the "feminization of aging" is a significant demographic trend with important implications for the future. Older women are at risk for extended years of widowhood, living alone, institutionalization, poverty, and mental health problems. Although the dementias of late life appear to…

  6. Health and Risk Behaviors of Massachusetts Youth, 2007: The Report

    ERIC Educational Resources Information Center

    Massachusetts Department of Elementary and Secondary Education, 2008

    2008-01-01

    This paper presents the results of two coordinated surveys of Massachusetts adolescents, the 2007 Massachusetts Youth Risk Behavior Survey (ESE) and the Massachusetts Youth Health Survey (DPH). These two surveys were supported by funding from the Centers for Disease Control and Prevention (CDC) and administered in a random selection of 124 public…

  7. Youth "At Risk"? Young People, Sexual Health and Consent

    ERIC Educational Resources Information Center

    Powell, Anastasia

    2007-01-01

    In Australia, there is a growing expectation that sexuality education should reduce the risks associated with youth sex by providing young people with information on protecting their sexual health. However, this information may be insufficient to ensure that young people make choices that support their sexual safety and autonomy. This paper…

  8. [Evaluating occupational health risk in titanium alloys production workers].

    PubMed

    Bazarova, E L

    2007-01-01

    The authors present data on evaluation of personified and non-personified occupational risk of health disorders in titanium alloys production workers, concerning hygienic, medical and biologic, social and psychologic criteria. One-digit assessment of the work conditions is suggested.

  9. Environmental Epigenetics: Potential Application in Human Health Risk Assessment

    EPA Science Inventory

    Although previous studies have shown a significant involvement of epigenetic dysregulation in human diseases, the applicability of epigenetic data in the current human health risk assessment paradigm is unclear. The goals of this study are to compare the relative sensitivities of...

  10. Contextual Stress and Health Risk Behaviors among African American Adolescents

    ERIC Educational Resources Information Center

    Copeland-Linder, Nikeea; Lambert, Sharon F.; Chen, Yi-Fu; Ialongo, Nicholas S.

    2011-01-01

    This study examined the longitudinal association between contextual stress and health risk behaviors and the role of protective factors in a community epidemiologically-defined sample of urban African American adolescents (N = 500; 46.4% female). Structural equation modeling was used to create a latent variable measuring contextual stress…

  11. Tattooing: another adolescent risk behavior warranting health education.

    PubMed

    Armstrong, M L; Murphy, K P

    1997-11-01

    A cross-sectional, convenient sample of adolescents (N = 2101) from 8 states were queried regarding interest in tattooing. Permanent markings and blood-borne diseases were reasons respondents refrain from tattooing, yet 55% (n = 1159) expressed an interest in tattooing. Tattooed adolescents in the sample (10%, n = 213) responded with their experiences. Tattooing was frequently done around the 9th grade and as early as 8 years of age; over half (56%, n = 120) report academic grades of As and Bs. Potential health risks and definite psychosocial findings of purchase and possession risks were evident, building on data from a similar 1994 study by Armstrong and McConnell. Health providers and educators should initiate applicable health education and become community adolescent advocates regarding this risk-taking behavior. Findings indicate that adolescents who want a tattoo will obtain one, regardless of money, regulations, or risks. Adolescents view the tattoos as objects of self-identity and body art, whereas adults perceive the markings as deviant behavior. Informed decision-making could be promoted in health education by incorporating information about the possibility of blood-borne diseases, permanent markings, and themselves as growing and changing people. PMID:9419914

  12. Risk Protection, Service Use, and Health Outcomes under Colombia's Health Insurance Program for the Poor.

    PubMed

    Miller, Grant; Pinto, Diana; Vera-Hernández, Marcos

    2013-10-01

    Unexpected medical care spending imposes considerable financial risk on developing country households. Based on managed care models of health insurance in wealthy countries, Colombia's Régimen Subsidiado is a publicly financed insurance program targeted to the poor, aiming both to provide risk protection and to promote allocative efficiency in the use of medical care. Using a "fuzzy" regression discontinuity design, we find that the program has shielded the poor from some financial risk while increasing the use of traditionally under-utilized preventive services - with measurable health gains.

  13. Risk Protection, Service Use, and Health Outcomes under Colombia's Health Insurance Program for the Poor.

    PubMed

    Miller, Grant; Pinto, Diana; Vera-Hernández, Marcos

    2013-10-01

    Unexpected medical care spending imposes considerable financial risk on developing country households. Based on managed care models of health insurance in wealthy countries, Colombia's Régimen Subsidiado is a publicly financed insurance program targeted to the poor, aiming both to provide risk protection and to promote allocative efficiency in the use of medical care. Using a "fuzzy" regression discontinuity design, we find that the program has shielded the poor from some financial risk while increasing the use of traditionally under-utilized preventive services - with measurable health gains. PMID:25346799

  14. University of Minnesota Duluth, gasifier health risk assessment

    SciTech Connect

    Meyer, H.R.; O'Donnell, F.R.; Van Hoesen, S.D.; Etnier, E.L.

    1984-09-01

    This document describes an investigation of potential public and occupational health impacts associated with operation of the small, low Btu gasifier at the University of Minnesota, Duluth (UMD). The purpose of this study is to identify and quantify, within the uncertainty limits imposed by the available data, major contributors to such impacts. Consequently, we have estimated potential occupational health impacts and the gasifier's potential for producing certain health endpoints in the general public. Endpoints are specifically noncancer acute and chronic effects (threshold effects), and cancer and SO/sub x/-related mortalities (linear, nonthreshold effects) associated with atmospheric releases (no direct releases to aquatic systems occur at the facility) and subsequent inhalation exposure to representatives of three classes of released materials - metals, organics, and criteria pollutants. Other potential pathways to public exposure (atmospherically-contaminated drinking water, ingestion of locally produced foods, etc.) should not be responsible for a significant fraction of estimated risk, given the high dilution potential of the city's drinking water source (Lake Superior), and the fact that a relatively small quantity of food is grown locally. The report is organized to provide the reader with: (1) discussion and estimation, as feasible, of gasifier worker health risks, (2) source term (release rate) data, environmental transport and population exposure information, and (3) an assessment of the general population health risk based on these exposure estimates. 82 references, 1 figure, 9 tables.

  15. Children's health and their mothers' risk of divorce or separation.

    PubMed

    Joesch, J M; Smith, K R

    1997-01-01

    The purpose of this study is to determine how children's health conditions are related to their mothers' risk of divorce or separation. The study is based on data from over 7,000 children born to once-married mothers identified in the 1988 Child Health Supplement to the National Health Interview Survey. The effects of 15 childhood health conditions on the mothers' risk of divorce are estimated with Cox's proportional hazard models. Controlling for demographic, marital, and reproductive measures, we find that mothers' prospects for divorce are affected both positively or negatively by their children's health status, depending on the type of childhood condition and, in the case of low birth weight children, timing within the marriage. Women whose children have congenital heart disease, cerebral palsy, are blind, or had low birth weight appear to have higher risks of marital disruption than mothers of healthy children. In contrast, mothers whose children have migraines, learning disabilities, respiratory allergies, missing/deformed digits or limbs, or asthma have somewhat lower rates of divorce.

  16. Associations of muscular fitness with psychological positive health, health complaints, and health risk behaviors in Spanish children and adolescents.

    PubMed

    Padilla-Moledo, Carmen; Ruiz, Jonatan R; Ortega, Francisco B; Mora, Jesús; Castro-Piñero, José

    2012-01-01

    We examined the association of muscular fitness with psychological positive health, health complaints, and health risk behaviors in 690 (n = 322 girls) Spanish children and adolescents (6-17.9 years old). Lower body muscular strength was assessed with the standing long jump test, and upper-body muscular strength was assessed with the throw basketball test. A muscular fitness index was computed by means of standardized measures of both tests. Psychosocial positive health, health complaints, and health risk behaviors were self-reported using the items of the Health Behavior in School-aged Children questionnaire. Psychological positive health indicators included the following: perceived health status, life satisfaction, quality of family relationships, quality of peer relationships, and academic performance. We computed a health complaints index from 8 registered symptoms: headache, stomach ache, backache, feeling low, irritability or bad temper, feeling nervous, difficulties getting to sleep, and feeling dizzy. The health risk behavior indicators studied included tobacco use, alcohol use, and getting drunk. Children and adolescents with low muscular fitness (below the mean) had a higher odds ratio (OR) of reporting fair (vs. excellent) perceived health status, low life satisfaction (vs. very happy), low quality of family relationships (vs. very good), and low academic performance (vs. very good). Likewise, children and adolescents having low muscular fitness had a significantly higher OR of reporting smoking tobacco sometimes (vs. never), drinking alcohol sometimes (vs. never), and getting drunk sometimes (vs. never). The results of this study suggest a link between muscular fitness and psychological positive health and health risk behavior indicators in children and adolescents.

  17. [Tobacco cadmium health risk assessment and reduction techniques: A review].

    PubMed

    Cao, Chen-liang; Ma, Yi-bing; Li, Ju-mei; Wei, Dong-pu; Shi, Yi

    2015-04-01

    Tobacco is one of the cadmium accumulation and tolerance plants. Decreasing cadmium content of tobacco contributes to environmental safety and human health. Three aspects on tobacco cadmium research were reviewed in this paper, i.e. uptake and distribution of cadmium in tobacco, and health risk assessment of cadmium in tobacco and reduction measures. The current situations and existing challenges in the research field were discussed. The cadmium tolerance mechanisms of tobacco were reviewed, the factors on cadmium uptake were analyzed, and the general distribution of cadmium in tobacco was summarized. From the point of health risk assessment, the lack of cadmium limits in tobacco was identified, the recommended formula to calculate cadmium limits of tobacco based on atmosphere cadmium limits and digestion cadmium limits was provided and the cadmium limits of tobacco were estimated using each formula, and suggestions on cadmium limits in tobacco were presented. At last, we put forward several effective reduction measures to lower cadmium level in tobacco leaves.

  18. Managing risk: a taxonomy of error in health policy.

    PubMed

    Joyce, Paul; Boaden, Ruth; Esmail, Aneez

    2005-12-01

    This paper discusses the current initiatives on error and adverse events within healthcare, with a particular focus on the NHS, within the context of health policy. One of the key features of the paper is the proposal for an emergent taxonomy of the medical error literature, developed from the ideologies and rationales that underpin their approaches. This taxonomy provides details of three categories--empiricists, organisational rationalists and reformers of professional culture--and these act as an organising framework for the exploration of the potential consequences of current policy on errors and adverse events. This discussion highlights the tension between optimising health outcomes for patients and managing the health system as effectively as possible. In particular, the inherent tension between explicit managerial formulations of risk and implicit risk management strategies associated with medical professionalism are considered. PMID:16435469

  19. Managing pesticide chronic health risks: U.S. policies.

    PubMed

    Goldman, Lynn R

    2007-01-01

    This paper provides an overview of U.S. government pesticide risk management efforts over time and in recent years, relevant to chronic health risks of pesticides. Pesticides are in widespread usage in the U.S. With hundreds of active ingredients and thousands of products on the market, management of pesticide risks has been a daunting challenge. The first legislation providing federal authority for regulating pesticides was enacted in 1910. With the establishment of the U.S. Environmental Protection Agency in 1970 and amendments to the pesticide law in 1972, the federal government was for the first time given the authority to regulate health and environmental risks of pesticides. However, older pesticide risks were not addressed until legislation was enacted in 1988, requiring "reregistration" and 1996, requiring that pesticide food standards are safe for children. In result, the U.S. has seen an expansion of development of pesticide products that are registered as "reduced risk" or are biologicals. Additionally a large number of older pesticides have been cancelled or reduced from the market and/or from individual food uses. Through biomonitoring data, the U.S. may now be seeing trends in reduction of exposure to certain pesticides, the organophosphate insecticides. However, pesticide sales data through 2001 do not provide evidence for such trends. PMID:18032337

  20. Toward a national health risk management approach in Australia.

    PubMed

    O'Donnell, Carol

    2002-01-01

    There has been increasing international consensus about the importance of competition for achieving national growth and community well-being. The Australian government accordingly has introduced policies to promote such competition. Major legislative review and many public inquiries have assisted implementation of national competition policy and the development of national goals and standards related to international agreements to promote health and sustainable development. Since the 1980s, Australia has had legislation that requires the identification and control of health risks arising at work. The management structures necessary for coordinated delivery of national programs designed for effective identification and control of health risks arising in communities to achieve national health and development goals are still being developed, however. Major difficulties related to this development are discussed. National health development programs should be approached primarily through establishment of regional partnerships between bodies responsible for managing community health, local government, and employment placement, in consultation with other relevant organizations and the community. Related research and evaluation programs are required. PMID:11905388

  1. DNA barcodes reveal species-specific mercury levels in tuna sushi that pose a health risk to consumers.

    PubMed

    Lowenstein, Jacob H; Burger, Joanna; Jeitner, Christian W; Amato, George; Kolokotronis, Sergios-Orestis; Gochfeld, Michael

    2010-10-23

    Excessive ingestion of mercury--a health hazard associated with consuming predatory fishes--damages neurological, sensory-motor and cardiovascular functioning. The mercury levels found in Bigeye Tuna (Thunnus obesus) and bluefin tuna species (Thunnus maccoyii, Thunnus orientalis, and Thunnus thynnus), exceed or approach levels permissible by Canada, the European Union, Japan, the US, and the World Health Organization. We used DNA barcodes to identify tuna sushi samples analysed for mercury and demonstrate that the ability to identify cryptic samples in the market place allows regulatory agencies to more accurately measure the risk faced by fish consumers and enact policies that better safeguard their health. PMID:20410032

  2. DNA barcodes reveal species-specific mercury levels in tuna sushi that pose a health risk to consumers.

    PubMed

    Lowenstein, Jacob H; Burger, Joanna; Jeitner, Christian W; Amato, George; Kolokotronis, Sergios-Orestis; Gochfeld, Michael

    2010-10-23

    Excessive ingestion of mercury--a health hazard associated with consuming predatory fishes--damages neurological, sensory-motor and cardiovascular functioning. The mercury levels found in Bigeye Tuna (Thunnus obesus) and bluefin tuna species (Thunnus maccoyii, Thunnus orientalis, and Thunnus thynnus), exceed or approach levels permissible by Canada, the European Union, Japan, the US, and the World Health Organization. We used DNA barcodes to identify tuna sushi samples analysed for mercury and demonstrate that the ability to identify cryptic samples in the market place allows regulatory agencies to more accurately measure the risk faced by fish consumers and enact policies that better safeguard their health.

  3. Using exposomics to assess cumulative risks and promote health.

    PubMed

    Smith, Martyn T; de la Rosa, Rosemarie; Daniels, Sarah I

    2015-12-01

    Under the exposome paradigm all nongenetic factors contributing to disease are considered to be 'environmental' including chemicals, drugs, infectious agents, and psychosocial stress. We can consider these collectively as environmental stressors. Exposomics is the comprehensive analysis of exposure to all environmental stressors and should yield a more thorough understanding of chronic disease development. We can operationalize exposomics by studying all the small molecules in the body and their influence on biological pathways that lead to impaired health. Here, we describe methods by which this may be achieved and discuss the application of exposomics to cumulative risk assessment in vulnerable populations. Since the goal of cumulative risk assessment is to analyze, characterize, and quantify the combined risks to health from exposures to multiple agents or stressors, it seems that exposomics is perfectly poised to advance this important area of environmental health science. We should therefore support development of tools for exposomic analysis and begin to engage impacted communities in participatory exposome research. A first step may be to apply exposomics to vulnerable populations already studied by more conventional cumulative risk approaches. We further propose that recent migrants, low socioeconomic groups with high environmental chemical exposures, and pregnant women should be high priority populations for study by exposomics. Moreover, exposomics allows us to study interactions between chronic stress and environmental chemicals that disrupt stress response pathways (i.e., 'stressogens'). Exploring the impact of early life exposures and maternal stress may be an interesting and accessible topic for investigation by exposomics using biobanked samples.

  4. A predictive Bayesian approach to risk analysis in health care

    PubMed Central

    Aven, Terje; Eidesen, Karianne

    2007-01-01

    Background The Bayesian approach is now widely recognised as a proper framework for analysing risk in health care. However, the traditional text-book Bayesian approach is in many cases difficult to implement, as it is based on abstract concepts and modelling. Methods The essential points of the risk analyses conducted according to the predictive Bayesian approach are identification of observable quantities, prediction and uncertainty assessments of these quantities, using all the relevant information. The risk analysis summarizes the knowledge and lack of knowledge concerning critical operations and other activities, and give in this way a basis for making rational decisions. Results It is shown that Bayesian risk analysis can be significantly simplified and made more accessible compared to the traditional text-book Bayesian approach by focusing on predictions of observable quantities and performing uncertainty assessments of these quantities using subjective probabilities. Conclusion The predictive Bayesian approach provides a framework for ensuring quality of risk analysis. The approach acknowledges that risk cannot be adequately described and evaluated simply by reference to summarising probabilities. Risk is defined by the combination of possible consequences and associated uncertainties. PMID:17714597

  5. Health risks from indoor formaldehyde exposures in northwest weatherized residences

    SciTech Connect

    Mellinger, P.J.; Sever, L.E.

    1986-10-01

    Conflicting opinions on the potential hazards associated with formaldehyde exposure triggered a national workshop to address the toxicological questions concerning the health effects of formaldehyde. Since quantitative human data are not available to derive a dose-response curve for formaldehyde risk assessment, nonhuman data are used. In the case of formaldehyde, data from animals exposed to high concentrations are used to estimate human risk at much lower concentrations. This study presents the several steps that make up a risk assessment and examines any additional data that might alter significantly the risk estimates presented in the 1984 EIS. Rat inhalation chronic bioassay data from a study sponsored by the Chemical Industry Institute of Toxicology (CIIT) have been used to develop a risk equation that was subsequently used by BPA in its EIS. The CIIT data base remains the only acceptable animal data that can support the estimation of a dose-response curve. The development of mathematical models continues with a great deal of energy, and the use of different models is largely responsible for the great variability of the formaldehyde risk estimates. While one can calculate different values for carcinogenic risk associated with formaldehyde exposure than were presented earlier in the BPA EIS, they are not likely to be any better.

  6. Comparative analysis of health risk assessments for municipal waste combustors

    SciTech Connect

    Levin, A.; Fratt, D.B.; Leonard, A.; Bruins, R.J.F.; Fradkin, L.

    1991-01-01

    Quantitative health risk assessments have been performed for a number of proposed municipal waste combustor (MWC) facilities over the past several years. The article presents the results of a comparative analysis of a total of 21 risk assessments, focusing on seven of the most comprehensive methodologies. The analysis concentrates on stack emissions of noncriteria pollutants and is comparative rather than critical in nature. Overall, the risk assessment methodologies used were similar whereas the assumptions and input values used varied from study to study. Some of the variability results directly from differences in site-specific characteristics, but much of it is due to absence of data, lack of field validation, lack of specific guidelines from regulatory agencies, and reliance on professional judgment. The results indicate that carcinogenic risks are more significant than chronic non-carcinogenic risks. In most instances polychlorodibenzodioxins, polychlorodibenzofurans, and cadmium contribute more significantly to the total carcinogenic risk from MWC stack emissions than other contaminants. In addition, the contribution to total risk of all indirect routes of exposure (ingestion and dermal contact) exceeds that of the direct inhalation route for most studies reviewed.

  7. Comparative analysis of health risk assessments for municipal waste combustors.

    PubMed

    Levin, A; Fratt, D B; Leonard, A; Bruins, R J; Fradkin, L

    1991-01-01

    Quantitative health risk assessments have been performed for a number of proposed municipal waste combustor (MWC) facilities over the past several years. This article presents the results of a comparative analysis of a total of 21 risk assessments, focusing on seven of the most comprehensive methodologies. The analysis concentrates on stack emissions of noncriteria pollutants and is comparative rather than critical in nature. Overall, the risk assessment methodologies used were similar whereas the assumptions and input values used varied from study to study. Some of this variability results directly from differences in site-specific characteristics, but much of it is due to absence of data, lack of field validation, lack of specific guidelines from regulatory agencies, and reliance on professional judgment. The results indicate that carcinogenic risks are more significant than chronic non-carcinogenic risks. In most instances polychlorodibenzodioxins, polychlorodibenzofurans, and cadmium contribute more significantly to the total carcinogenic risk from MWC stack emissions than other contaminants. In addition, the contribution to total risk of all indirect routes of exposure (ingestion and dermal contact) exceeds that of the direct inhalation route for most studies reviewed.

  8. Comparative analysis of health risk assessments for municipal waste combustors

    SciTech Connect

    Levin, A.; Fratt, D.B.; Leonard, A.; Bruins, R.J.; Fradkin, L. )

    1991-01-01

    Quantitative health risk assessments have been performed for a number of proposed municipal waste combustor (MWC) facilities over the past several years. This article presents the results of a comparative analysis of a total of 21 risk assessments, focusing on seven of the most comprehensive methodologies. The analysis concentrates on stack emissions of noncriteria pollutants and is comparative rather than critical in nature. Overall, the risk assessment methodologies used were similar whereas the assumptions and input values used varied from study to study. Some of this variability results directly from differences in site-specific characteristics, but much of it is due to absence of data, lack of field validation, lack of specific guidelines from regulatory agencies, and reliance on professional judgment. The results indicate that carcinogenic risks are more significant than chronic non-carcinogenic risks. In most instances polychlorodibenzodioxins, polychlorodibenzofurans, and cadmium contribute more significantly to the total carcinogenic risk from MWC stack emissions than other contaminants. In addition, the contribution to total risk of all indirect routes of exposure (ingestion and dermal contact) exceeds that of the direct inhalation route for most studies reviewed. 42 refs.

  9. Risk factors for latex sensitization among health care workers.

    PubMed

    Vila, L; Sánchez, G; Añó, M; Uasuf, C G; Sanz, M L

    1999-01-01

    Health care workers, children with spina bifida and rubber industry workers show higher prevalence of latex sensitization compared to the general population, and they are considered at-risk groups. Our aim was to establish the prevalence of latex allergy among health care workers at the Clínica Universitaria of Navarra and to analyze potential risk factors, including personal and family history of atopy, sex, as well as factors leading to enhanced exposure to latex, such as being a nurse, belonging to surgical departments, having undergone previous surgery and the number of gloves employed per week. Health care workers (n = 1,150) (doctors, nurses, assistant nurses, laboratory technicians and practicing medical and nursing students) were evaluated using a questionnaire and skin prick test (SPT). Serum specific IgE was determined by CAP-FEIA (Pharmacia, Sweden) in those with positive SPT. The participation index was 26.17%: 301 volunteers answered the questionnaire and underwent SPT. Fifteen subjects presented positive SPT to latex. It was found that 5% of the health care workers from the Clínica Universitaria were sensitized to latex allergens. Thirteen were females and two males. Mean age was 38.4 (+/- 7.09) years. Nine were nurses, three assistant nurses, one nursing student and two medical doctors. Eight belonged to medical, five to surgical and two to laboratory departments. There were no significant differences among the subjects in the prevalence of latex sensitization. Fourteen reported symptoms related to latex, mostly pruritus, dryness and/or redness of the hands (n = 12) and rhinitis (n = 6). Only one subject reported no symptoms when using latex products. Eight were atopic; personal history of atopy was the only significant (odds ratio = 5.10, p < 0.01) risk factor for latex sensitization. It was concluded that atopic health care workers show a more increased risk of latex sensitization than those who are nonatopic. PMID:10664929

  10. Acceptability of mobile health interventions to reduce inactivity-related health risk in central Pennsylvania adults.

    PubMed

    Yang, Chih-Hsiang; Maher, Jaclyn P; Conroy, David E

    2015-01-01

    Insufficient physical activity and excessive sedentary behavior elevate health risk. Mobile applications (apps) provide one mode for delivering interventions to modify these behaviors and reduce health risk. The purpose of this study was to characterize the need for and acceptability of health behavior interventions among rural adults and evaluate the interest in and the value of app-based interventions in this population. Central Pennsylvania adults with smartphones (N = 258) completed a brief web survey in October-November 2012. Most adults report one or both inactivity-related behavioral risk factors, would use a free app to modify those risk behaviors, and would pay a small amount for that app. Low-cost, efficacious apps to increase physical activity or reduce sedentary behavior should be promoted in public health practice. User experience should be at the forefront of this process to increase value and minimize burden in the service of long-term engagement, behavior change, and health risk reduction. PMID:26844135

  11. Guidelines for Exposure Assessment in Health Risk Studies Following a Nuclear Reactor Accident

    PubMed Central

    Bouville, André; Linet, Martha S.; Hatch, Maureen; Mabuchi, Kiyohiko

    2013-01-01

    Background: Worldwide concerns regarding health effects after the Chernobyl and Fukushima nuclear power plant accidents indicate a clear need to identify short- and long-term health impacts that might result from accidents in the future. Fundamental to addressing this problem are reliable and accurate radiation dose estimates for the affected populations. The available guidance for activities following nuclear accidents is limited with regard to strategies for dose assessment in health risk studies. Objectives: Here we propose a comprehensive systematic approach to estimating radiation doses for the evaluation of health risks resulting from a nuclear power plant accident, reflected in a set of seven guidelines. Discussion: Four major nuclear reactor accidents have occurred during the history of nuclear power production. The circumstances leading to these accidents were varied, as were the magnitude of the releases of radioactive materials, the pathways by which persons were exposed, the data collected afterward, and the lifestyle factors and dietary consumption that played an important role in the associated radiation exposure of the affected populations. Accidents involving nuclear reactors may occur in the future under a variety of conditions. The guidelines we recommend here are intended to facilitate obtaining reliable dose estimations for a range of different exposure conditions. We recognize that full implementation of the proposed approach may not always be feasible because of other priorities during the nuclear accident emergency and because of limited resources in manpower and equipment. Conclusions: The proposed approach can serve as a basis to optimize the value of radiation dose reconstruction following a nuclear reactor accident. Citation: Bouville A, Linet MS, Hatch M, Mabuchi K, Simon SL. 2014. Guidelines for exposure assessment in health risk studies following a nuclear reactor accident. Environ Health Perspect 122:1–5; http://dx.doi.org/10

  12. Survey of Ambient Air Pollution Health Risk Assessment Tools.

    PubMed

    Anenberg, Susan C; Belova, Anna; Brandt, Jørgen; Fann, Neal; Greco, Sue; Guttikunda, Sarath; Heroux, Marie-Eve; Hurley, Fintan; Krzyzanowski, Michal; Medina, Sylvia; Miller, Brian; Pandey, Kiran; Roos, Joachim; Van Dingenen, Rita

    2016-09-01

    Designing air quality policies that improve public health can benefit from information about air pollution health risks and impacts, which include respiratory and cardiovascular diseases and premature death. Several computer-based tools help automate air pollution health impact assessments and are being used for a variety of contexts. Expanding information gathered for a May 2014 World Health Organization expert meeting, we survey 12 multinational air pollution health impact assessment tools, categorize them according to key technical and operational characteristics, and identify limitations and challenges. Key characteristics include spatial resolution, pollutants and health effect outcomes evaluated, and method for characterizing population exposure, as well as tool format, accessibility, complexity, and degree of peer review and application in policy contexts. While many of the tools use common data sources for concentration-response associations, population, and baseline mortality rates, they vary in the exposure information source, format, and degree of technical complexity. We find that there is an important tradeoff between technical refinement and accessibility for a broad range of applications. Analysts should apply tools that provide the appropriate geographic scope, resolution, and maximum degree of technical rigor for the intended assessment, within resources constraints. A systematic intercomparison of the tools' inputs, assumptions, calculations, and results would be helpful to determine the appropriateness of each for different types of assessment. Future work would benefit from accounting for multiple uncertainty sources and integrating ambient air pollution health impact assessment tools with those addressing other related health risks (e.g., smoking, indoor pollution, climate change, vehicle accidents, physical activity).

  13. A framework for the animal health risk analysis of biotechnology-derived animals: a Canadian perspective.

    PubMed

    Moreau, P I; Jordan, L T

    2005-04-01

    This paper describes the framework used by the Canadian Food Inspection Agency to assess the risks to animal health associated with biotechnology-derived animals and their products. In Canada the risks to animal health associated with biotechnology-derived animals are one consideration among several other regulatory concerns (e.g. human health, the environment). The risk analysis process begins with hazard identification, includes a risk assessment for each hazard, and concludes with risk management and risk communication.

  14. Determining Best Practices to Reduce Occupational Health Risks in Firefighters.

    PubMed

    McDonough, Suzanne L; Phillips, Jonathan S; Twilbeck, Travis J

    2015-07-01

    The physical demands of firefighting are extensive, and firefighters face increased risk of cardiovascular and metabolic disease, musculoskeletal injury, and cancer. To reduce these risks, a tailored wellness initiative program (FIT Firefighter) was developed and executed. Implementation of FIT Firefighter, consisting of assessment, educational, instructional, and personal coaching and training elements regarding nutrition, health, fitness, wellness, and strength and conditioning, revealed enhanced healthy behavior change including increased motivation and marked improvements in blood pressure, resting heart rate, aerobic fitness, body mass index, waist circumference, percent body fat, back flexibility, and biceps strength among participating firefighters. PMID:25563676

  15. Health Risk Assessment for Cyanobacterial Toxins in Seafood

    PubMed Central

    Mulvenna, Vanora; Dale, Katie; Priestly, Brian; Mueller, Utz; Humpage, Andrew; Shaw, Glen; Allinson, Graeme; Falconer, Ian

    2012-01-01

    Cyanobacteria (blue-green algae) are abundant in fresh, brackish and marine waters worldwide. When toxins produced by cyanobacteria are present in the aquatic environment, seafood harvested from these waters may present a health hazard to consumers. Toxicity hazards from seafood have been internationally recognised when the source is from marine algae (dinoflagellates and diatoms), but to date few risk assessments for cyanobacterial toxins in seafood have been presented. This paper estimates risk from seafood contaminated by cyanobacterial toxins, and provides guidelines for safe human consumption. PMID:22690165

  16. Occupational exposure to environmental tobacco smoke and health risk assessment.

    PubMed Central

    Jaakkola, M S; Samet, J M

    1999-01-01

    This article addresses concepts of environmental tobacco smoke (ETS) exposure assessment relevant for health risk assessment based on human studies. We present issues that should be considered when selecting a method for ETS exposure assessment for the purposes of health risk assessment and review data on ETS exposure levels in the workplace and in home environments. Two types of estimates are needed for a quantitative risk assessment of the health effects resulting from occupational ETS exposure: (italic)a(/italic)) an unbiased estimate of the exposure-effect (or dose-response) relation between ETS and the health effect of interest, and (italic)b(/italic)) estimates of the distribution of ETS exposure in different workplaces. By combining the estimated exposure-effect relation with information on exposure distribution for a population of interest, we can calculate the proportions of disease cases attributable to occupational ETS exposure as well as the excess number of cases due to specified exposure conditions. Several dimensions of the exposure profile should be considered when assessing ETS exposure for estimating the exposure-effect relation, including the magnitude of exposure and the biologically relevant time specificity of exposure. The magnitude of exposure is determined by the ETS source strength, environmental factors modifying concentrations, and duration of exposure. Time specificity considerations include the latency period for each health outcome of interest, the time-exposure profile relevant for different disease mechanisms, and the sensitive age period with regard to health effects. The most appropriate indicator of ETS exposure depends on these factors and on the time period that can be assessed with different methods. Images Figure 1 Figure 3 Figure 4 PMID:10592138

  17. Human health risk characterization of petroleum coke calcining facility emissions.

    PubMed

    Singh, Davinderjit; Johnson, Giffe T; Harbison, Raymond D

    2015-12-01

    Calcining processes including handling and storage of raw petroleum coke may result in Particulate Matter (PM) and gaseous emissions. Concerns have been raised over the potential association between particulate and aerosol pollution and adverse respiratory health effects including decrements in lung function. This risk characterization evaluated the exposure concentrations of ambient air pollutants including PM10 and gaseous pollutants from a petroleum coke calciner facility. The ambient air pollutant levels were collected through monitors installed at multiple locations in the vicinity of the facility. The measured and modeled particulate levels in ambient air from the calciner facility were compared to standards protective of public health. The results indicated that exposure levels were, on occasions at sites farther from the facility, higher than the public health limit of 150 μg/m(3) 24-h average for PM10. However, the carbon fraction demonstrated that the contribution from the calciner facility was de minimis. Exposure levels of the modeled SO2, CO, NOx and PM10 concentrations were also below public health air quality standards. These results demonstrate that emissions from calcining processes involving petroleum coke, at facilities that are well controlled, are below regulatory standards and are not expected to produce a public health risk.

  18. Human health risk characterization of petroleum coke calcining facility emissions.

    PubMed

    Singh, Davinderjit; Johnson, Giffe T; Harbison, Raymond D

    2015-12-01

    Calcining processes including handling and storage of raw petroleum coke may result in Particulate Matter (PM) and gaseous emissions. Concerns have been raised over the potential association between particulate and aerosol pollution and adverse respiratory health effects including decrements in lung function. This risk characterization evaluated the exposure concentrations of ambient air pollutants including PM10 and gaseous pollutants from a petroleum coke calciner facility. The ambient air pollutant levels were collected through monitors installed at multiple locations in the vicinity of the facility. The measured and modeled particulate levels in ambient air from the calciner facility were compared to standards protective of public health. The results indicated that exposure levels were, on occasions at sites farther from the facility, higher than the public health limit of 150 μg/m(3) 24-h average for PM10. However, the carbon fraction demonstrated that the contribution from the calciner facility was de minimis. Exposure levels of the modeled SO2, CO, NOx and PM10 concentrations were also below public health air quality standards. These results demonstrate that emissions from calcining processes involving petroleum coke, at facilities that are well controlled, are below regulatory standards and are not expected to produce a public health risk. PMID:26520182

  19. Assessment of fitness for work in health care workers: biomechanical risk factors.

    PubMed

    Violante, E S; Mattioli, S; Camagni, Angela; Bottoli, Elena; Farioli, A; Bonfiglioli, Roberta

    2012-01-01

    In current practice the assessment of fitness for work in health care workers exposed to biomechanical risk factors is often based on conventional approaches rather than on evidence-based guidelines. However, an accurate evaluation of worker's psychophysical resources compared to job demand and potential occupational risk factors is essential in order to properly assess fitness for work. The latest published guidelines on the management of patients suffering from back pain reported that the evidence-based approach can minimize the period of inactivity by encouraging return to work (and to other non-dangerous physical activities) in a relatively short period of time. As for carpal tunnel syndrome, there is no scientific evidence supporting a restriction of physical activities requiring forceful movements of the hand/wrist. PMID:22838297

  20. Climate change and farmers' mental health: risks and responses.

    PubMed

    Berry, Helen L; Hogan, Anthony; Owen, Jennifer; Rickwood, Debra; Fragar, Lyn

    2011-03-01

    Climate change is exacerbating climate variability, evident in more frequent and severe weather-related disasters, such as droughts, fires, and floods. Most of what is known about the possible effects of climate change on rural mental health relates to prolonged drought. But though drought is known to be a disproportionate and general stressor, evidence is mixed and inconclusive. Over time, like drought other weather-related disasters may erode the social and economic bases on which farming communities depend. Rural vulnerability to mental health problems is greatly increased by socioeconomic disadvantage. Related factors may compound this, such as reduced access to health services as communities decline and a "stoical" culture that inhibits help-seeking. Australia has the world's most variable climate and is a major global agricultural producer. Yet despite Australia's (and, especially, rural communities') dependence on farmers' well-being and success, there is very little-and inconclusive-quantitative evidence about farmers' mental health. The aim of this review is to consider, with a view to informing other countries, how climate change and related factors may affect farmers' mental health in Australia. That information is a prerequisite to identifying, selecting, and evaluating adaptive strategies, to lessen the risks of adverse mental health outcomes. The authors identify the need for a systematic epidemiology of the mental health of farmers facing increasing climate change- related weather adversity.

  1. Mitigating the effects of preferentially selected monitoring sites for environmental policy and health risk analysis.

    PubMed

    Shaddick, Gavin; Zidek, James V; Liu, Yi

    2016-08-01

    The potential effects of air pollution are a major concern both in terms of the environment and in relation to human health. In order to support both environmental and health policy there is a need for accurate estimates of the exposures that populations might experience. The information for this typically comes from environmental monitoring networks but often the locations of monitoring sites are preferentially located in order to detect high levels of pollution. Using the information from such networks has the potential to seriously affect the estimates of pollution that are obtained and that might be used in health risk analyses. In this context, we explore the topic of preferential sampling within a long-standing network in the UK that monitored black smoke due to concerns about its effect on public health, the extent of which came to prominence during the famous London fog of 1952. Abatement measures led to a decline in the levels of black smoke and a subsequent reduction in the number of monitoring locations that were thought necessary to provide the information required for policy support. There is evidence of selection bias during this process with sites being kept in the most polluted areas. We assess the potential for this to affect the estimates of risk associated air pollution and show how using Bayesian spatio-temporal exposure models may be used to attempt to mitigate the effects of preferential sampling in this case. PMID:27494959

  2. Health Risk Assessment of Groundwater Arsenic Pollution in Southern Taiwan

    NASA Astrophysics Data System (ADS)

    Liang, Ching-Ping

    2015-04-01

    This study investigates the risk of arsenic (As) exposure to the residents in Pingtung Plain of Taiwan, where more than 50% of people extracts groundwater to meet the drinking purpose and monitoring groundwater shows that a considerable portion of groundwater has an As concentration of more than safe drinking water guideline of 10μg/L-1. Exposure and risk assessment are carried out in accordance with the provisional daily intake (PTDI) recommended by the FAO/WHO as well as hazard quotient and cancer risk standards based on the US Environmental Protection Agency. The variability of body weights and drinking water consumption scenarios are considered in exposure and risk assessment. Results shows that daily intake exceeds 2.1μg day-1 kg-1 BW for 2% of population, HQ level above unity for 20% , and can risk greater than 10-6 for 80%. These results implies that drinking water directly from groundwater will place many people at the risk of exposure and any efforts to supply safe drinking water is imperial for governing in order to protect the human health of inhabitants in Pingtung Plain.

  3. Multiple Health Risk Behaviors in Adolescents: An Examination of Youth Risk Behavior Survey Data

    ERIC Educational Resources Information Center

    Coleman, Casey; Wileyto, E. Paul; Lenhart, Clare M.; Patterson, Freda

    2014-01-01

    Background: Chronic disease risk factors tend to cooccur. Purpose: This study examined the cooccurrence of 8 negative health behaviors in a representative sample of urban adolescents to inform educational interventions. Methods: The prevalence, cooccurrence, and clustering of suicide attempt, lifetime history of sexual activity, tobacco use, cell…

  4. Assessment of regional human health risks from lead contamination in Yunnan province, southwestern China.

    PubMed

    Lu, Lu; Cheng, Hongguang; Liu, Xuelian; Xie, Jing; Li, Qian; Zhou, Tan

    2015-01-01

    Identification and management the 'critical risk areas' where hotspot lead exposures are a potential risk to human health, become a major focus of public health efforts in China. But the knowledge of health risk assessment of lead pollution at regional and national scales is still limited in China. In this paper, under the guidance of 'sources-pathways-receptors' framework, regional human health risk assessment model for lead contamination was developed to calculate the population health risk in Yunnan province. And the cluster and AHP (analytic hierarchy process) analysis was taken to classify and calculate regional health risk and the decomposition of the regional health risk in the greatest health risk region, respectively. The results showed that Yunnan province can be divided into three areas. The highest health risk levels, located in northeastern Yunnan, including Kunming, Qujing, Zhaotong region. In those regions, lead is present at high levels in air, food, water and soil, and high population density which pose a high potential population risk to the public. The current study also reveals that most regional health risk was derived from the child receptors (age above 3 years) 4.3 times than the child receptors (age under 3 years), and ingestion of lead-contaminated rice was found to be the most significant contributor to the health risk (accounting for more than 49% health risk of total). This study can provide a framework for regional risk assessment in China and highlighted some indicators and uncertainties. PMID:25893826

  5. Assessment of Regional Human Health Risks from Lead Contamination in Yunnan Province, Southwestern China

    PubMed Central

    Lu, Lu; Cheng, Hongguang; Liu, Xuelian; Xie, Jing; Li, Qian; Zhou, Tan

    2015-01-01

    Identification and management the 'critical risk areas' where hotspot lead exposures are a potential risk to human health, become a major focus of public health efforts in China. But the knowledge of health risk assessment of lead pollution at regional and national scales is still limited in China. In this paper, under the guidance of 'sources-pathways-receptors' framework, regional human health risk assessment model for lead contamination was developed to calculate the population health risk in Yunnan province. And the cluster and AHP (analytic hierarchy process) analysis was taken to classify and calculate regional health risk and the decomposition of the regional health risk in the greatest health risk region, respectively. The results showed that Yunnan province can be divided into three areas. The highest health risk levels, located in northeastern Yunnan, including Kunming, Qujing, Zhaotong region. In those regions, lead is present at high levels in air, food, water and soil, and high population density which pose a high potential population risk to the public. The current study also reveals that most regional health risk was derived from the child receptors (age above 3 years) 4.3 times than the child receptors (age under 3years), and ingestion of lead-contaminated rice was found to be the most significant contributor to the health risk (accounting for more than 49 % health risk of total). This study can provide a framework for regional risk assessment in China and highlighted some indicators and uncertainties. PMID:25893826

  6. Hazardous waste incineration: Evaluating the human health and environmental risks

    SciTech Connect

    Roberts, S.M.; Teaf, C.M.; Bean, J.A.

    1999-11-01

    this book investigates the issues regarding human health impacts from hazardous waste incinerators. It details the characterization of hazardous waste emissions; ways to model the atmospheric dispersion of these emissions; and steps to conduct a comprehensive risk assessment. This book also reviews epidemiology to study the effects of hazardous waste incineration. Background information on the fundamentals of hazardous incineration, and the regulations affecting operation of its facilities is provided.

  7. Applying the lessons of high risk industries to health care.

    PubMed

    Hudson, P

    2003-12-01

    High risk industries such as commercial aviation and the oil and gas industry have achieved exemplary safety performance. This paper reviews how they have managed to do that. The primary reasons are the positive attitudes towards safety and the operation of effective formal safety management systems. The safety culture provides an important explanation of why such organisations perform well. An evolutionary model of safety culture is provided in which there is a range of cultures from the pathological through the reactive to the calculative. Later, the proactive culture can evolve towards the generative organisation, an alternative description of the high reliability organisation. The current status of health care is reviewed, arguing that it has a much higher level of accidents and has a reactive culture, lagging behind both high risk industries studied in both attitude and systematic management of patient risks. PMID:14645741

  8. Applying the lessons of high risk industries to health care

    PubMed Central

    Hudson, P

    2003-01-01

    High risk industries such as commercial aviation and the oil and gas industry have achieved exemplary safety performance. This paper reviews how they have managed to do that. The primary reasons are the positive attitudes towards safety and the operation of effective formal safety management systems. The safety culture provides an important explanation of why such organisations perform well. An evolutionary model of safety culture is provided in which there is a range of cultures from the pathological through the reactive to the calculative. Later, the proactive culture can evolve towards the generative organisation, an alternative description of the high reliability organisation. The current status of health care is reviewed, arguing that it has a much higher level of accidents and has a reactive culture, lagging behind both high risk industries studied in both attitude and systematic management of patient risks. PMID:14645741

  9. Managing corporate governance risks in a nonprofit health care organization.

    PubMed

    Troyer, Glenn T; Brashear, Andrea D; Green, Kelly J

    2005-01-01

    Triggered by corporate scandals, there is increased oversight by governmental bodies and in part by the Sarbanes-Oxley Act of 2002. Corporations are developing corporate governance compliance initiatives to respond to the scrutiny of regulators, legislators, the general public and constituency groups such as investors. Due to state attorney general initiatives, new legislation and heightened oversight from the Internal Revenue Service, nonprofit entities are starting to share the media spotlight with their for-profit counterparts. These developments are changing nonprofit health care organizations as well as the traditional role of the risk manager. No longer is the risk manager focused solely on patients' welfare and safe passage through a complex delivery system. The risk manager must be aware of corporate practices within the organization that could allow the personal objectives of a few individuals to override the greater good of the community in which the nonprofit organization serves.

  10. Managing corporate governance risks in a nonprofit health care organization.

    PubMed

    Troyer, Glenn T; Brashear, Andrea D; Green, Kelly J

    2005-01-01

    Triggered by corporate scandals, there is increased oversight by governmental bodies and in part by the Sarbanes-Oxley Act of 2002. Corporations are developing corporate governance compliance initiatives to respond to the scrutiny of regulators, legislators, the general public and constituency groups such as investors. Due to state attorney general initiatives, new legislation and heightened oversight from the Internal Revenue Service, nonprofit entities are starting to share the media spotlight with their for-profit counterparts. These developments are changing nonprofit health care organizations as well as the traditional role of the risk manager. No longer is the risk manager focused solely on patients' welfare and safe passage through a complex delivery system. The risk manager must be aware of corporate practices within the organization that could allow the personal objectives of a few individuals to override the greater good of the community in which the nonprofit organization serves. PMID:20200865

  11. Risk of dependence associated with health, social support, and lifestyle.

    PubMed

    Alcañiz, Manuela; Brugulat, Pilar; Guillén, Montserrat; Medina-Bustos, Antonia; Mompart-Penina, Anna; Solé-Auró, Aïda

    2015-01-01

    OBJECTIVE To analyze the prevalence of individuals at risk of dependence and its associated factors. METHODS The study was based on data from the Catalan Health Survey, Spain conducted in 2010 and 2011. Logistic regression models from a random sample of 3,842 individuals aged ≥ 15 years were used to classify individuals according to the state of their personal autonomy. Predictive models were proposed to identify indicators that helped distinguish dependent individuals from those at risk of dependence. Variables on health status, social support, and lifestyles were considered. RESULTS We found that 18.6% of the population presented a risk of dependence, especially after age 65. Compared with this group, individuals who reported dependence (11.0%) had difficulties performing activities of daily living and had to receive support to perform them. Habits such as smoking, excessive alcohol consumption, and being sedentary were associated with a higher probability of dependence, particularly for women. CONCLUSIONS Difficulties in carrying out activities of daily living precede the onset of dependence. Preserving personal autonomy and function without receiving support appear to be a preventive factor. Adopting an active and healthy lifestyle helps reduce the risk of dependence.

  12. Risk of dependence associated with health, social support, and lifestyle

    PubMed Central

    Alcañiz, Manuela; Brugulat, Pilar; Guillén, Montserrat; Medina-Bustos, Antonia; Mompart-Penina, Anna; Solé-Auró, Aïda

    2015-01-01

    OBJECTIVE To analyze the prevalence of individuals at risk of dependence and its associated factors. METHODS The study was based on data from the Catalan Health Survey, Spain conducted in 2010 and 2011. Logistic regression models from a random sample of 3,842 individuals aged ≥ 15 years were used to classify individuals according to the state of their personal autonomy. Predictive models were proposed to identify indicators that helped distinguish dependent individuals from those at risk of dependence. Variables on health status, social support, and lifestyles were considered. RESULTS We found that 18.6% of the population presented a risk of dependence, especially after age 65. Compared with this group, individuals who reported dependence (11.0%) had difficulties performing activities of daily living and had to receive support to perform them. Habits such as smoking, excessive alcohol consumption, and being sedentary were associated with a higher probability of dependence, particularly for women. CONCLUSIONS Difficulties in carrying out activities of daily living precede the onset of dependence. Preserving personal autonomy and function without receiving support appear to be a preventive factor. Adopting an active and healthy lifestyle helps reduce the risk of dependence. PMID:26018786

  13. Risk of dependence associated with health, social support, and lifestyle.

    PubMed

    Alcañiz, Manuela; Brugulat, Pilar; Guillén, Montserrat; Medina-Bustos, Antonia; Mompart-Penina, Anna; Solé-Auró, Aïda

    2015-01-01

    OBJECTIVE To analyze the prevalence of individuals at risk of dependence and its associated factors. METHODS The study was based on data from the Catalan Health Survey, Spain conducted in 2010 and 2011. Logistic regression models from a random sample of 3,842 individuals aged ≥ 15 years were used to classify individuals according to the state of their personal autonomy. Predictive models were proposed to identify indicators that helped distinguish dependent individuals from those at risk of dependence. Variables on health status, social support, and lifestyles were considered. RESULTS We found that 18.6% of the population presented a risk of dependence, especially after age 65. Compared with this group, individuals who reported dependence (11.0%) had difficulties performing activities of daily living and had to receive support to perform them. Habits such as smoking, excessive alcohol consumption, and being sedentary were associated with a higher probability of dependence, particularly for women. CONCLUSIONS Difficulties in carrying out activities of daily living precede the onset of dependence. Preserving personal autonomy and function without receiving support appear to be a preventive factor. Adopting an active and healthy lifestyle helps reduce the risk of dependence. PMID:26018786

  14. Impact of a comprehensive worksite wellness program on health risk, utilization, and health care costs.

    PubMed

    Hochart, Cindy; Lang, Michelle

    2011-06-01

    In 2005, Blue Cross Blue Shield of Kansas City initiated a comprehensive worksite wellness program designed to impact employer culture and to assist healthy employees to stay at low risk and to reduce risk levels for those at moderate or high risk. Fifteen employer groups (9637 employees) participated in the A Healthier You (AHY) program for 3 consecutive years, 2006-2008. The results of health risk appraisals and biometric screening were used to evaluate program impact. Among the 4230 employees (44.0% of eligible employees) who completed health risk appraisals in all 3 years, 85.8% of individuals in the low-risk category in 2006 remained at low risk in 2008. There were also improvements in other risk categories, with 39.9% of those in the medium-risk category and 48.9% of those in the high-risk category in 2006 moving to a lower risk category in 2008. There were improvements in blood pressure control and total cholesterol, but no improvement in weight control. To assess financial and utilization outcomes, claims for the participating employer groups were compared to those for 7 employers (3800 employees) who did not participate in AHY in 2006-2008. Although none of the utilization measures was statistically different, the AHY groups had significantly smaller increases in both overall and emergency room costs per member per month. The AHY program now has over 180 employer groups, which will allow future evaluations to examine the impact of the program on a much larger population and to focus on the comparative effectiveness of different intervention strategies across implementations. PMID:21241173

  15. Propagating uncertainty from hydrology into human health risk assessment

    NASA Astrophysics Data System (ADS)

    Siirila, E. R.; Maxwell, R. M.

    2013-12-01

    Hydro-geologic modeling and uncertainty assessment of flow and transport parameters can be incorporated into human health risk (both cancer and non-cancer) assessment to better understand the associated uncertainties. This interdisciplinary approach is needed now more than ever as societal problems concerning water quality are increasingly interdisciplinary as well. For example, uncertainty can originate from environmental conditions such as a lack of information or measurement error, or can manifest as variability, such as differences in physiological and exposure parameters between individuals. To complicate the matter, traditional risk assessment methodologies are independent of time, virtually neglecting any temporal dependence. Here we present not only how uncertainty and variability can be incorporated into a risk assessment, but also how time dependent risk assessment (TDRA) allows for the calculation of risk as a function of time. The development of TDRA and the inclusion of quantitative risk analysis in this research provide a means to inform decision makers faced with water quality issues and challenges. The stochastic nature of this work also provides a means to address the question of uncertainty in management decisions, a component that is frequently difficult to quantify. To illustrate this new formulation and to investigate hydraulic mechanisms for sensitivity, an example of varying environmental concentration signals resulting from rate dependencies in geochemical reactions is used. Cancer risk is computed and compared using environmental concentration ensembles modeled with sorption as 1) a linear equilibrium assumption and 2) first order kinetics. Results show that the up scaling of these small-scale processes controls the distribution, magnitude, and associated uncertainty of cancer risk.

  16. Health risks in wastewater irrigation: comparing estimates from quantitative microbial risk analyses and epidemiological studies.

    PubMed

    Mara, D D; Sleigh, P A; Blumenthal, U J; Carr, R M

    2007-03-01

    The combination of standard quantitative microbial risk analysis (QMRA) techniques and 10,000-trial Monte Carlo risk simulations was used to estimate the human health risks associated with the use of wastewater for unrestricted and restricted crop irrigation. A risk of rotavirus infection of 10(-2) per person per year (pppy) was used as the reference level of acceptable risk. Using the model scenario of involuntary soil ingestion for restricted irrigation, the risk of rotavirus infection is approximately 10(-2) pppy when the wastewater contains < or =10(6) Escherichia coli per 100ml and when local agricultural practices are highly mechanised. For labour-intensive agriculture the risk of rotavirus infection is approximately 10(-2) pppy when the wastewater contains < or = 10(5) E. coli per 100ml; however, the wastewater quality should be < or = 10(4) E. coli per 100ml when children under 15 are exposed. With the model scenario of lettuce consumption for unrestricted irrigation, the use of wastewaters containing < or =10(4) E. coli per 100ml results in a rotavirus infection risk of approximately 10(-2) pppy; however, again based on epidemiological evidence from Mexico, the current WHO guideline level of < or =1,000 E. coli per 100ml should be retained for root crops eaten raw. PMID:17402278

  17. Oral health and mortality risk in the institutionalised elderly

    PubMed Central

    Sandvik, Leiv; Gil-Montoya, José A.; Willumsen, Tiril

    2012-01-01

    Objective: Examining oral health and oral hygiene as predictors of subsequent one-year survival in the institutionalized elderly. Design: It was hypothesized that oral health would be related to mortality in an institutionalized geriatric population. A 12-month prospective study of 292 elderly residing in nine geriatric institutions in Granada, Spain, was thus carried out to evaluate the association between oral health and mortality. Independent samples, T-test, chi-square test and Cox regression analysis were used to analyze the data. Sixty-three participants died during the 12-month follow-up. Results: Mortality was increased in denture users (RR = 2.18, p= 0.007) and in people suffering severe cognitive impairment (RR = 2. 24, p= 0.003). One-year mortality was 50% in participants having both these characteristics. Conclusions: Oral hygiene was not significantly associated with mortality. Cognitive impairment and wearing dentures increased the risk of death. One-year mortality was 50% in cognitively impaired residents wearing dentures as opposed to 10% in patients without dentures and cognitive impairment. Key words:Oral health, mortality risk, institutionalised elderly. PMID:22322487

  18. Climate change and human health: present and future risks.

    PubMed

    McMichael, Anthony J; Woodruff, Rosalie E; Hales, Simon

    2006-03-11

    There is near unanimous scientific consensus that greenhouse gas emissions generated by human activity will change Earth's climate. The recent (globally averaged) warming by 0.5 degrees C is partly attributable to such anthropogenic emissions. Climate change will affect human health in many ways-mostly adversely. Here, we summarise the epidemiological evidence of how climate variations and trends affect various health outcomes. We assess the little evidence there is that recent global warming has already affected some health outcomes. We review the published estimates of future health effects of climate change over coming decades. Research so far has mostly focused on thermal stress, extreme weather events, and infectious diseases, with some attention to estimates of future regional food yields and hunger prevalence. An emerging broader approach addresses a wider spectrum of health risks due to the social, demographic, and economic disruptions of climate change. Evidence and anticipation of adverse health effects will strengthen the case for pre-emptive policies, and will also guide priorities for planned adaptive strategies.

  19. [Health risks linked to recent migratory patterns: myth or reality?].

    PubMed

    Durieux-Paillard, Sophie

    2016-05-01

    The migratory crisis currently faced by Europe is of exceptional magnitude since the Second World War. It is mainly related to the conflict in Syria, as well as recurring violations of human rights in other regions of the world. Widely relayed by the media, the unusual number of refugee applicants and the precariousness of their migration routes raise the question of the health risk. From the old concept of quarantine to the new paradigm of migrants' health, it is important to contextualize the screening measures, taking into account the epidemiology of communicable diseases in the countries of origin and of the regions crossed, the ruptures of access to treatments for chronic diseases, but also the impact of multiple trauma (war, violence) on the mental health of refugees. PMID:27323478

  20. Evidence-based health information and risk competence

    PubMed Central

    Mühlhauser, Ingrid; Albrecht, Martina; Steckelberg, Anke

    2015-01-01

    Consumers and patients want to be included in decisions regarding their own health and have an ethically justified claim on informed decisions. Therefore, sound information is required, but health information is often misleading and based on different interests. The risks of disease and the benefits of medical interventions tend to be overestimated, whereas harm is often underestimated. Evidence-based health information has to fulfil certain criteria, for instance, it should be evidence-based, independent, complete, true as well as understandable. The aim of a medical intervention has to be explained. The different therapeutic options including the option not to intervene have to be delineated. The probabilities for success, lack of success and unwanted side effects have to be communicated in a numerical and understandable manner. Patients have the right to reject medical interventions without any sanctions. PMID:26195924

  1. FIFTH NHEERL SYMPOSIUM FLYER -- INDICATORS IN HEALTH AND ECOLOGICAL RISK ASSESSMENT

    EPA Science Inventory

    Announcement for NHEERL Fifth Symposium - Indicators in Health and Ecological Risk Assessment. The purpose of the symposium is to address assessment of risk to public health or environmental resources which requires competent characterization of stressors and corresponding effec...

  2. Impact of microbial count distributions on human health risk estimates.

    PubMed

    Duarte, A S R; Nauta, M J

    2015-02-16

    Quantitative microbiological risk assessment (QMRA) is influenced by the choice of the probability distribution used to describe pathogen concentrations, as this may eventually have a large effect on the distribution of doses at exposure. When fitting a probability distribution to microbial enumeration data, several factors may have an impact on the accuracy of that fit. Analysis of the best statistical fits of different distributions alone does not provide a clear indication of the impact in terms of risk estimates. Thus, in this study we focus on the impact of fitting microbial distributions on risk estimates, at two different concentration scenarios and at a range of prevalence levels. By using five different parametric distributions, we investigate whether different characteristics of a good fit are crucial for an accurate risk estimate. Among the factors studied are the importance of accounting for the Poisson randomness in counts, the difference between treating "true" zeroes as such or as censored below a limit of quantification (LOQ) and the importance of making the correct assumption about the underlying distribution of concentrations. By running a simulation experiment with zero-inflated Poisson-lognormal distributed data and an existing QMRA model from retail to consumer level, it was possible to assess the difference between expected risk and the risk estimated with using a lognormal, a zero-inflated lognormal, a Poisson-gamma, a zero-inflated Poisson-gamma and a zero-inflated Poisson-lognormal distribution. We show that the impact of the choice of different probability distributions to describe concentrations at retail on risk estimates is dependent both on concentration and prevalence levels. We also show that the use of an LOQ should be done consciously, especially when zero-inflation is not used. In general, zero-inflation does not necessarily improve the absolute risk estimation, but performance of zero-inflated distributions in QMRA tends to be

  3. Socioeconomic inequalities in health after age 50: Are health risk behaviors to blame?

    PubMed Central

    Shaw, Benjamin A.; McGeever, Kelly; Grubert, Elizabeth; Agahi, Neda; Fors, Stefan

    2013-01-01

    Recent studies indicate that socioeconomic inequalities in health extend into the elderly population, even within the most highly developed welfare states. One potential explanation for socioeconomic inequalities in health focuses on the role of health behaviors, but little is known about the degree to which health behaviors account for health inequalities among older adults, in particular. Using data from the Health and Retirement Study (N=19,245), this study examined the degree to which four behavioral risk factors – smoking, obesity, physical inactivity, and heavy drinking – are associated with socioeconomic position among adults aged 51 and older, and whether these behaviors mediate socioeconomic differences in mortality, and the onset of disability among those who were disability-free at baseline, over a 10-year period from 1998–2008. Results indicate that the odds of both smoking and physical inactivity are higher among persons with lower wealth, with similar stratification in obesity, but primarily among women. The odds of heavy drinking decrease at lower levels of wealth. Significant socioeconomic inequalities in mortality and disability onset are apparent among older men and women; however, the role that health behaviors play in accounting for these inequalities differs by age and gender. For example, these health behaviors account for between 23–45% of the mortality disparities among men and middle aged women, but only about 5% of the disparities found among women over 65 years. Meanwhile, these health behaviors appear to account for about 33% of the disparities in disability onset found among women survivors, and about 9–14% among men survivors. These findings suggest that within the U.S. elderly population, behavioral risks such as smoking and physical inactivity contribute moderately to maintaining socioeconomic inequalities in health. As such, promoting healthier lifestyles among the socioeconomically disadvantaged older adults should help

  4. Lack of health maintenance examinations and risk in myeloma patients.

    PubMed

    Tariman, Joseph D; Gleason, Charise; Faiman, Beth; Doss, Deborah; Catamero, Donna; Bishop-Royse, Jessica; Katz, Mike; Kurtin, Sandra; Moran, Diane; Lonial, Sagar

    2016-07-01

    Health maintenance (HM) practices are essential to prevent illness, promote well-being, and maximize health. Patients with multiple myeloma (MM) are at increased risk for cardiovascular disease and cancers, yet, research on HM practices and preventative care of MM survivors has limited report. The study comprised a descriptive, correlational, and cross-sectional online survey design. Survey of patients with MM was carried out through the International Myeloma Foundation (IMF) and the Association of Cancer Online Resources (ACOR) e-mail list services. The members of the IMF and ACOR e-mail list services were surveyed, of which 237 patients responded. The modified Medical Expenditure Preventive Survey-Preventive Care questionnaire was used; it included items that ask patients regarding their healthcare practices that relate to dental care, cancer prevention, addiction, lifestyles, sensory screening, immunizations, cardiovascular, endocrine, psychosocial, and bone health. Descriptive statistics, Pearson's chi-square, and Spearman's rho correlation coefficient were obtained. In this study, men had statistically significant inferior global health maintenance scores than women (P = 0.002). Being employed (P = 0.054) and married or partnered (P = 0.017) were significantly correlated with better health maintenance patterns among male respondents. In contrast, no statistically significant correlations between sociodemographic factors and health maintenance patterns were found in women. Patients with MM, particularly men, require continued education and close monitoring of health maintenance practices. These findings are consistent with publications looking at gender disparities in healthcare utilization in the United States. Studies show that men, in general, are less likely to seek preventative healthcare screenings. Healthcare providers must incorporate health maintenance promotion during clinic visits.

  5. Lack of health maintenance examinations and risk in myeloma patients.

    PubMed

    Tariman, Joseph D; Gleason, Charise; Faiman, Beth; Doss, Deborah; Catamero, Donna; Bishop-Royse, Jessica; Katz, Mike; Kurtin, Sandra; Moran, Diane; Lonial, Sagar

    2016-07-01

    Health maintenance (HM) practices are essential to prevent illness, promote well-being, and maximize health. Patients with multiple myeloma (MM) are at increased risk for cardiovascular disease and cancers, yet, research on HM practices and preventative care of MM survivors has limited report. The study comprised a descriptive, correlational, and cross-sectional online survey design. Survey of patients with MM was carried out through the International Myeloma Foundation (IMF) and the Association of Cancer Online Resources (ACOR) e-mail list services. The members of the IMF and ACOR e-mail list services were surveyed, of which 237 patients responded. The modified Medical Expenditure Preventive Survey-Preventive Care questionnaire was used; it included items that ask patients regarding their healthcare practices that relate to dental care, cancer prevention, addiction, lifestyles, sensory screening, immunizations, cardiovascular, endocrine, psychosocial, and bone health. Descriptive statistics, Pearson's chi-square, and Spearman's rho correlation coefficient were obtained. In this study, men had statistically significant inferior global health maintenance scores than women (P = 0.002). Being employed (P = 0.054) and married or partnered (P = 0.017) were significantly correlated with better health maintenance patterns among male respondents. In contrast, no statistically significant correlations between sociodemographic factors and health maintenance patterns were found in women. Patients with MM, particularly men, require continued education and close monitoring of health maintenance practices. These findings are consistent with publications looking at gender disparities in healthcare utilization in the United States. Studies show that men, in general, are less likely to seek preventative healthcare screenings. Healthcare providers must incorporate health maintenance promotion during clinic visits. PMID:27119422

  6. Assessment of mercury health risks to adults from coal combustion

    SciTech Connect

    Lipfert, F.W.; Moskowitz, P.D.; Fthenakis, V.M.; DePhillips, M.P.; Viren, J.; Saroff, L.

    1994-05-01

    The U.S. Environmental Protection Agency (EPA) is preparing, for the U.S. Congress, a report evaluating the need to regulate mercury (Hg) emissions from electric utilities. This study, to be completed in 1995, will have important health and economic implications. In support of these efforts, the U.S. Department of Energy, Office of Fossil Energy, sponsored a risk assessment project at Brookhaven National Laboratory (BNL) to evaluate methylmercury (MeHg) hazards independently. In the BNL study, health risks to adults resulting from Hg emissions from a hypothetical 1000 MW{sub e} coal-fired power plant were estimated using probabilistic risk assessment techniques. The approach draws on the extant knowledge in each of the important steps in the calculation chain from emissions to health effects. Estimated results at key points in the chain were compared with actual measurements to help validate the modeled estimates. Two cases were considered: the baseline case (no local impacts), and the impact case (maximum local power-plant impact). The BNL study showed that the effects of emissions of a single power plant may double the background exposures to MeHg resulting from consuming fish obtained from a localized area near the power plant. Many implicit and explicit sources of uncertainty exist in this analysis. Those that appear to be most in need of improvement include data on doses and responses for potentially sensitive subpopulations (e.g., fetal exposures). Rather than considering hypothetical situations, it would also be preferable to assess the risks associated with actual coal-fired power plants and the nearby sensitive water bodies and susceptible subpopulations. Finally, annual total Hg emissions from coal burning and from other anthropogenic sources are still uncertain; this makes it difficult to estimate the effects of U.S. coal burning on global Hg concentration levels, especially over the long term.

  7. Uses of Youth Risk Behavior Survey and School Health Profiles Data: Applications for Improving Adolescent and School Health

    ERIC Educational Resources Information Center

    Foti, Kathryn; Balaji, Alexandra; Shanklin, Shari

    2011-01-01

    Background: To monitor priority health risk behaviors and school health policies and practices, respectively, the Centers for Disease Control and Prevention (CDC) developed the Youth Risk Behavior Surveillance System (YRBSS) and the School Health Profiles (Profiles). CDC is often asked about the use and application of these survey data to improve…

  8. Incidence of Online Health Information Search: A Useful Proxy for Public Health Risk Perception

    PubMed Central

    Scammon, Debra L

    2013-01-01

    Background Internet users use search engines to look for information online, including health information. Researchers in medical informatics have found a high correlation of the occurrence of certain search queries and the incidence of certain diseases. Consumers’ search for information about diseases is related to current health status with regard to a disease and to the social environments that shape the public’s attitudes and behaviors. Objective This study aimed to investigate the extent to which public health risk perception as demonstrated by online information searches related to a health risk can be explained by the incidence of the health risk and social components of a specific population’s environment. Using an ecological perspective, we suggest that a population’s general concern for a health risk is formed by the incidence of the risk and social (eg, media attention) factors related with the risk. Methods We constructed a dataset that included state-level data from 32 states on the incidence of the flu; a number of social factors, such as media attention to the flu; private resources, such as education and health insurance coverage; public resources, such as hospital beds and primary physicians; and utilization of these resources, including inpatient days and outpatient visits. We then explored whether online information searches about the flu (seasonal and pandemic flu) can be predicted using these variables. We used factor analysis to construct indexes for sets of social factors (private resources, public resources). We then applied panel data multiple regression analysis to exploit both time-series and cross-sectional variation in the data over a 7-year period. Results Overall, the results provide evidence that the main effects of independent variables—the incidence of the flu (P<.001); social factors, including media attention (P<.001); private resources, including life quality (P<.001) and health lifestyles (P=.009); and public

  9. Risk Perception and Risk Communication for Training Women Apprentice Welders: A Challenge for Public Health Nursing

    PubMed Central

    Bonow, Clarice Alves; Cezar-Vaz, Marta Regina; de Almeida, Marlise Capa Verde; Rocha, Laurelize Pereira; Borges, Anelise Miritz; Piexak, Diéssica Roggia; Vaz, Joana Cezar

    2013-01-01

    This research has aimed to identify the perceptions of women apprentice welders about physical, chemical, biological, and physiological risk factors to which they are exposed and evaluate the identification of health disorders self-reported for women apprentice welders before and after implementation of a nursing socioenvironmental intervention. A quantitative study was performed with 27 women apprentice welders (first phase) and before and after an intervention with 18 women (second phase) in Southern Brazil in 2011. The data were analysed using SPSS 19.0. The participants identified the following risk types: physical (96.2%), chemical (96.2%), physiological (88.8%), and biological (62.9%). The results show a significant difference of the pre- and posttest averages for the musculoskeletal system and a posttest average increase for the integumentary, respiratory, and auditory system. A correlation of the women apprentices' ages and the identification of health disorders were made. It was understood that the perception of women apprentices regarding a particular set of occupational risks is essential for public health nursing to develop an effective risk communication as a positive tool for teaching and learning. PMID:24288604

  10. Dust-Metal Sources in an Urbanized Arid Zone: Implications for Health-Risk Assessments.

    PubMed

    García-Rico, Leticia; Meza-Figueroa, Diana; Gandolfi, A Jay; Del Río-Salas, Rafael; Romero, Francisco M; Meza-Montenegro, Maria Mercedes

    2016-04-01

    The available information concerning metal pollution in different dust sources and the health effects in children remains limited in Mexico. This study focuses on Hermosillo, which is an urbanized area located in the Sonoran Desert in which soil resuspension and dust emission processes are common. The metal content of arsenic (As), chromium (Cr), manganese (Mn), and lead (Pb) were determined in three dust sources (playgrounds, roofs, and roads), each representing different exposure media (EM) for these elements. The metal levels in dust were found in the order of Mn > Cr > Pb > As with the highest metal content found in road dust. Despite the similar average metal distributions, principal component analysis shows a clear separation of the three EM with playground dust related to Cr and Mn and road dust to As and Pb. However, the geoaccumulation index results indicate that dust samples are uncontaminated to moderately polluted, except for Pb in road dust, which is considerably high. In addition, the enrichment factor suggests an anthropogenic origin for all of the studied metals except for Mn. In this context, the hazard index (HI) for noncarcinogenic risk is >1 in this population and thus represents a potential health risk. The spatial distribution for each metal on EM and the HI related to the marginality index could represent a more accurate decision-making tool in risk assessment studies.

  11. Communication about environmental health risks: A systematic review

    PubMed Central

    2010-01-01

    Background Using the most effective methods and techniques for communicating risk to the public is critical. Understanding the impact that different types of risk communication have played in real and perceived public health risks can provide information about how messages, policies and programs can and should be communicated in order to be most effective. The purpose of this systematic review is to identify the effectiveness of communication strategies and factors that impact communication uptake related to environmental health risks. Methods A systematic review of English articles using multiple databases with appropriate search terms. Data sources also included grey literature. Key organization websites and key journals were hand searched for relevant articles. Consultation with experts took place to locate any additional references. Articles had to meet relevance criteria for study design [randomized controlled trials, clinical controlled trials, cohort analytic, cohort, any pre-post, interrupted time series, mixed methods or any qualitative studies), participants (those in community-living, non-clinical populations), interventions (including, but not limited to, any community-based methods or tools such as Internet, telephone, media-based interventions or any combination thereof), and outcomes (reported measurable outcomes such as awareness, knowledge or attitudinal or behavioural change). Articles were assessed for quality and data was extracted using standardized tools by two independent reviewers. Articles were given an overall assessment of strong, moderate or weak quality. Results There were no strong or moderate studies. Meta-analysis was not appropriate to the data. Data for 24 articles were analyzed and reported in a narrative format. The findings suggest that a multi-media approach is more effective than any single media approach. Similarly, printed material that offers a combination of information types (i.e., text and diagrams) is a more effective

  12. Health Risk Surveillance and Health Promotion in a Predominantly Female Border Workforce.

    ERIC Educational Resources Information Center

    Villas, Paul

    This paper looks at the feasibility of investigating how health risk behaviors established during youth contribute to the leading causes of morbidity and mortality in a young workforce. The population of interest consists of Mexican women living and working on the Mexican side of the United States-Mexico border. Proposed goals would (1) establish…

  13. 78 FR 38315 - Registration Review; Draft Human Health and Ecological Risk Assessments; Notice of Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-26

    ... registered for use as a pre-plant pineapple seed treatment. The Agency has conducted a human health risk... AGENCY Registration Review; Draft Human Health and Ecological Risk Assessments; Notice of Availability... availability of EPA's draft human health and ecological risk assessments for the registration review...

  14. Sexual Victimization and Health-Risk Behaviors: A Prospective Analysis of College Women

    ERIC Educational Resources Information Center

    Gidycz, Christine A.; Orchowski, Lindsay M.; King, Carrie R.; Rich, Cindy L.

    2008-01-01

    The present study utilizes the National College Health Risk Behavior Survey to examine the relationship between health-risk behaviors and sexual victimization among a sample of college women. A prospective design is utilized to examine the relationship between health-risk behaviors as measured at baseline and sexual victimization during a 3-month…

  15. Reproducibility and Transparency of Omics Research - Impacts on Human Health Risk Assessment

    EPA Science Inventory

    Omics technologies are becoming more widely used in toxicology, necessitating their consideration in human health hazard and risk assessment programs. Today, risk assessors in the United States Environmental Protection Agency’s Integrated Risk Information System (IRIS) Toxicologi...

  16. A health risk assessment for fluoride in Central Europe.

    PubMed

    Fordyce, F M; Vrana, K; Zhovinsky, E; Povoroznuk, V; Toth, G; Hope, B C; Iljinsky, U; Baker, J

    2007-04-01

    Like many elements, fluorine (which generally occurs in nature as fluoride) is beneficial to human health in trace amounts, but can be toxic in excess. The links between low intakes of fluoride and dental protection are well known; however, fluoride is a powerful calcium-seeking element and can interfere with the calcified structure of bones and teeth in the human body at higher concentrations causing dental or skeletal fluorosis. One of the main exposure routes is via drinking water and the World Health Organisation currently sets water quality guidelines for the element. In Central Europe, groundwater resources that exceed the guideline value of 1.5 mg l-1 are widespread and effects on health of high fluoride in water have been reported. The aim of the current project was to develop a geographic information system (GIS) to aid the identification of areas where high-fluoride waters and fluorosis may be a problem; hence, where water treatment technologies should be targeted. The development of the GIS was based upon the collation and digitisation of existing information relevant to fluoride risk in Ukraine, Moldova, Hungary and Slovakia assembled for the first time in a readily accessible form. In addition, geochemistry and health studies to examine in more detail the relationships between high-fluoride drinking waters and health effects in the population were carried out in Moldova and Ukraine demonstrating dental fluorosis prevalence rates of 60-90% in adolescents consuming water containing 2-7 mg l-1 fluoride.

  17. [Risk Society and inequalities in the health of workers].

    PubMed

    Tamez-González, Silvia; Pérez-Domínguez, Josué F

    2012-06-01

    This is a reflection on the current health situation of workers, as well as a reflection on the characteristics of their care system in the context of a globalized world. In order to present this reflection, the first part is focused on the discussion of the main concepts of globalization and risk society. On the second part, and according to the conceptual framework established on the first part, a statistical perspective of workers' health around the world is suggested, emphasizing on the existing inequity between thought-to-be developed world and the developing or poor countries. On the next part, a discussion related to health insurance systems and their incompetence to tackle efficiently workers' health outcomes is established. On the final part, a reflection on the need to reframe the approach and action strategies for improving health status of workers and their families is suggested; this part of the reflection is focused on the recovery of "good life" and human sense of life.

  18. Patterns of Health-Risk Behavior among Japanese High School Students.

    ERIC Educational Resources Information Center

    Takakura, Minoru; Nagayama, Tomoko; Sakihara, Seizo; Willcox, Craig

    2001-01-01

    Surveyed Japanese high school students' health risk behavior patterns, examining clustering and accumulation of health risk behaviors. Physical inactivity and alcohol use were the most common risk behaviors. Prevalence rates for most risk behaviors varied by demographic variables. Smoking, drinking, and sexual intercourse clustered among both…

  19. Relationships between Sports Team Participation and Health-Risk Behaviors among Alternative High School Students

    ERIC Educational Resources Information Center

    Johnson, Karen E.; Eisenberg, Marla E.; Bearinger, Linda H.; Fulkerson, Jayne A.; Sieving, Renee E.

    2014-01-01

    Background: Evidence suggests that sports team participation differentially relates to health-risk behaviors. Few studies have explored relationships among high-risk youth. Purpose: To examine associations between weekly sports team participation and health-risk behaviors (substance use, sexual risk-taking, violence involvement) among alternative…

  20. Human health risk assessment from arsenic exposures in Bangladesh.

    PubMed

    Joseph, Tijo; Dubey, Brajesh; McBean, Edward A

    2015-09-15

    High arsenic exposures, prevalent through dietary and non-dietary sources in Bangladesh, present a major health risk to the public. A quantitative human health risk assessment is described as a result of arsenic exposure through food and water intake, tea intake, accidental soil ingestion, and chewing of betel quid, while people meet their desirable dietary intake requirements throughout their lifetime. In evaluating the contribution of each intake pathway to average daily arsenic intake, the results show that food and water intake combined, makes up approximately 98% of the daily arsenic intake with the balance contributed to by intake pathways such as tea consumption, soil ingestion, and quid consumption. Under an exposure scenario where arsenic concentration in water is at the WHO guideline (0.01 mg/L), food intake is the major arsenic intake pathway ranging from 67% to 80% of the average daily arsenic intake. However, the contribution from food drops to a range of 29% to 45% for an exposure scenario where arsenic in water is at the Bangladesh standard (0.05 mg/L). The lifetime excess risk of cancer occurrence from chronic arsenic exposure, considering a population of 160 million people, based on an exposure scenario with 85 million people at the WHO guideline value and 75 million people at the Bangladesh standard, and assuming that 35 million people are associated with a heavy activity level, is estimated as 1.15 million cases.

  1. Distribution and potential health risk of groundwater uranium in Korea.

    PubMed

    Shin, Woosik; Oh, Jungsun; Choung, Sungwook; Cho, Byong-Wook; Lee, Kwang-Sik; Yun, Uk; Woo, Nam-Chil; Kim, Hyun Koo

    2016-11-01

    Chronic exposure even to extremely low specific radioactivity of natural uranium in groundwater results in kidney problems and potential toxicity in bones. This study was conducted to assess the potential health risk via intake of the groundwater containing uranium, based on the determination of the uranium occurrence in groundwater. The groundwater was investigated from a total of 4140 wells in Korea. Most of the groundwater samples showed neutral pH and (sub-)oxic condition that was influenced by the mixing with shallow groundwater due to long-screened (open) wells. High uranium contents exceeding the WHO guideline level of 30 μg L(-1) were observed in the 160 wells located mainly in the plutonic bedrock regions. The statistical analysis suggested that the uranium component was present in groundwater by desorption and re-dissolution processes. Predominant uranium phases were estimated to uranyl carbonates under the Korean groundwater circumstances. These mobile forms of uranium and oxic condition facilitate the increase of potential health risk downgradient. In particular, long-term intake of groundwater containing >200 μg U L(-1) may induce internal exposure to radiation as well as the effects of chemical toxicity. These high uranium concentrations were found in twenty four sampling wells of rural areas in this study, and they were mainly used for drinking. Therefore, the high-level uranium wells and neighboring areas must be properly managed and monitored to reduce the exposure risk for the residents by drinking groundwater. PMID:27522182

  2. Distribution and potential health risk of groundwater uranium in Korea.

    PubMed

    Shin, Woosik; Oh, Jungsun; Choung, Sungwook; Cho, Byong-Wook; Lee, Kwang-Sik; Yun, Uk; Woo, Nam-Chil; Kim, Hyun Koo

    2016-11-01

    Chronic exposure even to extremely low specific radioactivity of natural uranium in groundwater results in kidney problems and potential toxicity in bones. This study was conducted to assess the potential health risk via intake of the groundwater containing uranium, based on the determination of the uranium occurrence in groundwater. The groundwater was investigated from a total of 4140 wells in Korea. Most of the groundwater samples showed neutral pH and (sub-)oxic condition that was influenced by the mixing with shallow groundwater due to long-screened (open) wells. High uranium contents exceeding the WHO guideline level of 30 μg L(-1) were observed in the 160 wells located mainly in the plutonic bedrock regions. The statistical analysis suggested that the uranium component was present in groundwater by desorption and re-dissolution processes. Predominant uranium phases were estimated to uranyl carbonates under the Korean groundwater circumstances. These mobile forms of uranium and oxic condition facilitate the increase of potential health risk downgradient. In particular, long-term intake of groundwater containing >200 μg U L(-1) may induce internal exposure to radiation as well as the effects of chemical toxicity. These high uranium concentrations were found in twenty four sampling wells of rural areas in this study, and they were mainly used for drinking. Therefore, the high-level uranium wells and neighboring areas must be properly managed and monitored to reduce the exposure risk for the residents by drinking groundwater.

  3. Health risk assessment of petroleum hydrocarbons in environmental media

    SciTech Connect

    Shull, L.R.; Jones, M.K.; Yost, K.J.

    1994-12-31

    Over the past decade, health risk assessment (HRA) has become the preferred decision-making tool for judging whether a site (ex., hazardous waste site) or an activity (ex., facility operation) may be safe or unsafe. Currently, no consensus HRA methodology has evolved for evaluating complex mixtures such as petroleum hydrocarbons, either for assessing baseline health risk or for setting environmental corrective action goals. The most common HRA approach is to evaluate individual compounds, not complex mixtures. Because no consensus approach has been forthcoming, regulatory agencies have adopted widely varying requirements related to environmental remediation programs for petroleum hydrocarbons, particularly total petroleum hydrocarbons (TPH). Corrective action goals for TPH are known to range in degree of conservatism from a concentration equivalent to the practical limit of quantification (PLQ) to ignoring the TPH component altogether. The primary objectives of this paper are two-fold; (1) to review the various methods employed for setting TPH corrective action goals, and (2) to evaluate HRA methodologies applicable to residual TPH in environmental media. This paper will also discuss and evaluate an HRA methodology, herein referred to as a fractionation approach, which the authors believe to be the most scientific and logical approach for assessing risk for petroleum hydrocarbons in environmental media. Rationale for this HRA methodology as opposed to other approaches are discussed.

  4. Advanced korean industrial safety and health policy with risk assessment.

    PubMed

    Kwon, Hyuckmyun; Cho, Jae Hyun; Moon, Il; Choi, Jaewook; Park, Dooyong; Lee, Youngsoon

    2010-09-01

    This article describes a systematic roadmap master plan for advanced industrial safety and health policy in Korea, with an emphasis on. Since Korean industries had first emergence of industrial safety and health policy in 1953, enormous efforts have been made on upgrading the relevant laws in order to reflect real situation of industrial work environment in accordance with rapid changes of Korean and global business over three decades. Nevertheless, current policy has major defects; too much techniques-based articles, diverged contents in less organization, combined enforcement and punishments and finally enforcing regulations full of commands and control. These deficiencies have make it difficult to accommodate changes of social, industrial and employment environment in customized fashion. The approach to the solution must be generic at the level of paradigm-shift rather than local modifications and enhancement. The basic idea is to establish a new system integrated with a risk assessment scheme, which encourages employers to apply to their work environment under comprehensive responsibility. The risk assessment scheme is designed to enable to inspect employers' compliances afterwards. A project comprises four yearly phases based on applying zones; initially designating and operating a specified risk zone, gradually expanding the special zones during a period of 3 years (2010-2012) and the final zone expanded to entire nation. In each phase, the intermediate version of the system is updated through a process of precise and unbiased validation in terms of its operability, feasibility and sustainability with building relevant infrastructures as needed. PMID:22953160

  5. Financial risk sharing with providers in health maintenance organizations, 1999.

    PubMed

    Gold, Marsha R; Lake, Timothy; Hurley, Robert; Sinclair, Michael

    2002-01-01

    The transfer of financial risk from health maintenance organizations (HMOs) to providers is controversial. To provide timely national data on these practices, we conducted a telephone survey in 1999 of a multi-staged probability sample of HMOs in 20 of the nation's 60 largest markets, accounting for 86% of all HMO enrollees nationally. Among those sampled, 82% responded. We found that HMOs' provider networks with physicians, hospitals, skilled nursing homes, and home health agencies are complex and multi-tiered Seventy-six percent of HMOs in our study use contracts for their HMO products that involve global, professional services, or hospital risk capitation to intermediate entities. These arrangements account for between 24.5 million and 27.4 million of the 55.9 million commercial and Medicare HMO enrollees in the 60 largest markets. While capitation arrangements are particularly common in California, they are more common elsewhere than many assume. The complex layering of risk sharing and delegation of care management responsibility raise questions about accountability and administrative costs in managed care. Do complex structures provide a way to involve providers more directly in managed care, or do they diffuse authority and add to administrative costs? PMID:12067073

  6. Advanced korean industrial safety and health policy with risk assessment.

    PubMed

    Kwon, Hyuckmyun; Cho, Jae Hyun; Moon, Il; Choi, Jaewook; Park, Dooyong; Lee, Youngsoon

    2010-09-01

    This article describes a systematic roadmap master plan for advanced industrial safety and health policy in Korea, with an emphasis on. Since Korean industries had first emergence of industrial safety and health policy in 1953, enormous efforts have been made on upgrading the relevant laws in order to reflect real situation of industrial work environment in accordance with rapid changes of Korean and global business over three decades. Nevertheless, current policy has major defects; too much techniques-based articles, diverged contents in less organization, combined enforcement and punishments and finally enforcing regulations full of commands and control. These deficiencies have make it difficult to accommodate changes of social, industrial and employment environment in customized fashion. The approach to the solution must be generic at the level of paradigm-shift rather than local modifications and enhancement. The basic idea is to establish a new system integrated with a risk assessment scheme, which encourages employers to apply to their work environment under comprehensive responsibility. The risk assessment scheme is designed to enable to inspect employers' compliances afterwards. A project comprises four yearly phases based on applying zones; initially designating and operating a specified risk zone, gradually expanding the special zones during a period of 3 years (2010-2012) and the final zone expanded to entire nation. In each phase, the intermediate version of the system is updated through a process of precise and unbiased validation in terms of its operability, feasibility and sustainability with building relevant infrastructures as needed.

  7. Process-dependent risk of delayed health effects for welders.

    PubMed Central

    Stern, R M

    1981-01-01

    In most industrialized countries large numbers of workers are exposed to welding fumes. Although the general pattern of welders' health may not significantly differ from that of workers in other dusty industrial occupations which demonstrate elevated incidence of respiratory tract diseases with long latency periods, the extremely wide range of substances at potentially high concentrations produced by various welding technologies may give rise to undetected process-specific high-risk working conditions: ("hot spots"). The origin, prevalence and range of magnitude of such hot spots, especially for cancer of the respiratory tract, is discussed, with emphasis placed on the assessment of risk resulting from exposure to Cr(VI) and Ni accompanying the use of various technologies for the welding of stainless and high alloy steels. The wide variation of health effects found within the industry, however, indicates the need for a standard protocol for future epidemiological studies, as well as for the development of suitable methodologies for experimental risk assessment. PMID:7333241

  8. Health protection and risks for rescuers in cases of floods.

    PubMed

    Janev Holcer, Nataša; Jeličić, Pavle; Grba Bujević, Maja; Važanić, Damir

    2015-03-01

    Floods can pose a number of safety and health hazards for flood-affected populations and rescuers and bring risk of injuries, infections, and diseases due to exposure to pathogenic microorganisms and different biological and chemical contaminants. The risk factors and possible health consequences for the rescuers involved in evacuation and rescuing operations during the May 2014 flood crisis in Croatia are shown, as well as measures for the prevention of injuries and illnesses. In cases of extreme floods, divers play a particularly important role in rescuing and first-response activities. Rescuing in contaminated floodwaters means that the used equipment such as diving suits should be disinfected afterwards. The need for securing the implementation of minimal health and safety measures for involved rescuers is paramount. Data regarding injuries and disease occurrences among rescuers are relatively scarce, indicating the need for medical surveillance systems that would monitor and record all injuries and disease occurrences among rescuers in order to ensure sound epidemiological data. The harmful effects of flooding can be reduced by legislation, improvement of flood forecasting, establishing early warning systems, and appropriate planning and education. PMID:25741935

  9. The presence of health-risk behaviour in Roma family.

    PubMed

    Niksić, Dragana; Kurspahić-Mujcić, Amira

    2007-05-01

    Roma people in B&H are a marginalised population group. Their health condition; is considerably worse than the condition of other population groups. The health problems of Roma people correlate with inadequate living and dwelling conditions. Roma children are facing the impossibility of being health care beneficiaries, because their parents are unemployed. The objective of this survey was to examine the family surrounding of children in age up to 8 years, including the social conditions under which they live and the presence of health risk behaviour. The research presents a descriptive cross-section study. We interviewed 1100 non-Roma parents and children and 383 Roma parents and children (in the communities of domicile Roma people) in B&H Federation. The results obtained indicate that only 17,8 % of Roma parents are secondary-school leavers, while remaining percentage covers those with incomplete primary school or without education at all, against 63,6% of non-Roma parents who have secondary education. The parents consider themselves good providers for their children (59,3% of Roma parents and 75% of non-Roma parents often play with their children). The Roma parents seek for medical attention for their children only in the cases when urgent health problems occur, such as fever/increased body temperature (one-half of the interviewed parents) or diarrhoea (31,9%). Physical punishment of children occurs more frequently in Roma families (23,7% - this is only the top of an iceberg) then in non-Roma families (11,4%). The parents usually beat children by using their hands or punish them by flogging. The domestic violence is accepted amongst Roma people and it has most sever impact on children, who suffer emotionally and physically. In the future, it will be necessary to create the kind of family environment that would enable improvement of health condition and decrease the behaviour that endangers the health of children.

  10. Research and Evaluations of the Health Aspects of Disasters, Part VIII: Risk, Risk Reduction, Risk Management, and Capacity Building.

    PubMed

    Birnbaum, Marvin L; Loretti, Alessandro; Daily, Elaine K; O'Rourke, Ann P

    2016-06-01

    There is a cascade of risks associated with a hazard evolving into a disaster that consists of the risk that: (1) a hazard will produce an event; (2) an event will cause structural damage; (3) structural damage will create functional damages and needs; (4) needs will create an emergency (require use of the local response capacity); and (5) the needs will overwhelm the local response capacity and result in a disaster (ie, the need for outside assistance). Each step along the continuum/cascade can be characterized by its probability of occurrence and the probability of possible consequences of its occurrence, and each risk is dependent upon the preceding occurrence in the progression from a hazard to a disaster. Risk-reduction measures are interventions (actions) that can be implemented to: (1) decrease the risk that a hazard will manifest as an event; (2) decrease the amounts of structural and functional damages that will result from the event; and/or (3) increase the ability to cope with the damage and respond to the needs that result from an event. Capacity building increases the level of resilience by augmenting the absorbing and/or buffering and/or response capacities of a community-at-risk. Risks for some hazards vary by the context in which they exist and by the Societal System(s) involved. Birnbaum ML , Loretti A , Daily EK , O'Rourke AP . Research and evaluations of the health aspects of disasters, part VIII: risk, risk reduction, risk management, and capacity building. Prehosp Disaster Med. 2016;31(3):300-308. PMID:27025980

  11. Associations of Health-Risk Behaviors and Health Cognition With Sexual Orientation Among Adolescents in School

    PubMed Central

    Lee, Dong-Yun; Kim, Seo-Hee; Woo, Sook Young; Yoon, Byung-Koo; Choi, DooSeok

    2016-01-01

    Abstract Homosexual adolescents may face significant health disparities. We examined health-risk behaviors and health cognition related to homosexual behavior in a representative sample of adolescents. Data were obtained from 129,900 adolescents between 2008 and 2012 over 5 cycles of the Korean Youth Risk Behavior Survey, a national survey of students in grades 7 to 12. Various health-risk behaviors and aspects of health cognition were compared between homosexual and heterosexual adolescents and analyzed with multiple logistic regression models. Compared with heterosexual adolescents (n = 127,594), homosexual adolescents (n = 2306) were more likely to engage in various health-risk behaviors and to have poor health cognition. In multiple logistic regression analysis, not living with parents, alcohol experience (adjusted odds ratio, 1.50; 95% confidence interval, 1.26–1.78 for males and 1.66; 1.33–2.07 for females), smoking experience (1.80; 1.54–2.10 for males and 3.15; 2.61–3.79 for females), and drug experience (3.65; 2.81–4.80 for males and 3.23; 2.35–4.46 for females) were associated with homosexual behavior. Homosexual adolescents were more likely to use adult internet content (2.82; 2.27–3.50 for males and 7.42; 4.19–13.15 for females), and to be depressed (1.21; 1.03–1.43 for males and 1.32; 1.06–1.64 for females). In addition, suicide ideation (1.51; 1.26–1.81 for males and 1.47; 1.16–1.86 for females) and attempts (1.67; 1.37–2.05 for males and 1.65; 1.34–2.03 for females) were significantly more prevalent among homosexual adolescents. Homosexual adolescents report disparities in various aspects of health-risk behavior and health cognition, including use of multiple substances, adult internet content and inappropriate weight loss methods, suicide ideation and attempts, and depressive mood. These factors should be addressed relevantly to develop specific interventions regarding sexual minorities. PMID:27227939

  12. Gap between technically accurate information and socially appropriate information for structural health monitoring system installed into tall buildings

    NASA Astrophysics Data System (ADS)

    Mita, Akira

    2016-04-01

    The importance of the structural health monitoring system for tall buildings is now widely recognized by at least structural engineers and managers at large real estate companies to ensure the structural safety immediately after a large earthquake and appeal the quantitative safety of buildings to potential tenants. Some leading real estate companies decided to install the system into all tall buildings. Considering this tendency, a pilot project for the west area of Shinjuku Station supported by the Japan Science and Technology Agency was started by the author team to explore a possibility of using the system to provide safe spaces for commuters and residents. The system was installed into six tall buildings. From our experience, it turned out that viewing only from technological aspects was not sufficient for the system to be accepted and to be really useful. Safe spaces require not only the structural safety but also the soundness of key functions of the building. We need help from social scientists, medical doctors, city planners etc. to further improve the integrity of the system.

  13. Differences in Health Care Costs and Utilization among Adults with Selected Lifestyle-Related Risk Factors.

    ERIC Educational Resources Information Center

    Tucker, Larry A.; Clegg, Alan G.

    2002-01-01

    Examined the relationship between lifestyle-related health risks and health care costs and utilization among young adults. Data collected at a primarily white collar worksite in over 2 years indicated that health risks, particularly obesity, stress, and general lifestyle, were significant predictors of health care costs and utilization among these…

  14. Health risks due to radon in drinking water

    SciTech Connect

    Hopke, P.K. Borak, T.B.; Doull, J.

    2000-03-15

    Following more than a decade of scientific debate about the setting of a standard for {sup 222}Rn in drinking water, Congress established a timetable for the promulgation of a standard in the 1996 Amendments to the Safe Drinking Water Act. As a result of those Amendments, the EPA contracted with the National Academy of Sciences to undertake a risk assessment for exposure to radon in drinking water. In addition, the resulting committee was asked to address several other scientific issues including the national average ambient {sup 222}Rn concentration and the increment of {sup 222}Rn to the indoor-air concentration arising from the use of drinking water in a home. A new dosimetric analysis of the cancer risk to the stomach from ingestion was performed. The recently reported risk estimates developed by the BEIR VI Committee for inhalation of radon decay products were adopted. Because the 1996 Amendments permit states to develop programs in which mitigation of air-producing health-risk reductions equivalent to that which would be achieved by treating the drinking water, the scientific issues involved in such multimedia mitigation programs were explored.

  15. Health risks due to radon in drinking water

    USGS Publications Warehouse

    Hopke, P.K.; Borak, T.B.; Doull, J.; Cleaver, J.E.; Eckerman, K.F.; Gundersen, L.C.S.; Harley, N.H.; Hess, C.T.; Kinner, N.E.; Kopecky, K.J.; Mckone, T.E.; Sextro, R.G.; Simon, S.L.

    2000-01-01

    Following more than a decade of scientific debate about the setting of a standard for 222Rn in drinking water, Congress established a timetable for the promulgation of a standard in the 1996 Amendments to the Safe Drinking Water Act. As a result of those Amendments, the EPA contracted with the National Academy of Sciences to undertake a risk assessment for exposure to radon in drinking water. In addition, the resulting committee was asked to address several other scientific issues including the national average ambient 222Rn concentration and the increment of 222Rn to the indoor- air concentration arising from the use of drinking water in a home. A new dosimetric analysis of the cancer risk to the stomach from ingestion was performed. The recently reported risk estimates developed by the BEIR VI Committee for inhalation of radon decay products were adopted. Because the 1996 Amendments permit states to develop programs in which mitigation of air- producing health-risk reductions equivalent to that which would be achieved by treating the drinking water, the scientific issues involved in such 'multimedia mitigation programs' were explored.

  16. Vibrio bacteria in raw oysters: managing risks to human health.

    PubMed

    Froelich, Brett A; Noble, Rachel T

    2016-03-01

    The human-pathogenic marine bacteria Vibrio vulnificus and V. parahaemolyticus are strongly correlated with water temperature, with concentrations increasing as waters warm seasonally. Both of these bacteria can be concentrated in filter-feeding shellfish, especially oysters. Because oysters are often consumed raw, this exposes people to large doses of potentially harmful bacteria. Various models are used to predict the abundance of these bacteria in oysters, which guide shellfish harvest policy meant to reduce human health risk. Vibrio abundance and behaviour varies from site to site, suggesting that location-specific studies are needed to establish targeted risk reduction strategies. Moreover, virulence potential, rather than simple abundance, should be also be included in future modeling efforts. PMID:26880841

  17. Risk assessment of genetically modified crops for nutrition and health.

    PubMed

    Magaña-Gómez, Javier A; de la Barca, Ana M Calderón

    2009-01-01

    The risk assessment of genetically modified (GM) crops for human nutrition and health has not been systematic. Evaluations for each GM crop or trait have been conducted using different feeding periods, animal models, and parameters. The most common result is that GM and conventional sources induce similar nutritional performance and growth in animals. However, adverse microscopic and molecular effects of some GM foods in different organs or tissues have been reported. Diversity among the methods and results of the risk assessments reflects the complexity of the subject. While there are currently no standardized methods to evaluate the safety of GM foods, attempts towards harmonization are on the way. More scientific effort is necessary in order to build confidence in the evaluation and acceptance of GM foods. PMID:19146501

  18. Risk assessment of genetically modified crops for nutrition and health.

    PubMed

    Magaña-Gómez, Javier A; de la Barca, Ana M Calderón

    2009-01-01

    The risk assessment of genetically modified (GM) crops for human nutrition and health has not been systematic. Evaluations for each GM crop or trait have been conducted using different feeding periods, animal models, and parameters. The most common result is that GM and conventional sources induce similar nutritional performance and growth in animals. However, adverse microscopic and molecular effects of some GM foods in different organs or tissues have been reported. Diversity among the methods and results of the risk assessments reflects the complexity of the subject. While there are currently no standardized methods to evaluate the safety of GM foods, attempts towards harmonization are on the way. More scientific effort is necessary in order to build confidence in the evaluation and acceptance of GM foods.

  19. Health risks from exposure to metals in household dusts.

    PubMed

    Lemus, R; Abdelghani, A A; Akers, T G; Horner, W E

    1996-01-01

    The levels of arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), iron (Fe), lead (Pb), mercury (Hg), and nickel (Ni) were determined in a total of 315 indoor and outdoor dust samples collected from 53 households in Louisiana. Inductively coupled plasma analysis revealed that in many samples, the metal content exceeded the United States Environmental Protection Agency (EPA) Risk-Based Concentration (RBC) guidelines. For example, the number of dust samples above the EPA-RBC included 64 for Cd, 52 for Hg, 43 for As, 4 for Fe, 4 for Cu, 3 for Cr, and 2 for Ni. One-hundred fifty-two samples exceeded the street-dust level for Pb published by the U.S. Agency for Toxic Substances and Disease Registry. The results of this study indicate that exposure to indoor and/or outdoor dust presents a potential health risk for Louisiana residents.

  20. Exploring electronic health records as a population health surveillance tool of cardiovascular disease risk factors.

    PubMed

    Sidebottom, Abbey C; Johnson, Pamela Jo; VanWormer, Jeffrey J; Sillah, Arthur; Winden, Tamara J; Boucher, Jackie L

    2015-04-01

    The objective of this study was to examine the utility of using electronic health record (EHR) data for periodic community health surveillance of cardiovascular disease (CVD) risk factors through 2 research questions. First, how many years of EHR data are needed to produce reliable estimates of key population-level CVD health indicators for a community? Second, how comparable are the EHR estimates relative to those from community screenings? The study takes place in the context of the Heart of New Ulm Project, a 10-year population health initiative designed to reduce myocardial infarctions and CVD risk factor burden in a rural community. The community is served by 1 medical center that includes a clinic and hospital. The project screened adult residents of New Ulm for CVD risk factors in 2009. EHR data for 3 years prior to the heart health screenings were extracted for patients from the community. Single- and multiple-year EHR prevalence estimates were compared for individuals ages 40-79 years (N=5918). EHR estimates also were compared to screening estimates (N=3123). Single-year compared with multiyear EHR data prevalence estimates were sufficiently precise for this rural community. EHR and screening prevalence estimates differed significantly-systolic blood pressure (BP) (124.0 vs. 128.9), diastolic BP (73.3 vs. 79.2), total cholesterol (186.0 vs. 201.0), body mass index (30.2 vs. 29.5), and smoking (16.6% vs. 8.2%)-suggesting some selection bias depending on the method used. Despite differences between data sources, EHR data may be a useful source of population health surveillance to inform and evaluate local population health initiatives.

  1. What risk assessments of genetically modified organisms can learn from institutional analyses of public health risks.

    PubMed

    Rajan, S Ravi; Letourneau, Deborah K

    2012-01-01

    The risks of genetically modified organisms (GMOs) are evaluated traditionally by combining hazard identification and exposure estimates to provide decision support for regulatory agencies. We question the utility of the classical risk paradigm and discuss its evolution in GMO risk assessment. First, we consider the problem of uncertainty, by comparing risk assessment for environmental toxins in the public health domain with genetically modified organisms in the environment; we use the specific comparison of an insecticide to a transgenic, insecticidal food crop. Next, we examine normal accident theory (NAT) as a heuristic to consider runaway effects of GMOs, such as negative community level consequences of gene flow from transgenic, insecticidal crops. These examples illustrate how risk assessments are made more complex and contentious by both their inherent uncertainty and the inevitability of failure beyond expectation in complex systems. We emphasize the value of conducting decision-support research, embracing uncertainty, increasing transparency, and building interdisciplinary institutions that can address the complex interactions between ecosystems and society. In particular, we argue against black boxing risk analysis, and for a program to educate policy makers about uncertainty and complexity, so that eventually, decision making is not the burden that falls upon scientists but is assumed by the public at large. PMID:23193357

  2. What Risk Assessments of Genetically Modified Organisms Can Learn from Institutional Analyses of Public Health Risks

    PubMed Central

    Rajan, S. Ravi; Letourneau, Deborah K.

    2012-01-01

    The risks of genetically modified organisms (GMOs) are evaluated traditionally by combining hazard identification and exposure estimates to provide decision support for regulatory agencies. We question the utility of the classical risk paradigm and discuss its evolution in GMO risk assessment. First, we consider the problem of uncertainty, by comparing risk assessment for environmental toxins in the public health domain with genetically modified organisms in the environment; we use the specific comparison of an insecticide to a transgenic, insecticidal food crop. Next, we examine normal accident theory (NAT) as a heuristic to consider runaway effects of GMOs, such as negative community level consequences of gene flow from transgenic, insecticidal crops. These examples illustrate how risk assessments are made more complex and contentious by both their inherent uncertainty and the inevitability of failure beyond expectation in complex systems. We emphasize the value of conducting decision-support research, embracing uncertainty, increasing transparency, and building interdisciplinary institutions that can address the complex interactions between ecosystems and society. In particular, we argue against black boxing risk analysis, and for a program to educate policy makers about uncertainty and complexity, so that eventually, decision making is not the burden that falls upon scientists but is assumed by the public at large. PMID:23193357

  3. What risk assessments of genetically modified organisms can learn from institutional analyses of public health risks.

    PubMed

    Rajan, S Ravi; Letourneau, Deborah K

    2012-01-01

    The risks of genetically modified organisms (GMOs) are evaluated traditionally by combining hazard identification and exposure estimates to provide decision support for regulatory agencies. We question the utility of the classical risk paradigm and discuss its evolution in GMO risk assessment. First, we consider the problem of uncertainty, by comparing risk assessment for environmental toxins in the public health domain with genetically modified organisms in the environment; we use the specific comparison of an insecticide to a transgenic, insecticidal food crop. Next, we examine normal accident theory (NAT) as a heuristic to consider runaway effects of GMOs, such as negative community level consequences of gene flow from transgenic, insecticidal crops. These examples illustrate how risk assessments are made more complex and contentious by both their inherent uncertainty and the inevitability of failure beyond expectation in complex systems. We emphasize the value of conducting decision-support research, embracing uncertainty, increasing transparency, and building interdisciplinary institutions that can address the complex interactions between ecosystems and society. In particular, we argue against black boxing risk analysis, and for a program to educate policy makers about uncertainty and complexity, so that eventually, decision making is not the burden that falls upon scientists but is assumed by the public at large.

  4. Human health risks in megacities due to air pollution

    NASA Astrophysics Data System (ADS)

    Gurjar, B. R.; Jain, A.; Sharma, A.; Agarwal, A.; Gupta, P.; Nagpure, A. S.; Lelieveld, J.

    2010-11-01

    This study evaluates the health risks in megacities in terms of mortality and morbidity due to air pollution. A new spreadsheet model, Risk of Mortality/Morbidity due to Air Pollution (Ri-MAP), is used to estimate the excess numbers of deaths and illnesses. By adopting the World Health Organization (WHO) guideline concentrations for the air pollutants SO 2, NO 2 and total suspended particles (TSP), concentration-response relationships and a population attributable-risk proportion concept are employed. Results suggest that some megacities like Los Angeles, New York, Osaka Kobe, Sao Paulo and Tokyo have very low excess cases in total mortality from these pollutants. In contrast, the approximate numbers of cases is highest in Karachi (15,000/yr) characterized by a very high concentration of total TSP (˜670 μg m -3). Dhaka (7000/yr), Beijing (5500/yr), Karachi (5200/yr), Cairo (5000/yr) and Delhi (3500/yr) rank highest with cardiovascular mortality. The morbidity (hospital admissions) due to Chronic Obstructive Pulmonary Disease (COPD) follows the tendency of cardiovascular mortality. Dhaka and Karachi lead the rankings, having about 2100/yr excess cases, while Osaka-Kobe (˜20/yr) and Sao Paulo (˜50/yr) are at the low end of all megacities considered. Since air pollution is increasing in many megacities, and our database of measured pollutants is limited to the period up to 2000 and does not include all relevant components (e.g. O 3), these numbers should be interpreted as lower limits. South Asian megacities most urgently need improvement of air quality to prevent excess mortality and morbidity due to exceptionally high levels of air pollution. The risk estimates obtained from Ri-MAP present a realistic baseline evaluation for the consequences of ambient air pollution in comparison to simple air quality indices, and can be expanded and improved in parallel with the development of air pollution monitoring networks.

  5. Exposure to oxidized nitrogen: lipid peroxidation and neonatal health risk.

    PubMed

    Tabacova, S; Baird, D D; Balabaeva, L

    1998-01-01

    Pregnant women exposed to extensive environmental contamination by oxidized nitrogen compounds were studied at parturition, their neonatal health status was assessed and the involvement of oxidative stress in pathology was evaluated. Methemoglobin in maternal and cord blood was measured as a biomarker of individual exposure. Blood lipid peroxides and glutathione (reduced and total) were determined as oxidative stress biomarkers. Birthweight, Apgar scores, and clinical diagnosis at birth were used as neonatal health endpoints. Elevated exposure to oxidized nitrogen compounds was associated with increased lipid peroxidation in both maternal and cord blood. Poor birth outcome was associated with high blood lipid peroxides. Controlling for maternal age, parity, and smoking did not affect the relationships materially. The results showed that maternal/fetal exposure to oxidized nitrogen compounds is associated with increased risk of adverse birth outcome and suggest a role of oxidative damage in the pathogenic pathway.

  6. Childhood obesity: a life-long health risk.

    PubMed

    Barton, Matthias

    2012-02-01

    Childhood obesity has become major health concern for physicians, parents, and health agencies around the world. Childhood obesity is associated with an increased risk for other diseases not only during youth but also later in life, including diabetes, arterial hypertension, coronary artery disease, and fatty liver disease. Importantly, obesity accelerates atherosclerosis progression already in children and young adults. With regard to pathophysiological changes in the vasculature, the striking similarities between physiological changes related to aging and obesity-related abnormalities are compatible with the concept that obesity causes "premature" vascular aging. This article reviews factors underlying the accelerated vascular disease development due to obesity. It also highlights the importance of recognizing childhood obesity as a disease condition and its permissive role in aggravating the development of other diseases. The importance of childhood obesity for disease susceptibility later in life, and the need for prevention and treatment are also discussed.

  7. Wind turbines: is there a human health risk?

    PubMed

    Roberts, Jennifer D; Roberts, Mark A

    2013-04-01

    The term "Wind Turbine Syndrome" was coined in a recently self-published book, which hypothesized that a multitude of symptoms such as headache and dizziness resulted from wind turbines generating low frequency sound (LFS). The objective of this article is to provide a summary of the peer-reviewed literature on the research that has examined the relationship between human health effects and exposure to LFS and sound generated from the operation of wind turbines. At present, a specific health condition has not been documented in the peer-reviewed literature that has been classified as a disease caused by exposure to sound levels and frequencies generated by the operation of wind turbines. Communities are experiencing a heightened sense of annoyance and fear from the development and siting of wind turbine farms. High-quality research and effective risk communication can advance this course from one of panic to one of understanding and exemplification for other environmental advancements.

  8. Linking family economic pressure and supportive parenting to adolescent health behaviors: two developmental pathways leading to health promoting and health risk behaviors.

    PubMed

    Kwon, Josephine A; Wickrama, K A S

    2014-07-01

    Adolescent health behaviors, especially health risk behaviors, have previously been linked to distal (i.e., family economic pressure) and proximal (i.e., parental support) contributors. However, few studies have examined both types of contributors along with considering health promoting and health risk behaviors separately. The present study investigated the influences of family economic hardship, supportive parenting as conceptualized by self-determination theory, and individual psychosocial and behavioral characteristics (i.e., mastery and delinquency, respectively) on adolescents' health promoting and health risk behaviors. We used structural equation modeling to analyze longitudinal data from a sample of Caucasian adolescent children and their mothers and fathers (N = 407, 54 % female) to examine direct and indirect effects, as well as gender symmetry and asymmetry. Findings suggest that family economic pressure contributed to adolescent mastery and delinquency through supportive parenting. Further, supportive parenting indirectly affected adolescent health risk behaviors only through delinquency, whereas supportive parenting indirectly influenced health promoting behaviors only through mastery, suggesting different developmental pathways for adolescent health risk and health promoting behaviors. Testing for gender symmetry of the full model showed that maternal and paternal parenting contributed to females' health risk behaviors directly, while maternal and paternal parenting contributed to males' health risk behaviors through delinquency. Gender symmetry was largely unsupported. The study highlights key direct and indirect pathways to adolescent health risk and health promoting behaviors within a family stress model and self-determination theory framework, and also highlights important gender differences in these developmental pathways.

  9. Health Risk Assessment for Area 514 RCRA Closure

    SciTech Connect

    Gallegos, G M; Hall, L C

    2005-05-26

    Lawrence Livermore National Laboratory (LLNL) is a USDOE research and development institution for science and technology applied to national security. The specific area that is the subject of this document, Area 514, was the location of active LLNL waste treatment facilities until November 2003, and the operations there were authorized under interim status. The site is being closed pursuant to the requirements of the Resource Conservation Recovery Act. The DTSC-approved ''Closure Plan for Area 514 Treatment and Storage Facility, LLNL 2004'', states clean closure concentrations for certain organic compounds, metals and metalloids. if all soil samples contained measured concentrations less than these levels, it was agreed that the site would meet the requirements for clean closure. However, if the samples had measured concentrations greater than the clean closure levels, a more detailed risk assessment could be prepared to evaluate the potential effects of the actual measured levels. Soil samples collected from 33 locations in Area 514 were analyzed for 37 constituents of potential concern, as identified by the Closure Plan. Many of these compounds and elements were not detected. However, 10 metals or metalloids were present at levels above the clean closure requirements, and 19 organic compounds were identified as contaminants of potential concern. Following the guidance in the Closure Plan, a health risk assessment is presented in this document to demonstrate the low level of potential health effects from the remaining constituents and to support clean closure of the site. Three types of hypothetical receptors were identified: an intrusive construction worker conducting trenching in the area, a bystander worker in a nearby building, and a future resident. Of the worker receptors, the intrusive construction worker was found to have the greater overall chronic exposure, with a theoretical calculated carcinogenic risk of 4 x 10{sup -8}, a chronic hazard index of 8 x

  10. Environmental and human health risks of aerosolized silver nanoparticles.

    PubMed

    Quadros, Marina E; Marr, Linsey C

    2010-07-01

    Silver nanoparticles (AgNPs) are gaining attention from the academic and regulatory communities, not only because of their antimicrobial effects and subsequent product applications, but also because of their potential health and environmental risks. Whereas AgNPs in the aqueous phase are under intensive study, those in the atmosphere have been largely overlooked, although it is well established that inhalation of nanoparticles is associated with adverse health effects. This review summarizes the present state of knowledge concerning airborne AgNPs to shed light on the possible environmental exposure scenarios that may accompany the production and popularization of silver nanotechnology consumer products. The current understanding of the toxicity of AgNPs points toward a potential threat via the inhalation exposure route. Nanoparticle size, chemical composition, crystal structure, surface area, and the rate of silver ion release are expected to be important variables in determining toxicity. Possible routes of aerosolization of AgNPs from the production, use, and disposal of existing consumer products are presented. It is estimated that approximately 14% of silver nanotechnology products that have been inventoried could potentially release silver particles into the air during use, whether through spraying, dry powder dispersion, or other methods. In laboratory and industrial settings, six methods of aerosolization have been used to produce airborne AgNPs: spray atomization, liquid-flame spray, thermal evaporation-condensation, chemical vaporization, dry powder dispersion, and manual handling. Fundamental uncertainties remain about the fate of AgNPs in the environment, their short- and long-term health effects, and the specific physical and chemical properties of airborne particles that are responsible for health effects. Thus, to better understand the risks associated with silver nanotechnology, it is vital to understand the conditions under which AgNPs could become

  11. Health risks from acid rain: a Canadian perspective.

    PubMed

    Franklin, C A; Burnett, R T; Paolini, R J; Raizenne, M E

    1985-11-01

    Acidic deposition, commonly referred to as acid rain, is causing serious environmental damage in eastern Canada. The revenues from forest products, tourism and sport fishing are estimated to account for about 8% of the gross national product. The impact on human health is not as clearcut and a multi-department program on the Long-Range Transport of Airborne Pollutants (LRTAP) was approved by the federal government in June 1980. The objectives of the LRTAP program are to reduce wet sulfate deposition to less than 20 kg/ha per year in order to protect moderately sensitive areas. This will require a 50% reduction in Canadian SO2 emissions east of the Saskatchewan/Manitoba border and concomitant reductions in the eastern U.S.A. The objectives of the health sector of the program are to assess the risk to health posed by airborne pollutants which are subjected to long-range transport and to monitor the influence of abatement programs. Two major epidemiology studies were undertaken in 1983, one in which the health effects related to acute exposure to transported air pollutants were studied in asthmatic and nonasthmatic children, and another in which the effects of chronic exposure to these pollutants were studied in school children living in towns with high and low levels of pollutants. Preliminary analysis of the data do not indicate major health effects, but definitive conclusions must await final analysis. Studies on the indirect effects of acid deposition on water quality have shown that acidified lake water left standing in the plumbing system can adversely affect water quality and that federally set guidelines for copper and lead are exceeded. Flushing of the system before using the water rectifies the situation. Additional studies are planned to further delineate the magnitude of the health effects of acidified lake water.

  12. Health risks from acid rain: a Canadian perspective.

    PubMed Central

    Franklin, C A; Burnett, R T; Paolini, R J; Raizenne, M E

    1985-01-01

    Acidic deposition, commonly referred to as acid rain, is causing serious environmental damage in eastern Canada. The revenues from forest products, tourism and sport fishing are estimated to account for about 8% of the gross national product. The impact on human health is not as clearcut and a multi-department program on the Long-Range Transport of Airborne Pollutants (LRTAP) was approved by the federal government in June 1980. The objectives of the LRTAP program are to reduce wet sulfate deposition to less than 20 kg/ha per year in order to protect moderately sensitive areas. This will require a 50% reduction in Canadian SO2 emissions east of the Saskatchewan/Manitoba border and concomitant reductions in the eastern U.S.A. The objectives of the health sector of the program are to assess the risk to health posed by airborne pollutants which are subjected to long-range transport and to monitor the influence of abatement programs. Two major epidemiology studies were undertaken in 1983, one in which the health effects related to acute exposure to transported air pollutants were studied in asthmatic and nonasthmatic children, and another in which the effects of chronic exposure to these pollutants were studied in school children living in towns with high and low levels of pollutants. Preliminary analysis of the data do not indicate major health effects, but definitive conclusions must await final analysis. Studies on the indirect effects of acid deposition on water quality have shown that acidified lake water left standing in the plumbing system can adversely affect water quality and that federally set guidelines for copper and lead are exceeded. Flushing of the system before using the water rectifies the situation. Additional studies are planned to further delineate the magnitude of the health effects of acidified lake water. Images FIGURE 1. FIGURE 2. PMID:4076081

  13. Water quality associated public health risk in Bo, Sierra Leone.

    PubMed

    Jimmy, David H; Sundufu, Abu J; Malanoski, Anthony P; Jacobsen, Kathryn H; Ansumana, Rashid; Leski, Tomasz A; Bangura, Umaru; Bockarie, Alfred S; Tejan, Edries; Lin, Baochuan; Stenger, David A

    2013-01-01

    Human health depends on reliable access to safe drinking water, but in many developing countries only a limited number of wells and boreholes are available. Many of these water resources are contaminated with biological or chemical pollutants. The goal of this study was to examine water access and quality in urban Bo, Sierra Leone. A health census and community mapping project in one neighborhood in Bo identified the 36 water sources used by the community. A water sample was taken from each water source and tested for a variety of microbiological and physicochemical substances. Only 38.9% of the water sources met World Health Organization (WHO) microbial safety requirements based on fecal coliform levels. Physiochemical analysis indicated that the majority (91.7%) of the water sources met the requirements set by the WHO. In combination, 25% of these water resources met safe drinking water criteria. No variables associated with wells were statistically significant predictors of contamination. This study indicated that fecal contamination is the greatest health risk associated with drinking water. There is a need to raise hygiene awareness and implement inexpensive methods to reduce fecal contamination and improve drinking water safety in Bo, Sierra Leone.

  14. Water quality associated public health risk in Bo, Sierra Leone.

    PubMed

    Jimmy, David H; Sundufu, Abu J; Malanoski, Anthony P; Jacobsen, Kathryn H; Ansumana, Rashid; Leski, Tomasz A; Bangura, Umaru; Bockarie, Alfred S; Tejan, Edries; Lin, Baochuan; Stenger, David A

    2013-01-01

    Human health depends on reliable access to safe drinking water, but in many developing countries only a limited number of wells and boreholes are available. Many of these water resources are contaminated with biological or chemical pollutants. The goal of this study was to examine water access and quality in urban Bo, Sierra Leone. A health census and community mapping project in one neighborhood in Bo identified the 36 water sources used by the community. A water sample was taken from each water source and tested for a variety of microbiological and physicochemical substances. Only 38.9% of the water sources met World Health Organization (WHO) microbial safety requirements based on fecal coliform levels. Physiochemical analysis indicated that the majority (91.7%) of the water sources met the requirements set by the WHO. In combination, 25% of these water resources met safe drinking water criteria. No variables associated with wells were statistically significant predictors of contamination. This study indicated that fecal contamination is the greatest health risk associated with drinking water. There is a need to raise hygiene awareness and implement inexpensive methods to reduce fecal contamination and improve drinking water safety in Bo, Sierra Leone. PMID:22350346

  15. Climate change impacts and risks for animal health in Asia.

    PubMed

    Forman, S; Hungerford, N; Yamakawa, M; Yanase, T; Tsai, H-J; Joo, Y-S; Yang, D-K; Nha, J-J

    2008-08-01

    The threat of climate change and global warming is now recognised worldwide and some alarming manifestations of change have occurred. The Asian continent, because of its size and diversity, may be affected significantly by the consequences of climate change, and its new status as a 'hub' of livestock production gives it an important role in mitigating possible impacts of climate variability on animal health. Animal health may be affected by climate change in four ways: heat-related diseases and stress, extreme weather events, adaptation of animal production systems to new environments, and emergence or re-emergence of infectious diseases, especially vector-borne diseases critically dependent on environmental and climatic conditions. To face these new menaces, the need for strong and efficient Veterinary Services is irrefutable, combined with good coordination of public health services, as many emerging human diseases are zoonoses. Asian developing countries have acute weaknesses in their Veterinary Services, which jeopardises the global surveillance network essential for early detection of hazards. Indeed, international cooperation within and outside Asia is vital to mitigating the risks of climate change to animal health in Asia.

  16. Possible health risks from low level exposure to beryllium.

    PubMed

    Stange, A W; Hilmas, D E; Furman, F J

    1996-07-17

    The first case of chronic beryllium disease (CBD) at the Rocky Flats Environmental Technology Site (Rocky Flats) was diagnosed in a machinist in 1984. Rocky Flats, located 16 miles northwest of Denver, Colorado, is part of the United States Department of Energy (DOE) nuclear weapons complex. Research and development operations using beryllium began at Rocky Flats in 1953, and beryllium production operations began in 1957. Exposures could have occurred during foundry operations, casting, shearing, rolling, cutting, welding, machining, sanding, polishing, assembly, and chemical analysis operations. The Beryllium Health Surveillance Program (BHSP) was established in June 1991 at Rocky Flats to provide health surveillance for beryllium exposed employees using the Lymphocyte Proliferation Test (LPT) to identify sensitized individuals. Of the 29 cases of CBD and 76 cases of beryllium sensitization identified since 1991, several cases appear to have had only minimal opportunistic exposures to beryllium, since they were employed in administrative functions rather than primary beryllium operations. In conjunction with other health surveillance programs, a questionnaire and interview are administered to obtain detailed work and health histories. These histories, along with other data, are utilized to estimate the extent of an individual's exposure. Additional surveillance is in progress to attempt to characterize the possible risks from intermittent or brief exposures to beryllium in the workplace. PMID:8711738

  17. Emergency Department Screening for Suicide and Mental Health Risk.

    PubMed

    Babeva, Kalina; Hughes, Jennifer L; Asarnow, Joan

    2016-11-01

    Suicide is the second leading cause of death among youth ages 10-24. An estimated 1.5 million US adolescents receive their primary health care in the emergency department (ED); this is particularly true for low-income and minority youths who often lack a regular source of care. ED visits can provide a window of opportunity to screen and identify youths with suicide and mental health risk, triage youths based on need, and facilitate effective follow-up care. Recently developed brief therapeutic assessment approaches have demonstrated success in improving rates of follow-up care after discharge from the ED. Furthermore, there is some data supporting clinical benefits when youths receive evidence-based outpatient follow-up care. ED screening combined with effective follow-up, therefore, may provide one strategy for improving mental health and reducing health disparities in our nation. This paper reviews the context in which ED screenings occur, available tools and strategies, and evidence for the effectiveness of tested approaches. PMID:27671917

  18. Putting risk in its place: methodological considerations for investigating extreme event health risk.

    PubMed

    Smoyer, K E

    1998-12-01

    Health is affected by the places in which people live, work and interact, yet many epidemiological studies overlook the characteristics of places and instead focus solely on the people who inhabit them. Place-based investigations of disparities in health outcomes are concerned with the healthiness of places and not merely the healthiness of the populations in these places. A place-based approach has been used within medical geography and medical sociology, typically in the study of health differentials associated with long-term, cumulative exposures to a wide range of environmental variables. This approach has rarely been extended, however, to health research that looks at the effects of extreme events (such as industrial accidents or hurricanes). The purpose of this paper is to incorporate a place-based framework into extreme event health research. The paper first discusses methodological considerations for a place-based approach and then illustrates the use of spatial analysis techniques as the first step in identifying place-based risk factors in mortality associated with heat waves. The study centers on St. Louis, Missouri, a city where heat waves are frequent and heat-related mortality is high. The results show that heat-related mortality rates during the most severe heat waves were generally higher in the warmer, less stable and more disadvantaged areas of St. Louis and lower in the cooler and more affluent parts of the city. During the milder years analyzed, there was little evidence of a relationship between place-based characteristics and the distribution of heat-related mortality. These findings about extreme event mortality risk would not have been evident from a population-based analysis. Ongoing dialog between epidemiologists and social scientists can help to bring place into the arena of extreme event research and to increase understanding of the role of place in risk.

  19. Ethics in public health research: privacy and public health at risk: public health confidentiality in the digital age.

    PubMed

    Myers, Julie; Frieden, Thomas R; Bherwani, Kamal M; Henning, Kelly J

    2008-05-01

    Public health agencies increasingly use electronic means to acquire, use, maintain, and store personal health information. Electronic data formats can improve performance of core public health functions, but potentially threaten privacy because they can be easily duplicated and transmitted to unauthorized people. Although such security breaches do occur, electronic data can be better secured than paper records, because authentication, authorization, auditing, and accountability can be facilitated. Public health professionals should collaborate with law and information technology colleagues to assess possible threats, implement updated policies, train staff, and develop preventive engineering measures to protect information. Tightened physical and electronic controls can prevent misuse of data, minimize the risk of security breaches, and help maintain the reputation and integrity of public health agencies.

  20. [Establishment of Method for Health Risk Assessment of Pollutants from Fixed Sources].

    PubMed

    Chen, Qiang; Wu, Huan-bo

    2016-05-15

    A health risk assessment method of pollutants from fixed sources was developed by applying AERMOD model in the health risk assessment. The method could directly forecast the health risks of toxic pollutants from source by some exposure pathway. Using the established method, in combination with the data of sources and traditional health risk assessment method as well as the measured data of PAHs in inhalation particle matter (PM₁₀) in Lanzhou, the health risk of polycyclic aromatic hydrocarbons (PAHs) and benzo [a] pyrene (BaP) in PM₁₀ from the three fire power plants and the health risk of PAHs and BaP in PM₁₀ at the receptor point by inhalation exposure in heating and non-heating seasons was calculated, respectively. Then the contribution rates of the health risk caused by the three fire power plants to the health risk at the receptor point were calculated. The results showed that the contribution rates were not associated with sex and age, but were associated with time period and risk types. The contribution rates in the non-heating seasons were greater than those in heating seasons, and the contribution rates of the carcinogenic risk index were greater than those of the cancer risk value. The reliability of the established method was validated by comparing with the traditional method. This method was applicable to health risk assessment of toxic pollutants from all fixed sources and environmental risk assessment of environmental impact assessment. PMID:27506015

  1. Estimating risk at a Superfund site using passive sampling devices as biological surrogates in human health risk models.

    PubMed

    Allan, Sarah E; Sower, Gregory J; Anderson, Kim A

    2011-10-01

    Passive sampling devices (PSDs) sequester the freely dissolved fraction of lipophilic contaminants, mimicking passive chemical uptake and accumulation by biomembranes and lipid tissues. Public Health Assessments that inform the public about health risks from exposure to contaminants through consumption of resident fish are generally based on tissue data, which can be difficult to obtain and requires destructive sampling. The purpose of this study is to apply PSD data in a Public Health Assessment to demonstrate that PSDs can be used as a biological surrogate to evaluate potential human health risks and elucidate spatio-temporal variations in risk. PSDs were used to measure polycyclic aromatic hydrocarbons (PAHs) in the Willamette River; upriver, downriver and within the Portland Harbor Superfund megasite for 3 years during wet and dry seasons. Based on an existing Public Health Assessment for this area, concentrations of PAHs in PSDs were substituted for fish tissue concentrations. PSD measured PAH concentrations captured the magnitude, range and variability of PAH concentrations reported for fish/shellfish from Portland Harbor. Using PSD results in place of fish data revealed an unacceptable risk level for cancer in all seasons but no unacceptable risk for non-cancer endpoints. Estimated cancer risk varied by several orders of magnitude based on season and location. Sites near coal tar contamination demonstrated the highest risk, particularly during the dry season and remediation activities. Incorporating PSD data into Public Health Assessments provides specific spatial and temporal contaminant exposure information that can assist public health professionals in evaluating human health risks.

  2. Estimating risk at a Superfund site using passive sampling devices as biological surrogates in human health risk models

    PubMed Central

    Allan, Sarah E.; Sower, Gregory J.; Anderson, Kim A.

    2013-01-01

    Passive sampling devices (PSDs) sequester the freely dissolved fraction of lipophilic contaminants, mimicking passive chemical uptake and accumulation by biomembranes and lipid tissues. Public Health Assessments that inform the public about health risks from exposure to contaminants through consumption of resident fish are generally based on tissue data, which can be difficulties to obtain and requires destructive sampling. The purpose of this study is to apply PSD data in a Public Health Assessment to demonstrate that PSDs can be used as a biological surrogate to evaluate potential human health risks and elucidate spatio-temporal variations in risk. PSDs were used to measure polycyclic aromatic hydrocarbons (PAHs) in the Willamette River; upriver, downriver and within the Portland Harbor Superfund megasite for three years during wet and dry seasons. Based on an existing Public Health Assessment for this area, concentrations of PAHs in PSDs were substituted for fish tissue concentrations. PSD measured PAH concentrations captured the magnitude, range and variability of PAH concentrations reported for fish/shellfish from Portland Harbor. Using PSD results in place of fish data revealed an unacceptable risk level for cancer in all seasons but no unacceptable risk for non-cancer endpoints. Estimated cancer risk varied by several orders of magnitude based on season and location. Sites near coal tar contamination demonstrated the highest risk, particularly during the dry season and remediation activities. Incorporating PSD data into Public Health Assessments provides specific spatial and temporal contaminant exposure information that can assist public health professionals in evaluating human health risks. PMID:21741671

  3. [Health risks induced by secondhand smoke and declines of risks after comprehensive smoke-free legislation].

    PubMed

    Yamato, Hiroshi

    2013-03-01

    Secondhand smoke is the major health risk among non-smokers. It is estimated that more than 6,800 non-smokers who are exposed to secondhand smoke die every year in Japan. WHO Framework Convention on Tobacco Control requires all the governments to implement comprehensive smoking ban in order to protect non-smokers' health. Many countries and municipal offices implemented comprehensive smoking ban in workplaces and public spaces including restaurants and bars. The number of patients of acute coronary syndrome and respiratory disease rapidly decreased in those countries. These facts should be announced to the people and policy makers where comprehensive smoking ban has not implemented yet in order to protect non-smokers' health. PMID:23631236

  4. A global human health risk assessment for Decamethylcyclopentasiloxane (D5).

    PubMed

    Franzen, Allison; Van Landingham, Cynthia; Greene, Tracy; Plotzke, Kathy; Gentry, Robinan

    2016-02-01

    Decamethylcyclopentasiloxane (D5) is a low-molecular-weight cyclic siloxane used primarily as an intermediate in the production of several widely-used industrial and consumer products and intentionally added to consumer products, personal products and some dry cleaning solvents. The global use requires consideration of consumer use information and risk assessment requirements from various sources and authoritative bodies. A global "harmonized" risk assessment was conducted to meet requirements for substance-specific risk assessments conducted by regulatory agencies such as USEPA's Integrated Risk Information System (IRIS), Health Canada and various independent scientific committees of the European Commission, as well as provide guidance for chemical safety assessments under REACH in Europe, and other relevant authoritative bodies. This risk assessment incorporates global exposure information combined with a Monte Carlo analysis to determine the most significant routes of exposure, utilization of a multi-species, multi-route physiologically based pharmacokinetic (PBPK) model to estimate internal dose metrics, benchmark modeling to determine a point of departure (POD), and a margin of safety (MOS) evaluation to compare the estimates of intake with the POD. Because of the specific pharmacokinetic behaviors of D5 including high lipophilicity, high volatility with low blood-to-air partition coefficients and extensive metabolic clearance that regulate tissue dose after exposure, the use of a PBPK model was essential to provide a comparison of a dose metric that reflects these processes. The characterization of the potential for adverse effects after exposure to D5 using a MOS approach based on an internal dose metric removes the subjective application of uncertainty factors that may be applied across various regulatory agencies and allows examination of the differences between internal dose metrics associated with exposure and those associated with adverse effects. PMID

  5. Advancing human health risk assessment: integrating recent advisory committee recommendations.

    PubMed

    Dourson, Michael; Becker, Richard A; Haber, Lynne T; Pottenger, Lynn H; Bredfeldt, Tiffany; Fenner-Crisp, Penelope A

    2013-07-01

    Over the last dozen years, many national and international expert groups have considered specific improvements to risk assessment. Many of their stated recommendations are mutually supportive, but others appear conflicting, at least in an initial assessment. This review identifies areas of consensus and difference and recommends a practical, biology-centric course forward, which includes: (1) incorporating a clear problem formulation at the outset of the assessment with a level of complexity that is appropriate for informing the relevant risk management decision; (2) using toxicokinetics and toxicodynamic information to develop Chemical Specific Adjustment Factors (CSAF); (3) using mode of action (MOA) information and an understanding of the relevant biology as the key, central organizing principle for the risk assessment; (4) integrating MOA information into dose-response assessments using existing guidelines for non-cancer and cancer assessments; (5) using a tiered, iterative approach developed by the World Health Organization/International Programme on Chemical Safety (WHO/IPCS) as a scientifically robust, fit-for-purpose approach for risk assessment of combined exposures (chemical mixtures); and (6) applying all of this knowledge to enable interpretation of human biomonitoring data in a risk context. While scientifically based defaults will remain important and useful when data on CSAF or MOA to refine an assessment are absent or insufficient, assessments should always strive to use these data. The use of available 21st century knowledge of biological processes, clinical findings, chemical interactions, and dose-response at the molecular, cellular, organ and organism levels will minimize the need for extrapolation and reliance on default approaches. PMID:23844697

  6. Advancing human health risk assessment: Integrating recent advisory committee recommendations

    PubMed Central

    Becker, Richard A.; Haber, Lynne T.; Pottenger, Lynn H.; Bredfeldt, Tiffany; Fenner-Crisp, Penelope A.

    2013-01-01

    Over the last dozen years, many national and international expert groups have considered specific improvements to risk assessment. Many of their stated recommendations are mutually supportive, but others appear conflicting, at least in an initial assessment. This review identifies areas of consensus and difference and recommends a practical, biology-centric course forward, which includes: (1) incorporating a clear problem formulation at the outset of the assessment with a level of complexity that is appropriate for informing the relevant risk management decision; (2) using toxicokinetics and toxicodynamic information to develop Chemical Specific Adjustment Factors (CSAF); (3) using mode of action (MOA) information and an understanding of the relevant biology as the key, central organizing principle for the risk assessment; (4) integrating MOA information into dose–response assessments using existing guidelines for non-cancer and cancer assessments; (5) using a tiered, iterative approach developed by the World Health Organization/International Programme on Chemical Safety (WHO/IPCS) as a scientifically robust, fit-for-purpose approach for risk assessment of combined exposures (chemical mixtures); and (6) applying all of this knowledge to enable interpretation of human biomonitoring data in a risk context. While scientifically based defaults will remain important and useful when data on CSAF or MOA to refine an assessment are absent or insufficient, assessments should always strive to use these data. The use of available 21st century knowledge of biological processes, clinical findings, chemical interactions, and dose–response at the molecular, cellular, organ and organism levels will minimize the need for extrapolation and reliance on default approaches. PMID:23844697

  7. Private health care coverage and increased risk of obstetric intervention

    PubMed Central

    2014-01-01

    Background When clinically indicated, common obstetric interventions can greatly improve maternal and neonatal outcomes. However, variation in intervention rates suggests that obstetric practice may not be solely driven by case criteria. Methods Differences in obstetric intervention rates by private and public status in Ireland were examined using nationally representative hospital discharge data. A retrospective cohort study was performed on childbirth hospitalisations occurring between 2005 and 2010. Multivariate logistic regression analysis with correction for the relative risk was conducted to determine the risk of obstetric intervention (caesarean delivery, operative vaginal delivery, induction of labour or episiotomy) by private or public status while adjusting for obstetric risk factors. Results 403,642 childbirth hospitalisations were reviewed; approximately one-third of maternities (30.2%) were booked privately. After controlling for relevant obstetric risk factors, women with private coverage were more likely to have an elective caesarean delivery (RR: 1.48; 95% CI: 1.45-1.51), an emergency caesarean delivery (RR: 1.13; 95% CI: 1.12-1.16) and an operative vaginal delivery (RR: 1.25; 95% CI: 1.22-1.27). Compared to women with public coverage who had a vaginal delivery, women with private coverage were 40% more likely to have an episiotomy (RR: 1.40; 95% CI: 1.38-1.43). Conclusions Irrespective of obstetric risk factors, women who opted for private maternity care were significantly more likely to have an obstetric intervention. To better understand both clinical and non-clinical dynamics, future studies of examining health care coverage status and obstetric intervention would ideally apply mixed-method techniques. PMID:24418254

  8. Implications of Type 2 Diabetes on Adolescent Reproductive Health Risk

    PubMed Central

    Downs, Julie S.; Arslanian, Silva; de Bruin, Wändi Bruine; Copeland, Valire Carr; Doswell, Willa; Herman, William; Lain, Kristine; Mansfield, Joan; Murray, Pamela J.; White, Neil; Charron-Prochownik, Denise

    2012-01-01

    Purpose The purpose of this article was to summarize scientific knowledge from an expert panel on reproductive health among adolescents with type 2 diabetes (T2D). Methods Using a mental model approach, a panel of experts—representing perspectives on diabetes, adolescents, preconception counseling, and reproductive health—was convened to discuss reproductive health issues for female adolescents with T2D. Results Several critical issues emerged. Compared with adolescents with type 1 diabetes, (1) adolescents with T2D may perceive their disease as less severe and have less experience managing it, putting them at risk for complications; (2) T2D is more prevalent among African Americans, who may be less trusting of the medical establishment; (3) T2D is associated with obesity, and it is often difficult to change one’s lifestyle within family environments practicing sedentary and dietary behaviors leading to obesity; (4) teens with T2D could be more fertile, because obesity is related to earlier puberty; (5) although obese teens with T2D have a higher risk of polycystic ovary syndrome, which is associated with infertility, treatment with metformin can increase fertility; and (6) women with type 2 diabetes are routinely transferred to insulin before or during pregnancy to allow more intensive management. Conclusions Findings from the expert panel provide compelling reasons to provide early, developmentally appropriate, culturally sensitive preconception counseling for teens with T2D. PMID:20944055

  9. Transitioning from a pen-and-paper health risk appraisal to an online health risk appraisal at a petroleum company.

    PubMed

    Kashima, Sara R

    2006-10-01

    Chevron Texaco's Health and Medical Services Department made the decision to use existing technology and transition from a paper health risk appraisal (HRA) to an online questionnaire. A cross-functional team was formed and a year was spent researching online tools to find a vendor who could supply a product best suited to Chevron Texaco's employee workforce. The purpose of this article is to describe the evolution of a paper-based HRA to an online tool as well as describe the project scope and strategy that a team of employees used in selecting the vendor. The article also describes implementation successes, challenges, and lessons learned in using the online tool with an industrial workforce. The strategy that was followed in deploying the Web site along with initial participation rates for this group of industrial employees are described.

  10. Health Risks of Limited-Contact Water Recreation

    PubMed Central

    Pratap, Preethi; Wroblewski, Meredith; Hryhorczuk, Daniel O.; Li, Hong; Liu, Li C.; Scheff, Peter A.

    2011-01-01

    Background: Wastewater-impacted waters that do not support swimming are often used for boating, canoeing, fishing, kayaking, and rowing. Little is known about the health risks of these limited-contact water recreation activities. Objectives: We evaluated the incidence of illness, severity of illness, associations between water exposure and illness, and risk of illness attributable to limited-contact water recreation on waters dominated by wastewater effluent and on waters approved for general use recreation (such as swimming). Methods: The Chicago Health, Environmental Exposure, and Recreation Study was a prospective cohort study that evaluated five health outcomes among three groups of people: those who engaged in limited-contact water recreation on effluent-dominated waters, those who engaged in limited-contact recreation on general-use waters, and those who engaged in non–water recreation. Data analysis included survival analysis, logistic regression, and estimates of risk for counterfactual exposure scenarios using G-computation. Results: Telephone follow-up data were available for 11,297 participants. With non–water recreation as the reference group, we found that limited-contact water recreation was associated with the development of acute gastrointestinal illness in the first 3 days after water recreation at both effluent-dominated waters [adjusted odds ratio (AOR) 1.46; 95% confidence interval (CI): 1.08, 1.96] and general-use waters (1.50; 95% CI: 1.09, 2.07). For every 1,000 recreators, 13.7 (95% CI: 3.1, 24.9) and 15.1 (95% CI: 2.6, 25.7) cases of gastrointestinal illness were attributable to limited-contact recreation at effluent-dominated waters and general-use waters, respectively. Eye symptoms were associated with use of effluent-dominated waters only (AOR 1.50; 95% CI: 1.10, 2.06). Among water recreators, our results indicate that illness was associated with the amount of water exposure. Conclusions: Limited-contact recreation, both on effluent

  11. Rosiglitazone: can meta-analysis accurately estimate excess cardiovascular risk given the available data? Re-analysis of randomized trials using various methodologic approaches

    PubMed Central

    Friedrich, Jan O; Beyene, Joseph; Adhikari, Neill KJ

    2009-01-01

    statistically significant. Conclusion We have shown that alternative reasonable methodological approaches to the rosiglitazone meta-analysis can yield increased or decreased risks that are either statistically significant or not significant at the p = 0.05 level for both myocardial infarction and cardiovascular death. Completion of ongoing trials may help to generate more accurate estimates of rosiglitazone's effect on cardiovascular outcomes. However, given that almost all point estimates suggest harm rather than benefit and the availability of alternative agents, the use of rosiglitazone may greatly decline prior to more definitive safety data being generated. PMID:19134216

  12. Toxicity and human health risk of hair dyes.

    PubMed

    Nohynek, Gerhard J; Fautz, Rolf; Benech-Kieffer, Florence; Toutain, Herve

    2004-04-01

    Hair dyes and their ingredients have moderate to low acute toxicity. Human poisoning accidents are rare and have only been reported following oral ingestion. Contact sensitisation to hair dyes has been a safety issue, mainly as a consequence of unprotected professional exposure. Although the use of hair dyes has dramatically increased in industrialised countries during the last decades, the prevalence of sensitisation to hair dyes in the general and professional populations has stabilised or declined. In vitro genotoxicity tests on hair dye ingredients frequently had positive results, although their correlation with in vivo carcinogenicity for the chemical class of oxidative hair dye ingredients (aromatic amines) is uncertain. Positive in vivo genotoxicity results on hair dyes are rare. Studies in man found no evidence of genotoxic effects of hair dyes or their ingredients. On the basis of mechanistic studies, some in vivo positive hair dye ingredients (p-aminophenol, Lawsone) have been shown to pose no or negligible risk to human health. Although a recent case-control epidemiology study suggested an association of hair dye use and bladder cancer, a number of other studies, including prospective investigations on large populations, found no or negative correlations for bladder or other cancers. Although in vivo topical carcinogenicity studies on hair dye ingredients or commercial formulations yielded no evidence for systemic toxicity or carcinogenicity, oral carcinogenicity studies on hair dye ingredients at oral doses up to the maximum tolerated dose (MTD) suggested that some ingredients are carcinogenic in rodents. Human systemic exposure to various (14)C-labelled oxidative hair dyes under conditions of use was below 1.0% of the amount applied. Conservative risk assessments suggested no or negligible cancer risk, including for ingredients that were found to be positive in oral carcinogenicity studies. The results of reproductive toxicity studies and

  13. Health risk assessment for radium discharged in produced waters

    SciTech Connect

    Hamilton, L.D.; Meinhold, A.F.; Nagy, J.

    1991-12-31

    Produced water generated during the production of oil and gas can contain enhanced levels of radium. This naturally occurring radioactive material (NORM) is discharged into freshwater streams, estuarine, coastal and outer continental shelf waters. Large volumes of produced waters are discharged to coastal waters along the Gulf Coast of Louisiana. The Gulf of Mexico is an important producer of fish and shellfish, and there is concern that radium discharged to coastal Louisiana could contaminate fish and shellfish used by people for food, and present a significant increase in cancer risk. This paper describes a screening-level assessment of the potential cancer risks posed by radium discharged to coastal Louisiana in oil-field produced waters. This screening analysis was performed to determine if a more comprehensive and realistic assessment is necessary, and because of the conservative assumptions embedded in the analysis overestimates the risk associated with the discharge of radium in produced waters. Two isotopes of radium (Ra-226 and Ra-228) are the radionuclides of most concern in produced water in terms of potential human health effects.

  14. Health risk assessment for radium discharged in produced waters

    SciTech Connect

    Hamilton, L.D.; Meinhold, A.F.; Nagy, J.

    1991-01-01

    Produced water generated during the production of oil and gas can contain enhanced levels of radium. This naturally occurring radioactive material (NORM) is discharged into freshwater streams, estuarine, coastal and outer continental shelf waters. Large volumes of produced waters are discharged to coastal waters along the Gulf Coast of Louisiana. The Gulf of Mexico is an important producer of fish and shellfish, and there is concern that radium discharged to coastal Louisiana could contaminate fish and shellfish used by people for food, and present a significant increase in cancer risk. This paper describes a screening-level assessment of the potential cancer risks posed by radium discharged to coastal Louisiana in oil-field produced waters. This screening analysis was performed to determine if a more comprehensive and realistic assessment is necessary, and because of the conservative assumptions embedded in the analysis overestimates the risk associated with the discharge of radium in produced waters. Two isotopes of radium (Ra-226 and Ra-228) are the radionuclides of most concern in produced water in terms of potential human health effects.

  15. Metals bioaccumulation in two edible bivalves and health risk assessment.

    PubMed

    El-Shenawy, Nahla S; Loutfy, Naglaa; Soliman, Maha F M; Tadros, Menerva M; Abd El-Azeez, Ahmed A

    2016-03-01

    Our aim was to quantify the bioaccumulation of 13 metals in two edible bivalves (Ruditapes decussatus and Paphia undulata) in Lake Timsah, Egypt. A potential human health risk assessment was conducted to evaluate the hazards from bivalve consumption. Fe, Al, Zn, and Sr had the highest concentrations in the bivalve samples. The levels of Cd were much lower than the maximum permissible level, while Pb concentrations in the two bivalves were nearly two times the permissible level. The extent of bioaccumulation factor was site- and species-specific. For low and high bivalve-consuming groups, the estimated daily intake of Pb and Cd ranged from 0.01 to 0.76 μg/kg/day. For low and high bivalve-consuming groups, hazard quotients (HQs) for metals were found to be less than 1 for both bivalve species, except for Co in the high-consuming group. In conclusion, even though there was no apparent risk to bivalve consumers from being exposed to single metals, there is a risk from being exposed to the 13 studied metals together, especially for high bivalve-consuming groups such as fishermen.

  16. Quantifying human health risks from virginiamycin used in chickens.

    PubMed

    Cox, Louis A; Popken, Douglas A

    2004-02-01

    The streptogramin antimicrobial combination Quinupristin-Dalfopristin (QD) has been used in the United States since late 1999 to treat patients with vancomycin-resistant Enterococcus faecium (VREF) infections. Another streptogramin, virginiamycin (VM), is used as a growth promoter and therapeutic agent in farm animals in the United States and other countries. Many chickens test positive for QD-resistant E. faecium, raising concern that VM use in chickens might compromise QD effectiveness against VREF infections by promoting development of QD-resistant strains that can be transferred to human patients. Despite the potential importance of this threat to human health, quantifying the risk via traditional farm-to-fork modeling has proved extremely difficult. Enough key data (mainly on microbial loads at each stage) are lacking so that such modeling amounts to little more than choosing a set of assumptions to determine the answer. Yet, regulators cannot keep waiting for more data. Patients prescribed QD are typically severely ill, immunocompromised people for whom other treatment options have not readily been available. Thus, there is a pressing need for sound risk assessment methods to inform risk management decisions for VM/QD using currently available data. This article takes a new approach to the QD-VM risk modeling challenge. Recognizing that the usual farm-to-fork ("forward chaining") approach commonly used in antimicrobial risk assessment for food animals is unlikely to produce reliable results soon enough to be useful, we instead draw on ideas from traditional fault tree analysis ("backward chaining") to reverse the farm-to-fork process and start with readily available human data on VREF case loads and QD resistance rates. Combining these data with recent genogroup frequency data for humans, chickens, and other sources (Willems et al., 2000, 2001) allows us to quantify potential human health risks from VM in chickens in both the United States and Australia, two

  17. Health benefits of 'grow your own' food in urban areas: implications for contaminated land risk assessment and risk management?

    PubMed Central

    2009-01-01

    Compelling evidence of major health benefits of fruit and vegetable consumption, physical activity, and outdoor interaction with 'greenspace' have emerged in the past decade - all of which combine to give major potential health benefits from 'grow-your-own' (GYO) in urban areas. However, neither current risk assessment models nor risk management strategies for GYO in allotments and gardens give any consideration to these health benefits, despite their potential often to more than fully compensate the risks. Although urban environments are more contaminated by heavy metals, arsenic, polyaromatic hydrocarbons and dioxins than most rural agricultural areas, evidence is lacking for adverse health outcomes of GYO in UK urban areas. Rarely do pollutants in GYO food exceed statutory limits set for commercial food, and few people obtain the majority of their food from GYO. In the UK, soil contamination thresholds triggering closure or remediation of allotment and garden sites are based on precautionary principles, generating 'scares' that may negatively impact public health disproportionately to the actual health risks of exposure to toxins through own-grown food. By contrast, the health benefits of GYO are a direct counterpoint to the escalating public health crisis of 'obesity and sloth' caused by eating an excess of saturated fats, inadequate consumption of fresh fruit and vegetables combined with a lack of exercise. These are now amongst the most important preventable causes of illness and death. The health and wider societal benefits of 'grow-your-own' thus reveal a major limitation in current risk assessment methodologies which, in only considering risks, are unable to predict whether GYO on particular sites will, overall, have positive, negative, or no net effects on human health. This highlights a more general need for a new generation of risk assessment tools that also predict overall consequences for health to more effectively guide risk management in our

  18. Concentrations and Potential Health Risks of Metals in Lip Products

    PubMed Central

    Liu, Sa; Rojas-Cheatham, Ann

    2013-01-01

    Background: Metal content in lip products has been an issue of concern. Objectives: We measured lead and eight other metals in a convenience sample of 32 lip products used by young Asian women in Oakland, California, and assessed potential health risks related to estimated intakes of these metals. Methods: We analyzed lip products by inductively coupled plasma optical emission spectrometry and used previous estimates of lip product usage rates to determine daily oral intakes. We derived acceptable daily intakes (ADIs) based on information used to determine public health goals for exposure, and compared ADIs with estimated intakes to assess potential risks. Results: Most of the tested lip products contained high concentrations of titanium and aluminum. All examined products had detectable manganese. Lead was detected in 24 products (75%), with an average concentration of 0.36 ± 0.39 ppm, including one sample with 1.32 ppm. When used at the estimated average daily rate, estimated intakes were > 20% of ADIs derived for aluminum, cadmium, chromium, and manganese. In addition, average daily use of 10 products tested would result in chromium intake exceeding our estimated ADI for chromium. For high rates of product use (above the 95th percentile), the percentages of samples with estimated metal intakes exceeding ADIs were 3% for aluminum, 68% for chromium, and 22% for manganese. Estimated intakes of lead were < 20% of ADIs for average and high use. Conclusions: Cosmetics safety should be assessed not only by the presence of hazardous contents, but also by comparing estimated exposures with health-based standards. In addition to lead, metals such as aluminum, cadmium, chromium, and manganese require further investigation. PMID:23674482

  19. Do free-living amoebae in treated drinking water systems present an emerging health risk?

    PubMed

    Thomas, Jacqueline M; Ashbolt, Nicholas J

    2011-02-01

    There is an expanding body of evidence that free-living amoebae (FLA) increase both the numbers and virulence of water-based, human-pathogenic, amoeba-resisting microorganisms (ARM). Legionella spp., Mycobacterium spp., and other opportunistic human pathogens are known to be both ARM and also the etiologic agents of potentially fatal human lung infections. However, comparatively little is known about the FLA that may facilitate ARM growth in drinking water. This review examines the available literature on FLA in treated drinking water systems; in total 26 studies from 18 different countries. FLA were reported to breakthrough the water treatment barrier and enter distribution systems, in addition to the expected post-treatment system ingress. Once in the distribution system there is evidence of FLA colonization and regrowth especially in reservoirs and in-premise plumbing storage tanks. At the point of use the average FLA detection rate was 45% but highly variable (n = 16, σ = 31) due to both differences in both assay methods and the type of water systems examined. This review reveals that FLA are consistently detected in treated drinking water systems around the world and present a yet unquantified emerging health risk. However, more research is urgently required before accurate risks assessments can be undertaken to assess the impacts on human health, in households and institutions, due to exposure to FLA facilitated pathogenic ARM. PMID:21194220

  20. Do free-living amoebae in treated drinking water systems present an emerging health risk?

    PubMed

    Thomas, Jacqueline M; Ashbolt, Nicholas J

    2011-02-01

    There is an expanding body of evidence that free-living amoebae (FLA) increase both the numbers and virulence of water-based, human-pathogenic, amoeba-resisting microorganisms (ARM). Legionella spp., Mycobacterium spp., and other opportunistic human pathogens are known to be both ARM and also the etiologic agents of potentially fatal human lung infections. However, comparatively little is known about the FLA that may facilitate ARM growth in drinking water. This review examines the available literature on FLA in treated drinking water systems; in total 26 studies from 18 different countries. FLA were reported to breakthrough the water treatment barrier and enter distribution systems, in addition to the expected post-treatment system ingress. Once in the distribution system there is evidence of FLA colonization and regrowth especially in reservoirs and in-premise plumbing storage tanks. At the point of use the average FLA detection rate was 45% but highly variable (n = 16, σ = 31) due to both differences in both assay methods and the type of water systems examined. This review reveals that FLA are consistently detected in treated drinking water systems around the world and present a yet unquantified emerging health risk. However, more research is urgently required before accurate risks assessments can be undertaken to assess the impacts on human health, in households and institutions, due to exposure to FLA facilitated pathogenic ARM.

  1. Bioethics and the Framing of Climate Change's Health Risks.

    PubMed

    Valles, Sean A

    2015-06-01

    Cheryl Cox MacPherson recently argued, in an article for this journal, that 'Climate Change is a Bioethics Problem'. This article elaborates on that position, particularly highlighting bioethicists' potential ability to help reframe the current climate change discourse to give more attention to its health risks. This reframing process is especially important because of the looming problem of climate change skepticism. Recent empirical evidence from science framing experiments indicates that the public reacts especially positively to climate change messages framed in public health terms, and bioethicists are particularly well positioned to contribute their expertise to the process of carefully developing and communicating such messages. Additionally, as climate framing research and practice continue, it will be important for bioethicists to contribute to the creation of that project's nascent ethical standards. The discourse surrounding antibiotic resistance is posited as an example that can lend insight into how communicating a public health-framed message, including the participation of bioethicists, can help to override public skepticism about the findings of politically contentious scientific fields. PMID:25186465

  2. Supplemental risk-assessment guidance for the Superfund program. Part 1. Guidance for Public-Health Risk Assessments. Part 2. Guidance for ecological Risk Assessments. Draft report (Final)

    SciTech Connect

    Not Available

    1989-06-01

    This guidance manual was developed to address the practical aspects and issues pertaining to the Superfund risk-assessment process for both public health and environment concerns. Part 1, Guidance for Public Health Risk Assessments, supplements the Superfund Public Health Evaluation Manual and Superfund Exposure Assessment Manual and the Endangerment Assessment Handbook. Explicit guidance on technical matters which should be followed in developing public health risk assessments for EPA Region 1. The guidance addresses hazard identification, dose-response assessment, exposure assessment, risk characterization, and uncertainty/limitations. Part 2 of the manual, Guidance for Ecological Risk Assessments, addresses the collection of site-specific data needed to support an ecological risk assessment, describes a framework for conducting the assessments, and provides several specific approaches for assessing risks to systems exposed to chemical contamination in different media.

  3. There is more to risk and safety planning than dramatic risks: Mental health nurses' risk assessment and safety-management practice.

    PubMed

    Higgins, Agnes; Doyle, Louise; Downes, Carmel; Morrissey, Jean; Costello, Paul; Brennan, Michael; Nash, Michael

    2016-04-01

    Risk assessment and safety planning are considered a cornerstone of mental health practice, yet limited research exists into how mental health nurses conceptualize 'risk' and how they engage with risk assessment and safety planning. The aim of the present study was to explore mental health nurses' practices and confidence in risk assessment and safety planning. A self-completed survey was administered to 381 mental health nurses in Ireland. The findings indicate that nurses focus on risk to self and risk to others, with the risk of suicide, self-harm, substance abuse, and violence being most frequently assessed. Risk from others and 'iatrogenic' risk were less frequently considered. Overall, there was limited evidence of recovery-oriented practice in relation to risk. The results demonstrate a lack of meaningful engagement with respect to collaborative safety planning, the identification and inclusion of protective factors, and the inclusion of positive risk-taking opportunities. In addition, respondents report a lack of confidence working with positive risk taking and involving family/carers in the risk-assessment and safety-planning process. Gaps in knowledge about risk-assessment and safety-planning practice, which could be addressed through education, are identified, as are the implications of the findings for practice and research.

  4. Assessment of arsenic (As) occurrence in arable soil and its related health risk in China.

    PubMed

    Zhang, Xiuying; Zhong, Taiyang; Chen, Dongmei; Cheng, Min; Liu, Lei; Zhang, Xiaomin; Li, Xinhui

    2016-06-01

    Arsenic (As) is a major global environmental pollutant due to its high toxicity on human and animal health. This study collected 427 relevant papers to study As concentrations in Chinese arable soil and evaluate the health risk of exposure to As for humans. Results showed that the average of As concentration was 9.46 mg/kg in Chinese arable soil. Soil As concentrations in Hunan Province and Guangxi Zhuang Autonomous Region posed high carcinogenic and non-cancer risks on human health through diet, Yunnan, Guizhou, Guangdong, and Xinjiang provinces had relative high health risks, while As concentrations in the other provinces posed low health risks on humans. The physical factors controlled the spatial pattern of health risk on a provincial scale, but the As-related human activities introduced high health risk on people, particularly the agricultural activities such as sewage irrigation and fertilizer application should be given more attention due to its large area. PMID:26209282

  5. Overview of Space Radiation Health Risks (Cancer, Cognition, Cardiovascular) and Potential Common Pathways Such as Senescence and Inflammation

    NASA Technical Reports Server (NTRS)

    Patel, Zarana S.; Huff, Janice L.; Simonsen, Lisa C.

    2016-01-01

    The radiation environment in space poses significant challenges to human health and is a major concern for long duration, manned space missions. Outside the Earth's protective magnetosphere, astronauts are exposed to higher levels of galactic cosmic rays, whose physical characteristics are distinct from terrestrial sources of radiation such as x-rays and gamma-rays. Galactic cosmic rays consist of high energy, high charge (HZE) particles as well as high energy protons; they impart unique biological damage as they traverse through tissue with impacts on human health that are largely unknown. Understanding the quantitative and qualitative differences in biological responses produced by galactic cosmic radiation compared to Earth-based radiation is a major focus of space radiation research and is imperative for accurate risk assessment for long duration space missions. The major health issues of concern are epithelial carcinogenesis, central nervous system effects that may result in acute (inflight) cognitive impairment and late neurological disorders, degenerative tissue effects including cardiovascular, digestive and respiratory risks as well as possible acute radiation syndromes in the event of an unshielded exposure to a large solar particle event. In this presentation, we review evidence for health risks associated with heavy ion exposure and research strategies to enable manned space flight outside low Earth orbit. We are currently focused on common risk pathways that can be targeted for mitigation via countermeasures, and senescence and inflammation are prime areas for investigation.

  6. State High-Risk Pools: An Update on the Minnesota Comprehensive Health Association

    PubMed Central

    Spencer, Donna; Burke, Courtney E.

    2011-01-01

    State health insurance high-risk pools are a key component of the US health care system's safety net, because they provide health insurance to the “uninsurable.” In 2007, 34 states had individual high-risk pools, which covered more than 200 000 people at a total cost of $1.8 billion. We examine the experience of the largest and oldest pool in the nation, the Minnesota Comprehensive Health Association, to document key issues facing state high-risk pools in enrollment and financing. We also considered the role and future of high-risk pools in light of national health care finance reform. PMID:21228286

  7. State high-risk pools: an update on the Minnesota Comprehensive Health Association.

    PubMed

    Blewett, Lynn A; Spencer, Donna; Burke, Courtney E

    2011-02-01

    State health insurance high-risk pools are a key component of the US health care system's safety net, because they provide health insurance to the "uninsurable." In 2007, 34 states had individual high-risk pools, which covered more than 200 000 people at a total cost of $1.8 billion. We examine the experience of the largest and oldest pool in the nation, the Minnesota Comprehensive Health Association, to document key issues facing state high-risk pools in enrollment and financing. We also considered the role and future of high-risk pools in light of national health care finance reform. PMID:21228286

  8. Risk assessment and toxicology databases for health effects assessment

    SciTech Connect

    Lu, P.Y.; Wassom, J.S.

    1990-12-31

    Scientific and technological developments bring unprecedented stress to our environment. Society has to predict the results of potential health risks from technologically based actions that may have serious, far-reaching consequences. The potential for error in making such predictions or assessment is great and multiplies with the increasing size and complexity of the problem being studied. Because of this, the availability and use of reliable data is the key to any successful forecasting effort. Scientific research and development generate new data and information. Much of the scientific data being produced daily is stored in computers for subsequent analysis. This situation provides both an invaluable resource and an enormous challenge. With large amounts of government funds being devoted to health and environmental research programs and with maintenance of our living environment at stake, we must make maximum use of the resulting data to forecast and avert catastrophic effects. Along with the readily available. The most efficient means of obtaining the data necessary for assessing the health effects of chemicals is to utilize applications include the toxicology databases and information files developed at ORNL. To make most efficient use of the data/information that has already been prepared, attention and resources should be directed toward projects that meticulously evaluate the available data/information and create specialized peer-reviewed value-added databases. Such projects include the National Library of Medicine`s Hazardous Substances Data Bank, and the U.S. Air Force Installation Restoration Toxicology Guide. These and similar value-added toxicology databases were developed at ORNL and are being maintained and updated. These databases and supporting information files, as well as some data evaluation techniques are discussed in this paper with special focus on how they are used to assess potential health effects of environmental agents. 19 refs., 5 tabs.

  9. Information resources used in health risk assessment by the New Jersey Department of Environmental Protection

    SciTech Connect

    Post, G.B.; Baratta, M.; Wolfson, S.; McGeorge, L.

    1990-12-31

    The New Jersey Department of Environmental Protection`s responsibilities related to health-based risk assessment are described, including its research projects and its development of health based compound specific standards and guidance levels. The resources used by the agency to support health risk assessment work are outlined.

  10. Health risks of snorkel swimming in untreated water.

    PubMed

    Philipp, R; Evans, E J; Hughes, A O; Grisdale, S K; Enticott, R G; Jephcott, A E

    1985-12-01

    There are certain health risks associated with recreational exposure to bacteriologically polluted water. In this study, 27% (21/77) of swimmers who took part in a snorkel swimming event, experienced gastrointestinal symptoms within 48 hours of entering the untreated water. The incidence of these symptoms was statistically significantly greater than the incidence of such symptoms reported by two control populations (p less than 0.001), but not significantly different to 25% of people who had experienced gastrointestinal symptoms in a previous snorkel event in the same water environment. As the water quality came within the confidence intervals of the EEC standards for bathing water the adequacy of these standards needs further appraisal.

  11. Examining relationships between multiple health risk behaviors, well-being, and productivity.

    PubMed

    Evers, Kerry E; Castle, Patricia H; Prochaska, James O; Prochaska, Janice M

    2014-06-01

    Traditionally, the concept of health promotion has emphasized the reduction of health risk behaviors to reduce disease and impairment. Well-being research expands this focus to include positive constructs such as thriving, productivity, life-evaluation, and emotional and physical health. The objective of the present study was to examine the relationships between health risk behaviors and specific measures of individual well-being. Participants (N = 790) from 49 states completed a one-time online assessment that included the Life-Evaluation Index, Emotional and Physical Health Ladders, the Health Risk Intervention Assessment, and the Work Productivity and Activity Improvement Questionnaire for General Health. Life Evaluation and physical and emotional health were all inversely related to the number of health risk behaviors, with higher well-being scores associated with lower number of risk behaviors. Across the three Life Evaluation categories (Suffering, Struggling, and Thriving) the number of health risk behaviors decreased, productivity loss decreased, and emotional and physical health increased. The results add to previous research on how reducing multiple health risk behaviors can be combined with well-being, i.e., an emphasis on increasing life-evaluation, emotional and physical health, better functioning, and productivity.

  12. A Qualitative Comparison of Susceptibility and Behavior in Recreational and Occupational Risk Environments: Implications for Promoting Health and Safety.

    PubMed

    Haas, Emily Joy; Mattson, Marifran

    2016-06-01

    Although internal factors that influence risk are frequently studied to understand human behavior, external factors, including social, cultural, and institutional factors, should be better utilized to inform ways to efficiently target, tailor, and promote safety messaging to at-risk populations. Semi-structured interviews obtained data from 37 motorcyclists and 18 mineworkers about their risk perceptions and behaviors within their respective dynamic environments. A comparative thematic analysis revealed information about external factors that influence risk perceptions and behaviors. Results support the importance of qualitative approaches for assessing and targeting individuals' risk perceptions and behaviors. In addition, segmenting at-risk subgroups within target populations and tailoring messages for these at-risk groups is critical for safety behavior modification. Practitioners should utilize strategic, culture-centric risk communication that takes into account external factors when determining when, who, and what to communicate via health promotion activities to more accurately disseminate valid, empathetic, and engaging communication with a higher level of fidelity. PMID:27186684

  13. Health literacy in Korean immigrants at risk for type 2 diabetes.

    PubMed

    Choi, Sarah E; Rush, Elizabeth; Henry, Shayna

    2013-06-01

    Rising incidence of type 2 diabetes (DM) in Korean immigrants has highlighted the need for better prevention efforts. Health literacy is an important predictor in the utilization of preventative health measures, however little is known about health literacy in Korean immigrants. This study examined DM risk factors in a sample of 145 at-risk Korean immigrants, their level of health literacy, and associations between health literacy and DM risk factors. Findings indicated a high prevalence of DM risk factors and a low level of health literacy in the sample. Health literacy was correlated with English proficiency, acculturation, and lower waist to hip ratios among all participants, and with lower blood glucose levels among highly acculturated participants. Korean immigrants who are less acculturated may have lower health literacy than those who are more acculturated. Thus, linguistically and culturally sensitive health education should be incorporated into diabetes prevention efforts.

  14. Proposals for enhanced health risk assessment and stratification in an integrated care scenario

    PubMed Central

    Dueñas-Espín, Ivan; Vela, Emili; Pauws, Steffen; Bescos, Cristina; Cano, Isaac; Cleries, Montserrat; Contel, Joan Carles; de Manuel Keenoy, Esteban; Garcia-Aymerich, Judith; Gomez-Cabrero, David; Kaye, Rachelle; Lahr, Maarten M H; Lluch-Ariet, Magí; Moharra, Montserrat; Monterde, David; Mora, Joana; Nalin, Marco; Pavlickova, Andrea; Piera, Jordi; Ponce, Sara; Santaeugenia, Sebastià; Schonenberg, Helen; Störk, Stefan; Tegner, Jesper; Velickovski, Filip; Westerteicher, Christoph; Roca, Josep

    2016-01-01

    Objectives Population-based health risk assessment and stratification are considered highly relevant for large-scale implementation of integrated care by facilitating services design and case identification. The principal objective of the study was to analyse five health-risk assessment strategies and health indicators used in the five regions participating in the Advancing Care Coordination and Telehealth Deployment (ACT) programme (http://www.act-programme.eu). The second purpose was to elaborate on strategies toward enhanced health risk predictive modelling in the clinical scenario. Settings The five ACT regions: Scotland (UK), Basque Country (ES), Catalonia (ES), Lombardy (I) and Groningen (NL). Participants Responsible teams for regional data management in the five ACT regions. Primary and secondary outcome measures We characterised and compared risk assessment strategies among ACT regions by analysing operational health risk predictive modelling tools for population-based stratification, as well as available health indicators at regional level. The analysis of the risk assessment tool deployed in Catalonia in 2015 (GMAs, Adjusted Morbidity Groups) was used as a basis to propose how population-based analytics could contribute to clinical risk prediction. Results There was consensus on the need for a population health approach to generate health risk predictive modelling. However, this strategy was fully in place only in two ACT regions: Basque Country and Catalonia. We found marked differences among regions in health risk predictive modelling tools and health indicators, and identified key factors constraining their comparability. The research proposes means to overcome current limitations and the use of population-based health risk prediction for enhanced clinical risk assessment. Conclusions The results indicate the need for further efforts to improve both comparability and flexibility of current population-based health risk predictive modelling approaches

  15. Health risk equations and risk assessment of airborne benzene homologues exposure to drivers and passengers in taxi cabins.

    PubMed

    Chen, Xiaokai; Feng, Lili; Luo, Huilong; Cheng, Heming

    2016-03-01

    Interior air environment and health problems of vehicles have attracted increasing attention, and benzene homologues (BHs) including benzene, toluene, ethylbenzene, xylenes, and styrene are primary hazardous gases in vehicular cabins. The BHs impact on the health of passengers and drivers in 38 taxis is assessed, and health risk equations of in-car BHs to different drivers and passengers are induced. The health risk of in-car BHs for male drivers is the highest among all different receptors and is 1.04, 6.67, and 6.94 times more than ones for female drivers, male passengers, and female passengers, respectively. In-car BHs could not lead to the non-cancer health risk to all passengers and drivers as for the maximal value of non-cancer indices is 0.41 and is less than the unacceptable value (1.00) of non-cancer health risk from USEPA. However, in-car BHs lead to cancer health risk to drivers as for the average value of cancer indices is 1.21E-04 which is 1.21 times more than the unacceptable value (1.00E-04) of cancer health risk from USEPA. Finally, for in-car airborne benzene concentration (X, μg/m(3)) to male drivers, female drivers, male passengers, and female passengers, the cancer health risk equations are Y = 1.48E-06X, Y = 1.42E-06X, Y = 2.22E-07X, and Y = 2.13E-07X, respectively, and the non-cancer health risk equations are Y = 1.70E-03X, Y = 1.63E-03X, Y = 2.55E-04X, and Y = 2.45E-04X, respectively.

  16. Attitude to health risk in the Canadian population: a cross-sectional survey

    PubMed Central

    Bansback, Nick; Harrison, Mark; Sadatsafavi, Mohsen; Stiggelbout, Anne; Whitehurst, David G.T.

    2016-01-01

    Background: Risk is a ubiquitous part of health care. Understanding how people respond to risks is important for predicting how populations make health decisions. Our objective was to seek preliminary descriptive insights into the attitude to health risk in the Canadian population and factors associated with heterogeneity in risk attitude. Methods: We used a large market-research panel to survey (in English and French) a representative sample of the Canadian general population that reflected the age, sex and geography of the population. The survey included the Health-Risk Attitude Scale, which predicts how a person resolves risky health decisions related to treatment, prevention of disease and health-related behaviour. In addition, we assessed participants' numeracy and risk understanding, as well as income band and level of education. We summarized the responses, and we explored the independent associations between demographics, numeracy, risk understanding and risk attitude in multivariable models. Results: Of 6780 respondents, 4949 (73.0%) were averse to health risks; however, but there was considerable heterogeneity in the magnitude of risk aversion. We found significant gradients of risk averse attitudes with increasing age and being female (p < 0.001) using the multivariable model. French-speaking participants appeared to be more risk averse than those who were English-speaking (p < 0.001), as were individuals scoring higher on the Subjective Numeracy Scale (p < 0.001). Interpreation: In general, Canadians were averse to health risks, but we found that a sizeable, identifiable group of risk takers exists. Heterogeneity in preferences for risk can explain variations in health care utilization in the context of patient-centred care. Understanding risk preference heterogeneity can help guide policy and assist in patient-physician decisions. PMID:27398375

  17. Assessment of OEP health's risk in nuclear medicine

    NASA Astrophysics Data System (ADS)

    Santacruz-Gomez, K.; Manzano, C.; Melendrez, R.; Castaneda, B.; Barboza-Flores, M.; Pedroza-Montero, M.

    2012-10-01

    The use of ionizing radiation has been increased in recent years within medical applications. Nuclear Medicine Department offers both treatment and diagnosis of diseases using radioisotopes to controlled doses. Despite the great benefits to the patient, there is an inherent risk to workers which remains in contact with radiation sources for long periods. These personnel must be monitored to avoid deterministic effects. In this work, we retrospectively evaluated occupationally exposed personnel (OEP) to ionizing radiation in nuclear medicine during the last five years. We assessed both area and personal dosimetry of this department in a known Clinic in Sonora. Our results show an annual equivalent dose average of 4.49 ± 0.70 mSv in OEP without showing alarming changes in clinical parameters analyzed. These results allow us to conclude that health of OEP in nuclear medicine of this clinic has not been at risk during the evaluated period. However, we may suggest the use of individual profiles based on specific radiosensitivity markers.

  18. Outdoor radioactivity and health risks in Balikesir, northwestern Turkey.

    PubMed

    Kapdan, E; Varinlioglu, A; Karahan, G

    2012-02-01

    External irradiation from radionuclides naturally present in the environment or released from man-made practices or events is usually an important component of the exposure of human populations. These exposures derive primarily from gamma radiation arising from the decay of these radionuclides at locations outside the human body. The main objective of this study is to evaluate the radioactivity levels and health risks due to terrestrial radionuclides in the soil of Balikesir, one of the largest cities of the country, northwestern Turkey. For this purpose, activity concentrations of radionuclides in soil and outdoor gamma dose rates (terrestrial and cosmic) have been investigated in the city of Balikesir. In addition, maps for the radionuclide activity concentrations of soil and the outdoor gamma dose rate distributions have been plotted for the region. The average activities of radionuclides, (238)U, (232)Th, (40)K, (235)U and (137)Cs in the soil were determined to be 37.6 ± 10.8, 54.7 ± 15.1, 674.5 ± 203.2, 3.6 ± 1.6, 3.4 ± 2.2 Bq kg(-1), respectively, in the region. The average outdoor gamma dose rates due to terrestrial and cosmic radiations were found to be 78.5 ± 12.4 and 48.9 ± 5.8 nGy h(-1) with the total of 127.4 ± 18.9 nGy h(-1) in the region. Annual effective dose due to environmental outdoor gamma radiation exposures was determined to be 156.3 nSv. The mean estimated cancer risk values were found to be 0.063 × 10(-2) for the region using risk factors of ICRP 103. The results of the study were discussed with the studies done in other cities of Turkey and the worldwide averages. PMID:21441564

  19. Outdoor radioactivity and health risks in Balikesir, northwestern Turkey.

    PubMed

    Kapdan, E; Varinlioglu, A; Karahan, G

    2012-02-01

    External irradiation from radionuclides naturally present in the environment or released from man-made practices or events is usually an important component of the exposure of human populations. These exposures derive primarily from gamma radiation arising from the decay of these radionuclides at locations outside the human body. The main objective of this study is to evaluate the radioactivity levels and health risks due to terrestrial radionuclides in the soil of Balikesir, one of the largest cities of the country, northwestern Turkey. For this purpose, activity concentrations of radionuclides in soil and outdoor gamma dose rates (terrestrial and cosmic) have been investigated in the city of Balikesir. In addition, maps for the radionuclide activity concentrations of soil and the outdoor gamma dose rate distributions have been plotted for the region. The average activities of radionuclides, (238)U, (232)Th, (40)K, (235)U and (137)Cs in the soil were determined to be 37.6 ± 10.8, 54.7 ± 15.1, 674.5 ± 203.2, 3.6 ± 1.6, 3.4 ± 2.2 Bq kg(-1), respectively, in the region. The average outdoor gamma dose rates due to terrestrial and cosmic radiations were found to be 78.5 ± 12.4 and 48.9 ± 5.8 nGy h(-1) with the total of 127.4 ± 18.9 nGy h(-1) in the region. Annual effective dose due to environmental outdoor gamma radiation exposures was determined to be 156.3 nSv. The mean estimated cancer risk values were found to be 0.063 × 10(-2) for the region using risk factors of ICRP 103. The results of the study were discussed with the studies done in other cities of Turkey and the worldwide averages.

  20. [The socio-hygienic monitoring as an integral system for health risk assessment and risk management at the regional level].

    PubMed

    Kuzmin, S V; Gurvich, V B; Dikonskaya, O V; Malykh, O L; Yarushin, S V; Romanov, S V; Kornilkov, A S

    2013-01-01

    The information and analytical framework for the introduction of health risk assessment and risk management methodologies in the Sverdlovsk Region is the system of socio-hygienic monitoring. Techniques of risk management that take into account the choice of most cost-effective and efficient actions for improvement of the sanitary and epidemiologic situation at the level of the region, municipality, or a business entity of the Russian Federation, have been developed and proposed. To assess the efficiency of planning and activities for health risk management common method approaches and economic methods of "cost-effectiveness" and "cost-benefit" analyses provided in method recommendations and introduced in the Russian Federation are applied.

  1. The Impact of Health-Promoting Behaviors on Low-Income Children's Health: A Risk and Resilience Perspective

    ERIC Educational Resources Information Center

    Yoo, Joan; Slack, Kristen S.; Holl, Jane L.

    2010-01-01

    This study's objective was to examine whether five child health-promoting behaviors by caregivers would be associated with caregivers' assessments of their children's health as "excellent," controlling for an array of risk factors for adverse health outcomes. The study used the third and fourth waves of the Illinois Families Study-Child Well-being…

  2. Managing facility risk: external threats and health care organizations.

    PubMed

    Reid, Daniel J; Reid, William H

    2014-01-01

    Clinicians and clinical administrators should have a basic understanding of physical and financial risk to mental health facilities related to external physical threat, including actions usually viewed as "terrorism" and much more common sources of violence. This article refers to threats from mentally ill persons and those acting out of bizarre or misguided "revenge," extortionists and other outright criminals, and perpetrators usually identified as domestic or international terrorists. The principles apply both to relatively small and contained acts (such as a patient or ex-patient attacking a staff member) and to much larger events (such as bombings and armed attack), and are relevant to facilities both within and outside the U.S. Patient care and accessibility to mental health services rest not only on clinical skills, but also on a place to practice them and an organized system supported by staff, physical facilities, and funding. Clinicians who have some familiarity with the non-clinical requirements for care are in a position to support non-clinical staff in preventing care from being interrupted by external threats or events such as terrorist activity, and/or to serve at the interface of facility operations and direct clinical care. Readers should note that this article is an introduction to the topic and cannot address all local, state and national standards for hospital safety, or insurance providers' individual facility requirements. PMID:24733720

  3. Cosmetics as endocrine disruptors: are they a health risk?

    PubMed

    Nicolopoulou-Stamati, Polyxeni; Hens, Luc; Sasco, Annie J

    2015-12-01

    Exposure to chemicals from different sources in everyday life is widespread; one such source is the wide range of products listed under the title "cosmetics", including the different types of popular and widely-advertised sunscreens. Women are encouraged through advertising to buy into the myth of everlasting youth, and one of the most alarming consequences is in utero exposure to chemicals. The main route of exposure is the skin, but the main endpoint of exposure is endocrine disruption. This is due to many substances in cosmetics and sunscreens that have endocrine active properties which affect reproductive health but which also have other endpoints, such as cancer. Reducing the exposure to endocrine disruptors is framed not only in the context of the reduction of health risks, but is also significant against the background and rise of ethical consumerism, and the responsibility of the cosmetics industry in this respect. Although some plants show endocrine-disrupting activity, the use of well-selected natural products might reduce the use of synthetic chemicals. Instruments dealing with this problem include life-cycle analysis, eco-design, and green labels; in combination with the committed use of environmental management systems, they contribute to "corporate social responsibility". PMID:26825071

  4. Mapping heatwave health risk at the community level for public health action

    PubMed Central

    2012-01-01

    Background Climate change poses unprecedented challenges, ranging from global and local policy challenges to personal and social action. Heat-related deaths are largely preventable, but interventions for the most vulnerable populations need improvement. Therefore, the prior identification of high risk areas at the community level is required to better inform planning and prevention. We aimed to demonstrate a simple and flexible conceptual framework relying upon satellite thermal data and other digital data with the goal of easily reproducing this framework in a variety of urban configurations. Results The study area encompasses Rennes, a medium-sized French city. A Landsat ETM + image (60 m resolution) acquired during a localized heatwave (June 2001) was used to estimate land surface temperature (LST) and derive a hazard index. A land-use regression model was performed to predict the LST. Vulnerability was assessed through census data describing four dimensions (socio-economic status, extreme age, population density and building obsolescence). Then, hazard and vulnerability indices were combined to deliver a heatwave health risk index. The LST patterns were quite heterogeneous, reflecting the land cover mosaic inside the city boundary, with hotspots of elevated temperature mainly observed in the city center. A spatial error regression model was highly predictive of the spatial variation in the LST (R2 = 0.87) and was parsimonious. Three land cover descriptors (NDVI, vegetation and water fractions) were negatively linked with the LST. A sensitivity analysis (based on an image acquired on July 2000) yielded similar results. Southern areas exhibited the most vulnerability, although some pockets of higher vulnerability were observed northeast and west of the city. The heatwave health risk map showed evidence of infra-city spatial clustering, with the highest risks observed in a north–south central band. Another sensitivity analysis gave a very high

  5. Should health authorities offer risk-sharing contracts to pharmaceutical firms? A theoretical approach.

    PubMed

    Antonanzas, Fernando; Juarez-Castello, Carmelo; Rodriguez-Ibeas, Roberto

    2011-07-01

    In this paper, we characterise the risk-sharing contracts that health authorities can design when they face a regulatory decision on drug pricing and reimbursement in a context of uncertainty. We focus on two types of contracts. On the one hand, the health authority can reimburse the firm for each treated patient regardless of health outcomes (non risk-sharing). Alternatively, the health authority can pay for the drug only when the patient is cured (risk-sharing contract). The optimal contract depends on the trade-off between the monitoring costs, the marginal production cost and the utility derived from treatment. A non-risk-sharing agreement will be preferred by the health authority, if patients who should not be treated impose a relatively low cost to the health system. When this cost is high, the health authority would prefer a risk-sharing agreement for relatively low monitoring costs.

  6. Lead exposure from backyard chicken eggs: a public health risk?

    PubMed

    Bautista, Adrienne C; Puschner, Birgit; Poppenga, Robert H

    2014-09-01

    Although the USA has made significant strides in reducing lead exposure, new and emerging sources are raising cause for public concern. Recent reports of finding lead in eggs from chickens raised in urban gardens has highlighted the need to consider the potential health risks of consuming eggs from backyard chickens. Following the detection of 0.33 μg/g lead in the edible portion of eggs submitted for lead analysis from a backyard chicken owner, further investigation was conducted to determine the source and extent of lead exposure in the flock. Several birds, almost two dozen eggs, and environmental samples were submitted to the California Animal Health and Food Safety Laboratory for further testing. Lead was detected in the blood, liver, kidney, and bone at varying concentrations in all birds but was not detected in the muscle tissue. All egg shells contained detectable amounts of lead, while only a little over half of the edible portion of the eggs contained lead. The detected concentrations in the edible portion approached or exceeded the recommended threshold of lead consumption per day that should not be exceeded by young children if a child consumed one average-sized egg. Peeling paint from a wooded structure adjacent to the flock's coop was the likely lead source containing 3,700 μg/g lead. Thus, removal of the chickens from the source and periodic testing of eggs for lead were recommended. This case illustrates the need for consumers and health care workers to be aware of potential sources for lead exposure such as backyard chickens. PMID:24943230

  7. 59 FR- Human Health and Environmental Risk Ranking; Notice of Availability of Proceedings Document from...

    Federal Register 2010, 2011, 2012, 2013, 2014

    1994-08-30

    ... AGENCY Human Health and Environmental Risk Ranking; Notice of Availability of Proceedings Document from Relative Risk Ranking Conference AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of Availability. SUMMARY: EPA is announcing the availability of a document entitled ``Proceedings...

  8. Evaluating uncertainty to strengthen epidemiologic data for use in human health risk assessments

    EPA Science Inventory

    Background: There is a recognized need to improve the application of epidemiologic data in human health risk assessment especially for understanding and characterizing risks from environmental and occupational exposures. While most epidemiologic studies result in uncertainty, tec...

  9. Zika Won't Pose Risks At the Olympics: Health Experts

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_160250.html Zika Won't Pose Risks at the Olympics: Health ... Brazil won't trigger a global spread of Zika virus, with little risk of potentially infected competitors ...

  10. Metabolic Risk and Health Behaviors in Minority Youth at Risk for Type 2 Diabetes

    PubMed Central

    Holl, Marita G.; Jaser, Sarah S.; Womack, Julie A.; Jefferson, Vanessa L.; Grey, Margaret

    2011-01-01

    OBJECTIVE The purpose of this study was to determine the impact of sex and race/ethnicity on metabolic risk and health behaviors in minority youth. RESEARCH DESIGN AND METHODS A total of 173 seventh graders (46% male and 54% female; 49% Hispanic and 51% African American) with BMI ≥85th percentile and a family history of diabetes were assessed with weight, height, BMI, percent body fat, and waist circumference measures. Laboratory indexes included 2-h oral glucose tolerance tests with insulin levels at 0 and 2 h, fasting A1C, and lipids. Insulin resistance was estimated by homeostasis model assessment (HOMA-IR). Youth also completed questionnaires evaluating health behaviors. RESULTS Average BMI (31.6 ± 6.4 kg/m2) and percent body fat (39.5 ± 10.6%) were high. All participants demonstrated insulin resistance with elevated HOMA-IR values (8.5 ± 5.2). Compared with African American youth, Hispanic youth had higher triglycerides and lower HDL cholesterol despite similar BMI. Hispanic youth reported lower self-efficacy for diet, less physical activity, and higher total fat intake. Male youth had higher glucose (0 and 2 h) and reported more physical activity, more healthy food choices, and higher calcium intake than female youth. CONCLUSIONS Screening high-risk youth for insulin resistance and lipid abnormalities is recommended. Promoting acceptable physical activities and healthy food choices may be especially important for Hispanic and female youth. PMID:20855552

  11. 2013 Immune Risk Standing Review Panel Research Plan Review for: The Risk of Crew Adverse Health Event Due to Altered Immune Response

    NASA Technical Reports Server (NTRS)

    Steinberg, Susan

    2014-01-01

    The 2013 Immune Risk Standing Review Panel (from here on referred to as the SRP) participated in a meeting with representatives from the Human Research Program (HRP) Human Health Countermeasures (HHC) Element and HRP management on February 3-4, 2014 in Houston, TX to review the updated Research Plan for the Risk of Crew Adverse Health Event Due to Altered Immune Response in the HRP Integrated Research Plan. The SRP is impressed with the work the immune discipline has done since the 2012 SRP review and agrees with the new wording of the Gaps, no longer questions, now statements. The SRP also likes the addition of adding targets for closing the Gaps, but it is not clear how they got to some of the interim stages (interval percentages). A major concern that the SRP has mentioned since the initial 2009 SRP meeting is that there is still not enough emphasis on the interdisciplinary aspect of the immune risk associated with other risks (i.e., nutrition, radiation, etc.). The SRP recommends that a "translational SRP" or advisory group be developed that is composed of members from all of the HRP SRPs. The SRP also thinks that the immune discipline should consider a more systems biology approach. Lastly, the SRP is concerned that the risks observed in research from low Earth orbit (LEO) missions may not accurately reflect all the risks of longer duration flight beyond LEO. Also, there does not seem to be a concern for immune responses that may occur when someone is in space longer than six months, for example, a Mars mission would take three years. The absence of disease in past and current flight scenarios does not mean the risk may not be there in future flight settings.

  12. Are health-based payments a feasible tool for addressing risk segmentation?

    PubMed

    Rogal, D L; Gauthier, A K

    1998-01-01

    As they attempt to increase health insurance coverage and improve the efficiency of the market, researchers, policymakers, and health plan representatives have been addressing the issue of risk segmentation. Many risk assessment tools and risk-adjusted payment methodologies have been developed and demonstrated for a variety of populations and payers experiencing various market constraints. The evidence shows that risk-adjusted payments are feasible for most populations receiving acute care, while technical obstacles, political issues, and some research gaps remain.

  13. Misclassification in assessment of diabetogenic risk using electronic health records†

    PubMed Central

    Winterstein, Almut G.; Kubilis, Paul; Bird, Steve; Cooper-DeHoff, Rhonda M.; Nichols, Greg A.; Delaney, Joseph A.

    2016-01-01

    Purpose Suspected diabetogenic effects or drug indication may increase testing for diabetes mellitus (DM), resulting in measurement bias when evaluating diabetogenic drug effects. We sought to evaluate the validity of electronic health record data in determining DM risk. Methods We used time-dependent Cox proportional hazard models within a retrospective cohort design to assess associations between use of antihypertensives, statins, atypical antipsychotics, and antidepressants, and two endpoints: (i) DM onset defined as fasting blood glucose (BG) ≥126 mg/dl, random BG ≥200 mg/dl, HbA1c ≥7.0%, or antidiabetic drug initiation; and (ii) first negative DM test. We used Poisson regression to assess the influence of these drugs on DM testing rates. Patients aged 35–64 years enrolled in Kaiser Permanente Northwest between 1997 and 2010 entered the cohort at the first negative BG test after ≥6 months without manifest DM. Results All drug classes showed significant associations not only with DM onset but also with first negative BG test and with DM testing rates. Antipsychotics had the greatest diabetogenic risk (adjusted hazard ratio [HR] = 1.73 [1.44–2.08]), the greatest propensity for a first negative test (adjusted HR = 1.87 [1.74–2.01]), and the highest testing rate (adjusted rate ratio = 1.76 [1.72–1.81]. Although renin–angiotensin system blockers and calcium channel blockers have shown no diabetogenic risk in clinical trials, both were associated with DM (HR = 1.19 [1.12–1.26] and 1.27 [1.17–1.38]), a negative glucose test (1.38 [1.35–1.41] and 1.24 [1.20–1.28]), and increased testing rates (rate ratio = 1.26 [1.24–1.27] and 1.27 [1.25–1.28]). Conclusion Caution should be used when diabetogenic risk is evaluated using data that rely on DM testing in general practice. PMID:24923707

  14. Adolescence, sexual behavior and risk factors to health

    PubMed Central

    de Assis, Simone Gonçalves; Gomes, Romeu; Pires, Thiago de Oliveira

    2014-01-01

    OBJECTIVE To analyze the relationships between sexual behavior and risk factors to physical and mental health in adolescents. METHODS Study of 3,195 pupils aged 15 to 19 in secondary education, in public and private schools in 10 state capitals in Brazil between 2007 and 2008. Multi-stage (schools and pupils) cluster sampling was used in each city and public and private educational network. All of the students selected completed a questionnaire on the following items: socioeconomic and demographic data; sexual behavior; having sex with those of the same sex, the opposite sex, or both; alcohol and cannabis use; using condoms; traumatic sexual experiences as a child or adolescent; suicidal thoughts. The analysis included describing frequencies, Chi-square test, analysis of multiple and cluster correspondence. Responses to an open ended question in which the adolescent expressed general comments about themselves and their lives were qualitatively analyzed using content analysis. RESULTS Around 3.0% of adolescents reported homosexual or bisexual behavior, with no difference according to sex, age, skin color, social status family structure or educational network. Adolescents with homosexual/bisexual sexual behavior, compared to their heterosexual peers, reported: (p < 0.05): getting drunk (18.7% and 10.5%, respectively), frequent cannabis use (6.1% and 2.1%, respectively), suicidal thoughts (42.5% and 18.7%, respectively), and having been the victim of sexual violence (11.7% and 1.5%; respectively). Adolescents with homosexual/bisexual sexual behavior reported that they used condoms less frequently (74.2%) than their heterosexual peers (48.6%, p < 0.001). In the correspondence analysis, three groups were found, one composed of adolescents with homosexual/bisexual behavior and experiencing risk factors; suffering sexual violence, never using a condom, suicidal thoughts, frequent cannabis use; another composed of occasional cannabis and condom users, who got drunk

  15. Radiofrequency (mobile telephones) Exposures and Health Risks: Findings and Controversies - Linet

    Cancer.gov

    Radiofrequency (mobile telephones) Exposures and Health Risks: Findings and Controversies by Dr. Martha Linet - part of the Radiation Epidemiology and Dosimetry Course on the health effects of radiation exposure

  16. What You Should Know about Hormone Therapy Health Risks and Benefits

    MedlinePlus

    ... HAT Y OU S HOULD K NOW A BOUT Hormone Therapy Health Risks and Benefits V aginal dryness ... Women _ s Health Ini- tiative in 1993 to study hormone effects. Researchers were expecting to find that hormones ...

  17. Health Behaviors and Health Status of At-Risk Latino Students for Diabetes

    PubMed Central

    Hurtado-Ortiz, Maria T.; Santos, Silvia; Reynosa, Astrid

    2012-01-01

    This research study examined the behavioral lifestyle patterns and health status of at-risk Latino college students for future diabetes onset in relation to their age, gender, and acculturation status. Participants were 156 Latino (34% male and 66% female) university students who had a first and/or second degree relative afflicted with diabetes. Findings indicated that Latino students exhibit similar lifestyle patterns in terms of dietary intake, physical activity, and drinking and smoking behaviors observed in the general and college population that have been linked to obesity—a particularly problematic risk factor among those who already have a genetic predisposition for diabetes. The reported findings are of importance for the development of culturally-relevant treatment interventions targeting young Latinos in college. PMID:26566366

  18. Withholding differential risk information on legal consumer nicotine/tobacco products: The public health ethics of health information quarantines.

    PubMed

    Kozlowski, Lynn T; Sweanor, David

    2016-06-01

    The United States provides an example of a country with (a) legal tobacco/nicotine products (e.g., snus, other smokeless tobacco, cigarettes) differing greatly in risks to health and (b) respected health information websites that continue to omit or provide incorrect differential risk information. Concern for the principles of individual rights, health literacy, and personal autonomy (making decisions for oneself), which are key principles of public health ethics, has been countered by utilitarian arguments for the use of misleading or limited information to protect public health overall. We argue that omitting key health relevant information for current or prospective consumers represents a kind of quarantine of health-relevant information. As with disease quarantines, the coercive effects of quarantining information on differential risks need to be justified, not merely by fears of net negative public health effects, but by convincing evidence that such measures are actually warranted, that public health overall is in imminent danger and that the danger is sufficient to override principles of individual autonomy. Omitting such health-relevant information for consumers of such products effectively blindfolds them and impairs their making informed personal choices. Moral psychological issues that treat all tobacco/nicotine products similarly may also be influencing the reluctance to inform on differential risks. In countries where tobacco/nicotine products are legally sold and also differ greatly in disease risks compared to cigarettes (e.g., smokeless tobacco and vape), science-based, comprehensible, and actionable health information (consistent with health literacy principles) on differential risks should be available and only reconsidered if it is established that this information is causing losses to population health overall. PMID:27209528

  19. Withholding differential risk information on legal consumer nicotine/tobacco products: The public health ethics of health information quarantines.

    PubMed

    Kozlowski, Lynn T; Sweanor, David

    2016-06-01

    The United States provides an example of a country with (a) legal tobacco/nicotine products (e.g., snus, other smokeless tobacco, cigarettes) differing greatly in risks to health and (b) respected health information websites that continue to omit or provide incorrect differential risk information. Concern for the principles of individual rights, health literacy, and personal autonomy (making decisions for oneself), which are key principles of public health ethics, has been countered by utilitarian arguments for the use of misleading or limited information to protect public health overall. We argue that omitting key health relevant information for current or prospective consumers represents a kind of quarantine of health-relevant information. As with disease quarantines, the coercive effects of quarantining information on differential risks need to be justified, not merely by fears of net negative public health effects, but by convincing evidence that such measures are actually warranted, that public health overall is in imminent danger and that the danger is sufficient to override principles of individual autonomy. Omitting such health-relevant information for consumers of such products effectively blindfolds them and impairs their making informed personal choices. Moral psychological issues that treat all tobacco/nicotine products similarly may also be influencing the reluctance to inform on differential risks. In countries where tobacco/nicotine products are legally sold and also differ greatly in disease risks compared to cigarettes (e.g., smokeless tobacco and vape), science-based, comprehensible, and actionable health information (consistent with health literacy principles) on differential risks should be available and only reconsidered if it is established that this information is causing losses to population health overall.

  20. Health risk behaviors and dating violence victimization: An examination of associated risk behaviors among detained female youth

    PubMed Central

    King, Dione Moultrie; Hatcher, Schnavia Smith; Blakey, Joan Marie; Mbizo, Justice

    2016-01-01

    There are many health risk behaviors that may elevate the risk of adolescents engaging in teenage dating violence. The purpose of this investigation was to examine the health risk behaviors that are associated with a sample of female juvenile offenders to identify the extent to which those behaviors contribute to dating violence. The survey assessed respondents’ health risk behaviors prior to incarceration, their perceptions of quality of life, post-incarceration expectations, psychosocial factors and other social determinants. Results indicated youth exposure to dating violence, alcohol, drug and risky sexual behaviors in the year prior to incarceration. These findings demonstrate the need to address teen dating violence with at-risk adolescents in addition to risky behaviors. PMID:26408099

  1. Health-Risk Behaviors and Dating Violence Victimization: An Examination of the Associated Risk Behaviors Among Detained Female Youth.

    PubMed

    King, Dione Moultrie; Hatcher, Schnavia Smith; Blakey, Joan Marie; Mbizo, Justice

    2015-01-01

    There are many health-risk behaviors that may elevate the risk of adolescents engaging in teenage dating violence. The purpose of this investigation was to examine the health-risk behaviors that are associated with a sample of female juvenile offenders to identify the extent to which those behaviors contribute to dating violence. The survey assessed respondents' health-risk behaviors prior to incarceration, their perceptions of quality of life, post-incarceration expectations, psychosocial factors, and other social determinants. Results indicated youth exposure to dating violence, alcohol, drug, and risky sexual behaviors in the year prior to incarceration. These findings demonstrate the need to address teen dating violence with at-risk adolescents in addition to risky behaviors. PMID:26408099

  2. Characteristics of self-selected responders to a health risk appraisal: generalizability of corporate health assessments.

    PubMed

    Lynch, W D; Golaszewski, T J; Clearie, A; Vickery, D M

    1989-07-01

    Selected characteristics and total medical claims of health risk appraisal (HRA) responders and non-responders were compared in a sample of employees having a three-year employment and claims history. HRA responders were younger and more likely to file medical claims than non-responders. Although mean medical claims were greater for HRA responders than non-responders, when adjusted for age and sex this difference reflected the proportion of employees reporting claims, not a difference in the claims amount. PMID:2735480

  3. Public health risk communication by text message in response to a cluster of invasive meningococcal infection in a primary school.

    PubMed

    Bradley, Declan T; Johnston, Jillian; Smyth, Brian

    2014-05-01

    Public health risk communication during emergencies should be rapid and accurate in order to allow the audience to take steps to prevent adverse outcomes. Delays to official communications may cause unnecessary anxiety due to uncertainty or inaccurate information circulating within the at-risk group. Modern electronic communications present opportunities for rapid, targeted public health risk communication. We present a case report of a cluster of invasive meningococcal disease in a primary school in which we used the school's mass short message service (SMS) text message system to inform parents and guardians of pupils about the incident, to tell them that chemoprophylaxis would be offered to all pupils and staff, and to advise them when to attend the school to obtain further information and antibiotics. Following notification to public health on a Saturday, an incident team met on Sunday, sent the SMS messages that afternoon, and administered chemoprophyaxis to 93% of 404 pupils on Monday. The use of mass SMS messages enabled rapid communication from an official source and greatly aided the public health response to the cluster.

  4. Problems in Comprehensive Ambulatory Health Care for High-Risk Adolescents.

    ERIC Educational Resources Information Center

    Fielding, Jon E., Ed.

    This volume contains 21 articles on aspects held to be important for delivering comprehensive health care to young adults who are at higher than average risk levels for a number of health and health-related problems; choice of topics for the articles is based on experience gained in directing the health program for the Job Corps. Most of the…

  5. Comparing Changes in Health Risk Factors and Medical Costs over Time.

    ERIC Educational Resources Information Center

    Haynes, George; Dunnagan, Tim

    2002-01-01

    Employed a 6-year retrospective cohort design to examine the relationship between health indicators variables, health insurance costs, and utilization. Data collected from 1,940 employees who belonged to a worksite health plan indicated that employees with problematic health risk factors had a significantly higher probability of submitting health…

  6. Weight Misperception and Health Risk Behaviors in Youth: the 2011 US YRBS

    PubMed Central

    Jiang, Yongwen; Kempner, Marga; Loucks, Eric B.

    2015-01-01

    Objectives To evaluate dose-response associations between misperceived weight and 32 health risk behaviors in a nationally representative sample of US adolescents. Methods Participants included 13,864 US high school students in the 2011 Youth Risk Behavior Survey. Comparing the degree of agreement between perceived and reported actual weight, weight misperception was determined as 5 categories. Multivariable-adjusted logistic regression analyses evaluated associations of weight misperception with 32 health risk behaviors. Results Both underestimated and overestimated weight were statistically significantly associated with all 32 health risk behaviors in a dose-response manner after adjustment for age, sex and race/ethnicity, where greater weight misperception was associated with higher engagement in health risk behaviors. Conclusions Understanding potential impacts of weight misperception on health risk behaviors could improve interventions that encourage healthy weight perception and attainment for adolescents. PMID:24933146

  7. Space Radiation: The Number One Risk to Astronaut Health beyond Low Earth Orbit.

    PubMed

    Chancellor, Jeffery C; Scott, Graham B I; Sutton, Jeffrey P

    2014-09-11

    Projecting a vision for space radiobiological research necessitates understanding the nature of the space radiation environment and how radiation risks influence mission planning, timelines and operational decisions. Exposure to space radiation increases the risks of astronauts developing cancer, experiencing central nervous system (CNS) decrements, exhibiting degenerative tissue effects or developing acute radiation syndrome. One or more of these deleterious health effects could develop during future multi-year space exploration missions beyond low Earth orbit (LEO). Shielding is an effective countermeasure against solar particle events (SPEs), but is ineffective in protecting crew members from the biological impacts of fast moving, highly-charged galactic cosmic radiation (GCR) nuclei. Astronauts traveling on a protracted voyage to Mars may be exposed to SPE radiation events, overlaid on a more predictable flux of GCR. Therefore, ground-based research studies employing model organisms seeking to accurately mimic the biological effects of the space radiation environment must concatenate exposures to both proton and heavy ion sources. New techniques in genomics, proteomics, metabolomics and other "omics" areas should also be intelligently employed and correlated with phenotypic observations. This approach will more precisely elucidate the effects of space radiation on human physiology and aid in developing personalized radiological countermeasures for astronauts.

  8. Space Radiation: The Number One Risk to Astronaut Health beyond Low Earth Orbit.

    PubMed

    Chancellor, Jeffery C; Scott, Graham B I; Sutton, Jeffrey P

    2014-01-01

    Projecting a vision for space radiobiological research necessitates understanding the nature of the space radiation environment and how radiation risks influence mission planning, timelines and operational decisions. Exposure to space radiation increases the risks of astronauts developing cancer, experiencing central nervous system (CNS) decrements, exhibiting degenerative tissue effects or developing acute radiation syndrome. One or more of these deleterious health effects could develop during future multi-year space exploration missions beyond low Earth orbit (LEO). Shielding is an effective countermeasure against solar particle events (SPEs), but is ineffective in protecting crew members from the biological impacts of fast moving, highly-charged galactic cosmic radiation (GCR) nuclei. Astronauts traveling on a protracted voyage to Mars may be exposed to SPE radiation events, overlaid on a more predictable flux of GCR. Therefore, ground-based research studies employing model organisms seeking to accurately mimic the biological effects of the space radiation environment must concatenate exposures to both proton and heavy ion sources. New techniques in genomics, proteomics, metabolomics and other "omics" areas should also be intelligently employed and correlated with phenotypic observations. This approach will more precisely elucidate the effects of space radiation on human physiology and aid in developing personalized radiological countermeasures for astronauts. PMID:25370382

  9. Space Radiation: The Number One Risk to Astronaut Health beyond Low Earth Orbit

    PubMed Central

    Chancellor, Jeffery C.; Scott, Graham B. I.; Sutton, Jeffrey P.

    2014-01-01

    Projecting a vision for space radiobiological research necessitates understanding the nature of the space radiation environment and how radiation risks influence mission planning, timelines and operational decisions. Exposure to space radiation increases the risks of astronauts developing cancer, experiencing central nervous system (CNS) decrements, exhibiting degenerative tissue effects or developing acute radiation syndrome. One or more of these deleterious health effects could develop during future multi-year space exploration missions beyond low Earth orbit (LEO). Shielding is an effective countermeasure against solar particle events (SPEs), but is ineffective in protecting crew members from the biological impacts of fast moving, highly-charged galactic cosmic radiation (GCR) nuclei. Astronauts traveling on a protracted voyage to Mars may be exposed to SPE radiation events, overlaid on a more predictable flux of GCR. Therefore, ground-based research studies employing model organisms seeking to accurately mimic the biological effects of the space radiation environment must concatenate exposures to both proton and heavy ion sources. New techniques in genomics, proteomics, metabolomics and other “omics” areas should also be intelligently employed and correlated with phenotypic observations. This approach will more precisely elucidate the effects of space radiation on human physiology and aid in developing personalized radiological countermeasures for astronauts. PMID:25370382

  10. Health impacts of large releases of radionuclides. Mental health, stress and risk perception: insights from psychological research.

    PubMed

    Renn, O

    1997-01-01

    Risk perceptions are only slightly correlated with the expected values of a probability distribution for negative health impacts. Psychometric studies have documented that context variables such as dread or personal control are important predictors for the perceived seriousness of risk. Studies about cultural patterns of risk perceptions emphasize different response sets to risk information, depending on cultural priorities such as social justice versus personal freedom. This chapter reports the major psychological research results pertaining to the factors that govern individual risk perception and discusses the psychometric effects due to people's risk perception and the experience of severe stress. The relative importance of the psychometric context variables, the signals pertaining to each health risks and symbolic beliefs are explained. PMID:9339320

  11. Evaluation and use of epidemiological evidence for environmental health risk assessment: WHO guideline document.

    PubMed Central

    2000-01-01

    Environmental health risk assessment is increasingly being used in the development of environmental health policies, public health decision making, the establishment of environmental regulations, and research planning. The credibility of risk assessment depends, to a large extent, on the strength of the scientific evidence on which it is based. It is, therefore, imperative that the processes and methods used to evaluate the evidence and estimate health risks are clear, explicit, and based on valid epidemiological theory and practice. Epidemiological Evidence for Environmental Health Risk Assessment is a World Health Organization (WHO) guideline document. The primary target audiences of the guidelines are expert review groups that WHO (or other organizations) might convene in the future to evaluate epidemiological evidence on the health effects of environmental factors. These guidelines identify a set of processes and general approaches to assess available epidemiological information in a clear, consistent, and explicit manner. The guidelines should also help in the evaluation of epidemiological studies with respect to their ability to support risk assessment and, consequently, risk management. Conducting expert reviews according to such explicit guidelines would make health risk assessment and subsequent risk management and risk communication processes more readily understood and likely to be accepted by policymakers and the public. It would also make the conclusions reached by reviews more readily acceptable as a basis for future WHO guidelines and other recommendations, and would provide a more rational basis for setting priorities for future research. PMID:11049823

  12. Evaluation and use of epidemiological evidence for environmental health risk assessment: WHO guideline document.

    PubMed

    2000-10-01

    Environmental health risk assessment is increasingly being used in the development of environmental health policies, public health decision making, the establishment of environmental regulations, and research planning. The credibility of risk assessment depends, to a large extent, on the strength of the scientific evidence on which it is based. It is, therefore, imperative that the processes and methods used to evaluate the evidence and estimate health risks are clear, explicit, and based on valid epidemiological theory and practice. Epidemiological Evidence for Environmental Health Risk Assessment is a World Health Organization (WHO) guideline document. The primary target audiences of the guidelines are expert review groups that WHO (or other organizations) might convene in the future to evaluate epidemiological evidence on the health effects of environmental factors. These guidelines identify a set of processes and general approaches to assess available epidemiological information in a clear, consistent, and explicit manner. The guidelines should also help in the evaluation of epidemiological studies with respect to their ability to support risk assessment and, consequently, risk management. Conducting expert reviews according to such explicit guidelines would make health risk assessment and subsequent risk management and risk communication processes more readily understood and likely to be accepted by policymakers and the public. It would also make the conclusions reached by reviews more readily acceptable as a basis for future WHO guidelines and other recommendations, and would provide a more rational basis for setting priorities for future research. PMID:11049823

  13. Health Risk Assessment of Inhalable Particulate Matter in Beijing Based on the Thermal Environment

    PubMed Central

    Xu, Lin-Yu; Yin, Hao; Xie, Xiao-Dong

    2014-01-01

    Inhalable particulate matter (PM10) is a primary air pollutant closely related to public health, and an especially serious problem in urban areas. The urban heat island (UHI) effect has made the urban PM10 pollution situation more complex and severe. In this study, we established a health risk assessment system utilizing an epidemiological method taking the thermal environment effects into consideration. We utilized a remote sensing method to retrieve the PM10 concentration, UHI, Normalized Difference Vegetation Index (NDVI), and Normalized Difference Water Index (NDWI). With the correlation between difference vegetation index (DVI) and PM10 concentration, we utilized the established model between PM10 and thermal environmental indicators to evaluate the PM10 health risks based on the epidemiological study. Additionally, with the regulation of UHI, NDVI and NDWI, we aimed at regulating the PM10 health risks and thermal environment simultaneously. This study attempted to accomplish concurrent thermal environment regulation and elimination of PM10 health risks through control of UHI intensity. The results indicate that urban Beijing has a higher PM10 health risk than rural areas; PM10 health risk based on the thermal environment is 1.145, which is similar to the health risk calculated (1.144) from the PM10 concentration inversion; according to the regulation results, regulation of UHI and NDVI is effective and helpful for mitigation of PM10 health risk in functional zones. PMID:25464132

  14. Health risk assessment of inhalable particulate matter in Beijing based on the thermal environment.

    PubMed

    Xu, Lin-Yu; Yin, Hao; Xie, Xiao-Dong

    2014-12-01

    Inhalable particulate matter (PM10) is a primary air pollutant closely related to public health, and an especially serious problem in urban areas. The urban heat island (UHI) effect has made the urban PM10 pollution situation more complex and severe. In this study, we established a health risk assessment system utilizing an epidemiological method taking the thermal environment effects into consideration. We utilized a remote sensing method to retrieve the PM10 concentration, UHI, Normalized Difference Vegetation Index (NDVI), and Normalized Difference Water Index (NDWI). With the correlation between difference vegetation index (DVI) and PM10 concentration, we utilized the established model between PM10 and thermal environmental indicators to evaluate the PM10 health risks based on the epidemiological study. Additionally, with the regulation of UHI, NDVI and NDWI, we aimed at regulating the PM10 health risks and thermal environment simultaneously. This study attempted to accomplish concurrent thermal environment regulation and elimination of PM10 health risks through control of UHI intensity. The results indicate that urban Beijing has a higher PM10 health risk than rural areas; PM10 health risk based on the thermal environment is 1.145, which is similar to the health risk calculated (1.144) from the PM10 concentration inversion; according to the regulation results, regulation of UHI and NDVI is effective and helpful for mitigation of PM10 health risk in functional zones.

  15. Human health risk associated with brominated flame-retardants (BFRs).

    PubMed

    Lyche, Jan L; Rosseland, Carola; Berge, Gunnar; Polder, Anuschka

    2015-01-01

    The purposes of this review are to assess the human exposure and human and experimental evidence for adverse effects of brominated flame-retardants (BFRs) with specific focus on intake from seafood. The leakage of BFRs from consumer products leads to exposure of humans from fetal life to adulthood. Fish and fish products contain the highest levels of BFRs and dominate the dietary intake of frequent fish eaters in Europe, while meat, followed by seafood and dairy products accounted for the highest US dietary intake. House dust is also reported as an important source of exposure for children as well as adults. The levels of BFRs in the general North American populations are higher than those in Europe and Japan and the highest levels are detected in infants and toddlers. The daily intake via breast milk exceeds the RfD in 10% of US infants. BFRs including PBDEs, HBCDs and TBBP-A have induced endocrine-, reproductive- and behavior effects in laboratory animals. Furthermore, recent human epidemiological data demonstrated association between exposure to BFRs and similar adverse effects as observed in animal studies. Fish including farmed fish and crude fish oil for human consumption may contain substantial levels of BFRs and infants and toddlers consuming these products on a daily basis may exceed the tolerable daily intake suggesting that fish and fish oil alone represent a risk to human health. This intake comes in addition to exposure from other sources (breast milk, other food, house dust). Because potential harmful concentrations of BFRs and other toxicants occur in fish and fish products, research on a wider range of products is warranted, to assess health hazard related to the contamination of fish and fish products for human consumption.

  16. [Health risks of residual fumigants in international transport containers].

    PubMed

    Baur, X; Budnik, L T; Preisser, A M

    2010-03-01

    The increasing transport of goods worldwide is mainly carried in standard containers. These containers are frequently fumigated in order to protect freight from pests and to follow regulations of importing countries. Fumigants as well as toxic industrial chemicals can adsorb to goods and be emitted from them over various periods of time. This review is based on a literature search, analyses of air samples from a randomized selection of import containers at the port of Hamburg and clinical investigations of intoxicated subject. These data indicate that about 70% of imported containers exceed national or international threshold levels, about one sixth exceeding occupational exposure limits of fumigants and/or toxic industrial chemical, 0.5% had concentrations immediately dangerous to life or health. Intoxications by inhalation mainly occur in workers in the logistics area. No information exists on possible fumigation in small and medium-sized companies where the container units are unloaded. Neurological and respiratory ailments dominated in patients from our outpatient clinic and those reported in the literature: symptoms were often misdiagnosed. Our results confirm findings of other investigators that subjects who unload containers or have otherwise intensive contact with imported goods are frequently exposed to toxic or very toxic volatile chemicals. It can be assumed that there are many unrecognized cases and also health risks to the ultimate consumers of transported goods. History taking targeted on potential exposure is of great diagnostic importance in elucidating typical temporal relationship between exposure by inhalation and symptoms such as headache, skin irritation, cough, dyspnea, diarrhoea and neurological deficits. Detailed investigations by medical specialists is necessary to confirm suspected diagnoses. This should be combined with immediate special analyses of air samples and laboratory tests (biological monitoring).

  17. As health care technology advances: benefits and risks.

    PubMed

    Funk, Marjorie

    2011-07-01

    Technology permeates every dimension of critical care. Bedside technology is integral to the assessment and monitoring of patients and to the provision of treatment. It also helps with access to vital information and can enhance communication. Although it offers extraordinary benefits to patients and clinicians, technology may also create problems. Our research addresses the wise use of technology in the care of critically ill patients. It examines the appropriate and safe use of technology, its equitable distribution, and the human-machine interface. Given that some devices are more effective and safe than others, it is important to assess the appropriateness of a specific technology in a specific situation. Just because a particular device is available, is it necessary to use it in every possible situation? Do we use it just because it is there? Do we employ "heroic" measures sometimes when it would be kinder not to? Studies on the safe use of technology in patient care lead to a consideration of the risk-benefit ratio. Our research on gender and racial differences in the use of cardiac procedures in patients with acute myocardial infarction focused on the equitable distribution of technology. The results of this line of research, along with those of numerous other studies, suggest possible racism in our health care practices. The human-machine interface, or how clinicians and patients interact with health care technology, is a crucial focus of research. Technology is at the heart of critical care. It allows clinicians to perform miracles, but is also a seductive and self-perpetuating force that needs careful monitoring by those who use it.

  18. Social Comparison Framing in Health News and Its Effect on Perceptions of Group Risk

    PubMed Central

    Bigman, Cabral A.

    2013-01-01

    News about health disparities often compares health risks faced by different demographic groups. Does this social comparison produce a contrast effect? It was hypothesized that when two racial groups are compared, people would perceive the relatively more at-risk group to be more, and the less at-risk group to be less, at-risk than if the same risk information was presented without the comparative reference group. Three experiments with Black and White respondents tested effects of intergroup social comparison framing (SCF) on perceptions of risk for sexually transmitted infections and skin cancer. SCF (including one White and two Black disparity frames) did not raise respondents’ perceived risk regarding the more at-risk racial group, but consistently lowered respondents’ risk ratings for the less at-risk racial group. The finding that the same statistic was perceived differently in comparative and non-comparative contexts underscores the importance of considering effects of communication about disparities. PMID:23829419

  19. [Health Risk Assessment of Drinking Water Quality in Tianjin Based on GIS].

    PubMed

    Fu, Gang; Zeng, Qiang; Zhao, Liang; Zhang, Yue; Feng, Bao-jia; Wang, Rui; Zhang, Lei; Wang, Yang; Hou, Chang-chun

    2015-12-01

    This study intends to assess the potential health hazards of drinking water quality and explore the application of geographic information system( GIS) in drinking water safety in Tianjin. Eight hundred and fifty water samples from 401 sampling points in Tianjin were measured according to the national drinking water standards. The risk assessment was conducted using the environmental health risk assessment model recommended by US EAP, and GIS was combined to explore the information visualization and risk factors simultaneously. The results showed that the health risks of carcinogens, non-carcinogens were 3.83 x 10⁻⁵, 5.62 x 10⁻⁹ and 3.83 x 10⁻⁵ for total health risk respectively. The rank of health risk was carcinogen > non-carcinogen. The rank of carcinogens health risk was urban > new area > rural area, chromium (VI) > cadmium > arsenic > trichlormethane > carbon tetrachloride. The rank of non-carcinogens health risk was rural area > new area > urban, fluoride > cyanide > lead > nitrate. The total health risk level of drinking water in Tianjin was lower than that of ICRP recommended level (5.0 x 10⁻⁵), while was between US EPA recommended level (1.0 x 10⁻⁴-1.0 x 10⁻⁶). It was at an acceptable level and would not cause obvious health hazards. The main health risks of drinking water came from carcinogens. More attentions should be paid to chromium (VI) for carcinogens and fluoride for non-carcinogens. GIS can accomplish information visualization of drinking water risk assessment and further explore of risk factors.

  20. [Health Risk Assessment of Drinking Water Quality in Tianjin Based on GIS].

    PubMed

    Fu, Gang; Zeng, Qiang; Zhao, Liang; Zhang, Yue; Feng, Bao-jia; Wang, Rui; Zhang, Lei; Wang, Yang; Hou, Chang-chun

    2015-12-01

    This study intends to assess the potential health hazards of drinking water quality and explore the application of geographic information system( GIS) in drinking water safety in Tianjin. Eight hundred and fifty water samples from 401 sampling points in Tianjin were measured according to the national drinking water standards. The risk assessment was conducted using the environmental health risk assessment model recommended by US EAP, and GIS was combined to explore the information visualization and risk factors simultaneously. The results showed that the health risks of carcinogens, non-carcinogens were 3.83 x 10⁻⁵, 5.62 x 10⁻⁹ and 3.83 x 10⁻⁵ for total health risk respectively. The rank of health risk was carcinogen > non-carcinogen. The rank of carcinogens health risk was urban > new area > rural area, chromium (VI) > cadmium > arsenic > trichlormethane > carbon tetrachloride. The rank of non-carcinogens health risk was rural area > new area > urban, fluoride > cyanide > lead > nitrate. The total health risk level of drinking water in Tianjin was lower than that of ICRP recommended level (5.0 x 10⁻⁵), while was between US EPA recommended level (1.0 x 10⁻⁴-1.0 x 10⁻⁶). It was at an acceptable level and would not cause obvious health hazards. The main health risks of drinking water came from carcinogens. More attentions should be paid to chromium (VI) for carcinogens and fluoride for non-carcinogens. GIS can accomplish information visualization of drinking water risk assessment and further explore of risk factors. PMID:27011993

  1. A study of the perception of health risks among college students in China.

    PubMed

    Zhang, Chenggang; Fan, Jingbo

    2013-06-01

    The present survey was designed to investigate the perception of health risks among college students in China. The data are the responses of a sample of 3,069 college students at one university to surveys that include measures of several dimensions of public judgments about fifteen specific hazards. Chinese college students conveyed their concerns as falling into three broad categories: Environmental (e.g., global warming, natural catastrophes, the ozone hole, air pollution, chemical pollution, pesticides in food), Technological (e.g., nuclear power stations, thermal power, genetically modified food, medical X-rays), and Social (cigarette smoking, drinking alcohol, overtime study or work, mental stress, motor vehicle accidents). The data were collected with a self-report questionnaire. Descriptive statistics were used to illustrate the levels of perceived risk according to the percent of "high risk" responses as well as the mean response values. Generally, the hazards that were perceived as posing the greatest health risk were those belonging to the social health risks; items related to technology risks received the lowest percentage of "high health risk" rankings. Traditional environmental risks such as natural catastrophes, pollution issues (chemical pollution, air pollution), and pesticides in food were ranked as being relatively high risks. The respondents were less concerned about new emerging issues and long-term environmental risks (global warming). In this survey, motor vehicle accidents were considered to be a "high health risk" by the greatest percentage of respondents. Generally speaking, the female respondents' degree of recognition of health risks is higher than that of male respondents. Only for the item of smoking was the male respondents' degree higher than that of females. There is also a geographic imbalance in the health risk perceptions. The degree of recognition of health risks from respondents in municipalities is generally lower than that of

  2. A study of the perception of health risks among college students in China.

    PubMed

    Zhang, Chenggang; Fan, Jingbo

    2013-06-01

    The present survey was designed to investigate the perception of health risks among college students in China. The data are the responses of a sample of 3,069 college students at one university to surveys that include measures of several dimensions of public judgments about fifteen specific hazards. Chinese college students conveyed their concerns as falling into three broad categories: Environmental (e.g., global warming, natural catastrophes, the ozone hole, air pollution, chemical pollution, pesticides in food), Technological (e.g., nuclear power stations, thermal power, genetically modified food, medical X-rays), and Social (cigarette smoking, drinking alcohol, overtime study or work, mental stress, motor vehicle accidents). The data were collected with a self-report questionnaire. Descriptive statistics were used to illustrate the levels of perceived risk according to the percent of "high risk" responses as well as the mean response values. Generally, the hazards that were perceived as posing the greatest health risk were those belonging to the social health risks; items related to technology risks received the lowest percentage of "high health risk" rankings. Traditional environmental risks such as natural catastrophes, pollution issues (chemical pollution, air pollution), and pesticides in food were ranked as being relatively high risks. The respondents were less concerned about new emerging issues and long-term environmental risks (global warming). In this survey, motor vehicle accidents were considered to be a "high health risk" by the greatest percentage of respondents. Generally speaking, the female respondents' degree of recognition of health risks is higher than that of male respondents. Only for the item of smoking was the male respondents' degree higher than that of females. There is also a geographic imbalance in the health risk perceptions. The degree of recognition of health risks from respondents in municipalities is generally lower than that of

  3. Reporting risk, producing prejudice: how news reporting on obesity shapes attitudes about health risk, policy, and prejudice.

    PubMed

    Saguy, Abigail C; Frederick, David; Gruys, Kjerstin

    2014-06-01

    News reporting on research studies may influence attitudes about health risk, support for public health policies, or attitudes towards people labeled as unhealthy or at risk for disease. Across five experiments (N = 2123) we examined how different news framings of obesity research influence these attitudes. We exposed participants to either a control condition, a news report on a study portraying obesity as a public health crisis, a news report on a study suggesting that obesity may not be as much of a problem as previously thought, or an article discussing weight-based discrimination. Compared to controls, exposure to the public health crisis article did not increase perception of obesity-related health risks but did significantly increase the expression of antifat prejudice in four out of seven comparisons. Across studies, compared to controls, participants who read an article about weight-based discrimination were less likely to agree that overweight constitutes a public health crisis or to support various obesity policies. Effects of exposure to an article questioning the health risks associated with overweight and obesity were mixed. These findings suggest that news reports on the "obesity epidemic" - and, by extension, on public health crises commonly blamed on personal behavior - may unintentionally activate prejudice.

  4. Community health risk assessment after a fire with asbestos containing fallout

    PubMed Central

    Bridgman, S

    2001-01-01

    BACKGROUND—A factory fire in Tranmere, Merseyside, England, deposited asbestos containing fallout in an urban area. There was considerable community anxiety for months after the incident. Therefore an assessment of the long term health risks of this acute environmental incident were requested by the local health authority.
METHODS—The facts of the incident were gathered and appraised from unpublished and press reports, involved personnel, and further analysis of material collected at the time of the incident. The literature on the long term health risks of asbestos was reviewed, and combined with evidence on asbestos exposure to estimate community health risk.
RESULTS—Risk was almost entirely from exposure to fire fallout of chrysotile in asbestos bitumen paper covering the factory roof. Amosite was only detected in a few samples and in trace amounts. The number of people who lived in the area of fallout was 16 000 to 48 000. From a non-threshold model with assumptions likely to overestimate risk, the lung cancer risk is estimated to be undetectably small. Risk of mesothelioma from chrysotile exposure, and risks of lung cancer and mesothelioma from amosite exposure were based on observational studies and were estimated to be even lower than that of lung cancer risk from chrysotile exposure. Academically, there are assumptions that while reasonable cannot be proven, for example, the validity of extrapolating observed risk from much higher exposures to lower exposures, estimates of individual exposure, and that there is no threshold for asbestos to cause cancer.
CONCLUSIONS—The author is unaware of a similar study on long term health risks in a community exposed to asbestos in a fire. It is concluded that, using methods that do not underestimate risk, risk is undetectably small. Practical lessons from this methodology and approach to health risk assessment are discussed.


Keywords: asbestos; environmental pollutants; mesothelioma; health risk

  5. Risks to health care workers from nano-enabled medical products.

    PubMed

    Murashov, Vladimir; Howard, John

    2015-01-01

    Nanotechnology is rapidly expanding into the health care industry. However, occupational safety and health risks of nano-enabled medical products have not been thoroughly assessed. This manuscript highlights occupational risk mitigation practices for nano-enabled medical products throughout their life cycle for all major workplace settings including (1) medical research laboratories, (2) pharmaceutical manufacturing facilities, (3) clinical dispensing pharmacies, (4) health care delivery facilities, (5) home health care, (6) health care support, and (7) medical waste management. It further identifies critical research needs for ensuring worker protection in the health care industry. PMID:25950806

  6. [Health risks study in a pottery environment in Morocco].

    PubMed

    Laraqui, C H; Caubet, A; Laraqui, O; Rahhali, A E; Curtes, J P; Verger, C

    2000-01-01

    Morocco is famous for its potteries, the largest of which are located at Rabat, Safi, Marrakech and Fes. This cross-sectional, descriptive epidemiological survey was carried out over an eight-month period, from January to August 1997. The study population consisted of 290 male workers from 36 workshops. The study involved a social and medical survey (a questionnaire and medical examination for all workers, with biological assessment for a representative sample of 95 craftsmen) and an analysis of the working conditions in which atmospheric pollution at the pottery was evaluated. Atmospheric concentrations of zinc, copper, iron, chrome and lead were determined. Only lead levels were found to be significantly high and were analyzed on three occasions. This study demonstrates poor working conditions and a lack of respect for the regulations concerning specific prevention measures and the health rules applicable to establishments where personnel are routinely exposed to the risk of lead poisoning. Various pathological conditions were observed, with the following prevalences: skeletal muscle 67.6%, dermatological 8.3%, digestive 58%, respiratory 28% and neurological 35.5%. Several nonspecific, often minor, clinical signs were recorded for most of the potters but the toxicological analysis confirmed lead contamination in 74% of the exposed subjects (plasma lead concentration, CPU, ALAU). The potteries of Morocco are not subject to any protection. Special technical and medical surveillance should be introduced and the laws concerning exposure to lead should be applied.

  7. Biomedical applications and potential health risks of nanomaterials: molecular mechanisms.

    PubMed

    Lanone, Sophie; Boczkowski, Jorge

    2006-09-01

    Nanotechnologies, defined as techniques aimed to conceive, characterize and produce material at the nanometer scale, represent a fully expanding domain, and one can predict without risk that production and utilization of nanomaterials will increase exponentially in the coming years. Applications of nanotechnologies are numerous, in constant development, and their potential use in the medical field as diagnosis and therapeutics tools is very attractive. The size particularity of these nanomaterials gives them novel properties, allowing them to adopt new comportments because of the laws of quantum physics that exist at this scale. However, worries are expressed regarding the exact properties that make these nanomaterials attractive, and questions are raised regarding their potential toxicity, their long-term secondary effects or their biodegradability, particularly when thinking of their use in the (nano)medical field. These questions are justified by the knowledge of the toxic effects of atmospheric pollution micrometric particles on health, and the fear to get an amplification of these effects because of the size of the materials blamed. In this paper, we first expose the sensed medical applications of nanomaterials, and the physicochemical and molecular determinants potentially responsible for nanomaterials biological effects. Finally, we present a synthesis of the actual knowledge regarding toxicological effects of nanomaterials. It is clear that, in regard to the almost empty field of what is known on the subject, there's an urge to better understand biological effects of nanomaterials, which will allow their safe use, in particular in the nanomedicine field.

  8. Jewelry boxes contaminated by Aspergillus oryzae: an occupational health risk?

    PubMed

    Bellanger, Anne-Pauline; Roussel, Anaïs; Millon, Laurence; Delaforge, Marcel; Reboux, Gabriel

    2012-01-01

    In 2009, 100,000 jewelry boxes, manufactured in China, were delivered to a jewelry manufacturer in Besançon, France. All the boxes were contaminated by mold. Because the workers refused to handle these jewelry boxes, the company contacted our laboratory to determine how to deal with the problem. Three choices were available: (1) decontaminate the boxes, (2) return the boxes to the Chinese manufacturer, or (3) destroy the entire shipment. Based on microscopic identification, the culture analysis was positive for A. oryzae. This could not be confirmed by molecular techniques because of the genetic proximity of A. oryzae and A. flavus. Because A. flavus can produce aflatoxins, we tested for them using mass spectrometry. Aflatoxins B1, B2, G1, G2, and M1 were not detected; however, given the specifics of this situation, we could not discard the possibility of the presence of other aflatoxins, such as P1, B3, GM2, and ethoxyaflatoxin B2. We concluded that the contamination by A. oryzae was probably due to food products. However, because of the possible presence of aflatoxins, occupational health risks could not be entirely ruled out. The decision was therefore taken to destroy all the jewelry boxes by incineration. To avoid a similar situation we propose: (1) to maintain conditions limiting mold contamination during production (not eating on the work site, efficient ventilation systems); (2) to desiccate the products before sending them; and (3) to closely control the levels of dampness during storage and transport.

  9. Health benefits and risk associated with adopting a vegetarian diet.

    PubMed

    Pilis, Wiesław; Stec, Krzysztof; Zych, Michał; Pilis, Anna

    2014-01-01

    A vegetarian diet may be adopted for various reasons that can include ecological, economic, religious, ethical and health considerations. In the latter case they arise from the desire to lose weight, in tackling obesity, improving physical fitness and/or in reducing the risk of acquiring certain diseases. It has been shown that properly applied vegetarian diet is the most effective way of reducing body mass (expressed as BMI), improving the plasma lipid profile and in decreasing the incidence of high arterial blood pressure, cardiovascular disease, stroke, metabolic syndrome and arteriosclerosis. In addition, improved insulin sensitivity together with lower rates of diabetes and cancer has been observed. Some studies have however found that a vegetarian diet may result in changes adversely affecting the body. These could include; hyperhomocysteinaemia, protein deficiency, anaemia, decreased creatinine content in muscles and menstrual disruption in women who undertake increased physical activity. Some of these changes may decrease the ability for performing activities that require physical effort. Nevertheless, on balance it can be reasonably concluded that the beneficial effects of a vegetarian diet significantly, by far, outweigh the adverse ones. It should also be noted that the term 'vegetarian diet' is not always clearly defined in the literature and it may include many dietary variations.

  10. [Ixodes ricinus. Health risks and approaches in prevention].

    PubMed

    Voigt, Thomas F

    2006-05-01

    Ticks belong to the parasitical mites. There are more than 1000 different species worldwide which do need blood of warm-blooded organisms for their own development. As ticks are well known to be vectors of several pathogens which could cause insidious infectious diseases, they are important in human and veterinarian medicine as well. It is not possible to control ticks in nature. Therefore the first step should be an effective prevention. In case of a bite the tick must be removed as soon as possible. Although Ixodes ricinus is more or less responsible for all health risks caused by ticks in Germany, further species like Rhipicephalus sanguineus, Dermacentor marginatus and Argas reflexus must not be forgotten, as these ticks have appeared more frequently in the recent past and they can be vectors of several diseases as well. This paper describes first and foremost the biological behaviour and development of Ixodes ricinus and the medical importance of this tick in human and veterinarian medicine.

  11. [Water pollution and health risks at Yaoundé, Cameroon].

    PubMed

    Youmbi, Jean Ghislain Tabué; Feumba, Roger; Njitat, Valérie Tsama; de Marsily, Ghislain; Ekodeck, Georges Emmanuel

    2013-01-01

    The aim of this article consists of developing an ecosystemic approach to collect information about groundwater pollution in order to determine its origin and infer the health risks in Mingoa's watershed through the study of 12 spontaneous settlements. From an environmental point of view, family interviews and direct observations allowed us to inventory springs, wells and latrines, and to collect information. So, we have selected, on the basis of predefined criteria, 21 wells and springs for physico-chemical and bacteriological laboratory analyses. Two hundred children aged less than 5 years were subjected to KOAP examination. A number of 1224 latrines were inventoried, for an average use of 15 people per latrine, producing 913.3 kg/year of excreta. Most of 91% of people use these latrines. The superficial aquifers, connected to the wells and springs, present high values of nitrogen, phosphorous pollutant and fecal contamination indicators (coliforms and fecal streptococcus), which make water inappropriate to human consumption. PCA analysis establishes that water pollution comes mainly from traditional pit latrines. The overall prevalence of diarrhea and parasite infestation was important (=40%). The presence of cysts of Entamoeba histolytica, Ascaris limbricoides, and Entamoeba coli confirms this high prevalence and testify to very approximate hygiene and environment conditions.

  12. Perception of Suicide Risk in Mental Health Professionals

    PubMed Central

    Gale, Tim M.; Hawley, Christopher J.; Butler, John; Morton, Adrian; Singhal, Ankush

    2016-01-01

    This study employed an independent-groups design (4 conditions) to investigate possible biases in the suicide risk perception of mental health professionals. Four hundred participants comprising doctors, nurses and social workers viewed a vignette describing a fictitious patient with a long-term mental illness. The case was presented as being drawn from a sample of twenty similar clinical case reports, of which 10 were associated with an outcome of suicide. The participant tasks were (i) to decide whether the presented vignette was one of those cases or not, and (ii) to provide an assessment of confidence in that decision. The 4 conditions were used to investigate whether the presence of an associated face, and the nature of the emotional state expressed by that face, affected the response profile. In fact, there were no significant differences between conditions, but there was a significant bias across all conditions towards associating the vignette with suicide, despite the base rate being pre-determined at 50%. The bias was more pronounced in doctors and in male respondents. Moreover, many participants indicated substantial confidence in their decisions. The results are discussed in terms of availability bias and over-confidence bias. PMID:26909886

  13. HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention.

    PubMed Central

    Clements-Nolle, K; Marx, R; Guzman, R; Katz, M

    2001-01-01

    OBJECTIVES: This study described HIV prevalence, risk behaviors, health care use, and mental health status of male-to-female and female-to-male transgender persons and determined factors associated with HIV. METHODS: We recruited transgender persons through targeted sampling, respondent-driven sampling, and agency referrals; 392 male-to-female and 123 female-to-male transgender persons were interviewed and tested for HIV. RESULTS: HIV prevalence among male-to-female transgender persons was 35%. African American race (adjusted odds ratio [OR] = 5.81; 95% confidence interval [CI] = 2.82, 11.96), a history of injection drug use (OR = 2.69; 95% CI = 1.56, 4.62), multiple sex partners (adjusted OR = 2.64; 95% CI = 1.50, 4.62), and low education (adjusted OR = 2.08; 95% CI = 1.17, 3.68) were independently associated with HIV. Among female-to-male transgender persons, HIV prevalence (2%) and risk behaviors were much lower. Most male-to-female (78%) and female-to-male (83%) transgender persons had seen a medical provider in the past 6 months. Sixty-two percent of the male-to-female and 55% of the female-to-male transgender persons were depressed; 32% of each population had attempted suicide. CONCLUSIONS: High HIV prevalence suggests an urgent need for risk reduction interventions for male-to-female transgender persons. Recent contact with medical providers was observed, suggesting that medical providers could provide an important link to needed prevention, health, and social services. PMID:11392934

  14. Computerized Radiological Risk Investigation System for Assessing Doses and Health Risks from Atmospheric Releases of Radionuclides.

    1998-11-10

    Version: 00 CRRIS consists of eight fully integrated computer codes which calculate environmental transport of atmospheric releases of radionuclides and resulting doses and health risks to individuals or populations. Each code may be used alone for various assessment applications. Because of its modular structure, CRRIS allows assessments to be tailored to the user's needs. Radionuclides are handled by CRRIS either in terms of the released radionuclides or the exposure radionuclides which consist of both themore » released nuclides and decay products that build up during environmental transport. Atmospheric dispersion calculations are performed by the ANEMOS computer code for distances less than 100 km and by the RETADD-II computer code for regional-scale distances. Both codes estimate annual-average air concentrations and ground deposition rates by location. SUMIT will translate and scale multiple ANEMOS runs onto a master grid. TERRA reads radionuclide air concentrations and deposition rates to estimate concentrations of radionuclides in food and surface soil. Radiologic decay and ingrowth, soil leaching, and transport through the food chain are included in the calculations. MLSOIL computes an effective radionuclide ground-surface concentration to be used in computing external health effects. The five-layer model of radionuclide transport through soil in MLSOIL provides an alternative to the single-layer model used in TERRA. DFSOIL computes dose factors used in MLSOIL to compute doses from the five soil layers and from the ground surface. ANDROS reads environmental concentrations of radionuclides computed by the other CRRIS codes and produces tables of doses and risks to individuals or populations from atmospheric releases of radionuclides.« less

  15. Computerized Radiological Risk Investigation System for Assessing Doses and Health Risks from Atmospheric Releases of Radionuclides.

    SciTech Connect

    RAINE, III, DUDLEY A.

    1998-11-10

    Version: 00 CRRIS consists of eight fully integrated computer codes which calculate environmental transport of atmospheric releases of radionuclides and resulting doses and health risks to individuals or populations. Each code may be used alone for various assessment applications. Because of its modular structure, CRRIS allows assessments to be tailored to the user's needs. Radionuclides are handled by CRRIS either in terms of the released radionuclides or the exposure radionuclides which consist of both the released nuclides and decay products that build up during environmental transport. Atmospheric dispersion calculations are performed by the ANEMOS computer code for distances less than 100 km and by the RETADD-II computer code for regional-scale distances. Both codes estimate annual-average air concentrations and ground deposition rates by location. SUMIT will translate and scale multiple ANEMOS runs onto a master grid. TERRA reads radionuclide air concentrations and deposition rates to estimate concentrations of radionuclides in food and surface soil. Radiologic decay and ingrowth, soil leaching, and transport through the food chain are included in the calculations. MLSOIL computes an effective radionuclide ground-surface concentration to be used in computing external health effects. The five-layer model of radionuclide transport through soil in MLSOIL provides an alternative to the single-layer model used in TERRA. DFSOIL computes dose factors used in MLSOIL to compute doses from the five soil layers and from the ground surface. ANDROS reads environmental concentrations of radionuclides computed by the other CRRIS codes and produces tables of doses and risks to individuals or populations from atmospheric releases of radionuclides.

  16. Drinking-Smoking Status and Health Risk Behaviors among High School Students in Thailand

    ERIC Educational Resources Information Center

    Saingam, Darika; Assanangkornchai, Sawitri; Geater, Alan F.

    2012-01-01

    Drinking, smoking, and health risk behaviors are significant problems for Thai adolescents. However, little is known about the association and magnitude among alcohol, tobacco, or co-using and health risk behaviors. Data of the National School Survey of 2007 were analyzed. The sample consisted of 50,033 high school and vocational college students.…

  17. Exploration of health risks related to air pollution and temperature in three Latin American cities.

    PubMed

    Romero-Lankao, Patricia; Qin, Hua; Borbor-Cordova, Mercy

    2013-04-01

    This paper explores whether the health risks related to air pollution and temperature extremes are spatially and socioeconomically differentiated within three Latin American cities: Bogota, Colombia, Mexico City, Mexico, and Santiago, Chile. Based on a theoretical review of three relevant approaches to risk analysis (risk society, environmental justice, and urban vulnerability as impact), we hypothesize that health risks from exposure to air pollution and temperature in these cities do not necessarily depend on socio-economic inequalities. To test this hypothesis, we gathered, validated, and analyzed temperature, air pollution, mortality and socioeconomic vulnerability data from the three study cities. Our results show the association between air pollution levels and socioeconomic vulnerabilities did not always correlate within the study cities. Furthermore, the spatial differences in socioeconomic vulnerabilities within cities do not necessarily correspond with the spatial distribution of health impacts. The present study improves our understanding of the multifaceted nature of health risks and vulnerabilities associated with global environmental change. The findings suggest that health risks from atmospheric conditions and pollutants exist without boundaries or social distinctions, even exhibiting characteristics of a boomerang effect (i.e., affecting rich and poor alike) on a smaller scale such as areas within urban regions. We used human mortality, a severe impact, to measure health risks from air pollution and extreme temperatures. Public health data of better quality (e.g., morbidity, hospital visits) are needed for future research to advance our understanding of the nature of health risks related to climate hazards. PMID:23434119

  18. High-Risk Health and Credit Behavior among 18- to 25-Year-Old College Students

    ERIC Educational Resources Information Center

    Adams, Troy; Moore, Monique

    2007-01-01

    The number of students accumulating credit card debt--and the amount of debt itself--on college campuses is increasing. If high-risk credit and health behavior are associated, health behavior interventions might apply to high-risk credit behavior. Objective: The authors' purpose was to examine these possible associations. Participants and Methods:…

  19. Applying the National College Health Risk Behavior Survey to Rural Campuses.

    ERIC Educational Resources Information Center

    Peterson, Yasenka

    2001-01-01

    Determined current health risk behaviors of rural college freshmen using elements of the National College Health Risk Behavior Survey (NCHRBS). Student surveys indicated that for some behaviors, the incidence among these rural students was higher than the incidence among freshmen from the NCHRBS (e.g., binge drinking, ever smoking marijuana, and…

  20. 21 CFR 101.82 - Health claims: Soy protein and risk of coronary heart disease (CHD).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... heart disease (CHD). 101.82 Section 101.82 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Health Claims § 101.82 Health claims: Soy protein and risk of coronary heart disease (CHD). (a... risk of CHD. (1) Cardiovascular disease means diseases of the heart and circulatory system. CHD is...

  1. 21 CFR 101.82 - Health claims: Soy protein and risk of coronary heart disease (CHD).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... heart disease (CHD). 101.82 Section 101.82 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Health Claims § 101.82 Health claims: Soy protein and risk of coronary heart disease (CHD). (a... risk of CHD. (1) Cardiovascular disease means diseases of the heart and circulatory system. CHD is...

  2. Psychiatric Disorders and Sexual Risk among Adolescents in Mental Health Treatment

    ERIC Educational Resources Information Center

    Brown, Larry K.; Hadley, Wendy; Stewart, Angela; Lescano, Celia; Whiteley, Laura; Donenberg, Geri; DiClemente, Ralph

    2010-01-01

    Objective: To examine the relationship between psychiatric disorders and sexual behaviors among adolescents receiving mental health treatment. Adolescents in mental health treatment have been found to have higher rates of HIV risk behavior than their peers, but data concerning the relationship between psychopathology and risk are inconsistent and…

  3. EXPOSURE DOMAINS: ROLE OF TIMING, PATTERN AND MAGNITUDE OF EXPOSURE ON HEALTH RISKS

    EPA Science Inventory

    Environmental health risk assessment may be broadly separated into assessment of risks from exposures to agents affecting health endpoints for which it may be presumed there is no dose threshold, and to agents affecting endpoints that more likely have a dose threshold. For hea...

  4. Single and Multiple Suicide Attempts and Associated Health Risk Factors in New Hampshire Adolescents

    ERIC Educational Resources Information Center

    Rosenberg, Harriet J.; Jankowski, Mary K.; Sengupta, Anjana; Wolfe, Rosemarie S.; Wolford, George L., II; Rosenberg, Stanley D.

    2005-01-01

    In this study we examined self-reported suicide attempts and their relationship to other health risk factors in a community sample of 16,644 adolescents. Fifteen percent endorsed suicide attempts (10% single; 5% multiple attempts). We hypothesized that multiple attempters would show higher prevalence of comorbid health risks than single or…

  5. [Concomitant influence of occupational and social risk factors on health of workers engaged into powder metallurgy].

    PubMed

    Shur, P Z; Zaĭtseva, N V; Kostarev, V G; Lebedeva-Nesevria, N A; Shliapnikov, D M

    2012-01-01

    Results of health risk evaluation in workers engaged into powder metallurgy, using complex of hygienic, medical, epidemiologic and sociologic studies, enable to define priority occupational and social risk factors, to assess degree of their influence on the workers' health and to identify occupationally induced diseases.

  6. New Directions in Health Risk Assessment: A REACH for the Future?

    EPA Science Inventory

    Health risk assessments have been used to support many decisions in the US to reduce risks from pollutant exposures. These decisions have been highly successful in protecting public health despite uncertainty due to gaps in knowledge and methodological limitations. In recent yea...

  7. Child, Family, School and Community Risk Factors for Poor Mental Health in Brazilian Schoolchildren

    ERIC Educational Resources Information Center

    Goodman, Anna; Fleitlich-Bilyk, Bacy; Patel, Vikram; Goodman, Robert

    2007-01-01

    Objective: To identify risk factors for poor child mental health in the southeastern Brazilian municipality of Taubate. Method: In 2001 we carried out a representative school-based survey of Brazilian schoolchildren ages 7 to 14 years (response rate, 83%). We collected extensive data on child mental health and on potential risk and protective…

  8. Exploration of health risks related to air pollution and temperature in three Latin American cities

    NASA Astrophysics Data System (ADS)

    Romero-Lankao, P.; Borbor Cordova, M.; Qin, H.

    2013-12-01

    We explore whether the health risks related to air pollution and temperature extremes are spatially and socioeconomically differentiated within three Latin American cities: Bogota, Colombia, Mexico City, Mexico, and Santiago, Chile. Based on a theoretical review of three relevant approaches to risk analysis (risk society, environmental justice, and urban vulnerability as impact), we hypothesize that health risks from exposure to air pollution and temperature in these cities do not necessarily depend on socio-economic inequalities. To test this hypothesis, we gathered, validated, and analyzed temperature, air pollution, mortality and socioeconomic vulnerability data from the three study cities. Our results show the association between air pollution levels and socioeconomic vulnerabilities did not always correlate within the study cities. Furthermore, the spatial differences in socioeconomic vulnerabilities within cities do not necessarily correspond with the spatial distribution of health impacts. The present study improves our understanding of the multifaceted nature of health risks and vulnerabilities associated with global environmental change. The findings suggest that health risks from atmospheric conditions and pollutants exist without boundaries or social distinctions, even exhibiting characteristics of a boomerang effect (i.e., affecting rich and poor alike) on a smaller scale such as areas within urban regions. We used human mortality, a severe impact, to measure health risks from air pollution and extreme temperatures. Public health data of better quality (e.g., morbidity, hospital visits) are needed for future research to advance our understanding of the nature of health risks related to climate hazards.

  9. FOCUSING ON CHILDREN’S INHALATION DOSIMETRY AND HEALTH EFFECTS FOR RISK ASSESSMENT: AN INTRODUCTION

    EPA Science Inventory

    Substantial effort has been invested in improving children’s health risk assessment in recent years. However, the body of scientific evidence in support of children’s health assessment is constantly advancing requiring continual updating of risk assessment methods. Children’s i...

  10. FOCUSING ON CHILDREN'S INHALATION DOSIMETRY AND HEALTH EFFECTS FOR RISK ASSESSMENT: AN INTRODUCTION (Journal Article)

    EPA Science Inventory

    Substantial effort has been invested in improving children’s health risk assessment in recent years. However, the body of scientific evidence in support of children’s health assessment is constantly advancing requiring continual updating of risk assessment methods. Children’s i...

  11. Exploration of health risks related to air pollution and temperature in three Latin American cities.

    PubMed

    Romero-Lankao, Patricia; Qin, Hua; Borbor-Cordova, Mercy

    2013-04-01

    This paper explores whether the health risks related to air pollution and temperature extremes are spatially and socioeconomically differentiated within three Latin American cities: Bogota, Colombia, Mexico City, Mexico, and Santiago, Chile. Based on a theoretical review of three relevant approaches to risk analysis (risk society, environmental justice, and urban vulnerability as impact), we hypothesize that health risks from exposure to air pollution and temperature in these cities do not necessarily depend on socio-economic inequalities. To test this hypothesis, we gathered, validated, and analyzed temperature, air pollution, mortality and socioeconomic vulnerability data from the three study cities. Our results show the association between air pollution levels and socioeconomic vulnerabilities did not always correlate within the study cities. Furthermore, the spatial differences in socioeconomic vulnerabilities within cities do not necessarily correspond with the spatial distribution of health impacts. The present study improves our understanding of the multifaceted nature of health risks and vulnerabilities associated with global environmental change. The findings suggest that health risks from atmospheric conditions and pollutants exist without boundaries or social distinctions, even exhibiting characteristics of a boomerang effect (i.e., affecting rich and poor alike) on a smaller scale such as areas within urban regions. We used human mortality, a severe impact, to measure health risks from air pollution and extreme temperatures. Public health data of better quality (e.g., morbidity, hospital visits) are needed for future research to advance our understanding of the nature of health risks related to climate hazards.

  12. Risk of future offense among probationers with co-occurring substance use and mental health disorders.

    PubMed

    Balyakina, Elizabeth; Mann, Christopher; Ellison, Michael; Sivernell, Ron; Fulda, Kimberly G; Sarai, Simrat Kaur; Cardarelli, Roberto

    2014-04-01

    The criminal justice system is the primary service delivery system for many adults with drug and alcohol dependence, mental health, and other health service needs. The purpose of this study was to examine the relationship between risk of future offense, mental health status and co-occurring disorders in a large substance abuse diversion probationer population. A purposive sample of 2,077 probationers completed an assessment to screen for mental health disorders, substance use disorders, risk of future crime and violence, and several demographic characteristics. Probationers who screened positive for co-occurring substance use and mental health disorders were significantly more likely to be at higher risk of future crime and violence compared to probationers who screened positive for only substance use, only a mental health disorder, or no substance use or mental health disorder. Implications for substance use and mental health service delivery are discussed, and recommendations are made for further research.

  13. Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania.

    PubMed

    Kuchibanda, Kizito; Mayo, Aloyce W

    2015-01-01

    The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interview, and observation checklist. The results revealed that healthcare wastes are not quantified or segregated in all the three hospitals. Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed of by on-site incineration and burning and some wastes are disposed off-site. At Kolandoto DDH only on-site burning and land disposal are practiced, while at Kambarage UHC healthcare solid wastes are incinerated, disposed of on land disposal, and burned. Waste management workers do not have formal training in waste management techniques and the hospital administrations pay very little attention to appropriate management of healthcare wastes. In light of this, it is evident that management of healthcare solid wastes is not practiced in accordance with the national and WHO's recommended standards. PMID:26779565

  14. Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania

    PubMed Central

    Kuchibanda, Kizito; Mayo, Aloyce W.

    2015-01-01

    The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interview, and observation checklist. The results revealed that healthcare wastes are not quantified or segregated in all the three hospitals. Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed of by on-site incineration and burning and some wastes are disposed off-site. At Kolandoto DDH only on-site burning and land disposal are practiced, while at Kambarage UHC healthcare solid wastes are incinerated, disposed of on land disposal, and burned. Waste management workers do not have formal training in waste management techniques and the hospital administrations pay very little attention to appropriate management of healthcare wastes. In light of this, it is evident that management of healthcare solid wastes is not practiced in accordance with the national and WHO's recommended standards. PMID:26779565

  15. Health risks of enteric viral infections in children.

    PubMed

    Nwachuku, Nena; Gerba, Charles P

    2006-01-01

    Children are at a greater risk of infections from serious enteric viral illness than adults for a number of reasons. Most important is the immune system, which is needed to control the infection processes. This difference can lead to more serious infections than in adults, who have fully developed immune systems. There are a number of significant physiological and behavioral differences between adults and children that place children at a greater risk of exposure and a greater risk of serious infection from enteric viruses. Although most enteric viruses cause mild or asymptomatic infections, they can cause a wide range of serious and life-threatening illnesses in children. The peak incidence of most enteric viral illnesses is in children <2yr of age, although all age groups of children are affected. Most of these infections are more serious and result in higher mortality in children than adults. The fetus is also affected by enterovirus and infectious hepatitis resulting in significant risk of fetal death or serious illness. In addition to the poliovirus vaccine, the only vaccine available is for hepatitis A virus (HAV). A vaccine for rotavirus has currently been withdrawn, pending review because of potential adverse effects in infants. No specific treatment is available for the other enteric viruses. Enteric viral infections are very common in childhood. Most children are infected with rotavirus during the first 2yr of life. The incidence of enteroviruses and the viral enteric viruses ranges from 10% to 40% in children and is largely dependent on age. On average, half or more of the infections are asymptomatic. The incidence of hepatitis A virus is much lower than the enteric diarrheal viruses. There is no current evidence for hepatitis E virus (HEV) acquisition in children in the U.S. Enteric viral diseases have a major impact on direct and indirect health care costs (i.e., lost wages) and amount to several billion dollars a year in the U.S. Total direct and

  16. Health risk factors in different seasons of carpet industry in Kashmir, India.

    PubMed

    Wani, Khursheed Ahmad; Jaiswal, Yogesh K

    2012-01-01

    Carpet workers are exposed to different types of health risk factors in different seasons of the year. As the environmental conditions become harsh, risk for developing various types of diseases increases. These problems are further aggravated when the environmental conditions at the workplace deteriorate. An attempt has been made to study the health risk factors in the carpet industry in different seasons of the year. It has been concluded that in winter weavers are affected by several types of health risk factors as compared to the other seasons.

  17. Integrating Health Into Disaster Risk Reduction Strategies: Key Considerations for Success

    PubMed Central

    Dar, Osman; Rokadiya, Sakib; Huda, Qudsia; Abrahams, Jonathan

    2014-01-01

    The human and financial costs of disasters are vast. In 2011, disasters were estimated to have cost $378 billion worldwide; disasters have affected 64% of the world’s population since 1992. Consequently, disaster risk reduction strategies have become increasingly prominent on national and international policy agendas. However, the function of health in disaster risk reduction strategies often has been restricted to emergency response. To mitigate the effect of disasters on social and health development goals (such as risk reduction Millennium Development Goals) and increase resilience among at-risk populations, disaster strategies should assign the health sector a more all-encompassing, proactive role. We discuss proposed methods and concepts for mainstreaming health in disaster risk reduction and consider barriers faced by the health sector in this field. PMID:25122022

  18. Integrating health into disaster risk reduction strategies: key considerations for success.

    PubMed

    Dar, Osman; Buckley, Emmeline J; Rokadiya, Sakib; Huda, Qudsia; Abrahams, Jonathan

    2014-10-01

    The human and financial costs of disasters are vast. In 2011, disasters were estimated to have cost $378 billion worldwide; disasters have affected 64% of the world's population since 1992. Consequently, disaster risk reduction strategies have become increasingly prominent on national and international policy agendas. However, the function of health in disaster risk reduction strategies often has been restricted to emergency response. To mitigate the effect of disasters on social and health development goals (such as risk reduction Millennium Development Goals) and increase resilience among at-risk populations, disaster strategies should assign the health sector a more all-encompassing, proactive role. We discuss proposed methods and concepts for mainstreaming health in disaster risk reduction and consider barriers faced by the health sector in this field.

  19. Integrating health into disaster risk reduction strategies: key considerations for success.

    PubMed

    Dar, Osman; Buckley, Emmeline J; Rokadiya, Sakib; Huda, Qudsia; Abrahams, Jonathan

    2014-10-01

    The human and financial costs of disasters are vast. In 2011, disasters were estimated to have cost $378 billion worldwide; disasters have affected 64% of the world's population since 1992. Consequently, disaster risk reduction strategies have become increasingly prominent on national and international policy agendas. However, the function of health in disaster risk reduction strategies often has been restricted to emergency response. To mitigate the effect of disasters on social and health development goals (such as risk reduction Millennium Development Goals) and increase resilience among at-risk populations, disaster strategies should assign the health sector a more all-encompassing, proactive role. We discuss proposed methods and concepts for mainstreaming health in disaster risk reduction and consider barriers faced by the health sector in this field. PMID:25122022

  20. What are the benefits and risks of using return on investment to defend public health programs?

    PubMed

    Brousselle, Astrid; Benmarhnia, Tarik; Benhadj, Lynda

    2016-06-01

    Return on investment (ROI) is an economic measure used to indicate how much economic benefit is derived from a program in relation to its costs. Interest in the use of ROI in public health has grown substantially over recent years. Given its potential influence on resource allocation, it is crucial to understand the benefits and the risks of using ROI to defend public health programs. In this paper, we explore those benefits and risks. We present two recent examples of ROI use in public health in the United States and Canada and conclude with a series of proposals to minimize the risks associated with using ROI to defend public health interventions.

  1. Proband Mental Health Difficulties and Parental Stress Predict Mental Health in Toddlers at High-Risk for Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Crea, Katherine; Dissanayake, Cheryl; Hudry, Kristelle

    2016-01-01

    Family-related predictors of mental health problems were investigated among 30 toddlers at familial high-risk for autism spectrum disorders (ASD) and 28 controls followed from age 2- to 3-years. Parents completed the self-report Depression Anxiety Stress Scales and the parent-report Behavior Assessment System for Children. High-risk toddlers were…

  2. Why income inequality indexes do not apply to health risks.

    PubMed

    Cox, Louis Anthony

    2012-02-01

    Several recent papers have sought to apply inequality measures from economics, such as the Atkinson Index (AI) for inequality of income distributions, to compare the risk inequality of different mortality risk distributions in an effort to help promote efficiency and environmental justice in pollution-reducing interventions. Closer analysis suggests that such applications are neither logically coherent nor necessarily ethically desirable. Risk inequality comparisons should be based on axioms that apply to probabilistic risks, and should consider the multidimensional and time-varying nature of individual and community risks in order to increase efficiency and justice over time and generations. In light of the limitations of the AI applied to mortality risk distributions, it has not been demonstrated to have ethical or practical value in helping policymakers to identify air pollution management interventions that reduce (or minimize) risk and risk inequity.

  3. Health-risk based approach to setting drinking water standards for long-term space missions

    NASA Technical Reports Server (NTRS)

    Macler, Bruce A.; Dunsky, Elizabeth C.

    1992-01-01

    In order to develop plausible and appropriate drinking water contaminant standards for longer-term NASA space missions, such as those planned for the Space Exploration Initiative, a human health risk characterization was performed using toxicological and exposure values typical of space operations and crew. This risk characterization showed that the greatest acute waterborne health concern was from microbial infection leading to incapacitating gastrointestinal illness. Ingestion exposure pathways for toxic materials yielded de minimus acute health risks unlikely to affect SEI space missions. Risks of chronic health problems were within acceptable public health limits. Our analysis indicates that current Space Station Freedom maximum contamination levels may be unnecessarily strict. We propose alternative environmental contaminant values consistent with both acceptable short and long-term crew health safety.

  4. Communicating with Risk Takers: Information Sources and Health Attitudes, Beliefs, and Involvement.

    ERIC Educational Resources Information Center

    Ferguson, M. A.; And Others

    Seven studies explored the relationships between risk-taking predispositions and health attitudes, beliefs, and involvement. Data were gathered from surveys, and from lab and field experiments on 1,323 subjects. Findings indicated five risk-taking factors: adventurousness, rebelliousness, impulsiveness, physical risk taking, and unconventional…

  5. Gambling with Your Health: Predictors of Risk for AIDS.

    ERIC Educational Resources Information Center

    Lasorsa, Dominic L.; Shoemaker, Pamela J.

    To examine risk for Acquired Immune Deficiency Syndrome (AIDS) in terms of risk-related behaviors, and to investigate the factors that may be involved in putting one at risk, a study conducted telephone interviews with 493 randomly selected adults (18 years or older) in Austin, Texas in the fall of 1987. Respondents answered approximately 40…

  6. Australian Adolescents' Perceptions of Health-Related Risks.

    ERIC Educational Resources Information Center

    Moore, Susan M.; Rosenthal, Doreen A.

    1992-01-01

    Evaluates the perceptions of adolescents (n=189) of their risks and ascertains the relationship between risk perception and actual risky behavior in five areas: AIDS, STDs, serious car accidents, lung cancer, and skin cancer. Results indicated that although late-adolescent students underestimated risk behavior, they were able to make judgments…

  7. Oral bioaccessibility of arsenic, mercury and methylmercury in marine species commercialized in Catalonia (Spain) and health risks for the consumers.

    PubMed

    Cano-Sancho, German; Perelló, Gemma; Maulvault, Ana Luísa; Marques, António; Nadal, Martí; Domingo, José L

    2015-12-01

    This study was aimed at characterizing the bioaccessibility of arsenic (As), mercury (Hg) and methylmercury (MeHg) in commercial fish and seafood species widely consumed by the population of Catalonia (Spain). An accurate evaluation on how bioaccessibility estimations may affect the outcomes of exposure assessment studies was also conducted. The concentrations of As, Hg, and MeHg in samples of fish and seafood incubated in a 3-compartmental (mouth, stomach, and small intestine) in vitro gastrointestinal model, were quantified and compared with the levels of these elements in cooked samples. Arsenic showed a high bioaccessibility in all the fish and seafood species, ranging from 72% (mackerel) to 89% (sardine). In contrast, the bioaccessibility of Hg was rather lower, being <50% for most species, while MeHg could be only quantified in swordfish and tuna. This study elucidates the potential overestimation of health risks to consumers, when the effects of bioaccessibility and cooking procedures are not taken into account in the risk assessment. Unlike As, whose risk is not generally overestimated, Hg and MeHg showed a lower and variable bioaccessibility in marine species, meaning an overestimation of health risks for the adult population. Further studies should assess the bioaccessibility of mercurial species for children. PMID:26409124

  8. [Health risks in different living circumstances of mothers. Analyses based on a population study].

    PubMed

    Sperlich, Stefanie

    2014-12-01

    The objective of this study was to determine the living circumstances ('Lebenslagen') in mothers which are associated with elevated health risks. Data were derived from a cross-sectional population based sample of German women (n = 3129) with underage children. By means of a two-step cluster analysis ten different maternal living circumstances were assessed which proved to be distinct with respect to indicators of socioeconomic position, employment status and family-related factors. Out of the ten living circumstances, one could be attributed to higher socioeconomic status (SES), while five were assigned to a middle SES and four to a lower SES. In line with previous findings, mothers with a high SES predominantly showed the best health while mothers with a low SES tended to be at higher health risk with respect to subjective health, mental health (anxiety and depression), obesity and smoking. However, there were important health differences between the different living circumstances within the middle and lower SES. In addition, varying health risks were found among different living circumstances of single mothers, pointing to the significance of family and job-related living conditions in establishing health risks. With this exploratory analysis strategy small-scale living conditions could be detected which were associated with specific health risks. This approach seemed particularly suitable to provide a more precise definition of target groups for health promotion. The findings encourage a more exrensive application of the concept of living conditions in medical sociology research as well as health monitoring.

  9. Health risk assessment maps for arsenic groundwater content: application of national geochemical databases.

    PubMed

    Rapant, Stanislav; Krcmová, Katarína

    2007-04-01

    This investigation assesses the feasibility of calculating and visualizing health risk estimates from exposure to groundwater contaminated with arsenic (As) using data from national geochemical databases. The potential health risk associated with As-contaminated groundwater was assessed based on an elaboration of existing geochemical data in accordance with accepted methodological procedures established for human health risk assessment (U.S. Environmental Protection Agency methodology). A screening analysis approach was used for estimating the contribution of As to the total chronic health risk from exposure to groundwater contaminated with potentially toxic elements, including As, Ba, Cd, Cu, Hg, Pb, Sb, Se and Zn, and the results indicate that As contributes significantly (>50%) to this total health chronic risk in about 10% of Slovak territory. Based on the calculation of the potential risk level by exposure modelling, increased chronic as well as carcinogenic risk levels (medium to high) were documented in approximately 0.2 and 11% of the total Slovak area, respectively. The areas characterized by high health risk levels are mainly those geogenically contaminated. High and very high carcinogenic risk was determined in 34 of 79 districts and in 528 of 2924 municipalities. PMID:17256097

  10. Health risk assessment maps for arsenic groundwater content: application of national geochemical databases.

    PubMed

    Rapant, Stanislav; Krcmová, Katarína

    2007-04-01

    This investigation assesses the feasibility of calculating and visualizing health risk estimates from exposure to groundwater contaminated with arsenic (As) using data from national geochemical databases. The potential health risk associated with As-contaminated groundwater was assessed based on an elaboration of existing geochemical data in accordance with accepted methodological procedures established for human health risk assessment (U.S. Environmental Protection Agency methodology). A screening analysis approach was used for estimating the contribution of As to the total chronic health risk from exposure to groundwater contaminated with potentially toxic elements, including As, Ba, Cd, Cu, Hg, Pb, Sb, Se and Zn, and the results indicate that As contributes significantly (>50%) to this total health chronic risk in about 10% of Slovak territory. Based on the calculation of the potential risk level by exposure modelling, increased chronic as well as carcinogenic risk levels (medium to high) were documented in approximately 0.2 and 11% of the total Slovak area, respectively. The areas characterized by high health risk levels are mainly those geogenically contaminated. High and very high carcinogenic risk was determined in 34 of 79 districts and in 528 of 2924 municipalities.

  11. Health-risk-based groundwater remediation system optimization through clusterwise linear regression.

    PubMed

    He, L; Huang, G H; Lu, H W

    2008-12-15

    This study develops a health-risk-based groundwater management (HRGM) model. The model incorporates the considerations of environmental quality and human health risks into a general framework. To solve the model, a proxy-based optimization approach is proposed, where a semiparametric statistical method (i.e., clusterwise linear regression) is used to create a set of rapid-response and easy-to-use proxy modules for capturing the relations between remediation policies and the resulting human health risks. Through replacing the simulation and health risk assessment modules with the proxy ones, many orders of magnitude of computational cost can be saved. The model solutions reveal that (i) a long remediation period corresponds to a low total pumping rate, (ii) a stringent risk standard implies a high total pumping rate, and (iii) the human health risk associated with benzene would be significantly reduced if it is regarded as constraints of the model. These implications would assist decision makers in understanding the effects of remediation duration and human-health risk level on optimal remediation policies and in designing a robust groundwater remediation system. Results from postoptimization simulation show that the carcinogenic risk would decrease to satisfy the regulated risk standard under the given remediation policies.

  12. Medical Geology in the Middle East: Potential Health Risks from Mineralized Dust Exposure

    NASA Astrophysics Data System (ADS)

    Lyles, M. B.; Fredrickson, H. L.; Bednar, A. J.; Fannin, H. B.; Griffin, D. W.; Sobecki, T. M.

    2012-04-01

    In the Middle East, dust and sand storms are a persistent problem delivering significant amounts of mineralized particulates via inhalation into the mouth, nasal pharynx, and lungs. The health risks of this dust inhalation are presently being studied but accurate characterization as to the potential health effects is still lacking. Experiments were designed to study the chemical composition, mineral content, and microbial flora of Kuwaiti and Iraqi dust particles for the potential to cause adverse human health effects both acute and chronic. Multiple site samples were collected and chemical and physical characterization including particle size distribution and inorganic analysis was conducted, followed by analysis and identification of biologic flora to include bacteria, fungi and viruses. Additionally, PM10 exposure data was collected hourly over a 12 day period (>10,000 ug/m3). Data indicates that the mineralized dust is composed of calcium carbonate and magnesium sulfate coating over a precipitated matrix of metallic silicate nanocrystals of various forms containing a variety of trace and heavy metals constituting ~3 % of the particles by weight. This includes ~ 1% by weight bioaccessible aluminum and reactive iron with the remaining 1% a mixture of bioaccessible trace and heavy metals. Microbial analysis reveals a significant biodiversity of bacteria of which ~25 % are known pathogens. Of the microbes identified, several have hemolytic properties and most have significant antibiotic resistance. Viral analysis indicates a tremendous amount of virons with a large percent of RNA viruses. The level of total suspended particle mass at PM10 constitutes an excessive exposure micro-particulates including PM 2.5 (~1,0000 ug/m3). Reported data on cell culture and animal studies have indicated a high level of toxicity to these dust particles. Taken together, these data suggest that at the level of dust exposure commonly found in the Middle East (i.e., Iraq, Kuwait, and

  13. Vulnerable Populations Perceive Their Health as at Risk from Climate Change.

    PubMed

    Akerlof, Karen L; Delamater, Paul L; Boules, Caroline R; Upperman, Crystal R; Mitchell, Clifford S

    2015-12-04

    Climate change is already taking a toll on human health, a toll that is likely to increase in coming decades. The relationship between risk perceptions and vulnerability to climate change's health threats has received little attention, even though an understanding of the dynamics of adaptation among particularly susceptible populations is becoming increasingly important. We demonstrate that some people whose health will suffer the greatest harms from climate change-due to social vulnerability, health susceptibility, and exposure to hazards-already feel they are at risk. In a 2013 survey we measured Maryland residents' climate beliefs, health risk perceptions, and household social vulnerability characteristics, including medical conditions (n = 2126). We paired survey responses with secondary data sources for residence in a floodplain and/or urban heat island to predict perceptions of personal and household climate health risk. General health risk perceptions, political ideology, and climate beliefs are the strongest predictors. Yet, people in households with the following characteristics also see themselves at higher risk: members with one or more medical conditions or disabilities; low income; racial/ethnic minorities; and residence in a floodplain. In light of these results, climate health communication among vulnerable populations should emphasize protective actions instead of risk messages.

  14. Vulnerable Populations Perceive Their Health as at Risk from Climate Change

    PubMed Central

    Akerlof, Karen L.; Delamater, Paul L.; Boules, Caroline R.; Upperman, Crystal R.; Mitchell, Clifford S.

    2015-01-01

    Climate change is already taking a toll on human health, a toll that is likely to increase in coming decades. The relationship between risk perceptions and vulnerability to climate change’s health threats has received little attention, even though an understanding of the dynamics of adaptation among particularly susceptible populations is becoming increasingly important. We demonstrate that some people whose health will suffer the greatest harms from climate change—due to social vulnerability, health susceptibility, and exposure to hazards—already feel they are at risk. In a 2013 survey we measured Maryland residents’ climate beliefs, health risk perceptions, and household social vulnerability characteristics, including medical conditions (n = 2126). We paired survey responses with secondary data sources for residence in a floodplain and/or urban heat island to predict perceptions of personal and household climate health risk. General health risk perceptions, political ideology, and climate beliefs are the strongest predictors. Yet, people in households with the following characteristics also see themselves at higher risk: members with one or more medical conditions or disabilities; low income; racial/ethnic minorities; and residence in a floodplain. In light of these results, climate health communication among vulnerable populations should emphasize protective actions instead of risk messages. PMID:26690184

  15. Vulnerable Populations Perceive Their Health as at Risk from Climate Change.

    PubMed

    Akerlof, Karen L; Delamater, Paul L; Boules, Caroline R; Upperman, Crystal R; Mitchell, Clifford S

    2015-12-01

    Climate change is already taking a toll on human health, a toll that is likely to increase in coming decades. The relationship between risk perceptions and vulnerability to climate change's health threats has received little attention, even though an understanding of the dynamics of adaptation among particularly susceptible populations is becoming increasingly important. We demonstrate that some people whose health will suffer the greatest harms from climate change-due to social vulnerability, health susceptibility, and exposure to hazards-already feel they are at risk. In a 2013 survey we measured Maryland residents' climate beliefs, health risk perceptions, and household social vulnerability characteristics, including medical conditions (n = 2126). We paired survey responses with secondary data sources for residence in a floodplain and/or urban heat island to predict perceptions of personal and household climate health risk. General health risk perceptions, political ideology, and climate beliefs are the strongest predictors. Yet, people in households with the following characteristics also see themselves at higher risk: members with one or more medical conditions or disabilities; low income; racial/ethnic minorities; and residence in a floodplain. In light of these results, climate health communication among vulnerable populations should emphasize protective actions instead of risk messages. PMID:26690184

  16. Iatrogenic risks and maternal health: Issues and outcomes

    PubMed Central

    Khaskheli, Meharun-nissa; Baloch, Shahla; Sheeba, Aneela

    2014-01-01

    Objective: To observe acute maternal morbidity and mortality due to iatrogenic factors and outcomes. Methods: This observational cross sectional study was conducted at intensive care unit of Liaquat University of Medical and Health sciences Jamshoro from 1-January-2011 to 31-December-2012. In this study all the delivered or undelivered women who needed intensive care unit (ICU) admission due to management related life threatening complication referred from periphery or within this hospital were included, while those women who had pregnancy complicated by medical conditions were excluded. These women were registered on the predesigned proforma containing variables like Demographic characteristics, various iatrogenic risk factors, complications and management out comes. The data was collected and analyzed on SPSS version 20. Results: During these study period 51 women needed ICU care for different complications due to adverse effects of medical treatments. Majority of these women were between 20-40 years of age 41(80.39%), multiparous 29(56.86%), unbooked 38(74.50%), referred from periphery 39(76.47%), common iatrogenic factors were misuse of oxytocin 16(31.37%), fluid overload/cardiac failure 8(15.68%), blood reaction 7(13.72%), anesthesia related problems were delayed recovery 3(5.88%), cardiac arrest 2(3.92%), spinal shock 2(3.92%), surgical problems were bladder injury 5(9.8%), post operative internal haemorrhage 3(5.88%), 37(72.54%) women recovered and 14(27.45%) expired. Conclusion: The maternal morbidity and mortality rate with iatrogenic factors was high and majority of these factors were avoidable. PMID:24639842

  17. Occupational stress among staff nurses: Controlling the risk to health

    PubMed Central

    Sharma, Parul; Davey, Anuradha; Davey, Sanjeev; Shukla, Arvind; Shrivastava, Kajal; Bansal, Rahul

    2014-01-01

    Introduction: Nursing has been identified as an occupation that has high levels of stress. Job stress brought about hazardous impacts not only on nurses’ health but also on their abilities to cope with job demands. Objectives: This study aimed at finding out the degree of work-related stress among the staff nurses and various determinants, which have a impact on it. Materials and Methods: Institutional-based cross-sectional study conducted on GNM qualified nurses. Predesigned and pre-tested questionnaire covering their sociodemographic variables in part I and professional life stress scale by David Fontana in part II. Analysis used was Chi-square test and logistic regression for various factors. Results: Risk for professional stress due to poor and satisfactory doctor's attitude was found about 3 and 4 times more than with excellent attitude of doctors toward the staff nurses. A statistically significant association (P < 0.024) between department of posting and level of stress. Nurses reported that they had no time for rest, of whom 42% were suffering from moderate-to-severe stress. The nurses who felt that the job was not tiring were found to be less stressed as those who perceived job as tiring (OR = 0.43). Conclusion: The main nurses’ occupational stressors were poor doctor's attitude, posting in busy departments (emergency/ICU), inadequate pay, too much work, and so on. Thus, hospital managers should initiate strategies to reduce the amount of occupational stress and should provide more support to the nurses to deal with the stress. PMID:25568598

  18. Cloud-Based Smart Health Monitoring System for Automatic Cardiovascular and Fall Risk Assessment in Hypertensive Patients.

    PubMed

    Melillo, P; Orrico, A; Scala, P; Crispino, F; Pecchia, L

    2015-10-01

    The aim of this paper is to describe the design and the preliminary validation of a platform developed to collect and automatically analyze biomedical signals for risk assessment of vascular events and falls in hypertensive patients. This m-health platform, based on cloud computing, was designed to be flexible, extensible, and transparent, and to provide proactive remote monitoring via data-mining functionalities. A retrospective study was conducted to train and test the platform. The developed system was able to predict a future vascular event within the next 12 months with an accuracy rate of 84 % and to identify fallers with an accuracy rate of 72 %. In an ongoing prospective trial, almost all the recruited patients accepted favorably the system with a limited rate of inadherences causing data losses (<20 %). The developed platform supported clinical decision by processing tele-monitored data and providing quick and accurate risk assessment of vascular events and falls. PMID:26276015

  19. Risk Protection, Service Use, and Health Outcomes under Colombia’s Health Insurance Program for the Poor

    PubMed Central

    Miller, Grant; Pinto, Diana

    2013-01-01

    Unexpected medical care spending imposes considerable financial risk on developing country households. Based on managed care models of health insurance in wealthy countries, Colombia’s Régimen Subsidiado is a publicly financed insurance program targeted to the poor, aiming both to provide risk protection and to promote allocative efficiency in the use of medical care. Using a “fuzzy” regression discontinuity design, we find that the program has shielded the poor from some financial risk while increasing the use of traditionally under-utilized preventive services – with measurable health gains. PMID:25346799

  20. Assessment of cardiovascular risk in primary health care

    PubMed Central

    Korhonen, Päivi; Vesalainen, Risto; Aarnio, Pertti; Kautiainen, Hannu; Järvenpää, Salme; Kantola, Ilkka

    2012-01-01

    Objective This study aimed at investigating whether cardiovascular risk factors and their impact on total risk estimation differ between men and women. Design Cross-sectional cohort study. Subjects Finnish cardiovascular risk subjects (n = 904) without established cardiovascular disease, renal disease, or known diabetes. Main outcome measures Ankle-brachial index (ABI), estimated glomerular filtration rate (eGFR), oral glucose tolerance test, and total cardiovascular risk using SCORE risk charts. Results According to the SCORE risk charts, 27.0% (95% CI 23.1–31.2) of the women and 63.1% (95% CI 58.3–67.7) of the men (p < 0.001) were classified as high-risk subjects. Of the women classified as low-risk subjects according to SCORE, 25% had either subclinical peripheral arterial disease or renal insufficiency. Conclusions The SCORE system does not take into account cardiovascular risk factors typical in women, and thus underestimates their total cardiovascular risk. Measurement of ABI and eGFR in primary care might improve cardiovascular risk assessment. especially in women. PMID:22643155